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 Features of dyssomnyas in primary episode of bipolar affective disorder

2019 ◽  
Vol 23 (3) ◽  
pp. 393-396
Author(s):  
Yu.I. Mysula ◽  
O.P. Wenger
Keyword(s):  
Sleep Disturbance ◽  
Sleep Disorders ◽  
Affective Disorder ◽  
Sleep Disturbances ◽  
Bipolar Affective Disorder ◽  
The Other ◽  
Men And Women ◽  
Falling Asleep ◽  
Wide Range ◽  
Mixed Variant

Bipolar affective disorder (BAD) is one of the actual problems in modern psychiatry. The aim of the study is to investigate dyssomnia in patients with primary episode of BAD, taking into account, the sex and clinical features of the diseases debut. We have clinically examined 65 men and 88 women diagnosed with bipolar affective disorder in the period 2015–2019. It was found that dyssomnia is present in 98.3% of all patients, in 97.7% of men and in 98.7% of women with depressive variant of the primary episode of BAD, accordingly in 30.4%, 26.7% and 37.5% of patients with manic variant and at 100,0% of patients with mixed variant. The structure of sleep disorders varies significantly depending on the variant of the primary episode: with depressive, prevail night and early awakenings (100.0%), sleep disturbance (75.6%, 70.5%, and 78.7%), unstable sleep (47.9%, 59.1% and 41.3%, p<0.05), nightmares (12.6%, 13.6% and 12.0%); at manic — unstable sleep (73.9%, 73.3% and 75.0%), sleep disturbance (17.4%, 13.3% and 25.0%) and frequent night awakenings (13.0%, 13.3% and 12.0%), in the mixed variant — falling asleep (72.7%, 66.7% and 80.0%), unstable sleep (72.7%, 83.3% and 60.0%), frequent night awakenings (54.5%, 66.7%, and 40.0%), early awakening (36.4%, 50.0%, and 20.0%) and nightmares (27.3%, 16.7% and 40.0%). Thus, the primary episode of bipolar affective disorder is accompanied by a wide range of dyssomnias, among which the leading are disorders of depth and stability of sleep. Manifestations of dyssomnia vary depending on the clinical type of the primary episode of BAD: with the depressive variant, prevail night awakenings, early awakenings and sleep disturbances, with unstable sleep, and with mixed sleep disturbance and unstable sleep. Dyssomnia prevalence is highest for mixed and lowest for manic variants. In depressive men, unstable sleep was more common, and the other disorders of sleep in men and women were not significantly different.

Prolactin ordering patterns in psychiatric inpatients and the impact this has on patient management

2020 ◽  
pp. 103985622093432
Author(s):  
Annabel S Jones ◽  
Shoshana Sztal-Mazer ◽  
Ilan Rauchberger ◽  
Peter Shane Hamblin
Keyword(s):  
Affective Disorder ◽  
Clinical Management ◽  
Bipolar Affective Disorder ◽  
Clinical History ◽  
First Episode ◽  
Antipsychotic Treatment ◽  
Asymptomatic Patients ◽  
Episode Psychosis ◽  
Alfred Hospital ◽  
The Impact

Objective: Guidelines stipulate that baseline prolactin be ordered prior to commencing antipsychotic treatment to facilitate investigation of any subsequent hyperprolactinaemic symptoms. The aim was to observe when and why prolactin levels are ordered for psychiatry inpatients commencing or continuing antipsychotics and how this alters clinical management. Methods: Psychiatry inpatients admitted to the Alfred Hospital, Melbourne, Australia, in 2018 with the diagnoses of psychosis, schizophrenia, schizo-affective disorder or bipolar affective disorder were retrospectively analysed. Results and clinical history data were collected in patients in whom prolactin was ordered during or within 12 months of the relevant admission. Results: Of 592 patients admitted during this period, 90 had prolactin ordered. Eight (8.9%) of the 90 tests were for hyperprolactinaemic symptoms, while the remainder were routine blood work. The results altered clinical management in 10 of the 90 (11.1%) patients. Of these 10, 8 were symptomatic. In the six patients with first episode psychosis, only one had prolactin ordered prior to antipsychotic commencement. Conclusions: Adherence to guideline recommendations of baseline prolactin testing was poor. When established on antipsychotics, measuring prolactin rarely changed management in asymptomatic patients; however, it did in those with hyperprolactinaemic symptoms. Measuring prolactin in asymptomatic patients on antipsychotics appears unhelpful.

