Abstract:
OBJECTIVES:The study was designed to test an audit-based quality improvement programme (QIP) addressing lithium prescribing and monitoring in UK mental health services. METHODS:A baseline clinical audit was conducted against the following standards: (i) measurement of renal and thyroid function before initiating treatment with lithium and (ii) recommended monitoring of serum lithium and renal and thyroid function during maintenance treatment. A re-audit was conducted at 18 months and a supplementary audit at three years. RESULTS:Data were submitted for patients at baseline (n = 3,373), re-audit (n = 3,647), and supplementary audit (n = 5,683), 57% of whom had bipolar disorder. The baseline findings prompted a patient safety alert issued by the National Patient Safety Agency. By supplementary audit, the proportion of patients having four serum lithium tests over the previous year had increased from 30% at baseline to 48%, and the respective proportions that had two tests of renal function from 55% to 70% and thyroid function from 49% to 66%. Elderly patients and those prescribed a drug known to interact with lithium were not more likely to be monitored in line with the audit standards. Between baseline and supplementary audit, the proportion of patients with a diagnosis of bipolar disorder prescribed an antidepressant increased from 36% to 41%. CONCLUSIONS:Improvements in biochemical monitoring of lithium treatment were achieved over time with participation in a QIP that included benchmarking of performance against clinical standards and customized change interventions. Nevertheless, gaps remain between the standard and current practice. Antidepressants are frequently prescribed in patients with bipolar disorder despite a paucity of evidence supporting their efficacy.
journal_name
Bipolar Disordjournal_title
Bipolar disordersauthors
Paton C,Adroer R,Barnes TRdoi
10.1111/bdi.12128subject
Has Abstractpub_date
2013-12-01 00:00:00pages
865-75issue
8eissn
1398-5647issn
1399-5618journal_volume
15pub_type
杂志文章abstract:OBJECTIVES:To compare the dimensional psychopathology in offspring of parents with bipolar disorder (BP) with offspring of community control parents as assessed by the Child Behavior Checklist (CBCL). METHODS:Offspring of parents with BP, who were healthy or had non-BP disorders (any psychiatric disorder other than BP...
journal_title:Bipolar disorders
pub_type: 杂志文章
doi:10.1111/j.1399-5618.2011.00966.x
更新日期:2011-11-01 00:00:00
abstract:OBJECTIVES:Objective physiological indices independently characterizing affective and schizophreniform psychoses would contribute to our understanding of the nature of their relationships. Magnetoencephalography (MEG)-based metrics of altered structural/functional asymmetry in the superior temporal gyrus have previousl...
journal_title:Bipolar disorders
pub_type: 杂志文章
doi:10.1111/j.1399-5618.2009.00701.x
更新日期:2009-06-01 00:00:00
abstract:OBJECTIVE:To identify the risk factors for suicidal ideation in subjects with bipolar depression. METHODS:One-hundred and thirty subjects diagnosed with bipolar depression were evaluated on the following scales: Beck Depression Inventory (BDI), Beck Hopelessness Scale (BHS), Patient Health Questionnaire-15 (PHQ-15), B...
journal_title:Bipolar disorders
pub_type: 杂志文章
doi:10.1111/bdi.12179
更新日期:2014-09-01 00:00:00
abstract:BACKGROUND:Approximate entropy (ApEn) measures regularity in time series data, while traditional linear statistics measure variability. Using self-reported mood data from patients with bipolar disorder, this preliminary study addressed whether ApEn could distinguish (i) the 60 days prior to the start of a manic or depr...
journal_title:Bipolar disorders
pub_type: 杂志文章
doi:10.1111/j.1399-5618.2006.00373.x
更新日期:2006-10-01 00:00:00
abstract:OBJECTIVES:Sufficient prefrontal top-down control of limbic affective areas, especially the amygdala, is essential for successful effortful emotion regulation (ER). Difficulties in effortful ER have been seen in patients with bipolar disorder (BD), which could be suggestive of a disturbed prefrontal-amygdala regulation...
journal_title:Bipolar disorders
pub_type: 杂志文章
doi:10.1111/bdi.12611
更新日期:2018-06-01 00:00:00
abstract:OBJECTIVES:Pediatric bipolar disorder is currently diagnosed based on signs and symptoms, and without objective diagnostic biomarkers. In the present study, we investigated the utility of structural neuroanatomical signatures of the amygdala to objectively differentiate individual subjects with pediatric bipolar disord...
journal_title:Bipolar disorders
pub_type: 杂志文章
doi:10.1111/bdi.12222
更新日期:2014-11-01 00:00:00
abstract:OBJECTIVES:Individuals with bipolar disorder (BD) have trait-like deficits in attention and working memory (WM). A fundamental dissociation for most verbal WM theories involves the separation of sensory-perceptual encoding, reliant upon attention, from the maintenance of this information in WM proper. The present study...
journal_title:Bipolar disorders
pub_type: 杂志文章
doi:10.1111/bdi.12126
更新日期:2014-05-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to evaluate the efficacy and safety of the dopaminergic-enhancing agent modafinil/armodafinil (MoArm) as adjunctive treatment for bipolar depression. METHODS:A comprehensive search of major electronic databases was conducted to identify randomized controlled trials (RCTs) of adjunct...
