23 research outputs found
Internet Use by Older Adults with Bipolar Disorder: International Survey Results
Background: The world population is aging and the number of older adults with bipolar disorder is increasing. Digital technologies are viewed as a framework to improve care of older adults with bipolar disorder. This analysis quantifies Internet use by older adults with bipolar disorder as part of a larger survey project about information seeking.
Methods: A paper-based survey about information seeking by patients with bipolar disorder was developed and translated into 12 languages. The survey was anonymous and completed between March 2014 and January 2016 by 1222 patients in 17 countries. All patients were diagnosed by a psychiatrist. General estimating equations were used to account for correlated data.
Results: Overall, 47% of older adults (age 60 years or older) used the Internet versus 87% of younger adults (less than 60 years). More education and having symptoms that interfered with regular activities increased the odds of using the Internet, while being age 60 years or older decreased the odds. Data from 187 older adults and 1021 younger adults were included in the analysis excluding missing values.
Conclusions: Older adults with bipolar disorder use the Internet much less frequently than younger adults. Many older adults do not use the Internet, and technology tools are suitable for some but not all older adults. As more health services are only available online, and more digital tools are developed, there is concern about growing health disparities based on age. Mental health experts should participate in determining the appropriate role for digital tools for older adults with bipolar disorder
Sign language translation system based on micro-inertial measurement units and ZigBee network
Does lithium reduce acute suicidal ideation and behavior? A protocol for a randomized, placebo-controlled multicenter trial of lithium plus Treatment As Usual (TAU) in patients with suicidal major depressive episode
Abstract
Background
Lithium has proven suicide preventing effects in the long-term treatment of patients with affective disorders. Clinical evidence from case reports indicate that this effect may occur early on at the beginning of lithium treatment. The impact of lithium treatment on acute suicidal thoughts and/or behavior has not been systematically studied in a controlled trial. The primary objective of this confirmatory study is to determine the association between lithium therapy and acute suicidal ideation and/or suicidal behavior in inpatients with a major depressive episode (MDE, unipolar and bipolar disorder according to DSM IV criteria). The specific aim is to test the hypothesis that lithium plus treatment as usual (TAU), compared to placebo plus TAU, results in a significantly greater decrease in suicidal ideation and/or behavior over 5 weeks in inpatients with MDE.
Methods/Design
We initiated a randomized, placebo-controlled multicenter trial. Patients with the diagnosis of a moderate to severe depressive episode and suicidal thoughts and/or suicidal behavior measured with the Sheehan-Suicidality-Tracking Scale (S-STS) will be randomly allocated to add lithium or placebo to their treatment as usual. Change in the clinician administered S-STS from the initial to the final visit will be the primary outcome.
Discussion
There is an urgent need to identify treatments that will acutely decrease suicidal ideation and/or suicidal behavior. The results of this study will demonstrate whether lithium reduces suicidal ideation and behavior within the first 5 weeks of treatment.
Trial registration
ClinicalTrials.gov identifier:
NCT0203947
Diameter Selection of Carbon Nanotubes in Polymer/SWCNT Nanowire Arrays Fabricated by Template Wetting
Synthesis of LaCoO3 from lanthanum trisoxalatocobaltate(III) (LTC) precursor employing microwave heating technique
Bio-cultural interactions and demography during the Middle to Upper Palaeolithic transition in Iberia: An agent-based modelling approach
The Middle to Upper Palaeolithic transition was a process of cultural and biological replacement, considered a turning point in human evolutionary history. Various hypotheses have been used to explain the disappearance of Neanderthals from Eurasia. However, very few studies have explicitly examined the causative role of demography on Neanderthal and anatomically modern humans (AMH) interaction. Here we use an integrative method based on computational modelling and the analysis of archaeological data to construct an agent based model that explores the influence of demographic variables (birth and death rates) and mobility (home range size) on the bio-cultural interaction between AMH and Neanderthals during the transition from the Middle to Upper Palaeolithic on the Iberian Peninsula (50 ka to 30 ka BP). Our simulation results are consistent with the current radiocarbon framework for the disappearance of Neanderthals in this region. This suggest that the extinction of Neanderthals could be explained by inter-specific differences in demographic behaviour and mobility patterns compared with AMH.S.L. and J.F.L were supported by the Ramón y Cajal Programme through the grants RYC-2012-01043 and RYC-2011-09363 respectively
Influence of birth cohort on age of onset cluster analysis in bipolar I disorder
Purpose: Two common approaches to identify subgroups of patients with
bipolar disorder are clustering methodology (mixture analysis) based on
the age of onset, and a birth cohort analysis. This study investigates
if a birth cohort effect will influence the results of clustering on the
age of onset, using a large, international database.
Methods: The database includes 4037 patients with a diagnosis of bipolar
I disorder, previously collected at 36 collection sites in 23 countries.
Generalized estimating equations (GEE) were used to adjust the data for
country median age, and in some models, birth cohort. Model-based
clustering (mixture analysis) was then performed on the age of onset
data using the residuals. Clinical variables in subgroups were compared.
Results: There was a strong birth cohort effect. Without adjusting for
the birth cohort, three subgroups were found by clustering. After
adjusting for the birth cohort or when considering only those born after
1959, two subgroups were found. With results of either two or three
subgroups, the youngest subgroup was more likely to have a family
history of mood disorders and a first episode with depressed polarity.
However, without adjusting for birth cohort (three subgroups), family
history and polarity of the first episode could not be distinguished
between the middle and oldest subgroups.
Conclusion: These results using international data confirm prior
findings using single country data, that there are subgroups of bipolar
I disorder based on the age of onset, and that there is a birth cohort
effect. Including the birth cohort adjustment altered the number and
characteristics of subgroups detected when clustering by age of onset.
Further investigation is needed to determine if combining both
approaches will identify subgroups that are more useful for research.
(C) 2014 Elsevier Masson SAS. All rights reserved