Obesity and the pharmacotherapy of bipolar disorder

Obesity, as an important risk factor for the development of diabetes, cancer or cardiovascular diseases, is one of the most important problems of modern medicine. Studies show that obesity often coexists with psychiatric disorders, including the bipolar disorder (BD) – the prevalence of obesity can be 1.5 times higher in BD patients when compared with the general population. Additionally, the risk of mood disorders in obese patients is also increased. The probable aetiology of the bidirectional relation between BD and overweight and obesity is likely complex – genetic factors, abnormalities in the immune system or an increased frequency of eating disorders are all present. Obesity in BD patients may be associated with an impairment of the mental and physical well-being, poorer co-operation in the treatment and lower quality of life. Drugs used in BD therapy have different predilections for inducing significant weight gain. The highest metabolic risk is associated with olanzapine and clozapine (among antipsychotics), amitriptyline, mirtazapine and paroxetine in the antidepressant group, and among the mood stabilizers (excluding antipsychotics) lithium and valproate. Amongst the possible therapeutic measures in patients with overweight or obesity, nonpharmacological as well as pharmacological procedures are mentioned. The newly registered antipsychotics with a possibly favourable metabolic profile (lurasidon, Cariprazine, and brexpiprazole) as well as the combination of bupropion/naltrexone or bariatric surgery carry interesting prospects for the future.

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Psychosocial and Diet-Related Lifestyle Clusters in Overweight and Obesity

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18126461 ◽

2021 ◽

Vol 18 (12) ◽

pp. 6461

Author(s):

Débora Godoy-Izquierdo ◽

Raquel Lara ◽

Adelaida Ogallar ◽

Alejandra Rodríguez-Tadeo ◽

María J. Ramírez ◽

...

Keyword(s):

Adult Population ◽

Well Being ◽

Overweight And Obesity ◽

Excess Weight ◽

Convenience Sample ◽

Excessive Weight ◽

Self Reports ◽

The Individual ◽

Composition Factors ◽

Overweight Or Obesity

This study explored intraindividual multidimensional profiles integrating psychosocial factors, namely, body image and satisfaction, weight-related self-stigma, positivity, and happiness, and behavioural-lifestyle factors, namely, adherence to a healthy diet, among Spanish adults with overweight or obesity. We further aimed to investigate the association of excess weight (i.e., measured body mass index, BMI) with the abovementioned multidimensional configurations. A convenience sample of 100 adult individuals (60% females) with excessive weight (69% overweight; 31% obesity) was recruited. They completed self-reports regarding the study variables, and their weight and height were measured. With a perspective centered on the individual, a cluster analysis was performed. Three distinct intraindividual psychosocial and diet-related profiles were identified: a group of healthy individuals with excess weight (46%); a group of individuals who were negatively affected by their excessive weight and showed the most distressed profile (18%); and a group of dysfunctional individuals who seemed to be excessively unrealistic and optimistic regarding their excessive weight and unhealthy lifestyles, but were troubled by their weight (36%). Furthermore, individuals in the affected cluster had higher obesity (mean BMI ± SD = 32.1 ± 3.7) than those in the clusters of healthy (28.0 ± 3.0) and dysfunctional individuals (28.1 ± 3.3) (p < 0.05). The results showed that there are specific psychosocial and lifestyle profiles in the adult population with excess weight and that there are relationships among psychological, behavioural, and body-composition factors. For clinical application purposes, it is important to account for the heterogeneity within individuals who are obese and to individualize the interventions, with a focus from weight change to the individual’s overall well-being.

