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Sample records for manic lks sooloks

  1. BEYOND THE PROHIBITION OF LKS IN INDONESIA: A REVIEW ON ENGLISH LKS USED IN ELEMENTARY SCHOOL

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    Emmi Naja

    2016-11-01

    Full Text Available The LKS (Lembar Kerja Siswa usage has been criticized by educational experts in the latest decade, including in Indonesia.Publishing permendikbud no 8 tahun 2016 that administered both textbook and non-textbook used in Indonesian schools becomes government respond to this issue. This present article tries to fnd facts that contradict to those rules by reviewing 8 English LKS for Elementary Students. Moreover, some theoretical controversies also fnd in those LKS such as grammatical errors, ignoring young learners’ characteristics, and less of enjoyable activities for young learners. So, this review results are supported to government decision in banning LKS usage in Indonesia.

  2. Pengembangan Lembar Kegiatan Siswa (Lks) Kimia Sma/ma Berbasis Learning Cycle 5e Pada Materi Laju Reaksi

    OpenAIRE

    Hapsari, Natalia Diyah; Masykuri, Mohammad; Yamtinah, Sri

    2016-01-01

    Penelitian ini bertujuan untuk: (1) mengembangkan Lembar Kegiatan Siswa (LKS) berbasis Learning Cycle 5E, (2) mengetahui kualitas Lembar Kegiatan Siswa (LKS) berbasis Learning Cycle 5E, (3) mengetahui efektivitas Lembar Kegiatan Siswa (LKS) berbasis Learning Cycle 5E untuk meningkatkan prestasi belajar siswa. Penelitian dan pengembangan Lembar Kegiatan Siswa (LKS) berbasis Learning Cycle 5E menggunakan prosedur penelitian dan pengembangan dari Borg and Gall yang disederhanakan menjadi 9 tahap...

  3. PENGEMBANGAN LKS BERBASIS PROJECT BASED LEARNING UNTUK PEMBELAJARAN MATERI SEGITIGA DI KELAS VII

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    Dian Novita

    2016-06-01

    Full Text Available Penelitian ini merupakan penelitian pengembangan yang bertujuan untuk (1mengetahui karakteristik LKS berbasis Project Based Learning (PjBL yang valid dan praktis dalam pembelajaran materi segitiga di kelas VII; (2mengetahui efek potensial penggunaan LKS berbasis PjBL terhadap hasil belajar siswa dalam pembelajaran materi segitiga di kelas VII. Metode penelitian pengembangan yang digunakan adalah model  ADDIE (Analysis, Design, Development, Implementation, and Evaluation. Teknik pengumpulan data yang digunakan adalah walkthrough, tes hasil belajar dan angket. Dari tes hasil belajar, diperoleh bahwa sebesar 82,5% siswa telah mencapai kategori tuntas dan 17,5% belum tuntas dengan KKM 75. Hasil angket respon siswa menunjukkan bahwa untuk pelaksanaan pembelajaran menggunakan LKS berbasis PjBL telah mencapai kriteria kepraktisan. Kemudian untuk LKS berbasis PjBL yang telah didesain, divalidasi oleh beberapa pakar, kemudian direvisi berdasarkan saran dari para pakar tersebut. LKS yang telah direvisi tersebut dianggap telah memenuhi kriteria kevalidan dan kepraktisan sehingga dapat digunakan dalam pembelajaran materi segitiga di kelas VII. Kesimpulan dari penelitian ini adalah (1 LKS bebasis PjBL yang dikembangkan valid, tergambar dari konten (sesuai dengan kurikulum untuk materi segitiga, konstruk (sesuai dengan prinsip PjBL, dan bahasa (sesuai dengan ejaan yang disempurnakan (EYD. Kepraktisan tergambar dari proses kerja siswa dalam melaksanakan LKS dan hasil angket respon siswa terhadap pembelajaran menggunakan LKS berbasis PjBL; (2 dari hasil latihan yang dikerjakan oleh siswa, LKS berbasis PjBL memiliki efek potensial terhadap hasil belajar, yakni sebanyak 33 siswa termasuk kategori tuntas (82,5% dan 7 orang belum tuntas (17,5%, dengan KKM 75. Kata Kunci : LKS, Project Based Learning DOI: http://dx.doi.org/10.22342/jpm.10.2.3626.1-12

  4. PENGEMBANGAN LKS DENGAN MODEL DISCOVERY LEARNING PADA MATERI IRISAN DUA LINGKARAN

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    Harisman Nizar

    2016-07-01

    Full Text Available This research aims at (1producing a valid and practical LKS (Student Worksheet in discovery learning model in two circles intersection material in class XI, and (2 to find out the potential effect toward the learning outcomes from the development of LKS with discovery learning model in two circles intersections material in class XI MIA. The design ofthis research is a developmental study. The subjects of this research were 33 students of XI MIA 1 SMA N 1 Indralaya in academic year 2015/2016. The data collecting technique used were observation, test, and interview. The result of the researches were : (1 This research produced a valid and practical LKS with discovery learning model in two circles intersections material in class XI MIA withsome characteristics such as, (a Contain the operational steps of discovery learning model, (b Help students in finding the concept of two circles intersections model. (c Make students active in learning. Being valid can be seen from the results of validator assessment, where the validator comments on the first prototype of LKS from content, construct, and language. Being practical can be seen from the results of  small group try out, in which it was based on analysis of the answer sheets of students, it was found that students were able to complete each steps there and students’ comments obtained from the sheets that stated the LKS given was easy to be done by students. (2 The developed LKS consisted of potential effect toward the learning outcomes from cognitive (knowledge, affective (attitude, and psychomotor (skill. In the cognitive domain 81.81% of students got score > 65, in the affective domain all of the students had shown an attitude of honesty and responsiveness shown by observations during LKS usage, as well as in the of psychomotor domain skills all of students had good skill that seen from the result of students performance.

  5. Developing Worksheet (LKS) Base on Process Skills in Curriculum 2013 at Elementary School Grade IV,V,VI

    Science.gov (United States)

    Subhan, M.; Oktolita, N.; Kn, M.

    2018-04-01

    The Lacks of students' skills in the learning process is due to lacks of exercises in the form of LKS. In the curriculum of 2013, there is no LKS as a companion to improve the students' skills. In order to solve those problem, it is necessary to develop LKS based on process skills as a teaching material to improve students' process skills. The purpose of this study is to develop LKS Process Skills based elementary school grade IV, V, VI which is integrated by process skill. The development of LKS can be used to develop the thematic process skills of elementary school students grade IV, V, VI based on curriculum 2013. The expected long-term goal is to produce teaching materials LKS Process Skill based of Thematic learning that is able to develop the process skill of elementary school students grade IV, V, VI. This development research refers to the steps developed by Borg & Gall (1983). The development process is carried out through 10 stages: preliminary research and gathering information, planning, draft development, initial test (limited trial), first product revision, final trial (field trial), product operational revision, Desemination and implementation. The limited subject of the this research is the students of SDN in Dharmasraya grade IV, V, VI. The field trial subjects in the experimental class are the students of SDN Dharmasraya grade IV, V, VI who have implemented the curriculum 2013. The data are collected by using LKS validation sheets, process skill observation sheets, and Thematic learning test (pre-test And post-test). The result of LKS development on the validity score is 81.70 (very valid), on practical score is 83.94 (very practical), and on effectiveness score is 86.67 (very effective). In the trial step the use of LKS using One Group Pretest-Posttest Design research design. The purpose of this trial is to know the effectiveness level of LKS result of development for improving the process skill of students in grade IV, V, and VI of elementary

  6. Pengembangan LKS Untuk Melatih Kemampuan Berpikir Kritis dalam Mata Pelajaran Matematika di Kelas VII SMP

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    Puji Astuti

    2017-10-01

    Full Text Available Tujuan pembelajaran matematika adalah untuk melatih siswa berpikir kritis. Oleh karena itu, perlu dikembangkan Lembar Kerja Siswa (LKS untuk melatih kemampuan berpikir kritis siswa. Penelitian ini bertujuan untuk menghasilkan LKS yang berkarakteristik untuk melatih kemampuan berpikir kritis siswa kelas VII SMP. Sampel pada penelitian ini adalah kelas VII7 berjumlah 30 siswa semester II SMP Negeri 9 Palembang. Metode penelitian yang digunakan adalah metode penelitian pengembangan yang terdiri dari analisis, desain, evaluasi dan revisi. Pengumpulan data dilakukan dengan cara prototyping.  Prototyping dilakukan untuk mengetahui bagaimana karakteristik LKS untuk melatih kemampuan berpikir kritis siswa kelas VII SMP. Hasil penelitian ini adalah karakteristik LKS untuk melatih kemampuan berpikir kritis siswa kelas VII SMP. Kata kunci: Kemampuan berpikir kritis, Lembar Kerja Siswa    Mathematics learning aims to develop students critical thinking. Therefore, it is necessary to develop Student Worksheet to train students' critical thinking skills. This research aims to develop student worksheet that has characteristics of critical thinking skill for 7th grade Junior High School students (SMP. The sample in this research is VII7 class with 30 students of the second semester of SMP Negeri 9 Palembang. The research method used is a development research method that consists of analysis, design, evaluation and revision. Data collection is done by prototyping. Prototyping was used to find out how the characteristics of student worksheet to develop critical thinking ability of grade  7th students. The result of this research is characteristic of student worksheet to develop critical thinking ability of 7th grade Junior High School student. Keywords: critical thinking ability, student worksheet

  7. Cardiovascular death and manic-depressive psychosis

    DEFF Research Database (Denmark)

    Weeke, A; Juel, K; Vaeth, M

    2013-01-01

    In order to study if tricyclic antidepressant drugs (TCA) in therapeutic doses increase the risk of death due to cardiovascular causes, the relative mortality from cardiovascular diseases was studied in two large groups of first hospitalized manic-depressive patients, one from the TCA era...... to the general population. Among 1133 such cases admitted between 1950 and 1956, the rate was 1.87. Our findings do not support the hypothesis that TCA contribute to the cardiovascular mortality in manic-depressives and even support suggestions that TCA treatment may lower the risk of death by cardiovascular...

  8. Predictors of the Onset of Manic Symptoms and a (Hypo)Manic Episode in Patients with Major Depressive Disorder

    NARCIS (Netherlands)

    Boschloo, Lynn; Spijker, Annet T.; Hoencamp, Erik; Kupka, Ralph; Nolen, Willem A.; Schoevers, Robert A.; Penninx, Brenda W. J. H.

    2014-01-01

    Objective: One third of patients with a major depressive episode also experience manic symptoms or, even, a (hypo) manic episode. Retrospective studies on the temporal sequencing of symptomatology suggest that the majority of these patients report depressive symptoms before the onset of manic

  9. Cannabis use and first manic episode.

    Science.gov (United States)

    Bally, Nathalie; Zullino, Daniele; Aubry, Jean-Michel

    2014-08-01

    Cannabis is the most commonly abused drug among patients with bipolar disorder. Available data has shown that the risk of psychotic disorders increases with the frequency and intensity of cannabis abuse. The present purpose was to review relevant studies to investigate whether cannabis use can be linked to the onset of mania in bipolar disorder. Articles published between 1972 and December 2013 were searched on Medline and PsychInfo using the following keywords: first manic episode, or onset mania, or bipolar disorder and cannabis. Relevant papers cited in the references of selected articles were further considered for inclusion into the review. Lifetime use of cannabis among bipolar patients appears to be around 70% and approximately 30% of patients with a bipolar disorder present a comorbidity of cannabis abuse or dependence. Cannabis use is associated with younger age at onset of first mania and with more frequent depressive or manic episodes, although the evidence is somewhat inconsistent. Likewise cannabis consumption is related to poorer outcome and an increased risk of rapid cycling or mixed episodes. In contrast, neuro-cognitive functioning seems to be positively affected in patients with psychiatric comorbidity. While cannabis use often precedes first manic episodes, the causal direction remains to be determined. Variations in definition of cannabis use/dependence. Lack of controlled studies limiting definite conclusions about a putative causal relationship between cannabis and onset of mania. Further investigations are needed to clarify the relationships between cannabis use and first manic episode. Copyright © 2014 Elsevier B.V. All rights reserved.

  10. [Time perception in depressed and manic patients].

    Science.gov (United States)

    Zhao, Qi-yuan; Ji, Yi-fu; Wang, Kai; Zhang, Lei; Liu, Ping; Jiang, Yu-bao

    2010-02-02

    To investigate the time perception in affective disorders by using neuropsychological tests and to try to elucidate its neurobiochemical mechanism. Using a time reproduction task, a comparative study was conducted for 28 depressive patients, 22 manic patients, and 26 age and education level matched healthy persons as healthy controls. Both depressive patients and manic patients are abnormal (P reproduction task in patients were not related to age, education, duration of illness, number of admission (P > 0.05), but had some relation to severity of illness.And the results were positively correlated with the score of HAMD in depressive patients (six times: r = 0.44, 0.46, 0.73, 0.61, 0.55, 0.50, P < 0.05), but negatively with the score of BRMS in manic patients (six times: r = -0.57, -0.54, -0.71, -0.69, -0.80, -0.71, P < 0.05). Emotion will affect one's time perception. And the neurotransmitter in brain may participate in the processes of time perception.

  11. Consequent implementation of a LKS concept using the natural gas storage cavern as an example; Konsequente Umsetzung eines LKS-Konzeptes am Beispiel des Erdgaskavernenspeichers Jemgum

    Energy Technology Data Exchange (ETDEWEB)

    Steller, Daniel; Buhr, Klaus-Dieter; Kruemmel, Dirk [Steffel KKS GmbH, Lachendorf (Germany); Engelke, Hermann [EWE Netz GmbH, Oldenburg (Germany)

    2013-07-01

    In Jengum (Federal Republic of Germany) EWE Gasspeicher GmbH (Oldenburg, Federal Republic of Germany) and astora GmbH and Co. KG (Kassel, Federal Republic of Germany) constructed commonly the second largest natural gas storage facility in Germany. With a planned storage capacity of 2.2 billion cubic meters of natural gas, this natural gas storage facility project provides a significant contribution to the energy supply in Germany. Technical measures such as cathodic corrosion protection play an important part in the construction of the natural gas storage facilities: All underground components of this storage facility have to be protected effectively against corrosion from security aspects and value-preserving aspects. For this, challenges such as topography, geology and structural features have to be considered. Furthermore, different operational requirements of each installation (sol technology and gas operation) are to be considered previously. This was achieved by means of a consistent implementation of the system-specific LKS protection plan and by means of a continuous supervision.

  12. PENGARUH PENGGUNAAN MEDIA INTERAKTIF DISERTAI LKS TERHADAP HASIL BELAJAR IPA PADA KELAS IX SMP

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    Siska Angreni

    2017-06-01

    Full Text Available The research was aimed to reveal the difference between learning achievement of the students involving taught by using media interactive Compact Disk (CD media and worksheet and interactive compact disk (CD media and those taught by using conventional media. This was a quasi-experiment research. The population of this research was class IX of SMP Negeri 5 Kerinci. The researcher then chose class IXC as the experimental class I taught by using interactive CD media with a worksheet, class IXD as the experimental class II taught by using media interactive CD media, and class IXE as the control class taught by using conventional method. The data it was analyzed by using One Way ANOVA and Post hoc Tukey HSD. The results of One Way ANOVA test is Fcalculated (13,76>Ftable (3,45. Based on the hypothesis acceptance criteria, if Fcalculated >Ftable, HI was accepted. After analyzing the data by using Way ANOVA, the data then was tested by using Post hoc Tukey HSD, and the result were: the result of te study suggested taught by using media interactive Compact Disk (CD media and worksheet and interactive compact disk (CD media had significant effect on the learning outcome, which means media interactive Compact Disk (CD media and worksheet and interactive compact disk (CD media had positive effect on the biology learning outcome.Penelitian ini bertujuan untuk mengetahui perbedaan hasil belajar peserta didik dengan menggunakan media CD interaktif disertai LKS dan media CD interaktif. Jenis penelitian adalah eksperimen semu. Sampel penelitian siswa kelas IXC sebagai eksperimen I, sedangkan siswa kelas IXD sebagai eksperimen II dan siswa kelas IXE sebagai kontrol Analisis data menggunakan uji Anova satu arah dan dilanjutkan dengan uji lanjutan (Post hoc Tuket HSD. Hasil penelitian uji Anova Satu Arah adalah hasil belajar  Fhitung (13,76 > Ftabel (3,45. Berdasarkan kriteria penerimaan hipotesis jika Fhitung > Ftabel, maka H1 diterima. Dengan demikian dapat

  13. PEMANFAATAN MODEL PLTL BERBANTUAN LKS BERBASIS INKUIRI UNTUK MENINGKATKAN KOMPETENSI KIMIA

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    Bunga Amelia

    2016-01-01

    Full Text Available Penelitian ini dilakukan untuk mengetahui bagaimana peningkatan kompetensi kimia dengan model pembelajaran PLTL berbantuan LKS berbasis inkuiri. Populasi penelitian ini adalah siswa Kelas XI IPA suatu SMA Negeri di Semarang. Pengambilan sampel dilakukan dengan cluster random sampling, yakni kelas XI IPA 1 sebagai eksperimen I dengan perlakuan model pembelajaran PLTL berbantuan LKS berbasis inkuiri, kelas XI IPA 2 sebagai eksperimen II dengan LKS berbasis inkuiri, dan kelas XI IPA 3 sebagai kontrol dengan metode ceramah dan diskusi pada pokok materi buffer dan hidrolisis. Pengumpulan data dalam penelitian ini menggunakan metode dokumentasi, tes, observasi, dan angket. Hasil penelitian menunjukkan perbedaan kognitif yang signifikan antara kelas XI IPA 1, XI IPA 2, dan XI IPA 3. Kelas eksperimen I memiliki peningkatan kompetensi kimia yang paling signifikan dengan rerata hasil belajar sebesar 87,5, sedangkan kelas eksperimen II memiliki rerata hasil belajar 83,43, dan kelas kontrol dengan rerata hasil belajar 77,35. Hasil respon siswa terhadap pembelajaran menunjukan frekuensi terbanyak pada kolom setuju dan sangat setuju sehingga siswa menyukai model pembelajaran yang digunakan. Simpulan penelitian ini 1 terdapat perbedaan signifikan kompetensi kimia antara kelas eksperimen I, II dan kontrol, 2 peningkatan kompetensi kimia yang signifikan pada kelas eksperimen I, 3 respon siswa terhadap pembelajaran baik. This research aims for knowing chemistry competence’s improving by application of PLTL model with Worksheet based on inquiry. The populations are XI grades natural sciences students of an high school in Semarang. Samples were taken by cluster random sampling and got XI IPA 1 as an experimental class I by application of PLTL model with Worksheet based on Inquiry while XI IPA 2 as an experimental class II by using Worksheet based on Inquiry, and XI IPA 3 as a control group using lecture and discussion on the subject buffer and hydrolysis. Data

  14. Mucuna pruriens (Konch Beej precipitates manic symptoms

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    Supriya Vaish

    2014-01-01

    Full Text Available Owing to the popular misconception that all ayurvedic preparations are completely safe, a vast majority of these are indiscriminately consumed by people procured as over the counter drugs. These preparations are combinations of multiple products that are often unidentified and dangerous and can precipitate various psychiatric symptoms. Hereby, we present a case of adolescent male in acute manic excitement after consumption of ayurvedic preparation containing "konchbeej" (Mucuna pruriens which is rich in l-3,4 dihydroxyphenyl alanine; precursor of dopamine.

  15. PENGEMBANGAN LEMBAR KERJA SISWA (LKS BERKARAKTERISTIK RME MATERI BARISAN DAN DERET UNTUK KELAS X

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    Arif Hidayatul Khusna

    2016-04-01

    : Penelitian ini merupakan penelitian pengembangan yang bertujuan menghasilkan bahan ajar yaitu Lembar Kerja Siswa berkarakteristik RME yang valid dan praktis sehingga layak digunakan dalam proses pembelajaran materi barisan dan deret. Model pengembangan yang digunakan dalam penelitian ini adalah model pengembangan Plomp yang terdiri dari tiga tahap yaitu 1 tahap investigasi awal, 2 tahap perancangan dan realisasi, 3 tahap tes, evaluasi, dan revisi. Berdasarkan analisis yang dilakukan diperoleh hasil, yaitu (1 tingkat kevalidan sebesar 3,7 dengan kriteria kevalidan sangat valid, dan (2 tungkat kepraktisan sebesar 3,5 dengan kriteria kepraktisan sangat praktis Jadi dapat disimpulkan bahwa LKS yang dikembangkan memenuhi kriteria baik dan layak digunakan sebagai alternatif bahan ajar matematika pada materi Barisan dan Deret yang dapat mengingkatkan tingkat penalaran matematis siswa.

  16. Course of insight in manic episode

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    A Kumar

    2013-01-01

    Full Text Available Background: Insight is an important factor associated with non compliance and poor outcome. Poor level of insight has been described as a characteristic in patients with acute bipolar disorder with more unawareness in social consequences with increasing severity in manic episode. Aim: Main aim of study was to see the baseline and longitudinal relationship between dimensions of insight with improvement in psychopathology. Setting and Design: Forty four patients diagnosed with mania, were selected from an inpatient setting at Institute of Mental Health and Hospital, Agra with mean age of 31.07(±9.00 years. They were assessed at base line and were followed up weekly or psychopathology and insight. Materials and Methods: The Young′s mania rating scale for psychopathology and insight was assessed on three dimensions of SUMD. Results: Twenty five patients eventually completed the study. There was a positive correlation with global insight and with psychopathology consistent in longitudinal follow-up (P<0.05, but not correlating for awareness for achieved effect of medication and social consequences. Linear regression showed a positive relationship at the first and second week of assessment of SUMD and YMRS scores (P=0.001; 0.019. Conclusion: Improvement in insight is graded in a manic episode as compared to psychopathology. There is slower improvement in awareness of social consequences of mental disorder. It means that improvement in psychopathology may not necessarily indicate remission and need further supervision to improve insight and hence monitoring.

  17. Electroconvulsive therapy in single manic episodes: a case series ...

    African Journals Online (AJOL)

    Objective: To evaluate the effectiveness of electroconvulsive therapy in the treatment of Bipolar I Disorder patients with a single manic episode. Method: In a retrospective study, we reviewed medical records of inpatients who had been admitted to treat a single manic episode of Bipolar I Disorder at Noor University Hospital, ...

  18. Suicide risk in placebo-controlled trials of treatment for acute manic episode and prevention of manic-depressive episode

    NARCIS (Netherlands)

    Storosum, Jitschak G.; Wohlfarth, Tamar; Gispen-de Wied, Christine C.; Linszen, Don H.; Gersons, Berthold P. R.; van Zwieten, Barbara J.; van den Brink, Wim

    2005-01-01

    Objective: The authors' goal was to investigate whether there is a greater suicide risk in the placebo arms of placebo-controlled studies of active medication for the treatment of acute manic episode and the prevention of manic/depressive episode. If so, this would be a strong ethical argument

  19. SCHIZOAFFECTIVE DISORDER WITH MANIC TYPE : A CASE REPORT

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    A.A. Gede Ocha Rama Kharisma Putra

    2014-02-01

    Full Text Available Schizoaffective disorder is a disease with persistent psychotic symptoms, such ashallucinations or delusions, occurs together with mood disorder such as depression,manic, or mixed episodes. Schizoaffective disorder is estimated to occur morefrequently than bipolar disorder. A psychotic disorder with symptoms of schizophreniaand manic air equally prominent in one episode of the same disease. This reportdescribes the case of b schizoaffective disorder with manic type in women aged 42years. These patients get therapy is pharmacotherapy Carbamazepine 2x200 mg orallyand Stelazine 2x5 mg orally.

  20. Experimentally induced, synergistic late effects of a single dose of radiation and aging: significance in LKS fraction as compared with mature blood cells.

    Science.gov (United States)

    Hirabayashi, Yoko; Tsuboi, Isao; Nakachi, Kei; Kusunoki, Yoichiro; Inoue, Tohru

    2015-03-01

    The number of murine mature blood cells recovered within 6 weeks after 2-Gy whole-body irradiation at 6 weeks of age, whereas in the case of the undifferentiated hematopoietic stem/progenitor cell (HSC/HPC) compartment [cells in the lineage-negative, c-kit-positive and stem-cell-antigen-1-positive (LKS) fraction], the numerical differences between mice with and without irradiation remained more than a year, but conclusively the cells showed numerical recovery. When mice were exposed to radiation at 6 months of age, acute damages of mature blood cells were rather milder probably because of their maturation with age; but again, cells in the LKS fraction were specifically damaged, and their numerical recovery was significantly delayed probably as a result of LKS-specific cellular damages. Interestingly, in contrast to the recovery of the number of cells in the LKS fraction, their quality was not recovered, which was quantitatively assessed on the basis of oxidative-stress-related fluorescence intensity. To investigate why the recovery in the number of cells in the LKS fraction was delayed, expression levels of genes related to cellular proliferation and apoptosis of cells in the bone marrow and LKS fraction were analyzed by real-time polymerase chain reaction (RT-PCR). In the case of 21-month-old mice after radiation exposure, Ccnd1, PiK3r1 and Fyn were overexpressed solely in cells in the LKS fraction. Because Ccnd1and PiK3r1 upregulated by aging were further upregulated by radiation, single-dose radiation seemed to induce the acceleration of aging, which is related to the essential biological responses during aging based on a lifetime-dependent relationship between a living creature and xenobiotic materials. Copyright © 2014 John Wiley & Sons, Ltd.

  1. Understanding Mathematic Concept in Relation and Function Method through Active Learning Type Group to Group Distributed LKS

    Science.gov (United States)

    Kudri, F.; Rahmi, R.; Haryono, Y.

    2018-04-01

    This research is motivated by the lack of understanding of mathematical concepts students and teachers have not familiarize students discussed in groups. This researchaims to determine whether an understanding of mathematical concepts junior class VIII SMPN 2 in Ranah Batahan Kabupaten Pasaman Barat by applying active learning strategy group to group types with LKS better than conventional learning. The type of research is experimental the design of randomized trials on the subject. The population in the study were all students VIII SMPN 2 Ranah Batahan Kabupaten Pasaman Barat in year 2012/2013 which consists of our class room experiment to determine the grade and control class with do nerandomly, so that classes VIII1 elected as a experiment class and class VIII4 as a control class. The instruments used in the test empirically understanding mathematical concepts are shaped by the essay with rt=0,82 greater than rt=0,468 means reliable tests used. The data analysis technique used is the test with the help of MINITAB. Based on the results of the data analisis known that both of the sample are normal and homogenity in real rate α = 0,05, so the hypothesis of this research is received. So, it can be concluded students’ understanding mathematical concept applied the active Group to Group learning strategy with LKS is better than the students’ understanding mathematical concept with Conventional Learning.

  2. Successful lithium treatment of transvestism associated with manic-depression.

    Science.gov (United States)

    Ward, N G

    1975-09-01

    A case of transvestism in a 24-year-old manic-depressive man is described. The behavior had been maintained for 2 years and disappeared soon after lithium treatment was begun. It has not returned during the first year on lithium. Dynamic and behavioral explanations for this unusual therapeutic response are considered. The dynamic explanation involves the assumption that the transvestism was perpetuated by mood-dependent motives that were eliminated by lithium. The behavioral explanation involves the assumption that the manic state itself became an intermittent reinforcer for the transvestism, and the lithium, by eliminating the mania, created a relatively permanent extinction period.

  3. A case report of isotretinoin-induced manic psychosis

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    Jisha M Lucca

    2016-01-01

    Full Text Available Isotretinoin, an oral vitamin A derivative, used to treat severe treatment-resistant acne. Psychiatric side effects of isotretinoin particularly depression and suicidal thoughts have been well documented. We report a case of isotretinoin-induced manic psychosis in a young female without a family history and history of mental illness.

  4. Temporality in the Manic Experience: A Selective Review

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    Bruno Trancas

    2012-06-01

    Full Text Available The human experience of time has been the object of study since antiquity, ranging from philosophers to contemporary neuroscience researchers. Some experiences may disturb the relation than Man has with Time, be they general and mundane situations – like a child playing with his toy (Thomas Fuchs – to diseases, such as depressive or manic experiences or the schizophrenic way-of-being-in-theworld. We outline some concepts regarding temporality and shortly after we head on to the disturbance of temporality in the manic experience, both in the world-time (chronometric, explicit and lived time (implicit dimensions, with contributions from several authors, such as Eugène Minkowski, Leston Havens, Ludwig Binswanger, Medard Boss and Thomas Fuchs.

  5. Can personality traits predict increases in manic and depressive symptoms?

    Science.gov (United States)

    Lozano, B E; Johnson, S L

    2001-03-01

    There has been limited research investigating personality traits as predictors of manic and depressive symptoms in bipolar individuals. The present study investigated the relation between personality traits and the course of bipolar disorder. The purpose of this study was to identify specific personality traits that predict the course of manic and depressive symptoms experienced by bipolar individuals. The sample consisted of 39 participants with bipolar I disorder assessed by the Structured Clinical Interview for DSM-IV. Personality was assessed using the NEO Five-Factor Inventory. The Modified Hamilton Rating Scale for Depression and the Bech-Rafaelsen Mania Rating Scale were used to assess symptom severity on a monthly basis. Consistent with previous research on unipolar depression, high Neuroticism predicted increases in depressive symptoms across time while controlling for baseline symptoms. Additionally, high Conscientiousness, particularly the Achievement Striving facet, predicted increases in manic symptoms across time. The current study was limited by the small number of participants, the reliance on a shortened version of a self-report personality measure, and the potential state-dependency of the personality measures. Specific personality traits may assist in predicting bipolar symptoms across time. Further studies are needed to tease apart the state-dependency of personality.

  6. Manic Symptoms during a Switch from Paliperidone ER to Paliperidone Palmitate in a Patient with Schizophrenia

    Directory of Open Access Journals (Sweden)

    Kadir Demirci

    2015-01-01

    Full Text Available Some antipsychotic drugs have treatment efficacy for mania and bipolar disorder. However, these drugs may rarely cause manic symptoms in some schizophrenic patients. We hereby report a 22-year-old female patient with schizophrenia who experienced a manic episode during a switch from paliperidone ER to paliperidone palmitate. This case is an important reminder that an abrupt switch from oral paliperidone to paliperidone palmitate may predispose certain patients to hypomanic or manic symptoms.

  7. IMPLEMENTASI MODEL LEARNING CYCLE “5E” DISERTAI LKS UNTUK MENINGKATKAN AKTIVITAS, KETERAMPILAN PROSES SAINS, DAN HASIL BELAJAR BIOLOGI

    Directory of Open Access Journals (Sweden)

    Ahmad Purwanto

    2014-05-01

    Full Text Available This research aims to implement the model learning cycle "5E" accompanied by worksheets to increase activity, science process skills and student learning outcomes. This model provides student involvement and hands-on experience for students, develop a collaborative manner with the group and share your knowledge with other students. Conclusions of this study is the implementation model of learning cycle "5E" with worksheets may enhance the activity, science process skills, and student learning outcomes of  X8 in the second semester  at senior high school 4th Metro on academic year 2011/2012. The increase can be observed as follows: the activity of reading the literature by 23%, experiment activity (drawing objects of observation by 25%, in a group discussion activity by 23%, the activity of asking questions by 17%, and argues activity by 10%. In the process skills of science students on aspects of the skill increased by 25% using the tool, the object classifies 30%, the cooperation within the group by 22%, delivering the acquisition of 23%. Learning outcomes of students has increased by 4% which is in cycle I of 71% to 75% in cycle II. As for the improvement of pre-survey to cycle II by 56% which is 19% in pre-survey become to 75% in Cycle II.   Kata kunci: model learning cycle "5E" disertai LKS, aktivitas belajar, keterampilan proses sains, hasil belajar

  8. Manic Defences in Contemporary Society. The Psychocultural Approach.

    Science.gov (United States)

    Rudan, Dusko; Jakovljevic, Miro; Marcinko, Darko

    2016-12-01

    The article discusses the impact of contemporary culture on the individual's personality. We used the "psychocultural" approach whose key feature is the amalgamation of theories and methods belonging to psychodynamic and psychosocial studies, as well as those used in the field of media and cultural studies. The idea of a potentially therapeutic effect of culture (therapy culture) can already been seen in Freud's and Lacan's texts, and it is often used in critical analyses of contemporary corporate culture, which is more or less developed in some parts of the world. In their criticisms, many contemporary authors emphasize that modern societies have a tendency towards the weakening of basic commitment, or lack thereof, to a social equivalent of Winnicott's concept of environmental provisions as an inalienable democratic right essential for human emotional and mental progress or emotional well-being. The article describes frequent resorting to the so-called manic defences that defensively distort, deny and obscure the awareness that a human being is not the omnipotent source of life, but instead depends on other human beings, and often tries to compensate for loss through various activities. The article describes excessive shopping as an activity that often serves as an attempt to find what was lost, i.e. to fill an emotional void. This solution (resorting to manic defences) is encouraged by contemporary culture, especially through promotional material (e.g. advertising). The main theses of this article are supported by quotations and data from world literature.

  9. Manic symptoms in patients with depressive and/or anxiety disorders

    NARCIS (Netherlands)

    van den Berg, Belinda; Penninx, Brenda; Zitman, Frans G.; Nolen, Willem A.

    2010-01-01

    Background: Previous studies found that patients with depressive disorders frequently have lifetime manic symptoms or even an unrecognized bipolar disorder and that these patients have more severe illness. In this study we investigated whether the presence of significant manic symptoms among

  10. Relationship between manic state after presenile onset and silent cerebral infarction; MRI findings and its distribution

    Energy Technology Data Exchange (ETDEWEB)

    Fujikawa, Tokumi; Yamawaki, Shigeto (Hiroshima Univ. (Japan). School of Medicine); Touhouda, Yoshikuni

    1993-11-01

    Magnetic resonance (MR) imaging was performed in 12 patients who incurred manic state after the age of 50 (manic group). Twelve other age- and sex-matched patients who incurred emotional disturbance at the young age served as controls. Patients with a history of cerebral stroke and local neurologic symptoms were excluded. Silent cerebral infarction (SCI) were concomitantly seen on MR images in 66.7% in the manic group, which was significantly higher than the control group (16.7%). Approximately half of the patients in the manic group seemed to be in the parenchymal manic state associated with SCI. Patients in the manic state associated with SCI was at a risk for developing cerebral stroke. Therefore, the treatment such as antithrombin therapy for cerebrovascular disorder was considered important, from the viewpoint of early treatment of cerebral infarction. Since lesions were frequently observed in the right frontal lobe and basal nucleus in manic patients with the associated SCI, these sites may be in part involved in the occurrence of manic state. (N.K.).

