Recurrent Affective Syndromes in Bipolar and Unipolar Mood Disorders at Follow-Up

1995 ◽  
Vol 166 (3) ◽  
pp. 382-385 ◽  
Author(s):  
Joseph F. Goldberg ◽  
Martin Harrow ◽  
Linda S. Grossman
Keyword(s):  
Psychosocial Functioning ◽  
Work Performance ◽  
Bipolar Disorders ◽  
Unipolar Depression ◽  
Work Impairment ◽  
Hospital Work ◽  
Bipolar Patients ◽  
Manic Patients ◽  
Overall Functioning

BackgroundIt is in dispute whether affective relapse disrupts psychosocial functioning to the same extent in depressed and manic patients.MethodA prospective, naturalistic, longitudinal follow-up of 84 unipolar and bipolar affectively disordered in-patients was conducted to examine the extent of recurrent affective syndromes and their relationship to overall outcome. Global adjustment relative to relapse was assessed at 2- and 4.5-year follow-ups.ResultsNearly half of the bipolar patients had subsequent syndromes, which were often associated with uniformly poor psychosocial functioning. Fewer than one-quarter of those with recurrences had steady work performance. Bipolar patients taking lithium alone had fewer recurrences than those taking lithium as well as neuroleptics (P<0.05). Bipolar and unipolar patients relapsed with equal frequency, but unipolar relapse was less often associated with readmission to hospital, work impairment, or uniformly poor functioning.ConclusionAffective relapse in bipolar disorders was more detrimental to overall functioning than was recurrence in unipolar depression.

Pharmacotherapy in bipolar disorders during hospitalization and at discharge predicts clinical and psychosocial functioning at follow-up

2014 ◽  
Vol 29 (6) ◽  
pp. 578-588 ◽  
Author(s):  
Maurizio Pompili ◽  
Marco Innamorati ◽  
Xenia Gonda ◽  
Gianluca Serafini ◽  
Denise Erbuto ◽  
...  
Keyword(s):  
Psychosocial Functioning ◽  
Bipolar Disorders

Has number of previous episodes any effect on response to group psychoeducation in bipolar patients? A 5-year follow-up post hoc analysis

2010 ◽  
Vol 22 (2) ◽  
pp. 50-53 ◽  
Author(s):  
Francesc Colom ◽  
María Reinares ◽  
Isabella Pacchiarotti ◽  
Dina Popovic ◽  
Lorenzo Mazzarini ◽  
...  
Keyword(s):  
Treatment Strategies ◽  
Bipolar Disorders ◽  
Study Entry ◽  
Mixed States ◽  
Psychological Therapies ◽  
Time To Recurrence ◽  
Group Psychoeducation ◽  
Bipolar Patients ◽  
Post Hoc

Colom F, Reinares M, Pacchiarotti I, Popovic D, Mazzarini L, Martínez-Arán A, Torrent C, Rosa A, Palomino-Otiniano R, Franco C, Bonnin CM, Vieta E. Has number of previous episodes any effect on response to group psychoeducation in bipolar patients? A 5-year follow-up post hoc analysis.Objective:One of the main utilities of staging in bipolar disorder is enhancing the formulation of pharmacological and non-pharmacological treatment strategies. Hence, it is essential to ascertain whether the number of previous episodes influences treatment response. Hereby, we present a 5-year post hoc study on the efficacy of group psychoeducation for bipolar disorders according to the number of previous episodes.Methods:For this subanalysis, we have compared the 5-year outcome of 120 euthymic psychoeducated versus non-psychoeducated bipolar patients according to the number of previous episodes at study entry.Results:Patients with more than seven episodes at study entry did not show any significant improvement with psychoeducation according to time to recurrence. Patients with more than 14 episodes did not benefit from psychoeducation in terms of a reduction of time spent ill. Patients with 7 or 8 episodes showed a benefit in terms of fewer days spent in hypomania, depression, mixed episodes or any episodes but not mania, while patients with 9–14 episodes showed a benefit in terms of fewer days spent in hypomania and depression but not in mixed states or mania. Only patients who presented up to 6 episodes showed reduction in time spent in any episode polarity.Conclusion:The number of previous episodes clearly worsens response to psychoeducation, perhaps in a more subtle way than that observed with other psychological therapies. Psychoeducation should be delivered as soon as possible in the illness course, supporting the idea of early intervention.

