FTHP412 Health Promotion and Behaviour Change

Introduction

Psychological disorder is condition is usually characterised by abnormal behaviours, thoughts and feelings which is found to impact the quality of life. The psychological disorder develops due to chemical imbalance in brain, illnesses, heredity, stress and prenatal exposures. The major mental illness are attention deficit-hyperactivity disorder, autism, schizophrenia, major depressive disorder and trauma-related disorder (Surveillance and Epidemiology Division, 2015). Bipolar disorder is regarded as a mental illness which is marked by extreme shifts in mood alteration. The symptoms comprise of alteration of mood known as mania. The condition results in the development of depression which stays for two weeks. A high manic episode is also found last for days and weeks. It has been found that almost 2.2% of individual residing in Canada is found to be suffering from bipolar disorder (canada.ca, 2021). The condition develops at late adolescence stage and it is found to begin in early childhood. The below paper will discuss about bipolar disorder and the prevalence of bipolar disorder in Canada.

Discussion

Overview

It is found that bipolar disorder is also known as manic-depressive illness which is characterised by severe mood swing cycle between the period of intense high and low sensation. It has been found that almost 1% of Canadian population aged above 15 year is found to be suffering from bipolar disorder and almost 1 in 50 adults of age between 25-44 year and 45- 64 years is found to be suffering from bipolar disorder at some point of time. It is also found that almost 9 out of 10 Canadians is found to have symptoms of bipolar disorder which consists of almost 86.9%. The development of bipolar disorder is found that the risk of suicide is also high due to bipolar disorder (Baldessarini et al., 2020). The disorder develops due to imbalance in the brain neurotransmitters in brain along with that genetic factors also plays an essential role in this case. Environment pressure is also found to trigger the development of bipolar disorder are family pressure, injury in the brain, hormone imbalance, work pressure and social pressure. The disorder is characterised by mood swings and alteration in mood for few weeks which is found to range from mild disorder to severe disorder. However, in maximum condition, bipolar disorder is characterised by severe mania which effects the person’s beliefs and ultimately resulting physical inactivity (Charney et al., 2020). The symptoms of mania are feeling of invincibility, enhanced physical energy, inappropriate excitement, excessive anger, enhanced physical activity, moving and enhanced sexual activity and thoughts. The symptoms of depression are sadness, loss of hope, feeling of worthlessness, feeling of impatience, irritability, loss of temper, loss of interest or changes in appetite or weight, alteration in sleeping patterns, reduced the ability to think, anxiety, muscle and joint pain. The disorder also results in the development of increased sexual thoughts, loss of self-control, delusion and hallucination. This episode might occur multiple times and thus needs effective intervention for reducing the condition.

Aim-The aim of the literature review is to gain a brief idea about bipolar disorder and also to determine the treatment and interventions used for treating the condition.

Methodology

Search Strategy

The search strategies which are used for collecting articles are “Bipolar Disorder”, “Cognitive behavioural treatment”, “Mood Stabilizers”, “Antidepressants”, “Antidepressant-antipsychotic and “Depression”.

Search Databases

The search engines which are used for collecting papers are “NCBI”, “Google Scholar”, “Medline”, “Canadian Government website” and “Psych info”. The articles published between the year 2015-2021 were included in the study. The articles which were published in English were included in the study.

Literature Review

Dome et al., (2019) performed a study for determining the suicidal risk among bipolar disorder patient. The study stated that bipolar disorder is found to be prevalent all over the world affecting almost 1% to 5% of population. It is found that bipolar disorder is one of the sole reasons for developing suicidal tendency and the rate increases by 10 to 30 times than normal time. The study determined few protective and risk factors of suicide in bipolar disorder. Some of the single predictors of suicidal death are previous suicide history, clinical history, high level of suicide after hospitalisation, enhanced rate of suicide, development of comorbidity and lack of education. The rate is higher among male in comparison to female and it depends upon sociodemographic factor. The condition can be treated by mood stabilizer such as lamotrigine, carbamazepine and valproic acid. The patient suffering from bipolar disorder can also be provided with antidepressants such as ketamine. However, electroconvulsive therapy can also be provided to the bipolar patient which will help in reducing the symptoms. Other non-pharmacological interventions are psychosocial intervention, cognitive-behavioural therapy and social rhythm therapy.

Rao et al., (2019) performed a study for determining the prevalence of bipolar disorder among adolescent and children. The study stated that the discharge diagnosis of bipolar disease is found to increase by 18% among minor. The rate has increased from 24.1% among adolescents between the year of 15-19 year. Thus, the study stated that bipolar disorder is most prevalent in comparison to other mental health disorder.

