scholarly journals Factors Influencing the Number of Relapse in Patients with Bipolar I Disorder

2020 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Omran Davarinejad ◽  
Tahereh Mohammadi Majd ◽  
Farzaneh Golmohammadi ◽  
Payam Mohamadi ◽  
Farnaz Radmehr ◽  
...  
Keyword(s):  
Risk Factors ◽  
Bipolar Disorder ◽  
Poisson Regression ◽  
Rate Ratio ◽  
Disease Onset ◽  
Study Data ◽  
Type I ◽  
Birth Season ◽  
Adherence To Medication ◽  
Bipolar Patients

Background: Type I bipolar disorder is a chronic mental illness with a recurrent nature. Objectives: This study was done to identify risk factors for relapse in patients with type I bipolar disorder using Poisson regression. Methods: In this retrospective cohort study, data were collected from 331 bipolar type I patients admitted to the largest and the only psychiatric hospital in West of Iran, Kermanshah. Poisson regression was used to identify risk factors for the relapse numbers in STATA software. Results: One hundred sixty six of 331 patients (50.2%) were men. Mean and standard deviation of relapse rates in males and females were 2.93 ± 0.16 and 2.93 ± 0.15, respectively. In multivariate analysis, the results showed that with increasing age of disease onset (RR = 0.98, 95% CI :(0.97 -0.99)) and adherence to medication (RR = 0.86, 95% CI :(0.75-0.98)), the relapse rate ratio decreased, and being divorced or widowed (RR = 1.20,95% CI :( 1.01-1.45)), cigarette smoking (RR = 1.28, 95% CI: (1.52-1.09)), and birth season of winter (RR = 1.18, 95% CI: (1.00-1.41)) increased the rate ratio of relapse. Conclusions: The results of this study showed that the frequency of relapse was lower in bipolar patients younger at the time of disease onset, cigarette smokers, divorced or widowed patients, and patients with no treatment adherent. It is necessary to prevent or reduce the likelihood of relapse, especially in patients who do not have therapeutic adherence through educational and therapeutic measurements.

scholarly journals Development of a Psychosocial Intervention to Promote Treatment Adherence in Patients with Bipolar Disorder at Risk of Cardiovascular Disease

2021 ◽  
Vol 10 (24) ◽  
pp. 5890
Author(s):  
Sandra I. Ralat ◽  
Giselle Alicea-Cuprill ◽  
Yashira Arroyo ◽  
William Otero
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
At Risk ◽  
Bipolar Disorder ◽  
Psychosocial Intervention ◽  
Effect Sizes ◽  
Type I ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Adherence To Medication

Nonadherence to treatment is a serious concern that affects the successful management of bipolar disorder (BD) patients. The aim of this study was to pilot test a psychosocial intervention (previously developed by this team) intended to increase adherence to medication and health behaviors targeting cardiovascular disease (CVD) risk factors in BD patients. An open, single-group design was used to assess the feasibility and acceptability of the intervention. The participants had BD, type I/II or unspecified, and CVD risk factors. Baseline demographic measures were taken. We also obtained preliminary effect sizes related to pre-post changes on measures of self-reported adherence to psychiatric medication, depressive and manic symptoms, and pharmacy records. At baseline, 29% of the participants reported recent adherence to psychiatric medications. A total of 71% of the participants completed the intervention. Pre-post improvements by medium and large effect sizes (Cohen’s d = 0.52–0.92) were seen in medication adherence, attitudes toward medication, and mania symptoms. The participants reported high levels of satisfaction with the intervention. A culturally sensitive psychosocial intervention for Puerto Rican BD patients who are at risk of CVD was found to be feasible and acceptable. Improvements in the key outcomes were seen in this small, preliminary study. Further research is needed with a larger sample size.

Blood Type and Bipolar Disorder

2002 ◽  
Vol 95 (3) ◽  
pp. 988-988
Author(s):  
Tamas Zonda ◽  
David Lester
Keyword(s):  
Bipolar Disorder ◽  
Blood Type ◽  
Type I ◽  
Type Ii ◽  
Bipolar Patients

Type I bipolar patients in Budapest were reported to have type O blood more often and types A and B blood less often than Type II bipolar patients.

