Ageing and Affective Disorders: The Age at First Onset of Affective Disorders in Scotland, 1969–1978

1985 ◽  
Vol 147 (2) ◽  
pp. 180-187 ◽  
Author(s):  
John M. Eagles ◽  
Lawrence J. Whalley
Keyword(s):  
Affective Disorder ◽  
Affective Disorders ◽  
Steady Increase ◽  
Social Psychological ◽  
Affective Psychosis ◽  
Affective Psychoses ◽  
Admission Rates ◽  
Clear Cut ◽  
Psychiatric Units ◽  
First Onset

SummaryFirst admission rates from 1969–78 for Scottish psychiatric units were calculated for discharge diagnoses of affective psychosis for each five-year age-group from 15 years to over 74 years. There were clear-cut linear increases in rates of depressive psychoses, mania, and all affective psychoses, consistent with a relatively steady increase in the rate of first-onset affective psychoses with increasing age. These findings are discussed in terms of social, psychological, and biological hypotheses of the causes of affective disorder. It is argued that no single factor could produce the observed linear increases with age and that the data appear more consistent with an integrative aetiological model of affective disorder.

scholarly journals Subdividing the functional psychoses: a family hereditary approach

1981 ◽  
Vol 11 (3) ◽  
pp. 637-640 ◽  
Author(s):  
Christian Scharfetter
Keyword(s):  
Affective Disorder ◽  
Affective Disorders ◽  
Psychotic Disorders ◽  
Genetic Data ◽  
Diagnostic Procedures ◽  
Genetic Evidence ◽  
Clear Cut ◽  
Significant Tendency ◽  
Functional Psychoses ◽  
Index Cases

SYNOPSISFamily genetic data, based on standardized and independent diagnostic procedures of index and secondary cases, confirmed the dichotomy between schizophrenias and affective disorders. The classical schizophrenic subtypes exhibited a significant tendency towards homotypia among their secondary cases. The genetic evidence did not support the monopolar–bipolar subdivision of affective disorder. Schizo-affective disorders impinged on the clear-cut schizophrenic and affective psychotic disorders and there was no homotypical tendency among the relatives of index cases with this diagnosis.

Decline in the Diagnosis of Schizophrenia among First Admissions to Scottish Mental Hospitals from 1969–78

1985 ◽  
Vol 146 (2) ◽  
pp. 151-154 ◽  
Author(s):  
John M. Eagles ◽  
Lawrence J. Whalley
Keyword(s):  
Affective Disorder ◽  
Community Based ◽  
Affective Psychoses ◽  
Admission Rates ◽  
Mental Hospitals ◽  
First Admission

SummaryAnnual age-standardised first admission rates from 1969–78 for Scottish mental hospitals were calculated for schizophrenia, paranoid states, reactive psychoses, all affective psychoses, mania, and depressive neuroses. Significant decreases were found in the diagnosis of schizophrenia (P <0.001) and, to a lesser extent, affective psychoses (P <0.01) and depressive neuroses (P <0.02). The incidence of paranoid states, reactive psychoses, and mania did not change significantly.Several factors possibly contributing to the decline in diagnoses of schizophrenia are discussed, but it is concluded that the figures probably reflect a genuine fall in incidence. The decline in the categories of affective disorder is likely to reflect trends towards increasing provision of community-based care.

Organic Affective Psychosis Associated with the Routine Use of Non-prescription Cold Preparations

1990 ◽  
Vol 156 (4) ◽  
pp. 572-575 ◽  
Author(s):  
Terry M. Brown ◽  
Robert N. Golden ◽  
Dwight L. Evans
Keyword(s):  
Affective Disorder ◽  
Affective Disorders ◽  
Short Term ◽  
Drug Induced ◽  
Affective Psychosis ◽  
Clinical Reaction ◽  
Balance Hypothesis

A patient experienced an organic affective psychosis on three separate occasions after taking recommended doses of non-prescription cold/sinus preparations. The possible underlying pharmacological mechanisms of this clinical reaction lend support to the cholinergic-adrenergic balance hypothesis of affective disorders. Recognition of this acute drug-induced state can lead to appropriate short-term pharmacotherapy and can prevent misdiagnosis of a major affective disorder or schizophrenia.

