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Post by Admin on Jan 3, 2017 13:47:53 GMT -4
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Post by Andrej Gabrovsek on Jan 3, 2017 22:55:37 GMT -4
So I was unaware of the possible links between bitpor disorder and cardiovascular and heart disease risk. Since I plan on going into family medicine this is something I will remember to test patient and follow more carefully. I personally found the potential effect on the hypothalamic-pituitary-adrenal axis as a possible cause of cardiovascular risk interesteing. This is just a good reminder to always keep an open mind to all possible risk factors as well as keeping upto date with the latest evidence based research.
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Post by Ferhan Saleem on Jan 3, 2017 23:09:29 GMT -4
The article brings up the important issue of how mental health affects our physical health. Bipolar disorder can affect the body's physiology in many different ways due to the stress it imposes. Manic as well as depressive episodes both put the cardiovascular system and other organ systems under extreme physiological strain through the roller coaster of emotions, thus contribute to mortality. Not only that, bipolar disorder can lead to individuals undertaking more risky behaviors which can result in the individual finding themselves in life threatening situations. Further research is needed to see what comorbidities develop in individuals who suffer from bipolar disorder and how it affects other organ systems in addition to the cardiovascular system.
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Post by M. Ismail on Jan 4, 2017 12:56:11 GMT -4
This article was an interesting read. Some of the points were somewhat intuitive; for instance, the higher incidence of risky behaviors such as abuse of alcohol and illicit drugs leading to heart disease found among people who suffer from mental health issues. However, I was not aware that there are possibly some pathophysiological links between heart disease and bipolar disorder. It's a finding that I believe deserves more research and a more hands on deck. I remember during one of my patient encounters during this rotation, I interviewed a patient who suffered from Schizophrenia. At one point, he was a resident at a group home. He mother was telling me about the grief that the patient was suffering from and some of it stemmed from recently losing one of his friends to a myocardial infarction. The woman was also a resident at the facility and she had been complaining of abdominal pain reportedly for days. She eventually passed away I assume because the diagnosis was missed. I don't know all of the circumstances surrounding the situation but I would venture to say that had this woman not suffered from a mental illness, she would have had a better chance of the correct diagnosis being made sooner. In any case, it is was an unfortunate occurrence.
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Post by julainelewis on Jan 4, 2017 21:53:29 GMT -4
This article highlights some of the issues faced by people with bipolar disorder. Of note, the use of drugs and alcohol to self medicate and cope is seen time and time again in this population. It is also interesting to note the link between bipolar disorder and cardiovascular disease in the this group who are not just two times more likely to get cardiovascular disease but they're also more likely develop these problems at an earlier age than the general population. This can be attributed to certain events throughout their life caused by certain bipolar medications that can lead to hyperlipidemia, diabetes and weight gain and by lifestyle choices such as drugs and alcohol abuse that can lead to cardiovascular stresses. With this knowledge it becomes important for us as physicians to emphasize to our patient the need for early monitoring and detection to help minimize these cardiovascular events.
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Post by Ifunanya Akusoba on Jan 5, 2017 6:10:05 GMT -4
I found this article very interesting and some things I read are very unfortunate. This article highlights to me that there is a disconnect somewhere in the health care system when dealing with individuals with mental disorders. We know individuals with bipolar disorder are at an increased risk for developing heart disease. However, it also seems that there is a failure to diagnose and treat these same individual's medical problems that are not considered "psych-related". This would obviously worsen the prognosis of many different diseases(CVD being the disease in discussion) even further. I believe that doctors of different specialties need to be in communication with each other regarding the management of their mutual patients. This would optimize the quality of care each patient receives.
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Post by Arshpal S. Gill on Jan 5, 2017 20:42:14 GMT -4
This is article restates the obvious but what can often be overlooked; that mental health has repercussions on physical health. Carrie Fisher's untimely death from a cardiac event might be attributed to the twofold increase risk in heart disease death in patients with bipolar disease. It adds another layer to an existing multi-dimensional puzzle when it comes to treating bipolar disease. The key implication in this article is that there are things that cannot be changed; and then there are things that can be changed. It described a hypothalamus-pituitary etiology as the attributable reason of death from heart disease deaths in bipolar patients. Perhaps there is not much that can be done about that outcome. However, this article also stated that patients with bipolar disease are less likely to be screened for heart disease. That is something that can be changed with the appropriate healthcare delivery method. Hopefully, there are more appropriate interdisciplinary screening methods and more cross-talk between different specialties to perhaps looks at some physical health implications in mental illnesses.
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Post by Pavankumar on Jan 6, 2017 3:14:21 GMT -4
I found this article to be very enlightening. One of the problems that I think specialists in any field have is that they tend to focus solely on their area of expertise and tend to forget the big picture. As a psych student when interviejng pts I always ask about things like chief complaint, mood, appetite, and sleep. The article was a great reminder that when we try to help a patient by treating them we need to inform them all the costs and benefits of said decision. We also need to inform them of the lifestyle modifications that may be needed in order to offset the costs associated with said treatment.
