Number Of Illness Episodes Research Articles

Differential clinical characteristics and possible predictors of bipolarity in a sample of unipolar and bipolar inpatients

Major affective conditions including both unipolar (UD) and bipolar disorders (BD) are associated with significant disability throughout the life course. We aimed to investigate the most relevant socio-demographic/clinical differences between UD and BD subjects. Our sample included 180 inpatients, of which 82 (45.5%) participants were diagnosed with UD and 98 (54.5%) with BD. Relative to UD patients, BD individuals were more likely to report prior psychoactive medications, lifetime psychotic symptoms, nicotine abuse, a reduced ability to provide to their needs, gambling behavior, and fewer nonsuicidal self-harm episodes. Moreover, BD patients were more likely to report severe side effects related to medications, a younger age at illness onset and first hospitalization, higher illness episodes, and longer illness duration in years than UD subjects. In a multivariate logistic analysis accounting for age, gender, and socio-demographic characteristics, a significant positive contribution to bipolarity was found only for higher lifetime psychotic symptoms (β = 1.178; p ≤ .05) and number of illness episodes (β = .155; p ≤ .05). The present findings suggest that specific clinical factors may be used in order to better distinguish between UD and BD subgroups. Further studies are required to replicate these findings in larger samples.

Does hygiene intervention at day care centres reduce infectious illnesses in children? An intervention cohort study

Day care attendance is a major risk factor for respiratory and gastrointestinal illnesses in preschool children. In this study, we describe the results of a hygiene intervention cohort trial at day care centres (DCCs) on the rates of febrile, respiratory, and gastrointestinal illnesses in preschool children. Thirty DCCs in 2 communities were included. The number of illness episodes was registered for each child every 6 months, as well as potential risk factors. The hygiene intervention was introduced in half of the DCCs and the results analysed using a multivariate mixed effects hierarchical Poisson regression model. The study lasted 2.5 y, of which the hygiene intervention lasted 1.5 y. Two thousand three hundred and forty-nine children participated, delivering 2832 person-y. Adjusted incidence rate ratios of the illnesses at the intervention and non-intervention DCCs were not significantly different for any of the illnesses. The intervention was not more effective in children less than 3 y of age than in older children and no significant effects were seen with time. Compliance with the hygiene protocol was good as measured by the use of hygiene products and by a survey among the staff at the DCCs. The most likely explanation for the lack of effects of the intervention is that the baseline standard of hygiene at the DCCs was probably too high for the intervention to demonstrate significant results, but recall bias cannot be excluded. Even though hygiene is important for minimizing the spread of microbes at DCCs, other risk factors need to be studied.

Psychosis and relapse in bipolar disorder are related to GRM3, DAOA, and GRIN2B genotype

Dysfunction in glutamate signalling is thought to play a role in the pathophysiology of bipolar disorder (BD). There is evidence of associations between single nucleotide polymorphisms (SNPs) in GRM3, GRIN2B, and DAOA genes and the diagnosis of BD. In this pilot study, we investigated the frequency of SNP variants in these 3 genes within South African population groups, and assessed interactions between genes and phenotypes of BD disease severity. Multiplex SNaPshotTM PCR was used to genotype 191 case and 188 control samples. Cases comprised of 191 individuals in a South African cohort of mixed ancestry and Caucasians, with BD Type 1. Phenotypes of BD disease severity were: age of onset, number of illness episodes, number of hospitalisations for depression or mania and history of psychotic symptoms. There were no significant difference in SNP allele frequencies between cases and controls. In the case-only analysis, the GRM3 rs6465084 heterozygote was associated with a 4-fold increased risk of lifetime history of psychotic symptoms, and the specific variants within the gene pair, DAOA and GRIN2B, had a significant interaction with the number of hospitalisations for mania, with lowest admission rates associated with both pairs of ancestral alleles. In BD, variations in glutamatergic genes may influence phenotypes related to the severity of illness. Speculatively, newly derived genes associated with various evolutionary advantages, may also increase the risk for more severe BD. These preliminary findings deserve validation in a larger cohort.