Rowland & Marwaha (2018) performed a study for determining risk factors and epidemiology of bipolar disorder. The study stated that genetical factors plays an essential role in this case which triggers the development of bipolar disorder. The study determined that the prevalence of bipolar spectrum disorder was 2.4%, while the rate is 0.6% for bipolar I and that of 0.4% for bipolar II. It is also found that polymorphisms in genes coding for brain-derived neurotrophic factor (BDNF) to be associated with bipolar and it can be regarded as a potential biomarker. It is also found that there exist an association between monoamine transporters and catechol-O-methyl transferase which is found to cause bipolar disorder. Calcium channel subunits such as CACNA1C are situated near to single nucleotide polymorphisms that have an association with bipolar disorder. Prenatal viral infection is also found to develop bipolar disorder. Environmental factor also results in the development of bipolar disorder such as childhood maltreatment enhances the chance of developing mental illness. Stress is considered to be another factor which is found to cause bipolar disease. Similarly, substance misuse is also triggers the development of bipolar disorder. It is evident that sedatives, cannabis, opioids and alcohol.

Dell’Osso et al., (2021) performed a study for determining whether the rate of bipolar disorder is higher among male or female. The study stated that bipolar disorder are disabling and severe psychiatric disorder which is equally affecting women and men. The study stated that in female the disease is often misdiagnosed as major depressive disorder and they often receive less or inaccurate treatment. The result stated that after analysis the rate of bipolar disorder is high among female with higher rate of rapid cycling, suicidal attempts, depressive polarity. The study also stated there exist lack of proper treatment which enhances the risk of bipolar disorder. This lack of treatment is also found to hamper the quality of life.

Bonnin et al., (2019) performed a study for determining the strategies which will help in improving the quality of life, improving functioning and wellbeing for patient suffering from bipolar disorder. The study stated that individual suffering from bipolar disorder is most frequently experiences persistent residual symptoms, cognitive impairment which effects the quality of life. The assessment of psychosocial operation should include dissimilar behavioural area like the persons’ aptitude to purpose socially or occupationally, to live self-sufficiently, and to involve in an idealistic life, with practical retrieval characteristically being clear as the refurbishment of normal role operation in the areas under scrutiny. The condition can be assessed by Global Assessment Functioning Scale which help in determining the stage of bipolar disease. The pharmacological intervention which will be effective in treating the condition by restoring the cognitive function which improves the psychosocial functioning and neurocognition. The study also stated that cognitive behavioural therapy also helps in restoring function and cognitive thinking (Juruena et al., 2020). However, physical exercise and diet also play a critical role in improving the condition and thereby reducing the chance of developing other associated condition such as obesity, hypertension, diabetes, cardiovascular disorder and obesity. Thus, proper nutritional and physical intervention will help in reducing bipolar disorder.

Similarly, Ayano et al., (2020) performed a systematic review and meta-analysis for determining the prevalence of bipolar disorder among homeless individual. The study stated that bipolar disorder is one of the most severe and common mental illness which is associated with increase risk of developing mortality and disability from medical causes such as HIV/AIDS, suicide, hypertension and tuberculosis. The study stated that maximum included papers used Diagnostic Statistical Manual of Mental disorder (DSM) scale for determining the disorder along with that Clinical Assessment of Neuropsychiatry (SCAN) and Neuropsychiatric Interview (MINI).  The result stated that the prevalence of bipolar disorder among homeless individuals were 11.4%. The prevalence of bipolar disorder is about 10.0% in Europe and that of 13.2% in other countries. Thus, it is clearly determined the prevalence of bipolar disorder is high among homeless individual which needs proper screening program and intervention for managing the condition.

Chiang et al., (2017) performed study a for determining the efficacy of cognitive behavioural therapy in reducing bipolar therapy. The study stated that CBT is found to be effective for treating bipolar disorder along with pharmacological intervention. The result of this study determined that cognitive behavioural therapy is helpful in reducing the relapse rate and improve the sign of depression. This therapy also helps in improving the mania severity and psychosocial functioning. Thus, CBT helps in improving depressive symptoms as well and thereby improving mild to moderate disorder.

Aldinger & Schulze (2017) performed a study for determining the determining the impact of life events, environmental factor and trauma in developing bipolar disorder. The study stated that the course and aetiology of bipolar disorder are determined by environmental and genetic factors. The study determined few factors such as entire lifespan, early life and prenatal factors governs the development of bipolar disorder. The study determined that environmental factors such as infection, climate and illness trigger the development of bipolar disorder. Similarly, maternal smoking, birth complication, job loss, high expressed emotions result in the development of bipolar disorder. Lack of social support also results in the development of bipolar disorder. It has been found that Toxoplasma gondii parasites results in bipolar disorder by influencing the dopamine metabolism but only few studies reported this incident. Bipolar disorder is also common among anorexia nervosa and schizophrenia patient and maternal smoking increases the risk of developing this disorder. Another most essential factor which is found to develop bipolar disorder is childhood trauma and which accounts for about almost 50% of cases. The study also stated that female with bipolar disorder had a strong connection with clinical course such as early age onset, major depressive episode and rapid cycling. It is found that unemployment status also results in bipolar disorder.  

Gomes et al., (2017) performed a RCT protocol for determining the efficacy of cognitive behavioural rehabilitation versus usual treatment among bipolar patient. The study planned at involving patient diagnosed with type I and type II bipolar disorder and the points which will be assessed during this phase are social functioning, mood function and quality of life. But it can be determined that the combined intervention will be effective in improving the cognitive function.