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General pharmacokinetic/pharmacodynamic concepts of mood stabilizers in the treatment of bipolar disorder

Mental Health Clinician ◽

10.9740/mhc.2016.01.054 ◽

2016 ◽

Vol 6 (1) ◽

pp. 54-61 ◽

Cited By ~ 2

Author(s):

Kenric Ware ◽

Erika Tillery ◽

Lauren Linder

Keyword(s):

Bipolar Disorder ◽

Valproic Acid ◽

Mood Stabilizer ◽

Patient Characteristics ◽

Well Being ◽

Mood Stabilizers ◽

Medline Search ◽

Recommended Treatment ◽

Clinical Databases ◽

Mitigating Factors

Abstract Introduction Mood stabilizers are the recommended treatment for patients who receive a diagnosis of bipolar disorder. Because of the necessity of mood stabilizer treatment in patients with bipolar disorder and the extent of pharmacokinetic and pharmacodynamic principles involved, the purpose of this review is to summarize the pharmacokinetic principles of lithium in addition to the pharmacodynamics of lithium, carbamazepine, lamotrigine, and valproic acid/valproate. Methods Practice guidelines, review articles, and clinical trials were located using online databases PubMed, CINAHL, IDIS, and Medline. Search terms included at least one of the following: bipolar disorder, carbamazepine, lamotrigine, lithium, mood stabilizers, pharmacokinetics, pharmacodynamics, valproate, and valproic acid. Online clinical databases Dynamed® and Lexicomp® were also used in the study. Results Mood stabilizers collectively possess distinct qualities that are closely regarded before, during, and after therapeutic initiation. Individual patient characteristics, coupled with these observed traits, add to the complexity of selecting the most optimal neurologic agent. Each medication discussed uniquely contributes to both the maintenance and restoration of overall patient well-being. Discussion Introduction of mood stabilizers into drug regimens is often done in the presence of an array of mitigating factors. Safety and efficacy measures are commonly used to gauge desired results. Careful monitoring of patients' responses to selected therapies is paramount for arriving at appropriate clinical outcomes.

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Parent emigration and physical health of children left behind: systematic review of the literature

European Journal of Public Health ◽

10.1093/eurpub/ckz186.024 ◽

2019 ◽

Vol 29 (Supplement_4) ◽

Author(s):

J Racaite ◽

G Surkiene ◽

M Jakubauskiene ◽

R Sketerskiene ◽

L Wulkau

Keyword(s):

Quality Of Life ◽

Systematic Review ◽

Physical Health ◽

Well Being ◽

Overweight And Obesity ◽

Unhealthy Lifestyle ◽

Poor Growth ◽

Left Behind ◽

Children Left Behind

Abstract Background Children left behind (CLB) are those, who have been left behind at their original residence while one or both parents migrate to other places for work. The aim of this study was to systematically review studies where the physical health consequences for CLB were analysed. Methods We searched the Web of Science, PubMed, Academic Search Complete, PsycINFO and Cochrane databases. We included studies reporting physical health outcomes of children affected by parent migration. Results We selected 35 studies from a total of 2191. The results reveal that, overall, the absence of one or both parents is related to poorer child health - the nutrition of CLB is not healthy or balanced and is insufficient, leading to higher rates of anaemia and poor growth indicators of affected children. Boys left by parents are smaller than boys who were never left behind. CLB face lower underweight or stunted growth risks due to the additional income from remittances which ensures sufficient food for the household, this can also lead, however, to overweight and obesity. Unhealthy lifestyle behaviours such as smoking, alcohol, food preferences, lower physical activity and higher risk of injuries were more prevalent among CLB. CLB were more likely not to have completed the recommended vaccination programme than those living with their parents. Opinions vary on how emigration of parents affects children’s well-being and quality of life. CLB had higher probabilities of higher well-being than children living in non-migrant households. However, health-related quality of life (HRQoL) of CLB scored significantly lower than HRQoL of non-left-behind children. Conclusions The migration of parents has negative impacts on the child’s physical health, however it can also have positive impacts on children’s well-being when basic needs for sufficient nutrition are not satisfied in the home countries. Public health interventions should be taken to ensure the health of the CLB population. Key messages This is the first systematic review on the physical health of CLB. The well-being of CLB is poorer and they are at risk of health problems, such as insufficient and/or unbalanced diet, unhealthy behaviours and incomplete vaccination status.

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Body Satisfaction, Weight Stigma, Positivity, and Happiness among Spanish Adults with Overweight and Obesity

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17124186 ◽

2020 ◽

Vol 17 (12) ◽

pp. 4186

Author(s):

Débora Godoy-Izquierdo ◽

Juan González-Hernández ◽

Alejandra Rodríguez-Tadeo ◽

Raquel Lara ◽

Adelaida Ogallar ◽

...

Keyword(s):

Body Image ◽

Body Satisfaction ◽

Well Being ◽

Overweight And Obesity ◽

Excess Weight ◽

Convenience Sample ◽

Mediation Effects ◽

Management Actions ◽

Related Stigma ◽

Overweight Or Obesity

Although previous evidence suggests that happiness is lower among individuals with obesity, research on the correlates of subjective well-being (SWB) is warranted to increase our knowledge. We aim to explore excess weight (i.e., measured and self-reported body mass index (BMI)), body image and satisfaction, self-stigma, positivity, and happiness among Spanish adults with overweight or obesity. We further aim to investigate the predictors of SWB in this sample. A convenience sample of 100 individuals with excess weight completed self-reports on the study variables and were weighed and their height measured. On average, the participants reported body perceptions revealing minor excessive weight, moderate body satisfaction, low-to-moderate weight-related stigma, and elevated positivity and happiness. BMI and gender/sex independently affected these variables, but there were no significant interaction effects. Furthermore, individuals with overweight or obesity with higher body satisfaction and elevated positivity were more likely to report being happy, independent of their age, gender/sex, weight, and weight-related stigma. Mediation effects were found for body satisfaction and positivity in the relationship between weight and happiness. Moreover, positive orientation suppressed the pervasive influence of stigma on SWB. Our findings confirm the key role of body image dimensions and weight-related stigma for happiness and add support to the relevance of positivity for overall well-being of individuals with excess weight. These results may inform obesity management actions focused on inclusive aesthetic models, combating social stigmatization and enhancing positivity for a flourishing and fulfilling life.

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Health-related quality of life in children and adolescents with overweight and obesity: results from the German KIGGS survey

BMC Public Health ◽

10.1186/s12889-020-09834-8 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Lara Meixner ◽

Caroline Cohrdes ◽

Anja Schienkiewitz ◽

Gert B. M. Mensink

Keyword(s):

Quality Of Life ◽

Children And Adolescents ◽

Well Being ◽

Normal Weight ◽

Overweight And Obesity ◽

Media Consumption ◽

Health Related Quality ◽

Related Quality ◽

Health Related

Abstract Background The well-being of persons with overweight and obesity, in particular of children and adolescents, may be impaired. The present study investigates the health-related quality of life (HRQoL) of girls and boys with overweight and obesity living in Germany as compared to those of normal-weight, while taking a selection of relevant determinants of HRQoL into account. Methods The sample comprises 1771 children and adolescents aged 11 to 17 years that took part in the cross-sectional German Health Interview and Examination Survey for Children and Adolescents (KIGGS Wave 2, 2014–2017). Sex-and age-specific BMI (kg/m2) percentiles were utilized to classify overweight and obesity. HRQoL was measured with the KIDSCREEN-27 questionnaire, which gathers detailed information about the five dimensions physical and psychological well-being, well-being regarding peers (i.e., social acceptance), parents (i.e., autonomy) and within the school environment. Multiple regression analyses were performed with HRQoL dimensions as outcomes to test for differences between children and adolescents with normal-weight vs. those with overweight and vs. those with obesity, separately for girls and boys. In a next step, age, physical activity, media consumption, social support and self-efficacy were considered as potential confounders in the analyses. Results 18.7% of the children and adolescents under study were affected by overweight and among them 8.0% by obesity. After adjusting for potential confounders, overweight and obesity were associated with lower physical well-being as compared to normal weight in both sexes (boys with overweight: standardized beta [β] = −.14, standard error [SE] = .03, p < .001, and obesity: β = −.16, SE = .03, p < .001; girls with overweight: β = −.09, SE = .04, p = .011, and obesity: β = −.11, SE = .03, p = .003). Results moreover suggest lower levels of psychological (β = −.10, SE = .04, p = .002) and parent-related well-being (β = −.08, SE = .04, p = .036) of boys with obesity as compared to normal-weight peers. Conclusion HRQoL of German children and adolescents with overweight and obesity is impaired according to physical well-being in general, while psychological and parent-related well-being is particularly affected in boys. Public health approaches should therefore promote children and adolescents with overweight and obesity by improving diverse facets of HRQoL as well as relevant associated factors (i.e., media consumption, self-efficacy) in general and in boys in particular.

