Relevant bibliographies by topics / Bipolar disorder, burden, course

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  2. Dissertations / Theses
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Academic literature on the topic 'Bipolar disorder, burden, course'

Author: Grafiati
Published: 4 June 2021
Last updated: 1 February 2022

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Journal articles on the topic "Bipolar disorder, burden, course"

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Treuer, T., and M. Tohen. "Predicting the course and outcome of bipolar disorder: A review." European Psychiatry 25, no. 6 (October 2010): 328–33. http://dx.doi.org/10.1016/j.eurpsy.2009.11.012.

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AbstractDespite of advances in pharmacological and non-pharmacological treatments, bipolar disorder often entails multiple relapses and impaired psychological functioning. The extent to which modern treatments have influenced the natural course of a mental disorder is uncertain. Prediction of the course and outcome of bipolar disorders continues to be challenging, despite the multiple research efforts worldwide. Due to a lack of laboratory diagnostic tests and biomarkers, psychiatric interview and examination provide the basis for outcome prediction. While considered to have more favorable prognosis than schizophrenia, it is not uncommon for bipolar disorder to include persisting alterations of psychosocial functioning. Although long-term symptomatic remission does not guarantee functional recovery, it may have a favorable impact on long-term overall prognosis. The high degree of treatment resistance in patients with bipolar disorder highlights the need to develop better identification of outcome predictors, prognosis and treatment intervention, designed to reverse or prevent this illness burden. This review summarizes the main factors involved in predicting the course and outcome of bipolar disorder.
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Wittchen, Hans-Ulrich, Stephan Mühlig, and Lukas Pezawas. "Natural course and burden of bipolar disorders." International Journal of Neuropsychopharmacology 6, no. 2 (June 2003): 145–54. http://dx.doi.org/10.1017/s146114570300333x.

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McIntyre, Roger. "Bipolar Disorder and ADHD: Clinical Concerns." CNS Spectrums 14, S6 (July 2009): 8–9. http://dx.doi.org/10.1017/s1092852900024822.

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During the past decade, a similar composite has emerged for both bipolar disorder and adult attention-deficit/hyperactive disorder (ADHD). First, both conditions have a relatively high prevalence, a low case detection, a protracted illness course, a high rate of comorbidity, multifactorial ideology, substantial heritable liability, and tremendous burden of illness in economic cost as well as interpersonal and vocational maladjustments. What has also been interesting along with these reports is that there has been emerging scientific studies implicating common brain regions and neural circuits subserving essential features of both conditions.
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Bermúdez-Ampudia, C., A. García-Alocén, M. Martínez-Cengotitabengoa, S. Alberich, I. González-Ortega, S. Barbeito Resa, and A. González-Pinto. "Mixed-effects models: Family burden and functionality in patients with bipolar disorder." European Psychiatry 33, S1 (March 2016): S331. http://dx.doi.org/10.1016/j.eurpsy.2016.01.1147.

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IntroductionThe bipolar disorder (BD) has an important effect over the lives of patients and families. The attitude of the family is a modifiable factor through specific interventions and it has been related with BD prognosis.ObjectivesStudy a sample of families and patients with BD.AimsCompare between two groups its course of burden of caring for family members with BD. Also, we will see the course of the functionality in patients.MethodsSample of 148 individuals who caring a familiar with BD. Seventy-six of these followed psychoeducation session are going to be experimental group (EG), and the others 72 did not followed any session are going to be control group (CG). There is a follow-up at 6 months and one year. To see the course of the burden and the functionality it will be used mixed models.ResultsAt baseline, there were not significant differences between CG and EG in objective and subjective burden and functionality. But over time there were significant results in the three cases. For objective burden (b = −0.016; P = 0.0001) EG presented a drop (b = −0.014; P = 0.0062), while CG did not show changes (b = 0.002; P = 0.4691). For subjective burden (b = −0.014; P = 0.0058) without significant results for CG (b = −0.352; P = 0.3203) and a significant decrease in EG (b = −0.017; P = 0.003). For the functionality (b = 1.474; P = 0.000) there was a significant increase in EG (b = 1.349; P = 0.000) but not for CG (b = −0.125; P = 0.3828).ConclusionsTwo groups did not differ at baseline however after the psychoeducation sessions appear clear differences, decreasing the burden for EG group and the functionality also improved for EG.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Forty, Liz, Anna Ulanova, Lisa Jones, Ian Jones, Katherine Gordon-Smith, Christine Fraser, Anne Farmer, et al. "Comorbid medical illness in bipolar disorder." British Journal of Psychiatry 205, no. 6 (December 2014): 465–72. http://dx.doi.org/10.1192/bjp.bp.114.152249.