  11. The structure of lifetime manic-hypomanic spectrum.

    Science.gov (United States)

    Cassano, G B; Mula, M; Rucci, P; Miniati, M; Frank, E; Kupfer, D J; Oppo, A; Calugi, S; Maggi, L; Gibbons, R; Fagiolini, A

    2009-01-01

    The observation that bipolar disorders frequently go unrecognized has prompted the development of screening instruments designed to improve the identification of bipolarity in clinical and non-clinical samples. Starting from a lifetime approach, researchers of the Spectrum Project developed the Mood Spectrum Self-Report (MOODS-SR) that assesses threshold-level manifestations of unipolar and bipolar mood psychopathology, but also atypical symptoms, behavioral traits and temperamental features. The aim of the present study is to examine the structure of mania/hypomania using 68 items of the MOODS-SR that explore cognitive, mood and energy/activity features associated with mania/hypomania. A data pool of 617 patients with bipolar disorders, recruited at Pittsburgh and Pisa, Italy was used for this purpose. Classical exploratory factor analysis, based on a tetrachoric matrix, was carried out on the 68 items, followed by an Item Response Theory (IRT)-based factor analytic approach. Nine factors were initially identified, that include Psychomotor Activation, Creativity, Mixed Instability, Sociability/Extraversion, Spirituality/Mysticism/Psychoticism, Mixed Irritability, Inflated Self-esteem, Euphoria, Wastefulness/Recklessness, and account overall for 56.4% of the variance of items. In a subsequent IRT-based bi-factor analysis, only five of them (Psychomotor Activation, Mixed Instability, Spirituality/Mysticism/Psychoticism, Mixed Irritability, Euphoria) were retained. Our data confirm the central role of Psychomotor Activation in mania/hypomania and support the definitions of pure manic (Psychomotor Activation and Euphoria) and mixed manic (Mixed Instability and Mixed Irritability) components, bearing the opportunity to identify patients with specific profiles for a better clinical and neurobiological definition.

  12. Continuum of depressive and manic mixed states in patients with bipolar disorder: quantitative measurement and clinical features

    OpenAIRE

    SWANN, ALAN C.; STEINBERG, JOEL L.; LIJFFIJT, MARIJN; MOELLER, GERARD F.

    2009-01-01

    Bipolar mixed states combine depressive and manic features, presenting diagnostic and treatment challenges and reflecting a severe form of the illness. DSM-IV criteria for a mixed state require combined depressive and manic syndromes, but a range of mixed states has been described clinically. A unified definition of mixed states would be valuable in understanding their diagnosis, mechanism and treatment implications. We investigated the manner in which depressive and manic features combine to...

  13. Daylight saving time transitions and hospital treatments due to accidents or manic episodes

    Directory of Open Access Journals (Sweden)

    Lönnqvist Jouko

    2008-02-01

    Full Text Available Abstract Background Daylight saving time affects millions of people annually but its impacts are still widely unknown. Sleep deprivation and the change of circadian rhythm can trigger mental illness and cause higher accident rates. Transitions into and out of daylight saving time changes the circadian rhythm and may cause sleep deprivation. Thus it seems plausible that the prevalence of accidents and/or manic episodes may be higher after transition into and out of daylight saving time. The aim of this study was to explore the effects of transitions into and out of daylight saving time on the incidence of accidents and manic episodes in the Finnish population during the years of 1987 to 2003. Methods The nationwide data were derived from the Finnish Hospital Discharge Register. From the register we obtained the information about the hospital-treated accidents and manic episodes during two weeks before and two weeks after the transitions in 1987–2003. Results The results were negative, as the transitions into or out of daylight saving time had no significant effect on the incidence of accidents or manic episodes. Conclusion One-hour transitions do not increase the incidence of manic episodes or accidents which require hospital treatment.

  14. Daylight saving time transitions and hospital treatments due to accidents or manic episodes

    Science.gov (United States)

    Lahti, Tuuli A; Haukka, Jari; Lönnqvist, Jouko; Partonen, Timo

    2008-01-01

    Background Daylight saving time affects millions of people annually but its impacts are still widely unknown. Sleep deprivation and the change of circadian rhythm can trigger mental illness and cause higher accident rates. Transitions into and out of daylight saving time changes the circadian rhythm and may cause sleep deprivation. Thus it seems plausible that the prevalence of accidents and/or manic episodes may be higher after transition into and out of daylight saving time. The aim of this study was to explore the effects of transitions into and out of daylight saving time on the incidence of accidents and manic episodes in the Finnish population during the years of 1987 to 2003. Methods The nationwide data were derived from the Finnish Hospital Discharge Register. From the register we obtained the information about the hospital-treated accidents and manic episodes during two weeks before and two weeks after the transitions in 1987–2003. Results The results were negative, as the transitions into or out of daylight saving time had no significant effect on the incidence of accidents or manic episodes. Conclusion One-hour transitions do not increase the incidence of manic episodes or accidents which require hospital treatment. PMID:18302734

  15. Mentalization deficit in bipolar patients during an acute depressive and manic episode: association with cognitive functions.

    Science.gov (United States)

    Bodnar, Anna; Rybakowski, Janusz K

    2017-12-06

    A number of studies in bipolar patients have shown a deficit in mentalization (theory of mind), one of the main aspects of social cognition. The aim of current study was to assess both cognitive and affective mentalization in well-defined groups of depressed and manic bipolar patients, compared to healthy control subjects, using a battery of tests measuring mentalization processes. The second aim was to investigate a possible relationship between cognitive and affective mentalization and cognitive functions in bipolar patients during a depressive and manic episode. The study involved 25 bipolar disorder type I patients (10 male, 15 female) during a depressive episode (mean 24 ± 2 points in the 17-item Hamilton Depression Rating Scale) and 25 patients (10 male, 15 female) during a manic episode (mean 27 ± 4 points in the Young Mania Rating Scale). The control group consisted of 25 healthy subjects (10 male, 15 female) without psychiatric disorders. To measure mentalization, a revised version of the Reading the Mind in the Eyes (R-MET), the Strange Stories (SS), the Faux Pas Recognition (FPR), and the Moving Shapes Paradigm (MSP) tests were used. Assessment of cognitive functioning was made using the Digit Span, Trail Making, and Wisconsin Card Sorting Tests. In bipolar patients significant deficits in both cognitive and affective mentalization were demonstrated during both acute depressive and manic episodes. The impairment in FPR in manic patients was more severe than that in the depressive ones. On the other hand, in MSP, manic patients showed significantly increased intentionality for non-mentalization animations, compared with depressive patients and for "cause and effect" animations compared with control subjects. A significant relationship was found between the decrease in cognitive and affective mentalization and deficits of cognitive functions during both the depressive and manic episodes. The results obtained confirm the deficits of mentalization in

  16. Electrophoresis of platelet monoamine oxidase in schizophrenia and manic-depressive illness

    International Nuclear Information System (INIS)

    Belmaker, R.H.; Ebstein, R.; Rimon, R.; Wyatt, R.J.; Murphy, D.L.

    1976-01-01

    Monoamine oxidase is an important enzyme in the catabolism of biogenic amines and can be measured in human platelets. Platelet MAO has been reported to be reduced in schizophrenic and manic-depressive patients, though other reports are contradictory. The present study evaluated the possibility that qualitative genetic enzyme abnormalities of MAO could be responsible for the different enzyme activities of platelet MAO in different populations. However, polyacrylamide gel electrophoresis of platelet MAO from 10 manic-depressive, 12 schizophrenic, and 11 normal individuals did not reveal any genetic mutant forms. (author)

  17. Social cognition and the manic defense: attributions, selective attention, and self-schema in bipolar affective disorder.

    Science.gov (United States)

    Lyon, H M; Startup, M; Bentall, R P

    1999-05-01

    Manic patients, depressed bipolar patients, and normal controls were compared on measures of social cognition. Manic patients showed a normal self-serving bias on the Attributional Style Questionnaire, but depressed patients attributed negative events more than positive events to self. On an implicit test of attributional style, both patient groups attributed negative events more than positive events to self. Both patient groups showed slowed color naming for depression-related but not euphoria-related words. Manic patients, like normal controls, endorsed mainly positive words as true of self but, like the depressed patients, recalled mainly negative words. Findings from the implicit tests indicate a common form of psychological organization in manic and depressed patients, whereas the contrasts between the scores on the implicit and explicit measures are consistent with the hypothesis of a manic defense.

  18. Co-occurring manic symptomatology as a dimension which may help explaining heterogeneity of depression

    NARCIS (Netherlands)

    Jabben, Nienke; Penninx, Brenda; Beekman, Aartjan T. F.; Smit, Johannes H.; Nolen, Willem A.

    Background: The dichotomous distinction between unipolar and bipolar disorders may be challenged by heterogeneity within diagnoses and overlap between different diagnoses. A broad mood disorder category in which patients differ as a result of variation along separate manic and depressive mood

  19. Manic fringe inhibits tumor growth by suppressing Notch3 degradation in lung cancer.

    Science.gov (United States)

    Yi, Fuming; Amarasinghe, Baru; Dang, Thao P

    2013-01-01

    Notch signaling plays an essential role in development as well as cancer. We have previously shown that Notch3 is important for lung cancer growth and survival. Notch receptors are activated through the interaction with their ligands, resulting in proteolytic cleavage of the receptors. This interaction is modulated by Fringe, a family of fucose-specific β1,3 N-acetylglucosaminyltransferases that modify the extracellular subunit of Notch receptors. Studies in developmental models showed that Fringe enhances Notch's response to Delta ligands at the expense of Jagged ligands. We observed that Manic Fringe expression is down-regulated in lung cancer. Since Jagged1, a known ligand for Notch3, is often over-expressed in lung cancer, we hypothesized that Fringe negatively regulates Notch3 activation. In this study, we show that re-expression of Manic Fringe down-regulates Notch3 target genes HES1 and HeyL and reduces tumor phenotype in vitro and in vivo. The mechanism for this phenomenon appears to be related to modulation of Notch3 protein stability. Proteasome inhibition reverses Manic Fringe-induced protein turnover. Taken together, our data provide the first evidence that Manic Fringe functions as a tumor suppressor in the lung and that the mechanism of its anti-tumor activity is mediated by inhibition of Notch3 activation.

  20. The Structure of Cognitive Abilities in Youths with Manic Symptoms: A Factorial Invariance Study

    Science.gov (United States)

    Beaujean, A. Alexander; Freeman, Megan Joseph; Youngstrom, Eric; Carlson, Gabrielle

    2012-01-01

    This study compared the structure of cognitive ability (specifically, verbal/crystallized ["Gc"] and visual-spatial ability ["Gv"]), as measured in the Wechsler Intelligence Scale for Children, in youth with manic symptoms with a nationally representative group of similarly aged youth. Multigroup confirmatory factor analysis…

  1. Cognitive manic symptoms in bipolar disorder associated with polymorphisms in the DAOA and COMT genes.

    Directory of Open Access Journals (Sweden)

    Dzana Sudic Hukic

    Full Text Available INTRODUCTION: Bipolar disorder is characterized by severe mood symptoms including major depressive and manic episodes. During manic episodes, many patients show cognitive dysfunction. Dopamine and glutamate are important for cognitive processing, thus the COMT and DAOA genes that modulate the expression of these neurotransmitters are of interest for studies of cognitive function. METHODOLOGY: Focusing on the most severe episode of mania, a factor was found with the combined symptoms of talkativeness, distractibility, and thought disorder, considered a cognitive manic symptoms (CMS factor. 488 patients were genotyped, out of which 373 (76% had talkativeness, 269 (55% distractibility, and 372 (76% thought disorder. 215 (44% patients were positive for all three symptoms, thus showing CMS (Table 1. As population controls, 1,044 anonymous blood donors (ABD were used. Case-case and case-control design models were used to investigate genetic associations between cognitive manic symptoms in bipolar 1 disorder and SNPs in the COMT and DAOA genes. [Table: see text]. RESULTS: The finding of this study was that cognitive manic symptoms in patients with bipolar 1 disorder was associated with genetic variants in the DAOA and COMT genes. Nominal association for DAOA SNPs and COMT SNPs to cognitive symptoms factor in bipolar 1 disorder was found in both allelic (Table 2 and haplotypic (Table 3 analyses. Genotypic association analyses also supported our findings. However, only one association, when CMS patients were compared to ABD controls, survived correction for multiple testing by max (T permutation. Data also suggested interaction between SNPs rs2391191 in DAOA and rs5993883 in COMT in the case-control model. [Table: see text] [Table: see text]. CONCLUSION: Identifying genes associated with cognitive functioning has clinical implications for assessment of prognosis and progression. Our finding are consistent with other studies showing genetic associations

  2. Assessment of implicit self-esteem in bipolar manic and euthymic patients using the implicit association test.

    Science.gov (United States)

    Park, Jin Young; Ryu, Vin; Ha, Ra Yeon; Lee, Su Jin; Choi, Won-Jung; Ha, Kyooseob; Cho, Hyun-Sang

    2014-04-01

    Although self-esteem is thought to be an important psychological factor in bipolar disorder, little is known about implicit and explicit self-esteem in manic patients. In this study, we investigated differences in implicit and explicit self-esteem among bipolar manic patients, bipolar euthymic patients, and healthy controls using the Implicit Association Test (IAT). Participants included 19 manic patients, 27 euthymic patients, and 27 healthy controls. Participants completed a self-esteem scale to evaluate explicit self-esteem and performed the self-esteem IAT to evaluate implicit self-esteem. There were no differences among groups in explicit self-esteem. However, there were significant differences among groups in implicit self-esteem. Manic patients had higher IAT scores than euthymic patients and a trend toward higher IAT scores than healthy controls. Our findings suggest that, on the latent level, a manic state is not simply the opposite of a depressed state. Furthermore, there may be a discontinuity of implicit self-esteem between manic and euthymic states. These unexpected results may be due to characteristics of the study participants or the methods used to assess implicit self-esteem. Nevertheless, they provide greater insights on the psychological status of manic patients. © 2014.

  3. Risk of recurrence after a single manic or mixed episode - a systematic review and meta-analysis

    DEFF Research Database (Denmark)

    Kessing, Lars Vedel; Andersen, Per Kragh; Vinberg, Maj

    2017-01-01

    OBJECTIVES: For the first time to estimate the risk of recurrence among patients with a single manic/mixed episode by systematically reviewing prior studies on cohorts of adults, and cohorts of children and adolescents, respectively. METHODS: A systematic literature search up to August 2017...... was carried out including studies in which mixed episode at inclusion. RESULTS: Three studies including a total of 293 adult patients with a single manic or mixed episode...... as children and adolescents. It is important that clinicians and patients as well as relatives are well informed about these high risks when deciding to start maintenance treatment or not following onset of a single manic or mixed episode....

  4. Cognitive reactivity to success and failure relate uniquely to manic and depression tendencies and combine in bipolar tendencies.

    Science.gov (United States)

    Raes, Filip; Ghesquière, Ine; Van Gucht, Dinska

    2012-01-01

    The present study examined simultaneously the relations between cognitive reactivity to success and failure, on the one hand, and depression, manic, and bipolar tendencies, on the other hand. Participants (161 students) completed measures of success and failure reactivity, current manic and depressive symptoms, and tendencies towards depression, mania, and bipolarity. Results showed that respondents with a greater tendency towards depression evidenced greater (negative) reactivity to failure, whereas those with a greater tendency toward mania evidenced greater (positive) reactivity to success. Depression vulnerability was unrelated to success reactivity, and manic vulnerability was unrelated to failure reactivity. Tendencies toward bipolarity correlated significantly with both failure and success reactivity in a negative and positive manner, respectively. These findings add to the growing body of literature, suggesting that different features or cognitive tendencies are related to depression vulnerability versus manic vulnerability and imply that these "mirrored" cognitive features both form part of vulnerability to bipolar disorder.

  5. Cognitive Reactivity to Success and Failure Relate Uniquely to Manic and Depression Tendencies and Combine in Bipolar Tendencies

    Directory of Open Access Journals (Sweden)

    Filip Raes

    2012-01-01

    Full Text Available The present study examined simultaneously the relations between cognitive reactivity to success and failure, on the one hand, and depression, manic, and bipolar tendencies, on the other hand. Participants (161 students completed measures of success and failure reactivity, current manic and depressive symptoms, and tendencies towards depression, mania, and bipolarity. Results showed that respondents with a greater tendency towards depression evidenced greater (negative reactivity to failure, whereas those with a greater tendency toward mania evidenced greater (positive reactivity to success. Depression vulnerability was unrelated to success reactivity, and manic vulnerability was unrelated to failure reactivity. Tendencies toward bipolarity correlated significantly with both failure and success reactivity in a negative and positive manner, respectively. These findings add to the growing body of literature, suggesting that different features or cognitive tendencies are related to depression vulnerability versus manic vulnerability and imply that these “mirrored” cognitive features both form part of vulnerability to bipolar disorder.

  6. Familial cosegregation of manic-depressive illness and a form of hereditary cerebellar ataxia

    Energy Technology Data Exchange (ETDEWEB)

    Piqueras, J.F.; Santos, J.; Puertollano, R. [Universidad Autonoma, Madrid (Spain)] [and others

    1995-06-19

    We report on a Spanish family with co-occurrence of manic-depression and a form of hereditary cerebellar ataxia. All affected individuals in the second generation showed cerebellar ataxia and manic-depression simultaneously. Since anticipation has been described in both disorders and the pattern of segregation may be autosomal as well as X-linked, we have searched for a possible involvement of two candidate genes which are located either on an autosome (SCA1) or on the X-chromosome (GABRA3). We concluded that expansion of trinucleotide repeats at SCA1 gene cannot be considered as a disease-causing mutation, and this gene should be initially discarded. 19 refs., 3 figs.

  7. Systematic chromosome examination of two families with schizophrenia and two families with manic depressive illness

    Energy Technology Data Exchange (ETDEWEB)

    Friedrich, U.; Mors, O.; Ewald, H. [Aarhus Univ. (Denmark)

    1996-02-16

    Systematic and detailed chromosome analysis, combined with a semistructured interview, was performed in 2 families with schizophrenia and in 2 families with manic depressive illness. Prometaphase technique did not reveal any subtle structural chromosome abnormalities. However, in standard techniques, gain and loss of sex chromosomes were observed. This occurred in patients at a younger age than in unaffected persons. This gives rise to the suspicion that sex chromosome aneuploidy may somehow be related to the development of psychosis. But since the data set is small, especially with respect to schizophrenia, further studies are needed to elucidate this observation. In one family, cosegregation of the disease locus with a marker on chromosome 21 was seen. Therefore, further research should determine if chromosome 21 contains a gene for manic depressive illness. 10 refs., 3 figs., 2 tabs.

  8. Acute manic episode is associated with an increased risk of lower limb edema.

    Science.gov (United States)

    Hochman, Eldar; Krivoy, Amir; Shoval, Gal; Valevski, Avi; Weizman, Abraham; Fischel, Tsvi

    2013-12-02

    Lower limb edema (LLE) was suggested to be associated with the use of psychotropic drugs among patients suffering from severe mental illnesses; however no direct mechanism was found. Therefore, we examined the association between the occurrence of LLE and acute untreated episode leading to hospitalization. A retrospective cross-sectional study was conducted using medical charts of 2529 patients admitted to Geha Mental Health Center between 2002 and 2012. Incident cases of LLE, demographic and clinical data were retrieved. Admission clinical status was modeled as three non-overlapping groups of patients: (i) Patients with a non-affective psychosis (NAP) episode (n = 1563), (ii) patients with a manic episode (n = 366), and (iii) patients with a depressive episode (n = 600). We performed a logistic regression analysis with LLE as the dependent variable controlling for the demographic and clinical variables that may be associated with LLE. LLE was diagnosed in 3.8% (n = 95) of the study population. The rate of LLE was 3-fold higher (χ(2) = 51.9, df = 2, p<0.001) in patients admitted with a manic episode (n = 38; 10.4%) compared to patients admitted with a NAP episode (n = 41; 2.6%) and patients admitted with a depressive episode (n = 16; 2.7%). Manic episode was associated with an increased risk for LLE compared to depressive episode (OR 8.72, 95% CI: 3.53-21.52, p<0.001) or NAP episode (OR 3.96, 95% CI: 2.16-7.26, p<0.001) after controlling for relevant confounders. Acute manic episode, leading to hospitalization, is associated with an increased risk of LLE, compared to NAP or depressive episode, suggesting causal relationship between mood and fluid imbalance. Yet, future prospective studies are needed to rule out the contribution of physical agitation and lithium treatment. © 2013.

  9. A case of adrenoleukodystrophy presenting with manic symptoms in a patient on steroids for Addison's disease.

    Science.gov (United States)

    Jyothi, K S; George, Cyriac; Shaji, K S

    2016-01-01

    Adrenoleukodystrophy (ALD) is an X-linked disorder with diverse clinical presentations. A 30-year-old male, previously diagnosed with Addison's disease, on steroid supplementation for 18 years, presented to us with manic symptoms for 4 years. He was found to have white matter hypodensities in computed tomography head and had white matter signal changes in magnetic resonance imaging, and therefore a diagnosis of ALD was made.

  10. The real world cost and health resource utilization associated to manic episodes: The MANACOR study.

    Science.gov (United States)

    Hidalgo-Mazzei, Diego; Undurraga, Juan; Reinares, María; Bonnín, Caterina del Mar; Sáez, Cristina; Mur, María; Nieto, Evaristo; Vieta, Eduard

    2015-01-01

    Bipolar disorder is a relapsing-remitting condition affecting approximately 1-2% of the population. Even when the treatments available are effective, relapses are still very frequent. Therefore, the burden and cost associated to every new episode of the disorder have relevant implications in public health. The main objective of this study was to estimate the associated health resource consumption and direct costs of manic episodes in a real world clinical setting, taking into consideration clinical variables. Bipolar I disorder patients who recently presented an acute manic episode based on DSM-IV criteria were consecutively included. Sociodemographic variables were retrospectively collected and during the 6 following months clinical variables were prospectively assessed (YMRS,HDRS-17,FAST and CGI-BP-M). The health resource consumption and associate cost were estimated based on hospitalization days, pharmacological treatment, emergency department and outpatient consultations. One hundred sixty-nine patients patients from 4 different university hospitals in Catalonia (Spain) were included. The mean direct cost of the manic episodes was €4,771. The 77% (€3,651) was attributable to hospitalization costs while 14% (€684) was related to pharmacological treatment, 8% (€386) to outpatient visits and only 1% (€50) to emergency room visits. The hospitalization days were the main cost driver. An initial FAST score>41 significantly predicted a higher direct cost. Our results show the high cost and burden associated with BD and the need to design more cost-efficient strategies in the prevention and management of manic relapses in order to avoid hospital admissions. Poor baseline functioning predicted high costs, indicating the importance of functional assessment in bipolar disorder. Copyright © 2014 SEP y SEPB. Published by Elsevier España. All rights reserved.

  11. Alcohol withdrawal delirium manifested by manic symptoms in an elderly patient.

    Science.gov (United States)

    Chan, Hung-Yu; Lee, Kuan-I

    2015-03-01

    Alcohol withdrawal syndrome is a commonly seen problem in psychiatric practice. Alcohol withdrawal delirium is associated with significant morbidity and mortality. Withdrawal symptoms usually include tremulousness, psychotic and perceptual symptoms, seizures, and consciousness disturbance. Herein, we report a case involving a 63-year-old man who had alcohol withdrawal delirium that was manifested mainly by manic symptoms. © 2014 The Authors. Psychogeriatrics © 2014 Japanese Psychogeriatric Society.

  12. Manic behavior and asymmetric right frontotemporal dementia from a novel progranulin mutation

    Directory of Open Access Journals (Sweden)

    Mendez MF

    2018-02-01

    Full Text Available Mario F Mendez1–3 1Department of Neurology, 2Department of Psychiatry & Biobehavioral Sciences, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA, USA; 3Neurology Service, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA Abstract: Studies suggest a relationship of manic behavior and bipolar disorder (BD with behavioral variant frontotemporal dementia (bvFTD. The nature of this relationship is unclear. This report presents a patient with initial manic behavior as the main manifestation of familial bvFTD from a novel progranulin (GRN mutation. In contrast, there are other reports of a long background of BD preceding a diagnosis of bvFTD. A review of the literature and this patient suggest that manic symptoms result from damage to right frontotemporal neural structures from longstanding BD, as well as from bvFTD and other focal neurological disorders. In addition, there is a subgroup of patients with a probable genetic predisposition to both BD and bvFTD. Keywords: frontotemporal dementia, mania, bipolar disorder, progranulin mutation

  13. Affect recognition across manic and euthymic phases of bipolar disorder in Han-Chinese patients.

    Science.gov (United States)

    Pan, Yi-Ju; Tseng, Huai-Hsuan; Liu, Shi-Kai

    2013-11-01

    Patients with bipolar disorder (BD) have affect recognition deficits. Whether affect recognition deficits constitute a state or trait marker of BD has great etiopathological significance. The current study aims to explore the interrelationships between affect recognition and basic neurocognitive functions for patients with BD across different mood states, using the Diagnostic Analysis of Non-Verbal Accuracy-2, Taiwanese version (DANVA-2-TW) as the index measure for affect recognition. To our knowledge, this is the first study examining affect recognition deficits of BPD across mood states in the Han Chinese population. Twenty-nine manic patients, 16 remitted patients with BD, and 40 control subjects are included in the study. Distinct association patterns between affect recognition and neurocognitive functions are demonstrated for patients with BD and control subjects, implicating alternations in emotion associated neurocognitive processing. Compared to control subjects, manic patients but not remitted subjects perform significantly worse in the recognition of negative emotions as a whole and specifically anger, after adjusting for differences in general intellectual ability and basic neurocognitive functions. Affect recognition deficit may be a relatively independent impairment in BD rather than consequences arising from deficits in other basic neurocognition. The impairments of manic patients in the recognition of negative emotions, specifically anger, may further our understanding of core clinical psychopathology of BD and have implications in treating bipolar patients across distinct mood phases. © 2013 Elsevier B.V. All rights reserved.

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

    Science.gov (United States)

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

    2016-05-30

    Bipolar disorder is associated with significant deficits in the decoding of others' mental states in comparison to healthy participants. However, differences in theory of mind decoding ability among patients in manic, depressed, and euthymic phases of bipolar disorder is currently unknown. Fifty-nine patients with bipolar I or II disorder (13 manic, 25 depressed, 20 euthymic) completed the "Reading the Mind in the Eyes" Task (Eyes task) and the Animals Task developed to control for non-mentalistic response demands of the Eyes Task. Patients also completed self-report and clinician-rated measures of depression, mania, and anxiety symptoms. Patients in the manic phase were significantly less accurate than those in the depressed and euthymic phases at decoding mental states in the Eyes task, and this effect was strongest for eyes of a positive or neutral valence. Further Eyes task performance was negatively correlated with the symptoms of language/thought disorder, pressured speech, and disorganized thoughts and appearance. These effects held when controlling for accuracy on the Animals task, response times, and relevant demographic and clinical covariates. Results suggest that the state of mania, and particularly psychotic symptoms that may overlap with the schizophrenia spectrum, are most strongly related to social cognitive deficits in bipolar disorder. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  15. Adjunctive treatment of manic agitation with lorazepam versus haloperidol: a double-blind study.

    Science.gov (United States)

    Lenox, R H; Newhouse, P A; Creelman, W L; Whitaker, T M

    1992-02-01

    While lithium is effective in treating the majority of bipolar patients during a manic episode, the addition of neuroleptic during the early phase of treatment has been common clinical practice in inpatient settings. In an earlier open study, we demonstrated the utility of the short-acting benzodiazepine lorazepam as an adjunct to lithium for the clinical management of manic agitation. We now present data from a randomized, double-blind clinical study of lorazepam versus haloperidol in 20 hospitalized patients with a DSM-III-R diagnosis of bipolar disorder who were being treated concomitantly with lithium. Patients were rated using the Mania Rating Scale, Brief Psychiatric Rating Scale, Physician Global Impression Scale, and side effects scales. Data were analyzed using standard group comparisons and survival analysis. There was no evidence for a significant difference between the two treatment groups in the magnitude of or time to response (5.0 +/- .82 days for haloperidol; 6.5 +/- .93 days for lorazepam). Of the patients who were terminated from the protocol early, nonresponse was the primary reason in the lorazepam group while side effects were the reason in the haloperidol group. Lorazepam may offer an efficacious and safe alternative to haloperidol as an adjunctive treatment to lithium in the clinical management of the early phase of manic agitation in a subgroup of bipolar patients.

  16. Manic tendencies are not related to being an entrepreneur, intending to become an entrepreneur, or succeeding as an entrepreneur.

    Science.gov (United States)

    Johnson, Sheri L; Freeman, Michael A; Staudenmaier, Paige J

    2015-03-01

    Popular literature suggests a relationship between entrepreneurship and manic tendencies, yet little scientific research has evaluated whether manic tendencies foster entrance into entrepreneurial roles, intent to become an entrepreneur, or success as an entrepreneur. In study 1, 225 undergraduates and business school students/affiliates took an online survey to assess engagement and intent as entrepreneurs, as well as manic tendencies, including family diagnoses as reported on the Family Index of Risk for Mania, subsyndromal manic tendencies as assessed with the Hypomanic Personality Scale, and self-reported diagnoses. In study 2, the sample of entrepreneurs identified in study 1 was enriched by recruiting a larger group of established entrepreneurs from the community. Entrepreneurs (n=210) completed items concerning their success in entrepreneurship, and we examined whether the three measures of manic tendencies were related to success. There was no evidence that those vulnerable to mania, regardless of definition, were more likely to be entrepreneurs, to intend to become entrepreneurs, or to succeed as entrepreneurs. The studies were limited by self-report measures and relatively small samples. More nuanced models may explain the frequent clinical observations of manic traits among entrepreneurs. Copyright © 2014 Elsevier B.V. All rights reserved.

  17. Amygdala-prefrontal cortex resting-state functional connectivity varies with first depressive or manic episode in bipolar disorder.

    Science.gov (United States)

    Wei, Shengnan; Geng, Haiyang; Jiang, Xiaowei; Zhou, Qian; Chang, Miao; Zhou, Yifang; Xu, Ke; Tang, Yanqing; Wang, Fei

    2017-02-22

    Bipolar disorder (BD) is one of the most complex mental illnesses, characterized by interactive depressive and manic states that are 2 contrary symptoms of disease states. The bilateral amygdala and prefrontal cortex (PFC) appear to play critical roles in BD; however, abnormalities seem to manifest differently in the 2 states and may provide further insight into underlying mechanisms. Sixteen participants with first-episode depressive and 13 participants with first-episode manic states of bipolar disorder as well as 30 healthy control (HC) participants underwent resting-state functional magnetic resonance imaging (fMRI). Resting-state functional connectivity (rsFC) between the bilateral amygdala and PFC was compared among the 3 groups. Compared with depressive state participants of the BD group, manic state participants of the BD group showed a significant decrease in rsFC between the amygdala and right orbital frontal cortex (pamygdala and left middle frontal cortex was significantly decreased in depressive and manic state participants of the BD group when compared with the HC group (pamygdala- left PFC functional connectivity might present the trait feature for BD, while deficits in amygdala- right PFC functional connectivity might be specific to manic episode, compared to depressive episode. Copyright © 2017 Elsevier B.V. All rights reserved.

  18. Search for a gene predisposing to manic-depression on chromosome 21

    Energy Technology Data Exchange (ETDEWEB)

    Byerley, W.; Holik, J.; Hoff, M.; Coon, H. [Univ. of Utah Medical Center, Salt Lake City, UT (United States)

    1995-06-19

    Six kindreds containing multiple cases of manic-depressive illness (MDI) were genotyped with seven highly polymorphic microsatellite loci used in the construction of an index map for chromosome 21. The kindreds were also genotyped with a microsatellite polymorphism for PFKL, a chromosome 21 locus that has shown suggestive linkage to MDI in one pedigree. Evidence of linkage was not found assuming either autosomal dominant or recessive inheritance. The nonparametric affected sib pair test did not yield significant evidence of linkage. 11 refs., 1 fig., 3 tabs.

  19. Manic-Like Psychosis Associated with Elevated Trough Tacrolimus Blood Concentrations 17 Years after Kidney Transplant

    Directory of Open Access Journals (Sweden)

    Giuseppe Bersani

    2013-01-01

    Full Text Available Several neurological side effects induced by tacrolimus are described in the scientific literature, ranging from mild neurological symptoms to delirium and psychosis. We report the case of a 46-year-old man with no prior psychiatric history who suddenly manifested manic-like psychosis associated with elevated trough tacrolimus blood concentrations 17 years after kidney transplant. The use of antipsychotics may improve the severity of symptoms; but in order to obtain a complete remission, the reduction in the dose of tacrolimus, or its replacement with alternative immunosuppressant therapies, is recommended.

  20. Decreased activation and subsyndromal manic symptoms predict lower remission rates in bipolar depression.

    Science.gov (United States)

    Caldieraro, Marco Antonio; Walsh, Samantha; Deckersbach, Thilo; Bobo, William V; Gao, Keming; Ketter, Terence A; Shelton, Richard C; Reilly-Harrington, Noreen A; Tohen, Mauricio; Calabrese, Joseph R; Thase, Michael E; Kocsis, James H; Sylvia, Louisa G; Nierenberg, Andrew A

    2017-11-01

    Activation encompasses energy and activity and is a central feature of bipolar disorder. However, the impact of activation on treatment response of bipolar depression requires further exploration. The aims of this study were to assess the association of decreased activation and sustained remission in bipolar depression and test for factors that could affect this association. We assessed participants with Diagnostic and Statistical Manual of Mental Disorders (4th ed) bipolar depression ( n = 303) included in a comparative effectiveness study of lithium- and quetiapine-based treatments (the Bipolar CHOICE study). Activation was evaluated using items from the Bipolar Inventory of Symptoms Scale. The selection of these items was based on a dimension of energy and interest symptoms associated with poorer treatment response in major depression. Decreased activation was associated with lower remission rates in the raw analyses and in a logistic regression model adjusted for baseline severity and subsyndromal manic symptoms (odds ratio = 0.899; p = 0.015). The manic features also predicted lower remission (odds ratio = 0.934; p bipolar depression. Patients with these features may require specific treatment approaches, but new studies are necessary to identify treatments that could improve outcomes in this population.

