Prevalence and Clinical Features Associated with Unrecognized Bipolar Disorder among Outpatients with Depressive Disorder in Thailand

2021 ◽  
Vol 104 (11) ◽  
pp. 1821-1827
Keyword(s):  
Bipolar Disorder ◽  
Depressive Disorder ◽  
Clinical Features ◽  
Suicide Attempts ◽  
Bipolar Depression ◽  
University Hospital ◽  
Cross Sectional ◽  
Atypical Depression ◽  
History Of ◽  
Self Harm

Objective: To determine the prevalence of unrecognized bipolar disorder and explore the clinical features of outpatients with depressive disorder associated with bipolar disorder. Materials and Methods: The present study was a cross-sectional study. One hundred six volunteer participants, diagnosed with depressive disorder at Naresuan University Hospital, Buddhachinaraj Phitsanulok Hospital, and Phichit Hospital participated in this study. Psychiatrists interviewed the participants to collect basic data and clinical characteristics to determine unrecognized bipolar disorder using the Thai version of the Mini International Neuropsychiatric Interview (MINI). Results: The results showed that the prevalence of unrecognized bipolar disorder was 18.9%. When multivariable logistic regression was used, it was found that there were two statistically significant factors associated with unrecognized bipolar disorder. These factors were a history of self-harm or suicide attempts (AOR 4.40, 95% CI 1.24 to 15.60), and atypical depression seen with overeating and hypersomnia (AOR 11.73, 95% CI 2.32 to 59.35). Conclusion: There are several misdiagnoses of patients with bipolar disorder because the patients are usually in a depressive state when they decide to consult a doctor. Therefore, doctors should further probe especially in patients with atypical depression, history of self-harm or attempted suicide. Keywords: Bipolar depression; Bipolar disorder; Diagnosis; Epidemiology; Prevalence

scholarly journals Comparison of depressive episodes in bipolar disorder and in major depressive disorder within bipolar disorder pedigrees

2011 ◽  
Vol 199 (4) ◽  
pp. 303-309 ◽  
Author(s):  
Philip B. Mitchell ◽  
Andrew Frankland ◽  
Dusan Hadzi-Pavlovic ◽  
Gloria Roberts ◽  
Justine Corry ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Clinical Features ◽  
Bipolar Depression ◽  
Bipolar Affective Disorder ◽  
Probabilistic Approach ◽  
Psychomotor Retardation ◽  
Major Depressive ◽  
Depressive Episodes

BackgroundAlthough genetic epidemiological studies have confirmed increased rates of major depressive disorder among the relatives of people with bipolar affective disorder, no report has compared the clinical characteristics of depression between these two groups.AimsTo compare clinical features of depressive episodes across participants with major depressive disorder and bipolar disorder from within bipolar disorder pedigrees, and assess the utility of a recently proposed probabilistic approach to distinguishing bipolar from unipolar depression. A secondary aim was to identify subgroups within the relatives with major depression potentially indicative of ‘genetic’ and ‘sporadic’ subgroups.MethodPatients with bipolar disorder types 1 and 2 (n = 246) and patients with major depressive disorder from bipolar pedigrees (n = 120) were assessed using the Diagnostic Interview for Genetic Studies. Logistic regression was used to identify distinguishing clinical features and assess the utility of the probabilistic approach. Hierarchical cluster analysis was used to identify subgroups within the major depressive disorder sample.ResultsBipolar depression was characterised by significantly higher rates of psychomotor retardation, difficulty thinking, early morning awakening, morning worsening and psychotic features. Depending on the threshold employed, the probabilistic approach yielded a positive predictive value ranging from 74% to 82%. Two clusters within the major depressive disorder sample were found, one of which demonstrated features characteristic of bipolar depression, suggesting a possible ‘genetic’ subgroup.ConclusionsA number of previously identified clinical differences between unipolar and bipolar depression were confirmed among participants from within bipolar disorder pedigrees. Preliminary validation of the probabilistic approach in differentiating between unipolar and bipolar depression is consistent with dimensional distinctions between the two disorders and offers clinical utility in identifying patients who may warrant further assessment for bipolarity. The major depressive disorder clusters potentially reflect genetic and sporadic subgroups which, if replicated independently, might enable an improved phenotypic definition of underlying bipolarity in genetic analyses.

