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3. Predictors of functional impairment in bipolar disorder: Results from 13 cohorts from seven countries by the global bipolar cohort collaborative.

Author

Burdick, Katherine, Millett, Caitlin, Yocum, Anastasia, Altimus, Cara, Andreassen, Ole, Aubin, Valerie, Belzeaux, Raoul, Berk, Michael, Biernacka, Joanna, Blumberg, Hilary, Cleare, Anthony, Diaz-Byrd, Claudia, Dubertret, Caroline, Etain, Bruno, Lagerberg, Trine, Leboyer, Marion, Martinez-Aran, Anabel, McElroy, Susan, Mitchell, Philip, Olie, Emilie, Olorunfemi, Phebe, Passerieux, Christine, Peters, Amy, Pham, Daniel, Polosan, Mircea, Potter, Julia, Sajatovic, Martha, Samalin, Ludovic, Schwan, Raymund, Shanahan, Megan, Solé, Brisa, Strawbridge, Rebecca, Stuart, Amanda, Torres, Ivan, Ueland, Torrill, Vieta, Eduard, Williams, Lana, Wrobel, Anna, Yatham, Lakshmi, Young, Allan, Nierenberg, Andrew, McInnis, Melvin, Forester, Brent, Fullerton, Janice, Frye, Mark, Gard, Sébastien, Godin, Ophelia, Haffen, Emmanuel, Eyler, Lisa, and Klaus, Federica

Subjects
Humans, Bipolar Disorder, Prospective Studies, Longitudinal Studies, Affect, Cohort Studies
Abstract

OBJECTIVES: Persistent functional impairment is common in bipolar disorder (BD) and is influenced by a number of demographic, clinical, and cognitive features. The goal of this project was to estimate and compare the influence of key factors on community function in multiple cohorts of well-characterized samples of individuals with BD. METHODS: Thirteen cohorts from 7 countries included n = 5882 individuals with BD across multiple sites. The statistical approach consisted of a systematic uniform application of analyses across sites. Each site performed a logistic regression analysis with empirically derived higher versus lower function as the dependent variable and selected clinical and demographic variables as predictors. RESULTS: We found high rates of functional impairment, ranging from 41 to 75%. Lower community functioning was associated with depressive symptoms in 10 of 12 of the cohorts that included this variable in the analysis. Lower levels of education, a greater number of prior mood episodes, the presence of a comorbid substance use disorder, and a greater total number of psychotropic medications were also associated with low functioning. CONCLUSIONS: The bipolar clinical research community is poised to work together to characterize the multi-dimensional contributors to impairment and address the barriers that impede patients complete recovery. We must also identify the core features which enable many to thrive and live successfully with BD. A large-scale, worldwide, prospective longitudinal study focused squarely on BD and its heterogeneous presentations will serve as a platform for discovery and promote major advances toward optimizing outcomes for every individual with this illness.

Published
2022

5. Cognitive Remediation in Bipolar (CRiB2): study protocol for a randomised controlled trial assessing efficacy and mechanisms of cognitive remediation therapy compared to treatment as usual

Author

Tsapekos, Dimosthenis, Strawbridge, Rebecca, Cella, Matteo, Goldsmith, Kimberley, Kalfas, Michail, Taylor, Rosie H., Swidzinski, Samuel, Marwaha, Steven, Grey, Libby, Newton, Elizabeth, Shackleton, Julie, Harrison, Paul J., Browning, Michael, Harmer, Catherine, Hartland, Hannah, Cousins, David, Barton, Stephen, Wykes, Til, and Young, Allan H.

Published
2023
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11. Predictors of outcome following psychological therapy for depression and anxiety in an urban primary care service: a naturalistic Bayesian prediction modeling approach.