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BackgroundIndividuals with a mental health disorder appear to be at increased risk of medical illness.AimsTo examine rates of medical illnesses in patients with bipolar disorder (n = 1720) and to examine the clinical course of the bipolar illness according to lifetime medical illness burden.MethodParticipants recruited within the UK were asked about the lifetime occurrence of 20 medical illnesses, interviewed using the Schedules for Clinical Assessment in Neuropsychiatry (SCAN) and diagnosed according to DSM-IV criteria.ResultsWe found significantly increased rates of several medical illnesses in our bipolar sample. A high medical illness burden was associated with a history of anxiety disorder, rapid cycling mood episodes, suicide attempts and mood episodes with a typically acute onset.ConclusionsBipolar disorder is associated with high rates of medical illness. This comorbidity needs to be taken into account by services in order to improve outcomes for patients with bipolar disorder and also in research investigating the aetiology of affective disorder where shared biological pathways may play a role.Declarations of interestNone.
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Coryell, W., J. Fiedorowicz, D. Solomon, and J. Endicott. "Age transitions in the course of bipolar I disorder." Psychological Medicine 39, no. 8 (April 1, 2009): 1247–52. http://dx.doi.org/10.1017/s0033291709005534.

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BackgroundThis analysis aimed to show whether symptoms of either pole change in their persistence as individuals move through two decades, whether such changes differ by age grouping, and whether age of onset plays an independent role in symptom persistence.MethodParticipants in the National Institute of Mental Health (NIMH) Collaborative Depression Study (CDS) who completed at least 20 years of follow-up and who met study criteria for bipolar I or schizo-affective manic disorder, before intake or during follow-up, were divided by age at intake into youngest (18–29 years, n=56), middle (30–44 years, n=68) and oldest (>44 years, n=24) groups.ResultsThe persistence of depressive symptoms increased significantly in the two younger groups. Earlier ages of onset were associated with higher depressive morbidity throughout the 20 years of follow-up but did not predict changes in symptom persistence. The proportions of weeks spent in episodes of either pole correlated across follow-up periods in all age groupings, although correlations were stronger for depressive symptoms and for shorter intervals.ConclusionsRegardless of age at onset, the passage of decades in bipolar illness seems to bring an increase in the predominance of depressive symptoms in individuals in their third, fourth and fifth decades and an earlier age of onset portends a persistently greater depressive symptom burden. The degree to which either depression or manic/hypomanic symptoms persist has significant stability over lengthy periods and seems to reflect traits that manifest early in an individual's illness.
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Rakofsky, Jeffrey J., Steven T. Levy, and Boadie W. Dunlop. "Conceptualizing Treatment Nonadherence in Patients with Bipolar Disorder and PTSD." CNS Spectrums 16, no. 1 (January 2011): 11–20. http://dx.doi.org/10.1017/s1092852912000119.

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AbstractTreatment nonadherence is a concern among patients with bipolar disorder and posttraumatic stress disorder (PTSD). PTSD is common among patients with bipolar disorder and those with this comorbidity often have a more severe course of illness. While many factors have been associated with nonadherence in bipolar disorder patients and in PTSD patients, almost no research has focused on the factors associated with non-adherence in bipolar disorder patients with comorbid PTSD. Studies in primary bipolar disorder samples reveal patient, illness, drug and clinician characteristics associated with nonadherence while studies in primary PTSD samples reveal a significantly shorter list of patient, illness and drug characteristics. Shared risk factors between these two populations and the characteristics that predict noncompliance in only one population but often present in the other, suggest a high likelihood of nonadherence in the bipolar disorder-PTSD population. For bipolar disorder-PTSD patients with early childhood trauma, noncompliance may be related to the trauma-related meanings attributed to interactions with their physicians and their prescribed medications. Given the high side effect burden of bipolar disorder treatments and the importance of lifelong adherence, clinicians should vigilantly monitor for nonadherence in their bipolar disorder-PTSD patients and be particularly aware of patient-physician psychodynamics that might contribute to this behavior.
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GOIKOLEA, J. M., F. COLOM, A. MARTÍNEZ-ARÁN, J. SÁNCHEZ-MORENO, A. GIORDANO, A. BULBENA, and E. VIETA. "Clinical and prognostic implications of seasonal pattern in bipolar disorder: a 10-year follow-up of 302 patients." Psychological Medicine 37, no. 11 (May 31, 2007): 1595–99. http://dx.doi.org/10.1017/s0033291707000864.