  1. The role of asenapine in the treatment of manic or mixed states associated with bipolar I disorder

    Directory of Open Access Journals (Sweden)

    Pompili M

    2011-05-01

    Full Text Available Maurizio Pompili1,2, Paola Venturini1, Marco Innamorati1, Gianluca Serafini1, Ludovica Telesforo1, David Lester3, Roberto Tatarelli1, Paolo Girardi11Department of Neurosciences, Mental Health and Sensory Functions, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy; 2McLean Hospital, Harvard Medical School, Boston, MA, USA; 3The Richard Stockton College of New Jersey, Pomona, NJ, USABackground: Bipolar disorders (BD are of particular public health significance as they are prevalent, severe and disabling, and often associated with elevated risks of premature mortality. The aim of this concise overview is to investigate the role of asenapine in the treatment of manic and mixed states associated with BD type 1 disorder.Method: MedLine, Excerpta Medica and PsycINFO searches were performed to identify papers in English published over the past 7 years. Search terms were "asenapine", "manic" OR "mixed states", "bipolar I disorder". Subjects included in this study suffered from BD type 1 disorder.Results: To date, only four studies of asenapine for the treatment of manic or mixed episodes associated with BD type 1 have been published.Conclusion: Research indicates that asenapine is generally well-tolerated, and that asenapine is efficacious and not inferior to olanzapine in the treatment of mixed or manic episodes associated with BD type 1 in the short-term and long-term.Keywords: asenapine, bipolar disorder, side effects

  2. The dominance behavioral system and manic temperament: Motivation for dominance, self-perceptions of power, and socially dominant behaviors

    OpenAIRE

    Johnson, Sheri L.; Carver, Charles S.

    2012-01-01

    The dominance behavioral system has been conceptualized as a biologically based system comprising motivation to achieve social power and self-perceptions of power. Biological, behavioral, and social correlates of dominance motivation and self-perceived power have been related to a range of psychopathological tendencies. Preliminary evidence suggests that mania and risk for mania (manic temperament) relate to the dominance system.

  3. Specific alterations in plasma proteins during depressed, manic, and euthymic states of bipolar disorder

    Energy Technology Data Exchange (ETDEWEB)

    Song, Y.R. [Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing (China); Chongqing Key Laboratory of Neurobiology, Chongqing (China); Institute of Neuroscience and the Collaborative Innovation Center for Brain Science, Chongqing Medical University, Chongqing (China); Wu, B. [Chongqing Key Laboratory of Neurobiology, Chongqing (China); Institute of Neuroscience and the Collaborative Innovation Center for Brain Science, Chongqing Medical University, Chongqing (China); Yang, Y.T.; Chen, J. [Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing (China); Chongqing Key Laboratory of Neurobiology, Chongqing (China); Institute of Neuroscience and the Collaborative Innovation Center for Brain Science, Chongqing Medical University, Chongqing (China); Zhang, L.J.; Zhang, Z.W. [Chongqing Key Laboratory of Neurobiology, Chongqing (China); Institute of Neuroscience and the Collaborative Innovation Center for Brain Science, Chongqing Medical University, Chongqing (China); Shi, H.Y. [Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing (China); Chongqing Key Laboratory of Neurobiology, Chongqing (China); Institute of Neuroscience and the Collaborative Innovation Center for Brain Science, Chongqing Medical University, Chongqing (China); Huang, C.L.; Pan, J.X. [Chongqing Key Laboratory of Neurobiology, Chongqing (China); Institute of Neuroscience and the Collaborative Innovation Center for Brain Science, Chongqing Medical University, Chongqing (China); Xie, P. [Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing (China); Chongqing Key Laboratory of Neurobiology, Chongqing (China); Institute of Neuroscience and the Collaborative Innovation Center for Brain Science, Chongqing Medical University, Chongqing (China)

    2015-09-08

    Bipolar disorder (BD) is a common psychiatric mood disorder affecting more than 1-2% of the general population of different European countries. Unfortunately, there is no objective laboratory-based test to aid BD diagnosis or monitor its progression, and little is known about the molecular basis of BD. Here, we performed a comparative proteomic study to identify differentially expressed plasma proteins in various BD mood states (depressed BD, manic BD, and euthymic BD) relative to healthy controls. A total of 10 euthymic BD, 20 depressed BD, 15 manic BD, and 20 demographically matched healthy control subjects were recruited. Seven high-abundance proteins were immunodepleted in plasma samples from the 4 experimental groups, which were then subjected to proteome-wide expression profiling by two-dimensional electrophoresis and matrix-assisted laser desorption/ionization-time-of-flight/time-of-flight tandem mass spectrometry. Proteomic results were validated by immunoblotting and bioinformatically analyzed using MetaCore. From a total of 32 proteins identified with 1.5-fold changes in expression compared with healthy controls, 16 proteins were perturbed in BD independent of mood state, while 16 proteins were specifically associated with particular BD mood states. Two mood-independent differential proteins, apolipoprotein (Apo) A1 and Apo L1, suggest that BD pathophysiology may be associated with early perturbations in lipid metabolism. Moreover, down-regulation of one mood-dependent protein, carbonic anhydrase 1 (CA-1), suggests it may be involved in the pathophysiology of depressive episodes in BD. Thus, BD pathophysiology may be associated with early perturbations in lipid metabolism that are independent of mood state, while CA-1 may be involved in the pathophysiology of depressive episodes.

  4. Specific alterations in plasma proteins during depressed, manic, and euthymic states of bipolar disorder

    International Nuclear Information System (INIS)

    Song, Y.R.; Wu, B.; Yang, Y.T.; Chen, J.; Zhang, L.J.; Zhang, Z.W.; Shi, H.Y.; Huang, C.L.; Pan, J.X.; Xie, P.

    2015-01-01

    Bipolar disorder (BD) is a common psychiatric mood disorder affecting more than 1-2% of the general population of different European countries. Unfortunately, there is no objective laboratory-based test to aid BD diagnosis or monitor its progression, and little is known about the molecular basis of BD. Here, we performed a comparative proteomic study to identify differentially expressed plasma proteins in various BD mood states (depressed BD, manic BD, and euthymic BD) relative to healthy controls. A total of 10 euthymic BD, 20 depressed BD, 15 manic BD, and 20 demographically matched healthy control subjects were recruited. Seven high-abundance proteins were immunodepleted in plasma samples from the 4 experimental groups, which were then subjected to proteome-wide expression profiling by two-dimensional electrophoresis and matrix-assisted laser desorption/ionization-time-of-flight/time-of-flight tandem mass spectrometry. Proteomic results were validated by immunoblotting and bioinformatically analyzed using MetaCore. From a total of 32 proteins identified with 1.5-fold changes in expression compared with healthy controls, 16 proteins were perturbed in BD independent of mood state, while 16 proteins were specifically associated with particular BD mood states. Two mood-independent differential proteins, apolipoprotein (Apo) A1 and Apo L1, suggest that BD pathophysiology may be associated with early perturbations in lipid metabolism. Moreover, down-regulation of one mood-dependent protein, carbonic anhydrase 1 (CA-1), suggests it may be involved in the pathophysiology of depressive episodes in BD. Thus, BD pathophysiology may be associated with early perturbations in lipid metabolism that are independent of mood state, while CA-1 may be involved in the pathophysiology of depressive episodes

  5. Effect of HIV infection on time to recovery from an acute manic episode

    Directory of Open Access Journals (Sweden)

    E Nakimuli-Mpungu

    2010-09-01

    Full Text Available E Nakimuli-Mpungu1,2,3, B Mutamba2,3, S Nshemerirwe2,3, MS Kiwuwa4, S Musisi21Mental Health Department, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA; 2Department of Psychiatry, Makerere College of Health Sciences, School of Medicine, Kampala; 3Butabika National Referral Mental Hospital, Ministry of Health, Kampala; 4Clinical Epidemiology Unit, Makerere College of Health Sciences, School of Medicine, Kampala, UgandaIntroduction: Understanding factors affecting the time to recovery from acute mania is critical in the management of manic syndromes. The aim of this study was to determine the effect of HIV infection on time to recovery from acute mania.Methods: We performed a retrospective study in which medical charts of individuals who were treated for acute mania were reviewed. Survival analysis with Cox regression models were used to compare time to recovery from an acute manic episode between human immunodeficiency virus (HIV-positive individuals and HIV-negative individuals.Results: Median survival time was one week for HIV-positive individuals and more than four weeks for HIV-negative individuals (Χ2 = 18.4, P value = 0.000. HIV infection was the only marginally significant independent predictor of survival probability on the acute admission ward (hazards ratio 2.87, P = 0.06.Conclusion: Acute mania in HIV-infected persons responds faster to psychotropic drugs compared with that in HIV-negative persons.Keywords: HIV-related mania, bipolar disorder, HIV infection, Uganda, immunodeficiency virus

  6. [The epidemiology of suicide in bipolar disorder in the manic episode--preliminary reports].

    Science.gov (United States)

    Wierzbiński, Piotr; Zdanowicz, Anna; Klekowska, Justyna; Broniarczyk-Czarniak, Marta; Zboralski, Krzysztof

    2014-04-01

    Suicide is among ten leading causes of death in each country and the third most common cause of death in the age group 16-35. The presence of mental illness is the most important risk factor for suicide. Affective disorders contribute to 15-25% of deaths due to suicide attempts. Depression is the most likely cause of the patients attempt on his life. Contrary to popular opinion, manic episode can also increase the risk of suicide, especially if the patient dominates by productive symptoms in the form of delusions. The aim of study was to determine the frequency of suicide attempts and their determinants in an episode of mania in bipolar disorder. The study included 16 people with a diagnosed bipolar disorder, hospitalized with manic episode at the age of 28-76. Patients hospitalized in the Department of Adult Psychiatry were selected randomly. The number of suicide attempts, comorbid conditions, and basic epidemiological data were estimated. Five patients declared suicide attempt, one of which wanted to make more than one attempt at suicide. 3 people took it during an episode of depression, two in an episode of mania. The methods of suicide were associated with an overdose of medication and this was accompanied by a greater amount of alcohol intake. 11 persons did not declare any willingness to attempt suicide. A mania episode did not increase the risk of suicide in bipolar disorder compared to an episode of depression in the study conducted. The importance of somatic illness in patients with bipolar disorder is increased if the suicide attempt occurs in an episode of depression. Alcohol abuse showed no negative effects on suicidal behavior of patients. During abuse was the most common way of commit suicide.

  7. Complicated grief and manic comorbidity in the aftermath of the loss of a son.

    Science.gov (United States)

    Carmassi, Claudia; Shear, M Katherine; Socci, Chiara; Corsi, Martina; Dell'osso, Liliana; First, Michael B

    2013-09-01

    Based on the recommendations of the sub-workgroup on trauma and dissociative disorders, the American Psychiatric Association (APA) removed the "bereavement exclusion" from the criteria for major depression in DSM-5. In addition, proposed DSM-5 research criteria for persistent complex bereavement disorder (PCBD) were included in the new manual in a section for conditions and criteria needing further research. We describe a case that warranted such a diagnosis. The patient was a 52- year-old woman who was admitted to the inpatient unit of our clinic on the birthday of her son who had died 18 months earlier. She was diagnosed with a manic episode with psychotic symptoms according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) criteria and was treated accordingly. Three months after discharge, she made a suicide attempt and was admitted and re-assessed. During this admission, she completed the Inventory of Complicated Grief (ICG), the Mood-Spectrum Rating Scale (MOODS-SR), and the Trauma and Loss Spectrum questionnaire (TALS-SR). She endorsed symptoms of intense yearning for her son, feelings of shock and disbelief, anger and bitterness related to his death, estrangement from others, auditory, tactile and visual hallucinations of the deceased, and intense emotional reactivity to memories of her son. These symptoms were sufficiently prolonged and severe to meet criteria for complicated grief. While complicated grief appeared to be the primary diagnosis for this patient, when she was diagnosed using only DSMIV-TR criteria, her treatment failed to address herprimary problem. This case draws attention to the occurrence of manic-like symptoms as well as depression-like manifestations following bereavement and highlights the importance of including the syndrome of complicated grief in the diagnostic nomenclature.

  8. The dominance behavioral system and manic temperament: motivation for dominance, self-perceptions of power, and socially dominant behaviors.

    Science.gov (United States)

    Johnson, Sheri L; Carver, Charles S

    2012-12-15

    The dominance behavioral system has been conceptualized as a biologically based system comprising motivation to achieve social power and self-perceptions of power. Biological, behavioral, and social correlates of dominance motivation and self-perceived power have been related to a range of psychopathological tendencies. Preliminary evidence suggests that mania and risk for mania (manic temperament) relate to the dominance system. Four studies examine whether manic temperament, measured with the Hypomanic Personality Scale (HPS), is related to elevations in dominance motivation, self-perceptions of power, and engagement in socially dominant behavior across multiple measures. In Study 1, the HPS correlated with measures of dominance motivation and the pursuit of extrinsically-oriented ambitions for fame and wealth among 454 undergraduates. In Study 2, the HPS correlated with perceptions of power and extrinsically-oriented lifetime ambitions among 780 undergraduates. In Study 3, the HPS was related to trait-like tendencies to experience hubristic (dominance-related) pride, as well as dominance motivation and pursuit of extrinsically-oriented ambitions. In Study 4, we developed the Socially Dominant Behavior Scale to capture behaviors reflecting high power. The scale correlated highly with the HPS among 514 undergraduates. The studies rely on self-ratings of manic temperament and dominance constructs, and findings have not yet been generalized to a clinical sample. Taken together, results support the hypothesis that manic temperament is related to a focus on achieving social dominance, ambitions related to achieving social recognition, perceptions of having achieved power, tendencies to experience dominance-related pride, and engagement in social behaviors consistent with this elevated sense of power. Copyright © 2012 Elsevier B.V. All rights reserved.

  9. Effects of mood state on divided attention in patients with bipolar disorder: evidence for beneficial effects of subclinical manic symptoms.

    Science.gov (United States)

    Koenders, Manja A; Spijker, Annet T; Hoencamp, Erik; Haffmans, Judith P M; Zitman, Frans G; Giltay, Erik J

    2014-12-15

    A relatively small number of studies have been dedicated to the differential effects of the current mood state on cognition in patients with a bipolar disorder (BD). The aim of the current study was to investigate the effect of current mood state on divided attention (DA) performance, and specifically examine possible beneficial effects of the (hypo-) manic state. Over a maximum period of 24 months, medication use, divided attention test (a subtest of the Test for Attentional Performance (TAP)) was assessed every 6 months in 189 outpatients with BD. Data were analyzed with multilevel regression analysis (i.e. linear mixed models). DA performance varied considerable over time within patients. Corrected for psychotropic medication a significant quadratic relationship between manic symptoms and DA performance was found, with mild hypomanic symptoms having a positive influence on divided attention scores and moderate to severe manic symptoms having a negative influence. No association between depressive symptoms and DA performance was found. In future research on mania and cognition as well as in the clinical practice both the beneficial and negative effects of mania should be taken into account. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  10. A comparative study of olanzapine versus asenapine in acute treatment of manic episode: A 3-week prospective study

    Directory of Open Access Journals (Sweden)

    Ajeet Sidana

    2014-01-01

    Full Text Available Introduction: Treatment of bipolar disorders has evolved over the years from conventional mood stabilizers to second-generation antipsychotics. Among the atypical antipsychotics, few have been approved by Food and Drug Administration as treatment of bipolar disorders. Aim: To study the efficacy and tolerability of olanzapine and asenapine in the acute treatment of bipolar disorder-manic episode in a 3-week randomized prospective study. Materials and Methods: A 3-week randomized, prospective, comparative, flexible doses of olanzapine (5-30 mg/day and asenapine (10-20 mg/day for acute treatment of bipolar disorder-current manic episode with or without psychotic symptoms in hospitalized patients. Results: The end-point reduction in mean score of Young Mania rating scale in the olanzapine group was 15.82 in comparison to 6.88 in the asenapine group. Mean score on clinical global impression for bipolar disorder and positive and negative syndrome scale was significantly less in the olanzapine group at the end of the study. 81.81% patients in olanzapine group and 17.60% patients in asenapine group had clinical response. There was significant average weight gain in the olanzapine group - 1.9 kg in comparison to 0.87 kg in asenapine group. Conclusion: The clinical response with olanzapine is significantly higher than the asenapine in the treatment of bipolar disorder-manic episode with or without psychotic symptoms. However, there is significant weight gain in olanzapine-treated patients.

  11. Service system finance: implications for children with depression and manic depression.

    Science.gov (United States)

    Glied, S; Neufeld, A

    2001-06-15

    An estimated 6.2% of children in the United States satisfy the criteria for a depression diagnosis, but approximately half of this group do not receive necessary treatment. Thus it is important to consider potential barriers to use through service system finance. This article reviews three major types of changes affecting access: parity legislation, managed care, and public contracting. How these developments will affect children with depression and manic depression (DMD) is unclear. To better understand the potential effects on children with DMD, this review uses new data from the Medical Expenditure Panel Survey to describe the service use patterns of this population. These children have higher levels of expenditures, higher rates of inpatient use, and higher rates of Medicaid payment than do other children with mental health diagnoses; they also are overrepresented among the costliest cases of mental illness in children. Children with DMD pay a relatively low out-of-pocket share, suggesting that parity efforts focusing only on copayments and deductibles will have little effect on the absolute out-of-pocket burden for these children. Because children with DMD are overrepresented among high utilizers of health services, health care rationing arrangements or techniques, such as utilization review and capitation, may place this population at particular risk.

  12. O Manicômio Judiciário: saúde ou justiça? The Judiciary Mental Hospital: a question of health or of law?

    Directory of Open Access Journals (Sweden)

    Evelin Naked de Castro Sá

    1985-10-01

    Full Text Available O Manicômio Judiciário, por ser um hospital-presídio, pode estar subordinado tanto à Secretaria da Saúde como à Justiça. Como elementos de análise dessa decisão, são apresentadas comparações estruturais e de recursos humanos entre o Manicômio Judiciário e a Penitenciária de Araraquara, entre a situação de recursos humanos do Manicômio em 1981 e 1984 e entre os salários de algumas funções de servidores ligados àqueles tipos de instituições. As conclusões apontam a Secretaria da Justiça como a mais adequada para subordinar o Manicômio Judiciário, desde que tomadas algumas medidas de modernização organizacional. É sugerido um quadro de pessoal estruturado percentualmente por subgrupos de funções. As propostas relativas ao pessoal necessitam ser tratadas em leis complementares que garantam, por sua hierarquia, o atendimento das condições excepcionais de trabalho do Manicômio Judiciário.As the Manicômio Judiciário (a Judiciary Mental Health Hospital is a hospital-prison it could be subordinated either to the State Health Department or to the Department of Justice. In order to reach a sound decision regarding this issue, structural and human resource comparisons as between the Manicômio Judiciário on one side and the Araraquara Prison on the other are provided. Comparisons between the status of the human resources of the Manicômio Judiciário in 1981 and 1984 and between the wages earned by workers exercising similar functions and belonging to similar institutions are also presented. The conclusion points to the Department of Justice as the most adequate institution to which the Manicômio Judiciário should be subordinated, provided some up-to-date managerial measures are taken. A personnel chart is suggested, showing percentages of people organized according to subgroups of functions. The proposals regarding personnel must be dealt with by, supplementary laws which guarantee, adequate provision for the

  13. Human right, disability and family life Mannréttindi, fötlun og fjölskyldulíf. Í tilefni yfirfærslu málefna fatlaðs fólks til sveitarfélaga

    Directory of Open Access Journals (Sweden)

    Hanna Björg Sigurjónsdóttir

    2009-12-01

    Full Text Available Abstract in English is unavailable.Samningur Sameinuðu þjóðanna um réttindi fatlaðs fólks var undirritaður af Íslandi í mars 2007, en með undirrituninni skuldbinda íslensk stjórnvöld sig til að gera ekkert sem gengur gegn efni samningsins. Um allan heim er nú litið til þessa samnings sem leiðarljóss í málefnum fatlaðs fólks og þjóðir heims, Ísland þar með talið, eru nú óðum að staðfesta samninginn og aðlaga lagaumhverfi sitt að honum. Eitt af lykilatriðunum við yfirfærslu málefna fatlaðra til sveitarfélaganna er kynning á þessum nýja samningi og mannréttindaáherslum sem þar er að finna, en þekking á innihaldi samningsins er nauðsynleg forsenda þess að jafnrétti og mannréttindi fatlaðs fólks hér á landi verði tryggð. Þessi grein fjallar um einn hóp fatlaðs fólks, foreldra með þroskahömlun, og rétt þeirra til fjölskyldulífs sem dæmi um breyttan skilning á stöðu fatlaðs fólks í samfélaginu og þá þjónustu sem það á rétt á. Rakið er hvernig réttur foreldra til samvista við börn sín hefur þróast á undanförnum áratugum í mannréttindasáttmálum og dómsúrskurðum. Niðurstöður sýna að ef foreldrar með þroskahömlun eiga að njóta þeirrar réttarverndar sem samræmist markmiðum stjórnarskrár íslenska lýðveldisins, mannréttindasáttmála Evrópu um friðhelgi fjölskyldulífs og samnings Sameinuðu þjóðanna um réttindi fatlaðs fólks er ljóst að þörf er á verulegu átaki og viðhorfsbreytingum innan stofnana ríkis og sveitarfélaga, sem hafa með höndum málefni fatlaðs fólks, barnaverndar og félagslegs stuðnings, svo og dómskerfisins alls, til að tryggja að foreldrar með þroskahömlun standi jafnfætis öðrum foreldrum.

  14. Lunatic, Manic and Radical Fringe Each Promote T and B Cell Development

    Science.gov (United States)

    Song, Yinghui; Kumar, Vivek; Wei, Hua-Xing; Qiu, Ju; Stanley, Pamela

    2015-01-01

    Lunatic, Manic and Radical Fringe (LFNG, MFNG and RFNG) are N-acetylglucosaminyltransferases that modify Notch receptors and regulate Notch signaling. Loss of LFNG affects thymic T cell development and LFNG and MFNG are required for marginal zone (MZ) B cell development. However, roles for MFNG and RFNG in T cell development, RFNG in B cell development, or Fringes in T and B cell activation, are not identified. Here we show that Lfng/Mfng/Rfng triple knockout (Fng tKO) mice exhibited reduced binding of DLL4 Notch ligand to CD4/CD8 double-negative (DN) T cell progenitors, and reduced expression of NOTCH1 targets Deltex1 and CD25. Fng tKO mice had reduced frequencies of DN1/cKit+ and DN2 T cell progenitors and CD4+CD8+ double positive (DP) T cell precursors, but increased frequencies of CD4+ and CD8+ single positive (SP) T cells in thymus. In spleen, Fng tKO mice had reduced frequencies of CD4+, CD8+, central memory T cells and marginal zone (MZ) B cells, and an increased frequency of effector memory T cells, neutrophils, follicular (Fo) and MZ P B cells. The Fng tKO phenotype was cell-autonomous and largely rescued in mice expressing one allele of a single Fng gene. Stimulation of Fng tKO splenocytes with anti-CD3/CD28 beads or lipopolysaccharide gave reduced proliferation compared to controls, and the generation of activated T cells by concanavalin A or L-PHA was also reduced in Fng tKO mice. Therefore, each Fringe contributes to T and B cell development, and Fringe is required for optimal in vitro stimulation of T and B cells. PMID:26608918

  15. Mixed states with predominant manic or depressive symptoms: baseline characteristics and 24-month outcomes of the EMBLEM cohort.

    Science.gov (United States)

    Azorin, Jean-Michel; Baraille, Laurent; Gérard, Stéphanie; Bertsch, Jordan; Reed, Catherine; Lukasiewicz, Michael

    2013-04-25

    While factors associated with mixed states have been extensively studied, data are scant regarding the clinical heterogeneity of mixed states. The EMBLEM study was a prospective, observational study on patients with manic and mixed states. We describe and compare baseline characteristics and 24-month clinical course of mixed states with predominant depressive symptoms (MSDS) and mixed states with predominant manic symptoms (MSMS). Adult inpatients/outpatients with bipolar disorder were enrolled within the standard course of care if they initiated or changed oral medication for acute mania or mixed states. A logistic regression was used to identify the baseline factors associated with each polarity. Comparisons with mixed episode without symptom predominance (OMS) were performed for informational purpose only. About 573 mixed patients were analyzed (23.7% of the cohort): 59.5% (n=341) had MSMS, 11.9% (n=68) had MSDS, and 28.6% (n=164) had OMS. At baseline, hallucinations/delusions during the index episode, inpatient status, high CGI-BP overall score, and low education level were more often associated with MSMS versus MSDS. Alcohol abuse or dependence and selective serotonin reuptake inhibitor (SSRI) or benzodiazepine use at inclusion were significantly more frequent with MSDS. MSDS had a significantly lower 24-month recurrence rate than MSMS; MSMS experienced more switches to mania whereas MSDS switched more to depression. The post hoc dimensional definitions in the study require caution in the interpretation of the results. These results present evidence of clinical heterogeneity within mixed states. Predominant manic or depressive symptoms within mixed episode could influence clinicians' decisions in term of hospitalization, treatment, and perception of bipolar severity. Copyright © 2012 Elsevier B.V. All rights reserved.

  16. Entre o delito e a loucura : a enfermagem em manicômio judiciário

    OpenAIRE

    Dayane de Aguiar Cicolella

    2014-01-01

    Os manicômios judiciários são instituições responsáveis pelo cuidado dos incapazes, destinados à proteção do todo social. Possuem o duplo objetivo de custodiar e tratar pessoas com doenças mentais declaradas perigosas, podendo ser considerados uma fusão entre hospital psiquiátrico e presídio. Essa instituição utiliza técnicas e procedimentos disciplinares com objetivo de normalizar loucos criminosos para torná-los aptos ao convívio social. A pesquisa propõe estudar os dispositivos disciplinar...

  17. Sleep-wake profiles predict longitudinal changes in manic symptoms and memory in young people with mood disorders.

    Science.gov (United States)

    Robillard, Rébecca; Hermens, Daniel F; Lee, Rico S C; Jones, Andrew; Carpenter, Joanne S; White, Django; Naismith, Sharon L; Southan, James; Whitwell, Bradley; Scott, Elizabeth M; Hickie, Ian B

    2016-10-01

    Mood disorders are characterized by disabling symptoms and cognitive difficulties which may vary in intensity throughout the course of the illness. Sleep-wake cycles and circadian rhythms influence emotional regulation and cognitive functions. However, the relationships between the sleep-wake disturbances experienced commonly by people with mood disorders and the longitudinal changes in their clinical and cognitive profile are not well characterized. This study investigated associations between initial sleep-wake patterns and longitudinal changes in mood symptoms and cognitive functions in 50 young people (aged 13-33 years) with depression or bipolar disorder. Data were based on actigraphy monitoring conducted over approximately 2 weeks and clinical and neuropsychological assessment. As part of a longitudinal cohort study, these assessments were repeated after a mean follow-up interval of 18.9 months. No significant differences in longitudinal clinical changes were found between the participants with depression and those with bipolar disorder. Lower sleep efficiency was predictive of longitudinal worsening in manic symptoms (P = 0.007). Shorter total sleep time (P = 0.043) and poorer circadian rhythmicity (P = 0.045) were predictive of worsening in verbal memory. These findings suggest that some sleep-wake and circadian disturbances in young people with mood disorders may be associated with less favourable longitudinal outcomes, notably for subsequent manic symptoms and memory difficulties. © 2016 European Sleep Research Society.

  18. Altered regional homogeneity in pediatric bipolar disorder during manic state: a resting-state fMRI study.

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    Qian Xiao

    Full Text Available UNLABELLED: Pediatric bipolar disorder (PBD is a severely debilitating illness, which is characterized by episodes of mania and depression separated by periods of remission. Previous fMRI studies investigating PBD were mainly task-related. However, little is known about the abnormalities in PBD, especially during resting state. Resting state brain activity measured by fMRI might help to explore neurobiological biomarkers of the disorder. METHODS: Regional homogeneity (ReHo was examined with resting-state fMRI (RS-fMRI on 15 patients with PBD in manic state, with 15 age-and sex-matched healthy youth subjects as controls. RESULTS: Compared with the healthy controls, the patients with PBD showed altered ReHo in the cortical and subcortical structures. The ReHo measurement of the PBD group was negatively correlated with the score of Young Mania Rating Scale (YMRS in the superior frontal gyrus. Positive correlations between the ReHo measurement and the score of YMRS were found in the hippocampus and the anterior cingulate cortex in the PBD group. CONCLUSIONS: Altered regional brain activity is present in patients with PBD during manic state. This study presents new evidence for abnormal ventral-affective and dorsal-cognitive circuits in PBD during resting state and may add fresh insights into the pathophysiological mechanisms underlying PBD.

  19. Recidiva criminal em 100 internos do Manicômio Judiciário de Franco da Rocha

    Directory of Open Access Journals (Sweden)

    Moscatello Roberto

    2001-01-01

    Full Text Available OBJETIVOS: Verificar a ocorrência de comportamento criminal recidivo em uma população de internos do Manicômio Judiciário de Franco da Rocha. MÉTODOS: Cem internos de um Manicômio Judiciário em cumprimento de medida de segurança foram entrevistados, sendo todos do sexo masculino e com idades variando de 26 a 80 anos. Os diagnósticos preencheram critérios da CID-10, e os delitos cometidos foram verificados segundo o Código Penal Brasileiro. RESULTADOS: Dos 100 internos avaliados, 41% cometeram um crime, e 59% cometeram mais de um crime. As psicoses esquizofrênicas foram os diagnósticos mais freqüentes nos internos que cometeram um crime e naqueles que cometeram mais de um crime. Os diagnósticos retardo mental e transtornos de personalidade seguiram em freqüência nos que cometeram um crime. Transtornos de personalidade e retardo mental foram os diagnósticos que seguiram em freqüencia nos que cometeram mais de um crime. CONCLUSÕES: As psicoses esquizofrênicas predominaram nos internos avaliados. Crimes contra a vida foram mais comuns entre os que cometeram um crime, enquanto crimes contra o patrimônio predominaram entre os que cometeram mais de um crime.

  20. Clinical and psychometric characterization of depression in mixed mania: a report from the French National Cohort of 1090 manic patients.

    Science.gov (United States)

    Hantouche, E G; Akiskal, H S; Azorin, J M; Châtenet-Duchêne, L; Lancrenon, S

    2006-12-01

    Despite extensive research recently focused on mixed mania, it is uncertain as how best to define it clinically, psychometrically (which has major bearing on its prevalence), and the methodology needed for future research. This topic is also of historical interest, because Magnan (1890) [Magnan, V., 1890. La Folie Intermittente. G Masson, Paris.] suggested that "combined [mixed] states" linked Falret's "circular insanity" with Baillarger's "dual insanity" (both described in 1854). This work eventually led to the Kraepelinian synthesis of all manic, mixed, and depressive states into the unitary rubric of "manic-depressive insanity (1899/1921). EPIMAN-II Thousand" (EPIMAN-II MILLE) is a French national collaborative study, which involved training 317 psychiatrists working in different sites representative of psychiatric practice in France. We recruited 1090 patients hospitalized for acute DSM-IV mania. assessed at index admission by the following measures: the Mania Rating Scale (MRS), the Beigel-Murphy Scale (MSRS), a newly derived checklist of depressive symptoms least contaminated by mania, MADRS for severity of depression, and the SAPS for psychotic features. The rate of mixed mania, as defined by at least 2 depressive symptoms, was 30%. Even with this broad definition, we found significantly higher female representation. This clinical sub-type of mania was characterized by high frequency of past diagnostic errors, particularly those of anxiety and personality disorders. Refined definition of co-exiting depression was obtained from an abbreviated version of the MADRS (6 items), with distinct "emotional-cognitive" symptoms, and "psychomotor inhibition" factors, both of which were separable from an "irritable" factor linked to lability and poor judgment. Mixed mania was psychometrically best identified by a MADRS score of 6 (80% sensitivity, 94% specificity) and validated by a mixed polarity of first episodes, a higher rate of recurrence, psychotic features, and

  1. Elevated levels of IL-6 and IL-18 in manic and hypomanic states in rapid cycling bipolar disorder patients

    DEFF Research Database (Denmark)

    Munkholm, Klaus; Weikop, Pia; Kessing, Lars Vedel

    2015-01-01

    obtained in affective states of varying polarity during 6-12 months in 37 rapid cycling bipolar disorder patients and compared with repeated measurements in 40 age- and gender matched healthy control subjects, using rigorous laboratory-, clinical- and statistical methodology. Adjusting for demographical...... were to assess alterations of peripheral cytokine levels between affective states in rapid cycling bipolar disorder patients and to compare these with levels in healthy control subjects. In a longitudinal design, repeated measurements of plasma levels of IL-6, IL-10, IL-18, IL-1β and TNF-α were......, clinical- and lifestyle factors, levels of IL-6 (prapid cycling bipolar disorder patients in a manic/hypomanic state, compared with a depressed and a euthymic state. Compared with healthy control subjects, unadjusted levels of IL-6 (p

  2. Cannabis use and first-episode psychosis: relationship with manic and psychotic symptoms, and with age at presentation.

    Science.gov (United States)

    Stone, J M; Fisher, H L; Major, B; Chisholm, B; Woolley, J; Lawrence, J; Rahaman, N; Joyce, J; Hinton, M; Johnson, S; Young, A H

    2014-02-01

    Cannabis use has been reported to be associated with an earlier onset of symptoms in patients with first-episode psychosis, and a worse outcome in those who continue to take cannabis. In general, studies have concentrated on symptoms of psychosis rather than mania. In this study, using a longitudinal design in a large naturalistic cohort of patients with first-episode psychosis, we investigated the relationship between cannabis use, age of presentation to services, daily functioning, and positive, negative and manic symptoms. Clinical data on 502 patients with first-episode psychosis were collected using the MiData audit database from seven London-based Early Intervention in psychosis teams. Individuals were assessed at two time points--at entry to the service and after 1 year. On each occasion, the Positive and Negative Syndrome Scale, Young Mania Rating Scale and Global Assessment of Functioning Scale disability subscale were rated. At both time points, the use of cannabis and other drugs of abuse in the 6 months preceding each assessment was recorded. Level of cannabis use was associated with a younger age at presentation, and manic symptoms and conceptual disorganization, but not with delusions, hallucinations, negative symptoms or daily functioning. Cannabis users who reduced or stopped their use following contact with services had the greatest improvement in symptoms at 1 year compared with continued users and non-users. Continued users remained more symptomatic than non-users at follow-up. Effective interventions for reducing cannabis use may yield significant health benefits for patients with first-episode psychosis.

