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Sample records for bipolar mode group

  1. Saline-enhanced hepatic radiofrequency ablation using a perfused-cooled electrode: comparison of dual probe bipolar mode with monopolar and single probe bipolar modes

    International Nuclear Information System (INIS)

    Lee, Jeong Min; Han, Joon Koo; Kim, Se Hyung; Lee, Jae Young; Kim, Dae Jin; Lee, Min Woo; Cho, Gyung Goo; Han, Chang Jin; Choi, Byung Ihn

    2004-01-01

    To determine whether saline-enhanced dual probe bipolar radiofrequency ablation (RFA) using perfused-cooled electrodes shows better in-vitro efficiency than monopolar or single probe bipolar RFA in creating larger coagulation necrosis. RF was applied to excised bovine livers in both bipolar and monopolar modes using a 200W generator (CC-3; Radionics) and the perfused-cooled electrodes for 10 mins. After placing single or double perfused-cooled electrodes in the explanted liver, 30 ablation zones were created at three different regimens: group A; saline-enhanced monopolar RFA, group B; saline-enhanced single probe bipolar RFA, and group C; saline-enhanced dual probe bipolar RFA. During RFA, we measured the tissue temperature at 15mm from the electrode. The dimensions of the ablation zones and changes in the impedance currents and liver temperature during RFA were then compared between the groups. The mean current values were higher for monopolar mode (group A) than for the bipolar modes (group B and C): 1550 ± 25 mA in group A, 764 ±189 mA in group B and 819 ± 98 mA in group C(ρ 3 in group A, 23.7 ±3.8 cm 3 in group B, and 34.2 ± 5.1 cm 3 in group C(ρ 0.05). The temperature at 15 mm from the electrode was higher in group C than in the other groups: 70 ± 18 .deg. C in group A, 59 ± 23 .deg. C in group B and 96 ± 16 .deg. C in group C (ρ < 0.05). Saline-enhanced bipolar RFA using dual perfused-cooled electrodes increases the dimension of the ablation zone more efficiently than monopolar RFA or single probe bipolar RFA

  2. Radiofrequency ablation in the liver using two cooled-wet electrodes in the bipolar mode

    International Nuclear Information System (INIS)

    Han, Joon Koo; Lee, Jeong Min; Kim, Se Hyung; Lee, Jae Young; Park, Hee Sun; Eo, Hong; Choi, Byung Ihn

    2005-01-01

    The purpose of this study was to demonstrate the efficacy of bipolar radiofrequency ablation (RFA) using cooled-wet electrodes inducing coagulation in ex vivo bovine livers and in in vivo canine livers. In ex vivo experiments, 20 coagulations were created by monopolar (group A), and bipolar RFA (group B) using a 200 W generator (Valleylab) and one or two cooled-wet electrodes. In in vivo experiments, one coagulation was created by bipolar RFA in each of eight dogs via laparotomy. In ex vivo and in vivo experiments, RF was applied to one or two electrodes at 100 W for 10 min. The dimensions of the coagulations were compared in the two groups. In ex vivo experiments, the mean volumes of the coagulations produced in group B (54.0±16.5 cm 3 ) were greater than those produced in group A (33.9±12.7 cm 3 ) (P=0.007). In in vivo experiments, bipolar RFA produced a coagulation of 39.4±15.6 cm 3 without a major complication. The present study showed that a RF electrode system using two cooled-wet electrodes in the bipolar mode created larger coagulation volumes than the monopolar mode, and this system can be used to create large coagulation without major complications. (orig.)

  3. Group interpersonal and social rhythm therapy for bipolar depression.

    Science.gov (United States)

    Hoberg, Astrid A; Ponto, Julie; Nelson, Pamela J; Frye, Mark A

    2013-10-01

    To evaluate the feasibility of 2-week interpersonal and social rhythm therapy group (IPSRT-G) for bipolar depression. Participants with bipolar depression received two individual sessions, six IPSRT-G sessions, and a 12-week telephone call. The Inventory of Depressive Symptomatology-Clinician Rated (IDS-C), Young Mania Rating Scale (YMRS), Sheehan Disability Scale (SDS), and Clinical Global Impressions-Bipolar Version (CGI-BP) were used. IDS-C and SDS scores improved significantly at 12 weeks. YMRS and CGI-BP scores improved but did not reach statistical significance. The promising antidepressive response supports further study of IPSRT-G for bipolar depression. © 2013 Wiley Periodicals, Inc.

  4. Dialectical Behavior Therapy Group Skills Training for Bipolar Disorder.

    Science.gov (United States)

    Eisner, Lori; Eddie, David; Harley, Rebecca; Jacobo, Michelle; Nierenberg, Andrew A; Deckersbach, Thilo

    2017-07-01

    There is growing evidence that the capacity for emotion regulation is compromised in individuals with bipolar disorder. Dialectical behavior therapy (DBT), an empirically supported treatment that specifically targets emotion dysregulation, may be an effective adjunct treatment for improving emotion regulation and residual mood symptoms in patients with bipolar disorder. In this open, proof-of-concept pilot study, 37 participants engaged in a 12-week DBT group skills training program, learning mindfulness, emotion regulation, and distress tolerance skills. Repeated measures mixed models revealed skill acquisition in the areas of mindfulness, emotion regulation and distress tolerance, as well as improved psychological well-being and decreased emotion reactivity. The results of this study support a burgeoning literature that DBT is a feasible adjunct intervention for patients with bipolar disorder. Copyright © 2017. Published by Elsevier Ltd.

  5. Radio frequency ablation in the rabbit lung using wet electrodes: comparison of monopolar and dual bipolar electrode mode

    International Nuclear Information System (INIS)

    Jin, Gong Yong; Park, Sang Hee; Han, Young Min; Chung, Gyung Ho; Kwak, Hyo Sung; Jeon, Soo Bin; Lee, Yong Chul

    2006-01-01

    To compare the effect of radio frequency ablation (RFA) on the dimensions of radio frequency coagulation necrosis in a rabbit lung using a wet electrode in monopolar mode with that in dual electrode bipolar mode at different infusion rates (15 mm/hr versus 30 ml/hr) and saline concentrations (0.9% normal versus 5.8% hypertonic saline. Fifty ablation zones (one ablation zone in each rabbit) were produced in 50 rabbit using one or two 16-guage wet electrodes with a 1- cm active tip. The RFA system used in the monopolar and dual electrode wet bipolar RFA consisted of a 375-kHz generator (Elektrotom HiTT 106, Berchtold, Medizinelektronik, Germany). The power used was 30 watts and the exposure time was 5 minutes. The rabbits were assigned to one of five groups. Group A (n = 10) was infused with 0.9% NaCl used at a rate of 30 ml/hr in a monopolar mode. Groups B (n=10) and C (n=10) were infused with 0.9% NaCl at a rate of 15 and 30ml/hr, respectively in dual electrode bipolar mode; groups D (n=10) and E (n=10) were infused with 5.8% NaCl at a rate of 15 and 30 ml/hr, respectively in a dual electrode bipolar mode. The dimensions of the ablation zones in the gross specimens from the groups were compared using one-way analysis of variance by means of the Scheffe test (post-hoc testing). The mean largest diameter of the ablation zones was larger in dual electrode bipolar mode (30.9 ± 4.4 mm) than in monopolar mode (22.5 ± 3.5 mm). The mean smallest diameter of the ablation zones was larger in dual electrode bipolar mode (22.3 ± 2.5 mm) than in monopolar mode (19.5 ± 3.5 mm). There were significant differences in the largest and smallest dimension between the monopolar (group A ) ana dual electrode wet bipolar mode (groups B-E). In dual electrode bipolar mode, the mean largest diameter of the ablation zones was larger at an infusion rate of 15 ml/hr (34.2 ± 4.0 mm) than at 30 ml/hr (27.6 ± 0.0 mm), and the mean smallest diameter of the ablation zones was larger at an

  6. Design and development of bipolar 4-quadrant switch-mode power converter for superconducting magnets

    International Nuclear Information System (INIS)

    Yashwant Kumar; Thakur, S.K.; Ghosh, M.K.; Tiwari, T.P.; De, Anirban; Kumari, S.; Saha, S.

    2011-01-01

    A uniform zero crossing magnetic field in a magnet can be achieved by using bipolar power converter with four quadrant operation. A high current bipolar switch-mode power converter (rated ±27 V max , ±7V flat top, ±300A, 100 ppm) has been designed and developed indigenously at VECC Kolkata. Four quadrants operation is accomplished by using power IGBTs in an H-bridge configuration with switching frequency around 20 kHz. The switch-mode power converter is used because of high dynamic response, low output ripple, high efficiency and low input current harmonics. In this paper, circuit topology, function of system components and key system specifications of high current bipolar switch mode power converter is discussed. (author)

  7. Regional homogeneity within the default mode network in bipolar depression: a resting-state functional magnetic resonance imaging study.

    Directory of Open Access Journals (Sweden)

    Chun-Hong Liu

    Full Text Available AIM: We sought to use a regional homogeneity (ReHo approach as an index in resting-state functional magnetic resonance imaging (fMRI to investigate the features of spontaneous brain activity within the default mode network (DMN in patients suffering from bipolar depression (BD. METHODS: Twenty-six patients with BD and 26 gender-, age-, and education-matched healthy subjects participated in the resting-state fMRI scans. We compared the differences in ReHo between the two groups within the DMN and investigated the relationships between sex, age, years of education, disease duration, the Hamilton Rating Scale for Depression (HAMD total score, and ReHo in regions with significant group differences. RESULTS: Our results revealed that bipolar depressed patients had increased ReHo in the left medial frontal gyrus and left inferior parietal lobe compared to healthy controls. No correlations were found between regional ReHo values and sex, age, and clinical features within the BD group. CONCLUSIONS: Our findings indicate that abnormal brain activity is mainly distributed within prefrontal-limbic circuits, which are believed to be involved in the pathophysiological mechanisms underlying bipolar depression.

  8. Psicoterapia em grupo de pacientes com transtorno afetivo bipolar Group psychotherapy for bipolar disorder patients

    Directory of Open Access Journals (Sweden)

    Bernardo Carramão Gomes

    2007-01-01

    treatment of bipolar patients. However, little is known about the effects of these approaches. OBJECTIVE: Evaluate the effectiveness of Group Therapy in the treatment of bipolar affective disorder. METHOD: Review of the literature using Medline, Lilacs, PubMed e ISI, selecting English language articles published between the years of 1975 and 2005. The reference sections of the selected articles, review articles and specialized books were also consulted. Only randomized controlled trails, with more than twenty subjects, were selected. RESULTS: Five published studies were identified; three of them have been published in the last five years. In three of the selected studies, models of Psychoeducation were used, showing an increase in the adherence to the pharmacological treatment. One showed reduction in the number of relapses and hospital admissions. The other two studies combined psychoeducation with some other form of psychotherapeutic approach. In one of them, not only an increase in the remission period but also symptom reduction was identified, concerning manic episodes. DISCUSSION: There has been a growing interest in evidence based psychotherapy interventions for the treatment of bipolar affective disorder over the last years. This fact contrasts with the low number of studies dedicated to group therapy, which could be very useful in institutions where a great number of patients are assisted. The clinical complexities of this disease, the presence of several comorbidities and the different levels of adherence to pharmacotherapy demand the development of diverse therapeutic options, in order to meet the needs of each individual. The studies show that group therapy could be an effective treatment option that deserves better investigations so that it can be used in clinical practice.

  9. International multi-site survey on the use of online support groups in bipolar disorder

    DEFF Research Database (Denmark)

    Bauer, Rita; Conell, Jörn; Glenn, Tasha

    2017-01-01

    BACKGROUND: Peer support is an established component of recovery from bipolar disorder, and online support groups may offer opportunities to expand the use of peer support at the patient's convenience. Prior research in bipolar disorder has reported value from online support groups. AIMS: To unde......BACKGROUND: Peer support is an established component of recovery from bipolar disorder, and online support groups may offer opportunities to expand the use of peer support at the patient's convenience. Prior research in bipolar disorder has reported value from online support groups. AIMS.......8% of the total sample). Given the benefits reported in prior research, clarification of the role of online support groups in bipolar disorder is needed. With only a minority of patients using online support groups, there are analytical challenges for future studies....

  10. Ex Vivo Experiment of Saline-Enhanced Hepatic Bipolar Radiofrequency Ablation with a Perfused Needle Electrode: Comparison with Conventional Monopolar and Simultaneous Monopolar Modes

    International Nuclear Information System (INIS)

    Lee, Jeong Min; Kim, Se Hyung; Han, Joon Koo; Sohn, Kyu Li; Choi, Byung Ihn

    2005-01-01

    The purpose of this study was to validate the saline-enhanced bipolar radiofrequency ablation (RFA) technique using a perfused electrode to increase RF-created coagulation necrosis, to compare that technique with monopolar RFAs and to find appropriate concentrations and volumes of perfused NaCl solution for the bipolar RFA. A total of 90 ablations were performed in explanted bovine livers. In the initial experiments to determine appropriate conditions for bipolar RFA, we created five thermal ablation zones in each condition, with instillations of varied concentrations (0.9-36%) or injection rates (30 mL/hr-120 mL/hr) of NaCl solution. After placement of one or two 16-gauge open-perfused electrodes into bovine livers, the NaCl solution was instilled into the tissue through the electrode. In the second part of the study, 10 ablation zones were created using one or two perfused electrodes for each of five groups under different conditions: a conventional monopolar mode with 0.9% NaCl solution (group A) or with 6% NaCl solution (group B), a simultaneous monopolar mode with 6% NaCl solution (group C) and a bipolar mode with 6% NaCl solution (groups D and E). RF was applied to each electrode for 20 min in groups A, B, C, and E, or for 10 min in group D. During RFA, we measured the tissue temperature 15 mm from the electrode. The temperature changes during the RFA and the dimensions of the ablation zones were compared among the groups. Bipolar RFA created larger short-axis diameters of coagulation necrosis with 6% NaCl solution (35.8 ± 15 mm) than with 0.9% NaCl solution (17 ± 9.7 mm) (P 0.05): 31.0 ± 5.4 mm (group A); 28.8 ± 3.8 mm (group B); 25.5 ± 6.4 mm (group C); 32.6 ± 4.2 mm (group D); 49.4 ± 5.0 mm (group E). Bipolar RFA with instillation of 6% NaCl solution through an open perfusion system demonstrates better efficacy in creating a larger ablation zone than does conventional or simultaneous monopolar modes at the various times examined. Therefore

  11. [Brain activitivation of euthymic patients with Type I bipolar disorder in resting state Default Mode Network].

    Science.gov (United States)

    Vargas, Cristian; Pineda, Julián; Calvo, Víctor; López-Jaramillo, Carlos

    2014-01-01

    As there are still doubts about brain connectivity in type I bipolar disorder (BID), resting-state functional magnetic resonance imaging (RS-fMRI) studies are necessary during euthymia for a better control of confounding factors. To evaluate the differences in brain activation between euthymic BID patients and control subjects using resting state- functional-magnetic resonance imaging (RS-fMRI), and to identify the lithium effect in these activations. A cross-sectional study was conducted on 21 BID patients (10 receiving lithium only, and 11 non-medicated) and 12 healthy control subjects, using RS fMRI and independent component analysis (ICA). Increased activation was found in the right hippocampus (P=.049) and posterior cingulate (P=.040) within the Default Mode Network (DMN) when BID and control group were compared. No statistically significant differences were identified between BID on lithium only therapy and non-medicated BID patients. The results suggest that there are changes in brain activation and connectivity in BID even during euthymic phase and mainly within the DMN network, which could be relevant in affect regulation. Copyright © 2013 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  12. Collector modulation in high-voltage bipolar transistor in the saturation mode: Analytical approach

    Science.gov (United States)

    Dmitriev, A. P.; Gert, A. V.; Levinshtein, M. E.; Yuferev, V. S.

    2018-04-01

    A simple analytical model is developed, capable of replacing the numerical solution of a system of nonlinear partial differential equations by solving a simple algebraic equation when analyzing the collector resistance modulation of a bipolar transistor in the saturation mode. In this approach, the leakage of the base current into the emitter and the recombination of non-equilibrium carriers in the base are taken into account. The data obtained are in good agreement with the results of numerical calculations and make it possible to describe both the motion of the front of the minority carriers and the steady state distribution of minority carriers across the collector in the saturation mode.

  13. International multi-site survey on the use of online support groups in bipolar disorder.

    Science.gov (United States)

    Bauer, Rita; Conell, Jörn; Glenn, Tasha; Alda, Martin; Ardau, Raffaella; Baune, Bernhard T; Berk, Michael; Bersudsky, Yuly; Bilderbeck, Amy; Bocchetta, Alberto; Bossini, Letizia; Castro, Angela M Paredes; Cheung, Eric Y W; Chillotti, Caterina; Choppin, Sabine; Zompo, Maria Del; Dias, Rodrigo; Dodd, Seetal; Duffy, Anne; Etain, Bruno; Fagiolini, Andrea; Hernandez, Miryam Fernández; Garnham, Julie; Geddes, John; Gildebro, Jonas; Gonzalez-Pinto, Ana; Goodwin, Guy M; Grof, Paul; Harima, Hirohiko; Hassel, Stefanie; Henry, Chantal; Hidalgo-Mazzei, Diego; Kapur, Vaisnvy; Kunigiri, Girish; Lafer, Beny; Larsen, Erik R; Lewitzka, Ute; Licht, Rasmus W; Hvenegaard Lund, Anne; Misiak, Blazej; Piotrowski, Patryk; Monteith, Scott; Munoz, Rodrigo; Nakanotani, Takako; Nielsen, René E; O'donovan, Claire; Okamura, Yasushi; Osher, Yamima; Reif, Andreas; Ritter, Philipp; Rybakowski, Janusz K; Sagduyu, Kemal; Sawchuk, Brett; Schwartz, Elon; Scippa, Ângela M; Slaney, Claire; Sulaiman, Ahmad H; Suominen, Kirsi; Suwalska, Aleksandra; Tam, Peter; Tatebayashi, Yoshitaka; Tondo, Leonardo; Vieta, Eduard; Vinberg, Maj; Viswanath, Biju; Volkert, Julia; Zetin, Mark; Whybrow, Peter C; Bauer, Michael

    2017-08-01

    Peer support is an established component of recovery from bipolar disorder, and online support groups may offer opportunities to expand the use of peer support at the patient's convenience. Prior research in bipolar disorder has reported value from online support groups. To understand the use of online support groups by patients with bipolar disorder as part of a larger project about information seeking. The results are based on a one-time, paper-based anonymous survey about information seeking by patients with bipolar disorder, which was translated into 12 languages. The survey was completed between March 2014 and January 2016 and included questions on the use of online support groups. All patients were diagnosed by a psychiatrist. Analysis included descriptive statistics and general estimating equations to account for correlated data. The survey was completed by 1222 patients in 17 countries. The patients used the Internet at a percentage similar to the general public. Of the Internet users who looked online for information about bipolar disorder, only 21.0% read or participated in support groups, chats, or forums for bipolar disorder (12.8% of the total sample). Given the benefits reported in prior research, clarification of the role of online support groups in bipolar disorder is needed. With only a minority of patients using online support groups, there are analytical challenges for future studies.

  14. Pragmatic randomised controlled trial of group psychoeducation versus group support in the maintenance of bipolar disorder

    Directory of Open Access Journals (Sweden)

    Roberts Christopher

    2011-07-01

    Full Text Available Abstract Background Non-didactically delivered curriculum based group psychoeducation has been shown to be more effective than both group support in a specialist mood disorder centre in Spain (with effects lasting up to five years, and treatment as usual in Australia. It is unclear whether the specific content and form of group psychoeducation is effective or the chance to meet and work collaboratively with other peers. The main objective of this trial is to determine whether curriculum based group psychoeducation is more clinically and cost effective than unstructured peer group support. Methods/design Single blind two centre cluster randomised controlled trial of 21 sessions group psychoeducation versus 21 sessions group peer support in adults with bipolar 1 or 2 disorder, not in current episode but relapsed in the previous two years. Individual randomisation is to either group at each site. The groups are carefully matched for the number and type of therapists, length and frequency of the interventions and overall aim of the groups but differ in content and style of delivery. The primary outcome is time to next bipolar episode with measures of the therapeutic process, barriers and drivers to the effective delivery of the interventions and economic analysis. Follow up is for 96 weeks after randomisation. Discussion The trial has features of both an efficacy and an effectiveness trial design. For generalisability in England it is set in routine public mental health practice with a high degree of expert patient involvement. Trial Registration ISRCTN62761948 Funding National Institute for Health Research, England.

  15. Switching bipolar hepatic radiofrequency ablation using internally cooled wet electrodes: comparison with consecutive monopolar and switching monopolar modes

    Science.gov (United States)

    Yoon, J H; Woo, S; Hwang, E J; Hwang, I; Choi, W; Han, J K; Choi, B I

    2015-01-01

    Objective: To evaluate whether switching bipolar radiofrequency ablation (SB-RFA) using three internally cooled wet (ICW) electrodes can induce coagulations >5 cm in porcine livers with better efficiency than consecutive monopolar (CM) or switching monopolar (SM) modes. Methods: A total of 60 coagulations were made in 15 in vivo porcine livers using three 17-gauge ICW electrodes and a multichannel radiofrequency (RF) generator. RF energy (approximately 200 W) was applied in CM mode (Group A, n = 20) for 24 min, SM mode for 12 min (Group B, n = 20) or switching bipolar (SB) mode for 12 min (Group C, n = 20) in in vivo porcine livers. Thereafter, the delivered RFA energy, as well as the shape and dimension of coagulations were compared among the groups. Results: Spherical- or oval-shaped ablations were created in 30% (6/20), 85% (17/20) and 90% (18/20) of coagulations in the CM, SM and SB groups, respectively (p = 0.003). SB-RFA created ablations >5 cm in minimum diameter (Dmin) in 65% (13/20) of porcine livers, whereas SM- or CM-RFA created ablations >5 cm in only 25% (5/20) and 20% (4/20) of porcine livers, respectively (p = 0.03). The mean Dmin of coagulations was significantly larger in Group C than in Groups A and B (5.1 ± 0.9, 3.9 ± 1.2 and 4.4 ± 1.0 cm, respectively, p = 0.002) at a lower delivered RF energy level (76.8 ± 14.3, 120.9 ± 24.5 and 114.2 ± 18.3 kJ, respectively, p 5 cm in diameter with better efficiency than do SM- or CM-RFA. Advances in knowledge: SB-RFA can create large, regular ablation zones with better time–energy efficiency than do CM- or SM-RFA. PMID:25873479

  16. On whistler-mode group velocity

    International Nuclear Information System (INIS)

    Sazhin, S.S.

    1986-01-01

    An analytical of the group velocity of whistler-mode waves propagating parallel to the magnetic field in a hot anisotropic plasma is presented. Some simple approximate formulae, which can be used for the magnetospheric applications, are derived. These formulae can predict some properties of this group velocity which were not previously recognized or were obtained by numerical methods. In particular, it is pointed out that the anisotropy tends to compensate for the influence of the electron temperature on the value of the group velocity when the wave frequency is well below the electron gyrofrequency. It is predicted, that under conditions at frequencies near the electron gyrofrequency, this velocity tends towards zero

  17. Comparing Executive Function and Behavioral Inhibition in Schizophrenia, Bipolar Mood Disorder Type I and Normal Groups

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    Marziye Khodaee

    2015-11-01

    Full Text Available Introduction: Cognitive performance in patients with schizophrenia and Bipolar I disorder seems to be different from the normal individuals, that these defects affect their treatment results. Therefore, this study aimed to compare executive function and behavioral inhibition within patients suffering from schizophrenia, bipolar type I as well as a normal group. Methods: In this descriptive-comparative study, out of all patients hospitalized in daily psychiatric clinic in Najafabad in 2014 due to these disorders, 20 schizophrenia and 20 bipolar type I as well as 20 normal individuals were selected via the convinience sampling. All the study participants completed the computerizing tests including Tower of London and Go-No Go. The study data were analyzed utilizing SPSS software (ver 22 via MANOVA. Results: The study findings revealed a significant difference between the two patient groups and the normal group in regard with executive function and behavioral inhibition (p<0.05, whereas no differences were detected between schizophrenics and bipolar patient groups. Furthermore, patients suffering from schizophrenia and bipolar I mood disorder demonstrated significantly poor performance in cognitive function and behavioral inhibition compared to the normal group. Conclusion: The present study results can be significantly applied in pathology and therapy of these disorders, so as recognizing the inability of such patients can be effective in developing cognitive rehabilitation programs in these patients.

  18. Interpersonal and social rhythm group therapy for patients with bipolar disorder

    NARCIS (Netherlands)

    C.G. Bouwkamp (Christian); M.E. de Kruiff (Marije); T.M. van Troost (Thea); M.L. Snippe (Martine); M.B.J. Blom (Marc); R.F.P. de Winter (Remco F.); P.M.J. Haffmans (P.M. Judith)

    2013-01-01

    textabstractThis article describes Interpersonal and Social Rhythm Therapy (IPSRT) adapted for use in a group setting for patients with bipolar disorder. In a preliminary efficacy study, we studied the pre-post group treatment effect on affective symptoms. One-year pre-post findings in the IPSRT

  19. Serotonin transporter gene polymorphism and its association with bipolar disorder across different ethnic groups in Malaysia.

    Science.gov (United States)

    Mohamed Saini, Suriati; Nik Jaafar, Nik Ruzyanei; Sidi, Hatta; Midin, Marhani; Mohd Radzi, Azizah; Abdul Rahman, Abdul Hamid

    2014-01-01

    The risk variants have been shown to vary substantially across populations and a genetic study in a heterogeneous population might shed a new light in the disease mechanism. This preliminary study aims to determine the frequency of the serotonin transporter gene polymorphism (5-HTTLPR) in the three main ethnic groups in Malaysia and its association with bipolar disorder. This is a candidate gene association study of randomly selected forty five unrelated bipolar disorder probands and sixty six controls. Diagnosis was evaluated using the Mini International Neuropsychiatric Interview (M.I.N.I). The control group consisted of healthy volunteers without personal psychiatric history and family history of mood disorder. Patients' whole blood was collected for genotyping. This study revealed that the frequency of the short variant of 5-HTTLPR in healthy control group was highest in Indians (42.9%) followed by Malays (23.5%) and was absent in Chinese. The association between the homozygous ss genotype of the 5-HTTLPR polymorphism with bipolar disorder was not found in the pooled subjects (χ(2)=1.52, d.f.=1, p=0.218, OR=4.67, 95% C.I.=0.69-7.58) and after stratification into Malays (p=0.315, OR=2.03, 95% CI=0.50-8.17), Indians (p=0.310; OR=0.44, 95% CI=0.21-0.92) and Chinese. The differences in the frequency of the short allele of 5-HTTLPR across the three main ethnic groups in Malaysia were noteworthy. The present study showed no significant association between the homozygous short variant of the 5-HTTLPR and bipolar disorder in the pooled subject and after stratification into the three main ethnic groups in Malaysia. Copyright © 2014 Elsevier Inc. All rights reserved.

  20. Becoming the denigrated other: Group relations perspectives on initial reactions to a bipolar disorder diagnosis

    Directory of Open Access Journals (Sweden)

    Susan G. Goldberg

    2012-09-01

    Full Text Available The initial reactions to a bipolar disorder diagnosis of research participants in a small, qualitative study consisted of astonishment, dread of being mad, and extremely negative associations. All had prior mental health diagnoses, including episodes of severe depression (all but one and alcoholism (one. All participants reported mental health histories prediagnosis and most had spent years contending with mental health labels, medications, symptoms, and hospitalizations. In addition, most participants were highly educated health professionals, quite familiar with the behaviors that the medical system considered to comprise bipolar disorder. Their negative associations to the initial bipolar disorder diagnosis, therefore, appeared inconsistent with their mental health histories and professional knowledge. This article contextualizes these initial reactions of shock and distress and proposes interpretations of these findings from societal and psychodynamic group relations perspectives. The participants’ initial negative reactions are conceptualized as involving the terror of being transported from the group of normal people into the group of mad or crazy people, i.e., people with mental illnesses, who may constitute a societal denigrated other.

  1. Cortical abnormalities in bipolar disorder: an MRI analysis of 6503 individuals from the ENIGMA Bipolar Disorder Working Group

    NARCIS (Netherlands)

    Hibar, D. P.; Westlye, L. T.; Doan, N. T.; Jahanshad, N.; Cheung, J. W.; Ching, C. R. K.; Versace, A.; Bilderbeck, A. C.; Uhlmann, A.; Mwangi, B.; Krämer, B.; Overs, B.; Hartberg, C. B.; Abé, C.; Dima, D.; Grotegerd, D.; Sprooten, E.; Bøen, E.; Jimenez, E.; Howells, F. M.; Delvecchio, G.; Temmingh, H.; Starke, J.; Almeida, J. R. C.; Goikolea, J. M.; Houenou, J.; Beard, L. M.; Rauer, L.; Abramovic, L.; Bonnin, M.; Ponteduro, M. F.; Keil, M.; Rive, M. M.; Yao, N.; Yalin, N.; Najt, P.; Rosa, P. G.; Redlich, R.; Trost, S.; Hagenaars, S.; Fears, S. C.; Alonso-Lana, S.; van Erp, T. G. M.; Nickson, T.; Chaim-Avancini, T. M.; Meier, T. B.; Elvsåshagen, T.; Haukvik, U. K.; Lee, W. H.; Schene, A. H.; Lloyd, A. J.; Young, A. H.; Nugent, A.; Dale, A. M.; Pfennig, A.; McIntosh, A. M.; Lafer, B.; Baune, B. T.; Ekman, C. J.; Zarate, C. A.; Bearden, C. E.; Henry, C.; Simhandl, C.; McDonald, C.; Bourne, C.; Stein, D. J.; Wolf, D. H.; Cannon, D. M.; Glahn, D. C.; Veltman, D. J.; Pomarol-Clotet, E.; Vieta, E.; Canales-Rodriguez, E. J.; Nery, F. G.; Duran, F. L. S.; Busatto, G. F.; Roberts, G.; Pearlson, G. D.; Goodwin, G. M.; Kugel, H.; Whalley, H. C.; Ruhe, H. G.; Soares, J. C.; Fullerton, J. M.; Rybakowski, J. K.; Savitz, J.; Chaim, K. T.; Fatjó-Vilas, M.; Soeiro-de-Souza, M. G.; Boks, M. P.; Zanetti, M. V.; Otaduy, M. C. G.; Schaufelberger, M. S.; Alda, M.; Ingvar, M.; Phillips, M. L.; Kempton, M. J.; Bauer, M.; Landén, M.; Lawrence, N. S.; van Haren, N. E. M.; Horn, N. R.; Freimer, N. B.; Gruber, O.; Schofield, P. R.; Mitchell, P. B.; Kahn, R. S.; Lenroot, R.; Machado-Vieira, R.; Ophoff, R. A.; Sarró, S.; Frangou, S.; Satterthwaite, T. D.; Hajek, T.; Dannlowski, U.; Malt, U. F.; Arolt, V.; Gattaz, W. F.; Drevets, W. C.; Caseras, X.; Agartz, I.; Thompson, P. M.; Andreassen, O. A.

    2017-01-01

    Despite decades of research, the pathophysiology of bipolar disorder (BD) is still not well understood. Structural brain differences have been associated with BD, but results from neuroimaging studies have been inconsistent. To address this, we performed the largest study to date of cortical gray

  2. Efficacy of Group Cognitive–behavioral Therapy in Maintenance Treatment and Relapse Prevention for Bipolar Adolescents

    Directory of Open Access Journals (Sweden)

    Soroor Arman

    2018-01-01

    Full Text Available Background: Despite conducting wide-ranging of pharmacotherapy for bipolar adolescents, many of them are showing a deficit in functioning with high relapse rate. The aim of the current study was to develop a manual and investigate the efficacy of group cognitive–behavioral therapy (G-CBT for female bipolar adolescents. Materials and Methods: During the first qualitative phase of a mixed-methods study, a manual of G-CBT was developed. Then, 32 female bipolar adolescents aged 12–19 years old, receiving usual maintenance medications (UMM, were selected. Participants were randomized to the control (UMM and intervention group (5, 2 h weekly sessions based on G-CBT manual with UMM. The parents in intervention group participated in three parallel sessions. All participants filled the following questionnaires before 1, 3, and 6 months after the initiation of the study: Young Mania Rating Scale, Children Depression Inventory and Global Assessment of Functioning. The results were analyzed using SPSS 21 software. The concurrent qualitative phase was analyzed through thematic analysis. Results: The results showed no significant differences in all questionnaires' scores through intervention and follow-up sessions (P > 0.05. However, using cutoff point of CDI, G-CBT was effective for intervention group (relapse rate: 25% vs. 44.4%. Two themes were extracted from the second qualitative phase: emotion recognition and emotion regulation, especially in anger control. Conclusions: The results showed that the addition of G-CBT to UMM leads to decrease in the depressive scores but has no effect on manic symptoms and relapse rate.

  3. Efficacy of Group Cognitive-behavioral Therapy in Maintenance Treatment and Relapse Prevention for Bipolar Adolescents.

    Science.gov (United States)

    Arman, Soroor; Golmohammadi, Farnaz; Maracy, Mohammadreza; Molaeinezhad, Mitra

    2018-01-01

    Despite conducting wide-ranging of pharmacotherapy for bipolar adolescents, many of them are showing a deficit in functioning with high relapse rate. The aim of the current study was to develop a manual and investigate the efficacy of group cognitive-behavioral therapy (G-CBT) for female bipolar adolescents. During the first qualitative phase of a mixed-methods study, a manual of G-CBT was developed. Then, 32 female bipolar adolescents aged 12-19 years old, receiving usual maintenance medications (UMM), were selected. Participants were randomized to the control (UMM) and intervention group (5, 2 h weekly sessions based on G-CBT manual with UMM). The parents in intervention group participated in three parallel sessions. All participants filled the following questionnaires before 1, 3, and 6 months after the initiation of the study: Young Mania Rating Scale, Children Depression Inventory and Global Assessment of Functioning. The results were analyzed using SPSS 21 software. The concurrent qualitative phase was analyzed through thematic analysis. The results showed no significant differences in all questionnaires' scores through intervention and follow-up sessions ( P > 0.05). However, using cutoff point of CDI, G-CBT was effective for intervention group (relapse rate: 25% vs. 44.4%). Two themes were extracted from the second qualitative phase: emotion recognition and emotion regulation, especially in anger control. The results showed that the addition of G-CBT to UMM leads to decrease in the depressive scores but has no effect on manic symptoms and relapse rate.

  4. Wide-range bipolar pulse conductance instrument employing current and voltage modes with sampled or integrated signal acquisition

    Energy Technology Data Exchange (ETDEWEB)

    Calhoun, R K; Holler, F J [Kentucky Univ., Lexington, KY (United States). Dept. of Chemistry; Geiger, jr, R F; Nieman, T A [Illinois Univ., Urbana, IL (United States). Dept. of Chemistry; Caserta, K J [Procter and Gamble Co., Cincinnati, OH (United States)

    1991-11-05

    An instrument for measuring solution conductance using the bipolar pulse technique is described. The instrument is capable of measuring conductances in the range of 5x10{sup -9}-10{Omega}{sup -1} with 1% accuracy or better in as little as 32 {mu}s. Accuracy of 0.001-0.01% is achievable over the range 1x10{sup -6}-1{Omega}{sup -1}. Circuitry and software are described that allow the instrument to adjust automatically the pulse height, pulse duration, excitation mode (current or voltage pulse) and data acquisition mode (sampled or integrated) to acquire data of optimum accuracy and precision. The urease-catalyzed decomposition of urea is used to illustrate the versality of the instrument, and other applications are cited. (author). 60 refs.; 7 figs.; 2 tabs.

  5. Mode group specific amplification length in an asymmetric LPG assisted few-mode EDFA

    Science.gov (United States)

    Rastogi, Vipul; Gaur, Ankita; Aschieri, Pierre; Dussardier, Bernard

    2017-01-01

    This article presents a scheme for few-mode EDFA, which allows to choose independent amplification lengths for different mode groups. The EDF is a dual concentric core fiber, where the central core is connected to the line FMF and the ring core is doped with erbium to provide amplification. The modes of FMF are launched into the central core of the EDF, are converted into ring modes using LPG for amplification and then converted back into central core modes using another LPG. The distance between the LPGs determines the amplification length. The amplification length, can thus, be chosen for a given mode group. We demonstrate the working of this concept by choosing LP11 and LP21 mode groups of the FMF and show that a suitable choice of amplification lengths for the two mode groups can tailor the differential modal gain (DMG) to any desired value. We demonstrate achieving zero DMG among all the mode of LP11 and LP21 mode groups using this concept while having gain in excess of 20 dB. The study should be useful for optical fiber communication system employing space-division multiplexing (SDM).

  6. Design considerations for a transparent mode group diversity multiplexing link

    NARCIS (Netherlands)

    Tsekrekos, C.; Martinez, A.; Huijskens, Frans; Koonen, A.M.J.

    2006-01-01

    Mode group diversity multiplexing (MGDM) is an optical multiple-input-multiple-output technique that aims at creating independent communication channels over a multimode fiber, using subsets of propagating modes. This letter deals with the analysis of an MGDM point-to-point link, transparent to the

  7. Whistler-mode signals: Group delay by cross correlation

    International Nuclear Information System (INIS)

    Thomson, N.R.

    1975-01-01

    Group travel times of 18.6 kHz whistler-mode signals from NLK, Seattle, to Wellington, New Zealand, are now being measured using the normal FSK transmissions. This is done using a mini-computer programmed to perform real-time cross correlations between two receivers: one receiver gets its signal from a whip aerial on which the ground wave (subionospheric mode) dominates, while the other gets its signal from a loop oriented for minimum ground wave. Group travel time can thus be measured continuously while there are whistler-mode signals present. Delays of 0.2--0.8 seconds have been found

  8. Distinguishing zero-group-velocity modes in photonic crystals

    International Nuclear Information System (INIS)

    Ghebrebrhan, M.; Ibanescu, M.; Johnson, Steven G.; Soljacic, M.; Joannopoulos, J. D.

    2007-01-01

    We examine differences between various zero-group-velocity modes in photonic crystals, including those that arise from Bragg diffraction, anticrossings, and band repulsion. Zero-group velocity occurs at points where the group velocity changes sign, and therefore is conceptually related to 'left-handed' media, in which the group velocity is opposite to the phase velocity. We consider this relationship more quantitatively in terms of the Fourier decomposition of the modes, by defining a measure of how much the ''average'' phase velocity is parallel to the group velocity--an anomalous region is one in which they are mostly antiparallel. We find that this quantity can be used to qualitatively distinguish different zero-group-velocity points. In one dimension, such anomalous regions are found never to occur. In higher dimensions, they are exhibited around certain zero-group-velocity points, and lead to unusual enhanced confinement behavior in microcavities

  9. No-touch radiofrequency ablation using multiple electrodes: An in vivo comparison study of switching monopolar versus switching bipolar modes in porcine livers.

    Directory of Open Access Journals (Sweden)

    Won Chang

    Full Text Available To evaluate the in vivo technical feasibility, efficiency, and safety of switching bipolar (SB and switching monopolar (SM radiofrequency ablation (RFA as a no-touch ablation technique in the porcine liver.The animal care and use committee approved this animal study and 16 pigs were used in two independent experiments. In the first experiment, RFA was performed on 2-cm tumor mimickers in the liver using a no-touch technique in the SM mode (2 groups, SM1: 10 minutes, n = 10; SM2: 15 minutes, n = 10 and SB-mode (1 group, SB: 10 minutes, n = 10. The technical success with sufficient safety margins, creation of confluent necrosis, ablation size, and distance between the electrode and ablation zone margin (DEM, were compared between groups. In the second experiment, thermal injury to the adjacent anatomic organs was compared between SM-RFA (15 minutes, n = 13 and SB-RFA modes (10 minutes, n = 13.The rates of the technical success and the creation of confluent necrosis were higher in the SB group than in the SM1 groups (100% vs. 60% and 90% vs. 40%, both p < 0.05. The ablation volume in the SM2 group was significantly larger than that in the SB group (59.2±18.7 cm3 vs. 39.8±9.7 cm3, p < 0.05, and the DEM in the SM2 group was also larger than that in the SB group (1.39±0.21 cm vs. 1.07±0.10 cm, p < 0.05. In the second experiment, the incidence of thermal injury to the adjacent organs and tissues in the SB group (23.1%, 3/13 was significantly lower than that in the SM group (69.2%, 8/13 (p = 0.021.SB-RFA was more advantageous for a no-touch technique for liver tumors, showing the potential of a better safety profile than SM-RFA.

  10. MOSFET-BJT hybrid mode of the gated lateral bipolar junction transistor for C-reactive protein detection.

    Science.gov (United States)

    Yuan, Heng; Kwon, Hyurk-Choon; Yeom, Se-Hyuk; Kwon, Dae-Hyuk; Kang, Shin-Won

    2011-10-15

    In this study, we propose a novel biosensor based on a gated lateral bipolar junction transistor (BJT) for biomaterial detection. The gated lateral BJT can function as both a BJT and a metal-oxide-semiconductor field-effect transistor (MOSFET) with both the emitter and source, and the collector and drain, coupled. C-reactive protein (CRP), which is an important disease marker in clinical examinations, can be detected using the proposed device. In the MOSFET-BJT hybrid mode, the sensitivity, selectivity, and reproducibility of the gated lateral BJT for biosensors were evaluated in this study. According to the results, in the MOSFET-BJT hybrid mode, the gated lateral BJT shows good selectivity and reproducibility. Changes in the emitter (source) current of the device for CRP antigen detection were approximately 0.65, 0.72, and 0.80 μA/decade at base currents of -50, -30, and -10 μA, respectively. The proposed device has significant application in the detection of certain biomaterials that require a dilution process using a common biosensor, such as a MOSFET-based biosensor. Copyright © 2011 Elsevier B.V. All rights reserved.

  11. Ventricular fibrillation induced by coagulating mode bipolar electrocautery during pacemaker implantation in Myotonic Dystrophy type 1 patient.

    Science.gov (United States)

    Russo, Vincenzo; Rago, Anna; DI Meo, Federica; Cioppa, Nadia Della; Papa, Andrea Antonio; Russo, Maria Giovanna; Nigro, Gerardo

    2014-12-01

    The occurrence of ventricular fibrillation, induced by bipolar electrocautery during elective dual chamber pacemaker implantation, is reported in a patient affected by Myotonic Distrophy type 1 with normal left ventricular ejection fraction.

  12. A randomized, controlled, pilot study of dialectical behavior therapy skills in a psychoeducational group for individuals with bipolar disorder.

    Science.gov (United States)

    Van Dijk, Sheri; Jeffrey, Janet; Katz, Mark R

    2013-03-05

    Bipolar disorder (BD) is a chronic and disabling psychiatric disorder characterized by recurrent episodes of mania/hypomania and depression. Dialectical behavior therapy (DBT) techniques have been shown to effectively treat borderline personality disorder, a condition also marked by prominent affective disturbances. The utility of DBT techniques in treating BD has been largely unexplored. The purpose of this research was to conduct a pilot study of a DBT-based psychoeducational group (BDG) in treating euthymic, depressed, or hypomanic Bipolar I or II patients. In this experiment, 26 adults with bipolar I or II were randomized to intervention or wait-list control groups and completed the Beck depression inventory II, mindfulness-based self-efficacy scale, and affective control scale at baseline and 12 weeks. The BDG intervention consisted of 12 weekly 90-min sessions which taught DBT skills, mindfulness techniques, and general BD psychoeducation. Using RM-ANOVA, subjects in BDG demonstrated a trend toward reduced depressive symptoms, and significant improvement in several MSES subscales indicating greater mindful awareness, and less fear toward and more control of emotional states (ACS). These findings were supported with a larger sample of patients who completed the BDG. Furthermore, group attendees had reduced emergency room visits and mental health related admissions in the six months following BDG. The small sample size in RCT affects power to detect between group differences. How well improvements after the12-week BDG were maintained is unknown. There is preliminary evidence that DBT skills reduce depressive symptoms, improve affective control, and improve mindfulness self-efficacy in BD. Its application warrants further evaluation in larger studies. Copyright © 2012 Elsevier B.V. All rights reserved.

  13. An investigation of group IV alloys and their applications in bipolar transistors

    International Nuclear Information System (INIS)

    Anteney, I.M.

    2000-09-01

    This thesis investigates the use of carbon in group IV alloys and their potential uses in bipolar transistors. The first part of the thesis investigates the ability of carbon to suppress transient enhanced diffusion in SiGe heterojunction bipolar transistors, whilst the second part deals with the impact of carbon incorporation on the electrical properties of polycrystalline silicon and silicon-germanium films. A background doping concentration (10 20 cm -3 ) of C has been introduced into the base of SiGe HBTs with the aim of studying the effects of C on TED of B from the base. An electrical method is used to extract the bandgap narrowing in the base of SiGe and SiGe:C HBTs through measurements of the temperature dependence of I c at different C/B reverse biases. The method is very sensitive to small amounts of dopant out-diffusion from the base and hence is ideal for determining the effect of C on TED. Extracted BGN values of 115meV and 173meV were obtained for the SiGe and SiGe:C HBTs respectively, for a C/B reverse bias of 0V. Increasing the C/B reverse bias to 1V increased the extracted BGN of the SiGe HBT to 145meV, but left the SiGe:C value unchanged. This demonstrates that no parasitic energy barrier exists in the SiGe:C HBT and that TED has been suppressed. The effect of carbon position and concentration has been studied by introducing a peak C concentration of 10 20 cm -3 in the collector and 1.1x10 19 cm -3 or 1.5x10 19 cm -3 C in the base. From these measurements it has been shown that TED is only suppressed in the device with 1.5x10 19 cm -3 C in the base, indicating that a C concentration of 1.5x10 19 cm -3 is needed to suppress TED and that the C needs to be co-located with the B profile. The effects of carbon on the electrical properties of polycrystalline Si and SiGe films have been investigated. The resistivity, Hall mobility (μ H ) and effective carrier concentration (N EFF ) of n- and p-type polySi 1-y C y and polySi 0.82-y Ge 0.18 C y layers

  14. Experimental characterization of Raman overlaps between mode-groups

    DEFF Research Database (Denmark)

    Christensen, Erik Nicolai; Koefoed, Jacob Gade; Friis, Søren Michael Mørk

    2016-01-01

    Mode-division multiplexing has the potential to further increase data transmission capacity through optical fibers. In addition, distributed Raman amplification is a promising candidate for multi-mode signal amplification due to its desirable noise properties and the possibility of mode-equalized......Mode-division multiplexing has the potential to further increase data transmission capacity through optical fibers. In addition, distributed Raman amplification is a promising candidate for multi-mode signal amplification due to its desirable noise properties and the possibility of mode......-equalized gain. In this paper, we present an experimental characterization of the intermodal Raman intensity overlaps of a few-mode fiber using backward-pumped Raman amplification. By varying the input pump power and the degree of higher order mode-excitation for the pump and the signal in a 10km long two......-mode fiber, we are able to characterize all intermodal Raman intensity overlaps. Using these results, we perform a Raman amplification measurement and demonstrate a mode-differential gain of only 0.25dB per 10dB overall gain. This is, to the best of our knowledge, the lowest mode differential gain achieved...

  15. Comparing Profile of Temperament and Character Dimensions in Patients with Major Depressive Disorder and Bipolar Mood Disorder and Control Group in the Iranian Sample

    Directory of Open Access Journals (Sweden)

    shahram hajirezaei

    2017-06-01

    Full Text Available Objective: This study was conducted to compare the profile of Temperament and Character dimensions in patients with major depressive disorder and bipolar mood disorder and control group.Methods: In this causal-comparative study the population consisted of two clinical groups (major depressive disorder and bipolar mood disorder and a non-clinical group. The sample was 193 subjects (77 patients with major depressive disorder, 86 patients with bipolar mood disorder, and 30 normal people with an age range of 18-65 years and the mean age of 40.1. They were selected from Roozbeh psychiatric hospital using available sampling method. Tools used in this research included Temperament and Character Inventory-140 and General Health Questionnaire-28. Collected data were analyzed by statistical methods of independent t-test and one-way analysis of variance using Statistical Package for the Social Sciences-22 software.Result: The results of comparing the groups showed that there was a significant difference among groups in dimensions of Novelty Seeking, Harm Avoidance, Persistence, Self-Directedness and Cooperativeness (P <0.05. The results showed that only in the Novelty Seeking dimension, the mean was different in males and females (P <0.05.Conclusion: In general, our results showed that patients with major depressive disorder and bipolar mood disorder have different personality profile in some dimensions of Temperament and Character compared with control group.

  16. Child and Family-Focused Cognitive-Behavioral Therapy for Pediatric Bipolar Disorder: Pilot Study of Group Treatment Format

    Science.gov (United States)

    West, Amy E.; Jacobs, Rachel H.; Westerholm, Robert; Lee, Adabel; Carbray, Julie; Heidenreich, Jodi; Pavuluri, Mani N.

    2009-01-01

    Introduction: This study is a preliminary report of a group adaptation of child- and family-focused cognitive behavior therapy (CFF-CBT) for pediatric bipolar disorder (PBD). Methods: CFF-CBT group treatment was provided to twenty six families who had children with a diagnosis of PBD ranging between six- and twelve-years-old. Results: Results indicated that CFF-CBT was feasible and acceptable to families. CFF-CBT resulted in significant improvement in manic, but not depressive, symptoms and in children’s psychosocial functioning post-treatment. In addition, although not statistically significant, parents reported an increased ability to cope with their child’s illness. Results of this study suggest that group psychosocial treatment provided alongside pharmacotherapy may help attain remission of symptoms, as well as increase overall psychosocial coping and well-being in both children and parents. Conclusion: Future work must include a more rigorous test of CFF-CBT in a randomized controlled trial. PMID:19718425

  17. A randomised controlled trial of carer-focussed multi-family group psychoeducation in bipolar disorder.

    LENUS (Irish Health Repository)

    Madigan, K

    2012-05-01

    In a RCT of family psychoeducation, 47 carers of 34 patients were allocated to one of three groups; Multifamily Group Psychoeducation, Solution Focussed Group Therapy or Treatment as Usual. Carers in both the MFGP intervention and the SFGP arm demonstrated greater knowledge and reduction in burden than those in the TAU arm.

  18. Comparison of the patient groups with and without dissociative disorder comorbidity among the inpatients with bipolar disorder

    Directory of Open Access Journals (Sweden)

    Bahadır Bakım

    2016-08-01

    Full Text Available Introduction: This study aims to compare sociodemographic characteristics of the patients with bipolar disorder (BD with and without comorbid dissociative disorder (DD and to investigate the eventual effect of the comorbidity on the treatment.Methods: We enrolled a total of 149 patients diagnosed with BD and treated as inpatients consecutively in Şişli Etfal Hospital, Psychiatry Clinic between 2010 and 2011. For the patients who were diagnosed with DD using SCID-D and with BD using SCID-I, sociodemographic characteristics, YMRS, HAM-D, BPRS, DES scores and duration and number of hospital stays were evaluated.Results: 23 patients (15.4% had dissociative disorder not otherwise specified (DD-NOS, 4 patients (2.6% had dissociative identity disorder (DID and 1 patient (0.6% had dissociative amnesia. BD patients with comorbid DD were found to be predominantly female (p=0.015 and younger (p=0.002 and to have significantly higher DES scores than BD patients without DD (p<0.001. The total score of DES was correlated with duration hospital stay (p=0.001, Spearman r=0.336 in the total sample. Total HAM-D score at the time of admission was significantly higher in the comorbidity group (p=0.027, and suicide item was found to be significantly higher both at admission and at discharge (p<0.001 and p=0.035. Among BPRS scores at admission, hallucinatory behavior item was found to be higher in the comorbidity group (p=0.019. Among YMRS scores both at admission and at discharge, velocity and amount of speech item (p=0.027 and insight item at admission (p=0.006 was found to be significantly higher in the pure bipolar group (p=0.018.Conclusion: In patients with BD, DD comorbidity should be investigated. The BD patients with DD comorbidity tend to be female and younger, and show higher depression scores, leading to a prolonged hospital stay. In the presence of dissociation comorbidity, attempts and number of suicides and hallucinatory behaviors seem to be increased.

  19. The efficacy of psycho-educational group program on medication adherence and global functioning of patients with bipolar disorder type I.

    Science.gov (United States)

    Bahredar, Mohammad Jafar; Asgharnejad Farid, Ali Asghar; Ghanizadeh, Ahmad; Birashk, Behrooz

    2014-01-01

    Psycho-education is now considered as part of the integrated treatment for bipolar disorder. This study aimed to determine the efficacy of group psycho-education on medication adherence and global functioning of patients with bipolar disorder type I. 45 patients with bipolar disorder type I were allocated one of the three groups of psycho-education plus pharmacotherapy, pharmacotherapy and placebo plus pharmacotherapy. A psycho-educational program was conducted for the psycho-educational group during 9 weekly sessions. Medication adherence and global functioning of all the three groups were evaluated before the intervention, three months and six months after the intervention using Medication Adherence Rating Scale (MARS) and Global Assessment of Functioning (GAF). ANOVA was performed to examine the data. In the first and second assessments, the mean score of medication adherence and gobal functioning for patients in the psycho-educational group was significantly higher than that in the control and placebo groups (P=0.001). Medication adherence score of the psycho-educational group was increased from 6.27(0.88) to 7.92(1.38). while the mean score of the psycho-educational group increased from 56.6 (3.58) to 64.17 (2.12):, the global functioning reduced from 56.27(3.17) to 54.17(5.08) in the control group and from 56.67 (3.58) to 56 (4.36) in the placebo group. Psycho-educational program plus pharmacotherapy was effective in improvement medication adherence and global functioning of bipolar patients.

  20. 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. ...

  1. The effectiveness of cognitive behavioral group therapy in treating bipolar disorder: a randomized controlled study A eficácia da terapia cognitivo-comportamental para o tratamento do transtorno bipolar: um estudo controlado e randomizado

    Directory of Open Access Journals (Sweden)

    Rafael Thomaz da Costa

    2011-06-01

    Full Text Available OBJECTIVE: Recent studies suggest that, when combined with pharmacotherapy, structured psychotherapy may modify the course of bipolar disorder. However, there are few studies that have examined the effects of cognitive behavioral group therapy on the course of this disorder. The aim of the present study was to evaluate the effectiveness of 14 sessions of cognitive behavioral group therapy, combined with pharmacotherapy, on the treatment of patients with bipolar disorder, and to compare our results against those from the use of pharmacotherapy alone. METHOD: Forty-one patients with bipolar I and II disorder participated in the study and were randomly allocated to one of two treatment groups; thirty-seven patients remained in the study until its completion. Mood and anxiety symptoms were measured in all subjects. Statistical analysis was used to investigate if the groups differed with respect to demographic characteristics and the scores recorded in the pre- and post-treatment stages, as well as during treatment (intra/inter groups. RESULTS: Patients showed statistically similar population characteristics. The association of cognitive behavioral group therapy and pharmacological treatment proved to be effective. Patients who had undergone cognitive behavioral group therapy presented fewer symptoms of mania, depression and anxiety, as well as fewer and shorter mood change episodes. CONCLUSION: Cognitive behavioral group therapy sessions substantially contributed to the improvement of depression symptoms.OBJETIVO: Estudos recentes sugerem que uma psicoterapia estruturada aplicada junto com a farmacoterapia pode alterar o curso do transtorno afetivo bipolar. Entretanto, poucos estudos investigam os resultados da terapia cognitivo-comportamental em grupo sobre este transtorno psiquiátrico. O objetivo desta pesquisa foi avaliar a eficácia de 14 sessões de terapia cognitivo-comportamental em grupo concomitante à farmacoterapia para bipolares e

  2. The effectiveness of cognitive behavioral group therapy in treating bipolar disorder: a randomized controlled study A eficácia da terapia cognitivo-comportamental para o tratamento do transtorno bipolar: um estudo controlado e randomizado

    Directory of Open Access Journals (Sweden)

    Rafael Thomaz da Costa

    2011-01-01

    Full Text Available OBJECTIVE: Recent studies suggest that, when combined with pharmacotherapy, structured psychotherapy may modify the course of bipolar disorder. However, there are few studies that have examined the effects of cognitive behavioral group therapy on the course of this disorder. The aim of the present study was to evaluate the effectiveness of 14 sessions of cognitive behavioral group therapy, combined with pharmacotherapy, on the treatment of patients with bipolar disorder, and to compare our results against those from the use of pharmacotherapy alone. METHOD: Forty-one patients with bipolar I and II disorder participated in the study and were randomly allocated to one of two treatment groups; thirty-seven patients remained in the study until its completion. Mood and anxiety symptoms were measured in all subjects. Statistical analysis was used to investigate if the groups differed with respect to demographic characteristics and the scores recorded in the pre- and post-treatment stages, as well as during treatment (intra/inter groups. RESULTS: Patients showed statistically similar population characteristics. The association of cognitive behavioral group therapy and pharmacological treatment proved to be effective. Patients who had undergone cognitive behavioral group therapy presented fewer symptoms of mania, depression and anxiety, as well as fewer and shorter mood change episodes. CONCLUSION: Cognitive behavioral group therapy sessions substantially contributed to the improvement of depression symptoms.OBJETIVO: Estudos recentes sugerem que uma psicoterapia estruturada aplicada junto com a farmacoterapia pode alterar o curso do transtorno afetivo bipolar. Entretanto, poucos estudos investigam os resultados da terapia cognitivo-comportamental em grupo sobre este transtorno psiquiátrico. O objetivo desta pesquisa foi avaliar a eficácia de 14 sessões de terapia cognitivo-comportamental em grupo concomitante à farmacoterapia para bipolares e

  3. Orbital angular momentum mode groups multiplexing transmission over 2.6-km conventional multi-mode fiber.

    Science.gov (United States)

    Zhu, Long; Wang, Andong; Chen, Shi; Liu, Jun; Mo, Qi; Du, Cheng; Wang, Jian

    2017-10-16

    Twisted light carrying orbital angular momentum (OAM) is a special kind of structured light that has a helical phase front, a phase singularity, and a doughnut intensity profile. Beyond widespread developments in manipulation, microscopy, metrology, astronomy, nonlinear and quantum optics, OAM-carrying twisted light has seen emerging application of optical communications in free space and specially designed fibers. Instead of specialty fibers, here we show the direct use of a conventional graded-index multi-mode fiber (MMF) for OAM communications. By exploiting fiber-compatible mode exciting and filtering elements, we excite the first four OAM mode groups in an MMF. We demonstrate 2.6-km MMF transmission using four data-carrying OAM mode groups (OAM 0,1 , OAM +1,1 /OAM -1,1 , OAM +2,1 , OAM +3,1 ). Moreover, we demonstrate two data-carrying OAM mode groups multiplexing transmission over the 2.6-km MMF with low-level crosstalk free of multiple-input multiple-output digital signal processing (MIMO-DSP). The demonstrations may open up new perspectives to fiber-based OAM communication/non-communication applications using already existing conventional fibers.

  4. The Role of Intrinsic Brain Functional Connectivity in Vulnerability and Resilience to Bipolar Disorder.

    Science.gov (United States)

    Doucet, Gaelle E; Bassett, Danielle S; Yao, Nailin; Glahn, David C; Frangou, Sophia

    2017-12-01

    Bipolar disorder is a heritable disorder characterized by mood dysregulation associated with brain functional dysconnectivity. Previous research has focused on the detection of risk- and disease-associated dysconnectivity in individuals with bipolar disorder and their first-degree relatives. The present study seeks to identify adaptive brain connectivity features associated with resilience, defined here as avoidance of illness or delayed illness onset in unaffected siblings of patients with bipolar disorder. Graph theoretical methods were used to examine global and regional brain network topology in head-motion-corrected resting-state functional MRI data acquired from 78 patients with bipolar disorder, 64 unaffected siblings, and 41 healthy volunteers. Global network properties were preserved in patients and their siblings while both groups showed reductions in the cohesiveness of the sensorimotor network. In the patient group, these sensorimotor network abnormalities were coupled with reduced integration of core default mode network regions in the ventromedial cortex and hippocampus. Conversely, integration of the default mode network was increased in the sibling group compared with both the patient group and the healthy volunteer group. The authors found that trait-related vulnerability to bipolar disorder was associated with reduced resting-state cohesiveness of the sensorimotor network in patients with bipolar disorder. However, integration of the default mode network emerged as a key feature differentiating disease expression and resilience between the patients and their siblings. This is indicative of the presence of neural mechanisms that may promote resilience, or at least delay illness onset.

  5. Geometrical relationship of flare-generated solar wind structures to the magnetic axes of bipolar sunspot groups adjacent to their originating solar flares

    International Nuclear Information System (INIS)

    Ivanov, K.G.; Evdokimova, L.V.; Mikerina, N.V.

    1982-01-01

    Occurrences of interplanetary shock waves near the Earth after the powerful isolated flares of 1957-1978 are investigated. The close connection between the occurrences of shock waves and the positions of magnetic axes of bipolar groups of sunspots is suggested on the basis of a statistical study. The shock waves are principally observed when the Earth finds itself near the planes that are projected through the flares in parallel to the appropriate magnetic axes of the nearest bipolar groups. This regularity is interpreted as an indirect argument for a three-dimensional geometry for the interplanetary shock waves which, when projected on these flattened to corresponding planes, are traces of large circular arcs. The typical angular scales of isolated interplanetary shock waves are estimated as approx. equal to 150 0 and approx. equal to 30 0 parallel and perpendicular, respectively, to the magnetic axes correspondingly. (orig.)

  6. Failure mode and effects analysis A fuzzy group MCDM approach

    Directory of Open Access Journals (Sweden)

    A. Hadi-Vencheh

    2013-08-01

    Full Text Available In this paper, a new fuzzy group decision making (FGDM model based on alpha-level sets, is proposed to generate, more accurate fuzzy using, risk priority numbers (RPNs and ensure to be robust against the uncertainty. This model allows decision makers (DMs to evaluate FMEA risk factors using linguistic terms rather than precise numerical values, allows them to express their opinions independently. A case study is investigated using the proposed model to illustrate its applications in RPN assessment.

  7. Symplectic Group Representation of the Two-Mode Squeezing Operator in the Coherent State Basis

    Science.gov (United States)

    Fan, Hong-Yi; Chen, Jun-Hua

    2003-11-01

    We find that the coherent state projection operator representation of the two-mode squeezing operator constitutes a loyal group representation of symplectic group, which is a remarkable property of the coherent state. As a consequence, the resultant effect of successively applying two-mode squeezing operators are equivalent to a single squeezing in the two-mode Fock space. Generalization of this property to the 2n-mode case is also discussed. The project supported by National Natural Science Foundation of China under Grant No. 10575057

  8. Innovative research on the group teaching mode based on the LabVIEW virtual environment

    Science.gov (United States)

    Liang, Pei; Huang, Jie; Gong, Hua-ping; Dong, Qian-min; Dong, Yan-yan; Sun, Cai-xia

    2017-08-01

    This paper discusses the widely existing problems of increasing demand of professional engineer in electronic science major and the backward of the teaching mode at present. From one specialized course "Virtual Instrument technique and LABVIEW programming", we explore the new group-teaching mode based on the Virtual Instrument technique, and then the Specific measures and implementation procedures and effect of this teaching mode summarized in the end.

  9. Resonant Hall effect under generation of a self-sustaining mode of spin current in nonmagnetic bipolar conductors with identical characters between holes and electrons

    Science.gov (United States)

    Sakai, Masamichi; Takao, Hiraku; Matsunaga, Tomoyoshi; Nishimagi, Makoto; Iizasa, Keitaro; Sakuraba, Takahito; Higuchi, Koji; Kitajima, Akira; Hasegawa, Shigehiko; Nakamura, Osamu; Kurokawa, Yuichiro; Awano, Hiroyuki

    2018-03-01

    We have proposed an enhancement mechanism of the Hall effect, the signal of which is amplified due to the generation of a sustaining mode of spin current. Our analytic derivations of the Hall resistivity revealed the conditions indispensable for the observation of the effect: (i) the presence of the transverse component of an effective electric field due to spin splitting in chemical potential in addition to the longitudinal component; (ii) the simultaneous presence of holes and electrons each having approximately the same characteristics; (iii) spin-polarized current injection from magnetized electrodes; (iv) the boundary condition for the transverse current (J c, y = 0). The model proposed in this study was experimentally verified by using van der Pauw-type Hall devices consisting of the nonmagnetic bipolar conductor YH x (x ≃ 2) and TbFeCo electrodes. Replacing Au electrodes with TbFeCo electrodes alters the Hall resistivity from the ordinary Hall effect to the anomalous Hall-like effect with an enhancement factor of approximately 50 at 4 T. We interpreted the enhancement phenomenon in terms of the present model.

  10. Bipolar disorders

    DEFF Research Database (Denmark)

    Vieta, Eduard; Berk, Michael; Schulze, Thomas G

    2018-01-01

    Bipolar disorders are chronic and recurrent disorders that affect >1% of the global population. Bipolar disorders are leading causes of disability in young people as they can lead to cognitive and functional impairment and increased mortality, particularly from suicide and cardiovascular disease...... and accurate diagnosis is difficult in clinical practice as the onset of bipolar disorder is commonly characterized by nonspecific symptoms, mood lability or a depressive episode, which can be similar in presentation to unipolar depression. Moreover, patients and their families do not always understand...... a bipolar disorder from other conditions. Optimal early treatment of patients with evidence-based medication (typically mood stabilizers and antipsychotics) and psychosocial strategies is necessary....

  11. Exploring the feasibility and acceptability of a recovery-focused group therapy intervention for adults with bipolar disorder: trial protocol.

