Search

Background: Phelan-McDermid syndrome is caused by a deletion at chromosome 22q13.3, and results in a phenotype characterised by intellectual disability, features of autism, physical and mental health conditions. It is becoming increasingly recognised that bipolar disorder represents part of this phenotype. Materials and methods: This case study describes 2 patients with Phelan-McDermid syndrome presenting with bipolar mania at inpatient unit for adults with intellectual disability. Both patients presented with severe disturbance of their behaviour, at times exhibiting aggression, disinhibition and hypersexuality. Results: Despite treatment with a number of atypical antipsychotics and anticonvulsant mood stabilising agents, both patients showed the greatest improvement when started on lithium, and were successfully treated with this medication. Conclusions: This adds further support to the growing evidence of bipolar disorder contributing to the phenotype of Phelan-McDermid syndrome, and clinicians should have a low threshold for considering the use of lithium in these patients.

Objective: Little is known about how first episode bipolar disorder (BD) is managed in early intervention for psychosis services (EIS). We aimed to investigate the knowledge and views of EIS staff on the assessment and treatment of BD. Methods: A 27-item anonymised online questionnaire was distributed to EIS mental health professionals in England. Descriptive data analysis was undertaken. Results: Responses were received from 117 EIS staff. Most were 'fairly confident' in their knowledge about causes, presentations and relapse indicators of BD, but less confident on pharmacological and psychological treatments. Eighty five percent expressed the view that more BD training was necessary in this area with 78% reporting no clear care packages within the service. Seventy two percent believe early BD should be treated within EIS only if patients have psychosis. Conclusions: Clearer care packages and staff training are needed for EIS staff to optimise care for BD. [ABSTRACT FROM AUTHOR]

Background: Cardiovascular disease is a major cause of mortality in patients with schizophrenia, and weight gain due to second generation antipsychotics contributes significantly to this. Lurasidone is a new antipsychotic with minimal metabolic side effects and represents a new treatment option where weight is a concern. Design: Description of four cases of patients switched to Lurasidone from other antipsychotics and their experience in terms of psychotic symptoms and weight changes. Results: Our findings suggest that Lurasidone offers the potential to reduce weight gain and even allow for potential weight loss in patients switched from another antipsychotic medication. Conclusions: Lurasidone may offer the potential for weight loss when patients are switched from other antipsychotic medication. Further randomised studies are needed to confirm this beneficial effect of Lurasidone. [ABSTRACT FROM AUTHOR]

It has become increasingly recognised that exposure to air pollution and poor air quality is having a detrimental impact on the health of millions in our society. Their findings suggest that areas with higher levels of air pollution were associated with increased rates of several mental illnesses, with bipolar disorder showing a particularly strong association in the US data. While the link between air quality and mental illness has received recent attention, the association between urban environment and the increased risk of developing psychiatric disorders, including mood disorders, anxiety and schizophrenia in particular is well recognised.[3] Urban environments have higher levels of air pollution, however, and Khan et al.[2] have discussed the complexity of quantifying and measuring air pollution alongside the difficulties of identifying air component "suspects" due to their collinear and likely synergistic contributions. [Extracted from the article]