Treating bipolar disorder in older adults: Gaps in knowledge remain

2002 ◽  
Author(s):  
M. Sajatovic
Keyword(s):  
Older Adults ◽  
Bipolar Disorder

scholarly journals Reliability and validity of the functioning assessment short test for older adults with bipolar disorder (FAST-O)

2020 ◽  
Vol 8 (1) ◽  
Author(s):  
Melis Orhan ◽  
Nicole Korten ◽  
Ralph Kupka ◽  
Patricia van Oppen ◽  
Max Stek ◽  
...  
Keyword(s):  
Older Adults ◽  
Bipolar Disorder ◽  
Internal Structure ◽  
Internal Consistency ◽  
Concurrent Validity ◽  
Cronbach’S Alpha ◽  
Occupational Functioning ◽  
Cronbach's Alpha ◽  
Short Test ◽  
Functioning Assessment

Abstract Background Many frequently used instruments fail to assess psychosocial functioning in patients with bipolar disorder. The Functioning Assessment Short Test (FAST) was developed in order to tackle this problem and to assess the main functioning problems experienced by patients with bipolar disorder. However, the original FAST is not fully applicable in older adults due to the domain of occupational functioning. The aim of our study was to validate an adapted version for Older adults (FAST-O) in a group of older adults with bipolar disorder (OABD). Methods 88 patients aged 50 years and over diagnosed with bipolar disorder were included. We adapted the items in the area of “work-related functioning” of the FAST into items assessing “societal functioning”. Several measurements were conducted in order to analyse the psychometric qualities of the FAST-O (confirmatory factor analysis for internal structure, Cronbach’s alpha for internal consistency, Spearman’s rho for concurrent validity, Mann–Whitney U test for discriminant validity). Results Mean age in the study sample was 65.3 (SD = 7.5) and 57.3% was female. The internal structure was most similar to the internal structure of the original FAST. The internal consistency was excellent (Cronbach’s alpha = .93). The concurrent validity when correlated with the Social and Occupational Functioning Assessment Scale was low, but significant. The FAST-O was also able to distinguish between euthymic and symptomatic OABD patients. Conclusions The FAST-O has strong psychometric qualities. Based on our results, we can conclude that the FAST-O is a short, efficient solution in order to replace global rating scales or extensive test batteries in order to assess daily functioning of older psychiatric patients in a valid and reliable manner.

scholarly journals Developing a recovery-focused therapy for older people with bipolar disorder: a qualitative focus group study

BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e049829
Author(s):  
Elizabeth Tyler ◽  
Fiona Lobban ◽  
Rita Long ◽  
Steven H Jones
Keyword(s):  
Older Adults ◽  
Bipolar Disorder ◽  
Focus Group ◽  
Older People ◽  
Focus Groups ◽  
Later Life ◽  
Focus Group Study ◽  
Age Related ◽  
Health Related ◽  
Age Related Changes

ObjectivesAs awareness of bipolar disorder (BD) increases and the world experiences a rapid ageing of the population, the number of people living with BD in later life is expected to rise substantially. There is no current evidence base for the effectiveness of psychological interventions for older adults with BD. This focus group study explored a number of topics to inform the development and delivery of a recovery-focused therapy (RfT) for older adults with BD.DesignA qualitative focus group study.SettingThree focus groups were conducted at a university in the North West of England.ParticipantsEight people took part in the focus groups; six older adults with BD, one carer and one friend.ResultsParticipant’s responses clustered into six themes: (1) health-related and age-related changes in later life, (2) the experience of BD in later life, (3) managing and coping with BD in later life, (4) recovery in later life, (5) seeking helping in the future and (6) adapting RfT for older people.ConclusionsParticipants reported a range of health-related and age-related changes and strategies to manage their BD. Participants held mixed views about using the term ‘recovery’ in later life. Participants were in agreement that certain adaptations were needed for delivering RfT for older adults, based on their experience of living with BD in later life. The data collected as part of the focus groups have led to a number of recommendations for delivering RfT for older adults with BD in a randomised controlled trial (Clinical Trial Registration: ISRCTN13875321).

scholarly journals Mental healthcare in older adults with schizophrenia: results from 118 French public psychiatric departments

2015 ◽  
Vol 27 (10) ◽  
pp. 1749-1750 ◽  
Author(s):  
Delphine Raucher-Chéné ◽  
Nicolas Hoertel ◽  
Céline Béra-Potelle ◽  
Sarah Terrien ◽  
Sarah Barrière ◽  
...  
Keyword(s):  
Older Adults ◽  
Bipolar Disorder ◽  
Life Expectancy ◽  
Healthcare System ◽  
Psychiatric Illness ◽  
Mental Healthcare ◽  
Geriatric Psychiatry

The increased life expectancy in people with severe and persistent psychiatric illness, such as schizophrenia or bipolar disorder, has been predicted to substantially affect mental healthcare system (Bartels et al., 2002) that must adapt to meet the needs of older adults (Jeste et al., 1999). Development of specialized geriatric psychiatry services is thus needed.