A Comparison of Self-Harm Presentations to Emergency Services

Crisis ◽  
2020 ◽  
Vol 41 (5) ◽  
pp. 389-397
Author(s):  
Hayley Chartrand ◽  
Bruce Tefft ◽  
Jitender Sareen ◽  
Diane Hiebert-Murphy ◽  
Laurence Y. Katz ◽  
...  
Keyword(s):  
Emergency Services ◽  
Suicide Attempts ◽  
Tertiary Care ◽  
Previous History ◽  
Adjustment Disorder ◽  
Cross Sectional ◽  
Need For Treatment ◽  
History Of ◽  
Self Harm ◽  
Cross Sectional Design

Abstract. Background: In the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, the distinction between nonsuicidal self-injury (NSSI) and suicide attempts (SA) is highlighted in the section of conditions for further study. Aims: The objective of this study was to examine the correlates of people who presented to emergency departments (ED) with NSSI compared with those who presented with SA and no self-harm or suicidal ideation (no SH or SI). Method: Data came from 4,772 presentations to ED of tertiary care hospitals in Manitoba, Canada, between January 2009 and June 2012. Chart reviews were conducted for presentations with NSSI ( n = 158), and a sample of SA ( n = 172) and no SH or SI ( n = 173). Results: NSSI was associated with borderline personality traits/disorders, previous history of SH, and aggression/impulsivity compared with no SH or SI. SA was associated with a lower likelihood of adjustment disorder ( OR = 0.58; 95 % CI [0.34, 0.99]) and previous history of NSSI ( OR = 0.30; 95 % CI [0.17, 0.53]) compared with NSSI. Limitations: A limitation of this study is its cross-sectional design. Conclusion: Given the distress associated with NSSI, the findings highlight the need for treatment plans that address all those who present to ED with SH regardless of intent.

Obesity is associated with previous suicide attempts in bipolar disorder

2010 ◽  
Vol 22 (2) ◽  
pp. 63-67 ◽  
Author(s):  
Fabiano A. Gomes ◽  
Márcia Kauer-Sant’Anna ◽  
Pedro V. Magalhães ◽  
Felice N. Jacka ◽  
Seetal Dodd ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Suicide Attempt ◽  
Suicide Attempts ◽  
University Hospital ◽  
Comprehensive Management ◽  
History Of ◽  
Axis I ◽  
Dsm Iv ◽  
Bipolar Patients ◽  
The University

Gomes FA, Kauer-Sant’Anna M, Magalhães PV, Jacka FN, Dodd S, Gama CS, Cunha Â, Berk M, Kapczinski F. Obesity is associated with previous suicide attempts in bipolar disorder.Objective:There is a paucity of data about risk factors for suicide attempts in bipolar disorder. The aim of this study is to examine the association between suicide attempts and obesity in people with bipolar disorder.Methods:Two hundred fifty-five DSM-IV out-patients with bipolar disorder were consecutively recruited from the Bipolar Disorder Program at Hospital das Clínicas de Porto Alegre and the University Hospital at the Universidade Federal de Santa Maria, Brazil. Diagnosis and clinical variables were assessed with Structured Clinical Interview for DSM-IV-axis I (SCID I) and Program structured protocol. History of suicide attempts was obtained from multiple information sources including patients, relatives and review of medical records. Patients with body mass index (BMI) ≥ 30 were classified as obese.Results:Over 30% of the sample was obese and over 50% had a history of suicide attempt. In the multivariate model, obese patients were nearly twice (OR = 1.97, 95% CI: 1.06–3.69, p = 0.03) as likely to have a history of suicide attempt(s).Conclusion:Our results emphasise the relevance of obesity as an associated factor of suicide attempts in bipolar disorder. Obesity may be seen as correlate of severity and as such, must be considered in the comprehensive management of bipolar patients.

Identifying Suicide Typologies Among Trauma-Exposed Veterans

Crisis ◽  
2020 ◽  
Vol 41 (4) ◽  
pp. 288-295 ◽  
Author(s):  
Nadia Bounoua ◽  
Jasmeet P. Hayes ◽  
Naomi Sadeh
Keyword(s):  
Latent Profile Analysis ◽  
Suicide Attempts ◽  
Clinical Symptoms ◽  
Profile Analysis ◽  
Risky Behaviors ◽  
Self Report ◽  
Cross Sectional ◽  
Research Priority ◽  
Self Harm ◽  
And Behaviors

