Lesley Berk1,2,3, Karen T Hallam4,5, Kamalesh Venugopal6, Andrew James Lewis7,8, David W Austin9, Jayashri Kulkarni10, Seetal Dodd1,2,11, Anthony de Castella10, Paul B Fitzgerald10, Michael Berk1,2,11,12. 1. Deakin University, IMPACT Strategic Research Centre, School of Medicine, Barwon Health, Geelong, Vic., Australia. 2. Department of Psychiatry, University of Melbourne, Parkville, Vic., Australia. 3. Melbourne School of Global and Population Health, University of Melbourne, Parkville, Vic., Australia. 4. Department of Psychology, The University of Melbourne, Parkville, Vic., Australia. 5. Department of Psychology, Victoria University, Melbourne, Vic., Australia. 6. South Australian Department for Health and Ageing, Adelaide, SA, Australia. 7. School of Psychology & Exercise Science, Murdoch University, Murdoch, WA, Australia. 8. Harry Perkins Institute of Medical Research, Fiona Stanley Hospital, Murdoch, WA, Australia. 9. School of Psychology, Faculty of Health, Deakin University, Burwood, Vic., Australia. 10. Monash Alfred Psychiatry Research Centre (MAPrc), Monash University Central Clinical School and The Alfred, Melbourne, Vic., Australia. 11. Centre for Youth Mental Health, University of Melbourne, Parkville, Vic., Australia. 12. Florey Institute for Neuroscience and Mental Health, Parkville, Vic., Australia.
Abstract
OBJECTIVES: Many people experience irritability when manic, hypomanic, or depressed, yet its impact on illness severity and quality of life in bipolar and schizoaffective disorders is poorly understood. This study aimed to examine the relationship between irritability and symptom burden, functioning, quality of life, social support, suicidality, and overall illness severity in a naturalistic cohort of people with bipolar I or schizoaffective disorder. METHODS: We used data from 239 adult outpatients with bipolar I or schizoaffective disorder in the Bipolar Comprehensive Outcomes Study (BCOS) - a non-interventional observational study with a 2-year follow-up period. Baseline demographic and clinical characteristics of participants with and without irritability were compared. A mixed-model repeated measures analysis was conducted to examine the longitudinal effect of irritability on clinical and quality-of-life variables over follow-up using significant baseline variables. RESULTS: At baseline, 54% of participants were irritable. Baseline irritability was associated with illness severity, mania, depression, psychotic symptoms, suicidality, poor functioning, and quality of life, but not diagnosis (schizoaffective/bipolar disorder). Participants with irritability were less likely to have a partner and perceived less adequate social support. On average, over follow-up, those with irritability reported more symptoms, functional impairment, and suicidality. Furthermore, the effects of irritability could not be fully explained by illness severity. CONCLUSIONS: Irritability was associated with more negative symptomatic, functional, and quality-of-life outcomes and suicidality. The identification, monitoring, and targeted treatment of irritability may be worth considering, to enhance health and wellbeing outcomes for adults with bipolar and schizoaffective disorders.
OBJECTIVES: Many people experience irritability when manic, hypomanic, or depressed, yet its impact on illness severity and quality of life in bipolar and schizoaffective disorders is poorly understood. This study aimed to examine the relationship between irritability and symptom burden, functioning, quality of life, social support, suicidality, and overall illness severity in a naturalistic cohort of people with bipolar I or schizoaffective disorder. METHODS: We used data from 239 adult outpatients with bipolar I or schizoaffective disorder in the Bipolar Comprehensive Outcomes Study (BCOS) - a non-interventional observational study with a 2-year follow-up period. Baseline demographic and clinical characteristics of participants with and without irritability were compared. A mixed-model repeated measures analysis was conducted to examine the longitudinal effect of irritability on clinical and quality-of-life variables over follow-up using significant baseline variables. RESULTS: At baseline, 54% of participants were irritable. Baseline irritability was associated with illness severity, mania, depression, psychotic symptoms, suicidality, poor functioning, and quality of life, but not diagnosis (schizoaffective/bipolar disorder). Participants with irritability were less likely to have a partner and perceived less adequate social support. On average, over follow-up, those with irritability reported more symptoms, functional impairment, and suicidality. Furthermore, the effects of irritability could not be fully explained by illness severity. CONCLUSIONS:Irritability was associated with more negative symptomatic, functional, and quality-of-life outcomes and suicidality. The identification, monitoring, and targeted treatment of irritability may be worth considering, to enhance health and wellbeing outcomes for adults with bipolar and schizoaffective disorders.
Authors: Jane E Persons; Paul Lodder; William H Coryell; John I Nurnberger; Jess G Fiedorowicz Journal: Psychiatry Res Date: 2021-11-21 Impact factor: 3.222
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Authors: Dan J Stein; Peter Szatmari; Wolfgang Gaebel; Michael Berk; Eduard Vieta; Mario Maj; Ymkje Anna de Vries; Annelieke M Roest; Peter de Jonge; Andreas Maercker; Chris R Brewin; Kathleen M Pike; Carlos M Grilo; Naomi A Fineberg; Peer Briken; Peggy T Cohen-Kettenis; Geoffrey M Reed Journal: BMC Med Date: 2020-01-27 Impact factor: 8.775
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