Findings

It has been found that bipolar disorder is common among all group of people and it is mostly prevalent among homeless individuals. The condition can be treated by antidepressants drugs and stabilizers which will help in reducing symptoms of bipolar disorder. Cognitive behavioural therapy will be effective in reducing bipolar disorder (Richardson & White, 2019). Thus, proper awareness program must be implemented by the healthcare professional by collaborating with government which will help in reducing the prevalence.

Conclusion

The paper discussed about bipolar disorder based upon literature. The psychological disorder develops due to chemical imbalance in brain, illnesses, heredity, stress and prenatal exposures. Bipolar disorder is regarded as a mental illness which is marked by extreme shifts in mood alteration. The symptoms comprise of alteration of mood known as mania. It is found that bipolar disorder is one of the sole reasons for developing suicidal tendency and the rate increases by 10 to 30 times than normal time. Lastly, the paper suggested interventions based upon literature review.

References

Aldinger, F., & Schulze, T. G. (2017). Environmental factors, life events, and trauma in the course of bipolar disorder. Psychiatry and clinical neurosciences, 71(1), 6–17. https://doi.org/10.1111/pcn.12433

Ayano, G., Shumet, S., Tesfaw, G., & Tsegay, L. (2020). A systematic review and meta-analysis of the prevalence of bipolar disorder among homeless people. BMC public health, 20, 1-10. https://doi.org/10.1186/s12889-020-08819-x

Baldessarini, R. J., Vázquez, G. H., & Tondo, L. (2020). Bipolar depression: a major unsolved challenge. International journal of bipolar disorders, 8(1), 1. https://doi.org/10.1186/s40345-019-0160-1

Bonnín, C. D. M., Reinares, M., Martínez-Arán, A., Jiménez, E., Sánchez-Moreno, J., Solé, B., ... & Vieta, E. (2019). Improving functioning, quality of life, and well-being in patients with bipolar disorder. International Journal of Neuropsychopharmacology, 22(8), 467-477. https://doi.org/10.1093/ijnp/pyz018

canada.ca. (2021). What Should I Know about Bipolar Disorder (Manic-Depression)? - Canada.ca. Retrieved 14 April 2021, from https://www.canada.ca/en/public-health/services/chronic-diseases/mental-illness/what-should-know-about-bipolar-disorder-manic-depression.html

Charney, A. W., Mullins, N., Park, Y. J., & Xu, J. (2020). On the diagnostic and neurobiological origins of bipolar disorder. Translational psychiatry, 10(1), 1-10. https://doi.org/10.1038/s41398-020-0796-8

Chiang, K. J., Tsai, J. C., Liu, D., Lin, C. H., Chiu, H. L., & Chou, K. R. (2017). Efficacy of cognitive-behavioral therapy in patients with bipolar disorder: A meta-analysis of randomized controlled trials. PloS one, 12(5), e0176849. https://doi.org/10.1371/journal.pone.0176849

Dell’Osso, B., Cafaro, R., & Ketter, T. A. (2021). Has Bipolar Disorder become a predominantly female gender related condition? Analysis of recently published large sample studies. International journal of bipolar disorders, 9(1), 1-7. https://doi.org/10.1186/s40345-020-00207-z

Dome, P., Rihmer, Z., & Gonda, X. (2019). Suicide Risk in Bipolar Disorder: A Brief Review. Medicina (Kaunas, Lithuania), 55(8), 403. https://doi.org/10.3390/medicina55080403

Gomes, B. C., Rocca, C. C., Belizario, G. O., & Lafer, B. (2017). Cognitive-behavioral rehabilitation vs. treatment as usual for bipolar patients: study protocol for a randomized controlled trial. Trials, 18(1), 1-7. https://doi.org/10.1186/s13063-017-1896-5

Juruena, M. F., Jelen, L. A., Young, A. H., & Cleare, A. J. (2020). New Pharmacological Interventions in Bipolar Disorder. doi: 10.1007/7854_2020_181.

Rao, P., Moore, J. K., Stewart, R., Runions, K., Bear, N., Wong, J. W., Holtmann, M., & Zepf, F. D. (2016). Bipolar disorder in children and adolescents: diagnostic inpatient rates from 2000 to 2013 in Germany. International journal of bipolar disorders, 4(1), 23. https://doi.org/10.1186/s40345-016-0064-2

Richardson, T., & White, L. (2019). The impact of a CBT-based bipolar disorder psychoeducation group on views about diagnosis, perceived recovery, self-esteem and stigma. The Cognitive Behaviour Therapist, 12, e43. DOI: https://doi.org/10.1017/S1754470X19000308

Rowland, T. A., & Marwaha, S. (2018). Epidemiology and risk factors for bipolar disorder. Therapeutic advances in psychopharmacology, 8(9), 251–269. https://doi.org/10.1177/2045125318769235

Surveillance and Epidemiology Division, Public Health Agency of Canada, CCDSS Mental Illness Working Group, CCDSS Science Committee, & CCDSS Technical Working Group (2015). Report Summary--Mental Illness in Canada, 2015. Health promotion and chronic disease prevention in Canada : research, policy and practice, 35(6), 95–96.

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