Medical comorbidity and health-related quality of life in bipolar disorder across the adult age span

Fenn, Howard H.; Bauer, Mark S.; Alshuler, Lori; Evans, Denise; Williford, William O.; Kilbourne, Amy M.; Beresford, Thomas P.; Kirk, Gail; Stedman, M.; Fiore, Louis D.

doi:10.1016/j.jad.2004.12.006

Cited by 108 publications

(125 citation statements)

References 73 publications

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“…64 Patients' functioning is further negatively infl uenced by medical and psychiatric co-morbidity. 65 No doubt, mood stabilizing medications enhance patients' quality of life through reduction in disruptive behavior, depression, and suicide potential. But improved functioning through effective treatments can be offset by side effects.…”

Section: Patient Focused Perspectivementioning

confidence: 99%

Pharmacotherapy of Bipolar I Disorder: Focus on Aripiprazole

Bastiaens

2009

Clinical Medicine. Therapeutics

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Bipolar disorder is a common and complex condition, starting early in life and continuing throughout the life cycle. Most people suffering from bipolar disorder manifest other problems as well, including metabolic disturbances, cardiovascular disease, anxiety disorders, substance use disorders, attention defi cit hyperactivity disorder, and borderline personality disorder, among others. The treatment of bipolar disorder needs to be conceptualized within this context of early onset, chronic course, and signifi cant co-morbidity. Because of its unique mode of action, its effi cacy and its good tolerability profi le, aripiprazole is well placed among the different treatment options to benefi t the patient with bipolar disorder. This article will focus on aripiprazole's pharmacology, effi cacy, effectiveness, and tolerability from a clinical perspective, while considering the complexities of bipolar disorder.

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Section: Patient Focused Perspectivementioning

confidence: 99%

Pharmacotherapy of Bipolar I Disorder: Focus on Aripiprazole

Bastiaens

2009

Clinical Medicine. Therapeutics

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“…Número de estudios: 17 estudios controlados 20,24,[26][27][28][30][31][32][33]35,[42][43][44][45][46][47][48] y 13 no controlados [34][35][36][37][38][39][49][50][51][52][53][54][55] .…”

Section: Patología Endocrinometabólicaunclassified

“…Número de estudios: 11 estudios controlados 20,23,24,26,28,30,[61][62][63][64][65] y 10 no controlados 34,[36][37][38]49,[66][67][68][69][70] .…”

Section: Patología Neurológicaunclassified

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Consenso Español de Salud Física del Paciente con Trastorno Bipolar

Bobes

Ruiz

Montes

et al. 2008

Revista de Psiquiatría y Salud Mental

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ResumenIntroducción y objetivos: Los pacientes con trastorno bipolar presentan una morbilidad físi-ca y una mortalidad muy superior a la de la población general. Además de una mayor mortalidad por suicidio, tienen también una mayor prevalencia de enfermedades físicas. El objetivo de este consenso, promovido por las Sociedades Españolas de Psiquiatría y Psiquiatría Biológica, en colaboración con las sociedades de médicos de asistencia primaria, es establecer recomendaciones prácticas sobre los procedimientos de detección, prevención e intervención en las enfermedades somáticas que coexisten con el trastorno bipolar para mejorar la calidad y esperanza de vida de estos pacientes. Método: Las Sociedades Españolas de Psiquiatría y Psiquiatría Biológica eligieron un ComitéCientífico que seleccionó a su vez a 32 psiquiatras expertos y 10 médicos expertos en otras especialidades médicas. Se crearon grupos de trabajo para cada especialidad con la finalidad de adaptar las guías aplicadas en la población general a pacientes con trastorno bipolar. Partiendo de una revisión sistemática sobre la comorbilidad médica y la mortalidad en el trastorno bipolar se realizaron dos reuniones para acordar el consenso. Resultados: En la revisión bibliográfica se detectó un riesgo aumentado, entre los pacientes con trastorno bipolar, de presentar hipertensión arterial, obesidad, tabaquismo, enfermedades pulmonares, migraña e infección por virus de la inmunodeficiencia humana (VIH). También se encontró evidencia de un aumento de mortalidad por enfermedades cardiovasculares, respiratorias e infecciones, además del suicidio. El grupo de expertos alcanzó el consenso en una serie de medidas básicas para la detección de comorbilidad médica aplicables a la monitorización de estos pacientes. Las recomendaciones resultantes serán asumidas y divulgadas por las sociedades promotoras. Conclusiones: El decálogo generado en el Consenso Español de Salud Física del Paciente con Trastorno Bipolar recoge los aspectos más relevantes para la mejora del funcionamiento psicosocial, la calidad y la esperanza de vida en los pacientes con esta patología.

