ABSTRACT
472 bipolar patients were followed up retrospectively over 17 years. The patients that died were compared with the general population and a control group. The former comparison showed greater mortality from suicide, cardiovascular and respiratory causes in the index population and the latter, that the deceased were more likely to have been unmarried, with greater frequency and duration of admissions, a shorter follow-up period and were less likely to have received lithium treatment. The suicides were significantly younger at onset and death than the index and control groups, and suicide was uncommon where follow-up extended over 10 years.
Subject(s)
Bipolar Disorder/mortality , Adult , Age of Onset , Bipolar Disorder/drug therapy , Cardiovascular Diseases/mortality , Cause of Death , Female , Humans , Lithium Carbonate/therapeutic use , Male , Marital Status , Middle Aged , Recurrence , Respiration Disorders/mortality , Retrospective Studies , Scotland/epidemiology , Socioeconomic Factors , Suicide/psychologyABSTRACT
A manic-depressive patient hid 3000 pounds during one manic phase and subsequently, when his mood stabilised, could not remember where he had hidden it. He found the money during a subsequent manic phase a few months later. We suggest that this is not a clear case of state-dependent memory, since the patient at no point explicitly recollected where he had hidden the money. Instead we suggest that this represents state-dependent action. The links between this case and previous research on state-dependent memory are outlined.
Subject(s)
Bipolar Disorder/psychology , Hospitalization , Mental Recall , Retention, Psychology , Adult , Arousal , Humans , Male , Orientation , Social EnvironmentABSTRACT
Seventy-six patients were interviewed within a week of admission following a parasuicide episode. Axis II diagnosis on DSM-III was made for schizotypal, borderline, histrionic, and antisocial personality disorder. In addition patients completed a self-rating questionnaire, the Schizotypy Questionnaire of Claridge & Broks (1984), which assesses schizotypal and borderline personality traits. The objective and subjective indices of schizotypal and borderline symptoms correlated significantly but allocation of patients to a diagnosis missed several patients who nevertheless rated themselves as having a high frequency of these symptoms. There was an asymmetry of symptom pattern reminiscent of Foulds & Bedford's (1975) hierarchy model. The presence of schizotypal symptoms appeared to be higher in the hierarchy: they predicted borderline symptoms, but a high frequency of borderline symptoms did not necessarily predict schizotypy. We suggest that the occurrence of schizotypal symptoms should become a more explicit focus of clinical assessment and treatment of these patients, especially those who repeatedly harm themselves and we suggest ways in which cognitive therapies may be adapted to do this.
Subject(s)
Borderline Personality Disorder/psychology , Schizotypal Personality Disorder/psychology , Suicide, Attempted/psychology , Adolescent , Adult , Aged , Borderline Personality Disorder/diagnosis , Drug Overdose/psychology , Female , Humans , Male , Middle Aged , Personality Inventory/statistics & numerical data , Psychiatric Status Rating Scales/statistics & numerical data , Psychometrics , Schizotypal Personality Disorder/diagnosis , Self-Injurious BehaviorABSTRACT
The pharmacokinetics of solid lithium (Priadel) were compared with liquid lithium citrate in nine manic depressive patients. The results show that whilst the 12-h steady-state levels are similar, there are significant differences in the degree and rate of absorption between the two preparations. The clinical implications of this are discussed further.
Subject(s)
Citrates , Depressive Disorder/blood , Lithium/pharmacokinetics , Adult , Biological Availability , Depressive Disorder/drug therapy , Humans , Lithium CarbonateABSTRACT
The efficacy of lithium prophylaxis in bipolar affective disorder in clinical practice was investigated. Comparison was made between 41 patients who were prescribed prophylactic lithium after two admissions in two years or three admissions in five years and a group of patients who did not receive lithium. The benefits conferred by the prescription of this drug were modest compared with the results from clinical trials.