Psychosocial Treatments for Bipolar Disorder

2007 ◽  
pp. 309-322 ◽  
Author(s):  
David J. Miklowitz ◽  
W. Edward Craighead
Keyword(s):  
Bipolar Disorder ◽  
Medication Adherence ◽  
Treatment Period ◽  
Pharmacological Treatment ◽  
Psychosocial Interventions ◽  
Improve Medication Adherence ◽  
Coping With Stress ◽  
Adherence To Medication ◽  
Bipolar Patients

Whereas pharmacological interventions remain the primary treatment for bipolar disorder, adjunctive psychosocial interventions have the potential to increase adherence to medication regimens, decrease hospitalizations and relapses, improve quality of life, and enhance mechanisms for coping with stress. Controlled studies have established that individual, family, and group psychoeducation, designed to provide information to bipolar patients and their families about the disorder, its pharmacological treatment, and the treatments’ side effects, leads to lower rates of recurrence and greater adherence to pharmacological treatment among bipolar patients. Type 1 and 2 studies have evaluated cognitive behavioral therapy (CBT) as an ancillary treatment. These studies indicate that CBT is associated with better medication adherence and significantly fewer recurrences and/or rehospitalizations. One Type 1 study has evaluated the effectiveness of IPSRT (interpersonal and social rhythm therapy) for bipolar disorder. IPSRT demonstrated its greatest symptomatic effects during a maintenance treatment period, especially if bipolar patients had been successful in stabilizing their daily and nightly routines during an acute treatment period. Finally, four Type 1 studies in adult and pediatric patients have shown that marital/ family therapy may be effectively combined with pharmacotherapy to reduce recurrences and improve medication adherence and family functioning.

scholarly journals Study of Risk Factors Associated with Suicide Attempt in Patients with Bipolar Disorder Type I

2020 ◽  
Vol 11 (02) ◽  
pp. 291-298
Author(s):  
Karthick Subramanian ◽  
Vikas Menon ◽  
Siddharth Sarkar ◽  
Vigneshvar Chandrasekaran ◽  
Nivedhitha Selvakumar
Keyword(s):  
Risk Factors ◽  
Bipolar Disorder ◽  
Logistic Regression ◽  
Family History ◽  
Suicide Attempt ◽  
Coping Strategies ◽  
Binary Logistic Regression ◽  
Type I ◽  
Factors Associated ◽  
History Of

Abstract Background Suicide is the leading contributor to mortality in bipolar disorder (BD). A history of suicidal attempt is a robust predictive marker for future suicide attempts. Personality profiles and coping strategies are the areas of contemporary research in bipolar suicides apart from clinical and demographic risk factors. However, similar research in developing countries is rarer. Objectives The present study aimed to identify the risk factors associated with suicidal attempts in BD type I (BD-I). Materials and Methods Patients with BD-I currently in clinical remission (N = 102) were recruited. Sociodemographic details and the clinical data were collected using a semistructured pro forma. The psychiatric diagnoses were confirmed using the Mini-International Neuropsychiatric Interview 5.0. The National Institute of Mental Health–Life Chart Methodology Clinician Retrospective Chart was used to chart the illness course. Presumptive Stressful Life Events Scale, Coping Strategies Inventory Short Form, Buss–Perry aggression questionnaire, Past Feelings and Acts of Violence, and Barratt Impulsivity scale were used to assess the patient’s stress scores, coping skills, aggression, violence, and impulsivity, respectively. Statistical Analysis Descriptive statistics were used for demographic details and characteristics of the illness course. Binary logistic regression analyses were performed to identify the predictors for lifetime suicide attempt in BD-I. Results A total of 102 patients (males = 49 and females = 53) with BD-I were included. Thirty-seven subjects (36.3%) had a history of suicide attempt. The illness course in suicide attempters more frequently had an index episode of depression, was encumbered with frequent mood episodes, especially in depression, and had a higher propensity for psychiatric comorbidities. On binary logistic regression analysis, the odds ratios (ORs) for predicting a suicide attempt were highest for positive family history of suicide (OR: 13.65, 95% confidence interval [CI]: 1.28–145.38, p = 0.030), followed by the presence of an index depressive episode (OR: 6.88, 95% CI: 1.70–27.91, p = 0.007), and lower scores on problem-focused disengagement (OR: 0.72, 95% CI: 0.56–0.92, p = 0.009). Conclusion BD-I patients with lifetime suicide attempt differ from non-attempters on various course-related and temperamental factors. However, an index episode depression, family history of suicide, and lower problem-focused engagement can predict lifetime suicide attempt in patients with BD-I.