  3. Examining the Proposed Disruptive Mood Dysregulation Disorder Diagnosis in Children in the Longitudinal Assessment of Manic Symptoms Study

    Science.gov (United States)

    Axelson, David; Findling, Robert L.; Fristad, Mary A.; Kowatch, Robert A.; Youngstrom, Eric A.; Horwitz, Sarah McCue; Arnold, L. Eugene; Frazier, Thomas W.; Ryan, Neal; Demeter, Christine; Gill, Mary Kay; Hauser-Harrington, Jessica C.; Depew, Judith; Kennedy, Shawn M.; Gron, Brittany A.; Rowles, Brieana M.; Birmaher, Boris

    2013-01-01

    Objective To examine the proposed disruptive mood dysregulation disorder (DMDD) diagnosis in a child psychiatric outpatient population. Evaluation of DMDD included 4 domains: clinical phenomenology, delimitation from other diagnoses, longitudinal stability, and association with parental psychiatric disorders. Method Data were obtained from 706 children aged 6–12 years who participated in the Longitudinal Assessment of Manic Symptoms (LAMS) study (sample was accrued from November 2005 to November 2008). DSM-IV criteria were used, and assessments, which included diagnostic, symptomatic, and functional measures, were performed at intake and at 12 and 24 months of follow-up. For the current post hoc analyses, a retrospective diagnosis of DMDD was constructed using items from the K-SADS-PL-W, a version of the Schedule for Affective Disorders and Schizophrenia for School-Age Children, which resulted in criteria closely matching the proposed DSM-5 criteria for DMDD. Results At intake, 26% of participants met the operational DMDD criteria. DMDD+ vs DMDD– participants had higher rates of oppositional defiant disorder (relative risk [RR] = 3.9, P conduct disorder (RR = 4.5, P oppositional defiant disorder (rate and symptom severity P values conduct disorder (rate, P disorders or in severity of inattentive, hyperactive, manic, depressive, or anxiety symptoms. Most of the participants with oppositional defiant disorder (58%) or conduct disorder (61%) met DMDD criteria, but those who were DMDD+ vs DMDD– did not differ in diagnostic comorbidity, symptom severity, or functional impairment. Over 2-year follow-up, 40% of the LAMS sample met DMDD criteria at least once, but 52% of these participants met criteria at only 1 assessment. DMDD was not associated with new onset of mood or anxiety disorders or with parental psychiatric history. Conclusions In this clinical sample, DMDD could not be delimited from oppositional defiant disorder and conduct disorder, had limited

  4. The maturational theory of brain development and cerebral excitability in the multifactorially inherited manic-depressive psychosis and schizophrenia.

    Science.gov (United States)

    Saugstad, L F

    1994-12-01

    An association has been established between the multifactorially inherited rate of physical maturation and the final step in brain development, when some 40% of synapses are eliminated. This may imply that similarly to endocrine disease entities, we have cerebral disease entities at the extremes of the maturational rate continuum. The restriction of prepubertal pruning to excitatory synapses leaving the number of inhibitory ones fairly constant, implies changes in cerebral excitability as a function of rate of maturation (age at puberty). In early maturation there will be an excess in excitatory drive due to prematurely abridged pruning, which compounds a synchronization tendency inherent in excessive synaptic density. Lowering excitatory level with antiepileptics is hypothesized to be a logical treatment in this type of brain dysfunction. In late maturation, a deficit in excitatory drive due to failure to shut down the pruning process associated with a tendency to the breakdown of circuitry and desynchronization, adds to a similar adversity inherent in reduced synaptic density. Raising the excitatory level with convulsants is hypothesized to be the treatment for this type of CNS dysfunction. The maturational theory of Kraepelin's psychoses holds that they are naturally occurring contrasting chemical signaling disorders in the brain at the extremes of the maturational rate continuum: manic depressive psychosis is a disorder of the early maturer and comprises raised cerebral excitability and a raised density of synapses. This is successfully treated with anti-epileptics like sodium valproate and carbamazepin. Schizophrenia is a disorder in late maturation with reduced cerebral excitability and reduced synaptic density. This is accordingly treated with convulsants such as typical and atypical neuroleptics. However, the conventional effective treatments in both disorders act on inhibition only by either lowering or raising inhibitory level. While the neuroleptics

  5. Suicidality and symptoms of anxiety, irritability, and agitation in patients experiencing manic episodes with depressive symptoms: a naturalistic study

    Directory of Open Access Journals (Sweden)

    Eberhard J

    2016-08-01

    Full Text Available Jonas Eberhard,1 Emmanuelle Weiller2 1Department of Clinical Sciences, Lund University, Lund, Sweden; 2H. Lundbeck A/S, Copenhagen, Denmark Purpose: Patients with a bipolar I disorder (BD-I manic episode meeting the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5, criteria for “with mixed features” have a high incidence of suicide attempts and of anxiety, irritability, and agitation (AIA symptoms. The aim of this analysis was to explore the relationship between suicidality and AIA symptoms in patients with BD-I experiencing mania with depressive symptoms, using data from a previous naturalistic study.Patients and methods: Psychiatrists completed an online questionnaire about their adult patients who had a current BD-I manic episode. Questions covered the DSM-5 “with mixed features” specifier, the severity of AIA symptoms, the frequency and controllability of suicidal ideation, and the number of suicide attempts.Results: Of 1,035 patients with BD-I mania who were included in the analyses, 348 (33.6% met the criteria for the DSM-5 “with mixed features” specifier (three or more depressive symptoms. These patients were further stratified according to the severity of their AIA symptoms: “mild AIA” (zero or one AIA symptom above a severity threshold; 105 patients or “severe AIA” (all three AIA symptoms above a severity threshold; 167 patients. A greater incidence of suicidal ideation was observed in the severe AIA group (71.9% than in the mild AIA group (47.6%. Twice as many patients had easily controlled suicidal ideation than difficult-to-control suicidal ideation in both subgroups. The mean number of suicide attempts was higher in the severe AIA group than in the mild AIA group, during the current episode (0.84 vs 0.34 attempts, respectively; P<0.05 and over the patient’s lifetime (1.56 vs 1.04 attempts, respectively.Conclusion: The high risk of suicide among BD-I mania patients with depressive

  6. In vivo assessment of dopamine D-2 and serotonin S-2 receptors measured by C-11 N-methylspiperone (NMSP) in manic-depressive illness

    International Nuclear Information System (INIS)

    Wong, D.F.; Pearlson, G.; Wagner, H.N. Jr.

    1985-01-01

    The hypothesis has been suggested that either the dopaminergic or serotonergic neurotransmitter systems may be involved in manic-depressive illness (MD). The authors have studied 16 subjects with C-11 NMSP PET imaging. Two had never received neuroleptics; 4 were drug free for 1 month at the time of scanning; of these 3 were acutely manic; the rest were on stable lithium treatment. The dopamine and serotonin binding was estimated by the 43 min. caudate/cerebellum (Ca/Cb) and frontal/cerebellum (FC/Cb) ratios, respectively. No statistically significant difference was detected when compared to 44 age and sex matched controls. Based upon the variance in the normal data and the average age of the patient group studied, the probability of detecting a difference of >30% between patients and normals is >0.8. Hence, identification of receptor abnormalities if present will be improved with increased sample size of both normals and patients

  7. A cena constituinte da psicose maníaco-depressiva no Brasil The emergence of manic depressive psychosis as a diagnosis in Brazil

    Directory of Open Access Journals (Sweden)

    Joel Birman

    2010-12-01

    Full Text Available A intenção deste ensaio é esboçar a leitura da psicose maníaco-depressiva no Brasil, no começo do século XX. Destaca a transformação teórica ocorrida na psiquiatria brasileira, que se deslocou da tradição francesa para a alemã. Sublinha o modo como a problemática da histeria foi substituída pela da psicose maníaco-depressiva nesse contexto histórico.This essay examines the early twentieth-century interpretation of manic depressive psychosis in Brazil, during a moment when Brazilian psychiatry witnessed a theoretical shift from the French to German traditions. It calls special attention to how the problem of hysteria was replaced by manic depressive psychosis within this historical context.

  8. Paliperidone palmitate once-monthly reduces risk of relapse of psychotic, depressive, and manic symptoms and maintains functioning in a double-blind, randomized study of schizoaffective disorder.

    Science.gov (United States)

    Fu, Dong-Jing; Turkoz, Ibrahim; Simonson, R Bruce; Walling, David P; Schooler, Nina R; Lindenmayer, Jean-Pierre; Canuso, Carla M; Alphs, Larry

    2015-03-01

    Schizoaffective disorder is a complex illness for which optimal treatment is not well established. Results of the first controlled, relapse-prevention study of paliperidone palmitate once-monthly injectable (paliperidone monthly) in schizoaffective disorder are presented. The study was conducted between September 20, 2010, and October 22, 2013. Patients with schizoaffective disorder (confirmed by the Structured Clinical Interview for DSM-IV Axis I Disorders) experiencing acute exacerbation of psychotic and depressive/manic symptoms were stabilized with paliperidone monthly as monotherapy or as adjunctive therapy to mood stabilizers or antidepressants and randomly assigned (1:1) to paliperidone monthly or placebo in a 15-month, double-blind, relapse-prevention phase. Randomization was stratified by administration as monotherapy or adjunctive therapy and by study center. The primary endpoint was time to relapse. 334 patients were evaluated. Paliperidone monthly significantly delayed time to relapse for psychotic, depressive, and manic symptoms compared with placebo (P schizoaffective disorder (5.9%, 3.0%), headache (3.5%, 5.5%), and nasopharyngitis (3.5%, 5.5%). Incidence of any extrapyramidal-related adverse event was 7.1% for placebo and 8.5% for paliperidone monthly. Paliperidone monthly as monotherapy or adjunctive therapy significantly delayed psychotic, depressive, and/or manic relapses; reduced their risk; and better maintained functioning in patients with schizoaffective disorder. Results support the value of maintenance treatment with paliperidone monthly in schizoaffective disorder. ClinicalTrials.gov identifier: NCT01193153. © Copyright 2015 Physicians Postgraduate Press, Inc.

  9. Candidate genes and favoured loci: strategies for molecular genetic research into schizophrenia, manic depression, autism, alcoholism and Alzheimer's disease.

    Science.gov (United States)

    Gurling, H

    1986-01-01

    It is argued that further research to achieve more detailed diagnostic systems in many psychiatric disorders is unlikely to be productive without taking genetic effects into account. Even when this is done, for example when carrying out segregation analysis to determine a mode of genetic transmission, mental illnesses often pose specific problems that preclude accurate analysis. Because techniques in molecular biology and genetics have made it possible to study gene effects in human disease systematically it should now be possible to specify the genes that are involved. When this has been achieved then a diagnostic system based on genetic causation can develop. This will have the advantage of helping to pinpoint environmental factors more accurately. Specific strategies will need to be adopted to overcome uncertain modes of inheritance, incomplete or non-penetrance of disease alleles and disease heterogeneity. Highly speculative hypotheses can be put forward for a locus causing Alzheimer's disease on a portion of the long arm of chromosome 21. For autism it is plausible that there is a disease locus at or near the fragile X site on the X chromosome. A locus for manic depression has been very tentatively mapped using DNA markers to chromosome 11 and in a small proportion of families DNA markers have also shown some evidence for X linkage. Schizophrenia does not seem to be associated with any favoured loci. Candidate genes for schizophrenia include those encoding dopamine, other neurotransmitter receptors or enzymes and various neuropeptides such as enkephalin and beta endorphin.

  10. The cost of relapse for patients with a manic/mixed episode of bipolar disorder in the EMBLEM study.

    Science.gov (United States)

    Hong, Jihyung; Reed, Catherine; Novick, Diego; Haro, Josep Maria; Windmeijer, Frank; Knapp, Martin

    2010-01-01

    Bipolar disorder (BD) is characterized by episodes of mania and depression. The debilitating symptoms during an acute episode require intensive treatment, frequently leading to inpatient psychiatric care, which places significant demands on health and social care systems and incurs substantial costs. However, no study to date has estimated the economic impact of relapse. To estimate the direct costs associated with relapse in the treatment of BD following an acute manic or mixed episode over a 21-month follow-up period in routine clinical practice in Europe, using data from a large, prospective, observational study. EMBLEM was a prospective, observational study on the outcomes of patients with a manic/mixed episode of BD conducted in 14 European countries. Patients eligible for analysis were those enrolled in the 21-month maintenance phase of the study, following the 3-month acute phase. Relapse was defined as achieving any one of the following criteria: (i) at least a one-point increase in Clinical Global Impression - Bipolar Disorder (CGI-BP) overall score from the previous visit, with a final rating of > or =4; (ii) inpatient admission for an acute episode of BD; or (iii) psychiatrists' confirmation of relapse. Data on healthcare resource use were recorded retrospectively for the four respective periods (3-6, 6-12, 12-18 and 18-24 month visits). Multivariate analyses were performed to compare the cost of resource use (inpatient stay, day care, psychiatrist visits and medication) for those who relapsed during the 21-month maintenance phase and those who never relapsed. A sensitivity analysis was also conducted to examine the 6-month costs during relapse. The analyses were adjusted for patient characteristics and took account of non-Normality of the cost data by using a log link function. UK unit costs were applied to resource use. The analysis was repeated after multiple imputation for missing data. All costs were presented as year 2007/08 values. A total of 1379

  11. HIERACIO UMBROSI-QUERCETUM PETRAEAE PÎNZARU, CANTEMIR, MANIC & POPESCU – ASS. NOVA, FROM THE CENTRAL MOLDOVAN PLATEAU OF THE REPUBLIC OF MOLDOVA

    Directory of Open Access Journals (Sweden)

    Pavel PÎNZARU

    2017-12-01

    Full Text Available The forests of sessile oak (Quercus petraea (Matt. Liebl. with Hieracium umbrosum Jord., found on the Central Moldovan Plateau, are described in this article. Based on 12 relevés, the authors have grouped these forests in an plant community that is new for science – Hieracio umbrosi-Quercetum petraeae Pînzaru, Cantemir, Manic et Popescu, included in the alliance Quercion pubescenti-petraeae Br.-Bl. 1932, the order Quercetalia pubescenti-petraeae Klika 1933, cl. QUERCO-FAGETEA Br.-Bl. et Vlieger in Vlieger 1937.

  12. Effects of asenapine on agitation and hostility in adults with acute manic or mixed episodes associated with bipolar I disorder

    Directory of Open Access Journals (Sweden)

    Citrome L

    2017-12-01

    Full Text Available Leslie Citrome,1 Ronald Landbloom,2 Cheng-Tao Chang,3 Willie Earley4 1Department of Psychiatry and Behavioral Sciences, New York Medical College, Valhalla, NY, USA; 2Department of Neuroscience, Merck, Whitehouse Station, NJ, USA; 3Biostatistics, Allergan, Jersey City, NJ, USA; 4Clinical Development, Allergan, Jersey City, NJ, USA Background: Bipolar disorder is associated with an increased risk of aggression. However, effective management of hostility and/or agitation symptoms may prevent patients from becoming violent. This analysis investigated the efficacy of the antipsychotic asenapine on hostility and agitation in patients with bipolar I disorder.Methods: Data were pooled from three randomized, double-blind, placebo-controlled, Phase III trials of asenapine in adults with manic or mixed episodes of bipolar I disorder (NCT00159744, NCT00159796, and NCT00764478. Post hoc analyses assessed the changes from baseline to day 21 on the Young Mania Rating Scale (YMRS and the Positive and Negative Syndrome Scale (PANSS hostility-related item scores in asenapine- or placebo-treated patients with at least minimal or mild symptom severity and on the PANSS-excited component (PANSS-EC total score in agitated patients. Changes were adjusted for improvements in overall mania symptoms to investigate direct effects on hostility.Results: Significantly greater changes in favor of asenapine versus placebo were observed in YMRS hostility-related item scores (irritability: least squares mean difference [95% confidence interval] =–0.5 [–0.87, –0.22], P=0.001; disruptive–aggressive behavior: –0.7 [–0.99, –0.37], P<0.0001, PANSS hostility item score (–0.2 [–0.44, –0.04]; P=0.0181, and PANSS-EC total score (–1.4 [–2.4, –0.4]; P=0.0055. Changes in the YMRS disruptive–aggressive behavior score and the sum of the hostility-related items remained significant after adjusting for improvements in other YMRS item scores.Conclusion: Asenapine

  13. Comparing the executive function of patients with schizophrenia, acute/chronic type I disorder (manic episode, and healthy controls on Wisconsin Card Sorting Test and Continuous Performance Test

    Directory of Open Access Journals (Sweden)

    Hossein Zare

    2017-05-01

    Full Text Available Introduction: From among various cognitive deficits, deficits in executive processes have an effective role in limiting the patients’ ability to retain, acquire, and re-learn the skills necessary for real-life performance. Thus, the present study aimed to compare the executive function of patients with schizophrenia, acute/chronic type I disorder, and the healthy group. Methods: The present research was an analytical-comparative study. The statistical population consisted of all the outpatients and inpatients with acute/chronic schizophrenia and acute/chronic type I disorder (manic episode visiting Shafa Psychiatric Hospital, Rasht, Iran. Using convenience sampling, 60 male subjects aging 18-49 years old were selected in 2014-2015. They were matched for the variables of sex, age, and education level. The Wisconsin Card Sorting Test, Continuous Performance Test, and Raven’s Progressive Matrices were administered, and the data were analyzed using MANOVA and Tukey post-hoc test. Results: A significant difference was observed between the acute/chronic schizophrenia group, acute/chronic type I disorder (manic episode, and healthy group on the two tests. Patients with schizophrenia had a weaker executive function and attention deficit compared to those with type I disorder and the healthy group (P0.05. Conclusion: Both schizophrenia and type I disorder patients show deficits in executive function and attention. However, the former group manifests higher impairment in cognitive activities, concept formation, cognitive flexibility, and attention deficit.

  14. Asenapine effects on individual Young Mania Rating Scale items in bipolar disorder patients with acute manic or mixed episodes: a pooled analysis

    Directory of Open Access Journals (Sweden)

    Cazorla P

    2013-03-01

    Full Text Available Pilar Cazorla, Jun Zhao, Mary Mackle, Armin Szegedi Merck, Rahway, NJ, USA Background: An exploratory post hoc analysis was conducted to evaluate the potential differential effects over time of asenapine and olanzapine compared with placebo on the eleven individual items comprising the Young Mania Rating Scale (YMRS in patients with manic or mixed episodes in bipolar I disorder. Methods: Data were pooled from two 3-week randomized, controlled trials in which the eleven individual items comprising the YMRS were measured over 21 days. An analysis of covariance model adjusted by baseline value was used to test for differences in changes from baseline in YMRS scores between groups. Results: Each of the eleven individual YMRS item scores was significantly reduced compared with placebo at day 21. After 2 days of treatment, asenapine and olanzapine were superior to placebo for six of the YMRS items: disruptive/aggressive behavior, content, irritability, elevated mood, sleep, and speech. Conclusion: Reduction in manic symptoms over 21 days was associated with a broad-based improvement across all symptom domains with no subset of symptoms predominating. Keywords: asenapine, Young Mania Rating Scale, bipolar disorder, YMRS, antipsychotic, olanzapine

  15. Twelve-hour brain lithium concentration in lithium maintenance treatment of manic-depressive disorder: daily versus alternate-day dosing schedule

    DEFF Research Database (Denmark)

    Jensen, H.V.; Plenge, P; Stensgaard, A

    1996-01-01

    The 12-h brain lithium concentration was measured by lithium-7 magnetic resonance spectroscopy in ten manic-depressive patients receiving daily or alternate-day lithium carbonate treatment. The median dose of lithium carbonate was 800 mg in the daily treatment group and 1200 mg in the alternate......-day group. Median 12-h serum lithium concentration in the two groups was 0.86 mmol l-1 and 0.55 mmol l-1, respectively, while the corresponding concentration in brain was 0.67 mmol l-1 and 0.52 mmol l-1, respectively. The 12-h brain lithium concentration was independent of lithium dosing schedule (multiple...... linear regression), but correlated significantly with the 12-h serum lithium concentration (P = 0.003; B = 0.53, 95% c.l. 0.24-0.82; beta = 0.83). Thus at identical 12-h serum lithium concentrations the 12-h brain lithium concentration is similar with both treatment regimes. As the risk of manic...

  16. Manic fringe is not required for embryonic development, and fringe family members do not exhibit redundant functions in the axial skeleton, limb, or hindbrain

    Science.gov (United States)

    Moran, Jennifer L.; Shifley, Emily T.; Levorse, John M.; Mani, Shyamala; Ostmann, Kristin; Perez-Balaguer, Ariadna; Walker, Dawn M.; Vogt, Thomas F.; Cole, Susan E.

    2009-01-01

    Tight regulation of Notch pathway signaling is important in many aspects of embryonic development. Notch signaling can be modulated by expression of fringe genes, encoding glycosyltransferases that modify EGF repeats in the Notch receptor. Although Lunatic fringe (Lfng) has been shown to play important roles in vertebrate segmentation, comparatively little is known regarding the developmental functions of the other vertebrate fringe genes, Radical fringe (Rfng) and Manic fringe (Mfng). Here we report that Mfng expression is not required for embryonic development. Further, we find that despite significant overlap in expression patterns, we detect no obvious synergistic defects in mice in the absence of two, or all three, fringe genes during development of the axial skeleton, limbs, hindbrain and cranial nerves. PMID:19479951

  17. Randomized, Double-Blind, Placebo-Controlled Trial of Asenapine Maintenance Therapy in Adults With an Acute Manic or Mixed Episode Associated With Bipolar I Disorder.

    Science.gov (United States)

    Szegedi, Armin; Durgam, Suresh; Mackle, Mary; Yu, Sung Yun; Wu, Xiao; Mathews, Maju; Landbloom, Ronald P

    2018-01-01

    The authors determined the efficacy and safety of asenapine in preventing recurrence of any mood episode in adults with bipolar I disorder. Adults with an acute manic or mixed episode per DSM-IV-TR criteria were enrolled in this randomized, placebo-controlled trial consisting of an initial 12- to 16-week open-label period and a 26-week double-blind randomized withdrawal period. The target asenapine dosage was 10 mg b.i.d. in the open-label period but could be titrated down to 5 mg b.i.d. After completing the open-label period, subjects meeting stabilization/stable-responder criteria were randomized to asenapine or placebo treatment in the double-blind period. The primary efficacy endpoint was time to recurrence of any mood event during the double-blind period. Kaplan-Meier estimation was performed, and 95% confidence intervals were determined. Safety was assessed throughout. A total of 549 subjects entered the open-label period, of whom 253 enrolled in the double-blind randomized withdrawal period (127 in the placebo group; 126 in the asenapine group). Time to recurrence of any mood episode was statistically significantly longer for asenapine- than placebo-treated subjects. In post hoc analyses, significant differences in favor of asenapine over placebo were seen in time to recurrence of manic and depressive episodes. The most common treatment-emergent adverse events were somnolence (10.0%), akathisia (7.7%), and sedation (7.7%) in the open-label period and mania (11.9% of the placebo group compared with 4.0% of the asenapine group) and bipolar I disorder (6.3% compared with 1.6%) in the double-blind period. Long-term treatment with asenapine was more effective than placebo in preventing recurrence of mood events in adults with bipolar I disorder and was generally well-tolerated.

  18. Accompanied manic symptoms in patients with major and bipolar depression%重性抑郁障碍或双相障碍患者抑郁发作伴随躁狂症状的临床特征

    Institute of Scientific and Technical Information of China (English)

    胡希文; 杨永秀; 郭玉娟; 谭忠林

    2016-01-01

    目的::了解重性抑郁障碍( MDD)或双相障碍抑郁发作患者出现躁狂症状的频率和程度。方法:对52例经简明国际神经精神访谈( MINI)、符合《美国精神障碍诊断与统计手册》第4版( DSM-IV)重性抑郁障碍或双相障碍抑郁发作的患者,采用情感障碍评估量表( ADE)评估患者本次抑郁发作中出现的躁狂症状。结果:52例患者中有36例重性抑郁障碍,16例为双相障碍抑郁发作。至少有1条躁狂症状的患者达86.5%(n=45),至少有3条躁狂症状的患者占32.7%(n=17),而没有任何躁狂症状的患者仅占13.5%(n=7)。结论:抑郁发作患者大多存在不同程度的躁狂症状,及时识别这些症状,对诊断与治疗有指导意义。情感障碍评估量表是一个值得应用的评估情感发作的工具。%Objective:To investigate the frequency and intensity of manic symptoms in patients with ma-jor and bipolar depression. Method:We assessed manic symptoms of 52 patients who met diagnostic and sta-tistical manual of mental disorders( DSM-IV) criteria for major depressive disorder or bipolar disorder depres-sive episode with international neuropsychiatric interview( MINI) and the affective disorder evaluation( ADE) . Results:Thirty-six patients met diagnostic criteria for major depressive disorder,and 16 patients for bipolar disorder depressive episode. 86. 5% patients(n=45) had at least one manic symptom,and 32. 7 %(n=17) had three or more manic symptoms. There are 13. 5%patients ( n = 7 ) without any manic symptoms. Conclusion:Most patients in depressive episode had manic symptoms. The affective disorder evaluation is a helpful instrument for assessing affective episode.

  19. Electroconvulsive therapy for manic state with mixed and psychotic features in a teenager with bipolar disorder and comorbid episodic obsessive-compulsive disorder: a case report.

    Science.gov (United States)

    Rask, Olof; Suneson, Klara; Holmström, Eva; Bäckström, Beata; Johansson, Björn Axel

    2017-12-12

    Comorbidity of bipolar disorder and obsessive-compulsive disorder is common in adolescence. Obsessive-compulsive disorder symptoms may be episodic and secondary to alterations in mood, and display specific features. Management of pediatric bipolar disorder-obsessive-compulsive disorder is challenging, as pharmacotherapy of obsessive-compulsive disorder may induce or exacerbate manic episodes and there is limited evidence of treatment efficacy. Electroconvulsive therapy is sparsely used in children and adolescents, but is documented to be a safe and efficacious intervention in adults with bipolar disorder. In view of the severity of symptoms in juvenile mania, studies on treatment strategies are warranted. We report a case of an adolescent with bipolar disorder-obsessive-compulsive disorder who was successfully treated with electroconvulsive therapy during an episode of severe mania. A 16-year-old girl of Middle East origin first presented to us with depressed mood, irritability, and increased obsessive-compulsive disorder symptoms, which were initially interpreted in the context of acute stress secondary to migration. She had been diagnosed with bipolar disorder and obsessive-compulsive disorder in her previous home country, but had difficulties in accounting for earlier psychiatric history. During hospitalization her mood switched to a manic state with mixed and psychotic features, at times showing aggression toward others. Interruption in her lithium treatment for a short period and possibly the introduction of an atypical antipsychotic could in part have been triggering factors. After 8 weeks of in-patient care and psychotropic drug trials, electroconvulsive therapy was initiated and administered every second or third day for 4 weeks, with marked positive response. No apparent side effects were reported. This case demonstrates the need for a detailed medical history, taking special note of periodicity and character of obsessive-compulsive disorder symptoms, in

  20. Manic depressive psychosis and schizophrenia are neurological disorders at the extremes of CNS maturation and nutritional disorders associated with a deficit in marine fat.

    Science.gov (United States)

    Saugstad, L F

    2001-12-01

    The maturational theory of brain development comprises manic depressive psychosis and schizophrenia. It holds that the disorders are part of human diversity in growth and maturation, which explains their ubiquity, shared susceptibility genes and multifactorial inheritance. Rate of maturation and age at puberty are the genotype; the disorders are localized at the extremes with normality in between. This is based on the association between onset of puberty and the final regressive event, with pruning of 40% of excitatory synapses leaving the inhibitory ones fairly unchanged. This makes excitability, a fundamental property of nervous tissue, a distinguishing factor: the earlier puberty, the greater excitability--the later puberty, the greater deficit. Biological treatment supports deviation from the norm: neuroleptics are convulsant; antidepressives are anti-epiletogenic. There is an association between onset of puberty and body-build: early maturers are pyknic broad-built, late ones linearly leptosomic. This discrepancy is similar to that in the two disorders, supporting the theory that body-build is the phenotype. Standard of living is the environmental factor, which affects pubertal age and shifts the panorama of mental illness accordingly. Unnatural death has increased with antipsychotics. Other treatment is needed. PUFA deficit has been observed in RBC in both disorders and striking improvements with addition of minor amounts of PUFA. This supports that dietary deficit might cause psychotic development and that prevention is possible. Other neurological disorders also profit from PUFA, underlining a general deficit in the diet.

  1. Ernst Rüdin's Unpublished 1922-1925 Study "Inheritance of Manic-Depressive Insanity": Genetic Research Findings Subordinated to Eugenic Ideology.

    Science.gov (United States)

    Kösters, Gundula; Steinberg, Holger; Kirkby, Kenneth Clifford; Himmerich, Hubertus

    2015-11-01

    In the early 20th century, there were few therapeutic options for mental illness and asylum numbers were rising. This pessimistic outlook favoured the rise of the eugenics movement. Heredity was assumed to be the principal cause of mental illness. Politicians, scientists and clinicians in North America and Europe called for compulsory sterilisation of the mentally ill. Psychiatric genetic research aimed to prove a Mendelian mode of inheritance as a scientific justification for these measures. Ernst Rüdin's seminal 1916 epidemiological study on inheritance of dementia praecox featured large, systematically ascertained samples and statistical analyses. Rüdin's 1922-1925 study on the inheritance of "manic-depressive insanity" was completed in manuscript form, but never published. It failed to prove a pattern of Mendelian inheritance, counter to the tenets of eugenics of which Rüdin was a prominent proponent. It appears he withheld the study from publication, unable to reconcile this contradiction, thus subordinating his carefully derived scientific findings to his ideological preoccupations. Instead, Rüdin continued to promote prevention of assumed hereditary mental illnesses by prohibition of marriage or sterilisation and was influential in the introduction by the National Socialist regime of the 1933 "Law for the Prevention of Hereditarily Diseased Offspring" (Gesetz zur Verhütung erbkranken Nachwuchses).

  2. Preventive effects of blueberry extract on behavioral and biochemical dysfunctions in rats submitted to a model of manic behavior induced by ketamine.

    Science.gov (United States)

    Debom, Gabriela; Gazal, Marta; Soares, Mayara Sandrielly Pereira; do Couto, Carlus Augustu Tavares; Mattos, Bruna; Lencina, Claiton; Kaster, Manuella Pinto; Ghisleni, Gabriele Codenonzi; Tavares, Rejane; Braganhol, Elizandra; Chaves, Vitor Clasen; Reginatto, Flávio Henrique; Stefanello, Francieli; Spanevello, Roselia Maria

    2016-10-01

    The aim of the present study was to evaluate the protective effects of blueberry extract on oxidative stress and inflammatory parameters in a model of mania induced by ketamine administration in rats. Male rats were pretreated with blueberry extract (200mg/kg, once a day for 14days), lithium chloride (45mg/kg, mood stabilizer used as a positive control, twice a day for 14days), or vehicle. Between the 8th and 14th days, rats also received an injection of ketamine (25mg/kg) or vehicle. In the 15th day, thirty minutes after ketamine administration the hyperlocomotion of the animals was assessed in the open - field apparatus. Immediately after the behavioral analysis brain and blood were collected for biochemical determinations. ketamine treatment induced hyperlocomotion and oxidative damage in cerebral cortex, hippocampus and striatum such as an increase in lipid peroxidation and a decrease in the antioxidant enzymes activities (superoxide dismutase, catalase e glutatione peroxidase). Ketamine administration also increased the IL-6 levels in serum in rats. Pretreatment of rats with blueberry extract or lithium prevented the hyperlocomotion, pro - oxidant effects and inflammation induced by ketamine. Our findings suggest that blueberry consumption has a neuroprotective potential against behavioral and biochemical dysfunctions induced in a preclinical model that mimic some aspects of the manic behavior. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. Ernst Rüdin’s Unpublished 1922-1925 Study “Inheritance of Manic-Depressive Insanity”: Genetic Research Findings Subordinated to Eugenic Ideology

    Science.gov (United States)

    Kösters, Gundula; Steinberg, Holger; Kirkby, Kenneth Clifford; Himmerich, Hubertus

    2015-01-01

    In the early 20th century, there were few therapeutic options for mental illness and asylum numbers were rising. This pessimistic outlook favoured the rise of the eugenics movement. Heredity was assumed to be the principal cause of mental illness. Politicians, scientists and clinicians in North America and Europe called for compulsory sterilisation of the mentally ill. Psychiatric genetic research aimed to prove a Mendelian mode of inheritance as a scientific justification for these measures. Ernst Rüdin’s seminal 1916 epidemiological study on inheritance of dementia praecox featured large, systematically ascertained samples and statistical analyses. Rüdin’s 1922–1925 study on the inheritance of “manic-depressive insanity” was completed in manuscript form, but never published. It failed to prove a pattern of Mendelian inheritance, counter to the tenets of eugenics of which Rüdin was a prominent proponent. It appears he withheld the study from publication, unable to reconcile this contradiction, thus subordinating his carefully derived scientific findings to his ideological preoccupations. Instead, Rüdin continued to promote prevention of assumed hereditary mental illnesses by prohibition of marriage or sterilisation and was influential in the introduction by the National Socialist regime of the 1933 “Law for the Prevention of Hereditarily Diseased Offspring” (Gesetz zur Verhütung erbkranken Nachwuchses). PMID:26544949

  4. Olanzapine approved for the acute treatment of schizophrenia or manic/mixed episodes associated with bipolar I disorder in adolescent patients

    Directory of Open Access Journals (Sweden)

    Ann E Maloney

    2010-11-01

    Full Text Available Ann E Maloney1,2, Linmarie Sikich31Maine Medical Center Research Institute, Scarborough, ME, USA; 2Department of Psychiatry, Tufts University School of Medicine, Boston, MA, USA; 3Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USABackground: Severe and persistent mental illnesses in children and adolescents, such as early-onset schizophrenia spectrum (EOSS disorders and pediatric bipolar disorder (pedBP, are increasingly recognized. Few treatments have demonstrated efficacy in rigorous clinical trials. Enduring response to current medications appears limited. Recently, olanzapine was approved for the treatment of adolescents with schizophrenia or acute manic/mixed episodes in pedBP.Methods: PubMed searches were conducted for olanzapine combined with pharmacology, schizophrenia, or bipolar disorder. Searches related to schizophrenia and bipolar disorder were limited to children and adolescents. The bibliographies of the retrieved articles were hand-checked for additional relevant studies. The epidemiology, phenomenology, and treatment of EOSS and pedBP, and olanzapine’s pharmacology are reviewed. Studies of olanzapine treatment in youth with EOSS and pedBP are examined.Results: Olanzapine is efficacious for EOSS and pedBP. However, olanzapine is not more efficacious than risperidone, molindone, or haloperidol in EOSS and is less efficacious than clozapine in treatment-resistant EOSS. No comparative trials have been done in pedBP. Olanzapine is associated with weight gain, dyslipidemia, and transaminase elevations in youth. Extrapyramidal symptoms, neuroleptic malignant syndrome, and blood dyscrasias have also been reported but appear rare.Conclusions: The authors conclude that olanzapine should be considered a second-line agent in EOSS and pedBP due to its risks for significant weight gain and lipid dysregulation. Awareness of the consistent weight and metabolic changes observed in olanzapine

  5. Affective temperaments are associated with specific clusters of symptoms and psychopathology: a cross-sectional study on bipolar disorder inpatients in acute manic, mixed, or depressive relapse.

