scholarly journals Lithium and pregnancy

2000 ◽  
Vol 24 (6) ◽  
pp. 229-231 ◽  
Author(s):  
Kelwyn Williams ◽  
Sarah Oke
Keyword(s):  
Bipolar Disorder ◽  
Mental Illness ◽  
Affective Disorder ◽  
Serious Mental Illness ◽  
Bipolar Affective Disorder ◽  
Unborn Child ◽  
Men And Women ◽  
Child Bearing ◽  
In Pregnancy ◽  
Algorithmic Form

The lifetime prevalence of bipolar affective disorder is approximately 1% in both men and women (Reiger et al, 1998). In women the illness is most prevalent in the child-bearing years (Robins et al, 1984). While lithium for the treatment of bipolar disorder is a cornerstone of modern psychopharmacology (Llewellyn et al, 1998), there are inherent problems in treating this sizeable subgroup of patients, as lithium presents small, but significant, risks to a potential foetus. It is also becoming increasingly obvious that serious mental illness poses a risk to the unborn child. This paper reviews those risks, presents a protocol in algorithmic form for dealing with the prescription of lithium in pregnancy and discusses practical issues pertaining to dosage and lithium monitoring.

scholarly journals ‘I want to be bipolar’…a new phenomenon

2010 ◽  
Vol 34 (3) ◽  
pp. 103-105 ◽  
Author(s):  
Diana Chan ◽  
Lester Sireling
Keyword(s):  
Bipolar Disorder ◽  
Mental Illness ◽  
Clinical Practice ◽  
Affective Disorder ◽  
Bipolar Affective Disorder ◽  
Epidemiological Studies ◽  
True Prevalence ◽  
Unusual Phenomenon ◽  
The Usa

SummaryThere has been renewed interest in the concept and diagnosis of bipolar affective disorder in recent years. Previous epidemiological studies have reported the prevalence of the disorder in the USA at 1–2% but further studies have shown that the disorder is underdiagnosed and the true prevalence may be as high as 11%. Despite the stigma attached to mental illness, we have noticed in our clinical practice a new and unusual phenomenon, where patients present to psychiatrists with self-diagnosed bipolar disorder. Here, we explore the background to this phenomenon, the diagnostic challenges and the implications for our patients and practice.

The krapellenian dicotomy in terms of employment outcomes

2011 ◽  
Vol 26 (S2) ◽  
pp. 1370-1370
Author(s):  
L. Dissanayke ◽  
M. Agius ◽  
R. Zaman ◽  
C.-H. Yoon
Keyword(s):  
Bipolar Disorder ◽  
Mental Illness ◽  
Serious Mental Illness ◽  
Employment Status ◽  
Social Inclusion ◽  
Ad Hoc ◽  
Bipolar Affective Disorder ◽  
Employment Outcomes ◽  
Gainful Employment ◽  
Bipolar Patients

BackgroundWe decided to examine the employment status of all patients with Schizophrenia actively treated by the Bedford East CMHT and compare this to the employment status of all those in the team who suffered from Bipolar Affective Disorder.MethodsCases of Schizophrenia and Bipolar Disorder were anonymously identified from a database held by the team and their employment status was established.Results124 patients were identified with schizophrenia, 24 with Schizoaffective disorder, and 60 with Bipolar Disorder.Of the Schizophrenia patients, 91 (73.38%) were unemployed, 15(12%) were employed, 10 (8%) were in voluntary employment and 8 (6.45%) were labelled ‘other’ [housewife, student etc].Of the Bipolar patients, 32 (53.33%) were unemployed, 14(23%) were employed, 5 (8.3%) were in voluntary employment and 9 (15%) were labelled ‘other’Of the Schizoaffective patients, 15 (62.5%) were unemployed, 4 (16.66%) were employed, 2 (8.33%) were in voluntary employment and 3 (12.5%) were labelled ‘other’.DiscussionEmployment Outcomes for serious mental illness were poor, however Schizophrenia patients had a lower chance of returning to employment, partly due to the heterogeneity of the condition. Bipolar patients had twice the chance of gainful employment as Schizophrenic ones.ConclusionIt is particularly difficult to achieve employment for patients with serious mental illness. This adds to the recently made argument for a more assertive approach by the creation of ad hoc chronic psychosis teams who could give ongoing support to aid patients to return to social inclusion and possibly work.

scholarly journals Neurocysticercosis presenting as bipolar disorder: a case report