Author

Hodsoll, John, Strawbridge, Rebecca, King, Sinead, Taylor, Rachael W., Breen, Gerome, Grant, Nina, Grey, Nick, Hepgul, Nilay, Hotopf, Matthew, Kitsune, Viryanaga, Moran, Paul, Tylee, André, Wingrove, Janet, Young, Allan H., and Cleare, Anthony J.

Subjects
*ANXIETY treatment, *PSYCHOTHERAPY, *PREDICTION models, *RESEARCH funding, *PRIMARY health care, *QUESTIONNAIRES, *SCIENTIFIC observation, *TREATMENT effectiveness, *SYMPTOM burden, *LONGITUDINAL method, *METROPOLITAN areas, *CONVALESCENCE, *QUALITY of life, *MENTAL depression
Abstract

Background: England's primary care service for psychological therapy (Improving Access to Psychological Therapies [IAPT]) treats anxiety and depression, with a target recovery rate of 50%. Identifying the characteristics of patients who achieve recovery may assist in optimizing future treatment. This naturalistic cohort study investigated pre-therapy characteristics as predictors of recovery and improvement after IAPT therapy. Methods: In a cohort of patients attending an IAPT service in South London, we recruited 263 participants and conducted a baseline interview to gather extensive pre-therapy characteristics. Bayesian prediction models and variable selection were used to identify baseline variables prognostic of good clinical outcomes. Recovery (primary outcome) was defined using (IAPT) service-defined score thresholds for both depression (Patient Health Questionnaire [PHQ-9]) and anxiety (Generalized Anxiety Disorder [GAD-7]). Depression and anxiety outcomes were also evaluated as standalone (PHQ-9/GAD-7) scores after therapy. Prediction model performance metrics were estimated using cross-validation. Results: Predictor variables explained 26% (recovery), 37% (depression), and 31% (anxiety) of the variance in outcomes, respectively. Variables prognostic of recovery were lower pre-treatment depression severity and not meeting criteria for obsessive compulsive disorder. Post-therapy depression and anxiety severity scores were predicted by lower symptom severity and higher ratings of health-related quality of life (EuroQol questionnaire [EQ5D]) at baseline. Conclusion: Almost a third of the variance in clinical outcomes was explained by pre-treatment symptom severity scores. These constructs benefit from being rapidly accessible in healthcare services. If replicated in external samples, the early identification of patients who are less likely to recover may facilitate earlier triage to alternative interventions. [ABSTRACT FROM AUTHOR]

Published
2024
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18. Biomarkers of inflammation as predictors of treatment response in depression

Author

Strawbridge, Rebecca Clare and Cleare, Anthony James

Subjects
150
Abstract

People suffering with depression often do not respond sufficiently to current treatments. A wealth of research suggests that mood disorders are associated with higher levels of inflammation, yet this literature currently provides an inadequate description of the nature of the depressive disorders studied and involves extensive heterogeneity between patients and study methodologies. This thesis comprises three studies examining a broad spectrum of circulating pro-inflammatory proteins before and after interventions for depression, to test specific hypotheses that raised inflammatory markers predict a poor response to treatment, and to detect inflammatory changes in relation to clinical response. Firstly, a systematic review and meta-analysis of inflammatory markers and treatment-response was undertaken (Study 1). Subsequently, investigations of inpatients with treatment-resistant depression (Study 2) and outpatients undertaking psychological therapy (Study 3) assessed 33 biomarkers alongside treatment and clinical outcome. Interleukin-6 (IL-6), Tumour necrosis factor (TNFα) and c-reactive protein (CRP) represent the most studied biomarkers. In meta-analyses, these were higher in depressed participants than controls and showed decreases with antidepressant treatment. In both subsequent studies, numerous biomarkers were higher in depressed patients than a non-depressed control group; few were lower in depression. IL-6, CRP and TNFα were predictive of treatment outcomes. Both inpatient and outpatient studies indicate increases in inflammatory levels with treatment. Results suggest that overall, inflammation is more closely linked with refractory or somatic depression but that age and other sociodemographic constructs also affect inflammatory activity. These results support previous evidence that inflammatory responses are dysregulated in mood disorders and provide novel candidates for future study. Reports of psychological interventions and those for treatment-resistant populations are scarce. Our findings provide promising indications that, if validated in future research, measures of inflammation may be useful in identifying patients less likely to respond to standard treatments or defining more homogenous subpopulations within affective disorders.

