66 research outputs found
Does the comorbidity of borderline personality disorder affect the response to treatment in bipolar patients?
No full text: Bipolar disorder (BD) is a highly prevalent condition whose response to pharmacological treatment is associated with a number of factors including psychiatric comorbidity. Borderline personality disorder (BPD) shares clinical symptoms and biological vulnerability with BD and the two conditions are frequently comorbid, thus representing a clinical challenge. The purpose of the present review is to summarize the data related to treatment response in bipolar patients with comorbid BPD. According to systematic review process, a literature search was performed on the PubMed, Embase, PsycInfo, Isi Web of Knowledge, Medscape, and Cochrane Library databases. Peer-reviewed articles until December 2022 were eligible for inclusion. Comorbidity with BPD seems to be associated with a more difficult clinical stabilization in bipolar patients, often requiring poly-therapy or a longer duration of hospitalization. However, three studies, assessing the effectiveness of mood stabilizers in bipolar patients, did not demonstrate a prominent influence of BPD comorbidity in achieving clinical response. The most frequently administered pharmacological treatments in the selected studies include mood stabilizers and atypical antipsychotics. The presence of comorbid BPD in bipolar patients may hamper treatment effectiveness. Future studies, comparing different treatments and with larger samples, are needed to confirm the results critically summarized in the present review
Maternal Functioning and Depression Scores Improve Significantly With Participation in Visiting Moms® Program
No full textBACKGROUND: Postpartum depression is the most common complication of childbearing can affect the entire family unit. Health professionals must strive to identify and develop effective, feasible solutions for women during this critical period. AIMS: To determine whether postpartum maternal functioning (as measured by the Barkin Index of Maternal Functioning) and depression symptoms (as measured by the Patient Health Questionnaire-9) were improved after participation in the Visiting Moms program. METHOD: Paired data were collected from women at program intake and after completion of the Visiting Moms program. Visiting Moms provides services through eastern and central Massachusetts and was designed to support new mothers throughout the infant's first year of life. The study population was composed of adult women living in the Jewish Family and Children's Services geographic catchment area, who enrolled in Visiting Moms between January 1, 2013, and December 31, 2015. Descriptive statistics were calculated for all 402 women enrolled in this timeframe. Utilizing a pretest/posttest design, paired t tests were performed for the Barkin Index of Maternal Functioning (n = 149) and for the Patient Health Questionnaire-9 (n = 156), where women had complete scores at both intake and completion, to determine the program's potential impact on depressive symptoms and functional status. RESULTS: Functioning and depression scores were significantly improved after participation in the program. CONCLUSIONS: Visiting moms, and similar programs, aimed at delivery of enhanced social support, may be effective in promoting mental and emotional wellness among new mothers who are require additional support in the postpartum period
Correlates of Postpartum Maternal Functioning in a Low-Income Obstetric Population
No full text BACKGROUND: Perinatal mental health has been characterized primarily via depression evaluation. However, there may be advantages to complementary assessment of postpartum functional status. OBJECTIVE: The purpose of this study was to examine sociodemographic and clinical factors associated with maternal functioning in low-income obstetrics patients. DESIGN: One hundred and twenty-eight women receiving postpartum obstetrical care at a large medical center in medically underserved, Middle Georgia were screened for depressive symptoms with the Edinburgh Postnatal Depression Scale. The women also completed the Barkin Index of Maternal Functioning and a sociodemographic survey. Multivariate analysis was performed to elucidate factors independently associated with maternal functioning. RESULTS: Higher Edinburgh Postnatal Depression Scale scores ( p < .0001) and being married ( p = .043) were associated with decreased maternal functioning. CONCLUSIONS: Health care providers should be cognizant of the relationship between postnatal depression and maternal functioning and its potential implications for family health. </jats:p
The Effect of Tele-Continuous Care on Maternal Functioning and Neonatal Perception among Iranian Primiparous Mothers: A Randomized Field Trial Study
No full textBackground/Objectives: New mothers face significant challenges during the postpartum period, which can impact their maternal performance. This study aimed to assess the effect of tele-continuous midwifery care on maternal functioning and neonatal perception in first-time Iranian mothers. Methods: A randomized controlled field trial was conducted from January to May 2023 on 48 first-time mothers in the postpartum ward at Arash Women’s Hospital, Tehran. Participants were randomly assigned to either an intervention or control group. The intervention group received tele-continuous care for six weeks postpartum, while the control group received standard care. The Barkin Index of Maternal Functioning (BIMF) and the Neonatal Perception Inventory (NPI) were used to collect data in the second and sixth weeks after delivery. Data were analyzed using SPSS 26. Results: The mean age was 26.2 ± 4.8 years in the intervention group and 28.0 ± 6.1 years in the control group. An independent t-test revealed a significant difference in maternal functioning (BIMF score) between the intervention and control groups by the sixth week postpartum (p < 0.0001). A significant improvement in BIMF scores was observed within the intervention group from the second to the sixth week (p = 0.007). However, the McNemar’s test on the NPI showed no significant difference in the proportions of negative and positive maternal perceptions within the intervention group (p = 0.219) and in the control group (p = 0.508). Conclusions: Tele-continuous midwifery care effectively enhances maternal functioning during the vulnerable postpartum period, highlighting the necessity of ongoing support for new mothers
Are There Any Differences in Clinical and Biochemical Variables between Bipolar Patients with or without Lifetime Psychotic Symptoms?