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ABSTRACTBackgroundMore than 20% of bipolar patients may present with seasonal pattern (SP). Seasonality can alter the course of bipolar disorder. However, to date, long-term follow-up studies of bipolar patients presenting with SP are scarce. We present a 10-year follow-up study comparing clinical and demographic features of bipolar patients with and without SP.MethodThree hundred and twenty-five bipolar I and II patients were followed up for at least 10 years. SP was defined according to DSM-IV criteria. Clinical variables were obtained from structured interviews with the patients and their relatives. Patients with and without SP were compared regarding clinical and sociodemographic variables and a stepwise logistic regression was performed.ResultsSeventy-seven patients (25·5%) were classified as presenting with SP, while 225 (74·5%) were considered as presenting with no significant seasonal variation. Twenty-three patients (7%) were excluded from the study because it was unclear whether they had seasonality or not. There were no differences between groups regarding demographic variables. Patients with SP predominantly presented with bipolar II disorder, depressive onset, and depressive predominant polarity. The greater burden of depression did not correlate with indirect indicators of severity, such as suicidality, hospitalizations or psychotic symptoms.ConclusionsOur study links the presence of SP with both bipolar II disorder and predominant depressive component. However, we could not find any difference regarding functionality or hospitalization rates. Modifications in the criteria to define SP are suggested for a better understanding of bipolar disorder.
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Muralidharan, Kesavan, Ivan J. Torres, Leonardo E. Silveira, Jan-Marie Kozicky, Joana Bücker, Nadeesha Fernando, and Lakshmi N. Yatham. "Impact of depressive episodes on cognitive deficits in early bipolar disorder: data from the Systematic Treatment Optimization Programme for Early Mania (STOP-EM)." British Journal of Psychiatry 205, no. 1 (July 2014): 36–43. http://dx.doi.org/10.1192/bjp.bp.113.135525.

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BackgroundAlthough manic episodes reportedly contribute to cognitive deficits in bipolar I disorder, the contribution of depressive episodes is poorly researched.AimsWe investigated the impact of depressive episodes on cognitive function early in the course of bipolar I disorder.MethodA total of 68 patients and 38 controls from the Systematic Treatment Optimization Programme for Early Mania (STOP-EM) first-episode mania programme were examined. We conducted (a) a cross-sectional analysis of the impact of prior depressive episodes on baseline cognitive function and (b) a prospective analysis assessing the contribution of depression recurrence within 1 year following a first episode of mania on cognitive functioning.ResultsThe cross-sectional analysis showed no significant differences between patients with past depressive episodes compared with those without, on overall or individual domains of cognitive function (allP>0.09). The prospective analysis failed to reveal a significant group×time interaction for cognitive decline from baseline to 1 year (P= 0.99) in patients with a recurrence of depressive episodes compared with those with no recurrence. However, impaired verbal memory at baseline was associated with a depression recurrence within 1 year.ConclusionsAlthough deficits in all domains of cognitive function are seen in patients early in the course of bipolar disorder, depressive episodes do not confer additional burden on cognitive function. However, poorer verbal memory may serve as a marker for increased susceptibility to depression recurrence early in the course of illness.
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Bilska, Karolina, Joanna Pawlak, Paweł Kapelski, Beata Narożna, Przemysław Zakowicz, Aleksandra Szczepankiewicz, Maria Skibińska, and Monika Dmitrzak-Węglarz. "Differences in the Clinical Picture in Women with a Depressive Episode in the Course of Unipolar and Bipolar Disorder." Journal of Clinical Medicine 10, no. 4 (February 10, 2021): 676. http://dx.doi.org/10.3390/jcm10040676.

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Due to current depression prevalence, it is crucial to make the correct diagnosis as soon as possible. The study aimed to identify commonly available, easy to apply, and quick to interpret tools allowing for a differential diagnosis between unipolar and bipolar disorder. The study group includes women with long duration of unipolar (UP, N = 34) and bipolar (BP, N = 43) affective disorder. The diagnosis was established according to the DSM criteria using SCID questionnaire. Additional questionnaires were used to differentiate between UP and BP. BP patients had an earlier age of onset, were hospitalized more times, and more often had a family history of psychiatric disorders than UP (p-value < 0.05). Moreover, BP achieved a higher impulsiveness score and more frequently had experienced severe problems with close individuals. To our knowledge, this is the first publication presenting results of numerous questionnaires applied simultaneously in patients on clinical group. Several of them suggest the direction of clinical assessment, such as: the age of onset, family psychiatric burdens, history of stressful life events, learning problems, social and job relations. Further studies are necessary to confirm the utility of this approach.
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Dissertations / Theses on the topic "Bipolar disorder, burden, course"

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Wittchen, Hans-Ulrich, Stephan Mühlig, and Lukas Pezawas. "Natural course and burden of bipolar disorders." Saechsische Landesbibliothek- Staats- und Universitaetsbibliothek Dresden, 2013. http://nbn-resolving.de/urn:nbn:de:bsz:14-qucosa-117282.

