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Dempsey RC, Dodd AL, Gooding PA, Jones SH. The Types of Psychosocial Factors Associated with Suicidality Outcomes for People Living with Bipolar Disorder: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:525. [PMID: 38791740 PMCID: PMC11120682 DOI: 10.3390/ijerph21050525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 04/19/2024] [Accepted: 04/20/2024] [Indexed: 05/26/2024]
Abstract
Bipolar Disorder is associated with high rates of suicidal thoughts, behaviors, and outcomes, yet the lived experience of suicidality and Bipolar Disorder is not particularly well understood. Understanding the role of psychosocial aetiologies in suicidality outcomes for those living with Bipolar Disorder is key for developing appropriately targeted interventions focusing on factors that are amenable to change. In line with PRISMA guidance, we conducted a scoping review to identify the types of psychosocial factors studied in relation to the experience of suicidality for people living with Bipolar Disorder diagnoses. Systematic literature searches identified a sample of 166 articles from which key study data were extracted and charted. A narrative synthesis of the reviewed literature is presented ordered by the factors investigated across studies, a frequency count of the types of psychological/social aetiologies studied, and a brief overview of the key findings for each aetiology. Most of the identified literature took the form of quantitative cross-sectional studies, with only one qualitative study and 18 quantitative prospective studies. The most studied aetiologies were trauma (specifically early adverse experiences and childhood traumas) and stressful life events, impulsivity (primarily subjective self-reported trait impulsivity), social support and functioning, and personality/temperament factors. Only six studies in the final sample reported basing their research questions and/or hypotheses on an explicit theoretical model of suicide. The literature was primarily focused on using self-report measurements of key aetiologies and on factors which lead to worsened suicidality rather than focusing on potentially protective or buffering factors. Future research needs to better justify the aetiologies investigated in relation to suicidality outcomes for people living with Bipolar Disorder, including a firmer basis in theory and hypothesis testing, more prospective designs, and the use of alternative assessments of psychosocial aetiologies in addition to self-report questionnaires.
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Affiliation(s)
- Robert C. Dempsey
- Department of Psychology, Faculty of Health and Education, Manchester Metropolitan University, Manchester M15 6BH, UK
| | - Alyson L. Dodd
- Department of Psychology, Faculty of Health & Life Sciences, Northumbria University, Newcastle upon Tyne NE1 8ST, UK
| | - Patricia A. Gooding
- Division of Psychology & Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester M13 9PL, UK
| | - Steven H. Jones
- Spectrum Centre for Mental Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster LA1 4YW, UK
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Manoli A, Wright LC, Shakoor S, Fisher HL, Hosang GM. The association between childhood bullying victimisation and childhood maltreatment with the clinical expression of bipolar disorder. J Psychiatr Res 2023; 158:226-230. [PMID: 36603317 DOI: 10.1016/j.jpsychires.2022.12.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 11/07/2022] [Accepted: 12/21/2022] [Indexed: 12/24/2022]
Abstract
Adverse childhood experiences are significantly associated with a worse clinical expression of bipolar disorder, however, the literature has mainly focused on childhood maltreatment (abuse and neglect) with little attention paid to other forms of adversity, such as childhood bullying victimisation (referred to here as bullying), although this is known to have a negative impact on different psychiatric illnesses. The current study aimed to investigate the association between bullying victimisation and the clinical expression of bipolar disorder individually and in combination with childhood maltreatment. This investigation consisted of 63 individuals with a diagnosis of bipolar disorder (mean age 61.4 years) who completed the Retrospective Bullying Questionnaire and the Childhood Trauma Questionnaire to measure exposure to bullying and childhood maltreatment, respectively. The clinical expression variables were assessed using self-report instruments, these were: the Cardiff Anomalous Perceptions Scale (psychotic symptoms), Suicide Behaviours Questionnaire, Self-Report Manic Inventory, Beck Anxiety and Depression Inventories. The results showed that exposure to bullying was significantly associated with more suicidal behaviours (F(1,61) = 11.02, p < .01, η2 = 0.15) and psychotic symptoms (F(1,61) = 4.21, p < .05, η2 = .06). When bullying and childhood maltreatment histories were combined, the results showed that individuals with a history of both adversity types reported significantly more suicidal behaviours (F(2,60) = 6.59, p < .01, R2=.18) compared to those with a history of one or neither form of adversity. The sample size, age and gender distribution, limit the generalisability of the findings. However, the current results underscore the need to account for bullying victimisation when considering the adverse childhood experiences-bipolar disorder relationship, especially its clinical expression.
