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Asri AK, Yeh CH, Chang HT, Lee HY, Lung SCC, Spengler JD, Wu CD. Greenspace related to bipolar disorder in Taiwan: Quantitative benefits of saving DALY loss and increasing income. Health Place 2023; 83:103097. [PMID: 37595541 DOI: 10.1016/j.healthplace.2023.103097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 08/02/2023] [Accepted: 08/03/2023] [Indexed: 08/20/2023]
Abstract
Scientific evidence reported that surrounding greenspace could promote better mental health. Considering bipolar disorder as the health outcome, this study aimed to investigate the association between greenspace and bipolar disorder in Taiwan and quantified the benefits of greenspace on bipolar disorder adjusted for the international greenspace availability standard. By examining datasets across 348 townships, two quantitative measures (i.e., disability-adjusted life year loss and income) were used to represent the benefits. The incidence rate of bipolar disorder was obtained from Taiwan's National Health Insurance Research Database. Normalized different vegetation index (NDVI) was measured as a proxy for the greenspace availability. A generalized additive mixed model coupled with a sensitivity test were applied to evaluate the statistical association. The prevented fraction for the population (PFP) was then applied to develop a scenario for quantifying benefit. The result showed a significant negative association between greenspace and bipolar disorder in Taiwan. Compared to low greenspace, areas with medium and high greenspace may reduce the bipolar risk by 21% (RR = 0.79; 95% CI = 0.76-0.83) and 51% (RR = 0.49; 95% CI = 0.45-0.53). Calculating benefits, we found that the development of a scenario by increasing greenspace adjusted for availability indicator in township categorized as low greenspace could save in DALY loss due to bipolar disorder up to10.97% and increase in income up to 11.04% from the current situation. Lastly, this was the first study in Asia-Pacific to apply a customized greenspace increment scenario to quantify the benefits to a particular health burden such as bipolar disorder.
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Affiliation(s)
- Aji Kusumaning Asri
- Department of Geomatics, College of Engineering, National Cheng Kung University, Tainan, 70101, Taiwan.
| | - Chia-Hao Yeh
- Department of Geomatics, College of Engineering, National Cheng Kung University, Tainan, 70101, Taiwan.
| | - Hao-Ting Chang
- Department of Geomatics, College of Engineering, National Cheng Kung University, Tainan, 70101, Taiwan.
| | - Hsiao-Yun Lee
- Department of Leisure Industry and Health Promotion, National Taipei University of Nursing and Health Sciences, Taipei, 112, Taiwan.
| | - Shih-Chun Candice Lung
- Research Center for Environmental Changes, Academia Sinica, Taipei, 115, Taiwan; Department of Atmospheric Sciences, National Taiwan University, Taipei, Taiwan; Institute of Environmental Health, School of Public Health, National Taiwan University, Taipei, Taiwan.
| | - John D Spengler
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, United States.
| | - Chih-Da Wu
- Department of Geomatics, College of Engineering, National Cheng Kung University, Tainan, 70101, Taiwan; National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli, 35053, Taiwan; Innovation and Development Center of Sustainable Agriculture, National Chung Hsing University, Taichung City, 402, Taiwan.
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Takano C, Kato M, Adachi N, Kubota Y, Azekawa T, Ueda H, Edagawa K, Katsumoto E, Goto E, Hongo S, Miki K, Tsuboi T, Yasui-Furukori N, Nakagawa A, Kikuchi T, Watanabe K, Kinoshita T, Yoshimura R. Clinical characteristics and prescriptions associated with a 2-year course of rapid cycling and euthymia in bipolar disorder: a multicenter treatment survey for bipolar disorder in psychiatric clinics. Front Psychiatry 2023; 14:1183782. [PMID: 37265558 PMCID: PMC10229865 DOI: 10.3389/fpsyt.2023.1183782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 04/26/2023] [Indexed: 06/03/2023] Open
Abstract
Objective In patients with bipolar disorder (BD), rapid cycling (RC) presents a risk for a more severe illness, while euthymia (EUT) has a better prognosis. This study focused on the progression of RC and EUT, which are contrasting phenomenology, and aimed to clarify the influence of patient backgrounds and prescription patterns on these different progressions, using a large sample from the first and second iterations of a multicenter treatment survey for BD in psychiatric clinics (MUSUBI). Methods In the cross-sectional study (MUSUBI), a questionnaire based on a retrospective medical record survey of consecutive BD cases (N = 2,650) was distributed. The first survey was conducted in 2016, and the second one in 2017. The questionnaire collected information on patient backgrounds, current episodes, and clinical and prescribing characteristics. Results In the first survey, 10.6% of the participants had RC and 3.6% had RC for two consecutive years, which correlated with BP I (Bipolar disorder type I), suicidal ideation, duration of illness, and the use of lithium carbonate and antipsychotic medications. Possible risk factors for switching to RC were comorbid developmental disorders and the prescription of anxiolytics and sleep medication. Moreover, 16.4% of the participants presented EUT in the first survey, and 11.0% presented EUT for two consecutive years. Possible factors for achieving EUT included older age; employment; fewer psychotic symptoms and comorbid personality disorders; fewer antidepressants, antipsychotics, and anxiolytics, and more lithium prescriptions. Conclusion RC and EUT generally exhibit conflicting characteristics, and the conflicting social backgrounds and factors contributing to their outcomes were distinctive. Understanding these clinical characteristics may be helpful in clinical practice for management of patients with BD.