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Despite an abundance of older and more recent retrospective and considerably fewer prospective-longitudinal studies in bipolar disorders I and II, there are still remarkable deficits with regard to our knowledge about the natural course and burden. The considerable general and diagnosis-specific challenges posed by the nature of bipolar disorders are specified, highlighting in particular problems in diagnostic and symptom assessment, shifts in diagnostic conventions and the broadening of the diagnostic concept by including bipolar spectrum disorders. As a consequence it still remains difficult to agree on several core features of bipolar disorders, such as when they begin, how many remit spontaneously and how many take a chronic course. On the basis of clinical and epidemiological findings this paper summarizes (i) a significant need to extend the study of the natural course of bipolar disorder in clinical samples beyond the snapshot of acute episodes to the study of the mid-term and long-term symptom course, associated comorbidities and the associated burden of the disease. (ii) In terms of epidemiological studies, that are also of key importance for resolving the critical issues of threshold definitions in the context of the bipolar spectrum concept, there is a clear need for identifying the most relevant risk factors for the first onset and those for the further illness progression in early stages. Since there are some indications that these critical processes might start as early as adolescence, such studies might concentrate on young cohorts and clearly before these prospective patients come to clinical attention. (iii) The value of both types of studies might be enhanced, if beyond the use of standardized diagnostic interview, special attempts are made to use prospective life- and episode-charting methods for bipolar illnesses.
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Wittchen, Hans-Ulrich, Stephan Mühlig, and Lukas Pezawas. "Natural course and burden of bipolar disorders." Technische Universität Dresden, 2003. https://tud.qucosa.de/id/qucosa%3A27010.

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Despite an abundance of older and more recent retrospective and considerably fewer prospective-longitudinal studies in bipolar disorders I and II, there are still remarkable deficits with regard to our knowledge about the natural course and burden. The considerable general and diagnosis-specific challenges posed by the nature of bipolar disorders are specified, highlighting in particular problems in diagnostic and symptom assessment, shifts in diagnostic conventions and the broadening of the diagnostic concept by including bipolar spectrum disorders. As a consequence it still remains difficult to agree on several core features of bipolar disorders, such as when they begin, how many remit spontaneously and how many take a chronic course. On the basis of clinical and epidemiological findings this paper summarizes (i) a significant need to extend the study of the natural course of bipolar disorder in clinical samples beyond the snapshot of acute episodes to the study of the mid-term and long-term symptom course, associated comorbidities and the associated burden of the disease. (ii) In terms of epidemiological studies, that are also of key importance for resolving the critical issues of threshold definitions in the context of the bipolar spectrum concept, there is a clear need for identifying the most relevant risk factors for the first onset and those for the further illness progression in early stages. Since there are some indications that these critical processes might start as early as adolescence, such studies might concentrate on young cohorts and clearly before these prospective patients come to clinical attention. (iii) The value of both types of studies might be enhanced, if beyond the use of standardized diagnostic interview, special attempts are made to use prospective life- and episode-charting methods for bipolar illnesses.
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Smith, Patrick (Patrick M. ). "Medical Comorbidity in the Course of Bipolar Disorder." Thesis, University of North Texas, 2016. https://digital.library.unt.edu/ark:/67531/metadc849606/.

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Bipolar disorder is a serious illness affecting approximately 2-4% of the population and is one of the world’s leading causes of disability. In individuals with bipolar disorder, medical comorbidity associated with cardiovascular, respiratory and endocrine disorders is related to increased rates of mortality. Recent updates to multi-system inflammatory related conceptualizations of bipolar disorder focus on the unique power that medical illness and biological processes may play as factors associated with course and outcome in bipolar disorder. The current study examined medical comorbidity and its associations with various demographic and psychological variables in individuals with bipolar disorder, schizophrenia, and major depressive disorder with psychotic features followed for 10 years from their first hospital admission. When compared to an age, gender and race-matched control sample from the population, those with bipolar disorder had significantly higher medical comorbidity across a range of medical diagnoses both at 6 months and 10 years after first hospital admission. Ten years following initial hospitalization, individuals in all three diagnostic groups reported increased rates of diabetes (OR: 2.0 – 3.7), stroke (OR: 4.6 – 7.0) and asthma (OR: 1.9 - 3.1), and individuals with bipolar disorder reported increased rates of cancer (OR = 2.1). A number of psychological and demographic symptoms were examined for their ability to predict the development of medical illness across the assessment interval. Overall rates of medical illness were elevated both early in illness course and 10 years after diagnosis, suggesting that broad sequelae of multi-system inflammation are present early and progress over time.
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Kim, Eunice Y. "Life stress and the course of early-onset bipolar disorder." Diss., Connect to online resource, 2005. http://wwwlib.umi.com/dissertations/fullcit/3178325.

