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Sample records for bipolar disorder candidate

  1. Bipolar Disorder.

    Science.gov (United States)

    Miller, Thomas H

    2016-06-01

    Bipolar disorder is a chronic mental health disorder that is frequently encountered in primary care. Many patients with depression may actually have bipolar disorder. The management of bipolar disorder requires proper diagnosis and awareness or referral for appropriate pharmacologic therapy. Patients with bipolar disorder require primary care management for comorbidities such as cardiovascular and metabolic disorders. PMID:27262007

  2. Bipolar Disorder

    Science.gov (United States)

    Bipolar disorder is a serious mental illness. People who have it go through unusual mood changes. They go from ... down feeling is depression. The causes of bipolar disorder aren't always clear. It runs in families. ...

  3. Bipolar disorder.

    Science.gov (United States)

    Grande, Iria; Berk, Michael; Birmaher, Boris; Vieta, Eduard

    2016-04-01

    Bipolar disorder is a recurrent chronic disorder characterised by fluctuations in mood state and energy. It affects more than 1% of the world's population irrespective of nationality, ethnic origin, or socioeconomic status. Bipolar disorder is one of the main causes of disability among young people, leading to cognitive and functional impairment and raised mortality, particularly death by suicide. A high prevalence of psychiatric and medical comorbidities is typical in affected individuals. Accurate diagnosis of bipolar disorder is difficult in clinical practice because onset is most commonly a depressive episode and looks similar to unipolar depression. Moreover, there are currently no valid biomarkers for the disorder. Therefore, the role of clinical assessment remains key. Detection of hypomanic periods and longitudinal assessment are crucial to differentiate bipolar disorder from other conditions. Current knowledge of the evolving pharmacological and psychological strategies in bipolar disorder is of utmost importance. PMID:26388529

  4. Bipolar Disorder

    Science.gov (United States)

    ... lows). These aren't the normal periods of happiness and sadness that everyone experiences from time to ... with long-lasting medical conditions (such as asthma , diabetes , or epilepsy ), teens with bipolar disorder need to ...

  5. Bipolar disorder

    OpenAIRE

    Goodwin, Frederick K; Ghaemi, S Nassir

    1999-01-01

    Bipolar disorder's unique combination of three characteristics - clear genetic diathesis, distinctive clinical features, early availability of an effective treatment (lithium) - explains its special place in the history of psychiatry and its contribution to the current explosive growth of neuroscience. This article looks at the state of the art in bipolar disorder from the vantage point of: (i) genetics (possible linkages on chromosomes 18 and 21q, polygenic hypothesis, research into genetic ...

  6. A cross-species genetic analysis identifies candidate genes for mouse anxiety and human bipolar disorder.

    Science.gov (United States)

    Ashbrook, David G; Williams, Robert W; Lu, Lu; Hager, Reinmar

    2015-01-01

    Bipolar disorder (BD) is a significant neuropsychiatric disorder with a lifetime prevalence of ~1%. To identify genetic variants underlying BD genome-wide association studies (GWAS) have been carried out. While many variants of small effect associated with BD have been identified few have yet been confirmed, partly because of the low power of GWAS due to multiple comparisons being made. Complementary mapping studies using murine models have identified genetic variants for behavioral traits linked to BD, often with high power, but these identified regions often contain too many genes for clear identification of candidate genes. In the current study we have aligned human BD GWAS results and mouse linkage studies to help define and evaluate candidate genes linked to BD, seeking to use the power of the mouse mapping with the precision of GWAS. We use quantitative trait mapping for open field test and elevated zero maze data in the largest mammalian model system, the BXD recombinant inbred mouse population, to identify genomic regions associated with these BD-like phenotypes. We then investigate these regions in whole genome data from the Psychiatric Genomics Consortium's bipolar disorder GWAS to identify candidate genes associated with BD. Finally we establish the biological relevance and pathways of these genes in a comprehensive systems genetics analysis. We identify four genes associated with both mouse anxiety and human BD. While TNR is a novel candidate for BD, we can confirm previously suggested associations with CMYA5, MCTP1, and RXRG. A cross-species, systems genetics analysis shows that MCTP1, RXRG, and TNR coexpress with genes linked to psychiatric disorders and identify the striatum as a potential site of action. CMYA5, MCTP1, RXRG, and TNR are associated with mouse anxiety and human BD. We hypothesize that MCTP1, RXRG, and TNR influence intercellular signaling in the striatum. PMID:26190982

  7. A cross-species genetic analysis identifies candidate genes for mouse anxiety and human bipolar disorder

    Directory of Open Access Journals (Sweden)

    David G Ashbrook

    2015-07-01

    Full Text Available Bipolar disorder (BD is a significant neuropsychiatric disorder with a lifetime prevalence of ~1%. To identify genetic variants underlying BD genome-wide association studies (GWAS have been carried out. While many variants of small effect associated with BD have been identified few have yet been confirmed, partly because of the low power of GWAS due to multiple comparisons being made. Complementary mapping studies using murine models have identified genetic variants for behavioral traits linked to BD, often with high power, but these identified regions often contain too many genes for clear identification of candidate genes. In the current study we have aligned human BD GWAS results and mouse linkage studies to help define and evaluate candidate genes linked to BD, seeking to use the power of the mouse mapping with the precision of GWAS. We use quantitative trait mapping for open field test and elevated zero maze data in the largest mammalian model system, the BXD recombinant inbred mouse population, to identify genomic regions associated with these BD-like phenotypes. We then investigate these regions in whole genome data from the Psychiatric Genomics Consortium’s bipolar disorder GWAS to identify candidate genes associated with BD. Finally we establish the biological relevance and pathways of these genes in a comprehensive systems genetics analysis.We identify four genes associated with both mouse anxiety and human BD. While TNR is a novel candidate for BD, we can confirm previously suggested associations with CMYA5, MCTP1 and RXRG. A cross-species, systems genetics analysis shows that MCTP1, RXRG and TNR coexpress with genes linked to psychiatric disorders and identify the striatum as a potential site of action. CMYA5, MCTP1, RXRG and TNR are associated with mouse anxiety and human BD. We hypothesize that MCTP1, RXRG and TNR influence intercellular signaling in the striatum.

  8. Association study of candidate genes for susceptibility to schizophrenia and bipolar disorder on chromosome 22Q13

    DEFF Research Database (Denmark)

    Severinsen, Jacob; Binderup, Helle; Mors, Ole;

    Chromosome 22q is suspected to harbor risk genes for schizophrenia as well as bipolar affective disorder. This is evidenced through genetic mapping studies, investigations of cytogenetic abnormalities, and direct examination of candidate genes. In a recent study of distantly related patients from...... the Faroe Islands we have obtained evidence suggesting two regions on chromosome 22q13 to potentially harbor susceptibility genes for both schizophrenia and bipolar affective disorder. We have selected a number of candidate genes from these two regions for further analysis, including the neuro-gene WKL1...... and unrelated controls, and in a Scottish case-control sample comprising 200 schizophrenics, 200 bipolar patients and 200 controls. None of the investigated SNPs have so far showed strong evidence of association to either bipolar disorder or schizophrenia....

  9. Bipolar Disorder

    Science.gov (United States)

    ... types of psychotherapies. Other Treatment Options Electroconvulsive Therapy (ECT) : ECT can provide relief for people with severe bipolar ... been able to recover with other treatments. Sometimes ECT is used for bipolar symptoms when other medical ...

  10. A cross-species genetic analysis identifies candidate genes for mouse anxiety and human bipolar disorder

    OpenAIRE

    Ashbrook, David G.; Robert W Williams; Lu eLu; Reinmar eHager

    2015-01-01

    Bipolar disorder (BD) is a significant neuropsychiatric disorder with a lifetime prevalence of ~1%. To identify genetic variants underlying BD genome-wide association studies (GWAS) have been carried out. While many variants of small effect associated with BD have been identified few have yet been confirmed, partly because of the low power of GWAS due to multiple comparisons being made. Complementary mapping studies using murine models have identified genetic variants for beha...

  11. Cytokines in bipolar disorder

    DEFF Research Database (Denmark)

    Munkholm, Klaus; Vinberg, Maj; Vedel Kessing, Lars

    2012-01-01

    BACKGROUND: Current research and hypothesis regarding the pathophysiology of bipolar disorder suggests the involvement of immune system dysfunction that is possibly related to disease activity. Our objective was to systematically review evidence of cytokine alterations in bipolar disorder according...... to affective state. METHODS: We conducted a systemtic review of studies measuring endogenous cytokine concentrations in patients with bipolar disorder and a meta-analysis, reporting results according to the PRISMA statement. RESULTS: Thirteen studies were included, comprising 556 bipolar disorder patients...

  12. Staging Bipolar Disorder.

    OpenAIRE

    Vieta i Pascual, Eduard, 1963-; Reinares, M.; Rosa, A. R.

    2011-01-01

    The purpose of this study was to analyze the evidence supporting a staging model for bipolar disorder. The authors conducted an extensive Medline and Pubmed search of the published literature using a variety of search terms (staging, bipolar disorder, early intervention) to find relevant articles, which were reviewed in detail. Only recently specific proposals have been made to apply clinical staging to bipolar disorder. The staging model in bipolar disorder suggests a progression from prodro...

  13. Neuroimaging in Bipolar Disorder

    Directory of Open Access Journals (Sweden)

    Kemal Kara

    2013-03-01

    Full Text Available Bipolar disorder is characterized by recurrent attacks, significantly disrupts the functionality of a chronic mental disorder. Although there is growing number of studies on the neurobiological basis of the disorder, the pathophysiology has not yet been clearly understood. Structural and functional imaging techniques present a better understanding of the etiology of bipolar disorder and has contributed significantly to the development of the diagnostic approach. Recent developments in brain imaging modalities have let us learn more about the underlying abnormalities in neural systems of bipolar patients. Identification of objective biomarkers would help to determine the pathophysiology of bipolar disorder, a disorder which causes significant deterioration in neurocognitive and emotional areas.

  14. Types of Bipolar Disorder

    Science.gov (United States)

    ... improve the lives of people who have mood disorders. The Power of Peers DBSA envisions wellness for people who live with depression and bipolar disorder. Because DBSA was created for and is led ...

  15. Neuroinflammation in bipolar disorders

    Directory of Open Access Journals (Sweden)

    Georgios D Kotzalidis

    2015-01-01

    Full Text Available Recent literature based on peripheral immunity findings speculated that neuroinflammation, with its connection to microglial activation, is linked to bipolar disorder. The endorsement of the neuroinflammatory hypotheses of bipolar disorder requires the demonstration of causality, which requires longitudinal studies. We aimed to review the evidence for neuroinflammation as a pathogenic mechanism of the bipolar disorder. We carried out a hyper inclusive PubMed search using all appropriate neuroinflammation-related terms and crossed them with bipolar disorder-related terms. The search produced 310 articles and the number rose to 350 after adding articles from other search engines and reference lists. Twenty papers were included that appropriately tackled the issue of the presence (but not of its pathophysiological role of neuroinflammation in bipolar disorder. Of these, 15 were postmortem and 5 were carried out in living humans. Most articles were consistent with the presence of neuroinflammation in bipolar disorder, but factors such as treatment may mask it. All studies were cross-sectional, preventing causality to be inferred. Thus, no inference can be currently made about the role of neuroinflammation in bipolar disorder, but a link is likely. The issue remains little investigated, despite an excess of reviews on this topic.

  16. Bipolar I disorder and schizophrenia: a 440-single-nucleotide polymorphism screen of 64 candidate genes among Ashkenazi Jewish case-parent trios.

    Science.gov (United States)

    Fallin, M Daniele; Lasseter, Virginia K; Avramopoulos, Dimitrios; Nicodemus, Kristin K; Wolyniec, Paula S; McGrath, John A; Steel, Gary; Nestadt, Gerald; Liang, Kung-Yee; Huganir, Richard L; Valle, David; Pulver, Ann E

    2005-12-01

    Bipolar, schizophrenia, and schizoaffective disorders are common, highly heritable psychiatric disorders, for which familial coaggregation, as well as epidemiological and genetic evidence, suggests overlapping etiologies. No definitive susceptibility genes have yet been identified for any of these disorders. Genetic heterogeneity, combined with phenotypic imprecision and poor marker coverage, has contributed to the difficulty in defining risk variants. We focused on families of Ashkenazi Jewish descent, to reduce genetic heterogeneity, and, as a precursor to genomewide association studies, we undertook a single-nucleotide polymorphism (SNP) genotyping screen of 64 candidate genes (440 SNPs) chosen on the basis of previous linkage or of association and/or biological relevance. We genotyped an average of 6.9 SNPs per gene, with an average density of 1 SNP per 11.9 kb in 323 bipolar I disorder and 274 schizophrenia or schizoaffective Ashkenazi case-parent trios. Using single-SNP and haplotype-based transmission/disequilibrium tests, we ranked genes on the basis of strength of association (Pfive replicate previous associations, and one, GRID1, shows a novel association with schizophrenia. In addition, six genes (DPYSL2, DTNBP1, G30/G72, GRID1, GRM4, and NOS1) showed overlapping suggestive evidence of association in both disorders. These results may help to prioritize candidate genes for future study from among the many suspected/proposed for schizophrenia and bipolar disorders. They provide further support for shared genetic susceptibility between these two disorders that involve glutamate-signaling pathways. PMID:16380905

  17. Epilepsy and bipolar disorder.

    Science.gov (United States)

    Knott, Sarah; Forty, Liz; Craddock, Nick; Thomas, Rhys H

    2015-11-01

    It is well recognized that mood disorders and epilepsy commonly co-occur. Despite this, our knowledge regarding the relationship between epilepsy and bipolar disorder is limited. Several shared features between the two disorders, such as their episodic nature and potential to run a chronic course, and the efficacy of some antiepileptic medications in the prophylaxis of both disorders, are often cited as evidence of possible shared underlying pathophysiology. The present paper aims to review the bidirectional associations between epilepsy and bipolar disorder, with a focus on epidemiological links, evidence for shared etiology, and the impact of these disorders on both the individual and wider society. Better recognition and understanding of these two complex disorders, along with an integrated clinical approach, are crucial for improved evaluation and management of comorbid epilepsy and mood disorders.

  18. Genetics of bipolar disorder

    Directory of Open Access Journals (Sweden)

    Kerner B

    2014-02-01

    Full Text Available Berit Kerner Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA Abstract: Bipolar disorder is a common, complex genetic disorder, but the mode of transmission remains to be discovered. Many researchers assume that common genomic variants carry some risk for manifesting the disease. The research community has celebrated the first genome-wide significant associations between common single nucleotide polymorphisms (SNPs and bipolar disorder. Currently, attempts are under way to translate these findings into clinical practice, genetic counseling, and predictive testing. However, some experts remain cautious. After all, common variants explain only a very small percentage of the genetic risk, and functional consequences of the discovered SNPs are inconclusive. Furthermore, the associated SNPs are not disease specific, and the majority of individuals with a “risk” allele are healthy. On the other hand, population-based genome-wide studies in psychiatric disorders have rediscovered rare structural variants and mutations in genes, which were previously known to cause genetic syndromes and monogenic Mendelian disorders. In many Mendelian syndromes, psychiatric symptoms are prevalent. Although these conditions do not fit the classic description of any specific psychiatric disorder, they often show nonspecific psychiatric symptoms that cross diagnostic boundaries, including intellectual disability, behavioral abnormalities, mood disorders, anxiety disorders, attention deficit, impulse control deficit, and psychosis. Although testing for chromosomal disorders and monogenic Mendelian disorders is well established, testing for common variants is still controversial. The standard concept of genetic testing includes at least three broad criteria that need to be fulfilled before new genetic tests should be introduced: analytical validity, clinical validity, and clinical utility. These criteria are

  19. Bipolar Disorder in Turkey

    Directory of Open Access Journals (Sweden)

    Bulent Kadri Gultekin

    2014-06-01

    Full Text Available Assessment of studies related with bipolar disorder in Turkey did not reveal an epidemiologically qualified field study. Most of the studies are hospital based or clinical studies which did not include a systematical scanning and did not aim to collect any epidemiological data and transfer information to health authorities. The generalizability of these studies to our community is far from being valid and reliable. On the other hand, a profile which will be created by reviewing the findings of these studies performed in various regions of Turkey will have a contribution to knowing the and ldquo;unique to us and rdquo; features of bipolar disorder and determining cultural risk factors. All this information can constitute a basis for formation and development of public mental health services related with bipolar disorder. In Turkey, the need for epidemiologically significant, polycentric, public sampled studies with broad participation is indispensable. Although our psychiatric epidemiology and clinical studies include necessary scientific basis, they are not powerful enough to evaluate the authentic and progressional relations such as rapid urbanization and immigration. The aim of this review is to evaluate and discuss prominent epidemiological findings, deficiencies and possibile future activities related with studies conducted in Turkey about bipolar disorder.. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2014; 6(2.000: 199-209

  20. Bipolar Affective Disorder and Migraine

    Directory of Open Access Journals (Sweden)

    Birk Engmann

    2012-01-01

    Full Text Available This paper consists of a case history and an overview of the relationship, aetiology, and treatment of comorbid bipolar disorder migraine patients. A MEDLINE literature search was used. Terms for the search were bipolar disorder bipolar depression, mania, migraine, mood stabilizer. Bipolar disorder and migraine cooccur at a relatively high rate. Bipolar II patients seem to have a higher risk of comorbid migraine than bipolar I patients have. The literature on the common roots of migraine and bipolar disorder, including both genetic and neuropathological approaches, is broadly discussed. Moreover, bipolar disorder and migraine are often combined with a variety of other affective disorders, and, furthermore, behavioural factors also play a role in the origin and course of the diseases. Approach to treatment options is also difficult. Several papers point out possible remedies, for example, valproate, topiramate, which acts on both diseases, but no first-choice treatments have been agreed upon yet.

  1. Bipolar Disorder and Cancer

    OpenAIRE

    Sermin Kesebir; Arzu Bayrak

    2012-01-01

    Prevalence studies and studies on causation relations have shown that the relation between psychiatric disorders and chronic physical diseases is neglected. For heterogeneous diseases an increasing number of susceptibility variants are being defined. Alzheimer disease, bipolar disorder, breast and prostate cancer, coronary artery disease, Chron's disease, systemic lupus eritematosus, type 1 and type 2 diabetes mellitus are mentioned together with epigenetic concept. In acrocentric zone of chr...

  2. The Genetics of Bipolar Disorder

    OpenAIRE

    Jennifer H Barnett; Smoller, Jordan W.

    2009-01-01

    Bipolar disorder is a mood disorder characterized by impairing episodes of mania and depression. Twin studies have established that bipolar disorder is among the most heritable of medical disorders and efforts to identify specific susceptibility genes have intensified over the past two decades. The search for genes influencing bipolar disorder has been complicated by a paucity of animal models, limited understanding of pathogenesis, and the genetic and phenotypic complexity of the syndrome. L...

  3. Prophylactic treatment in bipolar disorder

    OpenAIRE

    Eroğlu, Meliha Zengin; Özpoyraz, Nurgül; Tamam, Lut

    2014-01-01

    Objective: The aim of this study was to determine the prophylactic treatment response and its relationship between clinical variables among the bipolar disorder patient group followed up in the Bipolar Disorder Unit of Psychiatry Department of Cukurova University Faculty of Medicine. Methods: One hundred patients, in euthymic period, diagnosed as bipolar disorder, were included in this study. “Affective Disorders Patient Registry Form” developed by our unit, SCID-I, Young Mani Rating Scale...

  4. BIPOLAR DISORDER IN ADULTS

    Directory of Open Access Journals (Sweden)

    Yadav Jaya

    2013-06-01

    Full Text Available Bipolar disorder is a chronic illness, which may require life-long treatment. Patients will spend 3-5 times more days in the depressed episode then in the manic phase. Due to this variability in episodes, polypharmacy is used quite frequently in practice, though the evidence to do this remains quite limited. Many positive and negative outcomes can occur from this practice. Bipolar disorder is the 6th leading cause of disability in the developed world among those between the ages 15 and 44 years age groups. Serotonin is one of the neurotransmitter in the brain, and one of that strongly affects the person mood. Clozapine (clozaril, olanzapine (zyperexa, risperidone (Risperdal, and ziprasidone (zeldox and the clozapine may be helpful as mood stabilizer for people who do not respond to lithium and anticonvulsant.

  5. Bipolar Disorder and Obsessive Compulsive Disorder Comorbidity

    Directory of Open Access Journals (Sweden)

    Necla Keskin

    2014-08-01

    Full Text Available The comorbidity of bipolar disorder and anxiety disorders is a well known concept. Obsessive-compulsive disorder is the most commonly seen comorbid anxiety disorder in bipolar patients. Some genetic variants, neurotransmitters especially serotonergic systems and second-messenger systems are thought to be responsible for its etiology. Bipolar disorder alters the clinical aspects of obsessive compulsive disorder and is associated with poorer outcome. The determination of comorbidity between bipolar disorder and obsessive compulsive disorder is quite important for appropriate clinical management and treatment. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2014; 6(4.000: 429-437

  6. Treatment of bipolar disorder

    OpenAIRE

    Geddes, John R.; Miklowitz, David J.

    2013-01-01

    We review recent developments in the acute and long-term treatment of bipolar disorder and identify promising future routes to therapeutic innovation. Overall, advances in drug treatment remain quite modest. Antipsychotic drugs are effective in the acute treatment of mania; their efficacy in the treatment of depression is variable with the clearest evidence for quetiapine. Despite their widespread use, considerable uncertainty and controversy remains about the use of antidepressant drugs in t...

  7. Bipolar Disorder and Childhood Trauma

    Directory of Open Access Journals (Sweden)

    Evrim Erten

    2015-06-01

    Full Text Available Bipolar disorder is a chronic disorder in which irregular course of depressive, mania or mixed episodes or a complete recovery between episodes can be observed. The studies about the effects of traumatic events on bipolar disorder showed that they had significant and long-term effects on the symptoms of the disorder. Psychosocial stress might change the neurobiology of bipolar disorder over time. The studies revealed that the traumatic events could influence not only the onset of the disorder but also the course of the disorder and in these patients the rate of suicide attempt and comorbid substance abuse might increase. Bipolar patients who had childhood trauma had an earlier onset, higher number of episodes and comorbid disorders. In this review, the relationship between childhood trauma and bipolar disorder is reviewed. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2015; 7(2: 157-165

  8. Life expectancy in bipolar disorder

    DEFF Research Database (Denmark)

    Kessing, Lars Vedel; Vradi, Eleni; Andersen, Per Kragh

    2015-01-01

    OBJECTIVE: Life expectancy in patients with bipolar disorder has been reported to be decreased by 11 to 20 years. These calculations are based on data for individuals at the age of 15 years. However, this may be misleading for patients with bipolar disorder in general as most patients have a later...... onset of illness. The aim of the present study was to calculate the remaining life expectancy for patients of different ages with a diagnosis of bipolar disorder. METHODS: Using nationwide registers of all inpatient and outpatient contacts to all psychiatric hospitals in Denmark from 1970 to 2012 we...... remaining life expectancy in bipolar disorder and that of the general population decreased with age, indicating that patients with bipolar disorder start losing life-years during early and mid-adulthood. CONCLUSIONS: Life expectancy in bipolar disorder is decreased substantially, but less so than previously...

  9. Childhood trauma in bipolar disorder

    OpenAIRE

    Watson, S; Gallagher, P.; Dougall, D.; R Porter; Moncrieff, J.; Ferrier, I. N.; Young, A. H.

    2014-01-01

    Objective: There has been little investigation of early trauma in bipolar disorder despite evidence that stress impacts on the course of this illness. We aimed to compare the rates of childhood trauma in adults with bipolar disorder to a healthy control group, and to investigate the impact of childhood trauma on the clinical course of bipolar disorder. Methods: Retrospective assessment of childhood trauma was conducted using the Childhood Trauma Questionnaire (CTQ) in 60 outpatients with bipo...

  10. Bipolar Disorder and Diabetes Mellitus

    Directory of Open Access Journals (Sweden)

    Sermin Kesebir

    2010-04-01

    Full Text Available Comorbid endocrine and cardiovascular situations with bipolar disorder usually result from the bipolar disorder itself or as a consequence of its treatment. With habits and lifestyle, genetic tendency and side effects, this situation is becoming more striking. Subpopulations of bipolar disorders patients should be considered at high risk for diabetes mellitus. The prevalence of diabetes mellitus in bipolar disorder may be three times greater than in the general population. Comorbidity of diabetes causes a pathophysiological overlapping in the neurobiological webs of bipolar cases. Signal mechanisms of glycocorticoid/insulin and immunoinflammatory effector systems are junction points that point out the pathophysiology between bipolar disorder and general medical cases susceptible to stress. Glycogen synthetase kinase (GSK-3 is a serine/treonine kinase and inhibits the transport of glucose stimulated by insulin. It is affected in diabetes, cancer, inflammation, Alzheimer disease and bipolar disorder. Hypoglycemic effect of lithium occurs via inhibiting glycogen synthetase kinase. When comorbid with diabetes, the other disease -for example bipolar disorder, especially during its acute manic episodes-, causes a serious situation that presents its influences for a lifetime. Choosing pharmacological treatment and treatment adherence are another important interrelated areas. The aim of this article is to discuss and review the etiological, clinical and therapeutic properties of diabetes mellitus and bipolar disorder comorbidity.

  11. Tobacco Use in Bipolar Disorder

    Science.gov (United States)

    Thomson, Daniel; Berk, Michael; Dodd, Seetal; Rapado-Castro, Marta; Quirk, Shae E.; Ellegaard, Pernille K.; Berk, Lesley; Dean, Olivia M.

    2015-01-01

    Tobacco use in mental health in general and bipolar disorder in particular remains disproportionally common, despite declining smoking rates in the community. Furthermore, interactions between tobacco use and mental health have been shown, indicating the outcomes for those with mental health disorders are impacted by tobacco use. Factors need to be explored and addressed to improve outcomes for those with these disorders and target specific interventions for people with psychiatric illness to cease tobacco smoking. In the context of bipolar disorder, this review explores; the effects of tobacco smoking on symptoms, quality of life, suicidal behaviour, the biological interactions between tobacco use and bipolar disorder, the interactions between tobacco smoking and psychiatric medications, rates and factors surrounding tobacco smoking cessation in bipolar disorder and suggests potential directions for research and clinical translation. The importance of this review is to bring together the current understanding of tobacco use in bipolar disorder to highlight the need for specific intervention. PMID:25912533

  12. Bipolar Disorder in Children and Teens

    Science.gov (United States)

    ... is in crisis. What do I do? Share Bipolar Disorder in Children and Teens Download PDF Download ePub ... brochure will give you more information. What is bipolar disorder? Bipolar disorder is a serious brain illness. It ...

  13. Scientific attitudes towards bipolar disorders

    Directory of Open Access Journals (Sweden)

    Mohammad-Hossein Biglu

    2014-02-01

    Full Text Available Introduction: Bipolar disorder is a psychiatric condition that is also called manic-depressive disease. It causes unusual changes in mood, energy, activity levels, and the ability to carry out day-to-day tasks. In the present study, 3 sets of data were considered and analyzed: first, all papers categorized under Bipolar Disorders in Science Citation Index Expanded (SCI-E database through 2001-2011; second, papers published by the international journal of Bipolar Disorders indexed in SCI-E during a period of 11 years; and third, all papers distributed by the international journal of Bipolar Disorders indexed in MEDLINE during the period of study. Methods: The SCI-E database was used to extract all papers indexed with the topic of Bipolar Disorders as well as all papers published by The International Journal of Bipolar Disorders. Extraction of data from MEDLINE was restricted to the journals name from setting menu. The Science of Science Tool was used to map the co-authorship network of papers published by The International Journal of Bipolar Disorders through 2009-2011. Results: Analysis of data showed that the majority of publications in the subject area of bipolar disorders indexed in SCI-E were published by The International Journal of Bipolar Disorders. Although journal articles consisted of 59% of the total publication type in SCI-E, 65% of publications distributed by The Journal of Bipolar Disorders were in the form of meetingabstracts. Journal articles consisted of only 23% of the total publications. USA was the leading country regarding sharing data in the field of bipolar disorders followed by England, Canada, and Germany. Conclusion: The editorial policy of The International Journal of Bipolar Disorders has been focused on new themes and new ways of researching in the subject area of bipolar disorder. Regarding the selection of papers for indexing, the SCI-E database selects data more comprehensively than MEDLINE. The number of papers

  14. Bipolar disorder and metabolic syndrome: a systematic review

    OpenAIRE

    Letícia Czepielewski; Ledo Daruy Filho; Elisa Brietzke; Rodrigo Grassi-Oliveira

    2013-01-01

    OBJECTIVE: Summarize data on metabolic syndrome (MS) in bipolar disorder (BD). METHODS: A systematic review of the literature was conducted using the Medline, Embase and PsycInfo databases, using the keywords "metabolic syndrome", "insulin resistance" and "metabolic X syndrome" and cross-referencing them with "bipolar disorder" or "mania". The following types of publications were candidates for review: (i) clinical trials, (ii) studies involving patients diagnosed with bipolar disorder or (ii...

  15. Mathematical models of bipolar disorder

    OpenAIRE

    Daugherty, D; Roque-Urrea, T; Urrea-Roque, J; DE TROYER, J; Wirkus, S; Porter, M. A.

    2009-01-01

    We use limit cycle oscillators to model bipolar II disorder, which is characterized by alternating hypomanic and depressive episodes and afflicts about 1% of the United States adult population. We consider two non-linear oscillator models of a single bipolar patient. In both frameworks, we begin with an untreated individual and examine the mathematical effects and resulting biological consequences of treatment. We also briefly consider the dynamics of interacting bipolar II individuals using ...

  16. Mathematical Models of Bipolar Disorder

    OpenAIRE

    Daugherty, Darryl; Roque-Urrea, Tairi; Urrea-Roque, John; Snyder, Jessica; Wirkus, Stephen; Mason A. Porter

    2003-01-01

    We use limit cycle oscillators to model Bipolar II disorder, which is characterized by alternating hypomanic and depressive episodes and afflicts about one percent of the United States adult population. We consider two nonlinear oscillator models of a single bipolar patient. In both frameworks, we begin with an untreated individual and examine the mathematical effects and resulting biological consequences of treatment. We also briefly consider the dynamics of interacting bipolar II individual...

  17. Asenapine for bipolar disorder

    Directory of Open Access Journals (Sweden)

    Scheidemantel T

    2015-12-01

    Full Text Available Thomas Scheidemantel,1 Irina Korobkova,2 Soham Rej,3,4 Martha Sajatovic1,2 1University Hospitals Case Medical Center, 2Case Western Reserve University School of Medicine, Cleveland, OH, USA; 3Department of Psychiatry, University of Toronto, Toronto, ON, 4Geri PARTy Research Group, Jewish General Hospital, Montreal, QC, Canada Abstract: Asenapine (Saphris® is an atypical antipsychotic drug which has been approved by the US Food and Drug Administration for the treatment of schizophrenia in adults, as well as the treatment of acute manic or mixed episodes of bipolar I in both adult and pediatric populations. Asenapine is a tetracyclic drug with antidopaminergic and antiserotonergic activity with a unique sublingual route of administration. In this review, we examine and summarize the available literature on the safety, efficacy, and tolerability of asenapine in the treatment of bipolar disorder (BD. Data from randomized, double-blind trials comparing asenapine to placebo or olanzapine in the treatment of acute manic or mixed episodes showed asenapine to be an effective monotherapy treatment in clinical settings; asenapine outperformed placebo and showed noninferior performance to olanzapine based on improvement in the Young Mania Rating Scale scores. There are limited data available on the use of asenapine in the treatment of depressive symptoms of BD, or in the maintenance phase of BD. The available data are inconclusive, suggesting the need for more robust data from prospective trials in these clinical domains. The most commonly reported adverse effect associated with use of asenapine is somnolence. However, the somnolence associated with asenapine use did not cause significant rates of discontinuation. While asenapine was associated with weight gain when compared to placebo, it appeared to be modest when compared to other atypical antipsychotics, and its propensity to cause increases in hemoglobin A1c or serum lipid levels appeared to be

  18. A case-control association study and family-based expression analysis of the bipolar disorder candidate gene PI4K2B

    OpenAIRE

    Houlihan, Lorna; Christoforou, A.; Arbuckle, M I; Torrance, H. S.; Anderson, S. M.; Muir, Walter,; Porteous, D. J.; Blackwood, D H; Evans, K.L.

    2009-01-01

    Bipolar disorder, schizophrenia and recurrent major depression are complex psychiatric illnesses with a substantial, yet unknown genetic component. Linkage of bipolar disorder and recurrent major depression with markers on chromosome 4p15–p16 has been identified in a large Scottish family and three smaller families. Analysis of haplotypes in the four chromosome 4p-linked families, identified two regions, each shared by three of the four families, which are also supported by a case-control ass...

  19. Sleep Disturbances in Bipolar Disorder

    OpenAIRE

    Cátia Alves Moreira; Pedro Afonso

    2015-01-01

    Background: Bipolar disorder, characterized by episodes of mania, hypomania and depression is associated with sleep disturbances and circadian rhythm disruption. These changes have significant impact on quality of life and in the disease prognosis. Aims: Review of the main sleep disturbances observed in the bipolar disorder, their clinical impact and the hypothetical pathophysiological mechanisms involved. Methods: We conducted a non-systematic review of the literature in English through rese...

  20. : Genetic heterogeneity of bipolar disorder

    OpenAIRE

    Mathieu, Flavie; Dizier, Marie-Hélène; Etain, Bruno; Jamain, Stéphane; Rietschel, Marcella; Maier, Wolfgang; Albus, Margot; Mckeon, Patrick; Roche, Siobhan; Blackwood, Douglas; Muir, Walter,; Henry, Chantal; Malafosse, Alain; Preisig, Martin; Ferrero, François

    2010-01-01

    Bipolar disorder has a genetic component, but the mode of inheritance remains unclear. A previous genome scan conducted in 70 European families led to detect eight regions linked to bipolar disease. Here, we present an investigation of whether the phenotypic heterogeneity of the disorder corresponds to genetic heterogeneity in these regions using additional markers and an extended sample of families. The MLS statistic was used for linkage analyses. The predivided sample test and the maximum l...

  1. Bipolar spectrum disorders. New perspectives.

    OpenAIRE

    Piver, Andre; Yatham, Lakshmi N.; Raymond W. Lam

    2002-01-01

    OBJECTIVE: To review new perspectives on diagnosis, clinical features, epidemiology, and treatment of bipolar II and related disorders. QUALITY OF EVIDENCE: Articles were identified by searching MEDLINE and ClinPSYCH from January 1994 to August 2001 using the key words bipolar disorder, type II or 2; hypomania; spectrum; or variants. Reference lists from articles were reviewed. Overall, the quality of evidence was not high; we found no randomized controlled trials that specifically addressed ...

  2. Threat sensitivity in bipolar disorder.

    Science.gov (United States)

    Muhtadie, Luma; Johnson, Sheri L

    2015-02-01

    Life stress is a major predictor of the course of bipolar disorder. Few studies have used laboratory paradigms to examine stress reactivity in bipolar disorder, and none have assessed autonomic reactivity to laboratory stressors. In the present investigation we sought to address this gap in the literature. Participants, 27 diagnosed with bipolar I disorder and 24 controls with no history of mood disorder, were asked to complete a complex working memory task presented as "a test of general intelligence." Self-reported emotions were assessed at baseline and after participants were given task instructions; autonomic physiology was assessed at baseline and continuously during the stressor task. Compared to controls, individuals with bipolar disorder reported greater increases in pretask anxiety from baseline and showed greater cardiovascular threat reactivity during the task. Group differences in cardiovascular threat reactivity were significantly correlated with comorbid anxiety in the bipolar group. Our results suggest that a multimethod approach to assessing stress reactivity-including the use of physiological parameters that differentiate between maladaptive and adaptive profiles of stress responding-can yield valuable information regarding stress sensitivity and its associations with negative affectivity in bipolar disorder. (PsycINFO Database Record (c) 2015 APA, all rights reserved). PMID:25688436

  3. Bipolar I Disorder and Schizophrenia: A 440–Single-Nucleotide Polymorphism Screen of 64 Candidate Genes among Ashkenazi Jewish Case-Parent Trios

    OpenAIRE

    Fallin, M. Daniele ; Lasseter, Virginia K. ; Avramopoulos, Dimitrios ; Nicodemus, Kristin K. ; Wolyniec, Paula S. ; McGrath, John A. ; Steel, Gary ; Nestadt, Gerald ; Liang, Kung-Yee ; Huganir, Richard L. ; Valle, David ; Pulver, Ann E. 

    2005-01-01

    Bipolar, schizophrenia, and schizoaffective disorders are common, highly heritable psychiatric disorders, for which familial coaggregation, as well as epidemiological and genetic evidence, suggests overlapping etiologies. No definitive susceptibility genes have yet been identified for any of these disorders. Genetic heterogeneity, combined with phenotypic imprecision and poor marker coverage, has contributed to the difficulty in defining risk variants. We focused on families of Ashkenazi Jewi...

  4. Bipolar Disorder Among Adults

    Science.gov (United States)

    ... Children Autism Spectrum Disorder (ASD) Eating Disorders Among Adults - Anorexia Nervosa Eating Disorders Among Adults - Binge Eating Disorder Eating ... Children Autism Spectrum Disorder (ASD) Eating Disorders Among Adults - Anorexia Nervosa Eating Disorders Among Adults - Binge Eating Disorder Eating ...

  5. Refractory bipolar disorder and neuroprogression.

    Science.gov (United States)

    da Costa, Sabrina C; Passos, Ives C; Lowri, Caroline; Soares, Jair C; Kapczinski, Flavio

    2016-10-01

    Immune activation and failure of physiologic compensatory mechanisms over time have been implicated in the pathophysiology of illness progression in bipolar disorder. Recent evidence suggests that such changes are important contributors to neuroprogression and may mediate the cross-sensitization of episode recurrence, trauma exposure and substance use. The present review aims to discuss the potential factors related to bipolar disorder refractoriness and neuroprogression. In addition, we will discuss the possible impacts of early therapeutic interventions as well as the alternative approaches in late stages of the disorder. PMID:26368941

  6. Integrated neurobiology of bipolar disorder

    Directory of Open Access Journals (Sweden)

    Vladimir eMaletic

    2014-08-01

    Full Text Available From a neurobiological perspective there is no such thing as bipolar disorder. Rather, it is almost certainly the case that many somewhat similar, but subtly different, pathological conditions produce a disease state that we currently diagnose as bipolarity. This heterogeneity—reflected in the lack of synergy between our current diagnostic schema and our rapidly advancing scientific understanding of the condition—limits attempts to articulate an integrated perspective on bipolar disorder. However, despite these challenges, scientific findings in recent years are beginning to offer a provisional unified field theory of the disease. This theory sees bipolar disorder as a suite of related neurodevelopmental conditions with interconnected functional abnormalities that often appear early in life and worsen over time. In addition to accelerated loss of volume in brain areas known to be essential for mood regulation and cognitive function, consistent findings have emerged at a cellular level, providing evidence that bipolar disorder is reliably associated with dysregulation of glial-neuronal interactions. Among these glial elements are microglia—the brain’s primary immune elements, which appear to be overactive in the context of bipolarity. Multiple studies now indicate that inflammation is also increased in the periphery of the body in both the depressive and manic phases of the illness, with at least some return to normality in the euthymic state. These findings are consistent with changes in the HPA axis, which are known to drive inflammatory activation. In summary, the very fact that no single gene, pathway or brain abnormality is likely to ever account for the condition is itself an extremely important first step in better articulating an integrated perspective on both its ontological status and pathogenesis. Whether this perspective will translate into the discovery of innumerable more homogeneous forms of bipolarity is one of the great

  7. Social support and bipolar disorder

    OpenAIRE

    Paula Mendonça Studart; Severino Bezerra Filho; Ana Beatriz Didier Studart; Amanda Galvão-de Almeida; Ângela Miranda-Scippa

    2015-01-01

    Background Bipolar disorder is a chronic condition that affects the functioning of its carriers in many different ways, even when treated properly. Therefore, it’s also important to identify the psychosocial aspects that could contribute to an improvement of this population’s quality of life.Objective Carry out a literature review on the role of social support in cases of bipolar disorder.Method A research on the following online databases PubMed, Lilacs and SciELO was conducted by using the ...

  8. [Cognitive deficits in bipolar disorder].

    Science.gov (United States)

    Sachs, Gabriele; Schaffer, Markus; Winklbaur, Bernadette

    2007-01-01

    Bipolar disorders are often associated with cognitive deficits which have an influence on social functioning and the course of the illness. These deficits have an impact on occupational ability and social integration. To date, specific cognitive domains have been found which characterize bipolar affective disorders. However, there is evidence of stable and lasting cognitive impairment in all phases of the disorder, including the remission phase, in the following domains: sustained attention, memory and executive functions (e.g. cognitive flexibility and problem solving). Although their cognitive deficits are comparable the deficits in patients with schizophrenia are more severe than those with bipolar disorder. Recent brain imaging findings indicate structural and functional abnormalities in the cortical and limbic networks of the brain in patients with bipolar disorder compared to healthy controls. Mood stabilizer and atypical antipsychotics may reduce cognitive deficits in certain domains (e.g. executive functions and word fluency) and may have a positive effect on quality of life and social functioning. PMID:17640495

  9. Social support and bipolar disorder

    Directory of Open Access Journals (Sweden)

    Paula Mendonça Studart

    2015-08-01

    Full Text Available Background Bipolar disorder is a chronic condition that affects the functioning of its carriers in many different ways, even when treated properly. Therefore, it’s also important to identify the psychosocial aspects that could contribute to an improvement of this population’s quality of life.Objective Carry out a literature review on the role of social support in cases of bipolar disorder.Method A research on the following online databases PubMed, Lilacs and SciELO was conducted by using the keywords “social support” or “social networks” and “mood disorders” or “bipolar disorder” or “affective disorder,” with no defined timeline.Results Only 13 studies concerning the topic of social support and BD were found in the search for related articles. Generally speaking, the results show low rates of social support for BD patients.Discussion Despite the growing interest in the overall functioning of patients with bipolar disorder, studies on social support are still rare. Besides, the existing studies on the subject use different methodologies, making it difficult to establish data comparisons.

  10. The Noradrenaline Metabolite MHPG Is a Candidate Biomarker from the Manic to the Remission State in Bipolar Disorder I: A Clinical Naturalistic Study

    OpenAIRE

    Masatake Kurita; Satoshi Nishino; Yukio Numata; Yoshiro Okubo; Tadahiro Sato

    2014-01-01

    Remission is the primary goal of treatment for bipolar disorder I (BDI). Metabolites of noradrenaline and dopamine, 3-methoxy-4-hydroxyphenylglycol (MHPG) and homovanillic acid (HVA), respectively, are reduced by treatment with antipsychotics, but whether these phenomena are caused by antipsychotics or by the pathophysiology of BDI is not known. Interactions between brain-derived neurotrophic factor (BDNF) and mood disorders have also been suggested. We conducted a multifaceted study in BDI p...

  11. Bipolar disorder: staging and neuroprogression

    OpenAIRE

    Rodrigues, Aline André; Rosa, Adriana R.; Kunz, Maurício; Ascoli, Bruna; Kapczinski, Flávio

    2014-01-01

    In bipolar disorder illness progression has been associated with a higher number of mood episodes and hospitalizations, poorer response to treatment, and more severe cognitive and functional impairment. This supports the notion of the use of staging models in this illness. The value of staging models has long been recognized in many medical and malignant conditions. Staging models rely on the fact that different interventions may suit different stages of the disorder, and that better outcomes...

  12. Sleep Disturbances in Bipolar Disorder

    Directory of Open Access Journals (Sweden)

    Cátia Alves Moreira

    2015-11-01

    Full Text Available Background: Bipolar disorder, characterized by episodes of mania, hypomania and depression is associated with sleep disturbances and circadian rhythm disruption. These changes have significant impact on quality of life and in the disease prognosis. Aims: Review of the main sleep disturbances observed in the bipolar disorder, their clinical impact and the hypothetical pathophysiological mechanisms involved. Methods: We conducted a non-systematic review of the literature in English through research in PubMed with the keywords “sleep disturbance”, “bipolar disorder”, “polysomnography”. Results and Conclusions: Complaints about sleep pattern changes may occur during any phase of the disease. These in clude frequent night-time awakenings, poor sleep quality, reduction of the total sleeping time and decreased latency and increased density of REM sleep. The treatment of the sleep disturbances observed in bipolar disorder should be considered a priority, since it prevents symptoms recurrence and facilitate the socio-professional integration, thus providing greater success in patient’s rehabilitation and quality of life.

  13. Mathematical models of bipolar disorder

    Science.gov (United States)

    Daugherty, Darryl; Roque-Urrea, Tairi; Urrea-Roque, John; Troyer, Jessica; Wirkus, Stephen; Porter, Mason A.

    2009-07-01

    We use limit cycle oscillators to model bipolar II disorder, which is characterized by alternating hypomanic and depressive episodes and afflicts about 1% of the United States adult population. We consider two non-linear oscillator models of a single bipolar patient. In both frameworks, we begin with an untreated individual and examine the mathematical effects and resulting biological consequences of treatment. We also briefly consider the dynamics of interacting bipolar II individuals using weakly-coupled, weakly-damped harmonic oscillators. We discuss how the proposed models can be used as a framework for refined models that incorporate additional biological data. We conclude with a discussion of possible generalizations of our work, as there are several biologically-motivated extensions that can be readily incorporated into the series of models presented here.

  14. Targeting astrocytes in bipolar disorder.

    Science.gov (United States)

    Peng, Liang; Li, Baoman; Verkhratsky, Alexei

    2016-06-01

    Astrocytes are homeostatic cells of the central nervous system, which are critical for development and maintenance of synaptic transmission and hence of synaptically connected neuronal ensembles. Astrocytic densities are reduced in bipolar disorder, and therefore deficient astroglial function may contribute to overall disbalance in neurotransmission and to pathological evolution. Classical anti-bipolar drugs (lithium salts, valproic acid and carbamazepine) affect expression of astroglial genes and modify astroglial signalling and homeostatic cascades. Many effects of both antidepressant and anti-bipolar drugs are exerted through regulation of glutamate homeostasis and glutamatergic transmission, through K(+) buffering, through regulation of calcium-dependent phospholipase A2 (that controls metabolism of arachidonic acid) or through Ca(2+) homeostatic and signalling pathways. Sometimes anti-depressant and anti-bipolar drugs exert opposite effects, and some effects on gene expression in drug treated animals are opposite in neurones vs. astrocytes. Changes in the intracellular pH induced by anti-bipolar drugs affect uptake of myo-inositol and thereby signalling via inositoltrisphosphate (InsP3), this being in accord with one of the main theories of mechanism of action for these drugs. PMID:27015045

  15. Bipolar disorder diagnosis: challenges and future directions.

    Science.gov (United States)

    Phillips, Mary L; Kupfer, David J

    2013-05-11

    Bipolar disorder refers to a group of affective disorders, which together are characterised by depressive and manic or hypomanic episodes. These disorders include: bipolar disorder type I (depressive and manic episodes: this disorder can be diagnosed on the basis of one manic episode); bipolar disorder type II (depressive and hypomanic episodes); cyclothymic disorder (hypomanic and depressive symptoms that do not meet criteria for depressive episodes); and bipolar disorder not otherwise specified (depressive and hypomanic-like symptoms that do not meet the diagnostic criteria for any of the aforementioned disorders). Bipolar disorder type II is especially difficult to diagnose accurately because of the difficulty in differentiation of this disorder from recurrent unipolar depression (recurrent depressive episodes) in depressed patients. The identification of objective biomarkers that represent pathophysiologic processes that differ between bipolar disorder and unipolar depression can both inform bipolar disorder diagnosis and provide biological targets for the development of new and personalised treatments. Neuroimaging studies could help the identification of biomarkers that differentiate bipolar disorder from unipolar depression, but the problem in detection of a clear boundary between these disorders suggests that they might be better represented as a continuum of affective disorders. Innovative combinations of neuroimaging and pattern recognition approaches can identify individual patterns of neural structure and function that accurately ascertain where a patient might lie on a behavioural scale. Ultimately, an integrative approach, with several biological measurements using different scales, could yield patterns of biomarkers (biosignatures) to help identify biological targets for personalised and new treatments for all affective disorders. PMID:23663952

  16. Metabolic syndrome in bipolar disorders

    Directory of Open Access Journals (Sweden)

    Sandeep Grover

    2012-01-01

    Full Text Available To review the data with respect to prevalence and risk factors of metabolic syndrome (MetS in bipolar disorder patients. Electronic searches were done in PUBMED, Google Scholar and Science direct. From 2004 to June 2011, 34 articles were found which reported on the prevalence of MetS. The sample size of these studies varied from 15 to 822 patients, and the rates of MetS vary widely from 16.7% to 67% across different studies. None of the sociodemographic variable has emerged as a consistent risk factor for MetS. Among the clinical variables longer duration of illness, bipolar disorder- I, with greater number of lifetime depressive and manic episodes, and with more severe and difficult-to-treat index affective episode, with depression at onset and during acute episodes, lower in severity of mania during the index episode, later age of onset at first manic episode, later age at first treatment for the first treatment for both phases, less healthy diet as rated by patients themselves, absence of physical activity and family history of diabetes mellitus have been reported as clinical risk factors of MetS. Data suggests that metabolic syndrome is fairly prevalent in bipolar disorder patients.

  17. Internet use by patients with bipolar disorder

    DEFF Research Database (Denmark)

    Bauer, Rita; Conell, Jörn; Glenn, Tasha;

    2016-01-01

    There is considerable international interest in online education of patients with bipolar disorder, yet little understanding of how patients use the Internet and other sources to seek information. 1171 patients with a diagnosis of bipolar disorder in 17 countries completed a paper-based, anonymous...... on bipolar disorder or 63% of the total sample. More years of education in relation to the country mean, and feeling very confident about managing life decreased the odds of seeking information on bipolar disorder online, while having attended support groups increased the odds. Patients who looked online...... for information on bipolar disorder consulted medical professionals plus a mean of 2.3 other information sources such as books, physician handouts, and others with bipolar disorder. Patients not using the Internet consulted medical professionals plus a mean of 1.6 other information sources. The percentage...

  18. Risk factors for suicide among children and youths with bipolar spectrum and early bipolar disorder.

    Directory of Open Access Journals (Sweden)

    Aleksandra Rajewska-Rager

    2015-06-01

    the overview of recent years literature available in PubMed/MEDLINE database, including the following search criteria: early onset bipolar disorder, bipolar disorder in children and young people, the spectrum of bipolar disorder, and suicidal ideation, suicidal intent, suicide.

  19. The International Society for Bipolar Disorders (ISBD) Task Force Report on Antidepressant Use in Bipolar Disorders

    NARCIS (Netherlands)

    Pacchiarotti, Isabella; Bond, David J.; Baldessarini, Ross J.; Nolen, Willem A.; Grunze, Heinz; Licht, Rasmus W.; Post, Robert M.; Berk, Michael; Goodwin, Guy M.; Sachs, Gary S.; Tondo, Leonardo; Findling, Robert L.; Youngstrom, Eric A.; Tohen, Mauricio; Undurraga, Juan; Gonzalez-Pinto, Ana; Goldberg, Joseph F.; Yildiz, Aysegul; Altshuler, Lori L.; Calabrese, Joseph R.; Mitchell, Philip B.; Thase, Michael E.; Koukopoulos, Athanasios; Colom, Francesc; Frye, Mark A.; Malhi, Gin S.; Fountoulakis, Konstantinos N.; Vazquez, Gustavo; Perlis, Roy H.; Ketter, Terence A.; Cassidy, Frederick; Akiskal, Hagop; Azorin, Jean-Michel; Valenti, Marc; Mazzei, Diego Hidalgo; Lafer, Beny; Kato, Tadafumi; Mazzarini, Lorenzo; Martinez-Aran, Anabel; Parker, Gordon; Souery, Daniel; Ozerdem, Aysegul; McElroy, Susan L.; Girardi, Paolo; Bauer, Michael; Yatham, Lakshmi N.; Zarate, Carlos A.; Nierenberg, Andrew A.; Birmaher, Boris; Kanba, Shigenobu; El-Mallakh, Rif S.; Serretti, Alessandro; Rihmer, Zoltan; Young, Allan H.; Kotzalidis, Georgios D.; MacQueen, Glenda M.; Bowden, Charles L.; Ghaemi, S. Nassir; Lopez-Jaramillo, Carlos; Rybakowski, Janusz; Ha, Kyooseob; Perugi, Giulio; Kasper, Siegfried; Amsterdam, Jay D.; Hirschfeld, Robert M.; Kapczinski, Flavio; Vieta, Eduard

    2013-01-01

    Objective: The risk-benefit profile of antidepressant medications in bipolar disorder is controversial. When conclusive evidence is lacking, expert consensus can guide treatment decisions. The International Society for Bipolar Disorders (ISBD) convened a task force to seek consensus recommendations

  20. Swimming in Deep Water: Childhood Bipolar Disorder

    Science.gov (United States)

    Senokossoff, Gwyn W.; Stoddard, Kim

    2009-01-01

    The authors focused on one parent's struggles in finding a diagnosis and intervention for a child who had bipolar disorder. The authors explain the process of identification, diagnosis, and intervention of a child who had bipolar disorder. In addition to the personal story, the authors provide information on the disorder and outline strategies…

  1. [Oxidative stress in bipolar affective disorder].

    Science.gov (United States)

    Reininghaus, E Z; Zelzer, S; Reininghaus, B; Lackner, N; Birner, A; Bengesser, S A; Fellendorf, F T; Kapfhammer, H-P; Mangge, H

    2014-09-01

    The results of mortality studies have indicated that medical conditions, such as cardiovascular disease, obesity and diabetes are the most important causes of mortality among patients with bipolar disorder. The reasons for the increased incidence and mortality are not fully understood. Oxidative stress and an inadequate antioxidative system might be one missing link and could also help to further elucidate the pathophysiological basis of bipolar disorder. This article provides a comprehensive review of oxidative stress in general and about the existing data for bipolar disorder. In addition information is given about possible therapeutic strategies to reduce oxidative stress and the use in bipolar disorder. PMID:24441847

  2. Course of Subthreshold Bipolar Disorder in Youth: Diagnostic Progression from Bipolar Disorder Not Otherwise Specified

    Science.gov (United States)

    Axelson, David A.; Birmaher, Boris; Strober, Michael A.; Goldstein, Benjamin I.; Ha, Wonho; Gill, Mary Kay; Goldstein, Tina R.; Yen, Shirley; Hower, Heather; Hunt, Jeffrey I.; Liao, Fangzi; Iyengar, Satish; Dickstein, Daniel; Kim, Eunice; Ryan, Neal D.; Frankel, Erica; Keller, Martin B.

    2011-01-01

    Objective: To determine the rate of diagnostic conversion from an operationalized diagnosis of bipolar disorder not otherwise specified (BP-NOS) to bipolar I disorder (BP-I) or bipolar II disorder (BP-II) in youth over prospective follow-up and to identify factors associated with conversion. Method: Subjects were 140 children and adolescents…

  3. Evidence for genetic association of RORB with bipolar disorder

    Directory of Open Access Journals (Sweden)

    Mick Eric

    2009-11-01

    general and RORB in particular may be important candidates for further investigation in the search for the molecular basis of bipolar disorder.

  4. Major Ups and Downs: Bipolar Disorder Brings Extreme Mood Swings

    Science.gov (United States)

    ... our exit disclaimer . Subscribe Major Ups and Downs Bipolar Disorder Brings Extreme Mood Swings Most people feel happy ... Strike Out Stroke Wise Choices Links Dealing with Bipolar Disorder If you have bipolar disorder, get treatment and ...

  5. Neurocognitive function in bipolar disorder: a comparison between bipolar I and II disorder and matched controls

    OpenAIRE

    Pålsson, Erik; Figueras, Clara; Johansson, Anette GM; Ekman, Carl-Johan; Hultman, Björn; Östlind, Josefin; Landén, Mikael

    2013-01-01

    Background Cognitive deficits have been documented in patients with bipolar disorder. Further, it has been suggested that the degree and type of cognitive impairment differ between bipolar I and bipolar II disorder, but data is conflicting and remains inconclusive. This study aimed to clarify the suggested differences in cognitive impairment between patients with bipolar I and II disorder in a relatively large, clinically stable sample while controlling for potential confounders. Methods 67 p...

  6. Thyroid Functions and Bipolar Affective Disorder

    Directory of Open Access Journals (Sweden)

    Subho Chakrabarti

    2011-01-01

    Full Text Available Accumulating evidence suggests that hypothalamo-pituitary-thyroid (HPT axis dysfunction is relevant to the pathophysiology and clinical course of bipolar affective disorder. Hypothyroidism, either overt or more commonly subclinical, appears to the commonest abnormality found in bipolar disorder. The prevalence of thyroid dysfunction is also likely to be greater among patients with rapid cycling and other refractory forms of the disorder. Lithium-treatment has potent antithyroid effects and can induce hypothyroidism or exacerbate a preexisting hypothyroid state. Even minor perturbations of the HPT axis may affect the outcome of bipolar disorder, necessitating careful monitoring of thyroid functions of patients on treatment. Supplementation with high dose thyroxine can be considered in some patients with treatment-refractory bipolar disorder. Neurotransmitter, neuroimaging, and genetic studies have begun to provide clues, which could lead to an improved understanding of the thyroid-bipolar disorder connection, and more optimal ways of managing this potentially disabling condition.

  7. Developmental staging models in bipolar disorder

    OpenAIRE

    Passos, Ives C; Jansen, Karen; Kapczinski, Flavio

    2015-01-01

    The previous contribution of Duffy and colleagues suggests that a chain of behavioral events starting during childhood precedes the development of full-blown bipolar disorder. In this vein, the recent contribution of Keown-Stoneman and colleagues brings a new perspective to the study of prodromal symptoms of bipolar disorder.

  8. Diagnostic stability in pediatric bipolar disorder

    DEFF Research Database (Denmark)

    Vedel Kessing, Lars; Vradi, Eleni; Andersen, Per Kragh

    2015-01-01

    BACKGROUND: The diagnostic stability of pediatric bipolar disorder has not been investigated previously. The aim was to investigate the diagnostic stability of the ICD-10 diagnosis of pediatric mania/bipolar disorder.METHODS: All patients below 19 years of age who got a diagnosis of mania/bipolar...... disorder at least once in a period from 1994 to 2012 at psychiatric inpatient or outpatient contact in Denmark were identified in a nationwide register.RESULTS: Totally, 354 children and adolescents got a diagnosis of mania/bipolar disorder at least once; a minority, 144 patients (40.7%) got the diagnosis...... at the first contact whereas the remaining patients (210; 59.3%) got the diagnosis at later contacts before age 19. For the latter patients, the median time elapsed from first treatment contact with the psychiatric service system to the first diagnosis with a manic episode/bipolar disorder was nearly 1 year...

