Randomised controlled trial of efficacy of teaching patients with bipolar disorder to identify early symptoms of relapse and obtain treatment
BMJPublished 16 January 1999Open access
Amy Perry, Nicholas Tarrier, Richard Morriss, Ellen P. McCarthy, Kirsten Limb
Citations589
Generate an AI Snapshot to get a quick, structured summary of this paper.
Study Snapshot
ObjectiveStudy objective
MethodsResearch methodology
PopulationPopulation studied
Sample sizeSample sizes
OutcomesStudy outcomes here
ResultsStudy results comes here
LimitationsResearch study limitations comes here
A concise AI-generated summary of the paper will appear here once you click Generate AI Snapshot.
TL;DR
Teaching patients with bipolar disorder to recognise early symptoms of manic relapse and seek early treatment is associated with important clinical improvements in time to first manic relapse, social functioning, and employment.
Abstract
Teaching patients to recognise early symptoms of manic relapse and seek early treatment is associated with important clinical improvements in time to first manic relapse, social functioning, and employment.
Keywords
MedicineHealth Professions
American Journal of PsychiatryRelapse and impairment in bipolar disorder
764 Citations1995Michael Gitlin, Joël Swendsen +2 more
Even aggressive pharmacological maintenance treatment does not prevent relatively poor outcome in a significant number of bipolar patients, and poor psychosocial outcome paralleled poor syndromal course.
Archives of General PsychiatryFamily Factors and the Course of Bipolar Affective Disorder
613 Citations1988David J. Miklowitz
Levels of intrafamilial EE and AS were found to predict likelihood of patient relapse at follow-up, especially when used as conjoint predictors of patient outcome status.
Archives of General PsychiatryOutcome in Mania
536 Citations1990Mauricio Tohen
A 4-year follow-up of 75 patients was conducted to investigate outcome after recovery from an episode of mania, and predictors of an unfavorable outcome included poor occupational status prior to index episode, history of previous episodes, and history of alcoholism, psychotic features and symptoms during the index manic episode.
BMJAssociation between maternal anxiety in pregnancy and increased uterine artery resistance index: cohort based study
524 Citations1999Jeronima Teixeira, Nicholas M. Fisk +1 more
An association between maternal anxiety in pregnancy and increased uterine artery resistance index is shown, which suggests a mechanism by which the psychological state of the mother may affect fetal development, and may explain epidemiological associations between maternalxiety and low birth weight.
BMJRandomised controlled trial of intensive cognitive behaviour therapy for patients with chronic schizophrenia
459 Citations1998Nicholas Tarrier, Lawrence Yusupoff +5 more
Cognitive behaviour therapy is a potentially useful adjunct treatment in the management of patients with chronic schizophrenia and results in almost eight times greater odds of showing this improvement.
American Journal of Psychiatry12-Month Outcome of Patients With Bipolar Disorder Following Hospitalization for a Manic or Mixed Episode
458 Citations1998PE Keck, Susan L. McElroy +6 more
Archives of General PsychiatryOutcome in Manic Disorders
355 Citations1990Martin Harrow
It is suggested that many hospitalized manic patients have a severe, recurrent, and pernicious disorder; and in routine clinical practice, lithium carbonate treatment is an effective prophylaxis for fewer than the 70% to 80% of manic patients previously reported.
American Journal of PsychiatryLong-Term Outcome of Lithium Prophylaxis in Bipolar Disorder: A 5-Year Prospective Study of 402 Patients at a Lithium Clinic
240 Citations1998M. Maj, Raffaele Pirozzi +2 more
The impact of lithium prophylaxis on the course of bipolar disorder is severely limited by the high dropout rate; in bipolar patients taking lithium regularly for several years, a drastic reduction of time spent in the hospital is almost the rule.
The British Journal of PsychiatryRecurrence in affective disorder
212 Citations1998Lars Vedel Kessing, Tom Gert Bolwig +2 more
The course of severe unipolar and bipolar disorder seems to be progressive in nature despite the effect of treatment, and the rate of recurrence after successive episodes was the same for the two disorders.