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Affiliation(s)
- Chikashi Takano
- Department of Neuropsychiatry, Kansai Medical University, Osaka, Japan
| | - Masaki Kato
- Department of Neuropsychiatry, Kansai Medical University, Osaka, Japan
- Japanese Society of Clinical Neuropsychopharmacology, Tokyo, Japan
| | - Naoto Adachi
- Japanese Association of Neuro-Psychiatric Clinics, Tokyo, Japan
| | - Yukihisa Kubota
- Japanese Association of Neuro-Psychiatric Clinics, Tokyo, Japan
| | | | - Hitoshi Ueda
- Japanese Association of Neuro-Psychiatric Clinics, Tokyo, Japan
| | - Kouji Edagawa
- Japanese Association of Neuro-Psychiatric Clinics, Tokyo, Japan
| | | | - Eiichiro Goto
- Japanese Association of Neuro-Psychiatric Clinics, Tokyo, Japan
| | - Seiji Hongo
- Japanese Association of Neuro-Psychiatric Clinics, Tokyo, Japan
| | - Kazuhira Miki
- Japanese Association of Neuro-Psychiatric Clinics, Tokyo, Japan
| | - Takashi Tsuboi
- Japanese Society of Clinical Neuropsychopharmacology, Tokyo, Japan
- Department of Neuropsychiatry, Kyorin University School of Medicine, Tokyo, Japan
| | - Norio Yasui-Furukori
- Japanese Society of Clinical Neuropsychopharmacology, Tokyo, Japan
- Department of Psychiatry, Dokkyo Medical University, Tochigi, Japan
| | - Atsuo Nakagawa
- Japanese Society of Clinical Neuropsychopharmacology, Tokyo, Japan
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Toshiaki Kikuchi
- Japanese Society of Clinical Neuropsychopharmacology, Tokyo, Japan
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Koichiro Watanabe
- Japanese Society of Clinical Neuropsychopharmacology, Tokyo, Japan
- Department of Neuropsychiatry, Kyorin University School of Medicine, Tokyo, Japan
| | - Toshihiko Kinoshita
- Department of Neuropsychiatry, Kansai Medical University, Osaka, Japan
- Japanese Society of Clinical Neuropsychopharmacology, Tokyo, Japan
| | - Reiji Yoshimura
- Japanese Society of Clinical Neuropsychopharmacology, Tokyo, Japan
- Department of Psychiatry, University of Occupational and Environmental Health, Fukuoka, Japan
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Tokumitsu K, Yasui-Furukori N, Adachi N, Kubota Y, Watanabe Y, Miki K, Azekawa T, Edagawa K, Katsumoto E, Hongo S, Goto E, Ueda H, Kato M, Nakagawa A, Kikuchi T, Tsuboi T, Watanabe K, Shimoda K, Yoshimura R. Predictors of psychiatric hospitalization among outpatients with bipolar disorder in the real-world clinical setting. Front Psychiatry 2023; 14:1078045. [PMID: 37009121 PMCID: PMC10060542 DOI: 10.3389/fpsyt.2023.1078045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 02/20/2023] [Indexed: 03/18/2023] Open
Abstract
BackgroundBipolar disorder is a psychiatric disorder that causes recurrent manic and depressive episodes, leading to decreased levels of social functioning and suicide. Patients who require hospitalization due to exacerbation of bipolar disorder have been reported to subsequently have poor psychosocial functioning, and so there is a need to prevent hospitalization. On the other hand, there is a lack of evidence regarding predictors of hospitalization in real-world clinical practice.MethodsThe multicenter treatment survey on bipolar disorder (MUSUBI) in Japanese psychiatric clinics was an observational study conducted to provide evidence regarding bipolar disorder in real-world clinical practice. Psychiatrists were asked, as part of a retrospective medical record survey, to fill out a questionnaire about patients with bipolar disorder who visited 176 member clinics of the Japanese Association of Neuro-Psychiatric Clinics. Our study extracted baseline patient characteristics from records dated between September and October 2016, including comorbidities, mental status, duration of treatment, Global Assessment of Functioning (GAF) score, and pharmacological treatment details. The incidence and predictors of