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This paper reports outcomes from a holistic, recovery‐based, user‐led group training for people with DSM‐IV bipolar disorder. Drawn from professional therapies and personal experience of the illness by the user‐researcher, the training was delivered over 12 weekly sessions. Using a case‐study approach, an experimental design incorporated pilot (eight participants), main study (five) and control groups (six). Self‐report scales measured mood, coping, empowerment and quality of life pre‐, post‐ and six months post‐training. Semi‐structured interviews noted individual change within the same time frame. Interviews with mental health professionals, medical note analysis and user‐researcher observations also informed the study. Findings from self‐report questionnaires indicated that participants experienced improved mood stability, symptom severity, coping and quality of life and greater empowerment. Out of the six controls, two indicated slight but slow recovery, four continued to use poor coping skills, and two of these four experienced major relapses.

The term borderline applied to personality dynamics was first introduced by Adolph Stern in 1938. This new term included a particular group of patients who, in an organizational blurring, remained in the limbo between neurosis and psychosis. To find a more assertive and holistic characterization of borderline personality disorder (BPD), the purpose of this paper is to explore borderline phenomenology, setting boundaries and discussing points of approach and divergence of this personality disorder comparing them specifically to bipolar affective disorder (BAD) and also explore the differences in their treatment and prognosis.

This paper is a review and synthesis of the extant literature, mapping out the similar and unique aspects of each pathology.

Although there are approximation parameters between BPD and BAD, the phenomenology and the course of both diseases appear to be different. Indeed, this paper seems to have some uncertainty about the sphere of each entity and the domain of comorbidity. Despite the overlapping rates found, it is the understanding that the consequences and strategies for managing comorbidity are underexplored.

As the association of both disorders can be difficult not only in terms of management and understanding of their consequences and implications but also in long-term negative perpetuation, this review has direct implications for clinicians so that they can understand the similarities and particularities of each entity, leading to a more correct psychopathological approach in these individuals.

Purpose – This chapter explores the changing definition of bipolar disorder, examining how debates within psychiatry actually construct the definition of mental illness, thereby creating the appearance of an emerging epidemic with increasing prevalence.

Method – I review the recent psychiatric and epidemiological research to reveal that the intellectual and scientific debates that occur in the psychological laboratory and in survey research are in fact falsely increasing the figures that show that an epidemic of bipolar is emerging.

Findings – For centuries, bipolar disorder was equated with severe psychosis and had a prevalence rate between 0.4% and 1.6%. As spectrum and subthreshold conceptions of bipolar disorder become established in official psychiatric diagnostic manuals, however, estimates of the prevalence of bipolar spectrum disorders have risen to almost 25%. I demonstrate that nearly all of this increase is a result of changes in the scientific and intellectual definition of bipolar disorders among psychiatric professionals, and that rates of symptoms are not in fact increasing.

Contribution to field – The arbitrariness of diagnostic thresholds naturally leads researchers to argue for lower thresholds. This allows more individuals who were previously considered psychiatrically normal to be reclassified as psychiatrically disordered. Lowering diagnostic thresholds increases the risk of confusing normal elation or sadness with disordered states, increasing the potential of false-positive diagnoses and the false impression of rising rates of disorder.

The purpose of this paper is to study the role of social factors that determine the length of stay in a mental hospital and also understand the main factors leading to the phenomena as a step to solve it.

A case-control cross-sectional observational study is performed which studies correlates for the lengthy stay in a mental hospital. The study population consists of two groups: Group A (94 patients), taken from the patients hospitalized for more than one year, further subdivided into schizophrenia and schizoaffective inpatient group and bipolar affective inpatient group; and Group B (94 patients), receiving their treatment at the outpatient clinic after being admitted for less than six months, this group was further subdivided into same categories as Group A.

The study showed that the positive score in positive and negative symptoms scale (PANSS) showed highly statistically significant (p<0.01) correlation with the length of hospital stay for the schizophrenic and schizoaffective patients in the inpatient group. The results showed no statistically significant difference (p>0.05) between the inpatient schizophrenic cases and the inpatient affective cases regarding the length of hospital stay.

The linear regression model was used to understand the predictors of increased length of hospital stay. The linear regression analyzing the scale data of schizophrenic and schizoaffective patients found that the length of hospital stay for the schizophrenic and schizoaffective patients depends on the patient’s age and his positive PANSS score. On the other hand, linear regression model for bipolar affective patients in the study found no statistically significant attributes of the length of hospital stay.

The study found that the length of hospital stay for schizophrenic and schizoaffective patients depends on the patient’s age and his positive PANSS score.

The need for this study stems from the large numbers of mental inpatients who have been lengthily admitted in mental health hospitals in Egypt, while trying to understand main factors leading to the phenomena as a step to solve it. The study found that there is a highly significant difference between inpatient group and outpatient group regarding the marital status, education level, and psychosocial class, with inpatient group having more single, illiterate, and very low social class cases.

Research in the area of chronic psychiatric hospitalization and its effect on the course and prognosis of mental illness is still scarce, especially in the Arab world; therefore, the research will open the door for further research efforts in the future with a larger sample of patients to study the pros and cons of deinstitutionalization taking into account the past experience of health systems in other countries.

While hypothyroidism is common in lithium-treated patients, thyrotoxicosis is rarely reported. We present a female patient on lithium for maintenance therapy of bipolar affective disorder, who developed thyrotoxicosis for few months which was followed by hypothyroidism which continued. There was no further thyrotoxicosis episode during a five year follow up period. While she was treated for thyroid dysfunction, lithium was continued. There was no clinical impact on the maintenance of the bipolar affective disorder during the follow up period; she was maintained well in the community.

