Disorder Patients In Remission Research Articles

Comparative evaluation of craving, sleep quality, sexual function and quality of life in opioid use disorder patients in remission with buprenorphine/naloxone maintenance treatment.

To compare opioid use disorder (OUD) patients who continue to use opioids and are in remission with buprenorphine-naloxone (B/N) in terms of some parameters and to evaluate the relationship between B/N dose and these parameters. We included 141 OUD patients in remission with B/N maintenance treatment for at least 6months, 141 who still used opioids, and 141 healthy volunteers. Substance Craving Scale (SCS), Pittsburgh Sleep Quality Index (PSQI), Arizona Sexual Experiences Scale (ASEX), and Short Form 36 (SF-36) were administered. PSQI scores and ASEX scores were higher in those who continued to use opiates than in OUD in remission, and in OUD in remission compared to controls. OUD patients with current opioid use also had lower SF-36 scores compared to both patients in remission and healthy controls. SCS, PSQI, ASEX, and SF-36 scores were similar when the three groups were examined based on the dosage of B/N (below 8, 8-15, and 16mg/day and above) use in OUD in remission. Quality of life, craving, sleep and sexual functions improved significantly with B/N; however, these effects are not dependent on B/N dosage.

Quality of life and disability: a study on bipolar disorder patients in remission

Background: Throughout the world bipolar disorder is one of the leading causes of mental disability. But there are only few literature studies found on quality of life (QoL) and disability of patients with bipolar disorder. The study aims to assess inter-relationship between QoL and disability of patients with bipolar I disorder in remission and to assess the pathways of help seeking behaviors by the family members of bipolar I disorder patients.Methods: This study involves non-experimental research design with purposive sampling method. A total of 62 participants from clinical group (outpatient department of mental health institute (Centre of excellence), S. C. B. medical college) and 48 participants from matched healthy control group included. World health organization quality of life assessment (WHO-QoL) Bref Odia version and WHO disability assessment schedule (WHO DAS) 2.0 used.Results: Statistically significant differences (p<0.05) were found in all the four domains of QoL. Statistically significant differences (p<0.05) were found in cognition, mobility, life activity and participation in society domains of WHO DAS. There were significant negative correlations found in different domains of QoL and disability. A majority of family members consulted mental health professionals directly as the first modality of treatment.Conclusions: Both the QoL and mental disability burden are equally affected in chronic suffers of bipolar I disorder, which requires mental health intervention at earliest as possible.

A study on resilience and social support in bipolar affective disorder patients in remission visiting a tertiary care centre

Introduction: Bipolar affective disorder is one of the most complex psychiatric conditions characterized by recurrent mood episodes and longitudinally varied courses. It affects at least 1% of the population. Even though it is an episodic illness patients face many challenges during inter episodic period. The study aims to investigate social support by BPAD patients in remission and how it affect the resilience in them.Methodology: Cross sectional study.275 BPAD patients in remission were evaluated using semi-structured socio demographic perfoma, Connor-Davidson Resilience 25 item scale and Multidimensional Scale of Perceived Social Support Result: Study showed majority of the patients had moderate resilience. Patients had highest support from family and lowest support from friends.There was significant association between perceived social support and resilience in. the patients of BPAD.Conclusion: Higher perceived social support enhance resilience in patients of bipolar affective disorder.

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BACKGROUND:Negative symptoms are characterized by a reduction of normal functions. They have been appreciated as core features of schizophrenia but remain under-recognized and poorly treated. They include – affective flattening, alogia, avolition, apathy, anhedonia, asociality, and impairment of attention. Initially thought to be specific to schizophrenia, they are also seen in other disorders – schizoaffective disorder, neuropsychiatric disorders, and bipolar affective disorder.AIMS:To assess various negative symptoms in Schizophrenia and Bipolar affective disorder patients in remission.METHODS:100 patients in symptomatic remission were included in this cross sectional study. Remission was assessed using the Clinical Global Impression Scale (CGI). The Scale for assessment of Negative Symptoms (SANS) was used to evaluate negative symptoms.RESULTS:Negative symptoms were present in 84% of patients in the schizophrenia group and 56% in the bipolar affective disorder group. The overall negative symptom frequency and severity was higher in the schizophrenia group.The mean SANS summary score was 7.38±4.46 in the schizophrenia group, which was higher than the BPAD group(4.80±2.69) and the difference was statistically significant (p=0.005). Affective flattening, alogia, and attentional impairment were significantly impaired in patients with Schizophrenia. Although mean scores were higher on the Anhedonia and avolition domains, the difference was statistically insignificant.CONCLUSION:Residual negative symptoms are frequently present in bipolar disorder and schizophrenia patients in remission and need to be addressed as important treatment goals for better functional recovery and outcome.