Published
2017

23. The Human Phenotype Ontology in 2024: phenotypes around the world

Author

Gargano, Michael A, primary, Matentzoglu, Nicolas, additional, Coleman, Ben, additional, Addo-Lartey, Eunice B, additional, Anagnostopoulos, Anna V, additional, Anderton, Joel, additional, Avillach, Paul, additional, Bagley, Anita M, additional, Bakštein, Eduard, additional, Balhoff, James P, additional, Baynam, Gareth, additional, Bello, Susan M, additional, Berk, Michael, additional, Bertram, Holli, additional, Bishop, Somer, additional, Blau, Hannah, additional, Bodenstein, David F, additional, Botas, Pablo, additional, Boztug, Kaan, additional, Čady, Jolana, additional, Callahan, Tiffany J, additional, Cameron, Rhiannon, additional, Carbon, Seth J, additional, Castellanos, Francisco, additional, Caufield, J Harry, additional, Chan, Lauren E, additional, Chute, Christopher G, additional, Cruz-Rojo, Jaime, additional, Dahan-Oliel, Noémi, additional, Davids, Jon R, additional, de Dieuleveult, Maud, additional, de Souza, Vinicius, additional, de Vries, Bert B A, additional, de Vries, Esther, additional, DePaulo, J Raymond, additional, Derfalvi, Beata, additional, Dhombres, Ferdinand, additional, Diaz-Byrd, Claudia, additional, Dingemans, Alexander J M, additional, Donadille, Bruno, additional, Duyzend, Michael, additional, Elfeky, Reem, additional, Essaid, Shahim, additional, Fabrizzi, Carolina, additional, Fico, Giovanna, additional, Firth, Helen V, additional, Freudenberg-Hua, Yun, additional, Fullerton, Janice M, additional, Gabriel, Davera L, additional, Gilmour, Kimberly, additional, Giordano, Jessica, additional, Goes, Fernando S, additional, Moses, Rachel Gore, additional, Green, Ian, additional, Griese, Matthias, additional, Groza, Tudor, additional, Gu, Weihong, additional, Guthrie, Julia, additional, Gyori, Benjamin, additional, Hamosh, Ada, additional, Hanauer, Marc, additional, Hanušová, Kateřina, additional, He, Yongqun (Oliver), additional, Hegde, Harshad, additional, Helbig, Ingo, additional, Holasová, Kateřina, additional, Hoyt, Charles Tapley, additional, Huang, Shangzhi, additional, Hurwitz, Eric, additional, Jacobsen, Julius O B, additional, Jiang, Xiaofeng, additional, Joseph, Lisa, additional, Keramatian, Kamyar, additional, King, Bryan, additional, Knoflach, Katrin, additional, Koolen, David A, additional, Kraus, Megan L, additional, Kroll, Carlo, additional, Kusters, Maaike, additional, Ladewig, Markus S, additional, Lagorce, David, additional, Lai, Meng-Chuan, additional, Lapunzina, Pablo, additional, Laraway, Bryan, additional, Lewis-Smith, David, additional, Li, Xiarong, additional, Lucano, Caterina, additional, Majd, Marzieh, additional, Marazita, Mary L, additional, Martinez-Glez, Victor, additional, McHenry, Toby H, additional, McInnis, Melvin G, additional, McMurry, Julie A, additional, Mihulová, Michaela, additional, Millett, Caitlin E, additional, Mitchell, Philip B, additional, Moslerová, Veronika, additional, Narutomi, Kenji, additional, Nematollahi, Shahrzad, additional, Nevado, Julian, additional, Nierenberg, Andrew A, additional, Čajbiková, Nikola Novák, additional, Nurnberger, John I, additional, Ogishima, Soichi, additional, Olson, Daniel, additional, Ortiz, Abigail, additional, Pachajoa, Harry, additional, Perez de Nanclares, Guiomar, additional, Peters, Amy, additional, Putman, Tim, additional, Rapp, Christina K, additional, Rath, Ana, additional, Reese, Justin, additional, Rekerle, Lauren, additional, Roberts, Angharad M, additional, Roy, Suzy, additional, Sanders, Stephan J, additional, Schuetz, Catharina, additional, Schulte, Eva C, additional, Schulze, Thomas G, additional, Schwarz, Martin, additional, Scott, Katie, additional, Seelow, Dominik, additional, Seitz, Berthold, additional, Shen, Yiping, additional, Similuk, Morgan N, additional, Simon, Eric S, additional, Singh, Balwinder, additional, Smedley, Damian, additional, Smith, Cynthia L, additional, Smolinsky, Jake T, additional, Sperry, Sarah, additional, Stafford, Elizabeth, additional, Stefancsik, Ray, additional, Steinhaus, Robin, additional, Strawbridge, Rebecca, additional, Sundaramurthi, Jagadish Chandrabose, additional, Talapova, Polina, additional, Tenorio Castano, Jair A, additional, Tesner, Pavel, additional, Thomas, Rhys H, additional, Thurm, Audrey, additional, Turnovec, Marek, additional, van Gijn, Marielle E, additional, Vasilevsky, Nicole A, additional, Vlčková, Markéta, additional, Walden, Anita, additional, Wang, Kai, additional, Wapner, Ron, additional, Ware, James S, additional, Wiafe, Addo A, additional, Wiafe, Samuel A, additional, Wiggins, Lisa D, additional, Williams, Andrew E, additional, Wu, Chen, additional, Wyrwoll, Margot J, additional, Xiong, Hui, additional, Yalin, Nefize, additional, Yamamoto, Yasunori, additional, Yatham, Lakshmi N, additional, Yocum, Anastasia K, additional, Young, Allan H, additional, Yüksel, Zafer, additional, Zandi, Peter P, additional, Zankl, Andreas, additional, Zarante, Ignacio, additional, Zvolský, Miroslav, additional, Toro, Sabrina, additional, Carmody, Leigh C, additional, Harris, Nomi L, additional, Munoz-Torres, Monica C, additional, Danis, Daniel, additional, Mungall, Christopher J, additional, Köhler, Sebastian, additional, Haendel, Melissa A, additional, and Robinson, Peter N, additional