    Science.gov (United States)

    Beck, Alison K; Baker, Amanda; Jones, Steven; Lobban, Fiona; Kay-Lambkin, Frances; Attia, John; Banfield, Michelle

    2018-01-31

    Improving accessible, acceptable recovery-oriented service provision for people with bipolar disorder (BD) is an important priority. Mindfulness and acceptance-based cognitive and behavioural therapies (or 'third -wave' CBT) may prove fruitful due to the considerable overlap between these approaches and key features of personal recovery. Groups also confer therapeutic benefits consistent with personal recovery and may improve recovery-oriented service provision by adding another modality for accessing support. The primary objective of this trial is to explore the feasibility and acceptability of a new recovery-focused group therapy (RfGT) intervention for adults with BD. This is the first published feasibility assessment of a time-limited RfGTrecovery-focused group therapy intervention for BD. This protocol describes an open feasibility study, utilising a pre-treatment design versus post- treatment design and nested qualitative evaluation. Participants will be recruited from the Central Coast region of New South Wales, Australia, from primary care providers, specialist mental health services, non-government organisations and via self-referral. The primary outcomes are feasibility and acceptability as indexed by recruitment, retention, intervention adherence, adverse events (if any) and detailed consumer feedback. Clinical outcomes and process measures will be assessed to inform future research. Primary outcome data will utiliseuse descriptive statistics (eg, summarizingsummarising recruitment, demographics, attendance, attrition and intervention adherence). Secondary outcomes will be assessed using repeated-measures analysis of covariance across all time points (including change, effect size and variability). Ethical approval has been granted by the Northern Sydney Local Health District HREChuman research ethics committee (HREC) (HREC/16/HAWKE/69) and The University of Newcastle HREC (H-2016-0107). The Ffindings will be used to improve the intervention per user

  12. Minimizing differential modal gain in cladding-pumped EDFAs supporting four and six mode groups.

    Science.gov (United States)

    Kang, Qiongyue; Lim, Ee-Leong; Jung, Francesco Poletti Yongmin; Baskiotis, Catherine; Alam, Shaif-Ul; Richardson, David J

    2014-09-08

    We employ a Genetic Algorithm for the purpose of minimization of the maximum differential modal gain (DMG) over all the supported signal modes (at the same wavelength) of cladding-pumped four-mode and six-mode-group EDFAs. The optimal EDFA designs found through the algorithm provide less than 1 dB DMG across the C-band (1530-1565 nm) whilst achieving more than 20 dB gain per mode. We then analyze the sensitivity of the DMG to small variations from the optimal value of the erbium doping concentration and the structural parameters, and estimate the fabrication tolerance for reliable amplifier performance.

  13. Daily electronic self-monitoring in bipolar disorder using smartphones - the MONARCA I trial: a randomized, placebo-controlled, single-blind, parallel group trial.

    Science.gov (United States)

    Faurholt-Jepsen, M; Frost, M; Ritz, C; Christensen, E M; Jacoby, A S; Mikkelsen, R L; Knorr, U; Bardram, J E; Vinberg, M; Kessing, L V

    2015-10-01

    The number of studies on electronic self-monitoring in affective disorder and other psychiatric disorders is increasing and indicates high patient acceptance and adherence. Nevertheless, the effect of electronic self-monitoring in patients with bipolar disorder has never been investigated in a randomized controlled trial (RCT). The objective of this trial was to investigate in a RCT whether the use of daily electronic self-monitoring using smartphones reduces depressive and manic symptoms in patients with bipolar disorder. A total of 78 patients with bipolar disorder according to ICD-10 criteria, aged 18-60 years, and with 17-item Hamilton Depression Rating Scale (HAMD-17) and Young Mania Rating Scale (YMRS) scores ≤17 were randomized to the use of a smartphone for daily self-monitoring including a clinical feedback loop (the intervention group) or to the use of a smartphone for normal communicative purposes (the control group) for 6 months. The primary outcomes were differences in depressive and manic symptoms measured using HAMD-17 and YMRS, respectively, between the intervention and control groups. Intention-to-treat analyses using linear mixed models showed no significant effects of daily self-monitoring using smartphones on depressive as well as manic symptoms. There was a tendency towards more sustained depressive symptoms in the intervention group (B = 2.02, 95% confidence interval -0.13 to 4.17, p = 0.066). Sub-group analysis among patients without mixed symptoms and patients with presence of depressive and manic symptoms showed significantly more depressive symptoms and fewer manic symptoms during the trial period in the intervention group. These results highlight that electronic self-monitoring, although intuitive and appealing, needs critical consideration and further clarification before it is implemented as a clinical tool.

  14. DETERMINATION OF BRAKING OPTIMAL MODE OF CONTROLLED CUT OF DESIGN GROUP

    Directory of Open Access Journals (Sweden)

    A. S. Dorosh

    2015-06-01

    Full Text Available Purpose. The application of automation systems of breaking up process on the gravity hump is the efficiency improvement of their operation, absolute provision of trains breaking up safety demands, as well as improvement of hump staff working conditions. One of the main tasks of the indicated systems is the assurance of cuts reliable separation at all elements of their rolling route to the classification track. This task is a sophisticated optimization problem and has not received a final decision. Therefore, the task of determining the cuts braking mode is quite relevant. The purpose of this research is to find the optimal braking mode of control cut of design group. Methodology. In order to achieve the purpose is offered to use the direct search methods in the work, namely the Box complex method. This method does not require smoothness of the objective function, takes into account its limitations and does not require calculation of the function derivatives, and uses only its value. Findings. Using the Box method was developed iterative procedure for determining the control cut optimal braking mode of design group. The procedure maximizes the smallest controlled time interval in the group. To evaluate the effectiveness of designed procedure the series of simulation experiments of determining the control cut braking mode of design group was performed. The results confirmed the efficiency of the developed optimization procedure. Originality. The author formalized the task of optimizing control cut braking mode of design group, taking into account the cuts separation of design group at all elements (switches, retarders during cuts rolling to the classification track. The problem of determining the optimal control cut braking mode of design group was solved. The developed braking mode ensures cuts reliable separation of the group not only at the switches but at the retarders of brake position. Practical value. The developed procedure can be

  15. Tuning the Slide-Roll Motion Mode of Carbon Nanotubes via Hydroxyl Groups

    Science.gov (United States)

    Li, Rui; Wang, Shiwei; Peng, Qing

    2018-05-01

    Controlling the motion of carbon nanotubes is critical in manipulating nanodevices, including nanorobots. Herein, we investigate the motion behavior of SWCNT (10,10) on Si substrate utilizing molecular dynamics simulations. We show that hydroxyl groups have sensitive effect on the carbon nanotube's motion mode. When the hydroxyl groups' ratio on carbon nanotube and silicon substrate surfaces is larger than 10 and 20%, respectively, the motion of carbon nanotube transforms from sliding to rolling. When the hydroxyl groups' ratio is smaller, the slide or roll mode can be controlled by the speed of carbon nanotube, which is ultimately determined by the competition between the interface potential energy and kinetic energy. The change of motion mode holds true for different carbon nanotubes with hydroxyl groups. The chirality has little effect on the motion behavior, as opposed to the diameter, attributed to the hydroxyl groups' ratio. Our study suggests a new route to control the motion behavior of carbon nanotube via hydroxyl groups.

  16. 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…

  17. Mode change of millennial CO2 variability during the last glacial cycle associated with a bipolar marine carbon seesaw.

    Science.gov (United States)

    Bereiter, Bernhard; Lüthi, Dieter; Siegrist, Michael; Schüpbach, Simon; Stocker, Thomas F; Fischer, Hubertus

    2012-06-19

    Important elements of natural climate variations during the last ice age are abrupt temperature increases over Greenland and related warming and cooling periods over Antarctica. Records from Antarctic ice cores have shown that the global carbon cycle also plays a role in these changes. The available data shows that atmospheric CO(2) follows closely temperatures reconstructed from Antarctic ice cores during these variations. Here, we present new high-resolution CO(2) data from Antarctic ice cores, which cover the period between 115,000 and 38,000 y before present. Our measurements show that also smaller Antarctic warming events have an imprint in CO(2) concentrations. Moreover, they indicate that during Marine Isotope Stage (MIS) 5, the peak of millennial CO(2) variations lags the onset of Dansgaard/Oeschger warmings by 250 ± 190 y. During MIS 3, this lag increases significantly to 870 ± 90 y. Considerations of the ocean circulation suggest that the millennial variability associated with the Atlantic Meridional Overturning Circulation (AMOC) undergoes a mode change from MIS 5 to MIS 4 and 3. Ocean carbon inventory estimates imply that during MIS 3 additional carbon is derived from an extended mass of carbon-enriched Antarctic Bottom Water. The absence of such a carbon-enriched water mass in the North Atlantic during MIS 5 can explain the smaller amount of carbon released to the atmosphere after the Antarctic temperature maximum and, hence, the shorter lag. Our new data provides further constraints for transient coupled carbon cycle-climate simulations during the entire last glacial cycle.

  18. A comparative experimental study of the in-vitro efficiency of hypertonic saline-enhanced hepatic bipolar and monopolar radiofrequency ablation

    International Nuclear Information System (INIS)

    Lee, Jeong Min; Han, Joon Koo; Kim, Se Hyung; Sohn, Kyu Li; Lee, Kyoung Ho; Ah, Su Kyung; Choi, Byung Ihn

    2003-01-01

    To compare the in-vitro efficiency of a hypertonic saline (HS)- enhanced bipolar radiofrequency (RF) system with monopolar RF applications by assessing the temperature profile and dimensions of RF-created coagulation necrosis in bovine liver. A total of 27 ablations were performed in explanted bovine livers. After placement of two 16-gauge open-perfused electrodes at an interelectrode distance of 3 cm, 5% HS was instilled into tissue at a rate of 1 mL/min through the electrode. Seventeen thermal ablation zones were created in the monopolar mode (groups A, B), and ten more were created using the two open-perfused electrodes in the bipolar mode (group C). RF was applied to each electrode for 5 mins (for a total of 10 mins, group A) or 10 mins (for a total of 20 mins, group B) at 50W in the sequential monopolar mode, or to both electrodes for 10 min in the bipolar mode (group C). During RF instillation, we measured tissue temperature at the midpoint between the two electrodes. The dimensions of the thermal ablation zones and changes in impedance and wattage during RFA were compared between the groups. With open-perfusion electrodes, the mean accumulated energy output value was lower in the bipolar mode (group C: 26675±3047 Watt's) than in the monopolar mode (group A: 28778±1300 Watt's) but the difference was not statistically significant (p > 0.05). In the bipolar mode, there were impedance rises of more than 700 Ω during RF energy application, but in the monopolar modes, impedance did not changed markedly. In the bipolar mode, however, the temperature at the mid-point between the two probes was higher (85 .deg. C) than in the monopolar modes (65 .deg. C, 80 .deg. C for group A, B, respectively) (p<0.05). In addition, in HS-enhanced bipolar RFA (group C), the shortest diameter at the midpoint between the two electrodes was greater than in either of the monopolar modes: 5.4±5.6 mm (group A); 28.8±8.2 mm (group B); 31.2±7.6 mm (group C) (p<0.05) Using an open

  19. A Lightweight RFID Grouping-Proof Protocol Based on Parallel Mode and DHCP Mechanism

    Directory of Open Access Journals (Sweden)

    Zhicai Shi

    2017-07-01

    Full Text Available A Radio Frequency Identification (RFID grouping-proof protocol is to generate an evidence of the simultaneous existence of a group of tags and it has been applied to many different fields. For current grouping-proof protocols, there still exist some flaws such as low grouping-proof efficiency, being vulnerable to trace attack and information leakage. To improve the secure performance and efficiency, we propose a lightweight RFID grouping-proof protocol based on parallel mode and DHCP (Dynamic Host Configuration Protocol mechanism. Our protocol involves multiple readers and multiple tag groups. During the grouping-proof period, one reader and one tag group are chosen by the verifier by means of DHCP mechanism. When only a part of the tags of the chosen group exist, the protocol can also give the evidence of their co-existence. Our protocol utilizes parallel communication mode between reader and tags so as to ensure its grouping-proof efficiency. It only uses Hash function to complete the mutual authentication among verifier, readers and tags. It can preserve the privacy of the RFID system and resist the attacks such as eavesdropping, replay, trace and impersonation. Therefore the protocol is secure, flexible and efficient. It only uses some lightweight operations such as Hash function and a pseudorandom number generator. Therefore it is very suitable to some low-cost RFID systems.

  20. Exploring the psychosis functional connectome: aberrant intrinsic networks in schizophrenia and bipolar disorder

    Directory of Open Access Journals (Sweden)

    Vince D Calhoun

    2012-01-01

    Full Text Available Intrinsic functional brain networks (INs are regions showing temporal coherence with one another. These INs are present in the context of a task (as opposed to an undirected task such as rest, albeit modulated to a degree both spatially and temporally. Prominent networks include the default mode, attentional fronto-parietal, executive control, bilateral temporal lobe and motor networks. The characterization of INs has recently gained considerable momentum, however; most previous studies evaluate only a small subset of the intrinsic networks (e.g. default mode. In this paper we use independent component analysis to study INs decomposed from fMRI data collected in a large group of schizophrenia patients, healthy controls, and individuals with bipolar disorder, while performing an auditory oddball task. Schizophrenia and bipolar disorder share significant overlap in clinical symptoms, brain characteristics, and risk genes which motivates our goal of identifying whether functional imaging data can differentiate the two disorders. We tested for group differences in properties of all identified intrinsic networks including spatial maps, spectra, and functional network connectivity. A small set of default mode, temporal lobe, and frontal networks with default mode regions appearing to play a key role in all comparisons. Bipolar subjects showed more prominent changes in ventromedial and prefrontal default mode regions whereas schizophrenia patients showed changes in posterior default mode regions. Anti-correlations between left parietal areas and dorsolateral prefrontal cortical areas were different in bipolar and schizophrenia patients and amplitude was significantly different from healthy controls in both patient groups. Patients exhibited similar frequency behavior across multiple networks with decreased low frequency power. In summary, a comprehensive analysis of intrinsic networks reveals a key role for the default mode in both schizophrenia and

  1. Pattern of neural responses to verbal fluency shows diagnostic specificity for schizophrenia and bipolar disorder

    Directory of Open Access Journals (Sweden)

    Walshe Muriel

    2011-01-01

    Full Text Available Abstract Background Impairments in executive function and language processing are characteristic of both schizophrenia and bipolar disorder. Their functional neuroanatomy demonstrate features that are shared as well as specific to each disorder. Determining the distinct pattern of neural responses in schizophrenia and bipolar disorder may provide biomarkers for their diagnoses. Methods 104 participants underwent functional magnetic resonance imaging (fMRI scans while performing a phonological verbal fluency task. Subjects were 32 patients with schizophrenia in remission, 32 patients with bipolar disorder in an euthymic state, and 40 healthy volunteers. Neural responses to verbal fluency were examined in each group, and the diagnostic potential of the pattern of the neural responses was assessed with machine learning analysis. Results During the verbal fluency task, both patient groups showed increased activation in the anterior cingulate, left dorsolateral prefrontal cortex and right putamen as compared to healthy controls, as well as reduced deactivation of precuneus and posterior cingulate. The magnitude of activation was greatest in patients with schizophrenia, followed by patients with bipolar disorder and then healthy individuals. Additional recruitment in the right inferior frontal and right dorsolateral prefrontal cortices was observed in schizophrenia relative to both bipolar disorder and healthy subjects. The pattern of neural responses correctly identified individual patients with schizophrenia with an accuracy of 92%, and those with bipolar disorder with an accuracy of 79% in which mis-classification was typically of bipolar subjects as healthy controls. Conclusions In summary, both schizophrenia and bipolar disorder are associated with altered function in prefrontal, striatal and default mode networks, but the magnitude of this dysfunction is particularly marked in schizophrenia. The pattern of response to verbal fluency is highly

  2. Bipolar Disorder

    Science.gov (United States)

    ... one or other traumatic event Drug or alcohol abuse Complications Left untreated, bipolar disorder can result in serious problems that affect every area of your life, such as: Problems related to drug and alcohol use Suicide or suicide attempts Legal or financial problems Damaged ...

  3. Group psycho-education in patients with bipolar disorder associated with a dependency of toxic substances in patients who are in abstinence

    Directory of Open Access Journals (Sweden)

    Patricia González Alegre

    2009-01-01

    Full Text Available The high comorbility that exists among psychiatric disorders and addictive is important. In the latest years it is produced an increase of the sensibility related to this problem. A great deal it is due to the demand of Mental Health Services and also due to drug dependency, as a consequence of the lack of an integral approach. Because of this fact and because of the mentioned demand, we though it should be pertinent developing a research project in order to check if the carrying the psycho-educative preventive group project out in patients with a diagnose of bipolar disorder with an abuse of drugs history and/or dependency of toxic substance in abstinence at the moment influents in a positive way in the course of the number of relapses in the toxic consumption during at least six months subsequent to the intervention. And at this way, these patients will purchase a greater consciousness of the important of healthy habits in the bipolar disorder and the recovery in the toxic substance abuse. The program will be developed in an experimental research where the patients will be randomly assigned in group control/ experimentally, the intervention will last twenty sessions, each session will be an hour and a half long and will be held weekly. In these sessions we will deal with topics related to the psychiatric disorder and the toxic consume. At the same time we will bank on the development of practical relaxation workshops on in some of the sessions with the object of providing a resource in view of stress situations.

  4. Neutrality in bipolar structures

    DEFF Research Database (Denmark)

    Montero, Javier; Rodríguez, J. Tinguaro; Franco, Camilo

    2014-01-01

    In this paper, we want to stress that bipolar knowledge representation naturally allows a family of middle states which define as a consequence different kinds of bipolar structures. These bipolar structures are deeply related to the three types of bipolarity introduced by Dubois and Prade, but our...... approach offers a systematic explanation of how such bipolar structures appear and can be identified....

  5. Power of the muscular group's taekwondokas of the different qualification in steady-state mode.

    Directory of Open Access Journals (Sweden)

    Saienko Vladimir Grigor'evich

    2011-11-01

    Full Text Available Data are given meaningful totals display of force the muscle groups in athletes in the static mode. Displaying characteristics of muscle groups, hands (7, legs (5, trunk (2.The experiment involved 110 athletes (1-5 years experience training, age - 14-25 years old. Quantitative indicators, which reflect the individual level of informative power trained athletes. The optimum parameters of power qualities of athletes. Recommended use in training of special methods of strength training (isometric, concentric, eccentric, plyometric, isokinetic. In training must take into account the resistance, speed, joint angles, number of repetitions of the same approach.

  6. Bipolar Treatment: Are Bipolar I and Bipolar II Treated Differently?

    Science.gov (United States)

    ... The diagnosis and management of bipolar I and bipolar II disorders: Clinical practice update. Mayo Clinic Proceedings. 2017;92:1532. Haynes PL, et al. Social rhythm therapies for mood disorders: An update. Current Psychiatry Reports. ...

  7. Tourism forecasting using modified empirical mode decomposition and group method of data handling

    Science.gov (United States)

    Yahya, N. A.; Samsudin, R.; Shabri, A.

    2017-09-01

    In this study, a hybrid model using modified Empirical Mode Decomposition (EMD) and Group Method of Data Handling (GMDH) model is proposed for tourism forecasting. This approach reconstructs intrinsic mode functions (IMFs) produced by EMD using trial and error method. The new component and the remaining IMFs is then predicted respectively using GMDH model. Finally, the forecasted results for each component are aggregated to construct an ensemble forecast. The data used in this experiment are monthly time series data of tourist arrivals from China, Thailand and India to Malaysia from year 2000 to 2016. The performance of the model is evaluated using Root Mean Square Error (RMSE) and Mean Absolute Percentage Error (MAPE) where conventional GMDH model and EMD-GMDH model are used as benchmark models. Empirical results proved that the proposed model performed better forecasts than the benchmarked models.

  8. Bipolar electrochemistry.

    Science.gov (United States)

    Fosdick, Stephen E; Knust, Kyle N; Scida, Karen; Crooks, Richard M

    2013-09-27

    A bipolar electrode (BPE) is an electrically conductive material that promotes electrochemical reactions at its extremities (poles) even in the absence of a direct ohmic contact. More specifically, when sufficient voltage is applied to an electrolyte solution in which a BPE is immersed, the potential difference between the BPE and the solution drives oxidation and reduction reactions. Because no direct electrical connection is required to activate redox reactions, large arrays of electrodes can be controlled with just a single DC power supply or even a battery. The wireless aspect of BPEs also makes it possible to electrosynthesize and screen novel materials for a wide variety of applications. Finally, bipolar electrochemistry enables mobile electrodes, dubbed microswimmers, that are able to move freely in solution. Copyright © 2013 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  9. Transtorno bipolar

    Directory of Open Access Journals (Sweden)

    Alda Martin

    1999-01-01

    Full Text Available Os resultados de estudos de famílias sugerem que o transtorno bipolar tenha uma base genética. Essa hipótese foi reforçada em estudos de adoção e de gêmeos. A herança do transtorno bipolar é complexa, envolve vários genes, além de apresentar heterogeneidade e interação entre fatores genéticos e não-genéticos. Achados, que já foram replicados, já implicaram os cromossomos 4, 12, 18 e 21, entre outros, na busca por genes de suscetibilidade. Os resultados mais promissores foram obtidos através de estudos de ligação. Por outro lado, os estudos de associação geraram dados interessantes, mas ainda vagos. Os estudos de populações de pacientes homogêneos e a melhor definição do fenótipo deverão contribuir para avanços futuros. A identificação dos genes relacionados ao transtorno bipolar irá permitir o melhor entendimento e tratamento dessa doença.

  10. Research on Group Operation Mode of Once-through Steam Generator

    International Nuclear Information System (INIS)

    Hao, Cheng Ming; Liu, Xinkai; Peng, Min Jun; Xia, Genglei

    2011-01-01

    Integrated Pressurized Water Reactor (IPWR) owns more than one once-through steam generators (OTSGs). Flow instability may occur in secondary side of OTSG under certain conditions. Trying to avoid the occurrence of flow instability is of great important for the safe and stable operation of OTSG. Because of the fact that flow instability often occurs in certain regions, so when OTSGs operate with low load, OTSGs can be separated into several groups, which can avoid flow instability. In this paper, operational characteristics of IPWR are analyzed by RELAP5/MOD3.4 code and during the discussion of group operation, a rapid change load operation scheme using OTSG group operation mode which can be used in IPWR is proposed

  11. Research on Group Operation Mode of Once-through Steam Generator

    Energy Technology Data Exchange (ETDEWEB)

    Hao, Cheng Ming; Liu, Xinkai; Peng, Min Jun; Xia, Genglei [Harbin Engineering University, Harbin (China)

    2011-08-15

    Integrated Pressurized Water Reactor (IPWR) owns more than one once-through steam generators (OTSGs). Flow instability may occur in secondary side of OTSG under certain conditions. Trying to avoid the occurrence of flow instability is of great important for the safe and stable operation of OTSG. Because of the fact that flow instability often occurs in certain regions, so when OTSGs operate with low load, OTSGs can be separated into several groups, which can avoid flow instability. In this paper, operational characteristics of IPWR are analyzed by RELAP5/MOD3.4 code and during the discussion of group operation, a rapid change load operation scheme using OTSG group operation mode which can be used in IPWR is proposed.

  12. "Recovery" in bipolar disorder: how can service users be supported through a self-management intervention? A qualitative focus group study.

    Science.gov (United States)

    Todd, Nicholas J; Jones, Steven H; Lobban, Fiona A

    2012-04-01

    Bipolar disorder (BD) is a chronic and recurrent affective disorder. Recovery is defined as the process by which people can live fulfilling lives despite experiencing symptoms. To explore how an opportunistically recruited group of service users with BD experience recovery and self-management to understand more about how a service users' recovery may be supported. Twelve service users with BD took part in a series of focus groups. Service users' responses to questions about their personal experiences of self-management and recovery were analysed. Focus groups were transcribed verbatim and thematic analysis ([ Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77-101]) was employed to identify common themes in the data. Four key themes were identified: (1) Recovery is not about being symptom free; (2) Recovery requires taking responsibility for your own wellness; (3) Self-management: building on existing techniques; (4) Overcoming barriers to recovery: negativity, stigma and taboo. Service users with BD have provided further support for the concept of recovery and have suggested a number of ways recovery can be supported. A self-management approach informed by the recovery literature has been proposed as a way to support service users' recovery.

  13. Perception of the environmental impacts of current and alternative modes of pig production by stakeholder groups.

    Science.gov (United States)

    Petit, Jean; van der Werf, Hayo M G

    2003-08-01

    The current industrial pig production model is in crisis, due to its association with environmental pollution, doubtful product quality and lack of animal well-being. In Bretagne (France), a region of intensive pig production, a survey of seven stakeholder groups concerned with pig production was conducted, as part of a research programme dedicated to the assessment of the environmental impact of different modes of pig production. A very large majority of pig producers (93%) and their suppliers (100%) considers pig farms as an asset for the region, whereas a majority of scientists (58%), activists (78%) and consumers (54%) sees it as a handicap. Differences among stakeholder groups are minor with respect to the perceived importance of environmental and social issues. Stakeholders agree on the relative level of responsibility of pig farms with respect to specific problems. For all groups unpleasant odours and water quality come first with respect to responsibility, for most groups soil quality comes second, followed by product safety and air quality. For a future improved mode of pig production, 76% of pig producers and their suppliers prefer to adapt the current model, for all other groups the majority prefers an alternative model. While pig producers and their suppliers prefer a slurry-based housing system, all other groups prefer a straw-based system. Pig producers see the slurry-based system as technically superior and associate the straw-based system with poor working conditions, whereas consumers associate the slurry-based system in the first place with poor water quality and associate the straw-based system with less pollution. These results will be of use in the research programme on the environmental impact of modes of pig production, as they indicate the environmental impacts to be considered and their relative importance. The results will also help in deciding which options should be assessed. It is concluded that the poor image of the current pig

  14. A group ICA based framework for evaluating resting fMRI markers when disease categories are unclear: application to schizophrenia, bipolar, and schizoaffective disorders

    Science.gov (United States)

    Du, Yuhui; Pearlson, Godfrey D; Liu, Jingyu; Sui, Jing; Yu, Qingbao; He, Hao; Castro, Eduardo; Calhoun, Vince D.

    2015-01-01

    Schizophrenia (SZ), bipolar disorder (BP) and schizoaffective disorder (SAD) share some common symptoms, and there is a debate about whether SAD is an independent category. To the best of our knowledge, no study has been done to differentiate these three disorders or to investigate the distinction of SAD as an independent category using fMRI data. The present study is aimed to explore biomarkers from resting-state fMRI networks for differentiating these disorders and investigate the relationship among these disorders based on fMRI networks with an emphasis on SAD. Firstly, a novel group ICA method, group information guided independent component analysis (GIG-ICA), was applied to extract subject-specific brain networks from fMRI data of 20 healthy controls (HC), 20 SZ patients, 20 BP patients, 20 patients suffering SAD with manic episodes (SADM), and 13 patients suffering SAD with depressive episodes exclusively (SADD). Then, five-level one-way analysis of covariance and multiclass support vector machine recursive feature elimination were employed to identify discriminative regions from the networks. Subsequently, the t-distributed stochastic neighbor embedding (t-SNE) projection and the hierarchical clustering methods were implemented to investigate the relationship among those groups. Finally, to evaluate the generalization ability, 16 new subjects were classified based on the found regions and the trained model using original 93 subjects. Results show that the discriminative regions mainly include frontal, parietal, precuneus, cingulate, supplementary motor, cerebellar, insula and supramarginal cortices, which performed well in distinguishing different groups. SADM and SADD were the most similar to each other, although SADD had greater similarity to SZ compared to other groups, which indicates SAD may be an independent category. BP was closer to HC compared with other psychotic disorders. In summary, resting-state fMRI brain networks extracted via GIG-ICA provide

  15. EnviroAtlas - Commute Modes and Working from Home by Block Group for the Conterminous United States

    Data.gov (United States)

    U.S. Environmental Protection Agency — This EnviroAtlas dataset portrays the percent of workers who commute to work using various modes, and the percent who work from home within each Census Block Group...

  16. [Creativity and bipolar disorder].

    Science.gov (United States)

    Maçkalı, Zeynep; Gülöksüz, Sinan; Oral, Timuçin

    2014-01-01

    The relationship between creativity and bipolar disorder has been an intriguing topic since ancient times. Early studies focused on describing characteristics of creative people. From the last quarter of the twentieth century, researchers began to focus on the relationship between mood disorders and creativity. Initially, the studies were based on biographical texts and the obtained results indicated a relationship between these two concepts. The limitations of the retrospective studies led the researchers to develop systematic investigations into this area. The systematic studies that have focused on artistic creativity have examined both the prevalence of mood disorders and the creative process. In addition, a group of researchers addressed the relationship in terms of affective temperaments. Through the end of the 90's, the scope of creativity was widened and the notion of everyday creativity was proposed. The emergence of this notion led researchers to investigate the associations of the creative process in ordinary (non-artist) individuals. In this review, the descriptions of creativity and creative process are mentioned. Also, the creative process is addressed with regards to bipolar disorder. Then, the relationship between creativity and bipolar disorder are evaluated in terms of aforementioned studies (biographical, systematic, psychobiographical, affective temperaments). In addition, a new model, the "Shared Vulnerability Model" which was developed to explain the relationship between creativity and psychopathology is introduced. Finally, the methodological limitations and the suggestions for resolving these limitations are included.

  17. A YinYang bipolar fuzzy cognitive TOPSIS method to bipolar disorder diagnosis.

    Science.gov (United States)

    Han, Ying; Lu, Zhenyu; Du, Zhenguang; Luo, Qi; Chen, Sheng

    2018-05-01

    Bipolar disorder is often mis-diagnosed as unipolar depression in the clinical diagnosis. The main reason is that, different from other diseases, bipolarity is the norm rather than exception in bipolar disorder diagnosis. YinYang bipolar fuzzy set captures bipolarity and has been successfully used to construct a unified inference mathematical modeling method to bipolar disorder clinical diagnosis. Nevertheless, symptoms and their interrelationships are not considered in the existing method, circumventing its ability to describe complexity of bipolar disorder. Thus, in this paper, a YinYang bipolar fuzzy multi-criteria group decision making method to bipolar disorder clinical diagnosis is developed. Comparing with the existing method, the new one is more comprehensive. The merits of the new method are listed as follows: First of all, multi-criteria group decision making method is introduced into bipolar disorder diagnosis for considering different symptoms and multiple doctors' opinions. Secondly, the discreet diagnosis principle is adopted by the revised TOPSIS method. Last but not the least, YinYang bipolar fuzzy cognitive map is provided for the understanding of interrelations among symptoms. The illustrated case demonstrates the feasibility, validity, and necessity of the theoretical results obtained. Moreover, the comparison analysis demonstrates that the diagnosis result is more accurate, when interrelations about symptoms are considered in the proposed method. In a conclusion, the main contribution of this paper is to provide a comprehensive mathematical approach to improve the accuracy of bipolar disorder clinical diagnosis, in which both bipolarity and complexity are considered. Copyright © 2018 Elsevier B.V. All rights reserved.

  18. Genetics of bipolar disorder

    Directory of Open Access Journals (Sweden)

    Kerner B

    2014-02-01

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

  19. Bipolar disorder in adolescence.

    Science.gov (United States)

    DeFilippis, Melissa; Wagner, Karen Dineen

    2013-08-01

    Bipolar disorder is a serious psychiatric condition that may have onset in childhood. It is important for physicians to recognize the symptoms of bipolar disorder in children and adolescents in order to accurately diagnose this illness early in its course. Evidence regarding the efficacy of various treatments is necessary to guide the management of bipolar disorder in youth. For example, several medications commonly used for adults with bipolar disorder have not shown efficacy for children and adolescents with bipolar disorder. This article reviews the prevalence, diagnosis, course, and treatment of bipolar disorder in children and adolescents and provides physicians with information that will aid in diagnosis and treatment.

  20. Exercising control over bipolar disorder.

    Science.gov (United States)

    Malhi, Gin S; Byrow, Yulisha

    2016-11-01

    Following extensive research exercise has emerged as an effective treatment for major depressive disorder, and it is now a recognised therapy alongside other interventions. In contrast, there is a paucity of research examining the therapeutic effects of exercise for those with bipolar disorder. Given that dysfunctional reward processing is central to bipolar disorder, research suggests that exercise can perhaps be framed as a reward-related event that may have the potential to precipitate a manic episode. The behavioural activation system (BAS) is a neurobehavioural system that is associated with responding to reward and provides an appropriate framework to theoretically examine and better understand the effects of exercise treatment on bipolar disorder. This article discusses recent research findings and provides an overview of the extant literature related to the neurobiological underpinnings of BAS and exercise as they relate to bipolar disorder. This is important clinically because depending on mood state in bipolar disorder, we postulate that exercise could be either beneficial or deleterious with positive or negative effects on the illness. Clearly, this complicates the evaluation of exercise as a potential treatment in terms of identifying its optimal characteristics in this population. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  1. What do service users with bipolar disorder want from a web-based self-management intervention? A qualitative focus group study.

    Science.gov (United States)

    Todd, Nicholas J; Jones, Steven H; Lobban, Fiona A

    2013-01-01

    Bipolar disorder (BD) is a chronic and recurrent severe mental health problem. A web-based self-management intervention provides the opportunity to widen access to psychological interventions. This qualitative study aims to identify what an ideal web-based intervention would look like for service users with BD. Twelve service users with BD were recruited in the UK and took part in a series of focus groups to inform and refine the development of a web-based self-management intervention. Reported here is a subset analysis of data gathered with the primary aim of identifying the needs and desires of service users for such an intervention for BD. We analysed service users' responses to questions about content, outcomes, format, barriers and support. Focus groups were transcribed verbatim, and thematic analysis was employed. The data were ordered into four key themes: (1) gaining an awareness of and managing mood swings; (2) not just about managing mood swings: the importance of practical and interpersonal issues; (3) managing living within mood swings without losing the experience; (4) internet is the only format: freely accessible, instant and interactive; (5) professional and peer support to overcome low motivation and procrastination difficulties. The small group of participants are not representative of those living with BD. These findings have significantly enhanced our understanding of what service users with BD want from a web-based self-management intervention and have clear implications for the future development of such approaches. Service users desire a web-based self-management approach that gives them the techniques they need to not only manage their moods but also manage their lives alongside the disorder, including interpersonal and practical issues. Service users describe their primary outcome, not as a cure or reduction in their symptoms, but instead being able to live a fulfilling life alongside their condition. Service users see the internet as their

  2. Bipolar disorder diagnosis: challenges and future directions

    Science.gov (United States)

    Phillips, Mary L; Kupfer, David J

    2018-01-01

    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

  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 patients...

  4. Add-on treatment with N-acetylcysteine for bipolar depression: a 24-week randomized double-blind parallel group placebo-controlled multicentre trial (NACOS-study protocol).

    Science.gov (United States)

    Ellegaard, Pernille Kempel; Licht, Rasmus Wentzer; Poulsen, Henrik Enghusen; Nielsen, René Ernst; Berk, Michael; Dean, Olivia May; Mohebbi, Mohammadreza; Nielsen, Connie Thuroee

    2018-04-05

    Oxidative stress and inflammation may be involved in the development and progression of mood disorders, including bipolar disorder. Currently, there is a scarcity of useful treatment options for bipolar depressive episodes, especially compared with the efficacy of treatment for acute mania. N-Acetylcysteine (NAC) has been explored for psychiatric disorders for some time given its antioxidant and anti-inflammatory properties. The current trial aims at testing the clinical effects of adjunctive NAC treatment (compared to placebo) for bipolar depression. We will also explore the biological effects of NAC in this context. We hypothesize that adjunctive NAC treatment will reduce symptoms of depression, which will be reflected by changes in selected markers of oxidative stress. In the study, we will include adults diagnosed with bipolar disorder, in a currently depressive episode. Participants will undertake a 20-week, adjunctive, randomized, double-blinded, parallel group placebo-controlled trial comparing 3 grams of adjunctive NAC daily with placebo. The primary outcome is the mean change over time from baseline to end of study on the Montgomery-Asberg Depression Rating Scale (MADRS). Among the secondary outcomes are mean changes from baseline to end of study on the Bech-Rafaelsen Melancholia Scale (MES), the Young Mania Rating Scale (YMRS), the WHO-Five Well-being Index (WHO-5), the Global Assessment of Functioning scale (GAF-F), the Global Assessment of Symptoms scale (GAF-S) and the Clinical Global Impression-Severity scale (CGI-S). The potential effects on oxidative stress by NAC treatment will be measured through urine and blood samples. DNA will be examined for potential polymorphisms related to oxidative defences. Registered at The European Clinical Trials Database, ClinicalTrials.gov: NCT02294591 and The Danish Data Protection Agency: 2008-58-0035.

  5. Sensitive typing of reverse ABO blood groups with a waveguide-mode sensor.

    Science.gov (United States)

    Uno, Shigeyuki; Tanaka, Torahiko; Ashiba, Hiroki; Fujimaki, Makoto; Tanaka, Mutsuo; Hatta, Yoshihiro; Takei, Masami; Awazu, Koichi; Makishima, Makoto

    2018-07-01

    Portable, on-site blood typing methods will help provide life-saving blood transfusions to patients during an emergency or natural calamity, such as significant earthquakes. We have previously developed waveguide-mode (WM) sensors for forward ABO and Rh(D) blood typing and detection of antibodies against hepatitis B virus and hepatitis C virus. In this study, we evaluated a WM-sensor for reverse ABO blood typing. Since reverse ABO blood typing is a method for detection of antibodies against type A and type B oligosaccharide antigens on the surface of red blood cells (RBCs), we fixed a synthetic type A or type B trisaccharide antigen on the sensor chip of the WM sensor. We obtained significant changes in the reflectance spectra from a WM sensor on type A antigen with type B plasma and type O plasma and on type B antigen with type A plasma and type O plasma, and no spectrum changes on type A antigen or type B antigen with type AB plasma. Signal enhancement with the addition of a peroxidase reaction failed to increase the sensitivity for detection on oligosaccharide chips. By utilizing hemagglutination detection using regent type A and type B RBCs, we successfully determined reverse ABO blood groups with higher sensitivity compared to a method using oligosaccharide antigens. Thus, functionality of a portable device utilizing a WM sensor can be expanded to include reverse ABO blood typing and, in combination with forward ABO typing and antivirus antibody detection, may be useful for on-site blood testing in emergency settings. Copyright © 2018 The Society for Biotechnology, Japan. Published by Elsevier B.V. All rights reserved.

  6. An astrophysical interpretation of the remarkable g-mode frequency groups of the rapidly rotating γ Dor star, KIC 5608334

    Science.gov (United States)

    Saio, Hideyuki; Bedding, Timothy R.; Kurtz, Donald W.; Murphy, Simon J.; Antoci, Victoria; Shibahashi, Hiromoto; Li, Gang; Takata, Masao

    2018-06-01

    The Fourier spectrum of the γ-Dor variable KIC 5608334 shows remarkable frequency groups at ˜3, ˜6, ˜9, and 11-12 d-1. We explain the four frequency groups as prograde sectoral g modes in a rapidly rotating star. Frequencies of intermediate-to-high radial order prograde sectoral g modes in a rapidly rotating star are proportional to |m| (i.e. ν ∝ |m|) in the corotating frame as well as in the inertial frame. This property is consistent with the frequency groups of KIC 5608334 as well as the period versus period-spacing relation present within each frequency group, if we assume a rotation frequency of 2.2 d-1, and that each frequency group consists of prograde sectoral g modes of |m| = 1, 2, 3, and 4, respectively. In addition, these modes naturally satisfy near-resonance conditions νi ≈ νj + νk with mi = mj + mk. We even find exact resonance frequency conditions (within the precise measurement uncertainties) in many cases, which correspond to combination frequencies.

  7. Nutrition and Bipolar Depression.

    Science.gov (United States)

    Beyer, John L; Payne, Martha E

    2016-03-01

    As with physical conditions, bipolar disorder is likely to be impacted by diet and nutrition. Patients with bipolar disorder have been noted to have relatively unhealthy diets, which may in part be the reason they also have an elevated risk of metabolic syndrome and obesity. An improvement in the quality of the diet should improve a bipolar patient's overall health risk profile, but it may also improve their psychiatric outcomes. New insights into biological dysfunctions that may be present in bipolar disorder have presented new theoretic frameworks for understanding the relationship between diet and bipolar disorder. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. The effect of Group Cognitive-Behaviour Therapy in combination with Pharmacotherapy on Mania and Depression Symptoms and Awareness of warming signs of relapse in patients with Bipolar Disorder

    Directory of Open Access Journals (Sweden)

    Bahram Ali Ghanbari Hashemabadi

    2009-04-01

    Full Text Available "n Objective: This research has been done according to the cognitivebehavioral theories and biochemical model in order to evaluate the efficiency of Group Cognitive-Behavior Therapy in combination with Pharmacotherapy on Mania and Depression Symptoms and Awareness of warning signs of relapse in patients with Bipolar Disorder. "n "nMethods:In this study with the experimental pretest- posttest- follow up plan , 30 women suffering from bipolar disorder, randomly assigned to receive either the group cognitive-behavior therapy (experimental group, n=15 or usual treatment (control group, n=15;and were follow-up for a six months. patients in both groups were prescribed standard Pharmacotherapy. First all subjects were put to a pretest in equal conditions with measures of scale 2 and 9 of MMPI Test, and warning signs checklist. Then the experimental group received group cognitive-behavior therapy for 8 sessions in addition to their medication therapy. The control group only received medicine. At the end of the experiment, all subjects were tested under equal conditions. After completion of the treatment process, the subjects of both groups were supervised for 6 months. The findings of the study were analyzed by the statistical method of Multi-variable analysis of variance with repetitive measurements. "nResults:The findings showed that the group cognitive-behavior therapy had been significantly more efficient in reduction of mania symptoms {p=0/03} and increment of awareness of warning signs of relapse {p=0/00} in comparison with control group; but there is no significantly differences in depression symptoms between two groups. "nConclusion: The findings of this study suggest the beneficial effect of Group cognitive-behavior therapy in reducing of mania symptoms and increment of awareness of warning signs of relapse. Therefore, it can be used as a complementary treatment by clinicians

  9. ERG [Engineering Review Group] and GRG [Geologic Review Group] review of the horizontal versus vertical modes of waste emplacement at the Deaf Smith County site, Texas

    International Nuclear Information System (INIS)

    Chytrowski, B.R.

    1988-01-01

    The Engineering Review Group (ERG) and Geologic Review Group (GRG) were established by the Office of Nuclear Waste Isolation (ONWI) to help evaluate specific issues in the US Department of Energy's nuclear waste repository program. The December 1985 meeting and the February 1986 meeting dealt with the evaluation of the Fluor Technology, Inc., architect-engineer recommendation of the horizontal mode of waste package emplacement for the Site Characterization Plan Conceptual Design Report (SCP-CDR). The ONWI recommendation regarding horizontal and vertical modes of waste package emplacement and associated studies was reviewed. This report documents the ERG and GRG's comments and recommendations on this subject and ONWI responses to the specific points raised by these groups. The ERG and GRG joint review groups concurred with ONWI recommendations that additional studies are required in order to reach a decision on the method of emplacement to be used. In the opinion of these groups, both methods can be implemented; however, should the decision be reached today the vertical mode would be preferred

  10. Determining the group velocity dispersion by field analysis for the LP0X, LP1X, and LP2X mode groups independently of the fiber length: applications to step-index fibers

    DEFF Research Database (Denmark)

    Israelsen, Stine Møller; Usuga Castaneda, Mario A.; Rottwitt, Karsten

    2017-01-01

    By knowing the electric field distribution of a guided mode in an optical fiber, we are able to evaluate the group velocity dispersion in a weakly guiding step-index fiber for a pure mode in the LP0X, LP1X, and LP2X mode groups independently of the fiber length. We demonstrate the method numerica...

  11. Bipolar soft connected, bipolar soft disconnected and bipolar soft compact spaces

    Directory of Open Access Journals (Sweden)

    Muhammad Shabir

    2017-06-01

    Full Text Available Bipolar soft topological spaces are mathematical expressions to estimate interpretation of data frameworks. Bipolar soft theory considers the core features of data granules. Bipolarity is important to distinguish between positive information which is guaranteed to be possible and negative information which is forbidden or surely false. Connectedness and compactness are the most important fundamental topological properties. These properties highlight the main features of topological spaces and distinguish one topology from another. Taking this into account, we explore the bipolar soft connectedness, bipolar soft disconnectedness and bipolar soft compactness properties for bipolar soft topological spaces. Moreover, we introduce the notion of bipolar soft disjoint sets, bipolar soft separation, and bipolar soft hereditary property and study on bipolar soft connected and disconnected spaces. By giving the detailed picture of bipolar soft connected and disconnected spaces we investigate bipolar soft compact spaces and derive some results related to this concept.

  12. Genetics Home Reference: bipolar disorder

    Science.gov (United States)

    ... Email Facebook Twitter Home Health Conditions Bipolar disorder Bipolar disorder Printable PDF Open All Close All Enable Javascript to view the expand/collapse boxes. Description Bipolar disorder is a mental health condition that causes extreme ...

  13. BIPOLAR DISORDER: A REVIEW

    OpenAIRE

    Pathan Dilnawaz N; Ziyaurrahaman A.R; Bhise K.S.

    2010-01-01

    Bipolar disorder (BD) is a severe psychiatric disorder that results in poor global functioning, reduced quality of life and high relapse rates. Research finds that many adults with bipolar disorder identify the onset of symptoms in childhood and adolescence, indicating the importance of early accurate diagnosis and treatment. Accurate diagnosis of mood disorders is critical for treatment to be effective. Distinguishing between major depression and bipolar disorders, especially the depressed p...

  14. Bipolar Disorder in Women

    Directory of Open Access Journals (Sweden)

    Sermin Kesebir

    2013-06-01

    Full Text Available The research on gender's role in bipolar disorders has drawn significant interest recently. The presentation and course of bipolar disorder differs between women and men. Women experience depressive episodes, dysphoric mood, mixed states, rapid cycling and seasonal patterns more often than men. Comorbidity, particularly thyroid disease, migraine, obesity, and anxiety disorders laso occur more frequently in women than men. On the other hand men with bipolar disorder are also more likely than women to have problems with drug or alcohol abuse. The pregnancy and postpartum period is a time of high risk for onset and recurrence of bipolar disorder in women.

  15. Clinical status of comorbid bipolar disorder and borderline personality disorder.

    Science.gov (United States)

    Parker, Gordon; Bayes, Adam; McClure, Georgia; Del Moral, Yolanda Romàn Ruiz; Stevenson, Janine

    2016-09-01

    The status and differentiation of comorbid borderline personality disorder and bipolar disorder is worthy of clarification. To determine whether comorbid borderline personality disorder and bipolar disorder are interdependent or independent conditions. We interviewed patients diagnosed with either a borderline personality disorder and/or a bipolar condition. Analyses of participants grouped by DSM diagnoses established that those with comorbid conditions scored similarly to those with a borderline personality disorder alone on all key variables (i.e. gender, severity of borderline personality scores, developmental stressors, illness correlates, self-injurious behaviour rates) and differed from those with a bipolar disorder alone on nearly all non-bipolar item variables. Similar findings were returned for groups defined by clinical diagnoses. Comorbid bipolar disorder and borderline personality disorder is consistent with the formal definition of comorbidity in that, while coterminous, individuals meeting such criteria have features of two independent conditions. © The Royal College of Psychiatrists 2016.

  16. A two-input sliding-mode controller for a planar arm actuated by four pneumatic muscle groups.

    Science.gov (United States)

    Lilly, John H; Quesada, Peter M

    2004-09-01

    Multiple-input sliding-mode techniques are applied to a planar arm actuated by four groups of pneumatic muscle (PM) actuators in opposing pair configuration. The control objective is end-effector tracking of a desired path in Cartesian space. The inputs to the system are commanded input pressure differentials for the two opposing PM groups. An existing model for the muscle is incorporated into the arm equations of motion to arrive at a two-input, two-output nonlinear model of the planar arm that is affine in the input and, therefore, suitable for sliding-mode techniques. Relationships between static input pressures are derived for suitable arm behavior in the absence of a control signal. Simulation studies are reported.

  17. Climatic factors and bipolar affective disorder

    DEFF Research Database (Denmark)

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

    2008-01-01

    In bipolar disorder, the factors provoking a new episode are unknown. As a seasonal variation has been noticed, it has been suggested that weather conditions may play a role. The aim of the study was to elucidate whether meteorological parameters influence the development of new bipolar phases....... A group of patients with at least three previous hospitalizations for bipolar disorder was examined every 3 months for up to 3 years. At each examination an evaluation of the affective phase was made according to the Hamilton Depression Scale (HAM-D(17)), and the Bech-Rafaelsen Mania Rating Scale (MAS......). In the same period, daily recordings from the Danish Meteorological Institute were received. We found no correlations between onset of bipolar episodes [defined as MAS score of 11 or more (mania) and as HAM-D(17) score of 12 or more (depression)] and any meteorological parameters. We found a statistical...

  18. 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...... on bipolar disorder or 63% of the total sample. More years of education in relation to the country mean, and feeling very confident about managing life decreased the odds of seeking information on bipolar disorder online, while having attended support groups increased the odds. Patients who looked online...

  19. 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

  20. Thwarted interpersonal needs and suicide ideation: Comparing psychiatric inpatients with bipolar and non-bipolar mood disorders.

    Science.gov (United States)

    Taylor, Nathanael J; Mitchell, Sean M; Roush, Jared F; Brown, Sarah L; Jahn, Danielle R; Cukrowicz, Kelly C

    2016-12-30

    Psychiatric inpatients are at heightened risk for suicide, and evidence suggests that psychiatric inpatients with bipolar mood disorders may be at greater risk for suicide ideation compared to those with non-bipolar mood disorders. There is a paucity of research directly comparing risk factors for suicide ideation in bipolar versus non-bipolar mood disorders in an inpatient sample. The current study sought to clarify the association between two constructs from the interpersonal theory of suicide (i.e., perceived burdensomeness and thwarted belongingness) in leading to suicide ideation among psychiatric inpatients with bipolar and non-bipolar mood disorders. Participants were (N=90) psychiatric inpatients with a bipolar (n = 20) or non-bipolar mood disorder (n=70; per their medical charts). Perceived burdensomeness, but not thwarted belongingness, was significantly associated with suicide ideation after adjusting for other covariates. This suggests perceived burdensomeness may play a key role in suicide ideation among psychiatric inpatients with any mood disorder and highlights the importance of assessment and intervention of perceived burdensomeness in this population. Contrary to our hypothesis, mood disorder group (i.e., bipolar versus non-bipolar) did not moderate the relations between perceived burdensomeness/thwarted belongingness and suicide ideation. Published by Elsevier Ireland Ltd.

  1. Six years of evidence-based adult dissection tonsillectomy with ultrasonic scalpel, bipolar electrocautery, bipolar radiofrequency or 'cold steel' dissection.

    Science.gov (United States)

    Ragab, S M

    2012-10-01

    To conduct an adequately powered, prospective, randomised, controlled trial comparing adult dissection tonsillectomy using either ultrasonic scalpel, bipolar electrocautery, bipolar radiofrequency or 'cold steel' dissection. Three hundred patients were randomised into four tonsillectomy technique groups. The operative time, intra-operative bleeding, post-operative pain, tonsillar fossa healing, return to full diet, return to work and post-operative complications were recorded. The bipolar radiofrequency group had a shorter mean operative time. The mean intra-operative blood loss during bipolar radiofrequency tonsillectomy was significantly less compared with cold dissection and ultrasonic scalpel tonsillectomy. Pain scores were significantly higher after bipolar electrocautery tonsillectomy. Patients undergoing bipolar electrocautery tonsillectomy required significantly more days to return to full diet and work. The bipolar electrocautery group showed significantly reduced tonsillar fossa healing during the first and second post-operative weeks. In this adult series, bipolar radiofrequency tonsillectomy was superior to ultrasonic, bipolar electrocautery and cold dissection tonsillectomies. This method combines the advantages of 'hot' and 'cold' tonsillectomy.

  2. The use of Lorentz group formalism in solving polarization effects of a birefringent single mode optical fiber

    International Nuclear Information System (INIS)

    Ishiekwene, G.C.; Brown, C.S.; Mensah, S.Y.; Bak, A.E.

    2000-07-01

    A theoretical analysis on the polarization effects of a light beam propagating in a birefringent single-mode fiber is presented. We derive a system of differential equations representing the evolution of Stokes parameters and illustrate their application to polarization effects in a straight birefringent single mode optical fiber. The solutions to the set of equations are obtained using specifically the methods of the unified formalism for polarization optics which adopt the use of the Stokes-Mueller equation and the Lorentz group to model polarization phenomena in media such as optical fibers. The analytical results presented using this approach are identical to results obtained from other conventional methods. We observe the characteristic exponential decrease in the total intensity of the input light due to attenuation by the fiber. (author)

  3. Comparative familial aggregation of bipolar disorder in patients with bipolar I and bipolar II disorders.

    Science.gov (United States)

    Parker, Gordon B; Romano, Mia; Graham, Rebecca K; Ricciardi, Tahlia

    2018-05-01

    We sought to quantify the prevalence and differential prevalence of a bipolar disorder among family members of patients with a bipolar I or II disorder. The sample comprised 1165 bipolar and 1041 unipolar patients, with the former then sub-typed as having either a bipolar I or II condition. Family history data was obtained via an online self-report tool. Prevalence of a family member having a bipolar disorder (of either sub-type) was distinctive (36.8%). Patients with a bipolar I disorder reported a slightly higher family history (41.2%) compared to patients with a bipolar II disorder (36.3%), and with both significantly higher than the rate of bipolar disorder in family members of unipolar depressed patients (18.5%). Findings support the view that bipolar disorder is heritable. The comparable rates in the two bipolar sub-types support the positioning of bipolar II disorder as a valid condition with strong genetic underpinnings.

  4. Are working memory deficits in bipolar disorder markers for psychosis?

    Science.gov (United States)

    Allen, Daniel N; Randall, Carol; Bello, Danielle; Armstrong, Christina; Frantom, Linda; Cross, Chad; Kinney, Jefferson

    2010-03-01

    Working memory deficits have been identified in bipolar disorder, but there is evidence suggesting that these deficits may be markers for psychosis rather than affective disorder. The current study examined this issue by comparing two groups of individuals with bipolar disorder, one with psychotic features and one without psychotic features, with a group of normal controls. Working memory was conceptualized as a multicomponent system that includes auditory and visuospatial short-term stores, executive control processes, and an episodic buffer that allows for communication between short- and long-term memory stores (Baddeley & Logie, 1999). Results indicated that only executive control processes significantly differentiated the psychotic and nonpsychotic bipolar groups, although visuospatial working memory differentiated both bipolar groups from controls. The results support the idea that some aspects of working memory performance are markers for psychosis, while others may be more general markers for bipolar disorders. Copyright 2010 APA, all rights reserved

  5. Properties of Bipolar Fuzzy Hypergraphs

    OpenAIRE

    Akram, M.; Dudek, W. A.; Sarwar, S.

    2013-01-01

    In this article, we apply the concept of bipolar fuzzy sets to hypergraphs and investigate some properties of bipolar fuzzy hypergraphs. We introduce the notion of $A-$ tempered bipolar fuzzy hypergraphs and present some of their properties. We also present application examples of bipolar fuzzy hypergraphs.

  6. Internet support groups for suicide survivors: a new mode for gaining bereavement assistance.

    Science.gov (United States)

    Feigelman, William; Gorman, Bernard S; Beal, Karyl Chastain; Jordan, John R

    2008-01-01

    Taken among parents who sustained the loss of a child to suicide this study explores the participation of parents in Internet support groups, comparing their demographic and loss-related characteristics (N = 104) to other parent survivors participating in face-to-face support groups (N = 297). Contrary to expectations that Internet affiliates would be concentrated in under-served rural areas, we found similar levels of urban, suburban, small city and rural residents in both Internet and face-to-face subsamples. Bivariate and multivariate analyses suggested several important factors contributing to interest in Internet grief support including: 24/7 availability and opportunities to invest more time into this type of support group experience. Compared to their face-to-face group counterparts, Internet affiliates experienced greater suicide stigmatization from their families and other associates. Unable to find ready comfort and support from their personal communities, Internet users-and especially highly depressed survivors-sought and obtained valuable help from the Internet support resource.

  7. Functional Connectivity Between Anterior Insula and Key Nodes of Frontoparietal Executive Control and Salience Networks Distinguish Bipolar Depression From Unipolar Depression and Healthy Control Subjects.

    Science.gov (United States)

    Ellard, Kristen K; Zimmerman, Jared P; Kaur, Navneet; Van Dijk, Koene R A; Roffman, Joshua L; Nierenberg, Andrew A; Dougherty, Darin D; Deckersbach, Thilo; Camprodon, Joan A

    2018-05-01

    Patients with bipolar depression are characterized by dysregulation across the full spectrum of mood, differentiating them from patients with unipolar depression. The ability to switch neural resources among the default mode network, salience network, and executive control network (ECN) has been proposed as a key mechanism for adaptive mood regulation. The anterior insula is implicated in the modulation of functional network switching. Differential connectivity between anterior insula and functional networks may provide insights into pathophysiological differences between bipolar and unipolar mood disorders, with implications for diagnosis and treatment. Resting-state functional magnetic resonance imaging data were collected from 98 subjects (35 unipolar, 24 bipolar, and 39 healthy control subjects). Pearson correlations were computed between bilateral insula seed regions and a priori defined target regions from the default mode network, salience network, and ECN. After r-to-z transformation, a one-way multivariate analysis of covariance was conducted to identify significant differences in connectivity between groups. Post hoc pairwise comparisons were conducted and Bonferroni corrections were applied. Receiver-operating characteristics were computed to assess diagnostic sensitivity. Patients with bipolar depression evidenced significantly altered right anterior insula functional connectivity with the inferior parietal lobule of the ECN relative to patients with unipolar depression and control subjects. Right anterior insula-inferior parietal lobule connectivity significantly discriminated patients with bipolar depression. Impaired functional connectivity between the anterior insula and the inferior parietal lobule of the ECN distinguishes patients with bipolar depression from those with unipolar depression and healthy control subjects. This finding highlights a pathophysiological mechanism with potential as a therapeutic target and a clinical biomarker for bipolar

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

    Science.gov (United States)

    Rajewska-Rager, Aleksandra; Sibilski, Piotr; Lepczyńska, Natalia

    2015-01-01

    In recent years much attention has been given to determine risk factors for suicide among adults with bipolar disorder. Such studies concerning children and youths, which would also take into account the specificity of the developmental age, are still too few. The ability to identify risk factors for children and youths with mood disorders, as well as the possibility to monitor them, is an essential element in preventing suicidal behaviours. Previous studies have clearly indicated that in the group of patients with an early onset of the bipolar disorder the occurrence of suicidal thoughts and intentions were significantly increased. Identifying the risk of suicide is hindered further by the complexity of the phenomenon, which is a compound interaction of various factors: biological, environmental, sociological, psychological and clinical. This is especially true with young adults suffering from mental illness and presenting a number of other psychopathological symptoms. The following paper introduces and reviews the results of current studies, which analysed the risk factors for suicide among children and youths with bipolar spectrum or already diagnosed with bipolar disorder. For this purpose we conducted the overview of recent years literature available in PubMed/MEDLINE database, including the following search criteria: early onset bipolar disorder, bipolar disorder in children and young people, the spectrum of bipolar disorder, and suicidal ideation, suicidal intent, suicide.

  9. Is impulsivity a common trait in bipolar and unipolar disorders?

    Science.gov (United States)

    Henna, Elaine; Hatch, John P; Nicoletti, Mark; Swann, Alan C; Zunta-Soares, Giovana; Soares, Jair C

    2013-03-01

      Impulsivity is increased in bipolar and unipolar disorders during episodes and is associated with substance abuse disorders and suicide risk. Impulsivity between episodes predisposes to relapses and poor therapeutic compliance. However, there is little information about impulsivity during euthymia in mood disorders. We sought to investigate trait impulsivity in euthymic bipolar and unipolar disorder patients, comparing them to healthy individuals and unaffected relatives of bipolar disorder patients.   Impulsivity was evaluated by the Barratt Impulsiveness Scale (BIS-11A) in 54 bipolar disorder patients, 25 unipolar disorder patients, 136 healthy volunteers, and 14 unaffected relatives. The BIS-11A mean scores for all four groups were compared through the Games-Howell test for all possible pairwise combinations. Additionally, we compared impulsivity in bipolar and unipolar disorder patients with and without a history of suicide attempt and substance abuse disorder.   Bipolar and unipolar disorder patients scored significantly higher than the healthy controls and unaffected relatives on all measures of the BIS-11A except for attentional impulsivity. On the attentional impulsivity measures there were no differences among the unaffected relatives and the bipolar and unipolar disorder groups, but all three of these groups scored higher than the healthy participant group. There was no difference in impulsivity between bipolar and unipolar disorder subjects with and without suicide attempt. However, impulsivity was higher among bipolar and unipolar disorder subjects with past substance use disorder compared to patients without such a history.   Questionnaire-measured impulsivity appears to be relatively independent of mood state in bipolar and unipolar disorder patients; it remains elevated in euthymia and is higher in individuals with past substance abuse. Elevated attentional and lower non-planning impulsivity in unaffected relatives of bipolar disorder

  10. Chromosomal Speciation Revisited: Modes of Diversification in Australian Morabine Grasshoppers (Vandiemenella, viatica Species Group

    Directory of Open Access Journals (Sweden)

    Steven J. B. Cooper

    2011-03-01

    Full Text Available Chromosomal rearrangements can alter the rate and patterns of gene flow within or between species through a reduction in the fitness of chromosomal hybrids or by reducing recombination rates in rearranged areas of the genome. This concept, together with the observation that many species have structural variation in chromosomes, has led to the theory that the rearrangements may play a direct role in promoting speciation. Australian morabine grasshoppers (genus Vandiemenella, viatica species group are an excellent model for studying the role of chromosomal rearrangement in speciation because they show extensive chromosomal variation, parapatric distribution patterns, and narrow hybrid zones at their boundaries. This species group stimulated development of one of the classic chromosomal speciation models, the stasipatric speciation model proposed by White in 1968. Our population genetic and phylogeographic analyses revealed extensive non-monophyly of chromosomal races along with historical and on-going gene introgression between them. These findings suggest that geographical isolation leading to the fixation of chromosomal variants in different geographic regions, followed by secondary contact, resulted in the present day parapatric distributions of chromosomal races. The significance of chromosomal rearrangements in the diversification of the viatica species group can be explored by comparing patterns of genetic differentiation between rearranged and co-linear parts of the genome.

  11. Bipolar Disorder in Children

    Science.gov (United States)

    2014-01-01

    Although bipolar disorder historically was thought to only occur rarely in children and adolescents, there has been a significant increase in children and adolescents who are receiving this diagnosis more recently (Carlson, 2005). Nonetheless, the applicability of the current bipolar disorder diagnostic criteria for children, particularly preschool children, remains unclear, even though much work has been focused on this area. As a result, more work needs to be done to further the understanding of bipolar symptoms in children. It is hoped that this paper can assist psychologists and other health service providers in gleaning a snapshot of the literature in this area so that they can gain an understanding of the diagnostic criteria and other behaviors that may be relevant and be informed about potential approaches for assessment and treatment with children who meet bipolar disorder criteria. First, the history of bipolar symptoms and current diagnostic criteria will be discussed. Next, assessment strategies that may prove helpful for identifying bipolar disorder will be discussed. Then, treatments that may have relevance to children and their families will be discussed. Finally, conclusions regarding work with children who may have a bipolar disorder diagnosis will be offered. PMID:24800202

  12. Bipolar mixed features - Results from the comparative effectiveness for bipolar disorder (Bipolar CHOICE) study.

    Science.gov (United States)

    Tohen, Mauricio; Gold, Alexandra K; Sylvia, Louisa G; Montana, Rebecca E; McElroy, Susan L; Thase, Michael E; Rabideau, Dustin J; Nierenberg, Andrew A; Reilly-Harrington, Noreen A; Friedman, Edward S; Shelton, Richard C; Bowden, Charles L; Singh, Vivek; Deckersbach, Thilo; Ketter, Terence A; Calabrese, Joseph R; Bobo, William V; McInnis, Melvin G

    2017-08-01

    DSM-5 changed the criteria from DSM-IV for mixed features in mood disorder episodes to include non-overlapping symptoms of depression and hypomania/mania. It is unknown if, by changing these criteria, the same group would qualify for mixed features. We assessed how those meeting DSM-5 criteria for mixed features compare to those meeting DSM-IV criteria. We analyzed data from 482 adult bipolar patients in Bipolar CHOICE, a randomized comparative effectiveness trial. Bipolar diagnoses were confirmed through the MINI International Neuropsychiatric Interview (MINI). Presence and severity of mood symptoms were collected with the Bipolar Inventory of Symptoms Scale (BISS) and linked to DSM-5 and DSM-IV mixed features criteria. Baseline demographics and clinical variables were compared between mood episode groups using ANOVA for continuous variables and chi-square tests for categorical variables. At baseline, the frequency of DSM-IV mixed episodes diagnoses obtained with the MINI was 17% and with the BISS was 20%. Using DSM-5 criteria, 9% of participants met criteria for hypomania/mania with mixed features and 12% met criteria for a depressive episode with mixed features. Symptom severity was also associated with increased mixed features with a high rate of mixed features in patients with mania/hypomania (63.8%) relative to those with depression (8.0%). Data on mixed features were collected at baseline only and thus do not reflect potential patterns in mixed features within this sample across the study duration. The DSM-5 narrower, non-overlapping definition of mixed episodes resulted in fewer patients who met mixed criteria compared to DSM-IV. Copyright © 2017. Published by Elsevier B.V.

  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. The bipolar II disorder personality traits, a true syndrome?

    Science.gov (United States)

    Gudmundsson, Einar

    2015-06-01

    The author was struck by the similarities and commonality of complaints, aside from mood swings, made by Bipolar II patients and started registrating these complaints. This registrational work eventually led to the development of The Bipolar II Syndome Checklist. The aim of this work was to understand how widely the Bipolar II disorder affects the personality, and what disturbing personality traits are the most common? Deliberately, no attempt was made to diagnose psychiatric comorbidities, in the hope that one would get a clearer view of what symptoms, if any, could be considered a natural part of the Bipolar II Disorder. As far as the author knows this is a novel approach. 105 Bipolar II patients completed the Bipolar II Syndrome Checklist. The answers to the 44 questions on the list are presented in tables. Symptoms like anxiety, low self esteem, paranoia, extreme hurtfulness, migraine, Post Partum Depression, obsessive traits, alcoholism in the family are amongst the findings which will be presented in greater detail. No control group. Bipolar I patients excluded. The Bipolar II Syndrome Checklist has not been systematically validated. The results show that Bipolar II Disorder causes multiple symptoms so commonly that it may be justified to describe it as a syndrome, The Bipolar II Syndrome. Also these disturbances commonly lie in families of Bipolar II patients and are in all likelihood, greatly underdiagnosed. The clinical relevance of this study lies in increasing our knowledge and understanding of the nature of the Bipolar II Disorder, which in all probability will increase the diagnostic and treatment accuracy, since clinicians are more likely to scan for other symptoms needing treatment. Copyright © 2015 Elsevier B.V. All rights reserved.