    Science.gov (United States)

    Iasevoli, Felice; Valchera, Alessandro; Di Giovambattista, Emanuela; Marconi, Massimo; Rapagnani, Maria Paola; De Berardis, Domenico; Martinotti, Giovanni; Fornaro, Michele; Mazza, Monica; Tomasetti, Carmine; Buonaguro, Elisabetta F; Di Giannantonio, Massimo; Perugi, Giulio; de Bartolomeis, Andrea

    2013-11-01

    The aim of this study was to assess whether different affective temperaments could be related to a specific mood disorder diagnosis and/or to different therapeutic choices in inpatients admitted for an acute relapse of their primary mood disorder. Hundred and twenty-nine inpatients were consecutively assessed by means of the Structured and Clinical Interview for axis-I disorders/Patient edition and by the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego auto-questionnaire, Young Mania Rating Scale, Hamilton Scale for Depression and for Anxiety, Brief Psychiatry Rating Scale, Clinical Global impression, Drug Attitude Inventory, Barratt Impulsiveness Scale, Toronto Alexithymia Scale, and Symptoms Checklist-90 items version, along with records of clinical and demographic data. The following prevalence rates for axis-I mood diagnoses were detected: bipolar disorder type I (BD-I, 28%), type II (31%), type not otherwise specified (BD-NOS, 33%), major depressive disorder (4%), and schizoaffective disorder (4%). Mean scores on the hyperthymic temperament scale were significantly higher in BD-I and BD-NOS, and in mixed and manic acute states. Hyperthymic temperament was significantly more frequent in BD-I and BD-NOS patients, whereas depressive temperament in BD-II ones. Hyperthymic and irritable temperaments were found more frequently in mixed episodes, while patients with depressive and mixed episodes more frequently exhibited anxious and depressive temperaments. Affective temperaments were associated with specific symptom and psychopathology clusters, with an orthogonal subdivision between hyperthymic temperament and anxious/cyclothymic/depressive/irritable temperaments. Therapeutic choices were often poorly differentiated among temperaments and mood states. Cross-sectional design; sample size. Although replication studies are needed, current results suggest that temperament-specific clusters of symptoms severity and psychopathology domains could be

  6. Amphetamine sensitization in mice is sufficient to produce both manic- and depressive-related behaviors as well as changes in the functional connectivity of corticolimbic structures.

    Science.gov (United States)

    Pathak, G; Ibrahim, B A; McCarthy, S A; Baker, K; Kelly, M P

    2015-08-01

    It has been suggested that amphetamine abuse and withdrawal mimics the diverse nature of bipolar disorder symptomatology in humans. Here, we determined if a single paradigm of amphetamine sensitization would be sufficient to produce both manic- and depressive-related behaviors in mice. CD-1 mice were subcutaneously dosed for 5 days with 1.8 mg/kg d-amphetamine or vehicle. On days 6-31 of withdrawal, amphetamine-sensitized (AS) mice were compared to vehicle-treated (VT) mice on a range of behavioral and biochemical endpoints. AS mice demonstrated reliable mania- and depression-related behaviors from day 7 to day 28 of withdrawal. Relative to VT mice, AS mice exhibited long-lasting mania-like hyperactivity following either an acute 30-min restraint stress or a low-dose 1 mg/kg d-amphetamine challenge, which was attenuated by the mood-stabilizers lithium and quetiapine. In absence of any challenge, AS mice showed anhedonia-like decreases in sucrose preference and depression-like impairments in the off-line consolidation of motor memory, as reflected by the lack of spontaneous improvement across days of training on the rotarod. AS mice also demonstrated a functional impairment in nest building, an ethologically-relevant activity of daily living. Western blot analyses revealed a significant increase in methylation of histone 3 at lysine 9 (H3K9), but not lysine 4 (H3K4), in hippocampus of AS mice relative to VT mice. In situ hybridization for the immediate-early gene activity-regulated cytoskeleton-associated protein (Arc) further revealed heightened activation of corticolimbic structures, decreased functional connectivity between frontal cortex and striatum, and increased functional connectivity between the amygdala and hippocampus of AS mice. The effects of amphetamine sensitization were blunted in C57BL/6J mice relative to CD-1 mice. These results show that a single amphetamine sensitization protocol is sufficient to produce behavioral, functional, and biochemical

  7. Creatine kinase levels in patients with bipolar disorder: depressive, manic, and euthymic phases Comparação das fases de depressão, mania e eutimia sobre os níveis de creatina quinase em pacientes bipolares

    Directory of Open Access Journals (Sweden)

    Gustavo Feier

    2011-01-01

    Full Text Available OBJECTIVE: Bipolar disorder is a severe, recurrent, and often chronic psychiatric illness associated with significant functional impairment, morbidity, and mortality. Creatine kinase is an important enzyme, particularly for cells with high and fluctuating energy requirements, such as neurons, and is a potential marker of brain injury. The aim of the present study was to compare serum creatine kinase levels between bipolar disorder patients, in the various phases (depressive, manic, and euthymic, and healthy volunteers. METHOD: Forty-eight bipolar patients were recruited: 18 in the euthymic phase; 17 in the manic phase; and 13 in the depressive phase. The control group comprised 41 healthy volunteers. The phases of bipolar disorder were defined as follows: euthymic-not meeting the DSM-IV criteria for a mood episode and scoring 7 on the YMRS; depressive-scoring > 7 on the HDRS and OBJETIVO: O transtorno do humor bipolar é uma doença psiquiátrica grave, recorrente e crônica associada a significativo prejuízo funcional, morbidade e mortalidade. A creatina quinase tem sido proposta como um marcador de dano cerebral. A creatina quinase é uma enzima importante principalmente para células que necessitam de uma grande quantidade de energia, como os neurônios. O objetivo do presente estudo foi comparar os níveis de creatina quinase entre as fases depressiva, maníaca e eutímica de pacientes com transtorno do humor bipolar. MÉTODO: Para avaliação dos níveis de creatina quinase no soro, 48 pacientes bipolares foram recrutados; 18 estavam eutímicos, 17 estavam em mania e 13 em episódio depressivo. Foi feita também uma comparação com um grupo controle que incluiu 41 voluntários saudáveis. Grupo eutimia: foram incluídos os pacientes que não cumpriam os critérios do DSM-IV para episódios de humor e deveriam ter a pontuação inferior a oito nas escalas de avaliação de mania (YMRS e depressão (HDRS; grupo mania: foram incluídos os

  8. Creatine kinase levels in patients with bipolar disorder: depressive, manic, and euthymic phases Comparação das fases de depressão, mania e eutimia sobre os níveis de creatina quinase em pacientes bipolares

    Directory of Open Access Journals (Sweden)

    Gustavo Feier

    2011-06-01

    Full Text Available OBJECTIVE: Bipolar disorder is a severe, recurrent, and often chronic psychiatric illness associated with significant functional impairment, morbidity, and mortality. Creatine kinase is an important enzyme, particularly for cells with high and fluctuating energy requirements, such as neurons, and is a potential marker of brain injury. The aim of the present study was to compare serum creatine kinase levels between bipolar disorder patients, in the various phases (depressive, manic, and euthymic, and healthy volunteers. METHOD: Forty-eight bipolar patients were recruited: 18 in the euthymic phase; 17 in the manic phase; and 13 in the depressive phase. The control group comprised 41 healthy volunteers. The phases of bipolar disorder were defined as follows: euthymic-not meeting the DSM-IV criteria for a mood episode and scoring 7 on the YMRS; depressive-scoring > 7 on the HDRS and OBJETIVO: O transtorno do humor bipolar é uma doença psiquiátrica grave, recorrente e crônica associada a significativo prejuízo funcional, morbidade e mortalidade. A creatina quinase tem sido proposta como um marcador de dano cerebral. A creatina quinase é uma enzima importante principalmente para células que necessitam de uma grande quantidade de energia, como os neurônios. O objetivo do presente estudo foi comparar os níveis de creatina quinase entre as fases depressiva, maníaca e eutímica de pacientes com transtorno do humor bipolar. MÉTODO: Para avaliação dos níveis de creatina quinase no soro, 48 pacientes bipolares foram recrutados; 18 estavam eutímicos, 17 estavam em mania e 13 em episódio depressivo. Foi feita também uma comparação com um grupo controle que incluiu 41 voluntários saudáveis. Grupo eutimia: foram incluídos os pacientes que não cumpriam os critérios do DSM-IV para episódios de humor e deveriam ter a pontuação inferior a oito nas escalas de avaliação de mania (YMRS e depressão (HDRS; grupo mania: foram incluídos os

  9. Comparing the DSM-5 construct of Disruptive Mood Dysregulation Disorder and ICD-10 Mixed Disorder of Emotion and Conduct in the UK Longitudinal Assessment of Manic Symptoms (UK-LAMS) Study.

    Science.gov (United States)

    Sagar-Ouriaghli, I; Milavic, G; Barton, R; Heaney, N; Fiori, F; Lievesley, K; Singh, J; Santosh, Paramala

    2018-05-05

    It is important to understand new diagnostic entities in classifications of psychopathology such as the Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5) (code F34.8) construct of Disruptive Mood Dysregulation Disorder (DMDD) and to compare it with possible equivalent disorders in other classificatory systems such as the International Classification of Diseases-10 (ICD-10), which has a category that superficially appears similar, that is, Mixed Disorder of Emotion and Conduct (MDEC) (code F92). In this study, the United Kingdom (UK) arm (UK-LAMS) of the US National Institute of Mental Health (NIMH) supported Longitudinal Assessment of Manic Symptoms (LAMS) multi-site study was used to evaluate and retrospectively construct DMDD and MDEC diagnoses in order to compare them and understand the conditions they co-occur with, in order to improve the clinical understanding. In particular, the phenomenology of UK-LAMS participants (n = 117) was used to determine whether DMDD is a unique entity within the DSM-5. The findings showed that 24 of 68 participants with either DMDD or MDEC (35.3%) fulfilled both diagnostic criteria for DMDD and MDEC, suggesting that these entities do contain overlapping features, particularly symptoms relating to Oppositional Defiant Disorder (ODD)/Conduct Disorder (CD), Attention Deficit Hyperactivity Disorder (ADHD)/Hyperkinetic Disorder (HKD) and/or an anxiety disorder. The data also showed that most of the participants who met DMDD criteria also fulfilled the diagnostic criteria for ODD/CD, ADHD, followed by an anxiety disorder. In this context, this raises the issue whether DMDD is a unique construct or whether the symptomology for DMDD can be better explained as a specifier for ODD/CD and ADHD. Unlike DMDD, MDEC clearly specifies that the label should only be used if emotional and conduct disorders co-exist.

  10. The safety and effectiveness of open-label extended-release carbamazepine in the treatment of children and adolescents with bipolar I disorder suffering from a manic or mixed episode

    Directory of Open Access Journals (Sweden)

    Findling RL

    2014-08-01

    Full Text Available Robert L Findling,1,2 Lawrence D Ginsberg31Division of Child and Adolescent Psychiatry, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, 2Kennedy Krieger Institute, Baltimore, MD, USA; 3Red Oak Psychiatry Associates, PA, Houston, TX, USAObjective: To assess the safety and effectiveness of open-label treatment with extended-release carbamazepine (ERC in pediatric subjects suffering from bipolar I disorder.Method: Medically healthy youths aged 10–17 years suffering from an acute manic or mixed episode were eligible. After screening for study eligibility, the youths began a 5-week titration period in which doses of ERC were adjusted in order to optimize benefit whilst minimizing adverse events, at doses between 200–1,200 mg/day. Thereafter, subjects could continue to receive treatment during a subsequent 21-week period. Safety measures included spontaneously reported adverse events (AEs and laboratory assessments. The primary efficacy measure was the Young Mania Rating Scale (YMRS.Results: A total of 60 children (ages 10–12 and 97 adolescents (ages 13–17, with an overall average age of 13.4 years (standard deviation [SD] 2.0 years received ERC. The mean duration of study participation was 109.6 days (SD 70.2 days, with 66 (42% completing the entire study. At end of study participation (end point, the most prevalent dose of ERC was 1,200 mg: 31.7% of children and 24.7% of adolescents reached the 1,200 mg dose. The YMRS decreased from a mean of 28.6 (SD 6.2 at baseline to a mean of 13.8 (SD 9.4 (P<0.0001 at end point. A total of 26 subjects discontinued study participation because of AEs, the most common of which were rash (n=6, white blood cell count decreased (n=5, nausea (n=3, and vomiting (n=3. No deaths were reported. The most commonly reported AEs were headache (n=41, somnolence (n=30, nausea (n=22, dizziness (n=21, and fatigue (n=19.Conclusions: Open-label administration of ERC might be a safe

  11. Pengaruh penggunaan LKS berbasis hots terhadap motivasi dan hasil belajar IPA siswa SMP

    Directory of Open Access Journals (Sweden)

    Karsono Karsono

    2017-06-01

    Abstract This study aims to describe the effect of HOTS-based Student worksheet on motivation and learning outcome in science studies among grade 8 students of Junior High School 1 Petungkriyono Districk Pekalongan.This research was a quasy-experimental study involving student’s motivation and science learning outcomes as the dependent variable and the higher order thinking skills based student worksheet as the independent variabel. This study employed the non-equivalent control group design. The research subject consisted of 53 students  who were randomly selected, comprising 25 students in the experiment  group and 28 student in the control group. The research instrument consisted  of a test to measure science studies learning outcomes and questionaire to measure  student's motivation. The data were analyzed using the independent t-test and multivariate test (MANOVA at the significance level of 5% (α = 0.05. The result ofthe analysis on the everage score differences in motivation shows 0.000 (2-tailed  while the result on the everage score differences in  student’s  outcome shows 0.909 (2-tailed with significance level of 5%. The Result of multivariate test in Hottelling trace shows significance level at 0,000. This result shows that the use of HOTS-based student worksheet has positive and significant effect on student’s learning motivation, but it does  not have positive and significant effect on student’s science learning outcome. Keywords: HOTS-based Student worksheet, Motivation  and  Learning Outcome in Science Studies

  12. The Approximate Loebl-Komlos-Sos Conjecture III: The Finer Structure of LKS Graphs

    Czech Academy of Sciences Publication Activity Database

    Hladký, J.; Komlós, J.; Piguet, Diana; Simonovits, M.; Stein, M.; Szemerédi, E.

    2017-01-01

    Roč. 31, č. 2 (2017), s. 1017-1071 ISSN 0895-4801 R&D Projects: GA MŠk(CZ) 1M0545; GA ČR GJ16-07822Y Grant - others:EPRSC(GB) EP/D063191/1; EPRSC(GB) EP/J501414/1; FP7(XE) PIEF-GA-2009-253925; GA MŠK(CZ) CZ.1.05/1.1.00/02.0090 Institutional support: RVO:67985807 Keywords : extremal graph theory * Loebl–Komlós–Sós conjecture * regularity lemma Subject RIV: BA - General Mathematics OBOR OECD: Pure mathematics Impact factor: 0.755, year: 2016

  13. Sexual function in lithium-treated manic-depressive patients

    DEFF Research Database (Denmark)

    Kristensen, Ellids; Jørgensen, Per

    1987-01-01

      Sexual function in 24 patients with major affective disorders who were given prophylactic lithium treatment was compared with that of a control group of surgical outpatients with no known psychiatric disease. Changes in sexual function during lithium treatment were also recorded retrospectively...... in sexual function during lithium treatment were reported by one-fourth of the patients. Of these, four reported a positive influence of the treatment and five a negative influence. Statistically, significantly more patients than controls were dissatisfied with their present sex life....

  14. Electroconvulsive therapy in single manic episodes: a case series

    African Journals Online (AJOL)

    ... in pharmacotherapy, electroconvulsive therapy is an effective treatment strategy in ... Behavioral Sciences Research Center, Noor University Hospital,. Ostandari Street .... side effects of ECT such as cognitive impairment to the degree that the .... adolescents with mood disorders: patients' and parents' attitude. Psychiatry ...

  15. The approximate Loebl-Komlós-Sós Conjecture II: The rough structure of LKS graphs

    Czech Academy of Sciences Publication Activity Database

    Hladký, Jan; Komlós, J.; Piguet, Diana; Simonovits, M.; Stein, M.; Szemerédi, E.

    2017-01-01

    Roč. 31, č. 2 (2017), s. 983-1016 ISSN 0895-4801 R&D Projects: GA MŠk(CZ) 1M0545 EU Projects: European Commission(XE) 628974 - PAECIDM Institutional support: RVO:67985840 ; RVO:67985807 Keywords : extremal graph theory * Loebl–Komlós–Sós conjecture * regularity lemma Subject RIV: BA - General Mathematics; BA - General Mathematics (UIVT-O) OBOR OECD: Pure mathematics; Pure mathematics (UIVT-O) Impact factor: 0.755, year: 2016 http://epubs.siam.org/doi/10.1137/140982854

  16. Pengembangan Lembar Kerja Siswa (LKS) Berbasis Pendekatan Realistic Mathematic Education (RME) untuk Memfasilitasi Kemampuan Representasi Matematis Siswa SMP

    OpenAIRE

    Ranti Mustika Sari; Zubaidah Amir M. Z.; Risnawati Risnawati

    2017-01-01

    This research aimed at developing, producing a valid and practical students' workbook Realistic Mathematic Education Approach Based and facilitating student mathematic representing ability on Systems of Linear Equations in Two Variables material.The method of this research was a Research and Development (R&D) through the development of 4-D (Define, Design, Develop, and Disseminate) Model.This research was administered at State Junior High School 2 Pasir Penyu.The subjects of this research...

  17. LEMBAR KERJA SISWA (LKS MENGGUNAKAN MODEL GUIDED INQUIRY UNTUK MENINGKATKAN KETERAMPILAN BERPIKIR KRITIS DAN PENGUASAAN KONSEP SISWA

    Directory of Open Access Journals (Sweden)

    Eka Yuli Asmawati

    2015-03-01

    Full Text Available The learning process in 2013 curriculum for all levels of education carried out by using a scientific approach (scientific approach. Critical thinking skills and mastery of concepts students need to developed in a learning process that is as capital to criticize a variety of symptoms, problems that arise in the vicinity. The use of instructional media and learning models in physics very aid learners in understanding the concepts of physics. Based on the above, it is necessary to do a literature review on the develop of guided inquiry worksheets with models to improve critical thinking skills and mastery of concepts students. The study began with highlights of LKS and model of guided inquiry. Next, review the empirical research has done about critical thinking. Then the third part discusses the concept mastery. Furthermore, in the fourth part is the end of the literature review. Based on the literature study, the authors conclude that the develop the model of guided inquiry worksheets can used to improve critical thinking skills and mastery of concepts students.

  18. The approximate Loebl-Komlós-Sós Conjecture II: The rough structure of LKS graphs

    Czech Academy of Sciences Publication Activity Database

    Hladký, Jan; Komlós, J.; Piguet, Diana; Simonovits, M.; Stein, M.; Szemerédi, E.

    2017-01-01

    Roč. 31, č. 2 (2017), s. 983-1016 ISSN 0895-4801 R&D Projects: GA MŠk(CZ) 1M0545 EU Projects: European Commission(XE) 628974 - PAECIDM Institutional support: RVO:67985840 ; RVO:67985807 Keywords : extremal graph theory * Loebl–Komlós–Sós conjecture * regularity lemma Subject RIV: BA - General Mathematics ; BA - General Mathematics (UIVT-O) OBOR OECD: Pure mathematics ; Pure mathematics (UIVT-O) Impact factor: 0.755, year: 2016 http://epubs.siam.org/doi/10.1137/140982854

  19. Manic Monday to fabulous Friday: partnering to improve behavioral and mental health needs of students.

    Science.gov (United States)

    Schwind, Karen S; Freeman, Sally Ann; Garcia, Molly; Roberts, Ruth

    2015-01-01

    School nurses across the United States continue to see an increase in the number of children and families with behavioral and mental health issues that affect many aspects of overall health and education. When referral to a mental health professional is indicated, there are often few available community mental health providers, long waits for appointments, or both. This article describes how school nurses can leverage school district and community resources and increase their capacity to meet the behavioral and mental health needs of children in the school setting.

  20. Pediatric Bipolar Disorder versus Severe Mood Dysregulation: Risk for Manic Episodes on Follow-Up

    Science.gov (United States)

    Stringaris, Argyris; Baroni, Argelinda; Haimm, Caroline; Brotman, Melissa; Lowe, Catherine H.; Myers, Frances; Rustgi, Eileen; Wheeler, Wanda; Kayser, Reilly; Towbin, Kenneth; Leibenluft, Ellen

    2010-01-01

    Objective: An important question in pediatric bipolar research is whether marked nonepisodic irritability is a manifestation of bipolar disorder in youth. This study tests the hypothesis that youth with severe mood dysregulation (SMD), a category created for the purpose of studying children presenting with severe nonepisodic irritability, will be…

  1. [Age at Onset as a Marker of Subtypes of Manic-Depressive Illness].

    Science.gov (United States)

    Pedraza, Ricardo Sánchez; Losada, Jorge Rodríguez; Jaramillo, Luis Eduardo

    2012-09-01

    Age at onset of bipolar disorder has been reported as a variable that may be associated with different clinical subtypes. To identify patterns in the distributions of age at onset of bipolar disease and to determine whether age at onset is associated with specific clinical characteristics. Admixture analysis was applied to identify bipolar disorder subtypes according to age at onset. The EMUN scale was used to evaluate clinical characteristics and principal components were estimated to evaluate the relationship between subtypes according to age at onset and symptoms in the acute in the acute phase, using multivariable analyses. According to age at onset, three distributions have been found: early onset: 17.7 years (S.D. 2.4); intermediate-onset: 23.9 years (S.D. 5.6); late onset: 42.8 years (S.D. 12.1). The late-onset group is antisocial, with depressive symptoms, thinking and language disorders, and socially disruptive behaviors. In patients having bipolar disorder, age at onset is antisocial with three groups having specific clinical characteristics. Copyright © 2012 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  2. Convergent integration of animal model and human studies of bipolar disorder (manic-depressive illness).

    Science.gov (United States)

    Le-Niculescu, Helen; Patel, Sagar D; Niculescu, Alexander B

    2010-10-01

    Animal models and human studies of bipolar disorder and other psychiatric disorders are becoming increasingly integrated, prompted by recent successes. Particularly for genomics, the convergence and integration of data across species, experimental modalities and technical platforms is providing a fit-to-disease way of extracting reproducible and biologically important signal, in sharp contrast to the fit-to-cohort effect, disappointing findings to date, and limited reproducibility of human genetic analyses alone. Such work in psychiatry can provide an example of how to address other genetically complex disorders, and in turn will benefit by incorporating concepts from other areas, such as cancer biology and diabetes. Copyright © 2010. Published by Elsevier Ltd.

  3. Acoustic and Perceptual Correlates of Foreign Accent Syndrome with Manic Etiology: A Case Study

    Science.gov (United States)

    Lewis, Skye; Ball, Laura J.; Kitten, Suzanna

    2013-01-01

    In foreign accent syndrome (FAS), changes in articulation and prosody cause listeners to perceive the speaker as "foreign-sounding." Fewer than 100 cases of FAS have been described in the literature; commonly associated with brain damage, only a handful of these have been analyzed with respect to acoustic measures. Acoustic and…

  4. Progression of Amygdala Volumetric Abnormalities in Adolescents after Their First Manic Episode

    Science.gov (United States)

    Bitter, Samantha M.; Mills, Neil P.; Adler, Caleb M.; Strakowski, Stephen M.; DelBello, Melissa P.

    2011-01-01

    Objective: Although previous neuroimaging studies suggest that adolescents with bipolar disorder exhibit smaller amygdala volumes compared with healthy adolescents, whether these abnormalities are present at illness onset or instead develop over time remains unclear. The aim of this study was to conduct a prospective longitudinal investigation…

  5. Manic thinking: independent effects of thought speed and thought content on mood.

    Science.gov (United States)

    Pronin, Emily; Wegner, Daniel M

    2006-09-01

    This experiment found that the speed of thought affects mood. Thought speed was manipulated via participants' paced reading of statements designed to induce either an elated or a depressed mood. Participants not only experienced more positive mood in response to elation than in response to depression statements, but also experienced an independent increase in positive mood when they had been thinking fast rather than slow--for both elation and depression statements. This effect of thought speed extended beyond mood to other experiences often associated with mania (i.e., feelings of power, feelings of creativity, a heightened sense of energy, and inflated self-esteem or grandiosity).

  6. Landau-Kleffner Syndrome: An Exploration of Parent Experience of the Diagnostic Process

    Science.gov (United States)

    Lemard-Reid, Daunette

    2014-01-01

    Landau-Kleffner syndrome (LKS) is a rare childhood disorder that is often misdiagnosed as autism or childhood psychosis because of overlapping symptom presentation. Favorable prognoses in LKS depend on early diagnosis and treatment. While much is known about the clinical basis for LKS diagnosis, little is known about parents' lived experience with…

  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. Efficacy and safety of electroconvulsive therapy in the first trimester of pregnancy: a case of severe manic catatonia.

    Science.gov (United States)

    Pinna, Martina; Manchia, Mirko; Pillai, Gianluca; Salis, Piergiorgio; Minnai, Gian Paolo

    2015-08-01

    Electroconvulsive therapy (ECT) is an appropriate, albeit often neglected, option for managing severe or life-threatening psychiatric symptoms during pregnancy. We report on the rapid effectiveness and safety of ECT during the first trimester of pregnancy in a 28-year-old woman with severe catatonia. Catatonic symptoms were assessed using the Catatonia Rating Scale (CRS). The patient was treated with unilateral ECT using left anterior right temporal (LART) placement. Seizure quality and duration were monitored by a two-lead electroencephalograph (EEG) and by one-lead electromyography (EMG). During each ECT session, the fetal heart rate was monitored with electrocardiogram (ECG). After the second ECT treatment (day 13 of hospitalization), we observed remission of the catatonic symptoms, as shown by the drop in the CRS score from 22 to 0. No cognitive abnormalities were reported and no gynecological complications were detected (e.g. vaginal bleeding, abdominal pain, or uterine contraction). The patient delivered at term a healthy male neonate who presented normal growth as well as normal psychomotor development. This case highlights the effectiveness of ECT in treating severe catatonic mania during the first 3 months of pregnancy. In addition, ECT proved to be a safe therapeutic option, since neither mother nor infant experienced any adverse event. We suggest that ECT might be considered as a valid and safe option in the therapeutic decision-making process when catatonic symptoms manifest during pregnancy. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  9. Cannabis use and first-episode psychosis:relationship with manic and psychotic symptoms, and with age at presentation

    OpenAIRE

    Stone, J. M.; Fisher, H L; Major, B; Chisholm, B; Woolley, J; Lawrence, J; Rahaman, N; Joyce, J; Hinton, M.; Johnson, S; Young, A H

    2014-01-01

    Background: Cannabis use has been reported to be associated with an earlier onset of symptoms in patients with first-episode psychosis, and a worse outcome in those who continue to take cannabis. In general, studies have concentrated on symptoms of psychosis rather than mania. In this study, using a longitudinal design in a large naturalistic cohort of patients with first-episode psychosis, we investigated the relationship between cannabis use, age of presentation to services, daily functioni...

  10. Cross-cultural translation of the Lysholm knee score in Chinese and its validation in patients with anterior cruciate ligament injury.

    Science.gov (United States)

    Wang, W; Liu, L; Chang, X; Jia, Z Y; Zhao, J Z; Xu, W D

    2016-10-19

    The Lysholm Knee Score (LKS) is widely used and is one of the most effective questionnaires employed to assess knee injuries. Although LKS has been translated into multiple languages, there is no Chinese version even though China has the largest population of patients with knee-joint injuries. The objective of our study was to develop the Chinese version of LKS (C-LKS) and assess its reliability, validity and responsiveness in Chinese patients with anterior cruciate ligament (ACL) injuries. Study participants were mainly recruited among patients with ACL injuries scheduled for arthroscopic ACL reconstruction at our hospital. First, we developed the C-LKS in a five-step translation and cross-cultural adaptation procedure. Next, we calculated the Cronbach's alpha, intraclass correlation coefficient (ICC), Pearson's correlation coefficient (r), effect size (ES), and standardized response mean (SRM) to evaluate the reliability, validity, and responsiveness of C-LKS respectively. Overall, 126 patients with ACL injuries successfully completed the questionnaires. Acceptable internal consistency (Cronbach's alpha = 0.726) as well as excellent test-retest reliability (ICC = 0.935) was found for C-LKS. Good or moderate correlation (r = 0.514-0.837) was determined among C-LKS and International Knee Documentation Committee Subjective Knee Form (IKDC), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), physical subscales of SF-36; C-LKS also had fair or moderate correlation (r = 0.207-0.462) with the other subscales of SF-36, which adequately illustrated that good validity was included in C-LKS. In addition, good responsiveness was also observed in C-LKS (ES = 1.36,SRM = 1.26). We have shown that our developed C-LKS questionnaire is reliable, valid and responsible for the evaluation of Chinese-speaking patients with ACL injuries and it would be an effective instrument.

  11. Landau-Kleffner Syndrome, Electrical Status Epilepticus in Slow Wave Sleep, and Language Regression in Children

    Science.gov (United States)

    McVicar, Kathryn A.; Shinnar, Shlomo

    2004-01-01

    The Landau-Kleffner syndrome (LKS) and electrical status epilepticus in slow wave sleep (ESES) are rare childhood-onset epileptic encephalopathies in which loss of language skills occurs in the context of an epileptiform EEG activated in sleep. Although in LKS the loss of function is limited to language, in ESES there is a wider spectrum of…

  12. Regional Cerebral Blood-Flow with 99mTc-ECD Brain Perfusion SPECT in Landau-Kleffner Syndrome: Report of Two Cases

    Directory of Open Access Journals (Sweden)

    Reza Nemati

    2014-01-01

    Full Text Available Landau-Kleffner syndrome (LKS is a rare childhood disorder characterized by acquired aphasia and epilepsy. 99mTc-ECD SPECT imaging was performed in two right-handed children with LKS. A relative decrease in perfusion was found in the left frontal-temporal cortices of both patients as well as in the left and right parietal cortices of one patient with aphasia, without clinical epilepsy. The degree of regional cerebral perfusion impairment did not correlate with the severity of the clinical and EEG abnormalities, but the area of hypoperfusion was compatible with the speech area of the brain. Overall, although asymmetrical temporoparietal perfusion appears as a common finding in LKS, SPECT findings in LKS alone cannot elucidate the pathogenic features of the disorder in the brain. Here, we present two cases of LKS in which we investigated SPECT perfusion scans.

  13. Uma aventura no manicômio: a trajetória de Franco Basaglia An adventure in the insane asylum: the life of Franco Basaglia

    Directory of Open Access Journals (Sweden)

    Paulo Amarante

    1994-10-01

    Full Text Available O processo de transformações no campo da saúde mental e das reformas psiquiátricas mantém estreitas relações com as questões práticas e teóricas surgidas a partir da experiência de Franco Basaglia. O presente texto propõe-se a refletir sobre sua trajetória, destacando os principias conceitos e referências teóricas por ele operados, e procurando demarcar o caráter singular de suas contribuições em relação ao projeto atual de desinstitucionalização em psiquiatria. Basaglia opera uma ruptura ao exercer um profundo questionamento sobre o saber e as instituições psiquiátricas, o que possibilita um novo quadro epistemológico e, conseqüentemente, cultural e assistencial no lidar com a loucura. Partindo da constatação de que esta obra é muito pouco conhecida, este texto procura revisitar o pensamento de Basaglia, sublinhando a originalidade de suas contribuições e atentando para a necessidade de seu melhor conhecimento por parte daqueles que se dedicam ao campo da saúde mental e das instituições sociais.The process of change in the mental health field and psychiatric reforms bear a close relationship to practical and theoretical issues stemming from Franco Basaglia's experience. This article is intended as a reflection on Basaglia's career, stressing the main concepts and theoretical references he worked with and seeking to trace the unique nature of his contributions to the current project for de-institutionalizing psychiatry. Basaglia produces a break by profoundly challenging psychiatric knowledge and institutions, thus allowing for a new epistemological framework (a framework that was thus also new in relation to culture and mental health care in dealing with insanity. Based on the observation that Basaglia's work is little known, this article attempts to revisit his thinking, highlighting the unique nature of his contributions and stressing the need for a better understanding of his work by those who are devoted to the field of mental health and social institutions.

  14. Severe Interstitial Lung Disease and Manic Symptoms Secondary to Corticosteroids in a Patient with Systemic Lupus Erythematosus and Secondary Sjögren’s Syndrome

    Directory of Open Access Journals (Sweden)

    Sofia Silvério Serra

    2017-03-01

    We introduced monthly perfusion of cyclophosphamide for six months and later started mycophenolate mofetil 2 g/day, reducing prednisolone to 10 mg/day and maintaining hydroxychloroquine 400 mg/day, with control of disease activity.

  15. The relationship of manic episodes and drug abuse to sexual risk behavior in patients with co-occurring bipolar and substance use disorders: a 15-month prospective analysis.

    Science.gov (United States)

    Meade, Christina S; Fitzmaurice, Garrett M; Sanchez, Amy K; Griffin, Margaret L; McDonald, Leah J; Weiss, Roger D

    2011-11-01

    Risky sexual behavior is common among individuals with bipolar and substance use disorders. This 15-month prospective study examined the effects of between-subject differences and within-subject changes in mood symptoms and drug use on sexual risk behavior among 61 patients with both disorders. Participants completed five post-treatment follow-up assessments at 3-month intervals. Using a multivariate mixed-effects model analysis, more average weeks of mania (between-subject difference) was associated with greater sexual risk, but change in weeks of mania (within-subject change) was not; depression was unrelated to sexual risk. In addition, within-subject increases in days of cocaine use predicted increases in sexual risk. Results underscore the importance of substance abuse treatment and suggest that bipolar patients with active and/or recurrent mania are in need of targeted HIV prevention services. Further research is needed to test whether individual differences in impulsivity may explain the association between mania and sexual risk.

