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Sample records for bipolar ii disorder

  1. Management of Bipolar II Disorder

    OpenAIRE

    Michael M.C Wong

    2011-01-01

    Bipolar II disorder (BP II) disorder was recognized as a distinct subtype in the DSM-IV classification. DSM-IV criteria for BP II require the presence or history of one or more major depressive episode, plus at least one hypomanic episode, which, by definition, must last for at least 4 days. Various studies found distinct patterns of symptoms and familial inheritance for BP II disorder. BP II is commonly underdiagnosed or misdiagnosed. Making an early and accurate diagnosis of BP II is utmost...

  2. 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...

  3. 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.

  4. Poorer sustained attention in bipolar I than bipolar II disorder

    Directory of Open Access Journals (Sweden)

    Chen Shih-Heng

    2010-02-01

    Full Text Available Abstract Background Nearly all information processing during cognitive processing takes place during periods of sustained attention. Sustained attention deficit is among the most commonly reported impairments in bipolar disorder (BP. The majority of previous studies have only focused on bipolar I disorder (BP I, owing to underdiagnosis or misdiagnosis of bipolar II disorder (BP II. With the refinement of the bipolar spectrum paradigm, the goal of this study was to compare the sustained attention of interepisode patients with BP I to those with BP II. Methods In all, 51 interepisode BP patients (22 with BP I and 29 with BP II and 20 healthy controls participated in this study. The severity of psychiatric symptoms was assessed by the 17-item Hamilton Depression Rating Scale and the Young Mania Rating Scale. All participants undertook Conners' Continuous Performance Test II (CPT-II to evaluate sustained attention. Results After controlling for the severity of symptoms, age and years of education, BP I patients had a significantly longer reaction times (F(2,68 = 7.648, P = 0.001, worse detectability (d' values (F(2,68 = 6.313, P = 0.003 and more commission errors (F(2,68 = 6.182, P = 0.004 than BP II patients and healthy controls. BP II patients and controls scored significantly higher than BP I patients for d' (F = 6.313, P = 0.003. No significant difference was found among the three groups in omission errors and no significant correlations were observed between CPT-II performance and clinical characteristics in the three groups. Conclusions These findings suggested that impairments in sustained attention might be more representative of BP I than BP II after controlling for the severity of symptoms, age, years of education and reaction time on the attentional test. A longitudinal follow-up study design with a larger sample size might be needed to provide more information on chronological sustained attention deficit in BP patients, and to illustrate

  5. 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...

  6. Early- versus late-onset bipolar II disorder.

    OpenAIRE

    Benazzi, F

    2000-01-01

    OBJECTIVE: To compare the clinical features and the outcome between patients with early- and late-onset bipolar II disorder. DESIGN: Case series. SETTING: Outpatient private practice. PATIENTS: One hundred and seventy-nine consecutive outpatients with bipolar II disorder presenting for treatment of a major depressive episode. OUTCOME MEASURES: Duration of illness, severity of depression, recurrences, psychosis, chronicity, atypical features and comorbidity. RESULTS: Patients with early-onset ...

  7. 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

  8. 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...

  9. 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

  10. Bipolar Disorder

    Science.gov (United States)

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

  11. Bipolar Disorder

    Science.gov (United States)

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

  12. Progression along the Bipolar Spectrum: A Longitudinal Study of Predictors of Conversion from Bipolar Spectrum Conditions to Bipolar I and II Disorders

    OpenAIRE

    Alloy, Lauren B.; Urošević, Snežana; Abramson, Lyn Y.; Jager-Hyman, Shari; Nusslock, Robin; Whitehouse, Wayne G.; Hogan, Michael

    2011-01-01

    Little longitudinal research has examined progression to more severe bipolar disorders in individuals with “soft” bipolar spectrum conditions. We examine rates and predictors of progression to bipolar I and II diagnoses in a non-patient sample of college-age participants (n = 201) with high General Behavior Inventory scores and childhood or adolescent onset of “soft” bipolar spectrum disorders followed longitudinally for 4.5 years from the Longitudinal Investigation of Bipolar Spectrum (LIBS)...

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

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    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...

  14. Bipolar II compared with bipolar I disorder: baseline characteristics and treatment response to quetiapine in a pooled analysis of five placebo-controlled clinical trials of acute bipolar depression

    OpenAIRE

    Datto, Catherine; Pottorf, William J.; Feeley, Louisa; LaPorte, Scott; Liss, Charlie

    2016-01-01

    Background Bipolar I and II represent the most common and severe subtypes of bipolar disorder. Although bipolar I disorder is relatively well studied, the clinical characteristics and response to treatment of patients with bipolar II disorder are less well understood. Methods To compare the severity and burden of illness of patients with bipolar II versus bipolar I disorder, baseline demographic, clinical, and quality of life data were examined in 1900 patients with bipolar I and 973 patients...

  15. 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

  16. 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 F; Ødegaard, Ketil Joachim; Morken, Gunnar; Sundet, Kjetil; Vaaler, Arne E

    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.Methods: Acutely admitted BD I (n = 19) and BD II (n = 32) inp...

  17. Bipolar Disorder.

    Science.gov (United States)

    Spearing, Melissa

    Bipolar disorder, a brain disorder that causes unusual shifts in a person's mood, affects approximately one percent of the population. It commonly occurs in late adolescence and is often unrecognized. The diagnosis of bipolar disorder is made on the basis of symptoms, course of illness, and when possible, family history. Thoughts of suicide are…

  18. 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...

  19. 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

  20. 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 ...

  1. 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 ...

  2. Bipolar Affective Disorder and Migraine

    OpenAIRE

    Birk Engmann

    2012-01-01

    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 ...

  3. 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

  4. 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...

  5. 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 ...

  6. 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...

  7. 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

  8. 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

  9. 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

  10. Cognitive Dysfunction Is Worse among Pediatric Patients with Bipolar Disorder Type I than Type II

    Science.gov (United States)

    Schenkel, Lindsay S.; West, Amy E.; Jacobs, Rachel; Sweeney, John A.; Pavuluri, Mani N.

    2012-01-01

    Background: Impaired profiles of neurocognitive function have been consistently demonstrated among pediatric patients with bipolar disorder (BD), and may aid in the identification of endophenotypes across subtypes of the disorder. This study aims to determine phenotypic cognitive profiles of patients with BD Type I and II. Methods: Subjects (N =…

  11. 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.

  12. 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.

  13. Two Views: Do College Therapists Underdiagnose Bipolar II Disorder?

    Science.gov (United States)

    Perry, Jonathan; Keyes, Lee

    2014-01-01

    On February 17, 2014, Dr. Jonathan Perry, former director of counseling at the University of Arkansas, sparked a lively debate on the listserv of the Association of University and College Counseling Center Directors (AUCCCD) by warning about the likelihood and dangers of underdiagnosing borderline II disorder. Standing out among the many…

  14. 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 ...

  15. Even Keeled: A Practical Approach to Living with Someone with Bipolar II Disorder

    Science.gov (United States)

    Neal, Philip

    2008-01-01

    Bipolar II disorder can be better understood and addressed by applying appropriate psychological principles. One such principle is that, on a very basic level, emotion is neither good nor bad. It is however, the expressed reaction of the mind to its environment. From this perspective, emotion is very useful. Emotionality often gets a bad rap as…

  16. Help With Bipolar Disorders

    Science.gov (United States)

    ... a Psychiatrist Patients & Families All Topics Help With Bipolar Disorders Curated and updated for the community by APA Topic Information Bipolar disorders are brain disorders that cause changes in a ...

  17. A potential interaction between COMT and MTHFR genetic variants in Han Chinese patients with bipolar II disorder

    OpenAIRE

    Wang, Liang-Jen; Lee, Sheng-Yu; Chen, Shiou-Lan; Chang, Yun-Hsuan; Chen, Po See; Huang, San-Yuan; Tzeng, Nian-Sheng; Chen, Kao Chin; Lee, I Hui; Wang, Tzu-Yun; Yang, Yen Kuang; Lu, Ru-Band

    2015-01-01

    Bipolar II disorder (BP-II), characterized by recurrent dysregulation of mood, is a serious and chronic psychiatric illness. However, BP-II is commonly under-recognized, even in psychiatric settings. Because dopaminergic disturbance is thought to be involved in the development of bipolar disorder (BPD), it seems essential to investigate dopamine-related genes like the catechol-O-methyltransferase (COMT) gene, which are involved in dopamine metabolism, and the methylenetetrahydrofolate reducta...

  18. 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 ...

  19. 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...

  20. Neuropsychological performance and affective temperaments in Euthymic patients with bipolar disorder type II.

    Science.gov (United States)

    Romero, Ester; Holtzman, Jessica N; Tannenhaus, Lucila; Monchablon, Romina; Rago, Carlo Mario; Lolich, Maria; Vázquez, Gustavo H

    2016-04-30

    Affective temperament has been suggested as a potential mediator of the effect between genetic predisposition and neurocognitive functioning. As such, this report seeks to assess the extent of the correlation between affective temperament and cognitive function in a group of bipolar II subjects. 46 bipolar II outpatients [mean age 41.4 years (SD 18.2); female 58.9%] and 46 healthy controls [mean age 35.1 years (SD 18); female 56.5%] were evaluated with regard to their demographic and clinical characteristics, affective temperament, and neurocognitive performance. Crude bivariate correlation analyses and multiple linear regression models were constructed between five affective temperament subscales and eight neurocognitive domains. Significant correlations were identified in bipolar patients between hyperthymic temperament and verbal memory and premorbid IQ; cyclothymic temperament and attention; and irritable temperament, attention, and verbal fluency. In adjusting for potential confounders of the relationship between temperament and cognitive function, the strongest mediating factors among the euthymic bipolar patients were found to be residual manic and depressive symptoms. It is therefore concluded that affective temperaments may partially influence the neurocognitive performance of both healthy controls and euthymic patients with bipolar disorder type II in several specific domains. PMID:27086230

  1. 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

  2. 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...

  3. 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...

  4. Correlates of recovery of social functioning in type I and II bipolar disorder patients

    OpenAIRE

    Wingo, Aliza P.; Baldessarini, Ross J.; Compton, Michael T.; Harvey, Philip D.

    2010-01-01

    Since bipolar disorder (BPD) patients are often functionally impaired, and factors associated with recovery from disability are largely unknown, we investigated demographic, clinical, and neurocognitive correlates of current social functional recovery in 65 stable participants diagnosed with DSM-IV type I (n=42) or II (n=23) BPD. Regaining highest previous levels of social functioning was rated with the Interpersonal Relationships Questionnaire. We also considered neuropsychological test find...

  5. Mood Disorders in Family Practice: Beyond Unipolarity to Bipolarity

    OpenAIRE

    Manning, J. Sloan; Ahmed, Saeeduddin; McGuire, Hillary C.; Hay, Donald P.

    2002-01-01

    Primary care physicians increasingly have treated depressive disorders over the last decade. Unrecognized bipolar disorder, sometimes misdiagnosed as unipolar depression, may lead to treatment resistance or nonresponse. We describe differences between unipolar and bipolar disorders, focusing on recognition, diagnosis, and treatment of bipolar spectrum disorders such as bipolar I, bipolar II, antidepressant-induced mania, and cyclothymia. Broadening the understanding of these different disorde...

  6. 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 ...

  7. 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...

  8. Costs of Bipolar Disorder

    OpenAIRE

    Leah S. Kleinman; Ana Lowin; Emuella Flood; Gian Gandhi; Eric Edgell; Revicki, Dennis A

    2003-01-01

    Bipolar disorder is a chronic affective disorder that causes significant economic burden to patients, families and society. It has a lifetime prevalence of approximately 1.3%. Bipolar disorder is characterised by recurrent mania or hypomania and depressive episodes that cause impairments in functioning and health-related quality of life. Patients require acute and maintenance therapy delivered via inpatient and outpatient treatment. Patients with bipolar disorder often have contact with the s...

  9. 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…

  10. Treatment Resistant Bipolar Disorder

    OpenAIRE

    Elvan Ozalp; Ersin Hatice Karslioglu

    2015-01-01

    Many patients diagnosed with bipolar disorder respond incompletely or unsatisfactorily to available treatments. Defining refractoriness in bipolar disorder is a complex issue and should concern and include either every phase and pole or the disorder as a whole. There are only limited and sometimes confusing data on the treatment of refractory bipolar patients. The objective of this paper was to review the evidence for treatment options in treatment resistant patients on depressive, manic atta...

  11. Mood instability in bipolar disorder type I versus type II-continuous daily electronic self-monitoring of illness activity using smartphones

    DEFF Research Database (Denmark)

    Faurholt-Jepsen, Maria; Ritz, Christian; Frost, Mads;

    2015-01-01

    I and II using daily data. The objectives were to investigate differences in daily illness activity between bipolar disorder type I and II. METHODS: A smartphone-based system for self-monitoring was developed. A total of 33 patients treated in a mood clinic used the system for daily self......-monitoring during a median period of 310 days [IQR 189; 437]. Data presented summarize over 8500 observations. RESULTS: Patients with bipolar disorder type II (n=20), compared to patients with bipolar disorder type I (n=13), experienced a significant lower mean level of mood on a scale from -3; +3 (-0.54 (95% CI...... with bipolar disorder type I, but despite on-going treatment only for half of the time for patients with bipolar disorder type II. This emphasizes the need for improving treatment strategies for bipolar disorder type II....

  12. Dissociative experiences in bipolar disorder II: Are they related to childhood trauma and obsessive-compulsive symptoms?

    OpenAIRE

    Gul Eryilmaz; Sermin Kesebir; Işil Göğcegöz Gül; Eylem Özten; Kayihan Oğuz Karamustafalioğlu

    2015-01-01

    Objective The aim of this study is to investigate the presence of dissociative symptoms and whether they are related to childhood trauma and obsessive-compulsive symptoms in bipolar disorder type II (BD-II). Methods Thirty-three euthymic patients (HDRS

  13. 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 ...

  14. 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.

  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. Comparative clinical characteristics of depression in bipolar affective disorders types I and II

    Directory of Open Access Journals (Sweden)

    N. A. Tyuvina

    2016-01-01

    Full Text Available Objective: to investigate the clinical features of depression within bipolar affective disorders types I and II (BADI and BADII.Patients and methods. An examination was made in 100 depressive patients, including 25 with BADI, 37 with BADII, and 38 with recurrent depressive disorder (RDD (a comparison group. The patients' status was evaluated in accordance with the ICD-10 and DSM-V affective disorder criteria, by using a specially developed questionnaire.Results. BAD-related depression has features distinguishing it from RDD: sexual preference (men; an earlier age of disease onset; a shorter duration, but a higher frequency of exacerbations; a greater tendency for the continuum; a more marked decrease in social and family adaptation; development in people with predominantly hyperthymic premorbid; more frequently a family history of affective disorders, schizophrenia, and alcoholism; high comorbidity with metabolic diseases and psychoactive substance abuse; worse health more commonly in autumn and winter; a predominant anxious affect and an obviously decreasing interest in the structure of depression; a higher incidence of atypical sleep, appetite, and weight disorders; high suicidal activity; higher motor retardation (in BADI; relatively small involvement of somatic complaints in BAD I and frequent panic attacks in BADII.Conclusion. Knowledge of the specific features of BAD-related depression will be able to make a more accurate differential diagnosis and to perform more effective treatment in these patients.

  17. Evaluation of relationship between metacognition components and dysfunctional attitudes in outpatients with bipolar mood disorder II

    Directory of Open Access Journals (Sweden)

    H Kazemi

    2012-05-01

    Full Text Available Introduction: The aim of this study was to evaluate the relationship between metacognitive components and dysfunctional attitudes in outpatients with bipolar mood disorder II. Methods: Thirty-six young adult outpatients with current diagnoses of BMD II(20 females and 16 males were recruited from Esfahan Counseling Center. Diagnoses were based on the Structured Clinical Interview for DSM-IV Axis I Disorder-Clinical Version(SCID-CV. A battery of questionnaires including Metacognition Questionnaire and Dysfunctional Attitude Scale(DAS were self-assessed by patients before medical therapy. Results: Pearson's correlation analysis showed that the components of metacognition and its relationship with dysfunctional attitudes is positive and significant(r= 28/0, p<0/05. Multiple regression analysis showed that two of the metacognitive components emerged as potentially useful in prediction of dysfunctional attitudes(negative beliefs about uncontrollability, danger and thoughts control. Also, results indicated that those two components have a significant positive relationship with vulnerability, perfectionism and effectivenessR²= 0/29, 0/35; p<0/05. Components of positive beliefs about worry and beliefs about cognitive self-consciousness related to cognitive confidence in predicting the criterion variable and its components showed no significant contribution. Conclusion: Study findings suggest that DSM-IV BMD II outpatients with metacognitive distortions have shown higher levels of dysfunctional attitudes.

  18. P300 component in euthymic patients with bipolar disorder type I, bipolar disorder type II and healthy controls: a preliminary event-related potential study.

    Science.gov (United States)

    Bersani, Francesco S; Minichino, Amedeo; Fattapposta, Francesco; Mannarelli, Daniela; Pauletti, Caterina; Imperatori, Claudio; Spagnoli, Francesco; Biondi, Massimo; Delle Chiaie, Roberto

    2015-03-01

    The aim of the present study was to investigate P300 event-related potential components in euthymic bipolar disorder type I (BDI) and bipolar disorder type II (BDII) patients and matched controls. A total of 10 BDI patients, 10 BDII patients and 10 healthy individuals were enrolled in the study. Event-related potential data were collected according to a standard auditory 'oddball' paradigm. A significant groups effect in both the peak amplitude (P<0.001) and the mean amplitude (P<0.001) was observed; post-hoc comparisons showed that the peak and mean amplitudes of BDI and BDII patients were significantly lower than the peak and mean amplitudes of the healthy controls. The neurophysiological patterns found in the present study might at least partially reflect the presence of a mild selective cognitive impairment in euthymic BDI and BDII patients. From a clinical point of view, these evidences support the potential role of cognitive interventions in the treatment of BD. PMID:25674905

  19. EEG classification of adolescents with type I and type II of bipolar disorder.

    Science.gov (United States)

    Khaleghi, Ali; Sheikhani, Ali; Mohammadi, Mohammad Reza; Nasrabadi, Ali Moti; Vand, Safa Rafiei; Zarafshan, Hadi; Moeini, Mahdi

    2015-12-01

    Bipolar disorder (BD) is a severe psychiatric disorder and has two common types: type I and type II. Early diagnosis of the subtypes is very challenging particularly in adolescence. In this study, 38 adolescents are participated including 18 patients with BD I and 20 patients with BD II. The electroencephalogram signal is recorded by 19 electrodes in open eyes at resting state. After preprocessing, the state of the art methods from various domains are implemented to provide a good feature set for classifying the two groups. In order to improve the classification accuracy, four different feature selection methods named mutual information maximization (MIM), conditional mutual information maximization (CMIM), fast correlation based filter (FCBF), and double input symmetrical relevance (DISR) are applied to select the most informative features. Multilayer perceptron (MLP) neural network with a hidden layer containing five neurons is used for classification with and without applying the feature selection methods. The accuracy of 82.68, 86.33, 89.67, 84.61, and 91.83 % were observed using entire extracted features and selected features using MIM, CMIM, FCBF, and DISR methods by MLP, respectively. Therefore, the proposed method can be used in clinical setting for more validation. PMID:26472650

  20. 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 ...

  1. The clinical-familial correlates and naturalistic outcome of panic-disorder-agoraphobia with and without lifetime bipolar II comorbidity

    Directory of Open Access Journals (Sweden)

    Toni Cristina

    2008-11-01

    Full Text Available Abstract Background Much of the literature on panic disorder (PD-bipolar disorder (BP cormorbidity concerns BP-I. This literature emphasizes the difficulties encountered in pharmacologic treatment and outcome when such comorbidity is present. The present report explores these issues with respect to BP-II. Methods The sample comprised 326 outpatients (aged 34.5 ± 11.5 years old; 222 females with Diagnostic and Statistical Manual of Mental Disorders 3rd edn, revised (DSM-III-R PD-agoraphobia; among them 52 subjects (16% were affected by lifetime comorbidity with BP-II. Patients were evaluated by means of the Structured Clinical Interview for DSM-IV (SCID, the Panic-Agoraphobia Interview, and the Longitudinal Interview Follow-up Examination (Life-Up and treated according to routine clinical practice at the University of Pisa, Italy, for a period of 3 years. Clinical and course features were compared between subjects with and without BP-II. All patients received the clinicians' choice of antidepressants and, in the case of the subsample with BP-II, mood stabilizers (for example, valproate, lithium were among the mainstays of treatment. Results In comparison to patients without bipolar comorbidity, those with BP-II showed a significantly greater frequency of social phobia, obsessive-compulsive disorder, alcohol-related disorders, and separation anxiety during childhood and adolescence. Regarding family history, a significantly greater frequency of PD and mood disorders was present among the BP-II. No significant differences were observed in the long-term course of PD or agoraphobic symptoms under pharmacological treatment or the likelihood of spontaneous pharmacological treatment interruptions. Conclusion Although the severity and outcome of panic-agoraphobic symptomatology appear to be similar in patients with and without lifetime bipolar comorbidity, the higher number of concomitant disorders in our PD patients with BP-II does indicate a greater

  2. 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.

  3. Symptoms and signs of the initial prodrome of bipolar II disorder

    OpenAIRE

    2012-01-01

    Bipolar disorder (BD) is a chronic and debilitating illness characterized by severe dysregulation of mood, energy, and activity that results in episodes of depression and (hypo)mania. Approximately 60% of patients with BD experience the onset before the end of their teens. Thus, people who develop BD are often afflicted during their most vulnerable and formative years. A delay in appropriate treatment may worsen the course and outcome of the disorder. Hence, early identification and treatment...

  4. 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

  5. Evaluation of Cerebral Cortex Function in Clients with Bipolar Mood Disorder I (BMD I) Compared With BMD II Using QEEG Analysis

    OpenAIRE

    Ali Khaleghi; Ali Sheikhani; MohammadReza Mohammadi; Ali Moti-Nasrabadi

    2015-01-01

    Objective: Early diagnosis of type I and type II bipolar mood disorder is very challenging particularly in adolescence. Hence, we aimed to investigate the cerebral cortex function in these patients, using quantitative electroencephalography analysis to obtain significant differences between them.Methods: Thirty- eight adolescents (18 patients with bipolar disorder I and 20 with BMD II) participated in this study. We recorded the electroencephalogram signals based on 10-20 international system...

  6. 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

  7. Synapsin II is involved in the molecular pathway of lithium treatment in bipolar disorder.

    Directory of Open Access Journals (Sweden)

    Cristiana Cruceanu

    Full Text Available Bipolar disorder (BD is a debilitating psychiatric condition with a prevalence of 1-2% in the general population that is characterized by severe episodic shifts in mood ranging from depressive to manic episodes. One of the most common treatments is lithium (Li, with successful response in 30-60% of patients. Synapsin II (SYN2 is a neuronal phosphoprotein that we have previously identified as a possible candidate gene for the etiology of BD and/or response to Li treatment in a genome-wide linkage study focusing on BD patients characterized for excellent response to Li prophylaxis. In the present study we investigated the role of this gene in BD, particularly as it pertains to Li treatment. We investigated the effect of lithium treatment on the expression of SYN2 in lymphoblastoid cell lines from patients characterized as excellent Li-responders, non-responders, as well as non-psychiatric controls. Finally, we sought to determine if Li has a cell-type-specific effect on gene expression in neuronal-derived cell lines. In both in vitro models, we found SYN2 to be modulated by the presence of Li. By focusing on Li-responsive BD we have identified a potential mechanism for Li response in some patients.

  8. 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...

  9. 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...

  10. Efficacy and Safety of Risperidone and Quetiapine in Adolescents With Bipolar II Disorder Comorbid With Conduct Disorder.