  9. Bipolar disorder and neurophysiologic mechanisms

    Directory of Open Access Journals (Sweden)

    Simon M McCrea

    2008-11-01

    Full Text Available Simon M McCreaDepartments of Neurology and Neuroophthalmology, University of British Columbia, 2550 Willow Street, Vancouver, British Columbia, Canada V5Z 3N9Abstract: Recent studies have suggested that some variants of bipolar disorder (BD may be due to hyperconnectivity between orbitofrontal (OFC and temporal pole (TP structures in the dominant hemisphere. Some initial MRI studies noticed that there were corpus callosum abnormalities within specific regional areas and it was hypothesized that developmentally this could result in functional or effective connectivity changes within the orbitofrontal-basal ganglia-thalamocortical circuits. Recent diffusion tensor imaging (DTI white matter fiber tractography studies may well be superior to region of interest (ROI DTI in understanding BD. A “ventral semantic stream” has been discovered connecting the TP and OFC through the uncinate and inferior longitudinal fasciculi and the elusive TP is known to be involved in theory of mind and complex narrative understanding tasks. The OFC is involved in abstract valuation in goal and sub-goal structures and the TP may be critical in binding semantic memory with person–emotion linkages associated with narrative. BD patients have relative attenuation of performance on visuoconstructional praxis consistent with an atypical localization of cognitive functions. Multiple lines of evidence suggest that some BD alleles are being selected for which could explain the enhanced creativity in higher-ability probands. Associations between ROI’s that are not normally connected could explain the higher incidence of artistic aptitude, writing ability, and scientific achievements among some mood disorder subjects.Keywords: bipolar disorder, diffusion tensor imaging, white matter tractography, inferior longitudinal fasciculus, inferior fronto-occipital fasciculus, uncinate fasciculus, mood dysphoria, creativity, ventral semantic stream, writing ability, artistic aptitude

  10. A linkage study of bipolar disorder

    Energy Technology Data Exchange (ETDEWEB)

    Kelsoe, J.R. [Univ. of California, San Diego (United States); Sadovnick, A.D.; Remick, R.A. [Univ. of British Columbia, Vancouver (Canada)] [and others

    1994-09-01

    We are currently surveying the genome with polymorphic DNA markers in search of loci linked to bipolar disorder (manic-depressive illness) in three populations: 20 families (175 subjects) from the general North American population from San Diego (UCSD) and Vancouver (UBC); 3 Icelandic families (55 subjects); and an Old Order Amish pedigree 110 (118 subjects). Over 50 markers on chromosomes 1, 2, 5, 11, 17, 18, 20 and 21 have been examined. All markers have been tested in the Amish and Icelandic families, and a portion of them in the UCSD/UBC families, which we have only recently begun genotyping. The following candidate genes have been examined: {beta}-TSH, dopamine transporter (HDAT), {beta}2 adrenergic receptor (ADRB2), glucocorticoid type II receptor (GRL), D2 dopamine receptor, serotonin transporter (HSERT), and G{alpha}s G protein subunit (GNAS1). Linkage analysis was conducted using an autosomal dominant model with age-dependent reduced penetrance. Subjects with bipolar, schizoaffective, or recurrent major depressive disorders were considered affected. No significant evidence for linkage was obtained. Mildly positive lods ranging between 1.1 and 1.6 were obtained for three loci: D11S29, HDAT, and GRL.

  11. Valproate, bipolar disorder and polycystic ovarian syndrome

    Directory of Open Access Journals (Sweden)

    Okanović Milana

    2016-01-01

    Full Text Available Introduction. Polycystic ovarian syndrome is a syndrome of ovarian dysfunction with the principal features of hyperandrogenism and polycystic ovary morphology. A large number of studies conducted on this topic have suggested a possible role of anticonvulsants, particularly valproate, in the pathogenesis or risk factors associated with polycystic ovarian syndrome. Bipolar treatment guidelines from Canada and the United States of America recommend valproate as the first line strategy in the acute treatment of bipolar disorder. Discussion. Most persons with bipolar disorder require maintenance treatment. Long-term administration of valproate in women with bipolar disorder or epilepsy is believed to result in the increased risk of hyperandro­genism, menstrual abnormalities and polycystic ovaries. Valproate may also increase the risk of infertility and other associated symptoms of polycystic ovarian syndrome. Therefore, particular caution is indicated in the use of valproate in women of reproductive age. Conclusion. The treatment of the female patients with bipolar disorder presents various challenges for the clinician. Every woman of reproductive age needs to know the risk and benefits of her pharmacologic treatment options. Bipolar disorder should be considered chronic disorder, whose development is largely affected by hormonal changes and reproductive cycle in women. These issues should be researched more thoroughly in order to opt for the most appropriate treatment in women with bipolar disorder.

  12. Bipolar Disorder and Cognitive Therapy: A Commentary

    Science.gov (United States)

    Riskind, John H.

    2005-01-01

    This article comments on the three articles (Leahy, 2005; Newman, 2005; and Reilly-Harrington & Knauz, 2005) that deal with the applications of cognitive therapy to treatment of bipolar disorder. They focus on the uses of cognitive therapy in treating three important facets of the special problems of bipolar patients: rapid cycling, severe…

  13. Are rates of pediatric bipolar disorder increasing?

    DEFF Research Database (Denmark)

    Kessing, Lars Vedel; Vradi, Eleni; Andersen, Per Kragh

    2014-01-01

    Studies from the USA suggest that rates of pediatric bipolar disorder have increased since the mid-90s, but no study outside the USA has been published on the rates of pediatric bipolar disorder. Further, it is unclear whether an increase in rates reflects a true increase in the illness or more...... diagnostic attention. Using nationwide registers of all inpatients and outpatients contacts to all psychiatric hospitals in Denmark, we investigated (1) gender-specific rates of incident pediatric mania/bipolar disorder during a period from 1995 to 2012, (2) whether age and other characteristics...... for pediatric mania/bipolar disorder changed during the calendar period (1995 to 2003 versus 2004 to 2012), and (3) whether the diagnosis is more often made at first psychiatric contact in recent time compared to earlier according to gender. Totally, 346 patients got a main diagnosis of a manic episode (F30...

  14. Integrating Bipolar Disorder Management in Primary Care

    OpenAIRE

    Kilbourne, Amy M.; Goodrich, David E.; O’Donnell, Allison N.; Miller, Christopher J.

    2012-01-01

    There is growing realization that persons with bipolar disorder may exclusively be seen in primary (general medical) care settings, notably because of limited access to mental health care and stigma in seeking mental health treatment. At least two clinical practice guidelines for bipolar disorder recommend collaborative chronic care models (CCMs) to help integrate mental health care to better manage this illness. CCMs, which include provider guideline support, self-management support, care ma...

  15. Circadian rhythms in the neuorbiology of bipolar of bipolar disorder

    OpenAIRE

    Timothy, Joseph

    2015-01-01

    Daily rhythms of physiology and behaviour in mammals are orchestrated by a hierarchical network of cellular oscillators. The master pacemaker that defines local and systemic timing across the brain and body are the suprachiasmatic nuclei of the hypothalamus (SCN). Disruption to the timing of sleep and daily behavioural activity can manifest in a range of pathologies including neuropsychiatric disorders. Bipolar disorder (BPD) is once such neurological condition that exhibits profound associat...

  16. Optimising the management of bipolar disorder.

    Science.gov (United States)

    MsAbda Mahmood; Ebmeler, Klaus R

    2015-05-01

    NICE recommends that when adults present in primary care with depression, they should be asked about previous periods of overactivity or disinhibited behaviour. If this behaviour lasted for four or more days referral for a specialist mental health assessment should be considered. Although depressive episodes are not necessary for a diagnosis of bipolar disorder, they are common and dominate the lifetime pattern of the condition: 50% of the time is spent in a euthymic (well) state, 38% in a depressed and 12% in a manic state. If there have only been depressive symptoms, it is not possible to exclude bipolar disorder. A diagnosis of bipolar disorder is supported by diagnostic criteria and usually confirmed by a psychiatrist. If the GP suspects mania or severe depression, or if patients are a danger to themselves or others, an urgent referral should be made for a specialist mental health assessment. If a manic episode has been present during the history the diagnosis is bipolar I disorder, while a hypomanic episode is indicative of bipolar disorder. The patient's care plan should include current health status, social situation, social support, co-ordination arrangements with secondary care, details of early warning signs, and the patient's preferred course of action in the event of a clinical relapse. Physical health checks should focus on cardiovascular disease, diabetes, obesity and respiratory disease given the heightened risk for these illnesses in bipolar disorder. PMID:27254890

  17. The role of sleep in bipolar disorder

    Directory of Open Access Journals (Sweden)

    Gold AK

    2016-06-01

    Full Text Available Alexandra K Gold,1 Louisa G Sylvia,1,2 1Department of Psychiatry, Massachusetts General Hospital, 2Harvard Medical School, Boston, MA, USA Abstract: Bipolar disorder is a serious mental illness characterized by alternating periods of elevated and depressed mood. Sleep disturbances in bipolar disorder are present during all stages of the condition and exert a negative impact on overall course, quality of life, and treatment outcomes. We examine the partnership between circadian system (process C functioning and sleep–wake homeostasis (process S on optimal sleep functioning and explore the role of disruptions in both systems on sleep disturbances in bipolar disorder. A convergence of evidence suggests that sleep problems in bipolar disorder result from dysregulation across both process C and process S systems. Biomarkers of depressive episodes include heightened fragmentation of rapid eye movement (REM sleep, reduced REM latency, increased REM density, and a greater percentage of awakenings, while biomarkers of manic episodes include reduced REM latency, greater percentage of stage I sleep, increased REM density, discontinuous sleep patterns, shortened total sleep time, and a greater time awake in bed. These findings highlight the importance of targeting novel treatments for sleep disturbance in bipolar disorder. Keywords: bipolar disorder, circadian rhythms, sleep–wake homeostasis

  18. Imunologia do transtorno bipolar Immunology of bipolar disorder

    OpenAIRE

    Izabela Guimarães Barbosa; Rodrigo Barreto Huguet; Fernando Silva Neves; Moisés Evandro Bauer; Antônio Lúcio Teixeira

    2009-01-01

    OBJETIVO: Pesquisas recentes têm implicado fatores imunes na patogênese de diversos transtornos neuropsiquiátricos. O objetivo do presente trabalho é revisar os trabalhos que investigaram a associação entre transtorno bipolar e alterações em parâmetros imunes. MÉTODOS: Artigos que incluíam as palavras-chave: "bipolar disorder", "mania", "immunology", "cytokines", "chemokines", "interleukins", "interferon" e "tumor necrosis factor" foram selecionados em uma revisão sistemática da literatura. A...

  19. Rumination in bipolar disorder: evidence for an unquiet mind

    Directory of Open Access Journals (Sweden)

    Ghaznavi Sharmin

    2012-01-01

    Full Text Available Abstract Depression in bipolar disorder has long been thought to be a state characterized by mental inactivity. However, recent research demonstrates that patients with bipolar disorder engage in rumination, a form of self-focused repetitive cognitive activity, in depressed as well as in manic states. While rumination has long been associated with depressed states in major depressive disorder, the finding that patients with bipolar disorder ruminate in manic states is unique to bipolar disorder and challenges explanations put forward for why people ruminate. We review the research on rumination in bipolar disorder and propose that rumination in bipolar disorder, in both manic and depressed states, reflects executive dysfunction. We also review the neurobiology of bipolar disorder and recent neuroimaging studies of rumination, which is consistent with our hypothesis that the tendency to ruminate reflects executive dysfunction in bipolar disorder. Finally, we relate the neurobiology of rumination to the neurobiology of emotion regulation, which is disrupted in bipolar disorder.

  20. Circadian Rhythm Characteristics in Mood Disorders: Comparison among Bipolar I Disorder, Bipolar II Disorder and Recurrent Major Depressive Disorder

    OpenAIRE

    Chung, Jae Kyung; Lee, Kyu Young; KIM, SE HYUN; Kim, Eui-Joong; Jeong, Seong Hoon; Jung, Hee Yeon; Choi, Jung-Eun; Ahn, Yong Min; Kim, Yong Sik; Joo, Eun-Jeong

    2012-01-01

    Objective Morningness/eveningness (M/E) is a stable characteristic of individuals. Circadian rhythms are altered in episodes of mood disorder. Mood disorder patients were more evening-type than normal population. In this study, we compared the characteristics of M/E among the 257 patients with bipolar I disorder (BPD1), bipolar II disorder (BPD2) and major depressive disorder, recurrent (MDDR). Methods M/E was evaluated using the Korean version of the composite scale of morningness (CS). Fact...

  1. White matter microstructure alterations in bipolar disorder

    Science.gov (United States)

    Bellani, Marcella; Perlini, Cinzia; Ferro, Adele; Cerruti, Stefania; Rambaldelli, Gianluca; Isola, Miriam; Cerini, Roberto; Dusi, Nicola; Andreone, Nicola; Balestrieri, Matteo; Mucelli, Roberto Pozzi; Tansella, Michele; Brambilla, Paolo

    2012-01-01

    Summary Genetic, neuropathological and magnetic resonance imaging findings support the presence of diffuse white matter cytoarchitectural disruption in bipolar disorder. In this study, diffusion-weighted imaging (DWI) was applied to study cortical white matter microstructure organisation in 24 patients with DSM-IV bipolar disorder and 35 matched normal controls. DWI images were obtained using a 1.5 Tesla scanner and apparent diffusion coefficient (ADC) values were determined over regions of interest placed, bilaterally, in the frontal, temporal, parietal, and occipital white matter. Significantly increased ADC values were found in bipolar patients with respect to normal controls in the right temporal lobe, left parietal lobe and bilateral occipital lobes. ADC values did not associate significantly with age or with clinical variables (p>0.05). Diffuse cortical white matter alterations on DWI in bipolar disorder denote widespread disruption of white matter integrity and may be due to altered myelination and/or axonal integrity. PMID:22687164

  2. Big data for bipolar disorder.

    Science.gov (United States)

    Monteith, Scott; Glenn, Tasha; Geddes, John; Whybrow, Peter C; Bauer, Michael

    2016-12-01

    The delivery of psychiatric care is changing with a new emphasis on integrated care, preventative measures, population health, and the biological basis of disease. Fundamental to this transformation are big data and advances in the ability to analyze these data. The impact of big data on the routine treatment of bipolar disorder today and in the near future is discussed, with examples that relate to health policy, the discovery of new associations, and the study of rare events. The primary sources of big data today are electronic medical records (EMR), claims, and registry data from providers and payers. In the near future, data created by patients from active monitoring, passive monitoring of Internet and smartphone activities, and from sensors may be integrated with the EMR. Diverse data sources from outside of medicine, such as government financial data, will be linked for research. Over the long term, genetic and imaging data will be integrated with the EMR, and there will be more emphasis on predictive models. Many technical challenges remain when analyzing big data that relates to size, heterogeneity, complexity, and unstructured text data in the EMR. Human judgement and subject matter expertise are critical parts of big data analysis, and the active participation of psychiatrists is needed throughout the analytical process.

  3. Big data for bipolar disorder.

    Science.gov (United States)

    Monteith, Scott; Glenn, Tasha; Geddes, John; Whybrow, Peter C; Bauer, Michael

    2016-12-01

    The delivery of psychiatric care is changing with a new emphasis on integrated care, preventative measures, population health, and the biological basis of disease. Fundamental to this transformation are big data and advances in the ability to analyze these data. The impact of big data on the routine treatment of bipolar disorder today and in the near future is discussed, with examples that relate to health policy, the discovery of new associations, and the study of rare events. The primary sources of big data today are electronic medical records (EMR), claims, and registry data from providers and payers. In the near future, data created by patients from active monitoring, passive monitoring of Internet and smartphone activities, and from sensors may be integrated with the EMR. Diverse data sources from outside of medicine, such as government financial data, will be linked for research. Over the long term, genetic and imaging data will be integrated with the EMR, and there will be more emphasis on predictive models. Many technical challenges remain when analyzing big data that relates to size, heterogeneity, complexity, and unstructured text data in the EMR. Human judgement and subject matter expertise are critical parts of big data analysis, and the active participation of psychiatrists is needed throughout the analytical process. PMID:27068058

  4. The noradrenaline metabolite MHPG is a candidate biomarker from the manic to the remission state in bipolar disorder I: a clinical naturalistic study.

    Directory of Open Access Journals (Sweden)

    Masatake Kurita

    Full Text Available Remission is the primary goal of treatment for bipolar disorder I (BDI. Metabolites of noradrenaline and dopamine, 3-methoxy-4-hydroxyphenylglycol (MHPG and homovanillic acid (HVA, respectively, are reduced by treatment with antipsychotics, but whether these phenomena are caused by antipsychotics or by the pathophysiology of BDI is not known. Interactions between brain-derived neurotrophic factor (BDNF and mood disorders have also been suggested. We conducted a multifaceted study in BDI patients to ascertain if biological markers are associated with the manic state. Patients with Young Mania Rating Scale (YMRS scores >20 participated in the study. Final analyses involved 24 BDI patients (13 men and 11 women. We used YMRS scores to identify mania stages in individual BDI patients (i.e., manic syndrome, response and remission stages. Statistical analyses were done using one-way repeated-measures analyses of variance (rep-ANOVA throughout manic syndrome, response and remission stages. Plasma concentrations of MHPG and HVA were analyzed by high-performance liquid chromatography with electrochemical detection. Plasma levels of BDNF were measured by sandwich enzyme-linked immunosorbent assay. BDI patients had significantly reduced plasma levels of MHPG throughout manic syndrome, response and remission stages (rep-ANOVA, p = 0.002. Without a case of response state, there was a significant positive correlation between YMRS scores and plasma levels of MHPG (ρ = 0.33, p = 0.033, n = 48. Plasma levels of HVA and BDNF were not significantly altered throughout manic syndrome, response and remission stages. These data suggest that the peripheral level of MHPG (which is associated with noradrenaline levels in the brain could be used as a biomarker for the manic state in BDI. The MHPG level is likely to reflect the clinical characteristics of the manic syndrome in BDI, and noradrenaline may reflect the pathophysiology from manic to remission

  5. Kids with Bipolar Disorder More Likely to Abuse Drugs, Alcohol

    Science.gov (United States)

    ... html Kids With Bipolar Disorder More Likely to Abuse Drugs, Alcohol: Study And those who also have conduct disorder ... with bipolar disorder, the risk that they will abuse alcohol and drugs may increase as they get older, ...

  6. Attention-deficit hyperactivity disorder in bipolar disorder

    OpenAIRE

    Rydén, Eleonore

    2010-01-01

    Attention-deficit hyperactivity disorder (ADHD) is a developmental disorder, i.e., it is by definition present from childhood. The main features characterizing ADHD are the difficulties to regulate attention, activity level, and impulses. The hallmark of bipolar disorder is episodic mood alterations with restitution between episodes. Although debut in childhood may occur, bipolar disorder typically debuts in late adolescence or early adulthood. The overarching aim with this ...

  7. Genetic linkage study of bipolar disorder and the serotonin transporter

    Energy Technology Data Exchange (ETDEWEB)

    Kelsoe, J.R.; Morison, M.; Mroczkowski-Parker, Z.; Bergesch, P.; Rapaport, M.H.; Mirow, A.L. [Univ. of California, San Diego, CA (United States)] [and others

    1996-04-09

    The serotonin transporter (HTT) is an important candidate gene for the genetic transmission of bipolar disorder. It is the site of action of many antidepressants, and plays a key role in the regulation of serotonin neurotransmission. Many studies of affectively ill patients have found abnormalities in serotonin metabolism, and dysregulation of the transporter itself. The human serotonin transporter has been recently cloned and mapped to chromosome 17. We have identified a PstI RFLP at the HTT locus, and here report our examination of this polymorphism for possible linkage to bipolar disorder. Eighteen families were examined from three populations: the Old Order Amish, Iceland, and the general North American population. In addition to HTT, three other microsatellite markers were examined, which span an interval known to contain HTT. Linkage analyses were conducted under both dominant and recessive models, as well as both narrow (bipolar only) and broad (bipolar + recurrent unipolar) diagnostic models. Linkage could be excluded to HTT under all models examined. Linkage to the interval spanned by the microsatellites was similarly excluded under the dominant models. In two individual families, maximum lod scores of 1.02 and 0.84 were obtained at D17S798 and HTT, respectively. However, these data overall do not support the presence of a susceptibility locus for bipolar disorder near the serotonin transporter. 20 refs., 2 tabs.

  8. Comorbidade com transtornos de ansiedade em transtorno bipolar Anxiety disorders comorbidity in bipolar disorder

    Directory of Open Access Journals (Sweden)

    Cilly Klüger Issler

    2004-10-01

    Full Text Available Comorbidade elevada de transtornos de ansiedade em bipolares é freqüentemente relatada em estudos epidemiológicos e clínicos. A associação tem implicações importantes no diagnóstico, evolução clínica, tratamento e prognóstico do transtorno bipolar, que são apresentadas nesta revisão.High comorbidity between bipolar and anxiety disorders is frequently described in epidemiological and clinical studies. This association has important implications for diagnoses, clinical outcome, therapeutic intervention and prognoses of bipolar disorder that are presented in this review.

  9. The role of sleep in bipolar disorder.

    Science.gov (United States)

    Gold, Alexandra K; Sylvia, Louisa G

    2016-01-01

    Bipolar disorder is a serious mental illness characterized by alternating periods of elevated and depressed mood. Sleep disturbances in bipolar disorder are present during all stages of the condition and exert a negative impact on overall course, quality of life, and treatment outcomes. We examine the partnership between circadian system (process C) functioning and sleep-wake homeostasis (process S) on optimal sleep functioning and explore the role of disruptions in both systems on sleep disturbances in bipolar disorder. A convergence of evidence suggests that sleep problems in bipolar disorder result from dysregulation across both process C and process S systems. Biomarkers of depressive episodes include heightened fragmentation of rapid eye movement (REM) sleep, reduced REM latency, increased REM density, and a greater percentage of awakenings, while biomarkers of manic episodes include reduced REM latency, greater percentage of stage I sleep, increased REM density, discontinuous sleep patterns, shortened total sleep time, and a greater time awake in bed. These findings highlight the importance of targeting novel treatments for sleep disturbance in bipolar disorder. PMID:27418862

  10. The role of sleep in bipolar disorder

    Science.gov (United States)

    Gold, Alexandra K; Sylvia, Louisa G

    2016-01-01

    Bipolar disorder is a serious mental illness characterized by alternating periods of elevated and depressed mood. Sleep disturbances in bipolar disorder are present during all stages of the condition and exert a negative impact on overall course, quality of life, and treatment outcomes. We examine the partnership between circadian system (process C) functioning and sleep–wake homeostasis (process S) on optimal sleep functioning and explore the role of disruptions in both systems on sleep disturbances in bipolar disorder. A convergence of evidence suggests that sleep problems in bipolar disorder result from dysregulation across both process C and process S systems. Biomarkers of depressive episodes include heightened fragmentation of rapid eye movement (REM) sleep, reduced REM latency, increased REM density, and a greater percentage of awakenings, while biomarkers of manic episodes include reduced REM latency, greater percentage of stage I sleep, increased REM density, discontinuous sleep patterns, shortened total sleep time, and a greater time awake in bed. These findings highlight the importance of targeting novel treatments for sleep disturbance in bipolar disorder. PMID:27418862

  11. Rumination in bipolar disorder: evidence for an unquiet mind

    OpenAIRE

    Ghaznavi Sharmin; Deckersbach Thilo

    2012-01-01

    Abstract Depression in bipolar disorder has long been thought to be a state characterized by mental inactivity. However, recent research demonstrates that patients with bipolar disorder engage in rumination, a form of self-focused repetitive cognitive activity, in depressed as well as in manic states. While rumination has long been associated with depressed states in major depressive disorder, the finding that patients with bipolar disorder ruminate in manic states is unique to bipolar disord...

  12. The Mood Disorder Questionnaire: A Simple, Patient-Rated Screening Instrument for Bipolar Disorder

    OpenAIRE

    Hirschfeld, Robert M. A.

    2002-01-01

    Bipolar disorder is frequently encountered in primary care settings, often in the form of poor response to treatment for depression. Although lifetime prevalence of bipolar I disorder is 1%, the prevalence of bipolar spectrum disorders (e.g., bipolar I, bipolar II, and cyclothymia) is much higher, especially among patients with depression. The consequences of misdiagnosis can be devastating. One way to improve recognition of bipolar spectrum disorders is to screen for them. The Mood Disorder ...

  13. BIPOLAR DISORDER AND METABOLIC SYNDROME: COMORBIDITY OR SIDE EFFECTS OF TREATMENT OF BIPOLAR DISORDER

    OpenAIRE

    Babić, Dragan; Maslov, Boris; Nikolić, Katica; Martinac, Marko; Uzun, Suzana; Kozumplik, Oliver

    2010-01-01

    Objective: There is evidence that people with mental disorders are more likely to suffer from metabolic syndrome. In the last decades there has been an increase in interest for researching metabolic syndrome in psychiatric patients and plenty of evidence about their association. However, investigations on the prevalence of metabolic syndrome in patients with bipolar disorder are still surprisingly rare. The aim of this paper is to analyze comorbidity of bipolar disorder and metabolic syndrome...

  14. Cytokines in bipolar disorder vs. healthy control subjects

    DEFF Research Database (Denmark)

    Munkholm, Klaus; Braüner, Julie Vestergaard; Kessing, Lars Vedel;

    2013-01-01

    Bipolar disorder may be associated with peripheral immune system dysfunction; however, results in individual studies are conflicting. Our aim was to systematically review evidence of peripheral cytokine alterations in bipolar disorder integrating findings from various affective states....

  15. Assessment of subjective and objective cognitive function in bipolar disorder

    DEFF Research Database (Denmark)

    Demant, Kirsa M; Vinberg, Maj; Kessing, Lars V;

    2015-01-01

    Cognitive dysfunction is prevalent in bipolar disorder (BD). However, the evidence regarding the association between subjective cognitive complaints, objective cognitive performance and psychosocial function is sparse and inconsistent. Seventy seven patients with bipolar disorder who presented...

  16. Lithium Beats Newer Meds for Bipolar Disorder, Study Finds

    Science.gov (United States)

    ... for Treatment and Research of Bipolar Disorder at Zucker Hillside Hospital in Glen Oaks, N.Y., and ... Center for Treatment and Research of Bipolar Disorder, Zucker Hillside Hospital, Glen Oaks, N.Y.; May 11, ...

  17. Immune activation by casein dietary antigens in bipolar disorder

    NARCIS (Netherlands)

    Severance, E.G.; Dupont, D.; Dickerson, F.B.; Stallings, C.R.; Origoni, A.E.; Krivogorsky, B.; Yang, S.; Haasnoot, W.; Yolken, R.H.

    2010-01-01

    Objectives: Inflammation and other immune processes are increasingly linked to psychiatric diseases. Antigenic triggers specific to bipolar disorder are not yet defined. We tested whether antibodies to bovine milk caseins were associated with bipolar disorder, and whether patients recognized differe

  18. Comorbidity of Asperger's syndrome and Bipolar disorder

    OpenAIRE

    Azzoni Antonella; Raja Michele

    2008-01-01

    Abstract Background and objective Asperger's Syndrome (AS) is a pervasive developmental disorder that is sometimes unrecognized, especially in the adult psychiatric setting. On the other hand, in patients with an AS diagnosis, comorbid psychiatric disorders may be unrecognized in the juvenile setting. The aim of the paper is to show and discuss some troublesome and complex problems of the management of patients with AS and comorbid Bipolar Disorder (BD). Methods The paper describes three pati...

  19. Responsabilidade penal no transtorno bipolar Penal responsibility in bipolar disorder

    Directory of Open Access Journals (Sweden)

    Alexandre Martins Valença

    2010-01-01

    Full Text Available Os autores relatam o caso de uma mulher que cometeu delito de assalto e foi avaliada em perícia psiquiátrica para análise da responsabilidade penal. Conclui-se que ela apresentava doença mental, na forma de transtorno bipolar, daí ser inimputável. A avaliação da responsabilidade penal é de extrema importância, para que se possam aplicar medidas de segurança ou sanções penais e correcionais adequadas a cada caso.The authors report a case of a woman who committed the crime of assault and was evaluated in penal imputability exam to assess criminal responsibility. It was concluded that she had a mental illness, bipolar disorder, being inimputable. The evaluation of penal responsibility is extremely important, in order to apply adequate involuntary commitment or correctional and penal sanctions to each case.

  20. A Review of MR Spectroscopy Studies of Pediatric Bipolar Disorder

    OpenAIRE

    Kondo, D.G.; Hellem, T.L.; Shi, X.-F.; Sung, Y.H.; Prescot, A.P.; Kim, T.S.; Huber, R.S.; Forrest, L.N.; Renshaw, P.F.

    2014-01-01

    Pediatric bipolar disorder is a severe mental illness whose pathophysiology is poorly understood and for which there is an urgent need for improved diagnosis and treatment. MR spectroscopy is a neuroimaging method capable of in vivo measurement of neurochemicals relevant to bipolar disorder neurobiology. MR spectroscopy studies of adult bipolar disorder provide consistent evidence for alterations in the glutamate system and mitochondrial function. In bipolar disorder, these 2 phenomena may be...

  1. Comorbidity of Asperger's syndrome and Bipolar disorder

    Directory of Open Access Journals (Sweden)

    Azzoni Antonella

    2008-11-01

    Full Text Available Abstract Background and objective Asperger's Syndrome (AS is a pervasive developmental disorder that is sometimes unrecognized, especially in the adult psychiatric setting. On the other hand, in patients with an AS diagnosis, comorbid psychiatric disorders may be unrecognized in the juvenile setting. The aim of the paper is to show and discuss some troublesome and complex problems of the management of patients with AS and comorbid Bipolar Disorder (BD. Methods The paper describes three patients affected by AS and bipolar spectrum disorders. Results and conclusion Mood stabilizers and 2nd generation antipsychotics were effective in the treatment of these AS patients with comorbid BD, while the use of antidepressants was associated with worsening of the mood disorder. It is of importance to recognize both the psychiatric diagnoses in order to arrange an exhaustive therapeutic program and to define specific and realistic goals of treatment.

  2. Differences between Depression Episodes of Bipolar Disorder I and II

    Directory of Open Access Journals (Sweden)

    Leman Inanc

    2013-09-01

    Full Text Available In 1975 Fieve and Dunner made the distinction between hypomania and mania as hypomania does not usually cause social and occupational impair-ment and hospitalization is not needed, moreover patients do not experience psychosis. Bipolar disorder type I is defined by the presence of manic and depressive episodes and differs from Bipolar disorder type II characterized with hipomanic and depressive episodes. Bipolar disorder type I and II do not differ in their depressive episodes. It is still point of contention whether bipolar type II is a variant of bipolar disorder type I or is positioned on the spectrum between bipolar type I and unipolar disorder. Even there are some similarities in characteristics of depressive episodes and outcome features of different bipolar disorder subtypes, there are differences that can be useful in differential diagnosis and treatment. This paper aims to focus on those differences between bipolar disorder type I and II.

  3. Family Functioning and the Course of Adolescent Bipolar Disorder

    Science.gov (United States)

    Sullivan, Aimee E.; Judd, Charles M.; Axelson, David A.; Miklowitz, David J.

    2012-01-01

    The symptoms of bipolar disorder affect and are affected by the functioning of family environments. Little is known, however, about the stability of family functioning among youth with bipolar disorder as they cycle in and out of mood episodes. This study examined family functioning and its relationship to symptoms of adolescent bipolar disorder,…

  4. Genetic Association Study of the Alpha 7 Nicotinic Receptor (CHRNA7) with the Development of Schizophrenia and Bipolar Disorder in Korean Population

    OpenAIRE

    Joo, Eun-Jeong; Lee, Kyu Young; Kim, Hyun Sook; KIM, SE HYUN; Ahn, Yong Min; Kim, Yong Sik

    2010-01-01

    Objective CHRNA7 has been shown to be a strong candidate gene for schizophrenia and bipolar disorder. It is located on chromosome 15q13-q14, which is one of the replicated linkage spots for schizophrenia and bipolar disorder. Methods We conducted an association study to determine whether previous positive association is replicable in the Korean population. We included 254 patients with schizophrenia, 193 patients with bipolar disorder type I, 38 patients with bipolar disorder type II, 64 schi...

  5. GABA(A) Receptor Alpha5 Subunit as a Candidate Gene for Autism and Bipolar Disorder: A Proposed Endophenotype with Parent-of-Origin and Gain-of-Function Features, with or without Oculocutaneous Albinism

    Science.gov (United States)

    Delong, Robert

    2007-01-01

    Our earlier family history studies of individuals with autism found a high incidence of major affective disorder, especially bipolar disorder, and unusual talents or intellectual abilities among family members. We now describe a subgroup of such families, selected from a large clinical experience, illustrating specific features of major affective…

  6. Cognitive enhancement treatments for bipolar disorder

    DEFF Research Database (Denmark)

    Miskowiak, Kamilla W; Carvalho, André F; Vieta, Eduard;

    2016-01-01

    Cognitive dysfunction is an emerging treatment target in bipolar disorder (BD). Several trials have assessed the efficacy of novel pharmacological and psychological treatments on cognition in BD but the findings are contradictory and unclear. A systematic search following the PRISMA guidelines...

  7. Bias in emerging biomarkers for bipolar disorder

    DEFF Research Database (Denmark)

    Carvalho, A F; Köhler, C A; Fernandes, B S;

    2016-01-01

    BACKGROUND: To date no comprehensive evaluation has appraised the likelihood of bias or the strength of the evidence of peripheral biomarkers for bipolar disorder (BD). Here we performed an umbrella review of meta-analyses of peripheral non-genetic biomarkers for BD. METHOD: The Pubmed...

  8. Unraveling Psychomotor Slowing in Bipolar Disorde

    NARCIS (Netherlands)

    Morsel, A.M.; Temmerman, A.; Sabbe, B.G.C.; Hulstijn, W.; Morrens, M.

    2015-01-01

    Background/Aims: In addition to affective and cognitive symptomatology, psychomotor deficits are known to be present in bipolar disorder (BD). Psychomotor functioning includes all of the processes necessary for completing a movement, from planning to initiation and execution. While these psychomotor

  9. Bipolar disorder: from genes to behavior pathways

    OpenAIRE

    Martinowich, Keri; Schloesser, Robert J; Manji, Husseini K

    2009-01-01

    Bipolar disorder (BPD) is a devastating illness that is characterized by recurrent episodes of mania and depression. In addition to these cyclic episodes, individuals with BPD exhibit changes in psychovegetative function, cognitive performance, and general health and well being. In this article we draw from neuroimaging findings in humans, postmortem data, and human genetic and pharmacological studies as well as ...

  10. QUALITY OF LIFE IN BIPOLAR DISORDER

    Directory of Open Access Journals (Sweden)

    Nieznańska, Anna

    2014-12-01

    Full Text Available Background: Among the consequences of bipolar disorder there i s a decreased quality of life, including the deterioration of patients’ social functioning. Material: The paper contains an analysis of 24 major publica tions from the years 2009 to 2014, including 17 related to the assessment of quality of life and 7 articles on the bipolar patients’ social functioning. Results: There were selected 8 factors which are related with the assessment of the quality of life of persons with a diagnosis of bipolar disorder: the presence of depressive symptoms, substance use, sleep deficit, religious activity and social support, internalized stigma, suicide attempts in the past, the perception of emotions and impulsivity. It was defined that social functioning of bipolar patients is dependent on the emotional state of patients, and in particular the presence of depressive symptoms. It is dependent also on patients’ cognitive performance and internalized stigma. Conclusions: Assistance in mastering the first symptoms of a depressive phase can help bipolar patients in their smooth social functioning and quality of life. Taking into account the implementation of appropriate therapy with cognitive exercise and which is aimed at reducing internalized stigma, may contribute to improving the quality of life and improve the patients’ social functioning.

  11. A report on older-age bipolar disorder from the International Society for Bipolar Disorders Task Force

    DEFF Research Database (Denmark)

    Sajatovic, Martha; Strejilevich, Sergio A; Gildengers, Ariel G;

    2015-01-01

    OBJECTIVES: In the coming generation, older adults with bipolar disorder (BD) will increase in absolute numbers as well as proportion of the general population. This is the first report of the International Society for Bipolar Disorder (ISBD) Task Force on Older-Age Bipolar Disorder (OABD). METHO...

  12. Thought Suppression in Patients With Bipolar Disorder

    OpenAIRE

    Miklowitz, David J.; Alatiq, Yousra; Geddes, John R.; Goodwin, Guy M.; Williams, J. Mark G.

    2010-01-01

    Suppression of negative thoughts has been observed under experimental conditions among patients with major depressive disorder (MDD) but has never been examined among patients with bipolar disorder (BD). Patients with BD (n = 36), patients with MDD (n = 20), and healthy controls (n = 20) completed a task that required unscrambling 6-word strings into 5-word sentences, leaving out 1 word. The extra word allowed the sentences to be completed in a negative, neutral, or “hyperpositive” (manic/goa...

  13. Climatic factors and bipolar affective disorder

    DEFF Research Database (Denmark)

    Christensen, Ellen Margrethe; Larsen, Jens Knud; Gjerris, Annette;

    2008-01-01

    . A group of patients with at least three previous hospitalizations for bipolar disorder was examined every 3 months for up to 3 years. At each examination an evaluation of the affective phase was made according to the Hamilton Depression Scale (HAM-D(17)), and the Bech-Rafaelsen Mania Rating Scale (MAS......). In the same period, daily recordings from the Danish Meteorological Institute were received. We found no correlations between onset of bipolar episodes [defined as MAS score of 11 or more (mania) and as HAM-D(17) score of 12 or more (depression)] and any meteorological parameters. We found a statistical...

  14. [Bipolar disorders and self-stigma].

    Science.gov (United States)

    Richard-Lepouriel, H

    2015-09-16

    Despite wide media coverage in recent years, the stigmatization of people with bipolar disorder still exists. Bipolar people also have their own tendency to self-stigmatize that is to integrate their beliefs, prejudices and stigmatizing behaviors. The consequences are important: shame, guilt, withdrawal and renunciation to lead one's own life according to personal values increasing therefore the risk of mood relapses. Self-stigma is rarely assessed in clinical practice and few strategies have been designed to face them efficiently. Recognizing self-stigmatizing beliefs and challenging them are the first steps of this vast endeavour. PMID:26591079

  15. Rumination in bipolar disorder: a systematic review

    OpenAIRE

    Érico de M. Silveira Jr.; Marcia Kauer-Sant'Anna

    2015-01-01

    Objective:To conduct a systematic review of the literature about the symptom of rumination in bipolar disorder (BD).Methods:We searched the MEDLINE (PubMed), ISI Web of Knowledge, PsycINFO, and SciELO databases using the descriptors “rumination” and “bipolar disorder” and no time limits. This strategy yielded 105 references, of which 74 were selected. Inclusion criteria were studies involving patients with BD and the use of at least one validated scale for the assessment of rumination. Review...

  16. A composite peripheral blood gene expression measure as a potential diagnostic biomarker in bipolar disorder

    DEFF Research Database (Denmark)

    Munkholm, Klaus; Peijs, L; Vinberg, M;

    2015-01-01

    -operating characteristic curve of 0.81 (P test. The present findings of altered POLG, OGG1 and NDUFV2 expression point to disturbances within mitochondrial function and DNA repair mechanisms...... as a diagnostic and state biomarker in bipolar disorder. First, messenger RNA levels of 19 candidate genes were assessed in peripheral blood mononuclear cells of 37 rapid cycling bipolar disorder patients in different affective states (depression, mania and euthymia) during a 6-12-month period and in 40 age...... in bipolar disorder. Further, a composite gene expression measure could hold promise as a potential diagnostic biomarker....

  17. Genetic studies of bipolar disorder and recurrent major depression in a large Scottish family

    OpenAIRE

    Houlihan, Lorna M.

    2008-01-01

    Bipolar disorder and recurrent major depression are complex psychiatric illnesses with a substantial, yet unknown genetic component. Genetic studies have identified linkage of bipolar disorder and recurrent major depression with markers on chromosome 4p15-p16 in a large Scottish family and three smaller families. To focus the search for genetic factors for susceptibility to illness two approaches were adopted: a chromosome 4p15-p16 candidate gene study and a whole-genome linkag...

  18. Heritability of cognitive functions in families with bipolar disorder.

    Science.gov (United States)

    Antila, Mervi; Tuulio-Henriksson, Annamari; Kieseppä, Tuula; Soronen, Pia; Palo, Outi M; Paunio, Tiina; Haukka, Jari; Partonen, Timo; Lönnqvist, Jouko

    2007-09-01

    Bipolar disorder is highly heritable. Cognitive dysfunctions often observed in bipolar patients and their unaffected relatives implicate that these impairments may be associated with genetic predisposition to bipolar disorder and thus fulfill the criteria of a valid endophenotype for the disorder. However, the most fundamental criterion, their heritability, has not been directly studied in any bipolar population. This population-based study estimated the heritability of cognitive functions in bipolar disorder. A comprehensive neuropsychological test battery and the Structured Clinical Interview for DSM-IV were administered to a population-based sample of 110 individuals from 52 families with bipolar disorder. Heritability of cognitive functions as assessed with neuropsychological test scores were estimated using the Solar package. Significant additive heritabilities were found in verbal ability, executive functioning, and psychomotor processing speed. Genetic contribution was low to verbal learning functions. High heritability, in executive functioning and psychomotor processing speed suggest that these may be valid endophenotypic traits for genetic studies of bipolar disorder.

  19. Anticonvulsant Drugs for Nerve Pain, Bipolar Disorder and Fibromyalgia

    Science.gov (United States)

    Anticonvulsant Drugs for Nerve Pain, Bipolar Disorder &Fibromyalgia: Choosing What’sRight for You What are anticonvulsant drugs? Anticonvulsants are drugs used to treat seizures. They are also used to treat bipolar ...

  20. Factors associated with lithium efficacy in bipolar disorder.

    Science.gov (United States)

    Rybakowski, Janusz K

    2014-01-01

    About one-third of lithium-treated, bipolar patients are excellent lithium responders; that is, lithium monotherapy totally prevents further episodes of bipolar disorder for ten years and more. These patients are clinically characterized by an episodic clinical course with complete remission, a bipolar family history, low psychiatric comorbidity, mania-depression episode sequences, a moderate number of episodes, and a low number of hospitalizations in the pre-lithium period. Recently, it has been found that temperamental features of hypomania (a hyperthymic temperament) and a lack of cognitive disorganization predict the best results of lithium prophylaxis. Lithium exerts a neuroprotective effect, in which increased expression of brain-derived neurotrophic factor (BDNF) and inhibition of the glycogen synthase kinase-3 (GSK-3) play an important role. The response to lithium has been connected with the genotype of the BDNF gene and serum BDNF levels. A better response to lithium is connected with the Met allele of the BDNF Val/Met polymorphism, as is a hyperthymic temperament. Excellent lithium responders have normal cognitive functions and serum BDNF levels, even after long-term duration of the illness. The preservation of cognitive functions in long-term lithium-treated patients may be connected with the stimulation of the BDNF system, with the resulting prevention of affective episodes exerting deleterious cognitive effects, and possibly also with lithium's antiviral effects. A number of candidate genes that are related to neurotransmitters, intracellular signaling, neuroprotection, circadian rhythms, and other pathogenic mechanisms of bipolar disorder were found to be associated with the lithium prophylactic response. The Consortium on Lithium Genetics (ConLiGen) has recently performed the first genome-wide association study on the lithium response in bipolar disorder.

  1. Unmet needs of bipolar disorder patients

    Directory of Open Access Journals (Sweden)

    Hajda M

    2016-06-01

    Full Text Available Miroslav Hajda,1 Jan Prasko,1 Klara Latalova,1 Radovan Hruby,2 Marie Ociskova,1 Michaela Holubova,1,3 Dana Kamaradova,1 Barbora Mainerova1 1Department of Psychiatry, Faculty of Medicine and Dentistry, Palacky University Olomouc, University Hospital Olomouc, Olomouc, Czech Republic; 2Outpatient Psychiatric Department, Martin, Slovak Republic; 3Department of Psychiatry, Regional Hospital Liberec, Liberec, Czech Republic Background: Bipolar disorder (BD is a serious mental illness with adverse impact on the lives of the patients and their caregivers. BD is associated with many limitations in personal and interpersonal functioning and restricts the patients’ ability to use their potential capabilities fully. Bipolar patients long to live meaningful lives, but this goal is hard to achieve for those with poor insight. With progress and humanization of society, the issue of patients’ needs became an important topic. The objective of the paper is to provide the up-to-date data on the unmet needs of BD patients and their caregivers. Methods: A systematic computerized examination of MEDLINE publications from 1970 to 2015, via the keywords “bipolar disorder”, “mania”, “bipolar depression”, and “unmet needs”, was performed. Results: Patients’ needs may differ in various stages of the disorder and may have different origin and goals. Thus, we divided them into five groups relating to their nature: those connected with symptoms, treatment, quality of life, family, and pharmacotherapy. We suggested several implications of these needs for pharmacotherapy and psychotherapy. Conclusion: Trying to follow patients’ needs may be a crucial point in the treatment of BD patients. However, many needs remain unmet due to both medical and social factors. Keywords: bipolar disorder, unmet needs, stigma, treatment, medication, quality of life, family, psychotherapy

  2. Using the mood disorder questionnaire and bipolar spectrum diagnostic scale to detect bipolar disorder and borderline personality disorder among eating disorder patients

    OpenAIRE

    Nagata, Toshihiko; Yamada, Hisashi; Teo, Alan R.; Yoshimura, Chiho; Kodama, Yuya; van Vliet, Irene

    2013-01-01

    Background Screening scales for bipolar disorder including the Mood Disorder Questionnaire (MDQ) and Bipolar Spectrum Diagnostic Scale (BSDS) have been plagued by high false positive rates confounded by presence of borderline personality disorder. This study examined the accuracy of these scales for detecting bipolar disorder among patients referred for eating disorders and explored the possibility of simultaneous assessment of co-morbid borderline personality disorder. Methods Participants w...

  3. Genetic relationships between schizophrenia, bipolar disorder, and schizoaffective disorder.

    Science.gov (United States)

    Cardno, Alastair G; Owen, Michael J

    2014-05-01

    There is substantial evidence for partial overlap of genetic influences on schizophrenia and bipolar disorder, with family, twin, and adoption studies showing a genetic correlation between the disorders of around 0.6. Results of genome-wide association studies are consistent with commonly occurring genetic risk variants, contributing to both the shared and nonshared aspects, while studies of large, rare chromosomal structural variants, particularly copy number variants, show a stronger influence on schizophrenia than bipolar disorder to date. Schizoaffective disorder has been less investigated but shows substantial familial overlap with both schizophrenia and bipolar disorder. A twin analysis is consistent with genetic influences on schizoaffective episodes being entirely shared with genetic influences on schizophrenic and manic episodes, while association studies suggest the possibility of some relatively specific genetic influences on broadly defined schizoaffective disorder, bipolar subtype. Further insights into genetic relationships between these disorders are expected as studies continue to increase in sample size and in technical and analytical sophistication, information on phenotypes beyond clinical diagnoses are increasingly incorporated, and approaches such as next-generation sequencing identify additional types of genetic risk variant.

  4. Overview of patient care issues and treatment in bipolar spectrum and bipolar II disorder.

    Science.gov (United States)

    Calabrese, Joseph R

    2008-06-01

    Recent studies have reported lifetime prevalence estimates of 1.0% for bipolar I disorder, 1.1% for bipolar II disorder, and 2.4% to 4.7% for subthreshold bipolar disorder, illustrating the need for consensus definitions of bipolar spectrum disorders. These definitions will aid researchers in studying viable treatments options, as well as help clinicians in the differential diagnosis of patients. Broader definitions of bipolar spectrum disorders would also allow clinicians to more accurately diagnose patients, rather than placing them in the catchall category of bipolar disorder not otherwise specified. Bipolar symptoms that are currently labeled as subthreshold symptoms are becoming increasingly recognized as having relevant clinical implications. Despite diagnostic controversy, screening for the presence of mania in patients who present with depressive symptoms is a critical step in the appropriate treatment of bipolar spectrum disorders. Identifying the early onset of bipolar symptoms as manifested in prodromal disorders such as childhood major depressive disorder and attention-deficit/hyperactivity disorder is also important for possible early intervention and improved outcomes.

  5. Bipolar Disorder in Children: Implications for Speech-Language Pathologists

    Science.gov (United States)

    Quattlebaum, Patricia D.; Grier, Betsy C.; Klubnik, Cynthia

    2012-01-01

    In the United States, bipolar disorder is an increasingly common diagnosis in children, and these children can present with severe behavior problems and emotionality. Many studies have documented the frequent coexistence of behavior disorders and speech-language disorders. Like other children with behavior disorders, children with bipolar disorder…

  6. Perturbed reward processing in pediatric bipolar disorder: an antisaccade study

    OpenAIRE

    Mueller, Sven C; Ng, Pamela; Temple, Veronica; Hardin, Michael G.; Pine, Daniel S.; Leibenluft, Ellen; Ernst, Monique

    2010-01-01

    Pediatric bipolar disorder is a severe and impairing illness. Characterizing the impact of pediatric bipolar disorder on cognitive function might aid in understanding the phenomenology of the disorder. While previous studies of pediatric bipolar disorder have reported deficits in cognitive control and reward behavior, little is understood about how affective processes influence behavioral control. Relative to prior studies using manual-response paradigms, eye movement tasks provide a more pre...

  7. Quetiapine: A Pharmacoeconomic Review of its Use in Bipolar Disorder

    OpenAIRE

    Greg L. Plosker

    2012-01-01

    This article briefly summarizes the burden of bipolar disorder and the clinical profile of quetiapine (Seroquel) in the management of bipolar disorder, followed by a detailed review of pharmacoeconomic analyses. Quetiapine is an atypical antipsychotic that is available in numerous countries as immediate-release and extended-release tablets for the treatment of major psychiatric disorders, including bipolar disorder. Randomized, double-blind, placebo-controlled trials with quetiapine have demo...

  8. Bipolar disorder and metabolic syndrome: a systematic review

    Directory of Open Access Journals (Sweden)

    Letícia Czepielewski

    2013-03-01

    Full Text Available OBJECTIVE: Summarize data on metabolic syndrome (MS in bipolar disorder (BD. METHODS: A systematic review of the literature was conducted using the Medline, Embase and PsycInfo databases, using the keywords "metabolic syndrome", "insulin resistance" and "metabolic X syndrome" and cross-referencing them with "bipolar disorder" or "mania". The following types of publications were candidates for review: (i clinical trials, (ii studies involving patients diagnosed with bipolar disorder or (iii data about metabolic syndrome. A 5-point quality scale was used to assess the methodological weight of the studies. RESULTS: Thirty-nine articles were selected. None of studies reached the maximum quality score of 5 points. The prevalence of MS was significantly higher in BD individuals when compared to a control group. The analysis of MS subcomponents showed that abdominal obesity was heterogeneous. Individuals with BD had significantly higher rates of hypertriglyceridemia than healthy controls. When compared to the general population, there were no significant differences in the prevalence of low HDL-c in individuals with BD. Data on hypertension were also inconclusive. Rates of hyperglycemia were significantly greater in patients with BD compared to the general population. CONCLUSIONS: The overall results point to the presence of an association between BD and MS, as well as between their subcomponents.

  9. Unmet needs of bipolar disorder patients

    OpenAIRE

    Hajda M; Prasko J; Latalova K; Hruby R; Ociskova M; Holubova M; Kamaradova D; Mainerova B

    2016-01-01

    Miroslav Hajda,1 Jan Prasko,1 Klara Latalova,1 Radovan Hruby,2 Marie Ociskova,1 Michaela Holubova,1,3 Dana Kamaradova,1 Barbora Mainerova1 1Department of Psychiatry, Faculty of Medicine and Dentistry, Palacky University Olomouc, University Hospital Olomouc, Olomouc, Czech Republic; 2Outpatient Psychiatric Department, Martin, Slovak Republic; 3Department of Psychiatry, Regional Hospital Liberec, Liberec, Czech Republic Background: Bipolar disorder (BD) is a serious mental illness with advers...

  10. Partial Rodent Genetic Models for Bipolar Disorder

    OpenAIRE

    Chen, Guang; Henter, Ioline D.; Manji, Husseini K

    2011-01-01

    Bipolar disorder (BPD) is a complex clinical phenomenon. This episodic illness comprises at least four features/components: depression, mania, vulnerability to mood swings in euthymic BPD patients, and spontaneous cyclicity in at least some BPD patients. Currently, there is no rodent genetic model capable of encompassing the whole phenotype of BPD exists; however, recent genetic-behavioral studies have delineated partial models for some components of BPD, namely, depression, mania, and vulner...

  11. Tratamento do transtorno bipolar: eutimia Bipolar disorder treatment: euthymia

    Directory of Open Access Journals (Sweden)

    Fábio Gomes de Matos e Souza

    2005-01-01

    Full Text Available O transtorno bipolar é um quadro complexo caracterizado por episódios de depressão, mania ou hipomania e fases assintomáticas. O tratamento visa ao controle de episódios agudos e prevenção de novos episódios. O tratamento farmacológico iniciou-se com o lítio. Até o momento, o lítio permanece como o tratamento com mais evidências favoráveis na fase de manutenção. Outros tratamentos demonstram eficácia nessa fase, como o valproato, a carbamazepina e os antipsicóticos atípicos. Dos antipsicóticos atípicos o mais estudado nesta fase do tratamento é a olanzapina. Mais estudos prospectivos são necessários para confirmar a ação profilática de novos agentes.Bipolar disorder is a complex disorder characterized by depression episodes, mania or hypomania and asymptomatic phases. The treatment aims at the control of acute episodes and prevention of new episodes. The pharmacological treatment was inaugurated with lithium. Until the moment, lithium remains as the treatment with more favorable evidences in the maintenance phase. Other treatments demonstrate efficacy in this phase, as valproate, carbamazepine and atypical antipsychotics. Of the atypical antipsychotics, the most studied in this phase of treatment is olanzapine. More prospective studies are necessary to confirm prophylactic action of new agents.

  12. Systematic review of the prevalence of bipolar disorder and bipolar spectrum disorders in population-based studies

    Directory of Open Access Journals (Sweden)

    José Caetano Dell'Aglio Jr.

    2013-01-01

    Full Text Available This paper describes the findings of a systematic literature review aimed at providing an overview of the lifetime prevalence of bipolar disorder and bipolar spectrum disorders in population-based studies. Databases MEDLINE, ProQuest, Psychnet, and Web of Science were browsed for papers published in English between 1999 and May 2012 using the following search string: bipolar disorders OR bipolar spectrum disorders AND prevalence OR cross-sectional OR epidemiology AND population-based OR non-clinical OR community based. The search yielded a total of 434 papers, but only those published in peer-reviewed journals and with samples aged ≥ 18 years were included, resulting in a final sample of 18 papers. Results revealed rather heterogeneous findings concerning the prevalence of bipolar disorders and bipolar spectrum disorders. Lifetime prevalence of bipolar disorder ranged from 0.1 to 7.5%, whereas lifetime prevalence of bipolar spectrum disorders ranged from 2.4 to 15.1%. Differences in the rates of bipolar disorder and bipolar spectrum disorders may be related to the consideration of subthreshold criteria upon diagnosis. Differences in the prevalence of different subtypes of the disorder are discussed in light of diagnostic criteria and instruments applied.

  13. Diagnostic features, prevalence, and impact of bipolar disorder.

    Science.gov (United States)

    Ketter, Terrence A

    2010-06-01

    Bipolar disorder shares depressive symptoms with unipolar major depressive disorder but is defined by episodes of mania or hypomania. Bipolar disorder in its broadest sense has a community lifetime prevalence of 4% and is a severely impairing illness that impacts several aspects of patients' lives. Race, ethnicity, and gender have no effect on prevalence rates, but women are more likely to experience rapid cycling, mixed states, depressive episodes, and bipolar II disorder than men. Patients with bipolar disorder have high rates of disability and higher rates of mortality than individuals without bipolar disorder. Natural causes such as cardiovascular disease and diabetes, as well as suicide and other "unnatural" causes are key contributors to the high mortality rate. The costs associated with bipolar disorder include not only the direct costs of treatment, but also the much greater indirect costs of decreased productivity, excess unemployment, and excess mortality. PMID:20573324

  14. Olanzapine discontinuation emergent recurrence in bipolar disorder

    Directory of Open Access Journals (Sweden)

    Manu Arora

    2014-01-01

    Full Text Available Objective: The efficacy of atypical antipsychotics including olanzapine in acute treatment of manic episode has been established, whereas its role in maintenance treatment is not clear. Materials and Methods: Thirteen patients of bipolar disorder who were on regular treatment with mood stabilizer and subsequently relapsed into mania or depressive episode after discontinuation of olanzapine were studied for various socio-demographic and clinical factors using retrospective chart review. Results: There was no correlation found between the period of tapering olanzapine, time to recurrence of episode after discontinuation, and the dosage of olanzapine at the time of discontinuation. The predominant early signs of relapse after discontinuation of olanzapine included sleep disturbance (72.7%, lack of insight for change in behavior (72.7%, irritability (54.5%, and elevated mood (45.5%. Conclusion: Mood stabilizer alone as a maintenance therapy of bipolar disorder may be inadequate for long-term management. A low dose of olanzapine along with mood stabilizers might be useful for prevention of recurrence in bipolar disorder.

  15. Historical Underpinnings of Bipolar Disorder Diagnostic Criteria

    Directory of Open Access Journals (Sweden)

    Brittany L. Mason

    2016-07-01

    Full Text Available Mood is the changing expression of emotion and can be described as a spectrum. The outermost ends of this spectrum highlight two states, the lowest low, melancholia, and the highest high, mania. These mood extremes have been documented repeatedly in human history, being first systematically described by Hippocrates. Nineteenth century contemporaries Falret and Baillarger described two forms of an extreme mood disorder, with the validity and accuracy of both debated. Regardless, the concept of a cycling mood disease was accepted before the end of the 19th century. Kraepelin then described “manic depressive insanity” and presented his description of a full spectrum of mood dysfunction which could be exhibited through single episodes of mania or depression or a complement of many episodes of each. It was this concept which was incorporated into the first DSM and carried out until DSM-III, in which the description of episodic mood dysfunction was used to build a diagnosis of bipolar disorder. Criticism of this approach is explored through discussion of the bipolar spectrum concept and some recent examinations of the clinical validity of these DSM diagnoses are presented. The concept of bipolar disorder in children is also explored.

