Characterizing organic mood syndrome, manic type

Exposure to obstetric complications and subsequent development of bipolar disorder: Systematic review

BACKGROUND

Research has suggested an association between obstetric complications and bipolar disorder. However, no quantitative evaluation has been made of the pooled data from existing studies.

AIMS

To systematically review studies comparing exposure to obstetric complications in cases of bipolar disorder v. non-psychiatric controls, and in cases of bipolar disorder v. cases of other mental disorders.

METHOD

Publications were identified by computer searches of seven databases, by hand searches of reference lists and from raw data received from researchers.

RESULTS

Forty-six studies were identified, of which 22 met the inclusion criteria. The pooled odds ratio for exposure to obstetric complications and subsequent development of bipolar disorder was 1.01 (95% CI 0.76-1.35) compared with healthy controls, 1.13 (95% CI 0.64-1.99) compared with cases of unipolar disorder and 0.61 (95% CI 0.39-0.95) compared with those who developed schizophrenia.

CONCLUSIONS

There is no robust evidence that exposure to obstetric complications increases the risk of developing bipolar disorder. However, the range of events regarded as obstetric complications and methodological inadequacies make definitive conclusions difficult.

Medical assessment of patients presenting with psychiatric symptoms in the emergency setting

Psychiatrists in the emergency department (ED) are often asked to evaluate patients with disturbances of affect, behavior, and cognition. The first and most crucial step in the evaluation process is to eliminate possible medical causes for a patient presenting psychiatric symptoms. Failure to detect and diagnose underlying medical disorders may result in significant and unnecessary morbidity and mortality.