Timely care after hospitalization may not be decisive factor in readmission
June 1, 2022, ARLINGTON, VA—Longer hospital stays for psychiatric treatment may have more influence on readmission within 6 months than receiving timely outpatient care after discharge, a new study suggests.
American researchers looked at data from state-funded or state-operated facilities in six U.S. states, the District of Columbia, and Puerto Rico, focusing on people discharged with a bipolar, unipolar depression, or schizophrenia diagnosis. The researchers assessed how many received outpatient care within the recommended 30 days and how many were readmitted to the hospital one to six months after discharge.
They found that, on average, only 8.8 percent of people discharged with a bipolar diagnosis received outpatient care within 30 days. Among people treated at state facilities, that figure rose to 14 percent. However, receiving timely treatment did not appear to reduce hospital readmissions.
Overall, 11.4 percent of the group with bipolar had a subsequent hospitalization. People who stayed at a state hospital were much less likely to be readmitted than those who stayed at another type of inpatient facility, study authors noted. They concluded that longer median length of stay at state facilities—34 days, versus 7 days at other inpatient facilities—may be an important variable due to more complete symptom resolution on discharge.
The study, which appeared in the journal Psychiatric Quarterly, was entitled “Follow-up psychiatric care and risk of readmission in patients with serious mental illness in state funded or operated facilities.”
Anxiety linked to sense that sleep is disturbed
July 15, 2022, CARDIFF, United Kingdom—People with bipolar disorder in remission who also have anxiety appear more likely to subjectively report sleep disturbances, according to a new study by British and American researchers.
In self-assessments, study participants reported higher rates of reduced sleep quality. However, six weeks of monitoring using wristwatch-like sensors (actigraphy) didn’t identify worse sleep.
The authors said clinicians should be aware that co-existing anxiety in people with bipolar may increase the risk of experiencing subjective sleep disturbance. In addition, researchers examining associations between sleep and bipolar should also look for evidence of co-existing anxiety.
The study, which appeared in the Journal of Affective Disorders, was entitled “Associations between comorbid anxiety and sleep disturbance in people with bipolar disorder: Findings from actigraphy and subjective sleep measures.”
Bone health at risk in women with bipolar
July 1, 2022, GEELONG, Australia—Women with bipolar disorder appear more likely to have poorer bone health, a new study suggests.
Australian and Finnish researchers compared women with a bipolar diagnosis to women without bipolar who were participating in an osteoporosis study. Overall, the group with bipolar had 4.3 percent lower bone mineral density at the hip and 1.6 percent lower bone mineral density across their bodies. Among women over age 50, those with bipolar had, on average, 3.5 percent lower spine bone mineral density.
The authors said more research is needed into the underlying causes for the differences in bone quantity and quality.
The study, which appeared in the Journal of Affective Disorders, was entitled “Bipolar disorder and bone health: A case-control study.”
More support needed for caregivers
June 1, 2022, PORTO ALEGRE, Brazil—Primary family caregivers of people with bipolar disorder tend to experience significant impairments in quality of life, a new study has found.
Brazilian researchers looked at caregivers of people with either bipolar or schizophrenia being treated at an outpatient service of a teaching hospital. While caregivers of people with schizophrenia had a lower quality of life than caregivers of people with bipolar, both groups scored lower on a qualitative assessment tool when compared to the general population.
Presence of depressive symptoms in the caregiver, presence of a clinical disease, and being female were factors associated with lower quality of life.
The authors said the findings highlight the need for mental health services to develop support programs for caregivers.
The study, which appeared in the International Journal of Social Psychiatry, was entitled “Quality of life of family primary caregivers of individuals with bipolar disorder and schizophrenia in south of Brazil.”
Physical health needs a matter of concern
June 1, 2022, AMSTERDAM, the Netherlands—Among older adults with bipolar disorder, physical health problems are more common in women than men, a new study found. In addition, older men with bipolar have more physical health problems than men without the mood disorder.
An international team of researchers assessed 1,407 men and women ages 50 and older with a bipolar diagnosis for evidence of co-existing physical health problems affecting the respiratory, gastrointestinal, musculoskeletal, renal, and endocrinological systems.
The authors said their findings indicate that health services should be sure to address the physical health needs of older adults with bipolar disorder, especially women.
The study, entitled “Physical health burden among older men and women with bipolar disorder: Results from the GAGE-BD Collaboration,” appeared in the American Journal of Geriatric Psychiatry.
Bipolar-savvy treatment reduces costs
June 1, 2022, PARIS, France—Seeing specialists in bipolar care significantly reduces the direct medical cost of treating an individual with bipolar over time, a new study suggests.
French researchers looked at data covering more than 1,000 people treated at that country’s FondaMental Advanced Centers of Expertise in Bipolar Disorder (FACE-BD) and found the direct medical cost of treating an individual with bipolar averaged around $7,300 per year. Having bipolar I disorder, a co-existing addiction, and a history of suicide attempts were each associated with higher direct health care costs.
The researchers also followed a subsample of the FACE-BD cohort for two years and found that compared to general care, direct health care costs for those treated at the Centers of Expertise dropped by more than 50 percent. That strongly suggests the beneficial effect of specialized care, the authors said.
The study, which appeared in the Journal of Affective Disorders, was entitled “Direct medical cost of bipolar disorder: Insights from the FACE-BD longitudinal cohort.”
Genetic susceptibility to cancers highlighted
May 15, 2022, TAIPEI, Taiwan—People with bipolar disorder and their siblings who don’t have the mood disorder all appear at greater risk of developing malignant cancer than the general population, a new study suggests.
Taiwanese researchers said there is increased evidence that people with bipolar are more likely to develop malignant cancer, but little is known about cancer risk among close family members. In addition to greater risk for malignant tumors for all siblings, individuals under 50 were more likely to develop certain types of breast cancer than the general population.
The authors said the findings show the need to monitor cancer risk factors and warning signs in families with a demonstrated susceptibility to bipolar disorder.
The study, which appeared in the International Journal of Cancer, was entitled “Cancer risk in patients with bipolar disorder and unaffected siblings of such patients: A nationwide population-based study.”
Prescribing patterns show variance from recommended care
June 1, 2022, MIDLAND, TX—Many health care practitioners treating people with bipolar disorder don’t appear to follow evidence-based prescribing practices, a new study suggests.
American researchers looked at insurance claims for prescriptions from more than 40,000 people with bipolar to analyze treatment patterns. The most common medications prescribed for continuous treatment periods were mood stabilizers (43.8 percent), antidepressants (42.3 percent), atypical antipsychotics (31.7%), and benzodiazepines (20.7 percent).
Broken down by combination of medications, there were 2,067 different regimens, suggesting a wide diversity of care, the authors said.
In addition, 12.9 percent of antidepressant prescriptions were for monotherapy, with no accompanying mood stabilizer or antipsychotic.
The author said their findings show that antidepressants and benzodiazepines were frequently prescribed as part of treatment regimens for bipolar, despite guidelines recommending against their use as frontline therapy.
The study, which appeared in the journal Advances in Therapy, was entitled “Treatment patterns among patients with bipolar disorder in the United States: A retrospective claims database analysis.”