scholarly journals Persistence of cognitive impairment and its negative impact on psychosocial functioning in lithium-treated, euthymic bipolar patients: a 6-year follow-up study

2012 ◽  
Vol 43 (6) ◽  
pp. 1187-1196 ◽  
Author(s):  
E. Mora ◽  
M. J. Portella ◽  
I. Forcada ◽  
E. Vieta ◽  
M. Mur
Keyword(s):  
Cognitive Impairment ◽  
Processing Speed ◽  
Verbal Memory ◽  
Psychosocial Functioning ◽  
Repeated Measures ◽  
Rating Scale ◽  
Psychosocial Adaptation ◽  
Analysis Of Covariance ◽  
Bipolar Patients

BackgroundPrevious cross-sectional studies report that cognitive impairment is associated with poor psychosocial functioning in euthymic bipolar patients. There is a lack of long-term studies to determine the course of cognitive impairment and its impact on functional outcome.MethodA total of 54 subjects were assessed at baseline and 6 years later; 28 had DSM-IV TR bipolar I or II disorder (recruited, at baseline, from a Lithium Clinic Program) and 26 were healthy matched controls. They were all assessed with a cognitive battery tapping into the main cognitive domains (executive function, attention, processing speed, verbal memory and visual memory) twice over a 6-year follow-up period. All patients were euthymic (Hamilton Rating Scale for Depression score lower than 8 and Young mania rating scale score lower than 6) for at least 3 months before both evaluations. At the end of follow-up, psychosocial functioning was also evaluated by means of the Functioning Assessment Short Test.ResultsRepeated-measures multivariate analysis of covariance showed that there were main effects of group in the executive domain, in the inhibition domain, in the processing speed domain, and in the verbal memory domain (p<0.04). Among the clinical factors, only longer illness duration was significantly related to slow processing (p=0.01), whereas strong relationships were observed between impoverished cognition along time and poorer psychosocial functioning (p<0.05).ConclusionsExecutive functioning, inhibition, processing speed and verbal memory were impaired in euthymic bipolar out-patients. Although cognitive deficits remained stable on average throughout the follow-up, they had enduring negative effects on psychosocial adaptation of patients.

Emotion processing and social functioning in euthymic bipolar disorder

2016 ◽  
Vol 33 (S1) ◽  
pp. S125-S126
Author(s):  
A. Aparicio ◽  
E.M. Sánchez-Morla ◽  
J.L. Santos ◽  
J. Mateo
Keyword(s):  
Social Functioning ◽  
Psychosocial Functioning ◽  
Emotion Processing ◽  
Bipolar Disorders ◽  
Poor Performance ◽  
Premorbid Intelligence ◽  
Partial Correlations ◽  
Understanding Emotions ◽  
Competing Interest ◽  
Bipolar Patients

