Assessment of depressive symptom severity among patients with co-occurring bipolar disorder and substance dependence

Kolodziej, Monika E.; Griffin, Margaret L.; Bender, Rachel E.; Weiss, Roger D.

doi:10.1016/j.jad.2007.05.024

Cited by 7 publications

(5 citation statements)

References 35 publications

(57 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…High levels of disinhibition during manic or hypomanic phases of illness due to heavy alcohol or drug use may be an important underlying mechanism, 49,50 or increased risk of suicidality could be due to low mood induced or exacerbated by substance misuse during depressive illness phases. 51 Delusional thoughts may lead to suicidal ideation and acts in bipolar disorder, 52 and altered cognitive processing in relation to risk aversion 53 could be another common mechanism for these outcomes. Although we observed significant risk elevations in the unaffected sibling cohort, the ratios of effect sizes for the bipolar cohort versus those for the unaffected siblings were large, especially in relation to suicidality.…”

Section: Discussionmentioning

confidence: 99%

Suicide, Hospital-Presenting Suicide Attempts, and Criminality in Bipolar Disorder

Webb¹,

Lichtenstein²,

Larsson³

et al. 2014

J. Clin. Psychiatry

View full text Add to dashboard Cite

Objective:To compare risks for suicidality and criminality in a national cohort of people diagnosed with bipolar disorder, and to assess how risk factor profiles differ between these outcomes. Method:We conducted 2 case-cohort studies using interlinked Swedish national registers. Primarily, using International Classification of Diseases (ICD) coding, we identified 15,337 people diagnosed with bipolar disorder, 1973-2009, matched by age and gender to 20 individuals per case sampled randomly from the general population. We estimated risks of suicide and hospital-presenting attempted suicide, and violent and nonviolent criminal offending. We separately assessed these risks among 14,677 unaffected siblings matched to a second general population sample.Results: 22.2% of bipolar disorder cohort members engaged in suicidal or criminal acts after diagnosis. They were at greatly elevated risk for completed suicide (risk ratio = 18.8; 95% CI, 16.0-22.2), attempted suicide (risk ratio = 14.3; 95% CI, 13.5-15.2), violent crime (risk ratio = 5.0; 95% CI, 4.6-5.4), and nonviolent crime (risk ratio = 2.9; 95% CI, 2.8-3.1) compared with the general population. Elevations in risk were far less marked among the unaffected siblings than in the bipolar disorder cohort. Three factors independently predicted raised risk of all 4 adverse outcomes: if the first 2 patient episodes for bipolar disorder required admission, a history of attempted suicide, and a history of diagnosed alcohol/drug disorder. Criminal offending before bipolar diagnosis was an especially strong independent predictor of criminality after diagnosis. Conclusions:The combined risk of suicidality or criminality is substantially elevated in both relative and absolute terms. Clinical prediction rules focusing on multiple vulnerabilities following onset of bipolar disorder, especially when there is history of attempted suicide, substance misuse disorders, or criminal offending, may improve risk management. 2014;75(8):e809-e816 © Copyright 2014 Physicians Postgraduate Press, Inc. Submitted: November 22, 2013 accepted March 6, 2014 (doi:10.4088/JCP.13m08899). Corresponding author: Seena Fazel, MD, Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford OX3 7JX, United Kingdom (seena.fazel@psych.ox.ac.uk). J Clin Psychiatry People diagnosed with bipolar disorder more frequently die prematurely versus the general population, 1-3 and this mortality gap may have widened in recent decades. 4 They have a markedly elevated suicide risk, even when compared to people with other serious mental illnesses. An estimated 10%-15% of people with bipolar disorder may die by suicide, 5-7 although more recent work has reported a lower cumulative incidence.8 Risk for nonfatal suicidality is also raised.6,9,10 Higher risk of perpetrated interpersonal violence has been reported, 11-15 levels of aggression may be especially raised with bipolar disorder in comparison with other types of psychopathology, 16 and elevated criminality risk per se has also been sho...

show abstract

Section: Discussionmentioning

confidence: 99%

Suicide, Hospital-Presenting Suicide Attempts, and Criminality in Bipolar Disorder

Webb¹,

Lichtenstein²,

Larsson³

et al. 2014

J. Clin. Psychiatry

View full text Add to dashboard Cite

show abstract

“…There is, however, also other previous data indicating that affective psychiatric constructs such as depression and anxiety may not separate repeaters from nonrepeaters (Stein et al., 1998). Here, instead, troubles understanding, concentrating, or remembering, the ASI construct used to describe symptoms of cognitive difficulties (Kolodziej, Griffin, Bender, & Weiss, 2008; Mclellan, Erdlen, Erdlen, & O’brien, 1981; Niv & Hser, 2007), had an independent association with repeated attempt, and so did, to a lesser extent, difficulty controlling violent behavior. The association with difficulty controlling violent behavior is consistent with the findings of Stein et al.…”

Section: Discussionmentioning

confidence: 99%

Variables Associated with Repeated Suicide Attempt in a Criminal Justice Population

Håkansson

Brådvik

Schlyter

et al. 2011

Suicide & Life Threat Behav

View full text Add to dashboard Cite

The aim of this study was to identify factors associated with repeated suicide attempts among criminal justice clients examined for substance abuse using the Addiction Severity Index. Among suicide attempters (n=1,404), repeaters (two or more attempts, n=770) were compared to nonrepeaters. In logistic regression, repetition was associated with younger age, opioid analgesics, somatic medication, overdose, maternal psychiatric problems, delirium tremens, cognitive problems, and violent behavior. As in other settings, factors associated with repetition differed from those associated with suicide attempts in general. In this setting, substance use complications and cognitive problems were connected to repetition and should be addressed in risk assessments.

show abstract

“…First, our sample was enrolled at a specialised unit for treatment of BD type I and may not necessarily represent the whole population with this disorder. Second, although HDRS has been largely used in clinical practice in the evaluation of bipolar patients, its psychometric properties may fail to capture the phenomenological nuances of bipolar depression, as it is based on and skewed towards the characteristics of unipolar depression (14–17). Third, the sample size limited subgroup analysis, and some confounding variables, such as number of previous episodes, were not controlled.…”

Section: Discussionmentioning

confidence: 99%

A comparison of the symptomatic profile between two consecutive depressive episodes in patients with bipolar disorder type I

Macedo-Soares

Brietzke

Dias

et al. 2010

Acta Neuropsychiatr.

View full text Add to dashboard Cite

show abstract

Assessment of depressive symptom severity among patients with co-occurring bipolar disorder and substance dependence

Abstract: Background-We examined a modified version of the Hamilton Depression Rating Scale (HDRS) among treatment-seeking patients with co-occurring bipolar disorder and substance dependence in order to elucidate key features of depression in this specific population of patients.

Cited by 7 publications

References 35 publications

Suicide, Hospital-Presenting Suicide Attempts, and Criminality in Bipolar Disorder

Suicide, Hospital-Presenting Suicide Attempts, and Criminality in Bipolar Disorder

Variables Associated with Repeated Suicide Attempt in a Criminal Justice Population

A comparison of the symptomatic profile between two consecutive depressive episodes in patients with bipolar disorder type I

Contact Info

Product

Resources

About