Purpose
Psychotropic and somatic medications are both used in treating severe mental disorders (SMDs). Realistic estimates of the prevalence of use across medication categories are needed. We obtained this in a clinical cohort of patients with SMD and healthy controls (HCs).
Materials and methods
Prescriptions filled at Norwegian pharmacies the year before and after admittance to the Thematically Organized Psychosis (TOP) study were examined in 1406 patients with SMD (mean age 32.5 years, 48.2% women) and 920 HC (34.1 years, 46.2% women). Using data from the Norwegian Prescription Database (NorPD), the number of users in different anatomical therapeutic chemical (ATC) categories was compared using logistic regression. Population estimates were used as reference data.
Results
Use of antipsychotics (N05A), antiepileptics (N03A), antidepressants (N06A), anxiolytics (N05B), hypnotics and sedatives (N05C), anticholinergics (N04A), psychostimulants, attention deficit hyperactivity disorder and nootropic agents (N06B) and drugs for addiction disorders (N07B) was significantly more prevalent in patients with SMD than HC. Use of diabetes treatment (A10), antithrombotic drugs (B01), beta blockers (C07), lipid modifiers (C10), and thyroid and endocrine therapeutics (H03) was also more prevalent in patients with SMD, but with two exceptions somatic medication use was comparable to the general population. Among HC, there was low prevalence of use for most medication categories.
Conclusion
Patients were using psychiatric medications, but also several types of somatic medications, more often than HC. Still, somatic medication use was mostly not higher than in the general population. The results indicate that HC had low use of most medication types.
Introduction: The Diagnostic and Statistical Manual
of Mental Disorders (DSM)-IV diagnostic category
“Psychotic disorder not otherwise specified” (PNOS) is
seldom investigated, and we lack knowledge about longterm outcomes. We examined long-term symptom severity,
global functioning, remission/recovery rates, and diagnostic
stability after the first treatment for PNOS.
Methods: Participants with first-treatment PNOS (n = 32) were
reassessed with structured interviews after 7 to 10 years.
The sample also included narrow schizophrenia spectrum
disorders (SSD, n = 94) and psychotic bipolar disorders
(PBD, n = 54). Symptomatic remission was defined based
on the Remission in Schizophrenia Working Group criteria.
Clinical recovery was defined as meeting the criteria for
symptomatic remission and having adequate functioning
for the last 12 months.
Results: Participants with baseline PNOS or PBD had lower symptom severity and better global functioning at follow-up than those with SSD. More participants with PNOS and PBD were in symptomatic remission and clinical recovery compared to participants with SSD. Seventeen (53%) PNOS participants retained the diagnosis, while 15 participants were diagnosed with either SSD (22%), affective disorders (19%), or substanceinduced psychotic disorders (6%). Those rediagnosed with SSD did not differ from the other PNOS participants
regarding baseline clinical characteristics.
Conclusions: Long-term outcomes are more favorable in PNOS and PBD than in SSD. Our findings confirm diagnostic instability but also stability for a subgroup of participants with PNOS. However, it is challenging to predict diagnostic
outcomes of PNOS based on clinical characteristics at first
treatment.
Hindley, Guy Frederick Lanyon; Shadrin, Alexey; van der Meer, Dennis; Parker, Nadine; Cheng, Weiqiu & O'Connell, Kevin Sean
[Vis alle 23 forfattere av denne artikkelen](2023).
Multivariate genetic analysis of personality and cognitive traits reveals abundant pleiotropy.
Nature Human Behaviour.
ISSN 2397-3374.
7,
s. 1584–1600.
doi: 10.1038/s41562-023-01630-9.
Flaaten, Camilla Bärthel; Melle, Ingrid; Bjella, Thomas; Engen, Magnus Johan; Åsbø, Gina & Wold, Kristin Fjelnseth
[Vis alle 13 forfattere av denne artikkelen](2023).
Long-term course of cognitive functioning in bipolar disorder: A ten-year follow-up study.
Bipolar Disorders.
ISSN 1398-5647.
doi: 10.1111/bdi.13364.