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Pini, Stefano, Queiroz Valéria de, Daniel Pagnin, Lukas Pezawas, Jules Angst, Giovanni B. Cassano, and Hans-Ulrich Wittchen. "Prevalence and burden of bipolar disorders in European countries." Saechsische Landesbibliothek- Staats- und Universitaetsbibliothek Dresden, 2013. http://nbn-resolving.de/urn:nbn:de:bsz:14-qucosa-110193.

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A literature search, supplemented by an expert survey and selected reanalyses of existing data from epidemiological studies was performed to determine the prevalence and associated burden of bipolar I and II disorder in EU countries. Only studies using established diagnostic instruments based on DSM-III-R or DSM-IV, or ICD-10 criteria were considered. Fourteen studies from a total of 10 countries were identified. The majority of studies reported 12-month estimates of approximately 1% (range 0.5–1.1%), with little evidence of a gender difference. The cumulative lifetime incidence (two prospective-longitudinal studies) is slightly higher (1.5–2%); and when the wider range of bipolar spectrum disorders is considered estimates increased to approximately 6%. Few studies have reported separate estimates for bipolar I and II disorders. Age of first onset of bipolar disorder is most frequently reported in late adolescence and early adulthood. A high degree of concurrent and sequential comorbidity with other mental disorders and physical illnesses is common. Most studies suggest equally high or even higher levels of impairments and disabilities of bipolar disorders as compared to major depression and schizophrenia. Few data are available on treatment and health care utilization.
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Prichard, Adrine Biuckians m. d. "Anxiety, mood symptoms, and the course of early-onset bipolar disorder." Connect to online resource, 2007. http://gateway.proquest.com/openurl?url_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:dissertation&res_dat=xri:pqdiss&rft_dat=xri:pqdiss:3315762.

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Pini, Stefano, Queiroz Valéria de, Daniel Pagnin, Lukas Pezawas, Jules Angst, Giovanni B. Cassano, and Hans-Ulrich Wittchen. "Prevalence and burden of bipolar disorders in European countries." Technische Universität Dresden, 2005. https://tud.qucosa.de/id/qucosa%3A26819.

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A literature search, supplemented by an expert survey and selected reanalyses of existing data from epidemiological studies was performed to determine the prevalence and associated burden of bipolar I and II disorder in EU countries. Only studies using established diagnostic instruments based on DSM-III-R or DSM-IV, or ICD-10 criteria were considered. Fourteen studies from a total of 10 countries were identified. The majority of studies reported 12-month estimates of approximately 1% (range 0.5–1.1%), with little evidence of a gender difference. The cumulative lifetime incidence (two prospective-longitudinal studies) is slightly higher (1.5–2%); and when the wider range of bipolar spectrum disorders is considered estimates increased to approximately 6%. Few studies have reported separate estimates for bipolar I and II disorders. Age of first onset of bipolar disorder is most frequently reported in late adolescence and early adulthood. A high degree of concurrent and sequential comorbidity with other mental disorders and physical illnesses is common. Most studies suggest equally high or even higher levels of impairments and disabilities of bipolar disorders as compared to major depression and schizophrenia. Few data are available on treatment and health care utilization.
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Bain, Kathleen Marie. "Eight-Year Course of Cognitive Functioning in Bipolar Disorder with Psychotic Features." Thesis, University of North Texas, 2016. https://digital.library.unt.edu/ark:/67531/metadc862811/.

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The purpose of the current study was to examine neuropsychological functioning in patients with bipolar disorder (BD) with psychotic features. Data from a large, epidemiological study of patients with first-episode psychosis was used to examine verbal learning and working memory 10 years after onset of psychosis in patients with BD relative to patients with schizophrenia (SZ) and patients with psychotic major depressive disorder (MDD). Cross-sectional comparisons of verbal learning and working memory at the 10-year follow-up mirrored findings of relative performance at the 2-year follow-up (Mojtabai, 2000), as patients with SZ performed significantly worse than patients with psychotic affective disorders. When FEP patients' cognitive performance was examined longitudinally, all groups showed non-significant decline over time, with no significant diagnostic group differences after accounting for current symptoms. More frequent hospitalizations and longer treatment with antipsychotics were associated with poorer performance on cognitive testing 10 years after illness onset, but these associations disappeared when controlling baseline cognitive performance. Within the BD sample, current positive and negative psychotic symptoms were associated with poorer performance on cognitive testing. After controlling for baseline cognitive performance, markers of clinical course were unrelated to cognitive performance, consistent with existing literature on longitudinal cognitive functioning in patients with BD. The current findings support a neurodevelopmental model of verbal learning and working memory deficits in patients with bipolar disorder.
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Fiedorowicz, Jess G. "Course of illness and the development of vascular disease in individuals with bipolar disorder." Diss., University of Iowa, 2011. https://ir.uiowa.edu/etd/2699.