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Affiliation(s)
- Athina Manoli
- Centre for Psychiatry & Mental Health, Wolfson Institute of Population Health, Barts & The London Faculty of Medicine & Dentistry, Queen Mary University of London, UK
| | - Lucy C Wright
- Centre for Psychiatry & Mental Health, Wolfson Institute of Population Health, Barts & The London Faculty of Medicine & Dentistry, Queen Mary University of London, UK
| | - Sania Shakoor
- Centre for Psychiatry & Mental Health, Wolfson Institute of Population Health, Barts & The London Faculty of Medicine & Dentistry, Queen Mary University of London, UK
| | - Helen L Fisher
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK; ESRC Centre for Society and Mental Health, King's College London, UK
| | - Georgina M Hosang
- Centre for Psychiatry & Mental Health, Wolfson Institute of Population Health, Barts & The London Faculty of Medicine & Dentistry, Queen Mary University of London, UK.
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Yamagishi M, Satomura Y, Sakurada H, Kanehara A, Sakakibara E, Okada N, Koike S, Yagishita S, Ichihashi K, Kondo S, Jinde S, Fukuda M, Kasai K. Retrospective chart review-based assessment scale for adverse childhood events and experiences. PCN REPORTS : PSYCHIATRY AND CLINICAL NEUROSCIENCES 2022; 1:e58. [PMID: 38868652 PMCID: PMC11114386 DOI: 10.1002/pcn5.58] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 10/04/2022] [Accepted: 10/18/2022] [Indexed: 06/14/2024]
Abstract
Aim Adverse childhood experiences (ACEs) are highly prevalent in the general population, and their lifelong impact on physical and mental health is profound. In assessing ACEs, it is vital to consider the pathways and modalities by which an individual internalizes events as an adverse experience and its effects on their biological, psychological, and social function. However, conventional assessments of ACEs are inadequate in that they do not comprehensively assess the source of the adverse event and the pathway and mode of its impact on the individual. Methods This study developed an original scale for ACEs that classifies the source of the event and the pathway and mode of its impact on the individual from a retrospective review of medical charts. We also used this scale to investigate the ACEs in 536 patients with psychiatric disorders (depression, bipolar disorder, and schizophrenia). Results This scale consisted of 28 items, and its reliability and validity were sufficient. We also found that 45.9% of the patients studied had at least one ACE, ranging from 43.5% to 51.5% for all disorders. Psychological trauma (bullying) from peers was the most common cause at 27.2%. Conclusion We developed a retrospective chart review-based assessment tool for ACEs which enables the examination of the source of the events of ACEs and the pathways and modalities of their impact on the individual. The frequency of ACEs is high regardless of the type of psychiatric disorder, and horizontal trauma (bullying victimization) is as frequent as vertical trauma (parental maltreatment).
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Affiliation(s)
- Mika Yamagishi
- Department of Neuropsychiatry, Graduate School of MedicineThe University of TokyoTokyoJapan
| | - Yoshihiro Satomura
- Department of Neuropsychiatry, Graduate School of MedicineThe University of TokyoTokyoJapan
- Center for Diversity in Medical Education & Research, Graduate School of MedicineThe University of TokyoTokyoJapan
| | - Hanako Sakurada
- Department of Neuropsychiatry, Graduate School of MedicineThe University of TokyoTokyoJapan
| | - Akiko Kanehara
- Department of Neuropsychiatry, Graduate School of MedicineThe University of TokyoTokyoJapan
| | - Eisuke Sakakibara
- Department of Neuropsychiatry, Graduate School of MedicineThe University of TokyoTokyoJapan
| | - Naohiro Okada
- Department of Neuropsychiatry, Graduate School of MedicineThe University of TokyoTokyoJapan
- The International Research Center for NeurointelligenceThe University of Tokyo Institutes for Advanced StudyTokyoJapan
| | - Shinsuke Koike
- Department of Neuropsychiatry, Graduate School of MedicineThe University of TokyoTokyoJapan