IntroductionA large number of studies have found that patients with bipolar disorders have a poor performance in tasks assessing social cognition.Objectives and aimsThe present study aimed to investigate whether euthymic bipolar patients (EBP) have a dysfunction in emotion processing when compared to controls. An additional objective was to determine whether there is association between emotion processing and psychosocial functioning.MethodsA sample of 53 EBP and 53 healthy controls matched for age, gender, education level and premorbid intelligence were studied. All subjects were assessed using the MATRICS Consensus Cognitive Battery (MCCB) and two additional executive function measures: the Trail Making Test–Part B and the Stroop Test. Emotion processing was examined using the Mayer-Salovey-Caruso Emotional Intelligence Test (MSCEIT). Psychosocial functioning was assessed using the Global Assessment of Functioning (GAF) scale and the Functional Assessment Short Test (FAST).ResultsFor the MSCEIT, EBP obtained lower total scores (P = 0.001), experiential area scores (P = 0.012), strategic area scores (P = 0.000), perceiving emotions branch scores (P = 0.008), understanding emotions branch scores (P = 0.014) and managing emotions branch scores (P = 0.000) than controls. There were no significant differences between groups for the using emotions branch (P = 0.113). In addition, partial correlations controlling for sub-clinical psychopathology in EBP showed the existence of a significant correlation of MSCEIT total score and MSCEIT strategic area score with FAST total score.ConclusionsEBP exhibit deficits in several areas of emotion processing. Performance in emotion processing tasks is associated with social functioning in these patients.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Subthreshold Manifestations of Bipolar Disorders as Health Care’s tool

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
M. Mazza ◽  
D. Harnic ◽  
G. Marano ◽  
V. Catalano ◽  
L. Janiri ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Bipolar Disorder ◽  
Bipolar Disorders ◽  
Unipolar Depression ◽  
Response To Treatment ◽  
Type I ◽  
Male Patients ◽  
Bipolar Patients ◽  
Disorder Type

Introdution:Our study represents a pilot evaluation about how the MOOD-SR recognizes subthreshold manifestations that may be associated with clinical symptomatology in a group of bipolar patients.Methods:At Day Hospital of Psychiatry, Policlinico “A. Gemelli”, Bipolar Disorders Unit, it has been conducted an experimental study on a heterogeneous sample of 24 patients with a diagnosis of Bipolar Disorder type I. Patients have been assessed with the MOOD-SR, a clinical self-reported interview, that is specific for the spectrum of subthreshold pathology, and with the Quality of Life (QoL), that investigates the patient's quality of life.Results:We have found that 16 patients on 24 report a score higher than 60 (68,4%). Among these, 10 female patients on 15 have a total score higer than 61 (68.75%) while 6 male patients on 9 obtain a total score higher than 60 (62,5%). However, these results have only preliminary value, further studies are needed in order to obtain a deeper evaluation.Conclusion:Spectrum manifestations are both indicator of course and response to treatment and predictive for relapse. This finding may represent an important preventive instrument for maniacal relapse in patients with Bipolar Disorder, that is often underdiagnosed or confused for Unipolar Depression. By adequately recognizing the problem we will be able to refine diagnosis and individualize therapy.

Hospital Work and Family: A Four Year Study of Young Mental Hospital Patients

1966 ◽  
Vol 112 (483) ◽  
pp. 177-196 ◽  
Author(s):  
E. M. Goldberg
Keyword(s):  
Length Of Stay ◽  
Mental Hospital ◽  
Work Performance ◽  
Community Care ◽  
Young Male ◽  
Work And Family ◽  
Hospital Work ◽  
Before And After ◽  
Hospital Patients

While a study of schizophrenia and social class (Goldberg and Morrison, 1963) was in progress, it became obvious that some problems of hospital and community care among young male mental hospital patients should be pursued. Accordingly, it was decided to extend the project to a systematic follow up of the patients admitted to one of the two hospitals included in the study. This paper reports the findings in two parts; Part I relates length of stay in hospital to the severity of a patient's illness and to his circumstances before and after leaving hospital; Part II relates the patient's post-hospital work performance to certain other factors.

scholarly journals Effects of functional remediation on neurocognitively impaired bipolar patients: enhancement of verbal memory

2015 ◽  
Vol 46 (2) ◽  
pp. 291-301 ◽  
Author(s):  
C. M. Bonnin ◽  
M. Reinares ◽  
A. Martínez-Arán ◽  
V. Balanzá-Martínez ◽  
B. Sole ◽  
...  
Keyword(s):  
Functional Outcome ◽  
Verbal Memory ◽  
Psychosocial Functioning ◽  
Repeated Measures ◽  
Degrees Of Freedom ◽  
Treatment As Usual ◽  
Time Interaction ◽  
Bipolar Patients ◽  
The Impact