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Post by Kiara Swanier on Jan 6, 2017 11:00:40 GMT -4
This article was a very interesting read. I like how it emphasizes the impact that mental health has on cardiovascular disease. Although many studies have been done to show a connection between the two, increased awareness is still lacking. Many healthcare providers are not focused on the overlapping risk factors as much as they are on treating the individual's mental health illness. However, it is necessary to understand that individuals with bipolar disorder are more likely to experience negative lifestyle behaviors, being sedentary, cigarette smoking, as well as alcohol and substance abuse. Additionally, many of the medications to treat bipolar disorder may cause adverse effects such as "weight gain, increases in triglycerides, diabetes mellitus and even sudden cardiac death due to arrhythmia". Thus, it is very important to screen early for cardiovascular disease as well as other significant health issues. Through articles like this, future research may become more inclined to address these important medical connections in the near future.
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Post by Danny Barry on Jan 6, 2017 13:16:57 GMT -4
AS some other students pointed out earlier, I think a very important message to take from this weeks article is that when treating your patients you have to be aware of the whole picture and how it effects the entire body. I think as future doctors this is a very big issues that has to be tackled in the future. Up until this point a lot of the doctors I have worked with have started to stress this issue. Perfect example was a patient the patient I wrote my case study on. She is suffering from extreme anxiety/PTSD from a MVA and a major source of that anxiety is the constant physical pain she is in from injuries sustained during the accident. As a psychologist, you are primarily concerned with her mental state but I believe it is also your duty to make sure her physical health is being properly managed as well since it all ties together.
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Post by Ben Greenwood on Jan 6, 2017 13:27:45 GMT -4
I found the article very interesting, mostly because i was not aware of the association of cardiovascular disorder and bipolar disorder. I do agree that the article reaffirms the idea that we as doctors, no matter our specialty, have to take into account all organ systems in order to effectively treat our patients. I think that the article illuminates one of many reasons that we stress lifestyle modification, as the article describes that many of the factors attributed to the 2-fold increase in CV disease among bipolar patients has much to do with the negative lifestyle behaviours. This knowledge can be applied to any condition that results in a patient who refuses to or is unable to care for themselves adequately and should influence us as doctors to focus more attention on patients activity of daily life.
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Post by Jordan Hood on Jan 6, 2017 14:22:34 GMT -4
Prior to reading the article I was unaware of the possible correlation between bipolar disorder and increased risk of cardiovascular disease. I found it very interesting to learn that individuals with bipolar disorder are twice as likely to be diagnosed with cardiovascular disease as well as be diagnosed prematurely compared to the general population. The article mentioned that patients with bipolar disorder are typically not screened for cardiovascular risk factors. This data displays the importance of primary care providers educating patients and evaluating risk factors regardless of their mental health disorders. Hopefully there will be an increase in evidence based research for the direct connection between bipolar disorder and an increased risk of cardiovascular disease.
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Post by Tina Gaskin on Jan 7, 2017 12:00:29 GMT -4
The timeliness of this article is well received and highlights the possible medical implications associated with this psychiatric illness such as Bipolar Disorder. I have had the pleasure to care for some wonderful patients with Bipolar disorder in the Family practice setting. With that being said in many cases these patients are very cyclical in the psychiatric disease process and so we place focus on stabilizing the patient mental illness and sometimes lose focus on the overall health of the patient. I totally agree with this article in that their needs to be "interventional studies as well as treatment care plans" that focus on cardiovascular risk factors not only in Bipolar disorder but other mental illnesses as well.
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Post by Nupur Mishra on Jan 8, 2017 19:26:45 GMT -4
This was an interesting read. Psychiatry may deal exclusively with mental disorders, but after all, the mind is connected to the body. It makes sense that one would affect the other. I was surprised to read that bipolar disorder has been linked to a much higher risk of cardiovascular diseases, due to many factors, but in particular the hypothalamic-pituitary-adrenal axis, the autonomic nervous system, inflammation and possibly blood vessel structure. It reminded me that mental health disorders places a huge physiological strain as well, and has to be addressed. I’m happy that these studies can help to provide a more wholesome healthcare. Furthermore, I feel this integrative approach can help lessen the stigma surrounding mental disorders.
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Post by ianjvalmont on Jan 23, 2017 12:22:43 GMT -4
Like most students, I was not aware of the direct link between Bi-polar Disorder and an increase in Cardiovascular Risk.
Tangentially, this article touches on an issue that I've always wanted to discuss. The article makes a point of stating that Bi-polar's link to an increase in cardiovascular risk is both direct AND indirect. I don't believe the indirect links (e.g. being sedentary, cigarette smoking, and excessive use of alcohol) are all that surprising to be found as contributing factors. The direct cause is less obvious, less understood and more surprising. So the statement "persons with bipolar disorder are about twice as likely to develop or die from cardiovascular disease than would otherwise be expected", while ambiguous, is a good way to include both indirect and direct relationships.
This ambiguity in "X causes/is linked to Y" statements can cause confusion for patients. For example, we often tell patients that drugs like Seroquel can cause weight gain. As far as I know, what it actually causes is increased appetite, which in turn causes weight gain. Mentioning weight gain as a possible adverse effect is often enough to put some patients off of giving it a fair chance to work. However, providing the context of increased appetite on their way to weight gain allows them to understand that they are not completely at the mercy of the medication and can mitigate the possible damage by maintaining their current diet.
In short, I'd like to see more examples of identifying what are direct and indirect links in medicine. I feel that the distinction is important to true understanding and that it will lead to improved patient care.
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