Fulltekst i vitenarkiv
Introduction: The illness course of bipolar disorder (BD) is highly heterogeneous with substantial variation between individuals with the same BD subtype and within individuals over time. This heterogeneity is not well-delineated and hampers the development of more targeted treatment. Furthermore, although lifestyle-related behaviors are believed to play a role in the illness course, such mechanisms are poorly understood. To address some of these knowledge gaps, we aimed to develop an app for collection of multi-dimensional longitudinal data on BD-relevant symptoms and lifestyle-related behaviors.
Methods: An app named MinDag was developed at the Norwegian Center for Mental Disorders Research in Oslo, Norway. The app was designed to tap into selected areas: mood, sleep, functioning/activities (social, occupational, physical exercise, leisure), substance use, emotional reactivity, and psychotic experiences. Ethical, security and usability issues were highly prioritized throughout the development and for the final app solution. We conducted beta- and pilot testing to eliminate technical problems and enhance usability and acceptability.
Results: The final version of MinDag comprises six modules; three which are presented for the user once daily (the Sleep module in the morning and the Mood and Functoning/Activities modules in the evening) and three which are presented once weekly (Substance Use, Emotional Reactivity, and Psychotic Experiences modules). In general, MinDag was well received in both in the beta-testing and the pilot study, and the participants provided valuable feedback that was taken into account in the final development. MinDag is now in use as part of the research protocol at the NORMENT center and in a specialized treatment unit for BD at Oslo University Hospital in Norway.
Discussion: We believe that MinDag will generate unique longitudinal data well suited for capturing the heterogeneity of BD and clarifying important unresolved issues such as how life-style related behavior may influence BD symptoms. Also, the experiences and knowledge derived from the development of MinDag may contribute to improving the security, acceptability, and benefit of digital tools in mental health.
Background: Bipolar disorder is associated with circadian disruption and a high risk of suicidal behavior. In a previous exploratory study of patients with bipolar I disorder, we found that a history of suicide attempts was associated with differences between winter and summer levels of solar insolation. The purpose of this study was to confirm this finding using international data from 42% more collection sites and 25% more countries.
Methods: Data analyzed were from 71 prior and new collection sites in 40 countries at a wide range of latitudes. The analysis included 4876 patients with bipolar I disorder, 45% more data than previously analyzed. Of the patients, 1496 (30.7%) had a history of suicide attempt. Solar insolation data, the amount of the sun's electromagnetic energy striking the surface of the earth, was obtained for each onset location (479 locations in 64 countries).
Results: This analysis confirmed the results of the exploratory study with the same best model and slightly better statistical significance. There was a significant inverse association between a history of suicide attempts and the ratio of mean winter insolation to mean summer insolation (mean winter insolation/mean summer insolation). This ratio is largest near the equator which has little change in solar insolation over the year, and smallest near the poles where the winter insolation is very small compared to the summer insolation. Other variables in the model associated with an increased risk of suicide attempts were a history of alcohol or substance abuse, female gender, and younger birth cohort. The winter/summer insolation ratio was also replaced with the ratio of minimum mean monthly insolation to the maximum mean monthly insolation to accommodate insolation patterns in the tropics, and nearly identical results were found. All estimated coefficients were significant at p < 0.01.
Conclusion: A large change in solar insolation, both between winter and summer and between the minimum and maximum monthly values, may increase the risk of suicide attempts in bipolar I disorder. With frequent circadian rhythm dysfunction and suicidal behavior in bipolar disorder, greater understanding of the optimal roles of daylight and electric lighting in circadian entrainment is needed.
Anderssen, Jannicke Fjæra; Simonsen, Carmen Elisabeth; Büchmann, Camilla Bakkalia; Barrett, Elizabeth Ann; Bjella, Thomas & Lagerberg, Trine Vik
[Vis alle 10 forfattere av denne artikkelen](2019).
Sleep disturbances in schizophrenia spectrum and bipolar disorders ? a transdiagnostic perspective.
Comprehensive Psychiatry.
ISSN 0010-440X.
91,
s. 6–12.
doi: 10.1016/j.comppsych.2019.02.006.
Fulltekst i vitenarkiv
Nerhus, Mari; Berg, Akiah Ottesen; Simonsen, Carmen Elisabeth; Haram, Marit; Haatveit, Beathe Christin & Dahl, Sandra Rinne
[Vis alle 11 forfattere av denne artikkelen](2017).