  16. Historical Underpinnings of Bipolar Disorder Diagnostic Criteria.

    Science.gov (United States)

    Mason, Brittany L; Brown, E Sherwood; Croarkin, Paul E

    2016-01-01

    Mood is the changing expression of emotion and can be described as a spectrum. The outermost ends of this spectrum highlight two states, the lowest low, melancholia, and the highest high, mania. These mood extremes have been documented repeatedly in human history, being first systematically described by Hippocrates. Nineteenth century contemporaries Falret and Baillarger described two forms of an extreme mood disorder, with the validity and accuracy of both debated. Regardless, the concept of a cycling mood disease was accepted before the end of the 19th century. Kraepelin then described "manic depressive insanity" and presented his description of a full spectrum of mood dysfunction which could be exhibited through single episodes of mania or depression or a complement of many episodes of each. It was this concept which was incorporated into the first DSM and carried out until DSM-III, in which the description of episodic mood dysfunction was used to build a diagnosis of bipolar disorder. Criticism of this approach is explored through discussion of the bipolar spectrum concept and some recent examinations of the clinical validity of these DSM diagnoses are presented. The concept of bipolar disorder in children is also explored. PMID:27429010

  17. Recurrence and Relapse in Bipolar Mood Disorder

    Directory of Open Access Journals (Sweden)

    S Gh Mousavi

    2004-06-01

    Full Text Available Background: Despite the effectiveness of pharmacotherapy in acute phase of bipolar mood disorder, patients often experience relapses or recurrent episodes. Hospitalization of patients need a great deal of financial and humanistic resources which can be saved through understanding more about the rate of relapse and factors affecting this rate. Methods: In a descriptive analytical study, 380 patients with bipolar disorder who were hospitalized in psychiatric emergency ward of Noor hospital, Isfahan, Iran, were followed. Each patient was considered for; the frequency of relapse and recurrence, kind of pharmachotherapy, presence of psychotherapeutic treatments, frequency of visits by psychiatrist and the rank of present episode. Results: The overall prevalence of recurrence was 42.2%. Recurrence was lower in patients using lithium carbonate or sodium valproate or combined therapy (about 40%, compared to those using carbamazepine (80%. Recurrence was higher in patients treated with only pharmacotherapy (44.5% compared to those treated with both pharmacotherapy and psychotherapy (22.2%. Patients who were visited monthy by psychiatrist had lower rate of recurrence compared to those who had irregular visits. Conclusion: The higher rate of recurrence observed in carbamazepine therapy may be due to its adverse reactions and consequently poor compliance to this drug. Lower rates of recurrence with psychotherapy and regular visits may be related to the preventive effects of these procedures and especially to the effective management of stress. Keywords: Bipolar Mood Disorder, Recurrence, Relapse.

  18. [Confusing clinical presentations and differential diagnosis of bipolar disorder].

    Science.gov (United States)

    Gorwood, P

    2004-01-01

    An early recognition of bipolar disorders may have an important impact on the prognosis of this disorder according to different mechanisms. Bipolar disorder is nevertheless not easy to detect, the diagnosis being correctly proposed after, in average more than a couple of Years and three different doctors assessments. A short delay before introducing the relevant treatment should help avoiding inappropriate treatments (prescribing, for example, neuroleptics for long periods, antidepressive drugs each time depressive symptoms occurs, absence of treatment despite mood disorders), with their associated negative impact such as mood-switching, rapid cycling or presence of chronic side-effects stigmates. Furthermore, non-treated mood disorders in bipolar disorder are longer, more stigmatizing and may be associated with an increased risk of suicidal behaviour and mortality. Lastly, compliance, an important factor regarding the long term prognosis of bipolar disorder, should be improved when there is a short delay between correct diagnosis and treatment and onset of the disorder. We therefore propose to review the literature for the different pitfalls involved in the diagnosis of bipolar disorder. Non-bipolar mood-disorders are frequently quoted as one of the alternative diagnosis. Hyperthymic temperament, side-effects of prescribed treatments and organic comorbid disorders may be involved. Bipolar disorders have a sex-ratio closer to 1 (men are thus more frequently of the bipolar type in mood-disorders), with earlier age at onset, and more frequent family history of suicidal attempts and bipolar disorder. Schizo-affective disorders are also a major concern regarding the diagnosis of bipolar disorder. This is explained by flat affects sometimes close to anhedonia, presence of a schizoïd personality in bipolar disorder, persecutive hostility that can be considered to be related to irritability rather than a schizophrenic symptom. Rapid cycling, mixed episodes and short

  19. Bipolar disorder: Evidence for a major locus

    Energy Technology Data Exchange (ETDEWEB)

    Spence, M.A.; Flodman, P.L. [Univ. of California, Irvine, CA (United States); Sadovnick, A.D.; Ameli, H. [Univ. of British Columbia, Vancouver (Canada)] [and others

    1995-10-09

    Complex segregation analyses were conducted on families of bipolar I and bipolar II probands to delineate the mode of inheritance. The probands were ascertained from consecutive referrals to the Mood Disorder Service, University Hospital, University of British Columbia and diagnosed by DSM-III-R and Research Diagnostic Criteria. Data were available on over 1,500 first-degree relatives of the 186 Caucasian probands. The purpose of the analyses was to determine if, after correcting for age and birth cohort, there was evidence for a single major locus. Five models were fit to the data using the statistical package SAGE: (1) dominant, (2) recessive, (3) arbitrary mendelian inheritance, (4) environmental, and (5) no major effects. A single dominant, mendelian major locus was the best fitting of these models for the sample of bipolar I and II probands when only bipolar relatives were defined as affected (polygenic inheritance could not be tested). Adding recurrent major depression to the diagnosis {open_quotes}affected{close_quotes} for relatives reduced the evidence for a major locus effect. Our findings support the undertaking of linkage studies and are consistent with the analyses of the National Institutes of Mental Health (NIMH) Collaborative Study data by Rice et al. and Blangero and Elston. 39 refs., 4 tabs.

  20. O transtorno bipolar na mulher Bipolar disorder in women

    Directory of Open Access Journals (Sweden)

    Alexandro de Borja Gonçalves Guerra

    2005-01-01

    Full Text Available Diferenças sexuais, descritas em vários transtornos psiquiátricos, também parecem estar presentes no transtorno afetivo bipolar (TAB. A prevalência do TAB tipo I se distribui igualmente entre mulheres e homens. Mulheres parecem estar sujeitas a um risco maior de ciclagem rápida e mania mista, condições que fariam do TAB um transtorno com curso mais prejudicial no sexo feminino. Uma diátese depressiva mais marcante, uso excessivo de antidepressivos e diferenças hormonais surgem como hipóteses para explicar essas diferenças fenomenológicas, apesar das quais, mulheres e homens parecem responder igualmente ao tratamento medicamentoso. A indicação de anticonvulsivantes como primeira escolha em mulheres é controversa, a não ser para o tratamento da mania mista e, talvez, da ciclagem rápida. O tratamento do TAB na gravidez deve levar em conta tanto os riscos de exposição aos medicamentos quanto à doença materna. A profilaxia do TAB no puerpério está fortemente indicada em decorrência do grande risco de recorrência da doença nesse período. Embora, de modo geral, as medicações psicotrópicas estejam contra-indicadas durante a amamentação, entre os estabilizadores do humor, a carbamazepina e o valproato são mais seguros do que o lítio. Mais estudos são necessários para a confirmação das diferenças de curso do TAB entre mulheres e homens e a investigação de possíveis diferenças na efetividade dos tratamentos.Gender differences, described in several psychiatric disorders, seem to be also present in bipolar disorder (BD. The prevalence of bipolar I disorder is equally distributed between women and men. Women seem to be at higher risk for rapid cycling and mixed mania, conditions that could make BD a disorder with a more severe course in the female sex. A marked depressive diathesis among women, greatest use of antidepressants and hormonal differences have been mentioned as hypotheses to explain these

  1. Undiagnosed Bipolar Disorder: New Syndromes and New Treatments

    OpenAIRE

    Glick, Ira D.

    2004-01-01

    Recent studies have indicated that bipolar disorder is more common than previously believed. The socioeconomic and personal burdens of this illness are significant, and the lifetime risk of suicide attempts by patients with bipolar II disorder is high. It is not uncommon for patients with bipolar disorder, especially those presenting with depression, to be seen first in a primary care setting; therefore, primary care physicians need to be ready to diagnose and manage patients with these menta...

  2. Treating bipolar disorder. Evidence-based guidelines for family medicine.

    OpenAIRE

    McIntyre, Roger S; Mancini, Deborah A.; Lin, Peter; Jordan, John

    2004-01-01

    OBJECTIVE: To provide an evidence-based summary of medications commonly used for bipolar disorders and a practical approach to managing bipolar disorders in the office. QUALITY OF EVIDENCE: Articles from 1990 to 2003 were selected from MEDLINE using the key words "bipolar disorder," "antiepileptics," "antipsychotics," "antidepressants," and "mood stabilizers." Good-quality evidence for many of these treatments comes from randomized trials. Lithium, divalproex, carbamazepine, lamotrigine, oxca...

  3. The Neurobiology of Bipolar Disorder: An Integrated Approach

    OpenAIRE

    Muneer, Ather

    2016-01-01

    Bipolar disorder is a heterogeneous condition with myriad clinical manifestations and many comorbidities leading to severe disabilities in the biopsychosocial realm. The objective of this review article was to underline recent advances in knowledge regarding the neurobiology of bipolar disorder. A further aim was to draw attention to new therapeutic targets in the treatment of bipolar disorder. To accomplish these goals, an electronic search was undertaken of the PubMed database in August 201...

  4. Long-term Treatment in Bipolar Disorder

    Directory of Open Access Journals (Sweden)

    Meliha Zengin Eroglu

    2010-08-01

    Full Text Available Although the importance of long-term prophylactic treatment is certain in bipolar disorder, there is stil debate on how to which patients and evaluate the treatment response. Efficacious long-term treatment can reduce morbidity and mortality significantly and improve quality of life of bipolar patients. The concept of ideal response should also be defined very clearly in order to discuss the difficulties of measuring the effectiveness of the prophylactic treatment. The aims of this paper are to determine whether our currently methods and criteria are valid, reliable and sensitive evaluating the efficacy of the treatment response and to briefly inform the clinicians about the drugs used in pharmacologic prophylaxis in accordance with relevant data.

  5. Pediatric Bipolar Disorder: Evidence for Prodromal States and Early Markers

    Science.gov (United States)

    Luby, Joan L.; Navsaria, Neha

    2010-01-01

    Background: Childhood bipolar disorder remains a controversial but increasingly diagnosed disorder that is associated with significant impairment, chronic course and treatment resistance. Therefore, the search for prodromes or early markers of risk for later childhood bipolar disorder may be of great importance for prevention and/or early…

  6. Prevalence and correlates of eating disorders in 875 patients with bipolar disorder

    NARCIS (Netherlands)

    McElroy, Susan L.; Frye, Mark A.; Hellemann, Gerhard; Altshuler, Lori; Leverich, Gabriele S.; Suppes, Trisha; Keck, Paul E.; Nolen, Willem A.; Kupka, Ralph; Post, Robert M.

    2011-01-01

    Objective: Relatively little is known about the co-occurrence of bipolar and eating disorders. We therefore assessed the prevalence and clinical correlates of eating disorders in 875 patients with bipolar disorder. Method: 875 outpatients with DSM-IV bipolar I or II disorder were evaluated with stru

  7. State-related alterations of gene expression in bipolar disorder

    DEFF Research Database (Denmark)

    Munkholm, Klaus; Vinberg, Maj; Berk, Michael;

    2012-01-01

    Munkholm K, Vinberg M, Berk M, Kessing LV. State-related alterations of gene expression in bipolar disorder: a systematic review. Bipolar Disord 2012: 14: 684-696. © 2012 The Authors. Journal compilation © 2012 John Wiley & Sons A/S. Objective:  Alterations in gene expression in bipolar disorder...... on comprehensive database searches for studies on gene expression in patients with bipolar disorder in specific mood states, was conducted. We searched Medline, Embase, PsycINFO, and The Cochrane Library, supplemented by manually searching reference lists from retrieved publications. Results:  A total of 17...

  8. Cognitive dysfunction in bipolar disorder and schizophrenia

    DEFF Research Database (Denmark)

    Bortolato, Beatrice; Miskowiak, Kamilla W; Köhler, Cristiano A;

    2015-01-01

    Cognitive impairment is a core feature of schizophrenia (SZ) and bipolar disorder (BD). A neurocognitive profile characterized by widespread cognitive deficits across multiple domains in the context of substantial intellectual impairment, which appears to antedate illness onset, is a replicated...... deterioration in either SZ or BD, some findings point to more severe cognitive deficits in patients with early illness onset across both disorders. A compromised pattern of cognitive functioning in individuals at familiar and/or clinical risk to psychosis as well as in first-degree relatives of BD patients...... suggests that early neurodevelopmental factors may play a role in the emergence of cognitive deficits in both disorders. Premorbid intellectual impairment in SZ and at least in a subgroup of patients with BD may be related to a shared genetically determined influence on neurodevelopment....

  9. Loopy: The Political Ontology of Bipolar Disorder

    Directory of Open Access Journals (Sweden)

    RACHEL JANE LIEBERT

    2013-01-01

    Full Text Available This essay is at once a critical analysis, an experiment in form, and – with some irony – a cautionary tale. Triggered by the inclusion of prodromal diagnoses in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, and the recent call by the United States’ (U.S. Obama administration for increased mental health screening, I argue that shifts toward identifying and intervening on one’s potential madness, or risk, circulate with/in the contemporary U.S. climate of intensified discipline and terror, and use Bipolar Disorder as a site to critically explore how and with what implications this circulation occurs. Specifically, I weave Massumi’s ‘political ontology of threat’ with the narrative of a woman diagnosed with Bipolar Disorder in order to trace the pre-emptive politics and affective logic of a risk-based approach to madness. I contend that the diagnosing and drugging of potential is a self-perpetuating loop that is personally and politically harmful, and consider alternatives to this burgeoning practice.

  10. The structural neuroimaging of bipolar disorder.

    Science.gov (United States)

    Emsell, Louise; McDonald, Colm

    2009-01-01

    There is an increasing body of literature fuelled by advances in high-resolution structural MRI acquisition and image processing techniques which implicates subtle neuroanatomical abnormalities in the aetiopathogenesis of bipolar disorder. This account reviews the main findings from structural neuroimaging research into regional brain abnormalities, the impact of genetic liability and mood stabilizing medication on brain structure in bipolar disorder, and the overlapping structural deviations found in the allied disorders of schizophrenia and depression. The manifold challenges extant within neuroimaging research are highlighted with accompanying recommendations for future studies. The most consistent findings include preservation of total cerebral volume with regional grey and white matter structural changes in prefrontal, midline and anterior limbic networks, non-contingent ventriculomegaly and increased rates of white matter hyperintensities, with more pronounced deficits in juveniles suffering from the illness. There is increasing evidence that medication has observable effects on brain structure, whereby lithium status is associated with volumetric increase in the medial temporal lobe and anterior cingulate gyrus. However, research continues to be confounded by the use of highly heterogeneous methodology and clinical populations, in studies employing small scale, low-powered, cross-sectional designs. Future work should investigate larger, clinically homogenous groups of patients and unaffected relatives, combining both categorical and dimensional approaches to illness classification in cross-sectional and longitudinal designs in order to elucidate trait versus state mechanisms, genetic effects and medication/illness progression effects over time. PMID:20374145

  11. Climatic factors and bipolar affective disorder

    DEFF Research Database (Denmark)

    Christensen, Ellen Margrethe; Larsen, Jens Knud; Gjerris, Annette;

    2008-01-01

    . A group of patients with at least three previous hospitalizations for bipolar disorder was examined every 3 months for up to 3 years. At each examination an evaluation of the affective phase was made according to the Hamilton Depression Scale (HAM-D(17)), and the Bech-Rafaelsen Mania Rating Scale (MAS...... significant correlation between mean HAM-D(17) scores and change in mean and maximum temperature, and non-statistical significant correlations between mean MAS scores and rainfall plus atmospheric pressure, and non-statistical significant correlations between mean HAM-D(17) scores and hours of sunshine...

  12. Neurocognitive features in subgroups of bipolar disorder

    OpenAIRE

    Aminoff, Sofie Ragnhild; Hellvin, Tone; Lagerberg, Trine Vik; Berg, Akiah Ottesen; Andreassen, Ole A; Melle, Ingrid

    2013-01-01

    Objective To examine which subgroups of DSM-IV bipolar disorder (BD) [BD type I (BD-I) or BD type II (BD-II), and subgroups based on history of psychosis, presenting polarity, and age at onset] differentiate best regarding neurocognitive measures. Methods A total of 199 patients with BD were characterized by clinical and neurocognitive features. The distribution of subgroups in this sample was: BD-I, 64% and BD-II, 36%; 60% had a history of psychosis; 57% had depression as the presenting pola...

  13. Comorbid Bipolar Affective Disorder and Obsessive Compulsive Disorder in Childhood: A Case Study and Brief Review

    OpenAIRE

    Jana, Amlan K.; Samir Kumar Praharaj; Vinod Kumar Sinha

    2012-01-01

    Obsessive compulsive disorder and bipolar affective disorder in the pediatric population show a bidirectional overlap. Few studies that have addressed this issue show that the prevalence of obsessive compulsive disorder in bipolar affective disorder patients ranges from 0 to 54%, and 1.85 to 36% of the obsessive compulsive disorder patients have a comorbid bipolar affective disorder. We report a case of a patient with an onset of obsessive compulsive disorder at two-and-a-half years of age, w...

  14. Co-morbid disorders and sexual risk behavior in Nigerian adolescents with bipolar disorder

    OpenAIRE

    Bakare, Muideen O; Agomoh, Ahamefule O; Ebigbo, Peter O; Onyeama, Gabriel M; Eaton, Julian; Onwukwe, Jojo U; Okonkwo, Kevin O

    2009-01-01

    Background Adolescent onset bipolar disorder often presents with co-morbid disorders of which psychoactive substance use disorders are notable. Mania symptoms and co-morbid psychoactive substance use disorders prone adolescents with bipolar disorder to impulsivity, impaired judgment, and risk taking behavior which often includes sexual risk behavior. There are dearth of information on pattern of co-morbid disorders and sexual risk behavior in adolescent onset bipolar disorder in Nigeria. This...

  15. Lower switch rate in depressed patients with bipolar II than bipolar I disorder treated adjunctively with second-generation antidepressants

    NARCIS (Netherlands)

    Altshuler, LL; Suppes, T; Nolen, WA; Leverich, G; Keck, PE; Frye, MA; Kupka, R; McElroy, SL; Grunze, H; Kitchen, CMR; Post, R; Black, D.O.

    2006-01-01

    Objectives: The authors compared the switch rate into hypomania/mania in depressed patients treated with second-generation antidepressants who had either bipolar I or bipolar II disorder. Method: In a 10-week trial, 184 outpatients with bipolar depression (134 with bipolar I disorder, 48 with bipola

  16. Symptom severity of bipolar disorder during the menopausal transition

    OpenAIRE

    Marsh, Wendy K.; Gershenson, Bernice; Rothschild, Anthony J.

    2015-01-01

    Background Little is known about the mood symptom experience of women with bipolar disorder during the menopausal transition (MT). Yet times of rapid hormonal decline, such as the postpartum, are associated with increased risk of severe mood episodes in bipolar disorder, and the MT is a time of increased risk for unipolar depression in women with or without a history of depression. Methods Enrollment included 56 women 40–60 years old diagnosed in the bipolar spectrum who were experiencing men...

  17. Broadening the diagnosis of bipolar disorder: benefits vs. risks

    OpenAIRE

    Strakowski, Stephen M.; Fleck, David E.; MAJ, MARIO

    2011-01-01

    There is considerable debate over whether bipolar and related disorders that share common signs and symptoms, but are currently defined as distinct clinical entities in DSM-IV and ICD-10, may be better characterized as falling within a more broadly defined “bipolar spectrum”. With a spectrum view in mind, the possibility of broadening the diagnosis of bipolar disorder has been proposed. This paper discusses some of the rationale for an expanded diagnostic scheme from both cl...

  18. Polygenic risk scores for schizophrenia and bipolar disorder predict creativity

    NARCIS (Netherlands)

    Power, R.A.; Steinberg, S.; Bjornsdottir, G.; Rietveld, C.A.; Abdellaoui, A.; Nivard, M.M.; Johannesson, M.; Galesloot, T.E.; Hottenga, J.J.; Willemsen, G.; Cesarini, D.; Benjamin, D.J.; Magnusson, P.K.; Ullen, F.; Tiemeier, H.; Hofman, A.; Rooij, F.J. van; Walters, G.B.; Sigurdsson, E.; Thorgeirsson, T.E.; Ingason, A.; Helgason, A.; Kong, A.; Kiemeney, B.; Koellinger, P.; Boomsma, D.I.; Gudbjartsson, D.; Stefansson, H.; Stefansson, K.

    2015-01-01

    We tested whether polygenic risk scores for schizophrenia and bipolar disorder would predict creativity. Higher scores were associated with artistic society membership or creative profession in both Icelandic (P = 5.2 x 10(-6) and 3.8 x 10(-6) for schizophrenia and bipolar disorder scores, respectiv

  19. Premorbid intelligence and educational level in bipolar and unipolar disorders

    DEFF Research Database (Denmark)

    Sørensen, Holger Jelling; Sæbye, Ditte; Urfer-Parnas, Annick;

    2012-01-01

    Registry-based studies have found no or weak associations between premorbid intelligence and the broad entity of affective spectrum disorder, but none of the studies compared bipolar/unipolar subgroups.......Registry-based studies have found no or weak associations between premorbid intelligence and the broad entity of affective spectrum disorder, but none of the studies compared bipolar/unipolar subgroups....

  20. The Enigma of Bipolar Disorder in Children and Adolescents

    Science.gov (United States)

    Hatchett, Gregory T.

    2009-01-01

    In the past decade, there has been a proliferation in the number of children and adolescents diagnosed with bipolar disorder. Except in rare cases, the young people who receive this diagnosis do not meet the strict diagnostic criteria for bipolar disorder I or II in the DSM-IV-TR. Many pediatric psychiatrists insist there are important development…

  1. Olfactocentric Paralimbic Cortex Morphology in Adolescents with Bipolar Disorder

    Science.gov (United States)

    Wang, Fei; Kalmar, Jessica H.; Womer, Fay Y.; Edmiston, Erin E.; Chepenik, Lara G.; Chen, Rachel; Spencer, Linda; Blumberg, Hilary P.

    2011-01-01

    The olfactocentric paralimbic cortex plays a critical role in the regulation of emotional and neurovegetative functions that are disrupted in core features of bipolar disorder. Adolescence is thought to be a critical period in both the maturation of the olfactocentric paralimbic cortex and in the emergence of bipolar disorder pathology. Together,…

  2. Bipolar Disorder: not only in the Brain - immunological aspects

    NARCIS (Netherlands)

    E.M. Knijff (Esther)

    2006-01-01

    textabstractThe main objective of this thesis was to obtain more insight in the role of the immune system in the pathogenesis of bipolar disorder by investigating various aberrancies in the immune system of patients with bipolar disorder. In Chapter 1 some general concepts, important for the per

  3. Effects of erythropoietin on depressive symptoms and neurocognitive deficits in depression and bipolar disorder

    DEFF Research Database (Denmark)

    Miskowiak, Kamilla W; Vinberg, Maj; Harmer, Catherine J;

    2010-01-01

    BACKGROUND: Depression and bipolar disorder are associated with reduced neural plasticity and deficits in memory, attention and executive function. Drug treatments for these affective disorders have insufficient clinical effects in a large group and fail to reverse cognitive deficits. There is thus...... depression and reverses cognitive impairments in these patients and in patients with bipolar disorder in remission. METHODS/DESIGN: The trial has a double-blind, placebo-controlled, parallel-group design. 40 patients with treatment-resistant major depression and 40 patients with bipolar disorder in remission...... a need for more effective treatments which aid cognitive function. Erythropoietin (Epo) is involved in neuroplasticity and is a candidate for future treatment of affective disorders. The investigators have demonstrated that a single dose of Epo improves cognitive function and reduces neurocognitive...

  4. Redox Dysregulation in the Pathophysiology of Schizophrenia and Bipolar Disorder

    DEFF Research Database (Denmark)

    Kulak, Anita; Steullet, Pascal; Cabungcal, Jan-Harry;

    2013-01-01

    Abstract Significance: Schizophrenia (SZ) and bipolar disorder (BD) are classified as two distinct diseases. However, accumulating evidence shows that both disorders share genetic, pathological, and epidemiological characteristics. Based on genetic and functional findings, redox dysregulation due...

  5. Comparing clinical responses and the biomarkers of BDNF and cytokines between subthreshold bipolar disorder and bipolar II disorder

    OpenAIRE

    Tzu-Yun Wang; Sheng-Yu Lee; Shiou-Lan Chen; Yun-Hsuan Chang; Liang-Jen Wang; Po See Chen; Shih-Heng Chen; Chun-Hsien Chu; San-Yuan Huang; Nian-Sheng Tzeng; Chia-Ling Li; Yi-Lun Chung; Tsai-Hsin Hsieh; I Hui Lee; Kao Chin Chen

    2016-01-01

    Patients with subthreshold hypomania (SBP; subthreshold bipolar disorder) were indistinguishable from those with bipolar disorder (BP)-II on clinical bipolar validators, but their analyses lacked biological and pharmacological treatment data. Because inflammation and neuroprogression underlies BP, we hypothesized that cytokines and brain-derived neurotrophic factor (BDNF) are biomarkers for BP. We enrolled 41 drug-naïve patients with SBP and 48 with BP-II undergoing 12 weeks of pharmacologica...

  6. [Disease mongering and bipolar disorder in Japan].

    Science.gov (United States)

    Ihara, Hiroshi

    2011-01-01

    ,600 in 2003. At the same time, antidepressant sales have sextupled, from\\14.5 billion in 1998 to\\87 billion in 2006, according to statistics from GlaxoSmithKline. Recently, the pharmaceutical industry has shifted its focus from depression to bipolar disorder. Historically, Japanese psychiatrists have been familiar with Emil Kraepelin's "manic depressive insanity" (1899), whose definition was much narrower than that of its contemporary counterpart, bipolar disorder. Thus far, perhaps due partly to the reference in Kraepelin's definition of "manic depressive" disorder, Japanese psychiatrists have rather conservatively prescribed mood stabilizers for persons with frequent mood swings. Japanese psychiatrists can learn a great deal from their experience with the aggressive marketing of antidepressants. In the case of depression, over-medication arguably did more harm than good. The same risk exists with bipolar disorder. Disease mongering may occur whenever the interests of a pharmaceutical company exceed the expected benefits from the proposed pharmacotherapy on those affected by the putative bipolar disorder. In cases that are not severe enough for aggressive medication, psychiatrists should propose natural alternatives, such as an alteration of lifestyle and psychotherapy. PMID:22352006

  7. Starting lithium prophylaxis early v. late in bipolar disorder

    DEFF Research Database (Denmark)

    Kessing, Lars Vedel; Vradi, Eleni; Andersen, Per Kragh

    2014-01-01

    BACKGROUND: No study has investigated when preventive treatment with lithium should be initiated in bipolar disorder. AIMS: To compare response rates among patients with bipolar disorder starting treatment with lithium early v. late. METHOD: Nationwide registers were used to identify all patients...... with a diagnosis of bipolar disorder in psychiatric hospital settings who were prescribed lithium during the period 1995-2012 in Denmark (n = 4714). Lithium responders were defined as patients who, following a stabilisation lithium start-up period of 6 months, continued lithium monotherapy without being admitted......-response to lithium compared with the rate for patients starting lithium later (adjusted analyses: first v. later contact: Pbipolar disorder: P

  8. A hybrid KNN-MLP algorithm to diagnose bipolar disorder

    Directory of Open Access Journals (Sweden)

    Mozhgan Mohammad Ghasemi

    2014-12-01

    Full Text Available In this paper an attempt has been made to the other corner of the power of neural networks. According to the neural network in the diagnosis of diseases, we use neural network models for diagnosing bipolar disorder; bipolar disorder is the common disorder of depression mood. We have used two neural network models: MLP & KNN. With different percentages of the implementation of neural network models is discussed. And the error was calculated for each model. We can by using the MLP model achieve an error of 16% for the diagnosis of bipolar disorder.

  9. Terapia comportamental cognitiva para pessoas com transtorno bipolar Cognitive behavioral therapy for bipolar disorders

    OpenAIRE

    Francisco Lotufo Neto

    2004-01-01

    Descrição dos objetivos e principais técnicas da terapia comportamental cognitiva usadas para a psicoterapia das pessoas com transtorno bipolar.Objectives and main techniques of cognitive behavior therapy for the treatment of bipolar disorder patients are described.

  10. Terapia comportamental cognitiva para pessoas com transtorno bipolar Cognitive behavioral therapy for bipolar disorders

    Directory of Open Access Journals (Sweden)

    Francisco Lotufo Neto

    2004-10-01

    Full Text Available Descrição dos objetivos e principais técnicas da terapia comportamental cognitiva usadas para a psicoterapia das pessoas com transtorno bipolar.Objectives and main techniques of cognitive behavior therapy for the treatment of bipolar disorder patients are described.

  11. Subcortical Gray Matter Volume Abnormalities in Healthy Bipolar Offspring: Potential Neuroanatomical Risk Marker for Bipolar Disorder?

    Science.gov (United States)

    Ladouceur, Cecile D.; Almeida, Jorge R. C.; Birmaher, Boris; Axelson, David A.; Nau, Sharon; Kalas, Catherine; Monk, Kelly; Kupfer, David J.; Phillips, Mary L.

    2008-01-01

    A study is conducted to examine the extent to which bipolar disorder (BD) is associated with gray matter volume abnormalities in brain regions in healthy bipolar offspring relative to age-matched controls. Results show increased gray matter volume in the parahippocampus/hippocampus in healthy offspring at genetic risk for BD.

  12. Perturbed reward processing in pediatric bipolar disorder: an antisaccade study.

    Science.gov (United States)

    Mueller, Sven C; Ng, Pamela; Temple, Veronica; Hardin, Michael G; Pine, Daniel S; Leibenluft, Ellen; Ernst, Monique

    2010-12-01

    Pediatric bipolar disorder is a severe and impairing illness. Characterizing the impact of pediatric bipolar disorder on cognitive function might aid in understanding the phenomenology of the disorder. While previous studies of pediatric bipolar disorder have reported deficits in cognitive control and reward behavior, little is understood about how affective processes influence behavioral control. Relative to prior studies using manual-response paradigms, eye movement tasks provide a more precise assessment of reward sensitivity and cognitive and motor control. The current study compares 20 youths with bipolar disorder (mean age = 13.9 years ± 2.22) and 23 healthy subjects (mean age = 13.8 years ± 2.49) on a mixed pro-antisaccade task with monetary incentives. On both types of saccades, participants were presented with three types of incentives: those where subjects can win money, lose money, or neither win nor lose money. Impaired reward processing was found in youths with bipolar disorder relative to controls, particularly on antisaccades. This difference was reflected in lower error rates during incentive trials in the control but not in the bipolar disorder group. By comparison, no group differences were found on prosaccade trials. The results provide further evidence for deficits in cognitive and reward processing in bipolar disorder. PMID:20080923

  13. Rumination in bipolar disorder: a systematic review

    Directory of Open Access Journals (Sweden)

    Érico de M. Silveira Jr.

    2015-09-01

    Full Text Available Objective:To conduct a systematic review of the literature about the symptom of rumination in bipolar disorder (BD.Methods:We searched the MEDLINE (PubMed, ISI Web of Knowledge, PsycINFO, and SciELO databases using the descriptors “rumination” and “bipolar disorder” and no time limits. This strategy yielded 105 references, of which 74 were selected. Inclusion criteria were studies involving patients with BD and the use of at least one validated scale for the assessment of rumination. Review articles were excluded. Seventeen articles were ultimately analyzed and included in the review.Results:Rumination is present in all BD phases, is a stable interepisodic symptom, is associated with symptoms of depression, anxiety, and hypomania, and may occur in response to both positive and negative affect. There is no research on rumination and neurobiological findings in patients with BD.Conclusions:Rumination seems to be independent of mood state, but shows close relationship with it. It is possible that rumination has a negative impact on cognitive and executive functions, particularly inhibitory control. Finally, rumination is an important symptom in both phases of BD, and, therefore, may be a useful target for further exploration as a dimensional domain and a transdiagnostic phenomenon in Research Domain Criteria (RDoC projects.

  14. Prevalence and correlates of eating disorder co-morbidity in patients with bipolar disorder1

    OpenAIRE

    Wildes, Jennifer E.; Marcus, Marsha D.; Fagiolini, Andrea

    2008-01-01

    This study was designed to document eating disorder symptoms in a well-defined sample of patients with bipolar disorder and to evaluate the relationship of current loss of control over eating (LOC) to demographic and clinical features hypothesized to characterize bipolar patients at risk for disordered eating. Eighty-one patients enrolled in the Bipolar Disorder Center for Pennsylvanians provided demographic information and completed the Structured Clinical Interview for DSM-IV Axis I Disorde...

  15. Comorbidity of Anxiety Disorders and Substance Abusewith Bipolar Mood Disorders and Relationship with ClinicalCourse

    OpenAIRE

    Ali Reza Shafiee-Kandjani; Javad Golmirzaei; Salam Bakhshi; Shahrokh Amiri; Mohammad Ali Ghoreishizadeh

    2009-01-01

    "n Objective: Patients with bipolar mood disorder constitute a relatively large number of individuals hospitalized in psychiatric hospitals. This disorder is highly co-morbid with other psychiatric disorders and may effect their clinical course. The goal of this study was to determine the co-occurrence rate of anxiety disorders and substance abuse with bipolar mood disorders and their impact on clinical course. "n Methods: 153 bipolar patients (type I) were selected among the hospitalize...

  16. Problematic boundaries in the diagnosis of bipolar disorder: the interface with borderline personality disorder.

    Science.gov (United States)

    Zimmerman, Mark; Morgan, Theresa A

    2013-12-01

    It is clinically important to recognize both bipolar disorder and borderline personality disorder (BPD) in patients seeking treatment for depression, and it is important to distinguish between the two. The most studied question on the relationship between BPD and bipolar disorder is their diagnostic concordance. Across studies approximately 10 % of patients with BPD had bipolar I disorder and another 10 % had bipolar II disorder. Likewise, approximately 20 % of bipolar II patients were diagnosed with BPD, though only 10 % of bipolar I patients were diagnosed with BPD. While the comorbidity rates are substantial, each disorder is, nonetheless, diagnosed in the absence of the other in the vast majority of cases (80-90 %). In studies examining personality disorders broadly, other personality disorders were more commonly diagnosed in bipolar patients than was BPD. Likewise, the converse is also true: other axis I disorders such as major depression, substance abuse, and post-traumatic stress disorder are more commonly diagnosed in patients with BPD than is bipolar disorder. Studies comparing patients with BPD and bipolar disorder find significant differences on a range of variables. These findings challenge the notion that BPD is part of the bipolar spectrum. While a substantial literature has documented problems with the under-recognition and under-diagnosis of bipolar disorder, more recent studies have found evidence of bipolar disorder over-diagnosis and that BPD is a significant contributor to over-diagnosis. Re-conceptualizing the Diagnostic and Statistical Manual of Mental Disorders, fifth edition, diagnostic criteria for bipolar disorder as a type of test, rather than the final word on diagnosis, shifts the diagnostician from thinking solely whether a patient does or does not have a disorder to considering the risks of false-positive and false-negative diagnoses, and the ease by which each type of diagnostic error can be corrected by longitudinal observation

  17. Antidepressants for bipolar disorder: A meta-analysis of randomized, double-blind, controlled trials

    OpenAIRE

    Zhang, Yingli; Yang, Huan; Yang, Shichang; Liang, Wei; DAI, Ping; Wang, Changhong; Zhang, Yalin

    2013-01-01

    OBJECTIVE: To examine the efficacy and safety of short-term and long-term use of antidepressants in the treatment of bipolar disorder. DATA SOURCES: A literature search of randomized, double-blind, controlled trials published until December 2012 was performed using the PubMed, ISI Web of Science, Medline and Cochrane Central Register of Controlled Trials databases. The keywords “bipolar disorder, bipolar I disorder, bipolar II disorder, bipolar mania, bipolar depression, cyclothymia, mixed ma...

  18. Nosology, epidemiology and pathogenesis of bipolar disorder: Recent approaches

    OpenAIRE

    García Blanco, Ana Cristina; Sierra, Pilar; Livianos Aldana, Lorenzo

    2014-01-01

    Bipolar disorder is a highly prevalent, chronic and deteriorating mental illness that requires medical, psychological and social care for life. Realizing that bipolar disorder is more common than initially thought, the associated disability and the heterogeneity in their clinical presentation, has strengthened the research on this topic. Recent advances in the field of nosology, epidemiology and pathogenesis have begun to unravel some of the complexity of this disorder and have had a marked i...

  19. A hybrid KNN-MLP algorithm to diagnose bipolar disorder

    OpenAIRE

    Mozhgan Mohammad Ghasemi; Mehdi Khalili

    2014-01-01

    In this paper an attempt has been made to the other corner of the power of neural networks. According to the neural network in the diagnosis of diseases, we use neural network models for diagnosing bipolar disorder; bipolar disorder is the common disorder of depression mood. We have used two neural network models: MLP & KNN. With different percentages of the implementation of neural network models is discussed. And the error was calculated for each model. We can by using the MLP model achieve...

  20. ESPECTRA: Searching the Bipolar Spectrum in Eating Disorder patients

    OpenAIRE

    Moreno Ricardo A; Cordas Taki A; Angst Jules; Campos Rodolfo N

    2011-01-01

    Abstract Background Bipolar Disorder (BD) is a chronic, recurrent and highly prevalent illness. Despite the need for correct diagnosis to allow proper treatment, studies have shown that reaching a diagnosis can take up to ten years due to the lack of recognition of the broader presentations of BD. Frequent comorbidities with other psychiatric disorders are a major cause of misdiagnosis and warrant thorough evaluation. Methods/Design ESPECTRA (Occurrence of Bipolar Spectrum Disorders in Eating...

  1. Traumatic Stress Disorders and Risk of Subsequent Schizophrenia Spectrum Disorder or Bipolar Disorder

    DEFF Research Database (Denmark)

    Okkels, Niels; Trabjerg, Betina; Arendt, Mikkel;

    2016-01-01

    OBJECTIVE: Traumatic stress disorders are prevalent in patients with schizophrenia and bipolar disorder. However, there is a lack of prospective longitudinal studies investigating the risk of severe mental illness for people diagnosed with traumatic stress disorders. We aimed to assess if patients...... with acute stress reaction (ASR) or post-traumatic stress disorder (PTSD) are at increased risk of schizophrenia spectrum disorders or bipolar disorder. METHODS: We performed a prospective cohort study covering the entire Danish population including information on inpatient and outpatient mental hospitals...... over 2 decades. Predictors were in- or outpatient diagnoses of ASR or PTSD. We calculated incidence rate ratios (IRR) with 95% CIs of schizophrenia, schizophrenia spectrum disorder, and bipolar disorder. RESULTS: Persons with a traumatic stress disorder had a significantly increased risk...

  2. Visual sensory processing deficits in patients with bipolar disorder revealed through high-density electrical mapping.

    LENUS (Irish Health Repository)

    Yeap, Sherlyn

    2009-11-01

    investigation as a candidate endophenotype for bipolar disorder.

  3. Biomarkers for bipolar disorder: current insights

    Directory of Open Access Journals (Sweden)

    Duong A

    2015-11-01

    Full Text Available Angela Duong,1 Bushra Syed,1 Gustavo Scola2,3 1Department of Pharmacology and Toxicology, 2Department of Psychiatry, University of Toronto, 3Centre for Addiction and Mental Health, Toronto, ON, Canada Abstract: Currently, there exists a lack of definitive diagnostic tools for neuropsychiatric disorders, particularly molecular markers that could help assess the illness and develop more personalized treatments for different disorders. Understanding of the neurobiology and potential novel treatments for bipolar disorder (BD, one of the most complex psychiatric illnesses, remains poor. This review aims to compile the most reproducible findings regarding the molecular, genetic, and structural changes that occur in BD. Neuroimaging studies have indicated alterations in neural circuits, disrupted white matter integrity, alterations in reward activation, and decreased gray matter (GM volume. Genetic studies have identified variations in a number of genes that confer risk for BD development. Studies involving peripheral biomarkers include alterations in the levels of oxidative stress, inflammation, and neurotrophins. These potential molecular markers could be used as tools for diagnosis, to assess illness progression, and to help with the improvement of more specific and personalized treatments for patients with BD. Identification of biologically relevant markers could improve the quality of life of patients with BD and revolutionize public health. Keywords: biomarkers, neuroimaging, neural activation, gene regulation, microRNAs, oxidative stress, inflammation

  4. Commentary on N. Ghaemi's “Hippocratic Psychopharmacology of Bipolar Disorder” Maintenance Treatment in Bipolar Disorder

    OpenAIRE

    Tohen, Mauricio; Lin, Daniel

    2006-01-01

    Bipolar disorder is a chronic recurring condition that is associated with high mortality and severe functional and psychosocial impairments. Treatment strategies that prolong recovery from a mood episode and delay relapse into a new mood episode are essential for long-term improvements in outcomes. Maintenance treatments for bipolar disorder should be evaluated on the strength of the empirical evidence and with the recognition that some treatments may be more effective in preventing relapse i...

  5. Mortality and secular trend in the incidence of bipolar disorder

    DEFF Research Database (Denmark)

    Medici, Clara Reece; Videbech, Poul; Gustafsson, Lea Nørgreen;

    2015-01-01

    BACKGROUND: The world-wide interest in bipolar disorder is illustrated by an exponential increase in publications on the disorder registered in Pubmed since 1990. This inspired an investigation of the epidemiology of bipolar disorder. METHODS: This was a register-based cohort study. All first......-ever diagnoses of bipolar disorder (International Classification of Diseases-10: F31) were identified in the nationwide Danish Psychiatric Central Research Register between 1995 and 2012. Causes of death were obtained from The Danish Register of Causes of Death. Age- and gender standardized incidence rates......, standardized mortality ratio (SMR) and Kaplan-Meier survival estimates were calculated. RESULTS: We identified 15,334 incident cases of bipolar disorder. The incidence rate increased from 18.5/100,000 person-years (PY) in 1995 to 28.4/100,000 PY in 2012. The mean age at time of diagnosis decreased...

  6. Processamento cognitivo "Teoria da Mente" no transtorno bipolar Cognitive "Theory of Mind" processing in bipolar disorder

    Directory of Open Access Journals (Sweden)

    Hélio Anderson Tonelli

    2009-12-01

    Full Text Available OBJETIVO: O transtorno afetivo bipolar está associado ao comprometimento funcional persistente. Apesar de muitas pesquisas demonstrarem que bipolares podem apresentar déficits cognitivos, um número menor de trabalhos avaliou o papel de prejuízos no processamento cognitivo social, a Teoria da Mente (relacionado à capacidade de inferir estados mentais, no aparecimento de sintomas e complicações sociais em bipolares. O objetivo deste trabalho é o de revisar sistemática e criticamente a literatura sobre possíveis alterações do processamento Teoria da Mente no transtorno afetivo bipolar. MÉTODO: Foi realizada uma busca na base de dados Medline por trabalhos publicados em língua inglesa, alemã, espanhola ou portuguesa nos últimos 20 anos, utilizando a frase de busca "Bipolar Disorder"[Mesh] AND "Theory of Mind". Foram procurados por estudos clínicos envolvendo indivíduos bipolares e que empregaram uma ou mais tarefas cognitivas desenvolvidas para a avaliação de habilidades Teoria da Mente. Foram excluídos os relatos de caso e cartas ao editor. A busca inicial resultou em cinco artigos, sendo selecionados quatro. Outros quatro foram também selecionados a partir da leitura dos artigos acima. DISCUSSÃO: Os artigos selecionados avaliaram populações de bipolares adultos e pediátricos, incluindo indivíduos eutímicos, maníacos e deprimidos. A maioria dos trabalhos avaliados sugere que existam prejuízos no processamento Teoria da Mente em portadores de transtorno afetivo bipolar e que estes podem estar por trás dos sintomas e dos déficits funcionais do transtorno afetivo bipolar. CONCLUSÃO: Pesquisas futuras a respeito do tema em questão poderão esclarecer muito acerca do papel das alterações sociocognitivas no surgimento dos sintomas do transtorno afetivo bipolar, bem como ajudar no desenvolvimento de estratégias preventivas e terapêuticas do mesmo.OBJECTIVE: Bipolar disorder is associated to persistent functional

  7. Cognitive-Behavioral Therapy for Rapid Cycling Bipolar Disorder

    Science.gov (United States)

    Reilly-Harrington, Noreen A.; Knauz, Robert O.

    2005-01-01

    This article describes the application of cognitive-behavioral therapy (CBT) to the treatment of rapid cycling bipolar disorder. Between 10% and 24% of bipolar patients experience a rapid cycling course, with 4 or more mood episodes occurring per year. Characterized by nonresponse to standard mood-stabilizing medications, rapid cyclers are…

  8. Cortisol exposure, cognition and clinical course of bipolar disorder

    NARCIS (Netherlands)

    Spijker, Anne Titia

    2012-01-01

    In this dissertation, we aimed to identify the influence of cortisol exposure and cognitive performance on the clinical course of bipolar disorder. Data regarding sociodemographics, disease characteristics and genetic analysis of the cortisol receptors, were collected of 366 patients with bipolar d

  9. Tiagabine in treatment refractory bipolar disorder : a clinical case series

    NARCIS (Netherlands)

    Suppes, T; Chisholm, KA; Dhavale, D; Frye, MA; Atshuler, LL; McElroy, SL; Keck, PE; Nolen, WA; Kupka, R; Denicoff, KD; Leverich, GS; Rush, AJ; Post, RM

    2002-01-01

    Objectives: Anticonvulsants have provided major treatment advances for patients with bipolar disorder. Many of these drugs, including several with proven efficacy in bipolar mania or depression, enhance the activity of the gamma-amino butyric acid (GABA) neurotransmitter system. A new anticonvulsant

  10. Do young adults with bipolar disorder benefit from early intervention?

    DEFF Research Database (Denmark)

    Kessing, Lars Vedel; Hansen, Hanne Vibe; Christensen, Ellen Margrethe;

    2014-01-01

    BACKGROUND: It is unknown whether young adults with bipolar disorder are able to benefit from early intervention combining optimised pharmacological treatment and group psychoeducation. The aim of the present report was to compare the effects of early intervention among patients with bipolar...... disorder aged 18-25 years to that of patients aged 26 years or older. METHODS: Patients were randomised to early treatment in a specialised outpatient mood disorder clinic versus standard care. The primary outcome was risk of psychiatric re-hospitalisation. RESULTS: A total of 158 patients with mania/bipolar...... different, the observed differences of the point estimates was surprisingly larger for young adults suggesting that young adults with bipolar disorder may benefit even more than older adults from early intervention combining pharmacological treatment and group psychoeducation....

  11. Discrete neurocognitive subgroups in fully or partially remitted bipolar disorder

    DEFF Research Database (Denmark)

    Jensen, Johan Høy; Knorr, Ulla; Vinberg, Maj;

    2016-01-01

    BACKGROUND: Neurocognitive impairment in remitted patients with bipolar disorder contributes to functional disabilities. However, the pattern and impact of these deficits are unclear. METHODS: We pooled data from 193 fully or partially remitted patients with bipolar disorder and 110 healthy...... controls. Hierarchical cluster analysis was conducted to determine whether there are discrete neurocognitive subgroups in bipolar disorder. The pattern of the cognitive deficits and the characteristics of patients in these neurocognitive subgroups were examined with analyses of covariance and least...... was cross-sectional which limits inferences regarding the causality of the findings. CONCLUSION: Globally and selectively impaired bipolar disorder patients displayed more functional disabilities than those who were cognitively intact. The present findings highlight a clinical need to systematically screen...

  12. International Society for Bipolar Disorders Task Force on Suicide

    DEFF Research Database (Denmark)

    Schaffer, Ayal; Isometsä, Erkki T; Tondo, Leonardo;

    2015-01-01

    OBJECTIVES: Bipolar disorder is associated with a high risk of suicide attempts and suicide death. The main objective of the present study was to identify and quantify the demographic and clinical correlates of attempted and completed suicide in people with bipolar disorder. METHODS: Within...... the framework of the International Society for Bipolar Disorders Task Force on Suicide, a systematic review of articles published since 1980, characterized by the key terms bipolar disorder and 'suicide attempts' or 'suicide', was conducted, and data extracted for analysis from all eligible articles....... Demographic and clinical variables for which ≥ 3 studies with usable data were available were meta-analyzed using fixed or random-effects models for association with suicide attempts and suicide deaths. There was considerable heterogeneity in the methods employed by the included studies. RESULTS: Variables...

  13. Connection between Genetic and Clinical Data in Bipolar Disorder

    DEFF Research Database (Denmark)

    Mellerup, Erling; Andreassen, Ole; Bennike, Bente;

    2012-01-01

    Complex diseases may be associated with combinations of changes in DNA, where the single change has little impact alone. In a previous study of patients with bipolar disorder and controls combinations of SNP genotypes were analyzed, and four large clusters of combinations were found...... to be significantly associated with bipolar disorder. It has now been found that these clusters may be connected to clinical data....

  14. The role of childhood trauma in bipolar disorders

    OpenAIRE

    Aas, Monica; Henry, Chantal; Andreassen, Ole A; Bellivier, Frank; Melle, Ingrid; Etain, Bruno

    2016-01-01

    This review will discuss the role of childhood trauma in bipolar disorders. Relevant studies were identified via Medline (PubMed) and PsycINFO databases published up to and including July 2015. This review contributes to a new understanding of the negative consequences of early life stress, as well as setting childhood trauma in a biological context of susceptibility and discussing novel long-term pathophysiological consequences in bipolar disorders. Childhood traumatic events are risk factor...

  15. Sleep-wake disturbance in people with interepisode bipolar disorder

    OpenAIRE

    Ng, Ho-yee, Janet; 伍浩沂

    2014-01-01

    Over the past decade, researchers have shifted focus from the manic and depressive episodes to the interepisode period in the study of sleep-wake disturbance in bipolar disorder. The thesis consists of two studies: a systematic review and meta-analysis and a cross-sectional study. The first study aimed to compile and synthesize studies that employed sleep diary, actigraphy, polysomnography, and questionnaires to compare sleep-wake patterns in people with interepisode bipolar disorder or h...

  16. Emotional dysfunction as a marker of bipolar disorders

    OpenAIRE

    Henry, Chantal; Phillips, Mary; Leibenluft, Ellen; M'BAILARA, Katia; Houenou, Josselin; Leboyer, Marion

    2012-01-01

    Background assessment of emotional reactivity, defined as rapid emotional responses to salient environmental events, has been neglected in mood disorders. This article reviews data showing the relevance of using emotional reactivity to better characterize bipolar mood episodes. Method We reviewed clinical data on emotional reactivity during all phases of bipolar disorders (euthymic, manic, mixed and depressive states) and brain-imaging, neurochemical, genetic studies related to emotional reac...

  17. Life events in bipolar disorder: Towards more specific models

    OpenAIRE

    Johnson, Sheri L

    2005-01-01

    This article reviews the evidence concerning life events as a predictor of symptoms within bipolar disorder. First, key methodological issues in this area are described, and criteria used for including studies in this review are defined. Then findings that negative life events predict worse outcomes within bipolar disorder are reviewed. Beyond general studies on relapse, it is important to differentiate predictors of depression from predictors of mania. When severe negative life events occur,...

  18. Broadening the diagnosis of bipolar disorder: benefits vs. risks

    Science.gov (United States)

    STRAKOWSKI, STEPHEN M.; FLECK, DAVID E.; MAJ, MARIO

    2011-01-01

    There is considerable debate over whether bipolar and related disorders that share common signs and symptoms, but are currently defined as distinct clinical entities in DSM-IV and ICD-10, may be better characterized as falling within a more broadly defined “bipolar spectrum”. With a spectrum view in mind, the possibility of broadening the diagnosis of bipolar disorder has been proposed. This paper discusses some of the rationale for an expanded diagnostic scheme from both clinical and research perspectives in light of potential drawbacks. The ultimate goal of broadening the diagnosis of bipolar disorder is to help identify a common etiopathogenesis for these conditions to better guide treatment. To help achieve this goal, bipolar researchers have increasingly expanded their patient populations to identify objective biological or endophenotypic markers that transcend phenomenological observation. Although this approach has and will likely continue to produce beneficial results, the upcoming DSM-IV and ICD-10 revisions will place increasing scrutiny on psychiatry’s diagnostic classification systems and pressure to re-evaluate our conceptions of bipolar disorder. However, until research findings can provide consistent and converging evidence as to the validity of a broader diagnostic conception, clinical expansion to a dimensional bipolar spectrum should be considered with caution. PMID:21991268

  19. The Mood Disorder Questionnaire improves recognition of bipolar disorder in psychiatric care

    OpenAIRE

    Isometsä, Erkki; Suominen, Kirsi; Mantere, Outi; Valtonen, Hanna; Leppämäki, Sami; Pippingsköld, Marita; Arvilommi, Petri

    2003-01-01

    Background We investigated our translation of The Mood Disorder Questionnaire (MDQ) as a screening instrument for bipolar disorder in a psychiatric setting in Finland. Methods In a pilot study for the Jorvi Bipolar Study (JoBS), 109 consecutive non-schizophrenic psychiatric out- and inpatients in Espoo, Finland, were screened for bipolar disorder using the Finnish translation of the MDQ, and 38 of them diagnostically interviewed with the SCID. Results Forty subjects (37%) were positive in the...

  20. Bipolar disorder in general practice: challenges and opportunities.

    Science.gov (United States)

    Piterman, Leon; Jones, Kay M; Castle, David J

    2010-08-16

    General practitioners are involved in the continuing care and shared care of patients with chronic mental illness, including bipolar disorder. Psychiatrists are particularly reliant on GPs to monitor and treat comorbidities as well as the psychiatric condition itself. Management of chronic mental illness is compromised by a number of factors, including problems with diagnosis, physical comorbidity, erratic attendance and poor compliance with treatment. Diagnosis of bipolar disorder is often delayed, and differential diagnoses to be considered include unipolar depression, anxiety disorder, drug and alcohol dependence, personality disorder, attention deficit hyperactivity disorder, and general medical and central nervous system diseases. New Medicare items have been introduced under the Better Access to Mental Health Care initiative. However, uptake for patients with chronic psychiatric illness, including bipolar disorder, is low. Patients with bipolar disorder may be prone to a range of comorbid psychological, social and physical problems, and GPs need to be vigilant to detect and manage comorbidity and social problems as part of the overall plan. This includes assistance with certification for sickness and unemployment benefits. GPs may become involved during crises affecting patients and this may pose significant problems for GPs who need to provide ongoing care following patient discharge from hospital. Despite these difficulties, opportunities exist for GPs to play a vital and ongoing role in the management of patients with bipolar disorder. PMID:20712554

  1. Attention Deficit Hyperactivity Disorder Erroneously Diagnosed and Treated as Bipolar Disorder

    Science.gov (United States)

    Atmaca, Murad; Ozler, Sinan; Topuz, Mehtap; Goldstein, Sam

    2009-01-01

    Objective: There is a dearth of literature on patients erroneously diagnosed and treated for bipolar disorder. Method: The authors report a case of an adult with attention deficit hyperactivity disorder erroneously diagnosed and treated for bipolar disorder for 6 years. At that point, methylphenidate was initiated. The patient was judged to be a…

  2. Cardiovascular risk factors in outpatients with bipolar disorder: a report from the Brazilian Research Network in Bipolar Disorder

    OpenAIRE

    Fabiano A. Gomes; Karla M. Almeida; Pedro V. Magalhães; Caetano, Sheila C.; Márcia Kauer-Sant'Anna; Beny Lafer; Flávio Kapczinski

    2013-01-01

    Objective: Bipolar disorder (BD) is associated with significant morbidity and mortality due to comorbid general medical conditions, particularly cardiovascular disease. This study is the first report of the Brazilian Research Network in Bipolar Disorder (BRN-BD) that aims to evaluate the prevalence and clinical correlates of cardiovascular risk factors among Brazilian patients with BD. Methods: A cross-sectional study of 159 patients with DSM-IV BD, 18 years or older, consecutively recruited ...

  3. Valuing happiness is associated with bipolar disorder.

    Science.gov (United States)

    Ford, Brett Q; Mauss, Iris B; Gruber, June

    2015-04-01

    Although people who experience happiness tend to have better psychological health, people who value happiness to an extreme tend to have worse psychological health, including more depression. We propose that the extreme valuing of happiness may be a general risk factor for mood disturbances, both depressive and manic. To test this hypothesis, we examined the relationship between the extreme valuing of happiness and risk for, diagnosis of, and illness course for bipolar disorder (BD). Supporting our hypothesis, the extreme valuing of happiness was associated with a measure of increased risk for developing BD (Studies 1 and 2), increased likelihood of past diagnosis of BD (Studies 2 and 3), and worse prospective illness course in BD (Study 3), even when controlling for current mood symptoms (Studies 1-3). These findings indicate that the extreme valuing of happiness is associated with and even predicts BD. Taken together with previous evidence, these findings suggest that the extreme valuing of happiness is a general risk factor for mood disturbances. More broadly, what emotions people strive to feel may play a critical role in psychological health.

  4. The Relationship between Bipolar Disorder and Cannabis Use in Daily Life: An Experience Sampling Study

    OpenAIRE

    Elizabeth Tyler; Steven Jones; Nancy Black; Lesley-Anne Carter; Christine Barrowclough

    2015-01-01

    Objectives Although cannabis use is common in bipolar disorder and may contribute to worse clinical outcomes, little is understood about the relationship between this drug and bipolar disorder over the course of daily life. The aim of study was to examine the effect of cannabis on affect and bipolar symptoms in a group of individuals with bipolar disorder. Methods Twenty-four participants with bipolar disorder type I or type II completed diaries for 6 days using Experience Sampling Methodolog...

  5. Allostasis as a conceptual framework linking Bipolar Disorder and Addiction

    Directory of Open Access Journals (Sweden)

    Mauro ePettorruso

    2014-12-01

    Full Text Available Bipolar disorders and addictions constitute reciprocal risk factors and are best considered under a unitary perspective. The concepts of allostasis and allostatic load may contribute to the understanding of the complex relationships between bipolar disorder and addictive behaviors. Allostasis entails the safeguarding of reward function stability by recruitment of changes in the reward and stress system neurocircuitry and it may help to elucidate neurobiological underpinnings of vulnerability to addiction in bipolar patients. Conceptualizing bipolar disorder as an illness involving the cumulative build-up of allostatic states, we hypothesize a progressive dysregulation of reward circuits clinically expressed as negative affective states (i.e. anhedonia. Such negative affective states may render bipolar disorder patients more vulnerable to drug addiction, fostering a very rapid transition from occasional drug use to addiction, through mechanisms of negative reinforcement. The resulting addictive behavior-related allostatic loads, in turn, may contribute to illness progression. This framework could have a heuristic value to enhance research on pathophysiology and treatment of bipolar disorder and addiction comorbidity.

  6. Can risk-taking be an endophenotype for bipolar disorder? A study on patients with bipolar disorder type I and their first-degree relatives.