Frequency of psychiatric comorbid symptoms in bipolar disorder patients in remission.

Introduction:Psychiatric comorbidity has been detected in one-third of bipolar patients. The illness itself may be a precipitating factor for developing substance use and anxiety disorders. Comorbid anxiety disorders with bipolar disorder (BD) are associated with decreased chances of recovery, poorer role functioning, and quality of life, and greater likelihood of suicide attempts. Hence, identifying comorbid symptoms in remitting patients has important preventive and therapeutic implications.Aims:The aim of the study was to estimate the frequency of psychiatric comorbid symptoms in patients of bipolar affective disorder in remission and to identify its relationship with sociodemographic variables.Methodology:This is a cross-sectional study conducted in Father Muller Medical College and Hospital, Mangalore (April 2019–July 2019), which included 90 patients aged 18–50 years with BD, manic, or depressive episodes in remission for 8 weeks who were evaluated using mini international neuropsychiatric interview plus, Hamilton rating scale for depression, and young mania rating scale. Sociodemographic details were assessed by a semi-structured pro forma. The data were analyzed using frequency, Chi-square test, and t-test.Results:Most common psychiatry comorbid symptoms seen in BD were found to be drug dependence/abuse (n = 31), second most common being alcohol dependence/abuse (n = 21), followed by suicidality (n = 8), antisocial personality, social phobia, panic disorder, and agoraphobia. Significance was found for suicidality, agoraphobia, and social phobia if the last episode was depressive and for suicidality if index episode was depressive and if age of onset was >40 years.Conclusion:Psychiatric comorbidities in BD may worsen the course and prognosis of the disorder and hence, clinicians must maintain a high index of suspicion for them. Furthermore, comorbidities may need to be identified and appropriate interventions employed to prevent iatrogenic complications.

Are treatment adherence and insight related to quality of life in patients with schizophrenia and bipolar disorder in remission?

Objectives: The aim of this study is to investigate the association of treatment adherence, quality of life and insight among bipolar disorder and schizophrenia patients who are in remission and to reveal which variables predict the treatment adherence. Methods: We conducted a cross sectional study with 150 schizophrenia and 150 bipolar disorder patients in remission. The patients were administered Mini International Neuropsychiatric Interview (MINI), Brief Psychiatric Rating Scale (BPRS), the Schedule for Assessing the Three Components of Insight (SAI), World Health Organization Questionnaire on Quality of Life: Short Form (WHOQOL-BREF), Medication Adherence Rating Scale (MARS). We compared WHOQOL-BREF scores of the bipolar and schizophrenia patients. We checked the correlation between SAI scores and BPRS scores as well as between SAI scores and WHOQOL-BREF scores for both groups. We set MARS results (adherent vs. non-adherent) as a dependent variable and conducted logistic regression with all the clinical variables available to find a predictor for treatment adherence. Results: WHOQOL-BREF scores were found to be similar and positively correlated with insight for both groups. BPRS scores were found to be negatively correlated with insight for both groups. SAI treatment acceptance was found to be the only predictor of treatment adherence independent of the other clinical variables. Discussion: A strong positive rela-tionship between insight and treatment adherence suggests that treatment adherence of patients with good insight is better. The positive relationship between insight and quality of life shows that insight is an important factor in terms of quality of life and reveals the importance of insight oriented therapies.

Serum ischemia modified albumin (IMA) levels of patients with bipolar disorder in remission and healthy controls

Oxidative stress might play an important role in neurological and psychiatric diseases due to the central nervous system sensitivity to reactive oxygen species. Aim of this study is to contribute these data about oxidative stress in bipolar disorder, by detecting IMA levels of bipolar disorder patients in remission and also by comparing these results with healthy controls. Study population consisted of 35 outpatients with bipolar disorder, who being in remission. The patients meeting the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition criteria for bipolar disorder I. 36 healthy subjects were included as control group. Serum ischemia modified albumin levels of all participants were determined and the results were compared between these two groups. The age, gender and ischemia modified albumin levels were not significantly different between bipolar disorder patients and healthy controls. Studies focusing on oxidative stress in bipolar disorder have reached controversial results up till now. The many different markers have been investigated to explain the effects of oxidative stress on bipolar disorders, and this might be reason why there are conflicting results. In addition, the past episodes of patients who were in remission during this study are unclear. Further investigations are needed to be carrying out to illustrate possible changes of oxidative balance in psychiatric disorders, including bipolar disorder.

