Affective Spectrum Disorders in an Urban Swedish Adult Psychiatric Unit: A Descriptive Study

M Scharin,P Hellström,T Archer

doi:10.1155/2012/527827

Abstract

Background. Several studies have found that patients with affective-/anxiety-/stress-related syndromes present overlapping features such as cooccurrence within families and individuals and response to the same type of pharmacological treatment, suggesting that these syndromes share pathogenetic mechanisms. The term affective spectrum disorder (AfSD) has been suggested, emphasizing these commonalities. The expectancy rate, sociodemographic characteristics, and global level of functioning in AfSD has hitherto not been studied neglected. Material and Method. Out of 180 consecutive patients 94 were included after clinical investigations and ICD-10 diagnostics. Further investigations included well-known self-evaluation instruments assessing psychiatric symptoms, personality disorders, psychosocial stress, adaptation, quality of life, and global level of functioning. A neuropsychological screening was also included. Results. The patients were young, had many young children, were well educated, and had about expected (normal distribution of) intelligence. Sixty-one percent were identified as belonging to the group of AfSD. Conclusion. The study identifies a large group of patients that presents much suffering and failure of functioning. This group is shared between the levels of medical care, between primary care and psychiatry. The term AfSD facilitates identification of patient groups that share common traits and identifies individuals clinically, besides the referred patients, in need of psychiatric interventions.

Highlights

The organization of psychiatric treatment, following diagnosis, follows an ordering of treatment (1◦-2◦ care) within specialization, child psychiatry, forensic psychiatry, and general psychiatry, subspecialization, psychoses, and affective disorders, all of which facilitates general observations of the patient population
The main findings of this study are that in a group of consecutive patients referred to an outpatient clinic a majority (61%) presented symptoms corresponding to affective spectrum disorder (AfSD) or 87% according to the extended concept
The present study shows that primary care and psychiatry share the same patients at different times during the course of the illness

Summary

Introduction

The organization of psychiatric treatment, following diagnosis, follows an ordering of treatment (1◦-2◦ care) within specialization, child psychiatry, forensic psychiatry, and general psychiatry, subspecialization, psychoses, and affective disorders, all of which facilitates general observations of the patient population. It has been suggested that 14 psychiatric and medical disorders may share a specific (as yet unknown) neurophysiologic, etiologically specific abnormality: Affective Spectrum Disorder (AfSD), including 10 psychiatric conditions (attention-deficit/hyperactivity disorder, bulimia nervosa, dysthymic disorder, generalized anxiety disorder, major depressive disorder, obsessive-compulsive disorder, panic disorder, posttraumatic stress disorder, premenstrual dysphoric disorder, and social phobia) and four medical conditions (fibromyalgia, irritable bowel syndrome, migraine, and cataplexy) [2,3,4,5,6]. Further investigations included well-known self-evaluation instruments assessing psychiatric symptoms, personality disorders, psychosocial stress, adaptation, quality of life, and global level of functioning. The study identifies a large group of patients that presents much suffering and failure of functioning This group is shared between the levels of medical care, between primary care and psychiatry. The term AfSD facilitates identification of patient groups that share common traits and identifies individuals clinically, besides the referred patients, in need of psychiatric interventions

Methods

Results

Discussion

Conclusion