hospitalization among patients with bipolar disorder over a 1-year period extending from that baseline to September–October 2017 were examined.ResultsIn total, 2,389 participants were included in our study, 3.06% of whom experienced psychiatric hospitalization over the course of 1 year from baseline. Binomial logistic regression analysis revealed that the presence of psychiatric hospitalization was correlated with bipolar I disorder, lower baseline GAF scores, unemployment, substance abuse and manic state.ConclusionsOur study revealed that 3.06% of outpatients with bipolar disorder were subjected to psychiatric hospitalization during a 1-year period that extended to September–October 2017. Our study suggested that bipolar I disorder, lower baseline GAF scores, unemployment, substance abuse and baseline mood state could be predictors of psychiatric hospitalization. These results may be useful for clinicians seeking to prevent psychiatric hospitalization for bipolar disorder.
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Affiliation(s)
- Keita Tokumitsu
- Department of Psychiatry, Dokkyo Medical University School of Medicine, Tochigi, Japan
| | - Norio Yasui-Furukori
- Department of Psychiatry, Dokkyo Medical University School of Medicine, Tochigi, Japan
- The Japanese Society of Clinical Neuropsychopharmacology, Tokyo, Japan
- *Correspondence: Norio Yasui-Furukori
| | - Naoto Adachi
- The Japanese Association of Neuro-Psychiatric Clinics, Tokyo, Japan
| | - Yukihisa Kubota
- The Japanese Association of Neuro-Psychiatric Clinics, Tokyo, Japan
| | | | - Kazuhira Miki
- The Japanese Association of Neuro-Psychiatric Clinics, Tokyo, Japan
| | - Takaharu Azekawa
- The Japanese Association of Neuro-Psychiatric Clinics, Tokyo, Japan
| | - Koji Edagawa
- The Japanese Association of Neuro-Psychiatric Clinics, Tokyo, Japan
| | - Eiichi Katsumoto
- The Japanese Association of Neuro-Psychiatric Clinics, Tokyo, Japan
| | - Seiji Hongo
- The Japanese Association of Neuro-Psychiatric Clinics, Tokyo, Japan
| | - Eiichiro Goto
- The Japanese Association of Neuro-Psychiatric Clinics, Tokyo, Japan
| | - Hitoshi Ueda
- The Japanese Association of Neuro-Psychiatric Clinics, Tokyo, Japan
| | - Masaki Kato
- The Japanese Society of Clinical Neuropsychopharmacology, Tokyo, Japan
- Department of Neuropsychiatry, Kansai Medical University, Osaka, Japan
| | - Atsuo Nakagawa
- The Japanese Society of Clinical Neuropsychopharmacology, Tokyo, Japan
- Department of Neuropsychiatry, St. Marianna University School of Medicine, Kanagawa, Japan
| | - Toshiaki Kikuchi
- The Japanese Society of Clinical Neuropsychopharmacology, Tokyo, Japan
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Takashi Tsuboi
- The Japanese Society of Clinical Neuropsychopharmacology, Tokyo, Japan
- Department of Neuropsychiatry, Kyorin University School of Medicine, Tokyo, Japan
| | - Koichiro Watanabe
- The Japanese Society of Clinical Neuropsychopharmacology, Tokyo, Japan
- Department of Neuropsychiatry, Kyorin University School of Medicine, Tokyo, Japan
| | - Kazutaka Shimoda
- Department of Psychiatry, Dokkyo Medical University School of Medicine, Tochigi, Japan
| | - Reiji Yoshimura
- The Japanese Society of Clinical Neuropsychopharmacology, Tokyo, Japan
- Department of Psychiatry, University of Occupational and Environmental Health, Fukuoka, Japan
