Journal of affective disorders
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The burden experienced by caregivers of patients with bipolar disorder has been associated with increased caregiver depression, anxiety and mental health service use. As caregiver burden is also associated with poor patient outcome, these findings may indicate a source of distress not only for caregivers, but also for patients. This review presents what is currently known about psychiatric symptoms in this population and suggests directions for future research. ⋯ While not all of the data are consistent, the majority of papers report the presence of psychiatric symptoms in caregivers, such as depression, anxiety and increased mental health service use. Future research is needed to address methodological issues and focus on distinguishing symptoms and identifying effects of mediators such as caregiver-patient relationship, coping styles and stigma. Interventions tailored towards the psychiatric needs of bipolar families may result in improved caregiver and patient outcomes, as well as in decreased health care costs.
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Psychometric information on the World Health Organization Disability Assessment Schedule II (WHO-DAS II) in depressive primary care (PC) patients is scarce and has been obtained with the 36-item version of the instrument. The main objective of this study was to analyse the dimensionality, internal consistency and construct validity of the 12-item WHO-DAS II in a large sample of Spanish PC patients with a first diagnosed major depressive episode. ⋯ The 12-item WHO-DAS II is a reliable, valid and useful tool for assessing overall disability in PC patients with depression.
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Randomized Controlled Trial
Effectiveness of the extended release formulation of quetiapine as monotherapy for the treatment of acute bipolar depression.
To evaluate the effectiveness of quetiapine extended release once daily in bipolar depression. ⋯ Quetiapine XR (300 mg) once daily monotherapy was significantly more effective than placebo for treating episodes of depression in bipolar I disorder, throughout the 8-week study, with significance observed as early as Day 7. Adverse events were consistent with the known effects of quetiapine.
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To investigate pregnancy outcomes, including low birthweight, preterm births, and small-for-gestational-age (SGA) among women with bipolar disorder, schizophrenia compared with women with no history of mental illness using nationwide population-based data. ⋯ We conclude that women with bipolar disorder had increased risk of low birthweight, preterm births, and SGA than women without a history of mental illness. More active monitoring and early intervention to counter potential adverse pregnancy outcomes for pregnant women with bipolar disorder should be initiated.
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Multicenter Study Comparative Study
Factor analyses of the Suicidal Intent Scale (SIS) and the Risk-Rescue Rating Scale (RRRS): toward the identification of homogeneous subgroups of suicidal behaviors.
Suicidal behavior is a heterogeneous entity, determined by multiple factors. This heterogeneity has major implications for clinical management of patients and identification of risk factors. Our study aims at identifying homogeneous subgroups of patients with suicidal behavior. ⋯ The characterization of suicidal behaviors using SIS and RRRS sub-scores constitutes a first step toward the identification of homogeneous subgroups of suicide attempters. Prospective studies are needed to test the predictive value of these sub-scores for subsequent suicidal acts.