\
  The most prestigious law school admissions discussion board in the world.
BackRefresh Options Favorite

Brother-in-law is suffering from bipolar and depression

They live far away, but my sister told me what happened. He ...
Sadistic spot cuck
  03/07/18
is recovery possible? kind of but not really: Prognosis...
salmon codepig
  03/07/18
What’s his moniker
Slate bbw
  03/07/18
disco fries, obviously
contagious prole
  03/07/18
Sorry you are going through this. Is this the first time thi...
claret menage
  03/07/18
UPDATE He was in jail for like a week and is now out on b...
Sadistic spot cuck
  03/18/18
I pray it's not a M'Naghten jurisdiction
Offensive nursing home
  03/18/18
...
Sadistic spot cuck
  03/18/18
good luck with those kids
hairless theater really tough guy
  03/18/18
lol women always end up marrying and procreating with these ...
Bateful Giraffe Crackhouse
  03/18/18
Was this is first manic episode? What medications did they...
cream supple cruise ship
  03/18/18
yes, first episode. no prior criminal record. he's on heavy ...
Sadistic spot cuck
  03/18/18
What is the legal outcome for something like this, can the j...
Lascivious costumed circlehead
  03/18/18
Your only option is to marry your sister and raise those kid...
Milky masturbator pistol
  03/18/18


Poast new message in this thread



Reply Favorite

Date: March 7th, 2018 12:07 AM
Author: Sadistic spot cuck

They live far away, but my sister told me what happened. He was screaming early in the morning, freaking out, and the kids were scared to death. She called the cops, and he calmed down and told them that everything was fine. After they left, he threatened to hurt himself. Cops came again, and this time he got violent, assaulting the cops. He was arrested and released on bail and checked into a mental hospital. From what I've heard, he is not recovering.

They have 3 kids, so this is freaking me out. Has anyone dealt with anything like this? Is recovery possible? What can I do?



(http://www.autoadmit.com/thread.php?thread_id=3911857&forum_id=2#35551286)



Reply Favorite

Date: March 7th, 2018 12:12 AM
Author: salmon codepig

is recovery possible? kind of but not really:

Prognosis

Functional recovery is limited in people with bipolar disorder

Michael J Ostacher, MD, MPH

http://dx.doi.org/10.1136/ebmh.7.3.69

Tohen M, Zarate CA, Hennen J, et al. The McLean-Harvard first-episode mania study: prediction of recovery and first recurrence. Am J Psychiatry 2003;160:2099–107.CrossRefPubMedWeb of Science

Q What is the prognosis for people hospitalised with first episode bipolar disorder?

METHODS

Embedded ImageDesign:

Prospective cohort study, part of the larger decade long McLean-Harvard First-Episode Project.

Embedded ImageSetting:

Inpatient units at McLean Division of Massachusetts General Hospital; 1989 to 1996.

Embedded ImagePopulation:

173 people (mean age 33 years, 55% male) were consecutively recruited within 72 hours of psychiatric hospitalisation for manic (75%) or mixed (25%) episode bipolar disorder (DSM-IV criteria). Exclusions: current substance withdrawal, delirium, previous psychiatric hospitalisation unless for detoxification only, documented IQ <70, ill for >1 year, previous treatment with a mood stabiliser or antipsychotic for >3 months in total.

Embedded ImagePrognostic factors:

Participants were assessed weekly until discharge. Semistructured telephone interviews were conducted at 6, 12, 24, 26, and 48 months by experienced assessors. Information obtained included symptoms, occupational status, residential status, current treatment, and determination of syndromal, symptomatic, and functional recovery.

Embedded ImageOutcomes:

Likelihood of syndromal, symptomatic, and functional recovery (according to occupational and residential status); risks of first relapse or recurrence.

Embedded ImageFollow up period:

Average 4.86 years, 87% followed for &#10878;2 years.