    Science.gov (United States)

    Masi, Gabriele; Milone, Annarita; Stawinoga, Agnieszka; Veltri, Stefania; Pisano, Simone

    2015-10-01

    Although a frequent co-occurrence between bipolar disorder (BD) and conduct disorder (CD) in youth has been frequently reported, data about pharmacological management are scarce and focused on BD type I. Second generation antipsychotics are frequently used in clinical practice, but no comparative studies are available. The aim of this exploratory study was to compare efficacy and safety of risperidone and quetiapine in a sample of adolescents presenting a BD type II comorbid with CD. Twenty-two patients diagnosed with a structured interview according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, (male/female ratio, 12/10; mean (SD) age 15.0 (1.4) years) were randomized in 2 treatment groups (quetiapine [n = 12] vs risperidone [n = 10]), treated with flexible doses, and followed up for 12 weeks. Efficacy measures assessed manic symptoms, aggression, anxiety, depression, global clinical severity, and impairment. Safety measures included body mass index, serum prolactin, extrapyramidal adverse effects, and electrocardiogram. At the end of the study, all patients improved in all efficacy measures. Both treatments showed similar efficacy in reducing manic symptoms and aggression. Quetiapine was more effective in improving anxiety and depressive symptoms. A change in body mass index was found, and in a post hoc analysis, it was significant only in the risperidone group. Prolactin significantly increased only in the risperidone group. In BD type II, CD comorbidity, quetiapine, or risperidone monotherapy may be effective and relatively safe, although the small sample size, the limited duration of the study, and the design (lack of a blind assessments and of a placebo group) make it difficult to draw definitive conclusions. PMID:26226481

  11. 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

  12. 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...

  13. 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.

  14. 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...

  15. 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

  16. 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...

  17. [Antipsychotics in bipolar disorders].

    Science.gov (United States)

    Vacheron-Trystram, M-N; Braitman, A; Cheref, S; Auffray, L

    2004-01-01

    This article is a review of the various treatments that are currently available, in particular in France, for the treatment of bipolar disorders. This article specifically addresses the use of novel antipsychotic agents as alternative therapy to a lithium therapy and/or the use of conventional antipsychotics. The prevalence of bipolar disorder over a lifetime is around 1% of the general population. Bipolar disorder consists of alternating depressive and manic episodes. It mainly affects younger subjects, and is often associated with alcohol and drug addictions. There are two main subtypes of bipolar disorder. According to the DSM IV-R, type 1 of bipolar disorder is characterised when at least one manic episode (or a mixed episode) has been diagnosed. Type 2 of bipolar disorder is related to patients enduring recurrent depressive episodes but no manic episode. Type 2 affects women more frequently as opposed to type 1 affecting individuals of both sexes. Manic-depressive disorder (or cyclo-thymic disorder) appears in relation to patients who has never suffered manic episode, mixed episode or severe depressive episode but have undergone numerous periods with some symptoms of depression and hypomanic symptoms over a two-year period during which any asymptomatic periods last no longer than two months. The average age of the person going through a first episode (often a depressive one) is 20 years-old. Untreated bipolar patients may endure more than ten manic or depressive episodes. Finally, in relation to 10 to 20% of patients, the bipolar disorder will turn into a fast cycle form, either spontaneously or as a result of certain medical treatments. Psychiatrists are now able to initiate various treating strategies which are most likely to be effective as a result of the identification of clinical subtypes of the bipolar disorder. Lithium therapy has been effectively and acutely used for patients with pure or elated mania and its prophylaxis. However, lithium medication

  18. Bipolarna motnja razpoloženja: Bipolar disorder:

    OpenAIRE

    Dernovšek, Mojca Zvezdana; Frangeš, Tadeja

    2013-01-01

    Bipolar disorder is very prevalent in general population. According to Diagnostic and statistical manual ofmental disorders, fourth revision - DSM-IV, four types ofbipolar disorder are distinguished: bipolar disorder 1, bipolar disorder II, cyclothymia, and other types (not specified otherwise). Etiology of disorder is multifactorial with overlap between genetic, environmental"and neurobiological factors. Due to complexity of clinical features it represents diagnostical and therapeutical chal...

  19. 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...

  20. Scientific attitudes towards bipolar disorders

    OpenAIRE

    Mohammad-Hossein Biglu; Sahar Biglu

    2014-01-01

    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 d...

  1. 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.

  2. 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

  3. 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 ...

  4. Characteristics of Alpha Band Frequency in Adolescents with Bipolar II Disorder: A Resting-State QEEG Study.

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    Mahdi Moeini

    2015-03-01

    Full Text Available The aim of this study was to compare the QEEG of adolescents affected by bipolar II disorder with age and gender matched healthy controls, and to extract the characteristics of the alpha frequency band to better understand this disorder.Twenty one adolescents affected by acute episodes of bipolar II disorder (BMD II, both hypomanic and depressive episodes, were selected via convenience sampling based on DSM IV criteria and child and adolescent psychiatrist diagnosis. Eleven patients were going through a hypomanic episode and 10 patients were going through a depression episode. Of the participants, 18 who were matched with the patient group participated in this study as a normal group. Any major comorbidities and intellectual disabilities were excluded through applying K-SADS-PL and Raven's IQ test for all the patients and the healthy participants. Electroencephalogram signals were obtained according to 10-20 international system by 21 electrodes from participants in open and closed eyes in a resting state. We selected 40 seconds length segments from each recorded EEG signals that had minimal noise and artifacts. Power spectrum density (PSD was estimated for each segment and extracted alpha band frequency. We used only referential (unipolar montage for comparison. Eventually, data were analyzed by independent Mann-Whitney test and independent t test.We observed significant differences in the alpha frequency band in some brain regions. Alpha power increased in the fronto-central region and right parietal lobe in the patients (P < 0.05. In the patients with BMD II, entropy of alpha oscillations was larger than the normal participants in the central region and in the F3, F4 and P4 channels. Also, there were differences in the variance of alpha oscillations in these regions between the two groups (P < 0.05. In the occipital lobe, alpha wave had different skewness between the two groups (P < 0.05.Thalamus as a generator and modulator of at least a

  5. 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

  6. 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

  7. 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...

  8. Impaired Theory of Mind and psychosocial functioning among pediatric patients with Type I versus Type II bipolar disorder.

    Science.gov (United States)

    Schenkel, Lindsay S; Chamberlain, Todd F; Towne, Terra L

    2014-03-30

    Deficits in Theory of Mind (ToM) have been documented among pediatric patients with Bipolar Disorder (BD). However, fewer studies have directly examined differences between type I and type II patients and whether or not ToM deficits are related to psychosocial difficulties. Therefore, the aim of this study was to compare type I versus type II pediatric bipolar patients and matched Healthy Controls (HC) on ToM and interpersonal functioning tasks. All participants completed the Revised Mind in the Eyes Task (MET), the Cognitive and Emotional Perspective Taking Task (CEPTT), and the Index of Peer Relations (IPR). Type I BD patients reported greater peer difficulties on the IPR compared to HC, and also performed more poorly on the MET and the cognitive condition of the CEPTT, but did not differ significantly on the emotional condition. There were no significant group differences between type II BD patients and HC. More impaired ToM performance was associated with poorer interpersonal functioning. Type I BD patients show deficits in the ability to understand another's mental state, irrespective of emotional valence. Deficits in understanding others' mental states could be an important treatment target for type I pediatric patients with BD. PMID:24461271

  9. 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...

  10. 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

  11. Interaction of DRD2TaqI, COMT, and ALDH2 genes associated with bipolar II disorder comorbid with anxiety disorders in Han Chinese in Taiwan.

    Science.gov (United States)

    Hu, Ming-Chuan; Lee, Sheng-Yu; Wang, Tzu-Yun; Chang, Yun-Hsuan; Chen, Shiou-Lan; Chen, Shih-Heng; Chu, Chun-Hsien; Wang, Chen-Lin; Lee, I Hui; Chen, Po See; Yang, Yen Kuang; Lu, Ru-Band

    2015-06-01

    It is hypothesized that dopaminergic genes-dopamine type-2 receptor (DRD2), aldehyde dehydrogenase 2 (ALDH2), and catechol-O-methyltransferase (COMT)-are associated with bipolar disorder (BP) and anxiety disorder (AD). Bipolar II (BP-II) is reported to be highly comorbid with AD. We examined whether interactions among these three genes are susceptibility factors in BP-II with AD (BP-II(+AD)) and without AD (BP-II(-AD)). In this study, we hypothesize that the interaction of the dopaminergic genes between BP-II(+AD) and BP-II(-AD) is significant different. We recruited 1260 participants: 495 with BP-II(-AD), 170 with BP-II(+AD), and 595 healthy controls without BP-II or AD. Genotyping was done using polymerase chain reactions plus restriction fragment length polymorphism analysis. Genotypic frequencies of the DRD2TaqIA, COMT, and ALDH2 polymorphisms between the two BP-II groups were nonsignificant. In logistic regression, the ALDH2 and DRD2TaqIA genes showed a main effect that was protective against BP-II(-AD) (odds ratio [OR] = 0.497, p = 0.010, and OR = 0.415, p = 0.017, respectively). The interaction of DRD2TaqIA A1/A1 and ALDH2*1/*1 had a significant risk effect on the BP-II(-AD) group (OR = 7.177, p II(-AD) (OR = 0.205, p = 0.047). All of the significant results described above are found only in BP-II(-AD). This study supports the hypothesis the interaction of the dopaminergic genes between BP-II(+AD) and BP-II(-AD) is significant different,, and provides additional evidence that the DRD2TaqIA A1/A1, ALDH2*1/*1 and COMT genes interact in BP-II(-AD) but not in BP-II(+AD). PMID:25430946

  12. 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...

  13. 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...

  14. : 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...

  15. 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 ...

  16. 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

  17. Dissociative experiences in bipolar disorder II: Are they related to childhood trauma and obsessive-compulsive symptoms?

    Directory of Open Access Journals (Sweden)

    Gul Eryilmaz

    2015-04-01

    Full Text Available Objective The aim of this study is to investigate the presence of dissociative symptoms and whether they are related to childhood trauma and obsessive-compulsive symptoms in bipolar disorder type II (BD-II. Methods Thirty-three euthymic patients (HDRS<8, YMRS<5 and 50 healthy subjects were evaluated by SCID-I and SCID-NP. We excluded all first and second-axis comorbidities. All patients and healthy subjects were examined with the Dissociative Experiences Scale (DES, Childhood Trauma Questionnaire (CTQ-53, and Yale-Brown Obsessive-Compulsive Disorder scale (Y-BOCS. Results In pairwise comparisons between the BD-II and control groups, the total CTQ, emotional abuse, emotional neglect, DES, and total Y-BOCS scores in the BD-II group were significantly higher than those in the control group (p < 0.05. There were five cases with DES scores over 30 (15.2% and one case (2% in the control group. DES was weakly correlated with total CTQ and Y-BOCS in patients diagnosed with BD-II (r = 0.278, p < 0.05 and r = 0.217, p < 0.05, respectively. While there was no correlation between total CTQ and Y-BOCS, the CTQ sexual abuse subscale was found to be related to Y-BOCS (r = 0.330, p < 0.05. Discussion These results suggest that there is a relation between childhood traumas and obsessive-compulsive symptoms, or that dissociative symptoms are more associated with anxiety than obsessive symptoms, which prevents the increase of obsessive-compulsive symptoms in BD-II.

  18. 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…

  19. 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

  20. 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...

  1. [Comorbidity of eating disorders and bipolar affective disorders].

    Science.gov (United States)

    Kamińska, Katarzyna; Rybakowski, Filip

    2006-01-01

    Eating disorders--anorexia nervosa, bulimia nervosa and eating disorders not otherwise specified (EDNOS) occur usually in young females. The significant pathogenic differences between patients who only restrict food, and patients with binge eating and compensatory behaviours, such as vomiting and purging were described. The prevalence of bipolar affective disorders--especially bipolar II and bipolar spectrum disorders (BS) may reach 5% in the general population. About half of the depressive episodes are associated with a "mild" bipolar disorder, and such a diagnosis is suggested by impulsivity and mood-instability. Previously, majority of research on the comorbidity between eating and affective disorders focused on depressive symptomatology, however difficulties in the reliable assessment of hypomania may obfuscate the estimation of the co-occurrence of eating disorders with BS. Epidemiological studies suggest the association between BS and eating disorders with binge episodes (bulimia nervosa, anorexia- bulimic type and EDNOS with binge episodes). Co-occurrence of such disorders with depressive symptoms probably suggests the diagnosis of BS, not recurrent depression. Bulimic behaviours, impulsivity and affective disorders might be related to the impairment of the serotonergic neurotransmission, which may result from the genetic vulnerability and early life trauma. Currently, the first-line pharmacological treatment of co-occurring eating disorders with binge episodes and BS are selective serotonin reuptake inhibitors. However in some cases, the use of mood-stabilising agents as monotherapy or in combination with serotonergic drugs may be helpful. PMID:17037812

  2. The Bipolar II Depression Questionnaire: A Self-Report Tool for Detecting Bipolar II Depression

    OpenAIRE

    Leung, Chi Ming; Lapyim, Chi; Yan, Connie T. Y.; Chan, Cheuk Chi; XIANG, YU-TAO; Mak, Arthur D. P.; Fok, Marcella Lei-Yee; Ungvari, Gabor S.

    2016-01-01

    Bipolar II (BP-II) depression is often misdiagnosed as unipolar (UP) depression, resulting in suboptimal treatment. Tools for differentiating between these two types of depression are lacking. This study aimed to develop a simple, self-report screening instrument to help distinguish BP-II depression from UP depressive disorder. A prototype BP-II depression questionnaire (BPIIDQ-P) was constructed following a literature review, panel discussions and a field trial. Consecutively assessed patien...

  3. 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

  4. 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 ...

  5. The comparative short-term outcome of bipolar II disorder patients variably meeting or not meeting DSM-5 duration criteria following lamotrigine treatment.

    Science.gov (United States)

    McCraw, Stacey; Parker, Gordon

    2016-06-01

    There is accruing clinical and empirical evidence supporting the efficacy of lamotrigine as a treatment for bipolar II disorder. However, the treatment response experienced by those with 'short duration' hypomania (or 'other specified' bipolar disorder) has been under-researched. We reviewed a clinical sample of 123 patients diagnosed with a bipolar II disorder three months following their initial assessment. A research interview evaluated treatment strategies implemented, depressive and hypomanic episode pattern and functional outcomes. Of patients who had achieved a minimum level of 75 mg of lamotrigine, n = 51 were assigned to the BP II disorder group (i.e., hypomanic episodes lasted four days or longer) and n = 28 to the short duration group (i.e., hypomanic episodes always lasted less than four days). There were no significant differences between the two groups at the three-month follow-up on self-report measures of changes in depressive and hypomanic episode pattern or functioning across six domains (i.e., intimate relationships, family relationships, friendships, work relationships, work performance, overall quality of life), and with the majority of patients reporting some level of improvement. Study limitations include being an observational, uncontrolled design with a relatively small sample size for detecting statistical differences. Nonetheless, lamotrigine appeared to be a suitable medication to be trialled in patients who alternate between depressive episodes and short periods of hypomania, (as for those with DSM-defined hypomanic episodes), and should prompt further investigation. PMID:26905918

  6. [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

  7. 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

  8. An In Vivo Study of Cortical Plasticity in Bipolar II Disorder

    OpenAIRE

    2012-01-01

    Bakgrunn: Det er sterke bevis på at synaptisk plastisitet kan spille en rolle i patiofysologien til og behandlingen av både unipolar og bipolar depressiv lidelse. Men det meste av disse bevisene er indirekte, enten fra dyremodeller eller in vitro studier, grunnet mangel på metoder for å måle synaptisk plastisitet non-invasivt. Men nylig har det blitt vist at det er mulig å indusere VEP-plastisitet gjennom repetitiv visuell stimulering, og denne plastisiteten tror man gjenspeiler synaptisk ...

  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 DRD3 Ser9Gly Polymorphism Predicted Metabolic Change in Drug-Naive Patients With Bipolar II Disorder

    Science.gov (United States)

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

    2016-01-01

    Abstract Patients with bipolar II disorder (BDII) have a higher prevalence rate of metabolic disturbance. Whether BDII itself, in addition to its current standard treatment, is a risk factor for metabolic syndrome warrants additional study. The dopamine receptor D3 (DRD3) gene, one of the candidate genes for BDII, is also involved in the dopaminergic system. We investigated whether it is related to changes in the metabolic indices of patients with BDII given 12 weeks of standard treatment. Patients with a first diagnosis of BDII (n = 117) were recruited. Metabolic profiles (cholesterol, triglycerides, fasting serum glucose, body mass index) were measured at baseline and at 2, 8, and 12 weeks. The genotype of the DRD3 Ser9Gly polymorphism (rs6280) was determined. Multiple linear regressions with generalized estimating equation methods were used. Seventy-six (65.0%) patients completed the 12-week intervention. Significant differences in triglyceride change were associated with the DRD3 Ser9Gly genotype (P = 0.03). Patients with the Ser/Ser genotype had significantly smaller triglyceride increases and a lower risk of developing metabolic syndrome than did those with the Ser/Gly+Gly/Gly genotype. However, the associations between the DRD3 Ser9Gly polymorphism with changes in triglyceride level become nonsignificant after correcting for multiple comparisons. We conclude that the DRD3 Ser9Gly polymorphism is nominally associated with changes in triglycerides and metabolic syndrome after 12 weeks of standard BDII treatment. PMID:27310943

  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. 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. 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.

  14. Cognitive Behavioral Therapy in Bipolar Disorder

    OpenAIRE

    Zeynep Mackali; Ahmet Tosun

    2011-01-01

    Bipolar disorder is an early-onset, chronic disorder. It impairs occupational, social, and family functioning, which makes learning to adapt living with the disorder and its treatment critically important. Therefore, it has now become common knowledge that psychosocial interventions are also necessary in the treatment of bipolar disorder adjunctive to pharmacotherapy. Thus, whichever psychosocial interventions are more effective in bipolar disorder is a crucial research question. In this arti...

  15. 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

  16. Add-on memantine to valproate treatment increased HDL-C in bipolar II disorder

    OpenAIRE

    Lee, Sheng-Yu; Chen, Shiou-Lan; Chang, Yun-Hsuan; Chen, Po See; Huang, San-Yuan; Tzeng, Nian-Sheng; Wang, Yu-Shan; Wang, Liang-Jen; Lee, I Hui; Yeh, Tzung Lieh; Yang, Yen Kuang; Lu, Ru-band; Hong, Jau-Shyong

    2013-01-01

    Memantine is a noncompetitive NMDA receptor antagonist. As an augmenting agent, it has an antidepressant-like and mood-stabilizing effect. Memantine also reduces binge eating episodes and weight. We investigated whether memantine added on to valproate (VPA) is more effective than VPA alone for treating BP-II depression and improving the patient’s metabolic profile. This was a randomized, double-blind, controlled study. BP-II patients undergoing regular VPA treatments were randomly assigned to...

  17. 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)...

  18. 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.

  19. Nicotine dependence and psychosis in Bipolar disorder and Schizoaffective disorder, Bipolar type.

    Science.gov (United States)

    Estrada, Elena; Hartz, Sarah M; Tran, Jeffrey; Hilty, Donald M; Sklar, Pamela; Smoller, Jordan W; Pato, Michele T; Pato, Carlos N

    2016-06-01

    Patients with Bipolar disorder smoke more than the general population. Smoking negatively impacts mortality and clinical course in Bipolar disorder patients. Prior studies have shown contradictory results regarding the impact of psychosis on smoking behavior in Bipolar disorder. We analyzed a large sample of Bipolar disorder and Schizoaffective disorder, Bipolar Type patients and predicted those with a history of psychosis would be more likely to be nicotine dependent. Data from subjects and controls were collected from the Genomic Psychiatry Cohort (GPC). Subjects were diagnosed with Bipolar disorder without psychosis (N = 610), Bipolar disorder with psychosis (N = 1544). Participants were classified with or without nicotine dependence. Diagnostic groups were compared to controls (N = 10065) using logistic regression. Among smokers (N = 6157), those with Bipolar disorder had an increased risk of nicotine dependence (OR = 2.5; P Bipolar disorder with psychosis were more likely to be dependent than Bipolar disorder patients without psychosis (OR = 1.3; P = 0.03). Schizoaffective disorder, Bipolar Type patients had more risk of nicotine dependence when compared to Bipolar disorder patients with or without psychosis (OR = 1.2; P = 0.02). Bipolar disorder patients experiencing more severity of psychosis have more risk of nicotine dependence. © 2015 Wiley Periodicals, Inc. PMID:26467098

  20. Genome Scan Meta-Analysis of Schizophrenia and Bipolar Disorder, Part II: Schizophrenia

    OpenAIRE

    Lewis, Cathryn M.; Levinson, Douglas F.; Wise, Lesley H.; Delisi, Lynn E.; Straub, Richard E.; Hovatta, Iiris; Williams, Nigel M.; Schwab, Sibylle G.; Pulver, Ann E; Faraone, Stephen V.; Brzustowicz, Linda M.; Kaufmann, Charles A.; Garver, David L.; Gurling, Hugh M.D.; Lindholm, Eva

    2003-01-01

    Schizophrenia is a common disorder with high heritability and a 10-fold increase in risk to siblings of probands. Replication has been inconsistent for reports of significant genetic linkage. To assess evidence for linkage across studies, rank-based genome scan meta-analysis (GSMA) was applied to data from 20 schizophrenia genome scans. Each marker for each scan was assigned to 1 of 120 30-cM bins, with the bins ranked by linkage scores (1 = most significant) and the ranks averaged across stu...

  1. The differences in temperament–character traits, suicide attempts, impulsivity, and functionality levels of patients with bipolar disorder I and II

    Directory of Open Access Journals (Sweden)

    Izci F

    2016-01-01

    Full Text Available Filiz Izci,1 Ebru Kanmaz Findikli,2 Serkan Zincir,3 Selma Bozkurt Zincir,4 Merve Iris Koc4 1Department of Psychiatry, School of Medicine, Istanbul Bilim University, Istanbul, 2Department of Psychiatry, School of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaras, 3Department of Psychiatry, Kocaeli Gölcük Military Hospital, Kocaeli, 4Department of Psychiatry, Erenköy Training and Research Hospital for Psychiatric and Neurological Disorders, Istanbul, Turkey Background: The primary aim of this study was to compare the differences in temperament-character traits, suicide attempts, impulsivity, and functionality levels of patients with bipolar disorder I (BD-I and bipolar disorder II (BD-II.Methods: Fifty-two BD-I patients and 49 BD-II patients admitted to Erenköy Mental and Neurological Disease Training and Research Hospital psychiatry clinic and fifty age- and sex-matched healthy control subjects were enrolled in this study. A structured clinical interview for Diagnostic and Statistical Manual of Mental Disorders, 4th Edition Axis I Disorders, Temperament and Character Inventory, Barrett Impulsiveness Scale-11 (BIS-11, Hamilton Depression Inventory Scale, Young Mania Rating Scale, and Bipolar Disorder Functioning Questionnaire (BDFQ were administered to patients and to control group.Results: No statistically significant difference in sociodemographic features existed between the patient and control groups (P>0.05. Thirty-eight subjects (37.62% in the patient group had a suicide attempt. Twenty-three of these subjects (60.52% had BD-I, and 15 of these subjects (39.47% had BD-II. Suicide attempt rates in BD-I and II patients were 60.52% and 39.47%, respectively (P<0.05. Comparison of BD-I and II patients with healthy control subjects revealed that cooperativeness (C, self-directedness (Sdi, and self-transcendence (ST scores were lower and novelty seeking (NS1 and NS2, harm avoidance (HA4, and reward dependence (RD2 subscale scores

  2. Adolescent Bipolar Disorder: A Clinical Vignette

    OpenAIRE

    Rodgers, Melissa J.; Zylstra, Robert G.; McKay, Julia B.; Solomon, A. Lee; Choby, Beth A.

    2010-01-01

    Adolescence is a vulnerable developmental phase marked by physical, psychological, and social changes that rapidly expose young people to a wide range of new stressors. When differentiating between bipolar disorder and teenage “acting out,” a careful history is important. Adolescent bipolar disorder is a psychiatric illness characterized by fluctuating episodes of mood elevation and depression that is frequently neither recognized nor formally diagnosed. Adolescents with bipolar disorder ofte...