Published
2023
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25. Predictors of Functional Impairment in Bipolar Disorder: Results From 13 Cohorts From Seven Countries by the Global Bipolar Cohort Collaborative

Author

Burdick, Katherine E., primary, Millett, Caitlin E., additional, Yocum, Anastasia K., additional, Altimus, Cara M., additional, Andreassen, Ole A., additional, Aubin, Valerie, additional, Belzeaux, Raoul, additional, Berk, Michael, additional, Biernacka, Joanna M., additional, Blumberg, Hilary P., additional, Cleare, Anthony J., additional, Diaz-Byrd, Claudia, additional, Dubertret, Caroline, additional, Etain, Bruno, additional, Eyler, Lisa T., additional, Forester, Brent P., additional, Fullerton, Janice M., additional, Frye, Mark A., additional, Gard, Sébastien, additional, Godin, Ophelia, additional, Haffen, Emmanuel, additional, Klaus, Federica, additional, Lagerberg, Trine Vik, additional, Leboyer, Marion, additional, Martinez-Aran, Anabel, additional, McElroy, Susan, additional, Mitchell, Philip B., additional, Olie, Emilie, additional, Olorunfemi, Phebe, additional, Passerieux, Christine, additional, Peters, Amy T., additional, Pham, Daniel L., additional, Polosan, Mircea, additional, Potter, Julia R., additional, Sajatovic, Martha, additional, Samalin, Ludovic, additional, Schwan, Raymund, additional, Shanahan, Megan, additional, Solé, Brisa, additional, Strawbridge, Rebecca, additional, Stuart, Amanda L., additional, Torres, Ivan, additional, Ueland, Torrill, additional, Vieta, Eduard, additional, Williams, Lana J., additional, Wrobel, Anna L., additional, Yatham, Lakshmi N., additional, Young, Allan H., additional, Nierenberg, Andrew A., additional, and McInnis, Melvin G., additional

