exudates and Bipolar-Disorder

Previous studies conducted primarily in the USA and Europe have demonstrated the efficacy and safety of lurasidone 20-120 mg/day for the treatment of bipolar I depression. The aim of the current study was to evaluate the efficacy and safety of lurasidone monotherapy for the treatment of bipolar I depression among patients from diverse ethnic backgrounds, including those from Japan.. Patients were randomly assigned to double-blind treatment for 6 weeks with lurasidone, 20-60 mg/day (n = 184) or 80-120 mg/day (n = 169), or placebo (n = 172). The primary end-point was change from baseline to Week 6 on the Montgomery-Åsberg Depression Rating Scale (MADRS).. Lurasidone treatment significantly reduced mean MADRS total scores from baseline to Week 6 for the 20-60-mg/day group (-13.6; adjusted P = 0.007; effect size = 0.33), but not for the 80-120-mg/day group (-12.6; adjusted P = 0.057; effect size = 0.22) compared with placebo (-10.6). Treatment with lurasidone 20-60 mg/day also improved MADRS response rates, functional impairment, and anxiety symptoms. The most common adverse events associated with lurasidone were akathisia and nausea. Lurasidone treatments were associated with minimal changes in weight, lipids, and measures of glycemic control.. Monotherapy with once daily doses of lurasidone 20-60 mg, but not 80-120 mg, significantly reduced depressive symptoms and improved functioning in patients with bipolar I depression. Results overall were consistent with previous studies, suggesting that lurasidone 20-60 mg/day is effective and safe in diverse ethnic populations, including Japanese.

Topics: Adolescent; Adult; Aged; Antipsychotic Agents; Bipolar Disorder; Depressive Disorder, Major; Double-Blind Method; Female; Humans; Japan; Lithuania; Lurasidone Hydrochloride; Malaysia; Male; Middle Aged; Outcome Assessment, Health Care; Philippines; Psychiatric Status Rating Scales; Russia; Slovakia; Taiwan; Young Adult

The risk variants have been shown to vary substantially across populations and a genetic study in a heterogeneous population might shed a new light in the disease mechanism. This preliminary study aims to determine the frequency of the serotonin transporter gene polymorphism (5-HTTLPR) in the three main ethnic groups in Malaysia and its association with bipolar disorder.. This is a candidate gene association study of randomly selected forty five unrelated bipolar disorder probands and sixty six controls. Diagnosis was evaluated using the Mini International Neuropsychiatric Interview (M.I.N.I). The control group consisted of healthy volunteers without personal psychiatric history and family history of mood disorder. Patients' whole blood was collected for genotyping.. This study revealed that the frequency of the short variant of 5-HTTLPR in healthy control group was highest in Indians (42.9%) followed by Malays (23.5%) and was absent in Chinese. The association between the homozygous ss genotype of the 5-HTTLPR polymorphism with bipolar disorder was not found in the pooled subjects (χ(2)=1.52, d.f.=1, p=0.218, OR=4.67, 95% C.I.=0.69-7.58) and after stratification into Malays (p=0.315, OR=2.03, 95% CI=0.50-8.17), Indians (p=0.310; OR=0.44, 95% CI=0.21-0.92) and Chinese.. The differences in the frequency of the short allele of 5-HTTLPR across the three main ethnic groups in Malaysia were noteworthy. The present study showed no significant association between the homozygous short variant of the 5-HTTLPR and bipolar disorder in the pooled subject and after stratification into the three main ethnic groups in Malaysia.

Topics: Adult; Bipolar Disorder; Ethnicity; Female; Gene Frequency; Genetic Variation; Genotype; Humans; Malaysia; Male; Middle Aged; Polymorphism, Genetic

This study aimed to examine the rate and predictive factors of successful employment at 3 months upon enrolment into an employment program among patients with severe mental illness (SMI).. A cross-sectional study using universal sampling technique was conducted on patients with SMI who completed a 3-month period of being employed at Hospital Permai, Malaysia. A total of 147 patients were approached and 126 were finally included in the statistical analyses. Successful employment was defined as the ability to work 40 or more hours per month. Factors significantly associated with successful employment from bivariate analyses were entered into a multiple logistic regression analysis to identify predictors of successful employment.. The rate of successful employment at 3 months was 68.3% (n=81). Significant factors associated with successful employment from bivariate analyses were having past history of working, good family support, less number of psychiatric admissions, good compliance to medicine, good interest in work, living in hostel, being motivated to work, satisfied with the job or salary, getting a preferred job, being in competitive or supported employment and having higher than median scores of PANNS on the positive, negative and general psychopathology. Significant predictors of employment, from a logistic regression model were having good past history of working (p<0.021; OR 6.12; [95% CI 2.1-11.9]) and getting a preferred job (p<0.032; [OR 4.021; 95% CI 1.83-12.1]).. Results showed a high employment rate among patients with SMI. Good past history of working and getting a preferred job were significant predictors of successful employment.