scholarly journals PRIMARY EPISODE OF BIPOLAR AFFECTIVE DISORDER

2020 ◽  
Vol 5 (2) ◽  
pp. 69-75
Author(s):  
Yu. I. Mysula
Keyword(s):  
Affective Disorder ◽  
Bipolar Affective Disorder ◽  
Statistical Processing ◽  
New Methods ◽  
Treatment And Prevention ◽  
Personality Research ◽  
Clinical Variant ◽  
Gender Factor ◽  
Psychological Features ◽  
Quantitative Indicators

Background. Bipolar affective disorder (BAD) is a topical issue of contemporary psychiatry. The features of the primary episode (PE) of the disease are extremely important for prognosis, treatment and rehabilitation measures of BAD. Individual psychological features of the patients with PE of BAD are still unexplored that complicates development of new methods of prediction, treatment and prevention of BAD. Objective. The aim of the study was to investigate individual psychological features of the patients with a primary episode of bipolar affective disorder, taking into account the gender factor and clinical variant of the BAD debut. Methods. 153 patients (65 men and 88 women) with a primary episode of bipolar affective disorder were examined. The patients were divided into three groups according to the clinical variant of the course of PE of BAD: depressive variant, manic variant and mixed variant. The examination was carried out using the Standardized multifactor method of personality research (SMMPR). Statistical processing of the data was performed using the non-parametric Mann-Whitney test. Results. The most significant differences in the quantitative indicators of SMMPR were found when comparing depressive and manic, as well as depressive and mixed variants of PE of BAD, and lesser – when comparing manic and mixed variants. Most of all, these differences were expressed in terms of pessimism, impulsiveness, individualism and optimism.  Conclusions. Some peculiar features of male and female patients with depressive, manic and mixed variants of PE of BAD promoting to search for new methods of prediction, treatment and prevention of BAD have been defined.

Clozapine use – has practice changed?

2020 ◽  
Vol 34 (5) ◽  
pp. 567-573
Author(s):  
Roberta Rowntree ◽  
Sean Murray ◽  
Felicity Fanning ◽  
Dolores Keating ◽  
Atilla Szigeti ◽  
...  
Keyword(s):  
Hospital Admissions ◽  
First Episode Psychosis ◽  
Prescribing Patterns ◽  
First Episode ◽  
Service Utilisation ◽  
Treatment Resistant ◽  
Nice Guidelines ◽  
Episode Psychosis ◽  
The Mean ◽  
The Impact

Background: One-third of individuals with schizophrenia have treatment-resistant illness. Of these, up to 60% will respond to clozapine treatment. Aims: This study retrospectively examined clozapine prescribing patterns against National Institute for Health and Care Excellence (NICE) guidelines as treatment-resistant illness emerged in a first-episode psychosis cohort. Methods: A total of 339 individuals with a first-episode psychosis were included in the study. Clozapine prescribing patterns were compared against the NICE guidelines and the impact of clozapine use on one index of service utilisation (hospitalisation) was assessed. Results: A total of 32 individuals (9.4%) from the cohort were prescribed clozapine. The mean time to clozapine trial was 2.1 years (SD 1.95; range 0.17–6.25). The mean number of adequate trials of antipsychotic prior to starting clozapine was 2.74 (SD 1.13; range 1–5). Following clozapine initiation, mean hospital admissions per year reduced from 2.3 to 0.3 ( p=0.00). Mean hospital days pre- and post-clozapine also reduced (147 vs. 53; p=0.00). In total, 18 patients discontinued clozapine use during follow-up – 5 temporarily and 13 permanently. Conclusions: Patients are being prescribed clozapine earlier than previously demonstrated, though delays are still evident, and many patients discontinue treatment. More work needs to be undertaken to understand and address factors which lead to its discontinuation.