The epidemiology of affective disorders: national secular trends and local findings

1989 ◽  
Vol 4 (5) ◽  
pp. 287-298 ◽  
Author(s):  
P.G. Surtees ◽  
S.P. Sashidharan
Keyword(s):  
Affective Disorder ◽  
Affective Disorders ◽  
Secular Trends ◽  
Older Age ◽  
Research Approach ◽  
Case Register ◽  
Affective Psychoses ◽  
National Rate ◽  
Female Rate ◽  
Male Rate

SummaryThis paper examines aspects of the epidemiology of affective disorders in Scotland. Results from 3 investigations are described, each one indicative of a particular research approach (the use of national, case-register and direct-interview based data). In Part I of the paper secular trends in Scottish national and local (Edinburgh city) first admission rates of affective disorders, based upon ICD-9, are examined. The results, based upon the national data, show that during the last two decades the male admission rate declined by 29.4% and the female rate by 37.3%. However, the female rate has remained 1.8 to 2.2-fold that of the male rate throughout this period. Further investigation of these changes was undertaken after dividing the affective disorder category into either the “affective psychoses” or the “depressive neuroses”. Results revealed that whilst there was only a slight change in the Scottish national rate of affective psychoses, marked decreases in rates were revealed for the depressive neuroses for both sexes (males by 39.4% and females by 39.3%). Age-specific secular trends also demonstrated the extent to which the older age groups of both sexes experienced the highest rates of affective psychoses.Results based upon first admissions for affective disorder to the Royal Edinburgh Hospital over the years 1976-1987 showed that the overall male rate had remained relatively unchanged, whilst that for females had declined by about 24%. Subsequent analysis showed that the rates for affective psychoses had declined over the 12 years to a level which for the females was close to the national rate but that the male rate for these conditions had remained (in 1985) at 70% above the Scottish national rate.Part II of this paper presents results from two further studies concerned with investigating rates of affective disorder amongst women. The first of these was a general population survey of a random sample, the second a hospital study. Both studies were designed to be complementary, in that each was based upon samples of women living in the same geographical area of Edinburgh city. Results revealed that the hospital prevalence estimate for affective disorders was only about 1% of the community estimate, but over 5% of the community inception rate. Analyses examining the demographic correlates of affective disorders revealed the extent to which age and marital status differentially determined the ease with which women entered hospital care. Results revealed that being single and of older age was associated with an increased chance of receiving treatment for women with affective disorders.

Increased Risk of Affective Disorders in Males after Second Trimester Prenatal Exposure to the Dutch Hunger Winter of 1944–45

1995 ◽  
Vol 166 (5) ◽  
pp. 601-606 ◽  
Author(s):  
Alan S. Brown ◽  
Ezra S. Susser ◽  
Shang P. Lin ◽  
Richard Neugebauer ◽  
Jack M. Gorman
Keyword(s):  
Prenatal Exposure ◽  
Affective Disorders ◽  
Separate Analysis ◽  
Second Trimester ◽  
Birth Cohorts ◽  
Affective Psychosis ◽  
Affective Psychoses ◽  
Increased Risk ◽  
Famine Exposure ◽  
Prenatal Famine

BackgroundPrenatal and perinatal factors have been linked to affective disorders. We therefore undertook an exploratory study to determine whether prenatal exposure to severe famine was associated with an increased risk of affective disorders.MethodMonthly birth cohorts that were exposed and unexposed to the Dutch Hunger Winter of 1944–45 were identified. The cumulative incidences of affective psychoses and neurotic depression (ICD–9 criteria) were compared between exposed and unexposed cohorts during each trimester of gestation.ResultsThe relative risk (RR) of affective psychosis (broad and restricted definitions) among persons exposed to famine during the second trimester was significantly increased (broad: RR (95% confidence interval) = 1.62 (1.19, 2.20); restricted: 1.59 (1.14, 2.21)). Separate analysis by gender showed a significant association among males (broad: 2.26 (1.43, 3.57); restricted: 2.40 (1.49, 3.89)), but not females (broad: 1.28 (0.84, 1.94); restricted: 1.17 (0.73, 1.86)). The risk of neurotic depression was not increased after prenatal famine exposure.ConclusionsThese results suggest a possible relationship between prenatal famine during the second trimester and affective psychosis, lending plausibility to reports that have associated affective psychoses with prenatal exposures. Further studies of this relationship are warranted.