  15. Differential diagnosis of bipolar disorder and major depressive disorder.

    Science.gov (United States)

    Hirschfeld, R M

    2014-12-01

    Patients with bipolar disorder spend approximately half of their lives symptomatic and the majority of that time suffering from symptoms of depression, which complicates the accurate diagnosis of bipolar disorder. Challenges in the differential diagnosis of bipolar disorder and major depressive disorder are reviewed, and the clinical utility of several screening instruments is evaluated. The estimated lifetime prevalence of major depressive disorder (i.e., unipolar depression) is over 3 and one-half times that of bipolar spectrum disorders. The clinical presentation of a major depressive episode in a bipolar disorder patient does not differ substantially from that of a patient with major depressive disorder (unipolar depression). Therefore, it is not surprising that without proper screening and comprehensive evaluation many patients with bipolar disorder may be misdiagnosed with major depressive disorder (unipolar depression). In general, antidepressants have demonstrated little or no efficacy for depressive episodes associated with bipolar disorder, and treatment guidelines recommend using antidepressants only as an adjunct to mood stabilizers for patients with bipolar disorder. Thus, correct identification of bipolar disorder among patients who present with depression is critical for providing appropriate treatment and improving patient outcomes. Clinical characteristics indicative of bipolar disorder versus major depressive disorder identified in this review are based on group differences and may not apply to each individual patient. The overview of demographic and clinical characteristics provided by this review may help medical professionals distinguish between major depressive disorder and bipolar disorder. Several validated, easily administered screening instruments are available and can greatly improve the recognition of bipolar disorder in patients with depression. Copyright © 2014 Elsevier B.V. All rights reserved.

  16. Regulation of glycogen synthase kinase-3 during bipolar mania treatment.

    Science.gov (United States)

    Li, Xiaohong; Liu, Min; Cai, Zhuoji; Wang, Gang; Li, Xiaohua

    2010-11-01

    Bipolar disorder is a debilitating psychiatric illness presenting with recurrent mania and depression. The pathophysiology of bipolar disorder is poorly understood, and molecular targets in the treatment of bipolar disorder remain to be identified. Preclinical studies have suggested that glycogen synthase kinase-3 (GSK3) is a potential therapeutic target in bipolar disorder, but evidence of abnormal GSK3 in human bipolar disorder and its response to treatment is still lacking. This study was conducted in acutely ill type I bipolar disorder subjects who were hospitalized for a manic episode. The protein level and the inhibitory serine phosphorylation of GSK3 in peripheral blood mononuclear cells of bipolar manic and healthy control subjects were compared, and the response of GSK3 to antimanic treatment was evaluated. The levels of GSK3α and GSK3β in this group of bipolar manic subjects were higher than healthy controls. Symptom improvement during an eight-week antimanic treatment with lithium, valproate, and atypical antipsychotics was accompanied by a significant increase in the inhibitory serine phosphorylation of GSK3, but not the total level of GSK3, whereas concomitant electroconvulsive therapy treatment during a manic episode appeared to dampen the response of GSK3 to pharmacological treatment. Results of this study suggest that GSK3 can be modified during the treatment of bipolar mania. This finding in human bipolar disorder is in agreement with preclinical data suggesting that inhibition of GSK3 by increasing serine phosphorylation is a response of GSK3 to psychotropics used in bipolar disorder, supporting the notion that GSK3 is a promising molecular target in the pharmacological treatment of bipolar disorder. © 2010 John Wiley and Sons A/S.

  17. An Evaluation of Social and Adaptive Skills in Adults with Bipolar Disorder and Severe/Profound Intellectual Disability

    Science.gov (United States)

    Matson, Johnny L.; Terlonge, Cindy; Gonzalez, Melissa L.; Rivet, Tessa

    2006-01-01

    The purpose of this study was to explore the interrelationship of social and adaptive skills in adults with bipolar disorder and severe or profound intellectual disability. A bipolar group (N=14), a severe psychopathology group without bipolar disorder (N=14), and a control group with no DSM-IV Axis I diagnosis (N=14) were compared on the…

  18. (Anti-) selfdual Riemann curvature tensor in four spacelike compactified dimensions, O5 isometry group and chiral fermion zero modes

    International Nuclear Information System (INIS)

    Minkowski, P.

    1986-01-01

    The metric and contorsion tensors are constructed which yield a combined Riemann curvature tensor of the form Rsup(+-)sub(μνsigmatau)=(1/2a 2 )(gsub(μsigma)gsub(νtau) - gsub(μtau)gsub(νsigma)+-√g epsilonsub(μνsigmatau)). The metric with euclidean signature (++++) describes a sphere S 4 with radius a, i.e. admits the isometry group O5. For selfdual (antiselfdual) curvature tensor the contorsion tensor is given by the antiselfdual (selfdual) instanton configuration with respect to the spin gauge group SU2sub(R) (SU2sub(L)). The selfdual (antiselfdual) Riemann tensor admits two covariantly constant right-handed (left-handed) spin 1/2 fermion zero modes, one J=1/2 and one J=3/2 right-handed (left-handed) multiplet corresponding to L=1, transforming as a pseudoreal representation of O4 (SU2sub(R(L))). The hermitean Dirac equation retains only the two constant chiral modes. (orig.)

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

    Directory of Open Access Journals (Sweden)

    Alice Aita Cacilhas

    2009-12-01

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

  20. What is Bipolar Disorder?

    Science.gov (United States)

    ... down” Have trouble sleeping Think about death or suicide Can someone have bipolar disorder along with other problems? Yes. Sometimes people having very strong mood episodes may have psychotic symptoms. Psychosis affects thoughts ...

  1. [Care and Self-Care Among Families with a Person Suffering from Bipolar Disorder and Belonging to the Psychoeducational Group of the Psychiatry Department of the University of Antioquia, Colombia].

    Science.gov (United States)

    Correa, María Victoria Builes; Hernández, Mauricio Bedoya

    2013-03-01

    To analyze the families from the Psychoeducational Group of the Psychiatry Department of the University of Antioquia that have one member with bipolar disorder (BD) in order to identify their care-related practices. A comprehensive research project using the phenomenological and hermeneutic method. Semi-structured interviews were conducted with twelve families. The data obtained were analyzed using the Atlas ti qualitative software. Two main categories emerged: 1. Care and family life course and 2. Care and self-care in relation to bipolar disorder. The first category manifests itself through practices such as: Taking care of the diseased person by being physically present, providing physical or emotional support, or by transferring care-related actions to other family members. Two main perspectives could be identified in the second category, namely: the caretaker's perspective and that of the person being taken care of. Two tendencies were found regarding the first one: taking care of others brings about transformations in the caretakers and taking care of others is tough. The second perspective has the same number of tendencies: self-care as poetics and taking care of oneself in order to go from the Diving Bell to the Butterfly. Taking care of others is a way of building humanity. Conducting research on care and self-care practices (i.e. the practices of both the caretaker and the person being taken care of) results in a more aesthetic way of providing care and a more aesthetic patient-caretaker dyad. Copyright © 2013 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  2. Differential pattern of semantic memory organization between bipolar I and II disorders.

    Science.gov (United States)

    Chang, Jae Seung; Choi, Sungwon; Ha, Kyooseob; Ha, Tae Hyon; Cho, Hyun Sang; Choi, Jung Eun; Cha, Boseok; Moon, Eunsoo

    2011-06-01

    Semantic cognition is one of the key factors in psychosocial functioning. The aim of this study was to explore the differences in pattern of semantic memory organization between euthymic patients with bipolar I and II disorders using the category fluency task. Study participants included 23 euthymic subjects with bipolar I disorder, 23 matched euthymic subjects with bipolar II disorder and 23 matched control subjects. All participants were assessed for verbal learning, recall, learning strategies, and fluency. The combined methods of hierarchical clustering and multidimensional scaling were used to compare the pattern of semantic memory organization among the three groups. Quantitative measures of verbal learning, recall, learning strategies, and fluency did not differ between the three groups. A two-cluster structure of semantic memory organization was identified for the three groups. Semantic structure was more disorganized in the bipolar I disorder group compared to the bipolar II disorder. In addition, patients with bipolar II disorder used less elaborate strategies of semantic memory organization than those of controls. Compared to healthy controls, strategies for categorization in semantic memory appear to be less knowledge-based in patients with bipolar disorders. A differential pattern of semantic memory organization between bipolar I and II disorders indicates a higher risk of cognitive abnormalities in patients with bipolar I disorder compared to patients with bipolar II disorder. Exploring qualitative nature of neuropsychological domains may provide an explanatory insight into the characteristic behaviors of patients with bipolar disorders. Copyright © 2011 Elsevier Inc. All rights reserved.

  3. 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.

  4. Relationship between Childhood Maltreatment, Suicidality, and Bipolarity: A Retrospective Study

    OpenAIRE

    Park, Young-Min

    2017-01-01

    Objective The aims of current study were to determine whether childhood maltreatment contributes to the occurrence of major depressive disorder (MDD) with bipolarity or suicidality. Methods In total, 132 outpatients diagnosed with MDD between 2014 and 2015 on the medical records were included. The subjects were divided into two groups according to the presence of childhood maltreatment (CM group) and no childhood maltreatment (NCM group). Depression severity and bipolarity were identified usi...

  5. 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.

  6. Depression and Bipolar Support Alliance

    Science.gov (United States)

    Depression and Bipolar Support Alliance Crisis Hotline Information Coping with a Crisis Suicide Prevention Information Psychiatric Hospitalization ... sign-up Education info, training, events Mood Disorders Depression Bipolar Disorder Anxiety Screening Center Co-occurring Illnesses/ ...

  7. Bipolar Disorder and Cancer

    Directory of Open Access Journals (Sweden)

    Sermin Kesebir

    2012-06-01

    Full Text Available 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 chromosome 13, breast cancer, retinoblastoma, chronic Iymphocytic leukemia genes with B cells, dopamin loci of bipolar disorder are found together. Among bipolar and healthy individuals, an increase risk of breast cancer in female cases has been resported. On the other hand, psychosocial factors that affect stress and response to stress itself may be important variables in prognosis and progression of different cancer types. During the course of many cancer types –especially brain tumors- and during treatment of chemotherapeutic agents, bipolar symptomatology may appear. In this article, it is reviewed with relevant literature that whether an etiological relation between bipolar disorder and cancer exist and how both diseases affect each other's course and treatment.

  8. Preparation of polymer monolithic column functionalized by arsonic acid groups for mixed-mode capillary liquid chromatography.

    Science.gov (United States)

    Qin, Zhang-Na; Yu, Qiong-Wei; Wang, Ren-Qi; Feng, Yu-Qi

    2018-04-27

    A mixed-mode polymer monolithic column functionalized by arsonic acid groups was prepared by single-step in situ copolymerization of monomers p-methacryloylaminophenylarsonic acid (p-MAPHA) and pentaerythritol triacrylate (PETA). The prepared poly(p-MAPHA-co-PETA) monolithic column has a homogeneous monolithic structure with good permeability and mechanical stability. Zeta potential measurements reveal that the monolithic stationary phase holds a negative surface charge when the mobile phase resides in the pH range of 3.0-8.0. The retention mechanisms of prepared monolithic column are explored by the separation of selected polycyclic aromatic hydrocarbons (PAHs), nucleosides, and three basic compounds. The results indicate that the column functions in three different separation modes associated with reversed-phase chromatography based on hydrophobic interaction, hydrophilic interaction chromatography, and cation-exchange chromatography. The column efficiency of prepared monolithic column is estimated to be 70,000 and 76,000 theoretical plates/m for thiourea and naphthalene, respectively, at a linear flow velocity of 0.85 mm/s using acetonitrile/H 2 O (85/15, v/v) as the mobile phase. Furthermore, an analysis of the retention factors obtained for the PAHs indicates that the prepared monolithic column exhibits good reproducibility with relative standard deviations of 2.9%, 4.0%, and 4.7% based on run-to-run injections, column-to-column preparation, and batch-to-batch preparation, respectively. Finally, we investigate the separation performance of the proposed monolithic column for select phenols, sulfonamides, nucleobases and nucleosides. Copyright © 2018 Elsevier B.V. All rights reserved.

  9. Social dysfunction in bipolar disorder: pilot study.

    Science.gov (United States)

    de Almeida Rocca, Cristiana Castanho; de Macedo-Soares, Marcia Britto; Gorenstein, Clarice; Tamada, Renata Sayuri; Issler, Cilly Kluger; Dias, Rodrigo Silva; Schwartzmann, Angela Maria; Lafer, Beny

    2008-08-01

    The purpose of the present study was to assess the social skills of euthymic patients with bipolar disorder. A group of 25 outpatients with bipolar disorder type I were evaluated in comparison with a group of 31 healthy volunteers who were matched in terms of level of education, age, sex and intelligence. Both groups were assessed using a self-report questionnaire, the Brazilian Inventario de Habilidades Sociais (IHS, Social Skills Inventory). Two Wechsler Adult Intelligence Scale subtests (Picture Arrangement and Comprehension) were also used in order to assess subject ability to analyse social situations and to make judgements, respectively. Patients with bipolar disorder had lower IHS scores for the domains that assessed conversational skills/social self-confidence and social openness to new people/situations. Patients with anxiety disorders had high scores for the domain that assessed self-confidence in the expression of positive emotions. No differences were found between patients and controls in performance on the Wechsler Adult Intelligence Scale Picture Arrangement and Comprehension subtests. Euthymic patients with bipolar disorder present inhibited and overattentive behaviour in relation to other people and their environment. This behaviour might have a negative impact on their level of social functioning and quality of life.

  10. Add-on treatment with N-acetylcysteine for bipolar depression:a 24-week randomized double-blind parallel group placebo-controlled multicentre trial (NACOS-study protocol)

    OpenAIRE

    Ellegaard, Pernille Kempel; Licht, Rasmus Wentzer; Poulsen, Henrik Enghusen; Nielsen, René Ernst; Berk, Michael; Dean, Olivia May; Mohebbi, Mohammadreza; Nielsen, Connie Thuroee

    2018-01-01

    BACKGROUND: Oxidative stress and inflammation may be involved in the development and progression of mood disorders, including bipolar disorder. Currently, there is a scarcity of useful treatment options for bipolar depressive episodes, especially compared with the efficacy of treatment for acute mania. N-Acetylcysteine (NAC) has been explored for psychiatric disorders for some time given its antioxidant and anti-inflammatory properties. The current trial aims at testing the clinical effects o...

  11. Computer modeling of electrical and thermal performance during bipolar pulsed radiofrequency for pain relief

    International Nuclear Information System (INIS)

    Pérez, Juan J.; Pérez-Cajaraville, Juan J.; Muñoz, Víctor; Berjano, Enrique

    2014-01-01

    Purpose: Pulsed RF (PRF) is a nonablative technique for treating neuropathic pain. Bipolar PRF application is currently aimed at creating a “strip lesion” to connect the electrode tips; however, the electrical and thermal performance during bipolar PRF is currently unknown. The objective of this paper was to study the temperature and electric field distributions during bipolar PRF. Methods: The authors developed computer models to study temperature and electric field distributions during bipolar PRF and to assess the possible ablative thermal effect caused by the accumulated temperature spikes, along with any possible electroporation effects caused by the electrical field. The authors also modeled the bipolar ablative mode, known as bipolar Continuous Radiofrequency (CRF), in order to compare both techniques. Results: There were important differences between CRF and PRF in terms of electrical and thermal performance. In bipolar CRF: (1) the initial temperature of the tissue impacts on temperature progress and hence on the thermal lesion dimension; and (2) at 37 °C, 6-min of bipolar CRF creates a strip thermal lesion between the electrodes when these are separated by a distance of up to 20 mm. In bipolar PRF: (1) an interelectrode distance shorter than 5 mm produces thermal damage (i.e., ablative effect) in the intervening tissue after 6 min of bipolar RF; and (2) the possible electroporation effect (electric fields higher than 150 kV m −1 ) would be exclusively circumscribed to a very small zone of tissue around the electrode tip. Conclusions: The results suggest that (1) the clinical parameters considered to be suitable for bipolar CRF should not necessarily be considered valid for bipolar PRF, and vice versa; and (2) the ablative effect of the CRF mode is mainly due to its much greater level of delivered energy than is the case in PRF, and therefore at same applied energy levels, CRF, and PRF are expected to result in same outcomes in terms of thermal

  12. Computer modeling of electrical and thermal performance during bipolar pulsed radiofrequency for pain relief

    Energy Technology Data Exchange (ETDEWEB)

    Pérez, Juan J. [Instituto de Investigación Interuniversitario en Bioingeniería y Tecnología Orientada al Ser Humano, Universitat Politècnica de València, Valencia 46022 (Spain); Pérez-Cajaraville, Juan J. [Pain Unit and Department of Anesthesia and Critical Care, Clínica Universidad de Navarra, University of Navarra, Pamplona 31008 (Spain); Muñoz, Víctor [Neurotherm Spain, Barcelona 08303 (Spain); Berjano, Enrique, E-mail: eberjano@eln.upv.es [Biomedical Synergy, Electronic Engineering Department, Universitat Politècnica de València 46022 (Spain)

    2014-07-15

    Purpose: Pulsed RF (PRF) is a nonablative technique for treating neuropathic pain. Bipolar PRF application is currently aimed at creating a “strip lesion” to connect the electrode tips; however, the electrical and thermal performance during bipolar PRF is currently unknown. The objective of this paper was to study the temperature and electric field distributions during bipolar PRF. Methods: The authors developed computer models to study temperature and electric field distributions during bipolar PRF and to assess the possible ablative thermal effect caused by the accumulated temperature spikes, along with any possible electroporation effects caused by the electrical field. The authors also modeled the bipolar ablative mode, known as bipolar Continuous Radiofrequency (CRF), in order to compare both techniques. Results: There were important differences between CRF and PRF in terms of electrical and thermal performance. In bipolar CRF: (1) the initial temperature of the tissue impacts on temperature progress and hence on the thermal lesion dimension; and (2) at 37 °C, 6-min of bipolar CRF creates a strip thermal lesion between the electrodes when these are separated by a distance of up to 20 mm. In bipolar PRF: (1) an interelectrode distance shorter than 5 mm produces thermal damage (i.e., ablative effect) in the intervening tissue after 6 min of bipolar RF; and (2) the possible electroporation effect (electric fields higher than 150 kV m{sup −1}) would be exclusively circumscribed to a very small zone of tissue around the electrode tip. Conclusions: The results suggest that (1) the clinical parameters considered to be suitable for bipolar CRF should not necessarily be considered valid for bipolar PRF, and vice versa; and (2) the ablative effect of the CRF mode is mainly due to its much greater level of delivered energy than is the case in PRF, and therefore at same applied energy levels, CRF, and PRF are expected to result in same outcomes in terms of

  13. Computer modeling of electrical and thermal performance during bipolar pulsed radiofrequency for pain relief.

    Science.gov (United States)

    Pérez, Juan J; Pérez-Cajaraville, Juan J; Muñoz, Víctor; Berjano, Enrique

    2014-07-01

    Pulsed RF (PRF) is a nonablative technique for treating neuropathic pain. Bipolar PRF application is currently aimed at creating a "strip lesion" to connect the electrode tips; however, the electrical and thermal performance during bipolar PRF is currently unknown. The objective of this paper was to study the temperature and electric field distributions during bipolar PRF. The authors developed computer models to study temperature and electric field distributions during bipolar PRF and to assess the possible ablative thermal effect caused by the accumulated temperature spikes, along with any possible electroporation effects caused by the electrical field. The authors also modeled the bipolar ablative mode, known as bipolar Continuous Radiofrequency (CRF), in order to compare both techniques. There were important differences between CRF and PRF in terms of electrical and thermal performance. In bipolar CRF: (1) the initial temperature of the tissue impacts on temperature progress and hence on the thermal lesion dimension; and (2) at 37 °C, 6-min of bipolar CRF creates a strip thermal lesion between the electrodes when these are separated by a distance of up to 20 mm. In bipolar PRF: (1) an interelectrode distance shorter than 5 mm produces thermal damage (i.e., ablative effect) in the intervening tissue after 6 min of bipolar RF; and (2) the possible electroporation effect (electric fields higher than 150 kV m(-1)) would be exclusively circumscribed to a very small zone of tissue around the electrode tip. The results suggest that (1) the clinical parameters considered to be suitable for bipolar CRF should not necessarily be considered valid for bipolar PRF, and vice versa; and (2) the ablative effect of the CRF mode is mainly due to its much greater level of delivered energy than is the case in PRF, and therefore at same applied energy levels, CRF, and PRF are expected to result in same outcomes in terms of thermal damage zone dimension.

  14. Genetic utility of broadly defined bipolar schizoaffective disorder as a diagnostic concept

    Science.gov (United States)

    Hamshere, M. L.; Green, E. K.; Jones, I. R.; Jones, L.; Moskvina, V.; Kirov, G.; Grozeva, D.; Nikolov, I.; Vukcevic, D.; Caesar, S.; Gordon-Smith, K.; Fraser, C.; Russell, E.; Breen, G.; St Clair, D.; Collier, D. A.; Young, A. H.; Ferrier, I. N.; Farmer, A.; McGuffin, P.; Holmans, P. A.; Owen, M. J.; O’Donovan, M. C.; Craddock, N.

    2009-01-01

    Background Psychiatric phenotypes are currently defined according to sets of descriptive criteria. Although many of these phenotypes are heritable, it would be useful to know whether any of the various diagnostic categories in current use identify cases that are particularly helpful for biological–genetic research. Aims To use genome-wide genetic association data to explore the relative genetic utility of seven different descriptive operational diagnostic categories relevant to bipolar illness within a large UK case–control bipolar disorder sample. Method We analysed our previously published Wellcome Trust Case Control Consortium (WTCCC) bipolar disorder genome-wide association data-set, comprising 1868 individuals with bipolar disorder and 2938 controls genotyped for 276 122 single nucleotide polymorphisms (SNPs) that met stringent criteria for genotype quality. For each SNP we performed a test of association (bipolar disorder group v. control group) and used the number of associated independent SNPs statistically significant at Pschizoaffective disorder, bipolar type; DSM–IV: bipolar I disorder; bipolar II disorder; schizoaffective disorder, bipolar type. Results The RDC schizoaffective disorder, bipolar type (v. controls) stood out from the other diagnostic subsets as having a significant excess of independent association signals (Pschizoaffective features have either a particularly strong genetic contribution or that, as a group, are genetically more homogeneous than the other phenotypes tested. The results point to the importance of using diagnostic approaches that recognise this group of individuals. Our approach can be applied to similar data-sets for other psychiatric and non-psychiatric phenotypes. PMID:19567891

  15. Creativity and bipolar disorder: Touched by fire or burning with questions?☆

    Science.gov (United States)

    Johnson, Sheri L.; Murray, Greg; Fredrickson, Barbara; Youngstrom, Eric A.; Hinshaw, Stephen; Bass, Julie Malbrancq; Deckersbach, Thilo; Schooler, Jonathan; Salloum, Ihsan

    2012-01-01

    Substantial literature has linked bipolar disorder with creative accomplishment. Much of the thinking in this area has been inspired by biographical accounts of poets, musicians, and other highly accomplished groups, which frequently document signs of bipolar disorder in these samples. A smaller literature has examined quantitative measures of creativity among people with bipolar disorder or at risk for the disorder. In this paper, we provide a critical review of such evidence. We then consider putative mechanisms related to the link of bipolar disorder with creativity, by drawing on literature outside of bipolar disorder on personality, motivational, and affective predictors of creativity. Because so little research has directly evaluated whether these factors could help explain the elevations of creativity in bipolar disorder, we conclude with an agenda for future research on the theoretically and clinically compelling topic of creativity in bipolar disorder. PMID:22088366

  16. Types of Bipolar Disorder

    Science.gov (United States)

    ... Events Home Science News Meetings and Events Multimedia Social Media Press Resources Newsletters NIMH News Feeds About Us ... has a lot of money, or has special powers. Someone having psychotic symptoms ... Substance Abuse: People with bipolar disorder may also misuse alcohol ...

  17. Discrete bipolar universal integrals

    Czech Academy of Sciences Publication Activity Database

    Greco, S.; Mesiar, Radko; Rindone, F.

    2014-01-01

    Roč. 252, č. 1 (2014), s. 55-65 ISSN 0165-0114 R&D Projects: GA ČR GAP402/11/0378 Institutional support: RVO:67985556 Keywords : bipolar integral * universal integral * Choquet integral Subject RIV: BA - General Mathematics Impact factor: 1.986, year: 2014 http://library.utia.cas.cz/separaty/2014/E/mesiar-0432224.pdf

  18. El trastorno bipolar

    OpenAIRE

    Freaza Rodríguez, Paula

    2014-01-01

    Se exponen los aspectos más relevantes del trastorno bipolar, entender qué significa este concepto, conocer los tipos que existen, qué otros trastornos suelen aparecer al mismo tiempo y qué tratamientos son los que dan mejores resultados

  19. ON BIPOLAR SINGLE VALUED NEUTROSOPHIC GRAPHS

    OpenAIRE

    Said Broumi; Mohamed Talea; Assia Bakali; Florentin Smarandache

    2016-01-01

    In this article, we combine the concept of bipolar neutrosophic set and graph theory. We introduce the notions of bipolar single valued neutrosophic graphs, strong bipolar single valued neutrosophic graphs, complete bipolar single valued neutrosophic graphs, regular bipolar single valued neutrosophic graphs and investigate some of their related properties.

  20. Single-event burnout of epitaxial bipolar transistors

    Energy Technology Data Exchange (ETDEWEB)

    Kuboyama, S.; Sugimoto, K.; Shugyo, S.; Matsuda, S. [National Space Development Agency of Japan, Tsukuba, Ibaraki (Japan); Hirao, T. [Japan Atomic Energy Research Inst., Takasaki, Gunma (Japan)

    1998-12-01

    Single-Event Burnout (SEB) of bipolar junction transistors (BJTs) has been observed nondestructively. It was revealed that all the NPN BJTs, including small signal transistors, with thinner epitaxial layers were inherently susceptible to the SEB phenomenon. It was demonstrated that several design parameters of BJTs were responsible for SEB susceptibility. Additionally, destructive and nondestructive modes of SEB were identified.

  1. Single-event burnout of epitaxial bipolar transistors

    Energy Technology Data Exchange (ETDEWEB)

    Kuboyama, Satoshi; Sugimoto, Kenji; Matsuda, Sumio [National Space Development Agency of Japan, Ysukuba, Ibaraki (Japan); Hirao, Toshio

    1998-10-01

    Single-event burnout (SEB) of bipolar junction transistors (BJTs) has been observed nondestructively. It was revealed that all the NPN BJTs including small signal transistors with thinner epitaxial layer were inherently susceptible to the SEB phenomenon. It was demonstrated that several design parameters of BJTs were responsible for SEB susceptibility. Additionally, destructive and nondestructive modes of SEB were identified. (author)

  2. Cognitive vulnerability to bipolar disorder in offspring of parents with bipolar disorder.

    Science.gov (United States)

    Pavlickova, Hana; Turnbull, Oliver; Bentall, Richard P

    2014-11-01

    Bipolar disorder is a highly heritable illness, with a positive family history robustly predictive of its onset. It follows that studying biological children of parents with bipolar disorder may provide information about developmental pathways to the disorder. Moreover, such studies may serve as a useful test of theories that attribute a causal role in the development of mood disorders to psychological processes. Psychological style (including self-esteem, coping style with depression, domain-specific risk-taking, sensation-seeking, sensitivity to reward and punishment, and hypomanic personality and cognition) was assessed in 30 offspring of bipolar parents and 30 children of well parents. Parents of both child groups completed identical assessments. Although expected differences between parents with bipolar disorder and well parents were detected (such as low self-esteem, increased rumination, high sensitivity to reward and punishment), offspring of bipolar parents were, as a group, not significantly different from well offspring, apart from a modest trend towards lower adaptive coping. When divided into affected and non-affected subgroups, both groups of index children showed lower novelty-seeking. Only affected index children showed lower self-esteem, increased rumination, sensitivity to punishment, and hypomanic cognitions. Notably, these processes were associated with symptoms of depression. Psychological abnormalities in index offspring were associated with having met diagnostic criteria for psychiatric illnesses and the presence of mood symptoms, rather than preceding them. Implications of the present findings for our understanding of the development of bipolar disorder, as well as for informing early interventions, are discussed. © 2014 The British Psychological Society.

  3. 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....

  4. Suicide attempts and clinical features of bipolar patients.

    Science.gov (United States)

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

    2016-06-01

    To identify clinical predictors of suicide attempts in patients with bipolar disorder. This study included bipolar patients who were treated in the Psychiatry Department, Haseki Training and Research Hospital, Istanbul, Turkey, between 2013 and 2014; an informed consent was obtained from the participants. Two  hundred and eighteen bipolar patients were assessed by using the structured clinical interview for Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) Axis-I (SCID-I) in order to detect all possible psychiatric comorbid diagnoses. Clinical predictors of suicide attempts were examined in attempters and non-attempters. The study design was retrospective. The lifetime suicide attempt rate for the entire sample was 19.2%. Suicide attempters with bipolar disorder had more lifetime comorbidity of eating disorder. Female gender and family history of mood disorder were significant predictors for suicide attempts. There was no difference between groups in terms of bipolar disorder subtype, onset age of bipolar disorder, total number of episodes, first and predominant episode type, suicide history in first degree relatives, severity of episodes, and hospitalization and being psychotic. Our study revealed that female gender, family history of mood disorder, and eating disorder are more frequent in bipolar patients with at least one suicide attempt.

  5. Revealing the Value of “Green” and the Small Group with a Big Heart in Transportation Mode Choice

    Directory of Open Access Journals (Sweden)

    David Gaker

    2013-07-01

    Full Text Available To address issues of climate change, people are more and more being presented with the greenhouse gas emissions associated with their alternatives. Statements of pounds or kilograms of CO2 are showing up in trip planners, car advertisements, and even restaurant menus under the assumption that this information influences behavior. This research contributes to the literature that investigates how travelers respond to such information. Our objective is to better understand the “value of green” or how much travelers are willing to pay in money in order to reduce the CO2 associated with their travel. As with previous work, we designed and conducted a mode choice experiment using methods that have long been used to study value of time. The contributions of this paper are twofold. First, we employ revealed preference data, whereas previous studies have been based on stated preferences. Second, we provide new insight on how the value of green is distributed in the population. Whereas previous work has specified heterogeneity either systematically or with a continuous distribution, we find that a latent class choice model specification better fits the data and also is attractive behaviorally. The best fitting latent class model has two classes: one large class (76% of the sample who are not willing to spend any time or money to reduce their CO2 and a second class (24% of the sample who value reducing their CO2 at a very high rate of $2.68 per pound of reduction—our so-called small group with a big heart. We reanalyzed three datasets that we had previously collected and found considerable robustness of this two class result.

  6. 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...

  7. Identifying early indicators in bipolar disorder: a qualitative study.

    Science.gov (United States)

    Benti, Liliane; Manicavasagar, Vijaya; Proudfoot, Judy; Parker, Gordon

    2014-06-01

    The identification of early markers has become a focus for early intervention in bipolar disorder. Using a retrospective, qualitative methodology, the present study compares the early experiences of participants with bipolar disorder to those with unipolar depression up until their first diagnosed episode. The study focuses on differences in early home and school environments as well as putative differences in personality characteristics between the two groups. Finally we a compare and contrast prodromal symptoms in these two populations. Thirty-nine participants, 20 diagnosed with unipolar depression and 19 diagnosed with bipolar disorder, took part in the study. A semi-structured interview was developed to elicit information about participants' experiences prior to their first episode. Participants with bipolar disorder reported disruptive home environments, driven personality features, greater emotion dysregulation and adverse experiences during the school years, whereas participants with depression tended to describe more supportive home environments, and more compliant and introvert personality traits. Retrospective data collection and no corroborative evidence from other family members. No distinction was made between bipolar I and bipolar II disorder nor between melancholic and non-melancholic depression in the sample. Finally the study spanned over a 12-month period which does not allow for the possibility of diagnostic reassignment of some of the bipolar participants to the unipolar condition. These findings indicate that there may be benefits in combining both proximal and distal indicators in identifying a bipolar disorder phenotype which, in turn, may be relevant to the development of early intervention programs for young people with bipolar disorder.

  8. [Bipolar disorder in adolescence].

    Science.gov (United States)

    Brunelle, Julie; Milhet, Vanessa; Consoli, Angèle; Cohen, David

    2014-04-01

    Juvenile mania is a concept widely developed but also highly debated since the 1990s. In the heart of this debate, Severe Mood Dysregulation (SMD) and "Temper Dysregulation disorder with Dysphoria" (recently integrated in DSM-5) showed their interest. Actually, the objective is to distinguish two clinical phenotypes in order to avoid confusion between (1) what would raise more of mood dysregulation with chronic manic like symptoms, and (2) bipolar disorder type I with episodic and acute manic episodes. Therapeutic stakes are major. In adolescents, even if DSM adult diagnostic criteria can be used and bipolar disorder type I clearly established, differential diagnostic at onset between acute manic episode and schizophrenia onset remain sometimes difficult to assess. Furthermore, it is crucial to better assess outcome of these adolescents, in terms of morbidity and potential prognosis factors, knowing that a younger age at onset is associated with a poorer outcome according to several adult studies. Therapeutic implications could then be drawn.

  9. Depressive and bipolar disorders

    DEFF Research Database (Denmark)

    Kessing, Lars Vedel; Hansen, Hanne Vibe; Demyttenaere, Koen

    2005-01-01

    of the patients (40-80%) had erroneous views as to the effect of antidepressants. Older patients (over 40 years of age) consistently had a more negative view of the doctor-patient relationship, more erroneous ideas concerning the effect of antidepressants and a more negative view of antidepressants in general....... Moreover, their partners agreed on these negative views. Women had a more negative view of the doctor-patient relationship than men, and patients with a depressive disorder had a more negative view of antidepressants than patients with bipolar disorder. The number of psychiatric hospitalizations......BACKGROUND: There is increasing evidence that attitudes and beliefs are important in predicting adherence to treatment and medication in depressive and bipolar disorders. However, these attitudes have received little study in patients whose disorders were sufficiently severe to require...

  10. Bipolar Plates for PEM Systems

    OpenAIRE

    Lædre, Sigrid

    2016-01-01

    Summary of thesis: The Bipolar Plate (BPP) is an important component in both Proton Exchange Membrane Fuel Cells (PEMFCs) and Proton Exchange Membrane Water Electrolyzers (PEMWEs). Bipolar plate material and processing constitutes for a large fraction of the cost and weight of a PEM cell stack. The main tasks for the bipolar plates in both systems are to separate single cell in a stack, conduct current between single cells and remove heat from active areas. In addition, the BPPs distribu...

  11. N-acetyl Aspartate Levels in Adolescents With Bipolar and/or Cannabis Use Disorders

    Science.gov (United States)

    Bitter, Samantha M.; Weber, Wade A.; Chu, Wen-Jang; Adler, Caleb M.; Eliassen, James C.; Strakowski, Stephen M.; DelBello, Melissa P.

    2014-01-01

    Objective Bipolar and cannabis use disorders commonly co-occur during adolescence, and neurochemical studies may help clarify the pathophysiology underlying this co-occurrence. This study compared metabolite concentrations in the left ventral lateral prefrontal cortex among: adolescents with bipolar disorder (bipolar group; n=14), adolescents with a cannabis use disorder (cannabis use group, n=13), adolescents with cannabis use and bipolar disorders (bipolar and cannabis group, n=25), and healthy adolescents (healthy controls, n=15). We hypothesized that adolescents with bipolar disorder (with or without cannabis use disorder) would have decreased N-acetyl aspartate levels in the ventral lateral prefrontal cortex compared to the other groups, and that the bipolar and cannabis group would have the lowest N-acetyl aspartate levels of all groups. Methods N-acetyl aspartate concentrations in the left ventral lateral prefrontal cortex were obtained using Proton Magnetic Resonance Spectroscopy. Results Adolescents with bipolar disorder showed significantly lower left ventral lateral prefrontal cortex N-acetyl aspartate levels, but post-hoc analyses indicated that this was primarily due to increased N-acetyl aspartate levels in the cannabis group. The cannabis use disorder group had significantly higher N-acetyl aspartate levels compared to the bipolar disorder and the bipolar and cannabis groups (p=0.0002 and p=0.0002, respectively). Pearson correlations revealed a significant positive correlation between amount of cannabis used and N-acetyl aspartate concentrations. Conclusions Adolescents with cannabis use disorder showed higher levels of N-acetyl aspartate concentrations that were significantly positively associated with the amount of cannabis used; however, this finding was not present in adolescents with comorbid bipolar disorder. PMID:24729763

  12. Reviewing metallic PEMFC bipolar plates

    Energy Technology Data Exchange (ETDEWEB)

    Wang, H.; Turner, J.A. [National Renewable Energy Laboratory, Golden, CO (United States)

    2010-08-15

    A bipolar plate is one of the most important components in a polymer exchange membrane fuel cell (PEMFC) stack and has multiple functions. Metallic bipolar plate candidates have advantages over composite rivals in excellent electrical and thermal conductivity, good mechanical strength, high chemical stability, very wide alloy choices, low cost and, most importantly, existing pathways for high-volume, high-speed mass production. The challenges with metallic bipolar plates are the higher contact resistance and possible corrosion products, which may contaminate the membrane electrode assembly. This review evaluates the candidate metallic and coating materials for bipolar plates and gives the perspective of the research trends. (Abstract Copyright [2010], Wiley Periodicals, Inc.)

  13. Effect of component design in retrieved bipolar hip hemiarthroplasty systems.

    Science.gov (United States)

    Hess, Matthew D; Baker, Erin A; Salisbury, Meagan R; Kaplan, Lige M; Greene, Ryan T; Greene, Perry W

    2013-09-01

    Primary articulation of bipolar hemiarthroplasty systems is at the femoral head-liner interface. The purpose of this study was to compare observed damage modes on 36 retrieved bipolar systems with implant, demographic, intraoperative, and radiographic data to elucidate the effects of component design, specifically locking mechanism, on clinical performance. Retrieved bipolar hip hemiarthroplasty systems of 3 different design types were obtained, disassembled, and evaluated macro- and microscopically for varying modes of wear, including abrasion, burnishing, embedding, scratching, and pitting. Clinical record review and radiographic analysis were performed by a senior orthopedic surgery resident. Average bipolar hip hemiarthroplasty system term of service was 46 months (range, 0.27-187 months). All devices contained wear debris captured within the articulating space between the femoral head and liner. In 31% of patients without infection, lucency was observed on immediate prerevision radiographs. The system with a leaf locking mechanism showed significantly increased radiographically observed osteolysis (P=.03) compared with a system with a stopper ring locking mechanism. In addition, implant design and observed damage modes, including pitting and third-body particle embedding, were significantly associated with radiographically observed osteolysis. Copyright 2013, SLACK Incorporated.

  14. 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.

  15. Fast mode decision algorithm in MPEG-2 to H.264/AVC transcoding including group of picture structure conversion

    Science.gov (United States)

    Lee, Kangjun; Jeon, Gwanggil; Jeong, Jechang

    2009-05-01

    The H.264/AVC baseline profile is used in many applications, including digital multimedia broadcasting, Internet protocol television, and storage devices, while the MPEG-2 main profile is widely used in applications, such as high-definition television and digital versatile disks. The MPEG-2 main profile supports B pictures for bidirectional motion prediction. Therefore, transcoding the MPEG-2 main profile to the H.264/AVC baseline is necessary for universal multimedia access. In the cascaded pixel domain transcoder architecture, the calculation of the rate distortion cost as part of the mode decision process in the H.264/AVC encoder requires extremely complex computations. To reduce the complexity inherent in the implementation of a real-time transcoder, we propose a fast mode decision algorithm based on complexity information from the reference region that is used for motion compensation. In this study, an adaptive mode decision process was used based on the modes assigned to the reference regions. Simulation results indicated that a significant reduction in complexity was achieved without significant degradation of video quality.

  16. Early Maladaptive Schemas Related to Unipolar and Bipolar Depression: Similarities and Differences

    Directory of Open Access Journals (Sweden)

    Nergis LAPSEKİLİ

    2012-11-01

    Full Text Available Objective and methodology: Cognitive theory of depression has begun to examine the difference between bipolar and unipolar depression in the context of thinking features. Yet, little is known about the same and seperated points of bipolar and unipolar depression. The objective is evaluating relationship between cognitive schemas of bipolar and unipolar patients. Bipolar and unipolar depression patients and a control group were enrolled in the study. Beck Depression Inventory, Young Mania Scale and Young Schema Questionnaire were administered to the groups. Results: There was significant difference between unipolar and control groups in “Abandonment/instability”. In “mistrust/ abuse” significant difference was between unipolar and bipolar and between unipolar and control groups. ln “entitlement/self-centeredness” difference was between unipolar and control groups. In all other schemas, difference was between unipolar and control and bipolar and control groups. In these schemas, control group had significantly lower scores than others. Unipolar and bipolar groups were similar. Conclusion: In patient groups, schemas like defectiveness, incompetence, failure, vulnerability to danger and undeveloped self were indicative of low self-perception. This case draws attention to distortions in self-perception. When the absence of difference between bipolar and controls in “mistrust/abuse” and “abandonment/instability” schemas is evaluated in terms of cognitive triad, it is suggested that environmental perspective in this group of patients did not exhibit pessimistic features. The only significantly different schema between unipolar and bipolar groups was “mistrust/ abuse”. This suggests that bipolar group didn’t have negative thoughts like unipolar patients about the perception of the enviroment.

  17. Safety and efficacy of quetiapine in bipolar depression.

    Science.gov (United States)

    Bogart, Gregory T; Chavez, Benjamin

    2009-11-01

    To review the clinical data investigating the efficacy and safety of quetiapine in bipolar depression. Searches of MEDLINE and PubMed (1977-July 2009) were conducted using the key words quetiapine and bipolar depression. The references of literature found were cross-referenced. The pharmaceutical company that produces quetiapine was contacted to obtain the posters for the EMBOLDEN I and EMBOLDEN II trials. Only double-blind, placebo-controlled trials were included for review, as well as any subanalyses of the literature that matched this criterion. There was a total of 5 double-blind, placebo-controlled trials and 5 subanalyses reviewed. The results of these data demonstrated quetiapine's efficacy in the treatment of depressive phases of bipolar disorder, including statistically significant improvement in the Montgomery-Asberg Depression Rating Scale (MADRS). In the trials reviewed in this article, the change in MADRS scores ranged from -15.4 to -16.94 within the quetiapine groups, and from -10.26 to -11.93 in the placebo groups. There were also statistically significant improvements in the Hamilton Anxiety Rating Scale, the Short Form of the Quality of Life Enjoyment and Satisfaction Questionnaire, the Pittsburgh Sleep Quality Index, and the Sheehan Disability Scale. All of these trials had a duration of 8 weeks and therefore cannot be applied to the long-term use of quetiapine in bipolar depression. The most common adverse events were sedation, somnolence, and dry mouth. The overall dropout rates for the trials reviewed ranged from 24% to 47%. Based on the literature reviewed here, quetiapine appears to be a safe and efficacious short-term treatment option for bipolar depression. Patients with bipolar type I showed greater improvement on the MADRS than those with bipolar type II. Patients with a rapid-cycling disease course showed an improvement in depressive symptoms, regardless of bipolar type.

  18. Study of Attention Deficit in Patients with Schizophrenia and Bipolar Disorder

    Directory of Open Access Journals (Sweden)

    SM Kafi

    2013-05-01

    Full Text Available Abstract Background & aim: Attention deficit has significant effect on the life of patients suffering from schizophrenia and bipolar disorder. The aim of this study was to assess the attention deficit in patients with schizophrenia. Methods: In the present post-hoc study, 132 patients with schizophrenia and bipolar disorder were selected via non-randomized sampling at Shafa Hospital (Rasht, Iran and then divided into four equal groups: chronic schizophrenia patients, first-episode patients, chronic bipolar patients, and first-episode bipolar patients. Thirty-three healthy individuals were selected as the control group. Subjects were evaluated by Stroop color-word test. The gathered Data were analyzed by one-way ANOVA. Results: Attention deficit among chronic schizophrenics and patients suffering from bipolar disease was higher than the control group (p <1. Chronic schizophrenic patients compared with schizophrenia bipolar disease and first round schizophrenia showed more attention deficit. There was no significant difference among the first bipolar disease and schizophrenia, bipolar disorder, as well as the first round schizophrenia (p<0.05. Conclusion: Attention deficit is more severe in schizophrenic patients than bipolar disorder, and chronicity is more effective in schizophrenic patients. Key words: Attention, Schizophrenia, Chronicity

  19. Antidepressant monotherapy in pre-bipolar depression; predictive value and inherent risk.

    Science.gov (United States)

    O'Donovan, Claire; Garnham, Julie S; Hajek, Tomas; Alda, Martin

    2008-04-01

    To identify specific treatment-emergent symptoms in response to antidepressant therapy in depression preceding bipolar disorder. Retrospective chart review of response to antidepressants in "pre-bipolar" depression, compared to a matched unipolar sample. Family history of completed suicide (p=0.0003) and bipolar disorder (p=0.004) were more common in the pre-bipolar subgroup. Earlier age of onset of diagnosed depression (p=0.005) as well as even earlier episodes of untreated retrospectively diagnosed major depression (p<0.0001) were associated with a future bipolar course. The pre-bipolar group was less likely to respond to antidepressant treatment (p=0.009). Treatment-emergent "mixed" symptoms (two or more symptoms of DSM IV mania, mood lability, irritability/rage with co-existing depression) and in particular, "serious symptoms" (treatment emergent or increased agitation, rage or suicidality) occurred more commonly in the bipolar group. The two variables that best accounted for the between-group differences in logistic regression, were early age at first symptoms of depression and treatment-emergent agitation. Family history of completed suicide and/or bipolar disorder, early onset of depressive symptoms as well as treatment-emergent "mixed" symptoms are common in depression preceding the diagnosis of bipolar disorder.

  20. A current-controlled PWM bipolar power supply for a magnet load

    International Nuclear Information System (INIS)

    Kang, Y.G.; McGhee, D.G.

    1994-01-01

    The Advanced Photon Source, at Argonne National Laboratory will produce the world's brightest x-ray beams when it is complete. A number of correction magnets are used to maintain proper beam position. Basically, two different types of bipolar power supplies are used for all the correction magnets: one requires dc correction only, and the other requires dc and ac correction. Normally linear-mode power amplifiers would be used for the bipolar power supplies. However, linear-mode power amplifiers dissipate a substantial amount of power as heat, resulting in poor efficiency for their large size. In addition, most commercial bipolar power supplies are linear-mode and available for lower power levels. Therefore, for higher power levels it was necessary to design a bipolar power supply that uses switch-mode power conversion. This paper describes a control technique for a pulse-width-modulatcd bipolar power supply, which can deliver a controlled current, dc plus ac to a correction magnet. A design example of a 150A bipolar power supply is presented

  1. 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

  2. Epidemiology in Pediatric Bipolar Disorder

    Directory of Open Access Journals (Sweden)

    Caner Mutlu

    2015-12-01

    Full Text Available Childhood and adolescent bipolar disorder diagnosis has been increasing recently. Since studies evaluating attempted suicide rates in children and adolescents have shown bipolarity to be a significant risk factor, diagnosis and treatment of bipolarity has become a very important issue. Since there is a lack of specific diagnostic criteria for especially preadolescent samples and evaluations are made mostly symptomatically, suspicions about false true diagnosis and increased prevalence rates have emerged. This situation leads to controversial data about the prevalence rates of bipolar disorder in children and adolescents. The aim of this article is to review the prevalence of childhood and adolescent bipolar disorder in community, inpatient and outpatient based samples in literature.

  3. A new reactivity mode for the diazo group: diastereoselective 1,3-aminoalkylation reaction of β-amino-α-diazoesters to give triazolines.

    Science.gov (United States)

    Kuznetsov, Alexey; Gulevich, Anton V; Wink, Donald J; Gevorgyan, Vladimir

    2014-08-18

    A novel mode of reactivity for the diazo group, the 1,3-addition of a nucleophile and an electrophile to the diazo group, has been realized in the intramolecular aminoalkylation of β-amino-α-diazoesters to form tetrasubstituted 1,2,3-triazolines. The reaction exhibited a broad scope, good functional group tolerance, and excellent diastereoselectivity. In addition, a new Au-catalyzed intramolecular transannulation reaction of the obtained propargyl triazolines to give pyrroles has been discovered. © 2014 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  4. Early Intervention in Bipolar Disorder.

    Science.gov (United States)

    Vieta, Eduard; Salagre, Estela; Grande, Iria; Carvalho, André F; Fernandes, Brisa S; Berk, Michael; Birmaher, Boris; Tohen, Mauricio; Suppes, Trisha

    2018-05-01

    Bipolar disorder is a recurrent disorder that affects more than 1% of the world population and usually has its onset during youth. Its chronic course is associated with high rates of morbidity and mortality, making bipolar disorder one of the main causes of disability among young and working-age people. The implementation of early intervention strategies may help to change the outcome of the illness and avert potentially irreversible harm to patients with bipolar disorder, as early phases may be more responsive to treatment and may need less aggressive therapies. Early intervention in bipolar disorder is gaining momentum. Current evidence emerging from longitudinal studies indicates that parental early-onset bipolar disorder is the most consistent risk factor for bipolar disorder. Longitudinal studies also indicate that a full-blown manic episode is often preceded by a variety of prodromal symptoms, particularly subsyndromal manic symptoms, therefore supporting the existence of an at-risk state in bipolar disorder that could be targeted through early intervention. There are also identifiable risk factors that influence the course of bipolar disorder, some of them potentially modifiable. Valid biomarkers or diagnosis tools to help clinicians identify individuals at high risk of conversion to bipolar disorder are still lacking, although there are some promising early results. Pending more solid evidence on the best treatment strategy in early phases of bipolar disorder, physicians should carefully weigh the risks and benefits of each intervention. Further studies will provide the evidence needed to finish shaping the concept of early intervention. AJP AT 175 Remembering Our Past As We Envision Our Future April 1925: Interpretations of Manic-Depressive Phases Earl Bond and G.E. Partridge reviewed a number of patients with manic-depressive illness in search of a unifying endo-psychic conflict. They concluded that understanding either phase of illness was "elusive" and

  5. Novel multiple criteria decision making methods based on bipolar neutrosophic sets and bipolar neutrosophic graphs

    OpenAIRE

    Muhammad, Akram; Musavarah, Sarwar

    2016-01-01

    In this research study, we introduce the concept of bipolar neutrosophic graphs. We present the dominating and independent sets of bipolar neutrosophic graphs. We describe novel multiple criteria decision making methods based on bipolar neutrosophic sets and bipolar neutrosophic graphs. We also develop an algorithm for computing domination in bipolar neutrosophic graphs.

  6. Analysis of Misdiagnosis of Bipolar Disorder in An Outpatient Setting.

    Science.gov (United States)

    Shen, Hui; Zhang, Li; Xu, Chuchen; Zhu, Jinling; Chen, Meijuan; Fang, Yiru

    2018-04-25

    Bipolar disorder is a mental illness with a high misdiagnosis rate and commonly misdiagnosed as other mental disorders including depression, schizophrenia, anxiety disorders, obsessive-compulsive disorders, and personality disorders, resulting in the mistreatment of clinical symptoms and increasing of recurrent episodes. To understand the reasons for misdiagnosis of bipolar disorder in an outpatient setting in order to help clinicians more clearly identify the disease and avoid diagnostic errors. Data from an outpatient clinic included two groups: those with a confirmed diagnosis of bipolar disorder (CD group) and those who were misdiagnosed (i.e. those who did in fact have bipolar disorder but received a different diagnoses and those without bipolar disorder who received a bipolar diagnosis [MD group]). Information between these two groups was compared. There were a total of 177 cases that met the inclusion criteria for this study. Among them, 136 cases (76.8%) were in the MD group and 41 cases (23.2%) were in the CD group. Patents with depression had the most cases of misdiagnosis (70.6%). The first episode of the patients in the MD group was more likely to be a depressive episode (χ 2 =5.206, p =0.023) and these patients had a greater number of depressive episodes during the course of the disease ( Z =-2.268, p =0.023); the time from the onset of the disease to the first treatment was comparatively short ( Z =-2.612, p =0.009) in the group with misdiagnosis; the time from the onset of disease to a confirmed diagnosis was longer ( Z =-3.685, p bipolar and other related disorders in the misdiagnosis group than in the confirmed diagnosis group (11.0% v. 4.9%) and there were more patients in the MD group diagnosed with depressive episodes who had a recent episode (78.7% v. 65.9%). The rate of misdiagnosis of patients with bipolar receiving outpatient treatment was quite high and they often received a misdiagnosis of depression. In the misdiagnosis group the first

  7. The functional neuroanatomy of bipolar disorder: a consensus model

    Science.gov (United States)

    Strakowski, Stephen M; Adler, Caleb M; Almeida, Jorge; Altshuler, Lori L; Blumberg, Hilary P; Chang, Kiki D; DelBello, Melissa P; Frangou, Sophia; McIntosh, Andrew; Phillips, Mary L; Sussman, Jessika E; Townsend, Jennifer D

    2013-01-01

    Objectives Functional neuroimaging methods have proliferated in recent years, such that functional magnetic resonance imaging, in particular, is now widely used to study bipolar disorder. However, discrepant findings are common. A workgroup was organized by the Department of Psychiatry, University of Cincinnati (Cincinnati, OH, USA) to develop a consensus functional neuroanatomic model of bipolar I disorder based upon the participants’ work as well as that of others. Methods Representatives from several leading bipolar disorder neuroimaging groups were organized to present an overview of their areas of expertise as well as focused reviews of existing data. The workgroup then developed a consensus model of the functional neuroanatomy of bipolar disorder based upon these data. Results Among the participants, a general consensus emerged that bipolar I disorder arises from abnormalities in the structure and function of key emotional control networks in the human brain. Namely, disruption in early development (e.g., white matter connectivity, prefrontal pruning) within brain networks that modulate emotional behavior leads to decreased connectivity among ventral prefrontal networks and limbic brain regions, especially amygdala. This developmental failure to establish healthy ventral prefrontal–limbic modulation underlies the onset of mania and ultimately, with progressive changes throughout these networks over time and with affective episodes, a bipolar course of illness. Conclusions This model provides a potential substrate to guide future investigations and areas needing additional focus are identified. PMID:22631617

  8. Prevalences of autoimmune diseases in schizophrenia, bipolar I and II disorder, and controls.

    Science.gov (United States)

    Cremaschi, Laura; Kardell, Mathias; Johansson, Viktoria; Isgren, Anniella; Sellgren, Carl M; Altamura, A Carlo; Hultman, Christina M; Landén, Mikael

    2017-12-01

    Previous studies on the relationship between autoimmune diseases, schizophrenia, and bipolar disorder are mainly based on hospital discharge registers with insufficient coverage of outpatient data. Furthermore, data is scant on the prevalence of autoimmune diseases in bipolar subgroups. Here we estimate the self-reported prevalences of autoimmune diseases in schizophrenia, bipolar disorder type I and II, and controls. Lifetime prevalence of autoimmune diseases was assessed through a structured interview in a sample of 9076 patients (schizophrenia N = 5278, bipolar disorder type I N = 1952, type II N = 1846) and 6485 controls. Comparative analyses were performed using logistic regressions. The prevalence of diabetes type 1 did not differ between groups. Hyperthyroidism, hypothyroidism regardless of lithium effects, rheumatoid arthritis, and polymyalgia rheumatica were most common in bipolar disorder. Systemic lupus erythematosus was less common in bipolar disorder than in the other groups. The rate of autoimmune diseases did not differ significantly between bipolar subgroups. We conclude that prevalences of autoimmune diseases show clear differences between schizophrenia and bipolar disorder, but not between the bipolar subgroups. Copyright © 2017 Elsevier B.V. All rights reserved.

  9. Theory of mind and functionality in bipolar patients with symptomatic remission.

    Science.gov (United States)

    Barrera, Angeles; Vázquez, Gustavo; Tannenhaus, Lucila; Lolich, María; Herbst, Luis

    2013-01-01

    Functional deficits are commonly observed in bipolar disorder after symptomatic remission. Social cognition deficits have also been reported, which could contribute to dysfunction in patients with bipolar disorder in remission. Twelve bipolar disorder patients in symptomatic remission (7 patients with bipolar disorder type I and 5 with bipolar disorder type II) and 12 healthy controls completed the Reading the Mind in the Eyes Test and the Faux Pas Test to evaluate theory of mind (ToM). Both groups also completed the Functional Assessment Short Test (FAST). The performance of the bipolar patients in the cognitive component of ToM was below normal, although the difference between the control group was not statistically significant (P=.078), with a trend to a worse performance associated with a higher number of depressive episodes (P=.082). There were no statistically significant differences between groups for the emotional component of ToM. Global functionality was significantly lower in bipolar patients compared to the control group (P=.001). Significant differences were also observed between both groups in five of the six dimensions of functionality assessed. No significant correlation was found between functionality and theory of mind. Bipolar patients in symptomatic remission exhibit impairments in several areas of functioning. Cognitive ToM appears more affected than emotional ToM. Deficits in ToM were not related to functional impairment. Copyright © 2012 SEP y SEPB. Published by Elsevier Espana. All rights reserved.

  10. Neural Correlates of Irritability in Disruptive Mood Dysregulation and Bipolar Disorders.

    Science.gov (United States)

    Wiggins, Jillian Lee; Brotman, Melissa A; Adleman, Nancy E; Kim, Pilyoung; Oakes, Allison H; Reynolds, Richard C; Chen, Gang; Pine, Daniel S; Leibenluft, Ellen

    2016-07-01

    Bipolar disorder and disruptive mood dysregulation disorder (DMDD) are clinically and pathophysiologically distinct, yet irritability can be a clinical feature of both illnesses. The authors examine whether the neural mechanisms mediating irritability differ between bipolar disorder and DMDD, using a face emotion labeling paradigm because such labeling is deficient in both patient groups. The authors hypothesized that during face emotion labeling, irritability would be associated with dysfunctional activation in the amygdala and other temporal and prefrontal regions in both disorders, but that the nature of these associations would differ between DMDD and bipolar disorder. During functional MRI acquisition, 71 youths (25 with DMDD, 24 with bipolar disorder, and 22 healthy youths) performed a labeling task with happy, fearful, and angry faces of varying emotional intensity. Participants with DMDD and bipolar disorder showed similar levels of irritability and did not differ from each other or from healthy youths in face emotion labeling accuracy. Irritability correlated with amygdala activity across all intensities for all emotions in the DMDD group; such correlation was present in the bipolar disorder group only for fearful faces. In the ventral visual stream, associations between neural activity and irritability were found more consistently in the DMDD group than in the bipolar disorder group, especially in response to ambiguous angry faces. These results suggest diagnostic specificity in the neural correlates of irritability, a symptom of both DMDD and bipolar disorder. Such evidence of distinct neural correlates suggests the need to evaluate different approaches to treating irritability in the two disorders.

  11. Bipolar pulse forming line

    Science.gov (United States)

    Rhodes, Mark A.

    2008-10-21

    A bipolar pulse forming transmission line module for linear induction accelerators having first, second, third, fourth, and fifth planar conductors which form an interleaved stack with dielectric layers between the conductors. Each conductor has a first end, and a second end adjacent an acceleration axis. The first and second planar conductors are connected to each other at the second ends, the fourth and fifth planar conductors are connected to each other at the second ends, and the first and fifth planar conductors are connected to each other at the first ends via a shorting plate adjacent the first ends. The third planar conductor is electrically connectable to a high voltage source, and an internal switch functions to short a high voltage from the first end of the third planar conductor to the first end of the fourth planar conductor to produce a bipolar pulse at the acceleration axis with a zero net time integral. Improved access to the switch is enabled by an aperture through the shorting plate and the proximity of the aperture to the switch.

  12. Impulse control disorder comorbidity among patients with bipolar I disorder.

    Science.gov (United States)

    Karakus, Gonca; Tamam, Lut

    2011-01-01

    Impulsivity is associated with mood instability, behavioral problems, and action without planning in patients with bipolar disorder. Increased impulsivity levels are reported at all types of mood episodes. This association suggests a high comorbidity between impulse control disorders (ICDs) and bipolar disorder. The aim of this study is to compare the prevalence of ICDs and associated clinical and sociodemographic variables in euthymic bipolar I patients. A total of 124 consecutive bipolar I patients who were recruited from regular attendees from the outpatient clinic of our Bipolar Disorder Unit were included in the study. All patients were symptomatically in remission. Diagnosis of bipolar disorder was confirmed using the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Impulse control disorders were investigated using the modified version of the Minnesota Impulsive Disorders Interview. Impulsivity was measured with the Barratt Impulsiveness Scale Version 11. Furthermore, all patients completed the Zuckerman Sensation-Seeking Scale Form V. The prevalence rate of all comorbid ICDs in our sample was 27.4% (n = 34). The most common ICD subtype was pathologic skin picking, followed by compulsive buying, intermittent explosive disorder, and trichotillomania. There were no instances of pyromania or compulsive sexual behavior. There was no statistically significant difference between the sociodemographic characteristics of bipolar patients with and without ICDs with regard to age, sex, education level, or marital status. Comorbidity of alcohol/substance abuse and number of suicide attempts were higher in the ICD(+) group than the ICD(-) group. Length of time between mood episodes was higher in the ICD(-) group than the ICD(+) group. There was a statistically significant difference between the total number of mood episodes between the 2 groups, but the number of depressive episodes was higher in the ICD(+) patients

  13. Bipolar Disorder and the TCI: Higher Self-Transcendence in Bipolar Disorder Compared to Major Depression.

    Science.gov (United States)

    Harley, James A; Wells, J Elisabeth; Frampton, Christopher M A; Joyce, Peter R

    2011-01-01

    Personality traits are potential endophenotypes for genetic studies of psychiatric disorders. One personality theory which demonstrates strong heritability is Cloninger's psychobiological model measured using the temperament and character inventory (TCI). 277 individuals who completed the TCI questionnaire as part of the South Island Bipolar Study were also interviewed to assess for lifetime psychiatric diagnoses. Four groups were compared, bipolar disorder (BP), type 1 and 2, MDD (major depressive disorder), and nonaffected relatives of a proband with BP. With correction for mood state, total harm avoidance (HA) was higher than unaffected in both MDD and BP groups, but the mood disorder groups did not differ from each other. However, BP1 individuals had higher self-transcendence (ST) than those with MDD and unaffected relatives. HA may reflect a trait marker of mood disorders whereas high ST may be specific to BP. As ST is heritable, genes that affect ST may be of relevance for vulnerability to BP.

  14. Relationship between Chinese adjective descriptors of personality and emotional symptoms in young Chinese patients with bipolar disorders.

    Science.gov (United States)

    Yu, Enyan; Li, Huihui; Fan, Hongying; Gao, Qianqian; Tan, Yunfei; Lou, Junyao; Zhang, Jie; Wang, Wei

    2015-12-01

    To investigate whether personality traits are related to emotional symptoms (mania, hypomania, and depression) in Chinese patients with bipolar disorders. Patients with bipolar I and II disorders, and healthy volunteers, were assessed using the Chinese Adjective Descriptors of Personality (CADP) questionnaire, Mood Disorder Questionnaire (MDQ), Hypomanic Checklist (HCL-32), and Plutchik-van Praag Depression Inventory (PVP). Seventy-three patients with bipolar I disorder, 35 with bipolar II disorder and 216 healthy controls were included. Bipolar I and II groups scored significantly higher on MDQ, HCL-32 and PVP scales than controls; the bipolar II group scored lower on the MDQ, but higher on the HCL-32 and PVP than bipolar I. In the bipolar I group, the CADP Intelligent trait (β, 0.25) predicted MDQ; Intelligent (β, -0.24), Agreeable (β, 0.22) and Emotional (β, 0.34) traits predicted PVP. In the bipolar II group, Intelligent (β, 0.22), Agreeable (β, -0.24) and Unsocial (β, 0.31) traits predicted MDQ; Intelligent (β, -0.20), Agreeable (β, -0.31) and Emotional (β, -0.26) traits predicted HCL-32. Four out of five Chinese personality traits were associated with emotional symptoms in patients with bipolar I or II disorder, but displayed different associations depending on disorder type. © The Author(s) 2015.

  15. Psychotherapy for Bipolar Disorder in Adults: A Review of the Evidence

    Science.gov (United States)

    Swartz, Holly A.; Swanson, Joshua

    2015-01-01

    Although pharmacotherapy is the mainstay of treatment for bipolar disorder, medication offers only partial relief for patients. Treatment with pharmacologic interventions alone is associated with disappointingly low rates of remission, high rates of recurrence, residual symptoms, and psychosocial impairment. Bipolar-specific therapy is increasingly recommended as an essential component of illness management. This review summarizes the available data on psychotherapy for adults with bipolar disorder. We conducted a search of the literature for outcome studies published between 1995 and 2013 and identified 35 reports of 28 randomized controlled trials testing individual or group psychosocial interventions for adults with bipolar disorder. These reports include systematic trials investigating the efficacy and effectiveness of individual psychoeducation, group psychoeducation, individual cognitive-behavioral therapy, group cognitive-behavioral therapy, family therapy, interpersonal and social rhythm therapy, and integrated care management. The evidence demonstrates that bipolar disorder-specific psychotherapies, when added to medication for the treatment of bipolar disorder, consistently show advantages over medication alone on measures of symptom burden and risk of relapse. Whether delivered in a group or individual format, those who receive bipolar disorder-specific psychotherapy fare better than those who do not. Psychotherapeutic strategies common to most bipolar disorder-specific interventions are identified. PMID:26279641

  16. Impairment in emotion perception from body movements in individuals with bipolar I and bipolar II disorder is associated with functional capacity.

    Science.gov (United States)

    Vaskinn, Anja; Lagerberg, Trine Vik; Bjella, Thomas D; Simonsen, Carmen; Andreassen, Ole A; Ueland, Torill; Sundet, Kjetil

    2017-12-01

    Individuals with bipolar disorder present with moderate impairments in social cognition during the euthymic state. The impairment extends to theory of mind and to the perception of emotion in faces and voices, but it is unclear if emotion perception from body movements is affected. The main aim of this study was to examine if participants with bipolar disorder perform worse than healthy control participants on a task using point-light displays of human full figures moving in a manner indicative of a basic emotion (angry, happy, sad, fearful, neutral/no emotion). A secondary research question was whether diagnostic subtypes (bipolar I, bipolar II) and history of psychosis impacted on this type of emotion perception. Finally, symptomatic, neurocognitive, and functional correlates of emotion perception from body movements were investigated. Fifty-three individuals with bipolar I (n = 29) or bipolar II (n = 24) disorder, and 84 healthy control participants were assessed for emotion perception from body movements. The bipolar group also underwent clinical, cognitive, and functional assessment. Research questions were analyzed using analyses of variance and bivariate correlations. The bipolar disorder group differed significantly from healthy control participants for emotion perception from body movements (Cohen's d = 0.40). Analyses of variance yielded no effects of sex, diagnostic subtype (bipolar I, bipolar II), or history of psychosis. There was an effect of emotion, indicating that some emotions are easier to recognize. The lack of a significant group × emotion interaction effect points, however, to this being so regardless of the presence of bipolar disorder. Performance was unrelated to manic and depressive symptom load but showed significant associations with neurocognition and functional capacity. Individuals with bipolar disorder had a small but significant impairment in the ability to perceive emotions from body movement. The impairment was global, i

  17. Perisylvian GABA levels in schizophrenia and bipolar disorder.

    Science.gov (United States)

    Atagün, Murat İlhan; Şıkoğlu, Elif Muazzez; Soykan, Çağlar; Serdar Süleyman, Can; Ulusoy-Kaymak, Semra; Çayköylü, Ali; Algın, Oktay; Phillips, Mary Louise; Öngür, Dost; Moore, Constance Mary

    2017-01-10

    The aim of this study is to measure GABA levels of perisylvian cortices in schizophrenia and bipolar disorder patients, using proton magnetic resonance spectroscopy ( 1 H-MRS). Patients with schizophrenia (n=25), bipolar I disorder (BD-I; n=28) and bipolar II disorder (BD-II; n=20) were compared with healthy controls (n=30). 1 H-MRS data was acquired using a Siemens 3T whole body scanner to quantify right and left perisylvian structures' (including superior temporal lobes) GABA levels. Right perisylvian GABA values differed significantly between groups [χ 2 =9.62, df: 3, p=0.022]. GABA levels were significantly higher in the schizophrenia group compared with the healthy control group (p=0.002). Furthermore, Chlorpromazine equivalent doses of antipsychotics correlated with right hemisphere GABA levels (r 2 =0.68, p=0.006, n=33). GABA levels are elevated in the right hemisphere in patients with schizophrenia in comparison to bipolar disorder and healthy controls. The balance between excitatory and inhibitory controls over the cortical circuits may have direct relationship with GABAergic functions in auditory cortices. In addition, GABA levels may be altered by brain regions of interest, psychotropic medications, and clinical stage in schizophrenia and bipolar disorder. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  18. Hydroxyapatite does not improve the outcome of a bipolar hemiarthroplasty.

