Subsyndromal Depressive Symptoms Are Associated With Functional Impairment in Patients With Bipolar Disorder

Altshuler, Lori L.; Post, Robert M.; Black, David S.; Keck, Paul E.; Nolen, Willem A.; Frye, Mark A.; Suppes, Trisha; Grunze, Heinz; Kupka, Ralph; Leverich, Gabriele S.; McElroy, Susan L.; Walden, J.; Mintz, Jim

doi:10.4088/jcp.v67n1009

Cited by 191 publications

(140 citation statements)

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“…This group suggested that previous manic episodes may play a role in occupational disability and in family life whereas previous depressive episodes may be related to social life impairment (20). In contrast, it is highly consistent that current subsyndromal depressive symptoms have a negative impact on overall functioning (45). In their study on severity of mood symptoms and work productivity among bipolar patients, Simon et al (1) concluded that depressive symptoms were strongly associated with decreased probability of employment and with more days missed from work because of illness.…”

Section: Discussionmentioning

confidence: 99%

Occupational disability in bipolar disorder: analysis of predictors of being on severe disablement benefit (PREBIS study data)

Grande

Goikolea

Dios

et al. 2012

Acta Psychiatr Scand

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Grande I, Goikolea JM, de Dios C, González‐Pinto A, Montes JM, Saiz‐Ruiz J, Prieto E, Vieta E, for the PREBIS group. Occupational disability in bipolar disorder: analysis of predictors of being on severe disablement benefit PREBIS study data).Objective: Patients diagnosed with bipolar disorder (BD) are reported to have significant work impairment during interepisode intervals. This study was carried out to assess potential predictors of occupational disability in a longitudinal follow‐up of euthymic patients.Method: We included 327 euthymic patients diagnosed with BD type I or type II, 226 of whom were employed and 101 were receiving a severe disablement benefit (SDB). Sociodemographic data were studied and episode recurrence was assessed along a 1‐year follow‐up. Logistic regression analysis was applied to determine predictors of receiving SDB. Cox regression was built to study recurrences.Results: Predictors of receiving SDB were: axis II comorbidity [Odds Ratio (OR) = 2.94, CI: 1.26–6.86, P = 0.013], number of manic episodes (OR = 1.21, CI: 1.10–1.34, P < 0.001), being without stable partner (OR = 2.44, CI: 1.34–4.44, P = 0.004) and older age (OR = 1.08, CI: 1.05–1.12, P < 0.001). Bipolar patients receiving SDB presented more episodic recurrences regardless of polarity than employed bipolar patients (P = 0.002). The time until recurrence in 25% of the bipolar patients receiving SDB was 6.08 months (CI: 4.44–11.77) being 13.08 months (CI: 9.60 to –) in the employed group.Conclusion: Occupational disability in bipolar patients is associated with axis II comorbidity, more previous manic episodes, not having a stable relationship, older age, and more recurrences at 1‐year follow‐up.

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Section: Discussionmentioning

confidence: 99%

Occupational disability in bipolar disorder: analysis of predictors of being on severe disablement benefit (PREBIS study data)

Grande

Goikolea

Dios

et al. 2012

Acta Psychiatr Scand

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“…Dizinde yer bulan, bipolar bozukluğun yüksek sosyoekonomik düzeye sahip bireylerde daha sık görüldüğü bilgisi ülkemizde yapılmış çalışmalarda doğrulanmış bir bulgu değildir. [21] Beklenebileceği üzere, evli olma oranı bipolar bozukluk tanılı olgularda, sağlıklı kontrollerden düşük, çocuk sayıları daha azdır. [22] Ellouse ve arkadaşları bipolar bozukluk tanılı olguların eşlerinde yaşam kalitesini, sağlıklı bireylerden düşük bulmuşlar-dır.…”