Abstract. Background: Suicide among veterans has increased in recent years, making the identification of those at greatest risk for self-injurious behavior a high research priority. Aims: We investigated whether affective impulsivity and risky behaviors distinguished typologies of self-injurious thoughts and behaviors in a sample of trauma-exposed veterans. Method: A total of 95 trauma-exposed veterans (ages 21–55; 87% men) completed self-report measures of self-injurious thoughts and behaviors, impulsivity, and clinical symptoms. Results: A latent profile analysis produced three classes that differed in suicidal ideation, suicide attempts and nonsuicidal self-injury (NSSI): A low class that reported little to no self-injurious thoughts or behaviors; a self-injurious thoughts (ST) class that endorsed high levels of ideation but no self-harm behaviors; and a self-injurious thoughts and behaviors (STaB) class that reported ideation, suicide attempts and NSSI. Membership in the STaB class was associated with greater affective impulsivity, disinhibition, and distress/arousal than the other two classes. Limitations: Limitations include an overrepresentation of males in our sample, the cross-sectional nature of the data, and reliance on self-report measures. Conclusion: Findings point to affective impulsivity and risky behaviors as important characteristics of veterans who engage in self-injurious behaviors.

Malaria among migrants in a university hospital in Colombia during 2018: A case series

2020 ◽  
pp. 004947552098130
Author(s):  
Fabián R Carreño-Almánzar ◽  
Adán Coronado-Galán ◽  
Sonia A Cala-Gómez ◽  
Agustín Vega-Vera
Keyword(s):  
Latin American ◽  
Previous History ◽  
Case Series ◽  
Cross Sectional Study ◽  
Imported Malaria ◽  
University Hospital ◽  
Sectional Study ◽  
Cross Sectional ◽  
History Of ◽  
Clinical Profiles

Imported malaria has increased in Colombia since 2015 and has been attributed to migrants coming from Venezuela. We present a series of malaria cases, nested in a retrospective cross-sectional study between 2017 and 2018, aimed at calculating the prevalence of medical diseases among immigrants in a University Hospital in Colombia. Among 154 immigrants admitted for medical causes between 2017 and 2018, 8 were diagnosed with malaria, all due to Plasmodium vivax. Of these, seven had uncomplicated malaria, five had a previous history of malaria, one was critically ill, but none died. We highlight that, similar to other case series of imported malaria, Latin American migrants were young, with similar clinical profiles, having a low proportion of severe cases, and P. vivax was the most frequent cause.

Psychological, Structural, Social and Economic Determinants of Suicide Attempt: Risk Assessment and Decision Making Strategies

2021 ◽  
pp. 003022282110034
Author(s):  
Azam Farmani ◽  
Mojtaba Rahimianbougar ◽  
Yousef Mohammadi ◽  
Hossein Faramarzi ◽  
Siamak Khodarahimi ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Suicide Attempt ◽  
Suicide Attempts ◽  
Psychological Services ◽  
Cross Sectional ◽  
Economic Determinants ◽  
History Of ◽  
Cross Sectional Design ◽  
High Level ◽  
Risk Assessment And Management

The aim of this research was to conduct a risk assessment and management of psychological, structural, social and economic determinants (PSSED) in a suicide attempt. The sample consisted of 353 individuals who had a recorded history of suicidal attempt; and 20 professional individuals by purposive sampling method within a descriptive cross-sectional design. Worksheets for RAM and AHP were used for data collection in this study. The rate of suicide attempt was 7.21 per 100,000 population in this study. Analysis showed that depression and mental disorders; personality disorders; family problems; socio-cultural and economic problems; lack of awareness; and low level of education have a high level of risk for suicide attempts. Psychiatric and psychological services; awareness and knowledge of life skills; medical services to dysfunctional families; development of community-based planning for PSSED of suicide; and employment and entrepreneurship services may lower suicide attempt risk.

Prescribing practices of Indian psychiatrists in the treatment of bipolar disorder

2019 ◽  
Vol 53 (5) ◽  
pp. 458-469 ◽  
Author(s):  
YC Janardhan Reddy ◽  
Venugopal Jhanwar ◽  
Rajesh Nagpal ◽  
MS Reddy ◽  
Nilesh Shah ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Maintenance Treatment ◽  
Bipolar Depression ◽  
Mood Stabilizer ◽  
Self Report ◽  
Mood Stabilizers ◽  
Prescribing Practices ◽  
Term Outcome ◽  
Cross Sectional ◽  
Long Term Outcome