    NARCIS (Netherlands)

    Meijerink, H.J.; Gardeniers, J.W.M.; Buma, P.; Lemmens, J.A.M.; Schreurs, B.W.

    2004-01-01

    In a one-surgeon study the clinical and radiographic results of 30 cementless bipolar hip prostheses in 24 patients younger than 55 years were evaluated. Eleven noncoated prostheses (Noncoated Group) and 19 hydroxyapatite-coated prostheses (Hydroxyapatite Group) were compared after a mean followup

  19. A Security Solution for IEEE 802.11's Ad-hoc Mode:Password-Authentication and Group Diffie-Hellman Key Exchange

    Energy Technology Data Exchange (ETDEWEB)

    Emmanuel, Bresson; Olivier, Chevassut; David, Pointcheval

    2005-10-01

    The IEEE 802 standards ease the deployment of networkinginfrastructures and enable employers to accesscorporate networks whiletraveling. These standards provide two modes of communication calledinfrastructure and ad-hoc modes. A security solution for the IEEE802.11's infrastructure mode took several years to reach maturity andfirmware are still been upgraded, yet a solution for the ad-hoc modeneeds to be specified. The present paper is a first attempt in thisdirection. It leverages the latest developments in the area ofpassword-based authentication and (group) Diffie-Hellman key exchange todevelop a provably-secure key-exchange protocol for IEEE 802.11's ad-hocmode. The protocol allows users to securely join and leave the wirelessgroup at time, accommodates either a single-shared password orpairwise-shared passwords among the group members, or at least with acentral server; achieves security against dictionary attacks in theideal-hash model (i.e. random-oracles). This is, to the best of ourknowledge, the first such protocol to appear in the cryptographicliterature.

  20. Initial depressive episodes affect the risk of suicide attempts in Korean patients with bipolar disorder.

    Science.gov (United States)

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

    2010-09-01

    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. A total of 579 medical records were retrospectively reviewed. Bipolar patients were divided into two groups with the presence of a history of suicide attempts. We compared demographic characteristics and clinical features between the two groups using an analysis of covariance and chi-square tests. Finally, logistic regression was performed to evaluate significant risk factors associated with suicide attempts in bipolar disorder. The prevalence of suicide attempt was 13.1% in our patient group. The presence of a depressive first episode was significantly different between attempters and nonattempters. Logistic regression analysis revealed that depressive first episodes and bipolar II disorder were significantly associated with suicide attempts in those patients. Clinicians should consider the polarity of the first mood episode when evaluating suicide risk in bipolar patients. This study has some limitations as a retrospective study and further studies with a prospective design are needed to replicate and evaluate risk factors for suicide in patients with bipolar disorder.

  1. Social skills knowledge and performance among adolescents with bipolar disorder.

    Science.gov (United States)

    Goldstein, Tina R; Miklowitz, David J; Mullen, Kimberley L

    2006-08-01

    This study investigated social skills deficits among adolescents with bipolar disorder. Adolescents with DMS-IV bipolar disorder (n = 18) and their parents completed social skills assessments when they were experiencing minimal mood symptoms. The control group (n = 18) consisted of adolescents with no history of psychiatric disorders. Participants and their parents rated the adolescents' social performance using the Matson Evaluation of Social Skills with Youngsters. We measured the adolescents' knowledge of appropriate social skills using the Interpersonal Negotiation Strategy Interview. Raters 'blind' to psychiatric status rated the adolescents' responses and their social interactions with an examiner during the assessment. Adolescents with bipolar disorder displayed significantly more social skills performance deficits than controls. No significant differences emerged between the groups in social skills knowledge. Ratings of social interactions with the examiner failed to distinguish bipolar from control teens, but raters were successful in guessing the psychiatric status of the participants. These findings indicate that bipolar adolescents lag behind their peers in social skills performance, but not social skills knowledge. Results support the hypothesis that difficulties with emotion regulation interfere with the consistent exhibition of appropriate social behaviors.

  2. Decision making in euthymic bipolar I and bipolar II disorders.

    Science.gov (United States)

    Martino, D J; Strejilevich, S A; Torralva, T; Manes, F

    2011-06-01

    The main aim of this study was to compare a large population of patients with bipolar disorder (BD) types I and II strictly defined as euthymic with healthy controls on measures of decision making. An additional aim was to compare performance on a decision-making task between patients with and without a history of suicide attempt. Eighty-five euthymic patients with BD-I or BD-II and 34 healthy controls were included. All subjects completed tests to assess verbal memory, attention and executive functions, and a decision-making paradigm (the Iowa Gambling Task, IGT). Both groups of patients had worse performance than healthy controls on measures of verbal memory, attention and executive function. No significant differences were found between BD-I, BD-II and healthy controls on measures of decision making. By contrast, patients with a history of suicide attempt had lower performance in the IGT than patients without a history of suicide attempt. Patients with euthymic BD-I and BD-II had intact decision-making abilities, suggesting that this does not represent a reliable trait marker of the disorder. In addition, our results provide further evidence of an association between impairments in decision making and vulnerability to suicidal behavior.

  3. Choosing how to feel: emotion regulation choice in bipolar disorder.

    Science.gov (United States)

    Hay, Aleena C; Sheppes, Gal; Gross, James J; Gruber, June

    2015-04-01

    Individuals with bipolar disorder experience emotion regulation difficulties, even during remission, but are able to effectively employ emotion regulation strategies when instructed. We hypothesized that this puzzling discrepancy might be due to their maladaptive emotion regulation choices. To test this hypothesis, we used a previously validated paradigm (Sheppes, Scheibe, Suri, & Gross, 2011; Sheppes et al., 2014), and asked remitted individuals with bipolar I disorder (n = 25) and healthy individuals (n = 26) to view standardized positive and negative images of high and low intensity, and choose reappraisal or distraction to decrease their emotion intensity. Replicating and extending prior results, participants across both groups showed a pattern of choosing distraction more for high versus low intensity positive and negative images, but no between-groups differences were evident. These results suggest that emotion regulation choice patterns may be robust across samples, and add to growing evidence that several basic emotion regulation elements may remain intact in bipolar disorder. (c) 2015 APA, all rights reserved).

  4. Modeling suicide in bipolar disorders.

    Science.gov (United States)

    Malhi, Gin S; Outhred, Tim; Das, Pritha; Morris, Grace; Hamilton, Amber; Mannie, Zola

    2018-02-19

    Suicide is a multicausal human behavior, with devastating and immensely distressing consequences. Its prevalence is estimated to be 20-30 times greater in patients with bipolar disorders than in the general population. The burden of suicide and its high prevalence in bipolar disorders make it imperative that our current understanding be improved to facilitate prediction of suicide and its prevention. In this review, we provide a new perspective on the process of suicide in bipolar disorder, in the form of a novel integrated model that is derived from extant knowledge and recent evidence. A literature search of articles on suicide in bipolar disorder was conducted in recognized databases such as Scopus, PubMed, and PsycINFO using the keywords "suicide", "suicide in bipolar disorders", "suicide process", "suicide risk", "neurobiology of suicide" and "suicide models". Bibliographies of identified articles were further scrutinized for papers and book chapters of relevance. Risk factors for suicide in bipolar disorders are well described, and provide a basis for a framework of epigenetic mechanisms, moderated by neurobiological substrates, neurocognitive functioning, and social inferences within the environment. Relevant models and theories include the diathesis-stress model, the bipolar model of suicide and the ideation-to-action models, the interpersonal theory of suicide, the integrated motivational-volitional model, and the three-step theory. Together, these models provide a basis for the generation of an integrated model that illuminates the suicidal process, from ideation to action. Suicide is complex, and it is evident that a multidimensional and integrated approach is required to reduce its prevalence. The proposed model exposes and provides access to components of the suicide process that are potentially measurable and may serve as novel and specific therapeutic targets for interventions in the context of bipolar disorder. Thus, this model is useful not only

  5. Bipolar explosion models for hypernovae

    International Nuclear Information System (INIS)

    Maeda, Keiichi; Nomoto, Ken'ichi

    2003-01-01

    Bipolar explosion models for hypernovae (very energetic supernovae) are presented. These models provide a favorable situation to explain some unexpected features in observations of hypernovae, e.g., high velocity matter dominated by Fe and low velocity matter dominated by O. The overall abundance of these models gives a good fit, at least qualitatively, to abundances in extremely metal-poor stars. We suggest hypernovae be driven by bipolar jets and contribute significantly to the early Galactic chemical evolution

  6. Functional remediation for bipolar disorder

    OpenAIRE

    Martínez-Arán, Anabel, 1971-; Torrent, C.; Solé, B.; Bonnín, C.M.; Rosa, A.R.; Sánchez-Moreno, J.; Vieta i Pascual, Eduard, 1963-

    2014-01-01

    Neurocognitive impairment constitutes a core feature of bipolar illness. The main domains affected are verbal memory, attention, and executive functions. Deficits in these areas as well as difficulties to get functional remission seem to be increased associated with illness progression. Several studies have found a strong relationship between neurocognitive impairment and low functioning in bipolar disorder, as previously reported in other illnesses such as schizophrenia. Cognitive remediatio...

  7. Slow light effect with high group index and wideband by saddle-like mode in PC-CROW

    Science.gov (United States)

    Wan, Yong; Jiang, Li-Jun; Xu, Sheng; Li, Meng-Xue; Liu, Meng-Nan; Jiang, Cheng-Yi; Yuan, Feng

    2018-04-01

    Slow light with high group index and wideband is achieved in photonic crystal coupled-resonator optical waveguides (PC-CROWs). According to the eye-shaped scatterers and various microcavities, saddle-like curves between the normalized frequency f and wave number k can be obtained by adjusting the parameters of the scatterers, parameters of the coupling microcavities, and positions of the scatterers. Slow light with decent flat band and group index can then be achieved by optimizing the parameters. Simulations prove that the maximal value of the group index is > 104, and the normalized delay bandwidth product within a new varying range of n g > 102 or n g > 103 can be a new and effective criterion of evaluation for the slow light in PC-CROWs.

  8. Cognitions in bipolar affective disorder and unipolar depression: imagining suicide.

    Science.gov (United States)

    Hales, Susie A; Deeprose, Catherine; Goodwin, Guy M; Holmes, Emily A

    2011-01-01

    Bipolar disorder has the highest rate of suicide of all the psychiatric disorders. In unipolar depression, individuals report vivid, affect-laden images of suicide or the aftermath of death (flashforwards to suicide) during suicidal ideation but this phenomenon has not been explored in bipolar disorder. Therefore the authors investigated and compared imagery and verbal thoughts related to past suicidality in individuals with bipolar disorder (n = 20) and unipolar depression (n = 20). The study used a quasi-experimental comparative design. The Structured Clinical Interview for DSM-IV was used to confirm diagnoses. Quantitative and qualitative data were gathered through questionnaire measures (e.g., mood and trait imagery use). Individual interviews assessed suicidal cognitions in the form of (i) mental images and (ii) verbal thoughts. All participants reported imagining flashforwards to suicide. Both groups reported greater preoccupation with these suicide-related images than with verbal thoughts about suicide. However, compared to the unipolar group, the bipolar group were significantly more preoccupied with flashforward imagery, rated this imagery as more compelling, and were more than twice as likely to report that the images made them want to take action to complete suicide. In addition, the bipolar group reported a greater trait propensity to use mental imagery in general. Suicidal ideation needs to be better characterized, and mental imagery of suicide has been a neglected but potentially critical feature of suicidal ideation, particularly in bipolar disorder. Our findings suggest that flashforward imagery warrants further investigation for formal universal clinical assessment procedures. © 2011 John Wiley and Sons A/S.

  9. Bipolar mood cycles and lunar tidal cycles.

    Science.gov (United States)

    Wehr, T A

    2018-04-01

    In 17 patients with rapid cycling bipolar disorder, time-series analyses detected synchronies between mood cycles and three lunar cycles that modulate the amplitude of the moon's semi-diurnal gravimetric tides: the 14.8-day spring-neap cycle, the 13.7-day declination cycle and the 206-day cycle of perigee-syzygies ('supermoons'). The analyses also revealed shifts among 1:2, 1:3, 2:3 and other modes of coupling of mood cycles to the two bi-weekly lunar cycles. These shifts appear to be responses to the conflicting demands of the mood cycles' being entrained simultaneously to two different bi-weekly lunar cycles with slightly different periods. Measurements of circadian rhythms in body temperature suggest a biological mechanism through which transits of one of the moon's semi-diurnal gravimetric tides might have driven the patients' bipolar cycles, by periodically entraining the circadian pacemaker to its 24.84-h rhythm and altering the pacemaker's phase-relationship to sleep in a manner that is known to cause switches from depression to mania.

  10. Cognitive and functional deficits in bipolar disorder and schizophrenia as a function of the presence and history of psychosis.

    Science.gov (United States)

    Bowie, Christopher R; Best, Michael W; Depp, Colin; Mausbach, Brent T; Patterson, Thomas L; Pulver, Ann E; Harvey, Philip D

    2018-05-18

    Schizophrenia and bipolar disorder overlap considerably. Schizophrenia is a primary psychotic disorder, whereas approximately half of people with bipolar disorder will experience psychosis. In this study, we examined the extent to which cognitive and functional impairments are related to the presence and history of psychosis across the two disorders. A total of 633 participants with bipolar disorder I, schizophrenia, and schizoaffective disorder were recruited for a study on the genetics of cognition and functioning in bipolar disorder and schizophrenia. Participants were classified into five groups: bipolar disorder with current psychosis (N = 30), bipolar disorder with a history of psychosis (N = 162), bipolar disorder with no history of psychosis (N = 92), schizophrenia with current psychosis (N = 245), and schizophrenia with past psychosis (N = 104). Cognitive profiles of all groups were similar in pattern; however, both current psychosis (P bipolar disorder and schizophrenia experienced similar impairments in real-world functioning if they were experiencing current psychosis (P = .32). The presence of active psychosis is an important cross-diagnostic factor in cognition and functioning in both schizophrenia and bipolar disorder. Characterization and treatment of cognition and functional deficits in bipolar disorder should consider the effects of both current and history of psychosis. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  11. The 4-pyridylmethyl ester as a protecting group for glutamic and aspartic acids: 'flipping' peptide charge states for characterization by positive ion mode ESI-MS.

    Science.gov (United States)

    Garapati, Sriramya; Burns, Colin S

    2014-03-01

    Use of the 4-pyridylmethyl ester group for side-chain protection of glutamic acid residues in solid-phase peptide synthesis enables switching of the charge state of a peptide from negative to positive, thus making detection by positive ion mode ESI-MS possible. The pyridylmethyl ester moiety is readily removed from peptides in high yield by hydrogenation. Combining the 4-pyridylmethyl ester protecting group with benzyl ester protection reduces the number of the former needed to produce a net positive charge and allows for purification by RP HPLC. This protecting group is useful in the synthesis of highly acidic peptide sequences, which are often beset by problems with purification by standard RP HPLC and characterization by ESI-MS. Copyright © 2014 European Peptide Society and John Wiley & Sons, Ltd.

  12. Quetiapine monotherapy for bipolar depression

    Directory of Open Access Journals (Sweden)

    Michael E Thase

    2008-03-01

    Full Text Available Michael E ThaseDepartments of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, PA, USA; the Philadelphia Veterans Affairs Medical Center, Philadelphia, PA, USA; and the University of Pittsburgh Medical Center, Pittsburgh, PA, USAAbstract: Bipolar depression is more common, disabling, and difficult-to-treat than the manic and hypomanic phases that define bipolar disorder. Unlike the treatment of so-called “unipolar” depressions, antidepressants generally are not indicated as monotherapies for bipolar depressions and recent studies suggest that - even when used in combination with traditional mood stabilizers – antidepressants may have questionable value for bipolar depression. The current practice is that mood stabilizers are initiated first as monotherapies; however, the antidepressant efficacy of lithium and valproate is modest at best. Within this context the role of atypical antipsychotics is being evaluated. The combination of olanzapine and the antidepressant fluoxetine was the first treatment to receive regulatory approval in the US specifically for bipolar I depression. Quetiapine was the second medication to be approved for this indication, largely as the result of two pivotal trials known by the acronyms of BOLDER (BipOLar DEpRession I and II. Both studies demonstrated that two doses of quetiapine (300 mg and 600 mg given once daily at bedtime were significantly more effective than placebo, with no increased risk of patients switching into mania. Pooling the two studies, quetiapine was effective for both bipolar I and bipolar II depressions and for patients with (and without a history of rapid cycling. The two doses were comparably effective in both studies. Although the efficacy of quetiapine monotherapy has been established, much additional research is necessary. Further studies are needed to more fully investigate dose-response relationships and comparing quetiapine monotherapy to other mood stabilizers

  13. Dissecting disease entities out of the broad spectrum of bipolar-disorders.

    Science.gov (United States)

    Levine, Joseph; Toker, Lilach; Agam, Galila

    2018-01-01

    The etiopathology of bipolar disorders is yet unraveled and new avenues should be pursued. One such avenue may be based on the assumption that the bipolar broad spectrum includes, among others, an array of rare medical disease entities. Towards this aim we propose a dissecting approach based on a search for rare medical diseases with known etiopathology which also exhibit bipolar disorders symptomatology. We further suggest that the etiopathologic mechanisms underlying such rare medical diseases may also underlie a rare variant of bipolar disorder. Such an assumption may be further reinforced if both the rare medical disease and its bipolar clinical phenotype demonstrate a] a similar mode of inheritance (i.e, autosomal dominant); b] brain involvement; and c] data implicating that the etiopathological mechanisms underlying the rare diseases affect biological processes reported to be associated with bipolar disorders and their treatment. We exemplify our suggested approach by a rare case of autosomal dominant leucodystrophy, a disease entity exhibiting nuclear lamin B1 pathology also presenting bipolar symptomatology. Copyright © 2017 Elsevier B.V. All rights reserved.

  14. Bipolar Disorder and Heart Transplantation: A Case Report.

    Science.gov (United States)

    Ramírez-Giraldo, Ana María; Restrepo, Diana

    Bipolar disorder is a chronic and recurrent mood disease that includes symptoms that fluctuate from euphoria to depression. As a mood disorder, itis one of the main contraindications for transplantation procedures. The case is presented of a patient with bipolar disorder who had a heart transplant after a cardiac arrest. Heart transplantation is the treatment of choice in patients with heart failure and arrhythmias that do not respond to conventional treatment. Case report and narrative review of literature. A 34-year-old woman with bipolar disorder diagnosed when she was 13, treated with lithium and aripiprazole. She required a heart transplant as the only therapeutic option, after presenting with ventricular tachycardia refractory to conventional treatment. The patient did not suffer an emotional decompensation with the removal of the lithium and aripiprazole that were associated with prolonged QTc interval, and remained eurhythmic throughout the process. Heart transplantation can be performed safely and successfully in patients with bipolar disorder, when suitably followed-up by a liaison psychiatry group. Bipolar disorder should not be considered as an absolute contraindication for heart transplantation. Copyright © 2017 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  15. Cognitive functions in the euthymic patients with bipolar disorder

    International Nuclear Information System (INIS)

    Ozdel, O.; Karadag, F.; Atesci, Figen C.; Oguzhanoglu, N.K.; Cabuk, T.

    2007-01-01

    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)

  16. 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

  17. Treating patients with bipolar disorder and substance dependence: lessons learned.

    Science.gov (United States)

    Weiss, Roger D

    2004-12-01

    Although bipolar disorder is the Axis I psychiatric disorder associated with the highest rate of co-occurring substance use disorders, little research has focused on treatments specifically designed for these patients. The author and his colleagues have developed and studied Integrated Group Therapy (IGT) for this population. This paper describes common themes that have emerged in carrying out IGT for patients with bipolar disorder and substance dependence. These include the strong emphasis on depression, as opposed to mania; the predominance of hopelessness; specific patterns of medication noncompliance; and the implications of patients' labeling their substance use as self-medication. Therapeutic aspects involved in addressing these themes are discussed.

  18. 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.

  19. Bipolar Disorder and Alcoholism: Are They Related?

    Science.gov (United States)

    ... Are they related? Is there a connection between bipolar disorder and alcoholism? Answers from Daniel K. Hall-Flavin, M.D. Bipolar disorder and alcoholism often occur together. Although the association ...

  20. The seroprevalence of antithyroid peroxidase antibodies in bipolar families and bipolar twins: results from two longitudinal studies.

    Science.gov (United States)

    Snijders, G; de Witte, L; Mesman, E; Kemner, S; Vonk, R; Brouwer, R; Nolen, W A; Drexhage, H A; Hillegers, M H J

    2017-12-01

    Previous studies of our group among bipolar offspring and bipolar twins showed significant higher prevalence's and levels of antithyroid peroxidase antibodies (TPO-Abs) in offspring and co-twins (without a mood disorder) compared to controls, suggesting that TPO-Abs might be considered as vulnerability factor (trait marker) for BD development. Here we elucidate, in the same cohorts, but now after 12- and 6-year follow-up, whether TPO-abs should be considered as a 'trait' marker for BD. The present study aims to investigate whether TPO-Abs (1) are stable over time, (2) are associated with lithium-exposure, (3) share a common genetic background with BD and are related to psychopathology. In bipolar offspring and twins, the prevalence of TPO-Abs is stable over time (r s  = .72 p bipolar offspring (10,4% versus 4%) and higher TPO-abs titers were still present in co-twins of bipolar cases compared to control twins [mean 1.06 IU/ml (SD .82) versus mean .82 IU/ml (SD .67)], although statistical significance was lost. Although our results show a trend toward an increased inherited risk of the co-occurrence of BD and thyroid autoimmunity, large-scale studies can only draw final conclusions. Nationwide epidemiological and GWAS studies reach such numbers and support the view of a possible common (autoimmune) etiology of severe mood disorders and chronic recurrent infections and autoimmunity, including thyroid autoimmunity.

  1. Sleep and psychopatholgy : in the general population and bipolar disorder

    NARCIS (Netherlands)

    Verkooijen, Susanne

    2017-01-01

    This thesis set out to investigate the relation between sleep and psychopathology. We examined two groups; bipolar patients and adolescents from the general population that are both characterized by mood fluctuations and are vulnerable for disturbances in sleep-wake pattern. Using wearables

  2. Bipolar outflow in B335

    International Nuclear Information System (INIS)

    Hirano, N.; Kameya, O.; Nakayama, M.; Takakubo, K.

    1988-01-01

    The high-velocity (C-12)O (J = 1-0) emission in B335 with a high angular resolution of 16 arcsec has been mapped. The high-velocity emission shows distinct bipolar pattern centered at IRAS 19345+0727, toward which a strong high-velocity (C-12)O emission has been detected. The bipolar lobes delineate remarkable collimation toward the IRAS source, indicating that the flow is focused within 0.02 pc of the driving source. Each lobe is accompanied by significant wing emission with the opposite velocity shift, which clearly shows the association with IRAS 19345+0727. This feature is well explained as a bipolar flow the axis of which is nearly perpendicular to the line of sight. There is no evidence of another evolved bipolar flow which does not associate with any dense core as previously suggested. This suggests that B335 is a site of very recent star formation, containing a single bipolar flow with an age of about 30,000 yr. 15 references

  3. Gender differences in the treatment of patients with bipolar disorder: a study of 7354 patients.

    Science.gov (United States)

    Karanti, Alina; Bobeck, Christian; Osterman, Maja; Kardell, Mathias; Tidemalm, Dag; Runeson, Bo; Lichtenstein, Paul; Landén, Mikael

    2015-03-15

    Gender differences in treatment that are not supported by empirical evidence have been reported in several areas of medicine. Here, the aim was to evaluate potential gender differences in the treatment for bipolar disorder. Data was collected from the Swedish National Quality Assurance Register for bipolar disorder (BipoläR). Baseline registrations from the period 2004-2011 of 7354 patients were analyzed. Multiple logistic regression analysis was used to study the impact of gender on interventions. Women were more often treated with antidepressants, lamotrigine, electroconvulsive therapy, benzodiazepines, and psychotherapy. Men were more often treated with lithium. There were no gender differences in treatment with mood stabilizers as a group, neuroleptics, or valproate. Subgroup analyses revealed that ECT was more common in women only in the bipolar I subgroup. Contrariwise, lamotrigine was more common in women only in the bipolar II subgroup. As BipoläR contains data on outpatient treatment of persons with bipolar disorder in Sweden, it is unclear if these findings translate to inpatient care and to outpatient treatment in other countries. Men and women with bipolar disorder receive different treatments in routine clinical settings in Sweden. Gender differences in level of functioning, bipolar subtype, or severity of bipolar disorder could not explain the higher prevalence of pharmacological treatment, electroconvulsive therapy, and psychotherapy in women. Our results suggest that clinicians׳ treatment decisions are to some extent unduly influenced by patients׳ gender. Copyright © 2014 Elsevier B.V. All rights reserved.

  4. 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. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  5. Late Onset Bipolar Disorder: Case Report

    OpenAIRE

    Filipa Araújo; Adriana Horta

    2016-01-01

    Background: Bipolar disorder affects approximately 1% of the population, with diagnosis often being made during late adolescence and early adulthood, and only rarely (0.1%) in the elderly. Late onset bipolar disorder in the elderly has a impact on the nature and course of bipolar disorder. Aims: The authors report a case of bipolar disorder emerging in late life  (76years old) with no cleary identified organic cause. Conclusion: This case highlights the importance of a broad different...

  6. Imunologia do transtorno bipolar Immunology of bipolar disorder

    Directory of Open Access Journals (Sweden)

    Izabela Guimarães Barbosa

    2009-01-01

    Full Text Available 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. As bases de dados avaliadas foram MedLine e Scopus, entre os anos de 1980 e 2008. RESULTADOS: Foram identificados 28 trabalhos que estudaram alterações imunes em pacientes com transtorno bipolar. Seis artigos investigaram genes relacionados à resposta imune; cinco, autoanticorpos; quatro, populações leucocitárias; 13, citocinas e/ou moléculas relacionadas à resposta imune e seis, leucócitos de pacientes in vitro. CONCLUSÕES: Embora haja evidências na literatura correlacionando o transtorno bipolar a alterações imunes, os dados não são conclusivos. O transtorno bipolar parece estar associado a níveis mais elevados de autoanticorpos circulantes, assim como à tendência à ativação imune com produção de citocinas pró-inflamatórias e redução de parâmetros anti-inflamatórios.OBJECTIVE: Emerging research has implicated immune factors in the pathogenesis of a variety of neuropsychiatric disorders. The objective of the present paper is to review the studies that investigated the association between bipolar disorder and immune parameters. METHODS: Papers that included the keywords "bipolar to disorder", "mania", "immunology", "cytokines", "chemokines", "interleukins", "interferon" and "tumor necrosis factor" were selected in a systematic review of the literature. The evaluated databases were MedLine and Scopus in the period between 1980 and 2008. RESULTS: Twenty eight works were found. Six studies investigated immune response

  7. 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.

  8. The effect of psychoeducation on the functioning level of patients with bipolar disorder.

    Science.gov (United States)

    Kurdal, Ebru; Tanriverdi, Derya; Savas, Haluk Asuman

    2014-03-01

    Bipolar disorder has adverse effects on the lives of the individuals and the people around them and causes disability due to impaired social and occupational functioning, risk of suicide, and frequent relapses. This study was conducted as a two-group pretest-posttest design to determine the effect of psychoeducation on the functioning levels of patients with bipolar disorder. A total of 80 patients were assigned to either the experimental (n = 40) or the control group (n = 40). The data were collected using a questionnaire form, and the Bipolar Disorder Functioning Questionnaire. The experimental group scored significantly higher on the functioning levels (emotional functioning, intellectual functioning, feelings of stigmatization, social withdrawal, household relations, relations with friends, participating in social activities, daily activities and recreational activities, taking initiative and self-sufficiency, and occupation) (p < .05) compared with the control group after psychoeducation. Psychoeducation has become considerably effective in increasing the functioning levels of patients with bipolar disorder.

  9. Structural and functional changes in the somatosensory cortex in euthymic females with bipolar disorder.

    Science.gov (United States)

    Minuzzi, Luciano; Syan, Sabrina K; Smith, Mara; Hall, Alexander; Hall, Geoffrey Bc; Frey, Benicio N

    2017-12-01

    Current evidence from neuroimaging data suggests possible dysfunction of the fronto-striatal-limbic circuits in individuals with bipolar disorder. Somatosensory cortical function has been implicated in emotional recognition, risk-taking and affective responses through sensory modalities. This study investigates anatomy and function of the somatosensory cortex in euthymic bipolar women. In total, 68 right-handed euthymic women (bipolar disorder = 32 and healthy controls = 36) between 16 and 45 years of age underwent high-resolution anatomical and functional magnetic resonance imaging during the mid-follicular menstrual phase. The somatosensory cortex was used as a seed region for resting-state functional connectivity analysis. Voxel-based morphometry was used to evaluate somatosensory cortical gray matter volume between groups. We found increased resting-state functional connectivity between the somatosensory cortex and insular cortex, inferior prefrontal gyrus and frontal orbital cortex in euthymic bipolar disorder subjects compared to healthy controls. Voxel-based morphometry analysis showed decreased gray matter in the left somatosensory cortex in the bipolar disorder group. Whole-brain voxel-based morphometry analysis controlled by age did not reveal any additional significant difference between groups. This study is the first to date to evaluate anatomy and function of the somatosensory cortex in a well-characterized sample of euthymic bipolar disorder females. Anatomical and functional changes in the somatosensory cortex in this population might contribute to the pathophysiology of bipolar disorder.

  10. Is bipolar always bipolar? Understanding the controversy on bipolar disorder in children

    Science.gov (United States)

    Grimmer, Yvonne; Hohmann, Sarah

    2014-01-01

    Dramatically increasing prevalence rates of bipolar disorder in children and adolescents in the United States have provoked controversy regarding the boundaries of manic symptoms in child and adolescent psychiatry. The serious impact of this ongoing debate on the treatment of affected children is reflected in the concomitant increase in prescription rates for antipsychotic medication. A key question in the debate is whether this increase in bipolar disorder in children and adolescents is based on a better detection of early-onset bipolar disorder—which can present differently in children and adolescents—or whether it is caused by an incorrect assignment of symptoms which overlap with other widely known disorders. So far, most findings suggest that the suspected symptoms, in particular chronic, non-episodic irritability (a mood symptom presenting with easy annoyance, temper tantrums and anger) do not constitute a developmental presentation of childhood bipolar disorder. Additional research based on prospective, longitudinal studies is needed to further clarify the developmental trajectories of bipolar disorder and the diagnostic status of chronic, non-episodic irritability. PMID:25580265

  11. Awareness of complications and maintenance mode of oral piercing in a group of adolescents and young Italian adults with intraoral piercing

    Science.gov (United States)

    Fusco, Francesca; Corridore, Denise; Ottolenghi, Livia

    2015-01-01

    Background The aim of the study was to focus the awareness of complications of oral piercing among a group of adolescents and young Italian adults with intraoral piercings. Material and Methods A total of 225 teenagers were asked to complete a questionnaire on the awareness of complications of oral piercing. An additional questionnaire was administered in case of oral piercing worn, based on site piercing, knowledge about piercer license, oral and systemic risks due to oral piercing, disinfection and sterilization of the material pierced, information by the piercer about piercing hygiene maintenance and post-piercing dentist check-up. After questionnaire all partecipants received a brochure with some information about risks and maintenance mode of piercing. Results Data revealed that more than 50% of teens surveyed was found to wear a piercing. Only 25.3% was aware of the risk of HCV cross-infection and only 17.3% reported of knowledge about risk of endocarditis. Only 17% checked the piercer license and only 18% sterilization and disinfection of the materials used. 53.7% did not received explanations about the risks associated with piercing. With regard to the maintenance mode of the piercing, it has been suggested to brush the piercing bar in 17% of cases. The post piercing specialist visits have been suggested only in 7% of cases. Conclusions The general lack of awareness of complications and maintenance mode related to oral piercing needs to be addressed by some education programs performed at school and by dentists. Key words: Oral piercing, oral health, oral complications. PMID:25858082

  12. Bipolar dislocation of the clavicle

    Directory of Open Access Journals (Sweden)

    Wei Jiang

    2012-01-01

    Full Text Available Bipolar dislocation of the clavicle at acromioclavicular and sternoclavicular joint is an uncommon traumatic injury. The conservative treatments adopted in the past is associated with redislocation dysfunction and deformity. A 41 years old lady with bipolar dislocation of right shoulder is treated surgically by open reduction and internal fixation by oblique T-plate at sternoclavicular joint and Kirschner wire stabilization at acromioclavicular joint. The patient showed satisfactory recovery with full range of motion of the right shoulder and normal muscular strength. The case reported in view of rarity and at 2 years followup.

  13. Transcultural aspects of bipolar disorder

    OpenAIRE

    Sanches, Marsal; Jorge, Miguel Roberto

    2004-01-01

    Considerando-se que existem diferenças importantes na maneira como as emoções são vivenciadas e expressas em diferentes culturas, a apresentação e o manejo do transtorno afetivo bipolar sofrem influência de fatores culturais. O presente artigo realiza uma breve revisão da evidência referente aos aspectos transculturais do transtorno bipolar.Cultural variations in the expression of emotions have been described. Consequently, there are cross-cultural influences on the diagnosis and management o...

  14. Coexistence of unipolar and bipolar resistive switching behaviors in NiFe2O4 thin film devices by doping Ag nanoparticles

    Science.gov (United States)

    Hao, Aize; Ismail, Muhammad; He, Shuai; Huang, Wenhua; Qin, Ni; Bao, Dinghua

    2018-02-01

    The coexistence of unipolar and bipolar resistive switching (RS) behaviors of Ag-nanoparticles (Ag-NPs) doped NiFe2O4 (NFO) based memory devices was investigated. The switching voltages of required operations in the unipolar mode were smaller than those in the bipolar mode, while ON/OFF resistance levels of both modes were identical. Ag-NPs doped NFO based devices could switch between the unipolar and bipolar modes just by preferring the polarity of RESET voltage. Besides, the necessity of identical compliance current during the SET process of unipolar and bipolar modes provided an additional advantage of simplicity in device operation. Performance characteristics and cycle-to-cycle uniformity (>103 cycles) in unipolar operation were considerably better than those in bipolar mode (>102 cycles) at 25 °C. Moreover, good endurance (>600 cycles) at 200 °C was observed in unipolar mode and excellent nondestructive retention characteristics were obtained on memory cells at 125 °C and 200 °C. On the basis of temperature dependence of resistance at low resistance state, it was believed that physical origin of the RS mechanism involved the formation/rupture of the conducting paths consisting of oxygen vacancies and Ag atoms, considering Joule heating and electrochemical redox reaction effects for the unipolar and bipolar resistive switching behaviors. Our results demonstrate that 0.5% Ag-NPs doped nickel ferrites are promising resistive switching materials for resistive access memory applications.

  15. Study of short term memory status in adult bipolar disorder patients in south Indian population.

    Science.gov (United States)

    Aslam, Mohammed; Siddiq, Mohamed; Dhundasi, Salim A; Das, Kusal K; Kulkarni, B R

    2011-01-01

    The present study was undertaken to establish short term memory status in bipolar disorder cases as compared with normal age and sex matched control group in Bijapur (Karnataka). Results showed that a significant decrease in short term memory status in bipolar disorder cases as compared to their control group .Loss of attention, decreased processing speed and executive function patterns may be the probable causes of such observations.

  16. Social stress response in adolescents with bipolar disorder.

    Science.gov (United States)

    Casement, Melynda D; Goldstein, Tina R; Gratzmiller, Sarah M; Franzen, Peter L

    2018-05-01

    Theoretical models posit that stressors contribute to the onset and maintenance of bipolar disorder in adolescence through disruptions in stress physiology, but physiological response to stressors has not been evaluated in adolescents with bipolar illness. The present study tests the hypothesis that adolescents with bipolar disorder will have greater reactivity to a laboratory social stress task than healthy adolescents. Adolescents with bipolar illness (n = 27) and healthy adolescents (n = 28) completed a modified version of the Trier Social Stress Task. Stress response was assessed using high frequency heart rate variability (HF-HRV), heart rate (HR), mean arterial blood pressure (MAP), salivary cortisol, and subjective stress. Multilevel models were used to test for group differences in resting-state physiology, and stress reactivity and recovery. Adolescents with bipolar disorder had greater reactivity in HF-HRV (z = 3.32), but blunted reactivity in MAP (z = -3.08) and cortisol (z = -2.60), during the stressor compared to healthy adolescents. They also had lower resting HF-HRV (z = -3.49) and cortisol (z = -2.86), and higher resting HR (z = 3.56), than healthy adolescents. These results indicate that bipolar disorder is associated with disruptions in autonomic and endocrine response to stress during adolescence, including greater HF-HRV reactivity. Further research should evaluate whether these individual differences in stress physiology precede and predict the onset of mood episodes. Copyright © 2018 Elsevier Ltd. All rights reserved.

  17. Electronic monitoring in bipolar disorder.

    Science.gov (United States)

    Faurholt-Jepsen, Maria

    2018-03-01

    Major reasons for the insufficient effects of current treatment options in bipolar disorder include delayed intervention for prodromal depressive and manic symptoms and decreased adherence to psychopharmacological treatment. The reliance on subjective information and clinical evaluations when diagnosing and assessing the severity of depressive and manic symptoms calls for less biased and more objective markers. By using electronic devices, fine-grained data on complex psychopathological aspects of bipolar disorder can be evaluated unobtrusively over the long term. Moreover, electronic data could possibly represent candidate markers of diagnosis and illness activity in bipolar disorder and allow for early and individualized intervention for prodromal symptoms outside clinical settings. 
The present dissertation concerns the use of electronic monitoring as a marker and treatment intervention in bipolar disorder and investigated the scientific literature and body of evidence within the area, which includes ten original study reports and two systematic reviews, one of which included a meta-analysis, conducted by the author of the dissertation. 
Taken together, the literature presented in this dissertation illustrates that 1) smartphone-based electronic self-monitoring of mood seems to reflect clinically assessed depressive and manic symptoms and enables the long-term characterization of mood

instability in bipolar disorder; 2) preliminary results suggest that smartphone-based automatically generated data (e.g. the number of text messages sent/day; the number of incoming and outgoing calls/day; the number of changes in cell tower IDs/day; and voice features) seem to reflect clinically assessed depressive and manic symptoms in bipolar disorder; 3) smartphone-based electronic self-monitoring had no effects on the severity of depressive and manic symptoms in bipolar disorder, according to a randomized controlled trial; and 4) electronic monitoring of psychomotor

  18. Increased prospective health service use for depression among adults with childhood onset bipolar disorder.

    Science.gov (United States)

    Sala, Regina; Goldstein, Benjamin I; Wang, Shuai; Flórez-Salamanca, Ludwing; Iza, Miren; Blanco, Carlos

    2013-11-01

    To examine the prospective relationship between age of onset of bipolar disorder and the demographic and clinical characteristics, treatment, new onset of psychiatric comorbidity, and psychosocial functioning among adults with bipolar disorder. As part of the National Epidemiologic Survey on Alcohol and Related Conditions, 1600 adults who met lifetime Statistical Manual of Mental Disorders, 4th edition criteria for bipolar disorder-I (n = 1172) and bipolar disorder-II (n = 428) were included. Individuals were evaluated using the Alcohol Use Disorder and Associated Disabilities Interview Schedule-IV version for Diagnostic and Statistical Manual of Mental Disorders, 4th edition, and data were analyzed from Waves 1 and 2, approximately 3 years apart. Individuals with bipolar disorder were divided into three age at onset groups: childhood (adolescence (13-18 years old, n = 396), and adulthood (>19 year old, n = 1017). After adjusting for confounding factors, adults with childhood-onset bipolar disorder were more likely to see a counselor, have been hospitalized, and have received emergency room treatment for depression compared with those with adulthood-onset bipolar disorder. By contrast, there were no differences in the severity of mania or hypomania, new onset of comorbidity, and psychosocial functioning by age of bipolar disorder onset. Childhood-onset bipolar disorder is prospectively associated with seeking treatment for depression, an important proxy for depressive severity. Longitudinal studies are needed in order to determine whether prompt identification, accurate diagnosis, and early intervention can serve to mitigate the burden of childhood onset on the long-term depressive burden of bipolar disorder. Copyright © 2013 Mosby, Inc. All rights reserved.

  19. 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

  20. Brain structure–function associations in multi-generational families genetically enriched for bipolar disorder

    Science.gov (United States)

    Schür, Remmelt; Sjouwerman, Rachel; Service, Susan K.; Araya, Carmen; Araya, Xinia; Bejarano, Julio; Knowles, Emma; Gomez-Makhinson, Juliana; Lopez, Maria C.; Aldana, Ileana; Teshiba, Terri M.; Abaryan, Zvart; Al-Sharif, Noor B.; Navarro, Linda; Tishler, Todd A.; Altshuler, Lori; Bartzokis, George; Escobar, Javier I.; Glahn, David C.; Thompson, Paul M.; Lopez-Jaramillo, Carlos; Macaya, Gabriel; Molina, Julio; Reus, Victor I.; Sabatti, Chiara; Cantor, Rita M.; Freimer, Nelson B.; Bearden, Carrie E.

    2015-01-01

    Recent theories regarding the pathophysiology of bipolar disorder suggest contributions of both neurodevelopmental and neurodegenerative processes. While structural neuroimaging studies indicate disease-associated neuroanatomical alterations, the behavioural correlates of these alterations have not been well characterized. Here, we investigated multi-generational families genetically enriched for bipolar disorder to: (i) characterize neurobehavioural correlates of neuroanatomical measures implicated in the pathophysiology of bipolar disorder; (ii) identify brain–behaviour associations that differ between diagnostic groups; (iii) identify neurocognitive traits that show evidence of accelerated ageing specifically in subjects with bipolar disorder; and (iv) identify brain–behaviour correlations that differ across the age span. Structural neuroimages and multi-dimensional assessments of temperament and neurocognition were acquired from 527 (153 bipolar disorder and 374 non-bipolar disorder) adults aged 18–87 years in 26 families with heavy genetic loading for bipolar disorder. We used linear regression models to identify significant brain–behaviour associations and test whether brain–behaviour relationships differed: (i) between diagnostic groups; and (ii) as a function of age. We found that total cortical and ventricular volume had the greatest number of significant behavioural associations, and included correlations with measures from multiple cognitive domains, particularly declarative and working memory and executive function. Cortical thickness measures, in contrast, showed more specific associations with declarative memory, letter fluency and processing speed tasks. While the majority of brain–behaviour relationships were similar across diagnostic groups, increased cortical thickness in ventrolateral prefrontal and parietal cortical regions was associated with better declarative memory only in bipolar disorder subjects, and not in non-bipolar

  1. Gray Matter Volume Decrease Distinguishes Schizophrenia From Bipolar Offspring During Childhood and Adolescence.

    Science.gov (United States)

    Sugranyes, Gisela; de la Serna, Elena; Romero, Soledad; Sanchez-Gistau, Vanessa; Calvo, Anna; Moreno, Dolores; Baeza, Inmaculada; Diaz-Caneja, Covadonga M; Sanchez-Gutierrez, Teresa; Janssen, Joost; Bargallo, Nuria; Castro-Fornieles, Josefina

    2015-08-01

    There is increasing support toward the notion that schizophrenia and bipolar disorder share neurodevelopmental underpinnings, although areas of divergence remain. We set out to examine gray matter volume characteristics of child and adolescent offspring of patients with schizophrenia or bipolar disorder comparatively. In this 2-center study, magnetic resonance structural neuroimaging data were acquired in 198 children and adolescents (aged 6-17 years): 38 offspring of patients with schizophrenia, 77 offspring of patients with bipolar disorder, and 83 offspring of community controls. Analyses of global brain volumes and voxel-based morphometry (using familywise error correction) were conducted. There was an effect of group on total cerebral gray matter volume (F = 3.26, p = .041), driven by a decrease in offspring of patients with schizophrenia relative to offspring of controls (p = .035). At a voxel-based level, we observed an effect of group in the left inferior frontal cortex/anterior insula (F = 14.7, p bipolar disorder (p bipolar disorder and offspring of controls in either global or voxel-based gray matter volumes. This first comparative study between offspring of patients with schizophrenia and bipolar disorder suggests that gray matter volume reduction in childhood and adolescence may be specific to offspring of patients with schizophrenia; this may index a greater neurodevelopmental impact of risk for schizophrenia relative to bipolar disorder during youth. Copyright © 2015 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

  2. Risk of bipolar disorder among adolescents with allergic rhinitis: A nationwide longitudinal study.

    Science.gov (United States)

    Chen, Mu-Hong; Lan, Wen-Hsuan; Hsu, Ju-Wei; Huang, Kai-Lin; Chen, Ying-Sheue; Li, Cheng-Ta; Lin, Wei-Chen; Chang, Wen-Han; Chen, Tzeng-Ji; Pan, Tai-Long; Su, Tung-Ping; Bai, Ya-Mei

    2015-12-01

    Previous studies have suggested an immunological dysfunction in bipolar disorder, but none has investigated the temporal association between allergic rhinitis (AR) and bipolar disorder. Using Taiwan National Health Insurance Research Database, 9506 adolescents aged 12-18 years with allergic rhinitis were enrolled between 2000 and 2008 and compared to 38,024 age-and gender-matched (1:4) control groups. Subjects of bipolar disorder that occurred up to the end of follow-up (December 31, 2011) were identified. Adolescents with AR had a significantly higher incidence of developing bipolar disorder (0.77 vs. 0.18 per 1000 person-years, pAdolescents with AR had an increased risk (hazard ratio [HR]: 4.62, 95% confidence interval [CI]: 3.17-6.75) of developing bipolar disorder in their later life compared to the control group after adjusting for demographic data and comorbid allergic diseases. This is the first study showing a temporal association between AR and bipolar disorder, in that patients who had AR in adolescence exhibited an increased risk of developing bipolar disorder in later life. Further study would be required to investigate the underlying mechanism about this association. Copyright © 2015 Elsevier Inc. All rights reserved.

  3. Neurofunctional changes in adolescent cannabis users with and without bipolar disorder.

    Science.gov (United States)

    Bitter, Samantha M; Adler, Caleb M; Eliassen, James C; Weber, Wade A; Welge, Jeffrey A; Burciaga, Joaquin; Shear, Paula K; Strakowski, Stephen M; DelBello, Melissa P

    2014-11-01

    To compare regional brain activation among adolescents with bipolar disorder and co-occurring cannabis use disorder. Cross-sectional study. Cincinnati, OH, USA. Adolescents with bipolar disorder (BP, n = 14), adolescents with cannabis use disorder (MJ, n = 13), adolescents with co-occurring cannabis use and bipolar disorders (BPMJ, n = 25) and healthy adolescents (HC, n = 15). Cannabis craving, substance use, Blood Oxygenation Level Dependent (BOLD) signal assessed by the Marijuana Craving Questionnaire (MCQ), Teen-Addiction Severity Index (T-ASI) and a cannabis cue-reactivity task during a functional magnetic resonance imaging (fMRI) session, respectively. The BP group exhibited significantly greater brain activation than the BPMJ group in the right amygdala (F = 4.14, P = 0.046), left nucleus accumbens (F = 3.8, P = 0.02), left thalamus (F = 3.8, P adolescents with comorbid cannabis use do not exhibit the same over-activation of the regions involved in emotional processing as seen in adolescents with bipolar disorder alone. The absence of these findings in patients with comorbid bipolar and cannabis use disorders suggests that these individuals may have a unique endophenotype of bipolar disorder or that cannabis use may alter brain activation uniquely in bipolar disorder patients who use cannabis. © 2014 Society for the Study of Addiction.

  4. Bipolar electrocautery: A rodent model of Sunderland third-degree nerve injury.

    Science.gov (United States)

    Moradzadeh, Arash; Brenner, Michael J; Whitlock, Elizabeth L; Tong, Alice Y; Luciano, Janina P; Hunter, Daniel A; Myckatyn, Terence M; Mackinnon, Susan E

    2010-01-01

    To determine the Sunderland classification of a bipolar electrocautery injury. Twenty-two rats received crush (a reproducible Sunderland second-degree injury) or bipolar electrocautery injury and were evaluated for functional, histomorphometric, and immunohistochemical recovery at 21 or 42 days. Animal experiments were performed between July 3 and December 12, 2007. Axonal regeneration and end plate reinnervation were evaluated in double transgenic cyan fluorescent protein-conjugated Thy1 and green fluorescent protein-conjugated S100 mice. Compared with crush injury, bipolar electrocautery injury caused greater disruption of myelin and neurofilament architecture at the injury site and decreased nerve fiber counts and percentage of neural tissue distal to the injury (P =.007). Complete functional recovery was seen after crush but not bipolar electrocautery injury. Serial live imaging demonstrated axonal regeneration at week 1 after crush and at week 3 after bipolar electrocautery injury. Qualitative assessment of motor end plate reinnervation at 42 days demonstrated complete neuromuscular end plate reinnervation in the crush group and only limited reinnervation in the bipolar electrocautery group. Bipolar electrocautery injury in a rodent model resulted in a Sunderland third-degree injury, characterized by gradual, incomplete recovery without intervention.

  5. Social cognition and functional capacity in bipolar disorder and schizophrenia.

    Science.gov (United States)

    Thaler, Nicholas S; Sutton, Griffin P; Allen, Daniel N

    2014-12-15

    Social cognition is a functionally relevant predictor of capacity in schizophrenia (SZ), though research concerning its value for bipolar disorder (BD) is limited. The current investigation examined the relationship between two social cognitive factors and functional capacity in bipolar disorder. This study included 48 individuals with bipolar disorder (24 with psychotic features) and 30 patients with schizophrenia. Multiple regression controlling for estimated IQ scores was used to assess the predictive value of social cognitive factors on the UCSD Performance-Based Functional Skills Assessment (UPSA). Results found that for the bipolar with psychosis and schizophrenia groups, the social/emotion processing factor predicted the UPSA. The theory of mind factor only predicted the UPSA for the schizophrenia group.. Findings support the clinical utility of evaluating emotion processing in individuals with a history of psychosis. For BD, theory of mind may be better explained by a generalized cognitive deficit. In contrast, social/emotion processing may be linked to distinct neurobiological processes associated with psychosis. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  6. 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.

  7. Electronic monitoring in bipolar disorder

    DEFF Research Database (Denmark)

    Faurholt-Jepsen, Maria

    2018-01-01

    generated data (e.g. the number of text messages sent/day; the number of incoming and outgoing calls/day; the number of changes in cell tower IDs/day; and voice features) seem to reflect clinically assessed depressive and manic symptoms in bipolar disorder; 3) smartphone-based electronic self-monitoring had...

  8. Integrated Neurobiology of Bipolar Disorder

    Science.gov (United States)

    Maletic, Vladimir; Raison, Charles

    2014-01-01

    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 hypothalamic–pituitary–adrenal 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

  9. Is 'subthreshold' bipolar II disorder more difficult to differentiate from borderline personality disorder than formal bipolar II disorder?

    Science.gov (United States)

    Bayes, Adam; Graham, Rebecca K; Parker, Gordon B; McCraw, Stacey

    2018-06-01

    Recent research indicates that borderline personality disorder (BPD) can be diagnostically differentiated from the bipolar disorders. However, no studies have attempted to differentiate participants with sub-threshold bipolar disorder or SubT BP (where hypomanic episodes last less than 4 days) from those with a BPD. In this study, participants were assigned a SubT BP, bipolar II disorder (BP II) or BPD diagnosis based on clinical assessment and DSM-IV criteria. Participants completed self-report measures and undertook a clinical interview which collected socio-demographic information, a mood history, family history, developmental history, treatment information, and assessed cognitive, emotional and behavioural functioning. Both bipolar groups, whether SubT BP or BP II, differed to the BPD group on a number of key variables (i.e. developmental trauma, depression correlates, borderline personality scores, self-harm and suicide attempts), and compared to each other, returned similar scores on nearly all key variables. Borderline risk scores resulted in comparable classification rates of 0.74 (for BPD vs BP II) and 0.82 (for BPD vs sub-threshold BP II). Study findings indicate that both SubT BP and BP II disorder can be differentiated from BPD on a set of refined clinical variables with comparable accuracy. Copyright © 2018 Elsevier B.V. All rights reserved.

  10. Cognitive processes and attitudes in bipolar disorder: a study into personality, dysfunctional attitudes and attention bias in patients with bipolar disorder and their relatives.

    Science.gov (United States)

    Jabben, Nienke; Arts, Baer; Jongen, Ellen M M; Smulders, Fren T Y; van Os, Jim; Krabbendam, Lydia

    2012-12-20

    Research in cognitive processes and attitudes in bipolar disorder is scarce and has provided mixed findings, possibly due to differences in current mood state. It is unclear whether alterations in cognitive processes and attitudes are only related to the depressive mood states of bipolar patients or also represent a vulnerability marker for the development of future (depressive) episodes. This was investigated in the current study. Both implicit (attentional bias for emotional words) and explicit (dysfunctional attitudes and personality characteristics) measures of cognitive processes and attitudes were assessed in 77 bipolar patients with varying levels of depressive symptoms (depressed=17, euthymic n=60), their healthy first-degree relatives (n=39) and a healthy control group (n=61). Analyses of variance were used to investigate differences between groups. Mildly depressed patients with bipolar disorder demonstrated an attentional bias away from positive emotional words and showed increased dysfunctional attitudes and higher levels of neuroticism. Euthymic patients were largely comparable to healthy controls and only differed from controls in higher levels of neuroticism. Relatives were similar to controls on all measures, although they significantly differed from bipolar patients in displaying less neuroticism and more extraversion. No firm conclusions regarding causality can be drawn from the associations that were found between cognitive processes and attitudes and the evolution of mood symptoms in bipolar disorder. Alterations in cognitive processes and attitudes in bipolar patients appear to be mostly related to the expression of mood symptomatology rather than to the vulnerability for bipolar disorder. Copyright © 2012 Elsevier B.V. All rights reserved.

  11. Prevalence and correlates of bipolar disorders in patients with eating disorders.

    Science.gov (United States)

    Tseng, Mei-Chih Meg; Chang, Chin-Hao; Chen, Kuan-Yu; Liao, Shih-Cheng; Chen, Hsi-Chung

    2016-01-15

    To investigate the prevalence and correlates of bipolar disorders in patients with eating disorders (EDs), and to examine differences in effects between major depressive disorder and bipolar disorder on these patients. Sequential attendees were invited to participate in a two-phase survey for EDs at the general psychiatric outpatient clinics. Patients diagnosed with EDs (n=288) and controls of comparable age, sex, and educational level (n=81) were invited to receive structured interviews for psychiatric co-morbidities, suicide risks, and functional level. All participants also completed several self-administered questionnaires assessing general and eating-related pathology and impulsivity. Characteristics were compared between the control, ED-only, ED with major depressive disorder, and ED with bipolar disorder groups. Patients with all ED subtypes had significantly higher rates of major depressive disorder (range, 41.3-66.7%) and bipolar disorder (range, 16.7-49.3%) than controls did. Compared to patients with only EDs, patients with comorbid bipolar disorder and those with comorbid major depressive disorder had significantly increased suicidality and functional impairments. Moreover, the group with comorbid bipolar disorder had increased risks of weight dysregulation, more impulsive behaviors, and higher rates of psychiatric comorbidities. Participants were selected in a tertiary center of a non-Western country and the sample size of individuals with bipolar disorder in some ED subtypes was small. Bipolar disorders were common in patients with EDs. Careful differentiation between bipolar disorder and major depressive disorder in patients with EDs may help predict associated psychopathology and provide accurate treatment. Copyright © 2015 Elsevier B.V. All rights reserved.

  12. Five-year follow-up of cognitive impairment in older adults with bipolar disorder.

    Science.gov (United States)

    Schouws, Sigfried N T M; Comijs, Hannie C; Dols, Annemieke; Beekman, Aartjan T F; Stek, Max L

    2016-03-01

    To date, cognitive impairment has been thought to be an integral part of bipolar disorder. In clinical staging models, cognitive impairment is one of the hallmarks to define the clinical stage and it plays an important role in identifying the risk factors for progression to later stages of the illness. It is important to examine neurocognitive performance over longer periods to test the hypothesis of neuroprogression of bipolar disorder. A comprehensive neuropsychological test battery was applied at baseline and five years later to 56 euthymic older outpatients with bipolar disorder (mean age = 68.35 years, range: 60-90 years) and to a demographically matched sample of 44 healthy subjects. A group-by-time repeated measures multivariate analysis of variance was performed to measure changes over time for the two groups. The impact of baseline illness characteristics on the intra-individual change in neurocognitive performance within the bipolar disorder group was studied by using logistic regression analysis. At baseline and at follow-up, patients with bipolar disorder performed worse on all neurocognitive measures compared to the matched healthy subjects. However, there was no significant group-by-time interaction between the patients with bipolar disorder and the comparison group. Although older patients with bipolar disorder had worse cognitive function than healthy subjects, they did not have greater cognitive decline over a five-year period. The change in acquired cognitive impairment of patients with bipolar disorder might parallel the cognitive development as seen in normal aging. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  13. Facial emotion recognition, socio-occupational functioning and expressed emotions in schizophrenia versus bipolar disorder.

    Science.gov (United States)

    Thonse, Umesh; Behere, Rishikesh V; Praharaj, Samir Kumar; Sharma, Podila Sathya Venkata Narasimha

    2018-06-01

    Facial emotion recognition deficits have been consistently demonstrated in patients with severe mental disorders. Expressed emotion is found to be an important predictor of relapse. However, the relationship between facial emotion recognition abilities and expressed emotions and its influence on socio-occupational functioning in schizophrenia versus bipolar disorder has not been studied. In this study we examined 91 patients with schizophrenia and 71 with bipolar disorder for psychopathology, socio occupational functioning and emotion recognition abilities. Primary caregivers of 62 patients with schizophrenia and 49 with bipolar disorder were assessed on Family Attitude Questionnaire to assess their expressed emotions. Patients of schizophrenia and bipolar disorder performed similarly on the emotion recognition task. Patients with schizophrenia group experienced higher critical comments and had a poorer socio-occupational functioning as compared to patients with bipolar disorder. Poorer socio-occupational functioning in patients with schizophrenia was significantly associated with greater dissatisfaction in their caregivers. In patients with bipolar disorder, poorer emotion recognition scores significantly correlated with poorer adaptive living skills and greater hostility and dissatisfaction in their caregivers. The findings of our study suggest that emotion recognition abilities in patients with bipolar disorder are associated with negative expressed emotions leading to problems in adaptive living skills. Copyright © 2018 Elsevier B.V. All rights reserved.

  14. Normal pituitary volumes in children and adolescents with bipolar disorder: a magnetic resonance imaging study.

    Science.gov (United States)

    Chen, Hua Hsuan; Nicoletti, Mark; Sanches, Marsal; Hatch, John P; Sassi, Roberto B; Axelson, David; Brambilla, Paolo; Keshavan, Matcheri S; Ryan, Neal; Birmaher, Boris; Soares, Jair C

    2004-01-01

    The volume of the pituitary gland in adults with bipolar disorder has previously been reported to be smaller than that of healthy controls. Such abnormalities would be consistent with the HPA dysfunction reported in this illness. We conducted a study of children and adolescents with bipolar disorder to determine whether size abnormalities in the pituitary gland are already present early in illness course. Magnetic resonance imaging (MRI) morphometric analysis of the pituitary gland was carried out in 16 DSM-IV children and adolescents with bipolar disorder (mean age+/-sd=15.5+/-3.4 years) and 21 healthy controls (mean age+/-sd=16.9+/-3.8 years). Subjects underwent a 1.5 T MRI, with 3-D Spoiled Gradient Recalled (SPGR) acquisition. There was no statistically significant difference between pituitary gland volumes of bipolar patients compared to healthy controls (ANCOVA, age, gender, and ICV as covariates; F=1.77, df=1,32, P=.19). There was a statistically significant direct relationship between age and pituitary gland volume in both groups (r=.59, df=17, P=.007 for healthy controls; r=.61, df=12, P=.008 for bipolar patients). No evidence of size abnormalities in the pituitary gland was found in child and adolescent bipolar patients, contrary to reports involving adult bipolar patients. This suggests that anatomical abnormalities in this structure may develop later in illness course as a result of continued HPA dysfunction. (c) 2005 Wiley-Liss, Inc.

  15. Internet use by patients with bipolar disorder: Results from an international multisite survey.

    Science.gov (United States)

    Bauer, Rita; Conell, Jörn; Glenn, Tasha; Alda, Martin; Ardau, Raffaella; Baune, Bernhard T; Berk, Michael; Bersudsky, Yuly; Bilderbeck, Amy; Bocchetta, Alberto; Bossini, Letizia; Castro, Angela M Paredes; Cheung, Eric Yw; Chillotti, Caterina; Choppin, Sabine; Del Zompo, Maria; Dias, Rodrigo; Dodd, Seetal; Duffy, Anne; Etain, Bruno; Fagiolini, Andrea; Hernandez, Miryam Fernández; Garnham, Julie; Geddes, John; Gildebro, Jonas; Gonzalez-Pinto, Ana; Goodwin, Guy M; Grof, Paul; Harima, Hirohiko; Hassel, Stefanie; Henry, Chantal; Hidalgo-Mazzei, Diego; Kapur, Vaisnvy; Kunigiri, Girish; Lafer, Beny; Larsen, Erik R; Lewitzka, Ute; Licht, Rasmus W; Lund, Anne Hvenegaard; Misiak, Blazej; Monteith, Scott; Munoz, Rodrigo; Nakanotani, Takako; Nielsen, René E; O'Donovan, Claire; Okamura, Yasushi; Osher, Yamima; Piotrowski, Patryk; Reif, Andreas; Ritter, Philipp; Rybakowski, Janusz K; Sagduyu, Kemal; Sawchuk, Brett; Schwartz, Elon; Scippa, Ângela M; Slaney, Claire; Sulaiman, Ahmad H; Suominen, Kirsi; Suwalska, Aleksandra; Tam, Peter; Tatebayashi, Yoshitaka; Tondo, Leonardo; Vieta, Eduard; Vinberg, Maj; Viswanath, Biju; Volkert, Julia; Zetin, Mark; Whybrow, Peter C; Bauer, Michael

    2016-08-30

    There is considerable international interest in online education of patients with bipolar disorder, yet little understanding of how patients use the Internet and other sources to seek information. 1171 patients with a diagnosis of bipolar disorder in 17 countries completed a paper-based, anonymous survey. 81% of the patients used the Internet, a percentage similar to the general public. Older age, less education, and challenges in country telecommunications infrastructure and demographics decreased the odds of using the Internet. About 78% of the Internet users looked online for information on bipolar disorder or 63% of the total sample. More years of education in relation to the country mean, and feeling very confident about managing life decreased the odds of seeking information on bipolar disorder online, while having attended support groups increased the odds. Patients who looked online for information on bipolar disorder consulted medical professionals plus a mean of 2.3 other information sources such as books, physician handouts, and others with bipolar disorder. Patients not using the Internet consulted medical professionals plus a mean of 1.6 other information sources. The percentage of patients with bipolar disorder who use the Internet is about the same as the general public. Other information sources remain important. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  16. Bipolar polygenic loading and bipolar spectrum features in major depressive disorder

    NARCIS (Netherlands)

    Wiste, Anna; Robinson, Elise B.; Milaneschi, Yuri; Meier, Sandra; Ripke, Stephan; Clements, Caitlin C.; Fitzmaurice, Garrett M.; Rietschel, Marcella; Penninx, Brenda W.; Smoller, Jordan W.; Perlis, Roy H.

    Objectives Family and genetic studies indicate overlapping liability for major depressive disorder and bipolar disorder. The purpose of the present study was to determine whether this shared genetic liability influences clinical presentation. Methods A polygenic risk score for bipolar disorder,

  17. A prospective randomized study comparing unipolar versus bipolar hysteroscopic myomectomy in infertile women

    Directory of Open Access Journals (Sweden)

    Kallol K Roy

    2017-01-01

    Full Text Available Study Objective: To compare the operative and reproductive outcome of hysteroscopic myomectomy using unipolar resectoscope versus bipolar resectoscope in patients with infertility and menorrhagia. Design: Randomized, prospective, parallel, comparative, single-blinded study. Design Classification: Canadian Task Force classification I. Setting: Tertiary care institute. Patients: Sixty women with submucous myoma and infertility. Interventions: Hysteroscopic myomectomy performed with unipolar resectoscope or bipolar resectoscope. Measurements: Primary outcome measures were the pregnancy-related indicators. Secondary outcome measures were the operative parameters, harmful outcomes related to the procedure, and comparison of improvement levels in the menstrual pattern after surgery between the two groups. Main Results: A total of 60 patients were randomized into two groups of equal size. Baseline characteristics were not significantly different between the two groups. Reduction in sodium level from pre- to postsurgery was significantly (P = 0.001 higher in the unipolar group. Nine patients (30% in the unipolar group had hyponatremia in the postoperative period compared to none in the bipolar group (P = 0.002. However, there was no significant difference in the other operative parameters between the two groups. In both the groups, a significant improvement in the menstrual symptoms was observed after myomectomy. Pregnancy-related outcomes were similar in both the groups. Conclusion: The use of bipolar resectoscope for hysteroscopic myomectomy is associated with lesser risk of hyponatremia compared to unipolar resectoscope. Bipolar resectoscopic myomectomy is found to be an effective and safer alternative to unipolar resectoscopy with similar reproductive outcome.

