Clinical correlates of current level of functioning in primary care‐treated bipolar patients

Hájek, Tomáš; Slaney, Claire; Garnham, Julie; Ruzickova, Martina; Passmore, Michael J.; Alda, Martin

doi:10.1111/j.1399-5618.2005.00182.x

Cited by 57 publications

(44 citation statements)

References 29 publications

(24 reference statements)

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“…Particularly, we found that bipolar patients with long duration of illness reported lower employment qualification and occupational status. This finding is congruent with previous studies reporting that the number of episodes had a negative impact on social functioning (Tohen et al 1990, Goldberg et al 1995, MacQueen et al 2000, Hajek et al 2005. It is possible that the high number of episodes may determine brain long-lasting biochemical changes that could have some consequences on global functioning in bipolar patients (Young et al 1993, Post 1993.…”

Section: Discussionsupporting

confidence: 82%

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The impact of the number of episodes on the outcome of Bipolar Disorder

et al. 2006

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-Background: Bipolar disorder is a highly recurrent severe psychiatric disorder. The number of episodes has been found consistently associated with poor outcome. It has been suggested that bipolar patients with long duration of illness and highly recurrent course show great impairment of global functioning.Objectives: The aim of this study is to assess the clinical course and outcome of patients with bipolar disorder I and II with a high number of mood episodes.Methods: We compared a group of bipolar I and II subjects whose number of episode was higher than ten (N = 167) with a similar-size representative sample of bipolar patients whose number of episodes was lower or equal than ten (N = 131).Results: Bipolar patients with more than 10 episodes have a more severe outcome of bipolar disorder. Qualification and occupational status was clearly worse for the highly recurrent group which showed a predominance of depressive polarity.Conclusions: These data suggest that bipolar patients with a highly recurrent course have significant functional impairment. With the passing of time, bipolar illness tends to be ruled by depressive features. Treatment strategies may need to address this issue.

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Section: Discussionsupporting

confidence: 82%

“…Data from 1450 patients showed that 30-60% of bipolar patients had detectable levels of psychosocial impairment (MacQueen et al 2001). Long duration illness has been associated with impaired social functioning (Hajek et al 2005).…”

Section: Introductionmentioning

confidence: 99%

The impact of the number of episodes on the outcome of Bipolar Disorder

et al. 2006

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“…In general, RCBD has been associated with worse disease outcome 9,10 and more severe disability. 7,11,12 More specifically, many factors have been described to be associated with RC, such as female gender, 5,13 earlier age at onset, 6,12 increased risk for suicide, 13,14 predominance of depression, 15,16 hypothyroidism, 6,17 bipolar type II disorder, 8,18,19 and higher rates of antidepressants use. 7,20 However, some of these associations are still controversial, and many studies have been criticized regarding aspects such as lack of a uniform definition of RC and use of heterogeneous samples.…”

Section: Introductionmentioning

confidence: 99%

Psychiatric and clinical correlates of rapid cycling bipolar disorder: a cross-sectional study

Gigante

Barenboim

Dias

et al. 2016

Rev. Bras. Psiquiatr.

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Objective: Rapid cycling (RC) is a feature of bipolar disorder (BD) that has been associated with worse outcome and more severe disability. Our goal was to investigate the association of demographic and clinical factors with RC. Methods: We compared RC and non-rapid cycling (NRC) BD patients from the Brazilian Research Network in Bipolar Disorder (BRN-BD) regarding age at onset of BD; total number of episodes; previous number of manic, depressive, mixed, and hypomanic episodes; polarity of the first episode; gender; number of suicide attempts; number of lifetime hospitalizations and lifetime history of at least one hospitalization; family history of mood disorder; clinical comorbidities such as hypothyroidism, hyperthyroidism, seizures; and current use of medications such as lithium, anticonvulsants, antipsychotics, and antidepressants. Results: We studied 577 patients and found that 100 (17.3%) met the criteria for RC in the year before the investigation. RC patients had earlier age at onset, longer duration of disease, more lifetime depressive and manic episodes, higher number of suicide attempts, and higher rate antidepressant use. Conclusion: The presence of RC in the previous year was associated with specific clinical characteristics closely related to worse outcome in the course of BD.

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“…Medical risk factors and GMC affect the course and the severity of BD as well as its treatment 2,16,17 , and their impact is significant due to reasons including quality of life, delivery of psychiatry and medical services, mortality 10 and disability 18 .…”

Section: Introductionmentioning

confidence: 99%

Comorbidades médicas em pacientes ambulatoriais com transtorno do humor bipolar tipo I

Moreira¹,

Brietzke²,

Lafer³

2011

Rev. psiquiatr. clín.

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Background: Bipolar disorder (BD) has been associated with high rates of general medical comorbidities (GMC) and medical risk factors. There have been scarce reports about this prevalence in Brazilian subjects with BD. Objective: Describe the prevalence of GMC in a sample of BD type I patients. Methods: Clinical records of 195 patients with BD type I were reviewed for identification of GMC. Patients with and without GMC were compared using the Mann-Whitney nonparametric test and the chi-Square test. Results: Sixty-three percent of patients had at least one medical comorbidity. The most prevalent conditions were: migraine (31.8%), hypothyroidism (24.1%), hypertension (11.3%), traumatic brain injuries (10.3%), asthma (9.7%), epilepsy (8.2%), diabetes (5.1%), stroke (2.1%) and hyperthyroidism (1%). Age and duration of illness were positively associated with the presence of GMC (p < 0.001). Discussion: In our study, in accordance with previous reports, the majority of patients presented at least one general medical disorder. The principal limitation of this study is the fact that diagnose of GMC was made based on self-report. There are scarce studies addressing GMC in the Brazilian population with BD and this report can contribute to improve diagnostic vigilance, assessment, treatment planning and decrease the burden associated with BD.

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Clinical correlates of current level of functioning in primary care‐treated bipolar patients

Abstract: Functioning in primary care-treated bipolar patients in maintenance phase of treatment is decreased not only due to specific disorder-related variables, but also due to frequent comorbidity with other psychiatric and medical conditions.

Cited by 57 publications

References 29 publications

The impact of the number of episodes on the outcome of Bipolar Disorder

The impact of the number of episodes on the outcome of Bipolar Disorder

Psychiatric and clinical correlates of rapid cycling bipolar disorder: a cross-sectional study

Comorbidades médicas em pacientes ambulatoriais com transtorno do humor bipolar tipo I

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