journal_title:Bipolar disorders
pub_type: 杂志文章,meta分析
doi:10.1111/bdi.12859
更新日期:2020-03-01 00:00:00
abstract:OBJECTIVES:To investigate neurochemical abnormalities in the left and right ventrolateral prefrontal cortex (VLPFC) and anterior cingulate cortex (ACC) of youth at risk for bipolar disorder using proton magnetic resonance spectroscopy before and after their first mood episode. METHODS:Children and adolescents offsprin...
journal_title:Bipolar disorders
pub_type: 杂志文章
doi:10.1111/bdi.12770
更新日期:2019-06-01 00:00:00
abstract:OBJECTIVES:Hypomania in bipolar disorders is characterized by disinhibited, fearless and reward-seeking behavior. This behavioral pattern suggests that early and automatic responding to socio-emotional cues such as facial expressions might be aberrant in hypomania. The present study tested the predictions that particip...
journal_title:Bipolar disorders
pub_type: 杂志文章
doi:10.1111/j.1399-5618.2007.00425.x
更新日期:2007-11-01 00:00:00
abstract:BACKGROUND:Patients with mood disorders may benefit from psychosocial interventions through changes in brain networks underlying emotion processing. In this study, we used functional magnetic resonance imaging (fMRI) to investigate treatment-related changes in emotion processing networks in youth at familial high risk ...
journal_title:Bipolar disorders
pub_type: 杂志文章
doi:10.1111/bdi.13045
更新日期:2021-01-12 00:00:00
abstract::It has become increasingly appreciated that the long-term treatment of complex neuropsychiatric disorders like bipolar disorder (BD) involves the strategic regulation of signaling pathways and gene expression in critical neuronal circuits. Accumulating evidence from our laboratories and others has identified the famil...
journal_title:Bipolar disorders
pub_type: 杂志文章,评审
doi:10.1034/j.1399-5618.2000.20303.x
更新日期:2000-09-01 00:00:00
abstract:OBJECTIVES:We combined multimodal functional magnetic resonance imaging (fMRI) and structural magnetic resonance imaging to probe abnormalities in brain circuits underpinning episodic memory performance deficits in patients with bipolar disorder (BD). METHODS:We acquired whole-brain fMRI data in 21 patients with BD an...
journal_title:Bipolar disorders
pub_type: 杂志文章
doi:10.1111/bdi.12241
更新日期:2014-12-01 00:00:00
abstract:OBJECTIVES:Although it is well established that euthymic patients with bipolar disorder can have cognitive impairment, substantial heterogeneity exists and little is known about the extent and severity of impairment within the bipolar II disorder subtype. Therefore, the main aim of this study was to analyze cognitive v...
journal_title:Bipolar disorders
pub_type: 杂志文章
doi:10.1111/bdi.12385
更新日期:2016-05-01 00:00:00
abstract:OBJECTIVES:The present study examined the 5-year longitudinal course of cognitive functioning in a large sample of well-characterized patients with bipolar disorder (BP), compared to healthy controls (HCs), and the influence of cognitive reserve factors (e.g., education and IQ) on cognitive change over time. METHODS:P...
journal_title:Bipolar disorders
pub_type: 杂志文章
doi:10.1111/bdi.12470
更新日期:2017-02-01 00:00:00
abstract:OBJECTIVES:Significant debate exists on whether early onset bipolar disorder is mistakenly attributed to attention deficit hyperactivity disorder (ADHD) or conduct disorder (CD), or whether ADHD and CD are frequently misdiagnosed as mania. We review the literature on the extent to which these disorders can be reliably ...
journal_title:Bipolar disorders
pub_type: 杂志文章,评审
doi:10.1034/j.1399-5618.2002.01191.x
更新日期:2002-08-01 00:00:00
abstract:OBJECTIVES:We investigated the neuroprotective effects of lithium in an experimental neurodegeneration model gated to kainate (KA) receptor activation. METHODS:The hippocampus from KA-treated mice and hippocampal cell cultures were used to evaluate the pathways regulated by chronic lithium pretreatment in both in vivo...
journal_title:Bipolar disorders
pub_type: 杂志文章
doi:10.1111/j.1399-5618.2010.00825.x
更新日期:2010-06-01 00:00:00
abstract:OBJECTIVE:An emerging body of evidence supports a role for dysfunctional purinergic neurotransmission in mood disorders. Adenosine agonists have been shown to have properties similar to those of dopamine antagonists; there is a well-characterized interaction between adenosine and dopamine receptors in the ventral stria...
journal_title:Bipolar disorders
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1111/bdi.12202
更新日期:2014-06-01 00:00:00
abstract:OBJECTIVES:Bipolar disorder is frequently associated with cognitive impairment even during euthymia. Previous studies have reported significant impairments in functional and quality of life outcomes and a possible relationship between these variables and cognitive performance. Cognitive rehabilitation interventions hav...