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Implementing the clinical standards of the National Institute for Health and Care Excellence (NICE) bipolar clinical guideline

European Psychiatry ◽

10.1016/j.eurpsy.2016.01.825 ◽

2016 ◽

Vol 33 (S1) ◽

pp. S20-S21 ◽

Cited By ~ 5

Author(s):

M. Tremblay ◽

S. Palin

Keyword(s):

Bipolar Disorder ◽

Clinical Guideline ◽

Well Being ◽

Quality Of Services ◽

Treatment As Usual ◽

Clinical Standards ◽

Actual Service ◽

Competing Interest ◽

The Uk

In the UK, the National Institute for Health and Care Excellence (NICE) sets standards for interventions to drive improvement in the quality of services delivered. The actual update of clinical guidelines remains patchy and difficult to ascertain.NICE most recent guideline on the management of bipolar disorder in adults will be reviewed. A concept tool to facilitate adherence to NICE clinical standards will be presented along with detailed outcomes of its pilot application in a naturalistic treatment setting, which drove the average concordance from 32% for a team providing treatment as usual, to 92% for a team supporting their practice with the tool. This presentation will also address additional impacts of its use including allowing drawing key clinical characteristics of an index population of individuals suffering from bipolar disorder, supporting education and auditing the actual service delivery.The usefulness of the tool to shape clinical practice according to NICE evidence-based standards will be outlined. Its versatility and limitations will be debated. The discussion of the findings will include epidemiological considerations as well as implications for mental and physical well-being.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Key Predictors of Overweight and Obesity in Adult Population

Clinical Social Work and Health Intervention ◽

10.22359/cswhi_12_5_12 ◽

2021 ◽

Vol 12 (5) ◽

pp. 79-86

Author(s):

M. Popovicova ◽

M. Belovicova ◽

P. Snopek ◽

J. Babecka

Keyword(s):

Healthy Lifestyle ◽

Eating Habits ◽

Negative Impact ◽

Adult Population ◽

Overweight And Obesity ◽

Chi Square ◽

Chi Square Test ◽

And Gender ◽

Overweight Or Obesity

Introduction: According to experts, overweight and obesity, are the most dangerous civilization diseases of today. World- wide, over 312 million people are obese and another 1.3 billion suffer from obesity. Increased weight is a significant health risk and it means a decrease in quality of life and, especially in life expectancy. Because of this, in our research, weaddressthe problem of current society which is overweight and obesity. Methods:To verify hypotheses, we used chi-square test of inde- pendence. It is a universal statistical test with wide use. It is most often used to verify the relation between nominal type variables. Results:By analyzing the results, we have found that over- weight or obesity of the parents, respondents’ satisfaction, eating habits and gender are related to overweight and obesity of the respondents. However, we have not found a relation between the physical activity of the respondents and their overweight or obesity. In case our respondents do not exercise and have bad eating habits, their body weight would be likely to increase. Conclusion:To prevent the development of overweight and obesity and its complications that have a negative impact on our health, it is necessary to make a targeted and effective in- tervention that is aimed at a healthy lifestyle.