Published
2023
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29. Economic impact of reducing treatment gaps in depression

Author

McCrone, Paul, Young, Allan H., Zahn, Roland, Eberhard, Jonas, Wasserman, Danuta, Brambilla, Paolo, Balazs, Judit, Caldas-De-Almeida, Jose, Ulrichsen, Andrea, Baltzis, Spyridon, Carli, Vladmir, Antunes, Ana, Schiena, Giandomenico, Quoidbach, Vinciane, Boyer, Patrice, Strawbridge, Rebecca, and NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM)

Subjects
Psychiatry and Mental health, treatment gaps, SDG 3 - Good Health and Well-being, Economics, cost, depression
Abstract

Publisher Copyright: © 2023 Elsevier Masson SAS. All rights reserved. Background Major depressive disorder (MDD) is highly prevalent across Europe. While evidence-based treatments exist, many people with MDD have their condition undetected and/or untreated. This study aims to assess the cost-effectiveness of reducing treatment gaps using a modelling approach. Methods A decision tree model covering a 27-month time horizon was used. This followed a care pathway where MDD could be detected or not, and where different forms of treatment could be provided. Expected costs pertaining to Germany, Hungary, Italy, Portugal, Sweden and the UK were calculated and quality-adjusted life years (QALYs) were estimated. The incremental costs per QALY of reducing detect and treatment gaps were estimated. Results The expected costs with a detection gap of 69% and treatment gap of 50% were €1236 in Germany, €476 Hungary, €1413 Italy, €938 Portugal, €2093 Sweden, and €1496 in the UK. The incremental costs per QALY of reducing the detection gap to 50% ranged from €2429 in Hungary to €10,686 in Sweden. The figures for reducing the treatment gap to 25% ranged from €3146 in Hungary to €13,843 in Sweden. Conclusions Reducing detection and treatment gaps, and maintaining current patterns of care, is likely to increase healthcare costs in the short term. However, outcomes are improved and reducing these gaps to 50% and 25% respectively appears to be a cost-effective use of resources. authorsversion epub_ahead_of_print

Published
2023

30. Prospective cohort study of early biosignatures of response to lithium in bipolar-I-disorders: overview of the H2020-funded R-LiNK initiative

Author

Scott, Jan, Hidalgo-Mazzei, Diego, Strawbridge, Rebecca, Young, Allan, Resche-Rigon, Matthieu, Etain, Bruno, Andreassen, Ole A., Bauer, Michael, Bennabi, Djamila, Blamire, Andrew M., Boumezbeur, Fawzi, Brambilla, Paolo, Cattane, Nadia, Cattaneo, Annamaria, Chupin, Marie, Coello, Klara, Cointepas, Yann, Colom, Francesc, Cousins, David A., Dubertret, Caroline, Duchesnay, Edouard, Ferro, Adele, Garcia-Estela, Aitana, Goikolea, Jose, Grigis, Antoine, Haffen, Emmanuel, Høegh, Margrethe C., Jakobsen, Petter, Kalman, Janos L., Kessing, Lars V., Klohn-Saghatolislam, Farah, Lagerberg, Trine V., Landén, Mikael, Lewitzka, Ute, Lutticke, Ashley, Mazer, Nicolas, Mazzelli, Monica, Mora, Cristina, Muller, Thorsten, Mur-Mila, Estanislao, Oedegaard, Ketil Joachim, Oltedal, Leif, Pålsson, Erik, Papadopoulos Orfanos, Dimitri, Papiol, Sergi, Perez-Sola, Victor, Reif, Andreas, Ritter, Philipp, Rossi, Roberto, Schulze, Thomas, Senner, Fanny, Smith, Fiona E., Squarcina, Letizia, Steen, Nils Eiel, Thelwall, Pete E., Varo, Cristina, Vieta, Eduard, Vinberg, Maj, Wessa, Michele, Westlye, Lars T., and Bellivier, Frank

