- Email: [email protected]
Clinical characteristics and outcomes of patients with bipolar disorder after first hospitalization: A two-year follow-up
S50
Abstract/Journal of Affective Disorders 122 (2010) S42–S72
comparison. We conducted a controlled randomized study to investigate if a supportive, psychoeducational approach results in the same outcome (relapse prevention) as a sophisticated cognitive behavioural approach with several moduls, elements and techniques. Both interventions were well designed and manualised. Each patients is seen individually by a therapist over 9 months and 20 sessions. Therapists were trained, supervised, and controlled by video tapes. We plan to present the results of one and two year follow-up after termination of the interventions. Our results allow an answer if highly specific techniques and materials, intensive trainings of patients with a bipolar disorder are necessary and superior to a more simple, supportive intervention.
tative studies are needed to provide clinical information crucial to better design of quantitative studies aiming at exploring the difference and similarities of PPD and NPPD.
Keywords: Bipolar Disorder; Relapse Prevention; cognitive Behavioural Treatment; Supportive Psychoeducation
Clinical characteristics and outcomes of patients with bipolar disorder after first hospitalization: A two-year follow-up
doi:10.1016/j.jad.2010.02.049
Keywords: Postpartum depression, postnatal depression, Phenomenology, clinical symptoms doi:10.1016/j.jad.2010.02.050
[P1.3.07]
D.I. Jon⁎1, E. Lee2, K.R. Kim2, N. Hong1, K.H. Lee3, J.H. Seok1 et al. 1
Hallym University, Korea Yonsei University, Korea 3 Dongguk University, Korea 2
[P1.3.06] Phenomenological differences between post-partum depression and non-post-partum depression. A systematic review I. Roseth⁎1,3, U. Fredrik Malt2,3 1
Telemark Hospital, Norway Oslo University Hospital-Rikshospitalet, Norway 3 University of Oslo, Norway 2
Introduction: Five to 20 percent of new mothers develop some degree of depressive disorder (PPD) after delivery. Persistent PPD may have long-term negative effect on the cognitive, emotional and social development of the child. Neurobiological studies have suggested etiological differences between PPD and non-post partum depression (NPPD). However, there is no consensus to which extent the etiology and phenomenology of PPD differs from NPPD. We review the current evidence whether, and how, the phenomenology of PPD and NPPD may differ. Methods: The electronic databases Medline, PsycINFO British nursing Index, EMBASE, and Cochrane library were searched for studies comparing PPD vs NPPD. Key words were postnatal depression, postpartum depression, puerperal depression, phenomenology, and clinical symptoms. In addition we systematically followed-up reference lists. Results: Ten quantitative and no qualitative studies comparing PPD vs NPPD were identified. The studies provide conflicting results, seven studies claimed difference in phenomenology while three did not. Among studies suggesting phenomenological differences between PPD and NPPD, there was little agreement about what constitutes those differences. Three of the seven studies indicated that PPD had higher levels of symptoms of anxiety, while four reported that symptoms of depression were more prominent. Differences in specific symptoms were insufficiently reported. Discussion: Published studies do not allow any conclusions concerning similarities or differences in phenomenology of PPD versus NPPD. Several methodological issues may explain those inconclusive findings: different characteristics of the women included; different definitions of depression and PPD; variation in time from birth to assessment, and use of different assessment methods (questionnaires, semistructured interviews) tapping partly different symptoms and signs. Three of the studies did not address the issue of separating bipolar from non-bipolar post-partum depression. Comparing phenomenology of PPD and NPPD, requires standardized and focused assessment methods and definitions. Quali-
Introduction: This study was performed to determine the longitudinal clinical outcome and the patterns of medication use of first-admission bipolar patients in Korea under compulsory national health insurance system. Methods: Bipolar patients who were first-hospitalized in the psychiatric wards of four hospitals between 2001 and 2005 were included in this study. Outpatient charts for two years following their hospitalization were carefully evaluated. We defined the early discontinuation of treatment as the lost follow-up at least for three months, rehospitalization, or transfer to other hospital. Results: Medical records of 269 patients (male 133, female 136) were analyzed. The mean age at discharge was 37.6. The mean duration of treatment was 224.3 days. Eighty-two (30.5%) patients have never visited after discharge. Only 38 (14.1%) patients finished the two-year follow-up. Clinical Global Impression and Global Assessment of Function score were not associated with the treatment duration. Most common (46.5%) reason for early discontinuation was lost to followup. Majority of patients were administered a combination of a mood stabilizer and an atypical antipsychotic agent. The mean dosage of prescribed drugs at the last visit were lithium 915.8 mg/day, valproate 859.0 mg/day, risperidone 1.9 mg/day, olanzapine 7.8 mg/day, and quetiapine 170.1 mg/day. Common adverse events were sedation (first visit 9.9%, last visit 5.9%) and weight gain (first visit 3.9%, last visit 4.9%). Conclusion: These findings indicate that optimal maintenance treatment of bipolar disorder is still the unmet need in clinical setting. More enthusiastic psychoeducation and more careful treatment planning are needed. Keywords: Bipolar disorder; Clinical outcome; First hospitalization doi:10.1016/j.jad.2010.02.051
[P1.3.08] Does bipolar disorder impact on self and identity development? M.L. Inder⁎1, M.T. Crowe1, S. Moor1, S.E. Luty1, J.D. Carter2, P.R. Joyce1 1
University of Otago, Christchurch, New Zealand University of Canterbury, New Zealand
2
There has been little research focus on the impact of bipolar disorder on self and identity development despite adolescent years
Abstract/Journal of Affective Disorders 122 (2010) S42–S72
comparison. We conducted a controlled randomized study to investigate if a supportive, psychoeducational approach results in the same outcome (relapse prevention) as a sophisticated cognitive behavioural approach with several moduls, elements and techniques. Both interventions were well designed and manualised. Each patients is seen individually by a therapist over 9 months and 20 sessions. Therapists were trained, supervised, and controlled by video tapes. We plan to present the results of one and two year follow-up after termination of the interventions. Our results allow an answer if highly specific techniques and materials, intensive trainings of patients with a bipolar disorder are necessary and superior to a more simple, supportive intervention.