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New Approaches to Old Problems: The Well-Being of the Population of Russia from 1821 to 1910 as Measured by Physical Stature

Slavic Review ◽

10.2307/2672985 ◽

1999 ◽

Vol 58 (1) ◽

pp. 1-26 ◽

Cited By ~ 8

Author(s):

Boris N. Mironov

Keyword(s):

Quality Of Life ◽

Environmental Factors ◽

Medical Care ◽

Genetic Factors ◽

Well Being ◽

Living Conditions ◽

Physical Stature ◽

The Relationship ◽

Conditions Of Work

Scholars generally agree on the relationship between the physical stature, or height, of children and adults, and their quality of life, or their biological status, including diet, illnesses, intensity and conditions of work, availability of medical care, living conditions, psychological well-being, climate, water, air, and other environmental factors that have impinged on their lives prior to the point at which their height is measured. Genetic factors have an important effect on individual height, but genetic distinctions lose their significance when masses of individuals are measured and average heights are compared. The same effect holds at the level of entire populations: differences in height are determined, not by ethnic or racial attributes, but by living conditions.

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Sleep Disturbances in Patients With Psychiatric Illnesses

Journal of Pharmacy Practice ◽

10.1177/0897190007300735 ◽

2006 ◽

Vol 19 (6) ◽

pp. 369-378 ◽

Cited By ~ 2

Author(s):

Angela Singh ◽

Patty Ghazvini ◽

Natalie Robertson ◽

Angela J. Massey ◽

Otis Kirksey ◽

...

Keyword(s):

Quality Of Life ◽

Bipolar Disorder ◽

Cognitive Function ◽

Sleep Disturbances ◽

Treatment Options ◽

Well Being ◽

Psychiatric Illnesses ◽

Sleep Abnormalities ◽

Mental Well Being

Sleep is essential not only for our physical well-being but also for our mental well-being. Researchers, however, have determined that specific alterations in sleep patterns do exist among patients with psychiatric illnesses. The causes of these abnormalities include both direct and indirect mechanisms. These abnormalities lead to declines in both cognitive function and quality of life. Management should include both nonpharmacological and pharmacological methods. This article will review the types of sleep abnormalities associated with schizophrenia, depression, bipolar disorder, and anxiety disorders and will additionally review treatment options available for each illness.

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Psychosocial Resources and Diet-Related Lifestyle in Overweight and Obesity: A Cluster-Based Study

10.20944/preprints202103.0787.v1 ◽

2021 ◽

Author(s):

Débora Godoy-Izquierdo ◽

Raquel Lara ◽

Adelaida Ogallar ◽

Alejandra Rodríguez-Tadeo ◽

María J. Ramírez ◽

...

Keyword(s):

Adult Population ◽

Well Being ◽

Overweight And Obesity ◽

Excess Weight ◽

Convenience Sample ◽

Excessive Weight ◽

Self Reports ◽

The Individual ◽

Composition Factors ◽

Overweight Or Obesity

This study explored intraindividual multidimensional profiles integrating psychosocial factors, namely, body image and satisfaction, weight-related self-stigma, positivity, and happiness, and behavioural-lifestyle factors, namely, adherence to a healthy diet, among Spanish adults with overweight or obesity. We further aimed to investigate the association of excess weight (i.e., measured body mass index, BMI) with the abovementioned multidimensional configurations. A convenience sample of adult individuals with excessive weight completed self-reports regarding the study variables, and their weight and height were measured. With a perspective centered on the individual, a cluster analysis established three distinct intraindividual psychosocial and diet-related profiles: a group of healthy individuals with excess weight; a group of individuals who were negatively affected by their excessive weight and showed the most distressed profile; and a group of dysfunctional individuals who seemed to be excessively unrealistic and optimistic regarding their excessive weight and unhealthy lifestyles. Furthermore, individuals in the affected cluster had higher obesity. The results showed that there are specific psychosocial and lifestyle profiles in the adult population with excess weight and that there are relationships among psychological, behavioural, and body-composition factors. For clinical application purposes, it is important to account for the heterogeneity within individuals who are obese and to individualize the interventions, with a focus from weight change to individual's overall well-being.

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