BackgroundFunctional remediation is a novel intervention with demonstrated efficacy at improving functional outcome in euthymic bipolar patients. However, in a previous trial no significant changes in neurocognitive measures were detected. The objective of the present analysis was to test the efficacy of this therapy in the enhancement of neuropsychological functions in a subgroup of neurocognitively impaired bipolar patients.MethodA total of 188 out of 239 DSM-IV euthymic bipolar patients performing below two standard deviations from the mean of normative data in any neurocognitive test were included in this subanalysis. Repeated-measures analyses of variance were conducted to assess the impact of the treatment arms [functional remediation, psychoeducation, or treatment as usual (TAU)] on participants’ neurocognitive and functional outcomes in the subgroup of neurocognitively impaired patients.ResultsPatients receiving functional remediation (n = 56) showed an improvement on delayed free recall when compared with the TAU (n = 63) and psychoeducation (n = 69) groups as shown by the group × time interaction at 6-month follow-up [F2,158 = 3.37, degrees of freedom (df) = 2, p = 0.037]. However, Tukey post-hoc analyses revealed that functional remediation was only superior when compared with TAU (p = 0.04), but not with psychoeducation (p = 0.10). Finally, the patients in the functional remediation group also benefited from the treatment in terms of functional outcome (F2,158 = 4.26, df = 2, p = 0.016).ConclusionsFunctional remediation is effective at improving verbal memory and psychosocial functioning in a sample of neurocognitively impaired bipolar patients at 6-month follow-up. Neurocognitive enhancement may be one of the active ingredients of this novel intervention, and, specifically, verbal memory appears to be the most sensitive function that improves with functional remediation.

Impact of cognitive-psychoeducational interventions in bipolar patients and their relatives

2006 ◽  
Vol 21 (2) ◽  
pp. 81-86 ◽  
Author(s):  
Britta Bernhard ◽  
Annette Schaub ◽  
Petra Kümmler ◽  
Sandra Dittmann ◽  
Emanuel Severus ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Group Intervention ◽  
Bipolar Disorders ◽  
Warning Signs ◽  
Psychoeducational Group ◽  
Before And After ◽  
Expressed Emotions ◽  
Bipolar Patients ◽  
Psychoeducational Interventions

AbstractBackground.In recent years, several controlled studies could show that psychoeducational interventions have been effective for relapse prevention in bipolar disorders. We therefore established a cognitive-psychoeducational group intervention with 14 sessions providing information about the illness, early warning signs, cognitive and behavioural strategies for stress management and social rhythm. Additionally we offered a group intervention for the patients' relatives. The objective of this study was to describe the outcome associated with our psychoeducational intervention in bipolar patients and their relatives.Methods.Sixty-two bipolar patients attended 14 sessions (à 90 min) of cognitive-psychoeducational group therapy. Patients' knowledge of bipolar disorder and their satisfaction with the treatment were assessed using self-developed questionnaires before and after the group intervention. Additionally, 49 relatives of bipolar patients received two psychoeducational workshops of 4 hours each. We assessed demographic variables, burden, high expressed emotion and depressive symptoms of the relatives before and after the two workshops and at 1-year follow-up.Results.Patients significantly improved their knowledge of bipolar disorder. They also have benefited from the discussions and the exchange of useful coping strategies. Burden and high expressed emotions showed no significant reductions at post-assessment, however they were significantly reduced at 1-year follow-up. Relatives also felt significantly better informed about the illness.Conclusions.These findings show that psychoeducational interventions in bipolar patients and their relatives improve patients' and their relatives' knowledge of the illness and the burden of the disorder as well as high expressed emotions are reduced in relatives at 1-year follow-up.

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