Section: Yaygınlık Ve Sosyodemografik öZelliklerunclassified

Bipolar disorder in Turkey: A review

Gültekin¹,

Kesebir²,

Tamam³

2014

Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychia

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ÖzetTürkiye'de bipolar bozukluk ile ilgili yapılmış çalışmaların incelenmesinde epidemiyolojik anlamda nitelikli alan çalışmasına rastlanmamıştır. Çalışmaların çoğu, hastane başvurusu kaynaklı ve klinik çalışmalardır, sistematik bir tarama içermemekte, epidemiyolojik veri toplama ya da sağlık hizmetlerine bilgi aktarma amaçlı değildir. Bu çalışmaların bulgularının toplumumuza genellenebilirliği geçerli ve güvenilir olmaktan uzaktır. Bununla birlikte, ülkemizin değişik bölgelerinde yapılmış çalışmaların bulgularının gözden geçirilerek oluşturulacak bir profilin hastalığın bize özgü özellikle-rinin tanınmasına ve risk etkenlerinin saptanmasına katkısı olacaktır. Tüm bu bilgiler bipolar bozukluk ile ilgili olarak, toplum ruh sağlığı hizmetlerinin oluşturulup geliştirilmesine temel oluştu-rabilir. Ülkemizde epidemiyolojik anlamlılığı olan, çok merkezli, toplum örneklemli ve geniş katılım-lı çalışmalara gereksinimi vardır. Psikiyatrik epidemiyoloji ve klinik araştırmalarımız gerekli bilimsel bazı bulundurmakla birlikte, hızlı kentleşme ve göç gibi toplumsal, özgün ve gelişimsel ilişkileri değerlendirebilecek güçte değildir. Bu gözden geçirmede, Türkiye'de bipolar bozukluk ile ilgili yapılmış çalışmalarda, öne çıkan epidemiyolojik bulguların, eksikliklerin ve gelecekte konuyla ilgili neler yapılabileceğinin araştırılarak tartışılması amaçlanmıştır.Anahtar sözcükler: Bipolar bozukluk, epidemiyoloji, Türkiye. AbstractAssessment of studies related with bipolar disorder in Turkey did not reveal an epidemiologically qualified field study. Most of the studies are hospital based or clinical studies which did not include a systematical scanning and did not aim to collect any epidemiological data and transfer information to health authorities. The generalizability of these studies to our community is far from being valid and reliable. On the other hand, a profile which will be created by reviewing the findings of these studies performed in various regions of Turkey will have a contribution to knowing the "unique to us" features of bipolar disorder and determining cultural risk factors. All this information can constitute a basis for formation and development of public mental health services related with bipolar disorder. In Turkey, the need for epidemiologically significant, polycentric, public sampled studies with broad participation is indispensable. Although our psychiatric epidemiology and clinical studies include necessary scientific basis, they are not powerful enough to evaluate the authentic and progressional relations such as rapid urbanization and immigration. The aim of this review is to evaluate and discuss prominent epidemiological findings, deficiencies and possibile future activities related with studies conducted in Turkey about bipolar disorder..

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“…3,4 The progression of BD is frequently associated with an increased number of episodes, [5][6][7][8] subclinical symptoms in the interepisodic period, 9,10 higher rates of comorbidities, 11 increased risk of suicide, 12 a higher number of hospital admissions, 13 and poorer response to treatment. 6 Furthermore, several studies have shown a strong association between number of mood episodes and unfavorable clinical outcomes, especially cognitive and functional impairment.…”

Section: Introductionmentioning

confidence: 99%

Neurobiological underpinnings of bipolar disorder focusing on findings of diffusion tensor imaging: a systematic review

Duarte

Silva²,

Goldani³

et al. 2016

Rev. Bras. Psiquiatr.

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Objective: To review the available data on diffusion tensor imaging (DTI) of subjects with bipolar disorder (BD), with a particular focus on fractional anisotropy (FA) in white matter (WM) tracts. Methods: The PubMed/MEDLINE database was searched for relevant articles, which were included in a systematic review of the literature. FA reductions and WM abnormalities were divided anatomically into three groups: commissural tracts, association tracts, and projection tracts. Results: Eighteen studies met the inclusion criteria. The corpus callosum was the main impaired commissural tract as demonstrated by FA reductions. Five studies reported FA reductions in the cingulum. Two studies reported decreased FA in the anterior thalamic radiation, and one in the corticospinal tract. Conversely, three studies found increased FA values in WM tracts involved in BD pathophysiology. Conclusion: Despite considerable heterogeneity, these results indicate a direct link between executive cognitive functioning and abnormal WM microstructural integrity of fronto-limbic tracts in patients with remitted BD, providing further evidence of the neuronal disruption that underlies BD symptomatology.

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Subsyndromal Depressive Symptoms Are Associated With Functional Impairment in Patients With Bipolar Disorder

Cited by 191 publications

References 0 publications

Occupational disability in bipolar disorder: analysis of predictors of being on severe disablement benefit (PREBIS study data)

Occupational disability in bipolar disorder: analysis of predictors of being on severe disablement benefit (PREBIS study data)

Bipolar disorder in Turkey: A review

Neurobiological underpinnings of bipolar disorder focusing on findings of diffusion tensor imaging: a systematic review

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