  16. A possible utilization of the mice forced swim test for modeling manic-like increase in vigor and goal-directed behavior.

    Science.gov (United States)

    Flaisher-Grinberg, Shlomit; Einat, Haim

    2009-01-01

    The lack of appropriate animal models for bipolar disorder (BPD) is a major factor hindering the research of its pathophysiology and the development of new drug treatments. In line with the notion that BPD might represent a heterogeneous group of disorders, it was suggested that models for specific domains of BPD should be developed. The present study tested the possible utilization of the forced swim test (FST) as a model for the heightened vigor and goal-directed behavior domain of mania, using mice with low baseline immobility. Black Swiss mice were previously identified to have low immobility in the FST but similar spontaneous activity levels compared with several other mice strains. Thus, spontaneous activity and behavior in the FST were evaluated following treatment with the mood stabilizer valproate and the antidepressant imipramine. The results indicated that valproate increased immobility in the FST without affecting spontaneous activity whereas imipramine had no effect in the FST but increased spontaneous activity. These findings suggest that in mice with low baseline immobility scores, the FST might be a useful model for the elevated vigor and goal-directed behavior domain of mania. As such, this test might be well integrated into a battery of models for different domains of BPD.

  17. Is it fair to the children? Asenapine trials for acute manic or mixed episodes in children with bipolar disorder were misrepresented

    DEFF Research Database (Denmark)

    Danborg, Pia Brandt; Schumann, T

    % occurred in 26 (8.6%) patients on asenapine versus one on placebo, and there were 414 versus 43 non-serious AEs. During the OLE (described to assess safety), 613 serious AEs in 23 participants were registered in the trial register; self-harm was reported 192 times. Extrapyramidal symptoms events were...... was generally well tolerated”. Method: One unblinded observer extracted data on harms and quality of life from the paper and compared these to data from the trial register and the FDA clinical review. A second observer validated the data. Results: Of 404 participants, 303 were randomized to one of three...... reported 20 times and 109 experienced >7% weight gain. Non-serious AEs totaled 3437 events in 200 participants (62%) while the paper reported selected AEs. The pediatric Quality of Life Enjoyment and Satisfaction Questionnaire is a self-reported 70-point scale. Results were only reported in the trial...

  18. PENGEMBANGAN LEMBAR KERJA SISWA BAHASA INGGRIS BERMUATAN NILAI PENDIDIKAN KARAKTER KELAS V MADRASAH IBTIDAIYAH SEMARANG

    Directory of Open Access Journals (Sweden)

    Ma'as Shobirin

    2013-03-01

    Full Text Available AbstrakTujuan penelitian ini adalah mendeskripsikan kebutuhan terhadap LKS, meru- muskan prinsip penyusunan LKS, mengukur kevalidan LKS dan membuktikan keefektifan LKS bahasa Inggris bermuatan nilai karakter kelas V MI. Penelitian pengembangan ini mengikuti model Borg and Gall. Data penelitian diperoleh mela- lui pemberian angket, lembar penilaian, dan tes. Teknik analisisdata menggunakan t-tes dan N-gain. Hasil penelitian ini adalah 1 pemenuhan kebutuhan LKS meliputi aspek desain, isi dan ranah karakter; 2 prinsip penyusunan LKS meliputi prinsip kebermaknaan, keterpaduan dan estetika; 3 kevalidan LKS termasuk dalam kat- egori sangat baik; dan 4 LKS bahasa Inggris bermuatan nilai pendidikan karak- ter sangat efektif dalam meningkatkan hasil belajar siswa berdasarkan hasil perhi- tungan t test dan N-gain. Produk LKS bahasa Inggris bermuatan nilai pendidikan karakter perlu diujicobakan dalam skala luas. AbstractThe purposes of this research are describing needs to English student worksheet, formulating the principles of English student worksheet’s arrangement, measuring the validity of English student worksheet and going to show the effectiveness of English student worksheet consisting character education values of fifth grade students of Islamic elementary school. This rese- arch and development refers to Borg dan Gall’s model. The data collecting techniques uses students and teachers’ need questionnaire, expert assessment and test, then it is analyzed by t-test statistic and normalized gain. The result of this research are 1 fulfillment of English students worksheet’s need, include design, content and character domain; 2 the principles of English students worksheet’s arrangement include meaningfull, cohesiveness and aesthetics; 3 the validity of English student worksheet includes the excellent category; and 4 English student worksheet consisting character education values is very effective in increasing the stu- dent learning outcomes

  19. Gene expression profile and functionality of ESC-derived Lin-ckit+Sca-1+ cells are distinct from Lin-ckit+Sca-1+ cells isolated from fetal liver or bone marrow.

    Directory of Open Access Journals (Sweden)

    Irina Fernandez

    Full Text Available In vitro bioreactor-based cultures are being extensively investigated for large-scale production of differentiated cells from embryonic stem cells (ESCs. However, it is unclear whether in vitro ESC-derived progenitors have similar gene expression profiles and functionalities as their in vivo counterparts. This is crucial in establishing the validity of ESC-derived cells as replacements for adult-isolated cells for clinical therapies. In this study, we compared the gene expression profiles of Lin-ckit+Sca-1+ (LKS cells generated in vitro from mouse ESCs using either static or bioreactor-based cultures, with that of native LKS cells isolated from mouse fetal liver (FL or bone marrow (BM. We found that in vitro-generated LKS cells were more similar to FL- than to BM LKS cells in gene expression. Further, when compared to cells derived from bioreactor cultures, static culture-derived LKS cells showed fewer differentially expressed genes relative to both in vivo LKS populations. Overall, the expression of hematopoietic genes was lower in ESC-derived LKS cells compared to cells from BM and FL, while the levels of non-hematopoietic genes were up-regulated. In order to determine if these molecular profiles correlated with functionality, we evaluated ESC-derived LKS cells for in vitro hematopoietic-differentiation and colony formation (CFU assay. Although static culture-generated cells failed to form any colonies, they did differentiate into CD11c+ and B220+ cells indicating some hematopoietic potential. In contrast, bioreactor-derived LKS cells, when differentiated under the same conditions failed to produce any B220+ or CD11c+ cells and did not form colonies, indicating that these cells are not hematopoietic progenitors. We conclude that in vitro culture conditions significantly affect the transcriptome and functionality of ESC-derived LKS cells and although in vitro differentiated LKS cells were lineage negative and expressed both ckit and Sca-1

  20. Architecture of Human Language from the Perspective of a Case of Childhood Aphasia — Landau–Kleffner Syndrome

    Directory of Open Access Journals (Sweden)

    Koji Hoshi

    2016-12-01

    Full Text Available This paper addresses Landau–Kleffner syndrome (LKS, a childhood aphasia, from the perspective of I-language and the critical period for first language acquisition. LKS involves a language disorder and behavioral disturbances resembling autistic spectrum disorders due to electroencephalographic abnormalities with continuous spike-and-waves during sleep over the temporal regions. Comparing LKS with other childhood syndromes, the architecture of language is explored through elucidating the linguistic mechanisms behind the language disorder in LKS on the basis of Hickok & Poeppel’s (2007 dual-stream model of speech processing. It is claimed that early onset LKS provides further support for the critical period for first language acquisition and modularity of mind (the faculty of language, and that verbal auditory input during the critical period is most crucial for language recovery and development in LKS. Considering that electroencephalographic abnormalities affect cognitive/motor functions, ameliorating neural dysfunction in the affected brain areas with proper application of trans-cranial direct current stimulation is recommended.

  1. Manicômio em circuito: os percursos dos jovens e a internação psiquiátrica The psychiatric hospital circuit: the trajectories of yong people prior to psychiatric hospitalization

    Directory of Open Access Journals (Sweden)

    Andrea Cristina Coelho Scisleski

    2008-02-01

    Full Text Available Este artigo analisa a internação psiquiátrica de jovens, tomando-a não a partir de uma perspectiva psicopatológica individual, mas de uma dimensão subjetivo-social com base nos percursos desses jovens até a internação. O estudo foi realizado no Centro Integrado de Atenção Psicossocial para crianças e adolescentes do Hospital Psiquiátrico São Pedro, na cidade de Porto Alegre, Rio Grande do Sul, Brasil, por meio de oficinas com os jovens que estavam em atendimento na internação deste serviço. Percebeu-se uma recorrência que marca o percurso desses jovens e expressa um determinado modo de funcionamento da rede de atenção até a internação, acarretando na produção de um certo perfil desses jovens: pobreza sócio-econômica, baixa escolaridade e uso de drogas. Outro aspecto importante é o papel da ordem judicial nos encaminhamentos à internação, que obedece tanto a uma lógica de punição aos jovens e aos serviços, como também, paradoxalmente, constitui-se numa estratégia de acesso aos serviços de saúde.This article analyzes psychiatric hospitalization of young patients from a contemporary social-subjective (rather than a psychopathological perspective, following the trajectory of these youth prior to their admission. The study was conducted at the Center for Comprehensive Psychosocial Care for Children and Adolescents, São Pedro Psychiatric Hospital, in the city of Porto Alegre, Rio Grande do Sul State, Brazil. Recurrent traits in the trajectory of these youth expressed how the health care network functioned with them prior to their hospitalization, with a consistent pattern of socioeconomic deprivation, low schooling, and drug use. Another key aspect was the role of the court system in referring them for hospitalization, adhering to a kind of logic that punished both the youth and the services and paradoxically formed a strategy for access to health services.

  2. Effect of lithium and of other drugs used in the treatment of manic illness on the cation-transporting properties of Na+,K+-ATPase in mouse brain synaptosomes

    Energy Technology Data Exchange (ETDEWEB)

    Wood, A J; Elphick, M; Grahame-Smith, D G

    1989-04-01

    We have developed and used a novel technique to investigate the effects of lithium and other psychotropic drugs on the cation-transporting properties of the sodium- and potassium-activated ATPase enzyme (Na+,K+-ATPase) in intact synaptosomes. Rubidium-86 uptake into intact synaptosomes is an active process and is inhibited by approximately 75% in the presence of the Na+,K+-ATPase inhibitor acetylstrophanthidin. In vitro addition of lithium to synaptosomes prepared from untreated mice causes a progressive inhibition of acetylstrophanthidin-sensitive /sup 86/Rb uptake, but only at concentrations higher than the clinical therapeutic range. However, pretreatment of mice for 14 days in vivo with lithium, carbamazepine, and haloperidol, but not phenytoin, causes a significant stimulation of /sup 86/Rb uptake into synaptosomes via Na+,K+-ATPase.

  3. Emergency care in case of acute psychotic and/or manic symptoms: Lived experiences of patients and their families with the first interventions of a mobile crisis team. A phenomenological study.

    Science.gov (United States)

    Daggenvoorde, Thea H; Gijsman, Harm J; Goossens, Peter J J

    2017-09-27

    To explore the lived experiences of patients with a psychotic or bipolar disorder and their families with emergency care during the first contact with a mobile crisis team. Open individual interviews were held with ten patients and ten family members. Content data-analysis was conducted. Communication and cooperation was difficult in several cases. Personal crisis plans were not always used. Stigma was felt, especially when police-assistance was needed. A calm, understanding attitude was appreciated. Focus explicitly on communication with the patient, despite the acute condition, enhances the chance of cooperation. Taking time for contact is important. © 2017 Wiley Periodicals, Inc.

  4. The impact of childhood trauma on cognitive functioning in patients recently recovered from a first manic episode: data from the Systematic Treatment Optimization Program for Early Mania (STOP-EM).

    Science.gov (United States)

    Bücker, J; Kozicky, J; Torres, I J; Kauer-Sant'anna, M; Silveira, L E; Bond, D J; Lam, R W; Yatham, L N

    2013-06-01

    Both bipolar disorder (BD) and childhood trauma are associated with cognitive impairment. People with BD have high rates of childhood trauma, which confer greater overall disease severity, but, it is unknown if childhood trauma is associated with greater neurocognitive impairment in BD patients early in the course of their illnesses. In this study, we investigated the impact of childhood trauma on specific cognitive dysfunction in patients who recently recovered from their first episode of mania. Data were available for 64 patients and 28 healthy subjects matched by age, gender and pre-morbid IQ, recruited from a large university medical center. History of childhood trauma was measured using the Childhood Trauma Questionnaire. Cognitive function was assessed through a comprehensive neuropsychological test battery. Trauma was associated with poorer cognitive performance in patients on cognitive measures of IQ, auditory attention and verbal and working memory, and a different pattern was observed in healthy subjects. We had a modest sample size, particularly in the group of healthy subjects with trauma. Childhood trauma was associated with poorer cognition in BD patients who recently recovered from a first episode of mania compared to healthy subjects. The results require replication, but suggest that the co-occurrence of trauma and bipolar disorder can affect those cognitive areas that are already more susceptible in patients with BD. Copyright © 2012 Elsevier B.V. All rights reserved.

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

    NARCIS (Netherlands)

    R.C. Padmos (Roos)

    2009-01-01

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

  6. ANALISIS LEMBAR KERJA SISWA DALAM MENINGKATKAN KOMUNIKASI MATEMATIS TULIS SISWA

    Directory of Open Access Journals (Sweden)

    Fimmatur Rizka Ardina

    2016-02-01

    Komunikasi merupakan suatu kemampuan yang penting untuk dimiliki setiap manusia. Komunikasi dalam artikel ini difokuskan pada komunikasi matematis tulis. Komunikasi matematis tulis ini akan berhubungan dengan lembar kerja siswa yang dipakai dalam proses pembelajaran. Tujuan penulisan artikel ini adalah untuk mendeskripsikan proses analisis LKS sebagai alat untuk meningkatkan komunikasi matematis tulis siswa. Jenis penelitian yang digunakan adalah kualitatif deskriptif. LKS akan dianalisis menggunakan standar indikator kemampuan komunikasi NCTM (2000 yang dimodifikasi sehingga terdapat empat indikator yaitu (1 siswa dapat menuliskan ide yang dimiliki dengan jelas dan tepat (2 siswa dapat menuliskan alasan untuk jawaban yang diberikan (3 siswa dapat memberikan tanggapan untuk ide atau jawaban siswa lain (4 siswa dapat menuliskan kembali ide orang lain menggunakan bahasanya sendiri. Berdasarkan hasil penelitian dapat disimpulkan bahwa LKS oleh Tim MGMP Kota Malang tidak dapat digunakan sebagai alternatif untuk meningkatkan kemmapuan komunikasi matematis tulis siswa.

  7. Problem-Based Learning Model Used to Scientific Approach Based Worksheet for Physics to Develop Senior High School Students Characters

    Science.gov (United States)

    Yulianti, D.

    2017-04-01

    The purpose of this study is to explore the application of Problem Based Learning(PBL) model aided withscientific approach and character integrated physics worksheets (LKS). Another purpose is to investigate the increase in cognitive and psychomotor learning outcomes and to know the character development of students. The method used in this study was the quasi-experiment. The instruments were observation and cognitive test. Worksheets can improve students’ cognitive, psychomotor learning outcomes. Improvements in cognitive learning results of students who have learned using worksheets are higher than students who received learning without worksheets. LKS can also develop the students’ character.

  8. Fetal Abuse and the Criminalization of Behavior during Pregnancy.

    Science.gov (United States)

    Farr, Kathryn Ann

    1995-01-01

    Discusses efforts to criminalize fetal abuse, harm caused from a pregnant woman's use of illegal drugs. Such efforts have typically failed to withstand judicial scrutiny. Suggests that criminal prosecution for fetal abuse relies on questionable procedures, is unevenly applied, and may keep women from seeking drug treatment or prenatal care. (LKS)

  9. Häkkerid levitasid libauudist Obama surmast / Heiki Suurkask

    Index Scriptorium Estoniae

    Suurkask, Heiki, 1972-

    2011-01-01

    Häkkerid asetasid 4. juulil USA telekanalile Fox News kuuluvale Twitteri-leheküljele välksõnumi, et USA president Barack Obama olevat surnud. 2. mail Osama bin Ladeni tapmisest teatades oskas telekanal ekraanil edastada trükiveaga teadet "Obama bin Laden on surnud"

  10. Radiosonde Atmospheric Temperature Products for Assessing Climate (RATPAC): Towards a New Adjusted Radiosonde Dataset

    Science.gov (United States)

    Free, M. P.; Angell, J. K.; Durre, I.; Klein, S.; Lanzante, J.; Lawrimore, J.; Peterson, T.; Seidel, D.

    2002-05-01

    The objective of NOAA's RATPAC project is to develop climate-quality global, hemispheric and zonal upper-air temperature time series from the NCDC radiosonde database. Lanzante, Klein and Seidel (LKS) have produced an 87-station adjusted radiosonde dataset using a multifactor expert decision approach. Our goal is to extend this dataset spatially and temporally and to provide a method to update it routinely at NCDC. Since the LKS adjustment method is too labor-intensive for these purposes, we are investigating a first-difference method (Peterson et al., 1998) and an automated version of the LKS method. The first difference method (FD) can be used to combine large numbers of time series into spatial means, but also introduces a random error in the resulting large-scale averages. If the portions of the time series with suspect continuity are withheld from the calculations, it has the potential to reconstruct the real variability without the effects of the discontinuities. However, tests of FD on unadjusted radiosonde data and on reanalysis temperature data suggest that it must be used with caution when the number of stations is low and the number of data gaps is high. Because of these problems with the first difference approach, we are also considering an automated version of the LKS adjustment method using statistical change points, day-night temperature difference series, relationships between changes in adjacent atmospheric levels, and station histories to identify inhomogeneities in the temperature data.

  11. Public Support for Drunk-Driving Countermeasures: Social Policy for Saving Lives.

    Science.gov (United States)

    Applegate, Brandon K.; And Others

    1995-01-01

    Reports results of a community survey, conducted to investigate the option of addressing drunk driving as a public health issue rooted in social institutions, that found that the public endorsed reducing drunk driving through legal deterrence and rehabilitation, but was also willing to support several socially based interventions. (LKS)

  12. Bipolar patients sing more in singapore: singing as a signal for mania in psychotic patients.

    Science.gov (United States)

    Lim, Leslie; Leow, Me Lye; Soh, Bee Leng; Chan, Yiong Huak; Parker, Gordon

    2013-10-01

    Singing in psychotic patients has received little attention in the psychiatric literature. In this preliminary study, we test the hypothesis that manic patients sing more than schizophrenic patients (SPs). Manic patients and SP inpatients and outpatients were interviewed using a semi-structured questionnaire which included questions on musical interests, and how much they felt like singing prior to their most recent admission to hospital. They were asked if they were willing to sing during the interview and responses were observed. Of the 69 manic patients and 68 SPs interviewed, manic patients were more likely to report singing than SPs (76% vs 24%) prior to their most recent admission to hospital. There was a trend for manic inpatients to be more willing to sing during the interview. Increased singing is suggested as a useful symptom and sign in patients suffering from a manic illness.

  13. Panic Disorder and Women

    Science.gov (United States)

    ... health illnesses Alcoholism, substance abuse, and addictive behavior Anxiety disorders Attention deficit hyperactivity disorder Bipolar disorder (manic depressive illness) Borderline personality disorder Depression Eating disorders Post-traumatic ...

  14. Clinical Trials - Participants

    Science.gov (United States)

    ... Disorders (Pervasive Developmental Disorders) Bipolar Disorder (Manic-Depressive Illness) Borderline Personality Disorder Depression Eating Disorders Generalized Anxiety Disorder Obsessive-Compulsive Disorder (OCD) Panic Disorder Post- ...

  15. Acute mania after thyroxin supplementation in hypothyroid state

    Directory of Open Access Journals (Sweden)

    Rohit Verma

    2013-01-01

    Full Text Available The current literature variedly ascribes depressive and manic symptoms to hypo- and hyperthyroid state, respectively, reporting mania in hypothyroidism as an unusual entity. More unusual is precipitation of manic state in hypothyroid subjects after thyroxine supplementation for which studies report otherwise treating manic symptoms in hypothyroid state with thyroxine. We report a case of a patient whose acute mania appears to have been precipitated by thyroxine supplementation in hypothyroidism state. This case underscores the importance of thyroid screening in patients with mood and psychotic disorders, as well as the potency of thyroxine in producing manic symptoms.

  16. Increased oxidative stress as a mechanism for decreased BDNF levels in acute manic episodes Aumento do estresse oxidativo como um mecanismo para a diminuição dos níveis de BDNF em episódios maníacos agudos

    Directory of Open Access Journals (Sweden)

    Flávio Kapczinski

    2008-09-01

    Full Text Available OBJECTIVE AND METHOD: There is a growing amount of data indicating that alterations in brain-derived neurotrophic factor and increased oxidative stress may play a role in the pathophysiology of bipolar disorder. In light of recent evidence demonstrating that brain-derived neurotrophic factor levels are decreased in situations of increased oxidative stress, we have examined the correlation between serum thiobarbituric acid reactive substances, a measure of lipid peroxidation, and serum brain-derived neurotrophic factor levels in bipolar disorder patients during acute mania and in healthy controls. RESULTS: Serum thiobarbituric acid reactive substances and brain-derived neurotrophic factor levels were negatively correlated in bipolar disorder patients (r = -0.56; p = 0.001, whereas no significant correlation was observed in the control group.. CONCLUSION: These results suggest that alterations in oxidative status may be mechanistically associated with abnormal low levels of brain-derived neurotrophic factor observed in individuals with bipolar disorder.OBJETIVO E MÉTODO: Existem crescentes evidências indicando que alterações no fator neurotrófico derivado do cérebro e aumento do estresse oxidativo podem estar envolvidos na fisiopatologia do transtorno bipolar. Considerando os achados recentes de que os níveis de fator neurotrófico derivado do cérebro estão diminuídos em situações de aumento de estresse oxidativo, nós testamos a correlação entre os níveis séricos de substâncias reativas do ácido tiobarbitúrico, um índice de peroxidação lipídica, e os níveis séricos de fator neurotrófico derivado do cérebro em pacientes portadores de transtorno bipolar durante mania aguda e em controles saudáveis. RESULTADOS: Os níveis séricos de substâncias reativas do ácido tiobarbitúrico e fator neurotrófico derivado do cérebro apresentaram uma correlação negativa em pacientes bipolares (r = -0,56; p = 0,001, enquanto não houve correlação significativa no grupo controle. CONCLUSÃO: Estes resultados sugerem que alterações de estresse oxidativo podem ser mecanisticamente associadas com níveis reduzidos de BDNF observados em indivíduos com transtorno bipolar.

  17. Socio-cultural parameters in Yoruba Nigerian patients with affective disorders.

    Science.gov (United States)

    Makanjuola, R O

    1989-09-01

    One hundred and ten consecutive new patients presenting with major affective disorders were divided into five categories according to pattern of presentation: recurrent manic disorder, recurrent depressive disorder, bipolar disorder, single episodes of manic disorder, and single episodes of major depressive disorder. Manic patients predominated, and recurrent manic disorder was much more frequent than either recurrent depressive or bipolar disorder. The manic and bipolar patients were younger. Females predominated in all five groups of patients. The two manic groups were less likely to be married, but this was probably a reflection of their younger age. No differences were demonstrated with regard to educational status or occupation. There were no significant differences with regard to sibship position, family size, or polygamous/monogamous parents. Manic patients were more likely to have suffered permanent separation from one or both parents before the age of 12 years. A relatively low proportion of the patients had a positive history of mental disorder among first- or second-degree relatives. Manic and bipolar patients tended to present in hospital relatively early in their illness.

  18. Melanie Klein on mourning: Its relation to pastoral care.

    Science.gov (United States)

    Hart, C W

    1991-09-01

    This paper connects the work of Melanie Klein on mourning to the pastor's work with the grief sufferer. Klein holds that mourning is an illness of manic depressive character rooted in infantile development. Klein's description of manic defenses in the face of loss has adult behavioral analogues with which the pastor must deal to bring mourning to resolution.

  19. Life events and bipolar disorder : The influence of life events on the onset and course of bipolar disorder

    NARCIS (Netherlands)

    Kemner, Sanne

    2017-01-01

    In the Netherlands, bipolar disorder (also known as manic-depressive illness) is diagnosed in approximately 2% of the population. The disorder is characterized by alternating periods of raised activity and (manic) mood and periods of reduced activity with lowered (depressed) mood. Bipolar disorder

  20. Pharmacoeconomics of quetiapine for the management of acute mania in bipolar I disorder

    NARCIS (Netherlands)

    Klok, Rogier M; Al Hadithy, Asmar Fy; van Schayk, Nathalie Pjt; Antonisse, Ad Jj; Caro, Jaime J; Brouwers, Jacobus Rbj; Postma, Maarten J

    2007-01-01

    Bipolar disorder (or manic depression) is a lifelong, severe and complex psychiatric illness characterized by recurrent episodes of depression and mania. The aim of this study is to explore the cost-effectiveness of quetiapine compared with other alternatives for the treatment of acute manic

  1. Mania as complication of HIV infection: case reports | Sulyman ...

    African Journals Online (AJOL)

    These case reports highlight the fact that organic mood disorder, manic episode, in HIV infection AIDS might not be uncommon in this part of the world. Patients present with irritable mood rather than euphoria and they respond rapidly to psychotropic medications. Key words: Manic episode, HIV infection; Acquired immune ...

  2. Localized knowledge spillover and the emergence of new technology

    DEFF Research Database (Denmark)

    Tanner, Anne Nygaard

    2010-01-01

    For the past 20 years scholars have found support for the thesis that knowledge spills over in geographical and technological proximity to the source of knowledge creation. It is the objective of this paper to examine whether this understanding of LKS can contribute to a greater understanding...... of emerging technologies and their geographical distribution. The paper examines this by studying the emergence of a generic technology with a very complex knowledge base, namely the fuel cell (FC) technology. The analysis is carried out on an OECD dataset on regionalized PCT patent applications (OECD REGPAT......-related technology fields. These findings corroborate the usefulness of the theory on LKS in explaining elements of the emergence of new technologies. Moreover, the analysis sheds new light on regional development and diversification along new technological trajectory....

  3. Peraga Mikrometer Sekrup Braille untuk Siswa Tunanetra

    Directory of Open Access Journals (Sweden)

    Fithri Iradaty

    2017-06-01

    Full Text Available This research was conducted with Four D Models research design with a limited test involving three blind students at MAN Maguwoharjo, a physics teacher ath the school, and several students majoring in physics education FMIPA UNY. The result of the limited test shows that the props that have been developed can be applied as a screw micrometre model and the Braille-labeled LKS can also be used as a guide in a practicum implementation. The results of the assessment of the feasibility of the developed product are reviewed regarding several aspects which are the requirements of the measuring instrument that is validity (reliable, reliable, can be used internationally, is easy to produce, and safe. In general, Braille scarp micrometre displays are suitable for blind students. Besides, blind students strongly support the existence of braille screw micrometre displays equipped with this braille LKS as it will help them more easily understand micrometre screw gauges which in general this tool is still produced only for the non-blind. [Penelitian ini menggunakan desain Four D Models, dengan uji coba terbatas melibatkan tiga orang siswa tunanetra MAN Maguwoharjo, seorang guru fisika MAN Maguwoharjo, dan beberapa mahasiswa Jurusan Pendidikan Fisika FMIPA UNY. Hasil uji coba terbatas menunjukkan bahwa produk peraga yang telah dikembangkan dapat diterapkan sebagai peraga mikrometer sekrup dan LKS berhuruf Braille juga dapat dimanfaatkan sebagai pedoman dalam pelaksanaan praktikum. Hasil penilaian kelayakan produk peraga yang dikembangkan ditinjau dari beberapa aspek yang menjadi syarat alat ukur, yaitu valid (dapat dipercaya, reliable, dapat digunakan secara internasional, mudah diproduksi, dan aman. Secara umum, peraga mikrometer sekrup Braille layak digunakan bagi siswa tunanetra. Selain itu siswa tunanetra sangat mendukung keberadaan peraga mikrometer sekrup braille yang dilengkapi dengan LKS braille ini karena akan membantu mereka lebih mudah memahami

  4. U.S. EPA, Pesticide Product Label, FOOD PLANT FOGGING INSECTICIDE, 01/30/1990

    Science.gov (United States)

    2011-04-14

    ... w.lter. food, 01" fet:,1 hy ')lur.J,:!C 01 ,li· ••• u"> •• I. ... (his proJuct c. .• Z",.. IfitJ~f'!f.1.~. I)n thi') label" •• o 6""(l'r .' ... IJlIIC'i ,111 ri'1lks of J\\t~ ')lo.SI~I~ or'. ...

  5. Friend to Organize an Argumentative Text

    OpenAIRE

    Faisal, Faisal

    2013-01-01

    Writing is a process that helps the students develop their ideas and logical thinking. Principally, to write means to try to produce a written message. Because of these facts, it is necessary for teachers and students to master it well as writing plays a very important role in many processes including teaching and learning proc-esses. However, in the real teaching and learning process, junior high students who have been accustomed to LKS (Student Worksheet) consider writing a boring activi...

  6. Friend to Develop an Argumentative Essay

    OpenAIRE

    Faisal, Faisal

    2013-01-01

    Writing is a process that helps the students develop their ideas and logical thinking. Principally, to write means to try to produce a written message. Because of these facts, it is necessary for teachers and students to master it well as writing plays a very important role in many processes including teaching and learning proc-esses. However, in the real teaching and learning process, junior high students who have been accustomed to LKS (Student Worksheet) consider writing a boring activi...

  7. Development Of Phisyics Learning Documents Based Student's Learning Style In The Matter Of Temperature And Heat Subjects Of Class X High School

    OpenAIRE

    Resty Noriwita, Indah Resty Noriwita Indah; Nasir, Muhammad Nasir Muhammad; Ma’aruf, Zuhdi Ma’aruf Zuhdi

    2015-01-01

    This study aims to produce a learning documents physicsbased learning styles of students in the matter of temperature and heat of class subjectS X SMA valid. The subjects were learning documents that consists of a lesson plan (RPP), worksheets (LKS), medium of learning and achievement test of cognitive, affective, process, and psychomotor. Data collection instrument in this study is an instrument validity device physics-based learning students' learning styles in the matter of temperature and...

  8. INKONSISTENSI PRINSIP TIME VALUE OF MONEY DALAM OPERASIONAL TRANSAKSI KEUANGAN SYARIAH DAN SOLUSINYA

    Directory of Open Access Journals (Sweden)

    Siti Mujibatun

    2016-10-01

    Full Text Available The concept of Time Value of Money in the LKS is not accepted because of riba, but in practically mainly on small investors to invest, will face a big problem if it rejects the principle of Time Value of Money, whenever any country will have inflation. will be injustice when Islamic banking do not give a rate of return to the investor. The research is a qualitative, primary data sources and data collection consisted of a document. The Brochure of Product Financing Transactions in LKS, b. Fatwa DSN-MUI 2000, c. CD-ROM File Maushu'ah al-Hadith al-Sharif al-Tis'ah 1997 Edition II, d. The Books related to the concept of Time Value of Money, e. SOP (Standard Operational Product financing and acounting system. Secondary data consists of various books related to the concept of Time Value of Money both modern and classical fiqh books and  Research results related to this research problem. This research analyzes the discriftive approach, with results as follows: 1. Time Value of Money in the LKS is not acceptable, because the increase in the Time Value of Money earned should be of real business, not because of the debt contract / qardh 2. Time Value of Money by economic concepts Hadis Muhammad saw among other things contained in the contract of salam/ indent, BBA and 'disconto, araya and provision for debt payments 3. the occurrence of in-consistency between ideology Time Value of Money with praxis in LKS due in addition to not paying attention to the business logic of the Prophet, helplessness in operating system usage still based on the operating system Conventional Financial Institutions (LKK.

  9. PENGEMBANGAN PERANGKAT PEMBELAJARAN KOMPETENSI SULIT MATEMATIKA SMA DI RIAU

    Directory of Open Access Journals (Sweden)

    Ummi Aisyah

    2014-05-01

    Full Text Available Tujuan penelitian ini adalah untuk menghasilkan perangkat pembelajaran kompetensi sulit matematika SMA di Provinsi Riau yang berkualitas baik/layak yaitu valid, praktis, dan efektif. Penelitian ini merupakan penelitian pengembangan yang mengembangkan perangkat pembelajaran kompetensi sulit matematika SMA dengan menggunakan model pengembangan 4-D yang dikembangkan oleh Thiagarajan, Semmel & Semmel yang telah dimodifikasi sehingga hanya memuat tahap pen-definisian, perancangan, dan pengembangan. Penelitian ini menghasilkan perangkat pembelajaran kompetensi sulit matematika SMA yang meliputi silabus, rencana pelaksanaan pembelajaran (RPP, lembar kegiatan siswa (LKS, dan instrumen tes. Hasil validasi menunjukkan bahwa silabus, RPP, LKS yang dikembangkan memiliki kategori sangat valid untuk masing-masing silabus, RPP, LKS, dan test instrument. Hasil uji coba lapangan menunjukkan bahwa perangkat yang dikembangkan praktis dan efektif. Kepraktisan mencapai hasil sangat baik ditinjau dari penilaian guru dan siswa. Keefektifan ditinjau dari ketuntasan belajar siswa dan hasil observasi keterlaksanaan pembelajaran. Secara klasikal ketuntasan belajar mencapai 84,38%. Secara keseluruhan, hasil penelitian menunjukkan bahwa perangkat pembelajaran yang dikembangkan adalah layak untuk digunakan. Kata Kunci: pengembangan, perangkat pembelajaran, kompetensi sulit matematika

  10. The assessment of auditory function in CSWS: lessons from long-term outcome.

    Science.gov (United States)

    Metz-Lutz, Marie-Noëlle

    2009-08-01

    In Landau-Kleffner syndrome (LKS), the prominent and often first symptom is auditory verbal agnosia, which may affect nonverbal sounds. It was early suggested that the subsequent decline of speech expression might result from defective auditory analysis of the patient's own speech. Indeed, despite normal hearing levels, the children behave as if they were deaf, and very rapidly speech expression deteriorates and leads to the receptive aphasia typical of LKS. The association of auditory agnosia more or less restricted to speech with severe language decay prompted numerous studies aimed at specifying the defect in auditory processing and its pathophysiology. Long-term follow-up studies have addressed the issue of the outcome of verbal auditory processing and the development of verbal working memory capacities following the deprivation of phonologic input during the critical period of language development. Based on a review of neurophysiologic and neuropsychological studies of auditory and phonologic disorders published these last 20 years, we discuss the association of verbal agnosia and speech production decay, and try to explain the phonologic working memory deficit in the late outcome of LKS within the Hickok and Poeppel dual-stream model of speech processing.