MAIN RESULTS

Syndromal recovery: 98% experienced syndromal recovery at 2 years. Predictors of earlier syndromal recovery were shorter initial hospitalisations (HR 1.99, 95% CI 1.36 to 2.93, p<0.001), female sex (HR 1.72, 95% CI 1.16 to 2.56, p&#8202;=&#8202;0.008), and below median initial depression ratings (HR 1.65, 95% CI 1.14 to 2.39, p&#8202;=&#8202;0.008). Symptomatic recovery: 72% had symptomatic recovery at 2 years. Functional recovery: at 2 years, 43% had functional recovery. Predictors of functional recovery were age &#10878;30 years (OR 3.28, 95% CI 1.58 to 6.82, p&#8202;=&#8202;0.006) and shorter initial hospitalisations (OR 2.82, 95% CI 1.36 to 5.88, p&#8202;=&#8202;0.006). First relapse or recurrence: 20% had new episodes of mania, 20% new episodes of depression and 19% switched phases without recovery within 2 years (see http://www.ebmentalhealth.com/supplemental for table). Predictors of mania were initial mood-congruent psychotic features (HR 2.79, 95% CI 1.31 to 5.91, p&#8202;=&#8202;0.05); low premorbid occupational status (HR 2.53, 95% CI 1.15 to 5.55, p&#8202;=&#8202;0.02), and initial manic versus mixed state (HR 3.38, 95% CI 1.00 to 11.5 p&#8202;=&#8202;0.05). Predictors of depression were higher premorbid occupational status (HR 5.08, 95% CI 2.16 to 11.90, p<0.0001); initial mixed presentation (HR 4.52, 95% CI 2.23 to 9.16, p<0.0001); and any comorbidity (HR 2.60, 95% CI 1.20 to 5.66 p&#8202;=&#8202;0.02).

CONCLUSIONS

Among people with bipolar disorder who require hospitalisation, many have relapses, switches, and limited functional recovery.

Commentary

The classical description of affective disorders as episodic illnesses with full symptomatic and functional recovery between episodes is no longer valid. Kraeplin’s conceptualisation of functional decline as being pathognomonic of schizophrenia, and not affective disorders, no longer holds true.1 Many people with mood disorders, whether their symptoms persist or not, never return to their premorbid level of functioning after becoming ill.2,3 Even with adequate care, the long term course of bipolar I disorder appears to be one of chronicity, with recurrent or subsyndromal symptoms of mania or depression frequently present.4

By monitoring changes in functioning, Tohen et al have found that in spite of syndromal recovery following hospitalisation for a manic or mixed episode, many patients continue to exhibit subsyndromal symptoms (especially depression) and functional decline. Even when euthymic, compared with people without mood disorders, people with bipolar disorder have cognitive impairment, with the greatest impairment found in verbal and visual-spatial memory.5 This may in part explain why previously able people decline in their functioning.6

Advances in psychopharmacological treatments of acute bipolar mood episodes have come swiftly, and this study underscores the near term success of those agents in reducing mood symptoms. Successes at obtaining complete euthymia and at preventing relapse to new episodes have been fewer.4 Importantly, symptomatic recovery does not guarantee return of functioning, and newer agents have not yet had a positive impact on this problem.2 Because the rate of psychosis in this study (87%) is higher than expected, the participants in this study may be somewhat more ill than the average bipolar I patient.

Although 69% of subjects in this study were discharged from inpatient treatment on lithium, only 39% remained on that drug at two year follow up. Although antipsychotic and anticonvulsant use was less frequent at the time of the study, the use of those drugs remained more stable over the first two years of follow up. The difference may be due not only to effectiveness, but to tolerability. As the adverse cognitive effects of lithium and valproate are well known, it will be interesting to note whether newer drugs will have an impact on the likelihood of return to functioning.