scholarly journals Delphi survey of maintenance lithium treatment in older adults with bipolar disorder: An ISBD task force report

2018 ◽  
Vol 21 (2) ◽  
pp. 117-123 ◽  
Author(s):  
Kenneth I. Shulman ◽  
Osvaldo P. Almeida ◽  
Nathan Herrmann ◽  
Ayal Schaffer ◽  
Sergio A. Strejilevich ◽  
...  
Keyword(s):  
Older Adults ◽  
Bipolar Disorder ◽  
Task Force ◽  
Lithium Treatment ◽  
Delphi Survey ◽  
Task Force Report

Early and Late Onset Bipolar Disorders in Older Adults

2017 ◽  
Vol 41 (S1) ◽  
pp. S211-S211
Author(s):  
N. Smaoui ◽  
L. Zouari ◽  
N. Charfi ◽  
M. Maâlej-Bouali ◽  
N. Zouari ◽  
...  
Keyword(s):  
Older Adults ◽  
Bipolar Disorder ◽  
Early Onset ◽  
Age Of Onset ◽  
Late Onset ◽  
Age At Onset ◽  
Bipolar Disorders ◽  
Medical Diagnoses ◽  
The Mean ◽  
Bipolar Patients

IntroductionAge of onset of illness may be useful in explaining the heterogeneity among older bipolar patients.ObjectiveTo examine the relationship of age of onset with clinical, demographic and behavioral variables, in older patients with bipolar disorder.MethodsThis was a cross-sectional, descriptive and analytical study, including 24 patients suffering from bipolar disorders, aged 65 years or more and followed-up in outpatient psychiatry unit at Hedi Chaker university hospital in Sfax in Tunisia. We used a standardized questionnaire including socio-demographic, behavioral and clinical data. Age of onset was split at age 40 years into early-onset (< 40 years; n = 12) and late-onset (≥ 40 years; n = 12) groups.ResultsThe mean age for the entire sample was 68.95 years. The mean age of onset was 39.95 years. The majority (60%) of patients were diagnosed with bipolar I. Few meaningful differences emerged between early-onset and late-onset groups, except that tobacco use was significantly higher in the late-onset group (66.6% vs. 16.6%; P = 0.027). No significant differences between the early-onset and late-onset groups were seen on demographic variables, family history and number of medical diagnoses or presence of psychotic features.ConclusionOur study found few meaningful behavioral differences between early versus late age at onset in older adults with bipolar disorder.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Age-Related Differences in Medication Adherence, Symptoms, and Stigma in Poorly Adherent Adults With Bipolar Disorder

2019 ◽  
Vol 33 (5) ◽  
pp. 250-255 ◽  
Author(s):  
Stephen Smilowitz ◽  
Awais Aftab ◽  
Michelle Aebi ◽  
Jennifer Levin ◽  
Curtis Tatsuoka ◽  
...  
Keyword(s):  
Older Adults ◽  
Bipolar Disorder ◽  
Medication Adherence ◽  
Symptom Severity ◽  
Psychiatric Symptoms ◽  
Significant Finding ◽  
Internalized Stigma ◽  
Age Related ◽  
Severity Scores ◽  
Over Time

Objective: We present a secondary analysis of data reporting differences in medication adherence, psychiatric symptom severity, and internalized stigma levels in older (age ≥ 55 years) versus younger (age < 55 years) adults with bipolar disorder (BD) and poor medication adherence. Methods: Data used for this analysis came from 184 participants in a National Institute of Mental Health–funded randomized controlled trial, comparing a customized adherence enhancement (CAE) intervention intended to promote BD medication adherence with a BD-specific educational program (EDU). At screen, study participants were ≥20% nonadherent with BD medications as measured by the Tablets Routine Questionnaire (TRQ). Psychiatric symptoms, functional status, and internalized stigma were measured using validated scales. Results: Older adults had significantly lower anxiety disorder comorbidity ( P < .01 for 1 or more anxiety disorders), depressive symptom severity scores ( P = .011), and self-stigma scores ( P = .001) compared to their younger counterparts. In the analyses evaluating change over time in TRQ between older and younger participants by treatment arm (ie, CAE and EDU), there was a significant finding of interaction between time, age-group, and treatment arm ( P = .007). Conclusions: Older adults may be less anxious and depressed, with less self-stigma, compared to younger people with BD and poor adherence. With respect to medication adherence, older individuals in EDU appear to do less well than younger individuals over time.

Decreased Brain-Derived Neurotrophic Factor in Older Adults with Bipolar Disorder

2016 ◽  
Vol 24 (8) ◽  
pp. 596-601 ◽  
Author(s):  
Aline T. Soares ◽  
Ana C. Andreazza ◽  
Soham Rej ◽  
Tarek K. Rajji ◽  
Ariel G. Gildengers ◽  
...  
Keyword(s):  
Older Adults ◽  
Bipolar Disorder ◽  
Neurotrophic Factor ◽  
Brain Derived Neurotrophic Factor
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