Psychosocial Treatments for Bipolar Disorder

2015 ◽  
Author(s):  
Anjana Muralidharan ◽  
David J. Miklowitz ◽  
W. Edward Craighead
Keyword(s):  
Bipolar Disorder ◽  
Behavioral Therapy ◽  
Psychosocial Interventions ◽  
Primary Treatment ◽  
Coping With Stress ◽  
Adherence To Medication ◽  
Hospitalization Rates ◽  
Long Term Follow Up ◽  
Family Based ◽  
Bipolar Patients

Pharmacological interventions remain the primary treatment for bipolar disorder. However, adjunctive psychosocial interventions have the potential to increase adherence to medication regimens, decrease hospitalizations and relapses, decrease severity of symptoms, improve quality of life, and enhance mechanisms for coping with stress. Group psychoeducation, designed to provide information to bipolar patients about the disorder and its treatment, leads to lower rates of recurrence and greater adherence to medication among remitted bipolar patients at both short- and long-term follow-up. Cognitive-behavioral therapy as an ancillary treatment has found mixed results but generally supportive evidence indicating that it is useful in preventing relapse to depression in remitted patients. Family-based intervention, such as Family-Focused Therapy (FFT), may be combined with pharmacotherapy to reduce recurrences and hospitalization rates in adult patients.

Epidemiology and Risk Factors of Bipolar Disorder and Schizophrenia in the Conceptualization of the Disease Spectrum

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
C. Höschl ◽  
P. Stopková
Keyword(s):  
Risk Factors ◽  
Bipolar Disorder ◽  
Age Of Onset ◽  
Prenatal Development ◽  
Type I ◽  
Perinatal Complications ◽  
Birth Seasonality ◽  
Genetic Studies ◽  
Disease Spectrum ◽  
Disorder Type

Both disorders are worldwide, lifelong, and recurrent illnesses with periods of exacerbation and partial or full remissions. Lifetime prevalence of schizophrenia and bipolar disorder type I is around 1%. Women and men are affected at proximately equal rates and the typical age of onset is similar. Both disorders also share risk factors showing evidence for impaired prenatal development, such as birth seasonality, abnormal dermatoglyphs and higher incidence of perinatal complications. However, there is evidence for differences in prevalence in geographical isolates, in presence of minor physical abnormalities and possibly also in influence of psychosocial factors, urbanicity and use of cannabis. However, based only on similar epidemiological parameters, it is not possible to assume any degree of continuity between bipolar disorder and schizophrenia. The main evidence for partially shared pathophysiology is given by genetic studies.

Abnormal white matter integrity as a structural endophenotype for bipolar disorder

2016 ◽  
Vol 46 (7) ◽  
pp. 1547-1558 ◽  
Author(s):  
A. Sarıçiçek ◽  
N. Zorlu ◽  
N. Yalın ◽  
C. Hıdıroğlu ◽  
B. Çavuşoğlu ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
White Matter ◽  
Clinical State ◽  
Control Group ◽  
Type I ◽  
Healthy Controls ◽  
Corona Radiata ◽  
Left Posterior ◽  
Axis I ◽  
Bipolar Patients

BackgroundSeveral lines of evidence suggest that bipolar disorder (BD) is associated with white matter (WM) pathology. Investigation of unaffected first-degree relatives of BD patients may help to distinguish structural biomarkers of genetic risk without the confounding effects of burden of illness, medication or clinical state. In the present study, we applied tract-based spatial statistics to study WM changes in patients with BD, unaffected siblings and controls.MethodA total of 27 euthymic patients with BD type I, 20 unaffected siblings of bipolar patients and 29 healthy controls who did not have any current or past diagnosis of Axis I psychiatric disorders were enrolled in the study.ResultsFractional anisotropy (FA) was significantly lower in BD patients than in the control group in the corpus callosum, fornix, bilateral superior longitudinal fasciculus, inferior longitudinal fasciculus, inferior fronto-occipital fasciculus, anterior thalamic radiation, posterior thalamic radiation, cingulum, uncinate fasciculus, superior corona radiata, anterior corona radiata and left external capsule. In region-of-interest (ROI) analyses, we found that both unaffected siblings and bipolar patients had significantly reduced FA in the left posterior thalamic radiation, the left sagittal stratum, and the fornix compared with healthy controls. Average FA for unaffected siblings was intermediate between the healthy controls and bipolar patients within these ROIs.ConclusionsDecreased FA in the fornix, left posterior thalamic radiation and left sagittal stratum in both bipolar patients and unaffected siblings may represent a potential structural endophenotype or a trait-based marker for BD.