  3. 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.

  4. 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…

  5. Prepubertal bipolar disorder: available pharmacological treatment options.

    Science.gov (United States)

    Masi, Gabriele

    2005-04-01

    Awareness of bipolar spectrum disorders in children is rapidly increasing, with a more precise definition of their clinical subtypes and early signs. Paediatric bipolar disorder can lead to an important impairment in scholastic, familial and social functioning, and to a higher risk for substance abuse and suicide. In the context of a multimodal approach, the core treatment of early-onset bipolar disorder is pharmacological. This review focuses on the empirical evidence for pharmacotherapy in paediatric bipolar disorder. Mood stabilizers, including lithium, and older and newer anticonvulsivants will be considered, in mono- or polypharmacy. Atypical antipsychotics will be considered in more severe and/or treatment-resistant manic or mixed episodes. Finally, the prophylaxis of intercritical phases and the management of specific challenging conditions, such as bipolar depression and attention deficit hyperactivity disorder, with bipolar comorbidity, will be reviewed. PMID:15934881

  6. 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...

  7. 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 ...

  8. 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

  9. 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.

  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. 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.

  12. Bipolar Disorder in School-Age Children

    Science.gov (United States)

    Olson, Patricia M.; Pacheco, Mary Rae

    2005-01-01

    This article examines the individual components of bipolar disorder in children and the behaviors that can escalate as a result of misdiagnosis and treatment. The brain/behavior relationship in bipolar disorders can be affected by genetics, developmental failure, or environmental influences, which can cause an onset of dramatic mood swings and…

  13. White matter microstructure alterations in bipolar disorder

    OpenAIRE

    Bellani, M; Perlini, C.; Ferro, A.; Cerruti, S.; G. Rambaldelli; Isola, M.; CERINI, R.; N. Dusi; N. Andreone; Balestrieri, M.; R. Pozzi Mucelli; Tansella, M; Brambilla, P

    2012-01-01

    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.

  14. Evaluation of Cerebral Cortex Function in Clients with Bipolar Mood Disorder I (BMD I Compared With BMD II Using QEEG Analysis

    Directory of Open Access Journals (Sweden)

    Ali Khaleghi

    2015-10-01

    Full Text Available Objective: Early diagnosis of type I and type II bipolar mood disorder is very challenging particularly in adolescence. Hence, we aimed to investigate the cerebral cortex function in these patients, using quantitative electroencephalography analysis to obtain significant differences between them.Methods: Thirty- eight adolescents (18 patients with bipolar disorder I and 20 with BMD II participated in this study. We recorded the electroencephalogram signals based on 10-20 international system by 21 electrodes in eyes open and eyes closed condition resting conditions. Forty seconds segments were selected from each recorded signals with minimal noise and artifacts. Periodogram Welch was used to estimate power spectrum density from each segment. Analysis was performed in five frequency bands (delta, theta, alpha, beta and gamma, and we assessed power, mean, entropy, variance and skewness of the spectrums, as well as mean of the thresholded spectrum and thresholded spectrogram. We only used focal montage for comparison. Eventually, data were analyzed by independent Mann-Whitney test and independent t test.Results: We observed significant differences in some brain regions and in all frequency bands. There were significant differences in prefrontal lobe, central lobe, left parietal lobe, occipital lobe and temporal lobe between BMD I and BMD II (P < 0.05. In patients with BMD I, spectral entropy was compared to patients with BMD II. The most significant difference was observed in the gamma frequency band. Also, the power and entropy of delta frequency band was larger in the left parietal lobe in the BMD I patients compared to BMD II patients (P < 0.05. In the temporal lobe, significant differences were observed in the spectrum distribution of beta and gamma frequency bands (P < 0.05.Conclusion: The QEEG and entropy measure are simple and available tools to help detect cerebral cortex deficits and distinguish BMD I from BMD II.

  15. 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...

  16. The Valproate Serum Level in Maintenance Therapy for Bipolar Disorder in Japan

    OpenAIRE

    Machino, Akihiko; Jitsuiki, Hiroaki; Okamoto, Yasumasa; Izumitani, Satoru; Kimura, Yasuhiro; Suzuki, Katsuji; Tanaka, Teruaki; Inoue, Takeshi; Koyama, Tsukasa; Wada, Ken; Masaoka, Yukari; Sasaki, Takanobu; Yoshimura, Reiji; Nakamura, Jun; Sumitani, Satsuki

    2013-01-01

    The appropriate therapeutic serum valproate level in maintenance therapy for bipolar disorder is not well known. We studied the serum valproate levels in seventeen bipolar I and twenty-four bipolar II disorder outpatients who had been treated with stable doses of valproate successfully for at least 12 months as prophylactic therapy. The trough serum valproate levels were 52.2 ± 20.4 μg/ml in bipolar I, and 41.0 ± 18.3 μg/ml in bipolar II disorder patients, respectively. A greater trend toward...

  17. 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

  18. 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.

  19. A Review of Bipolar Disorder in Adults

    OpenAIRE

    Hilty, Donald M; Leamon, Martin H.; Lim, Russell F.; Kelly, Rosemary H.; Hales, Robert E.

    2006-01-01

    Objective: This article reviews the epidemiology, etiology, assessment, and management of bipolar disorder. Special attention is paid to factors that complicate treatment, including nonadherence, comorbid disorders, mixed mania, and depression. Methods: A Medline search was conducted from January of 1990 through December of 2005 using key terms of bipolar disorder, diagnosis, and treatment. Papers selected for further review included those published in English in peer-reviewed journals, with ...

  20. The relationship between borderline personality disorder and bipolar disorder

    OpenAIRE

    Zimmerman, Mark; Morgan, Theresa A

    2013-01-01

    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. Research considering whether BPD should be considered part of a bipolar spectrum reaches differing conclusions. We reviewed the most studied question on the relationship between BPD and bipolar disorder: their diagnostic concordance. Across studies, approximately 10% of patients with BPD had bi...

  1. 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…

  2. Comparison of quality of life among bipolar I and II disorder patients' spouse%单、双相抑郁障碍患者配偶的生活质量对比分析

    Institute of Scientific and Technical Information of China (English)

    张治华; 邓雪峰; 张俊成

    2014-01-01

    目的:比较单相抑郁障碍患者和双相抑郁障碍患者配偶生活质量水平的异同,并探讨其影响因素。方法:分别纳入单相抑郁障碍患者配偶(单相组)和双相抑郁障碍患者配偶(双相组)各80例,采用生活质量综合评定量表、汉密尔顿抑郁量表及汉密尔顿焦虑量表进行评估,对结果进行对比分析。结果:双相组患者的生活质量水平低于单相组,差异有统计学意义;双相组患者焦虑、抑郁水平均高于单相组,差异有统计学意义。结论:双相抑郁障碍对患者配偶造成的心理应激高于单相抑郁障碍,有必要对双相抑郁障碍患者配偶进行一定的临床干预。%Objective:To compare quality of life among bipolar I and II disorder patients' spouse, and explore the influencing factors. Methods:Totally 160 bipolar I and II disorder patients' spouses were enrolled, 80 for each group. world health organization quality of Life-brief ( WHOQOL-BREF) , Hamilton depression scale ( HAMD) and Hamilton anxiety scale ( HAMA) were used to as-sess the quality of life. Results:The quality of life was significantly worse in bipolar II disorder patients' spouses than that in bipolar I patients' spouse. Also, the depression level and anxiety level were significantly higher in bipolar II disorder patients' spouses. Conclu-sions:Bipolar II disorder would cause more psychological stress to the patients' spouses than Bipolar I disorder. It is suggested to pro-vide clinical interventions to the bipolar II disorder patents' spouses.

  3. 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.

  4. 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...

  5. 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...... 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...... 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...

  6. 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) or...

  7. 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...

  8. 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...

  9. Behavioral Treatment of Insomnia in Bipolar Disorder

    OpenAIRE

    Kaplan, Katherine A; Harvey, Allison G.

    2013-01-01

    Sleep disturbance is common in bipolar disorder. Stimulus control and sleep restriction are powerful, clinically useful behavioral interventions for insomnia, typically delivered as part of cognitive-behavioral therapy for insomnia (CBT-I). Both involve short-term sleep deprivation. The potential for manic or hypomanic symptoms to emerge after sleep deprivation in bipolar disorder raises questions about the appropriateness of these methods for treating insomnia. In a series of patients with b...

  10. 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...

  11. Are impulse-control disorders related to bipolar disorder?

    Science.gov (United States)

    McElroy, S L; Pope, H G; Keck, P E; Hudson, J I; Phillips, K A; Strakowski, S M

    1996-01-01

    We reviewed available evidence regarding a possible relationship between impulse-control disorders (ICDs) and bipolar disorder. Studies examining the phenomenology, course, comorbidity, family history, biology, and treatment response of ICDs were compared with similar studies of bipolar disorder. Although no studies directly compare a cohort of ICD patients with a cohort of mood disorder patients, available data suggest that ICDs and bipolar disorder share a number of features: (1) phenomenologic similarities, including harmful, dangerous, or pleasurable behaviors, impulsivity, and similar affective symptoms and dysregulation; (2) onset in adolescence or early adulthood and episodic and/or chronic course; (3) high comorbidity with one another and similar comorbidity with other psychiatric disorders; (4) elevated familial rates of mood disorder; (5) possible abnormalities in central serotonergic and noradrenergic neurotransmission; and (6) response to mood stabilizers and antidepressants. However, ICDs and bipolar disorder differ in important respects. In particular, some ICDs may be more closely related to obsessive-compulsive disorder (OCD) than is bipolar disorder. Although the similarities between ICDs and bipolar disorder may be coincidental, they suggest that the two conditions may be related and thus may share at least one common pathophysiologic abnormality. To explain this possible relationship, we hypothesize that impulsivity and bipolarity (or mania) are related, that compulsivity and unipolarity (or depression) are similarly related, and that each state may represent opposing poles of related, or even a single, psychological dimension. PMID:8826686

  12. 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

  13. 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...

  14. 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.

  15. 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

  16. 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

  17. 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 ...

  18. 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.

  19. [Non pharmacological treatment for bipolar disorder].

    Science.gov (United States)

    Mirabel-Sarron, Christine; Giachetti, Raphaël

    2012-12-01

    Bipolar disorder is a chronic and recurring disorder associated with significant psychosocial impairment. A number of psychosocial interventions have been developed to address impairment. The consensus makes mood stabilizer the treatment of bipolar disorder. However, numerous patients are not in complete remission despite a controlled observance. Every patient can follow a psycho educational program. What this paper adds. The review identifies that a range of interventions have demonstrated efficacy in extended periods of euthymia, improved social and occupational functioning and alleviation of subsyndromal symptoms. Adjunctive, short-term psychotherapies have been shown to offer fairly consistent benefits to bipolar disorder patients. Cognitive-behavioural therapy, family-focused therapy, and psychoeducation offer the most robust efficacy in regard to relapse prevention. The most complex situations including comorbidities can be helped by behavioral and cognitive therapy for bipolar disorder. Evaluations emphasize positive impact. The psychosocial interventions reviewed provide mental health nurses with evidence-based approaches to improving mental health care for patients with bipolar disorder. There is a need for mental health nurses to conduct high quality trials of the clinical effectiveness of these interventions. PMID:23395231

  20. Epidemiologia do transtorno bipolar Epidemiology of bipolar disorders

    Directory of Open Access Journals (Sweden)

    Maurício Silva de Lima

    2005-01-01

    Full Text Available A formulação de políticas em saúde mental depende essencialmente de informações a respeito da freqüência e distribuição dos transtornos mentais. Nas últimas duas décadas, pesquisas de base populacional em epidemiologia psiquiátrica têm sido conduzidas, gerando informações detalhadas sobre freqüência, fatores de risco, incapacidade social e utilização de serviços de saúde. Neste artigo, dados sobre a epidemiologia do transtorno bipolar (TB são discutidos, a partir de resultados de recentes pesquisas populacionais: o estudo da Área de Captação Epidemiológica do Instituto Nacional de Saúde Mental dos Estados Unidos (ECA-NIMH, a Pesquisa Nacional de Comorbidade (NCS, a Pesquisa de Morbidade Psiquiátrica na Grã-Bretanha (OPCS, o Estudo Brasileiro Multicêntrico de Morbidade Psiquiátrica e os estudos longitudinais conduzidos por Angst, em Zurique. As estimativas de prevalências de transtorno bipolar são relativamente baixas, independentemente do lugar onde a pesquisa foi conduzida, do tipo de instrumento diagnóstico usado e dos períodos de tempo para os quais a prevalência se aplica. A partir da introdução do conceito de espectro bipolar, ampliando as fronteiras diagnósticas do TB, as estimativas de prevalências encontradas são substancialmente mais altas. Tais estimativas, entretanto, ainda carecem de validação em estudos populacionais. O transtorno afetivo bipolar é igualmente prevalente entre homens e mulheres, sendo mais freqüente entre solteiros ou separados. Indivíduos acometidos têm maiores taxas de desemprego e estão mais sujeitos a utilizarem serviços médicos e serem hospitalizados. O custo e a eficácia dos tratamentos do TB devem ser balanceados com o alto custo individual e social associados à enfermidade.Information about the epidemiology of bipolar disorders is essential for providing a framework for the formulation of effective mental health policy. In the last two decades, population

  1. 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...

  2. 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

  3. Long-term Treatment in Bipolar Disorder

    OpenAIRE

    Meliha Zengin Eroglu; Nurgul Ozpoyraz

    2010-01-01

    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 ...

  4. QUALITY OF LIFE IN BIPOLAR DISORDER

    OpenAIRE

    Nieznańska, Anna; Baron, Urszula; Jaracz, Krystyna

    2014-01-01

    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 w...

  5. 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

  6. 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...

  7. Genetic determinants of white matter integrity in bipolar disorder

    OpenAIRE

    Sprooten, Emma

    2012-01-01

    Bipolar disorder is a heritable psychiatric disorder, and several of the genes associated with bipolar disorder and related psychotic disorders are involved in the development and maintenance of white matter in the brain. Patients with bipolar disorder have an increased incidence of white matter hyper-intensities, and quantitative brain imaging studies collectively indicate subtle decreases in white matter density and integrity in bipolar patients. This suggests that genetic vu...

  8. 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...

  9. Are bipolar II patients cognitively impaired? A systematic review

    OpenAIRE

    Solé, B.; Martínez-Arán, Anabel; Torrent, C.; Bonnín Roig, Caterina del Mar; Reinares, M.; Popovic, D; Sánchez-Moreno, José; Vieta i Pascual, Eduard, 1963-

    2011-01-01

    BACKGROUND: There is evidence that bipolar disorder (BD) is associated with significant neurocognitive deficits and this occurs in individuals with BD type I (BD I) and with BD type II (BD II). Only a few studies have focused on cognitive impairment in BD II. The aim of this study was to describe the pattern of cognitive impairment in patients with BD II, in order to identify specific cognitive deficits that distinguish BD II from BD I patients as well as from healthy subjects. METHOD: We per...

  10. Affective Bipolar Disorder and Borderline Personality Disorder - Comorbidity or Continuum

    Directory of Open Access Journals (Sweden)

    Berta Ferreira

    2014-10-01

    Full Text Available The association between bipolar disorder and borderline personality has been studied by several researchers. Comorbidity has been emphasized by some authors which observe a prognostic impairment of bipolar disorder because the delay of the diagnostic. Symptoms related with alcohol and drugs abuse, suicidary behaviour and impulsivity, often present in borderline patients, make the treatment difficult. Other authors consider these symptoms as being part of the bipolar disease, proposing a continuum between the two entities. In this case, borderline personality would be a mild form of an affective disorder. We will discuss different opinions and their cli- nical and therapeutic consequences.

  11. 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

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

    Science.gov (United States)

    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 – 5th 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.

  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. 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

  15. 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....

  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. 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...

  18. 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...

  19. TREATMENT OF HYPOTHYROIDISM IS IMPORTANT IN TREATING BIPOLAR AFFECTIVE DISORDER

    OpenAIRE

    Sainath B Reddy; B Deepika; Harish, S

    2014-01-01

    Bipolar affective disorder along with hypothyroidism is well documented. There are few studies regarding hypothyroidism in patients with bipolar affective disorder. Here our main motto is to report such a case who was presented with bipolar affective disorder along with hypothyroidism as a co-morbidity & to provide a brief information regarding association of hypothyroidism in bipolar affective disorder. Treatment approaches in such co-morbid conditions.

  20. Clinical, Demographic, and Familial Correlates of Bipolar Spectrum Disorders among Offspring of Parents with Bipolar Disorder

    Science.gov (United States)

    Goldstein, Benjamin I.; Shamseddeen, Wael; Axelson, David A.; Kalas, Cathy; Monk, Kelly; Brent, David A.; Kupfer, David J.; Birmaher, Boris

    2010-01-01

    Objective: Despite increased risk, most offspring of parents with bipolar disorder (BP) do not manifest BP. The identification of risk factors for BP among offspring could improve preventive and treatment strategies. We examined this topic in the Pittsburgh Bipolar Offspring Study (BIOS). Method: Subjects included 388 offspring, ages 7-17 years,…

  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. 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,…

  3. The Bipolar II Depression Questionnaire: A Self-Report Tool for Detecting Bipolar II Depression

    Science.gov (United States)

    Leung, Chi Ming; Yim, Chi Lap; Yan, Connie T. Y.; Chan, Cheuk Chi; Xiang, Yu-Tao; Mak, Arthur D. P.; Fok, Marcella Lei-Yee; Ungvari, Gabor S.

    2016-01-01

    Bipolar II (BP-II) depression is often misdiagnosed as unipolar (UP) depression, resulting in suboptimal treatment. Tools for differentiating between these two types of depression are lacking. This study aimed to develop a simple, self-report screening instrument to help distinguish BP-II depression from UP depressive disorder. A prototype BP-II depression questionnaire (BPIIDQ-P) was constructed following a literature review, panel discussions and a field trial. Consecutively assessed patients with a diagnosis of depressive disorder or BP with depressive episodes completed the BPIIDQ-P at a psychiatric outpatient clinic in Hong Kong between October and December 2013. Data were analyzed using discriminant analysis and logistic regression. Of the 298 subjects recruited, 65 (21.8%) were males and 233 (78.2%) females. There were 112 (37.6%) subjects with BP depression [BP-I = 42 (14.1%), BP-II = 70 (23.5%)] and 182 (62.4%) with UP depression. Based on family history, age at onset, postpartum depression, episodic course, attacks of anxiety, hypersomnia, social phobia and agoraphobia, the 8-item BPIIDQ-8 was constructed. The BPIIDQ-8 differentiated subjects with BP-II from those with UP depression with a sensitivity/specificity of 0.75/0.63 for the whole sample and 0.77/0.72 for a female subgroup with a history of childbirth. The BPIIDQ-8 can differentiate BP-II from UP depression at the secondary care level with satisfactory to good reliability and validity. It has good potential as a screening tool for BP-II depression in primary care settings. Recall bias, the relatively small sample size, and the high proportion of females in the BP-II sample limit the generalization of the results. PMID:26963908

  4. The Relationship Between Bipolar Disorder, Seasonality, and Premenstrual Symptoms

    OpenAIRE

    Kim, Deborah R.; Czarkowski, Kathryn A.; Epperson, C. Neill

    2011-01-01

    Cyclical mood disorders characterized by shifting affective states include bipolar disorder, seasonal affective disorder, and premenstrual syndrome/premenstrual dysphoric disorder. In this article, we explore the relationship between these disorders and bring the reader up to date on the advances made in the past year in understanding the relationship between bipolar disorder, seasonality, and premenstrual symptoms.

  5. Does the X-chromosome carry the gene responsible for bipolar disorder? An offspring with bipolar disorder and coexisting muscular dystrophy from a mother with bipolar disorder

    OpenAIRE

    tuba gokdogan edgunlu; ibrahim duvarci; esin sakali cetin

    2013-01-01

    According to family, twin and adoption studies, which consistently indicate a strong genetic component, the specific genes that are responsible for bipolar disorder remain unclear. While the mode of transmission is poorly characterized, genetic studies suggest that the X-chromosome may be responsible for bipolar disorder. Muscular dystrophy is an X-chromosome linked recessively inherited disorder. In this case, we present a 35 year-old male with bipolar disorder and coexisting muscular dystro...

  6. Shared Genetic Factors Influence Risk for Bipolar Disorder and Alcohol Use Disorders

    OpenAIRE

    Carmiol, Nasdia; Peralta, Juan M; Almasy, Laura; Contreras, Javier; Pacheco, Adriana; Escamilla, Michael A.; Knowles, Emma E; Raventós, Henriette; Glahn, David C.

    2013-01-01

    Bipolar disorder and alcohol use disorder (AUD) have a high rate of comorbidity, more than 50% of individuals with bipolar disorder also receive a diagnosis of AUD in their lifetimes. Although both disorders are heritable, it is unclear if the same genetic factors mediate risk for bipolar disorder and AUD. We examined 733 Costa Rican individuals from 61 bipolar pedigrees. Based on a best-estimate process, 32% of the sample met criteria for bipolar disorder, 17% had a lifetime AUD diagnosis, 3...

  7. 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...

  8. 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 ...

  9. Climatic factors and bipolar affective disorder

    DEFF Research Database (Denmark)

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

    2008-01-01

    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...

  10. 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). METHODS...

  11. 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.

  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. The influence of psychoeducation on regulating biological rhythm in a sample of patients with bipolar II disorder: a randomized clinical trial

    Directory of Open Access Journals (Sweden)

    Faria AD

    2014-06-01

    Full Text Available Augusto Duarte Faria,1 Luciano Dias de Mattos Souza,2 Taiane de Azevedo Cardoso,2 Karen Amaral Tavares Pinheiro,2 Ricardo Tavares Pinheiro,2 Ricardo Azevedo da Silva,2 Karen Jansen21Department of Clinical and Health Psychology, Universidade Federal do Rio Grande – FURG, Rio Grande, RS, Brazil; 2Health and Behavior Postgraduate Program, Universidade Católica de Pelotas – UCPEL, Pelotas, RS, BrazilIntroduction: Changes in biological rhythm are among the various characteristics of bipolar disorder, and have long been associated with the functional impairment of the disease. There are only a few viable options of psychosocial interventions that deal with this specific topic; one of them is psychoeducation, a model that, although it has been used by practitioners for some time, only recently have studies shown its efficacy in clinical practice.Aim: To assess if patients undergoing psychosocial intervention in addition to a pharmacological treatment have better regulation of their biological rhythm than those only using medication.Method: This study is a randomized clinical trial that compares a standard medication intervention to an intervention combined with drugs and psychoeducation. The evaluation of the biological rhythm was made using the Biological Rhythm Interview of Assessment in Neuropsychiatry, an 18-item scale divided in four areas (sleep, activity, social rhythm, and eating pattern. The combined intervention consisted of medication and a short-term psychoeducation model summarized in a protocol of six individual sessions of 1 hour each.Results: The sample consisted of 61 patients with bipolar II disorder, but during the study, there were 14 losses to follow-up. Therefore, the final sample consisted of 45 individuals (26 for standard intervention and 19 for combined. The results showed that, in this sample and time period evaluated, the combined treatment of medication and psychoeducation had no statistically significant impact on the

  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. [Psychotherapeutic interventions in bipolar disorder: a review].