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Kawamata Y, Yasui-Furukori N, Adachi N, Ueda H, Hongo S, Azekawa T, Kubota Y, Katsumoto E, Edagawa K, Goto E, Miki K, Kato M, Nakagawa A, Kikuchi T, Tsuboi T, Yoshimura R, Shimoda K, Watanabe K. Effect of age and sex on prescriptions for outpatients with bipolar disorder in the MUSUBI study: a cross‑sectional study. Ann Gen Psychiatry 2022; 21:37. [PMID: 36096797 PMCID: PMC9465914 DOI: 10.1186/s12991-022-00415-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 09/03/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Childbearing-aged female patients and elderly patients with bipolar disorder need special attention for pharmacological treatments, but current guidelines provide little information on their pharmacological treatment. In particular, the risk/benefit balance of pharmacological treatment for childbearing-aged females with bipolar disorder is a growing concern. Therefore, we aimed to address the effect of age and sex on psychotropic drug prescription for outpatients with bipolar disorder. METHODS The MUlticenter treatment SUrvey for BIpolar disorder in Japanese psychiatric clinics (MUSUBI) study was conducted, and data on age, sex, and details of pharmacological treatment were collected. RESULTS A total of 3106 outpatients were included in this study. Among young females (age ≤ 39), 25% were prescribed valproate. There was no significant difference in the frequency and daily dose of valproate prescription for young females among all groups. Valproate prescriptions were significantly less frequent among young males and more frequent among middle-aged males. Lithium prescriptions were significantly less frequent among young females and more frequent among older males (age ≥ 65) and older females. Lamotrigine prescriptions were significantly more frequent among young males and young females and less frequent among older males and older females. Carbamazepine prescriptions were significantly less frequent among young males and more frequent among older males. CONCLUSIONS Biased information about the risk and safety of valproate and lithium for young females was suggested, and further study to correct this bias is needed. Older patients were prescribed lithium more commonly than lamotrigine. Further studies are needed to determine the actual pharmacotherapy for elderly individuals.
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Affiliation(s)
- Yasushi Kawamata
- Department of Psychiatry, Dokkyo Medical University School of Medicine, 880 Kitakobayashi, Mibu, Tochigi, 321-0293, Japan
| | - Norio Yasui-Furukori
- Department of Psychiatry, Dokkyo Medical University School of Medicine, 880 Kitakobayashi, Mibu, Tochigi, 321-0293, Japan.
| | - Naoto Adachi
- The Japanese Association of Neuro-Psychiatric Clinics, Kodaira, Japan
| | - Hitoshi Ueda
- The Japanese Association of Neuro-Psychiatric Clinics, Kodaira, Japan
| | - Seiji Hongo
- The Japanese Association of Neuro-Psychiatric Clinics, Kodaira, Japan
| | - Takaharu Azekawa
- The Japanese Association of Neuro-Psychiatric Clinics, Kodaira, Japan
| | - Yukihisa Kubota
- The Japanese Association of Neuro-Psychiatric Clinics, Kodaira, Japan
| | - Eiichi Katsumoto
- The Japanese Association of Neuro-Psychiatric Clinics, Kodaira, Japan
| | - Koji Edagawa
- The Japanese Association of Neuro-Psychiatric Clinics, Kodaira, Japan
| | - Eiichiro Goto
- The Japanese Association of Neuro-Psychiatric Clinics, Kodaira, Japan
| | - Kazuhira Miki
- The Japanese Association of Neuro-Psychiatric Clinics, Kodaira, Japan
| | - Masaki Kato
- Department of Neuropsychiatry, Kansai Medical University, Osaka, Japan
| | - Atsuo Nakagawa
- Department of Neuropsychiatry, Keio University School of Medicine, Minato city, Japan
| | - Toshiaki Kikuchi
- Department of Neuropsychiatry, Keio University School of Medicine, Minato city, Japan
| | - Takashi Tsuboi
- Department of Neuropsychiatry, Kyorin University School of Medicine, Mitaka, Japan
| | - Reiji Yoshimura
- Department of Psychiatry, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Kazutaka Shimoda
- Department of Psychiatry, Dokkyo Medical University School of Medicine, 880 Kitakobayashi, Mibu, Tochigi, 321-0293, Japan
| | - Koichiro Watanabe
- Department of Neuropsychiatry, Kyorin University School of Medicine, Mitaka, Japan
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