    Science.gov (United States)

    Hıdıroğlu, Ceren; Demirci Esen, Özlem; Tunca, Zeliha; Neslihan Gűrz Yalçìn, Sehnaz; Lombardo, Lauren; Glahn, David C; Özerdem, Ayşegül

    2013-04-01

    Risk-taking behavior and impulsivity are core features of bipolar disorder. Whether they are part of the inherited aspect of the illness is not clear. We aimed to evaluate risk-taking behavior as a potential endophenotype for bipolar disorders, and its relationship with impulsivity and illness features. The Balloon Analogue Risk Task (BART) and Barratt Impulsiveness Scale-11 (BIS-11) were used to assess risk-taking behavior and impulsivity respectively in 30 euthymic bipolar I patients (BD), their 25 asymptomatic first-degree relatives (BD-R), and 30 healthy controls (HC). The primary BART outcome measure was the behavioral adjustment score (number of pumps after trials where the balloon did not pop minus the number of pumps after trials where the balloon popped). BD (p < .001) and BD-R (p = .001) had similar and significantly lower adjustment scores than HC. Only BD scored significantly higher on BIS-11 total (p = .01) and motor (p = .04) subscales than HC. Neither the BART, nor impulsivity scores associated with illness features. A limitation of this study is medicated patients and a heterogeneous BD-R were included. Riskiness may be a candidate endophenotype for bipolar disorder as it appears independently from illness features, presents similarly in BD and BD-R groups and differs from impulsivity. PMID:23410848

  7. Obsessive-Compulsive-Bipolar Disorder Comorbidity: A Case Report

    Directory of Open Access Journals (Sweden)

    João Pedro Ribeiro

    2013-12-01

    Full Text Available Anxiety disorders have been described as features of Bipolar Disorder (BD, and Obsessive-compulsive-bipolar disorder (OCBD may occur in as many as 56% of obsessive-compulsive patients. Mania in Obsessive-Compulsive Disorder (OCD can occur either as an independent comorbidity or as a result of an antidepressant-induced switch. We report the case of a 38-year-old male with a 3 year diagnosis of OCD treated with antidepressants, admitted due to a manic episode, and describe diagnostic and treatment challenges of this comorbidity.

  8. Impulsivity and risk taking in bipolar disorder and schizophrenia.

    Science.gov (United States)

    Reddy, L Felice; Lee, Junghee; Davis, Michael C; Altshuler, Lori; Glahn, David C; Miklowitz, David J; Green, Michael F

    2014-01-01

    Impulsive risk taking contributes to deleterious outcomes among clinical populations. Indeed, pathological impulsivity and risk taking are common in patients with serious mental illness, and have severe clinical repercussions including novelty seeking, response disinhibition, aggression, and substance abuse. Thus, the current study seeks to examine self-reported impulsivity (Barratt Impulsivity Scale) and performance-based behavioral risk taking (Balloon Analogue Risk Task) in bipolar disorder and schizophrenia. Participants included 68 individuals with bipolar disorder, 38 with schizophrenia, and 36 healthy controls. Self-reported impulsivity was elevated in the bipolar group compared with schizophrenia patients and healthy controls, who did not differ from each other. On the risk-taking task, schizophrenia patients were significantly more risk averse than the bipolar patients and controls. Aside from the diagnostic group differences, there was a significant effect of antipsychotic (AP) medication within the bipolar group: bipolar patients taking AP medications were more risk averse than those not taking AP medications. This difference in risk taking because of AP medications was not explained by history of psychosis. Similarly, the differences in risk taking between schizophrenia and bipolar disorder were not fully explained by AP effects. Implications for clinical practice and future research are discussed. PMID:23963117

  9. Bipolar and related disorders in DSM-5 and ICD-10.

    Science.gov (United States)

    Kaltenboeck, Alexander; Winkler, Dietmar; Kasper, Siegfried

    2016-08-01

    Bipolar disorders are a group of psychiatric disorders with profound negative impact on affected patients. Even if their symptomatology has long been recognized, diagnostic criteria have changed over time and diagnosis often remains difficult. The Fifth Edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), issued in May 2013, comprises several changes regarding the diagnosis of bipolar disorders compared to the previous edition. Diagnostic categories and criteria for bipolar disorders show some concordance with the internationally also widely used Tenth Edition of the International Statistical Classification of Diseases and Related Health Problems (ICD-10). However, there are also major differences that are worth highlighting. The aim of the following text is to depict and discuss those. PMID:27378177

  10. Genética do transtorno bipolar Genetics of bipolar disorder

    Directory of Open Access Journals (Sweden)

    Leandro Michelon

    2004-10-01

    Full Text Available O Transtorno bipolar (TB possui alta prevalência na população mundial e causa perdas significativas na vida dos portadores. É uma doença cuja herança genética se caracteriza por mecanismos complexos de transmissão envolvendo múltiplos genes. Na tentativa de identificar genes de vulnerabilidade para o TB, várias estratégias de investigação genética têm sido utilizadas. Estudos de ligação apontam diversas regiões cromossômicas potencialmente associadas ao TB, cujos marcadores ou genes podem ser candidatos para os estudos de associação. Genes associados aos sistemas monoaminérgicos e vias de sinalização intracelulares são candidatos para investigação da etiologia genética do TB. Novas técnicas de mapeamento de expressão gênica em tecidos especializados apontam para novos genes cujas mutações possam ser responsáveis pelo aparecimento da doença. Em virtude da complexidade do modo de transmissão do TB e de sua heterogeneidade fenotípica, muitas dificuldades são encontradas na determinação desses genes de vulnerabilidade. Até o momento, há apenas resultados preliminares identificando alguns genes associados à vulnerabilidade para desenvolver o TB. Entretanto, a compreensão crescente dos mecanismos epigenéticos de controle da expressão gênica e a abordagem dimensional dos transtornos mentais podem colaborar nas investigações futuras em genética psiquiátrica.Bipolar disorder (BD is a worldwide highly prevalent mental disease. This disorder has a genetic inheritance characterized by complex transmission mechanisms involving multiple genes. Many investigation strategies have been put forward in order to identify BD susceptibility genes. Linkage studies reveal markers and candidate genes for the association studies. Monoaminergic system genes and intracellular signaling pathway genes are also important candidates to be investigated in the etiology of this disorder. Recent techniques of gene expression

  11. Update on schizophrenia and bipolar disorder: focus on cariprazine

    Directory of Open Access Journals (Sweden)

    Roberts RJ

    2016-07-01

    Full Text Available Rona Jeannie Roberts,1 Lillian Jan Findlay,2 Peggy L El-Mallakh,2 Rif S El-Mallakh1 1Mood Disorders Research Program, Department of Psychiatry and Behavioral Sciences, University of Louisville School of Medicine, Louisville, 2School of Nursing, University of Kentucky, Lexington, KY, USA Abstract: Schizophrenia and bipolar disorder are severe psychiatric disorders that are frequently associated with persistent symptoms and significant dysfunction. While there are a multitude of psychopharmacologic agents are available for treatment of these illnesses, suboptimal response and significant adverse consequences limit their utility. Cariprazine is a new, novel antipsychotic medication with dopamine D2 and D3 partial agonist effects. Its safety and efficacy have been investigated in acute psychosis of schizophrenia, bipolar mania, bipolar depression, and unipolar depression. Efficacy has been demonstrated in schizophrenia and mania. It is unclear if cariprazine is effective in depression associated with unipolar or bipolar illness. Adverse consequences include extrapyramidal symptoms including akathisia, and various gastrointestinal symptoms. The US Food and Drug Administration (FDA has recently approved cariprazine. This review will provide clinicians with basic information regarding the research program of cariprazine. Keywords: cariprazine, dopamine D3 receptor, dopamine D2 receptor, bipolar disorder, mania, bipolar depression, schizophrenia

  12. [Dementia and bipolar disorder on the borderline of old age].

    Science.gov (United States)

    Kontis, D; Theochari, I; Tsalta, E

    2013-01-01

    Dementia and bipolar disorder have been traditionally considered two separate clinical entities. However, recent preclinical and clinical data in elderly people suggest that they are in fact related. Several theories have been put forward to interpret their relationship which could be summed up as follows: (1) Dementia could increase the risk for the emergence of bipolar symptoms, or (2) conversely, bipolar disorder might be associated with heightened risk for developing pseudodementia or dementia. (3) Alternatively, dementia, other brain diseases or drugs affecting brain function could lead to the combination of symptoms of dementia and bipolar disorder in elderly individuals. The two disorders demonstrate similarities with respect to their clinical expression (agitation, psychotic, mood and cognitive symptoms) and structural brain neuroimaging (enlarged lateral ventricles and white matter hyperintensities using magnetic resonance imaging-MRI). Despite the above similarities, the two disorders also have important differences. As expected, cognitive symptoms prevail in dementia and mood symptoms in bipolar disorder. In dementia but not in bipolar disorder there is evidence that brain structural abnormalities are diffuse and hippocampal volumes are smaller. Dementia and bipolar disorder present different abnormalities in functional brain neuroimaging. The pattern of "ventral" hyperactivity and "dorsal" hypoactivity in brain emotional circuits at rest is revealed in bipolar disorder but not dementia. With respect to their treatment, acetylcholinesterase inhibitors and memantine are indicated against cognitive symptoms in dementia and also improve behavioural and psychological symptoms appearing during the course of dementia. Lithium, anticonvulsants, antipsychotics and antidepressants are effective in the management of the acute episodes of bipolar disorder of younger adults, but there are not yet evidence-based data in elderly bipolar patients. It is likely that the

  13. Neuroimaging findings in late-onset schizophrenia and bipolar disorder.

    Science.gov (United States)

    Hahn, Changtae; Lim, Hyun Kook; Lee, Chang Uk

    2014-03-01

    In recent years, there has been an increasing interest in late-onset mental disorders. Among them, geriatric schizophrenia and bipolar disorder are significant health care risks and major causes of disability. We discussed whether late-onset schizophrenia (LOS) and late-onset bipolar (LOB) disorder can be a separate entity from early-onset schizophrenia (EOS) and early-onset bipolar (EOB) disorder in a subset of late-life schizophrenia or late-life bipolar disorder through neuroimaging studies. A literature search for imaging studies of LOS or LOB was performed in the PubMed database. Search terms used were "(imaging OR MRI OR CT OR SPECT OR DTI OR PET OR fMRI) AND (schizophrenia or bipolar disorder) AND late onset." Articles that were published in English before October 2013 were included. There were a few neuroimaging studies assessing whether LOS and LOB had different disease-specific neural substrates compared with EOS and EOB. These researches mainly observed volumetric differences in specific brain regions, white matter hyperintensities, diffusion tensor imaging, or functional neuroimaging to explore the differences between LOS and LOB and EOS and EOB. The aim of this review was to highlight the neural substrates involved in LOS and LOB through neuroimaging studies. The exploration of neuroanatomical markers may be the key to the understanding of underlying neurobiology in LOS and LOB. PMID:24401535

  14. Basic Principles of Interpersonal Social Rhythm Therapy in Bipolar Disorder

    Directory of Open Access Journals (Sweden)

    Gokben Hizli Sayar

    2014-08-01

    Full Text Available Interpersonal Social Rhythm Therapy is a psychotherapy modality that helps the patient recognize the relationship between disruptions in social rhythms and the onset of previous episodes of psychiatric disorders. It uses psychoeducation and behavioral techniques to maintain social rhythm and sleep/wake regularity. It is closely related to and ldquo;social zeitgeber theory and rdquo; that emphasizes the importance that social rhythm regularity may play in synchronization of circadian rhythms in individuals with or at risk for bipolar spectrum disorders. Interpersonal and social rhythm therapy have been shown to stabilize social rhythms and enhance course and outcome in bipolar disorder. This review focuses on the theoretical principles and the basic steps of interpersonal and social rhythm therapy as a psychotherapy approach in bipolar disorder. PubMed, Scopus, Google Scholar databases were searched without temporal restriction. Search terms included interpersonal social rhythm therapy, bipolar, mood disorders. Abstracts were reviewed for relevance, and randomized controlled trials of interpersonal and social rhythm therapy in bipolar disorder selected. These researches also summarized on the final part of this review. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2014; 6(4.000: 438-446

  15. Update on schizophrenia and bipolar disorder: focus on cariprazine.

    Science.gov (United States)

    Roberts, Rona Jeannie; Findlay, Lillian Jan; El-Mallakh, Peggy L; El-Mallakh, Rif S

    2016-01-01

    Schizophrenia and bipolar disorder are severe psychiatric disorders that are frequently associated with persistent symptoms and significant dysfunction. While there are a multitude of psychopharmacologic agents are available for treatment of these illnesses, suboptimal response and significant adverse consequences limit their utility. Cariprazine is a new, novel antipsychotic medication with dopamine D2 and D3 partial agonist effects. Its safety and efficacy have been investigated in acute psychosis of schizophrenia, bipolar mania, bipolar depression, and unipolar depression. Efficacy has been demonstrated in schizophrenia and mania. It is unclear if cariprazine is effective in depression associated with unipolar or bipolar illness. Adverse consequences include extrapyramidal symptoms including akathisia, and various gastrointestinal symptoms. The US Food and Drug Administration (FDA) has recently approved cariprazine. This review will provide clinicians with basic information regarding the research program of cariprazine. PMID:27524901

  16. Update on schizophrenia and bipolar disorder: focus on cariprazine

    Science.gov (United States)

    Roberts, Rona Jeannie; Findlay, Lillian Jan; El-Mallakh, Peggy L; El-Mallakh, Rif S

    2016-01-01

    Schizophrenia and bipolar disorder are severe psychiatric disorders that are frequently associated with persistent symptoms and significant dysfunction. While there are a multitude of psychopharmacologic agents are available for treatment of these illnesses, suboptimal response and significant adverse consequences limit their utility. Cariprazine is a new, novel antipsychotic medication with dopamine D2 and D3 partial agonist effects. Its safety and efficacy have been investigated in acute psychosis of schizophrenia, bipolar mania, bipolar depression, and unipolar depression. Efficacy has been demonstrated in schizophrenia and mania. It is unclear if cariprazine is effective in depression associated with unipolar or bipolar illness. Adverse consequences include extrapyramidal symptoms including akathisia, and various gastrointestinal symptoms. The US Food and Drug Administration (FDA) has recently approved cariprazine. This review will provide clinicians with basic information regarding the research program of cariprazine. PMID:27524901

  17. Circadian Phase Preference in Pediatric Bipolar Disorder

    Directory of Open Access Journals (Sweden)

    Kerri L. Kim

    2014-03-01

    Full Text Available Pediatric bipolar disorder (BD rates have notably increased over the past three decades. Given the significant morbidity and mortality associated with BD, efforts are needed to identify factors useful in earlier detection to help address this serious public health concern. Sleep is particularly important to consider given the sequelae of disrupted sleep on normative functioning and that sleep is included in diagnostic criteria for both Major Depressive and Manic Episodes. Here, we examine one component of sleep—i.e., circadian phase preference with the behavioral construct of morningness/eveningness (M/E. In comparing 30 BD and 45 typically developing control (TDC participants, ages 7–17 years, on the Morningness-Eveningness Scale for Children (MESC, no between-group differences emerged. Similar results were found when comparing three groups (BD−ADHD; BD+ADHD; TDC. Consistent with data available on circadian phase preference in adults with BD, however, we found that BD adolescents, ages 13 years and older, endorsed significantly greater eveningness compared to their TDC peers. While the current findings are limited by reliance on subjective report and the high-rate of comorbid ADHD among the BD group, this finding that BD teens demonstrate an exaggerated shift towards eveningness than would be developmentally expected is important. Future studies should compare the circadian rhythms across the lifespan for individuals diagnosed with BD, as well as identify the point at which BD youth part ways with their healthy peers in terms of phase preference. In addition, given our BD sample was overall euthymic, it may be that M/E is more state vs. trait specific in latency age youth. Further work would benefit from assessing circadian functioning using a combination of rating forms and laboratory-based measures. Improved understanding of sleep in BD may identify behavioral targets for inclusion in prevention and intervention protocols.

  18. Three times more days depressed than manic or hypomanic in both bipolar I and bipolar II disorder

    NARCIS (Netherlands)

    Kupka, Ralph W.; Altshuler, Lori L.; Nolen, Willem A.; Suppes, Trisha; Luckenbaugh, David A.; Leverich, Gabriele S.; Frye, Mark A.; Keck, Paul E.; McElroy, Susan L.; Grunze, Heinz; Post, Robert M.

    2007-01-01

    Objectives: To assess the proportion of time spent in mania, depression and euthymia in a large cohort of bipolar subjects studied longitudinally, and to investigate depression/mania ratios in patients with bipolar I versus bipolar II disorder. Methods: Clinician-adjusted self-ratings of mood were c

  19. Profile of moral reasoning in persons with bipolar affective disorder

    OpenAIRE

    Epa, Roksana; Czyżowska, Natalia; Dudek, Dominika; Siwek, Marcin; Gierowski, Józef Krzysztof

    2014-01-01

    Aim: The subject of the research presented in this paper was to analyze the relationships between bipolar disorder (BD) and the profile of moral reasoning according to the concept of James Rest. Material and methods: 86 persons took part in the research, including 43 bipolar patients and 43 healthy individuals. To measure the severity of depression and mania symptoms the following scales were used: Hamilton Rating Scale for Depression (HAM-D), Montgomery-Asberg Depression Rating Scale (MAD...

  20. Bifurcation analysis of parametrically excited bipolar disorder model

    Science.gov (United States)

    Nana, Laurent

    2009-02-01

    Bipolar II disorder is characterized by alternating hypomanic and major depressive episode. We model the periodic mood variations of a bipolar II patient with a negatively damped harmonic oscillator. The medications administrated to the patient are modeled via a forcing function that is capable of stabilizing the mood variations and of varying their amplitude. We analyze analytically, using perturbation method, the amplitude and stability of limit cycles and check this analysis with numerical simulations.

  1. Can cycles of chills and fever resolve bipolar disorder mania?

    Science.gov (United States)

    Setsaas, Audun; Vaaler, Arne Einar

    2014-01-01

    Treatment resistance is common in populations of patients with bipolar disorder stressing the need for new therapeutic strategies. Favourable effects of fever on mental disease have been noted throughout history. Today there is increasing evidence that immunological processes are involved in the pathophysiology of mental disorders. We present a case in which a patient with treatment resistant bipolar disorder mania seemingly recovered as a result of recurrent fever. This indicates that artificial fever might become a last resort therapy for treatment resistant mania. PMID:24728894

  2. Correlates of current suicide risk among Thai patients with bipolar I disorder: findings from the Thai Bipolar Disorder Registry

    Directory of Open Access Journals (Sweden)

    Suttajit S

    2013-11-01

    Full Text Available Sirijit Suttajit,1 Suchat Paholpak,2 Somrak Choovanicvong,3 Khanogwan Kittiwattanagul,4 Wetid Pratoomsri,5 Manit Srisurapanont1On behalf of the Thai Bipolar Registry Group1Department of Psychiatry, Chiang Mai University, Chiang Mai, 2Department of Psychiatry, Khon Kaen University, Khon Kaen, 3Srithanya Hospital, Nonthaburi, 4Khon Kaen Rajanagarindra Psychiatric Hospital, Khon Kaen, 5Chachoengsao Hospital, Chachoengsao, ThailandBackground: The Thai Bipolar Disorder Registry was a prospective, multisite, naturalistic study conducted in 24 hospitals across Thailand. This study aimed to examine the correlates of current suicide risk in Thai patients with bipolar I disorder.Methods: Participants were adult inpatients or outpatients with bipolar disorder, based on the Diagnosis and Statistical Manual of Mental Disorders, fourth edition. All were assessed by using the Mini International Neuropsychiatric Interview (MINI, version 5. The severity of current suicide risk was determined by using the total score of the MINI suicidality module. Mood symptoms were assessed by using the Young Mania Rating Scale and the Montgomery Asberg Depression Rating Scale.Results: The data of 383 bipolar I disorder patients were included in the analyses. Of these, 363 (94.8% were outpatients. The mean (standard deviation of the MINI suicide risk score was 1.88 (5.0. The demographic/clinical variables significantly associated with the MINI suicide risk scores included age, number of overall previous episodes, the Young Mania Rating Scale score, the Montgomery Asberg Depression Rating Scale scores, and the Clinical Global Impression Severity of Illness Scale for Bipolar Disorder mania score, depression score, and overall score. The variables affecting the differences of suicide risk scores between or among groups were type of first mood episode, a history of rapid cycling, anxiety disorders, and alcohol use disorders. The stepwise multiple linear regression model revealed

  3. Urbanicity during upbringing and bipolar affective disorders in Denmark

    DEFF Research Database (Denmark)

    Pedersen, Carsten Bøcker; Mortensen, Preben Bo

    2006-01-01

    disorder. Conclusions: We found no evidence of a dose-response relationship between urbanicity at birth (and during upbringing) and the risk of bipolar affective disorders in Denmark, but found some evidence that the diagnostic practices used in Aarhus differed from the rest of Denmark...

  4. Inflammatory Monocytes in Bipolar Disorder and Related Endocrine Autoimmune Diseases

    NARCIS (Netherlands)

    R.C. Padmos (Roos)

    2009-01-01

    textabstractBipolar disorder (also called manic-depressive illness) is one of the major mood disorders. The term manic-depressive illness was introduced by Emil Kraepelin (1856-1926) in the late nineteenth century.1 It is in most patients a chronic illness with recurrent manic and depressive episode

  5. The Role of Family Functioning in Bipolar Disorder in Families

    Science.gov (United States)

    Du Rocher Schudlich, Tina D.; Youngstrom, Eric A.; Calabrese, Joseph R.; Findling, Robert L.

    2008-01-01

    Investigated the association between family functioning and conflict and their links with mood disorder in parents and with children's risk for bipolar disorder. Participants were 272 families with a child between the ages of 5-17 years. Parents' history of psychiatric diagnoses and children's current diagnoses were obtained via semi-structured…

  6. Bipolar disorder and the pseudoautosomal region: An association study

    Energy Technology Data Exchange (ETDEWEB)

    Parsian, A.; Todd, R.D. [Washington Univ. School of Medicine, St. Louis, MO (United States)

    1994-03-15

    From family, adoption, and twin studies it is clear that genetic factors play an important role in the etiology of bipolar disorder (McGuffin and Katz: The Biology of Depression, Gaskell, London, 1986). Recently Yoneda et al. reported an association between an allele (A4) of a VNTR marker (DXYS20) for the pseudoautosomal region and bipolar disorder in a Japanese population. In order to test for this association in a Caucasian population, we have typed a sample of 52 subjects with bipolar disorder and 61 normal controls. The bipolar subjects are probands of multiple incidence families. The normal controls are an epidemiologically ascertained sample of middle-aged, unrelated individuals. The two groups were matched for sex and ethnic background. There were no significant differences in the allele or genotype frequencies of DXYS20 between the two groups. In particular, there was no significant difference in the frequency of the A4 allele in normal controls and bipolar patients (0.377 vs. 0.317, respectively). The prevalence of the A4 allele in bipolar patients and normal controls was 0.567 and 0.622, respectively. We were not able to replicate the results of the 1992 Yoneda et al. study. 15 refs., 2 tabs.

  7. Is 'bipolar disorder' the brain's autopoietic response to schizophrenia?

    Science.gov (United States)

    Llewellyn, Sue

    2009-10-01

    Evidence is accumulating that schizophrenia and bipolar disorder are related conditions. This paper proposes a particular form of relatedness. If 'schizophrenia' is a mind/brain 'trapped' between waking and dreaming, in a disordered in-between state, then bipolar 'disorder' could actually be an attempt to restore order. The mind/brain is a self-producing, self-organizing system. Autopoiesis applies to such systems. Neuromodulation accomplishes self-organization in the mind/brain. If schizophrenia is a state in-between waking and dreaming, characterized by aminergic/cholinergic interpenetration and dopaminergic imbalance then bipolar 'disorder' could be a modulatory response. This autopoietic reaction may take the form of either aminergic hyperactivity aimed at producing a purer waking state, (precipitating mania in the waking state), or cholinergic hyperactivity aimed at producing a purer dreaming state, (producing depression in the waking state), or both, resulting in rapid cycling bipolar disorder. Thus bipolar activity may be an autopoietic response aimed at restoring differentiation to the in-between state of schizophrenia. PMID:19589644

  8. Family Care giving in Bipolar disorder: Experiences of Stigma.

    Directory of Open Access Journals (Sweden)

    Farshid Shamsaei

    2013-12-01

    Full Text Available Stigma is a serious impediment to the well-being of those who experience it. Many family- caregivers are challenged by the stereotypes and prejudice that result from misconceptions about bipolar disorder.The purpose of this study was to explore the stigma experienced by family caregivers of patients with bipolar disorder.This was a qualitative and phenomenological study. In this study, we selected the family caregivers of patients with bipolar disorder in a psychiatric hospital (Iran using purposive sampling in 2011. By reaching data saturation, the number of participant was 12. Data were gathered through in-depth interviews and analyzed by the "Collaizi" method.Stigma was a pervasive concern to almost all participants. Family caregivers of patients with Bipolar disorders reported feelings and experiences of stigma and were most affected by them. Analysis of the interviews revealed 3 themes: Negative judgment, Shame, Stigmatization and Social Isolation.For a person with bipolar disorder, this illness is associated with the following problems: worse recovery, difficulty accessing health services, receiving poor treatment and support, and difficulty gaining community acceptance. Rejection of people with mental illness might also affect their family caregivers at various levels.

  9. A brief review of exercise, bipolar disorder, and mechanistic pathways

    Science.gov (United States)

    Thomson, Daniel; Turner, Alyna; Lauder, Sue; Gigler, Margaret E.; Berk, Lesley; Singh, Ajeet B.; Pasco, Julie A.; Berk, Michael; Sylvia, Louisa

    2015-01-01

    Despite evidence that exercise has been found to be effective in the treatment of depression, it is unclear whether these data can be extrapolated to bipolar disorder. Available evidence for bipolar disorder is scant, with no existing randomized controlled trials having tested the impact of exercise on depressive, manic or hypomanic symptomatology. Although exercise is often recommended in bipolar disorder, this is based on extrapolation from the unipolar literature, theory and clinical expertise and not empirical evidence. In addition, there are currently no available empirical data on program variables, with practical implications on frequency, intensity and type of exercise derived from unipolar depression studies. The aim of the current paper is to explore the relationship between exercise and bipolar disorder and potential mechanistic pathways. Given the high rate of medical co-morbidities experienced by people with bipolar disorder, it is possible that exercise is a potentially useful and important intervention with regard to general health benefits; however, further research is required to elucidate the impact of exercise on mood symptomology. PMID:25788889

  10. The Mood Disorder Questionnaire improves recognition of bipolar disorder in psychiatric care

    Directory of Open Access Journals (Sweden)

    Leppämäki Sami

    2003-07-01

    Full Text Available Abstract Background We investigated our translation of The Mood Disorder Questionnaire (MDQ as a screening instrument for bipolar disorder in a psychiatric setting in Finland. Methods In a pilot study for the Jorvi Bipolar Study (JoBS, 109 consecutive non-schizophrenic psychiatric out- and inpatients in Espoo, Finland, were screened for bipolar disorder using the Finnish translation of the MDQ, and 38 of them diagnostically interviewed with the SCID. Results Forty subjects (37% were positive in the MDQ screen. In the SCID interview, twenty patients were found to suffer from bipolar disorder, of whom seven (70% of ten patients with bipolar I but only two (20% of ten with bipolar II disorder had been previously clinically correctly diagnosed. The translated MDQ was found internally consistent (alpha 0.79 and a feasible screening tool. Conclusions Bipolar disorder, particularly type II, remains commonly unrecognized in psychiatric settings. The Mood Disorder Questionnaire is a feasible screen for bipolar disorder, which could well be integrated into psychiatric routine practice.

  11. [Psychoeducation and interpersonal and social rhythm therapy for bipolar disorder].

    Science.gov (United States)

    Mizushima, Hiroko

    2011-01-01

    In treating bipolar disorder, specific psychotherapies in adjunct to pharmacotherapy have been shown to be effective in preventing new episodes and treating depressive episodes. Among those, interpersonal and social rhythm therapy (IPSRT) developed by Frank, amalgamation of interpersonal psychotherapy (IPT) with behavioral therapy focused on social rhythm has been shown to be an efficacious adjunct to mediation in preventing new episodes in bipolar I patients and in treating depression in bipolar I arid II disorder. IPSRT has also been shown to enhance total functioning, relationship functioning and life satisfaction among patients with bipolar disorder, even after pretreatment functioning and concurrent depression were covaried. IPSRT was designed to directly address the major pathways to recurrence in bipolar disorder, namely medication nonadherence, stressful life events, and disruptions in social rhythms. IPT, originated by Klerman et al., is a strategic time-limited psychotherapy focused on one or two of four current interpersonal problem areas (ie, grief, interpersonal role disputes, role transitions, and interpersonal dificits). In IPSRT, the fifth problem area "grief for the lost healthy self" has been added in order to promote acceptance of the diagnosis and the need for life-long treatment. Social rhythm therapy is a behavioral approach aiming at increasing regularity of social rhythms using the Social Rhythm Metric (SRM), a chart to record daily social activities including how stimulating they were, developed from observation that disruptions in social rhythms often trigger affective episodes in patients with bipolar disorder. IPSRT also appears to be a promising intervention for a subset of individuals with bipolar II depression as monotherapy for the acute treatment.

  12. Mitochondrial variants in schizophrenia, bipolar disorder, and major depressive disorder.

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    Brandi Rollins

    Full Text Available BACKGROUND: Mitochondria provide most of the energy for brain cells by the process of oxidative phosphorylation. Mitochondrial abnormalities and deficiencies in oxidative phosphorylation have been reported in individuals with schizophrenia (SZ, bipolar disorder (BD, and major depressive disorder (MDD in transcriptomic, proteomic, and metabolomic studies. Several mutations in mitochondrial DNA (mtDNA sequence have been reported in SZ and BD patients. METHODOLOGY/PRINCIPAL FINDINGS: Dorsolateral prefrontal cortex (DLPFC from a cohort of 77 SZ, BD, and MDD subjects and age-matched controls (C was studied for mtDNA sequence variations and heteroplasmy levels using Affymetrix mtDNA resequencing arrays. Heteroplasmy levels by microarray were compared to levels obtained with SNaPshot and allele specific real-time PCR. This study examined the association between brain pH and mtDNA alleles. The microarray resequencing of mtDNA was 100% concordant with conventional sequencing results for 103 mtDNA variants. The rate of synonymous base pair substitutions in the coding regions of the mtDNA genome was 22% higher (p = 0.0017 in DLPFC of individuals with SZ compared to controls. The association of brain pH and super haplogroup (U, K, UK was significant (p = 0.004 and independent of postmortem interval time. CONCLUSIONS: Focusing on haplogroup and individual susceptibility factors in psychiatric disorders by considering mtDNA variants may lead to innovative treatments to improve mitochondrial health and brain function.

  13. Translational research in bipolar disorder: emerging insights from genetically based models

    OpenAIRE

    G. Chen; Henter, ID; Manji, HK

    2010-01-01

    Bipolar disorder (BPD) is characterized by vulnerability to episodic depression and mania and spontaneous cycling. Because of marked advances in candidate-gene and genome-wide association studies, the list of risk genes for BPD is growing rapidly, creating an unprecedented opportunity to understand the pathophysiology of BPD and to develop novel therapeutics for its treatment. However, genetic findings are associated with major unresolved issues, including whether and how risk variance leads ...

  14. Selective DNA Methylation of BDNF Promoter in Bipolar Disorder: Differences Among Patients with BDI and BDII

    OpenAIRE

    D'Addario, Claudio; Dell'Osso, Bernardo; Palazzo, Maria Carlotta; Benatti, Beatrice; Lietti, Licia; Cattaneo, Elisabetta; Galimberti, Daniela; Fenoglio, Chiara; Cortini, Francesca; Scarpini, Elio; Arosio, Beatrice; Di Francesco, Andrea; Di Benedetto, Manuela; Romualdi, Patrizia; Candeletti, Sanzio

    2012-01-01

    The etiology of bipolar disorder (BD) is still poorly understood, involving genetic and epigenetic mechanisms as well as environmental contributions. This study aimed to investigate the degree of DNA methylation at the promoter region of the brain-derived neurotrophic factor (BDNF) gene, as one of the candidate genes associated with major psychoses, in peripheral blood mononuclear cells isolated from 94 patients with BD (BD I=49, BD II=45) and 52 healthy controls. A significant BDNF gene expr...

  15. The role of childhood trauma in bipolar disorders.

    Science.gov (United States)

    Aas, Monica; Henry, Chantal; Andreassen, Ole A; Bellivier, Frank; Melle, Ingrid; Etain, Bruno

    2016-12-01

    This review will discuss the role of childhood trauma in bipolar disorders. Relevant studies were identified via Medline (PubMed) and PsycINFO databases published up to and including July 2015. This review contributes to a new understanding of the negative consequences of early life stress, as well as setting childhood trauma in a biological context of susceptibility and discussing novel long-term pathophysiological consequences in bipolar disorders. Childhood traumatic events are risk factors for developing bipolar disorders, in addition to a more severe clinical presentation over time (primarily an earlier age at onset and an increased risk of suicide attempt and substance misuse). Childhood trauma leads to alterations of affect regulation, impulse control, and cognitive functioning that might decrease the ability to cope with later stressors. Childhood trauma interacts with several genes belonging to several different biological pathways [Hypothalamic-pituitary-adrenal (HPA) axis, serotonergic transmission, neuroplasticity, immunity, calcium signaling, and circadian rhythms] to decrease the age at the onset of the disorder or increase the risk of suicide. Epigenetic factors may also be involved in the neurobiological consequences of childhood trauma in bipolar disorder. Biological sequelae such as chronic inflammation, sleep disturbance, or telomere shortening are potential mediators of the negative effects of childhood trauma in bipolar disorders, in particular with regard to physical health. The main clinical implication is to systematically assess childhood trauma in patients with bipolar disorders, or at least in those with a severe or instable course. The challenge for the next years will be to fill the gap between clinical and fundamental research and routine practice, since recommendations for managing this specific population are lacking. In particular, little is known on which psychotherapies should be provided or which targets therapists should focus

  16. Sleep disturbances in pediatric bipolar disorder: A comparison between Bipolar I and Bipolar NOS

    Directory of Open Access Journals (Sweden)

    Argelinda eBaroni

    2012-03-01

    Full Text Available Introduction: The diagnosis of Bipolar Disorder (BD in youths has been controversial, especially for the subtype BD Not Otherwise Specified (BD-NOS. In spite of growing evidence that sleep is a core feature of BD, few studies characterize and compare sleep disturbances in youth with BD type I (BD-I and BD-NOS. Sleep disturbances are frequently reported in clinical descriptions of children and adolescents with BD, however the reporting of the frequency and characteristics of sleep symptoms in youth with BD NOS and BD I during episodes remain poor. This study compares symptom of sleep disturbance as occurring in manic and depressive episodes in BD I and BD NOS youth using KSADS-PL interview data. The study also addresses whether symptoms of sleep disturbance vary in different age groups. Material and Methods: The sample consisted of 70 children and adolescent outpatients at an urban specialty clinic (42M/28F, 10.8±3.6 years old including 24 BP-I and 46 BP-NOS assessed using K-SADS-PL-parent interview. Results: Sleep disturbances including insomnia and decreased need for sleep were reported by 84.3% of the sample. Enuresis was diagnosed in 27% of sample. There were no significant differences in frequency of sleep symptoms between BD-I and BD-NOS. Regardless of BD subtype, current functioning was negatively correlated with decreased need for sleep but not insomnia, and regardless of BD subtype. Conclusion: The majority of youth with BD presents with sleep symptoms during mood episodes. BD NOS presents with the same proportion of sleep symptoms as BD I in our sample.

  17. Validation of the Italian version of the "Mood Disorder Questionnaire" for the screening of bipolar disorders

    OpenAIRE

    Carpiniello Bernardo; Dell'Osso Bernardo; Murru Andrea; Cadeddu Mariangela; Hardoy Maria; Morosini Pier; Calabrese Joseph R; Carta Mauro

    2005-01-01

    Abstract The study measured the accuracy of the Italian version of the Mood Disorder Questionnaire (MDQ) as a screening instrument for bipolar disorders in a psychiatric setting. Methods 154 consecutive subjects attending the Division of Psychiatry of the University of Cagliari (Italy), were screened for bipolar disorders using the Italian translation of the MDQ, and diagnostically interviewed with the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID) by physicians. Results On ...

  18. Impulsivity, anxiety, and alcohol misuse in bipolar disorder comorbid with eating disorders

    OpenAIRE

    Jen, Andrew; Saunders, Erika FH; Ornstein, Rollyn M; Kamali, Masoud; McInnis, Melvin G.

    2013-01-01

    Background Eating disorders (ED) are noted to occur with bipolar disorder (BD), but relationships between additional comorbidities, clinical correlates, and personality factors common to both remain largely unknown. Methods Using data from the Prechter Longitudinal Study of Bipolar Disorder, we measured the prevalence and demographic factors of comorbid ED with BD, presence of additional comorbidity of anxiety and substance use disorders, psychosis, suicide attempts, mixed symptoms, childhood...

  19. Two methylenetetrahydrofolate reductase gene (MTHFR) polymorphisms, schizophrenia and bipolar disorder

    DEFF Research Database (Denmark)

    Jönsson, Erik G; Larsson, Kristina; Vares, Maria;

    2008-01-01

    disorder. In a replication attempt the MTHFR C677T and A1298C SNPs were analyzed in three Scandinavian schizophrenia case-control samples. In addition, Norwegian patients with bipolar disorder were investigated. There were no statistically significant allele or genotype case-control differences....... The present Scandinavian results do not verify previous associations between the putative functional MTHFR gene polymorphisms and schizophrenia or bipolar disorder. However, when combined with previous studies in meta-analyses there is still evidence for association between the MTHFR C677T polymorphism......Recent meta-analyses of the methylenetetrahydrofolate reductase gene (MTHFR) have suggested association between two of its functional single gene polymorphisms (SNPs; C677T and A1298C) and schizophrenia. Studies have also suggested association between MTHFR C677T and A1298C variation and bipolar...

  20. The Management of Catatonia in Bipolar Disorder with Stimulants

    Directory of Open Access Journals (Sweden)

    Waheed K. Bajwa

    2015-01-01

    Full Text Available Catatonia, while not a rare occurrence in bipolar disorder, has not been widely discussed in the literature. We present a case of a married Caucasian male with a history of bipolar disorder, exhibiting catatonia and experiencing difficulty in day-to-day functioning. He demonstrated impairment in cognition and an inability to organize simple activities of daily life. After exhausting a number of options for medical management, including benzodiazepines, atypical antipsychotics, and amantadine, he only displayed significant clinical improvement with the addition of a stimulant, methylphenidate. In time, the patient saw a complete return to normal functioning. The use of stimulants for catatonia in bipolar disorder may be an interesting and effective option for treatment. While this is not the first time this treatment has been suggested, there is very little data in support of it; our case confirms the discoveries of previous case reports.

  1. Molecular neurobiological clues to the pathogenesis of bipolar disorder.

    Science.gov (United States)

    Harrison, Paul J

    2016-02-01

    Bipolar disorder is a serious psychiatric disorder, with a high heritability and unknown pathogenesis. Recent genome-wide association studies have identified the first loci, implicating genes such as CACNA1C and ANK3. The genes highlight several pathways, notably calcium signalling, as being of importance. Molecular studies suggest that the risk variants impact on gene regulation and expression. Preliminary studies using reprogrammed patient-derived cells report alterations in the transcriptome and in cellular adhesion and differentiation. Mouse models show that genes involved in circadian biology, acting via dopaminergic effects, reproduce aspects of the bipolar phenotype. These findings together represent significant advances in identification of the genetic and molecular basis of bipolar disorder, yet we are still far from an integrated, evidence-based understanding of its aetiopathogenesis.

  2. Effectiveness of Simple Individual Psychoeducation for Bipolar II Disorder.

    Science.gov (United States)

    Saito-Tanji, Yuka; Tsujimoto, Emi; Taketani, Reiko; Yamamoto, Ami; Ono, Hisae

    2016-01-01

    Several studies have proven the effectiveness of psychoeducation in bipolar II disorder patients; however, simpler psychoeducation is needed in daily medical practice. Therefore, we devised a simple individual psychoeducation program, which involved 20-minute sessions spent reading a textbook aloud in the waiting time before examination. Here, we report a successful case of simple individual psychoeducation with a patient with bipolar II disorder, a 64-year-old woman who had misconceptions surrounding her mood due to 24 years of treatment for depression. Her perception of mood state, particularly mixed state, was dramatically changed, and her quality of life was improved after the simple individual psychoeducation. This case suggests that the simple individual psychoeducation could be effective for bipolar II disorder by improving understanding of the disease and by meeting different individual needs. PMID:27559486

  3. Peripheral blood brain-derived neurotrophic factor in bipolar disorder

    DEFF Research Database (Denmark)

    Munkholm, K; Vinberg, M; Kessing, L V

    2016-01-01

    Peripheral blood brain-derived neurotrophic factor (BDNF) has been proposed as a potential biomarker related to disease activity and neuroprogression in bipolar disorder, speculated to mirror alterations in brain expression of BDNF. The research area is rapidly evolving; however, recent...... investigations have yielded conflicting results with substantial variation in outcomes, highlighting the need to critically assess the state of current evidence. The aims of the study were to investigate differences in peripheral blood BDNF concentrations between bipolar disorder patients and healthy control...... subjects and between affective states in bipolar disorder patients, including assessment of the effect of treatment of acute episodes on BDNF levels. A systematic review of English language studies without considering publication status was conducted in PubMed (January 1950-November 2014), Embase (1974...

  4. Two methylenetetrahydrofolate reductase gene (MTHFR) polymorphisms, schizophrenia and bipolar disorder

    DEFF Research Database (Denmark)

    Jönsson, Erik G; Larsson, Kristina; Vares, Maria;

    2008-01-01

    Recent meta-analyses of the methylenetetrahydrofolate reductase gene (MTHFR) have suggested association between two of its functional single gene polymorphisms (SNPs; C677T and A1298C) and schizophrenia. Studies have also suggested association between MTHFR C677T and A1298C variation and bipolar...... disorder. In a replication attempt the MTHFR C677T and A1298C SNPs were analyzed in three Scandinavian schizophrenia case-control samples. In addition, Norwegian patients with bipolar disorder were investigated. There were no statistically significant allele or genotype case-control differences....... The present Scandinavian results do not verify previous associations between the putative functional MTHFR gene polymorphisms and schizophrenia or bipolar disorder. However, when combined with previous studies in meta-analyses there is still evidence for association between the MTHFR C677T polymorphism...

  5. Hypothyroidism and bipolar affective disorder: Is there a connection?

    Directory of Open Access Journals (Sweden)

    Bindu Menon

    2014-01-01

    Full Text Available Context: Hypothalamic-pituitary-thyroid axis dysfunction in the pathophysiology of bipolar disorder has received less attention as compared with that in depressive disorder. Aims: To study the prevalence of hypothyroidism in patients diagnosed with bipolar disorder and compare it with a population norm. Settings and Design: The setting was the psychiatry inpatient unit of a tertiary care hospital. The design was retrospective and observational. Subjects and Methods: A retrospective observational study was performed, referring to the case records of 84 cases of bipolar disorder admitted to the Department of Psychiatry in a Tertiary Referral Center during the year 2010-2012. The prevalence of hypothyroidism both subclinical as demonstrated by elevated thyroid stimulating hormone (TSH levels (cut-off value 4.2 μU/ml and overt hypothyroidism (fasting T4 4.2 μU/ml was calculated. This was compared with the population prevalence of hypothyroidism as determined by an epidemiological study carried out in the year 2009, in the same region. The correlation between hypothyroidism, gender, lithium prophylaxis and family history of mood disorder was computed. Statistical Analysis: Percentage prevalence of hypothyroidism in the sample was calculated and compared to a population norm. The correlation between hypothyroidism, gender, lithium prophylaxis and family history of mood disorder was computed using the odds ratio (OR. Results: The total prevalence of hypothyroidism in both males and females in the bipolar group was comparable with that in the general population. There is a significant association between family history of mood disorder in first degree relatives and patients having hypothyroidism (OR 5.504 and P = 0.012. There were no statistically significant associations between thyroid abnormalities and age, duration of illness and lithium prophylaxis. Conclusions: There is no significant association between hypothyroidism and bipolar disorder

  6. GABAergic neuroactive steroids: a new frontier in bipolar disorders?

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    Carta Mauro Giovanni

    2012-12-01

    Full Text Available Abstract Neurosteroids are synthesized in the brain and modulate brain excitability. There is increasing evidence of their sedative, anesthetic and antiseizure properties, as well as their influence on mood. Currently neurosteroids are classified as pregnane neurosteroids (allopregnanolone and allotetrahydrodeoxycorticosterone, androstane neurosteroids (androstanediol and etiocholanone or sulfated neurosteroids (pregnenolone sulfate and dehydroepiandrosterone sulfate. Both preclinical and clinical findings indicate that progesterone derivative neurosteroids such as allopregnanolone and allotetrahydrodeoxycorticosterone play a role in mood disorders. Clozapine and olanzapine, which were shown to be effective in stabilizing bipolar disorder, elevate pregnenolone levels in rat hippocampus, cerebral cortex, and serum. In lithium-treated mice, the blood levels of allopregnanolone and pregnenolone were elevated compared to control levels. Women diagnosed with bipolar disorder typically show symptomatic exacerbation in relation to the menstrual cycle, and show vulnerability to the onset or recurrence of mood disorders immediately after giving birth, when the levels of neurosteroid derivatives of progesterone drop. Whereas in women who had recovered from bipolar disorder, the plasma concentration of allopregnanolone was elevated compared to either healthy controls or women with major depressive disorder during the premenstrual period. During depressive episodes, blood level of allopregnanolone is low. Treatment with fluoxetine tends to stabilize the levels of neurosteroids in depression. These findings converge to suggest that these steroids have significant mood-stabilizing effect. This hypothesis is consistent with the observation that a number of anticonvulsants are effective therapies for bipolar disorder, a finding also consistent with the antiseizure properties of neurosteroids. Further exploration of action of neuroactive steroids is likely to

  7. Therapy for depression in bipolar affective disorder

    Directory of Open Access Journals (Sweden)

    N. A. Tyuvina

    2016-01-01

    Full Text Available Objective: to evaluate the efficiency and safety of different therapy regimens for depression in relation to the clinical type of bipolar affective disorders (BAD and to choose optimal treatment regimens for depression in BAD type I (BADI and BAD type II (BADII.Patients and methods. A total of 65 depressive patients, including 25 with BADI and 37 with BADII, were examined. 212 depressive episodes were analyzed in BAD patients, of them there were 74 with BADI and 138 with BADII. The patients with BADI took a combination of an antidepressant (AD and a normothymic (NT, NT and a neuroleptic (NL, AD, NT and NL. Those with BADII received monotherapy with AD or NL, a combination of AD + NT, AD + NL. The patients' status was clinically evaluated using a specially designed questionnaire and the MADRS and CGI psychometric scales at baseline and then at the end of 1, 2, 4, and 8 weeks of therapy.Results. The AD-containing regimens used to treat patients with BADI proved to be more effective; this therapy led to a more marked reduction in depressive symptoms (55.73% in the AD + NT-treated patients; 54.07% in the AD + NT + NL group versus 33.64% in the NT + NL-treated patients, a higher response to therapy, and a larger number of remissions by the end of the investigation (80.0, 72.7, and 33.3%, respectively. Moreover, the incidence of transient hypomanic symptoms did not significantly differ in these groups (20.0, 27.3, and 8.3%, respectively. The depressive patients with BADII generally responded better to different therapy regimens (the reduction in depressive symptoms was 52.08, 58.82, 58.40, and 53.98% in the AD, NL, AD + NT, and AD + NL groups; the remission index by the end of the investigation was 60.6, 92.9, 77.8, and 69.2%, respectively; these patients were seen to have less frequently symptoms of an antipole during their treatment (18.2, 7.1, 0.0, and 15.4%, respectively.Conclusion. The incorporation of AD into a therapy regimen in BAD patients

  8. Late life bipolar disorder evolving into frontotemporal dementia mimic

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    Dols A

    2016-09-01

    Full Text Available Annemiek Dols,1 Welmoed Krudop,2 Christiane Möller,2 Kenneth Shulman,3 Martha Sajatovic,4 Yolande AL Pijnenburg2 1Department of Old Age Psychiatry, GGZInGeest, 2Alzheimer Centre and Department of Neurology, Neuroscience Campus Amsterdam, VU University Medical Centre, Amsterdam, the Netherlands; 3Department of Geriatric Psychiatry, Sunnybrook Health Science Centre, Faculty of Medicine, University of Toronto, Toronto, Canada; 4Department of Psychiatry and Neurology, Case Western Reserve University School of Medicine, University Hospitals Case Medical Center, Cleveland, OH, USA Objectives: Although bipolar disorder has been understood classically as a cyclic disease with full recovery between mood episodes, in the last decade, evidence has accumulated supporting progressive features. The clinical picture of advanced or end-stage bipolar disorder is heterogeneous with possible deficits in cognition and behavior, as illustrated by our case series.Cases: From our neuropsychiatric outpatient clinic, we describe four cases with bipolar disorder gradually developing a clinical syndrome, including apathy, disinhibition, loss of empathy, stereotypical behavior, and compulsiveness, fulfilling the criteria for possible behavioral variant frontotemporal dementia. All cases were diagnosed with bipolar 1 disorder at least 10 years before the onset of the current symptoms, which were not due to recent mood episodes or switches of medication. In all cases, 3–7 years of follow-up yielded no progression. Repeated neuroimaging was within normal limits. Cerebrospinal fluid biomarker studies were not supportive of underlying neurodegenerative pathology. C9orf72 mutation status was negative in all cases.Conclusion: Symptoms fitting the criteria for possible behavioral variant frontotemporal dementia may be present in end-stage of bipolar disorder. An alternative neurodegenerative nature seems unlikely based on repeated normal neuroimaging and the absence of clinical

  9. Comorbidity of Anxiety Disorders and Substance Abusewith Bipolar Mood Disorders and Relationship with ClinicalCourse

    Directory of Open Access Journals (Sweden)

    Ali Reza Shafiee-Kandjani

    2009-12-01

    Full Text Available "n Objective: Patients with bipolar mood disorder constitute a relatively large number of individuals hospitalized in psychiatric hospitals. This disorder is highly co-morbid with other psychiatric disorders and may effect their clinical course. The goal of this study was to determine the co-occurrence rate of anxiety disorders and substance abuse with bipolar mood disorders and their impact on clinical course. "n Methods: 153 bipolar patients (type I were selected among the hospitalized patients at Razi Psychiatric Hospital in Tabriz, Iran, from September 2007 to October 2008 through convenience sampling method. The participants were evaluated by a structured clinical interview based on DSM-IV criteria (SCID, Hamilton Rating Scale for Depression (HRSD and Young Mania Rating Scale (YMRS. Results: Co-morbidity of anxiety disorders was 43% . Occurrence of anxiety disorders was 26% for obsessive-compulsive disorder, 24.8% for generalized anxiety disorder, 3.9% for phobia and 2% for panic disorder. Co-morbidity of substance abuse was 7.2% and the highest occurrence of substance abuse was 5.2% for alcoholism and 3.9% for opium. No significant difference was observed between the severity of disease and duration of hospitalization in bipolar patients with or without anxiety disorder. The severity of disease and duration of hospitalization in bipolar patients with substance abuse was higher compared to bipolar patients without substance abuse (P<0.05. "nConclusions: This study suggests that there is a high co-morbidity between anxiety disorders and substance abuse with bipolar disorder. Further, this study suggests that co-occurrence of substance abuse disorder with bipolar disorder increases the severity of the disease and duration of hospitalization.

  10. Bipolar disorder and antithyroid antibodies: review and case series.

    Science.gov (United States)

    Bocchetta, Alberto; Traccis, Francesco; Mosca, Enrica; Serra, Alessandra; Tamburini, Giorgio; Loviselli, Andrea

    2016-12-01

    Mood disorders and circulating thyroid antibodies are very prevalent in the population and their concomitant occurrence may be due to chance. However, thyroid antibodies have been repeatedly hypothesized to play a role in specific forms of mood disorders. Potentially related forms include treatment-refractory cases, severe or atypical depression, and depression at specific phases of a woman's life (early gestation, postpartum depression, perimenopausal). With regard to bipolar disorder, studies of specific subgroups (rapid cycling, mixed, or depressive bipolar) have reported associations with thyroid antibodies. Offspring of bipolar subjects were found more vulnerable to develop thyroid antibodies independently from the vulnerability to develop psychiatric disorders. A twin study suggested thyroid antibodies among possible endophenotypes for bipolar disorder. Severe encephalopathies have been reported in association with Hashimoto's thyroiditis. Cases with pure psychiatric presentation are being reported, the antithyroid antibodies being probably markers of some other autoimmune disorders affecting the brain. Vasculitis resulting in abnormalities in cortical perfusion is one of the possible mechanisms. PMID:26869176

  11. Abordagens psicoterápicas no transtorno bipolar Psychoterapeutic approach in bipolar disorder

    Directory of Open Access Journals (Sweden)

    Paulo Knapp

    2005-01-01

    Full Text Available Embora o tratamento farmacológico seja essencial para o tratamento do transtorno bipolar, apenas 40% de todos os pacientes que aderem às medicações permanecem assintomáticos durante o período de seguimento, o que tem levado ao desenvolvimento de intervenções psicoterápicas associadas. O objetivo deste artigo é examinar as evidências atuais da eficácia de intervenções psicoterápicas no tratamento do transtorno bipolar. Foi realizada uma pesquisa bibliográfica por meio do MedLine, PsychoINFO, Lilacs e Cochrane Data Bank, até o ano de 2004, em que foram procurados artigos originais e revisões sobre as abordagens psicoterápicas utilizadas no tratamento do transtorno bipolar. Há várias abordagens que podem se mostrar úteis no tratamento do transtorno bipolar. A psicoeducação e a terapia cognitivo-comportamental apresentam as evidências mais consistentes e são as técnicas mais amplamente estudadas. As intervenções envolvendo familiares e a terapia interpessoal e de ritmo social se mostram tratamentos eficazes em determinadas situações. Há alguns estudos empregando a terapia psicodinâmica no transtorno bipolar, mas são estudos com limitações metodológicas. Apesar de haver evidências demonstrando a eficácia de determinadas abordagens psicoterápicas no transtorno bipolar, ainda é necessária a realização de estudos posteriores que comprovem tais dados e que desenvolvam tratamentos baseados em modelos etiológicos e que identifiquem tratamentos específicos para as diferentes fases e tipos de transtorno bipolar.Although pharmacological treatment is essential for treating bipolar disorder, less than half of all medication compliant patients are non-symptomatic during follow-up, which has led to developments of adjunctive psychosocial interventions. This paper examines the current evidence for effectiveness of psychotherapeutic interventions in the treatment of bipolar disorder. Searches were undertaken through Med

  12. Neurocognitive profiles in treatment-resistant bipolar I and bipolar II disorder depression

    OpenAIRE

    Kessler, Ute; Schøyen, Helle Kristine; Andreassen, Ole Andreas; Eide, Geir Egil; Hammar, Åsa; Malt, Ulrik Fredrik; Ødegaard, Ketil Joachim; Morken, Gunnar; Sundet, Kjetil Søren; Vaaler, Arne Einar

    2013-01-01

    Background The literature on the neuropsychological profiles in Bipolar disorder (BD) depression is sparse. The aims of the study were to assess the neurocognitive profiles in treatment-resistant, acutely admitted BD depression inpatients, to compare the neurocognitive functioning in patients with BD I and II, and to identify the demographic and clinical illness characteristics associated with cognitive functioning. Met...

  13. Innovative approaches to bipolar disorder and its treatment

    OpenAIRE

    Harrison, Paul J.; Cipriani, Andrea; Harmer, Catherine J.; Nobre, Anna C.; Saunders, Kate; Goodwin, Guy M.; Geddes, John R.

    2016-01-01

    All psychiatric disorders have suffered from a dearth of truly novel pharmacological interventions. In bipolar disorder, lithium remains a mainstay of treatment, six decades since its effects were serendipitously discovered. The lack of progress reflects several factors, including ignorance of the disorder's pathophysiology and the complexities of the clinical phenotype. After reviewing the current status, we discuss some ways forward. First, we highlight the need for a richer characterizatio...

  14. Nationwide and population-based prescription patterns in bipolar disorder

    DEFF Research Database (Denmark)

    Kessing, Lars Vedel; Vradi, Eleni; Andersen, Per Kragh

    2016-01-01

    OBJECTIVES: The aim of the present study was to describe prescription patterns and changes in these patterns over the last decade for patients diagnosed with bipolar disorder in mental healthcare, using population-based and nationwide data, and to relate the findings to recommendations from...... international guidelines. METHODS: A population-based, nationwide study was carried out. It included register-based longitudinal data on all patients with a first-ever contact with mental healthcare with a diagnosis of mania/bipolar disorder from the entire Danish population, and all prescription data...

  15. Synchronization of chaotic and nonchaotic oscillators: Application to bipolar disorder

    Energy Technology Data Exchange (ETDEWEB)

    Nono Dueyou Buckjohn, C., E-mail: bucknono@yahoo.f [Laboratoire de Mecanique, Departement de Physique, Faculte des Sciences, Universite de Yaounde I, B.P. 812 Yaounde (Cameroon); Siewe Siewe, M., E-mail: martinsiewesiewe@yahoo.f [Laboratoire de Mecanique, Departement de Physique, Faculte des Sciences, Universite de Yaounde I, B.P. 812 Yaounde (Cameroon); Tchawoua, C., E-mail: ctchawa@yahoo.f [Laboratoire de Mecanique, Departement de Physique, Faculte des Sciences, Universite de Yaounde I, B.P. 812 Yaounde (Cameroon); Kofane, T.C., E-mail: tckofane@yahoo.co [Laboratoire de Mecanique, Departement de Physique, Faculte des Sciences, Universite de Yaounde I, B.P. 812 Yaounde (Cameroon)

    2010-08-02

    In this Letter, we use a synchronization scheme on two bipolar disorder models consisting of a strong nonlinear system with multiplicative excitation and a nonlinear oscillator without parametric harmonic forcing. The stability condition following our control function is analytically demonstrated using the Lyapunov theory and Routh-Hurwitz criteria, we then have the condition for the existence of a feedback gain matrix. A convenient demonstration of the accuracy of the method is complemented by the numerical simulations from which we illustrate the synchronized dynamics between the two non-identical bipolar disorder patients.

  16. Synchronization of chaotic and nonchaotic oscillators: Application to bipolar disorder

    Science.gov (United States)

    Nono Dueyou Buckjohn, C.; Siewe Siewe, M.; Tchawoua, C.; Kofane, T. C.

    2010-08-01

    In this Letter, we use a synchronization scheme on two bipolar disorder models consisting of a strong nonlinear system with multiplicative excitation and a nonlinear oscillator without parametric harmonic forcing. The stability condition following our control function is analytically demonstrated using the Lyapunov theory and Routh-Hurwitz criteria, we then have the condition for the existence of a feedback gain matrix. A convenient demonstration of the accuracy of the method is complemented by the numerical simulations from which we illustrate the synchronized dynamics between the two non-identical bipolar disorder patients.

  17. Evidence-Based Pharmacologic Treatment of Pediatric Bipolar Disorder.

    Science.gov (United States)

    Findling, Robert L

    2016-01-01

    Pharmacotherapy is an important component of treatment for children and adolescents with bipolar disorder. The body of evidence supporting safe and effective treatments in this population is growing. Available data provide information on the risks and benefits of pharmacologic agents used for acute manic, mixed, and depressive episodes as well as for maintenance treatment. Lithium, anticonvulsants, and antipsychotics comprise the armamentarium for treating pediatric bipolar disorder. When selecting treatment, clinicians must consider the efficacy and side effect profile of potential pharmacotherapies, as well as the patient's history, including the presence of comorbidities, in order to develop a treatment plan that will ensure optimal outcomes. PMID:27570928

  18. Designing Mobile Health Technology for Bipolar Disorder

    DEFF Research Database (Denmark)

    Bardram, JE; Frost, Mads; Szántó, Károly;

    2013-01-01

    An increasing number of pervasive healthcare systems are being designed, that allow people to monitor and get feedback on their health and wellness. To address the challenges of self-management of mental illnesses, we have developed the MONARCA system - a personal monitoring system for bipolar...

