Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 5 de 5
Filter
2.
J Affect Disord ; 227: 713-720, 2018 02.
Article in English | MEDLINE | ID: mdl-29179141

ABSTRACT

BACKGROUND: Findings from efficacy trials of group psychoeducation (PE) for bipolar disorders (BD) led to its inclusion in evidence-based guidelines as a first-line mandatory treatment. However, pragmatic trials and observational studies are needed to determine its real-world effectiveness, impact on outcomes deemed important to patients and to clarify potential mediators of any benefits. METHODS: Individuals with BD were offered the opportunity to participate in 20h of PE and asked to complete pre- and post-intervention ratings of symptoms, knowledge about BD, medication adherence, and illness perception. A priori, two key patient outcomes were identified (social functioning and self-esteem); sample attrition due to dropout or relapse was recorded. RESULTS: Of 156 individuals who completed the pre-PE assessments, 103 completed the program and post-PE assessments. Only 4 of 53 dropouts were associated with BD relapse. Post-intervention, the PE completers demonstrated a statistically significant improvement in social functioning (p = 0.003, Effect Size (ES) = 0.26) and a trend towards improved self-esteem (ES = 0.14). Whilst there were significant changes in medication adherence (p = 0.002, ES = 0.28), knowledge of BD (p < 0.001, ES = 1.20), and illness perception (p < 0.001, ES = -0.37), mediational analysis demonstrated that only change in illness perception was associated to change in functioning (p=0.03) with no contribution from changes in knowledge of BD or medication adherence. CONCLUSIONS: In real-world settings, over 60% individuals completed 10-session course of PE. After controlling for demography and baseline clinical state, change in illness perception, rather than change in knowledge or medication adherence, emerged as a potential mediator of some benefits of PE.


Subject(s)
Cognitive Behavioral Therapy/methods , Medication Adherence/psychology , Patient Compliance/psychology , Patient Education as Topic/methods , Adult , Bipolar Disorder/psychology , Bipolar Disorder/therapy , Female , Humans , Male , Middle Aged , Recurrence , Secondary Prevention , Treatment Outcome
3.
Acta Psychiatr Scand ; 129(3): 163-79, 2014 Mar.
Article in English | MEDLINE | ID: mdl-24215721

ABSTRACT

OBJECTIVE: To provide a systematic review of the literature regarding the efficacy of anti-inflammatory drugs in three major mental disorders [major depressive disorder (MDD), schizophrenia and bipolar disorders]. METHOD: Four databases were explored, without any year or language restrictions. The baseline search paradigm was limited to open-labelled clinical and randomized controlled trials (RCTs). RESULTS: Four major classes of anti-inflammatory drugs were identified, namely polyunsaturated fatty acids (PUFAs), cyclooxygenase (COX) inhibitors, anti-TNFalpha and minocycline. Effectiveness and benefit/risk ratio of each class in MDD, bipolar disorders and schizophrenia was detailed when data were available. Several meta-analyses indicated effectiveness of PUFAs in MDD with a good tolerance profile. One meta-analysis indicated that COX-2 specific inhibitors showed effectiveness in schizophrenia. Anti-TNFalpha showed important effectiveness in resistant MDD with blood inflammatory abnormalities. Minocycline showed effectiveness in schizophrenia. CONCLUSION: Polyunsaturated fatty acids seem to have the best benefit/risk ratio profile but proved their effectiveness only in MDD. A number of anti-inflammatory drugs are available as adjunct treatment for treatment-resistant patients with MDD, schizophrenia and bipolar disorder. If used with caution regarding their possible side-effects, they may be reasonable therapeutic alternatives for resistant symptomatology.


Subject(s)
Anti-Bacterial Agents/pharmacology , Anti-Inflammatory Agents/pharmacology , Bipolar Disorder/drug therapy , Cyclooxygenase Inhibitors/pharmacology , Depressive Disorder, Major/drug therapy , Fatty Acids, Unsaturated/pharmacology , Minocycline/pharmacology , Schizophrenia/drug therapy , Tumor Necrosis Factor-alpha/antagonists & inhibitors , Anti-Bacterial Agents/adverse effects , Anti-Inflammatory Agents/adverse effects , Cyclooxygenase Inhibitors/adverse effects , Fatty Acids, Unsaturated/adverse effects , Humans , Minocycline/adverse effects
4.
Acta Psychiatr Scand ; 127(2): 136-44, 2013 Feb.
Article in English | MEDLINE | ID: mdl-22901015

ABSTRACT

OBJECTIVE: Duration of untreated illness represents a potentially modifiable component of any diagnosis-treatment pathway. In bipolar disorder (BD), this concept has rarely been systematically defined or not been applied to large clinically representative samples. METHOD: In a well-characterized sample of 501 patients with BD, we estimated the duration of untreated bipolar disorder (DUB: the interval between the first major mood episode and first treatment with a mood stabilizer). Associations between DUB and clinical onset and the temporal sequence of key clinical milestones were examined. RESULTS: The mean DUB was 9.6 years (SD 9.7; median 6). The median DUB for those with a hypomanic onset (14.5 years) exceeded that for depressive (13 years) and manic onset (8 years). Early onset BD cases have the longest DUB (P < 0.0001). An extended DUB was associated with more mood episodes (P < 0.0001), more suicidal behaviour (P = 0.0003) and a trend towards greater lifetime mood instability (e.g. rapid cycling, possible antidepressant-induced mania). CONCLUSION: Duration of untreated bipolar disorder (DUB) will only be significantly reduced by more aggressive case finding strategies. Reliable diagnosis (especially for BD-II) and/or instigation of recommended treatments is currently delayed by insufficient awareness of the early, polymorphous presentations of BD, lack of systematic screening and/or failure to follow established guidelines.


Subject(s)
Bipolar Disorder/therapy , Adult , Age of Onset , Bipolar Disorder/diagnosis , Bipolar Disorder/psychology , Delayed Diagnosis/psychology , Delayed Diagnosis/statistics & numerical data , Female , Humans , Male , Time Factors
5.
C R Acad Sci III ; 316(12): 1417-9, 1993 Dec.
Article in French | MEDLINE | ID: mdl-8087620

ABSTRACT

Cumene-hydroperoxide is a radical reaction promoter. Vero cells monolayers treated with this compound were irradiated with gamma-rays and their radiosensitization was compared with that of irradiated, non-treated control cells. Cumene-hydroperoxide treated cells showed a paradoxal radioresistance. We propose a possible buffer-like effect of cumene-hydroperoxide to explain these results.


Subject(s)
Benzene Derivatives/pharmacology , Radiation Tolerance , Vero Cells/radiation effects , Animals , Cells, Cultured , In Vitro Techniques
SELECTION OF CITATIONS
SEARCH DETAIL
...