References

&#8629;Kraeplin E. Manic Depressive Insanity and Paranoia. E&S Livingstone: Edinburgh, 1921.Google Scholar

&#8629;Coryell W, Endicott J, Maser JD, et al. The likelihood of recurrence in bipolar affective disorder: the importance of episode recency. J Affect Disord 1995;33:201–6.CrossRefPubMedWeb of ScienceGoogle Scholar

&#8629;Coryell W, Keller M, Lavori P, et al. Affective syndromes, psychotic features, and prognosis. Arch Gen Psychiatry 1990;47:658–62.CrossRefPubMedWeb of ScienceGoogle Scholar

&#8629;Judd LL, Akiskal HS, Schettler PJ, et al. The long-term natural history of the weekly symptomatic status of bipolar I disorder. Arch Gen Psychiatry 2002;59:530–7.CrossRefPubMedWeb of ScienceGoogle Scholar

&#8629;Martinez-Aran A, Vieta E, Reinares M, et al. Cognitive function across manic or hypomanic, depressed, and euthymic states in bipolar disorder. Am J Psychiatry 2004;161:262–70.CrossRefPubMedWeb of ScienceGoogle Scholar

&#8629;Rubinsztein JS, Michael A, Paykel ES, et al. Cognitive impairment in remission in bipolar affective disorder. Psychol Med 2000;30:1025–36.CrossRefPubMedWeb of ScienceGoogle Scholar



(http://www.autoadmit.com/thread.php?thread_id=3911857&forum_id=2#35551322)



Reply Favorite

Date: March 7th, 2018 12:12 AM
Author: Slate bbw

What’s his moniker

(http://www.autoadmit.com/thread.php?thread_id=3911857&forum_id=2#35551325)



Reply Favorite

Date: March 7th, 2018 12:23 AM
Author: contagious prole

disco fries, obviously

(http://www.autoadmit.com/thread.php?thread_id=3911857&forum_id=2#35551394)



Reply Favorite

Date: March 7th, 2018 12:23 AM
Author: claret menage

Sorry you are going through this. Is this the first time this has happened? There must be some signs before.

(http://www.autoadmit.com/thread.php?thread_id=3911857&forum_id=2#35551390)



Reply Favorite

Date: March 18th, 2018 8:16 PM
Author: Sadistic spot cuck

UPDATE

He was in jail for like a week and is now out on bond. He will go to trial for assaulting a cop. FUCK.

(http://www.autoadmit.com/thread.php?thread_id=3911857&forum_id=2#35633845)



Reply Favorite

Date: March 18th, 2018 8:46 PM
Author: Offensive nursing home

I pray it's not a M'Naghten jurisdiction

(http://www.autoadmit.com/thread.php?thread_id=3911857&forum_id=2#35634031)



Reply Favorite

Date: March 18th, 2018 8:32 PM
Author: Sadistic spot cuck



(http://www.autoadmit.com/thread.php?thread_id=3911857&forum_id=2#35633935)



Reply Favorite

Date: March 18th, 2018 8:40 PM
Author: hairless theater really tough guy

good luck with those kids

(http://www.autoadmit.com/thread.php?thread_id=3911857&forum_id=2#35633983)



Reply Favorite

Date: March 18th, 2018 8:41 PM
Author: Bateful Giraffe Crackhouse

lol women always end up marrying and procreating with these sorts.

(http://www.autoadmit.com/thread.php?thread_id=3911857&forum_id=2#35633991)



Reply Favorite

Date: March 18th, 2018 8:41 PM
Author: cream supple cruise ship

Was this is first manic episode?

What medications did they put him on? My guess would be Valproate or Lithium since he seemed have psychotic features.

(http://www.autoadmit.com/thread.php?thread_id=3911857&forum_id=2#35633998)



Reply Favorite

Date: March 18th, 2018 8:55 PM
Author: Sadistic spot cuck

yes, first episode. no prior criminal record. he's on heavy medication now.

(http://www.autoadmit.com/thread.php?thread_id=3911857&forum_id=2#35634103)



Reply Favorite

Date: March 18th, 2018 9:00 PM
Author: Lascivious costumed circlehead

What is the legal outcome for something like this, can the judge just say "well you were mentally ill so we'll let you off"

(http://www.autoadmit.com/thread.php?thread_id=3911857&forum_id=2#35634143)



Reply Favorite

Date: March 18th, 2018 9:01 PM
Author: Milky masturbator pistol

Your only option is to marry your sister and raise those kids as your own.

(http://www.autoadmit.com/thread.php?thread_id=3911857&forum_id=2#35634151)