    Science.gov (United States)

    Hausmann, Armand; Hörtnagl, Christine; Müller, Markus; Waack, Julie; Walpath, Michaela; Conca, Andreas

    2007-01-01

    The treatment of bipolar disorders is a demanding task involving patients, therapists and relatives. As bipolar disorders are associated to multiple psychosocial disturbances, the management of a bipolar disease should focus on psychosocial interventions. Despite an exploding literature on this topic, psychopharmacological interventions applied as a monotherapy have shown unsatisfactory outcomes. In order to enhance outcome, psychotherapy, such as cognitive behavioural therapy (CBT), psychoeducation, a modified form of interpersonal psychotherapy (IPSRT) or family focussed psychotherapy (FFT) were investigated. When used in conjunction with pharmacotherapy, these interventions may prolong time to relapse, reduce symptom severity, and increase medication adherence. These combinations are currently considered being the golden standard in the treatment of bipolar disorders. Psychotherapeutic interventions as an add-on strategy exert better effects when patients are euthymic at entry. Prevention of manic episodes seems to be more successful as compared to the prevention of depressive episodes. There are currently no hints for a method specific efficacy. Efficacy of psychoeducation seems to be rather short lived. Currently not yet evaluated booster-sessions might help. More data are needed in order to identify patients with a putative good response to psychotherapeutic interventions. PMID:17640496

  17. Análisis comparativo de costos directos y funcionamiento global en personas afectadas por trastorno bipolar I y II, en tratamiento ambulatorio Comparative Analysis for Direct Costs and Global Functions in Persons Affected By Bipolar Disorders I and II in Outpatient Treatment

    Directory of Open Access Journals (Sweden)

    Ana Igoa

    2011-10-01

    Full Text Available Objetivo: Evaluar los costos directos, el nivel de funcionamiento y la tasa de empleo reportada en una muestra aleatoria de personas con trastorno bipolar (TB I y II que se atienden en forma ambulatoria. Métodos: Se analizaron y compararon los costos directos de los tratamientos ambulatorios de 165 pacientes con diagnóstico de trastorno bipolar tipo I y II (el costo mensual del tratamiento farmacológico, el número de consultas mensuales, el número de internaciones y días de internación. Se estimó el funcionamiento global y se consignó la condición laboral. Resultados: El 51,5% (n=85 de los pacientes presentaba diagnóstico de TB tipo I y 48,5% (n=80 de TB tipo II. El 40,6% de los pacientes se encontraba desocupado; el puntaje de GAF fue 73 ± 12,59. Los costos mensuales del tratamiento farmacológico fueron de $480 ± $350,4 por paciente sin diferencia entre los TB. Un mayor porcentaje de pacientes con TB I había tenido internaciones y recibía antipsicóticos, mientras que un mayor porcentaje de pacientes con TB II recibía antidepresivos y asistía al psicólogo. Discusión: Los pacientes con diagnóstico de TB I y TB II deben afrontar tratamientos farmacológicos que implican un costo promedio equivalente a un cuarto del ingreso mínimo en nuestro país, independientemente del tipo de trastorno bipolar que padezcan. Ambos grupos de pacientes presentaban una elevada tasa de desempleo y puntajes de funcionamiento global relativamente bajos.Objective: To evaluate the direct costs, the functional level and the employment rate reported for a random sample of people with Bipolar Disorders (BD I and II that are cared for as outpatients. Methods: The direct costs of outpatient treatment for 165 patients diagnosed with types I and II bipolar disorders were compared and analyzed (the monthly cost of pharmacological treatments, the number of consultations per month, the number of hospitalizations and the days spent in hospital. Global

  18. 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 ...

  19. 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

  20. Daily electronic monitoring of subjective and objective measures of illness activity in bipolar disorder using smartphones- the MONARCA II trial protocol

    DEFF Research Database (Denmark)

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

    2014-01-01

    measures of illness activity; number of days hospitalized; psychosocial functioning (secondary); perceived stress; quality of life; self-rated depressive symptoms; self-rated manic symptoms; recovery; empowerment and adherence to medication (tertiary) between the intervention group and the control group...... use to the treatment of bipolar disorder in general and in larger scale. TRIAL REGISTRATION: ClinicalTrials.gov NCT02221336. Registered 26th of September 2014....

  1. Internet-Based Cognitive Behavioral Therapy for Residual Symptoms in Bipolar Disorder Type II: A Single-Subject Design Pilot Study

    OpenAIRE

    Holländare, Fredrik; Eriksson, Annsofi; Lövgren, Lisa; Humble, Mats B; Boersma, Katja

    2015-01-01

    Background Bipolar disorder is a chronic condition with recurring episodes that often lead to suffering, decreased functioning, and sick leave. Pharmacotherapy in the form of mood stabilizers is widely available, but does not eliminate the risk of a new depressive or (hypo)manic episode. One way to reduce the risk of future episodes is to combine pharmacological treatment with individual or group psychological interventions. However, access to such interventions is often limited due to a shor...

  2. Circadian secretion of cortisol in bipolar disorder

    Science.gov (United States)

    Cervantes, Pablo; Gelber, Stephen; Kin, François; Nair, Vasavan N.P.; Schwartz, George

    2001-01-01

    Objective To compare the 24-h cortisol secretion profiles of normal control subjects and patients with bipolar disorder who were in the depressive, manic and euthymic phases of the disorder. Participants Eighteen patients, 25–62 years of age, in depressed (n = 5), manic (n = 5) or euthymic (n = 8) phase of bipolar disorder recruited through a psychiatric outpatient clinic, and 5 control subjects, 24–41 years of age, recruited through advertisement or word of mouth. Outcome measures Subjects were interviewed and symptom ratings were obtained using the Hamilton Depression Rating Scale, Beck Depression Inventory and Young Mania Scale. Blood collection began at 0800 and continued at hourly intervals for 24 h. Serum cortisol levels were assayed using a validated commercial radioimmunoassay kit. Results An analysis of variance of the area under the cortisol 24-h time-concentration curve (AUC) revealed a significant difference between the control group and patient groups (F = 3.69, p = 0.03). The mean AUCs of the patients in the depressed (263.4 μg/dL) and hypomanic (262.2 μg/dL) phases were beyond the 95% confidence interval for the controls (120.9–253.3 μg/dL). There were no significant group differences in cosinor acrophase and no significant effects of sex, education, age of illness onset, duration of illness or duration of mood state at time of testing on the cortisol measures. Pearson correlations between symptom rating scores and cortisol secretion variables were not significant. Conclusion The increases in cortisol secretion in patients in both the depressed and manic phases of bipolar disorder suggest that cortisol level is probably not a state marker in bipolar disorder. PMID:11762208

  3. Inflammation's Association with Metabolic Profiles before and after a Twelve-Week Clinical Trial in Drug-Naive Patients with Bipolar II Disorder.

    Directory of Open Access Journals (Sweden)

    Sheng-Yu Lee

    Full Text Available Inflammation is thought to be involved in the pathophysiology of bipolar disorder (BP and metabolic syndrome. Prior studies evaluated the association between metabolic profiles and cytokines only during certain mood states instead of their changes during treatment. We enrolled drug-naïve patients with BP-II and investigated the correlation between changes in mood symptoms and metabolic indices with changes in plasma cytokine levels after 12 weeks of pharmacological treatment. Drug-naïve patients (n = 117 diagnosed with BP-II according to DSM-IV criteria were recruited. Metabolic profiles (cholesterol, triglyceride, HbA1C, fasting serum glucose, body mass index (BMI and plasma cytokines (TNF-α, CRP, IL-6, and TGF-β were measured at baseline and 2, 8, and 12 weeks post-treatment. To adjust within-subject dependence over repeated assessments, multiple linear regressions with generalized estimating equation methods were used. Seventy-six (65.0% patients completed the intervention. Changes in plasma CRP were significantly associated with changes in BMI (P = 1.7E-7 and triglyceride (P = 0.005 levels. Changes in plasma TGF-β1 were significantly associated with changes in BMI (P = 8.2E-6, cholesterol (P = 0.004, and triglyceride (P = 0.006 levels. However, changes in plasma TNF-α and IL-6 were not associated with changes in any of the metabolic indices. Changes in Hamilton Depression Rating Scale scores were significantly associated with changes in IL-6 (P = 0.003 levels; changes in Young Mania Rating Scale scores were significantly associated with changes in CRP (P = 0.006 and TNF-α (P = 0.039 levels. Plasma CRP and TGF-β1 levels were positively correlated with several metabolic indices in BP-II after 12 weeks of pharmacological intervention. We also hypothesize that clinical symptoms are correlated with certain cytokines. These new findings might be important evidence that inflammation is the pathophysiology

  4. 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...

  5. Efficacy of Electroconvulsive Therapy in Bipolar Disorder with Mixed Features

    OpenAIRE

    Miguel Palma; Berta Ferreira; Nuno Borja-Santos; Bruno Trancas; Céu Monteiro; Graça Cardoso

    2016-01-01

    BACKGROUND: The aim of this study was to investigate the effectiveness of electroconvulsive therapy (ECT) in medication-nonresponsive patients with mixed mania and bipolar depression. METHOD: Forty-one patients with mixed mania (DSM-IV diagnosis of bipolar I disorder, most recent episode mixed) and 23 patients with bipolar depression (DSM-IV diagnosis of bipolar I disorder, most recent episode depressed) consecutively assigned to ECT treatment were included in this study. Subjects we...

  6. 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...

  7. Validity and reliability of the Finnish version of the Functioning Assessment Short Test (FAST) in bipolar disorder

    OpenAIRE

    Suominen, Kirsi; Salminen, Elina; Lähteenmäki, Susanna; Tupala, Tiina; Isometsä, Erkki

    2015-01-01

    Background The Functioning Assessment Short Test (FAST) was developed for the clinical evaluation of functional impairment of patients suffering from bipolar disorder. The aim of this study was to validate the Finnish version of FAST. Methods Translation and back-translation of FAST were performed. Fifty patients with the Diagnostic and Statistical Manual of Mental Disorders-Fourth edition (DSM-IV) bipolar type I and II were interviewed at the Bipolar Disorder Research and Treatment Centre, C...

  8. Quality of Life Among Bipolar Disorder Patients Misdiagnosed With Major Depressive Disorder

    OpenAIRE

    Awad, A. George; Rajagopalan, Krithika; Bolge, Susan C.; McDonnell, Diana D.

    2007-01-01

    Objective: Bipolar disorder is frequently misdiagnosed as major depressive disorder (MDD). We aim to quantify the prevalence of misdiagnosed bipolar disorder among the depression population and evaluate the quality-of-life (QOL) impact of misdiagnoses.

  9. 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…

  10. [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

  11. 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...

  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. 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/Medline, E......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......) was observed in 11 meta-analyses. Heterogeneity was high for (I 2 ⩾ 50%) 16 meta-analyses. Only two biomarkers met criteria for suggestive evidence namely the soluble IL-2 receptor and morning cortisol. The median power of included studies, using the effect size of the largest dataset as the plausible...

  14. Clinical Implications of DSM-IV Subtyping of Bipolar Disorders in Referred Children and Adolescents

    Science.gov (United States)

    Masi, Gabriele; Perugi, Giulio; Millepiedi, Stefania; Mucci, Maria; Pari, Cinzia; Pfanner, Chiara; Berloffa, Stefano; Toni, Cristina

    2007-01-01

    Objective: According to DSM-IV, bipolar disorders (BDs) include four subtypes, BD I, BD II, cyclothymic disorder, and BD not otherwise specified (NOS). We explore the clinical implications of this subtyping in a naturalistic sample of referred youths with BD I, BD II, and BD-NOS. Method: The sample consisted of 217 patients, 135 males and 82…

  15. 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...

  16. Olanzapine Discontinuation Emergent Recurrence in Bipolar Disorder

    OpenAIRE

    Manu Arora; Samir Kumar Praharaj

    2014-01-01

    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. Result...

  17. 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...

  18. 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.

  19. 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.

  20. 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.

  1. 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

  2. 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.

  3. The high prevalence of "soft" bipolar (II) features in atypical depression.

    Science.gov (United States)

    Perugi, G; Akiskal, H S; Lattanzi, L; Cecconi, D; Mastrocinque, C; Patronelli, A; Vignoli, S; Bemi, E

    1998-01-01

    Seventy-two percent of 86 major depressive patients with atypical features as defined by the DSM-IV and evaluated systematically were found to meet our criteria for bipolar II and related "soft" bipolar disorders; nearly 60% had antecedent cyclothymic or hyperthymic temperaments. The family history for bipolar disorder validated these clinical findings. Even if we limit the diagnosis of bipolar II to the official DSM-IV threshold of 4 days of hypomania, 32.6% of atypical depressives in our sample would meet this conservative threshold, a rate that is three times higher than the estimates of bipolarity among atypical depressives in the literature. By definition, mood reactivity was present in all patients, while interpersonal sensitivity occurred in 94%. Lifetime comorbidity rates were as follows: social phobia 30%, body dysmorphic disorder 42%, obsessive-compulsive disorder 20%, and panic disorder (agoraphobia) 64%. Both cluster A (anxious personality) and cluster B (e.g., borderline and histrionic) personality disorders were highly prevalent. These data suggest that the "atypicality" of depression is favored by affective temperamental dysregulation and anxiety comorbidity, clinically manifesting in a mood disorder subtype that is preponderantly in the realm of bipolar II. In the present sample, only 28% were strictly unipolar and characterized by avoidant and social phobic features, without histrionic traits. PMID:9515190

  4. Bipolar Disorder: What Can Psychotherapists Learn From the Cognitive Research?

    OpenAIRE

    Johnson, Sheri; Tran, Tanya

    2007-01-01

    Randomized controlled trials of psychological treatment, principally cognitive therapy, for bipolar disorder have yielded inconsistent results. Given the status of this evidentiary base, we provide a more fine-grained analysis of the cognitive profiles associated with bipolar disorder to inform clinical practice. In this practice-friendly review, we consider evidence that both negative and positive cognitive styles are related to bipolar disorder. Cross-sectional and prospective evidence sugg...

  5. Valproate in Bipolar Disorder: Case Examples From a Family Practice

    OpenAIRE

    Manning, J. Sloan

    1999-01-01

    Valproate, an antiepileptic drug, is useful in the management of various nonepileptic disorders. It is an effective and generally well-tolerated medication for the treatment of bipolar disorder and has been approved by the Food and Drug Administration for use in manic states. Studies also suggest that it is effective in other bipolar spectrum illnesses. This report describes 2 clinical cases of DSM-IV bipolar disorder where valproate provided robust, sustained relief of mood symptoms. In the ...

  6. 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...

  7. 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...

  8. 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

  9. 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…

  10. Bipolar disorder and metabolic syndrome: a systematic review

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    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.

  11. 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.

  12. Subjective experiences in schizophrenia and bipolar disorders.

    Science.gov (United States)

    Arduini, Luca; Kalyvoka, Artemis; Stratta, Paolo; Gianfelice, Daniela; Rinaldi, Osvaldo; Rossi, Alessandro

    2002-02-01

    Studies comparing 'subjective experiences' in schizophrenic and affective disorders have reached inconclusive results. We investigated the pattern of 'subjective perceived cognitive disturbances' in a group of 55 schizophrenic patients and 39 bipolar patients hospitalized for an index psychotic episode. The assessment of the subjective experiences was made using the Frankfurter Beschwerde-Fragebogen (FBF). Comparing the two groups on the four FBF factors, schizophrenic patients showed significantly higher scores in the areas of 'central cognitive disturbances', 'perception and motility' other than a significantly higher FBF total score. Our results suggest that cognitive, perception and motility disturbances are the most characteristic subjective experiences of schizophrenic patients in comparison with bipolar patients. This finding need to be further explored in light of the issue of cognitive dysfunction in schizophrenia. PMID:12056578

  13. Assessment of basic symptoms in schizophrenia, schizoaffective and bipolar disorders.

    Science.gov (United States)

    Ricca, V; Galassi, F; La Malfa, G; Mannucci, E; Barciulli, E; Cabras, P L

    1997-01-01

    In order to evaluate the basic symptoms differences of schizophrenics, schizoaffectives and bipolar patients, a consecutive series of 72 outpatients participated in the study. According to DSM III-R criteria, 28 had a diagnosis of schizophrenia, 29 of bipolar disorder and 15 of schizoaffective disorder. The assessment of basic symptoms was performed using the Frankfurter Beschwerde-Fragebogen (FBF). Data obtained suggest that perception and thought disturbances are the most characteristic experiences of schizophrenic patients in comparison with bipolar patients. The FBF questionnaire did not highlight a characteristic basic symptoms profile of schizoaffective disorder, when compared with bipolar affective disorder and schizophrenia. PMID:9042683

  14. The role of lamotrigine in the management of bipolar disorder

    OpenAIRE

    Ng, Felicity; Hallam, Karen; Lucas, Nellie; Berk, Michael

    2007-01-01

    Lamotrigine has emerged with a distinct place in the pharmacological treatment of bipolar disorder, with the potential to treat and prevent bipolar depression, which is the dominant and arguably most disabling and under-treated phase of the illness. This review examines the published clinical trials of lamotrigine in bipolar treatment. While the data supports its tolerability and safety, the strongest evidence for its efficacy lies in the prevention of bipolar depression, with weaker evidence...

  15. Mitochondrial Variants in Schizophrenia, Bipolar Disorder, and Major Depressive Disorder

    OpenAIRE

    Rollins, Brandi; Martin, Maureen V.; Sequeira, P. Adolfo; Moon, Emily A.; Ling Z. Morgan; Watson, Stanley J.; Schatzberg, Alan,; Akil, Huda; Myers, Richard M.; Jones, Edward G.; Wallace, Douglas C.; Bunney, William E.; Vawter, Marquis P.

    2009-01-01

    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 Dorsolate...

  16. Effect of cariprazine across the symptoms of mania in bipolar I disorder: Analyses of pooled data from phase II/III trials.

    Science.gov (United States)

    Vieta, Eduard; Durgam, Suresh; Lu, Kaifeng; Ruth, Adam; Debelle, Marc; Zukin, Stephen

    2015-11-01

    Bipolar I disorder is a chronic disorder characterized by episodic recurrences of mania, depression, and mixed affective states interspersed with periods of full or partial remission; subsyndromal residual symptoms between episodes are common and disabling. Cariprazine, an atypical antipsychotic, is a potent dopamine D3 and D2 receptor partial agonist with preferential binding to D3 receptors. Post-hoc analyses of pooled data from 3 positive trials were conducted to evaluate the effect of cariprazine 3-12 mg/d on the symptoms of mania in inpatients (18-65 years) with bipolar I disorder and a current manic episode. Analyses were based on the pooled intent-to-treat (ITT) population (placebo=429; cariprazine=608). Mean change from baseline to the end of treatment on individual Young Mania Rating Scale (YMRS) items was analysed using a mixed-effects model for repeated measures (MMRM); categorical symptom severity shifts were analysed using logistic regression. Statistically significant improvement in mean change was seen for cariprazine versus placebo on all 11 YMRS items (pYMRS items (pYMRS core symptoms (irritability, speech, content, and disruptive-aggressive behaviour) (pYMRS items (pYMRS symptoms; a significant percentage of cariprazine- versus placebo-treated patients had mild/no symptoms at the end of treatment. PMID:26419293

  17. Caregiving burden and psychological distress among spouses of bipolar patients – comparative analysis of subtype I and II

    Directory of Open Access Journals (Sweden)

    Aleksandra Izabela Arciszewska

    2015-12-01

    The specific types of bipolar disorder (I and II have the different impact on partners, which affects their subjective and objective burden and relationship with patients, indicating a real need to offer them an adequate help, depending on subtype of patient’s bipolar disorder, as well as the spouse sex.

  18. 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...

  19. Loopy: The Political Ontology of Bipolar Disorder

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    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.

  20. The efficacy of Li in bipolar disorder

    Directory of Open Access Journals (Sweden)

    Lozano R

    2013-07-01

    Full Text Available R Lozano,1 R Marín,2 MJ Santacruz,2 I Freire,2 R Gomez21Department of Pharmacy, 2Department of Psychiatry, Hospital Real Nuestra Señora de Gracia, Zaragoza, SpainThe efficacy of lithium (Li for acute mania and as prophylaxis against recurrent episodes of mania in bipolar disorder has been well established, with the minimum effective Li serum concentration for acute mania in the range of 0.6–1.2 mEq/L, although lower maintenance concentrations can prove effective in some patients.1–5Thyroid disorders are also associated with alterations in mood, and patients with hypothyroidism may present with depression and cognitive dysfunction,6–8 while patients with hyperthyroidism may present with anxiety, depression, mood lability,7,9 and manic symptoms.10 However, considering that overt hyperthyroidism is uncommon in bipolar disorder, with a prevalence ≤2% across different studies,11,12 this has been largely attributed to lithium,13 with rates varying from 0 to 47% (average of about 10% among patients on long-term treatment with lithium.13–16

  1. 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

  2. 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.

  3. 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...

  4. 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

  5. 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...

  6. 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...

  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. Depressive Episode May Not Always Follow Mania in Bipolar Disorder

    Science.gov (United States)

    ... 5.7 million Americans have bipolar disorder, which causes cycles of mania (elevated or irritable mood) and depression. The new findings stem from an analysis of data from more than 34,000 American adults with bipolar disorder. "Although it has long been ...

  9. Risperidone Mono - Therapy as Prophylaxis in Bipolar Affective Disorders

    OpenAIRE

    Trivedi, Mohit; Pinto, Denzil; Safeekh, A.T.

    2004-01-01

    Risperidone has been found to be useful in the treatment of acute bipolar disorders. This is a case report where risperidone mono therapy has been found to be effective in prophylaxis of bipolar affective disorder. The pharmacological and clinical implications of risperidone in the management of BPAD are discussed

  10. Pharmacological Management of Bipolar Disorder in a Youth with Diabetes

    Science.gov (United States)

    DelBello, Melissa P.; Correll, Christoph U.; Carlson, Gabrielle A.; Carlson, Harold E.; Kratochvil, Christopher J.

    2007-01-01

    In this article, four clinicians respond to the following case vignette: A 12-year-old girl with insulin-dependent diabetes presents for treatment of her newly diagnosed bipolar disorder. How would you address the bipolar disorder pharmacologically, and how would the presence of diabetes affect your selection of medication and clinical management?

  11. Commentary: Treatment Guidelines for Child and Adolescent Bipolar Disorder

    Science.gov (United States)

    McClellan, Jon

    2005-01-01

    Once considered rare in children, pediatric bipolar disorder is now widely diagnosed in the United States. The illness has become a cultural phenomenon, adorning the cover of Time magazine and headlining national news broadcasts. Kowatch and colleagues, in compiling consensus recommendations for bipolar disorder in children and adolescents, have…

  12. 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,…

  13. 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

  14. 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

  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. Caregiving burden and psychological distress among spouses of bipolar patients – comparative analysis of subtype I and II

    OpenAIRE

    Aleksandra Izabela Arciszewska; Marcin Siwek; Dominika Dudek

    2015-01-01

    Objectives To assess the level of caregiving burden and psychological distress among spouses of bipolar disorder – BD (type I and II) patients. Methods 77 subjects (41 women and 36 men) were enrolled in the study – 44 spouses of bipolar I (BD I) patients and 33 spouses of bipolar II (BD II). The whole group was divided into 4 subgroups: (I) the wives of BD I patients: n=27, (II) the husbands of BD I patients: n=17, (III) the wives of BD II patients: n=14, (IV) the husbands of BD II ...

  17. Prevalence, clinical correlates and factors associated with course and outcome of anxiety disorders in youth with bipolar disorders

    OpenAIRE

    Sala Cassola, Regina

    2011-01-01

    [eng] OBJECTIVE: Anxiety disorders are among the most common comorbid conditions in youth with bipolar disorder (BP). We aimed to examine the prevalence, correlates, persistence (>50% of the follow-up time), and the onset of new anxiety disorders in youth with comorbid anxiety disorders and BP. METHODS: As part of the Course and Outcome of Bipolar Youth study (COBY), 446 youth ages 7 to 17, who met DSM-IV criteria for BP-I (n=260), BP-II (n=32) or operationalized criteria for BP not othe...

  18. International Society for Bipolar Disorders Task Force on Suicide

    DEFF Research Database (Denmark)

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

    2015-01-01

    suicide deaths in bipolar disorder. These findings do not address causation, and the heterogeneity of data sources should limit the direct clinical ranking of correlates. Our results nonetheless support the notion of incorporating diagnosis-specific data in the development of models of understanding......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...

  19. 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...... vulnerability pathways. This review therefore evaluated the evidence for whether gene expression in bipolar disorder is state or trait related. Methods:  A systematic review, using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guideline for reporting systematic reviews, based...... 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...

  20. 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

  1. Bipolar Bozukluk Tip I ile Tip II'nin Depresyon Atakları Arasındaki Farklılıklar

    OpenAIRE

    Leman Inanc; Sermin Kesebir; Gonul Yildirim

    2013-01-01

    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 po...