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“…Documenting the course of bipolar disorders requires reliable and clinically meaningful definitions of specific phases of illness, ideally based on operational criteria that facilitate comparisons across studies and support generalization of findings (Tohen et al, 1990a,b;1992a,b;Keller et al, 1993;Winokur ef a/., 1994;Keeker al, 1995;Strakowski etai, 2001;Chengappa et al, 2005;Conus et al, 2006;Harvey, 2006;Mclntyre et al, 2006;Shi et al, 2006). Bipolar disorders not only have high risks of multiple recurrences as well as sustained morbidity, but also very high rates of comorbidity with substance-use and anxiety disorders, variable disability, and premature mortality from extraordinarily high suicide rates as well as adverse outcomes of medical illness (Tsuang et al, 1980;Goodwin & Jamison, 1990;Tondo et al, 2003a;Fenn et al, 2005). To develop and implement sound and evidence-based clinical and public policies for treating bipolar disorder patients with scarce resources, much more information is required concerning their course and morbidity, ideally as early as possible to facilitate predictions.…”

Section: Longitudinal Studies In Bipolar Disordermentioning

confidence: 99%

Longitudinal research on bipolar disorders

Salvatore¹,

Tohen²,

Khalsa³

et al. 2007

Epidemiol Psichiatr Soc

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Abstract. Longitudinal assessment of the course of major psychiatric disorders has been advanced by studies from onset, but only rarely have large numbers of patients with a range of psychotic and major affective disorders been studied simultaneously and systematically from illness-onset. The decade-long McLean-Harvard First Episode Project & International Consortium for Bipolar Disorder Research has systematically followed-up large numbers of patients with DSM-IV bipolar or psychotic disorders from firsthospitalization. Major findings among patients with bipolar I disorder include: [a] full functional recovery from initial episodes was uncommon, and full symptomatic recovery, much slower than early syndromal recovery; [b] risks of relapse, recurrence, and switching were very high in the first two years; [c] most early morbidity was depressive-dysphoric, as reported in mid-course; [d] initial depression or mixed-states predicted more later depressive and overall morbidity, whereas initial mania or psychosis predicted later mania and a better prognosis; [e] based on within-subject modeling, most patients did not show progressive cycling over time, and illness-course was rather chaotic within and among patients; [f] treatment-latency or episode-counts were unassociated with responsiveness to long-term mood-stabilizing treatment; [g] very high rates of suicidal behavior and accidents occurred early; [h] early substance-use comorbidity associated with anxiety; [i] factor-analysis of prodromal symptoms predicted bipolar disorder much better than non-affective psychotic disorders. Project findings indicate that the course of bipolar I disorder is much less favorable than had been believed formerly, despite clinical treatment with modern mood-stabilizing and other treatments.

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Medical comorbidity and health-related quality of life in bipolar disorder across the adult age span

Cited by 108 publications

References 73 publications

Pharmacotherapy of Bipolar I Disorder: Focus on Aripiprazole

Pharmacotherapy of Bipolar I Disorder: Focus on Aripiprazole

Consenso Español de Salud Física del Paciente con Trastorno Bipolar

Longitudinal research on bipolar disorders

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