Number of prior episodes and the presence of depressive symptoms are associated with longer length of stay for patients with acute manic episodes

Martı́n-Carrasco, Manuel; González‐Pinto, Ana; Galan, J.L.; Ballesteros, Javier; Mauriño, Jorge; Vieta, Eduard

doi:10.1186/1744-859x-11-7

Cited by 19 publications

(11 citation statements)

References 36 publications

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“…In contrast to previous studies, we found no association between mixed mood and either quality of life or functioning in the present study. Further, previous studies have suggested that mixed symptoms in patients with bipolar disorder are associated with poorer prognosis and aggravated long‐term course of illness, including poorer treatment response , increased risk of relapse , decreased quality of life , decreased functioning and increased risk of suicide . In addition, in exploratory analyses we found results suggesting that there is no association between subsyndromal clinically rated manic symptoms and functioning and quality of life respectively.…”

Section: Discussionmentioning

confidence: 39%

“…However, a substantial proportion of patients with bipolar disorder experience subsyndromal symptoms on a daily basis, and this has been associated with impaired functioning, increased risk of hospitalization, high risk of relapse, and comorbid substance use disorder , overall emphasizing the chronic and serious nature of bipolar disorder. Within bipolar disorder, mixed states and mixed symptoms represent a complex and heterogenous syndrome which has been associated with overall poorer prognosis and aggravated long‐term course of illness, including poorer treatment response , increased risk of relapse , decreased quality of life , decreased functioning and increased risk of suicide .…”

Section: Introductionmentioning

confidence: 99%

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The association between mixed symptoms, irritability and functioning measured using smartphones in bipolar disorder

Faurholt‐Jepsen

Frost²,

Christensen

et al. 2019

Acta Psychiatr Scand

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LV. The association between mixed symptoms, irritability and functioning measured using smartphones in bipolar disorder Objective: To (i) validate patient-evaluated mixed symptoms and irritability measured using smartphones against clinical evaluations; (ii) investigate associations between mixed symptoms and irritability with stress, quality of life and functioning, respectively, in patients with bipolar disorder. Methods: A total of 84 patients with bipolar disorder used a smartphone-based system for daily evaluation of mixed symptoms and irritability for nine months. Clinically evaluated symptoms, stress, quality of life and clinically rated functioning were collected multiple times during follow-up. Results: Patients presented mild affective symptoms. Patient-reported mixed symptoms and irritability correlated with clinical evaluations. In analyses including confounding factors there was a statistically significant association between both mixed symptoms and irritability and stress (P < 0.0001) and between irritability and both quality of life and functioning (P < 0.0001) respectively. There was no association between mixed mood and both quality of life and functioning. Conclusion: Mixed symptoms and irritability can be validly selfreported using smartphones in patients with bipolar disorder. Mixed symptoms and irritability are associated with increased stress even during full or partial remission. Irritability is associated with decreased quality of life and functioning. The findings emphasize the clinical importance of identifying inter-episodic symptoms including irritability pointing towards smartphones as a valid tool. Significant outcomes• Daily evaluated mixed symptoms and irritability were validly self-reported using smartphones compared with clinically evaluated symptoms in patients with bipolar disorder.• Mixed symptoms and irritability were associated with increased perceived stress even during full or partial remission, and irritability was associated with decreased quality of life and functioning. Limitations• Data on perceived stress and quality of life were collected using questionnaires answered by patients who, due to the nature of the smartphone-based monitoring system, were not blinded to the monitoring tool.• The patients received different types of psychopharmacologic treatment during the study; thus, medication class were included as a covariate in the statistical analyses.• The findings were based on analyses of associations between variables, and the included covariates did not alter the estimates. It may be that other possible confounding factors could have affected the associations and thus interpretation should be taken with caution.

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Section: Discussionmentioning

confidence: 39%

Section: Introductionmentioning

confidence: 99%

The association between mixed symptoms, irritability and functioning measured using smartphones in bipolar disorder

Faurholt‐Jepsen

Frost²,

Christensen

et al. 2019

Acta Psychiatr Scand

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“…The p21-activated kinases (PAKs) are well-characterized Rac and Cdc42 effector proteins, which are involved in a variety of signaling pathways [38]. PAK2 has been shown to phosphorylate and activate c-Abl [39].…”

Section: Resultsmentioning

confidence: 99%

Salmonella Modulation of Host Cell Gene Expression Promotes Its Intracellular Growth

2013

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Salmonella Typhimurium has evolved a complex functional interface with its host cell largely determined by two type III secretion systems (T3SS), which through the delivery of bacterial effector proteins modulate a variety of cellular processes. We show here that Salmonella Typhimurium infection of epithelial cells results in a profound transcriptional reprogramming that changes over time. This response is triggered by Salmonella T3SS effector proteins, which stimulate unique signal transduction pathways leading to STAT3 activation. We found that the Salmonella-stimulated changes in host cell gene expression are required for the formation of its specialized vesicular compartment that is permissive for its intracellular replication. This study uncovers a cell-autonomous process required for Salmonella pathogenesis potentially opening up new avenues for the development of anti-infective strategies that target relevant host pathways.

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“…With respect to length of stay (LOS) in hospital for mood disorder patients, several correlates have been suggested, ranging from sociodemographic features (age, being a housewife, living alone), clinical features (correlation with life events as being in grief for a loss, number of previous episodes and admissions, melancholic features, negative symptoms, increased dependence for instrumental activities of daily living, comorbid alcohol or drug-related disorders) and treatment type [5][6][7][8].…”

Section: Introductionmentioning

confidence: 99%

A Snapshot of Treatment of Inpatients with A Mood Disorder Episode: Does Theory Match Everyday Clinical Practice?

Zeppegno¹,

Gramaglia²,

Gattoni³

et al. 2017

Clin Depress

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Mood disorders represent a major cause of hospitalization in psychiatric ward. We focused on sex differences, therapies and rehospitalization rates/length of stay in inpatients with mood disorders. Rehospitalization is often observed in patients with mental disorders, with rates up to 80%. Socio-demographic features, clinical features and treatment type influence the length of stay. The objective of this study was to assess how the literature findings match everyday clinical practice in an acute psychiatric ward. We performed a retrospective observational study extracting data from our medical records from 1 st July 2012 to 1 st July 2014. 85 patients were eligible for the study; the overall number of admittances to the ward was 103. We have not found any difference in the rates of Bipolar Disorder between males and females, we failed to find an higher frequency of Depressive disorders in females. In our sample the rates of early readmission is 17.5%. Patients with an involuntary admission included exclusively those with a manic or hypomanic episode; patients with depressive episodes were more likely to have committed a suicide attempt.

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Number of prior episodes and the presence of depressive symptoms are associated with longer length of stay for patients with acute manic episodes

Cited by 19 publications

References 36 publications

The association between mixed symptoms, irritability and functioning measured using smartphones in bipolar disorder

The association between mixed symptoms, irritability and functioning measured using smartphones in bipolar disorder

Salmonella Modulation of Host Cell Gene Expression Promotes Its Intracellular Growth

A Snapshot of Treatment of Inpatients with A Mood Disorder Episode: Does Theory Match Everyday Clinical Practice?

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