Published
2019
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31. Patterns of pharmacotherapy for bipolar disorder: A GBC survey.

Author

Singh, Balwinder, Yocum, Anastasia K., Strawbridge, Rebecca, Burdick, Katherine E., Millett, Caitlin E., Peters, Amy T., Sperry, Sarah H., Fico, Giovanna, Vieta, Eduard, Verdolini, Norma, Godin, Ophelia, Leboyer, Marion, Etain, Bruno, Tso, Ivy F., Coombes, Brandon J., McInnis, Melvin G., Nierenberg, Andrew A., Young, Allan H., Ashton, Melanie M., and Berk, Michael

Subjects
DRUG therapy, BIPOLAR disorder, LITHIUM carbonate, ANTICONVULSANTS, MOOD stabilizers
Abstract

Objectives: To understand treatment practices for bipolar disorders (BD), this study leveraged the Global Bipolar Cohort collaborative network to investigate pharmacotherapeutic treatment patterns in multiple cohorts of well‐characterized individuals with BD in North America, Europe, and Australia. Methods: Data on pharmacotherapy, demographics, diagnostic subtypes, and comorbidities were provided from each participating cohort. Individual site and regional pooled proportional meta‐analyses with generalized linear mixed methods were conducted to identify prescription patterns. Results: This study included 10,351 individuals from North America (n = 3985), Europe (n = 3822), and Australia (n = 2544). Overall, participants were predominantly female (60%) with BD‐I (60%; vs. BD‐II = 33%). Cross‐sectionally, mood‐stabilizing anticonvulsants (44%), second‐generation antipsychotics (42%), and antidepressants (38%) were the most prescribed medications. Lithium was prescribed in 29% of patients, primarily in the Australian (31%) and European (36%) cohorts. First‐generation antipsychotics were prescribed in 24% of the European versus 1% in the North American cohort. Antidepressant prescription rates were higher in BD‐II (47%) compared to BD‐I (35%). Major limitations were significant differences among cohorts based on inclusion/exclusion criteria, data source, and time/year of enrollment into cohort. Conclusions: Mood‐stabilizing anticonvulsants, second‐generation antipsychotics, and antidepressants were the most prescribed medications suggesting prescription patterns that are not necessarily guideline concordant. Significant differences exist in the prescription practices across different geographic regions, especially the underutilization of lithium in the North American cohorts and the higher utilization of first‐generation antipsychotics in the European cohorts. There is a need to conduct future longitudinal studies to further explore these differences and their impact on outcomes, and to inform and implement evidence‐based guidelines to help improve treatment practices in BD. [ABSTRACT FROM AUTHOR]

Published
2024
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35. sj-docx-1-jop-10.1177_02698811231161627 – Supplemental material for A transdiagnostic systematic review and meta-analysis of ketamine’s anxiolytic effects

Author

Hartland, Hannah, Mahdavi, Kimia, Jelen, Luke A, Strawbridge, Rebecca, Young, Allan H, and Alexander, Laith

Subjects
FOS: Psychology, FOS: Clinical medicine, 170199 Psychology not elsewhere classified, 110319 Psychiatry (incl. Psychotherapy), 111599 Pharmacology and Pharmaceutical Sciences not elsewhere classified, 110904 Neurology and Neuromuscular Diseases
Abstract