Vitamin D deficiency associated with cognitive functioning in psychotic disorders.
Journal of Clinical Psychiatry.
ISSN 0160-6689.
78(7),
s. e750–e757.
doi: 10.4088/JCP.16m10880.
Simonsen, Carmen Elisabeth; Færden, Ann; Romm, Kristin Lie; Berg, Akiah Ottesen; Bjella, Thomas & Sundet, Kjetil Søren
[Vis alle 9 forfattere av denne artikkelen](2017).
Early clinical recovery in first-episode psychosis: Symptomatic remission and its correlates at 1-year follow-up.
Psychiatry Research.
ISSN 0165-1781.
254,
s. 118–125.
doi: 10.1016/j.psychres.2017.04.050.
Aas, Monica; Henry, C.; Bellivier, F; Lajnef, M; Gard, S & Kahn, J-P
[Vis alle 13 forfattere av denne artikkelen](2017).
Affective lability mediates the association between childhood trauma and suicide attempts, mixed episodes and co-morbid anxiety disorders in bipolar disorders.
Psychological Medicine.
ISSN 0033-2917.
47(5),
s. 902–912.
doi: 10.1017/S0033291716003081.
Haram, Marit; Bettella, Francesco; Brandt, Christine Lycke; Quintana, Daniel; Nerhus, Mari & Bjella, Thomas
[Vis alle 11 forfattere av denne artikkelen](2016).
Contribution of oxytocin receptor polymorphisms to amygdala activation in schizophrenia spectrum disorders.
BJPsych Open.
ISSN 2056-4724.
2(6),
s. 353–358.
doi: 10.1192/bjpo.bp.116.003376.
Vitamin D deficiency is common among patients with psychotic disorders and could be due to unknown disease mechanisms or contingent factors. However most studies are performed in chronic patients and have often failed to address the influence of ethnicity on vitamin D levels in clinical samples. We investigated serum concentrations of 25-hydroxy vitamin D (S-25 OH D) in first episode patients compared to patients with multi episodes and healthy controls; with a specific focus on differences between visible ethnic minorities and participants from the majority population. A total of 284 participants were included in this cross-sectional study. First episode patients with a DSM-IV psychotic disorder were matched on age, gender and ethnicity to participants from a multi episode patient sample (1:1) and healthy controls (1:2). We did not find any differences between either patient groups or the healthy controls, but participants from visible ethnic minorities had significantly lower S-25 OH D than participants from the majority population. This implies that S-25 OH D should be routinely measured in persons from visible ethnic minorities since low levels are associated with higher levels of depressive symptoms
Aas, Monica; Pedersen, Geir Feigum; Henry, Chantal; Bjella, Thomas; Bellivier, Frank & Leboyer, Marion
[Vis alle 14 forfattere av denne artikkelen](2014).
Psychometric properties of the Affective Lability Scale (54 and 18-item version) in patients with bipolar disorder, first-degree relatives, and healthy controls.
Journal of Affective Disorders.
ISSN 0165-0327.
172,
s. 375–380.
doi: 10.1016/j.jad.2014.10.028.
Aas, Monica; Haukvik, Unn Kristin H.; Djurovic, Srdjan; Tesli, Martin Steen; Athanasiu, Lavinia & Bjella, Thomas
[Vis alle 11 forfattere av denne artikkelen](2014).
Interplay between childhood trauma and BDNF val66met variants on blood BDNF mRNA levels and on hippocampus subfields volumes in schizophrenia spectrum and bipolar disorders.
Journal of Psychiatric Research.
ISSN 0022-3956.
59,
s. 14–21.
doi: 10.1016/j.jpsychires.2014.08.011.
Aminoff, Sofie Ragnhild; Henry, Chantal; Bettella, Francesco; Etain, Bruno; Berg, Akiah Ottesen & Lagerberg, Trine Vik
[Vis alle 12 forfattere av denne artikkelen](2018).
Affective lability and polygenic risk in bipolar disorder.
Aminoff, Sofie Ragnhild; Lagerberg, Trine Vik; Aas, Monica; Bjella, Thomas; Henry, Chantal & Leboyer, Marion
[Vis alle 10 forfattere av denne artikkelen](2015).
Affective lability is Associated With Alcohol use disorders in Bipolar disorder.