journal_title:Bipolar disorders
pub_type: 杂志文章,随机对照试验
doi:10.1111/bdi.12784
更新日期:2019-11-01 00:00:00
abstract:OBJECTIVES:To evaluate the antimanic efficacy and safety of paliperidone extended-release (ER) tablets in patients with bipolar I disorder. METHODS:This study included a 3-week, double-blind, acute treatment phase (paliperidone ER versus placebo, with quetiapine as control), and a 9-week, double-blind, maintenance pha...
journal_title:Bipolar disorders
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1111/j.1399-5618.2010.00815.x
更新日期:2010-05-01 00:00:00
abstract:BACKGROUND:Bipolar illness is frequently misdiagnosed. Several studies have focused on the underdiagnosis of this condition and the frequent long delay in its recognition. However, the illness is difficult to diagnose and many of its symptoms are shared by other conditions. In order to determine the accuracy of the dia...
journal_title:Bipolar disorders
pub_type: 杂志文章
doi:10.1111/j.1399-5618.2007.00465.x
更新日期:2007-09-01 00:00:00
abstract:OBJECTIVES:Population isolates offer several advantages for those hoping to identify predisposition genes for bipolar disorder (BP). In this review article, the rationale for performing gene mapping studies in this type of population and the results of genetic mapping studies performed to date in population isolates ar...
journal_title:Bipolar disorders
pub_type: 杂志文章,评审
doi:10.1034/j.1399-5618.2001.30605.x
更新日期:2001-12-01 00:00:00
abstract:BACKGROUND:Depression research historically uses both self- and clinician ratings of symptoms with significant and substantial correlations. It is often assumed that manic patients lack insight and cannot accurately report their symptoms. This delayed the development of self-rating scales for mania, but several scales ...
journal_title:Bipolar disorders
pub_type: 杂志文章
doi:10.1111/bdi.12906
更新日期:2020-09-01 00:00:00
abstract:OBJECTIVES:There is evidence for differential neural alterations within the prefrontal cortex (PFC) in bipolar disorder I (BDI) and schizophrenia that may translate into different cognitive deficits. Our objective was to compare the cognitive profile of stable BDI and schizophrenic patients using neuropsychological tas...
journal_title:Bipolar disorders
pub_type: 杂志文章
doi:10.1111/j.1399-5618.2006.00274.x
更新日期:2006-02-01 00:00:00
abstract:BACKGROUND:There is wide recognition that symptom ratings alone are inadequate to measure outcomes in bipolar disorder (BD), and quality of life (QoL) has been proposed as an important separable construct. Although a literature on QoL in BD exists, there is no disorder-specific measure of QoL in BD. In 2004, we embarke...
journal_title:Bipolar disorders
pub_type: 杂志文章
doi:10.1111/j.1399-5618.2010.00865.x
更新日期:2010-11-01 00:00:00
abstract:BACKGROUND:Neurocognitive deficits are prevalent, persistent, and implicated as mediators of functional impairment in adults with bipolar disorder. Notwithstanding progress in the development of pharmacological treatments for various phases of bipolar disorder, no available treatment has been proven to be reliably effi...
journal_title:Bipolar disorders
pub_type: 杂志文章,随机对照试验
doi:10.1111/bdi.12006
更新日期:2012-11-01 00:00:00
abstract:OBJECTIVES: Inflammation and other immune processes are increasingly linked to psychiatric diseases. Antigenic triggers specific to bipolar disorder are not yet defined. We tested whether antibodies to bovine milk caseins were associated with bipolar disorder, and whether patients recognized different epitopes of the ...
journal_title:Bipolar disorders
pub_type: 杂志文章
doi:10.1111/j.1399-5618.2010.00879.x
更新日期:2010-12-01 00:00:00
abstract::Data from the imaging literature have led to suggestions that permanent structural brain changes may be associated with bipolar disorder. Individuals diagnosed with bipolar disorder display deficits on a range of neuropsychological tasks in both the acute and euthymic phases of illness, and correlations between experi...
journal_title:Bipolar disorders
pub_type: 杂志文章,评审
doi:10.1111/j.1399-5618.2005.00203.x
更新日期:2005-06-01 00:00:00
abstract:OBJECTIVES:To compare the quality of life (QOL) of patients having dual diagnosis of bipolar affective disorder and substance dependence with those having either diagnosis alone and with healthy controls. METHODS:Cross-sectional assessment of the four groups of subjects was made. Euthymic bipolar patients and those su...
journal_title:Bipolar disorders
pub_type: 杂志文章
doi:10.1111/j.1399-5618.2004.00173.x
更新日期:2005-04-01 00:00:00
abstract:OBJECTIVES:This study compared the relative risk for hospitalization of patients with bipolar and manic disorders receiving atypical and typical antipsychotics. METHODS:This retrospective study was based on administrative claims data extracted from the PharMetrics database during 1999 through 2003. Comparisons were ma...
journal_title:Bipolar disorders
pub_type: 杂志文章
doi:10.1111/j.1399-5618.2007.00394.x
更新日期:2007-05-01 00:00:00