2021 ◽  
Vol 34 (6) ◽  
pp. e100663
Author(s):  
Surbhi Batra ◽  
Sumit Kumar ◽  
Lokesh Singh Shekhawat
Keyword(s):  
Bipolar Disorder ◽  
Case Report ◽  
Depressive Symptoms ◽  
Affective Disorder ◽  
Postpartum Period ◽  
Bipolar Affective Disorder ◽  
Taenia Solium ◽  
Manic Episode ◽  
Symptoms And Signs ◽  
Rule Out

Neurocysticercosis is the most common neuro-parasitosis caused by the larval stage of Taenia solium. The most common manifestations include seizures and hydrocephalus. Psychiatric abnormalities are relatively rare but depressive symptoms are frequent in patients with neurocysticercosis. However, mania as a presentation is relatively rare. Pregnancy and the postpartum period are relatively vulnerable times and they can lead to reactivation of existing neurocysterci lesions. We are discussing the case of a 23-year-old female patient with neurocysticercosis leading to the reactivation of lesions in the peripartum and postpartum period leading to bipolar affective disorder. Improvement in the patient was seen with a combination of antipsychotics, antihelmintics, antiepileptics and steroids, along with improved radiological signs of neurocysterci lesions. Although neurocysticercosis is a common illness, its prevalence presenting as a manic episode is merely 2.6% and, hence, missed easily. Therefore, it is important to rule out organic aetiology in patients even with a classic presentation of bipolar affective disorder and those having any other neurological symptoms and signs.

scholarly journals Features of depressive and anxiety manifestations in the first episode of bipolar affective disorder

2019 ◽  
Vol 25 (3) ◽  
pp. 142-146
Author(s):  
Yu. I. Mysula
Keyword(s):  
Affective Disorder ◽  
Bipolar Affective Disorder ◽  
First Episode ◽  
Depression And Anxiety ◽  
Men And Women ◽  
Treatment And Prevention ◽  
The Mean ◽  
Gender Factor ◽  
The Impact ◽  
Mixed Variant

Background. The study of depression and anxiety in the first episode of BAR is important for the timely detection, treatment and prevention of poor diagnosis of the disease. Objective – the study of the features of depressive and anxiety symptoms of the first episode of bipolar affective disorder, taking into account the gender factor and the clinical type. Materials and methods. We have clinically examined 65 men and 88 women diagnosed with first episode (FE) of bipolar affective disorder (BAD). Results. In patients with depressive FE of BAD, all indicators, with the exception of the undifferentiated depression indicator, in men are slightly higher than in women: the overall indicator (respectively 22.55±3.61 points and 22.16±3.03 points); adynamic depression (17.41±2.62 points and 16.76±2.48 points); pervasive depression (9.75±3.13 points and 9.69±2.66 points); depression with fear (9.34±2.55 points and 9.51±2.27 points); undifferentiated depression (4.89±0.95 points and 5.01±1.22 points); in patients with the mixed variant are not significantly different: accordingly 15,83±2,64 points and 17,00±3,32 points; 11.00±1.67 points and 11.80±1.64 points; 6.67±1.63 points and 6.60±2.07 points; 7.33±1.21 points and 8.00±1.87 points; 3.67±1.03 points and 3.40±1.14 points; in patients with a manic type there are no signs of depression. The indicators of anxiety in men and women do not differ significantly: in the depressive variant, the total indicator was accordingly 21.41±7.01 points and 23.36±7.01 points; psychic anxiety – 13.25±3.86 points and 14.35±3.87 points; somatic anxiety – 8.16±4.05 points and 9.01±4.10 points; when mixed, accordingly, 20,00±4,52 points and 22,00±4,90 points; 13.33±3.27 points and 15.20±2.39 points; 6.67±3.27 points and 6.80±3.70 points; the manic variant showed no signs of anxiety. The mean Zung score for the depressed variant was 68.82±8.30 points and 65.97±8.41 points, accordingly, for the mixed one, 44.00±5.55 points and 50.40±5.32 points, accordingly, at a manic variant 2.13±1.64 points and 2.50±1.60 points. Conclusions. Differences in manifestations of depression and anxiety in the first episode of bipolar affective disorder are determined by the clinical option; the impact of gender on these manifestations is insignificant.

scholarly journals Changes to the Psychiatric Chatbot Landscape: A Systematic Review of Conversational Agents in Serious Mental Illness: Changements du paysage psychiatrique des chatbots: une revue systématique des agents conversationnels dans la maladie mentale sérieuse