The purpose of this paper is to suggest that student-led case studies are an important way to learn about mental health problems and to highlight this by presenting a case study of the comedic genius Spike Milligan.

Celebrities live their lives in the public eye. In recent years, many have talked about their struggles with mental health. This paper is based on a student-led case study of the celebrity Spike Milligan.

This case study suggests one previously under-emphasised issue and argues that Spike Milligan’s wartime experiences may have led to post-traumatic stress disorder. Second, that he may have developed neuro-inflammation, through contracting sandfly fever during the war. This could have been an additional trigger for bipolar disorder.

While this is a single case study, it draws on a wide variety of research sources to back up the arguments advanced.

Student-led case studies provide a way of engaging students more actively with mental health problems.

Mental illness is complex, if not more complex, than physical health problems. Case studies of celebrities like Spike Milligan can help develop a public understanding of mental illness, as they already have a working knowledge about the person.

The case study illustrates how Bipolar 1 disorder is a complex and unique condition and that every individual’s illness has different predisposing characteristics. It suggests that student-led case studies are a helpful learning tool.

The purpose of this paper is to explore and review the range and quality of international epidemiological and observational studies reporting impacts of psychiatric disorders on labour force activity. This information is needed to explore the relative priority of different diagnostic groups for more intensive forms of vocational rehabilitation.

The authors provide an overview of the current literature. A systematic review of papers measuring labour force variables and psychiatric disorders across a range of countries is conducted. These results are compared to OECD background unemployment rates during the same period. The results for each diagnostic category included are aggregated and compared to the other diagnostic categories.

The proportions of people employed decreased with the more severe disorder categories, indicating that severe psychiatric illnesses are contributing to employment struggles for people with these illnesses, across countries.

This review is exploratory and shows that there is little consistency in reporting of labour force variables. Future research should endeavour to utilise internationally agreed definitions of labour force activity.

This conclusion is relevant to matching community residents with psychiatric disorders to the more intensive and costly forms of vocational rehabilitation.

To our knowledge, no previous review has examined diagnostic categories of psychiatric disorders by labour force activity internationally while taking into account background unemployment. This review found an employment gradient related to severity of diagnostic category that will be of interest to clinicians and policy makers.

This study aims to use the database of consumers referred to the dual diagnosis shared care service to examine those connections. The Eastern Dual Diagnosis Service, based in Melbourne, Australia, has established a database of consumers with co-occurring mental health disorders and problematic substance use. An examination of mental health and substance-use information obtained over a two-year period in the delivery of dual diagnosis shared care to consumers of mental health services is supporting an improved understanding of substance use and the connections to specific mental health diagnoses of schizophrenia, bipolar disorder and schizoaffective disorder.

This research uses a quantitative approach to review the prevalence of primary substance use and mental health diagnoses for consumers referred to as dual diagnosis shared care. Reviewed are referrals from adult mental health community and rehabilitation teams operating within a mental health and well-being program between January 2019 and December 2020 inclusive.

Of the 387 clients referred to the specialist dual diagnosis shared care, methamphetamine, alcohol and cannabis are associated with 89.4% of the primary mental health diagnosis (PMHD). The most common PMHDs are schizophrenia, schizoaffective disorder and bipolar disorder. The most common PMHD and substance-use connection was schizophrenia and methamphetamine. Nicotine was reported to be used by 84% of consumers and often occurred in addition to another problematic primary substance.

Improved dual diagnosis data collection from a community-based clinical mental health service is increasing understanding of the mental health and substance-use relationship. This is now providing clarity on routes of investigation into co-occurring mental health and problematic substance-use trends and guiding improved integrated treatments within a contemporary mental health setting.

Acute and transient psychotic disorders (ATPD), introduced in the International Classification of Diseases (ICD-10) diagnostic system in 1992, are not receiving much attention in developing countries. Therefore, the main objective of this article is to review the literature related to the diagnostic stability of ATPD in developing countries. A PubMed search was conducted to review the studies concerned with this issue in the context of developing countries, as diagnostic stability is more of a direct test of validity of psychiatric diagnoses. Four publications were found. According to the literature search, the stability percentage of the ICD-10 ATPD diagnosis is 63-100%. The diagnostic shift is more commonly either towards bipolar disorder or schizophrenia, if any. Shorter duration of illness (<1 month) and abrupt onset (<48 hours) predict a stable diagnosis of ATPD. Based on available evidence, the diagnosis of ATPD appears to be relatively stable in developing countries. However, it is difficult to make a definitive conclusion, as there is a substantial lack of literature in developing country settings.

In this research we use data from the National Comorbidity Survey to examine the effects of affective mental disorders on the income and employment of women and men. We consider separately the effects of three major categories of affective illness: depression, bipolar illnesses, and dysthymia.We use a two-stage instrumental variables procedure to estimate the labor market effects of affective disorders in the presence of unmeasured heterogeneity between those with and without illness. In the first stage, we draw on respondents' family histories with illness to construct instrumental variables, which are theoretically and empirically relevant. These instruments are used in second stage regression and logistic analyses of annual income and employment.We find evidence that some affective disorders result in earnings losses for both women and men. For women, depression is associated with substantial earnings losses for working women, on the order of more than $6,000 per year. But, these losses are mitigated over time. Moreover, we find evidence that depression has substantial negative employment effects for women. For men, we find evidence of income losses associated with dysthymia, but we find no evidence of significant employment effects.