Palliative models of care for later stages of mental disorder: maximizing recovery, maintaining hope, and building morale

Berk, Michael; Berk, Lesley; Udina, Marc; Moylan, Steven; Stafford, Lesley; Hallam, K; Goldstone, Sherilyn; McGorry, Patrick D.

doi:10.1177/0004867411432072

Cited by 59 publications

(74 citation statements)

References 72 publications

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“…1,2 Bipolar disorder (BD) is among the most disabling diseases, 3 not only due to episode-related dysfunction but mostly because of long-term impairment. 4 Data reporting different patterns of neuroprotective, inflammatory, and neuroanatomical biomarkers in the early and late stages of BD reinforce the longitudinal and progressive course of this disorder, [5][6][7][8][9][10] and are corroborated by clinical deterioration and neuroanatomical changes.…”

Section: Introductionmentioning

confidence: 82%

Pharmacological treatment and staging in bipolar disorder: evidence from clinical practice

Goi

Bücker

Vianna-Sulzbach

et al. 2015

Rev. Bras. Psiquiatr.

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Section: Introductionmentioning

confidence: 82%

Pharmacological treatment and staging in bipolar disorder: evidence from clinical practice

Goi

Bücker

Vianna-Sulzbach

et al. 2015

Rev. Bras. Psiquiatr.

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“…It also supports the presence of a late stage that is associated with a more chronic and refractory disease, probably with depressive predominant polarity, psychotic features, and significant disability. It is disappointing that there is little research on the treatment effect at late stages (Berk et al, 2012), with only a few exceptions (Torrent et al, 2013). The use of biomarkers might, in the near future, facilitate the validation of staging systems and their therapeutic utility (Vieta, 2015).…”

Section: Introductionmentioning

confidence: 99%

The International College of Neuropsychopharmacology (CINP) Treatment Guidelines for Bipolar Disorder in Adults (CINP-BD-2017), Part 1: Background and Methods of the Development of Guidelines

Fountoulakis

Young

Yatham

et al. 2016

IJNPPY

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Background:This paper includes a short description of the important clinical aspects of Bipolar Disorder with emphasis on issues that are important for the therapeutic considerations, including mixed and psychotic features, predominant polarity, and rapid cycling as well as comorbidity.Methods:The workgroup performed a review and critical analysis of the literature concerning grading methods and methods for the development of guidelines.Results:The workgroup arrived at a consensus to base the development of the guideline on randomized controlled trials and related meta-analyses alone in order to follow a strict evidence-based approach. A critical analysis of the existing methods for the grading of treatment options was followed by the development of a new grading method to arrive at efficacy and recommendation levels after the analysis of 32 distinct scenarios of available data for a given treatment option.Conclusion:The current paper reports details on the design, method, and process for the development of CINP guidelines for the treatment of Bipolar Disorder. The rationale and the method with which all data and opinions are combined in order to produce an evidence-based operationalized but also user-friendly guideline and a specific algorithm are described in detail in this paper.

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“…In summary, a number of recent efforts have focused on identifying and refining the areas where palliative medicine intersects with the care of the mentally ill (Irwin & Ferris, 2008; Berk et al, 2012). One critically important area is end-of-life care for patients with chronic psychiatric disease who come to receive hospice care after a sub-lethal suicide attempt.…”

Section: Resultsmentioning

confidence: 99%

A retrospective case series of suicide attempts leading to hospice admission

Fairman

Irwin

2013

Pall Supp Care

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Objective This investigation sought to systematically identify and characterize a cohort of patients treated in hospice for life-limiting injuries sustained in a suicide attempt that was not immediately lethal. Method We developed a case series of all completed suicides in a large, community-based hospice, from 2004 through 2010. Clinical documentation and county medical examiner reports were used to identify those deaths that resulted from a suicide attempt made prior to hospice admission. Cases were characterized in terms of basic demographic variables, the temporal sequence of events in the transition from hospital care to hospice, the mechanism of injury and medical complications, the presence of mental illness, and family involvement in decision making. Results Out of a total of 20,887 hospice deaths during the study period, 8 deaths resulted from an incomplete suicide attempt made prior to hospice admission. Subjects were nearly all male (6/8), and 46 years old on average; substantially younger than the general hospice population. Drug overdose was the most common method of suicide (5/8), and irreversible anoxic brain injury was the main medical complication. The majority of subjects (6/8) had evidence of serious mental illness. Most cases were complicated by estranged family relationships; however, family members were involved in end-of-life decision making for nearly all patients. Significance of results Whereas a failed suicide attempt leading to hospice appears to be a relatively rare event, patients in this population appear unique in several regards. Further study may serve to better characterize this group and prepare hospice agencies and clinicians for caring for this unique population.

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Palliative models of care for later stages of mental disorder: maximizing recovery, maintaining hope, and building morale

Cited by 59 publications

References 72 publications

Pharmacological treatment and staging in bipolar disorder: evidence from clinical practice

Pharmacological treatment and staging in bipolar disorder: evidence from clinical practice

The International College of Neuropsychopharmacology (CINP) Treatment Guidelines for Bipolar Disorder in Adults (CINP-BD-2017), Part 1: Background and Methods of the Development of Guidelines

A retrospective case series of suicide attempts leading to hospice admission

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