The progression of 102 Brazilian patients with bipolar disorder: outcome of first 12 months of prospective follow-up

Lifetime and point prevalence of psychotic symptoms in adults with bipolar disorders: a systematic review and meta-analysis

Psychotic symptoms, that we defined as delusions or hallucinations, are common in bipolar disorders (BD). This systematic review and meta-analysis aims to synthesise the literature on both lifetime and point prevalence rates of psychotic symptoms across different BD subtypes, including both BD type I (BDI) and BD type II (BDII). We performed a systematic search of Medline, PsycINFO, Embase and Cochrane Library until 5 August 2021. Fifty-four studies (N = 23 461) of adults with BD met the predefined inclusion criteria for evaluating lifetime prevalence, and 24 studies (N = 6480) for evaluating point prevalence. Quality assessment and assessment of publication bias were performed. Prevalence rates were calculated using random effects meta-analysis, here expressed as percentages with a 95% confidence interval (CI). In studies of at least moderate quality, the pooled lifetime prevalence of psychotic symptoms in BDI was 63% (95% CI 57.5-68) and 22% (95% CI 14-33) in BDII. For BDI inpatients, the pooled lifetime prevalence was 71% (95% CI 61-79). There were no studies of community samples or inpatient BDII. The pooled point prevalence of psychotic symptoms in BDI was 54% (95 CI 41-67). The point prevalence was 57% (95% CI 47-66) in manic episodes and 13% (95% CI 7-23.5) in depressive episodes. There were not enough studies in BDII, BDI depression, mixed episodes and outpatient BDI. The pooled prevalence of psychotic symptoms in BDI may be higher than previously reported. More studies are needed for depressive and mixed episodes and community samples.Prospero registration number: CRD 42017052706.

Living with bipolar disorder in Chile: A qualitative study

Bipolar disorder (BD) is an important factor contributing to rates of higher morbidity and mortality with serious consequences on the quality of life. There is limited literature on life experience of people living with BD in Chile. For this reason, this study examines the life experiences of Chilean clients with BD. Semi-structured interviews were conducted, and clients aged 40-65 years, euthymic, with a preserved judgement of reality were included. A thematic analysis was conducted, and two themes and subthemes were extracted. The first theme is the life experiences of the disease, and it comprises the subtheme information about BD, life experiences of relapses (with acute experiences of disease, professional assistance, and prodromal symptom management), accepting the disease, accepting the medication, and being bipolar as a stigma. The second theme is that of family environment, which includes the subthemes of family support, lack of family support, and family crisis resulting from BD. The findings provide evidence to support the importance of accepting the disease, the long-term course of the disease, in addition to pharmacological treatment, which requires interventions from nurses when personal risk factors of acute episodes are identified and addressed. Besides, client and family members have to be actively involved. Future research should examine the relationship between stigma from bipolar disorder, perceptions from family members, and educational interventions from nurses and people affected by BD in Chile.