The effect of duration of untreated illness on clinical severity indicators in mood disorders
Notice bibliographique
Résumé
Abstract Background. Research on duration of untreated illness in psychosis has consistently found that a longer period between psychotic symptom onset and treatment with antipsychotic medication is associated with a worse illness outcome. However in the case of mood disorders, an association between duration of untreated illness and clinical severity indicators has received little attention. It is important to investigate this association in order to determine if duration of untreated illness may be a risk factor for increased illness severity in mood disorders and to identify which aspects of illness severity are impacted. This information may be used to inform optimal design of screening models and intervention plans to reduce duration of untreated illness and its effect on illness course. Methods. Participants with diagnoses of major depression (n=72), bipolar disorder type I (n=77) or bipolar disorder type II (n=42) were recruited from the Mood Disorders Clinic of the Allan Memorial Institute in Montreal, Quebec, Canada. Mood disorder diagnosis was determined using the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID). Information regarding age of onset of psychiatric symptoms, age the individual first sought help, age of first psychiatric consult, psychiatric hospitalizations, lifetime suicide attempts, psychiatric comorbidities, and periods the individual was unable to attend work or school were obtained using the SCID as well. Binary and ordinal regressions adjusted for age and sex were performed to determine the association between duration of untreated illness and clinical severity indicators. Results. A longer duration of untreated illness in mood disorders was associated with fewer psychiatric hospitalizations, a lower likelihood of suicide attempts and fewer periods the individual was unable to attend work or school, but was also associated with more psychiatric comorbidities. Individuals with bipolar disorder type II were more at risk for psychiatric comorbidities and suicide attempts than those with either major depression or bipolar disorder type I. Discussion. Our results suggest that persons with more severe mood disorder symptomatology may seek professional help earlier than do those with less severe disorders. A longer duration of untreated mood disorder may allow time for the development of more comorbidities, which could be part of an adverse coping mechanism for the initial mood disorder. The period of time in the course of a mood disorder between onset of symptoms and psychiatric treatment presents an opportune time in which health care systems could promote healthy coping strategies and self-care in order to reduce the symptoms and avoid the need for psychiatric services. Improving mental health literacy may also aid in helping individuals to be able to identify milder symptoms in themselves and address them before they affect functioning.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,003 | 0,018 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».