Medicine
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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty
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Item Diagnostic overlap between adolescent affective instability in borderline personality and juvenile bipolar disorder in Sri Lanka(Sri Lanka College of Psychiatrists, 2019) Chandradasa, M.; Fernando, W.K.T.R.; Kuruppuarachchi, K.A.L.A.Borderline personality disorder (BPD) and bipolar disorder (BD) could present a diagnostic challenge in the adolescent due to the presence of overlapping symptoms such as impulsivity, affective instability, and sexual arousal. Of these symptoms, affective instability is a central feature of BPD, and there is a rapid shift from the neutral affect to an intense affect, and this is associated with a dysfunctional modulation of emotions. We describe three Sri Lankan adolescents presenting with affective instability, treated with psychopharmacological agents as for BD. While BPD is characterized by transient mood shifts induced by interpersonal stressors, in BD, there are sustained mood changes. A longitudinal assessment of the symptomatic profile and collateral information clarified the diagnosis as being BPD. An examination of the nature of affective instability is vital for a proper diagnosis and provision of evidence-based treatment.Item A preliminary study of the psycho-social burden of bipolar disorder on siblings(Sri Lanka Medical Association, 2017) Fernando, P.S.; Ranaweera, H.P.A.L.; Karunarathna, K.A.S.T.; Kaushalya, N.I.; Samarasinghe, G.; Peiris, M.U.P.K.; Williams, S.S.INTRODUCTION & OBJECTIVES: Bipolar disorder (BD) is a recurrent mood disorder with a prevalence of 1-2% in the general population. Individuals with BD experience significant impacts on family and social relationships, suffer from occupational instability, and are at greater risk of self-harm and suicide. This research aims to examine experiences and concerns of siblings of individuals with BD. METHODS: Quantitative data was collected from siblings of persons with BD through the psychiatry clinics at North Colombo Teaching Hospital after informed consent. For data collection, the ‘Sibling Impact Questionnaire–Bipolar Disorder’ (SIQ-BD) was developed. The SIQ-BD measures the impact on a sibling of a person with BD, across three timeframes, the ‘past year’, ‘over the years’, and ’worst time’. RESULTS: Out of 48 siblings (14 males, 34 females; mean age 42.7 years), 44 (11 males, 33 females) act as care givers to their siblings. The highest burden was during the ‘worst time’; and during this ‘worst time’ 16.7% of siblings worried that their sibling may commit suicide ‘very much so’, followed by 12.5% and 6.2% during the ‘whole time’ and ‘past year’ respectively. On a positive note, stigma was reported as high by only one sibling during the ‘worst time’ and none during the ‘past year’ and ‘whole time’. The highest disruption to daily life was experienced during the ‘worst time’. Providing financial support during the past year was significantly associated with higher burden (p=0.002). CONCLUSION: Siblings of persons with BD experience a mixed burden with low perception of stigma in this preliminary study.