Objective: The treatment of bipolar disorder is challenging because of its clinical complexity and availability of multiple treatment options, none of which are ideal mood stabilizers. This survey studies prescription practices of psychiatrists in India and their adherence to guidelines. Method: In total, 500 psychiatrists randomly selected from the Indian Psychiatric Society membership directory were administered a face-to-face 22-item questionnaire pertaining to the management of bipolar disorder. Results: For acute mania, most practitioners preferred a combination of a mood stabilizer and an atypical antipsychotic to monotherapy. For acute depression, there was a preference for a combination of an antidepressant and a mood stabilizer over other alternatives. Electroconvulsive therapy was preferred in the treatment of severe episodes and to hasten the process of recovery. Approximately, 50% of psychiatrists prescribe maintenance treatment after the first bipolar episode, but maintenance therapy was rarely offered lifelong. While the majority (85%) of psychiatrists acknowledged referring to various clinical guidelines, their ultimate choice of treatment was also significantly determined by personal experience and reference to textbooks. Limitations: The study did not study actual prescriptions. Hence, the responses to queries in the survey are indirect measures from which we have tried to understand the actual practices, and of course, these are susceptible to self-report and social-desirability biases. This was a cross-sectional study; therefore, temporal changes in responses could not be considered. Conclusion: Overall, Indian psychiatrists seemed to broadly adhere to recommendations of clinical practice guidelines, but with some notable exceptions. The preference for antidepressants in treating depression is contrary to general restraint recommended by most guidelines. Therefore, the efficacy of antidepressants in treating bipolar depression in the context of Indian psychiatrists’ practice needs to be studied systematically. Not initiating maintenance treatment early in the course of illness may have serious implications on the long-term outcome of bipolar disorder.

scholarly journals Vulnerabilities of children admitted to a pediatric inpatient care unit

2014 ◽  
Vol 32 (4) ◽  
pp. 367-373 ◽  
Author(s):  
Larissa Natacha de Oliveira ◽  
Márcia Koja Breigeiron ◽  
Sofia Hallmann ◽  
Maria Carolina Witkowski
Keyword(s):  
Illicit Drugs ◽  
Total Sample ◽  
University Hospital ◽  
Cross Sectional ◽  
Health History ◽  
History Of ◽  
Pediatric Inpatient ◽  
Inpatient Units ◽  
Child Caregiver ◽  
Networks Of Support

OBJECTIVE: To identify the vulnerabilities of children admitted to a pediatric inpatient unit of a university hospital.METHODS: Cross-sectional, descriptive study from April to September 2013 with36 children aged 30 days to 12 years old, admitted to medical-surgical pediatric inpatient units of a university hospital and their caregivers. Data concerning sociocultural, socioeconomic and clinical context of children and their families were collected by interview with the child caregiver and from patients, records, and analyzed by descriptive statistics.RESULTS: Of the total sample, 97.1% (n=132) of children had at least one type of vulnerability, the majority related to the caregiver's level of education, followed by caregiver's financial situation, health history of the child, caregiver's family situation, use of alcohol, tobacco, and illicit drugs by the caregiver, family's living conditions, caregiver's schooling, and bonding between the caregiver and the child. Only 2.9% (n=4) of the children did not show any criteria to be classified in a category of vulnerability.CONCLUSIONS: Most children were classified has having a social vulnerability. It is imperative to create networks of support between the hospital and the primary healthcare service to promote healthcare practices directed to the needs of the child and family.

scholarly journals Recurrent Miscarriage and Consanguinity among Omani Women– A Cross Sectional Study

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Fatma Al Hoqani ◽  
Wadha Al Ghafri ◽  
Saneya El tayeb ◽  
Yahya Al Farsi ◽  
Vaidyanathan Gowri
Keyword(s):  
Recurrent Miscarriage ◽  
Cross Sectional Study ◽  
University Hospital ◽  
Control Group ◽  
P Value ◽  
Cross Sectional ◽  
Recurrent Miscarriages ◽  
Sultan Qaboos University ◽  
Chi Squared ◽  
History Of

Objective: to determine the prevalence of explained and unexplained recurrent miscarriages (RM) and to find out if there is a significant relationship between recurrent miscarriages and consanguinity. Methods: A cross sectional in which the cases group included all women with RM attending the outpatient clinic at Sultan Qaboos University Hospital from July 2006 to April 2012 and the controls group included women with no history of RM after matching them with cases for age (case to control ratio was 1:1). The main outcome measures were the prevalence of consanguinity in women with or without recurrent miscarriages. Results: During study period a total of 290 women with RM were seen. Of which, 150 (51.7%) women had unexplained RM. Control group with no history of RM were 300 women. Consanguinity rate among cases (49.5%) %) was less than the controls (52.7 %%). Both first cousin and second cousin marriages were more common in the controls than the cases and it was not statistically significant (p value 0.476, chi squared test). Conclusion: In this study we found that more than half of RM cases were unexplained and there was no significant association between RM and consanguinity.

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