  11. DEVELOPMENT OF PHYSICS STUDENT WORK SHEET (SWS TO BUILD SCIENCE PROCESS SKILL VALUED CONSERVATION

    Directory of Open Access Journals (Sweden)

    D. Yulianti

    2015-07-01

    Full Text Available Student Work Sheet (SWS which contains only a summary of the material and exercises does not train students to investigate and develop conservation values. The research objective is to also prepared worksheets guided inquiry that can enhance science process skills, understanding of the concept and develop conservation value. Elements of inquiry and conservation value generated through work instructions and investigation. The study was performed by using one group pretest-posttest design. Research procedures include observation and identification of weaknesses worksheets, planning, early product development and initial field trials. Feasibility and legibility using questionnaires and tests hiatus. The value of understanding the concept derived from the pretest-posttest. Data science process skills gained from the observation during the lesson. Conservation values obtained from the students' self-assessment questionnaire and assessment questionnaire between friends. The analysis showed guided inquiry SWS easy to understand and very fit for use as teaching materials. Test gain showed guided inquiry SWS can enhance science process skills and conceptual understanding, and can be used as a medium to develop conservation value.LKS yang hanya berisi ringkasan materi dan latihan soal tidak melatih siswa melakukan penyelidikan dan mengembangkan nilai konservasi. Tujuan penelitian R&D ini adalah menyususn LKS yang mampu meningkatkan keterampilan proses sains, pemahaman konsep dan nilai konservasi. Nilai konservasi dimunculkan melalui petunjuk kerja dan kegiatan penyelidikan.Ujicoba menggunakanOne Group Pretest-Posttest Design. Prosedur penelitian meliputi observasi dan identifikasi kelemahan LKS, perencanaan, pengembangan produk awal dan uji coba lapangan awal. Uji kelayakan dan keterbacaan menggunakan angket dan tes rumpang. Nilai pemahaman konsep  diperoleh dari pretest-posttest. Data keterampilan proses sains diperoleh dari hasil observasi

  12. A Case of Probable Amisulpride Induced Mania after Eight Months of Therapy

    Directory of Open Access Journals (Sweden)

    Prakash Thapa

    2017-01-01

    Full Text Available Development of manic symptoms during treatment with atypical antipsychotics can be a troublesome side effect that has been described with most atypical antipsychotics. However, reports of amisulpride induced mania have been rare. Here, we report the case of an 18-year-old male patient diagnosed with schizophrenia, who developed manic symptoms while on treatment with amisulpride. While previous reports have described occurrence of mania within days to three months of treatment with amisulpride, we report a case where manic symptoms occurred after around eight months of therapy. We have also attempted to describe the possible risk factors based on the available case studies.

  13. Muusika : Muusika igaks asendiks ja meeleoluks. Plaadid kauplusest Lasering

    Index Scriptorium Estoniae

    2005-01-01

    Heliplaatidest: Robbie Williams "Greatest Hits", Gotan Project "Insipracion Espiracion", Manic Street Preachers "Lifeblood", Daddy G "DJ Kicks", Eminem "Encore", Kalm "Generalissimus Kalm", U2 "How to dismantle an atomic bomb"

  14. Suicide Prevention: does it work?

    African Journals Online (AJOL)

    Arun Kumar Agnihotri

    2016-03-05

    Mar 5, 2016 ... suicide, family violence (including physical or sexual abuse), having guns or other ... treatment of mental and addictive disorders, restricted access to lethal means of .... therapy in manic-depressive disorders25 and addiction.

  15. Storm in My Brain: Kids and Mood Disorders (Bipolar Disorder and Depression)

    Science.gov (United States)

    ... Brain Kids and Mood Disorders (Bipolar Disorder and Depression) What is a mood disorder? Everyone feels sad, ... one part of bipolar disorder, also called manic depression. In bipolar disorder, moods change between mania (excited ...

  16. Genetic Aspects of Epilepsy

    African Journals Online (AJOL)

    schizophrenia and manic-depressive psychosis, extensive work in the sphere of ... of convulsions, epileptic disease should not be expected .... The reasons why Metrakos' theory would appear to constitute ... risk of I in 10 can be borne in mind.

  17. Pop / Tõnu Kaalep

    Index Scriptorium Estoniae

    Kaalep, Tõnu, 1966-2018

    2004-01-01

    Heliplaatidest: Marianne Faithfull "Before the Poison", Louis Armstrong "What A Wonderful World", Depeche Mode "Remixes '81-'04", Manic Street Preachers "Lifeblood", Seal "Best 1991-2004", Dream Theater "Live At Budokan"

  18. The role of electro-encephalography in Third-World psychiatry

    African Journals Online (AJOL)

    have no excuse for not diagnosing these patients as schizophrenic.' TABLE I. PSYCHIATRIC PRESENTATIONS OF ORGANIC. BRAIN DISEASE. Anxiety catatonic schizophrenia. Depression. Hebephrenic schizophrenia. Hysteria. Mania. Manic-depressive psychosis. Obsessive/compulsive disorder. Paranoid schizophrenia.

  19. Plaadid / Margit Tõnson

    Index Scriptorium Estoniae

    Tõnson, Margit, 1978-

    2004-01-01

    Uutest heliplaatidest Travis "Singles", Talking Heads "The Best Of", The Hidden Cameras "Mississauga Goddam", Aberfeldy "Young Forever", The Music "Welcome To The North", Bitch Alert "Kill Your Darlings", Manic Street Preachers "Lifeblood", Depeche Mode "Remixes81-04"

  20. Toxic cannabis psychosis IS a valid entIty

    African Journals Online (AJOL)

    1990-10-20

    Oct 20, 1990 ... Psychotic features included: formal thought disorder; hallucinations; delusions; ..... Major depressive episode. Manic episode ... Anxiety disorder. Temporal ... admission to hospital were in fact suffering from a mixed dagga and ...

  1. Bipolar disorder: an overview

    African Journals Online (AJOL)

    manic-depressive disorder, is a chronic disorder characterised by abnormal mood ... of onset, family history, atypical features and mixed symptoms. Screening tools .... has been associated with mood irritability, anxiety, mania and psychosis.

  2. Pop / Tristan Priimägi

    Index Scriptorium Estoniae

    Priimägi, Tristan, 1976-

    2005-01-01

    Heliplaatidest: Manic Street Preachers "Holy Bible - 10th Anniversary Edition", Psychoterror "Freddy, löö esimesena!", Filmimuusika "Ray", Daddy G "DJ Kicks", Gwen Stefani "Love Angel Music Baby", Tarwater "The Needle Was Travelling"

  3. Pattern of adult psychiatric emergency cases presenting at a ...

    African Journals Online (AJOL)

    , current episode manic without psychotic symptoms constituted 17.2% of the cases, while 9.4% were cases of Mental and Behavioural Disorder due to Psychoactive Substance Use. Other cases included depressive illness, mania and delirium.

  4. Plaadid / Valner Valme

    Index Scriptorium Estoniae

    Valme, Valner, 1970-

    2005-01-01

    Uutest heliplaatidest "...And You Will Know Us By The Trail Of Dead. Worlds Apart", Matthew Herbert Big Band "Goodbye Swingtime", Vangelis "Alexander OST", "The Phantom of the Opera", Manic Street Preachers "Lifeblood"

  5. SJP0704Pg001ED

    African Journals Online (AJOL)

    Enrique

    and an updated overview of newer research in this field. It also gives practical ... schizophrenia, manic episodes, major depressive disorder sec- ondary to schizophrenia ..... of Cerebral Disorder. 3rd ed. London: Blackwell Science, 1998. 16.

  6. Feeling and Time: The Phenomenology of Mood Disorders, Depressive Realism, and Existential Psychotherapy

    OpenAIRE

    Ghaemi, S. Nassir

    2006-01-01

    Phenomenological research suggests that pure manic and depressive states are less common than mixtures of the two and that the two poles of mood are characterized by opposite ways of experiencing time. In mania, the subjective experience of time is sped up and in depression it is slowed down, perhaps reflecting differences in circadian pathophysiology. The two classic mood states are also quite different in their effect on subjective awareness: manic patients lack insight into their excitatio...

  7. Diagnosis and characterization of mania: Quantifying increased energy and activity in the human behavioral pattern monitor

    OpenAIRE

    Perry, William; McIlwain, Meghan; Kloezeman, Karen; Henry, Brook L.; Minassian, Arpi

    2016-01-01

    Increased energy or activity is now an essential feature of the mania of Bipolar Disorder (BD) according to DSM-5. This study examined whether objective measures of increased energy can differentiate manic BD individuals and provide greater diagnostic accuracy compared to rating scales, extending the work of previous studies with smaller samples. We also tested the relationship between objective measures of energy and rating scales. 50 hospitalized manic BD patients were compared to healthy s...

  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. Sibutramine-induced mania as the first manifestation of bipolar disorder

    OpenAIRE

    Waszkiewicz, Napoleon; Zalewska-Szajda, Beata; Szajda, Sławomir Dariusz; Simonienko, Katarzyna; Zalewska, Anna; Szulc, Agata; Ładny, Jerzy Robert; Zwierz, Krzysztof

    2012-01-01

    Abstract Background Sibutramine, used in obesity treatment, has been associated with many neuropsychiatric side effects including hypomanic and manic episodes. Hypomanic/manic episodes related to sibutramine treatment were earlier reported in patients who had previous history of bipolar disorder, after sibutramine overdose, after over-the-counter product illegally containing very high dose of sibutramine, together with psychotic symptoms, in organic patient, or after interaction of sibutramin...

  10. Distinguishing between Unipolar Depression and Bipolar Depression: Current and Future Clinical and Neuroimaging Perspectives

    OpenAIRE

    de Almeida, Jorge Renner Cardoso; Phillips, Mary Louise

    2012-01-01

    Differentiating bipolar disorder (BD) from recurrent unipolar depression (UD) is a major clinical challenge. Main reasons for this include the higher prevalence of depressive relative to hypo/manic symptoms during the course of BD illness and the high prevalence of subthreshold manic symptoms in both BD and UD depression. Identifying objective markers of BD might help improve accuracy in differentiating between BD and UD depression, to ultimately optimize clinical and functional outcome for a...

  11. Aggression Protects Against the Onset of Major Depressive Episodes in Individuals With Bipolar Spectrum Disorder.

    Science.gov (United States)

    Ng, Tommy H; Freed, Rachel D; Titone, Madison K; Stange, Jonathan P; Weiss, Rachel B; Abramson, Lyn Y; Alloy, Lauren B

    2017-05-01

    A growing body of research suggests that bipolar spectrum disorders (BSDs) are associated with high aggression. However, little research has prospectively examined how aggression may affect time to onset of hypomanic/manic versus major depressive episodes. In a longitudinal study, we tested the hypothesis that aggression would prospectively predict a shorter time to the onset of hypomanic/manic episodes and a longer time to the onset of major depressive episodes, based on the behavioral approach system theory of BSDs. Young adults (N = 120) diagnosed with cyclothymia, bipolar II disorder, or bipolar disorder not otherwise specified were followed every 4 months for an average of 3.55 years. Participants completed measures of depressive and manic symptoms, family history of mood disorder, impulsivity, and aggression at baseline and were followed prospectively with semistructured diagnostic interview assessments of hypomanic/manic and major depressive episodes and treatment seeking for mood problems. Cox proportional hazard regression analyses indicated that overall, physical, and verbal aggression predicted a longer time to major depressive episode onset, even after controlling for baseline depressive and manic symptoms, family history of mood disorder, treatment seeking for mood problems, and impulsivity. Aggression, however, did not significantly predict time to onset of hypomanic/manic episodes, controlling for the same covariates. The findings suggest that approach-related behaviors may be utilized to delay the onset of major depressive episodes among people with BSDs. Copyright © 2016. Published by Elsevier Ltd.

  12. Serial auditory-evoked potentials in the diagnosis and monitoring of a child with Landau-Kleffner syndrome.

    Science.gov (United States)

    Plyler, Erin; Harkrider, Ashley W

    2013-01-01

    A boy, aged 2 1/2 yr, experienced sudden deterioration of speech and language abilities. He saw multiple medical professionals across 2 yr. By almost 5 yr, his vocabulary diminished from 50 words to 4, and he was referred to our speech and hearing center. The purpose of this study was to heighten awareness of Landau-Kleffner syndrome (LKS) and emphasize the importance of an objective test battery that includes serial auditory-evoked potentials (AEPs) to audiologists who often are on the front lines of diagnosis and treatment delivery when faced with a child experiencing unexplained loss of the use of speech and language. Clinical report. Interview revealed a family history of seizure disorder. Normal social behaviors were observed. Acoustic reflexes and otoacoustic emissions were consistent with normal peripheral auditory function. The child could not complete behavioral audiometric testing or auditory processing tests, so serial AEPs were used to examine central nervous system function. Normal auditory brainstem responses, a replicable Na and absent Pa of the middle latency responses, and abnormal slow cortical potentials suggested dysfunction of auditory processing at the cortical level. The child was referred to a neurologist, who confirmed LKS. At age 7 1/2 yr, after 2 1/2 yr of antiepileptic medications, electroencephalographic (EEG) and audiometric measures normalized. Presently, the child communicates manually with limited use of oral information. Audiologists often are one of the first professionals to assess children with loss of speech and language of unknown origin. Objective, noninvasive, serial AEPs are a simple and valuable addition to the central audiometric test battery when evaluating a child with speech and language regression. The inclusion of these tests will markedly increase the chance for early and accurate referral, diagnosis, and monitoring of a child with LKS which is imperative for a positive prognosis. American Academy of Audiology.

  13. Peran Lembaga Keuangan Syariah dalam Pemberdayaan UMKM di Indonesia

    Directory of Open Access Journals (Sweden)

    Singgih Muheramtohadi

    2017-06-01

    in early history of Islam, then was developed into Syariah Financial Institution. So, the purpose of Syariah Financial Institution is not merely for profit orientation. Further, it should be in accordance with Islamic value and the human philanthropy. Most of Syariah Financial Institution’s financing is for business sector and its ability to reach the micro business, that can’t be done by commercial banks. The financing for small business is funded by Islamic institutions due to Grameen Bank effect. Previously, Grameen Bank was built in mid-decade of 1970. The Financing of Syariah Financial Institution, in any sort, including cooperative union or BMT (Baitul Maal wa Tamwil, increased over time in both Institution Revenue and the Financing Rate. According to Financial Service Authority, most of financing of Syariah Banking is for the Micro, Small, Medium Enterprises that is very important for the nation economy, because it is engaged in the real sector of economy. And the other characters of the Micro, Small, medium enterprises in Indonesia are holding the honesty ethics and resistante to the crisis. They are the strengths of UMKM which must be considered to make the decision by the government or the Financial Institutions. Lembaga Keuangan Syariah (LKS berarti badan yang bergerak di bidang keuangan yang dilandaskan pada ajaran Islam yang bersumber pada al Qur’an dan As Sunnah. Praktek ini sudah terdapat pada sejarah awal Islam, dan asas moralitas Islam dikembangkan dalam bentuk LKS. Sehingga, tujuan dari LKS tidak semata Profit Oriented, melainkan terdapat unsur-unsur keislaman dan kemanusiaan di dalamnya. Lembaga Keuangan syariah sebagian besar pembiayaannya diperuntukkan kepada sektor usaha, dan punya kemampuan untuk menjangkau usaha mikro, Sesuatu yang jarang dilakukan oleh pihak perbankan konvensional. Pembiayaan kepada UMKM ini tidak lepas juga dari pengaruh Grameen Bank sebelumnya, yang telah berdiri sejak medio 1970-an. Pembiayaan

  14. PENGEMBANGAN PERANGKAT PEMBELAJARAN BERBASIS PEMECAHAN MASALAH UNTUK MENINGKATKAN KEMAMPUAN BERPIKIR KRITIS SISWA SMP KELAS IX

    Directory of Open Access Journals (Sweden)

    Dwi Hidayanti

    2016-04-01

    Tujuan dari penelitian ini adalah mengembangkan perangkat pembelajaran berupa RPP dan LKS berbasis pemecahan masalah yang valid, praktis, dan efektif. Model pengembangan yang digunakan dalam pengembangan ini adalah model pengembangan Plomp. Model pengembangan Plomp ini terdiri atas tiga tahapan, yaitu penelitian awal, tahap pembuatan prototip, dan tahap asesmen. Berdasarkan analisis data uji kevalidan, kepraktisan dan keefektifan, perangkat pembelajaran yang dikembangkan memenuhi kriteria valid, praktis, dan efektif dengan skor kevalidan 3,86 yang berarti valid tanpa revisi, skor kepraktisan 3,32 yang berarti tingkat kepraktisannya tinggi, dan dapat meningkatkan rata-rata nilai tes kemampuan berpikir kritis sebesar 74%.

  15. Differences in symptom expression between unipolar and bipolar spectrum depression: Results from a nationally representative sample using item response theory (IRT).

    Science.gov (United States)

    Hoertel, Nicolas; Blanco, Carlos; Peyre, Hugo; Wall, Melanie M; McMahon, Kibby; Gorwood, Philip; Lemogne, Cédric; Limosin, Frédéric

    2016-11-01

    The inclusion of subsyndromal forms of bipolarity in the fifth edition of the DSM has major implications for the way in which we approach the diagnosis of individuals with depressive symptoms. The aim of the present study was to use methods based on item response theory (IRT) to examine whether, when equating for levels of depression severity, there are differences in the likelihood of reporting DSM-IV symptoms of major depressive episode (MDE) between subjects with and without a lifetime history of manic symptoms. We conducted these analyses using a large, nationally representative sample from the USA (n=34,653), the second wave of the National Epidemiologic Survey on Alcohol and Related Conditions. The items sadness, appetite disturbance and psychomotor symptoms were better indicators of depression severity in participants without a lifetime history of manic symptoms, in a clinically meaningful way. DSM-IV symptoms of MDE were substantially less informative in participants with a lifetime history of manic symptoms than in those without such history. Clinical information on DSM-IV depressive and manic symptoms was based on retrospective self-report The clinical presentation of depressive symptoms may substantially differ in individuals with and without a lifetime history of manic symptoms. These findings alert to the possibility of atypical symptomatic presentations among individuals with co-occurring symptoms or disorders and highlight the importance of continued research into specific pathophysiology differentiating unipolar and bipolar depression. Copyright © 2016 Elsevier B.V. All rights reserved.

  16. Sibutramine-induced mania as the first manifestation of bipolar disorder.

    Science.gov (United States)

    Waszkiewicz, Napoleon; Zalewska-Szajda, Beata; Szajda, Sławomir Dariusz; Simonienko, Katarzyna; Zalewska, Anna; Szulc, Agata; Ładny, Jerzy Robert; Zwierz, Krzysztof

    2012-05-18

    Sibutramine, used in obesity treatment, has been associated with many neuropsychiatric side effects including hypomanic and manic episodes. Hypomanic/manic episodes related to sibutramine treatment were earlier reported in patients who had previous history of bipolar disorder, after sibutramine overdose, after over-the-counter product illegally containing very high dose of sibutramine, together with psychotic symptoms, in organic patient, or after interaction of sibutramine with other drugs. We report the first case of a patient with clear manic episode, after treatment with recommended dose of sibutramine, without previous history of mood disorders, organic changes or drug interactions, that was followed by episode of depression. Minimal recommended dose of sibutramine induced manic episode that was the first manifestation of bipolar disorder. The manic episode, associated with sibutramine treatment, was induced in a person without previous history of mood disorders. Potential risks associated with the treatment of obesity using sibutramine warn physicians to be alert not only to common and cardiovascular but also to psychiatric adverse effects. A careful assessment of patient's mental state and detailed psychiatric family history should be done before sibutramine treatment. In patients with a family history for bipolar disorder the use of even minimal dose of sibutramine should be contraindicated.

  17. Sibutramine-induced mania as the first manifestation of bipolar disorder

    Directory of Open Access Journals (Sweden)

    Waszkiewicz Napoleon

    2012-05-01

    Full Text Available Abstract Background Sibutramine, used in obesity treatment, has been associated with many neuropsychiatric side effects including hypomanic and manic episodes. Hypomanic/manic episodes related to sibutramine treatment were earlier reported in patients who had previous history of bipolar disorder, after sibutramine overdose, after over-the-counter product illegally containing very high dose of sibutramine, together with psychotic symptoms, in organic patient, or after interaction of sibutramine with other drugs. Case presentation We report the first case of a patient with clear manic episode, after treatment with recommended dose of sibutramine, without previous history of mood disorders, organic changes or drug interactions, that was followed by episode of depression. Conclusion Minimal recommended dose of sibutramine induced manic episode that was the first manifestation of bipolar disorder. The manic episode, associated with sibutramine treatment, was induced in a person without previous history of mood disorders. Potential risks associated with the treatment of obesity using sibutramine warn physicians to be alert not only to common and cardiovascular but also to psychiatric adverse effects. A careful assessment of patient’s mental state and detailed psychiatric family history should be done before sibutramine treatment. In patients with a family history for bipolar disorder the use of even minimal dose of sibutramine should be contraindicated.

  18. Implantation of Right Kidneys: Is the Risk of Technical Graft Loss Real?

    Science.gov (United States)

    Khan, Taqi T; Ahmad, Nadeem; Siddique, Kashif; Fourtounas, Konstantinos

    2018-05-01

    The left kidney (LK) is preferred by transplant surgeons, because its vein is always of good length and has a thick wall that enables safe suturing. On the other hand, the right renal vein is generally shorter and thinner walled, and well known for its technical difficulty during venous anastomosis, and can result in graft loss. We examined our living (LD) and deceased donor (DD) recipient data and compared the incidence of technical graft loss and early graft function in right and left kidneys. A cohort of 58 adult and pediatric recipients received an LD or DD kidney between January 2015 and December 2016. The donor and recipient data were retrieved and retrospectively analyzed. Technical graft loss was defined as graft thrombosis within the 7 days after transplant. Right kidneys (RKs) were not a risk factor for technical graft loss, and no graft was lost for technical reasons in either LD or DD transplants. Early graft function in LK and RKs was also comparable in the LD cohort, and there were no LKs in the DD cohort. Based on our data, the use of RKs was not a risk factor for technical graft loss and early graft function was comparable to LKs.

  19. Acquired auditory agnosia in childhood and normal sleep electroencephalography subsequently diagnosed as Landau-Kleffner syndrome: a report of three cases.

    Science.gov (United States)

    van Bogaert, Patrick; King, Mary D; Paquier, Philippe; Wetzburger, Catherine; Labasse, Catherine; Dubru, Jean-Marie; Deonna, Thierry

    2013-06-01

      We report three cases of Landau-Kleffner syndrome (LKS) in children (two females, one male) in whom diagnosis was delayed because the sleep electroencephalography (EEG) was initially normal.   Case histories including EEG, positron emission tomography findings, and long-term outcome were reviewed.   Auditory agnosia occurred between the age of 2 years and 3 years 6 months, after a period of normal language development. Initial awake and sleep EEG, recorded weeks to months after the onset of language regression, during a nap period in two cases and during a full night of sleep in the third case, was normal. Repeat EEG between 2 months and 2 years later showed epileptiform discharges during wakefulness and strongly activated by sleep, with a pattern of continuous spike-waves during slow-wave sleep in two patients. Patients were diagnosed with LKS and treated with various antiepileptic regimens, including corticosteroids. One patient in whom EEG became normal on hydrocortisone is making significant recovery. The other two patients did not exhibit a sustained response to treatment and remained severely impaired.   Sleep EEG may be normal in the early phase of acquired auditory agnosia. EEG should be repeated frequently in individuals in whom a firm clinical diagnosis is made to facilitate early treatment. © The Authors. Developmental Medicine & Child Neurology © 2012 Mac Keith Press.

  20. Keefektifan Implementasi CTL berbantuan Komik Matematika dan Langkah Penyelesaian Krulik dan Rudnick untuk Meningkatkan Kemampuan Pemahaman dan Disposisi Matematis Siswa

    Directory of Open Access Journals (Sweden)

    Christina Widayanti

    2017-03-01

    Full Text Available This study aims to know the effectiveness of the CTL models aided by mathematical comics and Krulik and Rudnick’s steps in problem solving to improve the ability of student’s mathematical understanding and disposition. Population in this study were VIIIA grade students up to VIIIE of SMP Negeri 1 Pulokulon year 2015/2016 with a true experimental design types posttest­only control design and samples are chosen randomly. Data analysis that used in this study were an average of completeness test, the proportion test, the average difference test, and Mann­Whitney test. The results showed that (1 the ability of student’s mathematical understanding of the subject that have gained CTL models aided by mathematical comics and Krulik and Rudnick’s steps in problem solving have achieved the completeness in groups and classical; (2 the ability of student’s mathematical understanding of students who have gained CTL models aided by mathematical comics and Krulik and Rudnick’s steps in problem solving more than students with expository models aided by LKS, (3 the mathematical disposition of student’s who have gained CTL models aided by mathematical comics and Krulik and Rudnick’s steps in problem solving more than students with expository models aided by LKS.

  1. Pengembangan Bahan Ajar Mata Kuliah IPA Berbasis Pendekatan Scientific Approach

    Directory of Open Access Journals (Sweden)

    Fitroh Setyo Putro Pribowo

    2017-05-01

    Full Text Available Scientific Approach is one instructional approach used in the curriculum of 2013. That prompted LPTK to generate prospective teachers who understand the essence of the curriculum of 2013. Based on observations activity and low student motivation to learn science. LKS assumed teaching materials can enhance the activity and motivation of students in the learning process. Research conducted by the method of research and development (research and development. Development of research methods used in this study adapt the model ADDIE. This model consists of five main phases or stages: 1 analyze, 2 design, 3 develop, 4 implement, 5 Evaluate. LKS development results-oriented IPA 1 aprroach by expert scientific learning technology obtained a score of V = 87.5 (very valid, while the practicality of the product gained a score of V = 71.5 with practicality criteria quite well. The effectiveness of the product was assessed by increased activity and student motivation. Activities students obtain a score of 73.21 with the active category as well as the motivation to study obtained a score of 63.94 with a category quite well. student worksheets produced meet the elements of a valid, practical, and effective.

  2. Diagnostic subtypes of bipolar disorder in older versus younger adults

    DEFF Research Database (Denmark)

    Kessing, Lars Vedel

    2006-01-01

    OBJECTIVE: To investigate differences in diagnostic subtypes of bipolar disorder as according to ICD-10 between patients whose first contact with psychiatric health care occurs late in life (over 50 years of age) and patients who have first contact earlier in life (50 years of age or below......). METHODS: From 1994 to 2002 all patients who received a diagnosis of a manic episode or bipolar disorder at initial contact with the mental healthcare system, whether outpatient or inpatient, were identified in Denmark's nationwide register. RESULTS: A total of 852 (49.6%) patients, who were over age 50......, and 867 patients, who were 50 or below, received a diagnosis of a manic episode or bipolar disorder at the first contact ever. Older inpatients presented with psychotic symptoms (35.4%) significantly less than younger inpatients (42.6%) due specifically to a lower prevalence of manic episodes...

  3. [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.

  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. The International College of Neuro-Psychopharmacology (CINP) Treatment Guidelines for Bipolar Disorder in Adults (CINP-BD-2017), Part 2: Review, Grading of the Evidence, and a Precise Algorithm

    Science.gov (United States)

    Yatham, Lakshmi; Grunze, Heinz; Vieta, Eduard; Young, Allan; Blier, Pierre; Kasper, Siegfried; Moeller, Hans Jurgen

    2017-01-01

    Abstract Background: The current paper includes a systematic search of the literature, a detailed presentation of the results, and a grading of treatment options in terms of efficacy and tolerability/safety. Material and Methods: The PRISMA method was used in the literature search with the combination of the words ‘bipolar,’ ‘manic,’ ‘mania,’ ‘manic depression,’ and ‘manic depressive’ with ‘randomized,’ and ‘algorithms’ with ‘mania,’ ‘manic,’ ‘bipolar,’ ‘manic-depressive,’ or ‘manic depression.’ Relevant web pages and review articles were also reviewed. Results: The current report is based on the analysis of 57 guideline papers and 531 published papers related to RCTs, reviews, posthoc, or meta-analysis papers to March 25, 2016. The specific treatment options for acute mania, mixed episodes, acute bipolar depression, maintenance phase, psychotic and mixed features, anxiety, and rapid cycling were evaluated with regards to efficacy. Existing treatment guidelines were also reviewed. Finally, Tables reflecting efficacy and recommendation levels were created that led to the development of a precise algorithm that still has to prove its feasibility in everyday clinical practice. Conclusions: A systematic literature search was conducted on the pharmacological treatment of bipolar disorder to identify all relevant random controlled trials pertaining to all aspects of bipolar disorder and graded the data according to a predetermined method to develop a precise treatment algorithm for management of various phases of bipolar disorder. It is important to note that the some of the recommendations in the treatment algorithm were based on the secondary outcome data from posthoc analyses. PMID:27816941

  6. Ovarian Tumor-Stroma Interactions in an In Vivo Orthotopic Model

    Science.gov (United States)

    2012-08-01

    schizophrenia, and manic depression [40, 41]; Pcdh7, cell-cell interactions in the developing brain [42]; Pgap1, otocephaly [43]; Slc1a1, post-synaptic...Ross, R.G., et al. 2000. NURR1 mutations in cases of schizophrenia and manic- depressive disorder. Am J Med Genet 96:808-813.(PMID: 11121187) 41...molecular basis of death due to malignancy. CA Cancer J Clin 2007; 57: 225- 241. [14] Talmadge JE and Fidler IJ. AACR centennial series: the biology of

  7. Síndrome de Landau-Kleffner e regressão autística: a importância do diagnóstico diferencial Landau-Kleffner and autistic regression: the importance of differential diagnosis

    Directory of Open Access Journals (Sweden)

    Karla M.N. Ribeiro

    2002-09-01

    Full Text Available Algumas doenças neurológicas podem apresentar sinais e sintomas psiquiátricos, portanto a exploração do diagnóstico etiológico é crucial. O objetivo deste estudo é relatar o caso de um paciente com um distúrbio neurológico, diagnosticado durante internação psiquiátrica. Um menino com desenvolvimento neuropsicomotor normal até 3 anos, quando começou a apresentar crises epilépticas, seguidas por distúrbio de comportamento e deterioração da linguagem. Durante o acompanhamento neurológico, o paciente foi encaminhado ao Departamento de Psiquiatria com a suspeita de autismo, regressão autística (RA. Durante internação, o diagnóstico de síndrome de Landau-Kleffner (SLK foi estabelecido em bases clínicas e eletrencefalográficas. A SLK é caracterizada por afasia adquirida, epilepsia, anormalidades eletrencefalográficas e distúrbios de comportamento, incluindo traços autísticos. A regressão da linguagem é observada na SLK e na RA. Enfatizamos as principais diferenças entre estas entidades, pois o diagnóstico errôneo adia a intervenção precoce e benefícios, como observado em nosso caso.Some neurological disorders may present psychiatric signs and symptoms, therefore the search for an etiological diagnosis is crucial. The aim of this study is to report the case of a patient with a neurological disorder, diagnosed during a psychiatric admission. A boy with normal neuropsychomotor development until the age of 3 years, started presenting epileptic seizures, followed by behavioral disorder and language deterioration. During neurologic follow-up, the patient was referred to the Psychiatry Department with a diagnosis of autism, in this case an autistic regression (AR. During his admission, diagnosis of Landau-Kleffner syndrome (LKS was established on clinical and EEG grounds. LKS is characterized by acquired aphasia, epilepsy, EEG abnormalities and behavioral changes, including autistic traits. Language regression is

  8. Suprasensory phenomena in those with a bipolar disorder.

    Science.gov (United States)

    Parker, Gordon; Paterson, Amelia; Romano, Mia; Granville Smith, Isabelle

    2018-03-01

    To increase awareness of the sensory changes experienced during hypo/manic and depressive states by those with a bipolar disorder and determine if the prevalence of such features is similar across differing bipolar sub-types. We interviewed 66 patients who acknowledged sensory changes during hypo/manic states. They were allocated to bipolar I, bipolar II and soft bipolar diagnostic categories and the prevalence of 10 differing sensory changes was quantified during hypo/manic and depressive phases. Bipolar I patients were just as likely, if not more likely, to report suprasensory changes which typically involved enhancement of senses during hypo/manic phases and muting or blunting during depressive phases. The high prevalence of changes in intuition, empathy, appreciation of danger and predictive capacities suggests that these are more part of the intrinsic bipolar mood domain states and not necessarily suprasensory, while changes in primary senses of smell, taste, vision, touch and hearing appear to more commonly define the suprasensory domain. It is important for clinicians and patients with a bipolar disorder to be aware of non-psychotic, suprasensory phenomena. Identification of such features may aid diagnosis and also explain the recognised increased creativity in those with a bipolar condition.

  9. Longitudinal Assessment of Mental Disorders, Smoking, and Hazardous Drinking Among a Population-Based Cohort of US Service Members

    Science.gov (United States)

    2014-08-01

    diagnosed by a health care professional with PTSD, depression, manic-depressive disorder, or schizophre- nia or psychosis at baseline were indicated as...Wingard DL, Ryan MA, et al. Prior assault and posttraumatic stress disorder after combat deployment. Epidemiology 2008c;19(3): 505 –512. Smith TC. The US

  10. A different perspective on bipolar disorder? : epidemiology, consequences, concept, and recognition of bipolar spectrum disorder in the general population

    NARCIS (Netherlands)

    Regeer, Eline Janet

    2008-01-01

    Bipolar disorder, or manic-depressive illness, is a mood disorder in which episodes of mania, hypomania and depression occur in alternation with intervals of normal mood. Bipolar disorder is typically a recurrent illness and may have serious consequences such as poor social and occupational

  11. Medicinal Uses of Inorganic Compounds - 1

    Indian Academy of Sciences (India)

    Worldwide sales of inorganic drugs are growing rapidly. Although about 26 elements in the periodic table are considered essential for mammalian life, both ... Lithium like alcohol can influence mood. Lithium drugs such as lithium carbonate Li2C03. , are used for the treatment of manic-depressive disorders, most likely ...

  12. Download this PDF file

    African Journals Online (AJOL)

    Enrique

    safe and effective treatment for various psychiatric disorders. This is mainly due to ... mental illnesses such as bipolar mood disorder (in both the manic .... illness and a shorter duration of symptoms as well as schizophrenia associated ..... testing and learning ability. ... Space-occupying lesions may present a problem since.

