Hospitalization For Manic Episode Research Articles

Short-term air pollution exposure is associated with lower severity and mixed features of manic episodes in hospitalized bipolar patients: A cross-sectional study in Milan, Italy

Bipolar Disorder (BD) alternates depressive, manic or hypomanic phases. A manic episode (ME) is the main psychopathological condition of BD and it often requires hospitalization. Air pollution is thought to play a role in onset and exacerbation of several psychiatric disorders. We aimed to verify the association between exposure to particulate matter ≤10 μm (PM10) and ME severity, assessed through the Young Mania Rating Scale (YMRS).We evaluated clinical records regarding 414 hospital admissions of 186 patients residing in Milan (Italy), hospitalized for ME in the Psychiatry Unit of the Policlinico Hospital from 2007 to 2019. Patients were assigned mean daily PM10 and apparent temperature levels of the Milan municipality. As exposure windows, we considered single days preceding hospitalization (lag0 to 7) and their average estimates (lag0-1 to 0-7). We applied mixed effect models, adjusted for relevant confounders.Short-term PM10 exposure was associated with a reduction in YMRS, both when considering daily lags [β: −0.43 (95% Confidence Interval: −0.83; −0.03) at lag0] and their average [−0.47 (−0.90; −0.04) at lag0-1]. YMRS was higher in psychotic patients (24.8) and lower in ME with mixed components (15.5) if compared to episodes characterized by neither mixed nor psychotic features (17.4, p < 0.001). While PM10 did not influence the risk of psychotic symptoms at admission, it was associated with a higher risk of ME with mixed features, with Odds Ratios ranging from 2.43 (1.02; 5.76) at lag0 to 3.60 (1.22; 10.7) at lag0-2.Our findings show that increasing levels of PM10 move the ME towards the depressive pole of the BD spectrum and augment the probability of hospitalization for ME with mixed components. These results have important clinical implications, as mixed features worsen the course of ME and make the management of bipolar patients challenging.

Short-term PM10 exposure is associated with lower severity of manic episodes in hospitalized bipolar patients

Background: Bipolar Disorder (BD) alternates depressive, manic or hypomanic phases. A manic episode (ME) is the main psychopathological condition of BD and it often requires hospitalization. Air pollution is thought to play a role in onset and exacerbation of several psychiatric disorders. We thus aimed to verify the association between exposure to particulate matter ≤10µm (PM10) and ME severity, assessed through the Young Mania Rating Scale (YMRS). Methods: We evaluated clinical records regarding 414 hospital admissions of 186 patients residing in Milan (Italy), hospitalized for ME in the Psychiatry Unit of the Policlinico Hospital from 2007 to 2019. Patients were assigned mean daily PM10 and apparent temperature levels of the city of Milan. Different exposure windows were considered: single days preceding hospitalization (lag 0 to 15) and their average estimates (lag 0-1 to 0-15). We applied mixed effect models, adjusted for age at hospitalization/onset, sex, smoking habit, number of cigarettes per day, year of hospitalization, season, and apparent temperature. Results: Short-term PM10 exposure was associated with a reduction in YMRS, both when considering daily lags [β: -0.46 (95% Confidence Interval: -0.87; -0.06) at lag0] and their average [-0.50 (-0.94; -0.07) at lag0-1]. YMRS was higher in psychotic patients (24.7 vs. 16.6, p &lt; 0.001) and lower when considering ME with vs. without mixed components (18.2 vs. 21.2, p &lt; 0.001). Interestingly, while PM10 did not influence the risk of patients being psychotic at admission, it was associated with a 34% increased risk of having a ME with mixed features (i.e. with dysphoric and/or depressive symptoms) at lag0-1 [Odds Ratio: 1.34 (1.01; 1.78)]. Conclusions: Our findings show that PM10 exposure moves the ME towards the depressive pole of the BD spectrum and increases the probability of hospitalization for ME with mixed components.

Personality traits and affective morbidity in patients with bipolar I disorder: The five-factor model perspective

In this study, we aimed to extend the present knowledge regarding the relationship of personality traits, as specified by the five-factor model (FFM), with the affective morbidity of bipolar I disorder. The primary aim of this study is to investigate the association of personality traits with affective morbidity, particularly with hospitalization for depressive, manic, or mixed episodes, in patients with bipolar I disorder. The Revised NEO Personality Inventory was administered to 83 subjects who showed a euthymic mood state. Multivariate Poisson regression analysis was performed to identify associations between five domains of personality and the number of hospitalizations for affective episode(s) (manic, depressive, and mixed state). As a secondary research interest, we attempted to determine personality traits which would be significantly different between subjects with Affective Switch from mania into depression Without Euthymia (ASWE) and non-ASWE. The Neuroticism score was positively associated with the number of hospitalization for depression and the total number of hospitalizations Extraversion and Openness scores showed a negative relationship with the number of hospitalizations for depression and the total number of hospitalizations. We found that ASWE patients showed significantly higher Neuroticism scores than did the non-ASWE group. However, there was no significant association between the hospitalization for manic episode and any particular personality trait based on the FFM. This study reveals that personality traits based on the FFM may contribute to an increased likelihood of depressive morbidity and switch into depression.