Previous studies of bipolar disorders indicate that childhood abuse and substance abuse are associated with the disorder. Whether both influence the clinical picture, or if one is mediating the association of the other, has not previously been investigated.
A total of 587 patients with bipolar disorders were recruited from Norway and France. A history of childhood abuse was obtained using the Childhood Trauma Questionnaire. Diagnosis and clinical variables, including substance abuse, were based on structured clinical interviews (Structured Clinical Interview for DSM-IV Axis I disorders or French version of the Diagnostic Interview for Genetic Studies).
Cannabis abuse was significantly associated with childhood abuse, specifically emotional and sexual abuse (? 2 = 8.63, p = 0.003 and ? 2 = 7.55, p = 0.006, respectively). Cannabis abuse was significantly associated with earlier onset of the illness (z = -4.17, p
Many studies have shown associations between a history of childhood trauma and more severe or complex clinical features of bipolar disorders (BD), including suicide attempts and earlier illness onset. However, the psychopathological mechanisms underlying these associations are still unknown. Here, we investigated whether affective lability mediates the relationship between childhood trauma and the severe clinical features of BD.
A total of 342 participants with BD were recruited from France and Norway. Diagnosis and clinical characteristics were assessed using the Diagnostic Interview for Genetic Studies (DIGS) or the Structured Clinical Interview for DSM-IV Axis I disorders (SCID-I). Affective lability was measured using the short form of the Affective Lability Scale (ALS-SF). A history of childhood trauma was assessed using the Childhood Trauma Questionnaire (CTQ). Mediation analyses were performed using the SPSS process macro.
Using the mediation model and covariation for the lifetime number of major mood episodes, affective lability was found to statistically mediate the relationship between childhood trauma experiences and several clinical variables, including suicide attempts, mixed episodes and anxiety disorders. No significant mediation effects were found for rapid cycling or age at onset.
Our data suggest that affective lability may represent a psychological dimension that mediates the association between childhood traumatic experiences and the risk of a more severe or complex clinical expression of BD.
OBJECTIVE: There is considerable skepticism outside the US over the prevalence of pediatric bipolar disorder (BD). We wished to evaluate the epidemiology of BD in children and adolescents in non-US samples. METHOD: We reviewed studies on the prevalence of BD in children and adolescents in international samples. We also describe our sample of 27 children with BD at the University of Navarra. RESULTS: There are important and frequently overlooked differences in the definition of BD between the International Classification of Diseases 10th edition (ICD-10) and DSM-IV and methodological differences in epidemiological studies that may partially explain international differences in prevalence of pediatric BD. The prevalence of bipolar spectrum disorder in young adults in Switzerland is 11%. In Holland the 6-month prevalence of mania in adolescents was 1.9% and of hypomania 0.9%. Only 1.2% of hospitalized youth (
Longitudinal epidemiological studies have shown worse outcomes in patients with psychotic disorder than in the general population. The reproductive pattern may be seen as a measure of outcome following psychotic disorder onset, and it may be measured as the rate of child births where the rate is a proxy measure of well-being.
To examine reproductive patterns following psychotic disorder onset by comparing the fertility rates of patients with schizophrenia and bipolar disorder with those of other psychiatric patients and the general population, taking into account parental status at disease-onset, time since onset, and the possible effect of abortions-rates.
A prospective register-based cohort study drawing on the entire Danish population born after 1950. Incidence Rate Ratios (IRRs) of fertility were analysed using survival analysis.
Compared with the general population, the lowest first-child fertility rate was found among men (IRR=0.10) and women (IRR=0.18) with schizophrenia. In comparison, bipolar male patients had an IRR=0.32 and female patients an IRR=0.36, while male unipolar patients had an IRR=0.46 and female patients an IRR=0.57. In the group with other psychiatric disorders men had an IRR=0.51 and women an IRR=0.70.
The results of the present study show a selection process where persons with more severe disorders are less likely to become parents. The reduced fertility was strongly influenced by the time since psychiatric disorder onset; thus, the longer the time since onset, the higher the fertility.
Social rhythm refers to the regularity with which one engages in social activities throughout the week, and has established links with bipolar disorder, as well as some links with depression and anxiety. The aim of the present study is to examine social rhythm and its relationship to various aspects of health, including physical health, negative mental health, and positive mental health.
Questionnaire data were obtained from a large-scale multi-national sample of 8095 representative participants from the U.S., Russia, and Germany.
Results indicated that social rhythm irregularity is related to increased reporting of health problems, depression, anxiety, and stress. In contrast, greater regularity is related to better overall health state, life satisfaction, and positive mental health. The effects are generally small in size, but hold even when controlling for gender, marital status, education, income, country, and social support. Further, social rhythm means differ across Russia, the U.S., and Germany. Relationships with mental health are present in all three countries, but differ in magnitude.
Social rhythm irregularity is related to mental health in Russia, the U.S., and Germany.
Cites: BMC Psychol. 2016;4:826865173
Cites: Am J Geriatr Psychiatry. 2013 Nov;21(11):1144-5323567367
Personality features may indicate risk for both mood disorders and suicidal acts. How dimensions of temperament and character predispose to suicide attempts remains unclear.
Patients (n = 597) from 3 prospective cohort studies (Vantaa Depression Study [VDS], Jorvi Bipolar Study [JoBS], and Vantaa Primary Care Depression Study [PC-VDS]) were interviewed at baseline, at 18 months, and, in VDS and PC-VDS, at 5 years (1997-2003). Personality was measured with the Temperament and Character Inventory-Revised (TCI-R), and follow-up time spent in major depressive episodes (MDEs) as well as lifetime (total) and prospectively ascertained suicide attempts during the follow-up were documented.
Overall, 219 patients had 718 lifetime suicide attempts; 88 patients had 242 suicide attempts during the prospective follow-up. The numbers of both the total and prospective suicide attempts were associated with low self-directedness (ß = -0.266, P = .004, and ß = -0.294, P