Two Weeks of Zinc Administration to Nepalese Children with Pneumonia Does Not Reduce the Incidence of Pneumonia or Diarrhea during the Next Six Months1–3

Diarrhea and pneumonia are the 2 main causes of death in children under 5 y of age. Short courses of zinc administration are now recommended for treatment of childhood diarrhea and some studies have also shown its beneficial effect on treatment of pneumonia. The objective of our study was to assess the efficacy of zinc administration (10 mg/d for children 2–11 mo and 20 mg/d for ge 12 mo of age) for 14 d on preventing diarrheal and respiratory illnesses for 6 mo of follow-up. This was a randomized, double-blind, placebo-controlled trial in children 2–35 mo of age with community-acquired pneumonia. The number of illness episodes and time until the first episode of various illnesses were compared between the 2 study groups. After 14 d of zinc supplementation, plasma zinc was significantly higher in the group receiving zinc. However, this difference was not detectable at 1 and 2.5 mo after the end of zinc administration. Of 2628 enrolled cases, a total of 2599 (99%) were available for assessment after the completion of zinc supplementation. The number of hospital visits and the median number of days until the first episode of pneumonia, diarrhea, and dysentery was similar in the 2 groups. The hazard ratios (95% CI) were 1.02 (0.92, 1.14) for nonsevere pneumonia, 1.11 (0.72, 1.73) for severe pneumonia, 1.07 (0.91, 1.26) for diarrhea, and 0.96 (0.69, 1.34) for dysentery. A short course of zinc supplementation given during an episode of pneumonia did not prevent diarrheal or respiratory illness over the next 6 mo.

Catch-up growth in Malawian babies, a longitudinal study of normal and low birthweight babies born in a malarious endemic area

Introduction Infant growth has not been studied in developing countries in relation to maternal factors related to malaria in pregnancy and maternal illiteracy. Objective To describe growth patterns in infants with low and normal birthweight and determine maternal risk factors for infant undernutrition. Methods Babies born in a rural district of southern Malawi were recruited. An infant cohort was selected on the basis of low or normal birthweight. Weight and length were recorded at birth and at 4-weekly intervals until at 52 weeks after birth. Maternal characteristics at first antenatal attendance and delivery were obtained. Odds ratios in univariate analysis were adjusted for birthweight. Factors included in the multivariate regression included maternal illiteracy, season of birth, maternal iron deficiency and number of infant illness episodes. Results Low birthweight infants were shorter and lighter throughout infancy than either normal birthweight or international reference values. At 12 months, placental or peripheral malaria at delivery (adjusted odds 1.8; 1.0, 3.1), number of infant illness episodes (AOR = 2.1; 1.2, 3.6) and maternal illiteracy (AOR = 2.7; 1.5, 4.9) were independently associated with low weight for age. Maternal short stature (AOR = 1.8; 1.1. 3.2), male sex (AOR = 2.4; 1.4, 4.1), number of infant illness episodes (AOR = 2.6; 1.5, 4.4), and birth in the rainy season (2.1; 1.2, 3.7) were independently associated with stunting. Placental or peripheral malaria at delivery (AOR = 2.2; 1.1, 4.4) and number of illness episodes (AOR = 2.2; 1.1, 4.5) were independently associated with thinness. Conclusion Malaria during pregnancy and maternal illiteracy are important maternal characteristics associated with infant undernutrition. Innovative health/literacy strategies are required to address malaria control in pregnancy in order to reduce the magnitude of its effects on infant undernutrition.