Supplemental material, sj-docx-1-jop-10.1177_02698811231161627 for A transdiagnostic systematic review and meta-analysis of ketamine’s anxiolytic effects by Hannah Hartland, Kimia Mahdavi, Luke A Jelen, Rebecca Strawbridge, Allan H Young and Laith Alexander in Journal of Psychopharmacology

Published
2023
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40. Economic impact of reducing treatment gaps in depression

Author

McCrone, Paul, primary, Young, Allan H., additional, Zahn, Roland, additional, Eberhard, Jonas, additional, Wasserman, Danuta, additional, Brambilla, Paolo, additional, Balazs, Judit, additional, Caldas-de-Almeida, Jose, additional, Ulrichsen, Andrea, additional, Carli, Vladmir, additional, Antunes, Ana, additional, Schiena, Giandomenico, additional, Quoidbach, Vinciane, additional, Boyer, Patrice, additional, and Strawbridge, Rebecca, additional

Published
2023
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44. Contributors

Author

Ahmetspahic, Diana, primary, Alferink, Judith, additional, Anderson, George, additional, Arandjelovic, Katarina, additional, Arolt, Volker, additional, Baune, Bernhard T., additional, Benros, Michael Eriksen, additional, Borsini, Alessandra, additional, Bradburn, Steven, additional, Brinker, Dana, additional, Cannon, Abigail R., additional, Capuron, Lucile, additional, Carpenter, Joanne S., additional, Carvalho, André F., additional, Castanon, Nathalie, additional, Choudhry, Mashkoor A., additional, Ciobanu, Liliana G., additional, Cleare, Anthony J., additional, Corrigan, Frances, additional, Dannlowski, Udo, additional, Doolin, Kelly, additional, Engelen, Jennifer, additional, Eyre, Harris A., additional, Farzana, Farheen, additional, Flor-Henry, Sophie, additional, Förster, Katharina, additional, Fourrier, Célia, additional, Frodl, Thomas, additional, Grande, Iria, additional, Gregory, Jonathan M., additional, Hammer, Adam M., additional, Hannan, Anthony J., additional, Hickie, Ian B., additional, Holmes, Joshua, additional, Hutchinson, Mark R., additional, Jawahar, Magdalene C., additional, Jörgens, Silke, additional, Köhler-Forsberg, Ole, additional, Lamers, Femke, additional, Lavretsky, Helen, additional, Licinio, Julio, additional, Lowry, Christopher A., additional, Maes, Michael, additional, Mak, Michael, additional, Martin-Santos, Rocío, additional, McIntyre, Roger S., additional, Merrill, David A., additional, Milaneschi, Yuri, additional, Mondelli, Valeria, additional, Müller, Norbert, additional, Murgatroyd, Chris, additional, Musker, Michael, additional, Najjar, Souhel, additional, Nettis, Maria A., additional, Nikkheslat, Naghmeh, additional, Opel, Nils, additional, Oriolo, Giovanni, additional, Pahlajani, Silky, additional, Pariante, Carmine M., additional, Parletta, Natalie, additional, Penninx, Brenda W.J.H., additional, Raison, Charles L., additional, Redlich, Ronny, additional, Renoir, Thibault, additional, Rook, Graham A.W., additional, Rosenblat, Joshua D., additional, Sawyer, Kristi M., additional, Scott, Elizabeth M., additional, Singh, Ajeet B., additional, Singhal, Gaurav, additional, Steiner, Johann, additional, Strawbridge, Rebecca, additional, Toben, Catherine, additional, Tozzi, Leonardo, additional, Vieta, Eduard, additional, Wong, Ma-Li, additional, Young, Allan H., additional, and Zunszain, Patricia A., additional

Published
2018
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45. Is there a 'bipolar iceberg' in UK primary care psychological therapy services?