  18. Evidence for crustal low shear-wave speed in western Saudi Arabia from multi-scale fundamental-mode Rayleigh-wave group-velocity tomography

    KAUST Repository

    Tang, Zheng

    2018-05-15

    We investigate the crustal and upper-mantle shear-velocity structure of Saudi Arabia by fundamental-mode Rayleigh-wave group-velocity tomography and shear-wave velocity inversion. The seismic dataset is compiled using ∼140 stations of the Saudi National Seismic Network (SNSN) operated by the Saudi Geological Survey (SGS). We measure Rayleigh-wave group-velocities at periods of 8–40 s from regional earthquakes. After obtaining 1-D shear-wave velocity models by inverting group-velocities at each grid node, we construct a 3-D shear-velocity model for Saudi Arabia and adjacent regions by interpolating the 1-D models. Our 3-D model indicates significant lateral variations in crustal and lithospheric thickness, as well as in the shear-wave velocity over the study region. In particular, we identify zones of reduced shear-wave speed at crustal levels beneath the Cenozoic volcanic fields in the Arabian Shield. The inferred reductions of 2–5% in shear-wave speed may be interpreted as possibly indicating the presence of partial melts. However, their precise origin we can only speculate about. Our study also reveals an upper-mantle low velocity zone (LVZ) below the Arabian Shield, supporting the model of lateral mantle flow from the Afar plume. Further geophysical experiments are needed to confirm (or refute) the hypothesis that partial melts may exist below the Cenozoic volcanism in western Saudi Arabia, and to build a comprehensive geodynamic–geological model for the evolution and present state of the lithosphere of the Arabian Plate and the Red Sea.

  19. Evidence for crustal low shear-wave speed in western Saudi Arabia from multi-scale fundamental-mode Rayleigh-wave group-velocity tomography

    KAUST Repository

    Tang, Zheng; Mai, Paul Martin; Chang, Sung-Joon; Zahran, Hani

    2018-01-01

    We investigate the crustal and upper-mantle shear-velocity structure of Saudi Arabia by fundamental-mode Rayleigh-wave group-velocity tomography and shear-wave velocity inversion. The seismic dataset is compiled using ∼140 stations of the Saudi National Seismic Network (SNSN) operated by the Saudi Geological Survey (SGS). We measure Rayleigh-wave group-velocities at periods of 8–40 s from regional earthquakes. After obtaining 1-D shear-wave velocity models by inverting group-velocities at each grid node, we construct a 3-D shear-velocity model for Saudi Arabia and adjacent regions by interpolating the 1-D models. Our 3-D model indicates significant lateral variations in crustal and lithospheric thickness, as well as in the shear-wave velocity over the study region. In particular, we identify zones of reduced shear-wave speed at crustal levels beneath the Cenozoic volcanic fields in the Arabian Shield. The inferred reductions of 2–5% in shear-wave speed may be interpreted as possibly indicating the presence of partial melts. However, their precise origin we can only speculate about. Our study also reveals an upper-mantle low velocity zone (LVZ) below the Arabian Shield, supporting the model of lateral mantle flow from the Afar plume. Further geophysical experiments are needed to confirm (or refute) the hypothesis that partial melts may exist below the Cenozoic volcanism in western Saudi Arabia, and to build a comprehensive geodynamic–geological model for the evolution and present state of the lithosphere of the Arabian Plate and the Red Sea.

  20. Increased timing variability in schizophrenia and bipolar disorder.

    Directory of Open Access Journals (Sweden)

    Amanda R Bolbecker

    Full Text Available Theoretical and empirical evidence suggests that impaired time perception and the neural circuitry underlying internal timing mechanisms may contribute to severe psychiatric disorders, including psychotic and mood disorders. The degree to which alterations in temporal perceptions reflect deficits that exist across psychosis-related phenotypes and the extent to which mood symptoms contribute to these deficits is currently unknown. In addition, compared to schizophrenia, where timing deficits have been more extensively investigated, sub-second timing has been studied relatively infrequently in bipolar disorder. The present study compared sub-second duration estimates of schizophrenia (SZ, schizoaffective disorder (SA, non-psychotic bipolar disorder (BDNP, bipolar disorder with psychotic features (BDP, and healthy non-psychiatric controls (HC on a well-established time perception task using sub-second durations. Participants included 66 SZ, 37 BDNP, 34 BDP, 31 SA, and 73 HC who participated in a temporal bisection task that required temporal judgements about auditory durations ranging from 300 to 600 milliseconds. Timing variability was significantly higher in SZ, BDP, and BDNP groups compared to healthy controls. The bisection point did not differ across groups. These findings suggest that both psychotic and mood symptoms may be associated with disruptions in internal timing mechanisms. Yet unexpected findings emerged. Specifically, the BDNP group had significantly increased variability compared to controls, but the SA group did not. In addition, these deficits appeared to exist independent of current symptom status. The absence of between group differences in bisection point suggests that increased variability in the SZ and bipolar disorder groups are due to alterations in perceptual timing in the sub-second range, possibly mediated by the cerebellum, rather than cognitive deficits.

  1. Cardiovascular risk and bipolar disorder: factors associated with a positive coronary calcium score in patients with bipolar disorder type 1

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    Aline R. Wageck

    2017-10-01

    Full Text Available Objective: Cardiovascular disease is the leading cause of death in patients with bipolar disorder. The aim of this study was to evaluate the factors associated with positive coronary calcium score (CCS in individuals with bipolar disorder type 1. Methods: Patients from the Bipolar Disorder Program at Hospital de Clínicas de Porto Alegre, Brazil, underwent computed tomography scanning for calcium score measurement. Clinical and sociodemographic variables were compared between patients according to their CCS status: negative (CCS = 0 or positive (CCS > 0. Poisson regression analysis was used to examine the association of CCS with number of psychiatric hospitalizations. Results: Out of 41 patients evaluated, only 10 had a positive CCS. Individuals in the CCS-positive group were older (55.2±4.2 vs. 43.1±10.0 years; p = 0.001 and had more psychiatric hospitalizations (4.7±3.0 vs. 2.6±2.5; p = 0.04 when compared with CCS- negative subjects. The number of previous psychiatric hospitalizations correlated positively with CCS (p < 0.001. Conclusion: Age and number of psychiatric hospitalizations were significantly associated with higher CCS, which might be a potential method for diagnosis and stratification of cardiovascular disease in bipolar patients. There is a need for increased awareness of risk assessment in this population.

  2. Unsplit bipolar pulse forming line

    Science.gov (United States)

    Rhodes, Mark A [Pleasanton, CA

    2011-05-24

    A bipolar pulse forming transmission line module and system for linear induction accelerators having first, second, third, and fourth planar conductors which form a sequentially arranged interleaved stack having opposing first and second ends, with dielectric layers between the conductors. The first and second planar conductors are connected to each other at the first end, and the first and fourth planar conductors are connected to each other at the second end via a shorting plate. The third planar conductor is electrically connectable to a high voltage source, and an internal switch functions to short at the first end a high voltage from the third planar conductor to the fourth planar conductor to produce a bipolar pulse at the acceleration axis with a zero net time integral. Improved access to the switch is enabled by an aperture through the shorting plate and the proximity of the aperture to the switch.

  3. 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…

  4. Bipolar (spectrum) disorder and mood stabilization: standing at the crossroads?

    OpenAIRE

    De Fruyt, Jurgen; Demyttenaere, Koen

    2007-01-01

    Diagnosis and treatment of bipolar disorder has long been a neglected discipline. Recent years have shown an upsurge in bipolar research. When compared to major depressive disorder, bipolar research still remains limited and more expert based than evidence based. In bipolar diagnosis the focus is shifting from classic mania to bipolar depression and hypomania. There is a search for bipolar signatures in symptoms and course of major depressive episodes. The criteria for hypomania are softened,...

  5. [Bipolar disorders in DSM-5].

    Science.gov (United States)

    Severus, E; Bauer, M

    2014-05-01

    In spring 2013 the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) edited by the American Psychiatric Association was published. The DSM-5 has also brought some important changes regarding bipolar disorders. The goal of this manuscript is to review the novelties in DSM-5 and to evaluate the implications of these changes. The diagnostic criteria as well as the additional remarks provided in the running text of DSM-5 were carefully appraised. For the first time diagnostic criteria are provided for disorders which up to now have been considered as subthreshold bipolar disorders. Furthermore, mixed episodes were eliminated and instead a mixed specifier was introduced. An increase in goal-directed activity/energy is now one of the obligatory symptoms for a (hypo)manic episode. Diagnostic guidance is provided as to when a (hypo)manic episode that has developed during treatment with an antidepressant has to be judged to be causally related to antidepressants and when this episode has only occurred coincidentally with antidepressant use. While some of the novelties are clearly useful, e.g. addition of increased goal-directed activity/energy as obligatory symptom for (hypo)manic episodes, this remains to be demonstrated for others, such as the definition of various subthreshold bipolar disorders.

  6. Virginia Woolf, neuroprogression, and bipolar disorder

    Directory of Open Access Journals (Sweden)

    Manuela V. Boeira

    2016-01-01

    Full Text Available Family history and traumatic experiences are factors linked to bipolar disorder. It is known that the lifetime risk of bipolar disorder in relatives of a bipolar proband are 5-10% for first degree relatives and 40-70% for monozygotic co-twins. It is also known that patients with early childhood trauma present earlier onset of bipolar disorder, increased number of manic episodes, and more suicide attempts. We have recently reported that childhood trauma partly mediates the effect of family history on bipolar disorder diagnosis. In light of these findings from the scientific literature, we reviewed the work of British writer Virginia Woolf, who allegedly suffered from bipolar disorder. Her disorder was strongly related to her family background. Moreover, Virginia Woolf was sexually molested by her half siblings for nine years. Her bipolar disorder symptoms presented a pernicious course, associated with hospitalizations, suicidal behavioral, and functional impairment. The concept of neuroprogression has been used to explain the clinical deterioration that takes places in a subgroup of bipolar disorder patients. The examination of Virgina Woolf’s biography and art can provide clinicians with important insights about the course of bipolar disorder.

  7. 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

  8. [Lithium and anticonvulsants in bipolar depression].

    Science.gov (United States)

    Samalin, L; Nourry, A; Llorca, P-M

    2011-12-01

    For decades, lithium and anticonvulsants have been widely used in the treatment of bipolar disorder. Their efficacy in the treatment of mania is recognized. These drugs have been initially evaluated in old and methodologically heterogeneous studies. Their efficacy in bipolar depression has not always been confirmed in more recent and methodologically more reliable studies. Thus, lithium's efficacy as monotherapy was challenged by the study of Young (2008) that showed a lack of efficacy compared with placebo in the treatment of bipolar depression. In two recent meta-analyses, valproate has shown a modest efficacy in the treatment of bipolar depression. As for lithium, valproate appeared to have a larger antimanic effect for acute phase and prophylaxis of bipolar disorder. In contrast, lamotrigine is more effective on the depressive pole of bipolar disorder with better evidence for the prevention of depressive recurrences. The guidelines include these recent studies and recommend lamotrigine as a first-line treatment of bipolar depression and for maintenance treatment. Because of more discordant data concerning lithium and valproate, these two drugs are placed either as first or as second line treatment of bipolar depression. The different safety/efficacy ratios of mood stabilizers underlie the complementarity and the importance of combination between them, or with some second-generation antipsychotics, in the treatment of patients with bipolar disorder. Copyright © 2011 L’Encéphale. Published by Elsevier Masson SAS.. All rights reserved.

  9. Late Onset Bipolar Disorder: Case Report

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    Filipa Araújo

    2016-07-01

    Full Text Available Background: Bipolar disorder affects approximately 1% of the population, with diagnosis often being made during late adolescence and early adulthood, and only rarely (0.1% in the elderly. Late onset bipolar disorder in the elderly has a impact on the nature and course of bipolar disorder. Aims: The authors report a case of bipolar disorder emerging in late life  (76years old with no cleary identified organic cause. Conclusion: This case highlights the importance of a broad differential diagnosis and pharmacologic management when approaching new-onset manic/depressive symptoms among geriatric patients.

  10. Dysfunctional gaze processing in bipolar disorder

    Directory of Open Access Journals (Sweden)

    Cristina Berchio

    2017-01-01

    The present study provides neurophysiological evidence for abnormal gaze processing in BP and suggests dysfunctional processing of direct eye contact as a prominent characteristic of bipolar disorder.

  11. [Emotional and impulsive dimensions in bipolar disorder and borderline personality disorder].

    Science.gov (United States)

    Leblanc, A; Jarroir, M; Vorspan, F; Bellivier, F; Leveillee, S; Romo, L

    2017-05-01

    Studies have shown that patients with borderline personality disorder are often misdiagnosed to have bipolar disorder and conversely. Indeed, a number of characteristics common to both disorders could explain this problem: emotional instability as well as impulsivity represent confounding factors and contribute to the risk of misdiagnosis. However, it appears that these characteristics manifest themselves in different ways according to the pathology. The aim of the study is to show differences between affective lability, emotional intensity and impulsivity dimensions. The clinical aim is to refine bipolar disorder and borderline personality disorder diagnosis, to improve psychological care for these patients in the long-term. We compared the emotional and impulsive dimensions in two groups of patients: a group of 21 patients with bipolar disorder and a group of 19 patients with borderline personality disorder. Tools: ALS, a self-report questionnaire to evaluate affective lability, AIM, a self-report questionnaire to see affective intensity, and UPPS, a self-report questionnaire to measure impulsivity according to several dimensions. The results indicate that borderline patients scored significantly higher than bipolar patients at the ALS and AIM scales. Regarding the UPPS, borderline patients scored significantly higher than bipolar patients for the dimensions "lack of premeditation" and "lack of perseverance"; however, bipolar patients had significantly higher scores than borderline patients for the dimension "negative emergency". This study shows that bipolar disorder and borderline personality can be differentiated thanks to emotional dimensions as well as different dimensions of impulsivity: borderline patients appear to have an affective lability and intensity more important than bipolar patients; it also appears that impulsivity manifests itself differently according to the disorder. Copyright © 2016 L'Encéphale, Paris. Published by Elsevier Masson SAS. All

  12. Cardiometabolic risks and omega-3 index in recent-onset bipolar I disorder.

    Science.gov (United States)

    Wulsin, Lawson R; Blom, Thomas J; Durling, Michelle; Welge, Jeffrey A; DelBello, Melissa P; Adler, Caleb M; McNamara, Robert K; Strakowski, Stephen M

    2018-02-26

    The aims of the present study were to characterize cardiometabolic risk factors in a cohort of bipolar disorder patients with limited exposure to psychotropic medications, and to evaluate their associations with mood symptoms and omega-3 polyunsaturated fatty acid (PUFA) blood levels. Cardiometabolic risk assessments were compared in individuals with bipolar I disorder experiencing a first manic or mixed episode or an early depressive episode (n=117) and healthy subjects (n=56). Patients were medication free at assessment and had no or limited exposure to mood-stabilizer or antipsychotic medications prior to the current admission. Associations among cardiometabolic parameters and Clinical Global Impression-Severity scale (CGI-S), manic (Young Mania Rating Scale [YMRS]), and depressive (Hamilton Depression Rating Scale [HDRS]) symptom ratings were evaluated within the bipolar group. Following adjustment for demographic variables (i.e., age, gender, and parental education), significantly higher fasting triglyceride levels were observed in the bipolar group compared to the healthy group (121.7 mg/dL vs 87.0 mg/dL; Pbipolar group and 6% of the healthy group met the criteria for metabolic syndrome (P=.23). The omega-3 index was lower in the bipolar group (3.4% vs 3.9%; Pbipolar group, no associations were found between the cardiometabolic parameters and CGI-S, YMRS, and HDRS symptom ratings. Recent-onset medication-free bipolar disorder is associated with higher triglyceride levels. These findings are suggestive of early metabolic dysregulation prior to long-term psychotropic medication exposure. Lower omega-3 PUFA levels in individuals with bipolar I disorder represent a potential therapeutic target for additional investigation. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  13. [Psychopathological Profiles of Offspring of Subjects with Bipolar Disorder].

    Science.gov (United States)

    Villa, Esteban Uribe; Briceño, Paola Gutiérrez; Palacio, Juan David; García, Jenny

    2012-03-01

    Bipolar Disorder (BD) has a high heritability and is more prevalent in first-degree relatives with family history. This makes the bipolar offspring (BO) an ideal study group to evaluate the natural history and the prodromal symptoms of this disorder. The main psychopathological findings for this group in various studies are described in this review. Articles comparing the psychopathology of bipolar offspring to either the offspring of other psychiatric patients or the offspring of healthy controls were reviewed. The reviewed studies showed that the BO group had higher rates of affective disorders when compared to the offspring of other psychiatric patients or the offspring of healthy controls. The high prevalence of anxiety disorders, ADHD, and disruptive behavior disorders in this population suggest that such disorders could be considered prodromes of mood disorders. The group of BO had a significantly higher risk of developing a wide range of psychiatric disorders besides BD. More longitudinal studies are needed to characterize this population at risk for BD and to elucidate the risk factors in the progression of this disorder. Copyright © 2012 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    Fatemeh Davari-Tanha

    2014-01-01

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

  15. Comparison of Risperidone and Olanzapine in Bipolar and Schizoaffective Disorders

    Science.gov (United States)

    Masand, Prakash S.; Wang, Xiaohong; Gupta, Sanjay; Schwartz, Thomas L.; Virk, Subhdeep; Hameed, Ahmad

    2002-01-01

    Objective: To compare risperidone and olanzapine for efficacy, tolerability, need for concomitant mood stabilizers, and cost of treatment in bipolar and schizoaffective disorders. Method: We conducted a retrospective chart review of 36 consecutive outpatients with DSM-IV bipolar or schizoaffective disorder seen in 3 settings who received risperidone or olanzapine for at least 1 month between May and August 1997. Results: The mean ± SD doses were 3.7 ± 3.5 mg/day of risperidone and 12.0 ± 5.4 mg/day of olanzapine. Between-treatment differences in patient characteristics, psychiatric history, Clinical Global Impressions scale ratings, and duration of treatment were not significant. Similar proportions of patients in the 2 groups reported side effects, including extrapyramidal symptoms, akathisia, tardive dyskinesia, and precipitation of mania by the respective drug. Patients in the olanzapine group received a significantly higher dose of concomitant lithium than those receiving risperidone (mean daily lithium doses: risperidone group, 750 ± 150 mg; olanzapine group, 1211 ± 186 mg; p = .006). The total daily acquisition cost per patient was $11.84 for olanzapine versus $5.81 for risperidone. Conclusion: Olanzapine and risperidone were equally efficacious and safe in the treatment of patients with bipolar or schizoaffective disorder, but treatment costs and dose of concomitant lithium were lower in risperidone-treated patients. PMID:15014747

  16. [Search association between cannabis abuse and bipolar disorder: A study on a sample of patients hospitalized for bipolar disorder].

    Science.gov (United States)

    Kazour, F; Awaida, C; Souaiby, L; Richa, S

    2018-02-01

    Cannabis use is very frequent in bipolar disorder and has been found to increase the duration and frequency of manic symptoms while decreasing those of depression. Bipolar patients who use cannabis were shown to have poorer compliance to treatment, more symptoms that are psychotic and a worse prognosis than patients who do not. In this study, we have evaluated the importance of cannabis use among bipolar patients admitted to the Psychiatric Hospital of the Cross, Lebanon (Hôpital Psychiatrique de la Croix [HPC]) as well as the clinical differences between cannabis users and non-users. Over a period of 13 months, we recruited the patients admitted to HPC for bipolar disorder according to the MINI DSM-IV criteria. These patients were screened for substance abuse/dependence and were accordingly divided into 2 groups: cannabis users and cannabis non-users. Both groups were interviewed by a medical student and asked to answer the following questionnaires: the MINI DSM-IV, the Young Mania Rating Scale (YMRS) for evaluating manic episodes, the Montgomery and Åsberg Depression Rating Scale (MADRS) for evaluating depressive episodes, the Scale for the Assessment of Positive Symptoms (SAPS) to assess psychotic symptoms associated to the bipolar disorder, and the Cannabis Abuse Screening Test (CAST) for evaluating the importance of cannabis consumption. The study's exclusion criteria were the following: diagnosis of a confusional state, schizophrenia and other psychotic disorders, dementia, age less than 18 years old or superior to 85 years old, and non-cooperation. Among the 100 bipolar patients included in the study, 27 (27 %) were cannabis users. Eight of these 27 patients were first admitted to HPC for substance abuse and then included in the study after a bipolar disorder was diagnosed according to the MINI DSM-IV criteria. Cannabis use was found to be more prevalent in young males with a mean age of 20.3 years old at the first contact with the substance

  17. 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. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  18. Does psychomotor agitation in major depressive episodes indicate bipolarity? Evidence from the Zurich Study.

    Science.gov (United States)

    Angst, Jules; Gamma, Alex; Benazzi, Franco; Ajdacic, Vladeta; Rössler, Wulf

    2009-02-01

    Kraepelin's partial interpretation of agitated depression as a mixed state of "manic-depressive insanity" (including the current concept of bipolar disorder) has recently been the focus of much research. This paper tested whether, how, and to what extent both psychomotor symptoms, agitation and retardation in depression are related to bipolarity and anxiety. The prospective Zurich Study assessed psychiatric and somatic syndromes in a community sample of young adults (N = 591) (aged 20 at first interview) by six interviews over 20 years (1979-1999). Psychomotor symptoms of agitation and retardation were assessed by professional interviewers from age 22 to 40 (five interviews) on the basis of the observed and reported behaviour within the interview section on depression. Psychiatric diagnoses were strictly operationalised and, in the case of bipolar-II disorder, were broader than proposed by DSM-IV-TR and ICD-10. As indicators of bipolarity, the association with bipolar disorder, a family history of mania/hypomania/cyclothymia, together with hypomanic and cyclothymic temperament as assessed by the general behavior inventory (GBI) [15], and mood lability (an element of cyclothymic temperament) were used. Agitated and retarded depressive states were equally associated with the indicators of bipolarity and with anxiety. Longitudinally, agitation and retardation were significantly associated with each other (OR = 1.8, 95% CI = 1.0-3.2), and this combined group of major depressives showed stronger associations with bipolarity, with both hypomanic/cyclothymic and depressive temperamental traits, and with anxiety. Among agitated, non-retarded depressives, unipolar mood disorder was even twice as common as bipolar mood disorder. Combined agitated and retarded major depressive states are more often bipolar than unipolar, but, in general, agitated depression (with or without retardation) is not more frequently bipolar than retarded depression (with or without agitation), and

  19. Differentiation without distancing. explaining bi-polarization of opinions without negative influence.

    Directory of Open Access Journals (Sweden)

    Michael Mäs

    Full Text Available Explanations of opinion bi-polarization hinge on the assumption of negative influence, individuals' striving to amplify differences to disliked others. However, empirical evidence for negative influence is inconclusive, which motivated us to search for an alternative explanation. Here, we demonstrate that bi-polarization can be explained without negative influence, drawing on theories that emphasize the communication of arguments as central mechanism of influence. Due to homophily, actors interact mainly with others whose arguments will intensify existing tendencies for or against the issue at stake. We develop an agent-based model of this theory and compare its implications to those of existing social-influence models, deriving testable hypotheses about the conditions of bi-polarization. Hypotheses were tested with a group-discussion experiment (N = 96. Results demonstrate that argument exchange can entail bi-polarization even when there is no negative influence.

  20. Trajectories of suicidal ideation over 6 months among 482 outpatients with bipolar disorder

    DEFF Research Database (Denmark)

    Köhler-Forsberg, Ole; Madsen, Trine; Behrendt-Møller, Ida

    2017-01-01

    INTRODUCTION: Suicidal ideation occurs frequently among individuals with bipolar disorder; however, its course and persistence over time remains unclear. We aimed to investigate 6-months trajectories of suicidal ideation among adults with bipolar disorder. METHODS: The Bipolar CHOICE study...... randomized 482 outpatients with bipolar disorder to 6 months of lithium- or quetiapine-based treatment including other psychotropic medications as clinically indicated. Participants were asked at 9 visits about suicidal ideation using the Concise Health Risk Tracking scale. We performed latent Growth Mixture...... Modelling analysis to empirically identify trajectories of suicidal ideation. Multinomial logistic regression analyses were applied to estimate associations between trajectories and potential predictors. RESULTS: We identified four distinct trajectories. The Moderate-Stable group represented 11...

  1. Differentiation without distancing. explaining bi-polarization of opinions without negative influence.

    Science.gov (United States)

    Mäs, Michael; Flache, Andreas

    2013-01-01

    Explanations of opinion bi-polarization hinge on the assumption of negative influence, individuals' striving to amplify differences to disliked others. However, empirical evidence for negative influence is inconclusive, which motivated us to search for an alternative explanation. Here, we demonstrate that bi-polarization can be explained without negative influence, drawing on theories that emphasize the communication of arguments as central mechanism of influence. Due to homophily, actors interact mainly with others whose arguments will intensify existing tendencies for or against the issue at stake. We develop an agent-based model of this theory and compare its implications to those of existing social-influence models, deriving testable hypotheses about the conditions of bi-polarization. Hypotheses were tested with a group-discussion experiment (N = 96). Results demonstrate that argument exchange can entail bi-polarization even when there is no negative influence.

  2. Neural Markers in Pediatric Bipolar Disorder and Familial Risk for Bipolar Disorder.

    Science.gov (United States)

    Wiggins, Jillian Lee; Brotman, Melissa A; Adleman, Nancy E; Kim, Pilyoung; Wambach, Caroline G; Reynolds, Richard C; Chen, Gang; Towbin, Kenneth; Pine, Daniel S; Leibenluft, Ellen

    2017-01-01

    Bipolar disorder (BD) is highly heritable. Neuroimaging studies comparing unaffected youth at high familial risk for BD (i.e., those with a first-degree relative with the disorder; termed "high-risk" [HR]) to "low-risk" (LR) youth (i.e., those without a first-degree relative with BD) and to patients with BD may help identify potential brain-based markers associated with risk (i.e., regions where HR+BD≠LR), resilience (HR≠BD+LR), or illness (BD≠HR+LR). During functional magnetic resonance imaging (fMRI), 99 youths (i.e., adolescents and young adults) aged 9.8 to 24.8 years (36 BD, 22 HR, 41 LR) performed a task probing face emotion labeling, previously shown to be impaired behaviorally in youth with BD and HR youth. We found three patterns of results. Candidate risk endophenotypes (i.e., where BD and HR shared deficits) included dysfunction in higher-order face processing regions (e.g., middle temporal gyrus, dorsolateral prefrontal cortex). Candidate resilience markers and disorder sequelae (where HR and BD, respectively, show unique alterations relative to the other two groups) included different patterns of neural responses across other regions mediating face processing (e.g., fusiform), executive function (e.g., inferior frontal gyrus), and social cognition (e.g., default network, superior temporal sulcus, temporo-parietal junction). If replicated in longitudinal studies and with additional populations, neural patterns suggesting risk endophenotypes could be used to identify individuals at risk for BD who may benefit from prevention measures. Moreover, information about risk and resilience markers could be used to develop novel treatments that recruit neural markers of resilience and attenuate neural patterns associated with risk. Clinical trial registration information-Studies of Brain Function and Course of Illness in Pediatric Bipolar Disorder and Child and Adolescent Bipolar Disorder Brain Imaging and Treatment Study; http://clinicaltrials.gov/; NCT

  3. A Comparison of Bipolar Electrocautery and Chemical Cautery for Control of Pediatric Recurrent Anterior Epistaxis.

    Science.gov (United States)

    Johnson, Nathan; Faria, John; Behar, Philomena

    2015-11-01

    To compare the outcome of children with anterior epistaxis treated intraoperatively with either bipolar electrocautery or silver nitrate chemical cautery. Case series with chart review. Tertiary-care pediatric otolaryngology practice. Children aged 2 to 18 years treated with either intraoperative bipolar electrocautery or silver nitrate chemical cautery of the anterior nasal septum for recurrent anterior epistaxis. Any reported bleeding event after surgery was recorded. The mean time from surgery to recurrent epistaxis was compared between groups. Fifty patients underwent bipolar electrocautery, while 60 patients underwent silver nitrate chemical cautery. Within 2 years, 1 (2%) patient in the bipolar electrocautery group and 13 (22%) patients in the silver nitrate chemical cautery group had recurrent epistaxis (P = .003). Two years after treatment, there was no difference between treatment groups. Overall, 4 patients (8%) had recurrent epistaxis postoperatively in the bipolar electrocautery group at a mean of 4.34 years after treatment, while 17 (28.3%) patients recurred after a mean of 1.53 years of treatment in the silver nitrate chemical cautery group (P = .01). Compared to those treated with chemical cautery, those treated with bipolar electrocautery had a longer nosebleed-free period and a lower incidence of recurrent epistaxis within 2 years of treatment. Beyond 2 years, the treatment methods are equivocal. Bipolar electrocautery may be a superior treatment in children who will not tolerate in-office chemical cautery, in those with a risk of severe bleeding, or when it can be combined with other operative procedures. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2015.

  4. Interepisodic Functioning in Patients with Bipolar Disorder in Remission

    OpenAIRE

    Wesley, Mareena Susan; Manjula, M.; Thirthalli, Jagadisha

    2018-01-01

    Background and Objectives: Patients with bipolar disorder (BD), despite recovering symptomatically, suffer from several functional impairments even in remission. The actual causes of impaired functioning are less known. Materials and Methods: The study aimed to examine the clinical and psychosocial determinants of functioning in patients with BD in remission. A cross-sectional single-group design was adopted (n = 150). Participants meeting the study criteria were screened with Mini-Internatio...

  5. A voxel-based diffusion tensor imaging study of white matter in bipolar disorder.

    Science.gov (United States)

    Mahon, Katie; Wu, Jinghui; Malhotra, Anil K; Burdick, Katherine E; DeRosse, Pamela; Ardekani, Babak A; Szeszko, Philip R

    2009-05-01

    There is evidence from post-mortem and magnetic resonance imaging studies that hyperintensities, oligodendroglial abnormalities, and gross white matter volumetric alterations are involved in the pathophysiology of bipolar disorder. There is also functional imaging evidence for a defect in frontal cortico-subcortical pathways in bipolar disorder, but the white matter comprising these pathways has not been well investigated. Few studies have investigated white matter integrity in patients with bipolar disorder compared to healthy volunteers and the majority of studies have used manual region-of-interest approaches. In this study, we compared fractional anisotropy (FA) values between 30 patients with bipolar disorder and 38 healthy volunteers in the brain white matter using a voxelwise analysis following intersubject registration to Talairach space. Compared to healthy volunteers, patients demonstrated significantly (p or =50) higher FA within the right and left frontal white matter and lower FA within the left cerebellar white matter. Examination of individual eigenvalues indicated that group differences in both axial diffusivity and radial diffusivity contributed to abnormal FA within these regions. Tractography was performed in template space on averaged diffusion tensor imaging data from all individuals. Extraction of bundles passing through the clusters that differed significantly between groups suggested that white matter abnormalities along the pontine crossing tract, corticospinal/corticopontine tracts, and thalamic radiation fibers may be involved in the pathogenesis of bipolar disorder. Our findings are consistent with models of bipolar disorder that implicate dysregulation of cortico-subcortical and cerebellar regions in the disorder and may have relevance for phenomenology.

  6. Diffusion Entropy: A Potential Neuroimaging Biomarker of Bipolar Disorder in the Temporal Pole.

    Science.gov (United States)

    Spuhler, Karl; Bartlett, Elizabeth; Ding, Jie; DeLorenzo, Christine; Parsey, Ramin; Huang, Chuan

    2018-02-01

    Despite much research, bipolar depression remains poorly understood, with no clinically useful biomarkers for its diagnosis. The paralimbic system has become a target for biomarker research, with paralimbic structural connectivity commonly reported to distinguish bipolar patients from controls in tractography-based diffusion MRI studies, despite inconsistent findings in voxel-based studies. The purpose of this analysis was to validate existing findings with traditional diffusion MRI metrics and investigate the utility of a novel diffusion MRI metric, entropy of diffusion, in the search for bipolar depression biomarkers. We performed group-level analysis on 9 un-medicated (6 medication-naïve; 3 medication-free for at least 33 days) bipolar patients in a major depressive episode and 9 matched healthy controls to compare: (1) average mean diffusivity (MD) and fractional anisotropy (FA) and; (2) MD and FA histogram entropy-a statistical measure of distribution homogeneity-in the amygdala, hippocampus, orbitofrontal cortex and temporal pole. We also conducted classification analyses with leave-one-out and separate testing dataset (N = 11) approaches. We did not observe statistically significant differences in average MD or FA between the groups in any region. However, in the temporal pole, we observed significantly lower MD entropy in bipolar patients; this finding suggests a regional difference in MD distributions in the absence of an average difference. This metric allowed us to accurately characterize bipolar patients from controls in leave-one-out (accuracy = 83%) and prediction (accuracy = 73%) analyses. This novel application of diffusion MRI yielded not only an interesting separation between bipolar patients and healthy controls, but also accurately classified bipolar patients from controls. © 2017 Wiley Periodicals, Inc.

  7. Nonlinear waves in bipolar complex viscous astroclouds

    Science.gov (United States)

    Karmakar, P. K.; Haloi, A.

    2017-05-01

    A theoretical evolutionary model to analyze the dynamics of strongly nonlinear waves in inhomogeneous complex astrophysical viscous clouds on the gravito-electrostatic scales of space and time is procedurally set up. It compositionally consists of warm lighter electrons and ions (Boltzmanian); and cold massive bi-polar dust grains (inertial fluids) alongside vigorous neutral dynamics in quasi-neutral hydrodynamic equilibrium. Application of the Sagdeev pseudo-potential method reduces the inter-coupled structure equations into a pair of intermixed forced Korteweg-de Vries-Burgers (f-KdVB) equations. The force-terms are self-consistently sourced by inhomogeneous gravito-electrostatic interplay. A numerical illustrative shape-analysis based on judicious astronomical parametric platform shows the electrostatic waves evolving as compressive dispersive shock-like eigen-modes. A unique transition from quasi-monotonic to non-monotonic oscillatory compressive shock-like patterns is found to exist. In contrast, the self-gravitational and effective perturbations grow purely as non-monotonic compressive oscillatory shock-like structures with no such transitory features. It is seen that the referral frame velocity acts as amplitude-reducing agent (stabilizing source) for the electrostatic fluctuations solely. A comparison in the prognostic light of various earlier satellite-based observations and in-situ measurements is presented. The paper ends up with synoptic highlights on the main implications and non-trivial applications in the interstellar space and cosmic plasma environments leading to bounded structure formation.

  8. Association of brain-derived neurotrophic factor (BDNF) Val66Met polymorphism with early-onset bipolar disorder.

    Science.gov (United States)

    Nassan, Malik; Croarkin, Paul E; Luby, Joan L; Veldic, Marin; Joshi, Paramjit T; McElroy, Susan L; Post, Robert M; Walkup, John T; Cercy, Kelly; Geske, Jennifer R; Wagner, Karen D; Cuellar-Barboza, Alfredo B; Casuto, Leah; Lavebratt, Catharina; Schalling, Martin; Jensen, Peter S; Biernacka, Joanna M; Frye, Mark A

    2015-09-01

    Brain-derived neurotrophic factor (BDNF) Val66Met (rs6265) functional polymorphism has been implicated in early-onset bipolar disorder. However, results of studies are inconsistent. We aimed to further explore this association. DNA samples from the Treatment of Early Age Mania (TEAM) and Mayo Clinic Bipolar Disorder Biobank were investigated for association of rs6265 with early-onset bipolar disorder. Bipolar cases were classified as early onset if the first manic or depressive episode occurred at age ≤19 years (versus adult-onset cases at age >19 years). After quality control, 69 TEAM early-onset bipolar disorder cases, 725 Mayo Clinic bipolar disorder cases (including 189 early-onset cases), and 764 controls were included in the analysis of association, assessed with logistic regression assuming log-additive allele effects. Comparison of TEAM cases with controls suggested association of early-onset bipolar disorder with the rs6265 minor allele [odds ratio (OR) = 1.55, p = 0.04]. Although comparison of early-onset adult bipolar disorder cases from the Mayo Clinic versus controls was not statistically significant, the OR estimate indicated the same direction of effect (OR = 1.21, p = 0.19). When the early-onset TEAM and Mayo Clinic early-onset adult groups were combined and compared with the control group, the association of the minor allele rs6265 was statistically significant (OR = 1.30, p = 0.04). These preliminary analyses of a relatively small sample with early-onset bipolar disorder are suggestive that functional variation in BDNF is implicated in bipolar disorder risk and may have a more significant role in early-onset expression of the disorder. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  9. Transient Stuttering in Catatonic Bipolar Patients

    Directory of Open Access Journals (Sweden)

    Anthony B. Joseph

    1991-01-01

    Full Text Available Two cases of transient stuttering occurring in association with catatonia and bipolar disorder are described. Affective decompensation has been associated with lateralized cerebral dysfunction, and it is hypothesized that in some bipolar catatonic patients a concomitant disorder of the lateralization of language function may lead to a variety of clinical presentations including aphasia, mutism, and stuttering.

  10. 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…

  11. 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…

  12. Perceived parental rearing of bipolar offspring

    NARCIS (Netherlands)

    Reichart, C. G.; van der Ende, J.; Hillegers, M. H. J.; Wals, M.; Bongers, I. L.; Nolen, W. A.; Ormel, J.; Verhulst, F. C.

    Objective: To explore the impact of growing up with a parent with a bipolar disorder. First, we compared parental rearing behavior perceived by young adult offspring of bipolar parents with parental rearing behavior perceived by same aged young adults from the general population. Secondly, we

  13. Cognitive behavioral therapy for bipolar disorders

    OpenAIRE

    Lotufo Neto, Francisco

    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.

  14. Clinical features, comorbidity, and cognitive impairment in elderly bipolar patients

    Directory of Open Access Journals (Sweden)

    Rise IV

    2016-05-01

    Full Text Available Ida Vikan Rise,1 Josep Maria Haro,2–4 Bjørn Gjervan,5,61Department of Psychiatry, Sorlandet Hospital, Arendal, Norway; 2Research Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain; 3Faculty of Medicine, Universitat de Barcelona, Barcelona, Spain; 4CIBERSAM (Centro de Investigación Biomédica En Red de Salud Mental, Madrid, Spain; 5Department of Psychiatry, North-Trondelag Hospital Trust, Levanger, Norway; 6Department of Medicine, Institute of Neuromedicine, Norwegian University of Science and Technology, Trondheim, NorwayIntroduction: Data specific to late-life bipolar disorder (BD are limited. Current research is sparse and present guidelines are not adapted to this group of patients.Objectives: We present a literature review on clinical characteristics, comorbidities, and cognitive impairment in patients with late-life BD. This review discusses common comorbidities that affect BD elders and how aging might affect cognition and treatment.Methods: Eligible studies were identified in MedLine by the Medical Subject Headings terms “bipolar disorder” and “aged”. We only included original research reports published in English between 2012 and 2015.Results: From 414 articles extracted, 16 studies were included in the review. Cardiovascular and respiratory conditions, type II diabetes, and endocrinological abnormalities were observed as highly prevalent. BD is associated with a high suicide risk. Bipolar elderly had an increased risk of dementia and performed worse on cognitive screening tests compared to age-matched controls across different levels of cognition. Despite high rates of medical comorbidity among bipolar elderly, a systematic under-recognition and undertreatment of cardiovascular disease have been suggested.Conclusion: There was a high burden of physical comorbidities and cognitive impairment in late-life BD. Bipolar elderly might be under-recorded and undertreated in primary medical care, indicating that

  15. Sexual behavior in women with bipolar disorder.

    Science.gov (United States)

    Mazza, Marianna; Harnic, Desiree; Catalano, Valeria; Di Nicola, Marco; Bruschi, Angelo; Bria, Pietro; Daniele, Antonio; Mazza, Salvatore

    2011-06-01

    There is a lack of studies regarding sexuality and sexual behavior in women with bipolar disorder. The aim of this study is to investigate sexual behavior in women affected by bipolar disorder in order to stimulate interest and debate in this area of care. Sixty women (30 BD I and 30 BD II) consent to participate in the study and were included in the sample. Moreover, sixty female healthy subjects without histories of psychiatric disorders were recruited as normal controls. Patients and healthy subjects were given the Sexual Interest and Sexual Performance Questionnaire, a questionnaire devised to explore various aspects of sexual behavior. The results of the present study suggest an increase of sexual interest in patients with BD I as compared both with BD II patients and healthy controls. In women with BD I such increase of interest was detected on some items of section I of the Sexual Interest and Sexual Performance Questionnaire, in particular "Actual Value of Sexuality" and "Implicit Sexual Interest", which implicitly explore sexual interest without overtly focusing upon sexual problems. Moreover, we observed a higher desired frequency of intercourse in women with BD I than BD II and a higher occurrence of repeated sexual intercourse in women with BD I than BD II. The main finding of the present study was an increase of sexual interest in BD I as compared with BD II female patients and normal controls. This result was detected when sexual interest was explored implicitly. Our study is limited by the small size of our subject groups. Further investigations on larger subject samples are needed to better clarify particular aspects of sexual behavior of BD patients. Copyright © 2010 Elsevier B.V. All rights reserved.

  16. Measuring cognitive insight in schizophrenia and bipolar disorder: a comparative study

    Directory of Open Access Journals (Sweden)

    Jónsdóttir Halldóra

    2007-12-01

    Full Text Available Abstract Background Beck Cognitive Insight Scale (BCIS has been designed for assessment of self-reflection on patients' anomalous experiences and interpretations of own beliefs. The scale has been developed and validated for patients with schizophrenia. We wanted to study the utility of the scale for patients with bipolar disorder. The relationship between the BCIS as a measure of cognitive insight and established methods for assessment of insight of illness was explored in both diagnostic groups. Methods The BCIS self-report inventory was administered to patients with schizophrenia (n = 143, bipolar disorder (n = 92 and controls (n = 64. The 15 items of the inventory form two subscales, self-reflectiveness and self-certainty. Results The internal consistency of the subscales was good for the patient groups and the controls. The mean subscale scores were not significantly different for the three groups. Four items in subscale self-reflectiveness referring to psychotic experiences gave, however, different results in the control subjects. Self-certainty and scores on insight item PANSS correlated significantly in the schizophrenia, but not in the bipolar group. Conclusion BCIS with its two subscales seems applicable for patients with bipolar disorder as well as for patients with schizophrenia. The self-report inventory can also be applied to control subjects if the items referring to psychotic experiences are omitted. In schizophrenia high scores on self-certainty is possibly associated with poor insight of illness. For the bipolar group the subscales are largely independent of traditional insight measures.

  17. 2017 Bipolar Plate Workshop Summary Report

    Energy Technology Data Exchange (ETDEWEB)

    Kopasz, John P. [Argonne National Lab. (ANL), Argonne, IL (United States); Benjamin, Thomas G. [Argonne National Lab. (ANL), Argonne, IL (United States); Schenck, Deanna [Argonne National Lab. (ANL), Argonne, IL (United States)

    2017-08-17

    The Bipolar Plate (BP) Workshop was held at USCAR1 in Southfield, Michigan on February 14, 2017 and included 63 participants from industry, government agencies, universities, and national laboratories with expertise in the relevant fields. The objective of the workshop was to identify research and development (R&D) needs, in particular early-stage R&D, for bipolar plates for polymer electrolyte membrane (PEM) fuel cells for transportation applications. The focus of the workshop was on materials, manufacturing, and design aspects of bipolar plates with the goal of meeting DOE’s 2020 bipolar plate targets. Of special interest was the cost target of ≤$3/kW for the bipolar plate.

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

    Directory of Open Access Journals (Sweden)

    Tonguç D. Berkol

    2016-03-01

    Full Text Available 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 retrospectively. Two hundred bipolar patients were assessed using the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, 4th Edition axis-I (SCID-I in order to detect all possible comorbid psychiatric diagnoses. The sample was split according to the presence of SAD comorbidity and the groups were compared. Results: The SAD comorbidity was detected in 17.5% (35/200 of the BD patients. The SAD comorbid bipolar patients were more educated, had earlier onset of BD, lower number of manic episodes, and more severe episodes. There was no difference between groups in terms of total number of episodes, hospitalization, suicidality, being psychotic, treatment response to lithium and anticonvulsants. Conclusion: Social anxiety disorder comorbidity may be associated with more severe episodes and early onset of BD. However, SAD comorbidity may not be related to treatment response in bipolar patients.

  19. Joint Effects: A Pilot Investigation of the Impact of Bipolar Disorder and Marijuana Use on Cognitive Function and Mood.

    Directory of Open Access Journals (Sweden)

    Kelly A Sagar

    Full Text Available Marijuana is the most widely used illicit substance in those diagnosed with bipolar I disorder. However, there is conflicting evidence as to whether marijuana may alleviate or exacerbate mood symptomatology. As bipolar disorder and marijuana use are individually associated with cognitive impairment, it also remains unclear whether there is an additive effect on cognition when bipolar patients use marijuana. The current study aimed to determine the impact of marijuana on mood in bipolar patients and to examine whether marijuana confers an additional negative impact on cognitive function. Twelve patients with bipolar disorder who smoke marijuana (MJBP, 18 bipolar patients who do not smoke (BP, 23 marijuana smokers without other Axis 1 pathology (MJ, and 21 healthy controls (HC completed a neuropsychological battery. Further, using ecological momentary assessment, participants rated their mood three times daily as well as after each instance of marijuana use over a four-week period. Results revealed that although the MJ, BP, and MJBP groups each exhibited some degree of cognitive impairment relative to HCs, no significant differences between the BP and MJBP groups were apparent, providing no evidence of an additive negative impact of BPD and MJ use on cognition. Additionally, ecological momentary assessment analyses indicated alleviation of mood symptoms in the MJBP group after marijuana use; MJBP participants experienced a substantial decrease in a composite measure of mood symptoms. Findings suggest that for some bipolar patients, marijuana may result in partial alleviation of clinical symptoms. Moreover, this improvement is not at the expense of additional cognitive impairment.

  20. Reasons for revision of failed hemiarthroplasty: Are there any differences between unipolar and bipolar?

    Science.gov (United States)

    Iamthanaporn, Khanin; Chareancholvanich, Keerati; Pornrattanamaneewong, Chaturong

    2018-03-16

    Hemiarthroplasty (HA) is an effective procedure for treatment of femoral neck fracture. However, it is debatable whether unipolar or bipolar HA is the most suitable implant. The purpose of this study was to compare the causes of failure and longevity in both types of HA. We retrospectively reviewed 133 cases that underwent revision surgery of HA between 2002 and 2012. The causes of revision surgery were identified and stratified into early (≤ 5 years) failure and late (> 5 years) failure. Survival analyses were performed for each implant type. The common causes for revision were aseptic loosening (49.6%), infection (22.6%) and acetabular erosion (15.0%). Unipolar and bipolar HA were not different in causes for revision, but the unipolar group had a statistically significantly higher number of acetabular erosion events compared with the bipolar group (p = 0.002). In the early period, 24 unipolar HA (52.9%) and 28 bipolar HA (34.1%) failed. There were no statistically significant differences in the numbers of revised HA in each period between the two groups (p = 0.138). The median survival times in the unipolar and bipolar groups were 84.0 ± 24.5 and 120.0 ± 5.5 months, respectively. However, the survival times of both implants were not statistically significantly different. Aseptic loosening was the most common reason for revision surgery after hemiarthroplasty surgery in early and late failures. Unipolar and bipolar hemiarthroplasty were not different in terms of causes of failure and survivorship except bipolar hemiarthroplasty had many fewer acetabular erosion events.

  1. Treating insomnia improves mood state, sleep, and functioning in bipolar disorder: a pilot randomized controlled trial.

    Science.gov (United States)

    Harvey, Allison G; Soehner, Adriane M; Kaplan, Kate A; Hein, Kerrie; Lee, Jason; Kanady, Jennifer; Li, Descartes; Rabe-Hesketh, Sophia; Ketter, Terence A; Neylan, Thomas C; Buysse, Daniel J

    2015-06-01

    To determine if a treatment for interepisode bipolar disorder I patients with insomnia improves mood state, sleep, and functioning. Alongside psychiatric care, interepisode bipolar disorder I participants with insomnia were randomly allocated to a bipolar disorder-specific modification of cognitive behavior therapy for insomnia (CBTI-BP; n = 30) or psychoeducation (PE; n = 28) as a comparison condition. Outcomes were assessed at baseline, the end of 8 sessions of treatment, and 6 months later. This pilot was conducted to determine initial feasibility and generate effect size estimates. During the 6-month follow-up, the CBTI-BP group had fewer days in a bipolar episode relative to the PE group (3.3 days vs. 25.5 days). The CBTI-BP group also experienced a significantly lower hypomania/mania relapse rate (4.6% vs. 31.6%) and a marginally lower overall mood episode relapse rate (13.6% vs. 42.1%) compared with the PE group. Relative to PE, CBTI-BP reduced insomnia severity and led to higher rates of insomnia remission at posttreatment and marginally higher rates at 6 months. Both CBTI-BP and PE showed statistically significant improvement on selected sleep and functional impairment measures. The effects of treatment were well sustained through follow-up for most outcomes, although some decline on secondary sleep benefits was observed. CBTI-BP was associated with reduced risk of mood episode relapse and improved sleep and functioning on certain outcomes in bipolar disorder. Hence, sleep disturbance appears to be an important pathway contributing to bipolar disorder. The need to develop bipolar disorder-specific sleep diary scoring standards is highlighted. (c) 2015 APA, all rights reserved).

  2. Early Maladaptive Schemas Related to Unipolar and Bipolar Depression: Similarities and Differences

    Directory of Open Access Journals (Sweden)

    Nergis LAPSEKÝLÝ

    2012-12-01

    Conclusion: In patient groups, schemas like defectiveness, incompetence, failure, vulnerability to danger and undeveloped self were indicative of low self-perception. This case draws attention to distortions in self-perception. When the absence of difference between bipolar and controls in “mistrust/abuse” and “abandonment/instability” schemas is evaluated in terms of cognitive triad, it is suggested that Environmental perspective in this group of patients did not exhibit pessimistic features. The only significantly different schema between unipolar and bipolar groups was “mistrust/abuse”. This suggests that bipolar group didn’t have negative thoughts like unipolar patients about the perception of the enviroment. [JCBPR 2012; 1(3.000: 145-151

  3. Progressive neurostructural changes in adolescent and adult patients with bipolar disorder.

    Science.gov (United States)

    Lisy, Megan E; Jarvis, Kelly B; DelBello, Melissa P; Mills, Neil P; Weber, Wade A; Fleck, David; Strakowski, Stephen M; Adler, Caleb M

    2011-06-01

    Several lines of evidence suggest that bipolar disorder is associated with progressive changes in gray matter volume (GMV), particularly in brain structures involved in emotional regulation and expression. The majority of these studies however, have been cross-sectional in nature. In this study we compared baseline and follow-up scans in groups of bipolar disorder and healthy subjects. We hypothesized bipolar disorder subjects would demonstrate significant GMV changes over time. A total of 58 bipolar disorder and 48 healthy subjects participated in structural magnetic resonance imaging (MRI). Subjects were rescanned 3-34 months after their baseline MRI. MRI images were segmented, normalized to standard stereotactic space, and compared voxel-by-voxel using statistical parametrical mapping software (SPM2). A model was developed to investigate differences in GMV at baseline, and associated with time and episodes, as well as in comparison to healthy subjects. We observed increases in GMV in bipolar disorder subjects across several brain regions at baseline and over time, including portions of the prefrontal cortex as well as limbic and subcortical structures. Time-related changes differed to some degree between adolescent and adult bipolar disorder subjects. The interval between scans positively correlated with GMV increases in bipolar disorder subjects in portions of the prefrontal cortex, and both illness duration and number of depressive episodes were associated with increased GMV in subcortical and limbic structures. Our findings support suggestions that widely observed progressive neurofunctional changes in bipolar disorder patients may be related to structural brain abnormalities in anterior limbic structures. Abnormalities largely involve regions previously noted to be integral to emotional expression and regulation, and appear to vary by age. © 2011 John Wiley and Sons A/S.

  4. Factor analysis of temperament and personality traits in bipolar patients: Correlates with comorbidity and disorder severity.

    Science.gov (United States)

    Qiu, Frank; Akiskal, Hagop S; Kelsoe, John R; Greenwood, Tiffany A

    2017-01-01

    Temperament and personality traits have been suggested as endophenotypes for bipolar disorder based on several lines of evidence, including heritability. Previous work suggested an anxious-reactive factor identified across temperament and personality inventories that produced significant group discrimination and could potentially be useful in genetic analyses. We have attempted to further characterize this factor structure in a sample of bipolar patients. A sample of 1195 subjects with bipolar I disorder was evaluated, all with complete data available. Dimension reduction across two inventories identified 18 factors explaining 39% of the variance. The two largest factors reflected affective instability and general anxiety/worry, respectively. Subsequent analyses of the clinical features associated with bipolar disorder revealed specificity for the factors in a predictable pattern. Cluster analysis of the factors identified a subgroup defined by a strong lack of general anxiety and low affective instability represented by the first two factors. The remaining subjects could be distinguished into two clusters by the presence of either more positive characteristics, including persistence/drive, spirituality, expressivity, and humor, or more negative characteristics of depression and anxiety. These analyses involved bipolar I subjects only and must be extended to other bipolar spectrum diagnoses, unaffected relatives, and individuals at risk. These results suggest that temperament and personality measures access latent traits associated with important clinical features of bipolar disorder. By translating clinical variables into quantitative traits, we may identify subgroups of bipolar patients with distinct clinical profiles, thereby facilitating both individual treatment strategies and genetic analyses. Copyright © 2016 Elsevier B.V. All rights reserved.

  5. Comparison of metabolic syndrome prevalence in patients with schizophrenia and bipolar I disorder.

    Science.gov (United States)

    Nayerifard, Razieh; Bureng, Majid Akbari; Zahiroddin, Alireza; Namjoo, Massood; Rajezi, Sepideh

    2017-11-01

    Research has shown that the metabolic syndrome is more prevalent among patients with schizophrenia or bipolar I disorder. Given the scarcity of research on the disorders, this paper aims to compare the prevalence of the syndrome among the two groups of patients. A total of 120 individuals participated in this cross sectional study: 60 patients with schizophrenia (26 males and 34 females) and 60 patients with bipolar I disorder (32 males and 28 females). The psychological disorders were diagnosed by some experienced psychiatrists according to the DSM-V. Furthermore, metabolic syndrome was diagnosed according to ATP III guidelines. Metabolic syndrome prevalence among schizophrenic and bipolar I patients was 28 and 36 percent, respectively; the disparity in prevalence is not significant. According to the results, compared to their male counterparts, females were more prone significant to metabolic syndrome. Moreover, diastolic blood pressure was significantly higher among bipolar I patients. On the other hand, schizophrenic males were observed to have higher fasting blood sugar levels in comparison to bipolar I males patients. Age, consumption of second generation antipsychotics or antidepressants, and the duration of the disorder were found to be related to metabolic syndrome. This study showed that metabolic syndrome is not more prevalent among bipolar I patients, compared to those with schizophrenia. Also, women are more likely to be affected by the syndrome. A number of factors such as age, consumption of medication, and duration of the disorder are associated with the likelihood of the syndrome. Copyright © 2017. Published by Elsevier Ltd.

  6. Insight in bipolar mania: evaluation of its heterogeneity and correlation with clinical symptoms.

    Science.gov (United States)

    Silva, Rafael de Assis da; Mograbi, Daniel C; Bifano, Jaqueline; Santana, Cristina M T; Cheniaux, Elie

    2016-07-15

    Studies on insight in bipolar mania are not numerous and usually consider insight as a unitary construct. Evaluate how different facets of insight are affected in bipolar mania and investigate correlations between insight for each specific object in bipolar disorder and manic symptomatology. A group of 165 bipolar patients were followed during a year, with 51 patients having manic episodes according to DSM-IV-TR criteria. Patients underwent a clinical assessment and insight was evaluated through the Insight Scale for Affective Disorders. The study found that insight regarding symptoms is worse than insight of having bipolar disorder, social relationships and self esteem. Moreover, poor global insight (total ISAD) correlates with more severe changes in mood, speech and thought structure, with worse insight about symptoms correlating with the same alterations and also with more severe symptoms of agitation/energy. Although a large sample of bipolar patients was followed up, the final sample composed of patients with at least one manic episode was relatively smaller. Moreover, the fact that the study was performed in a university hospital may have led to selection biases. Results suggest that patients with BD are reasonably capable of identifying that their condition implies consequences but have more impaired awareness of their energy and activity levels. A lower level of insight specifically about symptoms correlates with more severe symptoms of agitation/energy, which suggests a psychomotor nucleus able to impair insight in mania. Copyright © 2016 Elsevier B.V. All rights reserved.

  7. Are oxidative stress markers useful to distinguish schizoaffective disorder from schizophrenia and bipolar disorder?

    Science.gov (United States)

    Bulbul, Feridun; Virit, Osman; Alpak, Gokay; Unal, Ahmet; Bulut, Mahmut; Kaya, Mehmet Cemal; Altindag, Abdurrahman; Celik, Hakim; Savas, Haluk A

    2014-04-01

    Schizoaffective disorder is a disease with both affective and psychotic symptoms. In this study, we aimed to compare oxidative metabolism markers of schizoaffective disorder, bipolar disorder and schizophrenic patients. Furthermore, we also aimed to investigate whether schizoaffective disorder could be differentiated from schizophrenia and bipolar disorder in terms of oxidative metabolism. Total oxidant status (TOS) and total antioxidant status (TAS) were measured in the blood samples that were collected from schizoaffective patients (n = 30), bipolar disorder patients (n = 30) and schizophrenic patients (n = 30). Oxidative stress index (OSI) was calculated by dividing TOS by TAS. TOS and OSI were found to be higher in patients with schizoaffective disorder compared with those in schizophrenia and bipolar disorder patients. TAS was not significantly different between the groups. Schizoaffective disorder was found to be different from bipolar disorder and schizophrenia in terms of oxidative parameters. This result may indicate that schizoaffective disorder could differ from bipolar disorder and schizophrenia in terms of biochemical parameters. Increased TOS levels observed in schizoaffective disorder may suggest poor clinical course and may be an indicator of poor prognosis.

  8. DeepBipolar: Identifying genomic mutations for bipolar disorder via deep learning.

    Science.gov (United States)

    Laksshman, Sundaram; Bhat, Rajendra Rana; Viswanath, Vivek; Li, Xiaolin

    2017-09-01

    Bipolar disorder, also known as manic depression, is a brain disorder that affects the brain structure of a patient. It results in extreme mood swings, severe states of depression, and overexcitement simultaneously. It is estimated that roughly 3% of the population of the United States (about 5.3 million adults) suffers from bipolar disorder. Recent research efforts like the Twin studies have demonstrated a high heritability factor for the disorder, making genomics a viable alternative for detecting and treating bipolar disorder, in addition to the conventional lengthy and costly postsymptom clinical diagnosis. Motivated by this study, leveraging several emerging deep learning algorithms, we design an end-to-end deep learning architecture (called DeepBipolar) to predict bipolar disorder based on limited genomic data. DeepBipolar adopts the Deep Convolutional Neural Network (DCNN) architecture that automatically extracts features from genotype information to predict the bipolar phenotype. We participated in the Critical Assessment of Genome Interpretation (CAGI) bipolar disorder challenge and DeepBipolar was considered the most successful by the independent assessor. In this work, we thoroughly evaluate the performance of DeepBipolar and analyze the type of signals we believe could have affected the classifier in distinguishing the case samples from the control set. © 2017 Wiley Periodicals, Inc.

  9. Early-Onset Bipolar Disorder: Characteristics and Outcomes in the Clinic.

    Science.gov (United States)

    Connor, Daniel F; Ford, Julian D; Pearson, Geraldine S; Scranton, Victoria L; Dusad, Asha

    2017-12-01

    To assess patient characteristics and clinician-rated outcomes for children diagnosed with early-onset bipolar disorder in comparison to a depressive disorders cohort from a single clinic site. To assess predictors of bipolar treatment response. Medical records from 714 consecutive pediatric patients evaluated and treated at an academic tertiary child and adolescent psychiatry clinic between 2006 and 2012 were reviewed. Charts of bipolar children (n = 49) and children with depressive disorders (n = 58) meeting study inclusion/exclusion criteria were compared on variables assessing clinical characteristics, treatments, and outcomes. Outcomes were assessed by using pre- and post-Clinical Global Impressions (CGI)-Severity and Children's Global Assessment Scale (CGAS) scores, and a CGI-Improvement score ≤2 at final visit determined responder status. Bipolar outcome predictors were assessed by using multiple linear regression. Clinic prevalence rates were 6.9% for early-onset bipolar disorder and 1.5% for very early-onset bipolar disorder. High rates of comorbid diagnoses, symptom severity, parental stress, and child high-risk behaviors were found in both groups. The bipolar cohort had higher rates of aggression and higher lifetime systems of care utilization. The final CGI and CGAS outcomes for unipolar depression patients differed statistically significantly from those for the bipolar cohort, reflecting better clinical status and more improvement at outcome for the depression patients. Both parent-reported Child Behavior Checklist total T-score at clinic admission and the number of lifetime systems-of-care for the child were significantly and inversely associated with improvement for the bipolar cohort. Early-onset bipolar disorder is a complex and heterogeneous psychiatric disorder. Evidence-based treatment should emphasize psychopharmacology with adjunctive family and individual psychotherapy. Strategies to improve engagement in treatment may be especially

  10. 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

  11. Residual Negative Symptoms Differentiate Cognitive Performance in Clinically Stable Patients with Schizophrenia and Bipolar Disorder

    Directory of Open Access Journals (Sweden)

    Rajeev Krishnadas

    2014-01-01

    Full Text Available Cognitive deficits in various domains have been shown in patients with bipolar disorder and schizophrenia. The purpose of the present study was to examine if residual psychopathology explained the difference in cognitive function between clinically stable patients with schizophrenia and bipolar disorder. We compared the performance on tests of attention, visual and verbal memory, and executive function of 25 patients with schizophrenia in remission and 25 euthymic bipolar disorder patients with that of 25 healthy controls. Mediation analysis was used to see if residual psychopathology could explain the difference in cognitive function between the patient groups. Both patient groups performed significantly worse than healthy controls on most cognitive tests. Patients with bipolar disorder displayed cognitive deficits that were milder but qualitatively similar to those of patients with schizophrenia. Residual negative symptoms mediated the difference in performance on cognitive tests between the two groups. Neither residual general psychotic symptoms nor greater antipsychotic doses explained this relationship. The shared variance explained by the residual negative and cognitive deficits that the difference between patient groups may be explained by greater frontal cortical neurophysiological deficits in patients with schizophrenia, compared to bipolar disorder. Further longitudinal work may provide insight into pathophysiological mechanisms that underlie these deficits.

  12. Cost Analysis of Direct versus Indirect and Individual versus Group Modes of Manual-Based Speech-and-Language Therapy for Primary School-Age Children with Primary Language Impairment

    Science.gov (United States)

    Dickson, Kirstin; Marshall, Marjorie; Boyle, James; McCartney, Elspeth; O'Hare, Anne; Forbes, John

    2009-01-01

    Background: The study is the first within trial cost analysis of direct versus indirect and individual versus group modes of speech-and-language therapy for children with primary language impairment. Aims: To compare the short-run resource consequences of the four interventions alongside the effects achieved measured by standardized scores on a…

  13. Randomized, controlled trial of Interpersonal and Social Rhythm Therapy for young people with bipolar disorder.

    Science.gov (United States)

    Inder, Maree L; Crowe, Marie T; Luty, Suzanne E; Carter, Janet D; Moor, Stephanie; Frampton, Christopher M; Joyce, Peter R

    2015-03-01

    This randomized, controlled clinical trial compared the effect of interpersonal and social rhythm therapy (IPSRT) to that of specialist supportive care (SSC) on depressive outcomes (primary), social functioning, and mania outcomes over 26-78 weeks in young people with bipolar disorder receiving psychopharmacological treatment. Subjects were aged 15-36 years, recruited from a range of sources, and the patient groups included bipolar I disorder, bipolar II disorder, and bipolar disorder not otherwise specified. Exclusion criteria were minimal. Outcome measures were the Longitudinal Interval Follow-up Evaluation and the Social Adjustment Scale. Paired-sample t-tests were used to determine the significance of change from baseline to outcome period. Analyses of covariance were used to determine the impact of therapy, impact of lifetime and current comorbidity, interaction between comorbidity and therapy, and impact of age at study entry on depression. A group of 100 participants were randomized to IPSRT (n = 49) or SSC (n = 51). The majority had bipolar I disorder (78%) and were female (76%), with high levels of comorbidity. After treatment, both groups had improved depressive symptoms, social functioning, and manic symptoms. Contrary to our hypothesis, there was no significant difference between therapies. There was no impact of lifetime or current Axis I comorbidity or age at study entry. There was a relative impact of SSC for patients with current substance use disorder. IPSRT and SSC used as an adjunct to pharmacotherapy appear to be effective in reducing depressive and manic symptoms and improving social functioning in adolescents and young adults with bipolar disorder and high rates of comorbidity. Identifying effective treatments that particularly address depressive symptoms is important in reducing the burden of bipolar disorder. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  14. Prolonged hemodynamic response during incidental facial emotion processing in inter-episode bipolar I disorder.

    Science.gov (United States)

    Rosenfeld, Ethan S; Pearlson, Godfrey D; Sweeney, John A; Tamminga, Carol A; Keshavan, Matcheri S; Nonterah, Camilla; Stevens, Michael C

    2014-03-01

    This fMRI study examined whether hemodynamic responses to affectively-salient stimuli were abnormally prolonged in remitted bipolar disorder, possibly representing a novel illness biomarker. A group of 18 DSM-IV bipolar I-diagnosed adults in remission and a demographically-matched control group performed an event-related fMRI gender-discrimination task in which face stimuli had task-irrelevant neutral, happy or angry expressions designed to elicit incidental emotional processing. Participants' brain activation was modeled using a "fully informed" SPM5 basis set. Mixed-model ANOVA tested for diagnostic group differences in BOLD response amplitude and shape within brain regions-of-interest selected from ALE meta-analysis of previous comparable fMRI studies. Bipolar-diagnosed patients had a generally longer duration and/or later-peaking hemodynamic response in amygdala and numerous prefrontal cortex brain regions. Data are consistent with existing models of bipolar limbic hyperactivity, but the prolonged frontolimbic response more precisely details abnormalities recognized in previous studies. Prolonged hemodynamic responses were unrelated to stimulus type, task performance, or degree of residual mood symptoms, suggesting an important novel trait vulnerability brain dysfunction in bipolar disorder. Bipolar patients also failed to engage pregenual cingulate and left orbitofrontal cortex-regions important to models of automatic emotion regulation-while engaging a delayed dorsolateral prefrontal cortex response not seen in controls. These results raise questions about whether there are meaningful relationships between bipolar dysfunction of specific ventromedial prefrontal cortex regions believed to automatically regulate emotional reactions and the prolonged responses in more lateral aspects of prefrontal cortex.

