Background and Objectives: Predominant polarity (PP) may be a useful course specifier in at least a significant proportion of patients with Bipolar Disorder (BD), being associated with several clinically relevant correlates. Emerging evidence suggests that the concept of PP might influence the selection of maintenance treatments, based on a drug polarity index (PI) which measures the greater antidepressive vs. antimanic preventive efficacy of mood stabilizers over long-term maintenance treatment. In this study, we aimed to validate the PI in a large sample of Italian BD patients with accurate longitudinal characterization of the clinical course, which ensured a robust definition of the PP. Materials and Methods: Our sample is comprised of 653 patients with BD, divided into groups based on the predominant polarity (manic/hypomanic predominant polarity—MPP, depressive predominant polarity—DPP and no predominant polarity). Subsequently we calculated the mean total polarity index for each group, and we compared the groups. Results: When we examined the mean PI of treatments prescribed to individuals with DPP, MPP and no predominant polarity, calculated using two different methods, we failed to find significant differences, with the exception of the PI calculated with the Popovic method and using the less stringent criterion for predominant polarity (PP50%). Conclusions: Future prospective studies are needed in order to determine whether the predominant polarity is indeed one clinical factor that might guide the clinician in choosing the right mood stabilizer for BD maintenance treatment.
4 December 2024 in Journal of Psychiatric Research
Considering the elevated cancer mortality in individuals with psychiatric conditions, possibly associated with late diagnosis, this study investigated cancer screening participation rates among patients under the care of four Trieste community mental health centers (CMHCs). We conducted a retrospective cohort study on 1252 individuals with psychiatric disorders, retrieving their electronic health records up to December 2019. The study assessed participation rates in breast, cervical, and colorectal cancer screening programs. We explored differences in demographic and clinical characteristics of participants versus non-participants in screening programs. Patients with psychiatric conditions had lower screening participation rates compared to the general population of Trieste. The rates for breast and cervical cancers were approximately one-third lower, whereas the rate for colorectal cancer was halved. Psychiatric diagnosis influenced participation in breast cancer screening, with patients having anxiety disorders more likely to participate than those suffering from schizophrenia or disorders of adult personality and behavior. Age, nationality, marital status, employment status, and living situation all affected adherence to cervical cancer screening. Individuals who participated more frequently were in the 35-54 age range, of Italian nationality, employed, and had a family of their own. Conversely, non-participants were more likely to be widowed or unmarried. Finally, among patients eligible for colorectal cancer screening, those who participated were more likely to have a family of their own and have a diagnosis of affective or anxiety disorders, while those who did not adhere to the programs were more commonly widowed and had a higher frequency of diagnosis of schizophrenia or disorders of adult personality and behavior. Mental health services should focus on increasing patients' participation in cancer screening programs in order to improve their physical health and reduce mortality. This intervention could contribute to promoting equitable access to preventative care and to bridging the gap between mental health and general medical services.