tative studies are needed to provide clinical information crucial to better design of quantitative studies aiming at exploring the difference and similarities of PPD and NPPD.
Keywords: Bipolar Disorder; Relapse Prevention; cognitive Behavioural Treatment; Supportive Psychoeducation
Clinical characteristics and outcomes of patients with bipolar disorder after first hospitalization: A two-year follow-up
doi:10.1016/j.jad.2010.02.049
Keywords: Postpartum depression, postnatal depression, Phenomenology, clinical symptoms doi:10.1016/j.jad.2010.02.050
[P1.3.07]
D.I. Jon⁎1, E. Lee2, K.R. Kim2, N. Hong1, K.H. Lee3, J.H. Seok1 et al. 1
Hallym University, Korea Yonsei University, Korea 3 Dongguk University, Korea 2
[P1.3.06] Phenomenological differences between post-partum depression and non-post-partum depression. A systematic review I. Roseth⁎1,3, U. Fredrik Malt2,3 1
Telemark Hospital, Norway Oslo University Hospital-Rikshospitalet, Norway 3 University of Oslo, Norway 2
Introduction: Five to 20 percent of new mothers develop some degree of depressive disorder (PPD) after delivery. Persistent PPD may have long-term negative effect on the cognitive, emotional and social development of the child. Neurobiological studies have suggested etiological differences between PPD and non-post partum depression (NPPD). However, there is no consensus to which extent the etiology and phenomenology of PPD differs from NPPD. We review the current evidence whether, and how, the phenomenology of PPD and NPPD may differ. Methods: The electronic databases Medline, PsycINFO British nursing Index, EMBASE, and Cochrane library were searched for studies comparing PPD vs NPPD. Key words were postnatal depression, postpartum depression, puerperal depression, phenomenology, and clinical symptoms. In addition we systematically followed-up reference lists. Results: Ten quantitative and no qualitative studies comparing PPD vs NPPD were identified. The studies provide conflicting results, seven studies claimed difference in phenomenology while three did not. Among studies suggesting phenomenological differences between PPD and NPPD, there was little agreement about what constitutes those differences. Three of the seven studies indicated that PPD had higher levels of symptoms of anxiety, while four reported that symptoms of depression were more prominent. Differences in specific symptoms were insufficiently reported. Discussion: Published studies do not allow any conclusions concerning similarities or differences in phenomenology of PPD versus NPPD. Several methodological issues may explain those inconclusive findings: different characteristics of the women included; different definitions of depression and PPD; variation in time from birth to assessment, and use of different assessment methods (questionnaires, semistructured interviews) tapping partly different symptoms and signs. Three of the studies did not address the issue of separating bipolar from non-bipolar post-partum depression. Comparing phenomenology of PPD and NPPD, requires standardized and focused assessment methods and definitions. Quali-
Introduction: This study was performed to determine the longitudinal clinical outcome and the patterns of medication use of first-admission bipolar patients in Korea under compulsory national health insurance system. Methods: Bipolar patients who were first-hospitalized in the psychiatric wards of four hospitals between 2001 and 2005 were included in this study. Outpatient charts for two years following their hospitalization were carefully evaluated. We defined the early discontinuation of treatment as the lost follow-up at least for three months, rehospitalization, or transfer to other hospital. Results: Medical records of 269 patients (male 133, female 136) were analyzed. The mean age at discharge was 37.6. The mean duration of treatment was 224.3 days. Eighty-two (30.5%) patients have never visited after discharge. Only 38 (14.1%) patients finished the two-year follow-up. Clinical Global Impression and Global Assessment of Function score were not associated with the treatment duration. Most common (46.5%) reason for early discontinuation was lost to followup. Majority of patients were administered a combination of a mood stabilizer and an atypical antipsychotic agent. The mean dosage of prescribed drugs at the last visit were lithium 915.8 mg/day, valproate 859.0 mg/day, risperidone 1.9 mg/day, olanzapine 7.8 mg/day, and quetiapine 170.1 mg/day. Common adverse events were sedation (first visit 9.9%, last visit 5.9%) and weight gain (first visit 3.9%, last visit 4.9%). Conclusion: These findings indicate that optimal maintenance treatment of bipolar disorder is still the unmet need in clinical setting. More enthusiastic psychoeducation and more careful treatment planning are needed. Keywords: Bipolar disorder; Clinical outcome; First hospitalization doi:10.1016/j.jad.2010.02.051
[P1.3.08] Does bipolar disorder impact on self and identity development? M.L. Inder⁎1, M.T. Crowe1, S. Moor1, S.E. Luty1, J.D. Carter2, P.R. Joyce1 1
University of Otago, Christchurch, New Zealand University of Canterbury, New Zealand
2
There has been little research focus on the impact of bipolar disorder on self and identity development despite adolescent years