The Journal of Nervous and Mental DiseaseBipolar I: A Five-Year Prospective Follow-up
197 Citations1993Martín Keller, Philip W. Lavori +3 more
For those patients who relapsed, the mixed/cycling patients had the lowest cumulative probability of recovery from the first prospectively observed episode.
Psychological MedicineBipolar II illness: course and outcome over a five-year period
190 Citations1989William Coryell, Martin B. Keller +4 more
Data from a five year semi-annual follow-up of patients with non-bipolar, bipolar II and bipolar I major depression support the separation of bipolar I and bipolar II affective disorder.
Archives of General PsychiatrySubsyndromal Symptoms in Bipolar Disorder
183 Citations1992Martin B. Keller
A significant relationship was found between prescribed serum lithium level and the probability of major affective relapse and the occurrence of subsyndromal symptoms, and the patients originally randomized to receive standard-range lithium therapy were still better protected from relapse than were patients randomized to receiving low- range lithium treatment.
Psychological MedicineProdromes, coping strategies, insight and social functioning in bipolar affective disorders
173 Citations1997Dominic Lam, Grace Wong
Patients' level of social functioning was related to their level of insight, and to how well they coped with the prodromes of mania and whether they could detect prodrome of depression, a study of bipolar patients found.
Depression and AnxietyBipolar depression: An underestimated treatment challenge
119 Citations1997Stefanie A. Hlastala, Ellen Frank +4 more
Manic patients were significantly more likely to achieve clinical remission than the depressed patients and did so significantly more rapidly, suggesting that psychotherapy has a limited impact in the acute phase treatment of bipolar episodes.
American Journal of PsychiatryDuration and symptoms of bipolar prodromes
115 Citations1988G Molnár, Maria Feeney +1 more
The duration and symptoms of manic and depressive prodromes of 20 bipolar patients showed much interindividual variation, however, these features were consistent in successive episodes of the same type in the same patient.
The British Journal of PsychiatryRecurrence in affective disorder
112 Citations1998Lars Vedel Kessing
Social Psychiatry and Psychiatric EpidemiologyProdromal symptoms in manic depressive psychosis
75 Citations1992Jo Ann Smith, Nicholas Tarrier
The majority of patients could identify a time sequence to the retainment of insight during their prodromes and could also identify idiosyncratic symptoms.
Social Psychiatry and Psychiatric EpidemiologySocio-demographic associations with social disablement in a community sample
51 Citations1983Jamieson B. Hurry, E. Sturt +2 more
The associations between social disablement and socio-demographic factors have been examined in a random sample of 310 adults drawn from the general population of Camberwell, South London and an unsatisfactory marital relationship is significantly associated with disablement in women, but not in men.
Psychiatry ResearchProdromal symptoms and signs of bipolar relapse: A report based on prospectively collected data
38 Citations1992Emily S. Altman, Margaret Rea +4 more
Significant elevations in unusual thought content were found 1 month before manic relapse and depressive relapsers evidenced higher levels of conceptual disorganization throughout the prerelapse period.
Psychological MedicineThe contribution of childbearing to the sex difference in first admission rates for affective psychosis
32 Citations1989Richard Gater, Christine Dean +1 more
The contribution of childbearing to the sex difference in first admission rates for affective psychosis is examined and female parity is evident up to the age of 54, and it entirely accounts for thesex difference in relative risk.
Psychiatry ResearchRapidity of symptom onset in depression
23 Citations1985Michael A. Young, Paula Grabler
Patients with an onset of major depressive disorder during the previous 5-56 weeks were studied and a relationship between rapidity of symptom onset and the concepts of endogenous and primary depression was suggested.
Depression and AnxietyBipolar depression: An underestimated treatment challenge
17 Citations1997Stefanie A. Hlastala, Ellen Frank +4 more
Behavioural and Cognitive PsychotherapyIdentification of Prodromal Signs and Symptoms and Early Intervention in Manic Depressive Psychosis Patients: A Case Example
15 Citations1995Alison Perry, Nicholas Tarrier +1 more
The procedure of prodromal signs identification in manic depressive psychosis and the negotiation of an appropriate plan of action with the mental health services in order to abort the relapse or reduce its severity through early pharmacological intervention are described.