  19. Antisocial personality and bipolar disorder: interactions in impulsivity and course of illness

    OpenAIRE

    Swann, Alan C.

    2011-01-01

    Antisocial personality disorder (ASPD) and bipolar disorder are both characterized by impulsive behavior, increased incarceration or arrest, addictive disorders and suicidal behavior. These characteristics appear more severe in the combined disorders. Individuals with ASPD who also have bipolar disorder have higher rates of addictive disorders and suicidal behavior and are more impulsive, as measured by questionnaires or behavioral laboratory tests. Those with bipolar disorder who have ASPD h...

  20. Excessive cannabis use is associated with earlier age at onset in bipolar disorder

    OpenAIRE

    Lagerberg, Trine V; Sundet, Kjetil; Aminoff, Sofie R.; Berg, Akiah O.; Ringen, Petter A.; Ole A. Andreassen; Melle, Ingrid

    2011-01-01

    The aim of the study was to investigate which factors are associated with age at onset in bipolar disorder with a specific focus on excessive alcohol and cannabis use, and the sequence of the onsets of excessive substance use and bipolar disorder. We investigated a naturalistic sample of 151 patients with bipolar I and II disorder receiving psychiatric treatment. Whether the presence of excessive substance use prior to bipolar disorder onset or the type of substance used (alcohol or cannabis)...

  1. Gastroesophageal Reflux Disease and Risk for Bipolar Disorder: A Nationwide Population-Based Study

    OpenAIRE

    Wan-Shan Lin; Li-Yu Hu; Chia-Jen Liu; Chih-Chao Hsu; Cheng-Che Shen; Yen-Po Wang; Yu-Wen Hu; Chia-Fen Tsai; Chiu-Mei Yeh; Pan-Ming Chen; Tung-Ping Su; Tzeng-Ji Chen; Ti Lu

    2014-01-01

    BACKGROUND: Studies have shown that chronic inflammation may play a vital role in the pathophysiology of both gastroesophageal reflux disease (GERD) and bipolar disorder. Among patients with GERD, the risk of bipolar disorder has not been well characterized. OBJECTIVE: We explored the relationship between GERD and the subsequent development of bipolar disorder, and examined the risk factors for bipolar disorder in patients with GERD. METHODS: We identified patients who were diagnosed with GER...

  2. Gender and Depressive Symptoms in 711 Patients With Bipolar Disorder Evaluated Prospectively in the Stanley Foundation Bipolar Treatment Outcome Network

    NARCIS (Netherlands)

    Altshuler, Lori L.; Kupka, Ralph W.; Hellemann, Gerhard; Frye, Mark A.; Sugar, Catherine A.; McElroy, Susan L.; Nolen, Willem A.; Grunze, Heinz; Leverich, Gabriele S.; Keck, Paul E.; Zermeno, Melanie

    2010-01-01

    Objective: The authors assessed gender differences in the proportion of clinical visits spent depressed, manic, or euthymic in patients with bipolar disorder. Method: Data were analyzed from 711 patients with bipolar I or II disorder who were followed prospectively over 7 years (13,191 visits). The

  3. Practice Parameter for the Assessment and Treatment of Children and Adolescents with Bipolar Disorder

    Science.gov (United States)

    Journal of the American Academy of Child and Adolescent Psychiatry, 2007

    2007-01-01

    This practice parameter reviews the literature on the assessment and treatment of children and adolescents with bipolar disorder. The parameter focuses primarily on bipolar 1 disorder because that is the type most often studied in juveniles. The presentation of bipolar disorder in youth, especially children, is often considered atypical compared…

  4. Cardiovascular risk factors in outpatients with bipolar disorder: a report from the Brazilian Research Network in Bipolar Disorder

    Directory of Open Access Journals (Sweden)

    Fabiano A. Gomes

    2013-06-01

    Full Text Available Objective: Bipolar disorder (BD is associated with significant morbidity and mortality due to comorbid general medical conditions, particularly cardiovascular disease. This study is the first report of the Brazilian Research Network in Bipolar Disorder (BRN-BD that aims to evaluate the prevalence and clinical correlates of cardiovascular risk factors among Brazilian patients with BD. Methods: A cross-sectional study of 159 patients with DSM-IV BD, 18 years or older, consecutively recruited from the Bipolar Research Program (PROMAN in São Paulo and the Bipolar Disorder Program (PROTAHBI in Porto Alegre. Clinical, demographic, anthropometric, and metabolic variables were systematically assessed. Results: High rates of smoking (27%, physical inactivity (64.9%, alcohol use disorders (20.8%, elevated fasting glucose (26.4%, diabetes (13.2%, hypertension (38.4%, hypertriglyceridemia (25.8%, low HDL-cholesterol (27.7%, general (38.4% and abdominal obesity (59.1% were found in the sample. Male patients were more likely to have alcohol use disorders, diabetes, and hypertriglyceridemia, whereas female patients showed higher prevalence of abdominal obesity. Variables such as medication use pattern, alcohol use disorder, and physical activity were associated with selected cardiovascular risk factors in the multivariable analysis. Conclusion: This report of the BRN-BD provides new data regarding prevalence rates and associated cardiovascular risk factors in Brazilian outpatients with BD. There is a need for increasing both awareness and recognition about metabolic and cardiovascular diseases in this patient population.

  5. Validation of the Italian version of the "Mood Disorder Questionnaire" for the screening of bipolar disorders

    Directory of Open Access Journals (Sweden)

    Carpiniello Bernardo

    2005-07-01

    Full Text Available Abstract The study measured the accuracy of the Italian version of the Mood Disorder Questionnaire (MDQ as a screening instrument for bipolar disorders in a psychiatric setting. Methods 154 consecutive subjects attending the Division of Psychiatry of the University of Cagliari (Italy, were screened for bipolar disorders using the Italian translation of the MDQ, and diagnostically interviewed with the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID by physicians. Results On the basis of the SCID: 51 (33.1% received a diagnosis of bipolar or schizoaffective bipolar type disorders, 63 (40.9% were diagnosed as having at least one psychiatric disorder in Axis I (other than bipolar or schizoaffective bipolar type disorders, whilst 40 (25.9% were unaffected by any type of psychiatric disorder. MDQ showed a good accuracy for bipolar or schizoaffective bipolar type disorders: the cut-off 4 had sensitivity 0.90 and specificity 0.58; the cut-off 5 had sensitivity 0.84 and specificity 0.70; and the cut-off 6 had sensitivity 0.76 and specificity 0.86. The accuracy for bipolar II disorders was sufficient but not excellent: the cut-off 4 had sensitivity 0.80 and specificity 0.45; the cut-off 5 had sensitivity 0.70 and specificity 0.55; and the cut-off 6 had sensitivity 0.55 and specificity 0.65. Conclusion Our results seem to indicate a good accuracy of MDQ, and confirm the results of recent surveys conducted in the USA. Moreover the instrument needs to be validated in other settings (e.g. in general practice.

  6. Co-morbidity in bipolar disorder: A retrospective study

    Directory of Open Access Journals (Sweden)

    Ravindra Neelakanthappa Munoli

    2014-01-01

    Full Text Available Background: Bipolar disorder is a relatively common, long-term, and disabling psychiatric illness that is associated with high levels of functional impairment, morbidity, mortality, and an increased risk of suicide. Psychiatric co-morbidity in bipolar disorder ranges from 57.3% to 74.3%, whereas medical co-morbidity varies from 2.7-70%. Indian scenario in this aspect is not clear. Materials and Methods: The objective was to ascertain the prevalence of physical and psychiatric co-morbidities in patients attending a tertiary care center over a period of 1 year and its relationship with socio-demographic and clinical variables. One hundred and twenty-five case record files were included in the review. OPCRIT software was used for re-establishing the diagnosis of bipolar disorder, which yielded 120 cases. A semi-structured pro-forma, specifically designed for the study, was used to collect the socio-demographic and clinical details. Results: Co-morbid psychiatric disorders were found in 52 (43.3% of the sample, whereas co-morbid physical illness was present in 77 (64.2% patients. The most common psychiatric disorder associated was substance use disorder (27.5%, whereas co-morbid cardiovascular disorder was the most frequent physical diagnosis in the sample (20%. Discussion: The prevalence of co-morbid psychiatric disorders in bipolar patients was lower than that reported in western literature. It could be related to retrospective nature of study or reflect true lower prevalence rates. Also, certain disorders such as eating disorders were absent in our sample, and migraine diagnosis was very infrequent.

  7. Bipolar disorder and multiple sclerosis Transtorno bipolar e esclerose múltipla

    Directory of Open Access Journals (Sweden)

    Mariana Inés Ybarra

    2007-12-01

    Full Text Available Bipolar disorder may be overrepresented in multiple sclerosis (MS patients. Although research in this area is limited, studies assessing the nature of this association have focused on genetic aspects, adverse reaction to drugs and brain demyelinating lesions. Herein we report three patients with MS that also presented bipolar disorder. The coexistence of neurological and psychiatric symptoms in most MS relapses highlights the relevance of biological factors in the emergence of mood disorders in these patients.O transtorno bipolar do humor parece estar super-representado em pacientes com esclerose múltipla (EM. Apesar de a pesquisa nessa área ser limitada, estudos acerca da natureza dessa associação têm se concentrado em aspectos genéticos, reações adversas a drogas e lesões desmielinizantes no sistema nervoso central. Relatamos, aqui, três casos de pacientes com EM que também apresentaram transtorno bipolar do humor. A coexistência de sintomas neurológicos e psiquiátricos em grande parte das recaídas de EM reforça a importância de fatores biológicos na gênese dos sintomas afetivos nesses pacientes.

  8. Preliminary examination of microRNA expression profiling in bipolar disorder I patients during antipsychotic treatment.

    Science.gov (United States)

    Lim, Chor Hong; Zainal, Nor Zuraida; Kanagasundram, Sharmilla; Zain, Shamsul Mohd; Mohamed, Zahurin

    2016-09-01

    Although major progress has been achieved in research and development of antipsychotic medications for bipolar disorder (BPD), knowledge of the molecular mechanisms underlying this disorder and the action of atypical antipsychotics remains incomplete. The levels of microRNAs (miRNAs)-small non-coding RNA molecules that regulate gene expression, including genes involved in neuronal function and plasticity-are frequently altered in psychiatric disorders. This study aimed to examine changes in miRNA expression in bipolar mania patients after treatment with asenapine and risperidone. Using a miRNA microarray, we analyzed miRNA expression in the blood of 10 bipolar mania patients following 12 weeks of treatment with asenapine or risperidone. Selected miRNAs were validated by using real-time PCR. A total of 16 miRNAs were differentially expressed after treatment in the asenapine group, 14 of which were significantly upregulated and the other two significantly downregulated. However, all three differentially expressed miRNAs in the risperidone group were downregulated. MiRNA target gene prediction and gene ontology analysis revealed significant enrichment for pathways associated with immune system response and regulation of programmed cell death and transcription. Our results suggest that candidate miRNAs may be involved in the mechanism of action of both antipsychotics in bipolar mania. © 2016 Wiley Periodicals, Inc. PMID:27177356

  9. Profile of moral reasoning in persons with bipolar affective disorder

    Directory of Open Access Journals (Sweden)

    Epa, Roksana

    2014-06-01

    Full Text Available Aim: The subject of the research presented in this paper was to analyze the relationships between bipolar disorder (BD and the profile of moral reasoning according to the concept of James Rest. Material and methods: 86 persons took part in the research, including 43 bipolar patients and 43 healthy individuals. To measure the severity of depression and mania symptoms the following scales were used: Hamilton Rating Scale for Depression (HAM-D, Montgomery-Asberg Depression Rating Scale (MADRS and Young Rating Scale for Mania (YMRS. Profile of moral reasoning was defined on the basis of the results obtained in the Defining Issue Test (DIT by James Rest. Results: Statistical analysis showed that there is a relationship between bipolar disorder (and its phases and the profile of moral reasoning: bipolar patients significantly less often than healthy individuals chose answers indicating the postconventional thinking (p=0,000 – and more often – answers indicating stage 3 and those belonging to the anti-institutional thinking index (p=0,000. There was also a relationship shown between the development of moral reasoning and the phase of bipolar disorder: patients in mania less often than per- sons in euthymia chose answers indicating the final stage of moral thinking (p=0,050. There were no significant differences between the results of patients with a depressive episode and the results of patients in mania and between the results of patients with a depressive episode and the results of patients in euthymia. Conclusions: The results suggest that the psychological state of the individual may have an impact on the process of moral reasoning – bipolar disorder may to some extent influence the way of thinking about moral dilemmas. The collected data also seem to emphasize the specificity of the manic phase which is especially worth exploration when conducting further studies.

  10. Cognitive functioning in depression period of bipolar disorder

    Directory of Open Access Journals (Sweden)

    Świtalska, Julita

    2014-12-01

    Full Text Available Aim of the study. Study aims were to compare neuropsychological functioning of depressed bipolar patients and healthy controls and to estimate relationship between severity of depressive symptoms and cognitive functioning. Method. Cognitive functions were examined in 30 depressed bipolar patients aged 18-68 (M=45,6, SD=12,6; 18 women and 12 men who fulfilled ICD-10 criteria for depressive episode (Hamilton Depression Rating Scale score ≥11. The comparison group consisted of 30 healthy subjects aged 23-71 (M=46, 20 women and 10 men matched in age, years of education and gender to bipolar group. A neuropsychological battery assessed executive functions and working memory. Results. The bipolar patients in depression revealed neuropsychological deficits in working memory and some aspects of executive functions in comparison to healthy group. Only in WCST test both groups received similar results. Neuropsychological functioning seems to be independent of the severity of depressive symptoms. Discussion. Different aspects of working memory and executive functions are impaired in depression period of bipolar disorder and they seem independent of the severity of depressive symptoms. These results are consistent with previous reports. Conclusions. In patients with bipolar depression cognitive assessment should be taken into account in the diagnosis and the disturbances in executive functions and working memory should be treated with neuropsychological rehabilitation and / or pharmacotherapy.

  11. Association study of PDE4B gene variants in Scandinavian schizophrenia and bipolar disorder multicenter case-control samples

    DEFF Research Database (Denmark)

    Kähler, Anna K; Otnaess, Mona K; Wirgenes, Katrine V;

    2010-01-01

    The phosphodiesterase 4B (PDE4B), which is involved in cognitive function in animal models, is a candidate susceptibility gene for schizophrenia (SZ) and bipolar disorder (BP). Variations in PDE4B have previously been associated with SZ, with a suggested gender-specific effect. We have genotyped...

  12. Meta-Analysis of Amygdala Volumes in Children and Adolescents with Bipolar Disorder

    Science.gov (United States)

    Pfeifer, Jonathan C.; Welge, Jeffrey; Strakowski. Stephen M.; Adler, Caleb M.; Delbello, Melissa P.

    2008-01-01

    The size of amygdala of bipolar youths and adults is investigated using neuroimaging studies. Findings showed that smaller volumes of amygdala were observed in youths with bipolar youths compared with children and adolescents without bipolar disorder. The structural amygdala abnormalities in bipolar youths are examined further.

  13. Bipolar disorder and age-related functional impairment Prejuízo funcional associado à idade e transtorno bipolar

    Directory of Open Access Journals (Sweden)

    Alice Aita Cacilhas

    2009-12-01

    Full Text Available OBJECTIVE: Although bipolar disorder is a major contributor to functional impairment worldwide, an independent impact of bipolar disorder and ageing on functioning has yet to be demonstrated. The objective of the present study was to evaluate the effect of bipolar disorder on age-related functional status using matched controls as a standard. METHOD: One-hundred patients with bipolar disorder and matched controls were evaluated for disability. Age-related effects controlled for confounders were cross-sectionally evaluated. RESULTS: Patients were significantly more impaired than controls. Regression showed effects for aging in both groups. The effect, size, however, was significantly stronger in patients. CONCLUSION: Bipolar disorder was an important effect modifier of the age impact on functioning. While a longitudinal design is needed to effectively demonstrate this different impact, this study further depicts bipolar disorder as a chronic and progressively impairing illness.OBJETIVO: O transtorno bipolar é responsável por importante parcela do prejuízo funcional ao redor do mundo. Um efeito independente do transtorno bipolar e da idade no funcionamento ainda não foi demonstrado. O presente estudo tem o objetivo de avaliar o efeito do transtorno bipolar no prejuízo funcional relacionado à idade, com controles pareados como padrão. MÉTODO: Cem pacientes com transtorno bipolar e controles pareados foram avaliados para incapacidade. Efeitos relacionados à idade, com controle para confundidores, foram investigados. RESULTADOS: Pacientes tiveram significativamente mais prejuízo que controles. A regressão mostrou efeito para a idade em ambos os grupos, e o efeito foi significativamente mais forte nos pacientes. CONCLUSÃO: O transtorno bipolar foi um importante modificador de efeito no impacto da idade no funcionamento. Enquanto um desenho de estudo longitudinal é necessário para efetivamente demonstrar este impacto diferencial, este

  14. Smartphone data as objective measures of bipolar disorder symptoms

    DEFF Research Database (Denmark)

    Faurholt-Jepsen, Maria; Frost, Mads; Vinberg, Maj;

    2014-01-01

    The daily electronic self-monitoring Smartphone software "MONARCA" was used by 17 patients with bipolar disorder for 3 consecutive months. Patients were rated fortnightly using Hamilton Depression rating Scale 17 items (HDRS-17) and Young Mania rating Scale (YMRS) (102 ratings) with blinding...

  15. Parenting among Mothers with Bipolar Disorder: Children's Perspectives

    Science.gov (United States)

    Venkataraman, Meenakshi

    2011-01-01

    Four children from three families in which the mother had a bipolar disorder were interviewed to understand their perspectives on their mothers' parenting. Children identified strengths in their mother's parenting, such as helping them with homework and moods and providing for their wants. They also identified challenges, such as mothers sleeping…

  16. The role of estrogen in bipolar disorder, a review

    DEFF Research Database (Denmark)

    Meinhard, Ninja; Kessing, Lars Vedel; Vinberg, Maj

    2014-01-01

    tamoxifen studies found that tamoxifen was effective in producing antimanic effects. CONCLUSION: These results indicate that estrogen fluctuations may be an important factor in the etiology of bipolar disorder and it is obvious that more research on this topic is needed to clarify the role of estrogen...

  17. Early-Onset Bipolar Spectrum Disorders: Diagnostic Issues

    Science.gov (United States)

    Danner, Stephanie; Fristad, Mary A.; Arnold, L. Eugene; Youngstrom, Eric A.; Birmaher, Boris; Horwitz, Sarah M.; Demeter, Christine; Findling, Robert L.; Kowatch, Robert A.

    2009-01-01

    Since the mid 1990s, early-onset bipolar spectrum disorders (BPSDs) have received increased attention in both the popular press and scholarly press. Rates of diagnosis of BPSD in children and adolescents have increased in inpatient, outpatient, and primary care settings. BPSDs remain difficult to diagnose, particularly in youth. The current…

  18. Family Functionality and Coping Attitudes of Patients with Bipolar Disorder.

    Science.gov (United States)

    Çuhadar, Döndü; Savaş, Haluk Asuman; Ünal, Ahmet; Gökpınar, Fatma

    2015-10-01

    The coping of patients with prodromal syndromes prevents relapses, and the differences in coping strategies affect the results of bipolar disorder. The various functionality levels of bipolar disorder patients such as work, marital relations, parental abilities and social presentation are significantly related with how well they cope. The objective of this study was to determine the family functionality and coping attitudes of bipolar disorder patients. The study planned as a descriptive one was carried with 81 bipolar disorder patients. Personal description form, family assessment device and Coping Attitudes Scale were used as data acquisition tools. It was determined that the adaptive coping attitudes used most frequently by the patients were religious coping, positive reinterpretation, active coping, problem-focused coping and emotional focused coping, beneficial social support use, emotional social support use, planning, suppression of competing activities and restraint coping; maladaptive coping attitudes used most frequently by the patients were "focusing on the problem and venting of emotions and mental disengagement." It was determined that family functions affected the coping attitudes of patients and that the patients who evaluated family functions in a healthy manner made use of adaptive coping strategies more at a statistically significant level. PMID:25086849

  19. Comorbidity and Phenomenology of Bipolar Disorder in Children with ADHD

    Science.gov (United States)

    Serrano, Eduardo; Ezpeleta, Lourdes; Castro-Fornieles, Josefina

    2013-01-01

    Objective: To assess the comorbidity of bipolar disorder (BPD) in children with ADHD and to study the psychopathological profile of ADHD children with and without mania. Method: A total of 100 children with ADHD were assessed with a semistructured diagnostic interview and questionnaires of mania, ADHD, and general psychopathology. Results: 8% of…

  20. Online information seeking by patients with bipolar disorder

    DEFF Research Database (Denmark)

    Conell, Jörn; Bauer, Rita; Glenn, Tasha;

    2016-01-01

    -based, anonymous survey, translated into 12 languages, was completed by 1222 patients in 17 countries as a convenience sample between March 2014 and January 2016. All patients had a diagnosis of bipolar disorder from a psychiatrist. Data were analyzed using descriptive statistics and generalized estimating...

  1. Information Processing in Adolescents with Bipolar I Disorder

    Science.gov (United States)

    Whitney, Jane; Joormann, Jutta; Gotlib, Ian H.; Kelley, Ryan G.; Acquaye, Tenah; Howe, Meghan; Chang, Kiki D.; Singh, Manpreet K.

    2012-01-01

    Background: Cognitive models of bipolar I disorder (BD) may aid in identification of children who are especially vulnerable to chronic mood dysregulation. Information-processing biases related to memory and attention likely play a role in the development and persistence of BD among adolescents; however, these biases have not been extensively…

  2. CACNA1C hypermethylation is associated with bipolar disorder

    DEFF Research Database (Denmark)

    Starnawska, A; Demontis, D; Pen, A;

    2016-01-01

    The CACNA1C gene, encoding a subunit of the L-type voltage-gated calcium channel is one of the best-supported susceptibility genes for bipolar disorder (BD). Genome-wide association studies have identified a cluster of non-coding single-nucleotide polymorphisms (SNPs) in intron 3 to be highly...

  3. Hypomethylation of FAM63B in bipolar disorder patients

    DEFF Research Database (Denmark)

    Starnawska, Anna; Demontis, Ditte; McQuillin, Andrew;

    2016-01-01

    Bipolar disorder (BD) and schizophrenia (SZ) are known to share common genetic and psychosocial risk factors. A recent epigenome-wide association study performed on blood samples from SZ patients found significant hypomethylation of FAM63B in exon 9. Here, we used iPLEX-based methylation analysis...

  4. Corticolimbic metabolic dysregulation in euthymic older adults with bipolar disorder

    OpenAIRE

    Brooks, John O.; Hoblyn, Jennifer C.; Woodard, Stephanie A.; Rosen, Allyson C.; Ketter, Terence A.

    2008-01-01

    The corticolimbic dysregulation hypothesis of bipolar disorder suggests that depressive symptoms are related to dysregulation of components of an anterior paralimbic network (anterior cingulate, anterior temporal cortex, dorsolateral prefrontal cortex, parahippocampal gyrus, and amygdala) with excessive anterior limbic activity accompanied by diminished prefrontal activity. In younger patients, such abnormalities tend to resolve with remission of depression, but it remains to be established w...

  5. Risk factors for an anxiety disorder comorbidity among Thai patients with bipolar disorder: results from the Thai Bipolar Disorder Registry

    Directory of Open Access Journals (Sweden)

    Paholpak S

    2014-05-01

    Full Text Available Suchat Paholpak,1 Ronnachai Kongsakon,2 Wasana Pattanakumjorn,3 Roongsang Kanokvut,4 Wiroj Wongsuriyadech,5 Manit Srisurapanont6 On behalf of the Thai Bipolar Disorder Registry Study Group1Department of Psychiatry, Faculty of Medicine, Khon Kaen University, Khon Kaen, 2Department of Psychiatry, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, 3Department of Psychiatry, Ratchaburi Hospital, Ratchaburi, 4Department of Psychiatry, Buddhachinaraj Hospital, Phitsanulok, 5Department of Psychiatry, Udonthani Hospital, Udonthani, 6Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand Background: The aim of the study was to determine in a clinical setting the risk factors for current anxiety disorder (AD comorbidity among Thai patients with bipolar disorder (BD, being treated under the Thai Bipolar Disorder Registry Project (TBDR. Methods: The TBDR was a multisite naturalistic study conducted at 24 psychiatric units (ie, at university, provincial mental, and government general hospitals between February 2009 and January 2011. Participants were in- or out-patients over 18 years of age who were diagnosed with BD according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Instruments used in this study included the Thai Mini International Neuropsychiatric Interview version 5; Thai Montgomery–Åsberg Depression Rating Scale (MADRS; Thai Young Mania Rating Scale; Clinical Global Impression of Bipolar Disorder-Severity (CGI-BP-S, CGI-BP-S-mania, CGI-BP-S-depression, and CGI-BP-S-overall BP illness; and the Thai SF-36 quality of life questionnaire. Results: Among the 424 BD patients, 404 (95.3% had BD type I. The respective mean ± standard deviation of age of onset of mood disturbance, first diagnosis of BD, and first treatment of BD was 32.0±11.9, 36.1±12.2, and 36.2±12.2 years. The duration of illness was 10.7±9.0 years. Fifty-three (12.5% of the 424 participants had

  6. A review of potassium channels in bipolar disorder

    OpenAIRE

    Judy, Jennifer T.; Zandi, Peter P.

    2013-01-01

    Although bipolar disorder (BP) is one of the most heritable psychiatric conditions, susceptibility genes for the disorder have yet to be conclusively identified. It is likely that variants in multiple genes across multiple pathways contribute to the genotype–phenotype relationship in the affected population. Recent evidence from genome-wide association studies implicates an entire class of genes related to the structure and regulation of ion channels, suggesting that the etiology of BP may ar...

  7. Towards a deeper understanding of the genetics of bipolar disorder

    OpenAIRE

    Berit eKerner

    2015-01-01

    Bipolar disorder is a common, complex psychiatric disorder characterized by mania and depression. The disease aggregates in families, but despite much effort, it has been difficult to delineate the basic genetic model or identify specific genetic risk factors. Single gene Mendelian transmission and common variant hypotheses, but also multivariate threshold models and oligogenic quasi-Mendelian modes of inheritance have dominated the discussion at times. Almost complete sequence information of...

  8. Molecular neurobiological clues to the pathogenesis of bipolar disorder

    OpenAIRE

    Harrison, Paul J.

    2016-01-01

    Bipolar disorder is a serious psychiatric disorder, with a high heritability and unknown pathogenesis. Recent genome-wide association studies have identified the first loci, implicating genes such as CACNA1C and ANK3. The genes highlight several pathways, notably calcium signalling, as being of importance. Molecular studies suggest that the risk variants impact on gene regulation and expression. Preliminary studies using reprogrammed patient-derived cells report alterations in the transcripto...

  9. Toward a Deeper Understanding of the Genetics of Bipolar Disorder

    OpenAIRE

    Kerner, Berit

    2015-01-01

    Bipolar disorder is a common, complex psychiatric disorder characterized by mania and depression. The disease aggregates in families, but despite much effort, it has been difficult to delineate the basic genetic model or identify specific genetic risk factors. Not only single gene Mendelian transmission and common variant hypotheses but also multivariate threshold models and oligogenic quasi-Mendelian modes of inheritance have dominated the discussion at times. Almost complete sequence inform...

  10. Reverse translational strategies for developing animal models of bipolar disorder

    OpenAIRE

    Malkesman, Oz; Austin, Daniel R.; Chen, Guang; Manji, Husseini K

    2009-01-01

    Bipolar disorder (BD) affects a significant portion of the population of the world, yet there has been limited success in developing novel treatments for the disorder. One of the major reasons for this dearth is the absence of suitable animal models for BD. Traditionally, animal models of human phenomena have been evaluated based on similarity to the human syndrome, response to appropriately corresponding medications, and the degree to which a model supports a common mechanistic theory betwee...

  11. A review of potassium channels in bipolar disorder

    OpenAIRE

    Jennifer Toolan Judy; Peter eZandi

    2013-01-01

    Although bipolar disorder (BP) is one of the most heritable psychiatric conditions, susceptibility genes for the disorder have yet to be conclusively identified. It is likely that variants in multiple genes across multiple pathways contribute to the genotype-phenotype relationship. Recent evidence from genome-wide association studies (GWAS) implicates an entire class of genes related to the structure and regulation of ion channels, suggesting that the etiology of BP may arise from a channelop...

  12. Late Onset Bipolar Disorder due to a Lacunar State

    OpenAIRE

    Elena Antelmi; Margherita Fabbri; Lucia Cretella; Maria Guarino; Andrea Stracciari

    2014-01-01

    Objective. To describe a patient with a new onset bipolar disorder (BD) type II, secondary to a lacunar state. Background. Poststroke BD is rare and mainly associated with lesion in the prefrontal-striatal-thalamic circuit. Materials and Methods. A 51-year-old woman came to our attention for a mood disorder of recent onset. At 49, she had suffered acute left-sided limb weakness that improved spontaneously four days later. Arterial hypertension was subsequently diagnosed. After 6 months, she b...

  13. Mapping Corpus Callosum Morphology in Twin Pairs Discordant for Bipolar Disorder

    OpenAIRE

    Bearden, Carrie E.; van Erp, Theo G. M.; Dutton, Rebecca A.; Boyle, Christina; Madsen, Sarah; Luders, Eileen; Kieseppa, Tuula; Tuulio-Henriksson, Annamari; Huttunen, Matti; Partonen, Timo; Kaprio, Jaakko; Lönnqvist, Jouko; Thompson, Paul M.; Cannon, Tyrone D.

    2011-01-01

    Callosal volume reduction has been observed in patients with bipolar disorder, but whether these deficits reflect genetic vulnerability to the illness remains unresolved. Here, we used computational methods to map corpus callosum abnormalities in a population-based sample of twin pairs discordant for bipolar disorder. Twenty-one probands with bipolar I disorder (mean age 44.4 ± 7.5 years; 48% female), 19 of their non-bipolar co-twins, and 34 demographically matched control twin individuals un...

  14. Mood self-assessment in bipolar disorder: a comparison between patients in mania, depression, and euthymia

    OpenAIRE

    Rafael de Assis da Silva; Mograbi, Daniel C.; Luciana Angélica Silva Silveira; Ana Letícia Santos Nunes; Fernanda Demôro Novis; Paola Anaquim Cavaco; Landeira-Fernandez, J.; Elie Cheniaux

    2013-01-01

    BACKGROUND: Some studies indicate that mood self-assessment is more severely impaired in patients with bipolar disorder in a manic episode than in depression. OBJECTIVES: To investigate variations in mood self-assessment in relation to current affective state in a group of individuals with bipolar disorder. METHODS: A total of 165 patients with a diagnosis of bipolar disorder type I or type II had their affective state assessed using the Clinical Global Impressions Scale for use in bipolar il...

  15. Modeling complex genetic and environmental influences on comorbid bipolar disorder with tobacco use disorder

    Directory of Open Access Journals (Sweden)

    Ade Alex S

    2010-01-01

    Full Text Available Abstract Background Comorbidity of psychiatric and substance use disorders represents a significant complication in the clinical course of both disorders. Bipolar Disorder (BD is a psychiatric disorder characterized by severe mood swings, ranging from mania to depression, and up to a 70% rate of comorbid Tobacco Use Disorder (TUD. We found epidemiological evidence consistent with a common underlying etiology for BD and TUD, as well as evidence of both genetic and environmental influences on BD and TUD. Therefore, we hypothesized a common underlying genetic etiology, interacting with nicotine exposure, influencing susceptibility to both BD and TUD. Methods Using meta-analysis, we compared TUD rates for BD patients and the general population. We identified candidate genes showing statistically significant, replicated, evidence of association with both BD and TUD. We assessed commonality among these candidate genes and hypothesized broader, multi-gene network influences on the comorbidity. Using Fisher Exact tests we tested our hypothesized genetic networks for association with the comorbidity, then compared the inferences drawn with those derived from the commonality assessment. Finally, we prioritized candidate SNPs for validation. Results We estimate risk for TUD among BD patients at 2.4 times that of the general population. We found three candidate genes associated with both BD and TUD (COMT, SLC6A3, and SLC6A4 and commonality analysis suggests that these genes interact in predisposing psychiatric and substance use disorders. We identified a 69 gene network that influences neurotransmitter signaling and shows significant over-representation of genes associated with BD and TUD, as well as genes differentially expressed with exposure to tobacco smoke. Twenty four of these genes are known drug targets. Conclusions This work highlights novel bioinformatics resources and demonstrates the effectiveness of using an integrated bioinformatics approach

  16. Comorbid bipolar disorder and borderline personality disorder and substance use disorder.

    Science.gov (United States)

    Hidalgo-Mazzei, Diego; Walsh, Emily; Rosenstein, Lia; Zimmerman, Mark

    2015-01-01

    Bipolar disorder (BD) and borderline personality disorder (BPD) are disabling and life-threatening conditions. Both disorders share relevant comorbidities, particularly the risk of having a lifetime substance use disorder (SUD). We tested the hypothesis that patients with both BD type I (BDI) or II (BDII) and BPD would have a higher rate of SUD than would patients with either disorder alone. A total of 3651 psychiatric patients were evaluated with semistructured diagnostic interviews for Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, axis I and II disorders. A total of 63 patients were diagnosed with both BD and BPD, and these patients were significantly more likely to have a SUD compared with BDII patients without BPD (76% vs. 50%, χ = 9.69, p disorders increased the risk of having a SUD especially when compared with BDII alone. PMID:25494335

  17. Ziprasidone in the treatment of mania in bipolar disorder

    Directory of Open Access Journals (Sweden)

    Stephen E Nicolson

    2007-01-01

    Full Text Available Stephen E Nicolson1, Charles B Nemeroff21From the Department of Psychiatry, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA; 2From the Department of Psychiatry and Behavioral Sciences, Emory University, School of Medicine, Atlanta, GA, USAAbstract: Ziprasidone is an atypical antipsychotic with a unique receptor-binding profile. Currently, ziprasidone is approved by the US Food and Drug Administration for the acute treatment of psychosis in schizophrenia and mania in bipolar disorder. When compared to certain other atypical antipsychotics, ziprasidone appears to have a relatively benign side effect profile, especially as regards metabolic effects eg, weight gain, serum lipid elevations and glucose dysregulation. Taken together, these data suggest that ziprasidone may be a first line treatment for patients with bipolar mania. However, ziprasidone is a relatively new medication for which adverse events after long-term use and/or in vulnerable patient populations must be studied. Unstudied areas of particular importance include the efficacy and safety of ziprasidone in the treatment of bipolar depression and relapse prevention of mania as, well as in the subpopulations of pregnant women, the elderly and pediatric patients. The emergence of mania in patients taking ziprasidone is another topic for further study.Keywords: antipsychotic, bipolar disorder, mania, mood disorder, neuroleptic, ziprasidone

  18. Medical and substance-related comorbidity in bipolar disorder: translational research and treatment opportunities

    OpenAIRE

    Mclntyre, Roger S.; Nguyen, Ha T.; Soczynska, Joanna K.; Lourenco, Maria Teresa C; Woldeyohannes, Hanna O.; Konarski, Jakub Z.

    2008-01-01

    It is well established that individuals with bipolar disorder are differentially affected by substance-related as well as medical disorders (ie, cardiometabolic disorders, respiratory disorders, neurological disorders, and infectious diseases). Emerging evidence indicates that some comorbid conditions (eg, diabetes mellitus) in bipolar individuals may be subserved by overlapping neurobiological networks. Disturbances in glucocorticoid/insulin signaling and immunoinflammatory effector systems ...

  19. Medication Adherence in Patients with Bipolar Disorder: A Comprehensive Review.

    Science.gov (United States)

    Levin, Jennifer B; Krivenko, Anna; Howland, Molly; Schlachet, Rebecca; Sajatovic, Martha

    2016-09-01

    Poor medication adherence is a pervasive problem that causes disability and suffering as well as extensive financial costs among individuals with bipolar disorder (BD). Barriers to adherence are numerous and cross multiple levels, including factors related to bipolar pathology and those unique to an individual's circumstances. External factors, including treatment setting, healthcare system, and broader health policies, can also affect medication adherence in people with BD. Fortunately, advances in research have suggested avenues for improving adherence. A comprehensive review of adherence-enhancement interventions for the years 2005-2015 is included. Specific bipolar adherence-enhancement approaches that target knowledge gaps, cognitive patterns, specific barriers, and motivation may be helpful, as may approaches that capitalize on technology or novel drug-delivery systems. However, much work remains to optimally facilitate long-term medication adherence in people with BD. For adherence-enhancement approaches to be widely adapted, they need to be easily accessible, affordable, and practical. PMID:27435356

  20. Cytochrome p4502D6 and serotonin transporter polymorphism in patient with bipolar disorder type II

    OpenAIRE

    Kovak Mufić, Ana; Karlović, Dalibor

    2015-01-01

    Bipolar disorder can manifest itself for years with recurring depressive episodes before the first manic, hypomanic or mixed episode occurs. The depressive episode of the bipolar disorder thus frequently remains unrecognised and misdiagnosed as a major depressive disorder and therefore gets inadequately treated with antidepressant monotherapy. This paper reports a case of a patient with bipolar disorder type II, who was treated for several years as a major depressive disorder and failed to sh...

  1. Exposure to Perinatal Infections and Bipolar Disorder: A Systematic Review.

    Science.gov (United States)

    Barichello, T; Badawy, M; Pitcher, M R; Saigal, P; Generoso, J S; Goularte, J A; Simões, L R; Quevedo, J; Carvalho, A F

    2016-01-01

    Bipolar disorder (BD) is a debilitating psychiatric disorder and a growing global public health issue. Notwithstanding BD has been conceptualized as a neuroprogressive illness, there are some evidences to suggest a role for neurodevelopmental pathways in the patho-etiology of this disorder. Evidences on the associations between perinatal infections and risk for bipolar disorder have been inconsistent across studies. Here, we performed a systematic review of observational studies on the relationship between exposure to perinatal pathogens and bipolar disorder. A computerized literature search of the PubMed, Embase, and PsyINFO databases till January 31(st), 2015 was performed. Twenty-three studies ultimately met inclusion criteria. Studies investigated exposure to several pathogens namely Cytomegalovirus (CMV), Epstein-Barr Virus (EBV), Herpes simplex virus-1 (HSV-1), Herpes simplex virus-2 (HSV-2), Human herpesvirus 6 (HHV-6), Toxoplasma gondii, Influenza, and Varicella zoster virus (VZV). Overall, studies provided mixed evidences. Thus, contrary to schizophrenia, the role of perinatal infections as risk factors for BD remain inconclusive. Larger studies with a prospective design would be necessary to elucidate the role of previous exposure to infectious agents as a potential risk factor for BD. PMID:26812921

  2. Lurasidone as a potential therapy for bipolar disorder

    Directory of Open Access Journals (Sweden)

    Woo YS

    2013-10-01

    Full Text Available Young Sup Woo, Hee Ryung Wang, Won-Myong Bahk Department of Psychiatry, Yeouido St Mary's Hospital, The Catholic University of Korea, Seoul, Korea Abstract: Lurasidone is a benzisothiazol derivative and an atypical antipsychotic approved by the US Food and Drug Administration for the acute treatment of adults with schizophrenia (October 2010 and bipolar 1 depression (June 2013. Lurasidone has a strong antagonistic property at the D2, serotonin (5-HT2A, and 5-HT7 receptors, and partial agonistic property at the 5-HT1A receptor. Lurasidone also has lower binding affinity for the α2C and 5-HT2C receptor. Lurasidone is rapidly absorbed (time to maximum plasma concentration: 1–3 hours, metabolized mainly by CYP3A4 and eliminated by hepatic metabolism. In two large, well-designed, 6-week trials in adult patients with bipolar 1 depression, lurasidone monotherapy and adjunctive therapy with mood stabilizers were significantly more effective than placebo at improving depressive symptoms assessed using the Montgomery–Åsberg Depression Rating Scale total score. In both trials, lurasidone also reduced the Clinical Global Impression–Bipolar Severity depression score to a greater extent than placebo. In these two trials, discontinuation rates due to adverse events in the lurasidone group were small (<7% and were not different from those of the placebo group. The most common adverse events in the lurasidone group were headache, nausea, somnolence, and akathisia. The changes in lipid profiles, weight, and parameters of glycemic control were minimal, and these findings were in line with those observed in schizophrenia trials. Further active comparator trials and long-term tolerability and safety data in bipolar patients are required. Lurasidone may be an option for the management of depressive symptoms in patients with bipolar 1 disorder, and it may be considered as a treatment alternative for patients who are at high risk for metabolic abnormalities

  3. Cognitive functions in the euthymic patients with bipolar disorder

    International Nuclear Information System (INIS)

    Recent studies have focused on the nature of dysfunction in bipolar patients. The purpose of the current study was to investigate cognitive performance of individuals with bipolar disorder compared to healthy control subjects during a well-established euthymic period. The sample consisted of 27 bipolar euthymic patients and 21 control subjects. Verbal and visual memory performance, attention, executive functions and psychological functions were evaluated for each participant. Bipolar patients showed significant attentional deficit and executive dysfunction and also poor performance on verbal and visual memory tasks compared to the controls. Illness duration and lifetime total episode number and previous episode with psychotic features was associated with worsened performance on attention, executive and memory tasks. Psychological functioning was not associated with cognitive deficit. The present study showed persistent cognitive impairment on inhibitory control and selective attention as well as poor performance on verbal and visual memory tests in a group of bipolar euthymic patients. The impaired neuropsychological performance was associated with psychotic features. Attentional dysfunction seemed to be a trait abnormality for the sample studied. (author)

  4. Comparison of clinical and sociodemographic features of bipolar disorder patients with those of social anxiety disorder patients comorbid with bipolar disorder in Turkey

    OpenAIRE

    Berkol, Tonguç D.; Kırlı, Ebru; Islam, Serkan; Pınarbaşı, Rasim; Özyıldırım, İlker

    2016-01-01

    Objectives: To assess the impact of social anxiety disorder (SAD) comorbidity on the clinical features, illness severity, and response to mood stabilizers in bipolar disorder (BD) patients. Methods: This retrospective study included bipolar patients that were treated at the Department of Psychiatry, Haseki Training and Research Hospital, Istanbul, Turkey in 2015, and who provided their informed consents for participation in this study. The study was conducted by assessing patient files retros...

  5. Personality disorders in euthymic bipolar patients: a systematic review

    Directory of Open Access Journals (Sweden)

    Severino Bezerra-Filho

    2015-06-01

    Full Text Available Objective:To identify, by means of a systematic review, the frequency with which comorbid personality disorders (PDs have been assessed in studies of euthymic bipolar patients.Methods:PubMed, ciELO and PsychINFO databases were searched for eligible articles published between 1997 and 2013. After screening 1,249 empirical papers, two independent reviewers identified three articles evaluating the frequency of PDs in patients with bipolar disorders assessed in a state of euthymia.Results:The total sample comprised 376 euthymic bipolar patients, of whom 155 (41.2% had at least one comorbid PD. Among them, we found 87 (23.1% in cluster B, 55 (14.6% in cluster C, and 25 (6.6% in cluster A. The frequencies of PD subtypes were: borderline, 38 (10.1%; histrionic, 29 (7.7%; obsessive-compulsive, 28 (7.4%; dependent, 19 (5%; narcissistic, 17 (4.5%; schizoid, schizotypal, and avoidant, 11 patients each (2.95%; paranoid, five (1.3%; and antisocial, three (0.79%.Conclusion:The frequency of comorbid PD was high across the spectrum of euthymic bipolar patients. In this population, the most common PDs were those in cluster B, and the most frequent PD subtype was borderline, followed by histrionic and obsessive-compulsive.

  6. Class effect of pharmacotherapy in bipolar disorder: fact or misbelief?

    Directory of Open Access Journals (Sweden)

    Vieta Eduard

    2011-03-01

    Full Text Available Abstract Background Anecdotal reports suggests that most clinicians treat medications as belonging to a class with regard to all therapeutic indications; this means that the whole 'class' of drugs is considered to possesses a specific therapeutic action. The present article explores the possible existence of a true 'class effect' for agents available for the treatment of bipolar disorder. Methods We reviewed the available treatment data from randomized controlled trials (RCTs and explored 16 'agent class'/'treatment issue' cases for bipolar disorder. Four classes of agents were examined: first-generation antipsychotics (FGAs, second-generation antipsychotics (SGAs, antiepileptics and antidepressants, with respect to their efficacy on four treatment issues of bipolar disorder (BD (acute mania, acute bipolar depression, maintenance against mania, maintenance against depression. Results From the 16 'agent class'/' treatment issue' cases, only 3 possible class effects were detected, and they all concerned acute mania and antipsychotics. Four effect cases have not been adequately studied (FGAs against acute bipolar depression and in maintenance protection from depression, and antidepressants against acute mania and protection from mania and they all concern treatment cases with a high risk of switching to the opposite pole, thus research in these areas is poor. There is no 'class effect' at all concerning antiepileptics. Conclusions The available data suggest that a 'class effect' is the exception rather than the rule in the treatment of BD. However, the possible presence of a 'class effect' concept discourages clinicians from continued scientific training and reading. Focused educational intervention might be necessary to change this attitude.

  7. [Cognitive behavioral treatments of bipolar disorder: current knowledge and perspectives].

    Science.gov (United States)

    Khazaal, Y; Pomini, V

    2006-09-20

    A significant proportion of patients with bipolar disorder experience relapse, psychosocial impairment and persistent symptoms despite available pharmacotherapy. Prognosis is frequently worsened by poor adhesion to mood stabilizing agents. Cognitive and behavioural therapy (CBT) tends to diminish depressive symptoms, improve treatment adherence and reduce the risk of depressive and manic relapses. CBT effect appears to diminish in patients with a history of over twelve episodes. Most studies exclude patients with comorbid psychiatric disorder, rapid cycling, schizoaffective disorder or patients lacking adherence to mood stabilizing agents. Patients would benefit from development of CBT techniques focusing on the mentioned problems. PMID:17073177

  8. Depression diagnoses following the identification of bipolar disorder: costly incongruent diagnoses

    OpenAIRE

    Schultz Jennifer F; Stensland Michael D; Frytak Jennifer R

    2010-01-01

    Abstract Background Previous research has documented that the symptoms of bipolar disorder are often mistaken for unipolar depression prior to a patient's first bipolar diagnosis. The assumption has been that once a patient receives a bipolar diagnosis they will no longer be given a misdiagnosis of depression. The objectives of this study were 1) to assess the rate of subsequent unipolar depression diagnosis in individuals with a history of bipolar disorder and 2) to assess the increased cost...

  9. Identifying Functional Neuroimaging Biomarkers of Bipolar Disorder: Toward DSM-V

    OpenAIRE

    Phillips, Mary L.; Vieta, Eduard

    2007-01-01

    Bipolar disorder is one of the most debilitating and common illnesses worldwide. Individuals with bipolar disorder frequently present to clinical services when depressed but are often misdiagnosed with unipolar depression, leading to inadequate treatment and poor outcome. Increased accuracy in diagnosing bipolar disorder, especially during depression, is therefore a key long-term goal to improve the mental health of individuals with the disorder. The attainment of this goal can be facilitated...

  10. Functional impairment, stress, and psychosocial intervention in bipolar disorder.

    Science.gov (United States)

    Miklowitz, David J

    2011-12-01

    The longitudinal course of bipolar disorder (BD) is highly impairing. This article reviews recent research on functional impairment in the course of BD, the roles of social and intrafamilial stress in relapse and recovery, and the role of adjunctive psychosocial interventions in reducing risk and enhancing functioning. Comparative findings in adult and childhood BD are highlighted. Life events and family-expressed emotion have emerged as significant predictors of the course of BD. Studies of social information processing suggest that impairments in the recognition of facial emotions may characterize both adult- and early-onset bipolar patients. Newly developed psychosocial interventions, particularly those that focus on family and social relationships, are associated with more rapid recovery from episodes and better psychosocial functioning. Family-based psychoeducational approaches are promising as early interventions for children with BD or children at risk of developing the disorder. For adults, interpersonal therapy, mindfulness-based strategies, and cognitive remediation may offer promise in enhancing functioning.

  11. Electronic monitoring of patients with bipolar affective disorder

    DEFF Research Database (Denmark)

    Jacoby, Anne Sophie; Faurholt-Jepsen, Maria; Vinberg, Maj;

    2012-01-01

    Bipolar disorder is a great challenge to patients, relatives and clinicians, and there is a need for development of new methods to identify prodromal symptoms of affective episodes in order to provide efficient preventive medical and behavioural intervention. Clinical trials prove that electronic...... monitoring is a feasible, valid and acceptable method. Hence it is recommended, that controlled trials on the effect of electronic monitoring on patients' course of illness, level of function and quality of life are conducted.......Bipolar disorder is a great challenge to patients, relatives and clinicians, and there is a need for development of new methods to identify prodromal symptoms of affective episodes in order to provide efficient preventive medical and behavioural intervention. Clinical trials prove that electronic...

  12. Sexual risk behaviors among women with bipolar disorder.

    Science.gov (United States)

    Marengo, Eliana; Martino, Diego J; Igoa, Ana; Fassi, Guillermo; Scápola, María; Urtueta Baamonde, Mariana; Strejilevich, Sergio A

    2015-12-30

    The aim of this study was to investigate sexual health and sexual risk behaviors for sexually transmitted infections (STI) among women with bipolar disorder (BDW). Sixty-three euthymic women diagnosed with bipolar disorder type I, II or not otherwise specified were included and matched with a control group of 63 healthy women. Demographic and clinical data, structured sexual health measures and extensive assessment of sexual risk behavior were obtained and compared between groups. BDW had casual partners, were in non-monogamous sexual partnerships and had sex with partners with unknown HIV condition more frequently than healthy control women. History of two or more STI was more frequent among BDW. Inclusion of sexual behavior risk assessment among BDW in treatment is necessary to better identify those women with higher risk for STI and to take measures to improve their sexual health. PMID:26564549

  13. Determinants of long term course in Bipolar disorder

    OpenAIRE

    Backlund, Lena

    2010-01-01

    Introduction: Bipolar disorder (BP) is a common and severe psychiatric illness with a high variability. An early treatment is often crucial for a good prognosis, but it is difficult for clinicians to define high risk patients in order to predict a more severe course. Our aim was to investigate factors predicting the long-term course of BP. Methods: We have retrospectively investigated the course of illness in 100 BP patients, using a life-charting program. Predictors and th...

  14. Bipolar Disorder Patients Follow-up (BDPF): methods and materials

    OpenAIRE

    Amir Shabani; Aida Taheri; Sanaz Azadforouz; Chehreh Najd Abbasi; Zahra Mousavi; Kambiz Zangeneh; Seyed Vahid Shariat; Shabnam Nohesara; Morteza Naserbakht; Mojgan Taban; Sadaf Kokar; Samaneh Teimoorinejad; Mitra Hakimshooshtary; Elham Shirazi

    2010-01-01

    Background: The Bipolar Disorder Patients Follow-up (BDPF) project is a longitudinal, prospective and naturalistic study. The purpose of the present report is to introduce the project, elaborate its methods, and present the reliability data of the utilized symptoms rating scales. Methods: The sampling started in May 2008 and is still in progress. The probands are assessed at the beginning of the sampling and then 2 and 6 months later and then every 6 months using several instruments to ide...

  15. Stability of facial emotion recognition performance in bipolar disorder.

    Science.gov (United States)

    Martino, Diego J; Samamé, Cecilia; Strejilevich, Sergio A

    2016-09-30

    The aim of this study was to assess the performance in emotional processing over time in a sample of euthymic patients with bipolar disorder (BD). Performance in the facial recognition of the six basic emotions (surprise, anger, sadness, happiness, disgust, and fear) did not change during a follow-up period of almost 7 years. These preliminary results suggest that performance in facial emotion recognition might be stable over time in BD. PMID:27416537

  16. Smartphone data as objective measures of bipolar disorder symptoms

    OpenAIRE

    Faurholt-Jepsen, Maria; Frost, Mads; Vinberg, Maj; Christensen, Ellen Margrethe; Bardram, Jakob; Kessing, Lars Vedel

    2014-01-01

    The daily electronic self-monitoring Smartphone software “MONARCA” was used by 17 patients with bipolar disorder for 3 consecutive months. Patients were rated fortnightly using Hamilton Depression rating Scale 17 items (HDRS-17) and Young Mania rating Scale (YMRS) (102 ratings) with blinding for Smartphone data. Objective Smartphone measures such as physical and social activity correlated with clinically rated depressive symptoms. Self-monitored depressive symptoms correlated significantly wi...

  17. Everyday functional ability across different phases of bipolar disorder

    OpenAIRE

    Henry, Brook Lewis; Minassian, Arpi; Perry, William

    2013-01-01

    Bipolar Disorder (BD) is a chronic illness characterized by significant neurocognitive impairment and functional deficits. Functional status is typically assessed with self-report or observer ratingslimited by poor participant insight and subjective judgment, while application of performance-based measures has been limited. We assessed functional ability in manic, depressed, and euthymic BD individualsusing the UCSD Performance-Based Skills Assessment (UPSA-2), which simulates real-world task...

  18. Amygdala Functional Connectivity Predicts Pharmacotherapy Outcome in Pediatric Bipolar Disorder

    OpenAIRE

    Wegbreit, Ezra; Ellis, James A.; Nandam, Aneesh; Fitzgerald, Jacklynn M.; Passarotti, Alessandra M.; Pavuluri, Mani N.; Stevens, Michael C.

    2011-01-01

    The aim of this study was to determine functional connectivity among patients with pediatric bipolar disorder (PBD) who are responders to pharmacotherapy and those who are nonresponders, and learn how they differ from healthy controls (HC) while performing a task that engages affective and cognitive neural systems. PBD participants (n=34; 13.4±2.3 years) were defined as responders if there was ≥50% improvement in Young Mania Rating Scale (YMRS) scores (n=22) versus nonresponders with

  19. Genetic association of cyclic AMP signaling genes with bipolar disorder

    OpenAIRE

    McDonald, M-L; MacMullen, C.; Liu, D. J.; Leal, S M; Davis, R L

    2012-01-01

    The genetic basis for bipolar disorder (BPD) is complex with the involvement of multiple genes. As it is well established that cyclic adenosine monophosphate (cAMP) signaling regulates behavior, we tested variants in 29 genes that encode components of this signaling pathway for associations with BPD type I (BPD I) and BPD type II (BPD II). A total of 1172 individuals with BPD I, 516 individuals with BPD II and 1728 controls were analyzed. Single SNP (single-nucleotide polymorphism), haplotype...

  20. Contextual social cognition impairments in schizophrenia and bipolar disorder.

    Directory of Open Access Journals (Sweden)

    Sandra Baez

    Full Text Available BACKGROUND: The ability to integrate contextual information with social cues to generate social meaning is a key aspect of social cognition. It is widely accepted that patients with schizophrenia and bipolar disorders have deficits in social cognition; however, previous studies on these disorders did not use tasks that replicate everyday situations. METHODOLOGY/PRINCIPAL FINDINGS: This study evaluates the performance of patients with schizophrenia and bipolar disorders on social cognition tasks (emotional processing, empathy, and social norms knowledge that incorporate different levels of contextual dependence and involvement of real-life scenarios. Furthermore, we explored the association between social cognition measures, clinical symptoms and executive functions. Using a logistic regression analysis, we explored whether the involvement of more basic skills in emotional processing predicted performance on empathy tasks. The results showed that both patient groups exhibited deficits in social cognition tasks with greater context sensitivity and involvement of real-life scenarios. These deficits were more severe in schizophrenic than in bipolar patients. Patients did not differ from controls in tasks involving explicit knowledge. Moreover, schizophrenic patients' depression levels were negatively correlated with performance on empathy tasks. CONCLUSIONS/SIGNIFICANCE: Overall performance on emotion recognition predicted performance on intentionality attribution during the more ambiguous situations of the empathy task. These results suggest that social cognition deficits could be related to a general impairment in the capacity to implicitly integrate contextual cues. Important implications for the assessment and treatment of individuals with schizophrenia and bipolar disorders, as well as for neurocognitive models of these pathologies are discussed.

  1. Borderline personality disorder and bipolar disorder: what is the difference and why does it matter?

    Science.gov (United States)

    Paris, Joel; Black, Donald W

    2015-01-01

    Borderline personality disorder (BPD) and bipolar disorder (types I and II) are frequently confused because of their symptomatic overlap. Although affective instability is a prominent feature of each, the pattern is entirely different. BPD is characterized by transient mood shifts that occur in response to interpersonal stressors, whereas bipolar disorder is associated with sustained mood changes. These disorders can be further distinguished by comparing their phenomenology, etiology, family history, biological studies, outcome, and response to medication. Their distinction is of great clinical importance because misdiagnosis can deprive the patient of potentially effective treatment, whether it is psychotherapy for BPD or medication for bipolar disorder. On the basis of a comprehensive literature review, guidelines for differential diagnosis are suggested, and priorities for further research are recommended.

  2. Intervenções psicossociais no transtorno bipolar Psychosocial interventions for bipolar disorder

    Directory of Open Access Journals (Sweden)

    Luis Pereira Justo

    2004-01-01

    Full Text Available Neste trabalho, os autores, através de revisão bibliográfica narrativa, situam as intervenções psicossociais dentro do panorama terapêutico para o transtorno bipolar e constatam que ainda são insuficientes os estudos primários feitos com metodologia adequada para a obtenção de informações científicas de boa qualidade. São sucintamente descritos os trabalhos mais relevantes.In this paper, the authors review the status of psychosocial interventions within the general treatment for bipolar disorder. They have verified the scantiness of studies performed with adequate methodology to obtain scientific information of good quality. The more relevant studies are briefly described.