  2. [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

  3. Quality of Life in Bipolar Type I Disorder in a One-Year Followup

    OpenAIRE

    Amini, Homayoun; Sharifi, Vandad

    2012-01-01

    Objectives. The aims of this study were (i) to compare Quality of Life (QOL) of patients with bipolar disorder (BD) type I to those with schizophrenia during a one-year period after hospitalization and (ii) to assess the association of different domains of QOL with severity of clinical symptoms and level of functioning in bipolar patients group. Method. A hundred and two participants were consecutively recruited before discharge from an acute hospitalization. To measure QOL as the main outcom...

  4. 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.

  5. 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...

  6. 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...

  7. 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.

  8. 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.

  9. 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.

  10. The expanding pharmacopoeia for bipolar disorder.

    Science.gov (United States)

    Mitchell, Philip B; Malhi, Gin S

    2002-01-01

    Over the past decade, the number of treatments available for bipolar disorder has undergone an extraordinary expansion. In that period, valproate and olanzapine have received regulatory approval in the United States for the acute treatment of mania, and carbamazepine has been indicated for this condition in many other countries. In addition to those agents, a number of other anticonvulsants (in particular lamotrigine, gabapentin, and topiramate) are in trials, as are the atypical antipsychotics clozapine and risperidone, and other novel compounds. This article critically reviews the evidence from controlled trials of these proposed "mood stabilizers," highlighting the strengths and limitations of the data for each compound. A major challenge to the field is the capacity to prove the prophylactic properties of agents for which effectiveness in acute mania and/or bipolar depression has been demonstrated. Finally, as the mechanisms of agents such as lithium are now becoming apparent, and the possibility of understanding the molecular defects underpinning the condition is no longer highly fanciful, the prospect of targeted therapies is considered feasible by both academia and the pharmaceutical industry. PMID:11818469

  11. Studies of offspring of parents with bipolar disorder.

    Science.gov (United States)

    Chang, Kiki; Steiner, Hans; Ketter, Terence

    2003-11-15

    Children and adolescents who are the biological offspring of individuals with bipolar disorder (BD) (bipolar offspring) represent a population rich in potential for revealing important aspects in the development of BD. Multiple cross-sectional assessments of psychopathology in bipolar offspring have confirmed high incidences of BD, as well as mood and behavioral disorders, and other psychopathology in this population. Longitudinal studies of offspring have begun to shed light on precursors of BD development. Other assessments of bipolar offspring have included dimensional reports of psychiatric and psychosocial functioning, temperament assessments, and descriptions of family environments and parenting styles. Neurobiological studies in bipolar offspring are just beginning to yield findings that may be related to the underlying neuropathophysiology of BD. The future holds promise for longitudinal studies of bipolar offspring incorporating all of these facets, including genetic analyses, to further elucidate the factors involved in the evolution of BD. PMID:14601034

  12. 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

    schizophrenia (IRR 3.80, CI 2.33-5.80), schizophrenia spectrum disorder (IRR 2.34, CI 1.46-3.53), and bipolar disorder (IRR 4.22, CI 2.25-7.13). Risks were highest in the first year after diagnosis of the traumatic stress disorder and remained significantly elevated after more than 5 years. Mental illness in a......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...

  13. Current and Emerging Therapies for the Management of Bipolar Disorders

    OpenAIRE

    El-Mallakh, Rif S; Elmaadawi, Ahmed Z.; Yonglin Gao; Kavita Lohano; R. Jeannie Roberts

    2011-01-01

    Bipolar disorder is a complex condition to treat because agents that may be effective for a specific phase may not be effective for other phases, or may even worsen the overall course of the illness. Over the last decade there has been an increase in research activity in the treatment of bipolar illness. There are now several agents that are well established for the treatment of acute mania (lithium, divalproex, carbamazepine, nearly all antipsychotics), acute bipolar depression (lamotrigine,...

  14. Creativity and Bipolar Disorder: Igniting a Dialogue.

    Science.gov (United States)

    Johnson, Sheri L; Moezpoor, Michelle; Murray, Greg; Hole, Rachelle; Barnes, Steven J; Michalak, Erin E

    2016-01-01

    Bipolar disorder (BD) has been related to heightened creativity, yet core questions remain unaddressed about this association. We used qualitative methods to investigate how highly creative individuals with BD understand the role of symptoms and treatment in their creativity, and possible mechanisms underpinning this link. Twenty-two individuals self-identified as highly creative and living with BD took part in focus groups and completed quantitative measures of symptoms, quality of life (QoL), and creativity. Using thematic analysis, five themes emerged: the pros and cons of mania for creativity, benefits of altered thinking, the relationship between creativity and medication, creativity as central to one's identity, and creativity's importance in stigma reduction and treatment. Despite reliance on a small sample who self-identified as having BD, findings shed light on previously mixed results regarding the influence of mania and treatment and suggest new directions for the study of mechanisms driving the creative advantage in BD. PMID:25814521

  15. 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...

  16. 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...

  17. 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...

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

    OpenAIRE

    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 artifi...

  19. Adolescent with Tourette Syndrome and Bipolar Disorder: A Case Report

    OpenAIRE

    Shim, Se-Hoon; Kwon, Young-Joon

    2014-01-01

    Tourette syndrome consists of multiple motor tics and one or more vocal tics. Psychopathology occurs in approximately 90% of Tourette syndrome patients, with attention-deficit/hyperactivity, mood, and obsessive-compulsive disorders being common. Additionally, Tourette syndrome and bipolar disorder may be related in some individuals. However, it is unclear why bipolar disorder may be overrepresented in Tourette syndrome patients, and more research is needed. Herein, we report the case of a 15-...

  20. 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

  1. 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

  2. Early Intervention for Symptomatic Youth at Risk for Bipolar Disorder: A Randomized Trial of Family-Focused Therapy

    Science.gov (United States)

    Miklowitz, David J.; Schneck, Christopher D.; Singh, Manpreet K.; Taylor, Dawn O.; George, Elizabeth L.; Cosgrove, Victoria E.; Howe, Meghan E.; Dickinson, L. Miriam; Garber, Judy; Chang, Kiki D.

    2013-01-01

    Objective: Depression and brief periods of (hypo)mania are linked to an increased risk of progression to bipolar I or II disorder (BD) in children of bipolar parents. This randomized trial examined the effects of a 4-month family-focused therapy (FFT) program on the 1-year course of mood symptoms in youth at high familial risk for BD, and explored…

  3. Neurocognition as a stable endophenotype in bipolar disorder and schizophrenia.

    Science.gov (United States)

    Burdick, Katherine E; Goldberg, Joseph F; Harrow, Martin; Faull, Robert N; Malhotra, Anil K

    2006-04-01

    Linkage and association studies have paid increasing attention to neurocognition as a putative endophenotype. However, there exists little documentation of its trait stability in schizophrenia or bipolar disorder. Our aim was to determine the longitudinal stability of neurocognitive performance in bipolar versus schizophrenia probands. We administered a neurocognitive battery at two time points, approximately 5 years apart, in 16 schizophrenia and 16 bipolar disorder age-matched subjects. There were no significant changes over time on variables including education, estimated IQ, depression, psychosis, global functioning, or medication status. Schizophrenia subjects showed significant deterioration in one measure of executive functioning but no significant changes in seven of eight other domains. Bipolar patients showed stability over time in attentional measures but greater variability in other domains. These preliminary findings suggest that neurocognitive domains appear longitudinally stable across broad domains in schizophrenia. In contrast, stable functioning may be more limited to attentional domains in bipolar disorder. PMID:16614546

  4. CSF neuroinflammatory biomarkers in bipolar disorder are associated with cognitive impairment.

    Science.gov (United States)

    Rolstad, Sindre; Jakobsson, Joel; Sellgren, Carl; Isgren, Anniella; Ekman, Carl Johan; Bjerke, Maria; Blennow, Kaj; Zetterberg, Henrik; Pålsson, Erik; Landén, Mikael

    2015-08-01

    Persistent cognitive impairment in the euthymic state of bipolar disorder is increasingly recognized. Mounting evidence also suggests an association between neuroinflammation and cognitive dysfunction. The purpose of this study was to test if cerebrospinal fluid (CSF) markers of neuroinflammation could account for cognitive impairment in bipolar disorder. Hierarchical linear regression models were applied to account for performance in five cognitive domains using CSF neuroinflammatory biomarkers as predictors in patients with bipolar disorder type I and II (N=78). The associations between these biomarkers and cognition were further tested in healthy age- and sex-matched controls (N=86). In patients with bipolar disorder, the CSF biomarkers accounted for a significant proportion of the variance in executive functions (42.8%, p=bipolar subtype. The microglial marker YKL-40 had a high impact (beta=-.99), and was the only biomarker that contributed individually. CSF biomarkers were not associated with cognitive performance in healthy controls. The CSF neuroinflammation biomarker YKL-40 is associated with executive performance in euthymic bipolar disorder, but not in healthy controls. PMID:26024928

  5. 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...

  6. 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...

  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. 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

  10. Mechanisms underlying the benefits of anticonvulsants over lithium in the treatment of bipolar disorder.

    Science.gov (United States)

    Corrado, Alisa C; Walsh, John P

    2016-02-10

    Close to 3% of the world's population suffers from bipolar disease (I and II). Of this 3%, bipolar disease affects largely women (∼ 3 : 2 compared with men). The median age of diagnosis is 25 in women and even lower in men. A diagnosis of bipolar disease is an expensive psychiatric diagnosis, costing patients more than twice as much money as a diagnosis of unipolar depression. Bipolar I is characterized by one or more manic or mixed episodes, with both mania and depression occurring each day for at least 1 week, whereas bipolar II is characterized by one or more major depressive episode and at least one episode of hypomania. Bipolar I is the more severe diagnosis. A wide range of medications are available to help patients maintain a healthy lifestyle, including lithium, antidepressants, and anticonvulsants. Improved methods for identifying bipolar disease, including a more structured approach and a more complete use of medical records, have increased the rate of diagnosis, especially in children, which underscores the need for innovation in development and in practice of new treatment options for treating bipolar disease. Although lithium has been the 'gold standard' for treating bipolar disorder for decades, new research into other forms of treatment has shown anticonvulsants to be a particularly useful therapy for treating bipolar disease. Anticonvulsants have remarkable mood-stabilization abilities and they do not lead to serious side effects, which increases the tolerability, and consequently, patient adherence to this form of treatment. Recent studies have shown that anticonvulsants improve behavior in bipolar disease by modulating the balance of excitatory and inhibitory synapses through a number of complementary molecular cascades that affect gene expression and cell survival. PMID:26702549

  11. New perspectives on coping in bipolar disorder

    Directory of Open Access Journals (Sweden)

    Rodrigo Grassi-Oliveira

    2010-01-01

    Full Text Available Bipolar disorder (BD is a prevalent and highly disabling psychiatric condition. Despite the widely acknowledged importance of psychosocial interventions that involve a complex cognitive, behavioral, and biological process to help patients cope better with their illness, few studies have systematically evaluated coping in BD. Therefore, our objective was to examine recent developments in current research on coping in BD. Several studies have documented a strong association between BD and numerous neuroanatomical and neuropsychological abnormalities, particularly multiple episodes and longer durations of the disorder. The most marked effects of BD encompass brain areas involved in executive function, which may affect the mechanisms underlying an adequate selection of coping strategies. Thus, the ability of individuals to reduce their own stress burden is impaired, increasing vulnerability to stressful life events and negatively affecting the course of BD. Psychosocial interventions that focus on BD should be evaluated for their ability to improve coping abilities, and research on BD should consider neuropsychological impairment and cognitive-behavioral strategies for coping with stress.

  12. Thought Suppression in Patients With Bipolar Disorder

    Science.gov (United States)

    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/goal-oriented) way. Participants completed the sentences under conditions of cognitive load (rehearsing a 6-digit number), reward (a bell tone), load and reward, or neither load nor reward. We hypothesized that patients with BD would engage in more active suppression of negative and hyperpositive thoughts than would controls, as revealed by their unscrambling more word strings into negative or hyperpositive sentences. Under conditions of load or reward and in the absence of either load or reward, patients with BD unscrambled more negative sentences than did controls. Under conditions of reward, patients with BD unscrambled more negative sentences than did patients with MDD. Patients with BD also reported more use of negative thought suppression than did controls. These group differences in negative biases were no longer significant when current mood states were controlled. Finally, the groups did not differ in the proportion of hyperpositive sentence completions in any condition. Thought suppression may provide a critical locus for psychological interventions in BD. PMID:20455608

  13. 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....

  14. 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....

  15. Voice analysis as an objective state marker in bipolar disorder

    DEFF Research Database (Denmark)

    Faurholt-Jepsen, M.; Busk, Jonas; Frost, M.;

    2016-01-01

    Changes in speech have been suggested as sensitive and valid measures of depression and mania in bipolar disorder. The present study aimed at investigating (1) voice features collected during phone calls as objective markers of affective states in bipolar disorder and (2) if combining 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...... activities and electronic self-monitored data increased the accuracy, sensitivity and specificity of classification of affective states slightly. Voice features collected in naturalistic settings using smartphones may be used as objective state markers in patients with bipolar disorder....

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

    Directory of Open Access Journals (Sweden)

    Łojko,Dorota

    2014-04-01

    Full Text Available 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 popular all over the world, including countries where the ICD-10 classification is obligatory, and are widely used for clinical and neurobiological research in psychiatry. In this article, two chapters of the DSM-5 pertained to mood (affective disorders are presented, such as “Bipolar and related disorders” and “Depressive disorders” replacing the chapter titled “Mood disorders” in the previous version of DSM-IV. The aim of this article is to discuss a structure of new classification, to point out differences compared with previous version (DSM-IV. New diagnostic categories, such as e.g. disruptive mood dysregulation disorder or premenstrual dysphoric disorder were depicted as well as some elements of dimensional approach to mood disorders were presented.

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

    Institute of Scientific and Technical Information of China (English)

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

    2013-01-01

    OBJECTIVE: To examine the efficacy and safety of short-term and long-term use of antidepres-sants in the treatment of bipolar disorder. DATA SOURCES:A literature search of randomized, double-blind, control ed trials published until December 2012 was performed using the PubMed, ISI Web of Science, Medline and Cochrane Central Register of Control ed Trials databases. The keywords“bipolar disorder, bipolar I disorder, bipolar II disorder, bipolar mania, bipolar depression, cyclothymia, mixed mania and depression, rapid cycling and bipolar disorder”, AND “antidepressant agent, antidepressive agents second-generation, antidepressive agents tricyclic, monoamine oxidase inhibitor, noradrenaline uptake in-hibitor, serotonin uptake inhibitor, and tricyclic antidepressant agent” were used. The studies that were listed in the reference list of the published papers but were not retrieved in the above-mentioned databases were supplemented. STUDY SELECTION: Studies selected were double-blind randomized control ed trials assessing the efficacy and safety of antidepressants in patients with bipolar disorder. Al participants were aged 18 years or older, and were diagnosed as having primary bipolar disorder. Antidepressants or antidepressants combined with mood stabilizers were used in experimental interventions. Placebos, mood stabilizers, antipsychotics and other antide pressants were used in the control interventions. Studies that were quasi-randomized studies, or used antidepressants in combination with antipsy-chotics in the experimental group were excluded. Al analyses were conducted using Review Man-ager 5.1 provided by the Cochrane Col aboration. MAIN OUTCOME MEASURES:The primary outcome was the response and switching to mania. The secondary outcomes included remission, discontinuation rate, and suicidality. RESULTS: Among 5 001 treatment studies published, 14 double-blind randomized control ed trials involving 1 244 patients were included in the meta

  18. 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,...

  19. Carbamazepine extended-release capsules in bipolar disorder

    OpenAIRE

    Weisler, Richard H

    2006-01-01

    Carbamazepine (CBZ) has long been a therapeutic option for bipolar disorder. Carbamazepine extended-release capsules (CBZ-ERC) are a recent formulation of CBZ approved by the US Food and Drug Administration in 2004 for the treatment of acute manic and mixed episodes associated with bipolar I disorder. This new formulation was developed to improve dosing convenience and decrease daily fluctuations in serum CBZ concentration, thereby lowering the incidence of adverse events. Two randomized, dou...

  20. 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...

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

    OpenAIRE

    Tatiana Lauxen Peruzzolo; Silzá Tramontina; Luis Augusto Rohde; Cristian Patrick Zeni

    2013-01-01

    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 ...

  2. 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...

  3. 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....

  4. 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...

  5. Seasonal variation of metabolic syndrome prevalence in bipolar disorder

    OpenAIRE

    Altınbaş, Kürşat; Darçın, Aslı Enez; Gülöksüz, Sinan; Oral, Timuçin Esat

    2012-01-01

    Objective: Metabolic disturbances and diagnosis of metabolic syndrome are more prevalent in bipolar disorder patients than general population. The underlying biological pathway regarding this high rate of metabolic syndrome compared to general population in bipolar disorder is still unknown. The side effects of second generation antipsychotics causing weight gain and insulin resistance are considered as one of the main factors. However, this knowledge is not sufficient to understand the assoc...

  6. Análisis comparativo de costos directos y funcionamiento global en personas afectadas por trastorno bipolar I y II, en tratamiento ambulatorio Comparative Analysis for Direct Costs and Global Functions in Persons Affected By Bipolar Disorders I and II in Outpatient Treatment

    OpenAIRE

    Ana Igoa; Diego Martino; Clara Khan; Patricia Scchiavo; eliana Marengo; Sergio Strejilevich

    2011-01-01

    Objetivo: Evaluar los costos directos, el nivel de funcionamiento y la tasa de empleo reportada en una muestra aleatoria de personas con trastorno bipolar (TB) I y II que se atienden en forma ambulatoria. Métodos: Se analizaron y compararon los costos directos de los tratamientos ambulatorios de 165 pacientes con diagnóstico de trastorno bipolar tipo I y II (el costo mensual del tratamiento farmacológico, el número de consultas mensuales, el número de internaciones y días de internación). Se ...

  7. 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...

  8. Family Functioning, Social Impairment, and Symptoms Among Adolescents with Bipolar Disorder

    Science.gov (United States)

    Keenan-Miller, Danielle; Peris, Tara; Axelson, David; Kowatch, Robert A.; Miklowitz, David J.

    2012-01-01

    Objective: Impaired social functioning is common among youth with bipolar disorder (BD), emerges in multiple settings, and persists over time. However, little is known about factors associated with poor peer and family functioning in the early-onset form of BD. Using a sample of adolescents with BD I or II, we examined which symptoms of BD,…

  9. 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…

  10. Bipolar Disorder Comorbid With Attention-Deficit/Hyperactivity Disorder in Adult Inpatients With Acute Relapse

    OpenAIRE

    Marin, Alina; Scott, Duncan; Groll, Dianne L

    2013-01-01

    Objective: The aim of this prospective, observational study was to detect the rate of comorbid attention-deficit/hyperactivity disorder (ADHD) in a sample of inpatients diagnosed with bipolar disorder, and to identify differences between patients with bipolar disorder with concomitant ADHD and those without concomitant ADHD.

  11. 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.

  12. 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.

  13. 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

  14. 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 ...

  15. Prevalence of bipolar disorder in children and adolescents with attention-deficit hyperactivity disorder†

    OpenAIRE

    Hassan, Amani; Agha, Sharifah Shameem; Langley, Kate; Thapar, Anita

    2011-01-01

    Background Some research suggests that children with attention-deficit hyperactivity disorder (ADHD) have a higher than expected risk of bipolar affective disorder. No study has examined the prevalence of bipolar disorder in a UK sample of children with ADHD. Aims To examine the prevalence of bipolar disorder in children diagnosed with ADHD or hyperkinetic disorder. Method Psychopathology symptoms and diagnoses of bipolar disorder were assessed in 200 young people with ADHD (170 male, 30 fema...

  16. Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) collaborative update of CANMAT guidelines for the management of patients with bipolar disorder: update 2009.

    Science.gov (United States)

    Yatham, Lakshmi N; Kennedy, Sidney H; Schaffer, Ayal; Parikh, Sagar V; Beaulieu, Serge; O'Donovan, Claire; MacQueen, Glenda; McIntyre, Roger S; Sharma, Verinder; Ravindran, Arun; Young, L Trevor; Young, Allan H; Alda, Martin; Milev, Roumen; Vieta, Eduard; Calabrese, Joseph R; Berk, Michael; Ha, Kyooseob; Kapczinski, Flávio

    2009-05-01

    The Canadian Network for Mood and Anxiety Treatments (CANMAT) published guidelines for the management of bipolar disorder in 2005, with a 2007 update. This second update, in conjunction with the International Society for Bipolar Disorders (ISBD), reviews new evidence and is designed to be used in conjunction with the previous publications. The recommendations for the management of acute mania remain mostly unchanged. Lithium, valproate, and several atypical antipsychotics continue to be first-line treatments for acute mania. Tamoxifen is now suggested as a third-line augmentation option. The combination of olanzapine and carbamazepine is not recommended. For the management of bipolar depression, lithium, lamotrigine, and quetiapine monotherapy, olanzapine plus selective serotonin reuptake inhibitor (SSRI), and lithium or divalproex plus SSRI/bupropion remain first-line options. New data support the use of adjunctive modafinil as a second-line option, but also indicate that aripiprazole should not be used as monotherapy for bipolar depression. Lithium, lamotrigine, valproate, and olanzapine continue to be first-line options for maintenance treatment of bipolar disorder. New data support the use of quetiapine monotherapy and adjunctive therapy for the prevention of manic and depressive events, aripiprazole monotherapy for the prevention of manic events, and risperidone long-acting injection monotherapy and adjunctive therapy, and adjunctive ziprasidone for the prevention of mood events. Bipolar II disorder is frequently overlooked in treatment guidelines, but has an important clinical impact on patients' lives. This update provides an expanded look at bipolar II disorder. PMID:19419382

  17. Early-onset bipolar disorder: how about visual-spatial skills and executive functions?

    Science.gov (United States)

    Lera-Miguel, Sara; Andrés-Perpiñá, Susana; Calvo, Rosa; Fatjó-Vilas, Mar; Fañanás, Lourdes; Lourdes, Fañanás; Lázaro, Luisa

    2011-04-01

    Early-onset bipolar disorder is an impairing condition that is strongly associated with genetic inheritance. Neurocognitive deficits are core traits of this disorder which seem to be present in both young and adult forms. Deficits in verbal memory and attention are persistent within euthymic phases in bipolar adults, adolescents, and children. In younger samples, including type I or II and not otherwise specified patients, executive functions are not widely impaired and the existence of visual-spatial deficits remains unclear. The main aim of this study was to compare the neurocognitive performance in young stabilized type I or II bipolar patients and healthy controls. Fifteen medicated adolescents with bipolar disorder and 15 healthy adolescents, matched in age and gender, were compared on visual-spatial skills (reasoning, memory, visual-motor accuracy) and executive functioning (attention and working memory, set-shifting, inhibition) using t-tests and MANCOVA. Correcting for verbal competence, MANCOVA showed that patients performed significantly worse than controls in letters and numbers sequencing (P = 0.003), copy (P Test, interference of the Stroop Color-Word Test (P = 0.007) and non-perseverative errors on the Wisconsin Card Sorting Test (P = 0.038). Impaired cognitive performance was found in young bipolar patients in working memory, visual-motor skills, and inhibitory control. PMID:21086134

  18. 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

  19. 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

  20. 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

  1. 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

  2. The Relationship between Impulsivity and Quality of Life in Euthymic Patients with Bipolar Disorder

    OpenAIRE

    Kim, Yoon-Seok; Cha, Boseok; Lee, Dongyun; Kim, Sun-Mi; Moon, Eunsoo; Park, Chul-Soo; Kim, Bong-Jo; Lee, Cheol-Soon; Lee, Sojin

    2013-01-01

    Objective Bipolar disorder (BD) is characterized by elevated impulsivity, even during periods of remission. Many recovered BD patients have functional impairments, which can lead to poor quality of life (QoL). The aim of this study was to investigate the association between impulsivity and QoL in euthymic BD patients. Methods A total of 56 remitted or recovered patients with type I or II BD, diagnosed based on Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) crit...