Age-at-First-Registration and Heterogeneity in Affective Psychoses

2003 ◽  
Vol 37 (1) ◽  
pp. 66-69 ◽  
Author(s):  
Joy L. Welham ◽  
Richard Thomis ◽  
John J. Mcgrath
Keyword(s):  
Affective Disorders ◽  
Age Of Onset ◽  
Age Distribution ◽  
Unipolar Depression ◽  
Linear Increase ◽  
Diagnostic Group ◽  
Affective Psychosis ◽  
Affective Psychoses ◽  
Background Population ◽  
Age Range

Background: Previous research into age of onset in affective disorders has produced conflicting results. This paper examines the influence of heterogeneity on the age-at-firstregistration distribution for the ICD-9 diagnostic group ‘affective psychosis’. Method: For 1979–1991, data for age-at-first-registration for 4985 individuals diagnosed with affective psychosis (ICD-9 296.x) were extracted from a name-linked mental health register. These data were divided into (i) ‘296.1 only’, a category used to code unipolar depression (males = 700; females = 1321); and (ii) ‘296 other’, all 296 cases other than 296.1 (males = 1280; females = 1684). Inception rates for each 5-year age division were adjusted for the background population age-structure as a rate per 100 000 population. Results: The age-at-first-registration distribution for affective psychosis has a wide age range, with women outnumbering men. There is a near-linear increase in inception rates for both men and women with 296.1 only, while the bulk of those with affective psychoses (296 other) have an inverted U-shaped age distribution. Males have an earlier modal age-atfirst-registration for 296 other compared to females. Conclusion: The heterogeneity in terms of subtypes and sex in affective psychosis clouds the interpretation of age-at-first-registration. Separating those with unipolar psychotic depression from other subclassifications and differentiating by sex may provide clues to factors that precipitate the onset of affective psychosis.

Reduced influence of affective disorders on perioperative complication rates, length of hospital stay, and healthcare costs following spinal fusion for adolescent idiopathic scoliosis

2019 ◽  
Vol 24 (6) ◽  
pp. 722-727
Author(s):  
Aladine A. Elsamadicy ◽  
Andrew B. Koo ◽  
Megan Lee ◽  
Adam J. Kundishora ◽  
Christopher S. Hong ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Idiopathic Scoliosis ◽  
Affective Disorder ◽  
Affective Disorders ◽  
Complication Rates ◽  
Total Cost ◽  
Adolescent Patients ◽  
Perioperative Complication ◽  
The Impact

OBJECTIVEIn the past decade, a gradual transition of health policy to value-based healthcare has brought increased attention to measuring the quality of care delivered. In spine surgery, adolescents with scoliosis are a population particularly at risk for depression, anxious feelings, and impaired quality of life related to back pain and cosmetic appearance of the deformity. With the rising prevalence of mental health ailments, it is necessary to evaluate the impact of concurrent affective disorders on patient care after spinal surgery in adolescents. The aim of this study was to investigate the impact that affective disorders have on perioperative complication rates, length of stay (LOS), and total costs in adolescents undergoing elective posterior spinal fusion (PSF) (≥ 4 levels) for idiopathic scoliosis.METHODSA retrospective study of the Kids’ Inpatient Database for the year 2012 was performed. Adolescent patients (age range 10–17 years old) with AIS undergoing elective PSF (≥ 4 levels) were selected using the International Classification of Diseases, Ninth Revision, Clinical Modification coding system. Patients were categorized into 2 groups at discharge: affective disorder or no affective disorder. Patient demographics, comorbidities, complications, LOS, discharge disposition, and total cost were assessed. The primary outcomes were perioperative complication rates, LOS, total cost, and discharge dispositions.RESULTSThere were 3759 adolescents included in this study, of whom 164 (4.4%) were identified with an affective disorder (no affective disorder: n = 3595). Adolescents with affective disorders were significantly older than adolescents with no affective disorders (affective disorder: 14.4 ± 1.9 years vs no affective disorder: 13.9 ± 1.8 years, p = 0.001), and had significantly different proportions of race (p = 0.005). Aside from hospital region (p = 0.016), no other patient- or hospital-level factors differed between the cohorts. Patient comorbidities did not differ significantly between cohorts. The number of vertebral levels involved was similar between the cohorts, with the majority of patients having 9 or more levels involved (affective disorder: 76.8% vs no affective disorder: 79.5%, p = 0.403). Postoperative complications were similar between the cohorts, with no significant difference in the proportion of patients experiencing a postoperative complication (p = 0.079) or number of complications (p = 0.124). The mean length of stay and mean total cost were similar between the cohorts. Moreover, the routine and nonroutine discharge dispositions were also similar between the cohorts, with the majority of patients having routine discharges (affective disorder: 93.9% vs no affective disorder: 94.9%, p = 0.591).CONCLUSIONSThis study suggests that affective disorders may not have a significant impact on surgical outcomes in adolescent patients undergoing surgery for scoliosis in comparison with adults. Further studies are necessary to elucidate how affective disorders affect adolescent patients with idiopathic scoliosis, which may improve provider approach in managing these patients perioperatively and at follow-up in hopes to better the overall patient satisfaction and quality of care delivered.