No full textIntroduction: Psychotic symptoms occur in more than half of patients affected by Bipolar Disorder (BD) and are associated with an unfavorable course of the disorder. The objective of this study is to identify the differences in the clinical and biochemical parameters between bipolar patients with or without psychotic symptoms. Methods: A total of 665 inpatients were recruited. Demographic, clinical, and biochemical data related to the first day of hospitalization were obtained via a screening of the clinical charts and intranet hospital applications. The two groups identified via the lifetime presence of psychotic symptoms were compared using t tests for quantitative variables and χ2 tests for qualitative ones; binary logistic regression models were subsequently performed. Results: Patients with psychotic BD (compared to non-psychotic ones) showed a longer duration of hospitalization (p < 0.001), higher Young Mania Rating Scale scores (p < 0.001), lower Global Assessment of Functioning scores (p = 0.002), a less frequent history of lifetime suicide attempts (p = 0.019), less achievement of remission during the current hospitalization (p = 0.028), and a higher Neutrophile to Lymphocyte Ratio (NLR) (p = 0.006), but lower total cholesterol (p = 0.018) and triglycerides (p = 0.013). Conclusions: Patients with psychotic BD have a different clinical and biochemical profile compared to their counterparts, characterized by more clinical severity, fewer metabolic alterations, and a higher grade of inflammation. Further multi-center studies have to confirm the results of this present study
Recurrent pregnancy loss and neurological deficits in offspring: confirmation should precede modifications in patient counselling
No full textEditorial: Perinatal mood symptoms and postpartum maternal functioning: Describing the evidence related to effective and ineffective interventions
No full textGender differences in clinical and biochemical parameters among patients hospitalized for schizophrenia: towards precision medicine
No full textBackgroundThe scientific literature shows some gender differences in the clinical course of schizophrenia. The aim of this study is to identify gender differences in clinical and biochemical parameters in subjects affected by schizophrenia. This would allow for the implementation of individualized treatment strategies.MethodsWe examined a large set of clinical and biochemical parameters. Data were obtained from clinical charts and blood analyses from a sample of 555 schizophrenia patients consecutively admitted for exacerbation of symptoms to the inpatient clinic of Fondazione IRCCS Policlinico (Milan) or ASST Monza in Italy from 2008 to 2021. Univariate analyses, binary logistic regression, and a final logistic regression model were performed with gender as dependent variable.ResultsThe final logistic regression models showed that male patients (compared to females) were more prone to lifetime substance use disorders (p = 0.010). However, they also had higher GAF (global functioning) mean scores (p < 0.001) at the time of hospitalization. Univariate analyses showed that male patients (with respect to females) had an earlier age at onset (p < 0.001), a more frequent family history of multiple psychiatric disorders (p = 0.045), were more often smokers (p < 0.001), had a more frequent comorbidity with at least one psychiatric disorder (p = 0.001), and less often suffered from hypothyroidism (p = 0.011). In addition, men had higher levels of albumin (p < 0.001) and bilirubin (t = 2.139, p = 0.033), but lower levels of total cholesterol (t = 3.755, p < 0.001).ConclusionsOur analyses indicate a less severe clinical profile in female patients. This is evident especially in the early years of the disorder, as suggested by less comorbidity with psychiatric disorders or later age at onset; this is consistent with the related literature. In contrast, female patients seem to be more vulnerable to metabolic alterations as demonstrated by more frequent hypercholesterolemia and thyroid dysfunction. Further studies are needed to confirm these results in the framework of precision medicine
The Relationship between Maternal Functioning and Mental Health after Childbirth in Iranian Women
No full textThe postpartum period is critical for new mothers, in terms of performing maternal functions, which can be affected by physical or psychological complications. The purpose of the present study is to determine the relationship between maternal functioning and mental health in the postpartum period. This cross-sectional descriptive-analytic study was conducted on 530 eligible women who referred to health centers in Tabriz, Iran in 2018. The participants were selected through randomized cluster sampling, and data were collected by using a socio-demographic characteristics questionnaire, Mental Health Inventory (MHI), and the Barkin Index of Maternal Functioning (BIMF). These assessments were collected between 1 and 4 months postpartum. The relationship between maternal functioning and mental health was determined by conducting bivariate analysis via Pearson and Spearman correlation analysis and the general linear model (GLM) in a multivariate analysis. The mean (SD) mental health score in women was 79.1 (15.0) in the obtainable score range of 18 to 108, and the mean (SD) BIMF score in women was 97.4 (12.9) in the obtainable score range of 0 to 120. Based on Pearson or Spearman correlations, mental health and its sub-domains had positive, significant correlations with infant care, mother–child interaction, mental well-being, social support, management, adjustment, self-care, and maternal functioning (p < 0.001). Based on the GLM, increased maternal functioning was associated with higher total mental health score, having a moderate income, and receiving support for infant care (p < 0.05). High levels of postpartum mental health can have a positive impact on maternal functioning. Additionally, having support with infant care tasks can also improve functioning
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