  3. Improving the Recognition of Borderline Personality Disorder in a Bipolar World.

    Science.gov (United States)

    Zimmerman, Mark

    2016-06-01

    Both bipolar disorder and borderline personality disorder (BPD) are serious mental health disorders resulting in significant psychosocial morbidity, reduced health-related quality of life, and excess mortality. Yet research on BPD has received much less funding from the National Institute of Health (NIH) than has bipolar disorder during the past 25 years. Why hasn't the level of NIH research funding for BPD been commensurate with the level of psychosocial morbidity, mortality, and health expenditures associated with the disorder? In the present article, the author illustrates how the bipolar disorder research community has done a superior job of "marketing" their disorder. Studies of underdiagnosis, screening, diagnostic spectra, and economics are reviewed for both bipolar disorder and BPD. Researchers of bipolar disorder have conducted multiple studies highlighting the problem with underdiagnosis, developed and promoted several screening scales, published numerous studies of the operating characteristics of these screening measures, attempted to broaden the definition of bipolar disorder by advancing the concept of the bipolar spectrum, and repeatedly demonstrated the economic costs and public health significance of bipolar disorder. In contrast, researchers of BPD have almost completely ignored each of these four issues and research efforts. Although BPD is as frequent as (if not more frequent than) bipolar disorder, as impairing as (if not more impairing than) bipolar disorder, and as lethal as (if not more lethal than) bipolar disorder, it has received less than one-tenth the level of funding from the NIH and has been the focus of many fewer publications in the most prestigious psychiatric journals. The researchers of BPD should consider adopting the strategy taken by researchers of bipolar disorder before the diagnosis is eliminated in a future iteration of the DSM or the ICD. PMID:25893554

  4. Improving the Recognition of Borderline Personality Disorder in a Bipolar World.

    Science.gov (United States)

    Zimmerman, Mark

    2016-06-01

    Both bipolar disorder and borderline personality disorder (BPD) are serious mental health disorders resulting in significant psychosocial morbidity, reduced health-related quality of life, and excess mortality. Yet research on BPD has received much less funding from the National Institute of Health (NIH) than has bipolar disorder during the past 25 years. Why hasn't the level of NIH research funding for BPD been commensurate with the level of psychosocial morbidity, mortality, and health expenditures associated with the disorder? In the present article, the author illustrates how the bipolar disorder research community has done a superior job of "marketing" their disorder. Studies of underdiagnosis, screening, diagnostic spectra, and economics are reviewed for both bipolar disorder and BPD. Researchers of bipolar disorder have conducted multiple studies highlighting the problem with underdiagnosis, developed and promoted several screening scales, published numerous studies of the operating characteristics of these screening measures, attempted to broaden the definition of bipolar disorder by advancing the concept of the bipolar spectrum, and repeatedly demonstrated the economic costs and public health significance of bipolar disorder. In contrast, researchers of BPD have almost completely ignored each of these four issues and research efforts. Although BPD is as frequent as (if not more frequent than) bipolar disorder, as impairing as (if not more impairing than) bipolar disorder, and as lethal as (if not more lethal than) bipolar disorder, it has received less than one-tenth the level of funding from the NIH and has been the focus of many fewer publications in the most prestigious psychiatric journals. The researchers of BPD should consider adopting the strategy taken by researchers of bipolar disorder before the diagnosis is eliminated in a future iteration of the DSM or the ICD.

  5. Bipolar disorder in women with polycystic ovarian syndrome (PCO.

    Directory of Open Access Journals (Sweden)

    Fatemeh Davari-Tanha

    2014-01-01

    Full Text Available This study was designed to determine the prevalence of bipolar disorder in women with polycystic ovarian syndrome (PCO. One hundred and ten women with definite diagnosis of PCO and one hundred and ten age-matched infertile women due to other reasons except for PCO were enrolled in this case-control study. Ten ml fasting venous blood sample obtained to measure fasting glucose, LH and FSH. Height, weight and waist-to-hip ratio (WHR were also recorded by an expert technician. A psychiatrist examined all 220 cases in order to determine the prevalence of depression and bipolarity. Mean age of each group participants were not significantly different while FBS, LH and LH/FSH levels were significantly higher in PCO patients. Eighty eight case were depressed in PCO group while 96 were depressed in control group (P=0.03. Bipolar disorder were higher in PCO group in comparison with controls (8 vs. 0, P=0.004. Psychiatric disorders should be considered in PCO women.

  6. Screening for bipolar disorders in patients with alcohol or substance use disorders : Performance of the Mood Disorder Questionnaire

    NARCIS (Netherlands)

    van Zaane, Jan; van den Berg, Belinda; Draisma, Stasja; Nolen, Willem A.; van den Brink, Wim

    2012-01-01

    Background: Screening properties of the Mood Disorder Questionnaire (MDQ) to detect bipolar disorder (BD) in patients with substance use disorders are unknown. Methods: 403 treatment seeking patients with a substance use disorder completed the MDQ and subsequently 111 MDQ positives and 59 MDQ negati

  7. Childhood trauma and treatment outcome in bipolar disorder.

    Science.gov (United States)

    Cakir, Sibel; Tasdelen Durak, Rumeysa; Ozyildirim, Ilker; Ince, Ezgi; Sar, Vedat

    2016-01-01

    The aim of the present study was to investigate the potential influence of childhood trauma on clinical presentation, psychiatric comorbidity, and long-term treatment outcome of bipolar disorder. A total of 135 consecutive patients with bipolar disorder type I were recruited from an ongoing prospective follow-up project. The Childhood Trauma Questionnaire and the Structured Clinical Interview for DSM-IV Axis I Disorders were administered to all participants. Response to long-term treatment was determined from the records of life charts of the prospective follow-up project. There were no significant differences in childhood trauma scores between groups with good and poor responses to long-term lithium treatment. Poor responders to long-term anticonvulsant treatment, however, had elevated emotional and physical abuse scores. Lifetime diagnosis of posttraumatic stress disorder (PTSD) was associated with poor response to lithium treatment and antidepressant use but not with response to treatment with anticonvulsants. Total childhood trauma scores were related to the total number of lifetime comorbid psychiatric disorders, antidepressant use, and the presence of psychotic features. There were significant correlations between all types of childhood abuse and the total number of lifetime comorbid psychiatric diagnoses. Whereas physical neglect was related to the mean severity of the mood episodes and psychotic features, emotional neglect was related to suicide attempts. A history of childhood trauma or PTSD may be a poor prognostic factor in the long-term treatment of bipolar disorder. Whereas abusive experiences in childhood seem to lead to nosological fragmentation (comorbidity), childhood neglect tends to contribute to the severity of the mood episodes. PMID:26683845

  8. Childhood Bipolar Disorder: A Difficult Diagnosis

    Science.gov (United States)

    Sutton, Kimberly Kode

    2014-01-01

    Identifying children with emotional or behavior disorders has long been problematic. In a general sense, those children who are most likely to be noticed by teachers and, therefore, referred for possible special education placement are those who exhibit externalizing behaviors, including physical aggression, noncompliance, and rule-breaking. It is…

  9. Cannabis involvement in individuals with Bipolar Disorder

    OpenAIRE

    Agrawal, Arpana; Nurnberger, John I.; Lynskey, Michael T.

    2010-01-01

    In a study of 471 BD cases and 1761 controls, individuals with BD were 6.8 times more likely to report a lifetime history of cannabis use. Rates of DSM-IV cannabis use disorders in those with BD were 29.4% and were independently and significantly associated with increased suicide attempts, experience mixed episodes and disability attributable to BD.

  10. Substance Use Disorders and Suicide Attempts in Bipolar Subtypes

    OpenAIRE

    Sublette, M Elizabeth; Carballo, Juan J; Moreno, Carmen; Galfalvy, Hanga C.; Brent, David A.; BIRMAHER, BORIS; Mann, J. John; OQUENDO, MARIA A.

    2008-01-01

    Bipolar disorder (BD) is associated with high rates of suicide attempt and completion. Substance use disorders (SUD) have been identified as potent risk factors for suicidal behavior in BD. However, little is known concerning differences between BD subtypes with regard to SUD as a risk factor for suicidal behavior. We studied previous suicidal behavior in adults with a major depressive episode in context of BD type I (BD-I; N=96) or BD type II (BD-II; N=42), with and without history of SUD. L...

  11. Epidemiology, neurobiology and pharmacological interventions related to suicide deaths and suicide attempts in bipolar disorder

    DEFF Research Database (Denmark)

    Schaffer, Ayal; Isometsä, Erkki T; Tondo, Leonardo;

    2015-01-01

    OBJECTIVES: Bipolar disorder is associated with elevated risk of suicide attempts and deaths. Key aims of the International Society for Bipolar Disorders Task Force on Suicide included examining the extant literature on epidemiology, neurobiology and pharmacotherapy related to suicide attempts...... and deaths in bipolar disorder. METHODS: Systematic review of studies from 1 January 1980 to 30 May 2014 examining suicide attempts or deaths in bipolar disorder, with a specific focus on the incidence and characterization of suicide attempts and deaths, genetic and non-genetic biological studies...... and pharmacotherapy studies specific to bipolar disorder. We conducted pooled, weighted analyses of suicide rates. RESULTS: The pooled suicide rate in bipolar disorder is 164 per 100,000 person-years (95% confidence interval = [5, 324]). Sex-specific data on suicide rates identified a 1.7:1 ratio in men compared...

  12. Comparing Mental Health of School-Age Children of Parents With/Without Bipolar Disorders: A Case Control Study

    OpenAIRE

    Shamsaei; Cheraghi; Dehghani; Jahangard

    2015-01-01

    Background Children of parents with bipolar disorder appear to have an increased risk of early-onset Bipolar Disorder (BP), mood disorders and other psychiatric disorders. Objectives The aim of this study was to compare the mental health of school-age children of parents, with/without bipolar disorder. Materials and Methods This case-control study included one hundred children aged...

  13. Treatment of bipolar disorder: a complex treatment for a multi-faceted disorder

    OpenAIRE

    Fresno David; Oral Timucin; Magiria Stamatia; Valenti Marc; Siamouli Melina; Vieta Eduard; Fountoulakis Konstantinos N; Giannakopoulos Panteleimon; Kaprinis George S

    2007-01-01

    Abstract Background Manic-depression or bipolar disorder (BD) is a multi-faceted illness with an inevitably complex treatment. Methods This article summarizes the current status of our knowledge and practice of its treatment. Results It is widely accepted that lithium is moderately useful during all phases of bipolar illness and it might possess a specific effectiveness on suicidal prevention. Both first and second generation antipsychotics are widely used and the FDA has approved olanzapine,...

  14. The Treatment of Adult Bipolar Disorder with Aripiprazole: A Systematic Review.

    Science.gov (United States)

    Muneer, Ather

    2016-01-01

    Bipolar disorder is characterized by exacerbations of opposite mood polarity, ranging from manic to major depressive episodes. In the current nosological system of the Diagnostic and Statistical Manual - 5(th) edition (DSM-5), it is conceptualized as a spectrum disorder consisting of bipolar disorder type I, bipolar disorder type II, cyclothymic disorder, and bipolar disorder not otherwise specified. Treatment of all phases of this disorder is primarily with mood stabilizers, but many patients either show resistance to the conventional mood stabilizing medications or are intolerant to their side-effects. In this setting, second-generation antipsychotics have gained prominence as many bipolar subjects who are otherwise treatment refractory show response to these agents. Aripiprazole is a novel antipsychotic initially approved for the treatment of schizophrenia but soon found to be effective in bipolar disorder. This drug is well studied, as randomized controlled trials have been conducted in various phases of bipolar disorders. Aripiprazole exhibits the pharmacodynamic properties of partial agonism, functional selectivity, and serotonin-dopamine activity modulation - the new exemplars in the treatment of major psychiatric disorders. It is the first among a new series of psychotropic medications, which now also include brexpiprazole and cariprazine. The current review summarizes the data from controlled trials regarding the efficacy and safety of aripiprazole in adult bipolar patients. On the basis of this evidence, aripiprazole is found to be efficacious in the treatment and prophylaxis of manic and mixed episodes but has no effectiveness in acute and recurrent bipolar depression. PMID:27190727

  15. Transtorno bipolar do humor e gênero Bipolar affective disorder and gender

    Directory of Open Access Journals (Sweden)

    Rodrigo da Silva Dias

    2006-01-01

    Full Text Available Embora o transtorno bipolar (TB ocorra quase igualmente em ambos os sexos, a fenomenologia e o curso da doença diferem no homem e na mulher. No entanto, há evidências de que mulheres bipolares, mais que os homens, apresentariam início mais tardio (em especial na quinta década de vida, ciclagem rápida, mais episódios depressivos, mais mania disfórica que eufórica, estados mistos e evolução do tipo bipolar II, ainda que os achados nem sempre sejam consistentes. Embora o risco de comorbidades no TB inclua, para ambos os gêneros, abuso de álcool e drogas, homens bipolares teriam maior probabilidade de ser alcoolistas, não procurar tratamento e de se suicidar. Hipóteses sugeridas para explicar tais diferenças variam daquelas centradas em aspectos culturais ou psicológicos para as que focalizam os sistemas hormonais, como os esteróides gonadais ou o eixo tireoidiano, e até mesmo a anatomia cerebral. A influência do ciclo reprodutivo (ciclo menstrual, gravidez e menopausa sobre as opções terapêuticas no tratamento do TB é apresentada na última parte desta revisão.Although the bipolar disorder (BD occurs almost with the same frequency in both genders, the phenomenology and the outcome of the illness differ between them. Nevertheless, there is evidence that women with BD show, more than men, delayed beginning, especially in their fifth decade, more rapid cycling outcome, more depressive episodes, more dysphoric mania, more mixed states and more BD type II. Even so, the findings are not always consistent. Although the risk of comorbidities in BD includes, for both the sorts, excessive alcoholic consumption and drugs, bipolar men would have greater probability of being alcohol dependent, of not seeking treatment and of committing suicide. Suggested hypotheses to explain such differences vary from those centered in cultural or psychological aspects to those that focus on the steroids hormones, and other hormones such as cortisol

  16. Memory in Early Onset Bipolar Disorder and Attention-Deficit/Hyperactivity Disorder: Similarities and Differences

    Science.gov (United States)

    Udal, Anne H.; Oygarden, Bjorg; Egeland, Jens; Malt, Ulrik F.; Groholt, Berit

    2012-01-01

    Differentiating between early-onset bipolar disorder (BD) and attention-deficit/hyperactivity disorder (ADHD) can be difficult. Memory problems are commonly reported in BD, and forgetfulness is among the diagnostic criteria for ADHD. We compared children and adolescents with BD (n = 23), ADHD combined type (ADHD-C; n = 26), BD + ADHD-C (n = 15),…

  17. A bipolar disorder patient becoming asymptomatic after adjunctive anti-filiarasis treatment: a case report

    OpenAIRE

    Hamdani, Nora; Doukhan, Raphaël; Picard, Aline; Tamouza, Ryad; Leboyer, Marion

    2013-01-01

    International audience; BACKGROUND: Evidence suggests that neurotropic infectious agents might be involved in bipolar disorder. So far, few have been written for the association between parasitic infection and bipolar disorder. Filariasis is a parasitic disease acting ruthlessly via mosquitos and affecting more than 120 million people worldwide. We present here, to our knowledge, the first description of a filariasis infected manic bipolar disorder patient fully improved in terms of psychiatr...

  18. Mood stability versus mood instability in bipolar disorder: A possible role for emotional mental imagery

    OpenAIRE

    Holmes, Emily A.; Deeprose, Catherine; Fairburn, Christopher G.; Wallace-Hadrill, Sophie M.A.; Bonsall, Michael B.; Geddes, John R.; Goodwin, Guy M.

    2011-01-01

    A cognitive model of bipolar disorder suggests that mental imagery acts as an emotional amplifier of mood and may be heightened in bipolar disorder. First, we tested whether patients with bipolar disorder would score higher on mental imagery measures than a matched healthy control group. Second, we examined differences in imagery between patients divided into groups according to their level of mood stability. Mood ratings over approximately 6-months, made using a mobile phone messaging system...

  19. Dysregulation of the Behavioral Approach System (BAS) in Bipolar Spectrum Disorders: Review of Theory and Evidence

    OpenAIRE

    Urošević, Snez̆ana; Abramson, Lyn Y.; Harmon-Jones, Eddie; Alloy, Lauren B.

    2008-01-01

    In recent years, a call for increased research on bipolar disorder has been answered with methodologically diverse studies exploring goal striving, life events, cognitive style, decision-making, and neurobiological abnormalities in bipolar disorder. In order to further this spurt of research and to systematize our understanding of bipolar disorder, an integrative perspective is warranted. The behavioral approach system (BAS) dysregulation theory, proposed by Richard Depue and colleagues, prov...

  20. A Test of the Bidirectional Relationship between Sleep and Mood in Bipolar Disorder and Insomnia

    OpenAIRE

    Talbot, Lisa S.

    2010-01-01

    The present study investigates sleep, mood, and the proposed bidirectional relationship between the two in psychiatric disorders. Participants with interepisode bipolar disorder (n = 49), insomnia (n = 34), and no psychiatric history (n = 52) completed seven days of sleep diaries and mood measures. The interepisode bipolar and insomnia participants exhibited greater sleep disturbance than the healthy control individuals. Negative mood was equally heightened in both interepisode bipolar disord...

  1. Healthcare Costs of Atypical Antipsychotic Use for Patients with Bipolar Disorder in a Medicaid Programme

    OpenAIRE

    Ying Qiu; Fu, Alex Z; Gordon G. Liu; Christensen, Dale B.

    2010-01-01

    Background: A large body of clinical studies have demonstrated the efficacy of atypical antipsychotic use in the treatment of bipolar disorder. Facing increasing budget pressure, third-party payers, such as state Medicaid programmes in the US, are demanding better understanding of the medical costs beyond atypical antipsychotic drug costs alone in treating bipolar disorder. Objective: To examine healthcare costs associated with the atypical antipsychotic treatments for bipolar disorder from a...

  2. No evidence for allelic association between bipolar disorder and monoamine oxidase A gene polymorphisms

    Energy Technology Data Exchange (ETDEWEB)

    Craddock, N.; Daniels, J.; Roberts, E. [Univ. of Wales, College of Medicine, Cardiff (United Kingdom)] [and others

    1995-08-14

    We have tested the hypothesis that DNA markers in the MAOA gene show allelic association with bipolar affective disorder. Eighty-four unrelated Caucasian patients with DSM III-R bipolar disorder and 84 Caucasian controls were typed for three markers in MAOA: a dinucleotide repeat in intron 2, a VNTR in intron 1, and an Fnu4HI RFLP in exon 8. No evidence for allelic association was observed between any of the markers and bipolar disorder. 9 refs., 1 tab.

  3. Brain structure and the relationship with neurocognitive functioning in schizophrenia and bipolar disorder : MRI studies

    OpenAIRE

    2011-01-01

    Brain structural abnormalities as well as neurocognitive dysfunction, are found in schizophrenia and in bipolar disorder. Based on the fact that both brain structure and neurocognitive functioning are significantly heritable and affected in both schizophrenia and bipolar disorder, relationships between them are expected. However, previous studies report inconsistent findings. Also, schizophrenia and bipolar disorder are classified as separate disease entities, but demonstrate overlap with reg...

  4. As bases neurobiológicas do transtorno bipolar Neurobiological basis of bipolar disorder

    Directory of Open Access Journals (Sweden)

    Rodrigo Machado-Vieira

    2005-01-01

    Full Text Available Neste artigo, os autores revisam importantes aspectos associados às bases biológicas do transtorno de humor bipolar (THB. O THB está relacionado com o surgimento de diversas alterações bioquímicas e moleculares em sistemas de neurotransmissão e vias de segundos-mensageiros geradores de sinais intracelulares. Essas modificações em neurônios e glia parecem estar associadas com o surgimento de sintomas maníacos e depressivos. Ainda neste contexto, disfunções na homeostasia e no metabolismo energético cerebral tem sido associado com alterações comportamentais, na modulação do humor e ritmo circadiano em humanos e em modelos animais da doença. Assim, alterações metabólicas em neurônios e células gliais têm sido associadas com quadros depressivos e maníacos. Nos últimos anos, avanços nas técnicas de neuroimagem, genéticos e de biologia moleculares têm gerado novos conhecimentos acerca das bases biológicas da bipolaridade. Os autores destacam que a doença parece estar relacionada diretamente com disfunções em diferentes mecanismos adaptativos a estresse em células neurais, gerando perda na capacidade celular de induzir neuroplasticidade e neurotrofismo, facilitando assim o surgimento da doença.In this article, the authors review relevant aspects related to the neurobiological basis of bipolar disorder. This illness has been associated with complex biochemical and molecular changes in brain circuits linked to neurotransmission and intracellular signal transduction pathways, and changes on neurons and glia have been proposed to be directly associated with clinical presentation of mania and depression. In the same context, dysfunctions on brain homeostasis and energy metabolism have been associated with alterations on circadian rythms, behavior and mood in human and animal models of bipolarity. In the recent years, advances on techniques of neuroimaging, molecular biology and genetics has provided new insights about

  5. The ketogenic diet for type II bipolar disorder.

    Science.gov (United States)

    Phelps, James R; Siemers, Susan V; El-Mallakh, Rif S

    2013-01-01

    Successful mood stabilizing treatments reduce intracellular sodium in an activity-dependent manner. This can also be achieved with acidification of the blood, as is the case with the ketogenic diet. Two women with type II bipolar disorder were able to maintain ketosis for prolonged periods of time (2 and 3 years, respectively). Both experienced mood stabilization that exceeded that achieved with medication; experienced a significant subjective improvement that was distinctly related to ketosis; and tolerated the diet well. There were no significant adverse effects in either case. These cases demonstrate that the ketogenic diet is a potentially sustainable option for mood stabilization in type II bipolar illness. They also support the hypothesis that acidic plasma may stabilize mood, perhaps by reducing intracellular sodium and calcium. PMID:23030231

  6. Lower Orbital Frontal White Matter Integrity in Adolescents with Bipolar I Disorder

    Science.gov (United States)

    Kafantaris, Vivian; Kingsley, Peter; Ardekani, Babak; Saito, Ema; Lencz, Todd; Lim, Kelvin; Szeszko, Philip

    2009-01-01

    Patients with bipolar I disorder demonstrated white matter abnormalities in white matter regions as seen through the use of diffusion tensor imaging. The findings suggest that white matter abnormalities in pediatric bipolar disorder may be useful in constructing neurobiological models of the disorder.

  7. Differentiating Bipolar Disorder--Not Otherwise Specified and Severe Mood Dysregulation

    Science.gov (United States)

    Towbin, Kenneth; Axelson, David; Leibenluft, Ellen; Birmaher, Boris

    2013-01-01

    Objective: Bipolar disorder--not otherwise specified (BP-NOS) and severe mood dysregulation (SMD) are severe mood disorders that were defined to address questions about the diagnosis of bipolar disorder (BD) in youth. SMD and BP-NOS are distinct phenotypes that differ in clinical presentation and longitudinal course. The purpose of this review is…

  8. Transdiagnostic Treatment of Bipolar Disorder and Comorbid Anxiety with the Unified Protocol: A Clinical Replication Series

    Science.gov (United States)

    Ellard, Kristen K.; Deckersbach, Thilo; Sylvia, Louisa G.; Nierenberg, Andrew A.; Barlow, David H.

    2012-01-01

    Bipolar disorder (BD) is a chronic, debilitating disorder with recurrent manic and depressive episodes. More than 75% of bipolar patients have a current or lifetime diagnosis of a comorbid anxiety disorder. Comorbid anxiety in BD is associated with greater illness severity, greater functional impairment, and poorer illness-related outcomes.…

  9. Religiosidade e espiritualidade no transtorno bipolar do humor Religiosity and spirituality in bipolar disorder

    Directory of Open Access Journals (Sweden)

    André Stroppa

    2009-01-01

    Full Text Available CONTEXTO: Nos últimos vinte anos, estudos sistematizados têm identificado uma relação positiva entre espiritualidade/religiosidade (R/E e saúde, notadamente saúde mental. Entretanto, são escassas as informações sobre R/E e transtorno bipolar do humor (TBH. Este artigo objetiva revisar as evidências disponíveis sobre estas relações. MÉTODOS: Foram cruzadas as palavras "bipolar", "mania" e "manic" com as palavras "religio*" e "spiritu*" nas bases de dados PubMed e PsychINFO em novembro de 2008. Foram encontrados 122 artigos publicados entre os anos de 1957 e 2008. RESULTADO: Os estudos apontam que pacientes bipolares tendem a apresentar maior envolvimento religioso/espiritual, maior frequência de relatos de conversão e experiências de salvação e uso mais frequente de coping religioso e espiritual (CRE que pessoas com outros transtornos mentais. Indicam ainda, uma relação frequente e significativa entre sintomas maníacos e experiências místicas. Os estudos mais relevantes encontrados na literatura foram agrupados nesta revisão em cinco tópicos: delírios místicos, religiosidade e espiritualidade, coping religioso-espiritual, recursos comunitários e comunidades tradicionais. CONCLUSÃO: O TBH e a R/E possuem intensa e complexa inter-relação. Estudos sobre práticas religiosas saudáveis, espiritualidade e recursos de coping merecem ser ampliados, bem como sua relação com o cumprimento do tratamento e as recorrências da doença, as intervenções psicoterápicas e a psicoeducação de base espiritual.BACKGROUND: Over the past twenty years, systematic studies have identified a positive relationship between spirituality/religiosity (S/R and health, especially mental health. Although there is only scant information about S/R and BipolarDisorder. METHODS: The words "bipolar", "mania" and "manic" were crossed with the words "religio*" and "spiritu*" in the databases PubMed and PsychINFO in November 2008. It was found 122

  10. The prevalence and significance of substance use disorders in bipolar type I and II disorder

    Directory of Open Access Journals (Sweden)

    Strakowski Stephen M

    2007-10-01

    Full Text Available Abstract The aim of this paper is to provide a systematic review of the literature examining the epidemiology, outcome, and treatment of patients with bipolar disorder and co-occurring substance use disorders (SUDs. Articles for this review were initially selected via a comprehensive Medline search and further studies were obtained from the references in these articles. Given the lack of research in this field, all relevant studies except case reports were included. Prior epidemiological research has consistently shown that substance use disorders (SUDs are extremely common in bipolar I and II disorders. The lifetime prevalence of SUDs is at least 40% in bipolar I patients. Alcohol and cannabis are the substances most often abused, followed by cocaine and then opioids. Research has consistently shown that co-occurring SUDs are correlated with negative effects on illness outcome including more frequent and prolonged affective episodes, decreased compliance with treatment, a lower quality of life, and increased suicidal behavior. Recent research on the causal relationship between the two disorders suggests that a subgroup of bipolar patients may develop a relatively milder form of affective illness that is expressed only after extended exposure to alcohol abuse. There has been very little treatment research specifically targeting this population. Three open label medication trials provide limited evidence that quetiapine, aripiprazole, and lamotrigine may be effective in treating affective and substance use symptoms in bipolar patients with cocaine dependence and that aripiprazole may also be helpful in patients with alcohol use disorders. The two placebo controlled trials to date suggest that valproate given as an adjunct to lithium in bipolar patients with co-occurring alcohol dependence improves both mood and alcohol use symptoms and that lithium treatment in bipolar adolescents improves mood and SUD symptoms. Given the high rate of SUD co

  11. The psychosocial context of bipolar disorder: environmental, cognitive, and developmental risk factors.

    Science.gov (United States)

    Alloy, Lauren B; Abramson, Lyn Y; Urosevic, Snezana; Walshaw, Patricia D; Nusslock, Robin; Neeren, Amy M

    2005-12-01

    In this article, we review empirical research on the role of individuals' current environmental contexts, cognitive styles, and developmental histories as risk factors for the onset, course, and expression of bipolar spectrum disorders. Our review is focused on the following over arching question: Do psychosocial factors truly contribute risk to the onset, course, or expression of bipolar disorders? As a secondary issue, we also address whether the psychosocial risks for bipolar disorders are similar to those for unipolar depression. We begin by discussing the methodological requirements for demonstrating a psychosocial risk factor and the challenges posed by bipolar spectrum disorders for psychosocial risk research. Next, we review the extant studies on the role of recent life events and supportive and non-supportive social interactions (current environment) in bipolar disorders, as well as psychosocial treatments designed to remediate these current environmental factors. We then review the role of cognitive styles featured as vulnerabilities in theories of unipolar depression as risk factors for bipolar disorder alone and in combination with life events, including studies of cognitive-behavioral therapies for bipolar disorder. Finally, we review studies of parenting and maltreatment histories in bipolar disorders. We conclude with an assessment of the state of the psychosocial risk factors literature in bipolar disorder with regard to our guiding questions.

  12. Relation between Amygdala Structure and Function in Adolescents with Bipolar Disorder

    Science.gov (United States)

    Kalmar, Jessica H.; Wang, Fei; Chepenik, Lara G.; Womer, Fay Y.; Jones, Monique M.; Pittman, Brian; Shah, Maulik P.; Martin, Andres; Constable, R. Todd; Blumberg, Hilary P.

    2009-01-01

    Adolescents with bipolar disorder showed decreased amygdala volume and increased amygdala response to emotional faces. Amygdala volume is inversely related to activation during emotional face processing.

  13. [Research on Early Identification of Bipolar Disorder Based on Multi-layer Perceptron Neural Network].

    Science.gov (United States)

    Zhang, Haowei; Gao, Yanni; Yuan, Chengmei; Liu, Ying; Ding, Yuqing

    2015-06-01

    Multi-layer perceptron (MLP) neural network belongs to multi-layer feedforward neural network, and has the ability and characteristics of high intelligence. It can realize the complex nonlinear mapping by its own learning through the network. Bipolar disorder is a serious mental illness with high recurrence rate, high self-harm rate and high suicide rate. Most of the onset of the bipolar disorder starts with depressive episode, which can be easily misdiagnosed as unipolar depression and lead to a delayed treatment so as to influence the prognosis. The early identifica- tion of bipolar disorder is of great importance for patients with bipolar disorder. Due to the fact that the process of early identification of bipolar disorder is nonlinear, we in this paper discuss the MLP neural network application in early identification of bipolar disorder. This study covered 250 cases, including 143 cases with recurrent depression and 107 cases with bipolar disorder, and clinical features were statistically analyzed between the two groups. A total of 42 variables with significant differences were screened as the input variables of the neural network. Part of the samples were randomly selected as the learning sample, and the other as the test sample. By choosing different neu- ral network structures, all results of the identification of bipolar disorder were relatively good, which showed that MLP neural network could be used in the early identification of bipolar disorder.

  14. A genetic deconstruction of neurocognitive traits in schizophrenia and bipolar disorder.

    Directory of Open Access Journals (Sweden)

    Carla P D Fernandes

    Full Text Available BACKGROUND: Impairments in cognitive functions are common in patients suffering from psychiatric disorders, such as schizophrenia and bipolar disorder. Cognitive traits have been proposed as useful for understanding the biological and genetic mechanisms implicated in cognitive function in healthy individuals and in the dysfunction observed in psychiatric disorders. METHODS: Sets of genes associated with a range of cognitive functions often impaired in schizophrenia and bipolar disorder were generated from a genome-wide association study (GWAS on a sample comprising 670 healthy Norwegian adults who were phenotyped for a broad battery of cognitive tests. These gene sets were then tested for enrichment of association in GWASs of schizophrenia and bipolar disorder. The GWAS data was derived from three independent single-centre schizophrenia samples, three independent single-centre bipolar disorder samples, and the multi-centre schizophrenia and bipolar disorder samples from the Psychiatric Genomics Consortium. RESULTS: The strongest enrichments were observed for visuospatial attention and verbal abilities sets in bipolar disorder. Delayed verbal memory was also enriched in one sample of bipolar disorder. For schizophrenia, the strongest evidence of enrichment was observed for the sets of genes associated with performance in a colour-word interference test and for sets associated with memory learning slope. CONCLUSIONS: Our results are consistent with the increasing evidence that cognitive functions share genetic factors with schizophrenia and bipolar disorder. Our data provides evidence that genetic studies using polygenic and pleiotropic models can be used to link specific cognitive functions with psychiatric disorders.

  15. Comparing clinical responses and the biomarkers of BDNF and cytokines between subthreshold bipolar disorder and bipolar II disorder.

    Science.gov (United States)

    Wang, Tzu-Yun; Lee, Sheng-Yu; Chen, Shiou-Lan; Chang, Yun-Hsuan; Wang, Liang-Jen; Chen, Po See; Chen, Shih-Heng; Chu, Chun-Hsien; Huang, San-Yuan; Tzeng, Nian-Sheng; Li, Chia-Ling; Chung, Yi-Lun; Hsieh, Tsai-Hsin; Lee, I Hui; Chen, Kao Chin; Yang, Yen Kuang; Hong, Jau-Shyong; Lu, Ru-Band

    2016-01-01

    Patients with subthreshold hypomania (SBP; subthreshold bipolar disorder) were indistinguishable from those with bipolar disorder (BP)-II on clinical bipolar validators, but their analyses lacked biological and pharmacological treatment data. Because inflammation and neuroprogression underlies BP, we hypothesized that cytokines and brain-derived neurotrophic factor (BDNF) are biomarkers for BP. We enrolled 41 drug-naïve patients with SBP and 48 with BP-II undergoing 12 weeks of pharmacological treatment (valproic acid, fluoxetine, risperidone, lorazepam). The Hamilton Depression Rating Scale (HDRS) and Young Mania Rating Scale (YMRS) were used to evaluate clinical responses at baseline and at weeks 0, 1, 2, 4, 8, and 12. Inflammatory cytokines (tumour necrosis factor [TNF]-α, transforming growth factor [TGF]-β1, interleukin [IL]-6, IL-8 and IL-1β) and BDNF levels were also measured. Mixed models repeated measurement was used to examine the therapeutic effect and changes in BDNF and cytokine levels between the groups. HDRS and YMRS scores significantly (P < 0.001) declined in both groups, the SBP group had significantly lower levels of BDNF (P = 0.005) and TGF-β1 (P = 0.02). Patients with SBP and BP-II respond similarly to treatment, but SBP patients may have different neuroinflammation marker expression. PMID:27270858

  16. Effects of erythropoietin on depressive symptoms and neurocognitive deficits in depression and bipolar disorder

    Directory of Open Access Journals (Sweden)

    Paulson Olaf B

    2010-10-01

    Full Text Available Abstract Background Depression and bipolar disorder are associated with reduced neural plasticity and deficits in memory, attention and executive function. Drug treatments for these affective disorders have insufficient clinical effects in a large group and fail to reverse cognitive deficits. There is thus a need for more effective treatments which aid cognitive function. Erythropoietin (Epo is involved in neuroplasticity and is a candidate for future treatment of affective disorders. The investigators have demonstrated that a single dose of Epo improves cognitive function and reduces neurocognitive processing of negative emotional information in healthy and depressed individuals similar to effects seen with conventional antidepressants. The current study adds to the previous findings by investigating whether repeated Epo administration has antidepressant effects in patients with treatment resistant depression and reverses cognitive impairments in these patients and in patients with bipolar disorder in remission. Methods/design The trial has a double-blind, placebo-controlled, parallel-group design. 40 patients with treatment-resistant major depression and 40 patients with bipolar disorder in remission are recruited and randomised to receive weekly infusions of Epo (Eprex; 40,000 IU or saline (NaCl 0.9% for 8 weeks. Randomisation is stratified for age and gender. The primary outcome parameters for the two studies are: depression severity measured with the Hamilton Depression Rating Scale 17 items (HDRS-17 1 in study 1 and, in study 2, verbal memory measured with the Rey Auditory Verbal Learning Test (RAVLT 23. With inclusion of 40 patients in each study we obtain 86% power to detect clinically relevant differences between intervention and placebo groups on these primary outcomes. Trial registration The trial is approved by the Local Ethics Committee: H-C-2008-092, Danish Medicines Agency: 2612-4020, EudraCT: 2008-04857-14, Danish Data Agency

  17. [The trends of mood disorders in ICD-11: bipolar and depressive disorders].

    Science.gov (United States)

    Kurumaji, Akeo

    2013-01-01

    The international classification of diseases 11th (ICD-11) revision is due by 2015. The ICD-11 beta draft has recently been released, which includes a prospective change in the content of mood disorders. The ICD-11 may separate the disorders into bipolar and depressive disorders as a consequence of an evaluation for the feasibility of a meta-structure for mental and behavioral disorders. In addition, the bipolar disorders may be divided into type I and II disorders. The depressive disorders may include new diseases, i. e., disruptive mood dysregulation disorder, mixed depressive anxiety, and premenstrual dysphoric disorder. Our epidemiological data from patients with mood disorders diagnosed using the ICD-10 or DSM-IV have proven their utility in clinical use, and suggested a required revision for the criteria of the diagnosis. A part of persistent mood disorders, such as cyclothymia and dysthymia, seem to be the prodromal state of bipolar disorders. For an accurate assessment of manic and hypomanic episodes, a precise estimation of the physiological effects of antidepressants as well as a sufficient review of clinical information from family members of patients are mandatory. The mixed affective episode may be deleted in the new version, because our data also indicate that this episode is a very rare clinical state. Moreover, it appears that inpatients with bipolar II disorder diagnosed by the DSM-IV in our hospital showed heterogeneous clinical properties, such as the onset age and interval between the first depressive and first hypomanic episode. After a worldwide and intensive discussion, it appears that the newly revised ICD-11 will be an advanced scientific tool for psychiatry. PMID:23691796

  18. CAG repeat expansions in bipolar and unipolar disorders

    Energy Technology Data Exchange (ETDEWEB)

    Oruc, L.; Verheyen, G.R.; Raeymaekers, P.; Van Broeckhoven, C. [Univ. of Antwerp (Belgium)] [and others

    1997-03-01

    Family, twin, and adoption studies consistently have indicated that the familial aggregation of bipolar (BP) disorder and unipolar recurrent major depression (UPR) is accounted for largely by genetic factors. However, the mode of inheritance is complex. One of the possible explanations could be that a gene with variable penetrance and variable expression is involved. Recently there have been reports on a new class of genetic diseases caused by an abnormal trinucleotide-repeat expansion (TRE). In a number of genetic disorders, these dynamic mutations were proved to be the biological basis for the clinically observed phenomenon of anticipation. DNA consisting of repeated triplets of nucleotides becomes unstable and increases in size over generations within families, giving rise to an increased severity and/or an earlier onset of the disorder. It has been recognized for a long time that anticipation occurs in multiplex families transmitting mental illness. More recent studies also suggest that both BP disorder and UPR show features that are compatible with anticipation. Although the findings of anticipation in BP disorders and in UPR must be interpreted with caution because of the possible presence of numerous ascertainment biases, they support the hypothesis that pathological TREs are implicated in the transmission of these disorders. TRE combined with variable penetrance of expression could explain the complex transmission pattern observed in BP disorder. In view of this, the recent reports of an association between CAG-repeat length and BP disorder in a Belgian, Swedish, and British population are promising. 14 refs., 1 fig., 1 tab.

  19. Transtorno bipolar do humor e uso indevido de substâncias psicoativas Bipolar disorder and substance abuse

    Directory of Open Access Journals (Sweden)

    Marcelo Ribeiro

    2005-01-01

    Full Text Available O transtorno bipolar e o uso indevido de substâncias psicoativas são doenças com alto potencial de limitação de autonomia, tornando-se ainda mais sérios quando associados. Este artigo apresenta as evidências científicas disponíveis acerca da epidemiologia, etiologia, evolução clínica, diagnóstico e tratamento farmacoterápico e psicossocial da comorbidade transtorno bipolar do humor e o uso indevido de substâncias psicoativas.The bipolar disorder and substance abuse are illness with highly autonomy limitation potential, becoming still more serious when associates. This article presents the available scientific evidences concerning the epidemiology, etiology, clinical evolution, diagnosis and pharmacological and psychosocial approaches designed for the bipolar disorder and substance abuse comorbidity.

  20. Parenting with Bipolar Disorder: Coping with Risk of Mood Disorders to Children

    OpenAIRE

    Peay, Holly Landrum; Rosenstein, Donald L.; Biesecker, Barbara Bowles

    2013-01-01

    Children of individuals with bipolar disorder (BPD) have increased risk for mood disorders and other adverse psychosocial outcomes due to genetic and environmental risk. Though parents with BPD are aware of increased risk to children, little is known about efforts undertaken in response or their perceived utility. Among parents who self-report with BPD, this study identifies key variables associated with parental coping with children’s risk of mood disorders; and explores the relationship bet...

  1. Toward a Valid Animal Model of Bipolar Disorder: How the Research Domain Criteria Help Bridge the Clinical-Basic Science Divide.

    Science.gov (United States)

    Cosgrove, Victoria E; Kelsoe, John R; Suppes, Trisha

    2016-01-01

    Bipolar disorder is a diagnostically heterogeneous disorder, although mania emerges as a distinct phenotype characterized by elevated mood and increased activity or energy. While bipolar disorder's cyclicity is difficult to represent in animals, models of mania have begun to decode its fundamental underlying neurobiology. When psychostimulants such as amphetamine or cocaine are administered to rodents, a resulting upsurge of motor activity is thought to share face and predictive validity with mania in humans. Studying black Swiss mice, which inherently exhibit proclivity for reward seeking and risk taking, also has yielded some insight. Further, translating the biology of bipolar disorder in humans into animal models has led to greater understanding of roles for candidate biological systems such as the GRIK2 and CLOCK genes, as well as the extracellular signal-related kinase pathway involved in the pathophysiology of the illness. The National Institute of Mental Health Research Domain Criteria initiative seeks to identify building blocks of complex illnesses like bipolar disorder in hopes of uncovering the neurobiology of each, as well as how each fits together to produce syndromes like bipolar disorder or why so many mental illnesses co-occur together. Research Domain Criteria-driven preclinical models of isolated behaviors and domains involved in mania and bipolar disorder will ultimately inform movement toward nosology supported by neurobiology. PMID:26531027

  2. Ziprasidone in the treatment of mania in bipolar disorder.

    Science.gov (United States)

    Nicolson, Stephen E; Nemeroff, Charles B

    2007-12-01

    Ziprasidone is an atypical antipsychotic with a unique receptor-binding profile. Currently, ziprasidone is approved by the US Food and Drug Administration for the acute treatment of psychosis in schizophrenia and mania in bipolar disorder. When compared to certain other atypical antipsychotics, ziprasidone appears to have a relatively benign side effect profile, especially as regards metabolic effects eg, weight gain, serum lipid elevations and glucose dysregulation. Taken together, these data suggest that ziprasidone may be a first line treatment for patients with bipolar mania. However, ziprasidone is a relatively new medication for which adverse events after long-term use and/or in vulnerable patient populations must be studied. Unstudied areas of particular importance include the efficacy and safety of ziprasidone in the treatment of bipolar depression and relapse prevention of mania as, well as in the subpopulations of pregnant women, the elderly and pediatric patients. The emergence of mania in patients taking ziprasidone is another topic for further study. PMID:19300617

  3. Pharmacotherapy of bipolar disorder in children and adolescents: an update

    Directory of Open Access Journals (Sweden)

    Tatiana Lauxen Peruzzolo

    2013-12-01

    Full Text Available Objective: To review the options for acute and maintenance pharmacological treatment of bipolar disorder in children and adolescents, including the treatment of bipolar depression and comorbid attention deficit/hyperactivity disorder (ADHD. Methods: Narrative review of randomized clinical trials and open-label studies published from 2000 to 2012. The PubMed and PsycINFO websites were queried. Case series were included when a higher level of evidence was not available. Results: Published data from randomized controlled trials (RCTs in acute mania/hypomania with significant responses are available for lithium, topiramate, risperidone, olanzapine, and aripiprazole. Open trials of lithium and lamotrigine show that these drugs may be effective in the treatment of depressive episodes. No trials of selective serotonin reuptake inhibitors (SSRIs have been conducted. In the treatment of comorbid ADHD, there are encouraging findings with mixed amphetamine salts and atomoxetine; conflicting results are observed with methylphenidate. Conclusions: Published RCTs of traditional mood stabilizers are scarce, but the best available evidence (results from meta-analytic regression suggests that second-generation antipsychotics (SGAs as a group are more effective in reducing manic symptoms. Risperidone was the only one included in head-to-head comparisons (vs. lithium and divalproex, showing superiority in terms of efficacy, but with more metabolic side effects, which were also more common in most of the SGAs. There are few studies addressing the treatment of ADHD and depression. Brazilian guidelines for the treatment of pediatric bipolar disorder should also include some SGAs (especially risperidone and aripiprazole as first-line treatment, and these drugs should be provided by the public health services.

  4. Transtorno bipolar do humor e uso indevido de substâncias psicoativas Bipolar disorder and substance abuse

    OpenAIRE

    Marcelo Ribeiro; Ronaldo Laranjeira; Giuliana Cividanes

    2005-01-01

    O transtorno bipolar e o uso indevido de substâncias psicoativas são doenças com alto potencial de limitação de autonomia, tornando-se ainda mais sérios quando associados. Este artigo apresenta as evidências científicas disponíveis acerca da epidemiologia, etiologia, evolução clínica, diagnóstico e tratamento farmacoterápico e psicossocial da comorbidade transtorno bipolar do humor e o uso indevido de substâncias psicoativas.The bipolar disorder and substance abuse are illness with highly aut...

  5. Two Complex Genotypes Relevant to the Kynurenine Pathway and Melanotropin Function show Association with Schizophrenia and Bipolar Disorder

    OpenAIRE

    Miller, Christine L.; Murakami, Peter; Ruczinski, Ingo; Ross, Randal G.; Sinkus, Melissa; Sullivan, Bernadette; Leonard, Sherry

    2009-01-01

    Prior studies of mRNA expression, protein expression, and pathway metabolite levels have implicated dysregulation of the kynurenine pathway in the etiology of schizophrenia and bipolar disorder. Here we investigate whether genes involved in kynurenine pathway regulation might interact with genes that respond to kynurenine metabolites, to enhance risk for these psychiatric phenotypes. Candidate genes were selected from prior studies of genetic association, gene expression profiling and animal ...

  6. What psychotherapists should know about pharmacotherapies for bipolar disorder.

    Science.gov (United States)

    Goldberg, Joseph F

    2007-05-01

    This article provides a practice-friendly overview of current psychotropic agents used for the treatment of bipolar disorder. The author reviews definitions and concepts about mood stabilization according to the evidence base, in turn profiling a "clinical niche" for lithium, anticonvulsant drugs, atypical antipsychotics, and antidepressants. Results from randomized clinical trials are summarized to help clinicians individualize treatment decisions and tailor them to real-world patients. Recognition and management of common adverse effects are discussed alongside risk-benefit strategies to guide optimal treatment that balances clinical efficacy with drug safety and tolerability. PMID:17417812

  7. Synchronization of EEG activity in patients with bipolar disorder

    Science.gov (United States)

    Panischev, O. Yu; Demin, S. A.; Muhametshin, I. G.; Demina, N. Yu

    2015-12-01

    In paper we apply the method based on the Flicker-Noise Spectroscopy (FNS) to determine the differences in frequency-phase synchronization of the cortical electroencephalographic (EEG) activities in patients with bipolar disorder (BD). We found that for healthy subjects the frequency-phase synchronization of EEGs from long-range electrodes was significantly better for BD patients. In BD patients a high synchronization of EEGs was observed only for short-range electrodes. Thus, the FNS is a simple graphical method for qualitative analysis can be applied to identify the synchronization effects in EEG activity and, probably, may be used for the diagnosis of this syndrome.

  8. Verbal learning impairment in euthymic bipolar disorder: BDI v BDII

    OpenAIRE

    Bourne, Corin; Bilderbeck, Amy; Drennan, Rebecca; Atkinson, Lauren; Price, Jonathan; Geddes, John R.; Goodwin, Guy M.

    2015-01-01

    Objectives Cognitive impairment is known to occur in bipolar disorder (BD), even in euthymic patients, with largest effect sizes often seen in Verbal Learning and Memory Tasks (VLT). However, comparisons between BD Type-I and Type-II have produced inconsistent results partly due to low sample sizes. Methods This study compared the performance of 183 BDI with 96 BDII out-patients on an adapted version of the Rey Verbal Learning Task. Gender, age, years of education, mood scores and age at onse...

  9. Matricídio e transtorno bipolar Matricide and bipolar disorder

    Directory of Open Access Journals (Sweden)

    Alexandre Martins Valença

    2009-01-01

    Full Text Available CONTEXTO: Matricídio é o assassinato de uma mãe pelo filho ou filha, uma forma de homicídio raramente vista na prática psiquiátrica. Estudos de casos de matricídio têm revelado a presença de transtornos mentais, tais como esquizofrenia, transtorno bipolar, transtornos de personalidade e alcoolismo, assim como casos em que não há evidência de transtorno mental. OBJETIVO: Tem-se como objetivo relatar o caso de uma mulher com transtorno bipolar que assassinou a sua genitora e que foi avaliada em perícia psiquiátrica para avaliação da responsabilidade penal. MÉTODOS: Foi realizada entrevista psiquiátrica, sendo o diagnóstico psiquiátrico estabelecido com base na entrevista e observação dos registros periciais e hospitalares, utilizando-se os critérios diagnósticos DSM-IV-TR. RESULTADOS: A examinanda foi considerada inimputável, em virtude da presença de doença mental que afetou inteiramente o seu entendimento e determinação em relação ao delito praticado. Ela cumpre medida de segurança em Hospital de Custódia e Tratamento Psiquiátrico há dois anos. CONCLUSÃO: É importante que psiquiatras e outros profissionais da saúde mental estejam atentos para risco de comportamento violento em pacientes que apresentam história de doença mental de longa duração, com episódios de violência durante a fase aguda, ameaças contra familiares ou amigos e falta de tratamento psiquiátrico regular.BACKGROUND: Matricide is the killing of one's own mother, and a type of homicide rarely seen on psychiatric practice. Matricide cases studies have shown the presence of mental disorders, such as schizophrenia, bipolar disorder, personality disorders and alcoholism, and have also found cases where there is no evidence of mental disorders. OBJECTIVE: We aim to report a case of a woman with bipolar disorder that murdered her own mother and had a psychiatric forensic evaluation to ascertain her penal imputability. METHODS: Psychiatric

  10. The relationship between bipolar disorder and type 2 diabetes: more than just co-morbid disorders.

    Science.gov (United States)

    Calkin, Cynthia V; Gardner, David M; Ransom, Thomas; Alda, Martin

    2013-03-01

    Type 2 diabetes mellitus (T2DM) rates are three times higher in patients with bipolar disorder (BD), compared to the general population. This is a major contributing factor to the elevated risk of cardiovascular mortality, the leading cause of death in bipolar patients. There may be shared pathophysiology linking the two disorders, including hypothalamic-pituitary-adrenal and mitochondrial dysfunction, common genetic links, and epigenetic interactions. Life-style, phenomenology of bipolar symptoms, and adverse effects of pharmacotherapy may be contributing factors. Patients with BD and T2DM have a more severe course of illness and are more refractory to treatment. Control of their diabetes is poorer when compared to diabetics without BD, and an existing disparity in medical care may be partly responsible. Glucose abnormalities in bipolar patients need to be screened for and treated. Metformin appears to have the best benefit/risk ratio, and the dipeptidyl peptidase-4 inhibitors and glucagon-like peptide-1 receptor agonists and analogues also appear promising, although these agents have not been specifically studied in populations with mood disorders. Physicians need to be aware of the increased risk for T2DM and cardiovascular disease in bipolar patients, and appropriate prevention, screening, case finding, and treatment is recommended. PMID:22621171

  11. Working Memory and Response Inhibition in Patients With Bipolar I Disorder During Euthymic Period

    OpenAIRE

    Farahmand, Zahra; Tehrani-Doost, Mehdi; Amini, Homayoun; Mohammadi, Abolfazl; Mirzaei, Mosleh; Mohamadzadeh, Azar

    2015-01-01

    Background: Several cognitive domains, including attention, memory, and executive functions are impaired in bipolar disorder. Objectives: This study aimed to investigate two executive functions (working memory and response inhibition) in patients with bipolar I disorder during remission of the symptoms. Patients and Methods: In this case-control design, 30 bipolar I patients (18 to 45 years old) were matched with 30 ones in the control group in terms of age, gender, and education. The patient...

  12. Cognitive Functioning in Clinically Stable Patients with Bipolar Disorder I and II

    OpenAIRE

    Timea Sparding; Katja Silander; Erik Pålsson; Josefin Östlind; Carl Sellgren; Carl Johan Ekman; Erik Joas; Stefan Hansen; Mikael Landén

    2015-01-01

    Objectives Bipolar disorder is accompanied by cognitive impairments, which persists during euthymic phases. The purpose of the present study was to identify those neuropsychological tests that most reliably tell euthymic bipolar patients and controls apart, and to clarify the extent to which these cognitive impairments are clinically significant as judged from neuropsychological norms. Methods Patients with bipolar disorder (type I: n = 64; type II: n = 44) and controls (n = 86) were examined...

  13. The influence of life events on first and recurrent admissions in bipolar disorder

    OpenAIRE

    Kemner, Sanne M; van Haren, Neeltje E. M.; Bootsman, Florian; Eijkemans, Marinus J C; Vonk, Ronald; van der Schot, Astrid C.; Willem A Nolen; Hillegers, Manon H J

    2015-01-01

    Methods: We collected information about life events and admissions across the life span in 51 bipolar patients. We constructed four models to explore the decay of life event effects on admissions. To test their interaction, we used the Andersen-Gill model. Background: Life events play an important role in the onset and course of bipolar disorder. We will test the influence of life events on first and recurrent admissions in bipolar disorder and their interaction to test the kindling hypothesi...

  14. Clinical and course indicators of bipolar disorder type I with and without opioid dependence

    OpenAIRE

    amir shabani; Atefeh Ghanbari Jolfaei; Hajar Ahmadi Vazmalaei; Azizeh Afkham Ebrahimi; Morteza Naserbakht

    2010-01-01

    Abstract BACKGROUND: The existing evidence about the clinical situations of the bipolar patients with opioid dependence is scarce. The present study was carried out to compare the clinical features and course of the bipolar disorder type I regarding the two subgroups of opioid dependent and non-dependent. METHODS: 178 adult inpatients with bipolar disorder type I consecutively referred to the Iran Hospital of Psychiatry, Tehran, Iran, from January 2008 to January 2009 we...

  15. Differences in the ICD-10 diagnostic subtype of depression in bipolar disorder compared to recurrent depressive disorder

    DEFF Research Database (Denmark)

    Jensen, H.M.; Christensen, E.M.; Kessing, Lars Vedel

    2008-01-01

    Background: The aim of the study was to investigate whether patients with bipolar depression and patients with recurrent depressive disorder present with different subtypes of depressive episode as according to ICD-10. Sampling and Methods: All patients who got a diagnosis of bipolar affective......: Totally, 389 patients got a diagnosis of bipolar disorder, current episode of depression, and 5.391 patients got a diagnosis of recurrent depressive disorder, current episode of depression, at first contact. Compared with patients with a diagnosis of recurrent depressive disorder, patients with bipolar...... for patients with bipolar disorder, current episode of depression, compared with patients with a current depression as part of a recurrent depressive disorder (HR = 1.50, 95% CI = 1.20-1.86). Conclusions: The results consistently indicate that a depressive episode is severer and/or more often associated...

  16. Bipolar and related disorders and depressive disorders in DSM-5

    OpenAIRE

    Łojko, Dorota; Suwalska, Aleksandra; Rybakowski, Janusz,

    2014-01-01

    In 2013, a version of the Diagnostic and Statistical Manual of Mental Disorders (DSM), having number 5, was published. The DSM is a textbook which aims to present diagnostic criteria for each psychiatric disorder recognized by the U.S. healthcare system. The DSM-5 comprises the most updated diagnostic criteria of psychiatric disorders as well as their description, and provides a common language for clinicians to communicate about the patients. Diagnostic criteria of the DSM-5 have been popula...

  17. Characteristics, Correlates and Outcomes of Perceived Stigmatization in Bipolar Disorder Patients

    DEFF Research Database (Denmark)

    Nilsson, Kristine Kahr; Kugathasan, Pirathiv; Nielsen Straarup, Krista

    2016-01-01

    The aim of this study was to elucidate the characteristics, correlates and outcomes of perceived stigmatization in patients with Bipolar Disorder (BD).......The aim of this study was to elucidate the characteristics, correlates and outcomes of perceived stigmatization in patients with Bipolar Disorder (BD)....

  18. Bipolar disorder in the elderly; different effects of age and of age of onset

    DEFF Research Database (Denmark)

    Oostervink, Frits; Boomsma, Maarten M; Nolen, Willem A;

    2009-01-01

    Information about differences between younger and elderly patients with bipolar disorder and between elderly patients with early and late age of onset of illness is limited.......Information about differences between younger and elderly patients with bipolar disorder and between elderly patients with early and late age of onset of illness is limited....

  19. Reproductive function and risk for PCOS in women treated for bipolar disorder

    NARCIS (Netherlands)

    Rasgon, NL; Altshuler, LL; Fairbanks, L; Elman, S; Bitran, J; Labarca, R; Saad, M; Kupka, R; Nolen, WA; Frye, MA; Suppes, T; McElroy, SL; Keck, PE; Leverich, G; Grunze, H; Walden, J; Post, R; Mintz, J

    2005-01-01

    Introduction: This study examined the reproductive function and prevalence of polycystic ovary syndrome (PCOS) in women with bipolar disorder taking antimanic medications. Method: Women aged 18-45 treated for bipolar disorder and not taking steroid contraceptives were recruited to complete questionn

  20. Effects of cognitive remediation on cognitive dysfunction in partially or fully remitted patients with bipolar disorder

    DEFF Research Database (Denmark)

    Demant, Kirsa M; Almer, Glennie Marie; Vinberg, Maj;

    2013-01-01

    A large proportion of patients with bipolar disorder experience persistent cognitive dysfunction, such as memory, attention and planning difficulties, even during periods of full remission. The aim of this trial is to investigate whether cognitive remediation, a new psychological treatment......, improves cognitive function and, in turn, psychosocial function in patients with bipolar disorder in partial or full remission....

  1. Three-Dimensional Mapping of Hippocampal Anatomy in Adolescents with Bipolar Disorder

    Science.gov (United States)

    Bearden, Carrie E.; Soares, Jair C.; Klunder, Andrea D.; Nicoletti, Mark; Dierschki, Nicole; Hayashi, Kiralee M.; Narr, Katherine L.; Bhrambilla, Paolo; Sassi, Roberto B.; Axelson, David; Ryan, Neal; Birmaher, Boris; Thompson, Paul M.

    2008-01-01

    The article discusses the use of three-dimensional mapping methods in children and adolescents with bipolar disorder to find out if localized alterations in hippocampal structure are exhibited. It also explores the developmental differences where the patient with bipolar disorder showed increasing hippocampal size with increasing age.

  2. Daily electronic self-monitoring in bipolar disorder using smartphones - the MONARCA I trial

    DEFF Research Database (Denmark)

    Faurholt-Jepsen, Maria; Frost, Mads; Ritz, Christian;

    2015-01-01

    BACKGROUND: The number of studies on electronic self-monitoring in affective disorder and other psychiatric disorders is increasing and indicates high patient acceptance and adherence. Nevertheless, the effect of electronic self-monitoring in patients with bipolar disorder has never been...... investigated in a randomized controlled trial (RCT). The objective of this trial was to investigate in a RCT whether the use of daily electronic self-monitoring using smartphones reduces depressive and manic symptoms in patients with bipolar disorder. METHOD: A total of 78 patients with bipolar disorder...

  3. Schema therapy for bipolar disorder: a conceptual model and future directions.

    Science.gov (United States)

    Hawke, Lisa D; Provencher, Martin D; Parikh, Sagar V

    2013-05-15

    Schema therapy (ST) is an integrative form of psychotherapy developed for complex, chronic psychological disorders with a characterlogical underpinning. Bipolar disorder is just such a disorder--complex and often comorbid, with demonstrated stable cognitive and personality features that complicate the course of illness. This article presents the reasons justifying the application of ST to bipolar disorder and proposes a treatment rationale and future directions for treatment and research. If well adapted to the characteristics of bipolar disorder, ST might prove to be an effective adjunctive psychotherapy option that attenuates emotional reactivity, reduces symptoms and improves quality of life.