  3. 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.

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

    Directory of Open Access Journals (Sweden)

    Rafael de Assis da Silva

    2013-01-01

    Full Text Available 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 illness (CGI-BP, the Positive and Negative Syndrome Scale (PANSS, and the Global Assessment of Functioning (GAF. In addition, participants completed a self-report visual analog mood scale (VAMS. Patients were divided into three groups (euthymia, mania, and depression and compared with regard to VAMS results. RESULTS: Manic patients rated their mood similarly to patients in euthymia in 14 out of 16 items in the VAMS. By contrast, depressed patients rated only two items similarly to euthymic patients. CONCLUSION: Patients with bipolar disorder in mania, but not those in depression, poorly evaluate their affective state, reinforcing the occurrence of insight impairment in the manic syndrome.

  5. 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

  6. Pharmacological Treatment of Bipolar Disorder among Children and Adolescents

    OpenAIRE

    Blader, Joseph C.; Kafantaris, Vivian

    2007-01-01

    There is growing recognition that bipolar disorder (BD) frequently first presents in adolescence. Preadolescents with volatile behavior and severe mood swings also comprise a large group of patients whose difficulties may lie within the bipolar spectrum. However, the preponderance of scientific effort and clinical trials for this condition have focused on adults. This review summarizes the BD's complexity and diagnosis among young people. It proceeds to review the principles of pharmacotherap...

  7. 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...

  8. 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

  9. 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

  10. 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…

  11. 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...

  12. 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

  13. 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

  14. Genetic studies of bipolar affective disorder in large families.

    Science.gov (United States)

    Blackwood, D H; Visscher, P M; Muir, W J

    2001-06-01

    Background Genetic factors are known to be important in the aetiology of bipolar disorder. Aims To review linkage studies in extended families multiply affected with bipolar disorder. Method Selective review of linkage studies of bipolar disorder emphasising the gains and drawbacks of studying large multiply-affected families and comparing the statistical methods used for data analysis. Results Linkage of bipolar disorder to several chromosome regions including 4p, 4q, 10p, 12q, 16p, 18q, 21q and Xq has first been reported in extended families. In other families chromosomal rearrangements associated with affective illnesses provide signposts to the location of disease-related genes. Statistical analyses using variance component methods can be applied to extended families, require no prior knowledge of the disease inheritance, and can test multilocus models. Conclusion Studying single large pedigrees combined with variance component analysis is an efficient and effective strategy likely to lead to further insights into the genetic basis of bipolar disorders. PMID:11388952

  15. 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.

  16. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  18. A Comparative Study of Affective Bipolar Disorder with Schizoaffective Disorder from a Longitudinal Perspective

    Directory of Open Access Journals (Sweden)

    Miruna Milin

    2013-08-01

    Full Text Available Introduction: In the last years there is a great interest for the theory of the “psychotic continuum”, which accepts that there is a transition between schizophrenia and affective pathology, including bipolar disorder with psychotic interferences and the recently introduced diagnosis of schizoaffective disorder. There are few studies that analyze bipolar disorder with mood-incongruent psychosis. The purpose of this study was to observe the way in which the interference of mood-incongruent psychotic symptoms can influence the long term evolution of patients diagnosed with bipolar disorder and the similarities that exists between this type of pathology and schizoaffective disorder. Material and methods: Sixty subjects were selected, who are now diagnosed with schizoaffective disorder and bipolar disorder, with and without psychotic features. All cases have at least 15 years of evolution since the first episode of psychosis and were analyzed in term of their age of onset and longitudinal evolution. Results: The results showed that bipolar patients who had mood incongruent psychotic symptoms had an earlier age of onset and a higher rate of hospitalizations in their long term evolution compared to bipolar patients without psychotic features, which brings them closer to patients with schizoaffective disorder in term of their pattern of evolution. Conclusions: This study has demonstrated that the interference of mood-incongruent psychosis with bipolar disorder determines a worse prognosis of this disease, very similar with the evolution of patients with schizoaffective disorder

  19. 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

  20. Electrophysiological evidence of a typical cognitive distortion in bipolar disorder.

    Science.gov (United States)

    Kopf, Juliane; Volkert, Julia; Heidler, Sarah; Dresler, Thomas; Kittel-Schneider, Sarah; Gessner, Alexandra; Herrmann, Martin J; Ehlis, Ann-Christine; Reif, Andreas

    2015-05-01

    Patients suffering from bipolar disorder often report negative thoughts and a bias towards negative environmental stimuli. Previous studies show that this mood-congruent attentional bias could mediated by dysfunctions in anterior limbic regions. The Error-Related Negativity (ERN), which originates in the anterior cingulate cortex (ACC), has been used to research this negativity bias in depressed patients, and could also help to better understand the underlying mechanisms causing the negativity bias in bipolar patients. In this study we investigated error processing in patients with bipolar disorder. Acute depressive bipolar patients (n = 20) and age-matched healthy controls (n = 20) underwent a modified Eriksen Flanker Task to assess test performance and two error-related event-related potentials (ERPs), i.e., the ERN and Error Positivity (Pe) were measured by EEG. Half of the patients were measured again in a euthymic state. We found similar ERN amplitudes in bipolar patients as compared to healthy controls, but significantly reduced Pe amplitudes. Moreover, acutely depressed bipolar patients displayed an ERN and Pe even if they responded accurately or too slow, which indicates that correct responses are processed in a way similar to wrong responses. This can be interpreted as a psychophysiological correlate of typical cognitive distortions in depression, i.e., an erroneous perception of personal failures. This biased error perception partially remained when patients were in a euthymic state. Together, our data indicate that aberrant error processing of bipolar patients may be regarded a trait marker possibly reflecting a risk factor for depressive relapses in bipolar disorder. PMID:25824981

  1. 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 ...

  2. 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...

  3. Metabolic syndrome - the consequence of lifelong treatment of bipolar affective disorder.

    Science.gov (United States)

    Dadić-Hero, Elizabeta; Ruzić, Klementina; Grahovac, Tanja; Petranović, Duska; Graovac, Mirjana; Palijan, Tija Zarković

    2010-06-01

    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 cardiovascular disease. A 61-year old female patient has been receiving continuous and systematic psychiatric treatment for Bipolar Affective Disorder for the last 39 years. The first episode was a depressive one and it occurred after a child delivery. Seventeen years ago the patient developed diabetes (diabetes type II), and twelve years ago arterial hypertension was diagnosed. High cholesterol and triglyceride levels as well as weight gain were objective findings. During the last nine years she has been treated for lower leg ulcer. Since metabolic syndrome includes abdominal obesity, hypertension, diabetes mellitus, increased cholesterol and serum triglyceride levels, the aforesaid patient can be diagnosed with Metabolic Syndrome. When treating Bipolar Affective Disorder, the antipsychotic drug choice should be careful and aware of its side-effects in order to avoid the development or aggravation of metabolic syndrome. PMID:20562789

  4. Neuroleptic-induced deficit syndrome in bipolar disorder with psychosis.

    Science.gov (United States)

    Ueda, Satoshi; Sakayori, Takeshi; Omori, Ataru; Fukuta, Hajime; Kobayashi, Takashi; Ishizaka, Kousuke; Saijo, Tomoyuki; Okubo, Yoshiro

    2016-01-01

    Neuroleptics can induce not only physical adverse effects but also mental effects that produce deficit status in thought, affect, cognition, and behavior. This condition is known as neuroleptic-induced deficit syndrome (NIDS), which includes apathy, lack of initiative, anhedonia, indifference, blunted affect, and reduced insight into disease. Although this old concept now appears almost forgotten, neuroleptics, whether typical or atypical, can make depression or bipolar disorder resemble other more refractory conditions, readily leading to mistaken diagnosis and inappropriate treatment. The authors describe three cases of NIDS superimposed on depressive phase in bipolar disorder with psychosis, where the attending psychiatrist's failure to recognize NIDS prevented patients from receiving effective treatment and achieving remission. All cases achieved remission after reduction of neuroleptics and intensive therapy, including electroconvulsive therapy, for bipolar depression. The concept of NIDS was originally introduced for schizophrenia, and it has rarely been highlighted in other diseases. In recent years, however, atypical antipsychotics are being more often administered to patients with bipolar disorder. Psychiatrists, therefore, should also remember and exercise caution regarding NIDS in the pharmacotherapy of bipolar disorder with and without psychosis. The authors believe that the concept of NIDS needs to be reappraised in current psychiatry. PMID:26893564

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

    DEFF Research Database (Denmark)

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

    2014-01-01

    estrogen levels and women with bipolar disorder including studies of the anti manic effects of the selective estrogen receptor modulator tamoxifen. METHOD: A systematically literature search on PubMed was conducted: two studies regarding the connection between serum estrogen levels and women with bipolar...... hormones, e.g. estrogen, are fluctuating and particularly postpartum there is a steep fall in the levels of serum estrogen. The role of estrogen in women with bipolar disorder is, however, not fully understood. AIM: The main objective of this review is to evaluate the possible relation between serum...... disorder were identified. Furthermore, four studies were found concerning the antimanic effects of tamoxifen. RESULTS: Both studies in the estrogen studies showed very low levels of estrogen in women with postpartum psychosis and significant improvement of symptoms after treatment with estrogen. The four...

  6. Combinations of SNPs related to signal transduction in bipolar disorder

    DEFF Research Database (Denmark)

    Koefoed, Pernille; Andreassen, Ole A; Bennike, Bente;

    2011-01-01

    Any given single nucleotide polymorphism (SNP) in a genome may have little or no functional impact. A biologically significant effect may possibly emerge only when a number of key SNP-related genotypes occur together in a single organism. Thus, in analysis of many SNPs in association studies of...... complex diseases, it may be useful to look at combinations of genotypes. Genes related to signal transmission, e.g., ion channel genes, may be of interest in this respect in the context of bipolar disorder. In the present study, we analysed 803 SNPs in 55 genes related to aspects of signal transmission...... and calculated all combinations of three genotypes from the 3×803 SNP genotypes for 1355 controls and 607 patients with bipolar disorder. Four clusters of patient-specific combinations were identified. Permutation tests indicated that some of these combinations might be related to bipolar disorder...

  7. 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...

  8. 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 and......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...

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

    DEFF Research Database (Denmark)

    Jönsson, Erik G; Larsson, Kristina; Vares, Maria; Hansen, Thomas; Wang, August G; Djurovic, Srdjan; Rønningen, Kjersti S; Andreassen, Ole A; Agartz, Ingrid; Werge, Thomas; Terenius, Lars; Hall, Håkan

    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 and......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...

  10. 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

  11. 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.

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

    Directory of Open Access Journals (Sweden)

    ArgelindaBaroni

    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.

  13. Antipsychotic Medicines for Schizophrenia and Bipolar Disorder: What You Should Know

    Science.gov (United States)

    ... these four as Consumer Reports Best Buy Drugs: Clozapine (generic) Olanzapine (Zyprexa) Perphenazine (generic) Risperidone (generic) For bipolar disorder: Lithium is the standard treat- ment for bipolar disorder. Carbamazepine and valproic acid are also widely used. An ...

  14. Memantine in the management of a clinically challenging case of bipolar disorder

    OpenAIRE

    Agarwal, Vivek; Tripathi, Adarsh

    2009-01-01

    Use of memantine in bipolar disorders is not been studied except one case report. We report a case in which use of memantine lead to better medication tolerance and improvement in symptoms in bipolar disorder.

  15. 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

  16. 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...

  17. A latent class analysis of parental bipolar disorder: Examining associations with offspring psychopathology.

    Science.gov (United States)

    Freed, Rachel D; Tompson, Martha C; Otto, Michael W; Nierenberg, Andrew A; Henin, Aude

    2015-12-15

    Bipolar disorder (BD) is highly heterogeneous, and course variations are associated with patient outcomes. This diagnostic complexity challenges identification of patients in greatest need of intervention. Additionally, course variations have implications for offspring risk. First, latent class analysis (LCA) categorized parents with BD based on salient illness characteristics: BD type, onset age, polarity of index episode, pole of majority of episodes, rapid cycling, psychosis, anxiety comorbidity, and substance dependence. Fit indices favored three parental classes with some substantively meaningful patterns. Two classes, labeled "Earlier-Onset Bipolar-I" (EO-I) and "Earlier-Onset Bipolar-II" (EO-II), comprised parents who had a mean onset age in mid-adolescence, with EO-I primarily BD-I parents and EO-II entirely BD-II parents. The third class, labeled "Later-Onset BD" (LO) had an average onset age in adulthood. Classes also varied on probability of anxiety comorbidity, substance dependence, psychosis, rapid cycling, and pole of majority of episodes. Second, we examined rates of disorders in offspring (ages 4-33, Mage=13.46) based on parental latent class membership. Differences emerged for offspring anxiety disorders only such that offspring of EO-I and EO-II parents had higher rates, compared to offspring of LO parents, particularly for daughters. Findings may enhance understanding of BD and its nosology. PMID:26394919

  18. Psychological therapy for anxiety in bipolar spectrum disorders: a systematic review.

    Science.gov (United States)

    Stratford, Hannah J; Cooper, Myra J; Di Simplicio, Martina; Blackwell, Simon E; Holmes, Emily A

    2015-02-01

    Comorbid anxiety is common in bipolar spectrum disorders [BPSD], and is associated with poor outcomes. Its clinical relevance is highlighted by the "anxious distress specifier" in the revised criteria for Bipolar Disorders in the Diagnostic and Statistical Manual 5th Edition [DSM-5]. This article reviews evidence for the effectiveness of psychological therapy for anxiety in adults with BPSD (bipolar I, II, not otherwise specified, cyclothymia, and rapid cycling disorders). A systematic search yielded 22 treatment studies that included an anxiety-related outcome measure. Cognitive behavioural therapy [CBT] for BPSD incorporating an anxiety component reduces anxiety symptoms in cyclothymia, "refractory" and rapid cycling BPSD, whereas standard bipolar treatments have only a modest effect on anxiety. Preliminary evidence is promising for CBT for post-traumatic stress disorder and generalised anxiety disorder in BPSD. Psychoeducation alone does not appear to reduce anxiety, and data for mindfulness-based cognitive therapy [MBCT] appear equivocal. CBT during euthymic phases has the greatest weight of evidence. Where reported, psychological therapy appears acceptable and safe, but more systematic collection and reporting of safety and acceptability information is needed. Development of psychological models and treatment protocols for anxiety in BPSD may help improve outcomes. PMID:25462111

  19. The manic phase of Bipolar disorder significantly impairs theory of mind decoding.

    Science.gov (United States)

    Hawken, Emily R; Harkness, Kate L; Lazowski, Lauren K; Summers, David; Khoja, Nida; Gregory, James Gardner; Milev, Roumen

    2016-05-30

    Bipolar disorder is associated with significant deficits in the decoding of others' mental states in comparison to healthy participants. However, differences in theory of mind decoding ability among patients in manic, depressed, and euthymic phases of bipolar disorder is currently unknown. Fifty-nine patients with bipolar I or II disorder (13 manic, 25 depressed, 20 euthymic) completed the "Reading the Mind in the Eyes" Task (Eyes task) and the Animals Task developed to control for non-mentalistic response demands of the Eyes Task. Patients also completed self-report and clinician-rated measures of depression, mania, and anxiety symptoms. Patients in the manic phase were significantly less accurate than those in the depressed and euthymic phases at decoding mental states in the Eyes task, and this effect was strongest for eyes of a positive or neutral valence. Further Eyes task performance was negatively correlated with the symptoms of language/thought disorder, pressured speech, and disorganized thoughts and appearance. These effects held when controlling for accuracy on the Animals task, response times, and relevant demographic and clinical covariates. Results suggest that the state of mania, and particularly psychotic symptoms that may overlap with the schizophrenia spectrum, are most strongly related to social cognitive deficits in bipolar disorder. PMID:27039012

  20. Genetics of Bipolar Disorder: Recent Update and Future Directions.

    Science.gov (United States)

    Goes, Fernando S

    2016-03-01

    Although genetic studies of Bipolar Disorder have been pursued for decades, it has only been in the last several years that clearly replicated findings have emerged. These findings, typically of modest effects, point to a polygenic genetic architecture consisting of multiple common and rare susceptibility variants. While larger genome-wide association studies are ongoing, the advent of whole exome and genome sequencing should lead to the identification of rare, and potentially more penetrant, variants. Progress along both fronts will provide novel insights into the biology of Bipolar Disorder and help usher in a new era of personalized medicine and improved treatments. PMID:26876324

  1. 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 for this...

  2. 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.

  3. 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.

  4. 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

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

    International Nuclear Information System (INIS)

    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.

  6. 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...

  7. 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

  8. 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...

  9. The Role of the Behavioral Approach System (BAS) in Bipolar Spectrum Disorders

    OpenAIRE

    Alloy, Lauren B.; Abramson, Lyn Y.

    2010-01-01

    Bipolar spectrum disorders are characterized by highs and lows of mood, energy, motivation, cognition, and activity. The behavioral approach system (BAS) dysregulation theory provides an integrated model for understanding psychosocial and biological features of bipolar disorders. The theory emphasizes the role that sensitivity to rewards and goals plays in bipolar disorder. We review theory and evidence for the BAS-dysregulation model of bipolar disorders. We consider whether high BAS sensiti...

  10. Neuroleptic-induced deficit syndrome in bipolar disorder with psychosis

    Directory of Open Access Journals (Sweden)

    Ueda S

    2016-02-01

    Full Text Available Satoshi Ueda,1 Takeshi Sakayori,1 Ataru Omori,2 Hajime Fukuta,3 Takashi Kobayashi,3 Kousuke Ishizaka,1 Tomoyuki Saijo,4 Yoshiro Okubo1 1Department of Neuropsychiatry, Nippon Medical School, Tokyo, Japan; 2Tamachuo Hospital, Tokyo, Japan; 3Kurumegaoka Hospital, Tokyo, Japan; 4Saijo Clinic, Tokyo, Japan Abstract: Neuroleptics can induce not only physical adverse effects but also mental effects that produce deficit status in thought, affect, cognition, and behavior. This condition is known as neuroleptic-induced deficit syndrome (NIDS, which includes apathy, lack of initiative, anhedonia, indifference, blunted affect, and reduced insight into disease. Although this old concept now appears almost forgotten, neuroleptics, whether typical or atypical, can make depression or bipolar disorder resemble other more refractory conditions, readily leading to mistaken diagnosis and inappropriate treatment. The authors describe three cases of NIDS superimposed on depressive phase in bipolar disorder with psychosis, where the attending psychiatrist’s failure to recognize NIDS prevented patients from receiving effective treatment and achieving remission. All cases achieved remission after reduction of neuroleptics and intensive therapy, including electroconvulsive therapy, for bipolar depression. The concept of NIDS was originally introduced for schizophrenia, and it has rarely been highlighted in other diseases. In recent years, however, atypical antipsychotics are being more often administered to patients with bipolar disorder. Psychiatrists, therefore, should also remember and exercise caution regarding NIDS in the pharmacotherapy of bipolar disorder with and without psychosis. The authors believe that the concept of NIDS needs to be reappraised in current psychiatry. Keywords: neuroleptic-induced deficit syndrome (NIDS, bipolar disorder, psychosis, atypical antipsychotics, electroconvulsive therapy

  11. A locus for bipolar affective disorder on chromosome 4p.

    Science.gov (United States)

    Blackwood, D H; He, L; Morris, S W; McLean, A; Whitton, C; Thomson, M; Walker, M T; Woodburn, K; Sharp, C M; Wright, A F; Shibasaki, Y; St Clair, D M; Porteous, D J; Muir, W J

    1996-04-01

    The main clinical feature of bipolar affective disorder is a change of mood to depression or elation. Unipolar disorder, also termed major depressive disorder, describes the occurrence of depression alone without episodes of elevated mood. Little is understood about the underlying causes of these common and severe illnesses which have estimated lifetime prevalences in the region of 0.8% for bipolar and 6% for unipolar disorder. Strong support for a genetic aetiology is found in the familial nature of the condition, the increased concordance of monozygotic over dizygotic twins and adoption studies showing increased rates of illness in children of affected parents. However, linkage studies have met with mixed success. An initial report of linkage on the short arm of chromosome 11 (ref. 4) was revised and remains unreplicated. Reports proposing cosegregation of genes found on the X chromosome with bipolar illness have not been supported by others. More recently bipolar disorder has been reported to be linked with markers on chromosomes 18, 21, 16 and a region on the X chromosome different from those previously suggested. We have carried out a linkage study in twelve bipolar families. In a single family a genome search employing 193 markers indicated linkage on chromosome 4p where the marker D4S394 generated a two-point lod score of 4.1 under a dominant model of inheritance. Three point analyses with neighbouring markers gave a maximum lod score of 4.8. Eleven other bipolar families were typed using D4S394 and in all families combined there was evidence of linkage with heterogeneity with a maximum two-point lod score of 4.1 (theta = 0, alpha = 0.35). PMID:8630499

  12. 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.

  13. 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…

  14. Parenting among Mothers with Bipolar Disorder: Strengths, Challenges, and Service Needs

    Science.gov (United States)

    Venkataraman, Meenakshi; Ackerson, Barry J.

    2008-01-01

    Bipolar disorder is a severe form of mental illness with a primary disruption in mood. With fluctuating phases of mania and depression, bipolar disorder can have a serious impact on all activities of daily living, including parenting. Ten mothers with bipolar disorder were interviewed to understand their strengths, challenges, and service needs in…

  15. Family Intervention with a Case of Bipolar I Disorder with Family Conflict

    Science.gov (United States)

    Sahu, Kamlesh Kumar

    2013-01-01

    Bipolar disorder is a major mental illness. Inherited treatment of bipolar disorder has been focused on pharmacological treatments. Though, psychosocial variables appear to be important antecedents of bipolar disorder, poor drug compliance, expressed emotion or faulty communication and life events play a vital role in relapse. Conflict is commonly…

  16. 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.

  17. 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

  18. 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.

  19. The Effect of Bipolar Mood Disorder on Sadegh Hedayat's Letters.

    Science.gov (United States)

    Esmaeelpour, Elmira; Sasani, Farhad

    2016-04-01

    This paper studies linguistic characteristics of bipolar mood disorder in Sadegh Hedayat's letters. It attempts to explore the possibility of diagnosing bipolar disorder through qualitative analysis of text. The personal letters of Iranian author Sadegh Hedayat addressed to Shahid Nouraie are studied. The addressee is fixed to reduce effective factors, including linguistic differences among different registers and styles. Therefore, interpersonal variation is also neutralized. Letters are chosen to reduce the potential effects of aesthetic manipulation used in the author's narratives and published works. To analyze the data, semantic fields used in the letters are studied, and to find any instance of pressured speech and poverty of speech, topical shifts and moves are analyzed as well. Linguistic study of each letter reveals that different types of bipolar mood episodes (i.e., hypomanic, depressed, euthymic and mixed) can be diagnosed with this methodology. Other semantic criteria are explored, including themes of humiliation and ridicule. PMID:25708966

  20. 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.

  1. Decreased prefrontal, anterior cingulate, insula, and ventral striatal metabolism in medication-free depressed outpatients with bipolar disorder

    OpenAIRE

    Brooks, John O.; Wang, Po W.; Bonner, Julie C.; Rosen, Allyson C.; Hoblyn, Jennifer C.; Hill, Shelley J.; Ketter, Terence A.

    2008-01-01

    This study explored whether cerebral metabolic changes seen in treatment resistant and rapid cycling bipolar depression inpatients are also found in an outpatient sample not specifically selected for treatment resistance or rapid cycling. We assessed 15 depressed outpatients with bipolar disorder (six type I and nine type II) who were medication-free for at least 2 weeks and were not predominantly rapid cycling. The average 28-item Hamilton Depression Scale (HAM-D) total score was 33.9. The h...