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

    NARCIS (Netherlands)

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

    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

  16. Brief Report: A Family Risk Study Exploring Bipolar Spectrum Problems and Cognitive Biases in Adolescent Children of Bipolar Parents

    Science.gov (United States)

    Espie, Jonathan; Jones, Steven H.; Vance, Yvonne H.; Tai, Sara J.

    2012-01-01

    Children of parents with bipolar disorder are at increased risk of bipolar spectrum diagnoses. This cross-sectional study explores cognitive factors in the prediction of vulnerability to bipolar disorder. Adolescents at high-risk (with a parent with bipolar disorder; n = 23) and age and gender matched adolescents (n = 24) were recruited. Parent…

  17. Theory of mind deficit in bipolar disorder: is it related to a previous history of psychotic symptoms?

    Science.gov (United States)

    Lahera, Guillermo; Montes, José Manuel; Benito, Adolfo; Valdivia, María; Medina, Elena; Mirapeix, Isabel; Sáiz-Ruiz, Jerónimo

    2008-12-15

    It has been hypothesized that a Theory of Mind (ToM) deficit could be a vulnerability marker for psychosis. Recent studies, however, have shown ToM deficits in affective relapses of bipolar disorder as well as in the euthymic phase. This study analyzes the relationship between ToM and a previous history of psychotic symptoms in bipolar disorder. ToM, sustained attention and executive functions were analyzed in 75 bipolar euthymic patients with three or more previous relapses (42 of them had a history of psychotic symptoms and 33 did not) and 48 healthy subjects. ToM was assessed with the Advanced Test by Happé. ToM performance was similar in bipolar patients with or without a history of psychotic symptoms, and in both cases it was significantly reduced as compared with the healthy control group. Similarly, both bipolar groups showed impaired sustained attention and executive functions. This general cognitive deficit partially explains the differences obtained in ToM. The ToM instrument used shows low sensitivity for assessing ToM in bipolar patients and it could partially reflect general cognitive functioning rather than a specific deficit in psychosis. ToM deficit is not a trait marker for psychosis, given that it is present in bipolar disorder regardless of a previous history of psychotic symptoms.

  18. VALPROATE, BIPOLAR DISORDER AND POLYCYSTIC OVARIAN SYNDROME.

    Science.gov (United States)

    Okanović, Milana; Zivanović, Olga

    2016-01-01

    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. 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. 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. Bipolar plates for PEM fuel cells

    Science.gov (United States)

    Middelman, E.; Kout, W.; Vogelaar, B.; Lenssen, J.; de Waal, E.

    The bipolar plates are in weight and volume the major part of the PEM fuel cell stack, and are also a significant contributor to the stack costs. The bipolar plate is therefore a key component if power density has to increase and costs must come down. Three cell plate technologies are expected to reach targeted cost price levels, all having specific advantages and drawbacks. NedStack has developed a conductive composite materials and a production process for fuel cell plates (bipolar and mono-polar). The material has a high electric and thermal conductivity, and can be processed into bipolar plates by a proprietary molding process. Process cycle time has been reduced to less than 10 s, making the material and process suitable for economical mass production. Other development work to increase material efficiency resulted in thin bipolar plates with integrated cooling channels, and integrated seals, and in two-component bipolar plates. Total thickness of the bipolar plates is now less than 3 mm, and will be reduced to 2 mm in the near future. With these thin integrated plates it is possible to increase power density up to 2 kW/l and 2 kW/kg, while at the same time reducing cost by integrating other functions and less material use.

  20. Distinctions of bipolar disorder symptoms in adolescence.

    Science.gov (United States)

    Gudiene, Devika; Leskauskas, Darius; Markeviciūte, Aurelija; Klimavicius, Dalius; Adomaitiene, Virginija

    2008-01-01

    Bipolar disorder in adolescents is a serious mental illness with problematic diagnosis that adversely affects social, academic, emotional, and family functioning. The objective of this study was to analyze features of premorbid and clinical symptoms, comorbidity, and course of bipolar disorder in adolescence. Data for analysis were collected from all case histories (N=6) of 14-18-year-old patients, hospitalized with diagnosis of bipolar disorder in the Unit of Children's and Adolescents' Psychiatry, Department of Psychiatry, Hospital of Kaunas University of Medicine, during the period from 2000 to 2005. Analysis of bipolar disorder course showed that five patients previously had been diagnosed with an episode of depression. The most frequent symptoms typical to bipolar disorder were disobedience and impulsive behavior, rapid changes of mood. The most common premorbid features were frequent changes of mood, being active in communication, hyperactive behavior. Adolescence-onset bipolar disorder was frequently comorbid with emotionally instable personality disorder, borderline type. Findings of the study confirm the notion that oppositional or impulsive behavior, rapid changes of mood without any reason, dysphoric mood and euphoric mood episodes with increased energy were cardinal symptoms of bipolar disorder with mania in adolescents. Most frequent premorbid features of these patients were quite similar to attention-deficit/hyperactivity disorder making differential diagnosis problematic.

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

    DEFF Research Database (Denmark)

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

    2010-01-01

    BACKGROUND: Depression and bipolar disorder are associated with reduced neural plasticity and deficits in memory, attention and executive function. Drug treatments for these affective disorders have insufficient clinical effects in a large group and fail to reverse cognitive deficits. There is thus...... depression and reverses cognitive impairments in these patients and in patients with bipolar disorder in remission. METHODS/DESIGN: The trial has a double-blind, placebo-controlled, parallel-group design. 40 patients with treatment-resistant major depression and 40 patients with bipolar disorder in remission......) 1 in study 1 and, in study 2, verbal memory measured with the Rey Auditory Verbal Learning Test (RAVLT) 23. With inclusion of 40 patients in each study we obtain 86% power to detect clinically relevant differences between intervention and placebo groups on these primary outcomes. TRIAL REGISTRATION...

  2. Screening for bipolar disorders in Spanish-speaking populations: sensitivity and specificity of the Bipolar Spectrum Diagnostic Scale-Spanish Version.

    Science.gov (United States)

    Vázquez, Gustavo Héctor; Romero, Ester; Fabregues, Fernando; Pies, Ronald; Ghaemi, Nassir; Mota-Castillo, Manuel

    2010-01-01

    Bipolar disorder is commonly misdiagnosed, perhaps more so in Latin American and Spanish-speaking populations than in the United States. The Bipolar Spectrum Diagnostic Scale (BSDS) is a 19-item screening instrument designed to assist in screening for all types of bipolar disorder. The authors investigated the sensitivity of a Spanish-language version of the BSDS in a cohort of 65 outpatients with a diagnosis of bipolar disorder, based on a semi-structured interview and Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision criteria. To determine specificity, we assessed a control group of 36 outpatients with diagnosis of unipolar major depressive disorder. The overall sensitivity of the BSDS Spanish version with bipolar disorders types I, II, and NOS was 0.70, which was slightly lower than the sensitivity in the study using the English version of the BSDS (0.76). The specificity was 0.89. When the threshold was decreased from 13 to 12, the sensitivity of the Spanish BSDS increased to 0.76 and specificity dropped to 0.81. The Spanish version of the BSDS is promising as a screening instrument in Spanish-speaking populations. Copyright 2010 Elsevier Inc. All rights reserved.

  3. Fractionated bipolar radiofrequency and bipolar radiofrequency potentiated by infrared light for treating striae: A prospective randomized, comparative trial with objective evaluation.

    Science.gov (United States)

    Harmelin, Yona; Boineau, Dominique; Cardot-Leccia, Nathalie; Fontas, Eric; Bahadoran, Philippe; Becker, Anne-Lise; Montaudié, Henri; Castela, Emeline; Perrin, Christophe; Lacour, Jean-Philippe; Passeron, Thierry

    2016-03-01

    Very few treatments for striae are based on prospective randomized trials. The objective of this study was to assess the efficacy of bipolar fractional radiofrequency and bipolar radiofrequency potentiated with infrared light, alone or combined, for treating abdominal stretch marks. Bicentric prospective interventional randomized controlled trial in the department of Dermatology of University Hospital of Nice and Aesthetics Laser Center of Bordeaux, France. Men and women of age 18 years or above, who presented for the treatment of mature or immature abdominal striae were included. The patients' abdomens were divided into four equal quadrants. Bipolar radiofrequency potentiated with infrared light and fractional bipolar radiofrequency were applied, alone or combined, and compared to the remaining untreated quadrant. The main criterion of evaluation was the measurement of depth of striae, using 3D photography at 6 months follow-up. A global assessment was also rated by the physician performing the treatment and by the patients. Histological analysis and confocal laser microscopy were additionally performed. A total of 22 patients were enrolled, and 384 striae were measured. In per protocol analysis mean striae depth was decreased by 21.64%, observed at 6 months follow-up with the combined approach, compared to an increase of 1.73% in the control group (P radiofrequency, combined with bipolar radiofrequency potentiated by infrared light, is an effective treatment of both immature and mature striae of the abdomen. © 2016 Wiley Periodicals, Inc.

  4. 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

    2014-01-01

    BACKGROUND: Patients with bipolar disorder often show decreased adherence with mood stabilizers and frequently interventions on prodromal depressive and manic symptoms are delayed. METHODS: The MONARCA II trial uses a randomized controlled single-blind parallel-group design. Patients with bipolar...

  5. Suicidality in Bipolar Disorder: The Role of Emotion-Triggered Impulsivity.

    Science.gov (United States)

    Johnson, Sheri L; Carver, Charles S; Tharp, Jordan A

    2017-04-01

    A growing body of research suggests that impulsive responses to emotion more robustly predict suicidality than do other forms of impulsivity. This issue has not yet been examined within bipolar disorder, however. Participants diagnosed with bipolar I disorder (n = 133) and control participants (n = 110) diagnosed with no mood or psychotic disorder completed self-report measures of emotion-triggered impulsivity (Negative and Positive Urgency Scales) and interviews concerning lifetime suicidality. Analyses examined the effects of emotion-triggered impulsivity alone and in combination with gender, age of onset, depression severity, comorbid anxiety, comorbid substance use, and medication. A history of suicide ideation and attempts, as well as self-harm, were significantly more common in the bipolar disorder group compared with the control group. Impulsive responses to positive emotions related to suicide ideation, attempts, and self-harm within the bipolar group. Findings extend research on the importance of emotion-triggered impulsivity to a broad range of key outcomes within bipolar disorder. The discussion focuses on limitations and potential clinical implications. © 2016 The American Association of Suicidology.

  6. Brain structural changes in schizoaffective disorder compared to schizophrenia and bipolar disorder.

    Science.gov (United States)

    Amann, B L; Canales-Rodríguez, E J; Madre, M; Radua, J; Monte, G; Alonso-Lana, S; Landin-Romero, R; Moreno-Alcázar, A; Bonnin, C M; Sarró, S; Ortiz-Gil, J; Gomar, J J; Moro, N; Fernandez-Corcuera, P; Goikolea, J M; Blanch, J; Salvador, R; Vieta, E; McKenna, P J; Pomarol-Clotet, E

    2016-01-01

    Brain structural changes in schizoaffective disorder, and how far they resemble those seen in schizophrenia and bipolar disorder, have only been studied to a limited extent. Forty-five patients meeting DSM-IV and RDC criteria for schizoaffective disorder, groups of patients with 45 matched schizophrenia and bipolar disorder, and 45 matched healthy controls were examined using voxel-based morphometry (VBM). Analyses comparing each patient group with the healthy control subjects found that the patients with schizoaffective disorder and the patients with schizophrenia showed widespread and overlapping areas of significant volume reduction, but the patients with bipolar disorder did not. A subsequent analysis compared the combined group of patients with the controls followed by extraction of clusters. In regions where the patients differed significantly from the controls, no significant differences in mean volume between patients with schizoaffective disorder and patients with schizophrenia in any of five regions of volume reduction were found, but mean volumes in the patients with bipolar disorder were significantly smaller in three of five. The findings provide evidence that, in terms of structural gray matter brain abnormality, schizoaffective disorder resembles schizophrenia more than bipolar disorder. © 2015 The Authors. Acta Psychiatrica Scandinavica Published by John Wiley & Sons Ltd.

  7. Bipolar sealer not superior to standard electrocautery in primary total hip arthroplasty: a meta-analysis.

    Science.gov (United States)

    Yang, Yang; Zhang, Li-Chao; Xu, Fei; Li, Jia; Lv, Yong-Ming

    2014-10-10

    To assess whether bipolar sealer has advantages over standard electrocautery in primary total hip arthroplasty (THA). All studies published through November 2013 were systematically searched in PubMed, Embase, ScienceDirect, The Cochrane Library, and other databases. Relevant journals or conference proceedings were searched manually. Only randomized controlled trials were included. Two independent reviewers identified and assessed the literature. Mean difference in blood loss and risk ratios of transfusion rates and of complication rates in the bipolar sealer group versus the standard electrocautery group were calculated. The meta-analysis was conducted using RevMan 5.1 software. Five studies were included, with a total sample size of 559 patients. The use of bipolar sealer did not significantly reduce intraoperative blood loss, hemoglobin drop, hospital stay, and operative time. There were no significant differences in need for transfusion and the incidence of infection between the study groups. The available evidence suggests that the use of bipolar sealer was not superior to standard electrocautery in patients undergoing primary THA. The use of bipolar sealer is not recommended in primary THA.

  8. Paired structures and bipolar knowledge representation

    DEFF Research Database (Denmark)

    Montero, Javier; Bustince, Humberto; Franco, Camilo

    In this strictly positional paper we propose a general approach to bipolar knowledge representation, where the meaning of concepts can be modelled by examining their decomposition into opposite and neutral categories. In particular, it is the semantic relationship between the opposite categories...... and at the same time the type of neutrality rising in between opposites. Based on this first level of bipolar knowledge representation, paired structures in fact offer the means to characterize a specific bipolar valuation scale depending on the meaning of the concept that has to be verified. In this sense...

  9. Bipolar Disorder and Early Affective Trauma.

    Science.gov (United States)

    de Codt, Aloise; Monhonval, Pauline; Bongaerts, Xavier; Belkacemi, Ikram; Tecco, Juan Martin

    2016-09-01

    Bipolar disorder is a chronic psychiatric disease with a high prevalence and is a major psychosocial and medical burden. The exact etiological pathways of bipolar disorder are not fully understood. Genetic factors are known to play an important role in the etiology of bipolar disorder. However, high rates of discordance among identical twins and a growing body of evidence that environmental factors such as early stress can influence the onset and course of psychiatric diseases underline the importance of additional etiological mechanisms of bipolar disorders. There has been little investigation about early trauma in bipolar disorder. The aim of this study was to review the literature on the association between early traumatic interactions like child neglect, mistreatment, abuse or early parental separation and the occurrence of bipolar disorder in adulthood or impact on the course of the disease. Studies investigating associations between child neglect, mistreatment, abuse or early parental separation and occurrence of bipolar disorder in adulthood or impact on the course of the disease were searched in the Pubmed database. More than 700 articles were sorted independently by two of the authors using predefined criteria. Only research articles, reviews and meta-analyses were selected for this review. 53 articles met the inclusion criteria. To date, four systematic reviews partially addressed our research question. Early trauma is more frequently found in the past of bipolar patients than in the general population. Studies support a harmful effect of childhood trauma on the course of bipolar disease, with more anxious, depressive or psychotic symptoms, an early age of onset and a worse prognosis. Early trauma is more often found in the past of bipolar adult patients than the general population and studies support a harmful effect of childhood trauma on the course of bipolar disease, with more anxious, depressive or psychotic symptoms, an early age of onset and a

  10. Ionizing radiations simulation on bipolar components

    International Nuclear Information System (INIS)

    Montagner, X.

    1999-01-01

    This thesis presents the ionizing radiation effects on bipolar components and more specially their behavior facing the total dose. The first part is devoted to the radiation environments with a special attention to the spatial environments and new emergent environments. The specificities of bipolar components are then presented and their behavior facing the interactions. The physical mechanisms bound to the dose rate are also discussed. The second part presents a physical analysis of degradations induced by the cumulated dosimetry on bipolar components and simulation with the ATLAS code. The third part exposes an electric empirical simulation induced by the cumulated dose in static conditions. (A.L.B.)

  11. No-touch radiofrequency ablation: A comparison of switching bipolar and switching monopolar ablation in Ex Vivo bovine liver

    International Nuclear Information System (INIS)

    Chang, Won; Lee, Jeong Min; Lee, Sang Min; Hank, Joon Koo

    2017-01-01

    To evaluate the feasibility, efficiency, and safety of no-touch switching bipolar (SB) and switching monopolar (SM) radiofrequency ablation (RFA) using ex vivo bovine livers. A pork loin cube was inserted as a tumor mimicker in the bovine liver block; RFA was performed using the no-touch technique in the SM (group A1; 10 minutes, n = 10, group A2; 15 minutes, n = 10) and SB (group B; 10 minutes, n = 10) modes. The groups were compared based on the creation of confluent necrosis with sufficient safety margins, the dimensions, and distance between the electrode and ablation zone margin (DEM). To evaluate safety, small bowel loops were placed above the liver surface and 30 additional ablations were performed in the same groups. Confluent necroses with sufficient safety margins were created in all specimens. SM RFA created significantly larger volumes of ablation compared to SB RFA (all p < 0.001). The DEM of group B was significantly lower than those of groups A1 and A2 (all p < 0.001). Although thermal injury to the small bowel was noted in 90%, 100%, and 30% of the cases in groups A1, A2, and B, respectively, full depth injury was noted only in 60% of group A2 cases. The no-touch RFA technique is feasible in both the SB and SM modes; however, SB RFA appears to be more advantageous compared to SM RFA in the creation of an ablation zone while avoiding the unnecessary creation of an adjacent parenchymal ablation zone or adjacent small bowel injuries

  12. No-touch radiofrequency ablation: A comparison of switching bipolar and switching monopolar ablation in Ex Vivo bovine liver

    Energy Technology Data Exchange (ETDEWEB)

    Chang, Won; Lee, Jeong Min; Lee, Sang Min; Hank, Joon Koo [Dept. of Radiology, Seoul National University Hospital, Seoul (Korea, Republic of)

    2017-04-15

    To evaluate the feasibility, efficiency, and safety of no-touch switching bipolar (SB) and switching monopolar (SM) radiofrequency ablation (RFA) using ex vivo bovine livers. A pork loin cube was inserted as a tumor mimicker in the bovine liver block; RFA was performed using the no-touch technique in the SM (group A1; 10 minutes, n = 10, group A2; 15 minutes, n = 10) and SB (group B; 10 minutes, n = 10) modes. The groups were compared based on the creation of confluent necrosis with sufficient safety margins, the dimensions, and distance between the electrode and ablation zone margin (DEM). To evaluate safety, small bowel loops were placed above the liver surface and 30 additional ablations were performed in the same groups. Confluent necroses with sufficient safety margins were created in all specimens. SM RFA created significantly larger volumes of ablation compared to SB RFA (all p < 0.001). The DEM of group B was significantly lower than those of groups A1 and A2 (all p < 0.001). Although thermal injury to the small bowel was noted in 90%, 100%, and 30% of the cases in groups A1, A2, and B, respectively, full depth injury was noted only in 60% of group A2 cases. The no-touch RFA technique is feasible in both the SB and SM modes; however, SB RFA appears to be more advantageous compared to SM RFA in the creation of an ablation zone while avoiding the unnecessary creation of an adjacent parenchymal ablation zone or adjacent small bowel injuries.

  13. Comparison of the effects of laparoscopic bipolar electrocoagulation and intracorporeal suture application to ovarian reserve in benign ovarian cysts.

    Science.gov (United States)

    Özgönen, Hakan; Erdemoglu, Evrim; Günyeli, Ilker; Güney, Mehmet; Mungan, Tamer

    2013-04-01

    Aim of the present study is to determine the effects of bipolar electrocoagulation and intracorporeal suture on the ovarian reserve after ovarian cystectomy. Sixty patients aged 18-42 years old and with a persistent adnexal mass were recruited to the study. Patients were randomized into suture hemostasis group or bipolar hemostasis group. Laparoscopic ovarian cystectomy was performed to all patients. Hemostasis was obtained by bipolar coagulation in 30 patients and by intracorporeal sutures in 30 patients. Serum levels of FSH, LH, estradiol, inhibin B and ultrasonographic measurements (antral follicle count and ovarian volume) were analyzed and recorded at day 3 of menstrual cycle, 1 and 3 months after the surgery. Basal FSH level measurement at the postoperative third month was significantly increased to 6.96 ± 1.86 mIU/ml (p electrocoagulation group. However, the decreased ovarian volume and antral follicle count was restored at the postoperative third month in the bipolar electrocoagulation group. Preoperative and postoperative FSH, LH, estradiol and inhibin B levels and ultrasonographic measurements were similar in the intracorporeal suture group. The unwanted effect of bipolar electrocoagulation on ovarian reserve is probably transient and causes minimal damage to ovary. FSH levels may be slightly elevated. Gentle use of bipolar electrocoagulation or intracorporeal are not found to effect ovarian reserve.

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

    Science.gov (United States)

    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) project. Of 57 individuals with initial cyclothymia or bipolar disorder not otherwise specified (BiNOS) diagnoses, 42.1% progressed to a bipolar II diagnosis and 10.5% progressed to a bipolar I diagnosis. Of 144 individuals with initial bipolar II diagnoses, 17.4% progressed to a bipolar I diagnosis. Consistent with hypotheses derived from the clinical literature and the Behavioral Approach System (BAS) model of bipolar disorder, and controlling for relevant variables (length of follow-up, initial depressive and hypomanic symptoms, treatment-seeking, and family history), high BAS sensitivity (especially BAS Fun Seeking) predicted a greater likelihood of progression to bipolar II disorder, whereas early age of onset and high impulsivity predicted a greater likelihood of progression to bipolar I (high BAS sensitivity and Fun-Seeking also predicted progression to bipolar I when family history was not controlled). The interaction of high BAS and high Behavioral Inhibition System (BIS) sensitivities also predicted greater likelihood of progression to bipolar I. We discuss implications of the findings for the bipolar spectrum concept, the BAS model of bipolar disorder, and early intervention efforts. PMID:21668080

  15. Bipolar disorders in the Arab world: a critical review.

    Science.gov (United States)

    Kronfol, Ziad; Zakaria Khalil, Mostafa; Kumar, Pankaj; Suhre, Karsten; Karam, Elie; McInnis, Melvin

    2015-05-01

    Bipolar disorders are common psychiatric disorders that affect 1-5% of the population worldwide. Major advances in the epidemiology, pathophysiology, and treatment of the disorders have recently occurred. The majority of published reports, however, originate from the Western hemisphere, mostly Europe and the United States. There is a shortage of data from the Arab world on bipolar disorders. In an era of globalization and rapid communication, it is not clear to what extent research findings pertaining to one part of the world are by necessity applicable to other parts. Psychiatric disorders are known to be affected by the culture in which they occur, and knowledge of variations in illness presentation in different ethnic groups is also increasing. However, knowledge of variations affecting Arab populations remains quite limited. This paper provides a critical review of the literature on bipolar affective disorders in the Arab world, pointing to major gaps in knowledge and future opportunities to fill these gaps. © 2015 New York Academy of Sciences.

  16. Clinical correlates of loss of insight in bipolar depression

    Directory of Open Access Journals (Sweden)

    Rafael de Assis da Silva

    Full Text Available Abstract Introduction Affective state may influence insight, especially regarding mania. Nevertheless, studies have so far suggested that depression seems not to significantly impair insight. To the best of our knowledge, this study pioneers the evaluation of how insight variations in bipolar depression correlate with clinical variables. Method A group of 165 bipolar patients, 52 of whom had depressive episodes according to DSM-5 criteria, were followed during a year. All patients underwent clinical assessment, and insight was evaluated through the Insight Scale for Affective Disorders (ISAD. Repeated-measures ANOVA was calculated comparing scores on the four ISAD factors (insight into symptoms, the condition itself, self-esteem and social relationships in order to investigate differences in insight according to different objects. Correlational analysis explored which clinical symptoms were linked to reduced insight. Results Worse total insight correlated with suicide attempt/ideation and fewer subsyndromal manic symptoms such as mood elevation, increased energy and sexual interest. Worse self-esteem insight was associated with not only suicide ideation/attempt but also with activity reduction and psychomotor retardation. Worse symptom insight also correlated with psychomotor retardation. Better insight into having an affective disorder was associated with more intense hypochondria symptoms. Finally, worse insight into having an illness was associated with psychotic episodes. Conclusion Our study found that symptoms other than psychosis – suicide ideation, psychomotor retardation and reduction of activity and work – correlate with insight impairment in bipolar depression.

  17. Compare of Executive Function in Bipolar I Disorder and Schizophrenia

    Directory of Open Access Journals (Sweden)

    Mohammad Reza khodaei-Ardakani

    2013-10-01

    Full Text Available Objective: There is evidence for differential executive function in Bipolar I Disorder (BID and schizophrenia that may tend different cognitive deficits and abnormalities. The objective of this sudsy was to compare the executive function of BID and schizophrenic patients. Materials & Methods: We studied 50 patients with BID, and 50 with schizophrenia participants in outpatients' clinic of Rouzbeh hospital. All participants completed the Wisconsin Card Sorting Test (WCST the Persian version. The participants were mach in three basic variables which had most contributions in cognitive conditions in patients. They were Age, educational status and period of illness. Results: The two patient groups had compared performance on the WCST in compared with general population (P<0/05. In the WCST, schizophrenic patients showed impairment executive function than BID patients (P<0/05. Conclusion: findings indicated that schizophrenic patients had more dysfunctions executive function than the Bipolar disorder I patients. Although, both disorders may show impairment in executive function, but the dysfunction in schizophrenia greater than Bipolar I Disorder patients.

  18. Bipolar disorder and metabolic syndrome: a systematic review

    Directory of Open Access Journals (Sweden)

    Letícia Czepielewski

    2013-03-01

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

  19. Brain Structural Effects of Psychopharmacological Treatment in Bipolar Disorder

    Science.gov (United States)

    McDonald, Colm

    2015-01-01

    Bipolar disorder is associated with subtle neuroanatomical deficits including lateral ventricular enlargement, grey matter deficits incorporating limbic system structures, and distributed white matter pathophysiology. Substantial heterogeneity has been identified by structural neuroimaging studies to date and differential psychotropic medication use is potentially a substantial contributor to this. This selective review of structural neuroimaging and diffusion tensor imaging studies considers evidence that lithium, mood stabilisers, antipsychotic medication and antidepressant medications are associated with neuroanatomical variation. Most studies are negative and suffer from methodological weaknesses in terms of directly assessing medication effects on neuroanatomy, since they commonly comprise posthoc assessments of medication associations with neuroimaging metrics in small heterogenous patient groups. However the studies which report positive findings tend to form a relatively consistent picture whereby lithium and antiepileptic mood stabiliser use is associated with increased regional grey matter volume, especially in limbic structures. These findings are further supported by the more methodologically robust studies which include large numbers of patients or repeated intra-individual scanning in longitudinal designs. Some similar findings of an apparently ameliorative effect of lithium on white matter microstructure are also emerging. There is less support for an effect of antipsychotic or antidepressant medication on brain structure in bipolar disorder, but these studies are further limited by methodological difficulties. In general the literature to date supports a normalising effect of lithium and mood stabilisers on brain structure in bipolar disorder, which is consistent with the neuroprotective characteristics of these medications identified by preclinical studies. PMID:26412064

  20. A Cross-sectional, Comparative Study of Insight in Schizophrenia and Bipolar Patients in Remission.

    Science.gov (United States)

    Ramachandran, Arul Saravanan; Ramanathan, Rajkumar; Praharaj, Samir Kumar; Kanradi, Haridas; Sharma, Podila Satya Venkata Narasimha

    2016-01-01

    To study insight correlates in schizophrenia and bipolar mood disorder in remission among out-patients attending the Psychiatry Department of a Tertiary Care Hospital. In a cross-sectional, naturalistic study, adult patients with schizophrenia and bipolar mood disorder in remission (n = 80; schizophrenia-40, mania-20, bipolar depression-20) were compared on insight measures and clinical correlates. Scale to Assess the Unawareness of Mental Disorders (SUMD) was used as the main tool to assess current and past measures of insight. Hogan's Drug Attitude Inventory was used to assess the drug attitude and compliance. Positive and Negative Symptom Scale for Schizophrenia, Young's Mania Rating Scale, and HAMD were used to rate psychopathology. Clinical Global Improvement was used as a screening tool for remission. For comparison of the three clinical groups, analysis of variance and Chi-square test were used. In the post-hoc analysis, the Ryan-Einot-Gabriel-Welsch test was used to find the group difference. About 40% in the schizophrenia group were unaware of their mental illness as against none in the bipolar group. The awareness of mental disorder for the current period, the awareness of the achieved effects of medications, and the awareness of social consequence was better in the bipolar group. The drug attitude (compliant positive attitude) increased as the SUMD item scale decreased or in other words, as the insight improved. Insight, both current and retrospect, showed significant differences between the schizophrenia and bipolar patients. Insight is significantly correlated with the observed compliance and drug attitude of the patient groups.

  1. Suicide behavior and neuropsychological assessment of type I bipolar patients.

    Science.gov (United States)

    Malloy-Diniz, Leandro F; Neves, Fernando Silva; Abrantes, Suzana Silva Costa; Fuentes, Daniel; Corrêa, Humberto

    2009-01-01

    Neuropsychological deficits are often described in patients with bipolar disorder (BD). Some symptoms and/or associated characteristics of BD can be more closely associated to those cognitive impairments. We aimed to explore cognitive neuropsychological characteristics of type I bipolar patients (BPI) in terms of lifetime suicide attempt history. We studied 39 BPI outpatients compared with 53 healthy controls (HC) matched by age, educational and intellectual level. All subjects were submitted to a neuropsychological assessment of executive functions, decision-making and declarative episodic memory. When comparing BDI patients, regardless of suicide attempt history or HC, we observed that bipolar patients performed worse than controls on measures of memory, attention, executive functions and decision-making. Patients with a history of suicide attempt performed worse than non-attempters on measures of decision-making and there were a significant negative correlation between the number of suicide attempts and decision-making results (block 3 and net score). We also found significant positive correlation between the number of suicide attempts and amount of errors in Stroop Color Word Test (part 3). The sample studied can be considered small and a potentially confounding variable - medication status - were not controlled. Our results show the presence of neuropsychological deficits in memory, executive functions, attention and decision-making in BPI patients. Suicide attempts BPI scored worse than non-suicide attempt BPI on measures of decision-making. More suicide attempts were associated with a worse decision-making process. Future research should explore the relationship between the association between this specific cognitive deficits in BPIs, serotonergic function and suicide behavior in bipolar patients as well other diagnostic groups.

  2. 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.

  3. Prevalence of cognitive impairment in major depression and bipolar disorder.

    Science.gov (United States)

    Douglas, Katie M; Gallagher, Peter; Robinson, Lucy J; Carter, Janet D; McIntosh, Virginia Vw; Frampton, Christopher Ma; Watson, Stuart; Young, Allan H; Ferrier, I Nicol; Porter, Richard J

    2018-05-01

    The current study examines prevalence of cognitive impairment in four mood disorder samples, using four definitions of impairment. The impact of premorbid IQ on prevalence was examined, and the influence of treatment response. Samples were: (i) 58 inpatients in a current severe depressive episode (unipolar or bipolar), (ii) 69 unmedicated outpatients in a mild to moderate depressive episode (unipolar or bipolar), (iii) 56 outpatients with bipolar disorder, in a depressive episode, and (iv) 63 outpatients with bipolar disorder, currently euthymic. Cognitive assessment was conducted after treatment in Studies 1 (6 weeks of antidepressant treatment commenced on admission) and 2 (16-week course of cognitive behaviour therapy or schema therapy), allowing the impact of treatment response to be assessed. All mood disorder samples were compared with healthy control groups. The prevalence of cognitive impairment was highest for the inpatient depression sample (Study 1), and lowest for the outpatient depression sample (Study 2). Substantial variability in rates was observed depending on the definition of impairment used. Correcting cognitive performance for premorbid IQ had a significant impact on the prevalence of cognitive impairment in the inpatient depression sample. There was minimal evidence that treatment response impacted on prevalence of cognitive impairment, except in the domain of psychomotor speed in inpatients. As interventions aiming to improve cognitive outcomes in mood disorders receive increasing research focus, the issue of setting a cut-off level of cognitive impairment for screening purposes becomes a priority. This analysis demonstrates important differences in samples likely to be recruited depending on the definition of cognitive impairment and begins to examine the importance of premorbid IQ in determining who is impaired. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  4. Homer1a protein expression in schizophrenia, bipolar disorder, and major depression.

    Science.gov (United States)

    Leber, Stefan L; Llenos, Ida C; Miller, Christine L; Dulay, Jeannette R; Haybaeck, Johannes; Weis, Serge

    2017-10-01

    In recent years, there was growing interest in postsynaptic density proteins in the central nervous system. Of the most important candidates of this specialized region are proteins belonging to the Homer protein family. This family of scaffolding proteins is suspected to participate in the pathogenesis of a variety of diseases. The present study aims to compare Homer1a expression in the hippocampus and cingulate gyrus of patients with major psychiatric disorders including schizophrenia, bipolar disorder and major depression. Immunohistochemistry was used to analyze changes of Homer1a protein expression in the hippocampal formation and the cingulate gyrus from the respective disease groups. Glial cells of the cingulate gyrus gray matter showed decreased Homer1a levels in bipolar disorder when compared to controls. The same results were seen when comparing cingulate gyrus gray matter glial cells in bipolar disorder with major depression. Stratum oriens glial cells of the hippocampus showed decreased Homer1a levels in bipolar disorder when compared to controls and major depression. Stratum lacunosum glial cells showed decreased Homer1a levels in bipolar disorder when compared to major depression. In stratum oriens interneurons Homer1a levels were increased in all disease groups when compared to controls. Stratum lucidum axons showed decreased Homer1a levels in bipolar disorder when compared to controls. Our data demonstrate altered Homer1a levels in specific brain regions and cell types of patients suffering from schizophrenia, bipolar disorder and major depression. These findings support the role of Homer proteins as interesting candidates in neuropsychiatric pathophysiology and treatment.

  5. Seroreactive marker for inflammatory bowel disease and associations with antibodies to dietary proteins in bipolar disorder.

    Science.gov (United States)

    Severance, Emily G; Gressitt, Kristin L; Yang, Shuojia; Stallings, Cassie R; Origoni, Andrea E; Vaughan, Crystal; Khushalani, Sunil; Alaedini, Armin; Dickerson, Faith B; Yolken, Robert H

    2014-05-01

    Immune sensitivity to wheat glutens and bovine milk caseins may affect a subset of individuals with bipolar disorder. Digested byproducts of these foods are exorphins that have the potential to impact brain physiology through action at opioid receptors. Inflammation in the gastrointestinal (GI) tract might accelerate exposure of food antigens to systemic circulation and help explain elevated gluten and casein antibody levels in individuals with bipolar disorder. We measured a marker of GI inflammation, anti-Saccharomyces cerevisiae antibodies (ASCA), in non-psychiatric controls (n = 207), in patients with bipolar disorder without a recent onset of psychosis (n = 226), and in patients with bipolar disorder with a recent onset of psychosis (n = 38). We compared ASCA levels to antibodies against gluten, casein, Epstein-Barr virus (EBV), herpes simplex virus 1 (HSV-1), influenza A, influenza B, measles, and Toxoplasma gondii. Elevated ASCA conferred a 3.5-4.4-fold increased odds ratio of disease association (age-, race-, and gender-corrected multinomial logistic regressions, p ≤ 0.00001) that was independent of type of medication received. ASCA correlated with food antibodies in both bipolar disorder groups (R(2)  = 0.29-0.59, p ≤ 0.0005), and with measles and T. gondii immunoglobulin G (IgG) in the recent onset psychosis bipolar disorder group (R(2)  = 0.31-0.36, p ≤ 0.004-0.01). Elevated seropositivity of a GI-related marker and its association with antibodies to food-derived proteins and self-reported GI symptoms suggest a GI comorbidity in at least a subgroup of individuals with bipolar disorder. Marker seroreactivity may also represent part of an overall heightened activated immune state inherent to this mood disorder. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  6. Diffusion tensor imaging in euthymic bipolar disorder - A tract-based spatial statistics study

    NARCIS (Netherlands)

    Haarman, Bartholomeus C. M. ('Benno'); Riemersma-Van der Lek, Rixt F.; Burger, Huibert; de Groot, Jan Cees; Drexhage, Hemmo A.; Nolen, Willem A.; Cerliani, Leonardo

    2016-01-01

    Background: In the current DTI study we compared euthymic bipolar I disorder (BD-I) patients and healthy controls (HC). We subsequently divided the total patient group into lithium-users and non-lithium-users and estimated differences across the three groups. Methods: Twenty-one euthymic BD-I

  7. Increased Clinical and Neurocognitive Impairment in Children with Autism Spectrum Disorders and Comorbid Bipolar Disorder

    Science.gov (United States)

    Weissman, Adam S.; Bates, Marsha E.

    2010-01-01

    Bipolar (BD) symptomatology is prevalent in children with autism spectrum disorders (ASD) and may lead to increased impairment. The current study compared clinical and neurocognitive impairment in children (7-13 years) diagnosed with ASD (n=55), BD (n=34), ASD + BD (n=23), and a non-clinical control group (n=27). Relative to the ASD group, the ASD…

  8. The thermodynamics of bipolarity: a bifurcation model of bipolar illness and bipolar character and its psychotherapeutic applications.

    Science.gov (United States)

    Sabelli, H C; Carlson-Sabelli, L; Javaid, J I

    1990-11-01

    Two models dominate current formulations of bipolar illness: the homeostatic model implicit in Freud's psychodynamics and most neuroamine deficit/excess theories; and the oscillatory model of exaggerated biological rhythms. The homeostatic model is based on the closed systems approach of classic thermodynamics, while the oscillatory model requires the open systems approach of modern thermodynamics. Here we present a thermodynamic model of bipolarity that includes both homeostatic and oscillatory features and adds the most important feature of open systems thermodynamics: the creation of novel structures in bifurcation processes. According to the proposed model, bipolarity is the result of exaggerated biological energy that augments homeostatic, oscillatory and creative psychological processes. Only low-energy closed systems tend to rest ("point attractor") and entropic disorder. Open processes containing and exchanging energy fluctuate between opposite states ("periodic attractors"); they are characteristic of most physiological rhythms and are exaggerated in bipolar subjects. At higher energies, their strong fluctuations destroy pre-existing patterns and structures, produce turbulence ("chaotic attractors"), which sudden switches between opposite states, and create new and more complex structures. Likewise, high-energy bipolars develop high spontaneity, great fluctuations between opposite moods, internal and interpersonal chaos, and enhanced creativity (personal, artistic, professional) as well as psychopathology (personality deviations, psychotic delusions). Offered here is a theoretical explanation of the dual--creative and destructive--nature of bipolarity in terms of the new enantiodromic concept of entropy generalized by process theory. Clinically, this article offers an integrative model of bipolarity that accounts for many clinical features and contributes to a definition of the bipolar personality.

  9. Bipolar disorder: The importance of clinical assessment in identifying prognostic factors - An Audit. Part 3: A comparison between Italian and English mental health services and a survey of bipolar disorder.

    Science.gov (United States)

    Verdolini, Norma; Dean, Jonathon; Massucci, Giampaolo; Elisei, Sandro; Quartesan, Roberto; Zaman, Rashid; Agius, Mark

    2014-11-01

    Most of the prognostic factors of bipolar disorder, which determine disease course and outcome, could be detected from simple but often-unrecorded questions asked during the psychiatric clinic assessments. In previous parts of this research, we analysed various prognostic factors and focused on mixed states and rapid cycling subsets. We now compare our sample in England with a small sample from Italy to demonstrate the utility of focused prognostic questioning and of international comparison. We collected data from the clinical notes of 70 English bipolar and 8 Italian bipolar outpatients seen at the initial psychiatric assessment clinic about socio-demographic and clinical factors to determine whether various factors had relevance to prevalence, prognosis, or outcome. The sample comprised 16 bipolar I (22.9%) and 54 bipolar II (77.1%) English outpatients and 7 bipolar I (87.5%) and 1 bipolar II (12.5%) Italian outpatients. Differences between the groups are seen mainly in terms of age of onset, duration of both depressive and hypomanic episodes, presence of psychiatric family history, incidence of mixed state features and rapid cycling, presence of elated mood in response to past antidepressant treatment, and misuse of illicit drugs and alcohol. In order to promote improved mental health primary care, mental health systems in all countries should develop standardized epidemiological tools that are shared between countries. We recommend the use of a questionnaire that reminds clinicians of potentially prognostic information and suggest that this might identify important components of a potential standardized diagnostic and prognostic tool.

  10. Patients taking medications for bipolar disorder are more prone to metabolic syndrome than Korea's general population.

    Science.gov (United States)

    Lee, Nam Young; Kim, Se Hyun; Cho, Belong; Lee, Yeon Ji; Chang, Jae Seung; Kang, Ung Gu; Kim, Yong Sik; Ahn, Yong Min

    2010-10-01

    Despite growing concerns about the co-morbidity of metabolic syndrome (MetS) and bipolar disorder, few studies have been conducted on this topic in Asian populations. This study examined Korean patients with bipolar disorder to assess its co-morbidity with MetS and to compare the prevalence of MetS in patients with medication for bipolar disorder with that of healthy patients. We used cross-sectional data from the medical records of patients with bipolar disorder who presented to the psychiatric clinic in Seoul National University Hospital between June 2007 and June 2008. The control group, matched for age and gender, was randomly drawn from visitors to the Health Promotion Center at the same hospital during the same period. We compared the prevalence of MetS between these two groups with independent sample t-tests and chi-squared tests. We also calculated the indirectly standardized prevalence ratio (ISPR) with a standardization that used the Fourth Korean National Health and Nutrition Examination Survey (KNHNES, 2007). The prevalence of MetS in patients who took medication for bipolar disorder (N=152) was 27.0%, 25.0% and 25.7%, based on the definitions of the American Heart Association and the National Heart, Lung and Blood Institute's adaptation of the Adult Treatment Panel III (AHA), the National Cholesterol Education Program for Adult Treatment Panel III (ATPIII) and the International Diabetes Federation (IDF), respectively. The present study determined that the prevalence of MetS was significantly higher in patients with bipolar disorder than in the control group; the odds ratios (OR) (95% CI) were 2.44 (1.35-4.40), 2.48 (1.34-4.59) and 2.57 (1.40-4.74), based on the definition of the AHA, ATPIII and IDF, respectively. The ISPR (95% CI) was 1.48 (1.02-1.93), 1.54 (1.05-2.03) and 1.98 (1.36-2.60), respectively. Patients with medications for bipolar disorder showed a significantly higher prevalence of increased waist circumference, elevated triglycerides, and

  11. Bipolar Electrode Sample Preparation Devices

    Science.gov (United States)

    Wang, Yi (Inventor); Song, Hongjun (Inventor); Pant, Kapil (Inventor)

    2017-01-01

    An analyte selection device can include: a body defining a fluid channel having a channel inlet and channel outlet; a bipolar electrode (BPE) between the inlet and outlet; one of an anode or cathode electrically coupled with the BPE on a channel inlet side of the BPE and the other of the anode or cathode electrically coupled with the BPE on a channel outlet side of the BPE; and an electronic system operably coupled with the anode and cathode so as to polarize the BPE. The fluid channel can have any shape or dimension. The channel inlet and channel outlet can be longitudinal or lateral with respect to the longitudinal axis of the channel. The BPE can be any metallic member, such as a flat plate on a wall or mesh as a barrier BPE. The anode and cathode can be located at a position that polarizes the BPE.

  12. The utility of the combination of dextromethorphan and quinidine in the treatment of bipolar II and bipolar NOS.

    Science.gov (United States)

    Kelly, Tammas Frederick; Lieberman, Daniel Z

    2014-01-01

    Dextromethorphan is an over-the-counter antitussive agent that may be a rapidly acting treatment for bipolar depression. Like ketamine, it is an NMDA receptor antagonist. We conducted a retrospective chart review of depressed patients with treatment resistant bipolar II or bipolar NOS disorder who were treated with the combination of dextromethorphan 20 mg and quinidine 10 mg (DMQ). One pill of DMQ taken once or twice a day was added to participants׳ drug regimen. No changes were made to the pre-existing drug regimen during the course of treatment with DMQ. The primary outcome measure was the Clinical Global Impression-Improvement (CGI-I) score after 90 days of treatment. Seventy-seven participants met the inclusion criteria. All had been experiencing depressive symptoms for at least two years, and the mean number of failed medication trials was 21.2. The average CGI-I score at day 90 was 1.66 (1=slightly improved, 2=much improved). Some patients reported improvement within 1-2 days of starting DMQ. Nineteen patients discontinued treatment due to adverse effects, chiefly nausea. Because this was a retrospective chart review with no control group, conclusions about causation cannot be made. Nevertheless, the duration of depressive symptoms prior to starting DMQ makes spontaneous recovery less likely. DMQ, an NMDA antagonist, may be effective in the treatment of bipolar depression. Because its putative mechanism does not depend on the monoaminergic system, it may be appropriate for patients who have not responded to other medications. Unlike ketamine, DMQ does not require i.v. administration. Copyright © 2014 Elsevier B.V. All rights reserved.

  13. Psychosocial morbidity associated with bipolar disorder and borderline personality disorder in psychiatric out-patients: comparative study.

    Science.gov (United States)

    Zimmerman, Mark; Ellison, William; Morgan, Theresa A; Young, Diane; Chelminski, Iwona; Dalrymple, Kristy

    2015-10-01

    The morbidity associated with bipolar disorder is, in part, responsible for repeated calls for improved detection and recognition. No such commentary exists for the improved detection of borderline personality disorder. Clinical experience suggests that it is as disabling as bipolar disorder, but no study has directly compared the two disorders. To compare the levels of psychosocial morbidity in patients with bipolar disorder and borderline personality disorder. Patients were assessed with semi-structured interviews. We compared 307 patients with DSM-IV borderline personality disorder but without bipolar disorder and 236 patients with bipolar disorder but without borderline personality disorder. The patients with borderline personality disorder less frequently were college graduates, were diagnosed with more comorbid disorders, more frequently had a history of substance use disorder, reported more suicidal ideation at the time of the evaluation, more frequently had attempted suicide, reported poorer social functioning and were rated lower on the Global Assessment of Functioning. There was no difference between the two patient groups in history of admission to psychiatric hospital or time missed from work during the past 5 years. The level of psychosocial morbidity associated with borderline personality disorder was as great as (or greater than) that experienced by patients with bipolar disorder. From a public health perspective, efforts to improve the detection and treatment of borderline personality disorder might be as important as efforts to improve the recognition and treatment of bipolar disorder. © The Royal College of Psychiatrists 2015.

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

    Directory of Open Access Journals (Sweden)

    Shamsaei

    2015-05-01

    Full Text Available 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 six to twelve years, who had parents with bipolar disorder and 200 children of 163 demographically-matched control parents. Parents with bipolar disorder were recruited from Farshchian Psychiatric Hospital of Hamadan, Iran, during year 2014. The parent version of the Child Symptom Inventory-4 questionnaire was used to measure mental health. Mean comparisons were performed using Student’s t test while effect sizes were estimated by Cohen’s d coefficient. The Chi-square test was used to assess significant differences between frequency distribution of demographic variables in both groups. The significance level was considered less than 0.05. Results There were statistically significant differences between children of parents with and those without bipolar disorder regarding attention deficit hyperactivity disorder, oppositional defiant disorder, conduct, generalized anxiety disorder, schizophrenia, major depression, separation anxiety (P< 0.001 and social phobia (P < 0.05. Children of parents with BP are at high risk for psychiatric disorders. Conclusions These findings support that the careful evaluation and prospective following of the psychopathology of children of parents with bipolar disorder are critical for early identification and treatment.

  15. Bipolar or unipolar? : A brain teasing question

    NARCIS (Netherlands)

    Rive, M.M.

    2017-01-01

    During the depressed or remitted states, major depressive disorder (MDD) and bipolar disorder (BD) are difficult to distinguish clinically. Treatments for both disorders differ, and inadequate treatment may lead to chronicity, poor psychosocial functioning, or even suicide. Although early

  16. 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...

  17. Alteration of complex negative emotions induced by music in euthymic patients with bipolar disorder.

    Science.gov (United States)

    Choppin, Sabine; Trost, Wiebke; Dondaine, Thibaut; Millet, Bruno; Drapier, Dominique; Vérin, Marc; Robert, Gabriel; Grandjean, Didier

    2016-02-01

    Research has shown bipolar disorder to be characterized by dysregulation of emotion processing, including biases in facial expression recognition that is most prevalent during depressive and manic states. Very few studies have examined induced emotions when patients are in a euthymic phase, and there has been no research on complex emotions. We therefore set out to test emotional hyperreactivity in response to musical excerpts inducing complex emotions in bipolar disorder during euthymia. We recruited 21 patients with bipolar disorder (BD) in a euthymic phase and 21 matched healthy controls. Participants first rated their emotional reactivity on two validated self-report scales (ERS and MAThyS). They then rated their music-induced emotions on nine continuous scales. The targeted emotions were wonder, power, melancholy and tension. We used a specific generalized linear mixed model to analyze the behavioral data. We found that participants in the euthymic bipolar group experienced more intense complex negative emotions than controls when the musical excerpts induced wonder. Moreover, patients exhibited greater emotional reactivity in daily life (ERS). Finally, a greater experience of tension while listening to positive music seemed to be mediated by greater emotional reactivity and a deficit in executive functions. The heterogeneity of the BD group in terms of clinical characteristics may have influenced the results. Euthymic patients with bipolar disorder exhibit more complex negative emotions than controls in response to positive music. Copyright © 2015 Elsevier B.V. All rights reserved.

  18. Diffusion tensor imaging of cingulum bundle and corpus callosum in schizophrenia vs. bipolar disorder.

    Science.gov (United States)

    Nenadić, Igor; Hoof, Anna; Dietzek, Maren; Langbein, Kerstin; Reichenbach, Jürgen R; Sauer, Heinrich; Güllmar, Daniel

    2017-08-30

    Both schizophrenia and bipolar disorder show abnormalities of white matter, as seen in diffusion tensor imaging (DTI) analyses of major brain fibre bundles. While studies in each of the two conditions have indicated possible overlap in anatomical location, there are few direct comparisons between the disorders. Also, it is unclear whether phenotypically similar subgroups (e.g. patients with bipolar disorder and psychotic features) might share white matter pathologies or be rather similar. Using region-of-interest (ROI) analysis of white matter with diffusion tensor imaging (DTI) at 3 T, we analysed fractional anisotropy (FA), radial diffusivity (RD), and apparent diffusion coefficient (ADC) of the corpus callosum and cingulum bundle in 33 schizophrenia patients, 17 euthymic (previously psychotic) bipolar disorder patients, and 36 healthy controls. ANOVA analysis showed significant main effects of group for RD and ADC (both elevated in schizophrenia). Across the corpus callosum ROIs, there was not group effect on FA, but for RD (elevated in schizophrenia, lower in bipolar disorder) and ADC (higher in schizophrenia, intermediate in bipolar disorder). Our findings show similarities and difference (some gradual) across regions of the two major fibre tracts implicated in these disorders, which would be consistent with a neurobiological overlap of similar clinical phenotypes. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

  19. Enhanced prefrontal function with pharmacotherapy on a response inhibition task in adolescent bipolar disorder.

    Science.gov (United States)

    Pavuluri, Mani N; Passarotti, Alessandra M; Harral, Erin M; Sweeney, John A

    2010-11-01

    The aim of the current study is to determine whether pharmacotherapy normalizes cognitive circuitry function supporting voluntary behavioral inhibition in adolescent bipolar disorder. Healthy controls and unmedicated patients with DSM-IV adolescent bipolar disorder in manic, mixed, or hypomanic episodes were matched on demographics and IQ (n = 13 per group; mean age = 14.4 ± 2.4 years). Functional magnetic resonance imaging studies were performed at baseline and after 14 weeks, during which time patients with adolescent bipolar disorder were treated initially with second-generation antipsychotics (SGAs) followed by lamotrigine monotherapy. The primary outcome measure was a Response Inhibition Task, which involved a planned motor response, already "on the way" to execution, that had to be voluntarily inhibited by the subjects in the trials in which a stop signal was presented. There were 6 blocks, each with a predominant rate of either "go" or "stop" trials. The study was conducted from June 2006 through July 2009. All patients showed significant improvement (P adolescent bipolar disorder group than in healthy controls. Increased ventrolateral prefrontal cortex function was related to clinical treatment response. Treatment with SGAs followed by lamotrigine monotherapy enhanced prefrontal and temporal lobe activity during a Response Inhibition Task demonstrating the reversal of disorder-relevant neural circuitry dysfunction in patients with adolescent bipolar disorder. Patient performance was not slowed down with this treatment regimen. clinicaltrials.gov Identifier: NCT00176228. © Copyright 2010 Physicians Postgraduate Press, Inc.

  20. The Use of Bipolar Electrocautery Tonsillectomy in Patients with Pediatric Respiratory Tract Obstruction

    Directory of Open Access Journals (Sweden)

    Sinan Kocatürk

    2012-01-01

    Full Text Available Aim: This study offers a comparative analysis of the intraoperative and postoperative clinical results of bipolar electrocautery tonsillectomy and conventional tonsillectomy techniques in children with respiratory tract obstruction because of tonsillar hypertrophy. Material and Method: Results in 31 children who underwent bipolar electrocautery tonsillectomy were compared with those in 45 children who had conventional cold dissection tonsillectomy. Postoperative pain scores were measured in the early postoperative period by the %u201CModified Hannalah Scale%u201D and in the late postoperative period by the %u201CVisual Analog Score.%u201D Intraoperative blood loss, operation time, duration of oral intake, intake of painkillers, recovery time, and postoperative pain scores of the two groups are also compared.Result: Children who underwent bipolar electrocautery tonsillectomy group had significantly less scores in pain throughout their recovery period, intraoperative blood loss, operation time, duration of oral intake, intake of painkiller, recovery time, and postoperative pain than those who had conventional tonsillectomy. Discussion: Bipolar electrocautery tonsillectomy is as effective and safe as conventional tonsillectomy to relieve obstructive sleep apnea in pediatric patients. Bipolar electrocautery tonsillectomy reduces postoperative pain, improves the quality of life and shortens the recovery time. Therefore, this procedure is more tolerable in children than conventional tonsillectomy.

  1. 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.

  2. Biological dysrhythm in remitted bipolar I disorder.

    Science.gov (United States)

    Iyer, Aishwarya; Palaniappan, Pradeep

    2017-12-01

    Recent treatment guidelines support treatment of biological rhythm abnormalities as a part of treatment of bipolar disorder, but still, literature examining various domains (Sleep, Activity, Social, and Eating) of biological rhythm and its clinical predictors are less. The main aim of our study is to compare various domains of biological rhythm among remitted bipolar I subjects and healthy controls. We also explored for any association between clinical variables and biological rhythm among bipolar subjects. 40 subjects with Bipolar I disorder and 40 healthy controls who met inclusion and exclusion criteria were recruited for the study. Diagnoses were ascertained by a qualified psychiatrist using MINI 5.0. Sociodemographic details, biological rhythm (BRIAN-Biological Rhythm Interview of assessment in Neuropsychiatry) and Sleep functioning (PSQI- Pittsburgh Sleep Quality Index) were assessed in all subjects. Mean age of the Bipolar subjects and controls were 41.25±11.84years and 38.25±11.25 years respectively. Bipolar subjects experienced more biological rhythm disturbance when compared to healthy controls (total BRIAN score being 34.25±9.36 vs 28.2±6.53) (p=0.002). Subsyndromal depressive symptoms (HDRS) had significant positive correlation with BRIAN global scores(r=0.368, p=0.02). Linear regression analysis showed that number of episodes which required hospitalization (β=0.601, t=3.106, P=0.004), PSQI (β=0.394, t=2.609, p=0.014), HDRS (β=0.376, t=2.34, t=0.036) explained 31% of variance in BRIAN scores in remitted bipolar subjects. Biological rhythm disturbances seem to persist even after clinical remission of bipolar illness. More studies to look into the impact of subsyndromal depressive symptoms on biological rhythm are needed. Copyright © 2017 Elsevier B.V. All rights reserved.

  3. Suicide in bipolar disorder: a review.

    Science.gov (United States)

    Latalova, Klara; Kamaradova, Dana; Prasko, Jan

    2014-06-01

    Suicide is a leading cause of death in patients with bipolar disorder. Risk factors and prevention of suicide in this illness are the focus of considerable current research. MEDLINE data base was searched for the key words "bipolar disorder" with "suicide", "lithium" with "suicide", "anticonvulsants" with "bipolar disorder", and "anticonvulsants" with "bipolar disorder" and with "suicide". No language or time constraints were applied. The lists of references were searched manually to find additional articles. It is estimated that 25% to 50% of patients with bipolar disorder will attempt suicide at least once over their lifetime, and that 8% to 19% will complete suicide. Mortality rates from cardiovascular diseases are elevated in bipolar disorder. Risk factors for suicide include younger age of onset of the illness, history of past suicidal behavior, family history of suicide acts, comorbid borderline personality disorder and substance use disorders, and hopelessness. The warning signs calling for immediate action include the patients threatening to harm themselves, or looking for ways to kill themselves (seeking access to pills or weapons), or the patient talking or writing about death. Robust evidence supports the effects of lithium treatment in reducing suicidal attempts and completions in bipolar disorder. The evidence for antisuicidal effects of anticonvulsants is weaker. Nevertheless, valproate and other anticonvulsants are frequently prescribed as mood stabilizers. There have been controversial suggestions that this treatment may elevate the risk of suicide, but the data supporting this are not convincing. Psychoeducation can reduce the number of suicide attempts and completions. Suicide in bipolar disorder is a major public health problem. Recent research has expanded our knowledge of risk factors and warning signs. Nevertheless, it appears that the introduction of lithium treatment in the 1970s was the most recent important breakthrough in the prevention

  4. Preparation of bipolar membranes by electrospinning

    International Nuclear Information System (INIS)

    Pan, Jiefeng; Hou, Linxiao; Wang, Qiuyue; He, Yubin; Wu, Liang; Mondal, Abhishek N.; Xu, Tongwen

    2017-01-01

    A new preparative pathway for the bipolar membranes was initiated via the electrospinning and hot-press process. The prepared bipolar membrane was consisting of sulfonated poly (phenylene oxide), polyethylene glycol, and quaternized poly (phenylene oxide). The above mentioned membrane was fabricated by the continuous electrospinning of the respective layer, followed by the solvent atmosphere treatment and hot-pressing, to obtain a transparent and dense structure. The thickness of each layer can be easily tuned by controlling the electrospinning parameters. The clear interfacial structure was observed and confirmed by the scanning electron microscope. The bipolar performance is evaluated by the current–voltage curves and production yield of acid and base. The final optimized bipolar membrane had similar yield of acid and base as the casting membrane. However, extremely lower potential drop value was observed when they are applied for the production of acid and base. The experimental results showed that, electrospinning is an effective and well controlled way to fabricate bipolar membranes, in which anion or cation exchange layer as well as interfacial layer can be easily changed or added as requested. - Highlights: • Bipolar membranes were prepared through electrospinning followed by post-treatment. • As-prepared membranes were successfully applied in electrodialysis for production of acid and base. • Electrospun membranes exhibit better performance than the casting ones.

  5. Preparation of bipolar membranes by electrospinning

    Energy Technology Data Exchange (ETDEWEB)

    Pan, Jiefeng; Hou, Linxiao; Wang, Qiuyue; He, Yubin; Wu, Liang; Mondal, Abhishek N.; Xu, Tongwen, E-mail: twxu@ustc.edu.cn

    2017-01-15

    A new preparative pathway for the bipolar membranes was initiated via the electrospinning and hot-press process. The prepared bipolar membrane was consisting of sulfonated poly (phenylene oxide), polyethylene glycol, and quaternized poly (phenylene oxide). The above mentioned membrane was fabricated by the continuous electrospinning of the respective layer, followed by the solvent atmosphere treatment and hot-pressing, to obtain a transparent and dense structure. The thickness of each layer can be easily tuned by controlling the electrospinning parameters. The clear interfacial structure was observed and confirmed by the scanning electron microscope. The bipolar performance is evaluated by the current–voltage curves and production yield of acid and base. The final optimized bipolar membrane had similar yield of acid and base as the casting membrane. However, extremely lower potential drop value was observed when they are applied for the production of acid and base. The experimental results showed that, electrospinning is an effective and well controlled way to fabricate bipolar membranes, in which anion or cation exchange layer as well as interfacial layer can be easily changed or added as requested. - Highlights: • Bipolar membranes were prepared through electrospinning followed by post-treatment. • As-prepared membranes were successfully applied in electrodialysis for production of acid and base. • Electrospun membranes exhibit better performance than the casting ones.

  6. Comorbidity bipolar disorder and personality disorders.

    Science.gov (United States)

    Latalova, Klara; Prasko, Jan; Kamaradova, Dana; Sedlackova, Jana; Ociskova, Marie

    2013-01-01

    Outcome in bipolar patients can be affected by comorbidity of other psychiatric disorders. Comorbid personality disorders are frequent and may complicate the course of bipolar illness. We have much information about treating patients with uncomplicated bipolar disorder (BD) but much less knowledge about possibilities for patients with the comorbidity of BD and personality disorder. We conducted a series of literature searches using, as key words or as items in indexed fields, bipolar disorder and personality disorder or personality traits. Articles were obtained by searching MEDLINE from 1970 to 2012. In addition, we used other papers cited in articles from these searches, or cited in articles used in our own work. Tests of personality traits indicated that euthymic bipolar patients have higher scores on harm avoidance, reward dependence, and novelty seeking than controls. Elevation of novelty seeking in bipolar patients is associated with substance abuse comorbidity. Comorbidity with personality disorders in BD patients is associated with a more difficult course of illness (such as longer episodes, shorter time euthymic, and earlier age at onset) and an increase in comorbid substance abuse, suicidality and aggression. These problems are particularly pronounced in comorbidity with borderline personality disorder. Comorbidity with antisocial personality disorder elicits a similar spectrum of difficulties; some of the antisocial behavior exhibited by patients with this comorbidity is mediated by increased impulsivity.

  7. 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

  8. Classification of cognitive performance in bipolar disorder.

    Science.gov (United States)

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

    2017-09-01

    To understand the etiology of cognitive impairment associated with bipolar disorder, we need to clarify potential heterogeneity in cognitive functioning. To this end, we used multivariate techniques to study if the correlation structure of cognitive abilities differs between persons with bipolar disorder and controls. Clinically stable patients with bipolar disorder (type I: n = 64; type II: n = 44) and healthy controls (n = 86) were assessed with a wide range of cognitive tests measuring executive function, speed, memory, and verbal skills. Data were analysed with multivariate techniques. A distinct subgroup (∼30%) could be identified that performed significantly poorer on tests concerning memory function. This cognitive phenotype subgroup did not differ from the majority of bipolar disorder patients with respect to other demographic or clinical characteristics. Whereas the majority of patients performed similar to controls, a subgroup of patients with bipolar disorder differed substantially from healthy controls in the correlation pattern of low-level cognitive abilities. This suggests that cognitive impairment is not a general trait in bipolar disorder but characteristic of a cognitive subgroup. This has important clinical implications for cognitive rehabilitation and remediation.

  9. O transtorno bipolar na mulher Bipolar disorder in women

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    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

  10. Cortical morphology of adolescents with bipolar disorder and with schizophrenia.

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    Janssen, Joost; Alemán-Gómez, Yasser; Schnack, Hugo; Balaban, Evan; Pina-Camacho, Laura; Alfaro-Almagro, Fidel; Castro-Fornieles, Josefina; Otero, Soraya; Baeza, Inmaculada; Moreno, Dolores; Bargalló, Nuria; Parellada, Mara; Arango, Celso; Desco, Manuel

    2014-09-01

    Recent evidence points to overlapping decreases in cortical thickness and gyrification in the frontal lobe of patients with adult-onset schizophrenia and bipolar disorder with psychotic symptoms, but it is not clear if these findings generalize to patients with a disease onset during adolescence and what may be the mechanisms underlying a decrease in gyrification. This study analyzed cortical morphology using surface-based morphometry in 92 subjects (age range 11-18 years, 52 healthy controls and 40 adolescents with early-onset first-episode psychosis diagnosed with schizophrenia (n=20) or bipolar disorder with psychotic symptoms (n=20) based on a two year clinical follow up). Average lobar cortical thickness, surface area, gyrification index (GI) and sulcal width were compared between groups, and the relationship between the GI and sulcal width was assessed in the patient group. Both patients groups showed decreased cortical thickness and increased sulcal width in the frontal cortex when compared to healthy controls. The schizophrenia subgroup also had increased sulcal width in all other lobes. In the frontal cortex of the combined patient group sulcal width was negatively correlated (r=-0.58, padolescents with schizophrenia and bipolar disorder with psychotic symptoms there is cortical thinning, decreased GI and increased sulcal width of the frontal cortex present at the time of the first psychotic episode. Decreased frontal GI is associated with the widening of the frontal sulci which may reduce sulcal surface area. These results suggest that abnormal growth (or more pronounced shrinkage during adolescence) of the frontal cortex represents a shared endophenotype for psychosis. Copyright © 2014 Elsevier B.V. All rights reserved.

  11. Factor analysis of regional brain activation in bipolar and healthy individuals reveals a consistent modular structure.

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    Fleck, David E; Welge, Jeffrey A; Eliassen, James C; Adler, Caleb M; DelBello, Melissa P; Strakowski, Stephen M

    2018-07-01

    The neurophysiological substrates of cognition and emotion, as seen with fMRI, are generally explained using modular structures. The present study was designed to probe the modular structure of cognitive-emotional processing in bipolar and healthy individuals using factor analysis and compare the results with current conceptions of the neurophysiology of bipolar disorder. Exploratory factor analysis was used to assess patterns of covariation among brain regions-of-interest activated during the Continuous Performance Task with Emotional and Neutral Distractors in healthy and bipolar individuals without a priori constraints on the number or composition of latent factors. Results indicated a common cognitive-emotional network consisting of prefrontal, medial temporal, limbic, parietal, anterior cingulate and posterior cingulate modules. However, reduced brain activation to emotional stimuli in the frontal, medial temporal and limbic modules was apparent in the bipolar relative to the healthy group, potentially accounting for emotional dysregulation in bipolar disorder. This study is limited by a relatively small sample size recruited at a single site. The results have yet to be validated on a larger independent sample. Although the modular structure of cognitive-emotional processing is similar in bipolar and healthy individuals, activation in response to emotional/neutral cues varies. These findings are not only consistent with recent conceptions of mood regulation in bipolar disorder, but also suggest that regional activation can be considered within tighter modular structures without compromising data interpretation. This demonstration may serve as a template for data reduction in future region-of-interest analyses to increase statistical power. Copyright © 2018 Elsevier B.V. All rights reserved.