  4. Biomarkers and staging of bipolar disorder: a systematic review

    Directory of Open Access Journals (Sweden)

    Ângela Roda

    2015-03-01

    Full Text Available INTRODUCTION: A growing body of evidence suggests that bipolar disorder (BD is a progressive disease according to clinical, biochemical and neuroimaging findings. This study reviewed the literature on the relationship between specific biomarkers and BD stages.METHODS: A comprehensive literature search of MEDLINE and PubMed was conducted to identify studies in English and Portuguese using the keywords biomarker, neurotrophic factors, inflammation, oxidative stress, neuroprogression and staging models cross-referenced with bipolar disorder.RESULTS: Morphometric studies of patients with BD found neuroanatomic abnormalities, such as ventricular enlargement, grey matter loss in the hippocampus and cerebellum, volume decreases in the prefrontal cortex and variations in the size of the amygdala. Other studies demonstrated that serum concentrations of neurotrophic factors, inflammatory mediators and oxidative stress may be used as BD biomarkers.CONCLUSIONS: The analysis of neurobiological changes associated with BD progression and activity may confirm the existence of BD biomarkers, which may be then included in staging models that will lead to improvements in treatment algorithms and more effective, individually tailored treatment regimens. Biomarkers may also be used to define early interventions to control disease progression.

  5. Facial emotion recognition in adolescents with bipolar disorder.

    Directory of Open Access Journals (Sweden)

    Bonnie Bozorg

    2014-03-01

    Full Text Available Bipolar disorder (BD is associated with abnormalities in emotional competence. One of the main aspects of this competency is emotion recognition which is presented in the face. This study aimed to evaluate facial emotion recognition in adolescents with bipolar disorder when they are free of acute symptoms.Thirty patients diagnosed with BD aged 12 to 18 were selected from a large sample of consecutive admitted adolescents in Roozbeh hospital. They were compared with 30 matched normal developing adolescents who were recruited from mainstream schools at Tehran. All participants were evaluated using a facial emotion recognition task. The participants needed to recognize happy, sad, angry and neutral facial expressions The ANOVA was used to analyze the differences between the two groups in terms of emotion recognition variables.The patients with BD showed a significant deficit in recognizing emotions in general (p=.01 which was prominent in the angry faces. Their response time to recognize the facial expressions was longer compared to the normal individuals. This difference was significant in recognizing the happy and neutral faces (p<0.05.This study suggests an inaccurate recognition of facial expressions in adolescents with BD, particularly for anger, as well as slowness in detecting emotions especially happiness.

  6. Predominant mania course in Indian patients with bipolar I disorder.

    Science.gov (United States)

    Rangappa, Sushma Bilichodu; Munivenkatappa, Shashidhara; Narayanaswamy, Janardhanan C; Jain, Sanjeev; Reddy, Y C Janardhan

    2016-08-01

    Many long-term follow-up studies suggest that bipolar disorder (BD) is highly recurrent and that depressive episodes are commoner than hypomania/manic episodes. However, some studies from tropical countries including India suggest that the patients experience a greater proportion of manic episodes than depressive episodes. The aim of the present study was to examine the course of BD type 1 (BD I) in a sample of hospitalized Indian subjects. We examined the clinical course of 285 BD I subjects with at least 5 years of illness using standard life charting method. These subjects were hospitalized between October 2010 and October 2012. The predominant polarity (having at least two-thirds of their lifetime episodes at one polarity) was mania (79%). Unipolar mania (≥ 3 mania episodes and no episodes of depression) was observed in 48% of the subjects. The frequency of rapid cycling course was noted in 2.5% of the subjects. Predominant manic polarity group had the illness onset mostly with a manic episode (88.9%) and the predominant depressive polarity group with a depressive episode (73.8%). Mania was the predominant polarity with a high rate of unipolar mania and a majority of the subjects had greater number of manic episodes than depressive/mixed episodes. The onset polarity determined the predominant polarity during the course of illness. Predominantly, mania course could have significant implications in the treatment of bipolar disorder. PMID:27520890

  7. A genetic deconstruction of neurocognitive traits in schizophrenia and bipolar disorder

    NARCIS (Netherlands)

    C.P.D. Fernandes (Carla P.); A. Christoforou (Andrea); S. Giddaluru (Sudheer); K.M. Ersland (Kari); S. Djurovic (Srdjan); M. Mattheisen (Manuel); A.J. Lundervold (Astri); I. Reinvang (Ivar); M.M. Nöthen (Markus); M. Rietschel (Marcella); R.A. Ophoff (Roel); A. Hofman (Albert); A.G. Uitterlinden (André); T.M. Werge (Thomas); S. Cichon (Sven); T. Espeseth (Thomas); O.A. Andreassen (Ole); V.M. Steen (Vidar); S. Le Hellard (Stephanie)

    2013-01-01

    textabstractBackground: Impairments in cognitive functions are common in patients suffering from psychiatric disorders, such as schizophrenia and bipolar disorder. Cognitive traits have been proposed as useful for understanding the biological and genetic mechanisms implicated in cognitive function i

  8. A genetic deconstruction of neurocognitive traits in schizophrenia and bipolar disorder

    DEFF Research Database (Denmark)

    Fernandes, Carla P D; Christoforou, Andrea; Giddaluru, Sudheer;

    2013-01-01

    Impairments in cognitive functions are common in patients suffering from psychiatric disorders, such as schizophrenia and bipolar disorder. Cognitive traits have been proposed as useful for understanding the biological and genetic mechanisms implicated in cognitive function in healthy individuals...

  9. Quetiapine extended release for the treatment of bipolar disorder.

    Science.gov (United States)

    Samalin, Ludovic; Tremey, Aurore; Llorca, Pierre-Michel

    2014-09-01

    Management of bipolar disorder (BD) requires a complex combination of pharmacological and psychosocial interventions. Over recent decades the therapeutic arsenal for BD has expanded to include lithium, anticonvulsants and second-generation antipsychotics (SGAs). Immediate release (IR) quetiapine fumarate is a SGA approved in several countries for the treatment of patients with schizophrenia and BD or as an add-on treatment for major depressive disorders. Extended release (XR) quetiapine fumarate was developed more recently. There is interest in a once-daily formulation which may improve patient compliance but there may be some differences between quetiapine IR and XR in terms of safety and efficacy. This article provides an update of recent data on the efficacy and safety of quetiapine XR for the treatment of BD. PMID:25096854

  10. A review of potassium channels in bipolar disorder

    Directory of Open Access Journals (Sweden)

    Jennifer Toolan Judy

    2013-06-01

    Full Text Available Although bipolar disorder (BP is one of the most heritable psychiatric conditions, susceptibility genes for the disorder have yet to be conclusively identified. It is likely that variants in multiple genes across multiple pathways contribute to the genotype-phenotype relationship. Recent evidence from genome-wide association studies (GWAS implicates an entire class of genes related to the structure and regulation of ion channels, suggesting that the etiology of BP may arise from a channelopathy. In this review, we examine the evidence for this hypothesis, with a focus on the potential role of voltage gated potassium channels. We consider evidence from genetic and expression studies, and discuss the potential underlying biology. We consider animal models and treatment implications of the involvement of potassium ion channelopathy in BP. Finally, we explore intriguing parallels between BP and epilepsy, the signature channelopathy of the CNS.

  11. A Test of the Bidirectional Association Between Sleep and Mood in Bipolar Disorder and Insomnia

    Science.gov (United States)

    Talbot, Lisa S.; Stone, Susan; Gruber, June; Hairston, Ilana S.; Eidelman, Polina; Harvey, Allison G.

    2012-01-01

    The present study investigates sleep, mood, and the proposed bidirectional relationship between the two in psychiatric disorders. Participants with interepisode bipolar disorder (n = 49), insomnia (n = 34), and no psychiatric history (n = 52) completed seven consecutive days of sleep diaries and mood measures. The interepisode bipolar and insomnia participants exhibited greater sleep disturbance than the healthy control individuals. Negative mood was equally heightened in both interepisode bipolar disorder and insomnia, and there were no differences between the three groups in positive mood. Total wake time was associated with next morning negative mood in bipolar disorder, whereas evening negative mood was associated with subsequent total wake time in both bipolar disorder and insomnia. Additionally, positive mood was associated with subsequent total wake time for the insomnia group. Results support the theory that disruptions in nighttime sleep and daytime mood may be mutually maintaining and suggest the potential importance of transdiagnostic or universal processes. PMID:21842957

  12. More Pronounced Deficits in Facial Emotion Recognition for Schizophrenia than Bipolar Disorder

    OpenAIRE

    Goghari, Vina M.; Sponheim, Scott R.

    2012-01-01

    Schizophrenia and bipolar disorder are typically separated in diagnostic systems. Behavioural, cognitive, and brain abnormalities associated with each disorder nonetheless overlap. We evaluated the diagnostic specificity of facial emotion recognition deficits in schizophrenia and bipolar disorder to determine whether select aspects of emotion recognition differed for the two disorders. The investigation used an experimental task that included the same facial images in an emotion recognition c...

  13. Differential responses to lithium in hyperexcitable neurons from patients with bipolar disorder

    OpenAIRE

    Mertens, Jerome; Wang, Qiu-Wen; Kim, Yongsung; Yu, Diana X.; Pham, Son; Yang, Bo; Zheng, Yi; Diffenderfer, Kenneth E.; Zhang, Jian; Soltani, Sheila; Eames, Tameji; Schafer, Simon T.; Boyer, Leah; Marchetto, Maria C.; Nurnberger, John I.

    2015-01-01

    Bipolar disorder is a complex neuropsychiatric disorder that is characterized by intermittent episodes of mania and depression; without treatment, 15% of patients commit suicide1. Hence, it has been ranked by the World Health Organization as a top disorder of morbidity and lost productivity2. Previous neuropathological studies have revealed a series of alterations in the brains of patients with bipolar disorder or animal models3, such as reduced glial cell number in the prefrontal cortex of p...

  14. Early intervention for bipolar disorder: current imperatives, future directions Intervenção precoce no transtorno bipolar: necessidades atuais, rumos futuros

    OpenAIRE

    Matthew Taylor; Rodrigo Affonseca Bressan; Pedro Mario Pan; Elisa Brietzke

    2011-01-01

    OBJECTIVES: The objective of this article is to discuss the rationale/background for early intervention in bipolar disorder. METHOD: Narrative review. RESULTS: There are often significant delays before the diagnosis of bipolar disorder is made and effective management initiated. Growing evidence from both preclinical and clinical literature points to a clear need for improved early identification and early intervention in bipolar disorder. Increasing efforts are being applied to the identific...

  15. Elevated ambitions for fame among persons diagnosed with bipolar I disorder.

    Science.gov (United States)

    Johnson, Sheri L; Carver, Charles S; Gotlib, Ian H

    2012-08-01

    A growing body of evidence suggests that people with bipolar disorder are highly goal-oriented. Compared to other persons, they expend more effort to attain rewards and view goal pursuit as more important to their self-worth. Persons at risk for mania and those diagnosed with bipolar spectrum disorders have been shown to endorse highly ambitious life goals, such as becoming a multimillionaire or achieving fame. This study is the first examination of whether such elevated goals characterize persons diagnosed with bipolar I disorder. We also examined whether elevated ambitions predicted symptom change over time. Ninety-two persons with bipolar I disorder and 81 age- and sex-matched controls completed the Willingly Approached Set of Statistically Unlikely Pursuits, a measure of extremely high life ambitions. A subset of the bipolar participants completed a 3-month follow-up interview. Participants with bipolar disorder endorsed higher ambitions for popular fame than did controls; moreover, heightened ambitions for popular fame and financial success predicted increases in manic symptoms in those with bipolar disorder over the next three months. Discussion focuses on goal regulation in bipolar disorder. PMID:22103804

  16. Neuroanatomical voxel-based profile of schizophrenia and bipolar disorder.

    Science.gov (United States)

    Maggioni, E; Bellani, M; Altamura, A C; Brambilla, P

    2016-08-01

    Although schizophrenia (SCZ) and bipolar disorder (BD) share elements of pathology (Ellison-Wright and Bullmore, 2009), the neural mechanisms underlying these disorders are still under investigation. Up until now, many neuroimaging studies investigated the brain structural differences of SCZ and BD compared with healthy controls (HC), trying to identify the possible neuroanatomical markers for the two disorders. However, just a few studies focused on the brain structural changes between the two diagnoses. The present review summarises the findings of the voxel-based grey matter (GM) comparisons between SCZ and BD, with the objective to highlight the possible consistent anatomical differences between the two disorders. While the comparisons between patients and HC highlighted overlapping areas of GM reduction in insula and anterior cingulate cortex, the SCZ-BD comparisons suggest the presence of more generalised GM deficits in SCZ compared with BD. Indeed, in a number of studies, SCZ patients showed lower GM volumes than BD patients in fronto-temporal cortex, thalamus, hippocampus and amygdala. Conversely, only a couple of studies reported GM deficits in BD compared with SCZ, both at the level of cerebellum. In summary, the two disorders exhibit both common and specific neuroanatomical characteristics, whose knowledge is mandatory to develop innovative diagnostic and treatment strategies. PMID:27095442

  17. Anxiety Disorders and Rapid Cycling Data From a Cohort of 8129 Youths With Bipolar Disorder

    OpenAIRE

    Castilla-Puentes, Ruby; Sala, Regina; Ng, Bernardo; Galvez, Juan; Camacho, Alvaro

    2013-01-01

    Anxiety disorders (ADs) are common in youths with bipolar disorder (BD). We examine psychiatric comorbidity, hospitalization, and treatment in youths with versus without AD and rapid cycling (four or more cycles per year). Data from the Integrated Healthcare Information Services cohort were used and included 8129 youths (ages ≤18 years). Prevalence of AD, demographic, type of AD, hospitalization, and use of psychotropics were compared between rapid and nonrapid cycling. Overall, 51% of the yo...

  18. Memory mood congruency phenomenon in bipolar I disorder and major depression disorder patients

    OpenAIRE

    Delgado, V.B.; Kapczinski, F.; Chaves, M.L.F.

    2012-01-01

    The objective of the present study was to evaluate memory performance in tasks with and without affective content (to confirm the mood congruency phenomenon) in acutely admitted patients with bipolar I disorder (BD) and major depression disorder (MDD) and in healthy participants. Seventy-eight participants (24 BD, 29 MDD, and 25 healthy controls) were evaluated. Three word lists were used as the memory task with affective content (positive, negative and indifferent). Psychiatric symptoms were...

  19. The prevalence and significance of substance use disorders in bipolar type I and II disorder

    OpenAIRE

    Strakowski Stephen M; Cerullo Michael A

    2007-01-01

    Abstract The aim of this paper is to provide a systematic review of the literature examining the epidemiology, outcome, and treatment of patients with bipolar disorder and co-occurring substance use disorders (SUDs). Articles for this review were initially selected via a comprehensive Medline search and further studies were obtained from the references in these articles. Given the lack of research in this field, all relevant studies except case reports were included. Prior epidemiological res...

  20. Cross-cultural comparisons on Wisconsin Card Sorting Test performance in euthymic patients with bipolar disorder.

    Science.gov (United States)

    Liu, Yu-Ming; Tsai, Shang-Ying; Fleck, David E; Strakowski, Stephen M

    2011-10-30

    We compared executive dysfunction with the Wisconsin Card Sorting Test (WCST) among distinct national and ethnic patients with bipolar disorder in euthymia. Bipolar patients, aged 16-45years, from the United States (n=25) and Taiwan (n=30) did not differ significantly on any measure. The WCST score for number Failure to Maintain Set was significantly positively correlated with residual affective symptoms in Taiwanese and US patients. Selective executive dysfunction in euthymia is inherent to bipolar disorder. Euthymic bipolar patients of various ethnic groups may exhibit similar executive dysfunction.

  1. Role of extended release quetiapine in the management of bipolar disorders

    Directory of Open Access Journals (Sweden)

    Rayan K Al Jurdi

    2010-02-01

    Full Text Available Rayan K Al Jurdi1,2, Lena A Dixit1, Martha Sajatovic3 1Baylor College of Medicine, Department of Psychiatry, Houston, Texas, USA; 2South Central Mental Illness Research and Clinical Core, Department of Veterans Affairs, Houston, Texas; 3Department of Psychiatry, Case Western Reserve University School of Medicine, Cleveland, Ohio, USAAbstract: Atypical antipsychotics have become a widely utilized component of the bipolar disorder treatment armamentarium, with approximately 45% of bipolar patients prescribed atypicals. Over the last decade all atypical drugs except for clozapine have received a Food and Drug Administration (FDA bipolar indication. In October 2008, the FDA approved quetiapine XR monotherapy for the treatment of acute depressive episodes of bipolar disorder and acute manic or mixed episodes in bipolar I disorder based on two placebo-control trials. Quetiapine was also approved as adjunct therapy with lithium and divalproex for the treatment of acute manic or mixed episodes as well as maintenance of bipolar I disorder. In contrast to immediate release quetiapine which may require a twice-daily regimen, the XR formulation is intended for once-daily administration. This drug profile of quetiapine XR will address chemistry, pharmacodynamics, pharmacokinetics, metabolism, safety and tolerability and clinical trials in bipolar disorder.Keywords: quetiapine XR, bipolar disorder

  2. Rheumatoid arthritis and the risk of bipolar disorder: a nationwide population-based study.

    Directory of Open Access Journals (Sweden)

    Chih-Chao Hsu

    Full Text Available Studies have suggested that chronic inflammation plays an essential role in the pathophysiology of both rheumatoid arthritis (RA and bipolar disorder. The most common clinical features associated with RA are anxiety and depression. The risk of bipolar disorder among patients with RA has not been characterized adequately.To determine the association between RA and the subsequent development of bipolar disorder and examine the risk factors for bipolar disorder among patients with RA.We identified patients who were diagnosed with RA in the Taiwan National Health Insurance Research Database. A comparison cohort was created by matching patients without RA with those with RA according to age, sex, and comorbidities. The occurrence of bipolar disorder was evaluated in both cohorts.The RA cohort consisted of 2,570 patients, and the comparison cohort consisted of 2,570 matched control patients without RA. The incidence of bipolar disorder (incidence rate ratio  = 2.13, 95% confidence interval [CI]  = 1.12-4.24, P =  .013 was higher among patients with RA than among control patients. Multivariate, matched regression models revealed that asthma (hazard ratio [HR]  = 2.76, 95% CI 1.27-5.96, P =  .010, liver cirrhosis (HR  = 3.81, 95% CI  = 1.04-14.02, P =  .044, and alcohol use disorders (HR  = 5.29, 95% CI  = 1.71-16.37, P =  .004 were independent risk factors for the development of bipolar disorder among patients with RA.RA might increase the incidence of bipolar disorder development. Based on our data, we suggest that, following RA diagnosis, greater attention be focused on women with asthma, liver cirrhosis, and alcohol use disorder. Prospective clinical studies of the relationship between RA and bipolar disorder are warranted.

  3. Differential responses to lithium in hyperexcitable neurons from patients with bipolar disorder.

    Science.gov (United States)

    Mertens, Jerome; Wang, Qiu-Wen; Kim, Yongsung; Yu, Diana X; Pham, Son; Yang, Bo; Zheng, Yi; Diffenderfer, Kenneth E; Zhang, Jian; Soltani, Sheila; Eames, Tameji; Schafer, Simon T; Boyer, Leah; Marchetto, Maria C; Nurnberger, John I; Calabrese, Joseph R; Ødegaard, Ketil J; McCarthy, Michael J; Zandi, Peter P; Alda, Martin; Alba, Martin; Nievergelt, Caroline M; Mi, Shuangli; Brennand, Kristen J; Kelsoe, John R; Gage, Fred H; Yao, Jun

    2015-11-01

    Bipolar disorder is a complex neuropsychiatric disorder that is characterized by intermittent episodes of mania and depression; without treatment, 15% of patients commit suicide. Hence, it has been ranked by the World Health Organization as a top disorder of morbidity and lost productivity. Previous neuropathological studies have revealed a series of alterations in the brains of patients with bipolar disorder or animal models, such as reduced glial cell number in the prefrontal cortex of patients, upregulated activities of the protein kinase A and C pathways and changes in neurotransmission. However, the roles and causation of these changes in bipolar disorder have been too complex to exactly determine the pathology of the disease. Furthermore, although some patients show remarkable improvement with lithium treatment for yet unknown reasons, others are refractory to lithium treatment. Therefore, developing an accurate and powerful biological model for bipolar disorder has been a challenge. The introduction of induced pluripotent stem-cell (iPSC) technology has provided a new approach. Here we have developed an iPSC model for human bipolar disorder and investigated the cellular phenotypes of hippocampal dentate gyrus-like neurons derived from iPSCs of patients with bipolar disorder. Guided by RNA sequencing expression profiling, we have detected mitochondrial abnormalities in young neurons from patients with bipolar disorder by using mitochondrial assays; in addition, using both patch-clamp recording and somatic Ca(2+) imaging, we have observed hyperactive action-potential firing. This hyperexcitability phenotype of young neurons in bipolar disorder was selectively reversed by lithium treatment only in neurons derived from patients who also responded to lithium treatment. Therefore, hyperexcitability is one early endophenotype of bipolar disorder, and our model of iPSCs in this disease might be useful in developing new therapies and drugs aimed at its clinical

  4. Season of birth is associated with adult body mass index in patients with bipolar disorder.

    Science.gov (United States)

    Soreca, Isabella; Cheng, Yu; Frank, Ellen; Fagiolini, Andrea; Kupfer, David J

    2013-05-01

    Cardiovascular risk factors, such as abdominal obesity and obesity in general, are very prevalent among patients with bipolar disorder (BD). Although long-term use of psychotropic medications is an important determinant of these risk factors, other evidence suggests that early development may interact with the mood disorder diathesis to exponentially increase the risk of obesity. The goal of our study was to test whether season of birth is associated with adult body mass index (BMI) and abdominal obesity in individuals with bipolar disorder. We compared season of birth effects on BMI in 375 adult patients with bipolar disorder and 196 adult patients with unipolar major depression. We found a significant season of birth effect on BMI in patients with bipolar disorder, but not unipolar. In patients with bipolar disorder, season of birth was also associated with waist circumference, with a stronger effect in males. Season of birth affects adult BMI and waist circumference in patients with bipolar disorder, but not in patients with unipolar depression. Our results suggest that early environmental factors, yet to be identified, interact with specific neurobiological features of bipolar disorder to determine stable traits and disease risk factors in adult life. PMID:23445513

  5. Adherence to Antipsychotic Medication in Bipolar Disorder and Schizophrenic Patients

    Science.gov (United States)

    García, Saínza; Martínez-Cengotitabengoa, Mónica; López-Zurbano, Saioa; Zorrilla, Iñaki; López, Purificación; Vieta, Eduard; González-Pinto, Ana

    2016-01-01

    Abstract Antipsychotics are the drugs prescribed to treat psychotic disorders; however, patients often fail to adhere to their treatment, and this has a severe negative effect on prognosis in these kinds of illnesses. Among the wide range of risk factors for treatment nonadherence, this systematic review covers those that are most important from the point of view of clinicians and patients and proposes guidelines for addressing them. Analyzing 38 studies conducted in a total of 51,796 patients, including patients with schizophrenia spectrum disorders and bipolar disorder, we found that younger age, substance abuse, poor insight, cognitive impairments, low level of education, minority ethnicity, poor therapeutic alliance, experience of barriers to care, high intensity of delusional symptoms and suspiciousness, and low socioeconomic status are the main risk factors for medication nonadherence in both types of disorder. In the future, prospective studies should be conducted on the use of personalized patient-tailored treatments, taking into account risk factors that may affect each individual, to assess the ability of such approaches to improve adherence and hence prognosis in these patients. PMID:27307187

  6. Linkage studies of bipolar disorder in the region of the Darier`s disease gene on chromosome 12q23-24.1

    Energy Technology Data Exchange (ETDEWEB)

    Dawson, E.; Lim, L.; Sham, P.; Gill, M. [Institute of Psychiatry, London (United Kingdom)] [and others

    1995-04-24

    We have recently described a family in which there is cosegregation of major affective disorder with Darier`s disease and have mapped this autosomal dominant skin disorder to 12q23-q24.1. This has provided an interesting candidate region for genetic studies of bipolar disorder. We have studied the segregation of seven markers spanning the Darier`s disease locus in 45 bipolar disorder pedigrees and found modest evidence in support of linkage under heterogeneity for 5 of these markers. Nonparametric analyses were suggestive of linkage with a marker at the gene encoding a secretory form of phospholipase A2. Our sample has relatively low power to detect linkage under heterogeneity and independent researchers should examine markers from this region in further samples of bipolar pedigrees. 41 refs., 1 fig., 7 tabs.

  7. Management of bipolar disorders in women by nonpharmacological methods.

    Science.gov (United States)

    Naik, Sujit Kumar

    2015-07-01

    Several reasons justify the need for nonpharmacological interventions for bipolar disorder (BD) in women. This review focuses on psychosocial therapies for BDs in women. The research evidence for a wide range of psychosocial interventions for the management of BDs in women has been presented. All the interventions have some common components like targeting disease management, information regarding illness, and coping skills. There also are distinctive features like cognitive restructuring and self-rated mood charts in cognitive behavior therapy, regulation of sleep/wake cycles and daily routines in interpersonal sleep regulation therapy, and communication skill training in family treatments. Many psychosocial interventions hold promise as adjunctive therapies for bipolar patients. In India, there is a considerable dearth of literature in this area due lack of skilled staff for psychosocial interventions. Future trials need to: Clarify which populations are most likely to benefit from which strategies; identify putative mechanisms of action; systematically evaluate costs, benefits, and generalizability of effects, and record adverse effects. PMID:26330644

  8. Bipolar Disorder and the TCI: Higher Self-Transcendence in Bipolar Disorder Compared to Major Depression

    Directory of Open Access Journals (Sweden)

    James A. Harley

    2011-01-01

    With correction for mood state, total harm avoidance (HA was higher than unaffected in both MDD and BP groups, but the mood disorder groups did not differ from each other. However, BP1 individuals had higher self-transcendence (ST than those with MDD and unaffected relatives. HA may reflect a trait marker of mood disorders whereas high ST may be specific to BP. As ST is heritable, genes that affect ST may be of relevance for vulnerability to BP.

  9. Spotlight on quetiapine in acute mania and depression associated with bipolar disorder.

    Science.gov (United States)

    Dando, Toni M; Keating, Gillian M

    2006-01-01

    Quetiapine (Seroquel), an atypical antipsychotic with established efficacy in the treatment of schizophrenia, shows efficacy in the treatment of acute mania and depression associated with bipolar disorder.Quetiapine, either as monotherapy or in combination with lithium or divalproex sodium (valproate semisodium), is generally well tolerated and effective in reducing manic symptoms in adult and adolescent patients with acute bipolar mania, and is approved for use in adults for this indication. As monotherapy, the drug is also effective in reducing depressive symptoms in patients with bipolar depression. It is associated with a low incidence of extrapyramidal symptom (EPS)-related adverse events and low EPS ratings in bipolar disorder. Quetiapine thus shows potential in the treatment of bipolar depression, and represents a useful agent for the treatment of acute bipolar mania.

  10. Joint analysis of psychiatric disorders increases accuracy of risk prediction for schizophrenia, bipolar disorder, and major depressive disorder

    DEFF Research Database (Denmark)

    Maier, Robert; Moser, Gerhard; Chen, Guo-Bo;

    2015-01-01

    could be further improved. The gain in prediction accuracy of the multivariate approach is equivalent to an increase in sample size of 34% for schizophrenia, 68% for bipolar disorder, and 76% for major depressive disorders using single trait models. Because our approach can be readily applied to any...... prediction is low. Here we use a multivariate linear mixed model and apply multi-trait genomic best linear unbiased prediction for genetic risk prediction. This method exploits correlations between disorders and simultaneously evaluates individual risk for each disorder. We show that the multivariate...... approach significantly increases the prediction accuracy for schizophrenia, bipolar disorder, and major depressive disorder in the discovery as well as in independent validation datasets. By grouping SNPs based on genome annotation and fitting multiple random effects, we show that the prediction accuracy...

  11. Adesão ao tratamento no transtorno bipolar Compliance to treatment in bipolar disorder

    Directory of Open Access Journals (Sweden)

    Aida Santin

    2005-01-01

    Full Text Available O transtorno bipolar (TB é uma doença crônica, recorrente, presente em 1,5% da população, estando associada a altas taxas de mortalidade e prejuízos socioeconômicos. O lítio, a carbamazepina e o ácido valpróico são os estabilizadores de humor mais usados. Em tratamentos prolongados, como é o caso do TB, a má-adesão dos pacientes é uma das maiores dificuldades. Verifica-se que fatores ligados ao paciente, aos medicamentos e aos médicos possam ser responsáveis pela baixa adesão. A psicoeducação, a terapia cognitivo-comportamental e a terapia focada na família são estratégias propostas para o aumento da adesão.Bipolar disorder (BD is a chronic and recurrent illness that occurs in 1,5% of the population. This illness is associated with high rates of mortality and social/economic burden. Lithium, carbamazepine and valproic acid are the most used mood stabilizers. In long term treatments, as in BD, one of the main difficulties is the patient's adherence. It appears that factors associated to the patient, drug and the physician are responsible for the low adherence. The use of psycho-education, cognitive-behavioral therapy and focused family therapy have been put forward as a means to increase adherence.

  12. Differential Neurodevelopmental Trajectories in Patients With Early-Onset Bipolar and Schizophrenia Disorders

    OpenAIRE

    Arango, Celso; Fraguas, David; Parellada, Mara

    2013-01-01

    Schizophrenia and bipolar disorders share not only clinical features but also some risk factors such as genetic markers and childhood adversity, while other risk factors such as urbanicity and obstetric complications seem to be specific to schizophrenia. An intriguing question is whether the well-established abnormal neurodevelopment present in many children and adolescents who eventually develop schizophrenia is also present in bipolar patients. The literature on adult bipolar patients is co...

  13. Clinical features associated with trait-impulsiveness in euthymic bipolar disorder patients.

    OpenAIRE

    Etain, Bruno; Mathieu, Flavie; Liquet, Stéphanie; Raust, Aurélie; Cochet, Barbara; Richard, J. R.; Gard, Sébastien; Zanouy, L.; Kahn, Jean-Pierre; Cohen, Renaud; Bougerol, Thierry; Henry, Chantal; Leboyer, Marion; Bellivier, Frank

    2013-01-01

    International audience BACKGROUND: A strong association has been reported between trait-impulsiveness and bipolar disorder (BD). Much attention has been focused on this association, but subgroup analysis has generated conflicting results, raising questions about the role of trait-impulsiveness in suicidal behavior and substance misuse in bipolar patients. METHOD: We compared Barratt Impulsiveness Scale-10 scores between 385 euthymic bipolar patients and 185 healthy controls. We then invest...

  14. Voice analysis as an objective state marker in bipolar disorder

    DEFF Research Database (Denmark)

    Faurholt-Jepsen, M.; Busk, Jonas; Frost, M.;

    2016-01-01

    features with automatically generated objective smartphone data on behavioral activities (for example, number of text messages and phone calls per day) and electronic self-monitored data (mood) on illness activity would increase the accuracy as a marker of affective states. Using smartphones, voice...... features, automatically generated objective smartphone data on behavioral activities and electronic self-monitored data were collected from 28 outpatients with bipolar disorder in naturalistic settings on a daily basis during a period of 12 weeks. Depressive and manic symptoms were assessed using...... the Hamilton Depression Rating Scale 17-item and the Young Mania Rating Scale, respectively, by a researcher blinded to smartphone data. Data were analyzed using random forest algorithms. Affective states were classified using voice features extracted during everyday life phone calls. Voice features were found...

  15. Dandy-Walker variant associated with bipolar affective disorder

    Directory of Open Access Journals (Sweden)

    Anand Lingeswaran

    2009-01-01

    Full Text Available The Dandy-Walker malformation is a congenital brain malformation, typically involving the fourth ventricle and the cerebellum. To date, the Dandy-Walker syndrome has not been described in association with bipolar disorder type I mania, and therefore we briefly report the case of a Dandy-Walker variant associated with acute mania. A 10-year-old boy was brought by his mother to the outpatient clinic of the Department of Psychiatry of a tertiary care hospital, with symptoms of mania. The MRI brain of the patient showed a posterior fossa cystic lesion, a giant cisterna magna communicating with the fourth ventricle and mild hypoplasia of the cerebellar vermis, with the rest of the structures being normal and no signs of hydrocephalus. These findings showed that the patient had a Dandy-Walker variant. He responded partially to valproate and olanzepine, which controlled the acute manic symptoms in the ward.

  16. Bipolar affective disorder: A review of novel forms of therapy

    Directory of Open Access Journals (Sweden)

    Dziwota Ewelina

    2015-06-01

    Full Text Available Normothymic, antidepressant and antipsychotic pharmaceutics are, in accordance with international guidelines, employed both in the therapy and the prevention of bipolar disorder (BD. Long-term studies on the mechanisms of action of such medications, as well as on the pathogenetic background of BD, have led to the discovery of effective, albeit unconventional pharmacotherapeutic approaches. These methods have the potential to successfully treat mania and depression, as well as to counter affective episode relapse. Allopurinol - commonly used to treat gout, secondary hyperuricemia and Lesch-Nyhan syndrome, acts by inhibiting the synthesis of uric acid, levels of which are often increased in manic patients. Due to this, an evaluation of the potential effect of allopurinol on the reduction of mania symptoms seems to be reasonable. Additionally, the numerable research papers coming out of research regarding the role of purine neurotransmitters in mood alterations, indicate that adenosine agonists act analogously to dopamine antagonists.

  17. Internet use by patients with bipolar disorder: Results from an international multisite survey.

    Science.gov (United States)

    Bauer, Rita; Conell, Jörn; Glenn, Tasha; Alda, Martin; Ardau, Raffaella; Baune, Bernhard T; Berk, Michael; Bersudsky, Yuly; Bilderbeck, Amy; Bocchetta, Alberto; Bossini, Letizia; Castro, Angela M Paredes; Cheung, Eric Yw; Chillotti, Caterina; Choppin, Sabine; Del Zompo, Maria; Dias, Rodrigo; Dodd, Seetal; Duffy, Anne; Etain, Bruno; Fagiolini, Andrea; Hernandez, Miryam Fernández; Garnham, Julie; Geddes, John; Gildebro, Jonas; Gonzalez-Pinto, Ana; Goodwin, Guy M; Grof, Paul; Harima, Hirohiko; Hassel, Stefanie; Henry, Chantal; Hidalgo-Mazzei, Diego; Kapur, Vaisnvy; Kunigiri, Girish; Lafer, Beny; Larsen, Erik R; Lewitzka, Ute; Licht, Rasmus W; Lund, Anne Hvenegaard; Misiak, Blazej; Monteith, Scott; Munoz, Rodrigo; Nakanotani, Takako; Nielsen, René E; O'Donovan, Claire; Okamura, Yasushi; Osher, Yamima; Piotrowski, Patryk; Reif, Andreas; Ritter, Philipp; Rybakowski, Janusz K; Sagduyu, Kemal; Sawchuk, Brett; Schwartz, Elon; Scippa, Ângela M; Slaney, Claire; Sulaiman, Ahmad H; Suominen, Kirsi; Suwalska, Aleksandra; Tam, Peter; Tatebayashi, Yoshitaka; Tondo, Leonardo; Vieta, Eduard; Vinberg, Maj; Viswanath, Biju; Volkert, Julia; Zetin, Mark; Whybrow, Peter C; Bauer, Michael

    2016-08-30

    There is considerable international interest in online education of patients with bipolar disorder, yet little understanding of how patients use the Internet and other sources to seek information. 1171 patients with a diagnosis of bipolar disorder in 17 countries completed a paper-based, anonymous survey. 81% of the patients used the Internet, a percentage similar to the general public. Older age, less education, and challenges in country telecommunications infrastructure and demographics decreased the odds of using the Internet. About 78% of the Internet users looked online for information on bipolar disorder or 63% of the total sample. More years of education in relation to the country mean, and feeling very confident about managing life decreased the odds of seeking information on bipolar disorder online, while having attended support groups increased the odds. Patients who looked online for information on bipolar disorder consulted medical professionals plus a mean of 2.3 other information sources such as books, physician handouts, and others with bipolar disorder. Patients not using the Internet consulted medical professionals plus a mean of 1.6 other information sources. The percentage of patients with bipolar disorder who use the Internet is about the same as the general public. Other information sources remain important. PMID:27391371

  18. Clinical expression of obsessive-compulsive disorder in women with bipolar disorder Expressão clínica do transtorno obsessivo-compulsivo em uma amostra de mulheres com transtorno de humor bipolar

    OpenAIRE

    Cilly Klüger Issler; José Antonio de Mello Siqueira Amaral; Renata Sayuri Tamada; Angela Maria Schwartzmann; Roseli Gedanke Shavitt; Eurípedes Constantino Miguel; Beny Lafer

    2005-01-01

    OBJECTIVE: To study clinical and psychopathological features of obsessive-compulsive disorder (OCD) in women with bipolar disorder (BD). METHODS: Fifteen outpatients with concurrent bipolar disorder I (80.0%) or II (20.0%) and obsessive-compulsive disorder were studied. Most of them (80.0%) sought treatment for bipolar disorder. They were ascertained by means of the Structured Clinical Interview for DSM-IV (SCID/P), semi-structured interviews to investigate obsessions, compulsions and sensory...

  19. Risperidone treatment for ADHD in children and adolescents with bipolar disorder

    OpenAIRE

    Biederman, Joseph

    2008-01-01

    Joseph Biederman, Paul Hammerness, Robert Doyle, Gagan Joshi, Megan Aleardi, Eric MickPediatric Psychopharmacology Research Department, Massachusetts General Hospital, Boston, MA, USAObjective: Children and adolescents with bipolar disorder are also at high risk of having comorbid attention-deficit hyperactivity disorder (ADHD). The objective of this study was to estimate improvement in ADHD symptoms in children with bipolar disorder.Methods: This was an open-label, study of risperidone monot...

  20. A Genetic Deconstruction of Neurocognitive Traits in Schizophrenia and Bipolar Disorder

    OpenAIRE

    Carla P D Fernandes; Andrea Christoforou; Sudheer Giddaluru; Kari M Ersland; Srdjan Djurovic; Manuel Mattheisen; Lundervold, Astri J.; Ivar Reinvang; Nöthen, Markus M; Marcella Rietschel; Ophoff, Roel A.; Albert Hofman; André G Uitterlinden; Thomas Werge; Sven Cichon

    2013-01-01

    textabstractBackground: Impairments in cognitive functions are common in patients suffering from psychiatric disorders, such as schizophrenia and bipolar disorder. Cognitive traits have been proposed as useful for understanding the biological and genetic mechanisms implicated in cognitive function in healthy individuals and in the dysfunction observed in psychiatric disorders. Methods: Sets of genes associated with a range of cognitive functions often impaired in schizophrenia and bipolar dis...

  1. Bipolar disorder and diabetes mellitus: evidence for disease-modifying effects and treatment implications

    OpenAIRE

    Charles, Ellen F.; Lambert, Christophe G; Kerner, Berit

    2016-01-01

    Background Bipolar disorder refers to a group of chronic psychiatric disorders of mood and energy levels. While dramatic psychiatric symptoms dominate the acute phase of the diseases, the chronic course is often determined by an increasing burden of co-occurring medical conditions. High rates of diabetes mellitus in patients with bipolar disorder are particularly striking, yet unexplained. Treatment and lifestyle factors could play a significant role, and some studies also suggest shared path...

  2. Animal Models of Bipolar Disorder and Mood Stabilizer Efficacy: a Critical Need for Improvement

    OpenAIRE

    Gould, Todd D.; Einat, Haim

    2007-01-01

    The limited number of suitable animal models of bipolar disorder available for in-depth behavioral, biochemical, histological, and pharmacological analysis is a rate limiting step in the process of understanding the relevant neurobiology of the disorder, as well as the development of novel medications. In the search for new models, both new and old approaches hold promise for future discoveries. Clinical studies regarding the underlying genetics and pathophysiology of bipolar disorder are pro...

  3. Molecular hydrogen: an overview of its neurobiological effects and therapeutic potential for bipolar disorder and schizophrenia

    OpenAIRE

    Ghanizadeh, Ahmad; Berk, Michael

    2013-01-01

    Hydrogen gas is a bioactive molecule that has a diversity of effects, including anti-apoptotic, anti-inflammatory and anti-oxidative properties; these overlap with the process of neuroprogression in major psychiatric disorders. Specifically, both bipolar disorder and schizophrenia are associated with increased oxidative and inflammatory stress. Moreover, lithium which is commonly administered for treating bipolar disorder has effects on oxidative stress and apoptotic pathways, as do valproate...

  4. Perceived Emotional Intelligence is Impaired and Associated with Poor Community Functioning in Schizophrenia and Bipolar Disorder

    OpenAIRE

    Tabak, Naomi T.; Green, Michael F.; Wynn, Jonathan K; Proudfit, Greg H.; Altshuler, Lori; Horan, William P.

    2015-01-01

    Schizophrenia and bipolar disorder have been associated with shared and distinct emotion processing abnormalities. Initial findings indicate that these disorders differ with respect to the domain of emotional intelligence (EI). Individuals with schizophrenia display deficits on performance measures of EI, whereas those with bipolar disorder do not. However, no research has examined patients’ subjective beliefs about their own EI (referred to as “perceived EI”). This study examined perceived E...

  5. Differential diagnoses and management strategies in patients with schizophrenia and bipolar disorder

    OpenAIRE

    A Carlo Altamura; Jose M Goikolea

    2008-01-01

    A Carlo Altamura1, Jose M Goikolea21Department of Psychiatry, University of Milan, IRCCS Fondazione Ospedale Maggiore Policlinico Mangiagalli e Regina Elena, Milan, Italy; 2Bipolar Disorder Program, Hospital Clinic i Universitari, Barcelona, SpainAbstract: Successful treatment of psychiatric disorders, including bipolar disorder and schizophrenia, is complicated and is affected by a broad range of factors associated with the diagnosis, choice of treatment and social factors. In these patients...

  6. Psychotherapy for Bipolar II Disorder: The Role of Interpersonal and Social Rhythm Therapy

    OpenAIRE

    Swartz, Holly A.; Levenson, Jessica C.; Frank, Ellen

    2012-01-01

    Although bipolar II disorder is a highly prevalent, chronic illness that is associated with burdensome psychosocial impairment, relatively little is known about the best ways to treat the disorder. Moreover, psychosocial interventions for the management of bipolar II disorder have been largely unexplored, leaving psychologists with few evidence-based recommendations for best treatment practices. In this article, we provide information about interpersonal and social rhythm therapy (IPSRT), an ...

  7. Genetic association studies of symptoms, comorbidity and outcome in bipolar disorder and schizophrenia

    OpenAIRE

    Hukic, Dzana Sudic

    2016-01-01

    Schizophrenia and bipolar disorder are complex brain disorders. Research has focused on applying brain research to understand the etiology, as well as clinical research to improve treatment, prognosis and progression. Schizophrenia and bipolar disorder are not lethal in and of themselves, but suicide and the presence of associated physical illnesses are of great concern, since these are the major causes of shortened life in afflicted individuals. In particular, the prevalence o...

  8. Biology of lithium response in bipolar disorder : genetic mechanisms and telomeres

    OpenAIRE

    Martinsson, Lina

    2016-01-01

    Background: Bipolar disorder is a common, chronic and severe mental illness, causing suffering and large costs. Lithium treatment is the golden standard and works in 2/3 of patients, of which 50% are called lithium responders. There is strong evidence that both bipolar disorder and the degree of lithium response are highly heritable, although many mechanisms are unknown. Short telomere length has been found in both somatic and psychiatric disorders, but little is known about te...

  9. Brain structural and functional correlates of resilience to Bipolar Disorder

    Directory of Open Access Journals (Sweden)

    Sophia eFrangou

    2012-01-01

    Full Text Available Background: Resilient adaptation can be construed in different ways, but as used here it refers to the adaptive brain changes associated with avoidance of psychopathology despite familiar risk for Bipolar Disorder (BD. Although family history of BD is associated with elevated risk of affective morbidity a significant proportion of first-degree relatives of BD patients remains free of psychopathology. Examination of brain structure and function in these individuals may inform on adaptive changes that may pre-empt disease expression. Methods: Data presented here are derived from the Vulnerability to Bipolar Disorders (VIBES study which includes patients with BD, asymptomatic relatives and healthy controls. Participants underwent extensive investigations including brain structural (sMRI and functional magnetic resonance imaging (fMRI. The data presented here focus on sMRI voxel-based-morphometry and on conventional and connectivity analyses of fMRI data obtained during the Stroop Colour Word Test (SCWT, a task of cognitive control during conflict resolution. All analyses were implemented in SPM (www.fil.ion.ucl.ac.uk/spm. Resilience in relatives was operationalized as the absence of clinical-range symptoms.Results: Resilient relatives of BD patients expressed structural, functional and connectivity changes reflecting the effect of genetic risk on the brain. These included increased insular volume, decreased activation within the posterior and inferior parietal regions involved in selective attention during the SCWT, and reduced fronto-insular and fronto-cingulate connectivity.Resilience was associated with increased cerebellar vermal volume and enhanced functional coupling between the dorsal and the ventral prefrontal cortex. Conclusions: Our findings suggests the presence of biological mechanisms associated with resilient adaptation of brain networks and pave the way for the identification of outcome-specific trajectories given a particular

  10. Experience of Subjective Symptoms in Euthymic Patients with Bipolar Disorder

    OpenAIRE

    Joe, Soohyun; Joo,YeonHo; Kim, Seongyoon

    2008-01-01

    Bipolar patients often experience subjective symptoms even if they do not have active psychotic symptoms in their euthymic state. Most studies about subjective symptoms are conducted in schizophrenia, and there are few studies involving bipolar patients. We examined the nature of the subjective symptoms of bipolar patients in their euthymic state, and we also compared it to that of schizophrenia and normal control. Thirty bipolar patients, 25 patients with schizophrenia, and 21 normal control...

  11. Identification and management of prodromal symptoms in bipolar affective disorder: the role of individual, disorder, and treatment-related factors.

    OpenAIRE

    Gadon, Lisa Alexandre

    2011-01-01

    Background: Traditional psychosocial treatments have been adapted for use with individuals with bipolar affective disorders due to the limited prophylactic nature of pharmacotherapy and the recognition of the role of psychosocial factors in the course of this disorder. Psychosocial interventions that include a prodromal monitoring and management component have been empirically shown to be an effective adjunct to medication for the treatment of bipolar disorder. Aims: There i...

  12. Late Onset Bipolar Disorder due to a Lacunar State

    Directory of Open Access Journals (Sweden)

    Elena Antelmi

    2014-01-01

    Full Text Available Objective. To describe a patient with a new onset bipolar disorder (BD type II, secondary to a lacunar state. Background. Poststroke BD is rare and mainly associated with lesion in the prefrontal-striatal-thalamic circuit. Materials and Methods. A 51-year-old woman came to our attention for a mood disorder of recent onset. At 49, she had suffered acute left-sided limb weakness that improved spontaneously four days later. Arterial hypertension was subsequently diagnosed. After 6 months, she began to suffer from alternating brief periods of expansive and elevated mood with longer periods of depressed mood, with a suicide attempt. We performed extensive laboratory and instrumental investigations, as well as, psychiatric consultation, and a cognitive assessment, which was repeated 9 months later. Results. Brain magnetic resonance disclosed leukoaraiosis and a lacunar state of the basal ganglia. Transcranial Doppler showed a patent foramen ovale. A psychiatric consultation led to the diagnosis of BP type II. Neuropsychological evaluation detected deficits in attention/executive functions, verbal fluency, and memory. Nine months later, after specific psychiatric therapy, the psychiatric symptoms were remarkably improved. Conclusion. Our case sheds light on the role of the basal ganglia in mood disorders and the importance of ruling out brain injury in late onset BP.

  13. Fatores genéticos e ambientais na manifestação do transtorno bipolar Genetic and environmental factors in bipolar disorder

    Directory of Open Access Journals (Sweden)

    Leandro Michelon

    2005-01-01

    Full Text Available O transtorno bipolar (TB possui alta prevalência na população mundial e causa perdas significativas na vida dos portadores. É uma doença com importante fator genético, cuja herança se caracteriza por mecanismos complexos de transmissão envolvendo múltiplos genes que estão sob influência de inúmeros fatores ambientais. Várias estratégias de investigação genética têm sido utilizadas para identificar genes determinantes de vulnerabilidade ao TB. Estudos com gêmeos, de ligação e de associação permitiram caracterizar a herdabilidade dessa doença, identificar regiões cromossômicas potencialmente associadas ao TB e avaliar a contribuição de genes candidatos na sua etiologia. Em virtude da complexidade do modo de transmissão do TB e de sua heterogeneidade fenotípica muitas dificuldades são encontradas na identificação desses genes. Paralelamente, estudos psicossociais apontam para fatores ambientais de relevância no desencadeamento do TB. Com a compreensão crescente dos mecanismos epigenéticos de controle da expressão gênica, incluindo a interação do genoma com fatores ambientais, e a abordagem dimensional dos transtornos mentais, abrem-se perspectivas promissoras de pesquisas futuras para elucidar os fatores envolvidos na manifestação do transtorno bipolar.Bipolar disorder (BD is a highly prevalent mental disease worldwide. This disorder has a genetic inheritance characterized by complex transmission mechanisms involving multiple genes under the influence of several environmental factors. Many investigation strategies have been put forward in order to identify BD susceptibility genes. Twin, linkage and association studies have contributed to the characterization of its herdability through the identification of genomic regions potentially linked to BD and the candidate genes investigation approach. Because of the complexity of the transmission pattern for BD and its phenotypic heterogeneity many difficulties

  14. Korean Medication Algorithm Project for Bipolar Disorder: third revision

    Directory of Open Access Journals (Sweden)

    Woo YS

    2015-02-01

    Full Text Available Young Sup Woo,1 Jung Goo Lee,2,3 Jong-Hyun Jeong,1 Moon-Doo Kim,4 Inki Sohn,5 Se-Hoon Shim,6 Duk-In Jon,7 Jeong Seok Seo,8 Young-Chul Shin,9 Kyung Joon Min,10 Bo-Hyun Yoon,11 Won-Myong Bahk1 1Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, South Korea; 2Department of Psychiatry, Inje University Haeundae Paik Hospital, Busan, South Korea;3Paik Institute for Clinical Research, Inje Univeristy, Busan, South Korea; 4Department of Psychiatry, Jeju National University Hospital, Jeju, South Korea; 5Department of Psychiatry, Keyo Hospital, Keyo Medical Foundation, Uiwang, South Korea; 6Department of Psychiatry, Soonchunhyang University Cheonan Hospital, Soonchunhyang University, Cheonan, South Korea; 7Department of Psychiatry, Sacred Heart Hospital, Hallym University, Anyang, South Korea; 8Department of Psychiatry, School of Medicine, Konkuk University, Chungju, South Korea; 9Department of Psychiatry, Kangbuk Samsung Hospital, School of Medicine, Sungkyunkwan University, Seoul, South Korea; 10Department of Psychiatry, College of Medicine, Chung-Ang University, Seoul, South Korea; 11Department of Psychiatry, Naju National Hospital, Naju, South Korea Objective: To constitute the third revision of the guidelines for the treatment of bipolar disorder issued by the Korean Medication Algorithm Project for Bipolar Disorder (KMAP-BP 2014. Methods: A 56-item questionnaire was used to obtain the consensus of experts regarding pharmacological treatment strategies for the various phases of bipolar disorder and for special populations. The review committee included 110 Korean psychiatrists and 38 experts for child and adolescent psychiatry. Of the committee members, 64 general psychiatrists and 23 child and adolescent psychiatrists responded to the survey. Results: The treatment of choice (TOC for euphoric, mixed, and psychotic mania was the combination of a mood stabilizer (MS and an atypical antipsychotic (AAP; the TOC for

  15. Differences in clinical features and mental health service use in bipolar disorder across the lifespan

    OpenAIRE

    Depp, Colin A.; Lindamer, L A; Folsom, D P; Gilmer, T; Hough, R L; Garcia, P.; Jeste, D V

    2005-01-01

    Objective: Because of the scarcity of research in geriatric bipolar disorder, the authors examined the prevalence, clinical features, and service use of persons with bipolar disorder among older adults treated in a large public mental health system. Methods: From San Diego County's Adult and Older-Adult Mental Health Services database (N=34,970, fiscal year 2002-2003), the authors selected patients with bipolar disorder, divided them into three age-groups (young: age 18-39, middle-aged: age 4...

  16. Brain structure-function associations in multi-generational families genetically enriched for bipolar disorder.

    Science.gov (United States)

    Fears, Scott C; Schür, Remmelt; Sjouwerman, Rachel; Service, Susan K; Araya, Carmen; Araya, Xinia; Bejarano, Julio; Knowles, Emma; Gomez-Makhinson, Juliana; Lopez, Maria C; Aldana, Ileana; Teshiba, Terri M; Abaryan, Zvart; Al-Sharif, Noor B; Navarro, Linda; Tishler, Todd A; Altshuler, Lori; Bartzokis, George; Escobar, Javier I; Glahn, David C; Thompson, Paul M; Lopez-Jaramillo, Carlos; Macaya, Gabriel; Molina, Julio; Reus, Victor I; Sabatti, Chiara; Cantor, Rita M; Freimer, Nelson B; Bearden, Carrie E

    2015-07-01

    Recent theories regarding the pathophysiology of bipolar disorder suggest contributions of both neurodevelopmental and neurodegenerative processes. While structural neuroimaging studies indicate disease-associated neuroanatomical alterations, the behavioural correlates of these alterations have not been well characterized. Here, we investigated multi-generational families genetically enriched for bipolar disorder to: (i) characterize neurobehavioural correlates of neuroanatomical measures implicated in the pathophysiology of bipolar disorder; (ii) identify brain-behaviour associations that differ between diagnostic groups; (iii) identify neurocognitive traits that show evidence of accelerated ageing specifically in subjects with bipolar disorder; and (iv) identify brain-behaviour correlations that differ across the age span. Structural neuroimages and multi-dimensional assessments of temperament and neurocognition were acquired from 527 (153 bipolar disorder and 374 non-bipolar disorder) adults aged 18-87 years in 26 families with heavy genetic loading for bipolar disorder. We used linear regression models to identify significant brain-behaviour associations and test whether brain-behaviour relationships differed: (i) between diagnostic groups; and (ii) as a function of age. We found that total cortical and ventricular volume had the greatest number of significant behavioural associations, and included correlations with measures from multiple cognitive domains, particularly declarative and working memory and executive function. Cortical thickness measures, in contrast, showed more specific associations with declarative memory, letter fluency and processing speed tasks. While the majority of brain-behaviour relationships were similar across diagnostic groups, increased cortical thickness in ventrolateral prefrontal and parietal cortical regions was associated with better declarative memory only in bipolar disorder subjects, and not in non-bipolar disorder family

  17. Life Events as Predictors of Mania and Depression in Bipolar I Disorder

    OpenAIRE

    Johnson, Sheri L; Cueller, Amy K.; Ruggero, Camilo; Winett-Perlman, Carol; Goodnick, Paul; White, Richard; Miller, Ivan

    2008-01-01

    To date, few prospective studies of life events and bipolar disorder are available, and even fewer have separately examined the role of life events in depression and mania. The goal of this study was to prospectively examine the role of negative and goal-attainment life events as predictors of the course of bipolar disorder. One hundred twenty-five individuals with bipolar I disorder were interviewed monthly for an average of 27 months. Negative and goal-attainment life events were assessed w...

  18. Adverse Effects in the Pharmacologic Management of Bipolar Disorder During Pregnancy.

    Science.gov (United States)

    Hogan, Charlotte S; Freeman, Marlene P

    2016-09-01

    Management of bipolar disorder during pregnancy often involves medications with potential adverse effects, including risks to the mother and fetus. Although some specifics are known, many medications continue to have incompletely characterized reproductive safety profiles. Women with bipolar disorder who are planning pregnancy face challenging decisions about their treatment; careful risk-benefit discussions are necessary. With the goal of further informing these discussions, this article reviews the data currently available regarding medication safety in the management of bipolar disorder during pregnancy, with specific attention to lithium, valproic acid, lamotrigine, carbamazepine, and antipsychotic medications. PMID:27514299

  19. METABOLIC SYNDROME - THE CONSEQUENCE OF LIFELONG TREATMENT OF BIPOLAR AFFECTIVE DISORDER

    OpenAIRE

    Dadić-Hero, Elizabeta; Ružić, Klementina; Grahovac, Tanja; Petranović, Duška; Graovac, Mirjana; Žarković Palijan, Tija

    2010-01-01

    Mood disturbances are characteristic and dominant feature of Mood disorders. Bipolar Affective Disorder (BAD) is a mood disorder which occurs equally in both sexes. BAD may occur in co morbidity with other mental diseases and disorders such as: Anorexia Nervosa, Bulimia Nervosa, Attention Deficit, Panic Disorder and Social Phobia. However, medical disorders (one or more) can also coexist with BAD. Metabolic syndrome is a combination of metabolic disorders that increase the risk of developing ...

  20. Candidate gene studies in human anxiety disorders

    OpenAIRE

    Donner, Jonas

    2012-01-01

    Anxiety disorders, such as panic disorder (PD), obsessive-compulsive disorder, post-traumatic stress disorder, generalized anxiety disorder, and phobias are common psychiatric disorders, characterized by exaggerated, prolonged and debilitating levels of anxiety. They are complex diseases with onset influenced by both environmental and genetic factors, but so far little progress has been made in identifying solid susceptibility genes. The aim of this study was to shed light on the genetic basi...

  1. The relationship between bipolar disorder and cannabis use in daily life: an experience sampling study.

    Directory of Open Access Journals (Sweden)

    Elizabeth Tyler

    Full Text Available Although cannabis use is common in bipolar disorder and may contribute to worse clinical outcomes, little is understood about the relationship between this drug and bipolar disorder over the course of daily life. The aim of study was to examine the effect of cannabis on affect and bipolar symptoms in a group of individuals with bipolar disorder.Twenty-four participants with bipolar disorder type I or type II completed diaries for 6 days using Experience Sampling Methodology to investigate the temporal associations between cannabis, affect and bipolar disorder symptoms.The results indicated that higher levels of positive affect increase the odds of using cannabis (OR:1.25 ,CI:1.06-1.47, P=0.008. However, neither negative affect, manic nor depressive symptoms predicted the use of cannabis. Cannabis use was associated with subsequent increases in positive affect (β=0.35, CI:0.20-0.51, P=0.000, manic symptoms (β=0.20,CI:0.05-0.34, P=0.009 and depressive symptoms (β= 0.17,CI:0.04-0.29, P=0.008.The findings indicate that cannabis use is associated with a number of subsequent psychological effects. However there was no evidence that individuals with BD were using cannabis to self-medicate minor fluctuations in negative affect or bipolar disorder symptoms over the course of daily life. The findings in relation to existing literature and clinical implications are discussed.