Cognitive Functions of Bipolar Disorder Patients in Remission on Monotherapy: A Follow-Up Study

Multiple sectional studies indicate that the cognitive functions of bipolar disorder (BD) patients in remission are damaged. These studies also suggest that cognitive functions get worse over time. Although the results are inconsistent, there are limited follow-up studies that reveal any contradictory results. Interestingly, there have been major difficulties in the interpretation related to this subject. In particular, scarcity of longitudinal studies and not eliminating the role of multidrug side effects on cognitive functions are just a few. Due to these aforementioned limitations, the longitudinal course of cognitive functions and their sectional differences were investigated in BD patients that underwent remission with monotherapy in this study. In this study, the cognitive functions (premorbid IQ, attention, executive functions, memory, visual-spatial skills, and psychomotor speed) of BD patients (n=27) in remission and on monotherapy for at least 1 month were assessed at baseline and at an 18 (6-77) month follow-up period and compared to healthy controls (n=35). The BD group's performance was worse than those of the control group on tests that evaluated attention, executive functions including concept formation, mental flexibility, response inhibition, set shifting, and reasoning, verbal memory, and psychomotor speed. On the other hand, the BD group showed no significant differences at baseline and follow-up examinations. All cognitive functions of BD patients on monotherapy remained stable during the follow-up. This suggests that this group might be a sub-group of BD with good prognosis, and monotherapy may not be harmful on cognitive functions. On the other hand, it needs longer time to detect cognitive dysfunctions. Kewords: Bipolar disorder, neurocognition, euthymia, monotherapy, prospective design.

A comparative study of quality of life and disability among schizophrenia and obsessive-compulsive disorder patients in remission.

Background:Persons with long-term psychiatric disorders have greater deficits in living skills as well as greater problems in employment and relationship to their social environment. Thus, chronic psychiatric illnesses have psychosocial consequences such as disability and impaired quality of life (QOL) due to their symptomatology and chronic course.Objectives:Assessment and comparison of disability and QOL of patients suffering from schizophrenia and obsessive-compulsive disorder (OCD) in remission phase.Materials and Methods:A cross-sectional study carried out in the psychiatry outpatient Department of Mental Health Institute, S.C.B. Medical College and Neuropsychiatric Consultation Centre, Cuttack. The study sample consisted of fifty cases of each groups (schizophrenia and OCD), which included both males and females. All of them were assessed through the World Health Organization-QOL BREF and Indian Disability Evaluation and Assessment Scale.Results:Results revealed that schizophrenics have poor QOL and greater disability burden than patients of OCD.Conclusion:These psychiatric illnesses, i.e. schizophrenia and OCD, affect all areas of daily functioning leading to greater disability, and thus increasing the burden on the family, imposing greater challenges for the rehabilitation of these patients and their inclusion in the mainstream of the family and society.

P-172 - Subgroup of adult attention deficit hyperactivity disorder with bipolar disorder patients in remission the effect of disability and quality of life

Bipolar disorder (BD),attention deficit hyperactivity disorder (ADHD), the presence of clinical symptoms is quite often difficult treatment, symptomatology that makes the complex, the sharpness of diagnostic overshadowing, adversely affecting the course of the disease, is an important condition disrupts the quality of life and functionality. In this study, bipolar disorder, attention deficit and hyperactivity disorder by examining the sub-dimensions,to reach conclusions about the relationship has these symptoms,course of illness İUB,socio-demographic characteristics of this situation, to evaluate the relationship between disability and quality of life. In our study,20% of patients favor BD period, were the symptoms of attention deficit and hyperactivity. Hyperactivity is not component where only the size of the group of patients is the lack of attention,21.3% of patients BD comprised of. DHB mean age between the groups, except that a smaller group, gender, marital status, education level, and there was not a statistical difference at the level of significance for comparison of properties. Clinical presentation in the same way as the age of disease onset and exacerbations in patients with DHB group averages low,the average hospitalization than the other two patients were BD.In our study,no significant differences between the groups at the level of deterioration İGDÖ scores were found to be only BD group. Comparisons of quality of life variables,especially the pure DB group more than those in the DHB group was more impaired. Bipolar disorder, attention deficit and hyperactivity are the dimensions of the disease with increasing disability and impair quality of life.

