HEALTHCARE PROFESSIONALS
Below you will find a brief overview of schizophrenia, bipolar disorder and Major Depressive Disorder (MDD) which covers the definition, incidence in the UK and risk factors associated with disorders.
Schizophrenia is a chronic mental illness whose exact cause is unknown, although there are many associated risk factors.1 Schizophrenia symptoms can be divided into negative and positive symptoms.2 Negative symptoms are often experienced in the early prodromal period of schizophrenia prior to diagnosis and a patient’s first schizophrenic episode.2 Negative symptoms of schizophrenia include:2
- Lack of concentration, interest and motivation in life, hobbies, relationships and sex;
- Changes in sleeping patterns;
- Changes in body language, reduced range of emotions and reduced interaction with other people.
Patients are not usually diagnosed with schizophrenia until they experience positive symptoms also known as psychosis, these include:2
- Hallucinations, where someone sees, hears, smells, tastes or feels things that don’t exist outside of their mind (i.e., hearing voices);
- Delusions, which are beliefs the patient believes to be true although they may be mistaken, strange or unrealistic;
- Changes in behaviour such as becoming agitated, shouting or swearing for no apparent reason;
- Changes in thoughts and disorganised thinking such as the feeling their thoughts are not their own, becoming confused and losing track of their thoughts.
Mental Health Disorder Resources
Please click the links below to leave the Aspire Pharma website and find out more information about mental health disorders.
Bipolar disorder is a chronic mental disorder characterised by episodes of behaviour changes that can last for weeks or months which can be divided into two categories:3,4
- Mania or hypomania (lesser mania) symptoms include feeling elated, self-important and energetic, not sleeping or eating, and behaving in a way others may deem risky;
- Depression symptoms include feeling worthless, despair and pessimistic, having suicidal thoughts, delusions and hallucinations, and loss of interest in life.
Although the exact cause of bipolar disorder is unknown, it is widely believed that it is caused by an imbalance in the levels of one or more neurotransmitters in the brain.4 Bipolar disorder is commonly divided by NICE into two categories:3
- Type I, patients experience both manic and depressive episodes;
- Type II, patients experience severe depressive episodes and episodes of hypomania.
As patients become older, the time periods between episodes becomes shorter in duration.
Major Depressive Disorder also known as Clinical Depression is a mental illness characterised by symptoms of sadness, hopelessness and loss of interest in hobbies and interests for a period of weeks or months, which makes it almost impossible for the individual to carry on with their daily life.5 There are many symptoms of depression, including psychological, physical and social symptoms, however a patient may not present with all of them.5 Often, depression is caused by a combination of triggers and no one cause has been identified.6
Incidence
Approximately 1 in every 100 people is diagnosed with schizophrenia, and most people are diagnosed aged 18-35 years old.7 Some studies suggest that living in cities increases the risk of developing schizophrenia.
In the UK, African-Caribbean men are more likely to be diagnosed with schizophrenia.7
Approximately 1 in every 100 people will be diagnosed with bipolar disorder. Bipolar disorder can occur at any age, although it often develops in individuals aged 15-19 years old.8
In the UK, approximately 1 in every 10 people suffer from depression at some point during their lifetimes.9 Some studies have shown that individuals are more likely to suffer with depression as they grow older, others have shown it is more common in patients who live in difficult social and economic circumstances.6
Risk Factors
Although the cause of the Schizophrenia is not fully understood, there are several factors that can increase the risk of Schizophrenia, including:10
- Genetics; schizophrenia has been linked to heritable factors, however no individual gene has been identified as being responsible;
- Neurotransmitters; studies of neurotransmitters in the brains of schizophrenic patients show an imbalance in the levels of dopamine and serotonin;
- Brain development; studies of schizophrenic patients’ brains have shown subtle differences in brain structure, these aren’t seen in everyone with schizophrenia but they suggest schizophrenia may partly be a disorder of the brain;
- Pregnancy and birth complications; people with schizophrenia are more likely to have experienced complications before and during their birth such as low birth weight, premature labour or lack of oxygen during birth;
- Stress; stressful life events (i.e., death of a loved one, the end of a relationship, and physical, sexual or emotional abuse) can trigger schizophrenia in those individuals vulnerable to it;
- Drug abuse; increases the risk of developing schizophrenia, particularly cannabis, cocaine, LSD or amphetamines in individuals susceptible to schizophrenia.
There are several risk factors associated with bipolar disorder, including:11,12
- Chemical imbalance in the brain; some evidence exists that if there is an imbalance in the levels of one or more neurotransmitters, a person may develop some symptoms of bipolar disorder;
- Genetics; if an immediate family member has bipolar disorder there is a 5-10 times more likely risk of individuals developing it themselves;
- Physical illness and sleep disturbances;
- Stressful life events, including:
- Relationship breakdown;
- Physical, sexual or emotional abuse;
- Death of a loved one.
There are many different risk factors associated with MDD, it may be several factors that trigger an individual’s depression or just one. Risk factors for MDD include:6
- Stressful life events;
- Physical illnesses; chronic or life-threatening illness can trigger depression, severe head injuries can trigger mood swings and psychosis, and hypothyroidism;
- Low self-esteem or overly self-critical personality;
- Family history of depression;
- Giving birth; hormonal and physical changes after pregnancy as well as responsibility;
- Loneliness;
- Alcohol and drug abuse; alcohol and drugs, cannabis in particular, are depressants which worsen depression.
References: 1) NHS. Schizophrenia. www.nhs.uk/Conditions/Schizophrenia/Pages/Introduction.aspx. (accessed 30 November 2016).
2) NHS. Schizophrenia – Symptoms. www.nhs.uk/Conditions/Schizophrenia/Pages/Symptoms.aspx (accessed 30 November 2016).
3) Patient. Bipolar Disorder. www.patient.co.uk/doctor/bipolar-disorder-pro. (accessed 30 November 2016).
4) NHS. Bipolar Disorder – Symptoms. www.nhs.uk/Conditions/Bipolar-disorder/Pages/Symptoms.aspx. (accessed 30 November 2016).
5) NHS. Clinical Depression – Symptoms. www.nhs.uk/Conditions/Depression/Pages/Symptoms.aspx. (accessed 30 November 2016).
6) NHS. Clinical Depression – Causes. www.nhs.uk/Conditions/Depression/Pages/Causes.aspx. (accessed 30 November 2016).
7) Mind. Schizophrenia – Causes. www.mind.org.uk/information-support/types-of-mental-health-problems/schizophrenia/causes/. (accessed 30 November 2016).
8) NHS. Bipolar Disorder. www.nhs.uk/Conditions/Bipolar-disorder/Pages/Introduction.aspx. (accessed 30 November 2016).
9) NHS. Clinical Depression. www.nhs.uk/Conditions/Depression/Pages/Introduction.aspx. (accessed 30 November 2016).
10) NHS. Schizophrenia – Causes. www.nhs.uk/Conditions/Schizophrenia/Pages/Causes.aspx. (accessed 30 November 2016).
11) NHS. Bipolar Disorder – Causes. www.nhs.uk/Conditions/Bipolar-disorder/Pages/Causes.aspx. (accessed 30 November 2016).
12) Rethink. Bipolar Disorder – Causes. www.rethink.org/diagnosis-treatment/conditions/bipolar-disorder/causes. (accessed 30 November 2016).
Adverse events should be reported. Reporting forms and information can be found at www.mhra.gov.uk/yellowcard.
Adverse events should also be reported to Aspire Pharma Ltd on 01730 231148
For more information about Biquelle XL, please see the abbreviated prescribing information.
Revision reference – Biquelle XL_13_01/03/2017