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For over a century, there have been suggestions of a link between what is currently called bipolar disorder and cardiovascular mortality. In the contemporary epidemiological literature, this risk has been confirmed and approximates twice that expected based on age and gender. To date, however, this information has come primarily from clinical samples, which carry considerable risk of selection bias. The studies contained in this dissertation sought to assess this relationship using methods less vulnerable to selection bias and to determine the role that course of illness and treatments for illness may play in the development of vascular disease. In a nationally representative sample, we confirmed a link between mood disorders and vascular disease, which was particularly pronounced in women with bipolar disorder. In subsequent studies, a dose-response relationship between the duration of clinically significant hypomanic or manic symptoms and both cardiovascular mortality and endothelial function was seen. While medication exposure did not appear related to mortality or endothelial function, first generation antipsychotics were associated with arterial stiffness, an effect apparently mediated by elevations in blood pressure. In cross-sectional samples, our data suggests that vasculopathy is not present early in the course of bipolar disorder although is much greater than expected later in the course of illness. This dissertation purports that vasculopathy develops over the long-term course of bipolar disorder, is proportional to symptom burden, and is influenced by health behaviors and treatments. These findings may provide opportunities for clinicians and those afflicted to intervene to address this excess risk of vascular morbidity and mortality.
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Vesco, Anthony Thomas. "Examining the Course of Cyclothymic Disorder and Comparing it to Dysthymic Disorder and Other Bipolar Spectrum Disorders in Children." The Ohio State University, 2013. http://rave.ohiolink.edu/etdc/view?acc_num=osu1364907946.

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Books on the topic "Bipolar disorder, burden, course"

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Balzafiore, Danielle, Thalia Robakis, Sarah Borish, Vena Budhan, and Natalie Rasgon. The treatment of bipolar disorder in women. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198748625.003.0020.

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Sex-specific effects in the clinical presentation and course of bipolar disorder in women have important treatment implications for the management of symptoms across the menstrual cycle and reproductive lifespan. Women with bipolar disorder are particularly vulnerable to premenstrual mood symptoms, menstrual abnormalities, and polycystic ovary syndrome. Special considerations include understanding the interactions between these reproductive issues, oral contraceptives, and mood-stabilizing agents. Additionally, the management of bipolar disorder during the perinatal period requires a careful approach to psychotropic medication to optimize the maintenance of mood stability while minimizing the potential for adverse risk of fetal and neonatal outcomes. Non-pharmaceutical approaches, including electroconvulsive therapy, transcranial magnetic stimulation, selected psychotherapies, and social and behavioural interventions may represent efficacious treatment options to reduce medication burden. Lastly, women with bipolar disorder may be at particular risk for worsening of affective symptoms during the menopausal transition, and strategies to reduce sleep disruption are imperative.
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Bipolar disorders: Clinical course and outcome. Washington, DC: American Psychiatric Press, 1999.

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(Editor), Joseph F. Goldberg, and Martin Harrow (Editor), eds. Bipolar Disorders: Clinical Course and Outcome (Clinical Practice). American Psychiatric Publishing, Inc., 1999.

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Youngstrom, Eric, and Anna Van Meter. Comorbidity of Bipolar Disorder and Depression. Edited by C. Steven Richards and Michael W. O'Hara. Oxford University Press, 2013. http://dx.doi.org/10.1093/oxfordhb/9780199797004.013.003.

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There has been speculation about the relationship between depression and mania for centuries. Modern psychiatry and psychology have mostly viewed these as different subtypes within a “family” of mood disorders. Conceptual models of comorbidity provide an opportunity to re-examine the association between depression and other pathological mood states. We examine the evidence pertaining to rates of “comorbidity,” which, in this case, refer to the lifetime occurrence of depression and hypomanic, mixed, or manic episodes in the same individual. We explore factors that could contribute to artifactual comorbidity. We also examine data pertaining to similarities or differences in phenomenology, longitudinal course, associated features, family history, and treatment response. Multiple factors are likely involved in the comorbidity of depression and hypomania or mania, and the problems of poor reliability and inconsistent diagnostic definitions and methodology attenuate the significance of most research findings. However, evidence appears sufficient to conclude that not all depression is on the bipolar spectrum, that bipolar features moderate the course and outcome of depressive illness, and that depression and bipolar disorder most likely involve a blend of some shared and some specific mechanisms. Research and clinical work both will advance substantially by more systematically assessing for potential bipolar features “comorbid” with depression and following how these factors change the trajectory of depression over time.
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Henter, Ioline D., and Rodrigo Machado-Vieira. Novel therapeutic targets for bipolar disorder. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198748625.003.0030.

