Abstract
BackgroundAgitation is a common manifestation of bipolar disorder and schizophrenia which includes symptoms ranging from inner tension and unease to violence and aggression. Much of the existing literature has focused on agitation in the acute setting, with the patient experience poorly defined. Thus, the aim of this study was to characterize agitation and its management from a patient perspective, with the focus on those who reside in the community.MethodsSurveys were completed across Germany, Spain and the UK by 583 community dwelling patients with schizophrenia or bipolar disorder who experienced episodes of agitation. Patients were recruited via either their physician or through patient support groups. The survey captured information on demographics, disease characteristics, frequency of agitation episodes and different pre-defined severity levels ranging from mild to severe, symptoms experienced during an episode, awareness of agitation and coping strategies employed by the patient. Statistics were descriptive in nature.ResultsThe most commonly reported symptoms during an episode of agitation were feeling uneasy (n = 373, 64%), restless (n = 368, 63%) or nervous (n = 368, 63%). Patients experienced an average of 22.4 (SD 57.2) mild, 15.4 (SD 61.2) moderate, 6.8 (SD 63.3) moderate-intense and 2.9 (SD 24.4) severe episodes within the last 12 months; on average 2.7 (SD 6.8) required hospital attendance. Half of patients (n = 313) had attended hospital due to agitation. In total, 71% of patients (n = 412) were aware they were becoming agitated either always or sometimes and 61% of patients (n = 347) were aware of agitation triggers either always or sometimes. The majority of patients reported being able to sometimes control their agitation (56%, n = 329) but 16% (n = 94) stated that there is typically nothing they can do. To cope with episodes 55% (n = 125) of schizophrenia patients and 66% (n = 234) of bipolar disorder patients reported taking prescribed medication.ConclusionCommunity based patients with schizophrenia and bipolar disorder reported frequently experiencing agitation episodes which they defined most commonly as feeling uneasy, restless or nervous. A range of coping strategies were reported but they were not always successful, highlighting an area of unmet need in this population.
Highlights
Agitation is a common manifestation of bipolar disorder and schizophrenia which includes symptoms ranging from inner tension and unease to violence and aggression
Agitation is a common manifestation in a number of psychiatric conditions and in particular, dementia, bipolar disorder and schizophrenia [1, 2]
Further complicating the detection of agitation is the occurrence of akathesia, i.e. drug-induced restlessness which can arise from the anti-psychotic medication that is often used to treat schizophrenia and bipolar disorder [7]
Summary
Agitation is a common manifestation of bipolar disorder and schizophrenia which includes symptoms ranging from inner tension and unease to violence and aggression. Agitation is a common manifestation in a number of psychiatric conditions and in particular, dementia, bipolar disorder and schizophrenia [1, 2]. It has been described as a common, but often unaddressed problem in psychiatry [3]. A broad range of features have been described including physical or mental unease, inner tension, restlessness, irritability, excitement, uncooperativeness, anxiety, motor activity that is excessive, inappropriate or purposeless, and motor tension [3,4,5,6]. Further complicating the detection of agitation is the occurrence of akathesia, i.e. drug-induced restlessness which can arise from the anti-psychotic medication that is often used to treat schizophrenia and bipolar disorder [7]
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