Discuss Bipolar
Blog to discuss being Bipolar
Family income is associated with self-reported mood symptoms in patients with bipolar disorder, researchers have found.
“Investigations of a wide range of diseases and populations using diverse methodologies have found an inverse relation between socioeconomic status (SES) and health,” explain Michael Bauer (Technische Universität Dresden, Germany) and team.
“However, relatively little is understood about the impact of income on treatment response and outcome for patients with bipolar disorder,” they add.
To investigate whether there is a link between median family income and daily self-reported mood symptoms in such patients, the team studied 284 individuals with bipolar disorder, aged at least 18 years, who provided daily self-reported mood ratings for 6 months.
Data obtained for the census tract where each patient lived was used to estimate median family income, which ranged from $14,100 (€10,907) to $257,200 (€198,964). The participants were divided into low (29.5%), middle (42.0%), and high (28.5%) income groups based on median family incomes of $64,000 (€49,476) or less, $64,001-$103,999 (€49,464-€80,377), and $104,000 (€80,341) or higher, respectively.
Using income as both a continuous and categorical variable, the researchers found a significant positive association between income and euthymia, and a significant negative association between income and manic/hypomanic symptoms.
Overall, patients in the lower-income group spent 12.4% and 9.7% fewer days in a euthymic state than those in the upper- and middle-income groups, respectively. Patients in the lower-income group also spent 7.1% and 4.1% more days with manic/hypomanic symptoms than those in the upper- and middle-income groups, respectively.
However, there was no significant association between income and depressive symptoms among the participants.
Bauer and team conclude: “The results of this study suggest a clear association between family income and mood in bipolar disorder.”
They add: “Inclusion of income as a measure of SES is recommended for future studies of treatment response and outcome in bipolar disorder in the United States.”
MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2011
Among inpatients with affective disorder, clinical improvement and antidepressant treatment is associated with a significantly reduced risk for suicide during hospitalization and after discharge, study results show.
“The risk of suicide in patients with affective disorders is particularly high immediately after admission to, and discharge from a psychiatric hospital,” explain E Høyer, from the University of Aarhus in Denmark, and team.
However, they add that among such patients, “only few risk factors for suicide have been identified” and “little is known about the protective or other effects of treatment.“
To investigate further, the researchers studied data on 282 Danish patients, aged at least 18 years, who were admitted to hospital with affective disorder between 1994 and 1995. Of these, 141 died because of suicide, either during admission or shortly after discharge.
The researchers assessed the patients’ demographic and socioeconomic factors, family history, psychiatric history, treatment, and history of adverse life events, such as bereavement of close relative or friend, separation/divorce, and loss of a job.
Clinical improvement, or no such improvement, during hospitalization was noted if such information was available in the patients’ case files. If no such information was available, the clinical state of the patient at admission and at censoring date was used to make an evaluation.
The team identified four variables that were independent predictors of suicide.
As expected, a previous history of suicide attempts was associated with the greatest risk for death by suicide (incidence-rate ratio [IRR]=4.9). The team also found that loss of a job during the year prior to the index admission was associated with a significant increased risk for suicide, at an IRR of 2.9. This was the only adverse life event associated with an increased risk for suicide, note the researchers
Conversely, clinical improvement during the index admission and treatment with antidepressant drugs were associated with a reduced risk for suicide, both at IRRs of 0.3.
Høyer and team conclude: “Our interpretation of the findings is that clinical improvement of affective disorder and treatment with antidepressant drugs may reduce the risk of suicide. Therefore, and for clinical reasons in general, all efforts should be made to enhance clinical improvement and prevent further episodes of illness.”
They add: “It is important to be aware of the risk of suicide in patients with no or little clinical improvement during inpatient treatment, especially at discharge and during leave from the hospital.”
MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a part of Springer Science+Business Media. © Current Medicine Group Ltd; 2009
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