Journal of affective disorders
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Randomized Controlled Trial Multicenter Study
Efficacy of aripiprazole versus placebo as adjuncts to lithium or valproate in relapse prevention of manic or mixed episodes in bipolar I patients stratified by index manic or mixed episode.
Differences in response to treatment have been observed for bipolar disorder (BPD) patients with manic or mixed episodes. This post-hoc analysis examined the maintenance effect of aripiprazole in combination with lithium or valproate in subpopulations of patients entering a relapse prevention study with either manic or mixed bipolar episodes. ⋯ The continuation of aripiprazole in stabilized BPD patients treated with lithium or valproate increased the time to relapse of any mood episode for manic but not mixed patients; both groups achieved greater stability in YMRS total score with adjunctive aripiprazole. Thus, adjunctive aripiprazole may be more appropriate for stabilized patients with manic episodes.
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The aims of this study were to: (1) evaluate the psychometric properties of a French Canadian version of the Hospital Anxiety and Depression Scale (HADS-FC) in a large population of primary care patients in Quebec, Canada; (2) conduct a transcultural validation of the original HADS in a subsample of English-speaking patients; (3) explore HADS properties in subgroups with or without multimorbidity. ⋯ The HADS-FC and English HADS presented good psychometric properties in primary care patients, including patients with and without multimorbidity. However, its performance as a screening instrument in these settings with patients of varying clinical profiles requires more scrutiny.
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Different types of adverse events may have general or specific effects on depression and anxiety symptomatology. We examined the effects of adversities on the dimensions of the tripartite model: general distress, anhedonic depression and anxious arousal. ⋯ Distinct childhood traumas had different effects on the symptom dimensions, whereas most recent adult life events were associated with all three symptom dimensions. Our observations help to understand the often reported associations of these adversities with depressive and anxiety symptomatology. In addition, symptom dimensions of the tripartite model were shown to capture effects of adverse events on top of those captured by diagnostic categories.
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Bipolar disorder (BPD) is a serious mental disorder and a leading cause of premature mortality worldwide. Prevalence and risk factors of BPD have not been well studied in multi-ethnic Asian populations. The study aimed to establish the prevalence of BPD and examine the associated socio-demographic correlates, comorbidity, severity, impairment and treatment contact in the Singapore resident population. ⋯ The high comorbidity, clinical severity, and role impairment associated with BPD exert a heavy toll at an individual and societal level.
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Various consequences including suicidal behaviours can arise in the aftermath of natural disasters. The aim of the present review was to systematically analyse the existing literature on the potential impact of natural disasters on suicidal behaviours. ⋯ In light of the various methodological limitations observed, there is a need for further studies using proper designs. Mental health and suicidal behaviours should continue to be monitored for several years after the disaster.