A High Prevalence of Affective Disorder Discovered in a ‘Schizophrenia Clinic’

1977 ◽  
Vol 22 (4) ◽  
pp. 181-183 ◽  
Author(s):  
Morton S. Rapp ◽  
Peggy Edwards
Keyword(s):  
Affective Disorder ◽  
Affective Disorders ◽  
Correct Diagnosis ◽  
Lithium Carbonate ◽  
Case Histories ◽  
Clinical Notes ◽  
The Past ◽  
High Prevalence ◽  
Incorrect Diagnosis

Fifty outpatients in a ‘schizophrenia clinic’ were examined, and sixteen were found to be suffering from periodic affective disorders. Nine of these were given lithium carbonate, and eight responded well. Case histories illustrate three separate reasons for incorrect diagnosis. Examination of extensive old clinical notes of five of these patients suggests that the problems of diagnosis which have been described in the literature in the past, continue to represent obstacles to correct diagnosis. Suggestions for improvement are offered.

Genetic Models of Affective Disorder: Application to Twin Data

1980 ◽  
Vol 29 (4) ◽  
pp. 289-294 ◽  
Author(s):  
Miron Baron
Keyword(s):  
Affective Disorder ◽  
Affective Disorders ◽  
Monozygotic Twins ◽  
Threshold Models ◽  
Twin Data ◽  
Bipolar Illness ◽  
Major Locus ◽  
Unipolar Disorder ◽  
Locus Model ◽  
Multiple Threshold

Twin data on bipolar and unipolar affective disorders are analyzed by multiple threshold models of inheritance. The two illness types are represented in the models on a continuum of genetic–environmental liability in which bipolar illness has a higher liability threshold than unipolar disorder. Autosomal single major locus model provides an acceptable fit to observed concordance rates in monozygotic twins. The multifactorial-polygenic model is rejected.

scholarly journals Obstetric complications and affective psychoses

2000 ◽  
Vol 176 (6) ◽  
pp. 523-526 ◽  
Author(s):  
M. Bain ◽  
E. Juszczak ◽  
K. McInneny ◽  
R. E. Kendell
Keyword(s):  
Birth Cohort ◽  
Early Onset ◽  
Obstetric Complications ◽  
Affective Psychosis ◽  
Affective Psychoses ◽  
Patient Diagnosis

BackgroundUnlike schizophrenia, little interest has been taken in the incidence of obstetric complications in affective psychoses.AimsTo find out whether obstetric complications are more common in affective psychoses than matched controls.MethodTwo hundred and seventeen probands with an in-patient diagnosis of affective psychosis who had been born in Scotland in 1971–74, and a further 84 born in 1975–78, were closely matched with controls and the incidence of obstetric complications in the two compared using obstetric data recorded in a set format shortly after birth.ResultsAbnormal presentation of the foetus was the only complication significantly more common in the affective probands in the 1971–74 birth cohort and artificial rupture of the membranes was the only event more common in the probands in the 1975–78 cohort. Both are probably chance findings.ConclusionIt is unlikely that the incidence of obstetric complications is raised in people with affective psychoses of early onset.

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