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The long-term course of bipolar disorder (BD) comprises recurrent depressive episodes and persistent residual symptoms for which standard therapeutic options are scarce and often ineffective. Glutamate is the major excitatory neurotransmitter in the central nervous system, and glutamate and its cognate receptors have consistently been implicated in the pathophysiology of mood disorders and in the development of novel therapeutics for these disorders. Since the rapid and robust antidepressant effects of the N-methyl-D-aspartate (NMDA) antagonist ketamine were first observed in 2000, other NMDA receptor antagonists have been studied in major depressive disorder (MDD) and BD. This chapter reviews the clinical evidence supporting the use of novel glutamate receptor modulators for treating BD—particularly bipolar depression. We also discuss other promising, non-glutamatergic targets for potential rapid antidepressant effects in mood disorders, including the cholinergic system, the melatonergic system, the glucocorticoid system, the arachidonic acid (AA) cascade, and oxidative stress and bioenergetics.
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Fountoulakis, Konstantinos N., and Dimos Dimellis. The treatment of rapid cycling bipolar disorder. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198748625.003.0006.

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Rapid cycling may complicate the course of a significant proportion of patients with bipolar disorder (BD). It is defined in DSM-5 by the occurrence of at least four distinct mood episodes in 12 months. Rapid cycling BD has been consistently associated with worse outcomes compared with non-rapid cycling BD. Thus, rapid cycling BD may require specific treatment strategies. Antidepressants, antipsychotics, and mood stabilizers/anticonvulsants have been studied either as monotherapy or in combination treatments. Concerning the treatment of acute mood episodes, the best available data exist for atypical antipsychotics. On the other hand, maintenance or relapse-prevention treatment, and newer-generation antipsychotics and anticonvulsants seem to be efficacious for rapid cycling BD. Lithium may also be efficacious. Treatment with antidepressants should be avoided in this subpopulation of patients. Overall, few randomized controlled trials have been conducted, and many have been underpowered. Therefore, a significant gap remains in evidence-based treatment of rapid cycling BD.
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Milev, Roumen. The role of electroconvulsive therapy in the treatment of bipolar disorder. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198748625.003.0027.

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This chapter examines the use of electroconvulsive therapy (ECT) for treatment of patients with bipolar disorders. It briefly reviews the basics of ECT, stimulus parameters, placement of electrodes, and seizure threshold. The data for efficacy and tolerability of ECT for bipolar disorder, including mania, depression, mixed states, and across the lifespan is reviewed. Although there is a paucity of good-quality randomized studies, all available data, including case reports and naturalistic observations, support the use of ECT in this population, and reinforce the widespread use of ECT in everyday clinical practice. Good-quality randomized control trials are urgently needed to address numerous unanswered questions, in order to improve efficacy and reduce side-effect burden of one of the best treatments for bipolar disorder.
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Cavalcante Passos, Ives, and Flávio Kapczinski. Staging and neuroprogression in bipolar disorder: treatment implications. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198748625.003.0024.

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It is known that if, not all, a substantial proportion of patients with bipolar disorder (BD) present a progressive course with functional and cognitive impairment. In addition, patients with BD and multiple mood episodes have a worse response to lithium and cognitive behaviour therapy. However, many current treatment guidelines do not take these clinical features that change with illness progression into account. In order to clarify these clinical questions, the term ‘neuroprogression’ was conceptualized as the pathological rewiring of the brain that takes place in parallel with the clinical deterioration in the course of BD. It provides a heuristic basis for conceptualizing the biochemical foundation of changes in brain circuits related to the progressive course of BD. Herein, we aim to review risk factors, biological underpinnings, and treatment implications related to neuroprogression in BD.
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Fabbri, Chiara, and Alessandro Serretti. The treatment of bipolar disorder in the era of personalized medicine: myth or promise? Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198748625.003.0031.