  12. Oxidatively-induced DNA damage and base excision repair in euthymic patients with bipolar disorder.

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    Ceylan, Deniz; Tuna, Gamze; Kirkali, Güldal; Tunca, Zeliha; Can, Güneş; Arat, Hidayet Ece; Kant, Melis; Dizdaroglu, Miral; Özerdem, Ayşegül

    2018-05-01

    Oxidatively-induced DNA damage has previously been associated with bipolar disorder. More recently, impairments in DNA repair mechanisms have also been reported. We aimed to investigate oxidatively-induced DNA lesions and expression of DNA glycosylases involved in base excision repair in euthymic patients with bipolar disorder compared to healthy individuals. DNA base lesions including both base and nucleoside modifications were measured using gas chromatography-tandem mass spectrometry and liquid chromatography-tandem mass spectrometry with isotope-dilution in DNA samples isolated from leukocytes of euthymic patients with bipolar disorder (n = 32) and healthy individuals (n = 51). The expression of DNA repair enzymes OGG1 and NEIL1 were measured using quantitative real-time polymerase chain reaction. The levels of malondialdehyde were measured using high performance liquid chromatography. Seven DNA base lesions in DNA of leukocytes of patients and healthy individuals were identified and quantified. Three of them had significantly elevated levels in bipolar patients when compared to healthy individuals. No elevation of lipid peroxidation marker malondialdehyde was observed. The level of OGG1 expression was significantly reduced in bipolar patients compared to healthy individuals, whereas the two groups exhibited similar levels of NEIL1 expression. Our results suggest that oxidatively-induced DNA damage occurs and base excision repair capacity may be decreased in bipolar patients when compared to healthy individuals. Measurement of oxidatively-induced DNA base lesions and the expression of DNA repair enzymes may be of great importance for large scale basic research and clinical studies of bipolar disorder. Copyright © 2018 Elsevier B.V. All rights reserved.

  13. Association of obesity and treated hypertension and diabetes with cognitive ability in bipolar disorder and schizophrenia.

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    Depp, Colin A; Strassnig, Martin; Mausbach, Brent T; Bowie, Christopher R; Wolyniec, Paula; Thornquist, Mary H; Luke, James R; McGrath, John A; Pulver, Ann E; Patterson, Thomas L; Harvey, Philip D

    2014-06-01

    People with bipolar disorder or schizophrenia are at greater risk for obesity and other cardio-metabolic risk factors, and several prior studies have linked these risk factors to poorer cognitive ability. In a large ethnically homogenous outpatient sample, we examined associations among variables related to obesity, treated hypertension and/or diabetes and cognitive abilities in these two patient populations. In a study cohort of outpatients with either bipolar disorder (n = 341) or schizophrenia (n = 417), we investigated the association of self-reported body mass index and current use of medications for hypertension or diabetes with performance on a comprehensive neurocognitive battery. We examined sociodemographic and clinical factors as potential covariates. Patients with bipolar disorder were less likely to be overweight or obese than patients with schizophrenia, and also less likely to be prescribed medication for hypertension or diabetes. However, obesity and treated hypertension were associated with worse global cognitive ability in bipolar disorder (as well as with poorer performance on individual tests of processing speed, reasoning/problem-solving, and sustained attention), with no such relationships observed in schizophrenia. Obesity was not associated with symptom severity in either group. Although less prevalent in bipolar disorder compared to schizophrenia, obesity was associated with substantially worse cognitive performance in bipolar disorder. This association was independent of symptom severity and not present in schizophrenia. Better understanding of the mechanisms and management of obesity may aid in efforts to preserve cognitive health in bipolar disorder. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  14. Increased sensitivity to positive social stimuli in monozygotic twins at risk of bipolar vs. unipolar disorder.

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    Kærsgaard, S; Meluken, I; Kessing, L V; Vinberg, M; Miskowiak, K W

    2018-05-01

    Abnormalities in affective cognition are putative endophenotypes for bipolar and unipolar disorders but it is unclear whether some abnormalities are disorder-specific. We therefore investigated affective cognition in monozygotic twins at familial risk of bipolar disorder relative to those at risk of unipolar disorder and to low-risk twins. Seventy monozygotic twins with a co-twin history of bipolar disorder (n = 11), of unipolar disorder (n = 38) or without co-twin history of affective disorder (n = 21) were included. Variables of interest were recognition of and vigilance to emotional faces, emotional reactivity and -regulation in social scenarios and non-affective cognition. Twins at familial risk of bipolar disorder showed increased recognition of low to moderate intensity of happy facial expressions relative to both unipolar disorder high-risk twins and low-risk twins. Bipolar disorder high-risk twins also displayed supraliminal attentional avoidance of happy faces compared with unipolar disorder high-risk twins and greater emotional reactivity in positive and neutral social scenarios and less reactivity in negative social scenarios than low-risk twins. In contrast with our hypothesis, there was no negative bias in unipolar disorder high-risk twins. There were no differences between the groups in demographic characteristics or non-affective cognition. The modest sample size limited the statistical power of the study. Increased sensitivity and reactivity to positive social stimuli may be a neurocognitive endophenotype that is specific for bipolar disorder. If replicated in larger samples, this 'positive endophenotype' could potentially aid future diagnostic differentiation between unipolar and bipolar disorder. Copyright © 2018 Elsevier B.V. All rights reserved.

  15. Self-mutilation and suicide attempts: relationships to bipolar disorder, borderline personality disorder, temperament and character.

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    Joyce, Peter R; Light, Katrina J; Rowe, Sarah L; Cloninger, C Robert; Kennedy, Martin A

    2010-03-01

    Self-mutilation has traditionally been associated with borderline personality disorder, and seldom examined separately from suicide attempts. Clinical experience suggests that self-mutilation is common in bipolar disorder. A family study was conducted on the molecular genetics of depression and personality, in which the proband had been treated for depression. All probands and parents or siblings were interviewed with a structured interview and completed the Temperament and Character Inventory. Fourteen per cent of subjects interviewed reported a history of self-mutilation, mostly by wrist cutting. Self-mutilation was more common in bipolar I disorder subjects then in any other diagnostic groups. In multiple logistic regression self-mutilation was predicted by mood disorder diagnosis and harm avoidance, but not by borderline personality disorder. Furthermore, the relatives of non-bipolar depressed probands with self-mutilation had higher rates of bipolar I or II disorder and higher rates of self-mutilation. Sixteen per cent of subjects reported suicide attempts and these were most common in those with bipolar I disorder and in those with borderline personality disorder. On multiple logistic regression, however, only mood disorder diagnosis and harm avoidance predicted suicide attempts. Suicide attempts, unlike self-mutilation, were not familial. Self-mutilation and suicide attempts are only partially overlapping behaviours, although both are predicted by mood disorder diagnosis and harm avoidance. Self-mutilation has a particularly strong association with bipolar disorder. Clinicians need to think of bipolar disorder, not borderline personality disorder, when assessing an individual who has a history of self-mutilation.

  16. [Differential diagnosis between borderline personality disorder and bipolar disorder].

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    Herbst, Luis

    2010-01-01

    The relationship between bipolar disorder and borderline personality disorder remains controversial since in both conditions there are overlapping and similar symptomatic dimensions. Symptomatic dimensions suitable to subserve differential diagnosis are: mood, mood variability mode, and personal and family history. Characteristics of psychotic symptoms may also be useful in the differentiation. On the other hand, anxiety symptoms, neuropsychological profiles, neuro-imaging procedures and biomarkers seem not to contribute to differentiate between both diseases. The presentation of nonsuicidal self mutilation behavior can offer some differences between bipolar and borderline personality disorders, but both can coexist in clinical comorbid forms and do not significantly contribute to the differential diagnosis. Differential diagnosis is complicated by the fact that a low percentage of patients can experience comorbidity of both conditions. In this work we review all these issues, and particularly emphasize the importance of sitematically take into account the patient background, the course that follows his or her disorder, together with the outcome in response to medical decisions.

  17. Simple markers for subclinical inflammation in the different phases of bipolar affective disorder

    Directory of Open Access Journals (Sweden)

    Mesut Yildiz

    Full Text Available Abstract Background: Recently, a growing number of publications have suggested that the immune-inflammatory system may be involved in the etiology of bipolar disorder (BD. Objective: The aim of this study was to investigate neutrophil-lymphocyte ratio (NLR, platelet-lymphocyte ratio (PLR, and red cell distribution width (RDW in the three different phases of BD patients compared to each other and controls. Methods: One hundred eighty-seven bipolar patients (78 euthymic, 53 manic/hypomanic and 56 depressed, and 62 age and sex matched controls were enrolled. Sociodemographic variables and complete blood count parameters of the patients and the control group were recorded. Results: The groups did not differ from each other on the hematological parameters, except for NLR and RDW. Post-hoc analyses revealed that NLR values were significantly higher in the euthymic and manic/hypomanic bipolar groups compared to control group. In addition, post-hoc analyses revealed that RDW values were significantly higher in the manic/hypomanic bipolar group relative to the control group. Discussion: Longitudinal studies evaluating the levels of inflammatory markers in the early phases of the disorder, and their relationship with the development of different episodes and medical comorbidities may be useful to understand the role of inflammation in BD.

  18. 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,…

  19. Creativity and Bipolar Disorder: Igniting a Dialogue.

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    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. © The Author(s) 2015.

  20. [Circadian markers and genes in bipolar disorder].

    Science.gov (United States)

    Yeim, S; Boudebesse, C; Etain, B; Belliviera, F

    2015-09-01

    Bipolar disorder is a severe and complex multifactorial disease, characterized by alternance of acute episodes of depression and mania/hypomania, interspaced by euthymic periods. The etiological determinants of bipolar disorder yet, are still poorly understood. For the last 30 years, chronobiology is an important field of investigation to better understand the pathophysiology of bipolar disorder. We conducted a review using Medline, ISI Database, EMBase, PsyInfo up to January 2015, using the following keywords combinations: "mood disorder", "bipolar disorder", "depression", "unipolar disorder", "major depressive disorder", "affective disorder", for psychiatric conditions; and "circadian rhythms", "circadian markers", "circadian gene", "clock gene", "melatonin" for circadian rhythms. The search critera was presence of word in any field of the article. Quantitative and qualitative circadian abnormalities are associated with bipolar disorders both during acute episodes and euthymic periods, suggesting that these altered circadian rhythms may represent biological trait markers of the disorder. These circadian dysfunctions were assessed by various validated tools including polysomnography, actigraphy, sleep diaries, chronotype assessments and blood melatonin/cortisol measures. Other altered endogenous circadian activities have also been reported in bipolar patients, such as hormones secretion, core body temperature or fibroblasts activity. Moreover, these markers were also altered in healthy relatives of bipolar patients, suggesting a degree of heritability. Several genetic association studies have also showed associations between multiple circadian genes and bipolar disorder, such as CLOCK, ARTNL1, GSK3β, PER3, NPAS2, NR1D1, TIMELESS, RORA, RORB, and CSNK1ε. Thus, these circadian gene variants may contribute to the genetic susceptibility of the disease. Furthermore, the study of the clock system may help to better understand some phenotypic aspects like the

  1. Circadian Phase Preference in Pediatric Bipolar Disorder

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    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.

  2. Treatment response in relation to subthreshold bipolarity in patients with major depressive disorder receiving antidepressant monotherapy: a post hoc data analysis (KOMDD study

    Directory of Open Access Journals (Sweden)

    Park YM

    2016-05-01

    Full Text Available Young-Min Park,1 Bun-Hee Lee2 1Department of Psychiatry, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, 2Department of Psychiatry, Seoul Eunpyeong Hospital, Seoul, Republic of Korea Background: The aim of this observational study was to determine whether subthreshold bipolarity affects treatment response and remission in patients with major depressive disorder receiving antidepressant (AD monotherapy over a 6-month follow-up period. Methods: Seventy-eight patients with major depressive disorder were stratified into two subgroups according to the presence of subthreshold bipolarity, identified using the Korean version of the Mood Disorder Questionnaire (K-MDQ, which classifies patients as positive for a screening of bipolarity based on the cutoff for the total K-MDQ score (ie, 7 points. They received AD monotherapy such as escitalopram, sertraline, paroxetine, or tianeptine for 6 months. The Beck Depression Inventory (BDI, Hamilton Depression Rating Scale (HAMD, Hamilton Anxiety Scale, and Beck Scale for Suicide Ideation were applied at baseline, 1 week, 3 weeks, 2 months, 3 months, and 6 months. Results: The mean HAMD, BDI, and Beck Scale for Suicide Ideation scores were higher in the bipolarity group than in the nonbipolarity group at 3 weeks. The mean BDI score was also higher in the bipolarity group than in the nonbipolarity group at 6 months. Evaluation of the ratio of improvement for each scale revealed different patterns of percentage changes between the two groups over the 6-month follow-up period. Furthermore, the response and remission rates (as assessed using BDI and HAMD scores were higher in the nonbipolarity group than in the bipolarity group, with the exception of HAMD scores at the 3-week follow-up time point. Conclusion: The findings of this study showed that depressed patients with bipolarity had a worse response to AD monotherapy than did those without bipolarity. Keywords: subthreshold bipolarity

  3. Conflict monitoring and adaptation in individuals at familial risk for developing bipolar disorder.

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    Patino, Luis R; Adler, Caleb M; Mills, Neil P; Strakowski, Stephen M; Fleck, David E; Welge, Jeffrey A; DelBello, Melissa P

    2013-05-01

    To examine conflict monitoring and conflict-driven adaptation in individuals at familial risk for developing bipolar disorder. We recruited 24 adolescents who had a parent with bipolar disorder and 23 adolescents with healthy parents. Participants completed an arrow version of the Eriksen Flanker Task that included trials with three levels of conflict: neutral, congruent, and incongruent flanks. Differences in performance were explored based upon the level of conflict in the current and previous trials. Individuals at risk for developing bipolar disorder performed more slowly than youth with healthy parents in all trials. Analyses evaluating sequential effects revealed that at-risk subjects responded more slowly than youth of healthy parents for all trial types when preceded by an incongruent trial, for incongruent trials preceded by congruent trials, and for neutral and congruent trials when preceded by neutral trials. In contrast to the comparison group, at-risk adolescents failed to display a response time advantage for incongruent trials preceded by an incongruent trial. When removing subjects with attention-deficit hyperactivity disorder (ADHD), differences between groups in response time fell below significant level, but a difference in sequence modulation remained significant. Subjects at risk for bipolar disorder also displayed greater intra-subject response time variability for incongruent and congruent trials compared with the comparison adolescents. No differences in response accuracy were observed between groups. Adolescents at risk for developing bipolar disorder displayed specific deficits in cognitive flexibility, which might be useful as a potential marker related to the development of bipolar disorder. © 2013 John Wiley and Sons A/S. Published by Blackwell Publishing Ltd.

  4. Brain structure-function associations in multi-generational families genetically enriched for bipolar disorder.

    Science.gov (United States)

    Fears, Scott C; Schür, Remmelt; Sjouwerman, Rachel; Service, Susan K; Araya, Carmen; Araya, Xinia; Bejarano, Julio; Knowles, Emma; Gomez-Makhinson, Juliana; Lopez, Maria C; Aldana, Ileana; Teshiba, Terri M; Abaryan, Zvart; Al-Sharif, Noor B; Navarro, Linda; Tishler, Todd A; Altshuler, Lori; Bartzokis, George; Escobar, Javier I; Glahn, David C; Thompson, Paul M; Lopez-Jaramillo, Carlos; Macaya, Gabriel; Molina, Julio; Reus, Victor I; Sabatti, Chiara; Cantor, Rita M; Freimer, Nelson B; Bearden, Carrie E

    2015-07-01

    Recent theories regarding the pathophysiology of bipolar disorder suggest contributions of both neurodevelopmental and neurodegenerative processes. While structural neuroimaging studies indicate disease-associated neuroanatomical alterations, the behavioural correlates of these alterations have not been well characterized. Here, we investigated multi-generational families genetically enriched for bipolar disorder to: (i) characterize neurobehavioural correlates of neuroanatomical measures implicated in the pathophysiology of bipolar disorder; (ii) identify brain-behaviour associations that differ between diagnostic groups; (iii) identify neurocognitive traits that show evidence of accelerated ageing specifically in subjects with bipolar disorder; and (iv) identify brain-behaviour correlations that differ across the age span. Structural neuroimages and multi-dimensional assessments of temperament and neurocognition were acquired from 527 (153 bipolar disorder and 374 non-bipolar disorder) adults aged 18-87 years in 26 families with heavy genetic loading for bipolar disorder. We used linear regression models to identify significant brain-behaviour associations and test whether brain-behaviour relationships differed: (i) between diagnostic groups; and (ii) as a function of age. We found that total cortical and ventricular volume had the greatest number of significant behavioural associations, and included correlations with measures from multiple cognitive domains, particularly declarative and working memory and executive function. Cortical thickness measures, in contrast, showed more specific associations with declarative memory, letter fluency and processing speed tasks. While the majority of brain-behaviour relationships were similar across diagnostic groups, increased cortical thickness in ventrolateral prefrontal and parietal cortical regions was associated with better declarative memory only in bipolar disorder subjects, and not in non-bipolar disorder family

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

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

    2014-01-01

    Objective The risk-benefit profile of antidepressant medications in bipolar disorder is controversial. When conclusive evidence is lacking, expert consensus can guide treatment decisions. The International Society for Bipolar Disorders (ISBD) convened a task force to seek consensus recommendations on the use of antidepressants in bipolar disorders. Method An expert task force iteratively developed consensus through serial consensus-based revisions using the Delphi method. Initial survey items were based on systematic review of the literature. Subsequent surveys included new or reworded items and items that needed to be rerated. This process resulted in the final ISBD Task Force clinical recommendations on antidepressant use in bipolar disorder. Results There is striking incongruity between the wide use of and the weak evidence base for the efficacy and safety of antidepressant drugs in bipolar disorder. Few well-designed, long-term trials of prophylactic benefits have been conducted, and there is insufficient evidence for treatment benefits with antidepressants combined with mood stabilizers. A major concern is the risk for mood switch to hypomania, mania, and mixed states. Integrating the evidence and the experience of the task force members, a consensus was reached on 12 statements on the use of antidepressants in bipolar disorder. Conclusions Because of limited data, the task force could not make broad statements endorsing antidepressant use but acknowledged that individual bipolar patients may benefit from antidepressants. Regarding safety, serotonin reuptake inhibitors and bupropion may have lower rates of manic switch than tricyclic and tetracyclic antidepressants and norepinephrine-serotonin reuptake inhibitors. The frequency and severity of antidepressant-associated mood elevations appear to be greater in bipolar I than bipolar II disorder. Hence, in bipolar I patients antidepressants should be prescribed only as an adjunct to mood-stabilizing medications

  6. Inflammatory cytokine expression following the use of bipolar electrocoagulation, ultracision harmonic scalpel and cold knife biopsy.

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    Litta, Pietro; Saccardi, Carlo; Gizzo, Salvatore; Conte, Lorena; Ambrosi, Giulia; Sissi, Claudia; Palumbo, Manlio

    2015-08-01

    Electrical surgical devices may determine tissue damage through lateral thermal spread and activation of inflammatory processes. Several tissue effects are associated with the use of different surgical instruments. The aim of the present study was to compare tissue damage following the application of cold knife biopsy, bipolar electrocoagulation and the ultracision harmonic scalpel, through the analysis of inflammatory gene mediator expression. Three fragments of the round ligament (length 0.5 cm) were obtained from 22 females who had undergone total or subtotal laparoscopic hysterectomy using three different modes of resection: Cold knife biopsy, bipolar electrocoagulation and ultracision harmonic scalpel. The tissue fragments were examined by quantitative polymerase chain reaction (qPCR) analysis of selected cytokines. Gene expression analysis demonstrated large standard deviations due to individual variability among patients and indicated variability in the concentrations of cytokines in the three different samples. The quantity of cytokine mRNA in the cold knife biopsy samples was generally greater than those obtained by other techniques. Tumor necrosis factor-α expression was significantly higher in the sample obtained with the ultracision harmonic scalpel and bipolar electrocoagulation (P=0.033) when compared with cold knife biopsy. The inflammatory response was analyzed by the quantification of gene expression through the use of qPCR. The ultracision harmonic scalpel and bipolar electrocoagulation triggered the inflammatory cascade and resulted in an increased production of cytokines compared with cold knife biopsy.

  7. White matter tract integrity is associated with antidepressant response to lurasidone in bipolar depression.

    Science.gov (United States)

    Lan, Martin J; Rubin-Falcone, Harry; Motiwala, Fatima; Chen, Ying; Stewart, Jonathan W; Hellerstein, David J; Mann, J John; McGrath, Patrick J

    2017-09-01

    Patients with bipolar disorder spend the most time in the depressed phase, and that phase is associated with the most morbidity and mortality. Treatment of bipolar depression lacks a test to determine who will respond to treatment. White matter disruptions have been found in bipolar disorder. Previous reports suggest that white matter disruptions may be associated with resistance to antidepressant medication, but this has never been investigated in a prospective study using a Food and Drug Administration (FDA)-approved medication. Eighteen subjects with bipolar disorder who were in a major depressive episode and off all medications were recruited. Magnetic resonance imaging was acquired using a 64-direction diffusion tensor imaging sequence on a 3T scanner. Subjects were treated with 8 weeks of open-label lurasidone. The Montgomrey-Asberg Depression Rating Scale (MADRS) was completed weekly. Tract-Based Spatial Statistics were utilized to perform a regression analysis of fractional anisotropy (FA) data with treatment outcome as assessed by percent change in MADRS as a regressor while controlling for age and sex, using a threshold of P (threshold-free cluster enhancement-corrected) bipolar disorder were associated with poorer antidepressant response to lurasidone. The disruptions may potentially indicate treatment with a different antidepressant medication class. These results are limited by the open-label study design, sample size and lack of a healthy control group. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  8. Workplace productivity, employment issues, and resource utilization in patients with bipolar I disorder.

    Science.gov (United States)

    McMorris, Barbara J; Downs, Kristen E; Panish, Jessica M; Dirani, Riad

    2010-03-01

    To collect workplace productivity and healthcare utilization data from subjects with bipolar I disorder and compare the results with those from normative subjects. A cross sectional survey was administered to patients and recruiting physicians. Data collected included employment status, Endicott Workplace Productivity Scale (EWPS) results, healthcare resource utilization, and quality-of-life. In comparison with normative subjects, bipolar I subjects reported lower levels of work productivity (measured by the EWPS). Bipolar I subjects also reported more frequent outpatient visits and more prescribed pharmaceuticals. Bipolar I subjects were more likely to miss work, have worked reduced hours due to medical or mental health issues, receive disability payments, been involved in a crime, be uninsured or covered by Medicare, or have been fired or laid off. The study groups were age- and gender-matched to reduce the impact of selection bias associated with a non-randomized study design. Other potential limitations affecting the results of the study include recall bias and possibly an impact of different data collection methods (e.g. Internet versus telephone). Bipolar I disorder is associated with a negative effect on work productivity and resource utilization and is an appropriate disease management target for employers and healthcare decision makers.

  9. Mapping vulnerability to bipolar disorder: a systematic review and meta-analysis of neuroimaging studies

    Science.gov (United States)

    Fusar-Poli, Paolo; Howes, Oliver; Bechdolf, Andreas; Borgwardt, Stefan

    2012-01-01

    Background Although early interventions in individuals with bipolar disorder may reduce the associated personal and economic burden, the neurobiologic markers of enhanced risk are unknown. Methods Neuroimaging studies involving individuals at enhanced genetic risk for bipolar disorder (HR) were included in a systematic review. We then performed a region of interest (ROI) analysis and a whole-brain meta-analysis combined with a formal effect-sizes meta-analysis in a subset of studies. Results There were 37 studies included in our systematic review. The overall sample for the systematic review included 1258 controls and 996 HR individuals. No significant differences were detected between HR individuals and controls in the selected ROIs: striatum, amygdala, hippocampus, pituitary and frontal lobe. The HR group showed increased grey matter volume compared with patients with established bipolar disorder. The HR individuals showed increased neural response in the left superior frontal gyrus, medial frontal gyrus and left insula compared with controls, independent from the functional magnetic resonance imaging task used. There were no publication biases. Sensitivity analysis confirmed the robustness of these results. Limitations As the included studies were cross-sectional, it remains to be determined whether the observed neurofunctional and structural alterations represent risk factors that can be clinically used in preventive interventions for prodromal bipolar disorder. Conclusion Accumulating structural and functional imaging evidence supports the existence of neurobiologic trait abnormalities in individuals at genetic risk for bipolar disorder at various scales of investigation. PMID:22297067

  10. Mindfulness-based Cognitive Therapy for Non-remitted Patients with Bipolar Disorder

    Science.gov (United States)

    Deckersbach, Thilo; Hölzel, Britta K.; Eisner, Lori R.; Stange, Jonathan P.; Peckham, Andrew D.; Dougherty, Darin D.; Rauch, Scott L.; Lazar, Sara; Nierenberg, Andrew A.

    2013-01-01

    Introduction Bipolar disorder is characterized by recurrent episodes of depression and/or mania along with inter-episodic mood symptoms that interfere with psychosocial functioning. Despite periods of symptomatic recovery, many individuals with bipolar disorder continue to experience substantial residual mood symptoms that often lead to the recurrence of mood episodes. Aims The present study explored whether a new mindfulness-based cognitive therapy (MBCT) for bipolar disorder would increase mindfulness, reduce residual mood symptoms, and increase emotion regulation abilities, psychological well-being, positive affect and psychosocial functioning. Following a baseline clinical assessment, 12 individuals with DSM-IV bipolar disorder were treated with 12 group sessions of MBCT. Results At the end of treatment, as well as at the 3-months follow-up, participants showed increased mindfulness, lower residual depressive mood symptoms, less attentional difficulties, and increased emotion regulation abilities, psychological well-being, positive affect and psychosocial functioning. Conclusions These findings suggest that treating residual mood symptoms with MBCT may be another avenue to improving mood, emotion regulation, well-being and functioning in individuals with bipolar disorder. PMID:22070469

  11. Self Stigma Among People with Bipolar-I Disorder in Iran

    Directory of Open Access Journals (Sweden)

    Gita Sadighi

    2015-03-01

    Full Text Available Objectives: Psychiatric stigma refers to systemic and internalized stereotypical negative attitudes against individual with mental illness. This article describes the level of self stigma, stereotype endorsement and perceived discrimination experienced by patients with Bipolar-I disorder in Tehran. Methods: Data were collected from a total of 126 patients with Bipolar-I disorder who responded to acute phase treatment using the Internalized Stigma of Mental Illness scale. The ISMI scale has five subscales: Alienation, Stereotype Endorsement, Perceived Discrimination, Social Withdrawal and Stigma Resistance. Results: In this study 26.7% of participants reported moderate to high levels of self stigma, 57.49% moderate to high levels of stigma resistance and 18.3% moderate to high levels of Perceived discrimination. Discussion: The results suggest that, self stigma appears in over one fifth of individuals with Bipolar-I disorder in Iran. The symptoms of Bipolar-I disorder has profound impacts on the quality of life of affected patients. Psychosocial functioning and self-esteem is impaired in people with Bipolar-I disorder. Interventions are required to reduce the negative effects of internalized stigma in this group.

  12. Emotional intelligence and non-social cognition in schizophrenia and bipolar I disorder.

    Science.gov (United States)

    Frajo-Apor, B; Kemmler, G; Pardeller, S; Plass, T; Mühlbacher, M; Welte, A-S; Fleischhacker, W W; Hofer, A

    2017-01-01

    The different patterns of Emotional Intelligence (EI) deficits in schizophrenia and bipolar I disorder are are not yet well understood. This study compares EI levels among these groups and highlights the potential impact of non-social cognition on EI. Fifty-eight schizophrenia and 60 bipolar outpatients were investigated using the Mayer-Salovey-Caruso Emotional Intelligence Test (MSCEIT) and the Brief Assessment of Cognition in Schizophrenia (BACS). Analyses of covariance were performed with adjustment for the BACS composite score. Compared to bipolar subjects, schizophrenia patients showed significantly lower levels in both EI and non-social cognition. After adjustment for the BACS composite score, the difference in EI was lost. The mediation analysis revealed that differences between schizophrenia and bipolar patients in strategic EI are almost fully attributable to the mediating effect of non-social cognition. Our findings suggest that in both schizophrenia and bipolar patients EI is strongly influenced by non-social cognitive functioning. This has to be taken into account when interpreting MSCEIT data in comparative studies in serious mental illness and emphasizes the importance of cognitive remediation.

  13. Abnormal white matter integrity as a structural endophenotype for bipolar disorder.

    Science.gov (United States)

    Sarıçiçek, A; Zorlu, N; Yalın, N; Hıdıroğlu, C; Çavuşoğlu, B; Ceylan, D; Ada, E; Tunca, Z; Özerdem, A

    2016-05-01

    Several lines of evidence suggest that bipolar disorder (BD) is associated with white matter (WM) pathology. Investigation of unaffected first-degree relatives of BD patients may help to distinguish structural biomarkers of genetic risk without the confounding effects of burden of illness, medication or clinical state. In the present study, we applied tract-based spatial statistics to study WM changes in patients with BD, unaffected siblings and controls. A total of 27 euthymic patients with BD type I, 20 unaffected siblings of bipolar patients and 29 healthy controls who did not have any current or past diagnosis of Axis I psychiatric disorders were enrolled in the study. Fractional anisotropy (FA) was significantly lower in BD patients than in the control group in the corpus callosum, fornix, bilateral superior longitudinal fasciculus, inferior longitudinal fasciculus, inferior fronto-occipital fasciculus, anterior thalamic radiation, posterior thalamic radiation, cingulum, uncinate fasciculus, superior corona radiata, anterior corona radiata and left external capsule. In region-of-interest (ROI) analyses, we found that both unaffected siblings and bipolar patients had significantly reduced FA in the left posterior thalamic radiation, the left sagittal stratum, and the fornix compared with healthy controls. Average FA for unaffected siblings was intermediate between the healthy controls and bipolar patients within these ROIs. Decreased FA in the fornix, left posterior thalamic radiation and left sagittal stratum in both bipolar patients and unaffected siblings may represent a potential structural endophenotype or a trait-based marker for BD.

  14. Chronic stressors and trauma: prospective influences on the course of bipolar disorder

    Science.gov (United States)

    Gershon, A.; Johnson, S. L.; Miller, I.

    2013-01-01

    Background Exposure to life stress is known to adversely impact the course of bipolar disorder. Few studies have disentangled the effects of multiple types of stressors on the longitudinal course of bipolar I disorder. This study examines whether severity of chronic stressors and exposure to trauma are prospectively associated with course of illness among bipolar patients. Method One hundred and thirty-one participants diagnosed with bipolar I disorder were recruited through treatment centers, support groups and community advertisements. Severity of chronic stressors and exposure to trauma were assessed at study entry with in-person interviews using the Bedford College Life Event and Difficulty Schedule (LEDS). Course of illness was assessed by monthly interviews conducted over the course of 24 months (over 3000 assessments). Results Trauma exposure was related to more severe interpersonal chronic stressors. Multiple regression models provided evidence that severity of overall chronic stressors predicted depressive but not manic symptoms, accounting for 7.5% of explained variance. Conclusions Overall chronic stressors seem to be an important determinant of depressive symptoms within bipolar disorder, highlighting the importance of studying multiple forms of life stress. PMID:23419615

  15. Chronic stressors and trauma: prospective influences on the course of bipolar disorder.

    Science.gov (United States)

    Gershon, A; Johnson, S L; Miller, I

    2013-12-01

    Exposure to life stress is known to adversely impact the course of bipolar disorder. Few studies have disentangled the effects of multiple types of stressors on the longitudinal course of bipolar I disorder. This study examines whether severity of chronic stressors and exposure to trauma are prospectively associated with course of illness among bipolar patients. One hundred and thirty-one participants diagnosed with bipolar I disorder were recruited through treatment centers, support groups and community advertisements. Severity of chronic stressors and exposure to trauma were assessed at study entry with in-person interviews using the Bedford College Life Event and Difficulty Schedule (LEDS). Course of illness was assessed by monthly interviews conducted over the course of 24 months (over 3000 assessments). Trauma exposure was related to more severe interpersonal chronic stressors. Multiple regression models provided evidence that severity of overall chronic stressors predicted depressive but not manic symptoms, accounting for 7.5% of explained variance. Overall chronic stressors seem to be an important determinant of depressive symptoms within bipolar disorder, highlighting the importance of studying multiple forms of life stress.

  16. Bipolar postpartum depression: An update and recommendations.

    Science.gov (United States)

    Sharma, Verinder; Doobay, Minakshi; Baczynski, Christine

    2017-09-01

    Over the past few years there has been a surge of interest in the study of bipolar postpartum depression (PPD); however, questions remain about its prevalence, screening, clinical features, and treatment. Three electronic databases, MEDLINE/PubMed (1966-2016), PsycINFO (1806-2016), and the Cochrane Database of Systematic Reviews, were searched using a combination of the keywords bipolar, depression, postpartum, peripartum, prevalence, screening, diagnosis, treatment, drugs, and psychotherapy. The reference lists of articles identified were also searched. All relevant articles published in English were included. Depending on the population studied, 21.4-54% of women with PPD have a diagnosis of bipolar disorder (BD). Characteristic clinical features include younger age at illness onset, first onset of depression after childbirth, onset immediately after delivery, atypical depressive symptoms, psychotic features, mixed features, and history of BD in first-degree family members. Treatment should be guided by symptom acuity, safety concerns, the patient's response to past treatments, drug tolerability, and breastfeeding preference. In the absence of controlled treatment data, preference should be given to drugs normally indicated for bipolar depression including lithium, quetiapine and lamotrigine. Although antidepressants have been studied in combination with mood stabilizers in bipolar depression, these drugs should be avoided due to likelihood of elevated risk of induction of manic symptoms in the postpartum period. In the postpartum period, bipolar PPD is common, can be differentiated from unipolar PPD, and needs to be identified promptly in order to expedite appropriate treatment. Future studies on pharmacotherapy and psychotherapy should focus on the acute and preventative treatment of bipolar PPD. Copyright © 2017 Elsevier B.V. All rights reserved.

  17. Anxiety, stress and perfectionism in bipolar disorder.

    Science.gov (United States)

    Corry, Justine; Green, Melissa; Roberts, Gloria; Frankland, Andrew; Wright, Adam; Lau, Phoebe; Loo, Colleen; Breakspear, Michael; Mitchell, Philip B

    2013-12-01

    Previous reports have highlighted perfectionism and related cognitive styles as a psychological risk factor for stress and anxiety symptoms as well as for the development of bipolar disorder symptoms. The anxiety disorders are highly comorbid with bipolar disorder but the mechanisms that underpin this comorbidity are yet to be determined. Measures of depressive, (hypo)manic, anxiety and stress symptoms and perfectionistic cognitive style were completed by a sample of 142 patients with bipolar disorder. Mediation models were used to explore the hypotheses that anxiety and stress symptoms would mediate relationships between perfectionistic cognitive styles, and bipolar disorder symptoms. Stress and anxiety both significantly mediated the relationship between both self-critical perfectionism and goal attainment values and bipolar depressive symptoms. Goal attainment values were not significantly related to hypomanic symptoms. Stress and anxiety symptoms did not significantly mediate the relationship between self-critical perfectionism and (hypo)manic symptoms. 1. These data are cross-sectional; hence the causality implied in the mediation models can only be inferred. 2. The clinic patients were less likely to present with (hypo)manic symptoms and therefore the reduced variability in the data may have contributed to the null findings for the mediation models with (hypo) manic symptoms. 3. Those patients who were experiencing current (hypo)manic symptoms may have answered the cognitive styles questionnaires differently than when euthymic. These findings highlight a plausible mechanism to understand the relationship between bipolar disorder and the anxiety disorders. Targeting self-critical perfectionism in the psychological treatment of bipolar disorder when there is anxiety comorbidity may result in more parsimonious treatments. © 2013 Published by Elsevier B.V.

  18. Photovoltaic Cells Improvised With Used Bipolar Junction Transistors

    International Nuclear Information System (INIS)

    Akintayo, J. A

    2002-01-01

    The understanding of the underlying principle that the solar cell consists of a p-n junction is exploited to adapt the basic NPN or PNP Bipolar Junction Transistors (BJT) to serve as solar cells. In this mode the in improvised solar cell have employed just the emitter and the base sections with an intact emitter/base junction as the active PN area. The improvised devices tested screened and sorted are wired up in strings, blocks and modules. The photovoltaic modules realised tested as close replica of solar cells with output voltage following insolation level. Further work need be done on the modules to make them generate usable levels of output voltage and current

  19. Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder.

    Science.gov (United States)

    Yatham, Lakshmi N; Kennedy, Sidney H; Parikh, Sagar V; Schaffer, Ayal; Bond, David J; Frey, Benicio N; Sharma, Verinder; Goldstein, Benjamin I; Rej, Soham; Beaulieu, Serge; Alda, Martin; MacQueen, Glenda; Milev, Roumen V; Ravindran, Arun; O'Donovan, Claire; McIntosh, Diane; Lam, Raymond W; Vazquez, Gustavo; Kapczinski, Flavio; McIntyre, Roger S; Kozicky, Jan; Kanba, Shigenobu; Lafer, Beny; Suppes, Trisha; Calabrese, Joseph R; Vieta, Eduard; Malhi, Gin; Post, Robert M; Berk, Michael

    2018-03-01

    considered first-line for those initiating or switching treatment during the maintenance phase. In addition to addressing issues in bipolar I disorder, these guidelines also provide an overview of, and recommendations for, clinical management of bipolar II disorder, as well as advice on specific populations, such as women at various stages of the reproductive cycle, children and adolescents, and older adults. There are also discussions on the impact of specific psychiatric and medical comorbidities such as substance use, anxiety, and metabolic disorders. Finally, an overview of issues related to safety and monitoring is provided. The CANMAT and ISBD groups hope that these guidelines become a valuable tool for practitioners across the globe. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  20. Cognitive impairment in a Brazilian sample of patients with bipolar disorder Prejuízo cognitivo em uma amostra brasileira de pacientes com transtorno do humor bipolar

    Directory of Open Access Journals (Sweden)

    Júlia J Schneider

    2008-09-01

    Full Text Available OBJECTIVE: Persistent neurocognitive deficits have been described in bipolar mood disorder. As far as we are aware, no study have examined whether the cognitive impairment is presented in the same way in a Brazilian sample. METHOD: Cognitive function of 66 patients with bipolar disorder (32 with depressive symptoms and 34 euthymic and 28 healthy subjects was examined using a complete cognitive battery. RESULTS: Patients with bipolar disorder presented a significantly poorer performance in eight of the 12 subtests when compared to healthy subjects. There was no significant difference between the subgroups of patients. These patients showed impairment in both verbal and non-verbal cognitive function. CONCLUSION: Cognitive impairment was found in both groups of patients with bipolar disorder. The findings described here suggest an overall impairment of cognitive function, independent of mood symptoms. This is in line with data showing that cognitive deficits may be a persistent characteristic of bipolar disorder.OBJETIVO: Déficits neurocognitivos persistentes têm sido descritos no transtorno do humor bipolar; entretanto, não há estudos em amostras brasileiras para avaliar se o prejuízo se apresenta da mesma forma. MÉTODO: Foi realizada uma avaliação cognitiva em 66 pacientes bipolares (32 com sintomas depressivos e 34 eutímicos e 28 controles, utilizando-se uma bateria cognitiva completa. RESULTADOS: Em oito dos 12 subtestes avaliados os pacientes apresentaram desempenho significativamente inferior em relação aos controles. Não houve diferença significativa entre os grupos de pacientes. Foram encontrados prejuízos cognitivos tanto na área verbal como na área não verbal da cognição. CONCLUSÃO: Foi observada uma performance inferior em ambos os grupos de pacientes com transtorno bipolar. As dificuldades cognitivas encontradas apontam para um prejuízo global no funcionamento cognitivo, independente da presença de sintomas

  1. Drug Treated Schizophrenia, Schizoaffective and Bipolar Disorder Patients Evaluated by qEEG Absolute Spectral Power and Mean Frequency Analysis.

    Science.gov (United States)

    Wix-Ramos, Richard; Moreno, Xiomara; Capote, Eduardo; González, Gilbert; Uribe, Ezequiel; Eblen-Zajjur, Antonio

    2014-04-01

    Research of electroencephalograph (EEG) power spectrum and mean frequency has shown inconsistent results in patients with schizophrenic, schizoaffective and bipolar disorders during medication when compared to normal subjects thus; the characterization of these parameters is an important task. We applied quantitative EEG (qEEG) to investigate 38 control, 15 schizophrenic, 7 schizoaffective and 11 bipolar disorder subjects which remaine under the administration of psychotropic drugs (except control group). Absolute spectral power (ASP), mean frequency and hemispheric electrical asymmetry were measured by 19 derivation qEEG. Group mean values were compared with non parametrical Mann-Whitney test and spectral EEG maps with z-score method at p Schizoaffective patients received neuroleptic+benzodiazepine (71.4%) and for bipolar disorder patients neuroleptic+antiepileptic (81.8%). Schizophrenic (at all derivations except for Fp1, Fp2, F8 and T6) and schizoaffective (only at C3) show higher values of ASP (+57.7% and +86.1% respectively) compared to control group. ASP of bipolar disorder patients did not show differences against control group. The mean frequency was higher at Fp1 (+14.2%) and Fp2 (+17.4%) in bipolar disorder patients than control group, but no differences were found in frequencies between schizophrenic or schizoaffective patients against the control group. Majority of spectral differences were found at the left hemisphere in schizophrenic and schizoaffective but not in bipolar disorder subjects. The present report contributes to characterize quantitatively the qEEG in drug treated schizophrenic, schizoaffective or bipolar disorder patients.

  2. Modeling of charge transport in ion bipolar junction transistors.

    Science.gov (United States)

    Volkov, Anton V; Tybrandt, Klas; Berggren, Magnus; Zozoulenko, Igor V

    2014-06-17

    Spatiotemporal control of the complex chemical microenvironment is of great importance to many fields within life science. One way to facilitate such control is to construct delivery circuits, comprising arrays of dispensing outlets, for ions and charged biomolecules based on ionic transistors. This allows for addressability of ionic signals, which opens up for spatiotemporally controlled delivery in a highly complex manner. One class of ionic transistors, the ion bipolar junction transistors (IBJTs), is especially attractive for these applications because these transistors are functional at physiological conditions and have been employed to modulate the delivery of neurotransmitters to regulate signaling in neuronal cells. Further, the first integrated complementary ionic circuits were recently developed on the basis of these ionic transistors. However, a detailed understanding of the device physics of these transistors is still lacking and hampers further development of components and circuits. Here, we report on the modeling of IBJTs using Poisson's and Nernst-Planck equations and the finite element method. A two-dimensional model of the device is employed that successfully reproduces the main characteristics of the measurement data. On the basis of the detailed concentration and potential profiles provided by the model, the different modes of operation of the transistor are analyzed as well as the transitions between the different modes. The model correctly predicts the measured threshold voltage, which is explained in terms of membrane potentials. All in all, the results provide the basis for a detailed understanding of IBJT operation. This new knowledge is employed to discuss potential improvements of ion bipolar junction transistors in terms of miniaturization and device parameters.

  3. Role of 108 schizophrenia-associated loci in modulating psychopathological dimensions in schizophrenia and bipolar disorder.

    Science.gov (United States)

    Fabbri, Chiara; Serretti, Alessandro

    2017-10-01

    The Schizophrenia Working Group of the Psychiatric Genomics Consortium (PGC) identified 108 loci associated with schizophrenia, but their role in modulating specific psychopathological dimensions of the disease is unknown. This study investigated which symptom dimensions may be affected by these loci in schizophrenia, and bipolar disorder. Positive, negative and depressive symptoms, suicidal ideation, cognition, violent behaviors, quality of life, and early onset were investigated in schizophrenia and bipolar disorder using the clinical antipsychotic trials of intervention effectiveness (CATIE) and systematic treatment enhancement program for bipolar disorder (STEP-BD) studies. Individual loci were investigated, then genes within 50 Kbp from polymorphisms with p schizophrenia-associated variant (rs75059851) may modulate negative symptoms. Multi-locus models may provide interesting insights about the biological mechanisms that mediate psychopathological dimensions. © 2017 Wiley Periodicals, Inc.

  4. Daily electronic self-monitoring in bipolar disorder using smartphones - the MONARCA I trial

    DEFF Research Database (Denmark)

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

    2015-01-01

    BACKGROUND: The number of studies on electronic self-monitoring in affective disorder and other psychiatric disorders is increasing and indicates high patient acceptance and adherence. Nevertheless, the effect of electronic self-monitoring in patients with bipolar disorder has never been...... investigated in a randomized controlled trial (RCT). The objective of this trial was to investigate in a RCT whether the use of daily electronic self-monitoring using smartphones reduces depressive and manic symptoms in patients with bipolar disorder. METHOD: A total of 78 patients with bipolar disorder...... without mixed symptoms and patients with presence of depressive and manic symptoms showed significantly more depressive symptoms and fewer manic symptoms during the trial period in the intervention group. CONCLUSIONS: These results highlight that electronic self-monitoring, although intuitive...

  5. 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.

  6. Reduced mu suppression and altered motor resonance in euthymic bipolar disorder: Evidence for a dysfunctional mirror system?

    Science.gov (United States)

    Andrews, Sophie C; Enticott, Peter G; Hoy, Kate E; Thomson, Richard H; Fitzgerald, Paul B

    2016-01-01

    Social cognitive difficulties are common in the acute phase of bipolar disorder and, to a lesser extent, during the euthymic stage, and imaging studies of social cognition in euthymic bipolar disorder have implicated mirror system brain regions. This study aimed to use a novel multimodal approach (i.e., including both transcranial magnetic stimulation (TMS) and electroencephalogram (EEG)) to investigate mirror systems in bipolar disorder. Fifteen individuals with euthymic bipolar disorder and 16 healthy controls participated in this study. Single-pulse TMS was applied to the optimal site in the primary motor cortex (M1), which stimulates the muscle of interest during the observation of hand movements (goal-directed or interacting) designed to elicit mirror system activity. Single EEG electrodes (C3, CZ, C4) recorded mu rhythm modulation concurrently. Results revealed that the patient group showed significantly less mu suppression compared to healthy controls. Surprisingly, motor resonance was not significantly different overall between groups; however, bipolar disorder participants showed a pattern of reduced reactivity on some conditions. Although preliminary, this study indicates a potential mirror system deficit in euthymic bipolar disorder, which may contribute to the pathophysiology of the disorder.

  7. Bipolar pulse generator for intense pulsed ion beam accelerator

    International Nuclear Information System (INIS)

    Ito, H.; Igawa, K.; Kitamura, I.; Masugata, K.

    2007-01-01

    A new type of pulsed ion beam accelerator named ''bipolar pulse accelerator'' (BPA) has been proposed in order to improve the purity of intense pulsed ion beams. To confirm the principle of the BPA, we developed a bipolar pulse generator for the bipolar pulse experiment, which consists of a Marx generator and a pulse forming line (PFL) with a rail gap switch on its end. In this article, we report the first experimental result of the bipolar pulse and evaluate the electrical characteristics of the bipolar pulse generator. When the bipolar pulse generator was operated at 70% of the full charge condition of the PFL, the bipolar pulse with the first (-138 kV, 72 ns) and the second pulse (+130 kV, 70 ns) was successfully obtained. The evaluation of the electrical characteristics indicates that the developed generator can produce the bipolar pulse with fast rise time and sharp reversing time

  8. Application of Bipolar Fuzzy Sets in Graph Structures

    Directory of Open Access Journals (Sweden)

    Muhammad Akram

    2016-01-01

    Full Text Available A graph structure is a useful tool in solving the combinatorial problems in different areas of computer science and computational intelligence systems. In this paper, we apply the concept of bipolar fuzzy sets to graph structures. We introduce certain notions, including bipolar fuzzy graph structure (BFGS, strong bipolar fuzzy graph structure, bipolar fuzzy Ni-cycle, bipolar fuzzy Ni-tree, bipolar fuzzy Ni-cut vertex, and bipolar fuzzy Ni-bridge, and illustrate these notions by several examples. We study ϕ-complement, self-complement, strong self-complement, and totally strong self-complement in bipolar fuzzy graph structures, and we investigate some of their interesting properties.

  9. Cardiovascular risk factors in outpatients with bipolar disorder

    NARCIS (Netherlands)

    Klumpers, U.M.H.; Boom, K.; Janssen, F.M.G.; Tulen, J.H.M.; Loonen, Anton J. M.

    2004-01-01

    Background: The mortality due to cardiovascular diseases in bipolar patients is much higher than in the general population. It is unclear whether lithium treatment contributes to this cardiovascular morbidity. Methods: The cardiovascular risk factors in outpatients with bipolar disorder on

  10. 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....

  11. 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...

  12. Smartphone-based objective monitoring in bipolar disorder

    DEFF Research Database (Denmark)

    Faurholt-Jepsen, Maria; Bauer, Michael; Kessing, Lars Vedel

    2018-01-01

    , anxiety, substance abuse, eating disorder, schizophrenia and bipolar disorder have been developed and used. The present paper presents the status and findings from studies using automatically generated objective smartphone data in the monitoring of bipolar disorder, and addresses considerations...

  13. 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

  14. Bipolar disorder: an update | Outhoff | South African Family Practice

    African Journals Online (AJOL)

    Bipolar disorder, characterised by alternating discrete episodes of (hypo)mania and depression, provides unique diagnostic and treatment challenges. Updated diagnostic (DSM-5) and current pharmacological treatment recommendations are briefly reviewed here. Keywords: bipolar disorder; diagnosis; evidence-based ...

  15. “Edgeboost”: A Novel Technique to Extend the Ablation Zone Lateral to a Two-Probe Bipolar Radiofrequency Device

    International Nuclear Information System (INIS)

    Huo, Ya Ruth; Pillai, Krishna; Akhter, Javed; Morris, David L.

    2016-01-01

    BackgroundThe dual-electrode bipolar-RFA (B-RFA) is increasingly used to ablate large liver tumours (3–7 cm). However, the challenging aspect of B-RFA is the placement of the two electrodes around the tumour. Realignment often requires the electrodes to be extracted and reinserted.AimThe aim of this study is to examine “Edgeboost”, a novel technique to increase the lateral ablation dimension without requiring any realignment of the electrodes.Methods and MaterialsAn egg-white model and an ex vivo calf liver model were used compare the standard bipolar mode ablation to Edgeboost-1 (reaching full impedance in bipolar mode initially, then cycling in unipolar mode between left and right probes) and Edgeboost-2 (similar to Edgeboost-1 but not reaching full impedance initially in bipolar mode in order to minimize charring and, thus, to increase total ablation time).ResultsA significantly larger outer lateral ablation dimension to the probe was achieved with Edgeboost-1 compared to the standard method in the liver model (1.14 cm, SD: 0.16 vs. 0.44 cm, SD: 0.24, p = 0.04). Edgeboost-2 achieved the largest outer lateral ablation dimension of 1.75 cm (SD: 0.35). A similar association was seen in the egg model. Edgeboost-2 almost doubled the mass ablated with standard bipolar alone (mass ratio: 1:1.94 in egg white and 1:1.84 in liver).ConclusionThis study demonstrates that the novel “Edgeboost” technique can increase the outer lateral ablation dimension without requiring the two inserted electrodes to be reinserted. This would be beneficial for interventionists who use the dual B-RFA

  16. “Edgeboost”: A Novel Technique to Extend the Ablation Zone Lateral to a Two-Probe Bipolar Radiofrequency Device

    Energy Technology Data Exchange (ETDEWEB)

    Huo, Ya Ruth, E-mail: ruth.huo@gmail.com; Pillai, Krishna, E-mail: panthera6444@yahoo.com.au; Akhter, Javed, E-mail: s8603151@unsw.edu.au; Morris, David L., E-mail: david.morris@unsw.edu.au [St George Hospital, Hepatobiliary and Surgical Oncology Unit, UNSW Department of Surgery (Australia)

    2016-01-15

    BackgroundThe dual-electrode bipolar-RFA (B-RFA) is increasingly used to ablate large liver tumours (3–7 cm). However, the challenging aspect of B-RFA is the placement of the two electrodes around the tumour. Realignment often requires the electrodes to be extracted and reinserted.AimThe aim of this study is to examine “Edgeboost”, a novel technique to increase the lateral ablation dimension without requiring any realignment of the electrodes.Methods and MaterialsAn egg-white model and an ex vivo calf liver model were used compare the standard bipolar mode ablation to Edgeboost-1 (reaching full impedance in bipolar mode initially, then cycling in unipolar mode between left and right probes) and Edgeboost-2 (similar to Edgeboost-1 but not reaching full impedance initially in bipolar mode in order to minimize charring and, thus, to increase total ablation time).ResultsA significantly larger outer lateral ablation dimension to the probe was achieved with Edgeboost-1 compared to the standard method in the liver model (1.14 cm, SD: 0.16 vs. 0.44 cm, SD: 0.24, p = 0.04). Edgeboost-2 achieved the largest outer lateral ablation dimension of 1.75 cm (SD: 0.35). A similar association was seen in the egg model. Edgeboost-2 almost doubled the mass ablated with standard bipolar alone (mass ratio: 1:1.94 in egg white and 1:1.84 in liver).ConclusionThis study demonstrates that the novel “Edgeboost” technique can increase the outer lateral ablation dimension without requiring the two inserted electrodes to be reinserted. This would be beneficial for interventionists who use the dual B-RFA.

  17. Characteristics of patients diagnosed with schizoaffective disorder compared with schizophrenia and bipolar disorder.

    Science.gov (United States)

    Pagel, Tobias; Baldessarini, Ross J; Franklin, Jeremy; Baethge, Christopher

    2013-05-01

    Information on basic demographic and clinical characteristics of schizoaffective disorder is sparse and subject to sampling bias and low diagnostic reliability. In the present study we aimed to: (i) estimate the demographic and clinical descriptors in schizoaffective disorder patients and (ii) compare the findings with those with schizophrenia and bipolar disorder. To minimize sampling bias and low reliability, we systematically reviewed studies that simultaneously compared schizoaffective, schizophrenia, and bipolar disorder patients. We estimated demographic, clinical, and psychometric characteristics based on weighted pooling, and compared disorders by meta-analysis. We also estimated whether schizoaffective disorder is closer to schizophrenia or to bipolar disorder. We identified 50 studies that included 18312 patients. Most characteristics of the 2684 schizoaffective disorder patients fell between those of 4814 diagnosed with bipolar disorder and 10814 with schizophrenia. However, the schizoaffective group had the highest proportion of women (52%), had the youngest age at illness onset (23.3 ± 3.8 years), and had the highest standardized ratings of psychosis and depression. Differences in pooled parameters between schizoaffective versus schizophrenia and versus bipolar disorder subjects were similar. Values for patients with schizoaffective disorders mostly were intermediate between schizophrenia and bipolar disorder. However, the majority of studies showed schizoaffective patients to be more like schizophrenia than bipolar disorder patients in seven out of nine demographic and clinical categories as well as in five out of eight psychometric measures. These results remained similar when we restricted the analyses to studies with psychotic bipolar disorder patients only or to studies using the Diagnostic and Statistical Manual of Mental Disorders (DSM)-IIIR and DSM-IV only. The present study provided estimates of important characteristics of schizoaffective

  18. Bipolar hysteroscopic procedures and placement of Essure microinserts for tubal sterilization: a case control study.

    Science.gov (United States)

    Panel, Pierre; Grosdemouge, Isabelle; Houllier, Marie; Renouvel, Frédérique; Friederich, Ludovic; Le Tohic, Arnaud

    2011-06-01

    To assess the effectiveness and complication rate with Essure microinsert placements for tubal sterilization and the concomitant bipolar intrauterine surgical procedure. Case control study. Department of gynecology and obstetrics of a general hospital in France. 382 women, including 41 undergoing one or several concomitant uterine procedures with Essure placement, and 341 undergoing Essure placement only (controls). Essure placement with or without bipolar hysteroscopic procedure for polyp, myoma, or endometrial ablation. Success rate for microinsert placement and complications at 3 months. Forty-one patients had Essure microinserts placed in combination with a bipolar hysteroscopic procedure: endometrial resection (n=32), fibroma resection (n=4), or polyp ablation (n=5). They were compared with 341 patients who underwent Essure placement only. The success rate for Essure placement was 97.6% in the combination group versus 97.6% in the control group. The complication rate was 4.9% (n=2) in the combination group versus 2.6% (n=9) in the control group. The difference in the success and complication rates was not statistically significant. Performing intrauterine bipolar resection during hysteroscopy for sterilization is possible without reducing the Essure placement success rate and without increasing morbidity. Copyright © 2011 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  19. The effectiveness of lithium prophylaxis in bipolar and unipolar depressions and schizo-affective disorders

    NARCIS (Netherlands)

    Bouman, T.K.; Niemantsverdriet - van Kampen, J.G.; Ormel, J.; Slooff, C.J.

    1986-01-01

    The effectiveness of lithium prophylaxis in bipolar affective disorders is generally supported in the literature. The effects in this group, as well as in unipolar depressions and schizo-affective disorders were studied, using an individual retrospective control method, and the Life Table method.

  20. Nickel hydrogen bipolar battery electrode design

    Science.gov (United States)

    Puglisi, V. J.; Russell, P.; Verrier, D.; Hall, A.

    1985-01-01

    The preferred approach of the NASA development effort in nickel hydrogen battery design utilizes a bipolar plate stacking arrangement to obtain the required voltage-capacity configuration. In a bipolar stack, component designs must take into account not only the typical design considerations such as voltage, capacity and gas management, but also conductivity to the bipolar (i.e., intercell) plate. The nickel and hydrogen electrode development specifically relevant to bipolar cell operation is discussed. Nickel oxide electrodes, having variable type grids and in thicknesses up to .085 inch are being fabricated and characterized to provide a data base. A selection will be made based upon a system level tradeoff. Negative (hydrpogen) electrodes are being screened to select a high performance electrode which can function as a bipolar electrode. Present nickel hydrogen negative electrodes are not capable of conducting current through their cross-section. An electrode was tested which exhibits low charge and discharge polarization voltages and at the same time is conductive. Test data is presented.

  1. Comorbid medical illness in bipolar disorder.

    Science.gov (United States)

    Forty, Liz; Ulanova, Anna; Jones, Lisa; Jones, Ian; Gordon-Smith, Katherine; Fraser, Christine; Farmer, Anne; McGuffin, Peter; Lewis, Cathryn M; Hosang, Georgina M; Rivera, Margarita; Craddock, Nick

    2014-12-01

    Individuals with a mental health disorder appear to be at increased risk of medical illness. To examine rates of medical illnesses in patients with bipolar disorder (n = 1720) and to examine the clinical course of the bipolar illness according to lifetime medical illness burden. Participants recruited within the UK were asked about the lifetime occurrence of 20 medical illnesses, interviewed using the Schedules for Clinical Assessment in Neuropsychiatry (SCAN) and diagnosed according to DSM-IV criteria. We found significantly increased rates of several medical illnesses in our bipolar sample. A high medical illness burden was associated with a history of anxiety disorder, rapid cycling mood episodes, suicide attempts and mood episodes with a typically acute onset. Bipolar disorder is associated with high rates of medical illness. This comorbidity needs to be taken into account by services in order to improve outcomes for patients with bipolar disorder and also in research investigating the aetiology of affective disorder where shared biological pathways may play a role. Royal College of Psychiatrists.

  2. Bipolar magnetic semiconductor in silicene nanoribbons

    International Nuclear Information System (INIS)

    Farghadan, Rouhollah

    2017-01-01

    Highlights: • A new electronic phase for silicene nanoribbon in the presence of electric and magnetic fields. • Bipolar magnetic semiconductor with controllable spin-flip and spin-conserved gaps in silicene. • Robust bipolar magnetic semiconductor features in a rough silicene. • Perfect and reversible spin polarization in silicene nanoribbon junctions. - Abstract: A theoretical study was presented on generation of spin polarization in silicene nanoribbons using the single-band tight-binding approximation and the non-equilibrium Green’s function formalism. We focused on the effect of electric and exchange magnetic fields on the spin-filter capabilities of zigzag-edge silicene nanoribbons in the presence of the intrinsic spin-orbit interaction. The results show that a robust bipolar magnetic semiconductor with controllable spin-flip and spin-conserved gaps can be obtained when exchange magnetic and electric field strengths are both larger than the intrinsic spin-orbit interaction. Therefore, zigzag silicene nanoribbons could act as bipolar and perfect spin filter devices with a large spin-polarized current and a reversible spin polarization in the vicinity of the Fermi energy. We also investigated the effect of edge roughness and found that the bipolar magnetic semiconductor features are robust against edge disorder in silicene nanoribbon junctions. These results may be useful in multifunctional spin devices based on silicene nanoribbons.

  3. [Drug Abuse Comorbidity in Bipolar Disorder].

    Science.gov (United States)

    Ortiz, Óscar Medina

    2012-06-01

    Drug use among patients with bipolar disorder is greater than the one observed in the general population; psychotic episodes are likely to occur after consumption. This has implications in the prevention, etiology, management, and treatment of the disease. Bipolar disorder pathology is likely to have positive response to pharmacological treatment. Therefore, identifying the strategies with better results to be applied in these patients is fundamental for psychiatrists and primary care physicians. Review literature in order to determine the prevalence and characteristics of drug abuse in patients with bipolar disorder and establish the pharmacological strategies that have produced better results. Literature review. A great variety of studies demonstrate the relationship between bipolar disorder and drug use disorder. These patients are hospitalized more frequently, have an earlier onset of the disease, and present a larger number of depressive episodes and suicide attempts which affect the course of the disease. The drug with better results in the treatment of these patients is Divalproate. Satisfactory results have been also obtained with other mood stabilizers such as carbamazepine, lamotrigine, and the antipsychotic aripiprazole. Substance abuse is present in a large number of patients with bipolar disorder. The Divalproate is the drug that has shown better results in the studies. Copyright © 2012 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  4. Family History in Patients with Bipolar Disorder.

    Science.gov (United States)

    Özdemir, Osman; Coşkun, Salih; Aktan Mutlu, Elif; Özdemir, Pınar Güzel; Atli, Abdullah; Yilmaz, Ekrem; Keskin, Sıddık

    2016-09-01

    In this study, we aimed to better understand the genetic transmission of bipolar disorder by examining the family history of patients. Sixty-three patients with bipolar disorder and their families were included. The final sample comprised 156 bipolar patients and their family members. An inclusion criterion was the presence of bipolar disorder history in the family. The diagnosis of other family members was confirmed by analyzing their files, hospital records, and by calling them to the hospital. Sixty-five patients were women (41.6%) and 91 were men (58.3%) (ratio of men/women: 1.40). When analyzing the results in terms of the transition of disease from the mother's or father's side, similar results were obtained: 25 patients were from the mother's side and 25 patients were from the father's side in 63 cases. The results of our study support the fact that a significant relationship exists between the degree of kinship and the heritability of bipolar disorder and, furthermore, that the effect of the maternal and paternal sides is similar on the transmission of genetic susceptibility.

  5. Bipolar magnetic semiconductor in silicene nanoribbons

    Energy Technology Data Exchange (ETDEWEB)

    Farghadan, Rouhollah, E-mail: rfarghadan@kashanu.ac.ir

    2017-08-01

    Highlights: • A new electronic phase for silicene nanoribbon in the presence of electric and magnetic fields. • Bipolar magnetic semiconductor with controllable spin-flip and spin-conserved gaps in silicene. • Robust bipolar magnetic semiconductor features in a rough silicene. • Perfect and reversible spin polarization in silicene nanoribbon junctions. - Abstract: A theoretical study was presented on generation of spin polarization in silicene nanoribbons using the single-band tight-binding approximation and the non-equilibrium Green’s function formalism. We focused on the effect of electric and exchange magnetic fields on the spin-filter capabilities of zigzag-edge silicene nanoribbons in the presence of the intrinsic spin-orbit interaction. The results show that a robust bipolar magnetic semiconductor with controllable spin-flip and spin-conserved gaps can be obtained when exchange magnetic and electric field strengths are both larger than the intrinsic spin-orbit interaction. Therefore, zigzag silicene nanoribbons could act as bipolar and perfect spin filter devices with a large spin-polarized current and a reversible spin polarization in the vicinity of the Fermi energy. We also investigated the effect of edge roughness and found that the bipolar magnetic semiconductor features are robust against edge disorder in silicene nanoribbon junctions. These results may be useful in multifunctional spin devices based on silicene nanoribbons.

  6. The changing face of bipolar disorder: adolescence to adulthood.

    Science.gov (United States)

    Jairam, R; Hanstock, T L; Cahill, C M; Hazell, P L; Walter, G J; Malhi, G S

    2008-02-01

    Over the past decade, there has been greater acceptance of the existence of bipolar disorder (BD) in adolescents. The onset of BD during this period severely affects the acquisition of key developmental skills. Debate around diagnosis, comorbidity and treatment is strong and little is known about the long-term impact BD has on an adolescents as they approach adulthood, from both illness and functional perspectives. A review of psychological and medical databases using the search terms ''adolescent onset'', ''pediatric onset'', ''juvenile onset'', ''bipolar disorder'', ''course'' and ''outcome'' was conducted. Emphasis was placed on the information available from studies, which have described the outcome of adolescent onset BD either prospectively, retrospectively, or both. Twelve studies were identified that focused on the long-term course of adolescent onset BD. Findings on the course and outcomes are conflicting. These studies are from few centres or research groups and have small sample sizes, varied methodologies and relatively brief follow-up durations. There are few studies available on the course and outcome of adolescent onset BD. Although there seems to be less controversy in this age group compared to the prepubertal age group, there remains a need for prospective studies of large systematically ascertained samples.

  7. The Dutch Bipolar Offspring Study: 12-Year Follow-Up

    OpenAIRE

    Mesman, Esther; Nolen, Willem A.; Reichart, Catrien G.; Wals, Marjolein; Hillegers, Manon N. J.

    2013-01-01

    Objective: Offspring of bipolar parents have a genetically increased risk of developing mood disorders. In a longitudinal study, the authors followed a bipolar offspring cohort from adolescence into adulthood to determine the onset, prevalence, and early course of mood disorders and other psychopathology. Method: The Dutch bipolar offspring cohort is a fixed cohort initiated in 1997 (N=140; age range at baseline, 12-21 years). Bipolar offspring were psychiatrically evaluated at baseline and a...

  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. Pilot study of a culturally adapted psychoeducation (CaPE) intervention for bipolar disorder in Pakistan.