  2. Clinical characteristics and long-term response to mood stabilizers in patients with bipolar disorder and different age at onset

    OpenAIRE

    Dell’Osso, Bernardo; Buoli, Massimiliano; Riundi, Riccardo; D’Urso, Nazario; Pozzoli, Sara; Bassetti, Roberta; Mundo, Emanuela; Altamura, A Carlo

    2009-01-01

    Introduction Bipolar disorder (BD) is a prevalent, comorbid, and impairing condition. Potential predictors of response to pharmacological treatment are object of continuous investigation in patients with BD. The present naturalistic study was aimed to assess clinical features and long-term response to mood stabilizers in a sample of bipolar subjects with different ages at onset. Methods The study sample included 108 euthymic patients, diagnosed as affected by BD, either type I or II, accordin...

  3. Medication adherence among female inmates with bipolar disorder: results from a randomized controlled trial.

    Science.gov (United States)

    Ehret, Megan J; Shelton, Deborah; Barta, William; Trestman, Robert; Maruca, Annette; Kamath, Jayesh; Golay, Leslie

    2013-02-01

    To describe the differences in medication adherence between 2 groups of inmates in the Connecticut Department of Correction diagnosed with bipolar disorder treated with either the Texas Implementation of Medication Algorithm (TIMA) for Bipolar Disorder or treatment as usual (TAU). Using a prospective longitudinal analysis of secondary data and chart data, a comparison was made between participants who were assigned either to TIMA or TAU and treated for 12 weeks for either Bipolar Disorder Type I or II. A secondary data set containing 12 weeks of medication data was combined with medical chart data, including medication administration records, which were retrospectively reviewed to determine numbers of psychotropic and other medications prescribed, number of doses per day prescribed, number of times the medications were taken, any patterns and reasons for missed doses, and side effects experienced. High rates of psychotropic medication nonadherence were observed among female inmates with bipolar disorder, with the mood stabilizers as the most frequently missed medications. Analyses revealed an interaction of Treatment Condition × Baseline Adherence × Time in Treatment × Biweekly Symptom Severity. Regardless of treatment condition, participants exhibiting high baseline adherence exhibited greater decreases in daily adherence over time; in addition, participants at Time 8 (Weeks 7 and 8) and later exhibited poorer adherence if they had more severe symptoms during those weeks. TIMA participants missed fewer doses than TAU participants. Future research is needed to uncover what factors most significantly contribute to psychotropic medication adherence. PMID:23421363

  4. 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.

  5. Clinical variables and implications of the personality on the outcome of bipolar illness: a pilot study

    OpenAIRE

    Casas-Barquero, Nieves; García-López, Olga; Fernández-Argüelles, Pedro; Camacho-Laraña, Manuel

    2007-01-01

    Outcome in bipolar patients is affected by comorbidity. Comorbid personality disorders are frequent and may complicate the course of bipolar illness. This pilot study examined a series of 40 euthymic bipolar patients (DSM-IV criteria) (bipolar I disorder 31, bipolar II disorder 9) to assess the effect of clinical variables and the influence of comorbid personality on the clinical course of bipolar illness. Bipolar patients with a diagnosis of comorbid personality disorder (n = 30) were compar...

  6. Pediatric Bipolar Disorder: Diagnostic Challenges in Identifying Symptoms and Course of Illness

    OpenAIRE

    Singh, Tanvir

    2008-01-01

    Based on available literature, this article reviews the challenges associated with diagnosing pediatric bipolar disorder. The article also reviews and provides discussion on the assessment tools, complex mood cycling, and clinical symptoms of pediatric bipolar disorder. The challenge of differentiating common comorbid disorders like attention deficit hyperactivity disorder and conduct disorder from pediatric bipolar disorder is presented and discussed. A discussion of the validity of diagnosi...

  7. 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.

  8. Bimodal Effect of Lithium Plasma Levels on Hippocampal Glutamate Concentrations in Bipolar II Depression: A Pilot Study

    OpenAIRE

    Zanetti, Marcus V.; Otaduy, Maria C.; de Sousa, Rafael T.; GATTAZ, WAGNER F.; Busatto, Geraldo F; Claudia C Leite; Machado-Vieira, Rodrigo

    2015-01-01

    Background: The hippocampus has been highly implicated in the pathophysiology of bipolar disorder (BD). Nevertheless, no study has longitudinally evaluated hippocampal metabolite levels in bipolar depression under treatment with lithium. Methods: Nineteen medication-free BD patients (78.9% treatment-naïve and 73.7% with BD type II) presenting an acute depressive episode and 17 healthy controls were studied. Patients were treated for 6 weeks with lithium in an open-label trial. N-acetyl aspart...

  9. 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…

  10. 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…

  11. 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…

  12. Psychosocial interventions and medication adherence in bipolar disorder

    OpenAIRE

    Depp, Colin A.; Moore, David J.; Thomas L. Patterson; Lebowitz, Barry D.; Jeste, Dilip V.

    2008-01-01

    Recent research has indicated that psychosocial interventions can have a valuable role in reducing the substantial psychosocial disability associated with bipolar disorder. Randomized controlled trials of these interventions indicate that improvements are seen in symptoms, psychosocial functioning, and treatment adherence. These interventions systematically presented in the form of standardized treatment manuals, vary in format, duration, and theoretical basis. All are meant to augment pharma...

  13. CLASSIC ULTRA- RAPID CYCLER BIPOLAR DISORDER : A CASE REPORT

    OpenAIRE

    Garg, P.D.; Singh, Paramjit; Kumar, Nirdosh

    1998-01-01

    A 44 year old man presented with classical pattern of bipolar disorder with a fortnightly cycle of mania and depression for last many years. The patient was not responding to chronic lithium therapy but responded to a combination of carbamazepine and nifedipine

  14. Early Onset Bipolar Spectrum Disorder: Psychopharmacological, Psychological, and Educational Management

    Science.gov (United States)

    McIntosh, David E.; Trotter, Jeffrey S.

    2006-01-01

    Although published research continues to advocate medication as the first line of treatment for early onset bipolar spectrum disorder (EOBSD; N. Lofthouse & M.A. Fristad, 2004), preliminary research demonstrating the utility of cognitive, cognitive-behavioral, and psychoeducational therapies is promising. It appears as if future treatment of EOBSD…

  15. Understanding Bipolar Disorder: Implications for Mental Health Counselors.

    Science.gov (United States)

    Withrow, J. Steve; Hinkle, J. Scott

    1990-01-01

    Provides an overview of bipolar disorder, including a discussion of diagnostic indicators, etiological theories, and psychopharmacological treatment. Examines treatment implications for mental health counselors, including role in psychiatric liaison, individual counseling, marriage and family therapy, and vocational counseling. (Author/ABL)

  16. 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

  17. re:Mind - A mobile application for bipolar disorder patients

    DEFF Research Database (Denmark)

    Corradini, Andrea; Lyck Festersen, Pia

    2014-01-01

    Several personal healthcare monitoring systems have been proposed to target somatic diseases and specific mental illness. This paper reports on the re:Mind system, which is a helpful tool that supports the treatment of people diagnosed with bipolar disorder. We developed the system as a hybrid...

  18. 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...

  19. 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...

  20. 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...

  1. 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…

  2. 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 for...

  3. Reward Processing in Adolescents with Bipolar I Disorder

    Science.gov (United States)

    Singh, Manpreet K.; Chang, Kiki D.; Kelley, Ryan G.; Cui, Xu; Sherdell, Lindsey; Howe, Meghan E.; Gotlib, Ian H.; Reiss, Allan L.

    2013-01-01

    Objective: Bipolar disorder (BD) is a debilitating psychiatric condition that commonly begins in adolescence, a developmental period that has been associated with increased reward seeking. Because youth with BD are especially vulnerable to negative risk-taking behaviors, understanding the neural mechanisms by which dysregulated affect interacts…

  4. Peer Relationship Difficulties in Adolescents with Bipolar Disorder

    Science.gov (United States)

    Siegel, Rebecca S.; Freeman, Andrew J.; La Greca, Annette M.; Youngstrom, Eric A.

    2015-01-01

    Background: Pediatric bipolar disorder (PBD) is associated with psychosocial impairment, but few studies have examined peer relationship functioning and PBD. Adolescence is a crucial developmental period when peers become increasingly salient. Objective: This study compared perceived friendship quality and peer victimization in adolescents with…

  5. Electronic monitoring of patients with bipolar affective disorder

    DEFF Research Database (Denmark)

    Jacoby, Anne Sophie; Faurholt-Jepsen, Maria; Vinberg, Maj; Frost, Mads; Bardram, Jakob; Kessing, Lars Vedel

    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...

  6. 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

  7. 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...

  8. 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...

  9. 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...

  10. 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...

  11. 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...

  12. 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...

  13. Bipolar disorder preceding the onset of multiple sclerosis

    Directory of Open Access Journals (Sweden)

    Ciro Marangoni

    2015-01-01

    Full Text Available Multiple sclerosis (MS is the most common inflammatory demyelinating brain disease. The occurrence of psychiatric disorders, especially for major depression, in the course of MS is high. Reports concerning bipolar disorder (BD remain rather scarce although early descriptions were found in the old neurological literature. The purpose of this article is to provide a critical review of the epidemiology, comorbidity, and treatment findings regarding BD preceding the onset of MS.

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

    Directory of Open Access Journals (Sweden)

    Moreno Ricardo A

    2011-04-01

    Full Text Available 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 Disorder Patients is a single-site cross-sectional study involving a comparison group, designed to evaluate the prevalence of bipolar spectrum in an eating disorder sample. Women aged 18-45 years will be evaluated using the SCID-P and Zurich criteria for diagnosis and the HAM-D, YOUNG, SCI-MOODS, HCL-32, BIS-11, BSQ, WHOQoL and EAS instruments for rating symptoms and measuring clinical correlates. Discussion The classificatory systems in psychiatry are based on categorical models that have been criticized for simplifying the diagnosis and leading to an increase in comorbidities. Some dimensional approaches have been proposed aimed at improving the validity and reliability of psychiatric disorder assessments, especially in conditions with high rates of comorbidity such as BD and Eating Disorder (ED. The Bipolar Spectrum (BS remains under-recognized in clinical practice and its definition is not well established in current diagnostic guidelines. Broader evaluation of psychiatric disorders combining categorical and dimensional views could contribute to a more realistic understanding of comorbidities and help toward establishing a prognosis.

  15. 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...

  16. Social Support and Social Strain in Inter-episode Bipolar Disorder

    OpenAIRE

    Eidelman, Polina

    2010-01-01

    This study focused on social support and social strain and their cross-sectional associations with instabilities in sleep and social rhythms in inter-episode bipolar disorder (BD). Thirty-eight adults diagnosed with inter-episode BD Type I or II and 38 healthy controls completed measures of social support and social strain. Instabilities in sleep and social rhythms in the BD group were assessed with 28 days of diary and actigraphy. Associations between social support, social strain, and mood ...

  17. 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...

  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. 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

  20. [Anticonvulsants and antipsychotics in the treatment of bipolar disorder].

    Science.gov (United States)

    Moreno, Ricardo Alberto; Moreno, Doris Hupfeld; Soares, Márcia Britto de Macedo; Ratzke, Roberto

    2004-10-01

    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 effective in acute manic episodes. Lamotrigine has been shown to reduce cycling and effective in depressive episodes. Based on the available data, olanzapine was found to be the most appropriate atypical antipsychotic agent for the treatment of manic bipolar patients, although there are also studies suggesting the efficacy of risperidone, aripiprazole and clozapine. The preliminary data evaluating the efficacy of quetiapine and ziprasidone in bipolar disorder are still very limited. There is no consistent information supporting the prophylactic use of newer antipsychotics. PMID:15597138

  1. Bipolar disorder and comorbid alcoholism: prevalence rate and treatment considerations.

    Science.gov (United States)

    Frye, Mark A; Salloum, Ihsan M

    2006-12-01

    Classic Kraepelian observations and contemporary epidemiological studies have noted a high prevalence rate between bipolar disorder and alcoholism. The extent to which these two illnesses are comorbid (i.e., two distinct disease processes each with an independent course of illness), genetically linked, or different phenotypic expressions of bipolar illness itself continues to be investigated. It is increasingly clear that co-occurring alcohol abuse or dependence in bipolar disorder phenomenologically changes the illness presentation with higher rates of mixed or dysphoric mania, rapid cycling, increased symptom severity, and higher levels of novelty seeking, suicidality, aggressivity, and impulsivity. It is very encouraging that interest and efforts at evaluating pharmacotherapeutic compounds has substantially increased over the past few years in this difficult-to-treat patient population. This article will review the clinical studies that have evaluated the effectiveness of conventional mood stabilizers (lithium, carbamazepine, divalproex, and atypical antipsychotics) in the treatment of alcohol withdrawal and relapse prevention in patients with alcoholism and in the treatment of bipolar disorder with comorbid alcoholism. A number of add-on, adjunctive medications, such as naltrexone, acamprosate, topiramate, and the atypical antipsychotics quetiapine and clozapine, may be candidates for further testing. PMID:17156154

  2. Development and validation of a screening instrument for bipolar spectrum disorder: The Mood Disorder Questionnaire Thai version

    OpenAIRE

    Waleeprakhon, Punjaporn; Ittasakul, Pichai; Lotrakul, Manote; Wisajun, Pattarabhorn; Jullagate, Sudawan; Ketter, Terence A.

    2014-01-01

    Background The Mood Disorder Questionnaire (MDQ) has been translated to many languages and has been used in many countries as a screening instrument for bipolar disorder. The main objective of this study was to evaluate validity of the Thai version of the MDQ as a screening instrument for bipolar disorder in a psychiatric outpatient sample, and to determine its optimum question #1 item threshold value for bipolar disorder. Methods The English language Mood Disorder Questionnaire (MDQ) was tra...

  3. Quality of Life in Bipolar Type I Disorder in a One-Year Followup

    Directory of Open Access Journals (Sweden)

    Homayoun Amini

    2012-01-01

    Full Text Available Objectives. The aims of this study were (i to compare Quality of Life (QOL of patients with bipolar disorder (BD type I to those with schizophrenia during a one-year period after hospitalization and (ii to assess the association of different domains of QOL with severity of clinical symptoms and level of functioning in bipolar patients group. Method. A hundred and two participants were consecutively recruited before discharge from an acute hospitalization. To measure QOL as the main outcome variable, the Farsi (Persian version of the World Health Organization's QOL Instrument Short Version (WHOQOL BREF was used. Affective symptoms, overall functioning, and severity of mental illness were assessed as well. The assessment procedure was repeated four, eight, and 12 months after discharge. Results. No significant differences were found between patients with BD and schizophrenia on four domains of WHOQOL BREF at the baseline and the four, eight, and 12 month assessments. Within the subjects with bipolar I disorder, the most stable finding was negative association of depression severity with WHOQOL-BREF on the all four domains during repeated assessments. Conclusion. The findings suggest that persistent depressive symptoms might be the primary determinant of impaired QOL in patients with bipolar I disorder.

  4. [Schizophrenia and/or bipolar disorder: the neurocognitive endophenotypes].

    Science.gov (United States)

    Kaladjian, A; Azorin, J-M; Pomietto, P; Corréard, N; Belzeaux, R; Adida, M

    2012-12-01

    Although Kraepelinian dichotomous conceptualization of psychosis was historically beneficial, modern studies do not support the existence of a sub-typing of psychotic illnesses into schizophrenic and affective psychoses. Years of intensive investigation on the genetic bases of schizophrenia and bipolar disorder suggest that these disorders, rather than being wholly distinct disorders, share common genetic risks. However, one of the most serious difficulties for genetic research in these illnesses is their enormous phenotypic heterogeneity. A response to this problem is the use of neurocognitive functions as endophenotypes or intermediate phenotypes. A review of the literature suggests that in both schizophrenia and bipolar disorder, neurocognitive functions are influenced by genetic factors and that there exists neuropsychological deficits in the nonaffected relatives of probands. However, it is unclear whether or not patterns of performance on neurocognitive tasks across probands as well as unaffected family members offer potential for identifying shared and illness-specific neurocognitive phenotypes for schizophrenia and bipolar disorder. Overlapping and unique neurocognitive endophenotypic signatures of the two psychoses are comprehensively described. PMID:23279993

  5. 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

  6. 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...

  7. 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)

  8. 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...... patients. We conducted a 14 week field trial in which 12 patients used the system, and we report findings focusing on their experiences. The results were positive; compared to using paper-based forms, the adherence to self-assessment improved; the system was considered very easy to use; and the perceived...... usefulness of the system was high. Based on this study, the paper discusses three HCI questions related to the design of personal health technologies; how to design for disease awareness and self-treatment, how to ensure adherence to personal health technologies, and the roles of different types of...

  9. [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

  10. 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.

  11. 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.

  12. 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...

  13. 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...

  14. Algorithm-driven pharmacological management of bipolar disorder in Connecticut prisons.

    Science.gov (United States)

    Kamath, Jayesh; Zhang, Wanli; Kesten, Karen; Wakai, Sara; Shelton, Deborah; Trestman, Robert

    2013-02-01

    The objective of this study was to assess adaptation of the Texas Implementation of Medication Algorithm (TIMA) for bipolar disorder (BD) in the Connecticut Department of Correction. A nonrandomized sample of 20 males and 20 females, with diagnoses of BD Type I or II, was enrolled in the study. Two TIMA-trained psychiatrists treated the participants over a 12-week period following the TIMA protocol. The primary outcome measure was the Bipolar Disorder Symptom Scale. Secondary outcome measures evaluated global clinical status, comorbid symptomatology, and quality of life. Significant improvement was seen with the primary and secondary outcome measures (p < .001). Subanalyses showed differences in outcomes based on gender and whether a manic or depression algorithm was used. Antidepressant and antipsychotic medication use decreased, with increase in anticonvulsant and anxiolytic medication usage. This pilot study confirmed the effectiveness and benefits of TIMA for BD adaptation in the correctional setting. PMID:22116961

  15. Bipolar Disorder in Pregnancy and Postpartum: Principles of Management.

    Science.gov (United States)

    Khan, Sabrina J; Fersh, Madeleine E; Ernst, Carrie; Klipstein, Kim; Albertini, Elizabeth Streicker; Lusskin, Shari I

    2016-02-01

    Pregnancy and postpartum represent times of increased vulnerability for women with bipolar disorder, yet this condition remains under-diagnosed and under-treated. As 50 % of pregnancies are unplanned, the risks associated with the illness and the potential risks associated with treatment should be considered when a woman of reproductive age first presents for evaluation. This article reviews the epidemiology of perinatal bipolar disorder, screening recommendations, and treatment with pharmacotherapy and electroconvulsive therapy (ECT). An overview of the data in pregnancy and lactation is presented for lithium, lamotrigine, valproic acid, newer antipsychotics, and ECT. General principles of management include close monitoring in pregnancy and postpartum, careful adjustment of the treatment regimen to attenuate the risk of relapse, and avoidance of valproic acid when possible. Thoughtful consideration of these issues will minimize the risks to the mother and baby. PMID:26781551

  16. 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...... cognitive complaints underwent assessment of objective and subjective cognitive function and psychosocial functioning as part of their participation in two clinical trials. We investigated the association between global and domain-specific objective and subjective cognitive function and between global...... cognitive function and psychosocial function. We also identified clinical variables that predicted objective and subjective cognitive function and psychosocial functioning. There was a correlation between global subjective and objective measures of cognitive dysfunction but not within the individual...

  17. Sensory processing patterns, coping strategies, and quality of life among patients with unipolar and bipolar disorders

    Directory of Open Access Journals (Sweden)

    Batya Engel-Yeger

    2016-01-01

    Full Text Available Objective: To compare sensory processing, coping strategies, and quality of life (QoL in unipolar and bipolar patients; to examine correlations between sensory processing and QoL; and to investigate the relative contribution of sociodemographic characteristics, sensory processing, and coping strategies to the prediction of QoL. Methods: Two hundred sixty-seven participants, aged 16-85 years (53.6±15.7, of whom 157 had a diagnosis of unipolar major depressive disorder and 110 had bipolar disorder type I and type II, completed the Adolescent/Adult Sensory Profile, Coping Orientations to Problems Experienced, and 12-item Short-Form Health Survey version 2. The two groups were compared with multivariate analyses. Results: The unipolar and bipolar groups did not differ concerning sensory processing, coping strategies, or QoL. Sensory processing patterns correlated with QoL independently of mediation by coping strategies. Correlations between low registration, sensory sensitivity, sensation avoidance, and reduced QoL were found more frequently in unipolar patients than bipolar patients. Higher physical QoL was mainly predicted by lower age and lower sensory sensitivity, whereas higher mental QoL was mainly predicted by coping strategies. Conclusion: While age may predict physical QoL, coping strategies predict mental QoL. Future studies should further investigate the impact of sensory processing and coping strategies on patients’ QoL in order to enhance adaptive and functional behaviors related to affective disturbances.

  18. The reliability of self-assessment of affective state in different phases of bipolar disorder.

    Science.gov (United States)

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

    2014-05-01

    Some studies have indicated that the capacity of self-assessment of affective state is more compromised during mania than during depression. In the present study, we investigated whether the reliability of self-assessment in bipolar disorder varies as a function of actual affective state (i.e., euthymia, mania, or depression). Sixty-five patients with a diagnosis of type I and type II bipolar disorder were evaluated with regard to the occurrence of an affective syndrome using the Clinical Global Impressions Scale for use in bipolar illness, the Positive and Negative Syndrome Scale, and the Global Assessment of Functioning scale. In parallel, we applied the Analog Visual Mood Scale, a self-assessment tool to evaluate mood changes. The same individual prospectively completed the self-assessment scale in different affective states. During depression, the patients' evaluation was significantly different from when they were in manic or euthymic mood states. However, when in mania, the patients evaluated their mood state similarly to when they were euthymic. The bipolar patients in mania but not in depression did not reliably evaluate themselves with regard to their affective state. PMID:24727726

  19. White matter pathology – an endophenotype for bipolar disorder?

    OpenAIRE

    Borgwardt Stefan; Fusar-Poli Paolo

    2012-01-01

    Abstract Background Neuroimaging investigations of white matter abnormalities in subjects at genetic risk for bipolar disorders (BD) potentially predating the onset of BD offer several advantages. They are not confounded by the presence of illness duration or previous treatment with medication and may ultimately inform evaluation of risk for subsequent development of BD and subsequent therapeutic intervention. Discussion Although a number of imaging studies in subjects at genetic risk for BD ...

  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. 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...

  2. Comparison of five actigraphy scoring methods with bipolar disorder

    OpenAIRE

    Boudebesse, Carole; Leboyer, Marion; Begley, Amy; Wood, Annette; Miewald, Jean; Hall, Martica; Frank, Ellen; Kupfer, David; Germain, Anne

    2012-01-01

    The goal of this study was to compare five actigraphy scoring methods in a sample of 18 remitted patients with bipolar disorder. Actigraphy records were processed using five different scoring methods relying on the sleep diary; the event-marker; the software-provided automatic algorithm; the automatic algorithm supplemented by the event-marker; visual inspection (VI) only. The Algorithm and the VI methods differed from the other methods for many actigraphy parameters of interest. Particularly...

  3. Late-onset bipolar disorder following right thalamic injury

    OpenAIRE

    López, J.D.; Araúxo, A.; Paramo, M.

    2009-01-01

    Bipolar disorder occurs in the elderly ages and is frequentlyassociated to a brain injury -cerebrovascular disease.Its diagnosis is based on the finding of an ischemic injuryin specific regions of the brain. The case of a63-year-old male with cardiovascular risk factors, who wasadmitted due to maniform picture during a two-year longbipolar affective syndrome is presented. The neuroimagingtests showed lacunar infarction in the right thalamus anddiffuse foci of ischemia in subcortical white mat...

  4. Psychopharmacology of topiramate: from epilepsy to bipolar disorder

    OpenAIRE

    Mula, M; Cavanna, A. E.; Monaco, F.

    2006-01-01

    Topiramate (TPM) is one of the novel antiepileptic drugs and exhibits a wide range of mechanisms of action. Efficacy of TPM has been demonstrated in partial-onset seizures and primary generalized seizures in adults and children, as both monotherapy and adjunctive therapy. More recently, TPM has been proposed as an add-on treatment for patients with lithium-resistant bipolar disorder, especially those displaying rapid-cycling and mixed states. This paper reviews the multiple mechanisms of acti...

