OBJECTIVES: To describe the onset pattern, frequency, and severity of the signs and symptoms of the prodrome of the first hypomanic/manic episode and first depressive episode of bipolar disorder (BD) and to investigate the influence of a history of childhood maltreatment on the expression of prodromal symptoms. METHODS: Using a semi-structured interview, the Bipolar Prodrome Symptom Scale-Retrospective (BPSS-R), information regarding prodromal symptoms was assessed from patients with a DSM-IV diagnosis of BD. History of childhood maltreatment was evaluated using the Childhood Trauma Questionnaire (CTQ). RESULTS: Forty-three individuals with stable BD were included. On average, the prodrome of mania lasted 35.8 ± 68.7 months and was predominantly subacute or insidious, with rare acute presentations. The prodrome of depression lasted 16.6 ± 23.3 months and was also predominantly subacute or insidious, with few acute presentations. The prodromal symptoms most frequently reported prior to the first hypomanic or manic episode were mood lability, depressive mood, and impatience. A history of childhood abuse and neglect was reported by 81.4% of participants. Presence of childhood maltreatment was positively associated with prodromal symptoms, including social withdrawal, decreased functioning, and anhedonia. CONCLUSIONS: This study provides evidence of a long-lasting, symptomatic prodrome prior to first hypomanic/manic and depressive episode in BD and suggests that a history of childhood maltreatment influences the manifestations of this prodrome.
Bipolar Disorder/psychology , Child Abuse/psychology , Prodromal Symptoms , Psychological Trauma/psychology , Adult , Bipolar Disorder/etiology , Child , Depressive Disorder/psychology , Female , Humans , Late Onset Disorders/psychology , Male , Psychiatric Status Rating Scales , Psychological Trauma/complications , Psychometrics , Severity of Illness Index , Surveys and Questionnaires , Time Factors
Objectives: To describe the onset pattern, frequency, and severity of the signs and symptoms of the prodrome of the first hypomanic/manic episode and first depressive episode of bipolar disorder (BD) and to investigate the influence of a history of childhood maltreatment on the expression of prodromal symptoms. Methods: Using a semi-structured interview, the Bipolar Prodrome Symptom Scale-Retrospective (BPSS-R), information regarding prodromal symptoms was assessed from patients with a DSM-IV diagnosis of BD. History of childhood maltreatment was evaluated using the Childhood Trauma Questionnaire (CTQ). Results: Forty-three individuals with stable BD were included. On average, the prodrome of mania lasted 35.8±68.7 months and was predominantly subacute or insidious, with rare acute presentations. The prodrome of depression lasted 16.6±23.3 months and was also predominantly subacute or insidious, with few acute presentations. The prodromal symptoms most frequently reported prior to the first hypomanic or manic episode were mood lability, depressive mood, and impatience. A history of childhood abuse and neglect was reported by 81.4% of participants. Presence of childhood maltreatment was positively associated with prodromal symptoms, including social withdrawal, decreased functioning, and anhedonia. Conclusions: This study provides evidence of a long-lasting, symptomatic prodrome prior to first hypomanic/manic and depressive episode in BD and suggests that a history of childhood maltreatment influences the manifestations of this prodrome.
Adult , Child , Female , Humans , Male , Bipolar Disorder/psychology , Child Abuse/psychology , Prodromal Symptoms , Psychological Trauma/psychology , Bipolar Disorder/etiology , Depressive Disorder/psychology , Late Onset Disorders/psychology , Psychiatric Status Rating Scales , Psychological Trauma/complications , Psychometrics , Severity of Illness Index , Surveys and Questionnaires , Time Factors
O suicídio é um fenômeno complexo que envolve muitas pessoas além das vítimas como familiares, profissionais de saúde e de outros setores. É cercado de situações incômodas que envolvem sentimentos de impotência, o preconceito, medo e outros. São diversas as situações de vulnerabilidade para o suicídio que merecem atenção e está relacionado a múltiplos fatores (biológicos, genéticos, psicológicos, sociais, culturais e ambientais). Desta forma, é necessário desenvolver ações de vigilância, prevenção e controle de forma integral (AU)
Humans , Male , Female , Adolescent , Suicide , Suicide, Attempted , Suicide/ethnology , Suicide/prevention & control , Suicide/psychology , Suicide/trends