    Science.gov (United States)

    Husain, Muhammad Ishrat; Chaudhry, Imran B; Rahman, Raza R; Hamirani, Munir M; Mehmood, Nasir; Haddad, Peter M; Hodsoll, John; Young, Allan H; Naeem, Farooq; Husain, Nusrat

    2017-12-01

    Despite the use of maintenance medication, recurrence rates in bipolar affective disorder (BPAD) are high. To date, there are no clinical trials that have investigated the use of psychological interventions in bipolar disorder in Pakistan. The purpose of the study was to assess the feasibility and acceptability of a culturally adapted bipolar psychoeducation programme (CaPE) in Pakistan. Thirty-four euthymic bipolar I and II outpatients were randomized to either 12 weekly sessions of individual psychoeducation plus Treatment As Usual (Intervention) or Treatment As Usual (TAU) (Control). Outcomes were assessed using the Young Mania Rating Scale (YMRS), Beck Depression Inventory (BDI), EuroQoL (EQ-5D), Bipolar Knowledge and Attitudes and Questionnaire (BKAQ), and a self-reported measure of medication adherence (Morisky Medication Adherence Scale-4 items, MMAS-4). Effect sizes were derived from baseline adjusted standardized regression coefficients. Retention in the study was good, 80% of patients in the TAU follow-up assessment and 100% of patients in the CaPE group attended all 12 sessions. Patient satisfaction was higher in the CaPE group relative to control (ES = 1.41). Further, there were large effect sizes shown for CaPE versus TAU for medication adherence (MMAS-4: ES = 0.81), knowledge and attitudes towards bipolar (BKAQ: ES = 0.68), mania (YMRS: ES = 1.18), depression (BDI: ES = 1.17) and quality of life measures (EQ-5D: ES ⇒ 0.88). Culturally adapted psychoeducation intervention is acceptable and feasible, and can be effective in improving mood symptoms and knowledge and attitudes to BPAD when compared with TAU. Larger scale studies are needed to confirm our findings. Clinicaltrials.gov identifier NCT02210390.

  10. Flexible bipolar nanofibrous membranes for improving gradient microstructure in tendon-to-bone healing.

    Science.gov (United States)

    Li, Xiaoxi; Cheng, Ruoyu; Sun, Zhiyong; Su, Wei; Pan, Guoqing; Zhao, Song; Zhao, Jinzhong; Cui, Wenguo

    2017-10-01

    Enthesis is a specialized tissue interface between the tendon and bone. Enthesis structure is very complex because of gradient changes in its composition and structure. There is currently no strategy to create a suitable environment and to regenerate the gradual-changing enthesis because of the modular complexities between two tissue types. Herein, a dual-layer organic/inorganic flexible bipolar fibrous membrane (BFM) was successfully fabricated by electrospinning to generate biomimetic non-mineralized fibrocartilage and mineralized fibrocartilage in tendon-to-bone integration of enthesis. The growth of the in situ apatite nanoparticle layer was induced on the nano hydroxyapatite-poly-l-lactic acid (nHA-PLLA) fibrous layer in simulated body solution, and the poly-l-lactic acid (PLLA) fibrous layer retained its original properties to induce tendon regeneration. The in vivo results showed that BFM significantly increased the area of glycosaminoglycan staining at the tendon-bone interface and improved collagen organization when compared to the simplex fibrous membrane (SFM) of PLLA. Implanting the bipolar membrane also induced bone formation and fibrillogenesis as assessed by micro-CT and histological analysis. Biomechanical testing showed that the BFM group had a greater ultimate load-to-failure and stiffness than the SFM group at 12weeks after surgery. Therefore, this flexible bipolar nanofibrous membrane improves the healing and regeneration process of the enthesis in rotator cuff repair. In this study, we generated a biomimetic dual-layer organic/inorganic flexible bipolar fibrous membrane by sequential electrospinning and in situ biomineralization, producing integrated bipolar fibrous membranes of PLLA fibrous membrane as the upper layer and nHA-PLLA fibrous membrane as the lower layer to mimic non-mineralized fibrocartilage and mineralized fibrocartilage in tendon-to-bone integration of enthesis. Flexible bipolar nanofibrous membranes could be easily fabricated

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

    Directory of Open Access Journals (Sweden)

    Bakare Muideen O

    2009-06-01

    Full Text Available Abstract Background Adolescent onset bipolar disorder often presents with co-morbid disorders of which psychoactive substance use disorders are notable. Mania symptoms and co-morbid psychoactive substance use disorders prone adolescents with bipolar disorder to impulsivity, impaired judgment, and risk taking behavior which often includes sexual risk behavior. There are dearth of information on pattern of co-morbid disorders and sexual risk behavior in adolescent onset bipolar disorder in Nigeria. This study assessed the prevalence and pattern of co-morbid disorders and determined associated factors of sexual risk behavior among adolescents with bipolar disorder. Methods Socio-demographic information was obtained from the adolescents using socio-demographic questionnaire. Clinical interview, physical examination and laboratory investigations were employed to establish co-morbid disorders in these adolescents during the outpatient follow up visits over a one year period. Results A total of forty six (46 adolescents with bipolar disorder were followed up over a one year period. Twenty two (47.8% of the adolescents had co-morbid disorders with cannabis use disorders, alcohol use disorders, conduct disorder with or without other psychoactive substance use accounting for 23.9%, 8.7%, 13.0% respectively and HIV infection, though a chance finding accounting for 2.2%. Twenty one (45.7% of the adolescents had positive history of sexual risk behavior, which was significantly associated with presence of co-morbid disorders (p = 0.003, level of religion activities in the adolescents (p = 0.000, and marital status of the parents (p = 0.021. Conclusion When planning interventions for children and adolescents with bipolar disorder, special attention may need to be focused on group of adolescents with co-morbid disorders and propensity towards impulsivity and sexual risk behavior. This may help in improving long term outcome in this group of adolescents.

  12. The distinct temperament profiles of bipolar I, bipolar II and unipolar patients.

    Science.gov (United States)

    Akiskal, Hagop S; Kilzieh, Nael; Maser, Jack D; Clayton, Paula J; Schettler, Pamela J; Traci Shea, M; Endicott, Jean; Scheftner, William; Hirschfeld, Robert M A; Keller, Martin B

    2006-05-01

    Despite a plethora of studies, controversies abound on whether the long-term traits of unipolar and bipolar patients could be differentiated by temperament and whether these traits, in turn, could be distinguished from subthreshold affective symptomatology. 98 bipolar I (BP-I), 64 bipolar II (BP-II), and 251 unipolar major depressive disorder (UP-MDD) patients all when recovered from discrete affective episodes) and 617 relatives, spouses or acquaintances without lifetime RDC diagnoses (the comparison group, CG) were administered a battery of 17 self-rated personality scales chosen for theoretical relevance to mood disorders. Subsamples of each of the four groups also received the General Behavior Inventory (GBI). Of the 436 personality items, 103 that significantly distinguished the three patient groups were subjected to principal components analysis, yielding four factors which reflect the temperamental dimensions of "Mood Lability", "Energy-Assertiveness," "Sensitivity-Brooding," and "Social Anxiety." Most BP-I described themselves as near normal in emotional stability and extroversion; BP-II emerged as labile in mood, energetic and assertive, yet sensitive and brooding; MDD were socially timid, sensitive and brooding. Gender and age did not have marked influence on these overall profiles. Within the MDD group, those with baseline dysthymia were the most pathological (i.e., high in neuroticism, insecurity and introversion). Selected GBI items measuring hypomania and biphasic mood changes were endorsed significantly more often by BP-II. Finally, it is relevant to highlight a methodologic finding about the precision these derived temperament factors brought to the UP-BP differentiation. Unlike BP-I who were low on neuroticism, both BP-II and UP scored high on this measure: yet, in the case of BP-II high neuroticism was largely due to mood lability, in UP it reflected subdepressive traits. We used self-rated personality measures, a possible limitation generic to

  13. Plasma Modes

    Science.gov (United States)

    Dubin, D. H. E.

    This chapter explores several aspects of the linear electrostatic normal modes of oscillation for a single-species non-neutral plasma in a Penning trap. Linearized fluid equations of motion are developed, assuming the plasma is cold but collisionless, which allow derivation of the cold plasma dielectric tensor and the electrostatic wave equation. Upper hybrid and magnetized plasma waves in an infinite uniform plasma are described. The effect of the plasma surface in a bounded plasma system is considered, and the properties of surface plasma waves are characterized. The normal modes of a cylindrical plasma column are discussed, and finally, modes of spheroidal plasmas, and finite temperature effects on the modes, are briefly described.

  14. On Bipolar Valued Fuzzy k-Ideals in Hermirings

    International Nuclear Information System (INIS)

    Mahmood, T.; Ejaz, A.

    2015-01-01

    In this paper we discuss some results associated with bipolar valued fuzzy k -ideals of hermirings. We also define bipolar valued fuzzy k-intrinsic product and characterize k-hemiregular hermirings by using their bipolar valued fuzzy k -ideals. (author)

  15. Dose enhancement effects of X ray radiation in bipolar transistors

    International Nuclear Information System (INIS)

    Chen Panxun

    1997-01-01

    The author has presented behaviour degradation and dose enhancement effects of bipolar transistors in X ray irradiation environment. The relative dose enhancement factors of X ray radiation were measured in bipolar transistors by the experiment methods. The mechanism of bipolar device dose enhancement was investigated

  16. 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,…

  17. Comparison of bipolar electrocautry and cold steel dissection methods for tonsillectomy

    International Nuclear Information System (INIS)

    Ali, M.; Rafique, A.; Dastgir, M.; Rashid, M.; Maqbool, M.; Maqbool, S.; Bashir, S.

    2014-01-01

    To compare the efficacy and post-operative morbidity of bipolar electrocautry and cold steel dissection methods for tonsillectomy in pediatric population, in terms of operating time, peri-operative blood loss, post-operative pain and frequency of secondary hemorrhage. Study Design: Randomized controlled trial. Place and Duration: This study was conducted at department of ENT, Combined Military Hospital Kharian and Lahore between Jan 2009 to Jan 2012. Patients and Methods: Total 146 patients between age 6 to 12 years were enrolled in this study but only 102 patients who fulfilled the desired criteria and had regular follow up were placed in two groups. They were divided into two equal groups of 51 each labeled as A and B. Patients in group A were operated for tonsillectomy by bipolar electrocautry while group B underwent tonsillectomy by cold steel dissection method. All patients in both groups were assessed for operating time, peri-operative blood loss, secondary hemorrhage and postoperative pain on Visual Analogue Score. Results: In group A there were 27 males and 24 females while group B had 28 females and 23 males. Mean age of patients was 9.4 (SD +- 2.67) years. Patients in groups A had statistically significant lower operative time and blood loss than group B. While initial post-operative pain was not different in two groups. However late onset pain (pain on 7th and 14th day) and frequency of secondary hemorrhage was significantly higher in group A. Conclusion: Bipolar electrocautry dissection method of tonsillectomy is better than cold steel dissection method in terms of operating time and peri-operative blood loss. Although initial post-operative pain was not much significant in two groups but incidence of late onset pain and secondary hemorrhage is higher in bipolar electrocautry group. (author)

  18. Ion transport Modeling in a Bipolar Membrane

    International Nuclear Information System (INIS)

    Kim, Jung Soo; Park, Kwang Heon; Kim, Kwang Wook

    2010-01-01

    The COL(Carbonate-based Oxidative Leaching) process is an environmentally-friendly technique for collecting only uranium from spent fuel with oxidation leaching/ precipitation of carbonate solution. The bipolar membrane used for the electrolyte circulation of the salt used in the COL process is a special form of ion exchange membrane which combines CEM(cation exchange membrane) and AEM(anion exchange membrane). After arranging positive ion exchange layer toward negative terminal and positive ion exchange layer toward positive terminal, then supply electricity, water molecules are decomposed into protons and hydroxyl ions by a strong electric field in the transition region inside bipolar membrane.1) In this study, a theoretical approach to increase the efficiency of Na + and NO3 - ion collecting device using bipolar membrane was taken and simulating using the COMSOL program was tried. The details of results are also discussed

  19. Neuronal migration, apoptosis and bipolar disorder.

    Science.gov (United States)

    Uribe, Ezequiel; Wix, Richard

    2012-01-01

    Bipolar disorder, like the majority of psychiatric disorders, is considered a neurodevelopment disease of neurodevelopment. There is an increased rate of neuronal birth and death during this development period. In the particular case of the processes that determine neuronal death, it is known that those neurons that establish connections have to be removed from the central nervous system. There is a deficit of GABAergic interneurons in the cerebral cortex in bipolar disorder, accompanied by overexpression of proapoptic genes. There is also an alteration in the expression of molecules that mediate in the migration of these neurons and their inclusion in functional synapsis during the foetal stage. The role of these molecules in the neuronal death pathways by apoptosis will be reviewed here in an attempt to establish biological hypotheses of the genesis of bipolar disorder. Copyright © 2011 SEP y SEPB. Published by Elsevier Espana. All rights reserved.

  20. Concurrent hypokalemic periodic paralysis and bipolar disorder

    Directory of Open Access Journals (Sweden)

    Chia-Lin Lin

    2015-01-01

    Full Text Available Primary periodic paralysis is a rare autosomal dominant disorder of ion-channel dysfunction, manifested by episodic flaccid paresis secondary to abnormal sarcolemma excitability. Membrane destabilization involving Na, K-ATPase has been hypothesized to be a biological etiology of the bipolar disorder (BD and the mechanisms underlying lithium therapy have been linked to it. To date, there has been only one reported case of BD comorbid with periodic paralysis. Herein, we reported another case of concurrent bipolar mania and hypokalemic periodic paralysis (HPP, one special form of periodic paralysis. Consistent with the previous case, our patient responded well to lithium treatment for both bipolar mania and HPP. This might provide some support to the hypothesis that the therapeutic effects of lithium in both BD and HPP could be due to the correction of the underlying common pathophysiology.

  1. Fenomenologia do tempo vivido no transtorno bipolar

    Directory of Open Access Journals (Sweden)

    Virginia Moreira

    Full Text Available Com base na tradição da psicopatologia fenomenológica, este artigo se propõe a contribuir para a compreensão do mundo vivido do paciente bipolar, marcado por uma forte alteração do tempo vivido. Realizamos uma descrição deste tempo vivido significado de forma diferente nas oscilações de humor chamadas de fase maníaca e fase melancólica. Pensado a partir da temporalidade, na fase melancólica, o bipolar parece parar no tempo, não se lança em um devir. Na fase maníaca, o sujeito vive demasiadamente um agora como se tivesse explodido sua biografia. Concluímos que estas fases, ou dois pólos opostos no funcionamento temporal patológico do sofrimento bipolar, constituem fundamentalmente um mesmo mundo vivido.

  2. Genetic structure of personality factors and bipolar disorder in families segregating bipolar disorder.

    Science.gov (United States)

    Hare, Elizabeth; Contreras, Javier; Raventos, Henriette; Flores, Deborah; Jerez, Alvaro; Nicolini, Humberto; Ontiveros, Alfonso; Almasy, Laura; Escamilla, Michael

    2012-02-01

    Bipolar disorder (BPD) has been associated with variations in personality dimensions, but the nature of this relationship has been unclear. In this study, the heritabilities of BPD and the Big Five personality factors and the genetic correlations between BPD and personality factors are reported. The participants in this study were 1073 individuals from 172 families of Mexican or Central American ancestry. Heritabilities and genetic correlations were calculated under a polygenic model using the maximum-likelihood method of obtaining variance components implemented in the SOLAR software package. Heritabilities of 0.49, 0.43, and 0.43 were found for the narrowest phenotype (schizoaffective bipolar and bipolar I), the intermediate phenotype (schizoaffective bipolar, bipolar I, and bipolar II), and the broadest phenotype (schizoaffective bipolar, bipolar I, bipolar II, and recurrent depression), respectively. For the Big Five personality factors, heritabilities were 0.25 for agreeableness, 0.24 for conscientiousness, 0.24 for extraversion, 0.23 for neuroticism, and 0.32 for openness to experience. For the narrowest phenotype, a significant negative correlation (-0.32) with extraversion was found. For the broadest phenotype, negative correlations were found for agreeableness (-0.35), conscientiousness (-0.39), and extraversion (-0.44). A positive correlation (0.37) was found with neuroticism. It is not possible to determine whether aspects of personality are factors in the development of bipolar disorder or vice versa. The short form of the NEO does not provide the ability to examine in detail which facets of extraversion are most closely related to bipolar disorder or to compare our results with studies that have used the long version of the scale. This study establishes a partial genetic basis for the Big Five personality factors in this set of families, while the environmental variances demonstrate that non-genetic factors are also important in their influence on

  3. Nanosecond bipolar pulse generators for bioelectrics.

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    Xiao, Shu; Zhou, Chunrong; Yang, Enbo; Rajulapati, Sambasiva R

    2018-04-26

    Biological effects caused by a nanosecond pulse, such as cell membrane permeabilization, peripheral nerve excitation and cell blebbing, can be reduced or cancelled by applying another pulse of reversed polarity. Depending on the degree of cancellation, the pulse interval of these two pulses can be as long as dozens of microseconds. The cancellation effect diminishes as the pulse duration increases. To study the cancellation effect and potentially utilize it in electrotherapy, nanosecond bipolar pulse generators must be made available. An overview of the generators is given in this paper. A pulse forming line (PFL) that is matched at one end and shorted at the other end allows a bipolar pulse to be produced, but no delay can be inserted between the phases. Another generator employs a combination of a resistor, an inductor and a capacitor to form an RLC resonant circuit so that a bipolar pulse with a decaying magnitude can be generated. A third generator is a converter, which converts an existing unipolar pulse to a bipolar pulse. This is done by inserting an inductor in a transmission line. The first phase of the bipolar pulse is provided by the unipolar pulse's rising phase. The second phase is formed during the fall time of the unipolar pulse, when the inductor, which was previously charged during the flat part of the unipolar pulse, discharges its current to the load. The fourth type of generator uses multiple MOSFET switches stacked to turn on a pre-charged, bipolar RC network. This approach is the most flexible in that it can generate multiphasic pulses that have different amplitudes, delays, and durations. However, it may not be suitable for producing short nanosecond pulses (<100 ns), whereas the PFL approach and the RLC approach with gas switches are used for this range. Thus, each generator has its own advantages and applicable range. Copyright © 2018 Elsevier B.V. All rights reserved.

  4. Oxcarbazepine for acute affective episodes in bipolar disorder.

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    Vasudev, Akshya; Macritchie, Karine; Vasudev, Kamini; Watson, Stuart; Geddes, John; Young, Allan H

    2011-12-07

    groups, SMD=0.18, 95% CI -0.24 to 0.59, 2 studies, n=90, P=0.40). No primary or secondary efficacy outcome measures were found comparing oxcarbazepine with lithium monotherapy.As an adjunctive treatment to lithium, oxcarbazepine reduced depression rating scale scores more than carbamazepine in a group of manic participants on the Montgomery-Åsberg Depression Rating Scale (MADRS) (SMD=- 1.12, 95% CI -1.71 to -0.53, 1 study, n=52, P=0.0002) and on the Hamilton Depression Rating Scale (HDRS) (SMD=- 0.77, 95% CI -1.35 to -0.20, 1 study, n=52, P=0.008).There was a higher incidence of adverse effects, particularly neuropsychiatric, in participants randomised to oxcarbazepine compared to those on placebo (1 study, n=115, 17% to 39% of participants on oxcarbazepine had at least one such event compared to 7% to 10% on placebo).There was no difference in adverse events rates between oxcarbazepine and other mood stabilisers or haloperidol. Currently, there are insufficient trials of adequate methodological quality on oxcarbazepine in the acute treatment of bipolar disorder to inform us on its efficacy and acceptability. Studies predominantly examine the treatment of mania: there are data from subgroup analysis on mixed affective, hypomania and rapid-cycling states.From the few studies included in this review, oxcarbazepine did not differ in efficacy compared to placebo in children and adolescents. It did not differ from other active agents in adults. It may have a poorer tolerability profile compared to placebo. No data were found on outcomes relevant to patients and clinicians, such as length of hospital admission.  There is a need for adequately powered randomised controlled trials of good methodological quality to inform us of the therapeutic potential of oxcarbazepine across the spectrum of acute episodes in bipolar disorder.

  5. Differential impairment of social cognition factors in bipolar disorder with and without psychotic features and schizophrenia.

    Science.gov (United States)

    Thaler, Nicholas S; Allen, Daniel N; Sutton, Griffin P; Vertinski, Mary; Ringdahl, Erik N

    2013-12-01

    While it is well-established that patients with schizophrenia and bipolar disorder exhibit deficits in social cognition, few studies have separately examined bipolar disorder with and without psychotic features. The current study addressed this gap by comparing patients with bipolar disorder with (BD+) and without (BD-) psychotic features, patients with schizophrenia (SZ), and healthy controls (NC) across social cognitive measures. Principal factor analysis on five social cognition tasks extracted a two-factor structure comprised of social/emotional processing and theory of mind. Factor scores were compared among the four groups. Results identified differential patterns of impairment between the BD+ and BD- group on the social/emotional processing factor while all clinical groups performed poorer than controls on the theory of mind factor. This provides evidence that a history of psychosis should be taken into account while evaluating social cognition in patients with bipolar disorder and also raises hypotheses about the relationship between social cognition and psychosis. Copyright © 2013 Elsevier Ltd. All rights reserved.

  6. Pituitary gland volume in adolescent and young adult bipolar and unipolar depression.

    Science.gov (United States)

    MacMaster, Frank P; Leslie, Ronald; Rosenberg, David R; Kusumakar, Vivek

    2008-02-01

    Few studies have examined pituitary gland size in mood disorders, particularly in adolescents. We hypothesized increase in the pituitary gland size in early-onset mood disorders. Thirty subjects between the ages of 13 and 20 years participated in the study. Three groups (control, bipolar I depression and unipolar depression) of 10 subjects each (4 male, 6 female) underwent volumetric magnetic resonance imaging at 1.5 T. Analysis of covariance (covarying for age, sex and intracranial volume) revealed a significant difference in pituitary gland volume amongst the groups [F(2,24) = 7.092, p = 0.014]. Post hoc analysis revealed that controls had a significantly smaller pituitary gland volume than both bipolar patients (p = 0.019) and depressed patients (p = 0.049). Bipolar and depressed subjects did not differ significantly from each other with regard to pituitary gland volume (p = 0.653). Control females had larger pituitary glands than control males [F(1,8) = 10.523, p = 0.012], but no sex differences were noted in the mood disorder groups. Pituitary glands are enlarged in adolescents with mood disorders compared to controls. Healthy young females have larger pituitary glands than males, but such a difference is not evident in individuals with unipolar depression or bipolar disorder. These findings provide new evidence of abnormalities of the pituitary in early onset mood disorders, and are consistent with neuroendocrine dysfunction in early stages of such illnesses.

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

    NARCIS (Netherlands)

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

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

  8. Alcoholism and anxiety in bipolar illness : Differential lifetime anxiety comorbidity in bipolar I women with and without alcoholism

    NARCIS (Netherlands)

    Levander, Eric; Frye, Mark A.; McElroy, Susan; Suppes, Trisha; Grunze, Heinz; Nolen, Willem A.; Kupka, Ralph; Keck, Paul E.; Leverich, Gabriele S.; Altshuler, Lori L.; Hwang, Sun; Mintz, Jim; Post, Robert M.

    Introduction: This study was undertaken to evaluate the prevalence rate of anxiety comorbidity in bipolar subjects with and without alcohol use disorders (AUD). Methods: Bipolar men and women who entered the Stanley Foundation Bipolar Network (SFBN) underwent a Structured Clinical Interview for

  9. Sensitivity and specificity of the mood disorder questionnaire and the bipolar spectrum diagnostic scale in Argentinean patients with mood disorders.

    Science.gov (United States)

    Zaratiegui, Rodolfo M; Vázquez, Gustavo H; Lorenzo, Laura S; Marinelli, Marcia; Aguayo, Silvia; Strejilevich, Sergio A; Padilla, Eduardo; Goldchluk, Aníbal; Herbst, Luis; Vilapriño, Juan J; Bonetto, Gerardo García; Cetkovich-Bakmas, Marcelo G; Abraham, Estela; Kahn, Clara; Whitham, Elizabeth A; Holtzman, Niki S; Ghaemi, Nassir

    2011-08-01

    To assess the sensitivity and specificity of two self-report instruments for detection of bipolarity in a sample of Argentinean patients. Spanish versions of the MDQ and the BSDS were administered over four months at 11 sites in Argentina. Diagnoses were made using DSM-IV criteria and the MINI. The study sample consisted of patients diagnosed with Bipolar Disorder (BD) Types I, II, or NOS. BDNOS diagnoses were made using extended guidelines for bipolar spectrum symptoms. Unipolar patients were used as a control group. Of 493 patients screened, 354 completed evaluation by MDQ and MINI, and 363 by BSDS and MINI. Specificity of MDQ was 0.97 and BSDS was 0.81. MDQ sensitivity was 0.70 for bipolar type I (BD-I), 0.52 for bipolar II (BD-II) and 0.31 for bipolar not otherwise specified (BDNOS). BSDS sensitivities were 0.75, 0.70 and 0.51 respectively. This study was performed in specialized outpatient settings and thus its results are not necessarily representative for other clinical settings. There was not a systematic evaluation of comorbid psychiatric disease or test-retest reliability. The local versions of the MDQ and the BSDS showed a sensitivity and specificity comparable to previous research. Our results indicate that in this sample, MDQ was more specific for BD and BSDS was more sensitive to detect BD-II and NOS. Since BD-I is more readily recognized than bipolar spectrum disorders, enhanced sensitivity of BSDS for soft bipolarity may be an advantage. Copyright © 2011 Elsevier B.V. All rights reserved.

  10. Differential melatonin alterations in cerebrospinal fluid and serum of patients with major depressive disorder and bipolar disorder.

    Science.gov (United States)

    Bumb, J M; Enning, F; Mueller, J K; van der List, Till; Rohleder, C; Findeisen, P; Noelte, I; Schwarz, E; Leweke, F M

    2016-07-01

    Melatonin, which plays an important role for regulation of circadian rhythms and the sleep/wake cycle has been linked to the pathophysiology of major depressive and bipolar disorder. Here we investigated melatonin levels in cerebrospinal fluid (CSF) and serum of depression and bipolar patients to elucidate potential differences and commonalities in melatonin alterations across the two disorders. Using enzyme-linked immunosorbent assays, CSF and serum melatonin levels were measured in 108 subjects (27 healthy volunteers, 44 depressed and 37 bipolar patients). Covariate adjusted multiple regression analysis was used to investigate group differences in melatonin levels. In CSF, melatonin levels were significantly decreased in bipolar (Pdepressive disorder. In serum, we observed a significant melatonin decrease in major depressive (P=0.003), but not bipolar disorder. No associations were found between serum and CSF melatonin levels or between melatonin and measures of symptom severity or sleep disruptions in either condition. This study suggests the presence of differential, body fluid specific alterations of melatonin levels in bipolar and major depressive disorder. Further, longitudinal studies are required to explore the disease phase dependency of melatonin alterations and to mechanistically explore the causes and consequences of site-specific alterations. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. N-acetyl cysteine for depressive symptoms in bipolar disorder--a double-blind randomized placebo-controlled trial.

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    Berk, Michael; Copolov, David L; Dean, Olivia; Lu, Kristy; Jeavons, Sue; Schapkaitz, Ian; Anderson-Hunt, Murray; Bush, Ashley I

    2008-09-15

    Treatment-resistant subthreshold depression is a major problem in bipolar disorder. Both depression and bipolar disorder are complicated by glutathione depletion. We hypothesized that treatment with N-acetyl cysteine (NAC), a safe, orally bioavailable precursor of glutathione, may improve the depressive component of bipolar disorder. A randomized, double-blind, multicenter, placebo-controlled study of individuals (n = 75) with bipolar disorder in the maintenance phase treated with NAC (1 g twice daily) adjunctive to usual medication over 24 weeks, with a 4-week washout. The two primary outcomes were the Montgomery Asberg Depression Rating Scale (MADRS) and time to a mood episode. Secondary outcomes included the Bipolar Depression Rating Scale and 11 other ratings of clinical status, quality of life, and functioning. NAC treatment caused a significant improvement on the MADRS (least squares mean difference [95% confidence interval]: -8.05 [-13.16, -2.95], p = .002) and most secondary scales at end point. Benefit was evident by 8 weeks on the Global Assessment of Functioning Scale and Social and Occupational Functioning Assessment Scale and at 20 weeks on the MADRS. Improvements were lost after washout. There was no effect of NAC on time to a mood episode (log-rank test: p = .968) and no significant between-group differences in adverse events. Effect sizes at end point were medium to high for improvements in MADRS and 9 of the 12 secondary readouts. NAC appears a safe and effective augmentation strategy for depressive symptoms in bipolar disorder.

  12. 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.

  13. The Risk of Treatment-Emergent Mania With Methylphenidate in Bipolar Disorder.

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    Viktorin, Alexander; Rydén, Eleonore; Thase, Michael E; Chang, Zheng; Lundholm, Cecilia; D'Onofrio, Brian M; Almqvist, Catarina; Magnusson, Patrik K E; Lichtenstein, Paul; Larsson, Henrik; Landén, Mikael

    2017-04-01

    The authors sought to determine the risk of treatment-emergent mania associated with methylphenidate, used in monotherapy or with a concomitant mood-stabilizing medication, in patients with bipolar disorder. Using linked Swedish national registries, the authors identified 2,307 adults with bipolar disorder who initiated therapy with methylphenidate between 2006 and 2014. The cohort was divided into two groups: those with and those without concomitant mood-stabilizing treatment. To adjust for individual-specific confounders, including disorder severity, genetic makeup, and early environmental factors, Cox regression analyses were used, conditioning on individual to compare the rate of mania (defined as hospitalization for mania or a new dispensation of stabilizing medication) 0-3 months and 3-6 months after medication start following nontreated periods. Patients on methylphenidate monotherapy displayed an increased rate of manic episodes within 3 months of medication initiation (hazard ratio=6.7, 95% CI=2.0-22.4), with similar results for the subsequent 3 months. By contrast, for patients taking mood stabilizers, the risk of mania was lower after starting methylphenidate (hazard ratio=0.6, 95% CI=0.4-0.9). Comparable results were observed when only hospitalizations for mania were counted. No evidence was found for a positive association between methylphenidate and treatment-emergent mania among patients with bipolar disorder who were concomitantly receiving a mood-stabilizing medication. This is clinically important given that up to 20% of people with bipolar disorder suffer from comorbid ADHD. Given the markedly increased hazard ratio of mania following methylphenidate initiation in bipolar patients not taking mood stabilizers, careful assessment to rule out bipolar disorder is indicated before initiating monotherapy with psychostimulants.

  14. Childhood maltreatment and the medical morbidity in bipolar disorder: a case-control study.

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    Hosang, Georgina M; Fisher, Helen L; Uher, Rudolf; Cohen-Woods, Sarah; Maughan, Barbara; McGuffin, Peter; Farmer, Anne E

    2017-09-07

    Childhood maltreatment (abuse and neglect) can have long-term deleterious consequences, including increased risk for medical and psychiatric illnesses, such as bipolar disorder in adulthood. Emerging evidence suggests that a history of childhood maltreatment is linked to the comorbidity between medical illnesses and mood disorders. However, existing studies on bipolar disorder have not yet explored the specific influence of child neglect and have not included comparisons with individuals without mood disorders (controls). This study aimed to extend the existing literature by examining the differential influence of child abuse and child neglect on medical morbidity in a sample of bipolar cases and controls. The study included 72 participants with bipolar disorder and 354 psychiatrically healthy controls (average age of both groups was 48 years), who completed the Childhood Trauma Questionnaire, and were interviewed regarding various medical disorders. A history of any type of childhood maltreatment was significantly associated with a diagnosis of any medical illness (adjusted OR = 6.28, 95% confidence intervals 1.70-23.12, p = 0.006) and an increased number of medical illnesses (adjusted OR = 3.77, 95% confidence intervals 1.34-10.57, p = 0.012) among adults with bipolar disorder. Exposure to child abuse was more strongly associated with medical disorders than child neglect. No association between childhood maltreatment and medical morbidity was detected among controls. To summarise, individuals with bipolar disorder who reported experiencing maltreatment during childhood, especially abuse, were at increased risk of suffering from medical illnesses and warrant greater clinical attention.

  15. Similar familial underpinnings for full and subsyndromal pediatric bipolar disorder: A familial risk analysis.

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    Wozniak, Janet; Uchida, Mai; Faraone, Stephen V; Fitzgerald, Maura; Vaudreuil, Carrie; Carrellas, Nicholas; Davis, Jacqueline; Wolenski, Rebecca; Biederman, Joseph

    2017-05-01

    To examine the validity of subthreshold pediatric bipolar I disorder (BP-I), we compared the familial risk for BP-I in the child probands who had either full BP-I, subthreshold BP-I, ADHD, or were controls that neither had ADHD nor bipolar disorder. BP-I probands were youth aged 6-17 years meeting criteria for BP-I, full (N=239) or subthreshold (N=43), and also included were their first-degree relatives (N=687 and N=120, respectively). Comparators were youth with ADHD (N=162), controls without ADHD or bipolar disorder (N=136), and their first-degree relatives (N=511 and N=411, respectively). We randomly selected 162 non-bipolar ADHD probands and 136 non-bipolar, non-ADHD control probands of similar age and sex distribution to the BP-I probands from our case-control ADHD family studies. Psychiatric assessments were made by trained psychometricians using the Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children Epidemiological Version (KSADS-E) and Structured Clinical Interview for DSM-IV (SCID) structured diagnostic interviews. We analyzed rates of bipolar disorder using multinomial logistic regression. Rates of full BP-I significantly differed between the four groups (χ 2 3 =32.72, Pdisorder compared to relatives of control probands. Our results showed that youth with subthreshold BP-I had similarly elevated risk for BP-I and major depressive disorder in first-degree relatives as youth with full BP-I. These findings support the diagnostic continuity between subsyndromal and fully syndromatic states of pediatric BP-I disorder. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  16. Risk of bipolar disorder in patients with COPD: a population-based cohort study.

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    Tsai, Pei-Jung; Liao, Yin-To; Lee, Charles Tzu-Chi; Hsu, Chung-Yao; Hsieh, Ming-Hong; Tsai, Chia-Jui; Hsieh, Ming-Han; Chen, Vincent Chin-Hung

    2016-01-01

    Few studies have investigated the relationship between chronic obstructive pulmonary disease (COPD) and bipolar outcomes in the world. We sought to investigate the association between COPD and risk of bipolar disorder in a large national sample. The insured aged 15 years or more with a new primary diagnosis of COPD (ICD-9: 491, 492, 494 and 496) between 2000 and 2007 were identified from Taiwan's National Health Insurance Research Database. We included individuals with an inpatient diagnosis of COPD and/or at least 1 year of two diagnoses of COPD in outpatient services. These 35,558 cases were compared to 35,558 sex-, age-, residence- and insurance premium-matched controls. We followed both groups until the end of 2008 for incidence of bipolar disorder, defined as ICD-9 codes 296.0-296.16, 296.4-296.81 and 296.89. Competing risk-adjusted Cox regression analyses were applied with adjusting for sex, age, residence, insurance premium, prednisone use, Charlson comorbidity index, diabetes, hypertension, hyperlipidemia, cardiovascular diseases, hospital admission days, outpatients' visits and mortality. Of the total 71,116 subjects, 202 were newly diagnosed with bipolar disorder during the study period. The mean follow-up time was 6.0 (SD=2.2) years. COPD, younger age, lower economic status, lower dose of prednisone use, higher hospital admission days and higher outpatient visits were independent predictors of bipolar disorder. COPD was associated with increased risk of bipolar disorder independent of a number of potential confounding factors in this study. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. Neural correlates of emotional distractibility in bipolar disorder patients, unaffected relatives, and individuals with hypomanic personality.

    Science.gov (United States)

    Kanske, Philipp; Heissler, Janine; Schönfelder, Sandra; Forneck, Johanna; Wessa, Michèle

    2013-12-01

    Neuropsychological deficits and emotion dysregulation are present in symptomatic and euthymic patients with bipolar disorder. However, there is little evidence on how cognitive functioning is influenced by emotion, what the neural correlates of emotional distraction effects are, and whether such deficits are a consequence or a precursor of the disorder. The authors used functional MRI (fMRI) to investigate these questions. fMRI was used first to localize the neural network specific to a certain cognitive task (mental arithmetic) and then to test the effect of emotional distractors on this network. Euthymic patients with bipolar I disorder (N=22), two populations at high risk for developing the disorder (unaffected first-degree relatives of individuals with bipolar disorder [N=17]), and healthy participants with hypomanic personality traits [N=22]) were tested, along with three age-, gender-, and education-matched healthy comparison groups (N=22, N=17, N=24, respectively). There were no differences in performance or activation in the task network for mental arithmetic. However, while all participants exhibited slower responses when emotional distractors were present, this response slowing was greatly enlarged in bipolar patients. Similarly, task-related activation was generally increased under emotional distraction; however, bipolar patients exhibited a further increase in right parietal activation that correlated positively with the response slowing effect. The results suggest that emotional dysregulation leads to exacerbated neuropsychological deficits in bipolar patients, as evidenced by behavioral slowing and task-related hyperactivation. The lack of such a deficit in high-risk populations suggests that it occurs only after disease onset, rather than representing a vulnerability marker.

  18. Charge separation in excitonic and bipolar solar cells - A detailed balance approach

    International Nuclear Information System (INIS)

    Kirchartz, Thomas; Rau, Uwe

    2008-01-01

    A generalized solar cell model for excitonic and classical, bipolar solar cells is developed that describes the combined transport and interaction of electrons, holes and excitons. Both, conventional inorganic solar cells as well as organic solar cells, where excitons play a dominant role for energy transport, turn out to be special cases of this model. Due to the inclusion of photon recycling effects, the approach is compatible with the principle of detailed balance and the Shockley-Queisser limit. We show how varying the interaction between excitons and charge carriers as well as varying the respective mobilities of the different species changes the operation mode of the solar cell path between excitonic and bipolar

  19. TO DETERMINE THE PERSONALITY TRAITS, CLINICAL CHARACTERISTICS AND COGNITIVE FUNCTIONS IN BIPOLAR DISORDER PATIENTS WITH COMORBID ALCOHOL USE DISORDERS

    Directory of Open Access Journals (Sweden)

    Ahalya Thinaharan

    2016-12-01

    Full Text Available BACKGROUND Comorbidity of bipolar disorder and substance use disorder is common. It is difficult to treat bipolar disorder patients with comorbid alcohol use disorder since the disease course is more severe and they have greater difficulties in cognitive functions than those without alcohol use. Whether alcohol negatively affects specific cognitive functions or the deficits are more diffuse in nature is unclear. Alcoholic bipolar patients present with high scores in openness to experience and neuroticism personality traits. Personality to an extent mediates the co-occurrence of substance use in bipolar disorder. Thus, identifying these personality traits in bipolar or substance use disorder patients, will help us to prevent the co-occurrence of the second disorder. The aim of the study is to evaluate the clinical characteristics, personality traits and cognitive functions of patients with bipolar and comorbid alcohol use disorders. MATERIALS AND METHODS A sample of 100 patients, 50 with bipolar and alcohol use disorder (cases and 50 with bipolar disorder (controls attending tertiary care hospital outpatient department at Chennai was selected. Alcohol status was assessed using AUDIT (alcohol use disorder identification test and SADQ (severity of alcohol dependence questionnaire. Personality was assessed using NEO-five factor inventory. Cognition was assessed using frontal lobe assessment battery, Stroop test, DSST (digit symbol substitution test and verbal N back test. RESULTS The cases group had more number of hospitalisations and mixed episodes than control group. They also performed poorer on frontal lobe assessment battery, Stroop test and digit symbol substitution test. Duration of alcohol use was associated positively with total number of hospitalisations and number of episodes. The cases group scored significantly higher on the personality traits of neuroticism and openness to experience. CONCLUSION The study confirmed the higher

  20. Tacoma mode

    International Nuclear Information System (INIS)

    Courant, E.D.; Ruth, R.D.; Wang, J.M.

    1979-01-01

    The name Tacoma refers to the Tacoma Narrows Bridge which collapsed on November 8, 1940 due to massive oscillations caused by high winds. One of the destructive modes was a torsion mode which was excited by transverse wind, a dipole force, and continued until the bridge collapsed. The name is used to refer to a coherent mode of oscillation of a spectrum of oscillators in which the amplitude vs frequency graph contains one node, where the node occurs near the driving frequency and a ω is not symmetric about zero. When this result is applied to vertical instabilities in coasting beams, it implies the existence of a coherent skew quadrupole moment, Q/sub xy/, whenever a coherent dipole oscillation exists

  1. Tacoma mode

    International Nuclear Information System (INIS)

    Courant, E.D.; Ruth, R.D.; Wang, J.M.

    1979-01-01

    The name Tacoma refers to the Tacoma Narrows Bridge which collapsed on November 8, 1940 due to massive oscillations caused by high winds. One of the destructive modes was a torsion mode which was excited by transverse wind, a dipole force, and continued until the bridge collapsed. The name is used to refer to a coherent mode of oscillation of a spectrum of oscillators in which the amplitude vs frequency graph contains one node, where the node occurs near the driving frequency and a(ω) is not symmetric about zero. When this result is applied to vertical instabilities in coasting beams, it implies the existence of a coherent skew quadrupole moment, whenever a coherent dipole oscillation exists

  2. Prediction of transition from common adolescent bipolar experiences to bipolar disorder: 10-year study.

    Science.gov (United States)

    Tijssen, Marijn J A; van Os, Jim; Wittchen, Hans-Ulrich; Lieb, Roselind; Beesdo, Katja; Mengelers, Ron; Wichers, Marieke

    2010-02-01

    Although (hypo)manic symptoms are common in adolescence, transition to adult bipolar disorder is infrequent. To examine whether the risk of transition to bipolar disorder is conditional on the extent of persistence of subthreshold affective phenotypes. In a 10-year prospective community cohort study of 3021 adolescents and young adults, the association between persistence of affective symptoms over 3 years and the 10-year clinical outcomes of incident DSM-IV (hypo)manic episodes and incident use of mental healthcare was assessed. Transition to clinical outcome was associated with persistence of symptoms in a dose-dependent manner. Around 30-40% of clinical outcomes could be traced to prior persistence of affective symptoms. In a substantial proportion of individuals, onset of clinical bipolar disorder may be seen as the poor outcome of a developmentally common and usually transitory non-clinical bipolar phenotype.

  3. Trajectories of suicidal ideation over 6 months among 482 outpatients with bipolar disorder.

    Science.gov (United States)

    Köhler-Forsberg, Ole; Madsen, Trine; Behrendt-Møller, Ida; Sylvia, Louisa; Bowden, Charles L; Gao, Keming; Bobo, William V; Trivedi, Madhukar H; Calabrese, Joseph R; Thase, Michael; Shelton, Richard C; McInnis, Melvin; Tohen, Mauricio; Ketter, Terence A; Friedman, Edward S; Deckersbach, Thilo; McElroy, Susan L; Reilly-Harrington, Noreen A; Nierenberg, Andrew A

    2017-12-01

    Suicidal ideation occurs frequently among individuals with bipolar disorder; however, its course and persistence over time remains unclear. We aimed to investigate 6-months trajectories of suicidal ideation among adults with bipolar disorder. The Bipolar CHOICE study randomized 482 outpatients with bipolar disorder to 6 months of lithium- or quetiapine-based treatment including other psychotropic medications as clinically indicated. Participants were asked at 9 visits about suicidal ideation using the Concise Health Risk Tracking scale. We performed latent Growth Mixture Modelling analysis to empirically identify trajectories of suicidal ideation. Multinomial logistic regression analyses were applied to estimate associations between trajectories and potential predictors. We identified four distinct trajectories. The Moderate-Stable group represented 11.1% and was characterized by constant suicidal ideation. The Moderate-Unstable group included 2.9% with persistent thoughts about suicide with a more fluctuating course. The third (Persistent-low, 20.8%) and fourth group (Persistent-very-low, 65.1%) were characterized by low levels of suicidal ideation. Higher depression scores and previous suicide attempts (non-significant trend) predicted membership of the Moderate-Stable group, whereas randomized treatment did not. No specific treatments against suicidal ideation were included and suicidal thoughts may persist for several years. More than one in ten adult outpatients with bipolar disorder had moderately increased suicidal ideation throughout 6 months of pharmacotherapy. The identified predictors may help clinicians to identify those with additional need for treatment against suicidal thoughts and future studies need to investigate whether targeted treatment (pharmacological and non-pharmacological) may improve the course of persistent suicidal ideation. Copyright © 2017 Elsevier B.V. All rights reserved.

  4. Bipolar mood state reflected in cortico-amygdala resting state connectivity: A cohort and longitudinal study.

    Science.gov (United States)

    Brady, Roscoe O; Margolis, Allison; Masters, Grace A; Keshavan, Matcheri; Öngür, Dost

    2017-08-01

    Using resting-state functional magnetic resonance imaging (rsfMRI), we previously compared cohorts of bipolar I subjects in a manic state to those in a euthymic state to identify mood state-specific patterns of cortico-amygdala connectivity. Our results suggested that mania is reflected in the disruption of emotion regulation circuits. We sought to replicate this finding in a group of subjects with bipolar disorder imaged longitudinally across states of mania and euthymia METHODS: We divided our subjects into three groups: 26 subjects imaged in a manic state, 21 subjects imaged in a euthymic state, and 10 subjects imaged longitudinally across both mood states. We measured differences in amygdala connectivity between the mania and euthymia cohorts. We then used these regions of altered connectivity to examine connectivity in the longitudinal bipolar group using a within-subjects design. Our findings in the mania vs euthymia cohort comparison were replicated in the longitudinal analysis. Bipolar mania was differentiated from euthymia by decreased connectivity between the amygdala and pre-genual anterior cingulate cortex. Mania was also characterized by increased connectivity between amygdala and the supplemental motor area, a region normally anti-correlated to the amygdala in emotion regulation tasks. Stringent controls for movement effects limited the number of subjects in the longitudinal sample. In this first report of rsfMRI conducted longitudinally across mood states, we find that previously observed between-group differences in amygdala connectivity are also found longitudinally within subjects. These results suggest resting state cortico-amygdala connectivity is a biomarker of mood state in bipolar disorder. Copyright © 2017 Elsevier B.V. All rights reserved.

  5. The efficacy of bipolar sealer on blood loss in spine surgery: a meta-analysis.

    Science.gov (United States)

    Lan, Tao; Hu, Shi-Yu; Yang, Xin-Jian; Chen, Yang; Qiu, Yi-Yan; Guo, Wei-Zhuang; Lin, Jian-Ze; Ren, Kai

    2017-07-01

    The purpose of this meta-analysis of randomized controlled trials (RCTs) and non-RCTs was to gather data to evaluate the efficacy and safety of bipolar sealer versus standard electrocautery in the management of spinal disease. The electronic databases including Embase, PubMed and Cochrane library were searched to identify relevant studies published from the time of the establishment of these databases up to January 2017. The primary outcomes were total blood loss, requirement of transfusion (rate and amount), and operation time. The secondary outcomes were length of hospital stay and postoperative wound infection. Data analysis was conducted with RevMan 5.3 software. A total of five studies involving 500 patients (261 patients in the BS group and 239 in the control group) were included in the meta-analysis. The pooled results revealed that application of bipolar sealer could decrease the total blood loss in spine surgery [WMD = -467.49, 95% CI (685.47 to -249.51); p SMD = -0.36, 95% CI (-0.60 to -0.13), p infection [OR = 0.88, 95% CI (0.31-2.48), p = 0.81; I 2  = 0.0%] between both groups. The available evidence suggests that bipolar sealer is superior to standard electrocautery with less blood loss, shorter operation time and less transfusion requirement. There is no significant difference between both groups regarding length of hospitalization and wound infection. Hence, bipolar sealer is recommended in spine surgery. Because of the limitation of our study, more well-designed RCTs with large sample are required to provide further evidence of safety and efficacy between bipolar sealer and standard electrocautery in the treatment of spinal disease.

  6. Relative Risk of Acute Myocardial Infarction in People with Schizophrenia and Bipolar Disorder: A Population-Based Cohort Study.

    Directory of Open Access Journals (Sweden)

    Shu-I Wu

    Full Text Available Despite high mortality associated with serious mental illness, risk of acute myocardial infarction (AMI remains unclear, especially for patients with bipolar disorder. The main objective was to investigate the relative risk of AMI associated with schizophrenia and bipolar disorders in a national sample.Using nationwide administrative data, an 11-year historic cohort study was assembled, comprised of cases aged 18 and above who had received a diagnosis of schizophrenia or bipolar disorder, compared to a random sample of all other adults excluding those with diagnoses of serious mental illness. Incident AMI as a primary diagnosis was ascertained. Hazard ratios stratified by age and gender were calculated and Cox regression models were used to adjust for other covariates.A total of 70,225 people with schizophrenia or bipolar disorder and 207,592 people without serious mental illness were compared. Hazard ratios in men adjusted for age, income and urbanization were 1.15 (95% CI 1.01~1.32 for schizophrenia and 1.37 (1.08~1.73for bipolar disorder, and in women, 1.85 (1.58~2.18 and 1.88(1.47~2.41 respectively. Further adjustment for treated hypertension, diabetes and hyperlipidaemia attenuated the hazard ratio for men with schizophrenia but not the other comparison groups. Hazard ratios were significantly stronger in women than men and were stronger in younger compared to older age groups for both disorders; however, gender modification was only significant in people with schizophrenia, and age modification only significant in people with bipolar disorder.In this large national sample, schizophrenia and bipolar disorder were associated with raised risk of AMI in women and in the younger age groups although showed differences in potential confounding and modifying factors.

  7. The effects of mindfulness-based cognitive therapy in patients with bipolar disorder: a controlled functional MRI investigation.

    Science.gov (United States)

    Ives-Deliperi, Victoria L; Howells, Fleur; Stein, Dan J; Meintjes, Ernesta M; Horn, Neil

    2013-09-25

    Preliminary research findings have shown that mindfulness-based cognitive therapy improves anxiety and depressive symptoms in bipolar disorder. In this study, we further investigated the effects of MBCT in bipolar disorder, in a controlled fMRI study. Twenty three patients with bipolar disorder underwent neuropsychological testing and functional MRI. Sixteen of these patients were tested before and after an eight-week MBCT intervention, and seven were wait listed for training and tested at the same intervals. The results were compared with 10 healthy controls. Prior to MBCT, bipolar patients reported significantly higher levels of anxiety and symptoms of stress, scored significantly lower on a test of working memory, and showed significant BOLD signal decrease in the medial PFC during a mindfulness task, compared to healthy controls. Following MBCT, there were significant improvements in the bipolar treatment group, in measures of mindfulness, anxiety and emotion regulation, and in tests of working memory, spatial memory and verbal fluency compared to the bipolar wait list group. BOLD signal increases were noted in the medial PFC and posterior parietal lobe, in a repeat mindfulness task. A region of interest analysis revealed strong correlation between signal changes in medial PFC and increases in mindfulness. The small control group is a limitation in the study. These data suggest that MBCT improves mindfulness and emotion regulation and reduces anxiety in bipolar disorder, corresponding to increased activations in the medial PFC, a region associated with cognitive flexibility and previously proposed as a key area of pathophysiology in the disorder. © 2013 Elsevier B.V. All rights reserved.

  8. Relative Risk of Acute Myocardial Infarction in People with Schizophrenia and Bipolar Disorder: A Population-Based Cohort Study.

    Science.gov (United States)

    Wu, Shu-I; Chen, Su-Chiu; Liu, Shen-Ing; Sun, Fang-Ju; Juang, Jimmy J M; Lee, Hsin-Chien; Kao, Kai-Liang; Dewey, Michael E; Prince, Martin; Stewart, Robert

    2015-01-01

    Despite high mortality associated with serious mental illness, risk of acute myocardial infarction (AMI) remains unclear, especially for patients with bipolar disorder. The main objective was to investigate the relative risk of AMI associated with schizophrenia and bipolar disorders in a national sample. Using nationwide administrative data, an 11-year historic cohort study was assembled, comprised of cases aged 18 and above who had received a diagnosis of schizophrenia or bipolar disorder, compared to a random sample of all other adults excluding those with diagnoses of serious mental illness. Incident AMI as a primary diagnosis was ascertained. Hazard ratios stratified by age and gender were calculated and Cox regression models were used to adjust for other covariates. A total of 70,225 people with schizophrenia or bipolar disorder and 207,592 people without serious mental illness were compared. Hazard ratios in men adjusted for age, income and urbanization were 1.15 (95% CI 1.01~1.32) for schizophrenia and 1.37 (1.08~1.73)for bipolar disorder, and in women, 1.85 (1.58~2.18) and 1.88(1.47~2.41) respectively. Further adjustment for treated hypertension, diabetes and hyperlipidaemia attenuated the hazard ratio for men with schizophrenia but not the other comparison groups. Hazard ratios were significantly stronger in women than men and were stronger in younger compared to older age groups for both disorders; however, gender modification was only significant in people with schizophrenia, and age modification only significant in people with bipolar disorder. In this large national sample, schizophrenia and bipolar disorder were associated with raised risk of AMI in women and in the younger age groups although showed differences in potential confounding and modifying factors.

  9. 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...

  10. Association between family history of mood disorders and clinical characteristics of bipolar disorder: results from the Brazilian bipolar research network.

    Science.gov (United States)

    Berutti, Mariangeles; Nery, Fabiano G; Sato, Rodrigo; Scippa, Angela; Kapczinski, Flavio; Lafer, Beny

    2014-06-01

    To compare clinical characteristics of bipolar disorder (BD) in patients with and without a family history of mood disorders (FHMD) in a large sample from the Brazilian Research Network of Bipolar Disorders. Four-hundred eighty-eight DSM-IV BD patients participating in the Brazilian Research Network of Bipolar Disorders were included. Participants were divided between those with FHMD (n=230) and without FHMD (n=258). We compared these two groups on demographic and clinical variables and performed a logistic regression to identify which variables were most strongly associated with positive family history of mood disorders. BD patients with FHMD presented with significantly higher lifetime prevalence of any anxiety disorder, obsessive-compulsive disorder, social phobia, substance abuse, and were more likely to present history of suicide attempts, family history of suicide attempts and suicide, and more psychiatric hospitalizations than BD patients without FHMD. Logistic regression showed that the variables most strongly associated with a positive FHMD were any comorbid anxiety disorder, comorbid substance abuse, and family history of suicide. Cross-sectional study and verification of FHMD by indirect information. BD patients with FHMD differ from BD patients without FHMD in rates of comorbid anxiety disorder and substance abuse, number of hospitalizations and suicide attempts. As FHMD is routinely assessed in clinical practice, these findings may help to identify patients at risk for particular manifestations of BD and may point to a common, genetically determined neurobiological substrate that increases the risk of conditions such as comorbidities and suicidality in BD patients. Copyright © 2014 Elsevier B.V. All rights reserved.

  11. Majorana zero modes and long range edge correlation in interacting Kitaev chains: analytic solutions and density-matrix-renormalization-group study.

    Science.gov (United States)

    Miao, Jian-Jian; Jin, Hui-Ke; Zhang, Fu-Chun; Zhou, Yi

    2018-01-11

    We study Kitaev model in one-dimension with open boundary condition by using exact analytic methods for non-interacting system at zero chemical potential as well as in the symmetric case of Δ = t, and by using density-matrix-renormalization-group method for interacting system with nearest neighbor repulsion interaction. We suggest and examine an edge correlation function of Majorana fermions to characterize the long range order in the topological superconducting states and study the phase diagram of the interating Kitaev chain.

  12. Higher Order Mode Fibers

    DEFF Research Database (Denmark)

    Israelsen, Stine Møller

    This PhD thesis considers higher order modes (HOMs) in optical fibers. That includes their excitation and characteristics. Within the last decades, HOMs have been applied both for space multiplexing in optical communications, group velocity dispersion management and sensing among others......-radial polarization as opposed to the linear polarization of the LP0X modes. The effect is investigated numerically in a double cladding fiber with an outer aircladding using a full vectorial modesolver. Experimentally, the bowtie modes are excited using a long period grating and their free space characteristics...... and polarization state are investigated. For this fiber, the onset of the bowtie effect is shown numerically to be LP011. The characteristics usually associated with Bessel-likes modes such as long diffraction free length and selfhealing are shown to be conserved despite the lack of azimuthal symmetry...

  13. 1H-NMR, 1H-NMR T2-edited, and 2D-NMR in bipolar disorder metabolic profiling.

    Science.gov (United States)

    Sethi, Sumit; Pedrini, Mariana; Rizzo, Lucas B; Zeni-Graiff, Maiara; Mas, Caroline Dal; Cassinelli, Ana Cláudia; Noto, Mariane N; Asevedo, Elson; Cordeiro, Quirino; Pontes, João G M; Brasil, Antonio J M; Lacerda, Acioly; Hayashi, Mirian A F; Poppi, Ronei; Tasic, Ljubica; Brietzke, Elisa

    2017-12-01

    The objective of this study was to identify molecular alterations in the human blood serum related to bipolar disorder, using nuclear magnetic resonance (NMR) spectroscopy and chemometrics. Metabolomic profiling, employing 1 H-NMR, 1 H-NMR T 2 -edited, and 2D-NMR spectroscopy and chemometrics of human blood serum samples from patients with bipolar disorder (n = 26) compared with healthy volunteers (n = 50) was performed. The investigated groups presented distinct metabolic profiles, in which the main differential metabolites found in the serum sample of bipolar disorder patients compared with those from controls were lipids, lipid metabolism-related molecules (choline, myo-inositol), and some amino acids (N-acetyl-L-phenyl alanine, N-acetyl-L-aspartyl-L-glutamic acid, L-glutamine). In addition, amygdalin, α-ketoglutaric acid, and lipoamide, among other compounds, were also present or were significantly altered in the serum of bipolar disorder patients. The data presented herein suggest that some of these metabolites differentially distributed between the groups studied may be directly related to the bipolar disorder pathophysiology. The strategy employed here showed significant potential for exploring pathophysiological features and molecular pathways involved in bipolar disorder. Thus, our findings may contribute to pave the way for future studies aiming at identifying important potential biomarkers for bipolar disorder diagnosis or progression follow-up.

  14. An evidence map of psychosocial interventions for the earliest stages of bipolar disorder

    Science.gov (United States)

    Vallarino, Martine; Henry, Chantal; Etain, Bruno; Gehue, Lillian J; Macneil, Craig; Scott, Elizabeth M; Barbato, Angelo; Conus, Philippe; Hlastala, Stefanie A; Fristad, Mary; Miklowitz, David J; Scott, Jan

    2015-01-01

    Depression, schizophrenia, and bipolar disorder are three of the four most burdensome problems in people aged under 25 years. In psychosis and depression, psychological interventions are effective, low-risk, and high-benefit approaches for patients at high risk of first-episode or early-onset disorders. We review the use of psychological interventions for early-stage bipolar disorder in patients aged 15–25 years. Because previous systematic reviews had struggled to identify information about this emerging sphere of research, we used evidence mapping to help us identify the extent, distribution, and methodological quality of evidence because the gold standard approaches were only slightly informative or appropriate. This strategy identified 29 studies in three target groups: ten studies in populations at high risk for bipolar disorder, five studies in patients with a first episode, and 14 studies in patients with early-onset bipolar disorder. Of the 20 completed studies, eight studies were randomised trials, but only two had sample sizes of more than 100 individuals. The main interventions used were family, cognitive behavioural, and interpersonal therapies. Only behavioural family therapies were tested across all of our three target groups. Although the available interventions were well adapted to the level of maturity and social environment of young people, few interventions target specific developmental psychological or physiological processes (eg, ruminative response style or delayed sleep phase), or offer detailed strategies for the management of substance use or physical health. PMID:26360451

  15. Psychotherapy use in bipolar disorder: Association with functioning and illness severity.

    Science.gov (United States)

    Sylvia, Louisa G; Thase, Michael E; Reilly-Harrington, Noreen A; Salcedo, Stephanie; Brody, Benjamin; Kinrys, Gustavo; Kemp, David; Shelton, Richard C; McElroy, Susan L; Kocsis, James H; Bobo, William V; Kamali, Masoud; McInnis, Melvin; Friedman, Edward; Tohen, Mauricio; Bowden, Charles L; Ketter, Terence A; Singh, Vivek; Calabrese, Joseph; Nierenberg, Andrew A; Rabideau, Dustin J; Elson, Constance M; Deckersbach, Thilo

    2015-05-01

    This study examines characteristics of individuals with bipolar disorder who sought psychotherapy versus those who did not. Bipolar CHOICE was an 11-site comparative effectiveness study of lithium versus quetiapine in symptomatic outpatients (N = 482) with bipolar disorder. At baseline, participants' psychotherapy use within the past 3 months, mood, functioning, and overall health were assessed. Logistic regressions were used to test whether psychotherapy users and non-users differed on various demographic and clinical variables at baseline. Mixed-effects regression was used to determine whether psychotherapy groups differed on response to treatment over the 6-month study. Kaplan-Meier plots and log-rank tests were employed to test whether there were any differences in time to recovery (CGI-BP ≤ 2 for at least 8 weeks) between the groups. Thirty one percent of participants reported using psychotherapy services. Psychotherapy users reported greater medication side effect burden than non-users and were more likely to have moderate to high suicide risk and at least one anxiety disorder. Participants not utilizing medications or psychotherapy had greater mania symptom severity, were younger, and less educated than medication only users. Medication only users were more likely to be married than the other participants. These data suggest that a minority of individuals with bipolar disorder attend psychotherapy services, and those that do have greater illness burden. © The Royal Australian and New Zealand College of Psychiatrists 2015.

  16. 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.

  17. How specific are emotional deficits? A comparison of empathic abilities in schizophrenia, bipolar and depressed patients

    Science.gov (United States)

    Derntl, Birgit; Seidel, Eva-Maria; Schneider, Frank; Habel, Ute

    2012-01-01

    Empathy is a rather elaborated human ability and several recent studies highlight significant impairments in patients suffering from psychiatric disorders, such as schizophrenia, bipolar disorder or major depression. Therefore, the present study aimed at comparing behavioral empathy performance in schizophrenia, bipolar and depressed patients with healthy controls. All subjects performed three tasks tapping the core components of empathy: emotion recognition, emotional perspective taking and affective responsiveness. Groups were matched for age, gender, and verbal intelligence. Data analysis revealed three main findings: First, schizophrenia patients showed the strongest impairment in empathic performance followed by bipolar patients while depressed patients performed similar to controls in most tasks, except for affective responsiveness. Second, a significant association between clinical characteristics and empathy performance was only apparent in depression, indicating worse affective responsiveness with stronger symptom severity and longer duration of illness. Third, self-report data indicate that particularly bipolar patients describe themselves as less empathic, reporting less empathic concern and less perspective taking. Taken together, this study constitutes the first approach to directly compare specificity of empathic deficits in severe psychiatric disorders. Our results suggest disorder-specific impairments in emotional competencies that enable better characterization of the patient groups investigated and indicate different psychotherapeutic interventions. PMID:23116884

  18. Weight gain with add-on second-generation antipsychotics in bipolar disorder: a naturalistic study.

    Science.gov (United States)

    Najar, H; Joas, E; Kardell, M; Pålsson, E; Landén, M

    2017-06-01

    Our aim was to investigate the prevalence and magnitude of weight gain in-patients with bipolar disorder when treated with a second-generation antipsychotic as an add-on treatment to a mood stabilizer in routine clinical practice. Data were derived from the quality register for bipolar disorder in Sweden (BipoläR). Patients with bipolar disorder who started add-on treatment with a SGA (n = 575) were compared at next yearly follow-up with age and sex matched patients who were only treated with a mood stabilizer (n = 566). The primary outcome measure was change in body weight and body mass index (BMI). We also assessed the prevalence of clinically significant weight gain defined as ≥7% gain in body weight. The group that received add-on treatment with antipsychotics neither gained more weight nor were at higher risk for a clinically significant weight gain than the reference group. Instead, factors associated with clinically significant weight gain were female sex, young age, low-baseline BMI, and occurrence of manic/hypomanic episodes. We found no evidence of an overall increased risk of weight gain for patients with bipolar disorder after receiving add-on SGA to a mood stabilizer in a routine clinical setting. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  19. Attentional Bias Predicts Increased Reward Salience and Risk Taking in Bipolar Disorder.

    Science.gov (United States)

    Mason, Liam; Trujillo-Barreto, Nelson J; Bentall, Richard P; El-Deredy, Wael

    2016-02-15

    There is amassing evidence that risky decision-making in bipolar disorder is related to reward-based differences in frontostriatal regions. However, the roles of early attentional and later cognitive processes remain unclear, limiting theoretical understanding and development of targeted interventions. Twenty euthymic bipolar disorder and 19 matched control participants played a Roulette task in which they won and lost money. Event-related potentials and source analysis were used to quantify predominantly sensory-attentional (N1), motivational salience (feedback-related negativities [FRN]), and cognitive appraisal (P300) stages of processing. We predicted that the bipolar disorder group would show increased N1, consistent with increased attentional orienting, and reduced FRN, consistent with a bias to perceive outcomes more favorably. As predicted, the bipolar disorder group showed increased N1 and reduced FRN but no differences in P300. N1 amplitude was additionally associated with real-life risk taking, and N1 source activity was reduced in visual cortex but increased activity in precuneus, frontopolar, and premotor cortex, compared to those of controls. These findings demonstrate an early attentional bias to reward that potentially drives risk taking by priming approach behavior and elevating reward salience in the frontostriatal pathway. Although later cognitive appraisals of these inputs may be relatively intact in remission, interventions targeting attention orienting may also be effective in long-term reduction of relapse. Copyright © 2016 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

  20. 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

  1. Bipolar Disorder in Children and Teens

    Science.gov (United States)

    ... separation anxiety. Sometimes behavior problems go along with mood episodes. Young people may take a lot of risks, such as driving too fast or spending too much money. Some young people with bipolar disorder think about suicide. Watch for any signs of suicidal thinking. Take ...

  2. Cognitive Impairment in Euthymic Pediatric Bipolar Disorder

    DEFF Research Database (Denmark)

    Elias, Liana R.; Miskowiak, Kamilla W.; Vale, Antônio M. O.

    2017-01-01

    OBJECTIVE: To perform a systematic review and meta-analysis of studies investigating neurocognition in euthymic youths with bipolar disorder (BD) compared to healthy controls (HCs). METHOD: A systematic literature search was conducted in the PubMed/MEDLINE, PsycINFO, and EMBASE databases from inc...

  3. Bipolar Disorder in Adolescence: Diagnosis and Treatment.

    Science.gov (United States)

    Wilkinson, Great Buyck; Taylor, Priscilla; Holt, Jan R.

    2002-01-01

    Due to developmental issues and overlapping symptoms with other disorders, diagnosing bipolar