scholarly journals Gender Differences and Comorbidities in U.S. Adults with Bipolar Disorder

2018 ◽  
Vol 8 (9) ◽  
pp. 168 ◽  
Author(s):  
Rikinkumar Patel ◽  
Sanya Virani ◽  
Hina Saeed ◽  
Sai Nimmagadda ◽  
Jupi Talukdar ◽  
...  

Background: Past studies have evaluated the association of various comorbidities with bipolar disorder. This study analyzes differences in the prevalence and association of medical and psychiatric comorbidities in bipolar patients by gender. Methods: A retrospective analysis was conducted using the Nationwide Inpatient Sample (2010–2014). Using International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) codes, we narrowed the study population to comprise those with a primary diagnosis of bipolar disorder and then obtained information about comorbidities. The differences in comorbidities by gender were quantified using chi-square tests and the logistic regression model (odds ratio (OR)). Results: Hypertension (20.5%), asthma (12.5%) and hypothyroidism (8.1%) were the top medical comorbidities found in bipolar patients. Migraine and hypothyroidism were seen three times higher in females (OR = 3.074 and OR = 3.001; respectively). Females with bipolar disorder had higher odds of comorbid inflammatory disorders like asthma (OR = 1.755), Crohn’s disease (OR = 1.197) and multiple sclerosis (OR = 2.440) compared to males. Females had a two-fold higher likelihood of comorbid post-traumatic stress disorder (PTSD) (OR = 2.253) followed by personality disorders (OR = 1.692) and anxiety disorders (OR = 1.663) compared to males. Conclusion: Women with bipolar disorder have a much higher medical comorbidity burden than men and may highly benefit from an integrated team of physicians to manage their condition and improve their health-related quality of life.

2021 ◽  
Vol 2 (1) ◽  
pp. 79-95
Author(s):  
Deborah Morris ◽  
◽  
Elanor Lucy Webb ◽  
Jessica Holmes ◽  
Katharine Reynolds ◽  
...  

In response to differential clinical presentations of survivors of multiple or chronic exposure to trauma, complex post-traumatic stress disorder (CPTSD) has been included in the 11th revision of the International Classification of Diseases (ICD-11). A growing body of research has explored the prevalence of CPTSD in a range of populations, yet its prevalence in adults diagnosed with Emotionally Unstable Personality Disorder (EUPD) has been subject to limited evaluation, including in individuals requiring specialist inpatient care. The International Trauma Questionnaire (ITQ) was administered to 42 females with primary diagnoses of EUPD admitted to a specialist DBT service. Twenty-eight (66.8%) participants met full diagnostic criteria for either PTSD (11.9%, n=5) or CPTSD (54.8%, n=23). Additionally, PTSD and CPTSD symptomatology were highly prevalent in participants who did not meet the functional impairment criteria. Significant differences in the prevalence of CPTSD were found, dependent on whether a measure of functional impairment was included. This is the first study to explore the prevalence of CPTSD in an inpatient EUPD sample, using diagnostic thresholds. The findings highlight the importance of attending to trauma as well as EUPD-related needs. Theoretical, clinical and future research implications are discussed.


2021 ◽  
pp. 000486742110200
Author(s):  
Gordon Parker

The 2020 College guidelines for mood disorders banish bipolar II disorder – despite its formal status in Diagnostic and Statistical Manual of Mental Disorders and International Classification of Diseases manuals for more than two decades – and argue that there is no need to partition bipolar disorder into separate sub-types. Their single-entity model is seemingly based on opinion rather than any support from referenced scientific studies. The author challenges the Committee’s model of there being only one bipolar disorder and argues that it presents several clinical management risks, particularly of ‘over-treatment’.


1999 ◽  
Vol 9 ◽  
pp. 245-246 ◽  
Author(s):  
M. Namjoshi ◽  
T. Jacobs ◽  
T.M. Sanger ◽  
K.S. Gannon ◽  
M. Tohen ◽  
...  

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Mae'n Al-Dabbas ◽  
Jay Shah ◽  
devina adalja ◽  
Archana Gundabolu ◽  
Ashish Kumar ◽  
...  

Introduction: Hypertension has been reported as one of the most common risk factor causing atrial fibrillation (AF). Also, hypertension is associated with more persistent AF. However the epidemiology for incidence of hypertensive emergency in AF hospitalization is not well documented. Hypothesis: We hypothesize that frequency of hypertensive emergency has been increasingly associated with Atrial fibrillation. Methods: National inpatient sample from 2005 -2015 was used for the present analysis. Patients over 18 years, with AF as the primary diagnosis were identified using International Classification of Diseases, Ninth Revision-Clinical Modification (ICD-9-CM) code, 427.31. Patients with hypertensive emergency were identified using ICD-9-CM code. 401.0, 402.0, 403.0, 404.0, 405.0. Results: A total of 4,988,269 AF patients over 18 years of age were included in the present analysis. Of these hospitalization 49,423 had hypertensive emergency during hospitalizations and the rest 4,938,846 had no hypertensive emergency. There was a monotonic increase in the trend of rates of hypertensive emergency per 1000 AF hospitalizations, from 2005 - 2015. (P value <0.001) [Figure 1]. Conclusion: There has been a significant increase in the rates of hypertensive emergency among AF hospitalization, over the past decade. Further research is needed to investigate the reason for this increased trend.


Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Manpreet Kaur ◽  
Anas M Saad ◽  
Keerat Ahuja ◽  
Simrat Kaur ◽  
Toshiaki Isogai ◽  
...  

Background: Infective endocarditis (IE) after Transcatheter aortic valve replacement (TAVR) and Mitra Clip (MC) occurs less commonly but is associated with grave complications. We aim to report the incidence and outcomes of IE within 180 days of TAVR and MC. Methods: We used the Nationwide Readmissions Database (NRD) between 2014 and 2017 to select patients who underwent either TAVR or MC between January and June every year (to allow for at least 180 days of follow up in the NRD) using the appropriate International Classification of Diseases-9 th and 10 th revision (ICD) codes. We performed a chi-square test to compare baseline characteristics and rates of IE after TAVR and MC procedures. All statistical analyses were performed the using SPSS version 26. Results: We included 68,270 and 7,080 patients who underwent TAVR and MC respectively, of which 0.68% vs. 0.94% (P=.012), developed IE respectively within 180 days of procedure. During that index hospitalization, in-hospital mortality rates did not differ between the two groups (15.08% in TAVR vs. 17.91%, in MC P=.587). Other outcomes are presented in table 1. Conclusion: Our study suggests that the overall incidence of IE following TAVR and MC is relatively low but appropriate preventive measures should be taken after the procedures to reduce the morbidity and mortality. Further studies and analysis are required in modern MC and TAVR techniques to circumvent this critical complication.


2019 ◽  
Vol 27 (2) ◽  
Author(s):  
Janelle Monique Morhun ◽  
N.M. Racine ◽  
G.M.T. Guilcher ◽  
L.M. Tomfohr-Madsen ◽  
F.S.M. Schulte

Background: The unique psychosocial needs of parents and caregivers of young children with cancer are poorly understood.  The aims of this study were to examine: 1) the health-related quality of life (HRQL), stress, and psychological distress in parents of young children (0-4 years) diagnosed with cancer, and 2) the associations between parent psychosocial functioning and child treatment characteristics. Methods: Parents (N= 35) with a child (19 males, 54.3%) aged 0-48 months (M= 31.06 months) who were on active cancer therapy were recruited. Parents completed questionnaires related to demographics, parent HRQL, parenting stress, post-traumatic stress symptoms, and parent psychological distress. Results: Parents reported clinically elevated parenting stress (5.88%), post-traumatic stress symptoms (18.18%), and psychological distress (21.87%). Compared to population norms, parents reported lower HRQL in the vitality (t= 5.37, p< .001), mental health (t= 4.02, p< .001), role limitation/emotional (t= 3.52, p< .001), and general health (t= 2.25, p= .025) domains. Number of days since diagnosis (β= -.35, p= .030), child surgery (β= .360, p= .023), and parent social functioning (β= -.40, p= .009) predicted parent psychological distress F(3,24)= 9.11, p< .001, R2 =.53. Conclusions: A subset of parents of young children on active cancer treatment experience clinically-elevated psychosocial symptoms. Having a child who undergoes surgery and having poor social connections put parents at risk of experiencing higher psychological distress. Supports that focus on preventing the emergence of clinically significant distress should focus on parents of young children with cancer who are most at risk of poor outcomes.


2018 ◽  
Vol 49 (3) ◽  
pp. 483-490 ◽  
Author(s):  
Anna C. Barbano ◽  
Willem F. van der Mei ◽  
Richard A. Bryant ◽  
Douglas L. Delahanty ◽  
Terri A. deRoon-Cassini ◽  
...  

AbstractBackgroundProjected changes to post-traumatic stress disorder (PTSD) diagnostic criteria in the upcoming International Classification of Diseases (ICD)-11 may affect the prevalence and severity of identified cases. This study examined differences in rates, severity, and overlap of diagnoses using ICD-10 and ICD-11 PTSD diagnostic criteria during consecutive assessments of recent survivors of traumatic events.MethodsThe study sample comprised 3863 survivors of traumatic events, evaluated in 11 longitudinal studies of PTSD. ICD-10 and ICD-11 diagnostic rules were applied to the Clinician-Administered PTSD Scale (CAPS) to derive ICD-10 and ICD-11 diagnoses at different time intervals between trauma occurrence and 15 months.ResultsThe ICD-11 criteria identified fewer cases than the ICD-10 across assessment intervals (range −47.09% to −57.14%). Over 97% of ICD-11 PTSD cases met concurrent ICD-10 PTSD criteria. PTSD symptom severity of individuals identified by the ICD-11 criteria (CAPS total scores) was 31.38–36.49% higher than those identified by ICD-10 criteria alone. The latter, however, had CAPS scores indicative of moderate PTSD. ICD-11 was associated with similar or higher rates of comorbid mood and anxiety disorders. Individuals identified by either ICD-10 or ICD-11 shortly after traumatic events had similar longitudinal course.ConclusionsThis study indicates that significantly fewer individuals would be diagnosed with PTSD using the proposed ICD-11 criteria. Though ICD-11 criteria identify more severe cases, those meeting ICD-10 but not ICD-11 criteria remain in the moderate range of PTSD symptoms. Use of ICD-11 criteria will have critical implications for case identification in clinical practice, national reporting, and research.


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