- The International Research Center for NeurointelligenceThe University of Tokyo Institutes for Advanced StudyTokyoJapan
- University of Tokyo Institute for Diversity and Adaptation of Human MindThe University of TokyoTokyoJapan
- Center for Evolutionary Cognitive Sciences, Graduate School of Art and SciencesThe University of TokyoTokyoJapan
| | - Sho Yagishita
- Department of Structural Physiology, Graduate School of MedicineThe University of TokyoTokyoJapan
| | - Kayo Ichihashi
- Department of Neuropsychiatry, Graduate School of MedicineThe University of TokyoTokyoJapan
| | - Shinsuke Kondo
- Department of Neuropsychiatry, Graduate School of MedicineThe University of TokyoTokyoJapan
| | - Seiichiro Jinde
- Department of Neuropsychiatry, Graduate School of MedicineThe University of TokyoTokyoJapan
| | - Masato Fukuda
- Department of Psychiatry and NeuroscienceGunma University Graduate School of MedicineMaebashiJapan
| | - Kiyoto Kasai
- Department of Neuropsychiatry, Graduate School of MedicineThe University of TokyoTokyoJapan
- Center for Diversity in Medical Education & Research, Graduate School of MedicineThe University of TokyoTokyoJapan
- The International Research Center for NeurointelligenceThe University of Tokyo Institutes for Advanced StudyTokyoJapan
- University of Tokyo Institute for Diversity and Adaptation of Human MindThe University of TokyoTokyoJapan
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McIntyre RS, Alda M, Baldessarini RJ, Bauer M, Berk M, Correll CU, Fagiolini A, Fountoulakis K, Frye MA, Grunze H, Kessing LV, Miklowitz DJ, Parker G, Post RM, Swann AC, Suppes T, Vieta E, Young A, Maj M. The clinical characterization of the adult patient with bipolar disorder aimed at personalization of management. World Psychiatry 2022; 21:364-387. [PMID: 36073706 PMCID: PMC9453915 DOI: 10.1002/wps.20997] [Citation(s) in RCA: 50] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Bipolar disorder is heterogeneous in phenomenology, illness trajectory, and response to treatment. Despite evidence for the efficacy of multimodal-ity interventions, the majority of persons affected by this disorder do not achieve and sustain full syndromal recovery. It is eagerly anticipated that combining datasets across various information sources (e.g., hierarchical "multi-omic" measures, electronic health records), analyzed using advanced computational methods (e.g., machine learning), will inform future diagnosis and treatment selection. In the interim, identifying clinically meaningful subgroups of persons with the disorder having differential response to specific treatments at point-of-care is an empirical priority. This paper endeavours to synthesize salient domains in the clinical characterization of the adult patient with bipolar disorder, with the overarching aim to improve health outcomes by informing patient management and treatment considerations. Extant data indicate that characterizing select domains in bipolar disorder provides actionable information and guides shared decision making. For example, it is robustly established that the presence of mixed features - especially during depressive episodes - and of physical and psychiatric comorbidities informs illness trajectory, response to treatment, and suicide risk. In addition, early environmental exposures (e.g., sexual and physical abuse, emotional neglect) are highly associated with more complicated illness presentations, inviting the need for developmentally-oriented and integrated treatment approaches. There have been significant advances in validating subtypes of bipolar disorder (e.g., bipolar I vs. II disorder), particularly in regard to pharmacological interventions. As with other severe mental disorders, social functioning, interpersonal/family relationships and internalized stigma are domains highly relevant to relapse risk, health outcomes, and quality of life. The elevated standardized mortality ratio for completed suicide and suicidal behaviour in bipolar disorder invites the need for characterization of this domain in all patients. The framework of this paper is to describe all the above salient domains, providing a synthesis of extant literature and recommendations for decision support tools and clinical metrics that can be implemented at point-of-care.