Author

Strawbridge, Rebecca, Alexander, Laith, Richardson, Thomas, Young, Allan H., and Cleare, Anthony J.

Subjects
*TREATMENT of psychological stress, *ACCESS to primary care, *MENTAL depression, *DISEASE prevalence, *ELIGIBILITY (Social aspects), *BIPOLAR disorder, *MENTAL health services, *COMORBIDITY, *SYMPTOMS
Abstract

Background: Improving Access to Psychological Therapies (IAPT) is a primary care therapy service commissioned by England's National Health Service (NHS) for people with unipolar depression and anxiety-related disorders. Its scope does not extend to 'severe mental illness', including bipolar disorders (BD), but evidence suggests there is a high BD prevalence in ostensibly unipolar major depressive disorder (uMDD) samples. This study aimed to indicate the prevalence and characteristics of people with BD in a naturalistic cohort of IAPT patients. Methods: 371 participants were assessed before initiating therapy. Participants were categorised by indicated diagnoses: BD type-I (BD-I) or type-II (BD-II) as defined using a DSM diagnostic interview, bipolar spectrum (BSp, not meeting diagnostic criteria but exceeding BD screening thresholds), lifetime uMDD or other. Information about psychiatric history and co-morbidities was examined, along with symptoms before and after therapy. Results: 368 patients provided sufficient data to enable classification. 10% of participants were grouped as having BD-I, 20% BD-II, 40% BSp, 25% uMDD and 5% other. BD and uMDD participants had similar demographic characteristics, but patients meeting criteria for BD-I/BD-II had more complex psychiatric presentations. All three 'bipolar' groups had particularly high rates of anxiety disorders. IAPT therapy receipt was comparable between groups, as was therapy response (F 9704 = 1.113, p = 0.351). Conclusions: Notwithstanding the possibility that bipolar diathesis was overestimated, findings illustrate a high prevalence of BD in groups of people notionally with uMDD or anxiety. As well as improving the detection of BD, further substantive investigation is required to establish whether individuals affected by BD should be eligible for primary care psychological intervention. [ABSTRACT FROM AUTHOR]

Published
2023
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50. Is there a 'bipolar iceberg' in UK primary care psychological therapy services?

Author

Strawbridge, Rebecca, Alexander, Laith, Richardson, Thomas, Young, Allan, and Cleare, Anthony

Abstract

Background: Improving Access to Psychological Therapies (IAPT) is a primary care therapy service commissioned by England’s National Health Service (NHS) for people with unipolar depression and anxiety-related disorders. Its scope does not extend to ‘severe mental illness’, including bipolar disorders (BD), but evidence suggests there is a high BD prevalence in ostensibly unipolar major depressive disorder (uMDD) samples. This study aimed to indicate the prevalence and characteristics of people with BD in a naturalistic cohort of IAPT patients. Methods: 371 participants were assessed before initiating therapy. Participants were categorised by indicated diagnoses: BD type-I (BD-I) or type-II (BD-II) as defined using a DSM diagnostic interview, bipolar spectrum (BSp, not meeting diagnostic criteria but exceeding BD screening thresholds), lifetime uMDD or other. Information about psychiatric history and co-morbidities was examined, along with symptoms before and after therapy.Results: 10% of participants were grouped as having BD-I, 20% BD-II, 40% BSp, 25% uMDD and 5% other. BD and uMDD participants had similar demographic characteristics, but patients meeting criteria for BD-I/BD-II had more complex psychiatric presentations. All three ‘bipolar’ groups had particularly high rates of anxiety disorders. IAPT therapy receipt was comparable between groups, as was therapy response (F9,704=1.113, p=0.351). Conclusions: notwithstanding the possibility that bipolar diathesis was overestimated, findings illustrate a high prevalence of BD in groups of people notionally with uMDD or anxiety. As well as improving the detection of BD, further substantive investigation is required to establish whether individuals affected by BD should be eligible for primary care psychological intervention.

Published
2022

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