Influenza: Relation of Mortality to Morbidity Parameters-Netherlands, 1970—1989

The purpose of this study is to investigate the relationship between the number of influenza-like illness (ILI), weekly registered by the general practitioners (sentinel stations), and the monthly overall influenza mortality in people over 60 years of age, provided by the Dutch Statistical Bureau during the period July 1970 to June 1989. The quantitative impact of influenza-morbidity is expressed by three summary parameters, calculated from the 52 (53) weekly ILI-figures per season-year, (i) their sum (i.e. global extent of an epidemic), (ii) their standard deviation, and (iii) their maximum (i.e. peak number of ILI during an epidemic). In the analysis influenza A subtype is also included. These four parameters are mutually compared with respect to their predictability for yearly total influenza mortality in the 19 season-years available. In most cases, the standard deviation and the peak number of ILI are more powerful for prediction of mortality, than the global extent of the epidemic. The peak number of ILI is of special interest. It is particularly useful for estimating the effect on current influenza mortality during an ongoing epidemic. From the model it is possible to calculate a threshold (of weekly ILI) beyond which mortality increases proportionately more than the number of illness episodes. By using the peak value of morbidity it is possible to calculate the minimal impact of epidemic mortality. This study indicates that the weekly number of influenza-like illnesses has a certain prognostic value for the real impact of influenza. An electronic surveillance system could detect immediately the threshold above which influenza mortality increases more than proportionally.(ABSTRACT TRUNCATED AT 250 WORDS)

The influence of a supportive, problem-solving, group intervention on the health status of students with great recent life change

A small randomized trial was conducted with college students to test the efficacy of a supportive, problem-solving group intervention for reducing morbidity following accumulation of numerous life changes. The two intervention groups reported declines in number of illness episodes and number of disability days over the two semesters of study; one of the intervention groups also reported a decrease in number of days on which illness was experienced. The control group did significantly worse on these measures than the intervention groups.

Women's roles and illness episodes: a prospective study.

As more women enter the labor force, their roles proliferate. The purpose of this study was to determine whether proliferation of roles would have a deleterious effect on the women's health. A group of 96 women completed a family health diary for 3 weeks which included an estimate of stress level typical of the family on each day, the measures taken by the family to maintain health, an estimate of how each family member felt, whether or not behavior restriction was necessary, and any symptoms or complaints. An illness episode was considered to be any continued sequence of days during which health complaints were recorded in the health diary. The mean number of illness episodes for the 3-week diary-keeping period was 3.23 (SD = 1.50). Role proliferation did not correlate with the number of illness episodes (Spearman's rho = -.115 p < .132). The variables that best explained the variance in the number of illness episodes were the number of children and role reinforcement, both of which had modest negative effects on number of illness episodes; together they explained 11.3% of the variance. It was concluded that the number of episodes of illness women experience is a function of the compatibility of a woman's other roles with being ill and with the support available to her performing her roles.

Diagnosis and Lithium Treatment of Affective Disorder in the Retarded: Five Case Studies

The authors report on five institutionalized retarded patients who had symptoms strongly suggestive of manic-depressive illness and who showed significant symptom reduction in a single-blind placebo-controlled three-year trial of lithium. The number of illness episodes was reduced, and symptoms decreased in all major illness dimensions. These findings indicate that major affective disorder can be both diagnosed and treated in individuals with primary mental retardation.

Acute Mania

We examined the relationships among family history of psychiatric illness, demographic and historical variables, clinical course and presentation, and treatment response for 58 patients satisfying research criteria for mania. Nearly two thirds of the group had excellent responses to somatic treatment, particularly lithium ion, while one third had poor responses to lithium carbonate, neuroleptics, or electric convulsive therapy. Responders frequently exhibited euphoric moods, grandiose delusions, and tended to have cyclothymic premorbid personalities. Nonresponders were rarely euphoric, frequently exhibited incomplete auditory hallucinations, and tended to hve formal thought disorder and depressive-withdrawn premorbid personalities. Responders tended (nonsignificant) to have greater genetic loading for affective illness and alcoholism. We could not distinguish the two groups by their age at illness onset, duration of illness, or number of illness episodes per ill patient year.