Bipolar Disorder: Luutonen S

Isometsä E, Lindfors O, Luutonen S, Mattila M, Marttunen M, Pirkola S, Salminen JK, Seppälä I, Anonymous00181. · No affiliation provided · Duodecim. · Pubmed #16457111 No free full text.

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Salokangas RK, Luutonen S, Nieminen M, Huttunen J, Karlsson H. · Department of Psychiatry, University of Turku, Turku, Finland. · Nord J Psychiatry. · Pubmed #17990202 No free full text.

Abstract: We studied prevalence of depressive symptoms in primary care (PrC) and in psychiatric outpatient care (PsC), and how psychotic and manic symptoms are associated with current depressive symptoms. Altogether 563 patients attending PrC and 163 patients attending PsC filled in a questionnaire including the Depression Scale (DEPS), the Mood Disorder Questionnaire (MDQ) and questions on psychotic symptoms from the Composite International Diagnostic Interview (CIDI). Patients with depressive symptoms (DEPS score > 8) were interviewed by phone using the same checklist 6 months after baseline examination. From the PrC sample, 19.5% and from the PsC sample 73.0% were DEPS positive. In the PrC but not in the PsC sample, patients' background associated strongly with occurrence of depressive symptoms. Both at baseline and at follow-up, depressive symptoms correlated significantly with psychotic and manic symptoms. In multivariate analyses, when the effects of background, health and functioning were taken into account, baseline depressive symptoms associated significantly with lifetime psychotic symptoms. Depressive symptoms at follow-up associated significantly with psychotic symptoms during the follow-up period. In the PrC sample, this association was significant even when the effect of baseline depressive symptoms was controlled. About one-fifth of patients attending primary care and about three-quarters of patients attending psychiatric outpatient patient care suffer from depressive symptoms. Vulnerability to psychosis, indicated by occurrence of psychotic symptoms, increases the risk of and slower recovery from depressive symptoms in the patients attending primary care. Therefore, vulnerability to psychosis should be evaluated when treatment intervention for patients with depressive symptoms is planned.

Salokangas RK, Luutonen S, Nieminen M, Karlsson H. · Department of Psychiatry, University of Turku, Turku, Finland. · Nord J Psychiatry. · Pubmed #17162458 No free full text.

Abstract: Dimensions of psychotism have mainly been studied in clinical samples. We studied psychotism, its dimensions and their associations, in a primary care sample. In all, 1199 primary care patients over 18 years of age filled in a questionnaire including lists of psychotic (the Composite International Diagnostic Interview, CIDI), depressive (the Depression Scale, DEPS) and manic (the Mood Disorder Questionnaire, MDQ) symptoms. Psychotic symptoms were factored, and variance in factor scores was explained by patients' background and by depressive and manic symptoms. In the principal component solution, the first factor explained 22% of the total variance in psychotic (CIDI) symptoms and was named global psychotism. Varimax rotation produced seven interpretable dimensions: Schneiderian (9.7% of variance), passivity (8.9%), hallucinatory (8.5%), paranoid (7.7%), infidelity (7.6%), somatic (7.6%) and reference experiences (5.9%). Together they explained 52% of the total variance of CIDI symptoms. Global psychotism (P=0.000), as well as hallucinatory (P=0.003), paranoid (P=0.000) and infidelity (P=0.000) experiences associated inversely with age. Otherwise, patients' background associated differently with global psychotism and with factor dimensions in CIDI symptoms. Manic symptoms associated with global psychotism and with all CIDI dimensions, whereas depressive symptoms associated with global psychotism, passivity, paranoid and infidelity experiences. Psychotism is composed of a global factor and of independent dimensions, and is more prevalent in young people. Independently of patients' background, manic widely and depressive symptoms less widely associate with occurrence of psychotism.

Salokangas RK, Luutonen S, Nieminen M, Karlsson H. · Department of Psychiatry, University of Turku, Finland. · Nord J Psychiatry. · Pubmed #16195127 No free full text.

Abstract: We studied occurrence of psychotic symptoms and their associations with occurrence of depressive and manic symptoms; 563 patients attending primary care (PrC) and 163 patients attending psychiatric outpatient care (PsC) completed a questionnaire including lists of psychotic, manic and depressive symptoms, and patients with depressive symptoms were interviewed using the same questionnaire 6 months after baseline examination. Of PrC patients, 8.5% and of PsC patients, 36.2% reported at least seven lifetime psychotic symptoms. During the 6-month follow-up, the corresponding figures were 0.22% for PrC and 2.84% for PsC patients. Among PrC patients, men, young, never-married, students and unemployed reported more psychotic symptoms than others. In multivariate analyses, occurrence of psychotic symptoms was associated with young age, never being married, poor functioning and former psychiatric treatment, as well as with occurrence of manic and depressive symptoms. Psychotic symptoms are rather prevalent in primary care and very common in psychiatric care. In primary care, vulnerability to psychosis is associated with the patient's background more strongly than in psychiatric care. Concurrent occurrence of psychotic symptoms with manic and depressive symptoms is common.