Bipolar Affective Disorder in Adolescence: A 10-Year Study

1987 ◽  
Vol 21 (1) ◽  
pp. 36-43 ◽  
Author(s):  
Marie Bashir ◽  
Janice Russell ◽  
Gordon Johnson
Keyword(s):  
Affective Disorder ◽  
Bipolar Affective Disorder ◽  
Positive Family History ◽  
First Episode ◽  
First Year ◽  
Diagnostic Features ◽  
Adolescent Treatment ◽  
Major Teaching Hospital ◽  
Major Teaching ◽  
Better Than

A descriptive study of bipolar affective disorder in adolescent patients, conducted over a 10-year period, is presented. The diagnosis of 30 subjects referred to an adolescent treatment facility of a major teaching hospital was reviewed using DSM-III criteria, and antecedent symptomatology and signs were documented. Common diagnostic features included schizophreniform phenomenology, motoric and vegetative changes, suicidal and inappropriate sexual behaviour and a stormy first year of illness. A positive family history was frequently noted, as was the relevance of various forms of loss as a precipitant of the first episode. Timely recognition and multidisciplinary management, including the use of lithium, are discussed. It appears that the prognosis of bipolar affective disorder in adolescence is better than was previously believed, probably as a result of earlier diagnosis and more frequent recognition.

scholarly journals Incidence of bipolar affective disorder in three UK cities

2005 ◽  
Vol 186 (2) ◽  
pp. 126-131 ◽  
Author(s):  
Tuhina Lloyd ◽  
Noel Kennedy ◽  
Paul Fearon ◽  
James Kirkbride ◽  
Rosemarie Mallett ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Affective Disorder ◽  
Ethnic Groups ◽  
Bipolar Affective Disorder ◽  
Incidence Rates ◽  
First Episode ◽  
Minority Ethnic Groups ◽  
Incidence Studies ◽  
Significant Difference ◽  
Minority Ethnic

BackgroundThere has been a relative dearth of epidemiological research into bipolar affective disorder. Furthermore, incidence studies of bipolar disorder have been predominantly retrospective and most only included hospital admission cases.AimsTo determine the incidence of operationally defined bipolar disorder in three areas of the UK and to investigate any differences in gender and ethnicity.MethodAll patients who contacted mental health services with first-episode psychosis or non-psychotic mania between September 1997 and August 1999 were identified and diagnosed according to ICD–10 criteria. Incidence rates of bipolar affective disorder were standardised for age and stratified by gender and ethnic group across the three areas.ResultsThe incidence rate per 100 000 per year in south-east London was over twice that in Nottingham and Bristol. There was no significant difference in the rates of disorder in men and women. Incidence rates of bipolar disorder in the combined Black and minority ethnic groups in all three areas were significantly higher than those of the comparison White groups.ConclusionsThe incidence of bipolar disorder was higher in south-east London than in the other two areas, and was higher among Black and minority ethnic groups than in the White population.

