Depression and Bipolar info explaining the latest research in everyday English

1Sep/10Off

A review of findings from the world’s largest study of Bipolar Disorder

The Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD) ran from 1998 to 2005, with over 4,000 sufferers of Bipolar Disorder (BD) taking part in various trials and assessments over a two-year period.

Researchers were looking at how BD progresses through a person's life, how related it is to other psychiatric disorders, and how related it is to suicidality.

It found that few treatments alone were successful in treating BD, however psycho-social interventions (such as Cognitive Behaviour Therapy) and psycho-education interventions combined with mood stabilizers showed the most positive results.

BD was also shown to be strongly related to substance abuse and smoking, both of which affected the success or otherwise of chemical and psychological treatments.

Interestingly, paroxetine or bupropion were shown to be no more effective than a placebo in achieving sustained recovery (in this instance, determined as eight weeks of 'stable' behavior). So, too, were lamotrigine, risperidone, and inositol found to deliver minimal positive effects.

To the vexed, 'hidden', taboo subject of suicide -- the 'S' word not spoken of by the media (although thankfully that is slowly changing, at least in Australia). Suicidality persists with BD, even when treatment outcomes are good. The biggest predictor of suicidality being previous attempts.

The authors' conclusions
The authors of this review paper note seven contributions of the STEP-BD program:

1. Antidepressants remain poorly effective in treating BD;

2. BD is particularly disabling (tell me about it), and frequently doesn't respond to medications;

3. BD does respond modestly to intensive psycho-social interventions;

4. Other psychiatric disorders are common and destabilizing, yet anxiety disorders and smoking are able to be treated and when treated positively impact on BD;

5. An early age on onset of BD usually results in a more severe course of the illness, but rapid-cycling usually diminishes;

6. The sub-syndrome of Depression may be so strong as to mask the manic pole of BD, therefore careful symptom appraisal by psychiatrists is essential;

7. Suicidal thoughts persist in BD sufferers, and a previous attempt is a good indicator of a future event. However, by reducing feelings of 'hopelessness' in particular, there is the possibility of reducing the risk of suicide.

 

Source: Parikh, S.V., LeBlanc, S.R., & Ovanessian, M.M. 2010. Advancing Bipolar Disorder: Key Lessons From the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD). The Canadian Journal of Psychiatry, Vol. 55, No 3, p.p. 136-143.

 


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2Jan/10Off

Personality, health and coping

A Singaporean and Australian co-study, 189 Australian and 243 Singaporean university students (therefore, not a typical subset of the population, please note) completed the ‘Life Orientation Test-Revised’ and found some interesting differences.

Australians tended to be more agreeable, more conscientious, more optimistic and more satisfied with their lives.

On the other hand, Singaporeans tended to be more neurotic and pessimistic.

Using regression analysis, the researchers found that ‘optimism’ is the only significant predictor for life satisfaction.

Which means that if we want to be satisfied with our lives, being optimistic is an essential psychological component; without it we won’t be satisfied.

Similarly, if we want to be less stressed, we need to be less neurotic.

I know, it sounds obvious, doesn’t it. But obvious or not, such findings lend credence to previous findings that neuroticism is not a single ‘thing’ in our psychology, but comprised of many things (such as a lack of optimism, self-doubt, self-blame, emotional instability and worry).

Optimism, on the other hand, is a singular element in our psychology – you either have/create it within you or you don’t.

There is a difference, allegedly, between how the two nationalities deal with stress: Australians use more ‘tactics’ (both helpful and not-so-helpful) such as:

  • distraction
  • denial
  • substance use/abuse
  • emotional support
  • behavioural disengagement
  • venting and self-blaming
  • humour
  • reframing
  • acceptance (the ‘it is what it is’ or ‘build a bridge and get over it’ tactic)

Singaporeans, however, when faced with stressful situations are less likely to use any of the above positive tactics, which the authors of the study suggest may imply a general apathy toward coping tactics, no matter how adaptable that tactic might be to the situation at hand.

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Source:
Wong, S.S.; Lee, B.O.; Ang, R.P.; Oei, T.P.S.; & Ng, A.K. 2009. Personality, Health, and Coping: A cross-national study. Cross-Cultural Research, 43, 3; pp. 251-279


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