  2. Treatment of bipolar disorders during pregnancy: maternal and fetal safety and challenges

    Directory of Open Access Journals (Sweden)

    Epstein RA

    2014-12-01

    Full Text Available Richard A Epstein,1 Katherine M Moore,2 William V Bobo2 1Department of Psychiatry, Vanderbilt University School of Medicine, Nashville, TN, 2Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA Abstract: Treating pregnant women with bipolar disorder is among the most challenging clinical endeavors. Patients and clinicians are faced with difficult choices at every turn, and no approach is without risk. Stopping effective pharmacotherapy during pregnancy exposes the patient and her baby to potential harms related to bipolar relapses and residual mood symptom-related dysfunction. Continuing effective pharmacotherapy during pregnancy may prevent these occurrences for many; however, some of the most effective pharmacotherapies (such as valproate have been associated with the occurrence of congenital malformations or other adverse neonatal effects in offspring. Very little is known about the reproductive safety profile and clinical effectiveness of atypical antipsychotic drugs when used to treat bipolar disorder during pregnancy. In this paper, we provide a clinically focused review of the available information on potential maternal and fetal risks of untreated or undertreated maternal bipolar disorder during pregnancy, the effectiveness of interventions for bipolar disorder management during pregnancy, and potential obstetric, fetal, and neonatal risks associated with core foundational pharmacotherapies for bipolar disorder. Keywords: bipolar disorder, pregnancy, anticonvulsants, antiepileptics, antipsychotics, safety

  3. Evidence-Based Family Interventions for Adolescents and Young Adults With Bipolar Disorder.

    Science.gov (United States)

    Miklowitz, David J

    2016-01-01

    An individual can develop bipolar disorder at any age, but emergence during adolescence and young adulthood can lead to a number of problematic behaviors and outcomes. Several drugs are available as first-line treatments, but even optimal pharmacotherapy rarely leads to complete remission and recovery. When added to pharmacologic treatment, certain targeted psychosocial treatments can improve outcomes for young patients with bipolar disorder. Because bipolar disorder affects family members as well as patients, and because adolescents and young adults often live with and are dependent on their parents, the patient's family should usually be included in treatment. Family-focused treatment and dialectical behavior therapy are promising methods of conducting family intervention. With effective treatment and the support of their families, young patients with bipolar disorder can learn to manage their disorder and become independent and healthy adults. PMID:27570931

  4. Is autoimmune thyroiditis part of the genetic vulnerability (or an endophenotype) for bipolar disorder?

    NARCIS (Netherlands)

    Vonk, Ronald; van der Schot, Astrid C.; Kahn, Rene S.; Nolen, Willem A.; Drexhage, Hemmo A.

    2007-01-01

    Background: Both genetic and environmental factors are involved in the etiology of bipolar disorder; however, biological markers for the transmission of the bipolar genotype ("endophenotypes") have not been found. Autoimmune thyroiditis with raised levels of thyroperoxidase antibodies (TPO-Abs) is r

  5. Gender differences in prevalence, risk, and clinical correlates of alcoholism comorbidity in bipolar disorder

    NARCIS (Netherlands)

    Frye, MA; Altshuler, LL; McElroy, SL; Suppes, T; Keck, PE; Denicoff, K; Nolen, WA; Kupka, R; Leverich, GS; Pollio, C; Grunze, H; Walden, J; Post, RM

    2003-01-01

    Objective: The prevalence of lifetime alcohol abuse and/or dependence (alcoholism) in patients with bipolar disorder has been reported to be higher than in all other axis I psychiatric diagnoses. This study examined gender-specific relationships between alcoholism and bipolar illness, which have pre

  6. Differences in white matter abnormalities between bipolar I and II disorders

    NARCIS (Netherlands)

    Liu, Jia-Xiu; Chen, Yong-Sheng; Hsieh, Jen-Chuen; Su, Tung-Ping; Yeh, Tzu-Chen; Chen, Li-Fen

    2010-01-01

    Background: Although patients with bipolar I and II disorders exhibit heterogeneous clinical presentations and cognitive functions, it remains unclear whether these two subtypes have distinct neural substrates. This study aimed to differentiate the fiber abnormalities between bipolar I and II patien

  7. Pediatric Bipolar Disorder versus Severe Mood Dysregulation: Risk for Manic Episodes on Follow-Up

    Science.gov (United States)

    Stringaris, Argyris; Baroni, Argelinda; Haimm, Caroline; Brotman, Melissa; Lowe, Catherine H.; Myers, Frances; Rustgi, Eileen; Wheeler, Wanda; Kayser, Reilly; Towbin, Kenneth; Leibenluft, Ellen

    2010-01-01

    Objective: An important question in pediatric bipolar research is whether marked nonepisodic irritability is a manifestation of bipolar disorder in youth. This study tests the hypothesis that youth with severe mood dysregulation (SMD), a category created for the purpose of studying children presenting with severe nonepisodic irritability, will be…

  8. Relationship of Prior Antidepressant Exposure to Long-Term Prospective Outcome in Bipolar I Disorder Outpatients

    NARCIS (Netherlands)

    Post, Robert M.; Leverich, Gabriele S.; Altshuler, Lori L.; Frye, Mark A.; Suppes, Trisha; McElroy, Susan L.; Keck, Paul E.; Nolen, Willem A.; Rowe, Mike; Kupka, Ralph W.; Grunze, Heinz; Goodwin, Frederick K.

    2012-01-01

    Objective:The long-term impact of prior antidepressant exposure on the subsequent course of bipolar illness remains controversial. Method: 139 outpatients (mean age, 42 years) with bipolar I disorder diagnosed by DSM-IV criteria had a detailed retrospective examination of their prior course of illne

  9. The use of the GBI as predictor of bipolar disorder in a population of adolescent offspring of parents with a bipolar disorder

    NARCIS (Netherlands)

    Reichart, CG; van der Ende, J; Wals, M; Hillegers, MHJ; Nolen, WA; Ormel, J; Verhulst, FC

    2005-01-01

    Objective: To assess the usefulness of the General Behavior Inventory (GBI) to predict the development of mood disorders in the offspring of parents with bipolar disorder. Method: The GBI and the K-SADS (first measurement) and the SCID (last measurement) were used to assess psychopathology among 129

  10. CRY2 is associated with rapid cycling in bipolar disorder patients.

    Directory of Open Access Journals (Sweden)

    Louise K Sjöholm

    Full Text Available BACKGROUND: Bipolar disorder patients often display abnormalities in circadian rhythm, and they are sensitive to irregular diurnal rhythms. CRY2 participates in the core clock that generates circadian rhythms. CRY2 mRNA expression in blood mononuclear cells was recently shown to display a marked diurnal variation and to respond to total sleep deprivation in healthy human volunteers. It was also shown that bipolar patients in a depressive state had lower CRY2 mRNA levels, nonresponsive to total sleep deprivation, compared to healthy controls, and that CRY2 gene variation was associated with winter depression in both Swedish and Finnish cohorts. PRINCIPAL FINDINGS: Four CRY2 SNPs spanning from intron 2 to downstream 3'UTR were analyzed for association to bipolar disorder type 1 (n = 497, bipolar disorder type 2 (n = 60 and bipolar disorder with the feature rapid cycling (n = 155 versus blood donors (n = 1044 in Sweden. Also, the rapid cycling cases were compared with bipolar disorder cases without rapid cycling (n = 422. The haplotype GGAC was underrepresented among rapid cycling cases versus controls and versus bipolar disorder cases without rapid cycling (OR = 0.7, P = 0.006-0.02, whereas overrepresentation among rapid cycling cases was seen for AAAC (OR = 1.3-1.4, P = 0.03-0.04 and AGGA (OR = 1.5, P = 0.05. The risk and protective CRY2 haplotypes and their effect sizes were similar to those recently suggested to be associated with winter depression in Swedes. CONCLUSIONS: We propose that the circadian gene CRY2 is associated with rapid cycling in bipolar disorder. This is the first time a clock gene is implicated in rapid cycling, and one of few findings showing a molecular discrimination between rapid cycling and other forms of bipolar disorder.

  11. Child Behavior Checklist Profiles of Children and Adolescents with and at High Risk for Developing Bipolar Disorder

    Science.gov (United States)

    Giles, Lisa L.; DelBello, Melissa P.; Stanford, Kevin E.; Strakowski, Stephen M.

    2007-01-01

    In order to recognize behavioral patterns in children and adolescents at risk for developing bipolar disorder, this study examined Child Behavior Checklist (CBCL) profiles of bipolar offspring both with (BD group) and without ("at-risk" or AR group) bipolar disorder themselves. The BD youth had three CBCL subscale T scores greater than or equal to…

  12. Gastroesophageal reflux disease and risk for bipolar disorder: a nationwide population-based study.

    Directory of Open Access Journals (Sweden)

    Wan-Shan Lin

    Full Text Available BACKGROUND: Studies have shown that chronic inflammation may play a vital role in the pathophysiology of both gastroesophageal reflux disease (GERD and bipolar disorder. Among patients with GERD, the risk of bipolar disorder has not been well characterized. OBJECTIVE: We explored the relationship between GERD and the subsequent development of bipolar disorder, and examined the risk factors for bipolar disorder in patients with GERD. METHODS: We identified patients who were diagnosed with GERD in the Taiwan National Health Insurance Research Database. A comparison cohort without GERD was matched according to age, sex, and comorbidities. The occurrence of bipolar disorder was evaluated in both cohorts based on diagnosis and the prescription of medications. RESULTS: The GERD cohort consisted of 21,674 patients, and the comparison cohort consisted of 21,674 matched control patients without GERD. The incidence of bipolar disorder (incidence rate ratio [IRR] 2.29, 95% confidence interval [CI] 1.58-3.36, P<.001 was higher among GERD patients than among comparison cohort. Multivariate, matched regression models showed that the female sex (hazard ratio [HR] 1.78, 95% CI 1.76-2.74, P = .008, being younger than 60 years old (HR 2.35, 95% CI 1.33-4.16, P = .003, and alcohol use disorder (HR 4.89, 95% CI 3.06-7.84, P = .004 were independent risk factors for the development of bipolar disorder among GERD patients. CONCLUSIONS: GERD may increase the risk of developing bipolar disorder. Based on our data, we suggest that attention should be focused on female patients younger than 60 years, and patients with alcohol use disorder, following a GERD diagnosis.

  13. CACNA1C hypermethylation is associated with bipolar disorder.

    Science.gov (United States)

    Starnawska, A; Demontis, D; Pen, A; Hedemand, A; Nielsen, A L; Staunstrup, N H; Grove, J; Als, T D; Jarram, A; O'Brien, N L; Mors, O; McQuillin, A; Børglum, A D; Nyegaard, M

    2016-01-01

    The CACNA1C gene, encoding a subunit of the L-type voltage-gated calcium channel is one of the best-supported susceptibility genes for bipolar disorder (BD). Genome-wide association studies have identified a cluster of non-coding single-nucleotide polymorphisms (SNPs) in intron 3 to be highly associated with BD and schizophrenia. The mechanism by which these SNPs confer risk of BD appears to be through an altered regulation of CACNA1C expression. The role of CACNA1C DNA methylation in BD has not yet been addressed. The aim of this study was to investigate if CACNA1C DNA methylation is altered in BD. First, the methylation status of five CpG islands (CGIs) across CACNA1C in blood from BD subjects (n=40) and healthy controls (n=38) was determined. Four islands were almost completely methylated or completely unmethylated, while one island (CGI 3) in intron 3 displayed intermediate methylation levels. In the main analysis, the methylation status of CGI 3 was analyzed in a larger sample of BD subjects (n=582) and control individuals (n=319). Out of six CpG sites that were investigated, five sites showed significant hypermethylation in cases (lowest P=1.16 × 10(-7) for CpG35). Nearby SNPs were found to influence the methylation level, and we identified rs2238056 in intron 3 as the strongest methylation quantitative trait locus (P=2.6 × 10(-7)) for CpG35. In addition, we found an increased methylation in females, and no difference between bipolar I and II. In conclusion, we find that CACNA1C methylation is associated with BD and suggest that the regulatory effect of the non-coding risk variants involves a shift in DNA methylation. PMID:27271857

  14. Bipolar disorder: a neural network perspective on a disorder of emotion and motivation.

    Science.gov (United States)

    Wessa, Michèle; Kanske, Philipp; Linke, Julia

    2014-01-01

    Bipolar disorder (BD) is a severe, chronic disease with a heritability of 60-80%. BD is frequently misdiagnosed due to phenomenological overlap with other psychopathologies, an important issue that calls for the identification of biological and psychological vulnerability and disease markers. Altered structural and functional connectivity, mainly between limbic and prefrontal brain areas, have been proposed to underlie emotional and motivational dysregulation in BD and might represent relevant vulnerability and disease markers. In the present laboratory review we discuss functional and structural neuroimaging findings on emotional and motivational dysregulation from our research group in BD patients and healthy individuals at risk to develop BD. As a main result of our studies, we observed altered orbitofrontal and limbic activity and reduced connectivity between dorsal prefrontal and limbic brain regions, as well as reduced integrity of fiber tracts connecting prefrontal and subcortical brain structures in BD patients and high-risk individuals. Our results provide novel insights into pathophysiological mechanisms of bipolar disorder. The current laboratory review provides a specific view of our group on altered brain connectivity and underlying psychological processes in bipolar disorder based on our own work, integrating relevant findings from others. Thereby we attempt to advance neuropsychobiological models of BD.

  15. Psicoterapia em grupo de pacientes com transtorno afetivo bipolar Group psychotherapy for bipolar disorder patients

    Directory of Open Access Journals (Sweden)

    Bernardo Carramão Gomes

    2007-01-01

    treatment of bipolar patients. However, little is known about the effects of these approaches. OBJECTIVE: Evaluate the effectiveness of Group Therapy in the treatment of bipolar affective disorder. METHOD: Review of the literature using Medline, Lilacs, PubMed e ISI, selecting English language articles published between the years of 1975 and 2005. The reference sections of the selected articles, review articles and specialized books were also consulted. Only randomized controlled trails, with more than twenty subjects, were selected. RESULTS: Five published studies were identified; three of them have been published in the last five years. In three of the selected studies, models of Psychoeducation were used, showing an increase in the adherence to the pharmacological treatment. One showed reduction in the number of relapses and hospital admissions. The other two studies combined psychoeducation with some other form of psychotherapeutic approach. In one of them, not only an increase in the remission period but also symptom reduction was identified, concerning manic episodes. DISCUSSION: There has been a growing interest in evidence based psychotherapy interventions for the treatment of bipolar affective disorder over the last years. This fact contrasts with the low number of studies dedicated to group therapy, which could be very useful in institutions where a great number of patients are assisted. The clinical complexities of this disease, the presence of several comorbidities and the different levels of adherence to pharmacotherapy demand the development of diverse therapeutic options, in order to meet the needs of each individual. The studies show that group therapy could be an effective treatment option that deserves better investigations so that it can be used in clinical practice.

  16. Glucose metabolism alterations in patients with bipolar disorder.

    Science.gov (United States)

    Rosso, Gianluca; Cattaneo, Annamaria; Zanardini, Roberta; Gennarelli, Massimo; Maina, Giuseppe; Bocchio-Chiavetto, Luisella

    2015-09-15

    Patients with bipolar disorder (BD) are more frequently affected by metabolic syndrome (MetS) than the general population, but the neurobiological correlates underlying such association are still not clarified and few studies in BD have evaluated the role of regulators of lipid and glucose metabolism. The present study was aimed to investigate putative alterations in markers linked to metabolic dysfunctions as C-peptide, Ghrelin, GIP, GLP-1, Glucagon, Insulin, Leptin, PAI-1 (total), Resistin and Visfatin in a sample of BD patients compared to controls. Furthermore, associations between changes of metabolic markers and relevant clinical features, such as severity of symptomatology, number and type of past mood episodes, drug treatments and presence/absence of metabolic alterations (MetS, diabetes and cardiovascular disease) were analyzed. A total of 57 patients with BD and 49 healthy controls were recruited. The main results showed lower serum levels of Glucagon, GLP-1, Ghrelin, and higher levels of GIP in BD patients as compared to controls (p = 0.018 for Ghrelin; p < 0.0001 for Glucagon; p < 0.0001 for GLP-1; p < 0.0001 for GIP). Further, Glucagon and GLP-1 levels were significantly associated with the number of past mood episodes. These findings support the hypothesis that alterations in Glucagon, GLP-1, GIP and Ghrelin might be involved in BD pathogenesis and might represent useful biomarkers for the development of preventive and personalized therapies in this disorder. PMID:26120808

  17. Preserved white matter in unmedicated pediatric bipolar disorder.

    Science.gov (United States)

    Teixeira, Ana Maria A; Kleinman, Ana; Zanetti, Marcus; Jackowski, Marcel; Duran, Fábio; Pereira, Fabrício; Lafer, Beny; Busatto, Geraldo F; Caetano, Sheila C

    2014-09-01

    White matter (WM) abnormalities have been reported in bipolar disorder (BD) patients, as well as in their non-BD relatives, both children and adults. Although it is considered an emerging vulnerability marker for BD, there are no studies investigating WM alterations in pediatric unmedicated patients and young healthy offspring. In this study, we evaluated the presence of WM alterations in 18 pediatric, non medicated BD patients, as well as in 18 healthy offspring of BD type I parents and 20 healthy controls. 3T DT-MRI data were acquired and scans were processed with tract-based spatial statistics to provide measures of fractional anisotropy and diffusivity. We found no significant differences in WM microstructure between BD patients, healthy offspring and healthy controls. Previous studies that reported WM alterations investigated older subjects, either on medication (BD patients) or with psychiatric diagnoses other than BD (unaffected offspring). Our findings highlight the importance of the understanding of disease ontogeny and brain development dynamics in the search for early vulnerability markers for psychiatric disorders.

  18. Metacognition in psychosis: comparison of schizophrenia with bipolar disorder.

    Science.gov (United States)

    Tas, Cumhur; Brown, Elliot C; Aydemir, Omer; Brüne, Martin; Lysaker, Paul H

    2014-11-30

    While deficits in metacognition have been observed in schizophrenia (SZ), it is less clear whether these are specific to the disorder. Accordingly, this study compared metacognitive abilities of patients with schizophrenia and bipolar disorder (BD) and examined the degree to which neurocognition contributed to metacognitive deficits in both groups. Participants were 30 patients with SZ and 30 with BD. Metacognitive capacity was measured using the Metacognition Assessment Scale Abbreviated (MAS-A). This scale comprises four domains: self-reflectivity, understanding others' minds, decentration and mastery. Verbal memory, executive functioning and symptoms were concurrently assessed. Group comparisons revealed that SZ patients had greater deficits in metacognitive self-reflectivity, which correctly classified 85.2% of patients with SZ in a logistic regression. Self-reflectivity and understanding others'minds were related to verbal memory and executive functioning in the SZ group, but not in the BD group. Furthermore, greater positive and general psychotic symptoms were associated with poorer metacognition in SZ. Results suggest SZ involves unique deficits in the ability to self-reflect and that these deficits may be uniquely linked with neurocognition.

  19. Anticonvulsivantes e antipsicóticos no tratamento do transtorno bipolar Anticonvulsants and antipsychotics in the treatment of Bipolar Disorder

    Directory of Open Access Journals (Sweden)

    Ricardo Alberto Moreno

    2004-10-01

    Full Text Available O transtorno bipolar é uma condição médica complexa e até o momento não há um tratamento único comprovadamente eficaz no controle de todos aspectos da doença. Foram revisadas a literatura disponível sobre o uso de anticonvulsivantes (valproato, carbamazepina, oxcarbazepina, lamotrigina, gabapentina, topiramato, clonazepam e antipsicóticos atípicos (clozapina, risperidona, olanzapina, quetiapina, ziprasidona e aripiprazole no tratamento agudo e profilático do transtorno bipolar. Existe um acúmulo de evidências acerca da eficácia do lítio na profilaxia e de ser melhor no tratamento da mania aguda do que nos episódios depressivos. Outros dados indicam que a carbamazepina e o valproato são eficazes na mania aguda. A lamotrigina parece reduzir ciclagem e ser eficaz em episódios depressivos. Baseado nas informações disponíveis, as evidências apontam a olanzapina como o antipsicótico atípico mais apropriado no tratamento de pacientes bipolares em mania, embora existam estudos sugerindo a eficácia da risperidona, aripiprazol e da clozapina. Resultados preliminares avaliando a eficácia de ziprasidona e quetiapina no transtorno bipolar ainda são bastante limitadas. Não há dados consistentes apoiando o uso profilático dos novos antipsicóticos.Bipolar disorder is a complex medical condition, and up to the date there is no single treatment with proven efficacy in the control of all aspects of the illness. The available literature on the use of anticonvulsants (valproate, carbamazepine, oxcarbazepine, lamotrigine, gabapentin, topiramate, clonazepam and atypical antipsychotics (clozapine, risperidone, olanzapine, quetiapine, ziprasidone, and aripiprazole for acute and prophylactic treatment of bipolar disorder was reviewed. There is a large amount of evidence that lithium is efficacious in the prophylaxis of episodes and better for acute mania than for depressive episodes. Other data show that carbamazepine and valproate are

  20. Risperidone treatment for ADHD in children and adolescents with bipolar disorder

    Directory of Open Access Journals (Sweden)

    Joseph Biederman

    2008-03-01

    Full Text Available Joseph Biederman, Paul Hammerness, Robert Doyle, Gagan Joshi, Megan Aleardi, Eric MickPediatric Psychopharmacology Research Department, Massachusetts General Hospital, Boston, MA, USAObjective: Children and adolescents with bipolar disorder are also at high risk of having comorbid attention-deficit hyperactivity disorder (ADHD. The objective of this study was to estimate improvement in ADHD symptoms in children with bipolar disorder.Methods: This was an open-label, study of risperidone monotherapy for the treatment of pediatric bipolar disorder. Thirty-one children and adolescents 4–15 years of age (7.2 ± 2.8 years of both sexes (71%, N = 22 male with pediatric bipolar disorder (YMRS score = 32.9 ± 8.8 and ADHD (ADHD-RS score = 37.9 ± 8.9 were included in these analyses.Results: Improvement in ADHD symptoms was contingent on improvement in manic symptoms. Although both hyperactive/impulsive (−7.5 ± 5.5.6, p < 0.05 and inattentive (−6.8 ± 5.0, p < 0.05 ADHD symptoms were significantly improved with risperidone, improvement was modest, and only 29% of subjects (N = 6 showed a 30% reduction in ADHD rating scale scores and had a CGI-I ≤ 2.Conclusions: These results suggest that that treatment with risperidone is associated with tangible but generally modest improvement of symptoms of ADHD in children with bipolar disorder.Keywords: ADHD, bipolar disorder, children, risperidone

  1. Characteristics of stress-coping behaviors in patients with bipolar disorders.

    Science.gov (United States)

    Moon, Eunsoo; Chang, Jae Seung; Choi, Sungwon; Ha, Tae Hyon; Cha, Boseok; Cho, Hyun Sang; Park, Je Min; Lee, Byung Dae; Lee, Young Min; Choi, Yoonmi; Ha, Kyooseob

    2014-08-15

    Appropriate stress-coping strategies are needed to improve the outcome in the treatment of bipolar disorders, as stressful life events may aggravate the course of the illness. The aim of this study was to compare stress-coping behaviors between bipolar patients and healthy controls. A total of 206 participants comprising 103 bipolar patients fulfilling the Diagnostic and Statistical Manual for Axis I disorder fourth edition (DSM-IV) diagnostic criteria for bipolar I and II disorders and controls matched by age and sex were included in this study. Stress-coping behaviors were assessed using a 53-item survey on a newly-designed behavioral checklist. The characteristics of stress-coping behaviors between the two groups were compared by using t-test and factor analysis. Social stress-coping behaviors such as 'journey', 'socializing with friends', and 'talking something over' were significantly less frequent in bipolar patients than controls. On the other hand, pleasurable-seeking behaviors such as 'smoking', 'masturbation', and 'stealing' were significantly more frequent in bipolar patients than controls. These results suggest that bipolar patients may have more maladaptive stress-coping strategies than normal controls. It is recommended to develop and apply psychosocial programs to reduce maladaptive stress-coping behaviors of bipolar patients. PMID:24803186

  2. A validation of wrist actigraphy against polysomnography in patients with schizophrenia or bipolar disorder

    DEFF Research Database (Denmark)

    Baandrup, Lone; Jennum, Poul Jørgen

    2015-01-01

    PURPOSE: Sleep disturbances are frequent in patients with schizophrenia or bipolar disorder. Actigraphy has been established as a generally reliable method to examine these disturbances across varying time spans, but the validity against polysomnography (PSG) is not well investigated...... for this population. We validated wrist-worn actigraphy against PSG in a population of chronic, medicated patients with schizophrenia or bipolar disorder. PATIENTS AND METHODS: From a clinical trial, we derived data from 37 patients with schizophrenia and five patients with bipolar disorder who were examined with one...... for the number of awakenings, and low or zero for the other examined sleep variables. These findings were reproduced in the subgroup analyses that compared men and women, as well as patients with bipolar versus schizophrenia spectrum disorders. When excluding patients with extensive periods of wakefulness after...

  3. Smartphone data as an electronic biomarker of illness activity in bipolar disorder

    DEFF Research Database (Denmark)

    Faurholt-Jepsen, Maria; Vinberg, Maj; Frost, Mads;

    2015-01-01

    OBJECTIVES: Objective methods are lacking for continuous monitoring of illness activity in bipolar disorder. Smartphones offer unique opportunities for continuous monitoring and automatic collection of real-time data. The objectives of the paper were to test the hypotheses that (i) daily electronic...... self-monitored data and (ii) automatically generated objective data collected using smartphones correlate with clinical ratings of depressive and manic symptoms in patients with bipolar disorder. METHODS: Software for smartphones (the MONARCA I system) that collects automatically generated objective...... data and self-monitored data on illness activity in patients with bipolar disorder was developed by the authors. A total of 61 patients aged 18-60 years and with a diagnosis of bipolar disorder according to ICD-10 used the MONARCA I system for six months. Depressive and manic symptoms were assessed...

  4. Causes of decreased life expectancy over the life span in bipolar disorder

    DEFF Research Database (Denmark)

    Kessing, Lars Vedel; Vradi, Eleni; McIntyre, Roger S;

    2015-01-01

    expectancy due to natural causes (physical illnesses) and unnatural causes (suicide and accidents) in relation to age. RESULTS: A total of 22,635 patients with bipolar disorder were included in the study in addition to data from the entire Danish general population of 5.4 million people. At age 15 years......BACKGROUND: Accelerated aging has been proposed as a mechanism explaining the increased prevalence of comorbid general medical illnesses in bipolar disorder. AIMS: To test the hypothesis that lost life years due to natural causes starts in early and mid-adulthood, supporting the hypothesis......, remaining life expectancy before age 90 years was decreased 12.7 and 8.9 life years, respectively, for men and women with bipolar disorder. For 15-year old boys with bipolar disorder, natural causes accounted for 58% of all lost life years and for 15-year old girls, natural causes accounted for 67...

  5. Social and reproductive lives of women with bipolar disorder: A descriptive study from Turkey

    OpenAIRE

    Annagür, Bilge Burçak; Zincir, Selma Bozkurt; Bez, Yasin; İnanlı, Ikbal; Şahingöz, Mine; Ateş, Nazlı; Alpak, Gökay

    2013-01-01

    Aims: Bipolar disorder (BD) shows some differences across genders. Pregnancy, delivery, and lactation periods of women with BD may sometimes interfere with their treatment. In terms of social and reproductive lives, the characteristics of women with bipolar disorder living in our country have not been thoroughly studied yet. The aims of this study were to investigate the characteristics of marital life, fertility, and social life of the women with BD. Methods: The study was conducted in 5 ...

  6. Integrating Pharmacotherapy and Psychotherapy for Paediatric Bipolar Disorder: Translating Science to Service

    OpenAIRE

    Smita, Kampani; Mani N., Pavuluri

    2005-01-01

    Objective: For comprehensive management of paediatric bipolar disorder (PBD), it is imperative to combine psychopharmacotherapy with specific psychotherapy. This article proposes a model that incorporates (1) an overview of psychopathology, (2) a review of outcomes in psychopharmacotherapy trials, and (3) a summary of evidence-based forms of psychotherapy to complement pharmacotherapy. Results: The psychopathology of PBD is unique compared to that of adult bipolar disorder with promi...

  7. Childhood IQ and risk of bipolar disorder in adulthood: prospective birth cohort study

    OpenAIRE

    Smith, Daniel J; Anderson, Jana; Zammit, Stanley; Meyer, Thomas D; Pell, Jill P; MacKay, Daniel

    2015-01-01

    Background: Intellectual ability may be an endophenotypic marker for bipolar disorder. Aims: Within a large birth cohort, we aimed to assess whether childhood IQ (including both verbal IQ (VIQ) and performance IQ (PIQ) subscales) was predictive of lifetime features of bipolar disorder assessed in young adulthood. Method: We used data from the Avon Longitudinal Study of Parents and Children (ALSPAC), a large UK birth cohort, to test for an association between measures of childhood IQ a...

  8. The Diagnostic Dilemma: Why We Need to Change How We Diagnose Bipolar Disorder in Children

    OpenAIRE

    Dickstein, Daniel

    2010-01-01

    Editor’s note: Bipolar disorder diagnosis has been rising dramatically in children for the past decade. In response to this increase, writes Daniel Dickstein, M.D., of Bradley Hospital and Brown University, researchers at the National Institute of Mental Health and elsewhere are reviewing the diagnostic criteria. In coming years, Dickstein argues, recognizing and diagnosing bipolar disorder in children should be based more on biological markers, such as brain structure and the use of neural c...

  9. A Test of the Bidirectional Association Between Sleep and Mood in Bipolar Disorder and Insomnia

    OpenAIRE

    Talbot, Lisa S.; Stone, Susan; Gruber, June; Hairston, Ilana S.; Eidelman, Polina; Harvey, Allison G.

    2011-01-01

    The present study investigates sleep, mood, and the proposed bidirectional relationship between the two in psychiatric disorders. Participants with interepisode bipolar disorder (n = 49), insomnia (n = 34), and no psychiatric history (n = 52) completed seven consecutive days of sleep diaries and mood measures. The interepisode bipolar and insomnia participants exhibited greater sleep disturbance than the healthy control individuals. Negative mood was equally heightened in both interepisode bi...

  10. Has analytical flexibility increased in imaging studies of bipolar disorder and major depression?

    Science.gov (United States)

    Munafò, M R; Kempton, M J

    2015-02-01

    There has been extensive discussion of problems of reproducibility of research. Analytical flexibility may contribute to this, by increasing the likelihood that a reported finding represents a chance result. We explored whether analytical flexibility has increased over time, using human imaging studies of bipolar disorder and major depression. Our results indicate that the number of measures collected per study has increased over time for studies of bipolar disorder, but not for studies of major depression.

  11. Pre- and perinatal hypoxia associated with hippocampus/amygdala volume in bipolar disorder

    OpenAIRE

    2013-01-01

    Background Pre- and perinatal adversities may increase the risk for schizophrenia and bipolar disorder. Hypoxia-related obstetric complications (OCs) are associated with brain anatomical abnormalities in schizophrenia, but their association with brain anatomy variation in bipolar disorder is unknown. Method Magnetic resonance imaging brain scans, clinical examinations and data from the Medical Birth Registry of Norway were obtained for 219 adults, including 79 patients with a DSM-IV diagno...

  12. GSK-3 is a viable potential target for therapeutic intervention in bipolar disorder

    OpenAIRE

    Rowe, Michael K.; Wiest, Charlotte; Chuang, De-Maw

    2007-01-01

    Bipolar disorder is a serious psychiatric condition that has been treated for over fifty years with lithium. Lithium is a well established glycogen synthase kinase-3 (GSK-3) inhibitor, suggesting that manipulating GSK-3 may have therapeutic value in treating bipolar disorder. GSK-3 is regulated by a wide variety of mechanisms including phosphorylation, binding with protein complexes, phosphorylation state of its substrates, cellular localization and autoregulation, thus providing a wide numbe...

  13. Verbal and Visual Memory Impairments in Bipolar I and II Disorder

    OpenAIRE

    Ha, Tae Hyon; Kim, Ji Sun; Chang, Jae Seung; Oh, Sung Hee; Her, Ju Young; Cho, Hyun Sang; Park, Tae Sung; Shin, Soon Young; Ha, Kyooseob

    2012-01-01

    Objective To compare verbal and visual memory performances between patients with bipolar I disorder (BD I) and patients with bipolar II disorder (BD II) and to determine whether memory deficits were mediated by impaired organizational strategies. Methods Performances on the Korean-California Verbal Learning Test (K-CVLT) and the Rey-Osterrieth Complex Figure Test (ROCF) in 37 patients with BD I, 46 patients with BD II and 42 healthy subjects were compared. Mediating effects of impaired organi...

  14. Global prefrontal and fronto-amygdala dysconnectivity in bipolar I disorder with psychosis history

    OpenAIRE

    Anticevic, A; Brumbaugh, MS; Winkler, AM; Lombardo, LE; Barrett, J; Corlett, PR; Kober, H; Gruber, J.; REPOVS, G; Cole, MW; Krystal, JH; Pearlson, GD; Glahn, DC

    2013-01-01

    Background: Pathophysiological models of bipolar disorder postulate that mood dysregulation arises from fronto-limbic dysfunction, marked by reduced prefrontal cortex (PFC) inhibitory control. This might occur due to both disruptions within PFC networks and abnormal inhibition over subcortical structures involved in emotional processing. However, no study has examined global PFC dysconnectivity in bipolar disorder and tested whether regions with within-PFC dysconnectivity also exhibit fronto-...

  15. Multi-state models for investigating possible stages leading to bipolar disorder

    OpenAIRE

    Keown-Stoneman, Charles DG; HORROCKS, JULIE; Darlington, Gerarda A.; Goodday, Sarah; Grof, Paul; Duffy, Anne

    2015-01-01

    Background It has been proposed that bipolar disorder onsets in a predictable progressive sequence of clinical stages. However, there is some debate in regard to a statistical approach to test this hypothesis. The objective of this paper is to investigate two different analysis strategies to determine the best suited model to assess the longitudinal progression of clinical stages in the development of bipolar disorder. Methods Data previously collected on 229 subjects at high risk of developi...

  16. A Voxel-Based Diffusion Tensor Imaging Study of White Matter in Bipolar Disorder

    OpenAIRE

    Mahon, Katie; Wu, Jinghui; Malhotra, Anil K.; Burdick, Katherine E.; DeRosse, Pamela; Ardekani, Babak A.; Szeszko, Philip R.

    2009-01-01

    There is evidence from post-mortem and magnetic resonance imaging studies that hyperintensities, oligodendrioglial abnormalities and gross white matter volumetric alterations play a role in the pathophysiology of bipolar disorder. There is also functional imaging evidence for a defect in frontal cortico-subcortical pathways in bipolar disorder, but the white matter comprising these pathways has not been well-investigated. Few studies have investigated white matter integrity in patients with b...

  17. Bipolar Disorder: Clinical Perspectives and Implications with Cognitive Dysfunction and Dementia

    OpenAIRE

    Lopes, R; Fernandes, L

    2012-01-01

    Introduction. Cognitive dysfunction as a core feature in the course of bipolar affective disorder (BPD) is a current subject of debate and represents an important source of psychosocial and functional burden. Objectives. To stand out the connection and clinical implications between cognitive dysfunction, dementia, and BPD. Methods. A nonsystematic review of all English language PubMed articles published between 1995 and 2011 using the terms “bipolar disorder,” “cognitive dysfunction,” and “de...

  18. COGNITIVE DYSFUNCTION, DISSOCIATION AND QUALITY OF LIFE IN BIPOLAR AFFECTIVE DISORDERS IN REMISSION

    OpenAIRE

    Latalova, Klara; Prasko, Jan; Diveky, Tomas; Kamaradova, Dana; Velartova, Hana

    2010-01-01

    Background: Bipolar disorders are often associated with cognitive deficits, which have an influence on social functioning and the course of the illness. These deficits have an impact on occupational ability and social integration. Subjects and methods: To ascertain cognitive function, level of dissociation and quality of life and their interrelations in patients with bipolar affective disorder in remission. Data from D2 Attention Test, Verbal Fluency Test and Trial Making Test, Di...

  19. Long-term treatment of bipolar disorder with a radioelectric asymmetric conveyor

    OpenAIRE

    Mannu, Piero; Rinaldi, Salvatore; Fontani, Vania; Castagna, Alessandro

    2011-01-01

    Background: The bipolar spectrum disorders are considered an important and frequent psychiatric problem. The clinical complexity of these illnesses due to the coexistence of depressive and excitative phases is correlated with the global difficulty of adequate treatment; consequently, the prognosis is not optimal. For this reason, in recent years, novel nonpharmacologic physical approaches have been tested for bipolar disorders, with encouraging results. The aim of this study was to evaluate t...

  20. Sex Dependence of Cognitive Functions in Bipolar Disorder

    OpenAIRE

    Aleksandra Suwalska; Dorota Łojko

    2014-01-01

    The objective of the present study was to assess the performance of lithium treated euthymic bipolar patients in tests measuring spatial working memory (SWM), planning, and verbal fluency and to delineate the influence of gender on cognitive functioning. Fifty-nine euthymic bipolar patients, treated with lithium carbonate for at least 5 yr, were studied. Patients and controls underwent a neuropsychological assessment. Bipolar patients had significantly worse results than the healthy controls ...

  1. Corticolimbic functional connectivity in adolescents with bipolar disorder.

    Directory of Open Access Journals (Sweden)

    Fei Wang

    Full Text Available Convergent evidence supports regional dysfunction within a corticolimbic neural system that subserves emotional processing and regulation in adolescents and adults with bipolar disorder (BD, with abnormalities prominent within the amygdala and its major anterior paralimbic cortical connection sites including ventral anterior cingulate, orbitofrontal, insular and temporopolar cortices. Recent studies of adults with BD demonstrate abnormalities in the functional connectivity between the amygdala and anterior paralimbic regions suggesting an important role for the connections between these regions in the development of the disorder. This study tests the hypothesis that these functional connectivity abnormalities are present in adolescents with BD. Fifty-seven adolescents, twenty-one with BD and thirty-six healthy comparison (HC adolescents, participated in functional magnetic resonance imaging while processing emotional face stimuli. The BD and HC groups were compared in the strength of functional connectivity from amygdala to the anterior paralimbic cortical regions, and explored in remaining brain regions. Functional connectivity was decreased in the BD group, compared to the HC group, during processing of emotional faces in ventral anterior cingulate (VACC, orbitofrontal, insular and temporopolar cortices (p<0.005. Orbitofrontal and VACC findings for the happy condition, and additionally right insula for the neutral condition, survived multiple comparison correction. Exploratory analyses did not reveal additional regions of group differences. This study provides evidence for decreased functional connectivity between the amygdala and anterior paralimbic cortices in adolescents with BD. This suggests that amygdala-anterior paralimbic connectivity abnormalities are early features of BD that emerge at least by adolescence in the disorder.

  2. Update on quetiapine in the treatment of bipolar disorder: results from the BOLDER studies

    Directory of Open Access Journals (Sweden)

    Prashant Gajwani

    2007-01-01

    Full Text Available Prashant Gajwani1, David J Muzina2, David E Kemp3, Keming Gao1, Joseph R Calabrese11Case Western Reserve University (CWRU School of Medicine, 2Cleveland Clinic Lerner College of Medicine of CWRU, 3Case Western Reserve University, Cleveland OH, USAAbstract: The essential features of bipolar affective disorder involve the cyclical occurrence of high (manic or hypomanic episodes and low mood states. Depressive episodes in both bipolar I and II disorder are more numerous and last for longer duration than either manic or hypomanic episodes. In addition depressive episodes are associated with higher morbidity and mortality. While multiple agents, including all 5 atypical antipsychotics, have demonstrated efficacy and earned US FDA indication for manic phase of bipolar illness, the acute treatment of bipolar depression is less well-studied. The first treatment approved by the US FDA for acute bipolar depression was the combination of the atypical antipsychotic olanzapine and the antidepressant fluoxetine. Recently, quetiapine monotherapy has demonstrated efficacy in the treatment of depressive episodes associated with both bipolar I and II disorder and has earned US FDA indication for the same.Keywords: bipolar disorder, quetiapine, BOLDER studies

  3. 双相情感障碍的遗传学%The genetics of bipolar disorder

    Institute of Scientific and Technical Information of China (English)

    续稳稳(综述); 刘传新(审校)

    2016-01-01

    双相情感障碍(bipolar disorder,BD)又称心境障碍,目前其发病机制尚不明确。BD 具有遗传性,目前发现一些染色体区域和特定基因与 BD 相关,但尚不能明确这些特定基因的参与或序列变异的发生与 BD 的关系。因此,仍需进行大量研究来进一步探究 BD 遗传方式。%Bipolar disorder is also known as mood disorders and the pathogenesis is unclear until now. Family and twin studies have confirmed the genetics of bipolar disorder. Although the researchers have dis-covered some related chromosomal regions and specific genes,they have not confirmed the relationship be-tween the involvement of any specific gene or sequence variant and the bipolar disorder. The scholars both at home and abroad still needs a lot of studies to explore the genetics of bipolar disorder. We review the re-search status of the genetic of bipolar disorder in this paper.

  4. Indicators of fetal growth and bipolar disorder: a Danish national register-based study

    DEFF Research Database (Denmark)

    Øgendahl, Bettina; Agerbo, Esben; Byrne, Majella;

    2006-01-01

    Background. Several studies have found an association between indicators of fetal growth and/or obstetric complications and schizophrenia but only a few studies have investigated the possible association between these factors and bipolar disorder. Furthermore, the results of these studies have be...... with receiving a diagnosis of bipolar disorder.Conclusions. None of the indicators of fetal growth under study could be identified as risk factors for bipolar disorder, suggesting that the etiologies of schizophrenia and bipolar disorder, at least in part, are different......Background. Several studies have found an association between indicators of fetal growth and/or obstetric complications and schizophrenia but only a few studies have investigated the possible association between these factors and bipolar disorder. Furthermore, the results of these studies have been...... contradictory. The aim of this study was to investigate whether the risk of bipolar disorder is associated with exposure to indicators of fetal growth.Method. A national population nested case-control study based on Danish longitudinal register databases was carried out. Conditional logistic regression was used...

  5. Emotion-relevant impulsivity predicts sustained anger and aggression after remission in bipolar I disorder.

    Science.gov (United States)

    Johnson, Sheri L; Carver, Charles S

    2016-01-01

    Recent evidence suggests that anger and aggression are of concern even during remission for persons with bipolar I disorder, although there is substantial variability in the degree of anger and aggression across individuals. Little research is available to examine psychological models of anger and aggression for those with remitted bipolar disorder, and that was the goal of this study. Participants were 58 persons diagnosed with bipolar I disorder using the Structured Clinical Interview for DSM-IV, who were followed with monthly symptom severity interviews until they achieved remission, and then assessed using the Aggression-Short Form. We examined traditional predictors of clinical parameters and trauma exposure, and then considered three trait domains that have been shown to be elevated in bipolar disorder and have also been linked to aggression outside of bipolar disorder: emotion-relevant impulsivity, approach motivation, and dominance-related constructs. Emotion-relevant impulsivity was related to anger, hostility, verbal aggression, and physical aggression, even after controlling for clinical variables. Findings extend the importance of emotion-relevant impulsivity to another important clinical outcome and suggest the promise of using psychological models to understand the factors driving aggression and anger problems that persist into remission among persons with bipolar disorder.

  6. Elevated levels of plasma brain derived neurotrophic factor in rapid cycling bipolar disorder patients

    DEFF Research Database (Denmark)

    Munkholm, Klaus; Pedersen, Bente Klarlund; Kessing, Lars Vedel;

    2014-01-01

    Impaired neuroplasticity may be implicated in the pathophysiology of bipolar disorder, involving peripheral alterations of the neurotrophins brain derived neurotrophic factor (BDNF) and neurotrophin 3 (NT-3). Evidence is limited by methodological issues and is based primarily on case-control desi......Impaired neuroplasticity may be implicated in the pathophysiology of bipolar disorder, involving peripheral alterations of the neurotrophins brain derived neurotrophic factor (BDNF) and neurotrophin 3 (NT-3). Evidence is limited by methodological issues and is based primarily on case......-control designs. The aim of this study was to investigate whether BDNF and NT-3 levels differ between patients with rapid cycling bipolar disorder and healthy control subjects and whether BDNF and NT-3 levels alter with affective states in rapid cycling bipolar disorder patients. Plasma levels of BDNF and NT-3...... were measured in 37 rapid cycling bipolar disorder patients and in 40 age- and gender matched healthy control subjects using enzyme-linked immunosorbent assay (ELISA). In a longitudinal design, repeated measurements of BDNF and NT-3 were evaluated in various affective states in bipolar disorder...

  7. Processamento cognitivo "Teoria da Mente" no transtorno bipolar Cognitive "Theory of Mind" processing in bipolar disorder

    OpenAIRE

    Hélio Anderson Tonelli

    2009-01-01

    OBJETIVO: O transtorno afetivo bipolar está associado ao comprometimento funcional persistente. Apesar de muitas pesquisas demonstrarem que bipolares podem apresentar déficits cognitivos, um número menor de trabalhos avaliou o papel de prejuízos no processamento cognitivo social, a Teoria da Mente (relacionado à capacidade de inferir estados mentais), no aparecimento de sintomas e complicações sociais em bipolares. O objetivo deste trabalho é o de revisar sistemática e criticamente a literatu...

  8. Transtorno bipolar do humor e gênero Bipolar affective disorder and gender

    OpenAIRE

    Rodrigo da Silva Dias; Florence Kerr-Corrêa; Ricardo Cezar Torresan; Carlos Henrique R. dos Santos

    2006-01-01

    Embora o transtorno bipolar (TB) ocorra quase igualmente em ambos os sexos, a fenomenologia e o curso da doença diferem no homem e na mulher. No entanto, há evidências de que mulheres bipolares, mais que os homens, apresentariam início mais tardio (em especial na quinta década de vida), ciclagem rápida, mais episódios depressivos, mais mania disfórica que eufórica, estados mistos e evolução do tipo bipolar II, ainda que os achados nem sempre sejam consistentes. Embora o risco de comorbidades ...

  9. The influence of genes and environment on the development of bipolar disorder : A twin study

    NARCIS (Netherlands)

    Vonk, Ronald

    2016-01-01

    Bipolar disorder (or manic-depressive disorder) is a severe mood disorder in which episodes of (hypo) mania (e.g. elevated mood en hyperactivity) and depression (e.g. decreased mood and reduced activity) alternate with periods of normal mood and functioning. Genetic factors as well as environmental

  10. Can Bipolar Disorder-Specific Neuropsychological Impairments in Children Be Identified?

    Science.gov (United States)

    Henin, Aude; Mick, Eric; Biederman, Joseph; Fried, Ronna; Wozniak, Janet; Faraone, Stephen V.; Harrington, Kara; Davis, Stephanie; Doyle, Alysa E.

    2007-01-01

    This study examined neuropsychological deficits among children with bipolar disorder while attending to its comorbidity with attention-deficit/hyperactivity disorder (ADHD). Seventy-three unmedicated children (ages 6-17 years) with Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994) bipolar…

  11. Beyond diagnoses : attention deficit hyperactivity disorder vs. early onset bipolar disorder : A study of neurological diversity behind symptoms

    OpenAIRE

    2012-01-01

    Objective: The distinction between Bipolar Disorder (BD) and Attention Deficit/Hyperactivity Disorder (ADHD) in youths is difficult because of similar behaviour presentation. Delayed diagnosis and treatment of early onset psychiatric disorders is associated with considerable morbidity and mortality, and an adverse effect on psychosocial development and academic achievement. Identifying neuromotor and neurocognitive problems underlying similar symptoms may perhaps aid diagnostic accuracy, a...

  12. Dysregulation of the NF-κB pathway as a potential inducer of bipolar disorder.

    Science.gov (United States)

    Elhaik, Eran; Zandi, Peter

    2015-11-01

    A century of investigations enhanced our understanding of bipolar disorder although it remains a complex multifactorial disorder with a mostly unknown pathophysiology and etiology. The role of the immune system in this disorder is one of the most controversial topics in genetic psychiatry. Though inflammation has been consistently reported in bipolar patients, it remains unclear how the immunologic process influences the disorder. One of the core components of the immune system is the NF-κB pathway, which plays an essential role in the development of innate and adaptive immunity. Remarkably, the NF-κB pathway received only little attention in bipolar studies, as opposed to studies of related psychiatric disorders where immune dysregulation has been proposed to explain the neurodegeneration in patient conditions. If immune dysregulation can also explains the neurodegeneration in bipolar disorder, it will underscore the role of the immune system in the chronicity and pathophysiology of the disorder and may promote personalized therapeutic strategies. This is the first review to summarize the current knowledge of the pathophysiological functions of NF-κB in bipolar disorder.

  13. Can Psychological, Social and Demographical Factors Predict Clinical Characteristics Symptomatology of Bipolar Affective Disorder and Schizophrenia?

    Science.gov (United States)

    Maciukiewicz, Malgorzata; Pawlak, Joanna; Kapelski, Pawel; Łabędzka, Magdalena; Skibinska, Maria; Zaremba, Dorota; Leszczynska-Rodziewicz, Anna; Dmitrzak-Weglarz, Monika; Hauser, Joanna

    2016-09-01

    Schizophrenia (SCH) is a complex, psychiatric disorder affecting 1 % of population. Its clinical phenotype is heterogeneous with delusions, hallucinations, depression, disorganized behaviour and negative symptoms. Bipolar affective disorder (BD) refers to periodic changes in mood and activity from depression to mania. It affects 0.5-1.5 % of population. Two types of disorder (type I and type II) are distinguished by severity of mania episodes. In our analysis, we aimed to check if clinical and demographical characteristics of the sample are predictors of symptom dimensions occurrence in BD and SCH cases. We included total sample of 443 bipolar and 439 schizophrenia patients. Diagnosis was based on DSM-IV criteria using Structured Clinical Interview for DSM-IV. We applied regression models to analyse associations between clinical and demographical traits from OPCRIT and symptom dimensions. We used previously computed dimensions of schizophrenia and bipolar affective disorder as quantitative traits for regression models. Male gender seemed protective factor for depression dimension in schizophrenia and bipolar disorder sample. Presence of definite psychosocial stressor prior disease seemed risk factor for depressive and suicidal domain in BD and SCH. OPCRIT items describing premorbid functioning seemed related with depression, positive and disorganised dimensions in schizophrenia and psychotic in BD. We proved clinical and demographical characteristics of the sample are predictors of symptom dimensions of schizophrenia and bipolar disorder. We also saw relation between clinical dimensions and course of disorder and impairment during disorder. PMID:26646576

  14. Staging Models in Bipolar Disorder: A Systematic Review of the Literature.

    Science.gov (United States)

    Muneer, Ather

    2016-05-31

    Bipolar disorder is manifested as severe dysregulation of mood with recurrent manic and major depressive episodes. It is associated with psychiatric and medical comorbidities, inadequate response to currently available pharmacological agents and a progressively deteriorating course in many patients. The index episode is often depressive in nature, while the first manic or hypomanic episode may occur several years later in the course of the disorder causing delay in diagnosis and use of inappropriate treatment strategies. Staging has been used to great advantage in other branches of medicine like cardiology and oncology. There is growing realization that major mental disorders are fundamentally progressive, with simpler treatment requirements and better prognosis during initial stages of the illness. Defining these conditions into clinically applicable stages not only helps in better understanding the trajectory of a particular disorder, but also assists in management. Patients with a chronic, recalcitrant condition like bipolar disorder are likely to greatly benefit from this approach. If the illness is correctly identified early in its course, proper treatment can be instigated arresting progression to latter phases which are associated with myriad complications in the biopsychosocial realm. With these considerations, a search of the MEDLINE data base was conducted to seek out literature pertaining to staging models in bipolar disorder. A thorough scrutiny of the existing research work revealed that a number of investigators have endeavored to stage define bipolar disorder. This paper outlines staging proposals for bipolar disorder which have the greatest supporting evidence in the literature. PMID:27121423

  15. Expression of matrix metalloproteinases in patients with bipolar disorder

    Directory of Open Access Journals (Sweden)

    Fábria Chiarani

    2013-12-01

    Full Text Available Objective: High cardiovascular mortality rates have been reported in patients with bipolar disorder (BD. Studies indicate that matrix metalloproteinases (MMPs are implicated in cardiovascular diseases. We evaluated the expression pattern of MMP-2 and MMP-9 in blood from patients with BD during acute mania and after euthymia, in comparison with healthy controls. Methods: Twenty patients and 20 controls were recruited and matched for sex and age. MMP messenger RNA (mRNA levels were measured using real-time quantitative polymerase chain reaction (PCR. Body mass index (BMI was calculated for all subjects. Results: There were no significant differences in MMP-2 and MMP-9 mRNA expression between patients and controls. mRNA levels were not significantly different during mania and euthymia. However, MMP-2 mRNA levels were negatively associated with BMI in BD patients and positively associated with BMI in controls. There was no difference in the pattern of MMP-9 expression between patients and controls. Conclusions: Our results suggest a different pattern of association between MMP-2 and BMI in BD patients as compared with controls. Despite some study limitations, we believe that the role of MMPs in BD should be further investigated to elucidate its relationship with cardiovascular risk.

  16. A systematic review of cognitive rehabilitation for bipolar disorder

    Directory of Open Access Journals (Sweden)

    Bruno Kluwe-Schiavon

    2015-12-01

    Full Text Available Introduction: It has been shown that bipolar disorder (BD has a direct impact on neurocognitive functioning and behavior. This finding has prompted studies to investigate cognitive enhancement programs as potential treatments for BD, primarily focusing on cognitive reinforcement and daily functioning and not restricted to psychoeducation and coping strategies, unlike traditional psychosocial treatments. Objective: This study presents a systematic review of controlled trials of cognitive rehabilitation (CR for BD. Our main objective is to describe the results of studies of rehabilitation programs for BD and related methodological issues. Method: Electronic database searches (MEDLINE, Web of Science, and Embase were conducted to identify articles using terms related to BD and CR. The methodological quality of each article was measured using the 5-item Jadad scale. Results: A total of 239 articles were initially identified, but after application of exclusion criteria, only four were retained for this review. An average of 17 hours of intervention sessions were conducted, distributed as 0.95 hours per week and three of the four studies reported better executive function performance after CR interventions. Conclusions: We did not find robust evidence to support cognitive rehabilitation as an effective treatment for BD, because of: 1 the variety of intervention designs; 2 the methodological limitations of the studies; and 3 the lack of studies in the field.

  17. Increased BDNF levels in long-term bipolar disorder patients

    Directory of Open Access Journals (Sweden)

    Izabela Guimarães Barbosa

    2013-03-01

    Full Text Available INTRODUCTION: Bipolar disorder (BD is a prevalent, chronic and progressive illness. There is a growing body of evidence indicating that brain-derived neurotrophic factor (BDNF plays an important role in the pathophysiology of BD. OBJECTIVE: The aim of this study was to evaluate BDNF plasma levels in BD patients with long term illness in comparison with controls. METHODS: 87 BD type I patients and 58 controls matched by age, gender and education level were enrolled in this study. All subjects were assessed by the Mini-International Neuropsychiatric Interview and the patients by the Young Mania Rating Scale and the Hamilton Depression Rating Scale. The plasma levels of BDNF were measured by ELISA. RESULTS: On average, patients had suffered from BD for 23.4 years. In comparison with controls, BD patients with mania presented a 1.90-fold increase in BDNF plasma levels (p = .001, while BD patients in remission presented a 1.64-fold increase in BDNF plasma levels (p = .03. BDNF plasma levels were not influenced by age, length of illness or current medications. CONCLUSIONS: The present study suggests that long-term BD patients exhibit increased circulating levels of BDNF.

  18. Memantine in the treatment and prophylaxis of bipolar type II mood disorder and co-morbid eating disorder: a case report.

    Science.gov (United States)

    De Chiara, Lavinia; Serra, Giulia; Koukopoulos, Alexia Emilia; Koukopoulos, Athanasios; Serra, Gino

    2014-01-01

    We have recently reported that memantine has a clinically relevant antimanic and long-lasting mood-stabilizing effect in treatment- resistant bipolar disorders, both as augmenting agent and as a monotherapy. Moreover, we observed an acute antimanic and sustained mood-stabilizing effect also in "naïve" bipolar type I disorder. Here we report a case history of a young woman suffering from bipolar type II mood disorder, associated with a very severe eating disorder, showing an acute antimanic and a long-term prophylactic effect of memantine on bipolar disorder and comorbid eating disorder. PMID:25174697

  19. Hoarding Symptoms Respond to Treatment for Rapid Cycling Bipolar II Disorder.

    Science.gov (United States)

    Laurito, Luana D; Fontenelle, Leonardo F; Kahn, David A

    2016-01-01

    Although some studies have reported a relationship between hoarding and bipolar disorder, we are unaware of any previous description of how they may interact with each other and how they should be managed appropriately. A 48-year-old male depressed patient with hoarding symptoms and obsessive-compulsive disorder (OCD) was diagnosed with bipolar II disorder after 2 hypomanic episodes. The patient was treated unsuccessfully with different high-dose serotonin reuptake inhibitors and atypical antipsychotics, maintaining a pattern of 6 to 8 discrete, but severe, depressive episodes each year, always in association with a drastic worsening of his OCD and hoarding symptoms. T.he patient did not improve until the dose of the serotonin reuptake inhibitor was decreased and a combination of lamotrigine and methylphenidate was initiated. On this treatment regimen, the patient did not show clinically significant levels of depression or hoarding or other OCD symptoms. This case suggests that, in some patients, (1) hoarding-related cognitions and behaviors may be a part of bipolar depression, (2) the episodic nature of rapid cycling bipolar II disorder may protect against the development of severe clutter, and (3) treatment focusing on bipolar depression (eg, lamotrigine plus methylphenidate) may result in an improvement of hoarding symptoms when these are present in patients with rapid cycling bipolar II disorder. PMID:26813488

  20. Cognitive functioning in clinically stable patients with bipolar disorder I and II.

    Directory of Open Access Journals (Sweden)

    Timea Sparding

    Full Text Available Bipolar disorder is accompanied by cognitive impairments, which persists during euthymic phases. The purpose of the present study was to identify those neuropsychological tests that most reliably tell euthymic bipolar patients and controls apart, and to clarify the extent to which these cognitive impairments are clinically significant as judged from neuropsychological norms.Patients with bipolar disorder (type I: n = 64; type II: n = 44 and controls (n = 86 were examined with a comprehensive neuropsychological test battery yielding 47 measures of executive functioning, speed, memory, and verbal skills. Multivariate analysis was used to build a model of cognitive performance with the ability to expose underlying trends in data and to reveal cognitive differences between patients and controls.Patients with bipolar disorder and controls were partially separated by one predictive component of cognitive performance. Additionally, the relative relevance of each cognitive measure for such separation was decided. Cognitive tests measuring set shifting, inhibition, fluency, and searching (e.g., Trail Making Test, Color-Word had strongest discriminating ability and most reliably detected cognitive impairments in the patient group.Both bipolar disorder type I and type II were associated with cognitive impairment that for a sizeable minority is significant in a clinical neuropsychological sense. We demonstrate a combination of neuropsychological tests that reliably detect cognitive impairment in bipolar disorder.