Comparison of insight among schizophrenia and bipolar disorder patients in remission of affective and positive symptoms: Analysis and critique

BackgroundSchizophrenia and bipolar disorder are associated with impairments in insight, leading to a poorer clinical outcome and functioning. Earlier studies comparing the two disorders on the basis of insight included inpatients or patients who were clinically symptomatic. The current study therefore assessed patients in remission of affective symptoms and positive symptoms of schizophrenia. MethodsSchizophrenia and bipolar disorder patients (n=32, n=34; respectively) underwent clinical and functional evaluations. Insight was assessed using the Scale to assess Unawareness of Mental Disorder (SUMD) and the Positive and Negative Syndrome Scale (PANSS). Attention was assessed using a continuous performance task (CANTAB's Rapid Visual Information Processing). ResultsSchizophrenia patients displayed poorer insight into having a mental disorder and into the social consequences thereof compared to the bipolar disorder patients. They were also less aware of their anhedonia-asociality. Age, however, was significantly correlated with insight and differences in insight between the patient groups became nonsignificant when age was used as a covariate in the statistical analyses. Age was not a moderating variable of the relationship between diagnosis and insight. ConclusionsSignificant differences in insight held by the two patient groups might be related to age disparities between patient groups. Earlier studies did not adequately address these age differences, their cause and their potential effects on findings. These issues are explored with regard to the findings of the current study, as well as earlier studies, emphasizing the need for further research of the relationship between age and insight.

Influence of Clinical and Neuropsychological Variables on the Psychosocial and Occupational Outcome of Remitted Bipolar Patients

Objective: To measure the impact of the clinical course, the residual mood symptoms and the cognitive variables on the psychosocial and occupational functioning in bipolar disorder patients in remission. Method: Forty-four euthymic DSM-IV-TR bipolar lithium-treated outpatients were assessed with a clinical interview and neuropsychological testing. To assess psychosocial function, some psychometric scales were administered (Global Assessment of Functioning Scale and World Health Organization Disability Assessment Schedule), and to evaluate occupational function, the sample was divided according to the current work status (active vs. inactive). Cognitive assessment was performed by means of a neuropsychological test battery tapping into the main cognitive domains (executive function, attention, processing speed, verbal memory and visual memory). Results: Measures of psychosocial functioning were significantly correlated with cognition (processing speed, p = 0.004), clinical severity (p = 0.03) and residual depressive symptoms (p = 0.05). Occupational functioning showed a significant effect with a cognitive domain (visual memory, p = 0.006) and a clinical variable (chronicity, p = 0.04) but not with residual mood symptoms (p > 0.2). Conclusions: Remission in bipolar disorder is not synonymous with recovering in psychosocial and occupational functioning. Cognitive deficits, clinical course and persistent subsyndromal symptoms may compromise psychosocial functioning, and neurocognitive symptoms and chronicity may particularly affect occupational functioning.

Sleep EEG recordings in depressive disorders

Sleep polygraphic recordings were performed during 3 consecutive nights in a sample of 43 affectively ill inpatients. The patients were classified as major (n = 36) or minor depressive disorder (n = 7), according to the Research Diagnostic Criteria. Among the 36 patients with a major depressive disorder, 14 were in remission at the time of the sleep investigation. A two-way analysis of variance was performed to assess night and diagnostic effect on sleep variables. Shortening of REM latency was observed in depressed patients with major depressive disorder when compared to major depressive disorder patients in remission. Depressed patients with major depressive disorder also showed higher REM activity and REM density values than patients with minor depressive disorder. According to the linear discriminant analysis, sleep variables were able to correctly classify 68% of the patients.

Pharmacologic Evidence for Specificity of Pursuit Dysfunction to Schizophrenia

Conflicting findings regarding the prevalence of abnormal smooth-pursuit eye movements in patients with major affective disorders call into question the specificity of impaired smooth-pursuit eye movements to schizophrenia. We report that pursuit is impaired in 88% of lithium carbonate-treated affective disorder patients whose pursuit was normal prior to receiving this drug. Over half of lithium carbonate-treated affective disorder patients in remission also showed impairment of smooth-pursuit eye movements. In conjunction with recent prevalence data on family members of psychiatric patients, the findings support the specificity of abnormal pursuit as a biological trait associated with schizophrenia, but not with the major affective disorders. The mechanisms by which lithium carbonate impairs pursuit are discussed.