  5. GSK-3 and Wnt signaling in neurogenesis and bipolar disorder

    OpenAIRE

    Valvezan, Alexander J.; Klein, Peter S.

    2012-01-01

    The canonical Wnt signaling pathway is critical for development of the mammalian central nervous system and regulates diverse processes throughout adulthood, including adult neurogenesis. Glycogen synthase kinase-3 (GSK-3) antagonizes the canonical Wnt pathway and therefore also plays a central role in neural development and adult neurogenesis. Lithium, the first line of therapy for bipolar disorder, inhibits GSK-3, activates Wnt signaling and stimulates adult neurogenesis, which may be impor...

  6. Early-Onset Bipolar Spectrum Disorders: Diagnostic Issues

    OpenAIRE

    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 diagnostic system makes few modifications to accommodate children and adolescents. Researchers in this area have developed specific BPSD definitions that ...

  7. Improving Clinical Prediction of Bipolar Spectrum Disorders in Youth

    OpenAIRE

    Frazier, Thomas W; Youngstrom, Eric A.; Fristad, Mary A.; Christine Demeter; Boris Birmaher; Kowatch, Robert A; L. Eugene Arnold; David Axelson; Mary K. Gill; Horwitz, Sarah M.; Findling, Robert L

    2014-01-01

    This report evaluates whether classification tree algorithms (CTA) may improve the identification of individuals at risk for bipolar spectrum disorders (BPSD). Analyses used the Longitudinal Assessment of Manic Symptoms (LAMS) cohort (629 youth, 148 with BPSD and 481 without BPSD). Parent ratings of mania symptoms, stressful life events, parenting stress, and parental history of mania were included as risk factors. Comparable overall accuracy was observed for CTA (75.4%) relative to logistic...

  8. 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...

  9. 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...

  10. 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

  11. Bipolar affective disorder: A review of novel forms of therapy

    OpenAIRE

    Dziwota Ewelina; Drapala Barbara; Gaj Magdalena; Skoczen Nikodem; Olajossy Marcin

    2015-01-01

    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 affe...

  12. Spectrophotometric analysis of lithium carbonate used for bipolar disorder

    OpenAIRE

    May, J M; Hickey, M.; Triantis, I.; Palazidou, E; Kyriacou, P. A.

    2015-01-01

    Lithium therapy is the gold standard of treatment for patients with Bipolar Disorder. However, despite its effectiveness, it is a potentially hazardous drug requiring regular monitoring of blood levels to ensure toxic levels are not reached. This paper describes the spectrophotometric analysis of Lithium carbonate in solution as a first step in developing a portable home monitoring device for blood lithium analysis.. Using a high-end spectrophotometer, solutions of lithium carbonate (Li2CO3) ...

  13. Management of bipolar disorders in women by nonpharmacological methods

    OpenAIRE

    Naik, Sujit Kumar

    2015-01-01

    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...

  14. 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

  15. 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

  16. 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

  17. Comparative efficacy and tolerability of drug treatments for bipolar disorder.

    Science.gov (United States)

    Strakowski, S M; DelBello, M P; Adler, C M

    2001-01-01

    Lithium has been the backbone of treatment for bipolar disorder for several decades, although recent advances have identified a number of other medications that have efficacy in treating various phases of the illness. These include the antiepileptic drugs valproate semisodium (divalproex sodium) and carbamazepine and some new antiepileptic drugs (e.g. lamotrigine and topiramate), and the atypical antipsychotics (e.g. olanzapine, clozapine and risperidone). Conventional antipsychotics continue to be used frequently in bipolar disorder, although they may be somewhat less effective than other treatments. Otherwise, to date, none of these treatments have been shown to be consistently more effective than any other, so that drug adverse effects and tolerability often dictate which agents are used in an individual patient. Drugs commonly used for the treatment of bipolar disorder are generally tolerated by most patients in large samples. However, the unique adverse effect signature of a drug will often suggest that it will be less tolerable in some patients than in others. Identifying a specific treatment for a specific patient requires a careful individualised assessment of the risk of adverse effects for that patient's unique circumstances. PMID:11580309

  18. 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.

  19. 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

  20. Efficacy of Electroconvulsive Therapy in Bipolar Disorder with Mixed Features.

    Science.gov (United States)

    Palma, Miguel; Ferreira, Berta; Borja-Santos, Nuno; Trancas, Bruno; Monteiro, Céu; Cardoso, Graça

    2016-01-01

    Introduction. Mixed states represent a frequent presentation of bipolar disorder, associated with higher resistance to psychopharmacology. Limited evidence supports the use of ECT in these patients. We aim to report our experience on treating bipolar mixed states with ECT. Methods. Retrospective data were collected from all bipolar patients submitted to acute ECT treatment, between June 2006 and June 2011. Three groups were created in terms of affective polarity of the episode. CGI rating was used to establish clinical remission and demographic and clinical variables were compared among groups. Long-term outcome was assessed through readmission measures, considering the use of continuation or maintenance ECT. Results. During the study time frame, a total of 50 ECT course treatments were performed on 41 bipolar patients. All affective episodes, except one mixed state, showed a positive clinical response. Patients with mixed state presentation tended to be younger and have an earlier first hospitalization than depressed patients. No differences were found in terms of ECT sessions performed, length of hospital admission, referral to continuation ECT treatment, number of readmissions, and time until next readmission. Conclusions. Our results support the effectiveness of ECT in patients experiencing a mixed affective state. PMID:26881069

  1. 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…

  2. 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.

  3. Prefrontal hypoactivation during working memory in bipolar II depression

    OpenAIRE

    Brooks, JO; Vizueta, N; Penfold, C.; Townsend, JD; Bookheimer, SY; Altshuler, LL

    2015-01-01

    Copyright © Cambridge University Press 2015 Method.: An n-back working memory task was administered during a 3T functional magnetic resonance imaging scan in age- and gender-matched groups of 19 unmedicated, bipolar II depressed subjects and 19 healthy comparison subjects. Whole-brain and region-of-interest analyses were performed to determine regions of differential activation across memory-load conditions (0-, 1- and 2-back). Results.: Accuracy for all subjects decreased with higher memory ...

  4. Cortical Volume Alterations in Conduct Disordered Adolescents with and without Bipolar Disorder

    OpenAIRE

    Olvera, Rene L.; Glahn, David C.; Louise O'Donnell; Bearden, Carrie E.; Jair C. Soares; Winkler, Anderson M.; Pliszka, Steven R.

    2014-01-01

    Background: There is increasing evidence that bipolar disorder (BD) and conduct disorder (CD) are co-occurring disorders. Magnetic resonance imaging has revealed differences in the structure and function of the frontal cortex in these disorders when studied separately; however, the impact of BD comorbidity on brain structure in adolescents with CD has not yet been examined. Method: We conducted an optimized voxel based morphometry (VBM) study of juvenile offenders with the following diagnoses...

  5. Bipolar disorder affects behavior and social skills on the Internet.

    Directory of Open Access Journals (Sweden)

    Thaís Martini

    Full Text Available BACKGROUND: Bipolar disorder (BD is a significant cause of functional, cognitive, and social impairment. However, classic studies of functioning and social skills have not investigated how BD may impact behavior on the Internet. Given that the digital age has been changing the way people communicate, this study aims to investigate the pattern of Internet use in patients with BD. METHODS: This cross-sectional study assessed 30 patients with BD I or II and 30 matched controls. Patients were not in an acute mood episode, according to DSM-IV. A standard protocol examined sociodemographic variables and social behavior on the Internet, assessed by Facebook number of friends (FBN and lifetime estimated number of offline contacts (social network number, SNN. RESULTS: SNN (p<0.001 and FBN (p = 0.036 of patients with BD were significantly lower than those of controls. Also, variables related with Internet use were significantly lower in patients, e.g., close contacts on Facebook (p = 0.021, Internet experience (p = 0.020, and knowledge of terms associated with social networking sites (p = 0.042. Also, patients showed lower rates of the expected pattern of Internet use (based on their age generation, including a poorer knowledge of SNS (p = 0.018 and a lower frequency of Internet use (p = 0.010. DISCUSSION: This study suggests that patients with BD show smaller social networks both in real-world settings and on the Internet. Also, patients tend to use the Internet and social networking sites less frequently and show a poorer knowledge of Internet and social media than healthy controls, below the expected for their generation. These significant differences between patients and controls suggest that the effects of BD on social relationships and functioning extend to electronic media.

  6. 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...

  7. Excess mortality of acute and transient psychotic disorders: comparison with bipolar affective disorder and schizophrenia

    DEFF Research Database (Denmark)

    Castagnini, Augusto; Foldager, Leslie; Bertelsen, Aksel

    2013-01-01

    in the Danish Psychiatric Register between 1995 and 2008 with an ICD-10 diagnosis of ‘acute and transient psychotic disorders’ (ATPDs; n = 4157), bipolar disorder (n = 3200) and schizophrenia (n = 4576). Results: A total of 232 patients (5.6%) with ATPDs, 172 (5.4%) with bipolar disorder and 233 (5......Objective: To investigate mortality and causes of death of short-lived psychotic disorders, by carrying out a comparison with bipolar disorder and schizophrenia. Method: Record linkage study to the official register of causes of death of all cases aged 15–64 years who were listed for the first time.......1%) with schizophrenia had died over a mean follow-up period of 6.6 years. The standardized mortality ratio for all causes, natural causes and unnatural causes was significantly high for the three conditions. Mortality of ATPDs was greater in men, with about two-thirds of all deaths resulting from natural...

  8. 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,...

  9. 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),…

  10. Emotional Face Identification in Youths with Primary Bipolar Disorder or Primary Attention-Deficit/Hyperactivity Disorder

    Science.gov (United States)

    Seymour, Karen E.; Pescosolido, Matthew F.; Reidy, Brooke L.; Galvan, Thania; Kim, Kerri L.; Young, Matthew; Dickstein, Daniel P.

    2013-01-01

    Objective: Bipolar disorder (BD) and attention-deficit/hyperactivity disorder (ADHD) are often comorbid or confounded; therefore, we evaluated emotional face identification to better understand brain/behavior interactions in children and adolescents with either primary BD, primary ADHD, or typically developing controls (TDC). Method: Participants…

  11. Sleep Architecture as Correlate and Predictor of Symptoms and Impairment in Inter-episode Bipolar Disorder: Taking on the Challenge of Medication Effects

    OpenAIRE

    Eidelman, Polina; Talbot, Lisa S.; Gruber, June; Hairston, Ilana; Harvey, Allison G.

    2010-01-01

    This study was designed to clarify the association between inter-episode bipolar disorder and sleep architecture. Participants completed a baseline symptom and sleep assessment and, 3 months later, an assessment of symptoms and impairment. The effects of psychiatric medications on sleep architecture were also considered. Participants included 22 adults with bipolar I or II (inter-episode) and 22 non-psychiatric controls. The sleep assessment was conducted at the Sleep and Psychological Disord...

  12. Brain oscillations in bipolar disorder and lithium-induced changes

    OpenAIRE

    Atagün Mİ

    2016-01-01

    Murat İlhan Atagün Department of Psychiatry, Yıldırım Beyazıt University Medical School, Cankaya, Ankara, Turkey Abstract: Electroencephalography (EEG) studies in patients with bipolar disorder have revealed lower amplitudes in brain oscillations. The aim of this review is to describe lithium-induced EEG changes in bipolar disorder and to discuss potential underlying factors. A literature survey about lithium-induced EEG changes in bipolar disorder was performed. Lithium consistently e...

  13. 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...

  14. Behavioral addictions in euthymic patients with bipolar I disorder: a comparison to controls

    OpenAIRE

    Sapir, Ran; Zohar, Ada H; Bersudsky, Yuly; Belmaker, RH; Osher, Yamima

    2013-01-01

    Background Bipolar disorder may be associated with a hypersensitive behavioral approach system and therefore to increased reward sensitivity. The objective of this study is to explore the interrelationships between bipolar disorder, behavioral addictions, and personality/temperament traits in a group of euthymic outpatients with bipolar I disorder and in a group of comparison subjects. Methods Fifty clinically stable patients and 50 comparison subjects matched for age, sex, and educational le...

  15. 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...

  16. 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...

  17. 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...

  18. 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.

  19. 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...

  20. 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

    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 psychiatric symptoms by anti-hemin...

  1. Tools to Improve Differential Diagnosis of Bipolar Disorder in Primary Care

    OpenAIRE

    Manning, J. Sloan

    2010-01-01

    Among patients seen in a primary care setting for depressive and/or anxiety symptoms, 20% to 30% are estimated to have bipolar disorder. Although relatively common in primary care settings, bipolar disorder is still underrecognized, primarily due to misdiagnosis as unipolar depression. Patients often seek treatment when they are depressed but uncommonly present with mania or hypomania, the specific markers of bipolar spectrum disorders. An awareness of the prevalence, characteristics, and pre...

  2. Using Smartphones to Monitor Bipolar Disorder Symptoms: A Pilot Study

    Science.gov (United States)

    Kindermann, Sally; Maier, Andreas; Kerl, Christopher; Moock, Jörn; Barbian, Guido; Rössler, Wulf

    2016-01-01

    Background Relapse prevention in bipolar disorder can be improved by monitoring symptoms in patients' daily life. Smartphone apps are easy-to-use, low-cost tools that can be used to assess this information. To date, few studies have examined the usefulness of smartphone data for monitoring symptoms in bipolar disorder. Objective We present results from a pilot test of a smartphone-based monitoring system, Social Information Monitoring for Patients with Bipolar Affective Disorder (SIMBA), that tracked daily mood, physical activity, and social communication in 13 patients. The objective of this study was to investigate whether smartphone measurements predicted clinical symptoms levels and clinical symptom change. The hypotheses that smartphone measurements are (1) negatively related to clinical depressive symptoms and (2) positively related to clinical manic symptoms were tested. Methods Clinical rating scales were administered to assess clinical depressive and manic symptoms. Patients used a smartphone with the monitoring app for up to 12 months. Random-coefficient multilevel models were computed to analyze the relationship between smartphone data and externally rated manic and depressive symptoms. Overall clinical symptom levels and clinical symptom changes were predicted by separating between-patient and within-patient effects. Using established clinical thresholds from the literature, marginal effect plots displayed clinical relevance of smartphone data. Results Overall symptom levels and change in clinical symptoms were related to smartphone measures. Higher overall levels of clinical depressive symptoms were predicted by lower self-reported mood measured by the smartphone (beta=-.56, Psmartphone (ie, cell tower movements: beta=-.11, P=.03). Higher overall levels of clinical manic symptoms were predicted by lower physical activity on the smartphone (ie, distance travelled: beta=-.37, Psmartphone (beta=-.17, Psmartphone measurements, but not all smartphone

  3. 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.

  4. Child Comorbidity, Maternal Mood Disorder, and Perceptions of Family Functioning among Bipolar Youth

    Science.gov (United States)

    Esposito-Smythers, Christianne; Birmaher, Boris; Valeri, Sylvia; Chiappetta, Laurel; Hunt, Jeffrey; Ryan, Neal; Axelson, David; Strober, Michael; Leonard, Henrietta; Sindelar, Holly; Keller, Martin

    2006-01-01

    Objective: To examine the association between youth comorbid psychiatric disorders, maternal mood disorder, and perceptions of family cohesion and conflict among youth diagnosed with pediatric bipolar disorder (PBD). Method: Three hundred eighty-nine bipolar youths and their parents completed a diagnostic interview and instruments assessing family…

  5. 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…

  6. 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.…

  7. Kinins and microglial responses in bipolar disorder: a neuroinflammation hypothesis.

    Science.gov (United States)

    Naaldijk, Yahaira M; Bittencourt, Maria C; Sack, Ulrich; Ulrich, Henning

    2016-04-01

    Bipolar disorder (BD) is a severe psychiatric disorder that affects up to 15% of the worldwide population. Characterized by switches in mood between mania and depression, its etiology is still unknown and efforts have been made to elucidate the mechanisms involved in first episode, development and progression of the disorder. Microglia activation, abnormal activity of GSK-3β and reduction in neurotrophic factor expression related to neuroinflammatory processes have been indicated to be part of the disorder's pathophysiology. Lithium, the main mood stabilizer used for the treatment and prevention of relapses, acts as an anti-inflammatory agent. Based on that, here we suggest a neuroinflammatory pathway for would be BD progression, in which microglia activation states modulated via constitutive induction of kinin-B1 receptor and reduction of kinin-B2 receptor expression and activity. PMID:26859499

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

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    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

  9. [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. PMID:26485974

  10. 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.

  11. Managing bipolar disorder in the elderly: defining the role of the newer agents.

    Science.gov (United States)

    Sajatovic, Martha; Madhusoodanan, Subramoniam; Coconcea, Nicoleta

    2005-01-01

    Clinical research in geriatric psychopharmacology has been a relatively neglected focus compared with the wealth of information on younger populations, and there is a dearth of published, controlled trials. Similarly, these are limited data in the area of geriatric bipolar disorder. Although there is an absence of rigorous, evidence-based information, preliminary data on older adults with bipolar disorder suggest some promising treatment options and important differences in older versus younger patients with bipolar illness. Lithium, while widely utilised in younger populations, is often poorly tolerated in the elderly. Clinical evidence regarding use of antiepileptic compounds in late-life bipolar disorder is generally compiled from bipolar disorder studies in mixed populations, studies in older adults with seizure disorders, and studies on dementia and psychotic conditions other than bipolar disorder. Valproate semisodium and carbamazepine are widely prescribed compounds in older adults with bipolar disorder. However, the popularity of these compounds has occurred in context of an absence of evidence-based data. The atypical antipsychotics have expanded the treatment armamentarium for bipolar disorder in mixed populations and may offer particular promise in management of bipolar illness in older populations as well. Olanzapine, risperidone, quetiapine, ziprasidone and aripiprazole are atypical antipsychotics that have been approved by the US FDA for the treatment of bipolar disorder; however, there are no published, controlled trials with atypical antipsychotics specific to mania in geriatric patients. Preliminary reports on the use of clozapine, risperidone, olanzapine and quetiapine suggest a role for the use of these agents in late-life bipolar disorder. Information with ziprasidone and aripiprazole specific to geriatric bipolar disorder is still lacking. PMID:15663348

  12. Treatment and prevention of mania in bipolar I disorder: focus on aripiprazole

    Directory of Open Access Journals (Sweden)

    David J Muzina

    2009-05-01

    Full Text Available David J MuzinaCenter for Mood Disorders Treatment and Research, Cleveland Clinic Neurological Institute, Cleveland, Ohio, USAAbstract: Aripiprazole is a second-generation antipsychotic with a unique pharmacologic receptor profile that has efficacy in the treatment and prevention of mania in bipolar I disorder. This article reviews the evidence supporting treatment of adults with bipolar I disorder using aripiprazole as monotherapy or adjunctively during acute mania and its utility as an intramuscular agent for agitation in manic patients. Results from one of the longest bipolar maintenance trials which support aripiprazole as a prophylactic mood stabilizer, specifically against manic relapses, will be discussed as well as a post-hoc analysis that suggests efficacy for rapid cycling bipolar disorder. Safety and tolerability issues, patient-focused perspectives and aripiprazole’s place in therapy for bipolar mania will be covered.Keywords: bipolar disorder, mania, prevention, aripiprazole, rapid cycling

  13. Initial Depressive Episodes Affect the Risk of Suicide Attempts in Korean Patients with Bipolar Disorder

    OpenAIRE

    Ryu, Vin; Jon, Duk-In; Cho, Hyun Sang; Kim, Se Joo; Lee, Eun; Kim, Eun Joo; Seok, Jeong-Ho

    2010-01-01

    Purpose Suicide is a major concern for increasing mortality in bipolar patients, but risk factors for suicide in bipolar disorder remain complex, including Korean patients. Medical records of bipolar patients were retrospectively reviewed to detect significant clinical characteristics associated with suicide attempts. Materials and Methods A total of 579 medical records were retrospectively reviewed. Bipolar patients were divided into two groups with the presence of a history of suicide attem...

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

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    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. The influence of cognitive reserve on psychosocial and neuropsychological functioning in bipolar disorder.

    Science.gov (United States)

    Forcada, Irene; Mur, Maria; Mora, Ester; Vieta, Eduard; Bartrés-Faz, David; Portella, Maria J

    2015-02-01

    Cognitive reserve (CR) refers to the hypothesized capacity of an adult brain to cope with brain pathology in order to minimize symptomatology. CR was initially investigated in dementia and acute brain damage, but it is being applied to other neuropsychiatric conditions. The present study aims at examining the fit of this concept to a sample of euthymic bipolar patients compared with healthy controls in order to investigate the role of CR in predicting psychosocial and cognitive outcome in bipolar disorder (BD). The sample included 101 subjects: 52 patients meeting DSM-IV-TR criteria for BD type I or II and 49 healthy controls (HC) matched for age and gender. They were all assessed with a cognitive battery tapping into executive and memory functioning. CR was obtained using three different proxies: education-occupation, leisure activities and premorbid IQ. Psychosocial functioning was evaluated by means of the Functioning Assessment Short Test (FAST). MANCOVAs were performed to determine differences in cognitive and functioning variables. Linear regression analyses were carried out to predict neuropsychological and psychosocial outcomes. Euthymic bipolar patients showed worse neuropsychological performance and psychosocial functioning than HC. The linear regression models revealed that CR was significantly predictive of FAST score (β = -0.47, p bipolar outpatients. Therefore, CR may contribute to functional outcome in BD and may be applied in research and clinical interventions to prevent cognitive and functional impairment. PMID:25172270

  16. Trastorno afectivo bipolar en niños Bipolar Disorder in Children

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    Santiago Estrada-Jaramillo

    Full Text Available Introducción: La presentación clínica de los niños con posible diagnóstico de trastorno afectivo bipolar (TAB es un gran reto para el psiquiatra, el neurólogo y el pediatra. Objetivos: Proporcionar una visión clínica actualizada sobre el diagnóstico del TAB en los niños, que sirva de herramienta clínica para el psiquiatra, el neurólogo y el pediatra. Método: Se realizó una revisión selectiva con énfasis en la literatura reciente del TAB en los niños, en especial sobre los cambios en el estado de ánimo y el comportamiento; además, se revisó la literatura sobre el diagnóstico frente a otros trastornos de psiquiatría infantil. Resultados: Este artículo plantea dos puntos clave para realizar el abordaje clínico del niño con un posible diagnóstico de TAB, el primero se refiere al reconocimiento de las características de niños y adolescentes eutímicos (normales y de los bipolares, y el segundo, al diagnóstico diferencial, de acuerdo con tres grupos de edad: preescolar, escolar y adolescente. Conclusiones: El psiquiatra general, el neurólogo y el pediatra tienen suficientes herramientas para identificar y diagnosticar el TAB pediátrico y diferenciarlo de otros trastornos infantiles.Introduction: A children clinical presentation of a possible diagnosis of bipolar disorder (BD, becomes a great challenge for the psychiatrist, neurologist and/or pediatrician. Objective: To provide an updated clinical perspective of children with BD diagnosis, that will serve as clinical tool for the psychiatrist, neurologist and/or pediatrician. Method: a selective review of recent literature of children with BD was performed; especially about mood and behavioral changes, and differential diagnosis from other child psychiatry disorders. Results: This paper proposed two key points for the clinical assessment of a child with a possible diagnosis of BD, the first refers to recognize the children and adolescents’ features of euthymic (normal

  17. 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...

  18. Lifetime Prevalence of Psychiatric Disorders among Parents of Children with Bipolar I Disorder: Parental Difference

    OpenAIRE

    Shahrokh Amiri; Mohammad Ali Ghoreishizadeh; Yasaman Alavizadeh; Farnaz Saedi

    2014-01-01

    Background. Evaluation of family system is an important area in the context of child and adolescent mental health. This study aimed to estimate psychiatric disorders in parents of children and adolescents with bipolar I disorder (BID). Methods and Materials. In this cross-sectional study, during 2012-2013, all of the children and adolescents diagnosed with BID based on Kiddie Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version were included. All of the parents (bot...

  19. 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.

  20. 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