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.

scholarly journals The Interaction of the Oxytocin Receptor Gene and Subtypes of Child Abuse on Social Cognition in Euthymic Patients With Bipolar Disorder Type I

2020 ◽  
Author(s):  
Ulises Rios ◽  
Javier Moran ◽  
Jimena Hermosilla ◽  
Rene Gonzalez ◽  
Paulina Muñoz ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Child Abuse ◽  
Social Cognition ◽  
High Frequency ◽  
Oxytocin Receptor ◽  
Clinical Group ◽  
Type I ◽  
Environment Interaction ◽  
Early Stress ◽  
Bipolar Patients

Abstract Background: Most studies on cognitive impairment in Bipolar Disorder (BD) have neglected the role of early stress, despite the high frequency of childhood maltreatment in this clinical group. The aim of this study was to establish a connection between a history of emotional, physical, and sexual abuse in childhood and social cognition (SC) functioning in patients with BD type I in euthymia, and to test a possible moderating effect of the polymorphism rs53576 in the oxytocin receptor (OXTR) gene. Results: We found a high frequency of child abuse, indicating that BD patients who had been victims of physical and emotional abuse as children, and were carriers of the GG genotype at OXTR rs53576, displayed higher social cognition alterations, specifically in an emotion recognition test. Conclusions: The gene-environment interaction study presented here proposes a Differential Susceptibility model of a genetic polymorphism that can be plausibly associated with SC functioning. This evidence might help to identify at-risk clinical subgroups within a diagnostic category with well-established intra-group heterogeneity such as BD. Future research aimed at testing the inter-level impact of early stress constitutes an ethical-clinical duty in light of the high rates of childhood abuse reported in bipolar patients.

Bipolar Disorder and Cannabis

2017 ◽  
Vol 41 (S1) ◽  
pp. S118-S119
Author(s):  
G. Jmii ◽  
M. Zghal ◽  
F. Ghali ◽  
M. Mezghenni ◽  
L. Jouini ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Substance Dependence ◽  
Suicide Attempts ◽  
Bipolar Disorders ◽  
Cross Sectional Study ◽  
Cannabis Use ◽  
Type I ◽  
Cross Sectional ◽  
Average Hospital ◽  
Bipolar Patients

IntroductionPeople with bipolar disorder frequently struggle with substance abuse and dependence. Typically, cannabis is the most commonly abused drug in individuals with bipolar disorder. Some investigators have implied that cannabis may actually be mood stabilizing in patients with bipolar disorder. However, the relationships between cannabis use and bipolar disorders are complex and remain incompletely described.ObjectiveThe aim of this study was to identify the characteristics of addiction to cannabis in bipolar patients type I and determine the consequences of cannabis on the expression of bipolar illness and prognosis.MethodsThis is a comparative cross-sectional study which included patients followed in the psychiatry department of the G Razi hospital for bipolar disorder type I and for substance dependence according to DSM IV diagnostic criteria. Hetero-questionnaire on sociodemographic variables, clinical and treatment.ResultsThe average age was 41 years. The average hospital stay was 9.18 days. 33.33% of patients were monitored regularly. Most patients were single and worked as a day labourer. Cannabis was the most consumed substance. Cannabis use was prior to the expression of psychiatric illness in 55% of cases. The average number of hospitalisation in patients with a cannabis addiction was significantly greater than that observed in the non-addicted group. Similarly, the average number of suicide attempts among patients with cannabis addiction was significantly higher than the group without cannabis addiction.ConclusionsAggressive drug abuse treatment immediately after a first psychiatric hospitalisation might decrease rates of recurrence and new cases of cannabis use disorder in the course of bipolar disorder.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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