2020 ◽  
pp. 070674372096642
Author(s):  
Aditya Nrusimha Vaidyam ◽  
Danny Linggonegoro ◽  
John Torous
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Bipolar Disorder ◽  
Mental Illness ◽  
Serious Mental Illness ◽  
Therapeutic Efficacy ◽  
Digital Tools ◽  
Conversational Agent ◽  
Conversational Agents ◽  
Diagnostic Quality

Objective: The need for digital tools in mental health is clear, with insufficient access to mental health services. Conversational agents, also known as chatbots or voice assistants, are digital tools capable of holding natural language conversations. Since our last review in 2018, many new conversational agents and research have emerged, and we aimed to reassess the conversational agent landscape in this updated systematic review. Methods: A systematic literature search was conducted in January 2020 using the PubMed, Embase, PsychINFO, and Cochrane databases. Studies included were those that involved a conversational agent assessing serious mental illness: major depressive disorder, schizophrenia spectrum disorders, bipolar disorder, or anxiety disorder. Results: Of the 247 references identified from selected databases, 7 studies met inclusion criteria. Overall, there were generally positive experiences with conversational agents in regard to diagnostic quality, therapeutic efficacy, or acceptability. There continues to be, however, a lack of standard measures that allow ease of comparison of studies in this space. There were several populations that lacked representation such as the pediatric population and those with schizophrenia or bipolar disorder. While comparing 2018 to 2020 research offers useful insight into changes and growth, the high degree of heterogeneity between all studies in this space makes direct comparison challenging. Conclusions: This review revealed few but generally positive outcomes regarding conversational agents’ diagnostic quality, therapeutic efficacy, and acceptability, which may augment mental health care. Despite this increase in research activity, there continues to be a lack of standard measures for evaluating conversational agents as well as several neglected populations. We recommend that the standardization of conversational agent studies should include patient adherence and engagement, therapeutic efficacy, and clinician perspectives.

Depot Antipsychotics in the Prophylaxis of Bipolar Affective Disorder

1994 ◽  
Vol 165 (6) ◽  
pp. 827-829 ◽  
Author(s):  
R. Littlejohn ◽  
F. Leslie ◽  
J. Cookson
Keyword(s):  
Bipolar Disorder ◽  
British Journal ◽  
Affective Disorder ◽  
Antipsychotic Drugs ◽  
Prophylactic Treatment ◽  
Bipolar Affective Disorder ◽  
Manic Depressive ◽  
Depot Antipsychotic ◽  
Depot Antipsychotics ◽  
Depot Medication

BackgroundThe efficacy of depot antipsychotic drugs in the prophylaxis of bipolar affective disorder was investigated.MethodLife charts were constructed for 18 outpatients with bipolar disorder receiving prophylactic treatment with depot medication. The durations of affective episodes were compared during periods on or off medication.ResultsThe subjects suffered fewer relapses and spent significantly less time in hospital (P = 0.001) for treatment of manic, depressive and mixed affective illness during treatment with depot antipsychotics.ConclusionsDepot antipsychotic medication may be a useful prophylactic treatment for certain patients with bipolar affective disorder.British Journal of Psychiatry (1994), 165, 827–829

Bipolar affective disorder

2017 ◽  
Author(s):  
Tom Burns ◽  
Mike Firn
Keyword(s):  
Bipolar Disorder ◽  
Affective Disorder ◽  
Therapeutic Relationship ◽  
Bipolar Affective Disorder ◽  
Psychosocial Interventions ◽  
Mood Stabilizers ◽  
Psychotic Illness ◽  
Early Admission ◽  
Outreach Workers

This chapter deals with the other major psychotic illness, bipolar affective disorder. Bipolar disorder poses a difficult question for outreach workers, as patients are often well recovered between episodes—so should persisting outreach be provided? We report very good results in severe bipolar disorder where continuity of care has paid off. The chapter also deals with theories of causation and classification. The section on treatment identifies the importance of early admission in hypomania, the use of mood stabilizers, and the value of identifying and agreeing on relapse signatures. It also confirms the value of working hard to strengthen the therapeutic relationship and of psychosocial interventions such as psycho-education. Long-term work with these patients brings home just how persistent and disabling the depressive phases can be.

scholarly journals Is intimate partner violence more common in pregnant women with severe mental illness? A retrospective study