Adult Affective Disorder and Early Environment

1990 ◽  
Vol 157 (4) ◽  
pp. 539-550 ◽  
Author(s):  
Bryan Rodgers
Keyword(s):  
Affective Disorder ◽  
Early Life ◽  
Deleterious Effect ◽  
Population Sample ◽  
Depression And Anxiety ◽  
Early Environment ◽  
Men And Women ◽  
Symptoms Of Depression ◽  
Life Data ◽  
Number Of Factors

Childhood precursors of symptoms of depression and anxiety were investigated in a national population sample of over 3000 men and women, aged 36 years. Early-life data had been collected prospectively for all subjects. A number of factors, differing for men and women, were found to be significant predictors of adult disorder. Some factors showed strong effects but tended to apply to relatively few individuals, while other more common circumstances had modest influences. Overall, early environment did not seem to hold great significance for adult affective disorder, although multiple disadvantages had a cumulative deleterious effect. There was little evidence of early benefits being protective.

scholarly journals DEMOGRAPHIC VARIABLES ASSOCIATED WITH DRUG USE IN BIPOLAR PATIENTS

2021 ◽  
Vol 30 (03) ◽  
pp. 114-119
Author(s):  
Aysha Rashid ◽  
Mariam Haroon ◽  
Sumira Qambar Bokhari ◽  
Aysha Butt ◽  
Nauman Mazhar ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Drug Abuse ◽  
Drug Use ◽  
Affective Disorder ◽  
Bipolar Affective Disorder ◽  
Treatment Compliance ◽  
Bipolar Patient ◽  
Cross Sectional ◽  
The Mean ◽  
Bipolar Patients

Background: Substance Use is highly associated with bipolar affective disorder, however the reason for the co-occurrence is unknown. It was evident that if a bipolar patient use  drug of abuse his outcome will be poor. Either it can directly trigger the affective symptoms, or may affect the treatment compliance indirectly. Aims: The objective of this study was to study the demographic correlates of drug abuse in patients with bi-polar affective disorder. Method: Cross-Sectional research design and non-probability consecutive sampling was used to collect data from a private clinic in Lahore. Data was comprised of 368 patients of bipolar disorder. Results: Out of a total of 368 bipolar patients, drug abuse was found in 147 patients that is 39.9%. The results showed that the mean age of the patients was 31.03 ±5.837; mean monthly income was 229597.82 ±164626.77 PKR. The mean duration of illness was 6.54 ±5.157. The mean number of drugs used was 2 ±0.875. The mean cost of drug was 29945.7 ±19068.8 PKR. The mean number of hospitalization was 2.47 ±1.694. Association  between drug use and  occupation of  bipolar patients (0.006), factors leading to initiation of drug use (0.000), family history of drug use (0.001), current episode (0.000) and the type of drugs used (0.000)  was statistically significant. Conclusion: The cause and effect relationship between drug use and bipolar disorder cannot be clearly identified. However occupation of the patient, reasons of initiating drugs, drug abuse in family, current episode as well as  type of drugs used have  significant association  with drug abuse in bipolar patients .

scholarly journals Mood disorders and migration

2007 ◽  
Vol 190 (1) ◽  
pp. 6-10 ◽  
Author(s):  
Sanne G. H. A. Swinnen ◽  
Jean-Paul Selten
Keyword(s):  
Risk Factor ◽  
Relative Risk ◽  
Depressive Disorder ◽  
Affective Disorder ◽  
Mood Disorders ◽  
Bipolar Affective Disorder ◽  
Conclusive Evidence ◽  
Unipolar Depressive Disorder ◽  
Incidence Studies ◽  
The Mean

BackgroundMigration is a risk factor for the development of schizophrenia.AimsTo examine whether migration is also a risk factor for bipolar affective disorder, unipolar depressive disorder and mood disorders in general.MethodMedline was searched for population-based incidence studies concerning mood disorders among migrants and mean relative risks were computed using a mixed-effects statistical model.ResultsOnly a few studies of unipolar depressive disorder were retrieved. The mean relative risk of developing bipolar affective disorder among migrants was 2.47 (95% C11.33–4.59). However, after excluding people of African-Caribbean origin in the UK this risk was no longer significantly increased. The mean relative risk of mood disorders of unspecified polarity was 1.25 (95% CI 1.04–1.49) and that of any mood disorder was 1.38 (95% CI 1.17–1.62).ConclusionsThere is no conclusive evidence for a large increase in the risk of mood disorders associated with migration.

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