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Affiliation(s)
- Roger S McIntyre
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Department of Pharmacology, University of Toronto, Toronto, ON, Canada
| | - Martin Alda
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
- National Institute of Mental Health, Klecany, Czech Republic
| | - Ross J Baldessarini
- Harvard Medical School, Boston, MA, USA
- International Consortium for Bipolar & Psychotic Disorders Research, McLean Hospital, Belmont, MA, USA
- Mailman Research Center, McLean Hospital, Belmont, MA, USA
| | - Michael Bauer
- University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Michael Berk
- IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, VIC, Australia
- Orygen, National Centre of Excellence in Youth Mental Health, Centre for Youth Mental Health, University of Melbourne, Melbourne, VIC, Australia
| | - Christoph U Correll
- Department of Psychiatry, Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA
- Department of Psychiatry and Molecular Medicine, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
- Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Andrea Fagiolini
- Department of Molecular Medicine, University of Siena, Siena, Italy
| | - Kostas Fountoulakis
- 3rd Department of Psychiatry, Division of Neurosciences, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Mark A Frye
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, USA
| | - Heinz Grunze
- Allgemeinpsychiatrie Ost, Klinikum am Weissenhof, Weinsberg, Germany
- Paracelsus Medical Private University Nuremberg, Nuremberg, Germany
| | - Lars V Kessing
- Copenhagen Affective Disorder Research Center, Psychiatric Center Copenhagen, Copenhagen, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - David J Miklowitz
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles (UCLA) Semel Institute, Los Angeles, CA, USA
| | - Gordon Parker
- School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
| | - Robert M Post
- School of Medicine & Health Sciences, George Washington University, Washington, DC, USA
- Bipolar Collaborative Network, Bethesda, MD, USA
| | - Alan C Swann
- Department of Psychiatry, Baylor College of Medicine, Houston, TX, USA
| | - Trisha Suppes
- Department of Psychiatry and Behavioural Sciences, Stanford School of Medicine and VA Palo Alto Health Care -System, Palo Alto, CA, USA
| | - Eduard Vieta
- Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Allan Young
- Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
- South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Beckenham, UK
| | - Mario Maj
- Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy
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Grover S, Avasthi A, Chakravarty R, Dan A, Chakraborty K, Neogi R, Desouza A, Nayak O, Kumar Praharaj S, Menon V, Ramandeep, Bathla M, Subramanyam AA, Nebhinani N, Ghosh P, Lakdawala B, Bhattacharya R. Prevalence of psychotic symptoms and their impact on course and outcome of patients with bipolar disorder: Findings from the Bipolar Disorder Course and Outcome study from India (BiD-CoIN study). J Affect Disord 2022; 305:233-239. [PMID: 35248664 DOI: 10.1016/j.jad.2022.02.070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 01/15/2022] [Accepted: 02/27/2022] [Indexed: 11/24/2022]
Abstract
AIM Most of the available data on the prevalence and impact of psychotic symptoms on the course of bipolar disorder (BD) is from Western countries. We aimed to study the prevalence of at least one psychotic episode in the lifetime in patients with BD and its association with the long-term course and outcome. METHODOLOGY 773 patients recruited as part of the Bipolar Disorder Course and Outcome study from India (BiD-CoIN study) were divided into 2 groups, based on the presence or absence of at least one psychotic episode in the lifetime. RESULTS 326 (42.2%) patients had at least one psychotic episode in their lifetime. At least one psychotic episode in the lifetime was associated with overall more severe illness in terms of lower age of onset, a higher number of episodes in the first 5 years of illness; higher rates of BD-II, a higher rate of lifetime history of at least 1 suicide attempt, lifetime history of hospitalization, history of receiving Electroconvulsive Therapy, and a higher prescription rates of antipsychotics. However, presence of psychotics symptoms was associated with better cognitive functioning. CONCLUSIONS Our findings suggest that the presence of psychotic symptoms during episodes in patients with BD is associated with poorer course of BD.
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Affiliation(s)
- Sandeep Grover
- Post Graduate Institute of Medical Education & Research, Chandigarh, India.
| | - Ajit Avasthi
- Post Graduate Institute of Medical Education & Research, Chandigarh, India
| | - Rahul Chakravarty
- Post Graduate Institute of Medical Education & Research, Chandigarh, India
| | - Amitava Dan
- Burdwan Medical College & Hospital, Burdwan, India
| | | | | | - Avinash Desouza
- Lokmanya Tilak Municipal General Hospital (SION Hospital), Mumbai, India
| | - Omkar Nayak
- Lokmanya Tilak Municipal General Hospital (SION Hospital), Mumbai, India
| | - Samir Kumar Praharaj
- Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Vikas Menon
- Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Ramandeep
- All India Institute of Medical Sciences, New Delhi, India
| | - Manish Bathla
- Maharishi Markandeshwar Institute of Medical Sciences & Research, Mullana, Ambala, India
| | | | | | | | - Bhavesh Lakdawala
- Ahmedabad Municipal Corporation Medical Education Trust Medical College, Ahmedabad, India
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