Our study suggests that specific attention should be given to patients' family context, due to its crucial role in daily informal care and in the triggering of events leading to rehospitalization.
Introduction: There have been conflicting findings on the relationship between Thyroid function and psychiatric diagnosis, in particular Mood-and Anxiety-disorders. Objectives: Our aims were: to evaluate the incidence of thyroid dysfunctions in a psychiatric sample studying their association with psychiatric diagnosis and, for Bipolar Disorder (BD), to study the association of thyroid disorders with its sub-types, phases and cycling-patterns, weighing up Lithium-therapy effect. Methods: Carrying-out a retrospective analysis (period 2000-2010) we selected 1012 patients admitted to a University Psychiatric-Service who underwent a thyroid-hormones analysis (fT3, fT4, TSH) with or without anti-thyroid-antibodies dosage. Thence we studied the association between these laboratory-values and diagnostic categories, lithium-therapy and subtypes, phases and cycling-patterns of BD.ResultsBoth "hormonal situation" (p< 0.001) and "presence of auto-antibodies" ("Ab+") (p=0.001) were associated with "Diagnostic categories"; in particular "hypothyroidism" and "Ab+" were associated with BD and Borderline Personality Disorder (BPD). "Previous lithium-therapy" was associated with "hypothyroidism" (p< 0.001). Multivariate analysis showed BD, BPD and Lithium-therapy to be predictors of "hypothyroidism" and "Ab+". We found no association between hormonal/autoimmune dysfunctions and subtype, phase or Cycling-pattern of BD. Conclusions: The most relevant and novel finding of our study is that thyroid dysfunctions are associated with psychiatric disorders characterized by "high affective instability", such as BD and BPD. Lithium could be a "trigger" of thyroid dysfunction, but it seems to play a collateral role in BD.
Only 40 SRs (22 studies investigating pharmacological treatment) provided clear-cut answers to clinical questions examined. Results therefore showed that SRs provide a certain but rather limited contribution to scientific evidence in the field of schizophrenia.
Introduction: There is an increasing evidence that several cognitive areas as executive functioning, verbal memory and visual-spatial abilities, are impaired during the acute phase of Bipolar Disorder (BD) and persist even in the euthymic periods. Objectives and aims: The aim of the study was to characterize cognitive profile in subjects affected by BD-I and BD-II and to compare them to healthy controls (HC), in order to analyse the possible influence of depressive or euthymic phase on neuropsychological performances. Methods: We recruited 35 outpatients with BD (DSM-IV TR), 20 BD-I and 15 BD-II, in both euthymic or depressive phase clinically assessed. All subjects affected by any other DSM-IV TR axis I disorder were excluded. Results were compared to HC group composed by 11 subjects without neurological disorders, alcohol or drug abuse and any lifetime psychiatric treatment. Each group underwent a comprehensive neuropsychological assessment. Results: Our results indicated that case group (BD-I/II) showed significantly lower scores at the Raven Test (p< 0.001) and executive tests (p=0.007) compared to HC. No difference were observed between depressed and euthymic patients. Compared to healthy group euthymic and depressed patients showed significantly lower scores at Raven Test. Conclusions: In our sample cognitive impairment is present, as indicated in literature, in each phase of Bipolar Disorder. Logical reasoning seems to be the assessment tool more influenced by the clinical phase of the pathology. The analyses of the impact of depressive/euthymic phase did not show any difference between depressed and euthymic subgroups.
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