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Monday, November 2, 2009: 4:10 PM
Learning Objective 1: to understand the importance of the early warning sign intervention in the treatment of outpatients with a bipolar disorder
Learning Objective 2: support patients with bipolar disorder in developing an action plan to prevent relapse
Bipolar disorder has life time prevalence rates estimated to be 1.5 – 2% in the European Union. Treatment is largely symptomatic and aimed at the prevention of subsequent episodes and, when an episode does occur, reduction of its impact to the greatest degree possible. Early warning signs interventions, targeted at improving the recognition and self management of depressive and manic prodromes, in addition to treatment as usual included medication and regular visits to the mental health care professional have benefits on time to recurrence an hospitalization. The first stage is to train the patient to identify prodromal symptoms of manic or depressive relapse. The second stage is to produce an action plan to help the patient cope with the prodromes once they occur and are recognized by the patient and/or its relatives. It describes what actions are taken by whom once the prodrome is recognized. In order to avoid suffering and burden, it is necessary to teach the patient to identify prodromal symptoms as early as possible in the process of relapsing. Two goals were identified for the present study: (1) To identify the first prodromal symptom of manic or depressive relapse reported by outpatients with a bipolar disorder experienced during the process of relapse. (2) To identify the associations between the ability to identify prodromes of manic or depressive relapse and the clinical characteristics of a population of outpatients with a bipolar disorder. During interviews, participants (n=111) were asked to answer the following questions: “How can you tell an episode of mania or depression is coming on? Please tell me what the first sign or behavior is that you recognize in yourself that leads up to a manic or depressive episode?” In Addition, demographic and clinical characteristics were gathered using a questionnaire.
The results show that 27.9% of the respondents are not able to recognize the first symptoms of a manic or depressive relapse. The first prodromes of manic relapse that are reported most often are within the categories of energy level (n = 23), sleep functions (n=19), and social functioning n=18). Within the process of depressive relapse, the first prodromes are within the categories of thoughts (n=17), mood stability (n=13), energy level (n=13), social functioning (n=12), and sleep functions (n=11). The ability to recognize prodromal symptoms is correlated with the number of depressive / (hypo)manic episodes during life spam. Further, for patients diagnosed after 1999, a correlation was found between the ability to recognize prodromes of hypomania and having an action plan . No correlation between the ability to recognize prodromes of depression and having an action plan could be found for those patients. Because of the heavy burden caused by depressive symptoms it is recommended that more attention is given to teach patients to recognize prodromes of depression.
The results show that 27.9% of the respondents are not able to recognize the first symptoms of a manic or depressive relapse. The first prodromes of manic relapse that are reported most often are within the categories of energy level (n = 23), sleep functions (n=19), and social functioning n=18). Within the process of depressive relapse, the first prodromes are within the categories of thoughts (n=17), mood stability (n=13), energy level (n=13), social functioning (n=12), and sleep functions (n=11). The ability to recognize prodromal symptoms is correlated with the number of depressive / (hypo)manic episodes during life spam. Further, for patients diagnosed after 1999, a correlation was found between the ability to recognize prodromes of hypomania and having an action plan . No correlation between the ability to recognize prodromes of depression and having an action plan could be found for those patients. Because of the heavy burden caused by depressive symptoms it is recommended that more attention is given to teach patients to recognize prodromes of depression.