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Bipolar disorder (BD) is a chronic disease associated with high personal and socio-economic burden. Genetics accounts for 20–95% of variability in central nervous system drug disposition and pharmacodynamics, thus genetic markers are considered a promising way to develop tailored treatments and improve the prognosis of the disease. Among mood stabilizers, lithium response was the most investigated phenotype and the most replicated genes are involved in synaptic plasticity (BDNF), serotonergic (SLC6A4) and dopaminergic (DRD1) neurotransmission, and second messenger cascades (GSK3B). Relevant pharmacogenetic findings regarding other mood stabilizers are hyperammonaemia (CPS1 gene) and hepatic dysfunction (POLG gene) induced by valproate and immune-mediated cutaneous hypersensitivity reactions (HLA-B*1502) induced by lamotrigine or carbamazepine. Polymorphisms in cytochrome (CYP) P450 genes are expected to provide useful information particularly in case of polypharmacy. Despite few pharmacogenetic tests are currently recommended, the development of pharmacogenetics in other fields of medicine provides an encouraging perspective.
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da Costa, Sabrina C., Joao L. de Quevedo, and André F. Carvalho. Predominant polarity, polarity index, and treatment selection in bipolar disorder. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198748625.003.0015.

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Bipolar disorder (BD) is a chronic and disabling illness, with lifetime prevalence of 2.4% worldwide. Predominant polarity (PP), ie, depressive versus manic, may influence illness characteristics, treatment selection, and outcomes in BD. PP has been proposed as a course specifier for BD, although not included in the Diagnostic and Statistical Manual of Mental Disorders (5th edn) (DSM-5). The polarity index (PI), a metric algorithm that reflects antimanic versus antidepressant maintenance efficacy of available treatments for BD, is calculated as the ratio of number needed to treat (NNT) for prevention of depression and NNT for prevention of mania. Evidence indicates that the net PI of ongoing maintenance-treatment regimens for BD is related to the patient’s PP. Additionatlly, PP and PI may aid in treatment selection and outcome prediction in BD. Therefore, this chapter provides an overview of putative roles of PP and PI in the course and treatment selection for BD.
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Book chapters on the topic "Bipolar disorder, burden, course"

1

Fountoulakis, Kostas N. "Long-Term Course." In Bipolar Disorder, 81–107. Berlin, Heidelberg: Springer Berlin Heidelberg, 2014. http://dx.doi.org/10.1007/978-3-642-37216-2_3.

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Goldberg, Joseph F., and Carrie L. Ernst. "The Economic and Social Burden of Bipolar Disorder." In Bipolar Disorder, 441–501. Chichester, UK: John Wiley & Sons, Ltd, 2002. http://dx.doi.org/10.1002/047084650x.ch6.

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Fountoulakis, Kostas N. "Disability and Overall Burden Related with Bipolar Disorder." In Bipolar Disorder, 361–88. Berlin, Heidelberg: Springer Berlin Heidelberg, 2014. http://dx.doi.org/10.1007/978-3-642-37216-2_12.

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Judd, Lewis L., and Pamela J. Schettler. "The Long-Term Course and Clinical Management of Bipolar I and Bipolar II Disorders." In Bipolar Disorder, 17–30. Chichester, UK: John Wiley & Sons, Ltd, 2010. http://dx.doi.org/10.1002/9780470661277.ch3.

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Mitchell, Philip B., Dusan Hadzi-Pavlovic, and Colleen K. Loo. "Course and Outcome of Bipolar Disorder." In Behavioral Neurobiology of Bipolar Disorder and its Treatment, 1–18. Berlin, Heidelberg: Springer Berlin Heidelberg, 2010. http://dx.doi.org/10.1007/7854_2010_66.

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Angst, J. "The Course of Major Depression, Atypical Bipolar Disorder, and Bipolar Disorder." In New Results in Depression Research, 26–35. Berlin, Heidelberg: Springer Berlin Heidelberg, 1986. http://dx.doi.org/10.1007/978-3-642-70702-5_4.

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Vieta, Eduard. "Etiology and Disease Course." In Managing Bipolar Disorder in Clinical Practice, 23–39. Tarporley: Springer Healthcare Ltd., 2013. http://dx.doi.org/10.1007/978-1-908517-94-4_3.

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Clayton, P. J. "Clinical Picture and Course of Bipolar Affective Disorder." In Contemporary Psychiatry, 1579–86. Berlin, Heidelberg: Springer Berlin Heidelberg, 2001. http://dx.doi.org/10.1007/978-3-642-59519-6_99.

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Bauer, Michael, and Michael Gitlin. "Natural Course of Bipolar Disorder and Implications for Treatment." In The Essential Guide to Lithium Treatment, 11–23. Cham: Springer International Publishing, 2016. http://dx.doi.org/10.1007/978-3-319-31214-9_2.

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Escalona, Rodrigo, and Mauricio Tohen. "Course and Outcome of Bipolar Disorder: Focus on Depressive Aspects." In Bipolar Depression: Molecular Neurobiology, Clinical Diagnosis, and Pharmacotherapy, 33–51. Cham: Springer International Publishing, 2016. http://dx.doi.org/10.1007/978-3-319-31689-5_3.

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