2020 ◽  
Vol 66 (3) ◽  
pp. 225-231 ◽  
Author(s):  
Liana Suparare ◽  
Stuart J Watson ◽  
Ray Binns ◽  
Jacqueline Frayne ◽  
Megan Galbally
Keyword(s):  
Bipolar Disorder ◽  
Mental Illness ◽  
Intimate Partner Violence ◽  
Substance Use ◽  
Pregnant Women ◽  
Partner Violence ◽  
Psychotic Disorders ◽  
Intimate Partner ◽  
Illicit Substance Use ◽  
In Pregnancy

Objective: To examine the risk of past and current experiences of intimate partner violence (IPV) in women with severe mental illness (SMI) in pregnancy. Methods: We examined past and current experiences of IPV in women with SMI in pregnancy. The data of 304 women with SMI including schizophrenia and related psychotic disorders and Bipolar Disorder meeting International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Australian Modification (ICD-10-AM) criteria were extracted from hospital records at King Edward Memorial Hospital, Western Australia. Comparisons were made between our study data and the Australian population data reported by the Australian Bureau of Statistics, which included data on pregnant women in Western Australia. Additional measures included reported demographics, substance use and pregnancy variables. Results: Around 48% of pregnant women with SMI had experienced IPV and were three times the risk when compared with the general pregnant population in Australia. There was no difference in rates of IPV in those women with psychotic disorders when compared with bipolar disorder. Furthermore, the rates of smoking and illicit substance use were significantly higher in pregnant women with SMI who experienced IPV compared with those who have not experienced IPV. Conclusion: These findings suggest women with SMI in pregnancy are at significantly higher risk of having experienced or experiencing IPV. In addition, IPV in pregnant women with SMI may increase the risk of smoking and illicit substance use. Together this suggests that maternity and mental health services should ensure there are both screening and support pathways for IPV that are developed and evaluated specifically for pregnant women with SMI.

scholarly journals Impulsivity as a Clinical Marker for Bipolar Affective Disorder

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
A M Omar ◽  
A N Elbatrawy ◽  
W M Sabry ◽  
H A Elkholy ◽  
W A Farrag
Keyword(s):  
Bipolar Disorder ◽  
Affective Disorder ◽  
Behavioral Problems ◽  
Psychosocial Functioning ◽  
Bipolar Affective Disorder ◽  
Bipolar Disorders ◽  
First Degree Relatives ◽  
Adult Psychiatry ◽  
Healthy Functioning ◽  
Substantial Morbidity

Abstract Background Bipolar disorder is one of the world’s 10 most disabling conditions, taking away years of healthy functioning from individuals, all bipolar disorders are chronically recurring illnesses associated with substantial morbidity and mortality. Impulsivity considered an integral part of bipolar disorder. Operationalized as a predisposition to action without reflection or regard for consequences. Potential consequences of this increased impulsivity include substance abuse, suicidal attempts, and other serious behavioral problems. Aim of the Study The aim of the current study was to measure impulsivity in both BD euthymic patients and in healthy first-degree relatives of BD patients. And to assess the functional implications of impulsiveness, on psychosocial functioning and in bipolar disorder patients, their first-degree relatives. Patients and Methods A convenient sample of 50 patients; diagnosed with bipolar affective disorder according to DSM-IV diagnostic criteria were selected from the general adult psychiatry clinics and a convenient sample of 50 healthy first degree relatives of BD patients. Results We concluded by the end of this study that both cases and relatives have high overall impulsivity, and cases have higher impulsivity in comparison to relatives. Conclusion We suggest that impulsivity may be a potentially valuable candidate endophenotype for bipolar disorder.

scholarly journals Uncovering neurodevelopmental features in bipolar affective disorder

2019 ◽  
Vol 215 (01) ◽  
pp. 383-385 ◽  
Author(s):  
Isabel Valli ◽  
Chiara Fabbri ◽  
Allan H. Young
Keyword(s):  
Bipolar Disorder ◽  
Affective Disorder ◽  
Clinical Features ◽  
Neurodevelopmental Disorder ◽  
Bipolar Affective Disorder ◽  
Cognitive Profiles ◽  
Potential Utility ◽  
Cluster Analytic

SummarySchizophrenia and bipolar disorder are genetically related and their clinical features overlap. Schizophrenia is conceptualised as a neurodevelopmental disorder but the evidence for bipolar disorder is less clear. Cluster-analytic approaches reveal different cognitive profiles within bipolar disorder, possibly reflective of differing neurodevelopmental loads, which are also suggested by recent genetic and neuroimaging studies. Such studies suggest the potential utility of further clinical subcategories in bipolar disorder based on neurodevelopmental load.Declaration of interestNone.

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