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Demographics, family history, premorbid functioning, developmental characteristics, and course of patients with deteriorated affective disorder.
Am J Psychiatry. 1996 Feb; 153(2):248-55.AJ

Abstract

OBJECTIVE

This exploratory study examined the characteristics of a group of unusual and previously undescribed patients with major affective disorder who not only had been continuously symptomatic for prolonged periods of time but were also so functionally impaired that they required years of continuous care in psychiatric facilities or by family members.

METHOD

Twenty-seven inpatients with major mood disorders and 29 inpatients with schizophrenia were recruited from a large state hospital; 27 outpatients with major mood disorders were recruited from an affiliated outpatient facility. The research battery included the Structured Clinical Interview for DSM-III-R--Patient Version, the Premorbid Adjustment Scale, and a semistructured interview designed to assess demographic, family history, developmental, and course information.

RESULTS

Inpatients with deteriorated affective disorder differed from outpatients with nondeteriorated affective disorder along several important dimensions, including family history of mental illness, birth-related problems, physical disorders in infancy, premorbid functioning, presence of mixed episodes and rapid cycling, and medication non-compliance between hospitalizations. Inpatients with deteriorated affective disorder differed from inpatients with schizophrenia on the Premorbid Adjustment Scale. Patients with bipolar affective disorder differed from those with unipolar disorder on many of the variables associated with deterioration of functioning.

CONCLUSIONS

Birth-related problems, physical disorders in infancy, and poor premorbid adjustment in childhood and adolescence appear to play an important role in deterioration of functioning among patients with unipolar depression. Disruption in treatment because of medication noncompliance and the appearance of mixed episodes and rapid cycling are associated with functional decline in bipolar affective disorder. Several characteristics previously considered specific to deterioration of functioning in schizophrenia, such as a high rate of birth complications and poor premorbid adjustment, appear to be associated with functional deterioration among patients with major depression as well.

Authors+Show Affiliations

California School of Professional Psychology, Berkeley/Alameda, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

8561207

Citation

Vocisano, C, et al. "Demographics, Family History, Premorbid Functioning, Developmental Characteristics, and Course of Patients With Deteriorated Affective Disorder." The American Journal of Psychiatry, vol. 153, no. 2, 1996, pp. 248-55.
Vocisano C, Klein DN, Keefe RS, et al. Demographics, family history, premorbid functioning, developmental characteristics, and course of patients with deteriorated affective disorder. Am J Psychiatry. 1996;153(2):248-55.
Vocisano, C., Klein, D. N., Keefe, R. S., Dienst, E. R., & Kincaid, M. M. (1996). Demographics, family history, premorbid functioning, developmental characteristics, and course of patients with deteriorated affective disorder. The American Journal of Psychiatry, 153(2), 248-55.
Vocisano C, et al. Demographics, Family History, Premorbid Functioning, Developmental Characteristics, and Course of Patients With Deteriorated Affective Disorder. Am J Psychiatry. 1996;153(2):248-55. PubMed PMID: 8561207.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Demographics, family history, premorbid functioning, developmental characteristics, and course of patients with deteriorated affective disorder. AU - Vocisano,C, AU - Klein,D N, AU - Keefe,R S, AU - Dienst,E R, AU - Kincaid,M M, PY - 1996/2/1/pubmed PY - 1996/2/1/medline PY - 1996/2/1/entrez SP - 248 EP - 55 JF - The American journal of psychiatry JO - Am J Psychiatry VL - 153 IS - 2 N2 - OBJECTIVE: This exploratory study examined the characteristics of a group of unusual and previously undescribed patients with major affective disorder who not only had been continuously symptomatic for prolonged periods of time but were also so functionally impaired that they required years of continuous care in psychiatric facilities or by family members. METHOD: Twenty-seven inpatients with major mood disorders and 29 inpatients with schizophrenia were recruited from a large state hospital; 27 outpatients with major mood disorders were recruited from an affiliated outpatient facility. The research battery included the Structured Clinical Interview for DSM-III-R--Patient Version, the Premorbid Adjustment Scale, and a semistructured interview designed to assess demographic, family history, developmental, and course information. RESULTS: Inpatients with deteriorated affective disorder differed from outpatients with nondeteriorated affective disorder along several important dimensions, including family history of mental illness, birth-related problems, physical disorders in infancy, premorbid functioning, presence of mixed episodes and rapid cycling, and medication non-compliance between hospitalizations. Inpatients with deteriorated affective disorder differed from inpatients with schizophrenia on the Premorbid Adjustment Scale. Patients with bipolar affective disorder differed from those with unipolar disorder on many of the variables associated with deterioration of functioning. CONCLUSIONS: Birth-related problems, physical disorders in infancy, and poor premorbid adjustment in childhood and adolescence appear to play an important role in deterioration of functioning among patients with unipolar depression. Disruption in treatment because of medication noncompliance and the appearance of mixed episodes and rapid cycling are associated with functional decline in bipolar affective disorder. Several characteristics previously considered specific to deterioration of functioning in schizophrenia, such as a high rate of birth complications and poor premorbid adjustment, appear to be associated with functional deterioration among patients with major depression as well. SN - 0002-953X UR - https://www.unboundmedicine.com/medline/citation/8561207/Demographics_family_history_premorbid_functioning_developmental_characteristics_and_course_of_patients_with_deteriorated_affective_disorder_ L2 - https://ajp.psychiatryonline.org/doi/10.1176/ajp.153.2.248?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -