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Objective: The main purpose of this study was to evaluate the association between age at onset and social support in outpatients with bipolar disorder who were in the recovery phase. We also investigated the association between age at onset and disability. Methods: A total of 180 bipolar disorder I outpatients, of whom 50 had early onset with age at onset ≤18 years old, 108 had middle onset with age at onset between 19 and 39 years old, and 22 had late onset with age at onset ≥40 years old, were assessed with the Medical Outcomes Study Social Support Scale and Sheehan Disability Scale. Results: The early onset group had lower tangible social support, longer length of illness, more childless participants, lower income and more suicide attempters than the late onset group. Conclusions: Early onset seems to have inferior outcomes in tangible social support than late onset, but this trend should be considered as a starting point for future studies. [ABSTRACT FROM AUTHOR]

This study aims to evaluate sociodemographic and clinical factors, quality of life (QoL) and functioning associated with history of suicide attempts (SA) in a sample of bipolar disorder (BD) type I patients. A total of 417 BD type I patients, with and without history of SA were recruited from two Brazilian specialized Mood Disorder Centers. They were assessed with a sociodemographic and clinical questionnaire, the Young Mania Rating Scale, the Hamilton Depression Rating Scale, the Structured Clinical Interviews for DSM-IV Axis I Disorders, the World Health Organization Quality of Life-BREF, and the Sheehan Disability Scale. One hundred and seventy-nine (42.9%) patients had a history of SA. There were no statistically significant sociodemographic differences between BD patients with and without a history of SA. Logistic regression found that lifetime hospitalization, comorbid anxiety disorders, depressive polarity in the first episode, current intensity of depressive symptoms, history of rapid cycling, family history of suicide and age at onset were significantly associated with SA in BD. Multiple linear regression showed that SA had no effect on QoL and functioning, which were affected mainly by comorbid anxiety disorders and current intensity of depressive symptoms, even in patients considered euthymic. Suicidal behavior in patients with BD is a complex phenomenon and reflects a more severe course of illness. Patients with history of SA may have worse QoL and functional impairment not because of its direct effect, but because of the greater association with clinical factors related to poor prognosis. [ABSTRACT FROM AUTHOR]

Aim: Although there has been an increase in the social acceptance of the gender dysphoria (GD) population, these individuals still suffer a high degree of emotional stress, which highlights the importance of knowing their mental illness diagnosis. Methods: A systematic review was conducted to identify the frequency of lifetime Axis I mental disorders in this population, using the MEDLINE/PubMed, SciELO, Cochrane, EMBASE, and PsychINFO databases and manual searching, examining articles published after 1980. The search used the key words: ('transgender' OR 'gender identity disorder' OR 'gender dysphoria' OR 'transsexualism' OR 'gender dysphoric patients' OR 'gender incongruence') AND ('mental disorder' OR 'axis I' OR 'psychiatric disorders') AND ('comorbidity' OR 'comorbid' OR 'prevalence'). Results: From 233 papers found, five were included. The total sample comprised 577 individuals diagnosed with GD, of whom 307 (53.2%) had presented with at least one mental disorder in their lifetime. Among this high frequency of Axis I disorders, mood disorders were the most frequent (found in 243 individuals [42.1%]), followed by anxiety disorders (155 [26.8%]), and substance use/abuse disorders (85 [14.7%]). Conclusion: This study offers important data to researchers and clinicians so they can recognize and contribute to the development of public policy on the mental health of the population diagnosed with GD. The mental health of these individuals requires special attention as it contributes to their functional impairment. [ABSTRACT FROM AUTHOR]

Objective: To describe three cases of diagnostic shift from bipolar I disorder (BD) to schizoaffective disorder (SAD). Methods: BD patients were clinically assessed and followed up in a mood disorder program. A questionnaire was applied to assess clinical and socio-demographic characteristics, and a Structured Clinical Interview (SCID-I) was conducted. Results: We identified three patients with diagnosis conversion to SAD from 2005 to 2016. The mean time between BD diagnosis and the diagnostic shift to SAD was 9 years. Conclusions: Psychotic symptoms may become persistent, chronic and unrelated to the presence of mood episodes many years after the beginning of BD. Psychiatrists should be aware of this and reassess the diagnosis during the longitudinal course of BD, especially in those patients who present psychotic symptoms. [ABSTRACT FROM AUTHOR]

Aim: Although there has been an increase in the social acceptance of the gender dysphoria (GD) population, these individuals still suffer a high degree of emotional stress, which highlights the importance of knowing their mental illness diagnosis., Methods: A systematic review was conducted to identify the frequency of lifetime Axis I mental disorders in this population, using the MEDLINE/PubMed, SciELO, Cochrane, EMBASE, and PsychINFO databases and manual searching, examining articles published after 1980. The search used the key words: ('transgender' OR 'gender identity disorder' OR 'gender dysphoria' OR 'transsexualism' OR 'gender dysphoric patients' OR 'gender incongruence') AND ('mental disorder' OR 'axis I' OR 'psychiatric disorders') AND ('comorbidity' OR 'comorbid' OR 'prevalence')., Results: From 233 papers found, five were included. The total sample comprised 577 individuals diagnosed with GD, of whom 307 (53.2%) had presented with at least one mental disorder in their lifetime. Among this high frequency of Axis I disorders, mood disorders were the most frequent (found in 243 individuals [42.1%]), followed by anxiety disorders (155 [26.8%]), and substance use/abuse disorders (85 [14.7%])., Conclusion: This study offers important data to researchers and clinicians so they can recognize and contribute to the development of public policy on the mental health of the population diagnosed with GD. The mental health of these individuals requires special attention as it contributes to their functional impairment., (© 2019 The Authors. Psychiatry and Clinical Neurosciences © 2019 Japanese Society of Psychiatry and Neurology.)