Topics: Adult; Bipolar Disorder; Cross-Sectional Studies; Depressive Disorder, Major; Employment, Supported; Female; Humans; Malaysia; Male; Mental Disorders; Middle Aged; Outcome Assessment, Health Care; Schizophrenia; Severity of Illness Index; Time Factors

To determine the prevalence of alcohol-use disorder and associated correlates amongst bipolar patients in a university hospital in Malaysia.. In this cross-sectional study, a total of 121 bipolar disorder patients were included. Their alcohol use disorders were assessed with the Mini International Neuropsychiatric Interview (plus version) and the Addiction Severity Index-Lite-Clinical Factors version. The number of lifetime hospitalizations and the survival days (the number of days between the last discharge and the most current readmission) were calculated.. The prevalence of alcohol-use disorder amongst bipolar patients was 18.2%. Indian ethnicity was the only demographic factor that was statistically associated with alcohol-use disorder (p < 0.03). Those with alcohol-use disorder had a significantly higher rate of suicidal attempt (p < 0.01) and more psychiatric hospitalizations than those without after adjusting for gender, race, employment status, education level and duration of illness (p < 0.01).. The prevalence of alcohol-use disorder was low in bipolar patients but highin the general population of Malaysia. Since alcohol-use disorder, as well as the potential interactions with the course of the disorder, is highly prevalent amongst bipolar patients, alcohol use should be addressed in these patients.

Topics: Adult; Alcoholism; Asian People; Bipolar Disorder; Cross-Sectional Studies; Female; Hospitalization; Hospitals, University; Humans; Interview, Psychological; Kaplan-Meier Estimate; Malaysia; Male; Prevalence; Risk Factors; Severity of Illness Index; Sex Distribution; Suicide, Attempted

There is increasing evidence that genetic factors play a role in the etiology of schizophrenic disorders. One thousand eighty-nine first-degree relatives of schizophrenics and 1,137 controls were studied to discover their psychiatric morbidity. Psychiatric morbidity was found in 16.34% of the first-degree relatives (FDR) of schizophrenics (parents, 5.69%; siblings, 7.71%; offspring, 2.94%) as compared to 6.9% in the controls (P < 0.001). Schizophrenia was found in 8.3% of the patient group, which was significantly higher (0.2%) as compared to the controls. Schizoid-schizotypal personality disorder was found in 3.03% of FDRs of the schizophrenic group. Depressive disorder was found in 4.4% and 2.1% in the control and patient group, respectively, which was statistically significant. Morbidity risk of schizophrenia was found in 16.97%, 6.22% and 5.79% of schizophrenia, schizoid-schizotypal personality disorder and depressive disorder, respectively, in the FDR of schizophrenic group.

Topics: Adolescent; Adult; Antisocial Personality Disorder; Bipolar Disorder; Depressive Disorder; Family Health; Female; Humans; Malaysia; Male; Mental Disorders; Morbidity; Neurotic Disorders; Paranoid Disorders; Pedigree; Risk Factors; Schizophrenia

The aim of this study was to investigate how the prevalence and severity of psychiatric disabilities in patients with chronic schizophrenia compares with that in patients with chronic mood disorders. A total of 128 patients, 80 with chronic schizophrenia and 48 with chronic mood disorders as confirmed by DSM-III-R, were examined using the World Health Organization Psychiatric Disability Assessment Schedule (WHO/ DAS). There were no significant differences in the prevalence and severity of disabilities between the two disorders. Two-thirds of the patients with chronic schizophrenia and over half the patients with chronic mood disorders had dysfunctional behaviour and experienced significant disabilities. The prevalence of disabilities among these Malaysian patients was not markedly different from that seen in developed countries, suggesting that the prognosis in developing countries may not be as favourable as previously thought.

Topics: Adult; Bipolar Disorder; Chronic Disease; Cross-Cultural Comparison; Cross-Sectional Studies; Depressive Disorder; Developing Countries; Disability Evaluation; Female; Humans; Incidence; Malaysia; Male; Middle Aged; Schizophrenia; Schizophrenic Psychology

Nineteen acutely disturbed psychotic Asian patients were treated with a single intramuscular injection of 50 mg of zuclopenthixol acetate in Viscoleo. Patients were assessed clinically before and after treatment using the Brief Psychiatric Rating Scale (BPRS). Serum zuclopenthixol and the inactive geometric isomer trans(E)-clopenthixol were determined by high-performance liquid chromatography after intramuscular injection. All patients improved, with the BPRS being significantly reduced (p < 0.001) at 72 h after injection. Adverse effects were generally few. The mean +/- SEM serum zuclopenthixol concentrations at 24, 48, and 72 h were 19.9 +/- 2.8, 31.5 +/- 4.5, and 17.8 +/- 2.9 micrograms/L, respectively. trans(E)-Clopenthixol concentrations ranged from negligible to 39.5 micrograms/L. This study confirms that a single intramuscular injection of 50 mg is adequate for managing severely disturbed psychotic patients for the first 3 days. The serum zuclopenthixol concentrations attained in the Asian patients were higher than those reported in Caucasian psychiatric patients. In some patients, a considerable amount of zuclopenthixol had been transformed to trans(E)-clopenthixol.

Topics: Adolescent; Adult; Aged; Antipsychotic Agents; Bipolar Disorder; China; Clopenthixol; Female; Humans; India; Injections, Intramuscular; Malaysia; Male; Middle Aged; Psychotic Disorders; Schizophrenia; Singapore

Ten patients on long term lithium therapy (mean four years, range 1-10.5 years) were subjected to various renal, thyroid, haematological, cardiac and endocrine tests. There was impaired urinary concentrating ability in seven subjects, which was not responsive to vasopressin stimulation, suggesting a partial nephrogenic diabetes insipidus. Nine subjects had metabolic acidosis with higher urinary pH than expected suggesting presence of acidification defect in the kidney. No significant change in renal function, thyroid function, ECG or haematological parameters were detected. Our findings concur with previous reports from the West regarding the safety of lithium administration.

Topics: Acidosis; Adult; Bipolar Disorder; Diabetes Insipidus; Female; Humans; Kidney; Lithium; Malaysia; Male; Middle Aged