  13. Genetic mapping using haplotype, association and linkage methods suggests a locus for severe bipolar disorder (BPI) at 18q22-q23

    NARCIS (Netherlands)

    N.B. Freimer (Nelson); V.I. Reus (Victor); M.A. Escamilla (Michael); L. Alison McInnes (L.); M. Spesny (Mitzi); P. Leon (Pedro); S. Service (Susan); L.B. Smith (Lauren); S. Silva (Sandra); E. Rojas; M. Gallegos (Michael); L. Meza (Luis); E. Fournier (Eduardo); S. Baharloo (Siamak); K. Blankenship (Kathleen); D.J. Tyler (David); S. Batki (Steven); S. Vinogradov (Sophia); J. Weissenbach (Jean); S.H. Barondes (Samuel); L.A. Sandkuijl (Lodewijk)

    1996-01-01

    textabstractManic-depressive illness, or bipolar disorder (BP), is characterized by episodes of elevated mood (mania) and depression. We designed a multistage study in the genetically isolated population of the Central Valley of Costa Rica to identify genes that promote susceptibility to severe BP

  14. 5. CASE SERIES OF MANIA SECONDARY

    African Journals Online (AJOL)

    Esem

    meeting the criteria for DSM IV- TR is increasing. What is not clear with this increase is whether it is primary mania or secondary mania linked with HIV. METHODS. This study design was a case series in which patients with acute manic episodes were admitted to. Chainama Hills College Hospital and University. Teaching ...

  15. Cyborgization: Deaf Education for Young Children in the Cochlear Implantation Era

    Science.gov (United States)

    Valente, Joseph Michael

    2011-01-01

    The author, who was raised oral deaf himself, recounts a visit to a school for young deaf children and discovers that young d/Deaf children and their rights are subverted by the cochlear implantation empire. The hypercapitalist, techno-manic times of cochlear implantation has wreaked havoc to the lives of not only young children with deafness but…

  16. The Separate and Cumulative Effects of TBI and PTSD on Cognitive Function and Emotional Control

    Science.gov (United States)

    2012-10-01

    deficits , such as attention deficit hyperactivity disorder ( ADHD ), substance abuse...Peretz, J., & Pratt, H. (2011). Dis-regulation of response inhibition in adult Attention Deficit Hyperactivity Disorder ( ADHD ): An ERP study. Clinical... disorders such as attention - deficit / hyperactivity disorder ( ADHD ), borderline personality disor- der, substance abuse, and the manic phase of

  17. 75 FR 55331 - Determination of Regulatory Review Period for Purposes of Patent Extension; SAPHRIS

    Science.gov (United States)

    2010-09-10

    ... Price Competition and Patent Term Restoration Act of 1984 (Public Law 98-417) and the Generic Animal... phase and approval phase as specified in 35 U.S.C. 156(g)(1)(B). FDA recently approved for marketing the... treatment of schizophrenia in adults and acute treatment of manic or mixed episodes associated with bipolar...

  18. Preanesthetic Assessment of Herbal and Dietary Supplement Use

    Science.gov (United States)

    2000-10-01

    in the U.S. in 1995 were echinacea, garlic, goldenseal, ginseng, ginkgo, saw palmetto, ma huang, aloe, Siberian ginseng, and cranberry . Since then, St...should be avoided by patients taking prednisone and in patients with manic- depressive disorders and psychosis (Miller, 1998). Fishman, Catarau, Sachs

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

    NARCIS (Netherlands)

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

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

  20. Speaking Out for Yourself: A Self-Help Guide. Recovering Your Mental Health Series.

    Science.gov (United States)

    Copeland, Mary Ellen

    If you experience troubling emotional or psychological symptomslike depression, bipolar disorder or manic depression, schizophrenia, borderline personality disorder, obsessive-compulsive disorder, dissociative disorder, post traumatic stress disorder, an eating disorder, or an anxiety disorderyou may be looking for some information and support on…

  1. Variability among Research Diagnostic Interview Instruments in the Application of "DSM-IV-TR" Criteria for Pediatric Bipolar Disorder

    Science.gov (United States)

    Galanter, Cathryn A.; Hundt, Stephanie R.; Goyal, Parag; Le, Jenna; Fisher, Prudence W.

    2012-01-01

    Objective: The "DSM-IV-TR "criteria for a manic episode and bipolar disorder (BD) were developed for adults but are used for children. The manner in which clinicians and researchers interpret these criteria may have contributed to the increase in BD diagnoses given to youth. Research interviews are designed to improve diagnostic reliability and…

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

    Science.gov (United States)

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

    2012-01-01

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

  3. Anticonvulsants and suicide attempts in bipolar I disorders.

    Science.gov (United States)

    Bellivier, F; Belzeaux, R; Scott, J; Courtet, P; Golmard, J-L; Azorin, J-M

    2017-05-01

    To identify risk factors for suicide attempts (SA) in individuals commencing treatment for a manic or mixed episode. A total of 3390 manic or mixed cases with bipolar disorder (BD) type I recruited from 14 European countries were included in a prospective, 2-year observational study. Poisson regression models were used to identify individual and treatment factors associated with new SA events. Two multivariate models were built, stratified for the presence or absence of prior SA. A total of 302 SA were recorded prospectively; the peak incidence was 0-12 weeks after commencing treatment. In cases with a prior history of SA, risk of SA repetition was associated with younger age of first manic episode (P = 0.03), rapid cycling (P anticonvulsant at study entry (P anticonvulsant at study entry (P = 0.002). The introduction of anticonvulsants for a recent-onset manic or mixed episode may be associated with an increased risk of SA. Further BD studies must determine whether this link is causal. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  4. [Lithium and anticonvulsants in the treatment of mania and in the prophylaxis of recurrences].

    Science.gov (United States)

    Salvi, Virginio; Cat Berro, Alberto; Bechon, Elisa; Bogetto, Filippo; Maina, Giuseppe

    2011-01-01

    A mood stabilizer is an agent effective in treating both poles of the illness and at the same time being able to prevent both manic and depressive episodes in bipolar disorder. According to a broader definition, a mood stabilizer should be effective in decreasing the frequency or severity of any type of episode in bipolar disorder, without worsening the frequency or severity of episodes of opposite polarity. According to this, anticonvulsants and atypical antipsychotics can be considered as mood stabilizers. In this paper we review the use of lithium and other anticonvulsants that have proved effective in randomized controlled trials of the treatment of manic episodes and prevention of recurrences of bipolar disorder. Lithium and valproate are considered as first-line treatment options for acute mania while evidence regarding carbamazepine is insufficient to consider it as a first-line agent. Patients who fail to respond to first-line treatments may benefit from the adjunct of an atypical antipsychotic such as olanzapine, quetiapine, risperidone or aripiprazole. Lithium retains the strongest evidence of efficacy in the prophylaxis of manic episodes, lamotrigine in the prevention of depressive episodes. Valproate and carbamazepine have no indication for long-term treatment of bipolar disorder. Lithium can still be considered a gold standard in the treatment of manic episodes as well as in the prophylaxis of recurrences. Other anticonvulsants should be employed in particular situations, such as valproic acid in the treatment of mania and lamotrigine in the prevention of depressive recurrences.

  5. The influence of genes and environment on the development of bipolar disorder : A twin study

    NARCIS (Netherlands)

    Vonk, Ronald

    2016-01-01

    Bipolar disorder (or manic-depressive disorder) is a severe mood disorder in which episodes of (hypo) mania (e.g. elevated mood en hyperactivity) and depression (e.g. decreased mood and reduced activity) alternate with periods of normal mood and functioning. Genetic factors as well as environmental

  6. Effects of the Antipsychotic Drug, Haloperidol, on Reproduction in the Fathead Minnow

    Science.gov (United States)

    Haloperidol is a butyrophenone antipsychotic drug used for the treatment of human hyperactive and manic disorders, agitation, and schizophrenia. The drug is thought to act through antagonism of dopaminergic receptors. We have studied a variety of endocrine-disrupting chemicals wi...

  7. Tracking the PhD Students' Daily Computer Use

    Science.gov (United States)

    Sim, Kwong Nui; van der Meer, Jacques

    2015-01-01

    This study investigated PhD students' computer activities in their daily research practice. Software that tracks computer usage (Manic Time) was installed on the computers of nine PhD students, who were at their early, mid and final stage in doing their doctoral research in four different discipline areas (Commerce, Humanities, Health Sciences and…

  8. Validity of the Mania Subscale of the Diagnostic Assessment for the Severely Handicapped-II (DASH-II).

    Science.gov (United States)

    Matson, Johnny L.; Smiroldo, Brandi B.

    1997-01-01

    A study tested the validity of the Diagnostic Assessment for the Severely Handicapped-II (DASH-II) for determining the presence of mania (bipolar disorder) in 22 individuals with severe mental retardation. Results found the mania subscale to be internally consistent and able to be used to classify manic and control subjects accurately. (Author/CR)

  9. Author Details

    African Journals Online (AJOL)

    Alizadegan, S. Vol 14, No 1 (2011) - Articles Electroconvulsive therapy in single manic episodes: a case series. Abstract PDF. ISSN: 1994-8220. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's Partners · Terms and Conditions of Use ...

  10. Case Report: Valproic Acid and Risperidone Treatment Leading to Development of Hyperammonemia and Mania

    Science.gov (United States)

    Carlson, Teri; Reynolds, Charles A.; Caplan, Rochelle

    2007-01-01

    This case report describes two children who developed hyperammonemia together with frank manic behavior during treatment with a combination of valproic acid and risperidone. One child had been maintained on valproic acid for years and risperidone was added. In the second case, valproic acid was introduced to a child who had been treated with…

  11. Organic Creativity and the Faustian Bargain: Reconciling Opposites

    Science.gov (United States)

    Sriraman, Bharath

    2017-01-01

    The aim of this article is to provide the reader, or anyone interested in creativity, a glimpse into the findings of existing psychological and psychiatric literature on manic depression, its occurrence in creative individuals, ways in which it manifests and affects their functioning and creative output (positively and negatively), and the lessons…

  12. Plain Talk about Depression. Plain Talk Series.

    Science.gov (United States)

    Sargent, Marilyn

    Depression is defined as a "whole-body" illness, involving the body, mood, and thoughts. Three of the most prevalent types of depressive disorders are described: major depression, dysthymia, and bipolar disorders (formerly called manic-depressive illness). Eleven symptoms of depression and 10 symptoms of mania are listed. Causes of depression are…

  13. Plaadid / Villu Päärt

    Index Scriptorium Estoniae

    Päärt, Villu, 1972-

    2002-01-01

    Uutest plaatidest Nick Carter "Now Or Never", Brian Mcknight "From There To here 1989-2002", Rod Stuart "The Grat American Songbook", New Order "International", Justin Timberlake "Justified", Manic Street Prachers "Forever Delayed - Greatest Hits", LHB "Tell 'Em Who We Are"

  14. Priapisme induit par la chlorpromazine: A propos de deux cas

    African Journals Online (AJOL)

    I. Marrag

    We report here two cases of priapism associated with chlorpromazine. The first one ... who was admitted for a manic episode in the context of bipolar disorder. The second ... comportement à type d'hétéroagressivité verbale et physique envers.

  15. No neuronal autoantibodies detected in plasma of patients with a bipolar I disorder

    NARCIS (Netherlands)

    Snijders, Gijsje; Titulaer, Maarten J.; Bergink, Veerle; Bastiaansen, Anna E.; Schreurs, Marco W.J.; Ophoff, Roel A.; Boks, Marco P.; Kahn, René S.; de Witte, Lot D.

    2018-01-01

    A subpopulation of patients with bipolar disorder type I (BD-I) might suffer from undiagnosed autoimmune encephalitis. We tested plasma of 104 BD-I patients with a current or recent manic episode in the past 2 years for the presence of neuronal autoantibodies using immunohistochemistry,

  16. Disease: H01653 [KEGG MEDICUS

    Lifescience Database Archive (English)

    Full Text Available wn as manic depressive illness, is a severe chronic mood disorder, characterized by the recurrence of mania (hypomania), depression...patients with bipolar disorder present with a depressive episode that differs subtly from unipolar depression...d define the patient's mood state, because the therapeutic approach differs considerably for hypomania, mania, depression

  17. Reserpine for the treatment of refractory mania | Eloff | South African ...

    African Journals Online (AJOL)

    Reserpine is a centrally acting antihypertensive with anti-adrenergic properties. It has been found to reduce the duration of a manic episode rapidly in a small group of studies. This proved to be the case with this patient. Reserpine used in conjunction with other psychotropic medication may be considered in the treatment of ...

  18. Stemcell Information: SKIP000874 [SKIP Stemcell Database[Archive

    Lifescience Database Archive (English)

    Full Text Available from fibroblasts of a patient with manic type I bipolar disorder not responsive to lithium treatment 1型双極性障害患者由来iPS細胞...80 ... 注意欠陥多動障害 F900 Attention deficit hyperactivity disorder 143465 ... 22 20-29 Male ... No No iPS cell derived

  19. The preclinical discovery and development of quetiapine for the treatment of mania and depression.

    Science.gov (United States)

    Miranda, Aline Silva de; Moreira, Fabrício A; Teixeira, Antônio Lúcio

    2017-05-01

    Bipolar disorder is a chronic disabling condition characterized by alternating manic and depressive episodes. Bipolar disorder has been associated with functional impairment, poor quality of life, morbidity and mortality. Despite its significant clinical, social and economic burden, treatment options for bipolar disorder are still limited. Several clinical trials have shown efficacy of the atypical antipsychotic quetiapine (QTP) in the treatment of this condition. However, the mechanisms underlying the antidepressant and anti-manic effects of QTP remain poorly understood. Areas covered: The article provides the emerging evidence from pre-clinical studies regarding the antidepressant and anti-manic mechanisms of action of QTP. In combination with its primary active metabolite norquetiapine, QTP modulates several neurotransmitter systems, including serotonin, dopamine, noradrenaline and histamine. QTP also seems to influence mediators of the immune system. Expert opinion: Pre-clinical studies have provided valuable information on the potential antidepressant mechanisms of action of QTP, but pre-clinical studies on QTP's anti-manic effects are still scarce. A major problem refers to the lack of valid experimental models for bipolar disorder. Additionally, immune and genetic based studies are largely descriptive. The role of the QTP metabolite norquetiapine in modulating non-neurotransmitter systems also needs to be further addressed.

  20. Genome-wide association study of borderline personality disorder reveals genetic overlap with bipolar disorder, major depression and schizophrenia

    NARCIS (Netherlands)

    Witt, S.H.; Streit, F.; Jungkunz, M; Frank, J.; Awasthi, S; Reinbold, C S; Treutlein, J.; Degenhardt, F.; Forstner, A. J.; Heilmann-Heimbach, S.; Dietl, L; Schwarze, C E; Schendel, D.J.; Strohmaier, J.; Abdellaoui, A; Adolfsson, R; Air, T M; Akil, H.; Lopezz de Alda, M.; Alliey-Rodriguez, N; Andreassen, O. A.; Babadjanova, G; Bass, N.J.; Bauer, M.; Baune, Bernard T; Bellivier, F.; Bergen, S. E.; Bethell, A.; Biernacka, J.M.; Blackwood, D H R; Boks, Marco P; Boomsma, D I; Børglum, Anders D; Borrmann-Hassenbach, M; Brennan, P.; Budde, M.; Buttenschøn, H N; Byrne, Enda M; Cervantes, P; Clarke, T.K.; Craddock, N.; Cruceanu, C; Curtis, D.; de Geus, E J C; Fischer, S B; Hottenga, J-J; Middeldorp, C M; Milaneschi, Y; Penninx, B W J H; Willemsen, G

    2017-01-01

    Borderline personality disorder (BOR) is determined by environmental and genetic factors, and characterized by affective instability and impulsivity, diagnostic symptoms also observed in manic phases of bipolar disorder (BIP). Up to 20% of BIP patients show comorbidity with BOR. This report

  1. naturalistic study of olanzapine in treatment-resistant schizophrenia

    African Journals Online (AJOL)

    hi-tech

    2000-02-02

    Feb 2, 2000 ... of some 800,000 mixed race people, of whom the indigenous race ... severity of mania, depression, anxiety and OCD; (ii) the Clinical. Global Impression ... schizophrenia (36 or 56.3%), Bipolar I disorder, manic phase (8 or ...

  2. The Pattern of Physical Restraints applied to the Mentally-ill in the ...

    African Journals Online (AJOL)

    Diagnostic groups found among the patients included Bipolar Affective Disorder current episode manic with psychotic symptoms (30%), Delirium (25%), Schizophrenia (20%), Acute polymorphic psychotic disorder without symptoms of schizophrenia (20%) and Dementia (5%). The reason for the use of restraints was ...

  3. 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...

  4. The Bipolar Illness Onset study: research protocol for the BIO cohort study

    DEFF Research Database (Denmark)

    Kessing, Lars Vedel; Munkholm, Klaus; Faurholt-Jepsen, Maria

    2017-01-01

    Bipolar disorder is an often disabling mental illness with a lifetime prevalence of 1%-2%, a high risk of recurrence of manic and depressive episodes, a lifelong elevated risk of suicide and a substantial heritability. The course of illness is frequently characterised by progressive shortening of...

  5. First admissions for psychiatric disorders. A comparison between the Faroe Islands and Denmark

    DEFF Research Database (Denmark)

    Joensen, S; Wang, A G

    1983-01-01

    , in particular for women, for the age group 30-64, and also for the majority of diagnostic groups. The group manic-depressive psychosis come closest to Danish conditions, followed by reactive psychosis and alcohol and drug abuse. The greatest difference was found for the groups personal disorders, neuroses...

  6. A case of psychotic disorder, not otherwise specified: cycloid ...

    African Journals Online (AJOL)

    The inadequacy of Kraepelin's classification of mental disorders into schizophrenia and manic-depressive psychosis prompted the development and use of other concepts. Although Leonhard's cycloid does not appear in modern psychiatric classification, patients who meet Perri's diagnostic criteria for this disorder are ...

  7. Measures of the DSM-5 mixed-features specifier of major depressive disorder.

    Science.gov (United States)

    Zimmerman, Mark

    2017-04-01

    During the past two decades, a number of studies have found that depressed patients frequently have manic symptoms intermixed with depressive symptoms. While the frequency of mixed syndromes are more common in bipolar than in unipolar depressives, mixed states are also common in patients with major depressive disorder. The admixture of symptoms may be evident when depressed patients present for treatment, or they may emerge during ongoing treatment. In some patients, treatment with antidepressant medication might precipitate the emergence of mixed states. It would therefore be useful to systematically inquire into the presence of manic/hypomanic symptoms in depressed patients. We can anticipate that increased attention will likely be given to mixed depression because of changes in the DSM-5. In the present article, I review instruments that have been utilized to assess the presence and severity of manic symptoms and therefore could be potentially used to identify the DSM-5 mixed-features specifier in depressed patients and to evaluate the course and outcome of treatment. In choosing which measure to use, clinicians and researchers should consider whether the measure assesses both depression and mania/hypomania, assesses all or only some of the DSM-5 criteria for the mixed-features specifier, or assesses manic/hypomanic symptoms that are not part of the DSM-5 definition. Feasibility, more so than reliability and validity, will likely determine whether these measures are incorporated into routine clinical practice.

  8. New Forms of E-Business Based Value Creation?

    DEFF Research Database (Denmark)

    Henten, Anders; Skouby, Knud Erik

    It is two years ago since the burst of the dotcom bubble. The so-called new economy is in shambles. There is, however, nothing new in such manic and steep up- and down-turns in the economy. The tulip mania in the Netherlands in 1630s is an early example and the South American mining industry...

  9. 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...

  10. Lithium. Effects on excitable cell membranes

    NARCIS (Netherlands)

    Ploeger, Egbert Johan

    1974-01-01

    LITHIUM: Effects on excitable cell membranes. Lithium salts have been used in the treatment of manic-depressive psychosis for many years but their mechanism of action is not well understood. Many workers assume that the action of lithium on catecholamine metabolism and/or on electrolyte distribution

  11. Does perfectionism in bipolar disorder pedigrees mediate associations between anxiety/stress and mood symptoms?

    Science.gov (United States)

    Corry, Justine; Green, Melissa; Roberts, Gloria; Fullerton, Janice M; Schofield, Peter R; Mitchell, Philip B

    2017-10-06

    Bipolar disorder (BD) and the anxiety disorders are highly comorbid. The present study sought to examine perfectionism and goal attainment values as potential mechanisms of known associations between anxiety, stress and BD symptomatology. Measures of perfectionism and goal attainment values were administered to 269 members of BD pedigrees, alongside measures of anxiety and stress, and BD mood symptoms. Regression analyses were used to determine whether perfectionism and goal attainment values were related to depressive and (hypo)manic symptoms; planned mediation models were then used to test the potential for perfectionism to mediate associations between anxiety/stress and BD symptoms. Self-oriented perfectionism was associated with chronic depressive symptoms; socially-prescribed perfectionism was associated with chronic (hypo)manic symptoms. Self-oriented perfectionism mediated relationships between anxiety/stress and chronic depressive symptoms even after controlling for chronic hypomanic symptoms. Similarly, socially-prescribed perfectionism mediated associations between anxiety/stress and chronic hypomanic symptoms after controlling for chronic depressive symptoms. Goal attainment beliefs were not uniquely associated with chronic depressive or (hypo)manic symptoms. Cognitive styles of perfectionism may explain the co-occurrence of anxiety and stress symptoms and BD symptoms. Psychological interventions for anxiety and stress symptoms in BD might therefore address perfectionism in attempt to reduce depression and (hypo)manic symptoms in addition to appropriate pharmacotherapy.

  12. Pharmacotherapy for acute mania and disconcordance with treatment guidelines: bipolar mania pathway survey (BIPAS) in mainland China.

    Science.gov (United States)

    Wang, Zuowei; Gao, Keming; Hong, Wu; Xing, Mengjuan; Wu, Zhiguo; Chen, Jun; Zhang, Chen; Yuan, Chengmei; Huang, Jia; Peng, Daihui; Wang, Yong; Lu, Weihong; Yi, Zhenghui; Yu, Xin; Zhao, Jingping; Fang, Yiru

    2014-06-05

    With the recent attention to evidence-based medicine in psychiatry, a number of treatment guidelines for bipolar disorders have been published. This survey investigated prescribing patterns and predictors for guideline disconcordance in the acute treatment of a manic and mixed episode across mainland China. The pharmacological treatments of 2828 patients with a recent hypomanic/manic episode or mixed state were examined. Guidelines disconcordance was determined by comparing the medication(s) patients were prescribed with the recommendation(s) in the guidelines of the Canadian Network for Mood and Anxiety Treatments. The most common pattern of pharmacological treatments for an acute manic or mixed episode was a mood stabilizer plus an atypical antipsychotic (n = 1345, 47.6%), and the rate of guideline-disconcordant treatments was 11.1%. The patients who were treated in general hospitals were more likely to receive guideline-disconcordant treatments than those who were treated in psychiatric hospitals, with an OR of 1.84 (95% CI 1.44-2.36). Similarly, the patients with a mixed episode at study entry were more likely to receive guideline-disconcordant treatments than those with a manic episode, with an OR of 1.69 (95% CI 1.22-2.35). In contrast, the patients with a longer duration of disease (>5 years) were less likely to receive guideline-disconcordant treatments than those with a short duration, with an OR of 0.47 (95% CI 0.36-0.60). In mainland China, the disconcordance with treatment guidelines for a most recent acute manic or mixed episode was modest under naturalistic conditions. The higher risk for disconcordance in general hospitals than in psychiatric hospitals suggests that special education based on treatment guidelines to practitioners in general hospitals is necessary in order to reduce the risk for disconcordant treatments.

  13. Evaluating depressive symptoms in mania: a naturalistic study of patients with bipolar disorder

    Science.gov (United States)

    Young, Allan H; Eberhard, Jonas

    2015-01-01

    Objective This study aimed to evaluate patients with bipolar I disorder (BD-I) who have mania with depressive symptoms and who meet the new “with mixed features” specifier of the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5). Method This prospective, multinational, naturalistic study surveyed psychiatrists and their patients with BD-I from October 2013 to March 2014. Eligible patients had BD-I, had a (current) manic episode, and had experienced onset of a manic episode within the previous 3 months. Psychiatrists provided patient information on depressive symptoms (DSM-5 criteria); symptoms of anxiety, irritability, and agitation; suicide attempts; and physician satisfaction with treatment response. Data were stratified according to whether patients met the criteria for the BD-I “with mixed features” specifier of DSM-5 (≥3 depressive symptoms) or not, and characteristics were compared between the two subgroups. Patients also self-reported on depressive symptoms using the Mini-International Neuropsychiatric Interview module questionnaire. Results Overall, 34% of 1,035 patients met the criteria for BD-I “with mixed features,” exhibiting ≥3 depressive symptoms during their current manic episode. This correlated with the matched patient self-reports of depressive symptoms. During their current manic episode, BD-I patients “with mixed features” had more severe symptoms of anxiety, irritability, and agitation (average composite severity score of 4.1 vs 3.4), a higher incidence of suicide attempts (38% vs 9%), and more physician dissatisfaction with treatment response (22% vs 14%), compared to patients with 0–2 depressive symptoms (all P<0.05). Conclusion This study found that patients with BD-I “with mixed features” (ie, ≥3 depressive symptoms during a manic episode), suffered, on average, from a greater burden of disease than patients with pure mania. Improved identification of these patients may help to optimize

  14. Evaluating depressive symptoms in mania: a naturalistic study of patients with bipolar disorder.

    Science.gov (United States)

    Young, Allan H; Eberhard, Jonas

    2015-01-01

    This study aimed to evaluate patients with bipolar I disorder (BD-I) who have mania with depressive symptoms and who meet the new "with mixed features" specifier of the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5). This prospective, multinational, naturalistic study surveyed psychiatrists and their patients with BD-I from October 2013 to March 2014. Eligible patients had BD-I, had a (current) manic episode, and had experienced onset of a manic episode within the previous 3 months. Psychiatrists provided patient information on depressive symptoms (DSM-5 criteria); symptoms of anxiety, irritability, and agitation; suicide attempts; and physician satisfaction with treatment response. Data were stratified according to whether patients met the criteria for the BD-I "with mixed features" specifier of DSM-5 (≥3 depressive symptoms) or not, and characteristics were compared between the two subgroups. Patients also self-reported on depressive symptoms using the Mini-International Neuropsychiatric Interview module questionnaire. Overall, 34% of 1,035 patients met the criteria for BD-I "with mixed features," exhibiting ≥3 depressive symptoms during their current manic episode. This correlated with the matched patient self-reports of depressive symptoms. During their current manic episode, BD-I patients "with mixed features" had more severe symptoms of anxiety, irritability, and agitation (average composite severity score of 4.1 vs 3.4), a higher incidence of suicide attempts (38% vs 9%), and more physician dissatisfaction with treatment response (22% vs 14%), compared to patients with 0-2 depressive symptoms (all Pmixed features" (ie, ≥3 depressive symptoms during a manic episode), suffered, on average, from a greater burden of disease than patients with pure mania. Improved identification of these patients may help to optimize treatment outcomes.

  15. 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.

  16. 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.

  17. PERANAN PRAKTIKUM RIIL DAN PRAKTIKUM VIRTUAL DALAM MEMBANGUN KREATIFITAS SISWA

    Directory of Open Access Journals (Sweden)

    Ari Widodo

    2016-11-01

    Penelitian ini mengkaji perbedaan pembelajaran praktikum virtual dan praktikum riil dalam membangun keterampilan berpikir kreatif siswa. Sampel penelitian adalah 53 siswa kelas X salah satu SMA Negeri di Bandung. Instrumen kegiatan praktikum terdiri dari lembar kerja siswa (LKS untuk kegiatan praktikum riil dan software praktikum virtual dan instrumen pengumpul data. Keterampilan berpikir kreatif siswa diukur dengan menggunakan tes keterampilan berpikir kreatif berupa delapan soal esai tentang materi pertumbuhan dan perkembangan tumbuhan. Hasil penelitian menunjukkan bahwa rerata skor kelas praktikum riil lebih tinggi dari pada rerata skor pada kelas praktikum virtual. Selain itu, praktikum riil juga bisa meningkatkan keterampilan berpikir kreatif siswa pada semua aspek keterampilan berpikir kreatif (flexibility, fluency, elaboration dan originality. Hal ini menunjukkan bahwa praktikum riil memberikan kondisi yang lebih baik untuk pengembangan keterampilan berpikir kreatif siswa.

  18. Thermodynamic studies on the ferroelectric phase transition in neutron irradiated (LixK1-x)2SO4 crystals at high temperature

    International Nuclear Information System (INIS)

    Kassem, M.E.; El-Khatib, A.M.; Ammar, E.A.; Denton, M.M.

    1989-05-01

    Thermodynamic studies of (Li x K 1-x ) 2 SO 4 , LKS, mixed crystals have been made in the concentration range (x=0.1,0.2,...,x=0.5). The thermal behavior has been investigated by differential thermal analysis, DTA, and differential scanning calorimeter, DSC, in the vicinity of high temperature phases. Also, the effect of the mixed neutron field of fast and thermal neutrons (10% of the reactor neutron pile is fast neutrons) on the thermal properties of mixed crystals was studied. The results showed a change in the transition temperature Tc, as well as the value of specific heat Cp at transition temperature, due to the change of stoichiometric ratio and radiation doses. The change of enthalpy and entropy of mixed crystals have been estimated numerically. The obtained small values of ΔS/R is characteristic of incommensurate phase transition as previously confirmed by the results of neutron diffraction technique. (author). 16 refs, 5 figs, 1 tab

  19. Steering Angle Control of Car for Dubins Path-tracking Using Model Predictive Control

    Science.gov (United States)

    Kusuma Rahma Putri, Dian; Subchan; Asfihani, Tahiyatul

    2018-03-01

    Car as one of transportation is inseparable from technological developments. About ten years, there are a lot of research and development on lane keeping system(LKS) which is a system that automaticaly controls the steering to keep the vehicle especially car always on track. This system can be developed for unmanned cars. Unmanned system car requires navigation, guidance and control which is able to direct the vehicle to move toward the desired path. The guidance system is represented by using Dubins-Path that will be controlled by using Model Predictive Control. The control objective is to keep the car’s movement that represented by dinamic lateral motion model so car can move according to the path appropriately. The simulation control on the four types of trajectories that generate the value for steering angle and steering angle changes are at the specified interval.

  20. PEMBELAJARAN BERBASIS MIND MAP UNTUK MENINGKATKAN HASIL BELAJAR SISWA PADA MATERI RELASI & FUNGSI

    Directory of Open Access Journals (Sweden)

    Flavia Aurelia Hidajat

    2017-02-01

    Full Text Available Abstract: Mind map-based Learning to Enhance Students’ Learning Outcomes of Relations and Functions Materials. This study is a classroom action research that aims to describe the mind map-based learning that can improve student learning outcomes in relation and functions materials. The subjects were students of class X BKJ 2 SMKN 5 Jember. The results showed that the learning-based mind map that can improve student learning outcomes in the material of relations and functions include two-cycle with four phases: (1 planning to prepare and validate the lesson plan (RPP, student’ worksheet (LKS, observation sheet activities of teachers and students, and the final test cycle, (2 the implementation of action which include: a the activities of preliminary with deliver of learning objectives, given of motivate, provide an explanation of the use of mind mapping and conduct a question and answer for dig students' initial knowledge about previous material and the material to be learned; b the activities of core with forming of students in small groups, students are given worksheets, students discuss in small groups, write down the results of the discussion on worksheets, create a mind map related to the discussion results for presentation to the class, and then present it to the class. At the time of presentation occurs asked-questions and discussions in the class related to the result of presentations; c the activities of cover that is teachers evaluate the results of class discussion and the results of the mind map group that has been presented, (3 the observation made by three observer, (4 the reflection about the results of the test, mind map and observations. Keywords: Mind Map, Learning Outcomes, Relation & Functions          Abstrak: Pembelajaran Berbasis Mind Map Untuk Meningkatkan Hasil Belajar Siswa Pada Materi Relasi dan Fungsi. Penelitian ini merupakan tindakan kelas yang bertujuan untuk mendeskripsikan pembelajaran berbasis mind map

  1. Penggunaan Model Pembelajaran Picture and Picture Untuk Meningkatkan Kemampuan Siswa Menulis Karangan

    Directory of Open Access Journals (Sweden)

    Heriyanto Heriyanto

    2014-02-01

    Full Text Available Menulis merupakan keterampilan berbahasa yang kompleks, produktif dan ekspresif, karena penulis harus terampil menggunakan grofologi, struktur bahasa dan memiliki pengetahuan bahasa yang memadai, untuk itu perlu dilatih secara teratur dan cermat sejak kelas awal SD. Karangan sebagai salah satu hasil karya menulis, merupakan hasil pekerjaan dari mengarang. Menulis karangan dalam penelitian ini adalah menulis karangan narasi. Salah satu masalah dalam pembelajaran Bahasa Indonesia adalah kesulitan siswa dalam menulis karangan yang baik dan benar, yang juga terjadi pada siswa kelas IVA SDN Pinggir Papas 1. Pembelajaran menulis karangan dengan menggunakan model kooperatif tipe picture and picture  diharapkan mampu meningkatkan pemahaman siswa dalam hal menulis karangan. Untuk itu, dilakukan penelitian terhadap siswa kelas IVA SDN Pinggir Papas I Kecamatan Kalianget Kabupaten Sumenep yang berjumlah 33 siswa. Penelitian dengan judul “Penggunaan Model Pembelajaran Kooperatif Tipe Picture and Picture untuk Meningkatkan Kemampuan Siswa Menulis Karangan” ini menggunakan penelitian tindakan kelas sebanyak dua putaran. Setiap putaran terdiri dari tahap rancangan, kegiatan, pengamatan, dan refleksi. Data yang diperoleh berupa nilai hasil LKS dan kuis individu berupa menulis karangan, lembar observasi aktivitas guru dan siswa serta penilaian penggunaan model pembelajaran kooperatif picture and picture, juga hasil respon siswa. Dari hasil analis menunjukkan bahwa penggunaan model pembelajaran kooperatif tipe picture and picture dapat meningkatkan kemampuan menulis karangan siswa kelas IVA SDN Pinggir Papas 1. Peningkatan ini terjadi pada nilai rata-rata LKS, yaitu dari 55 menjadi 71,6. Adapun hasil karangan individu siswa dari rata-rata 56,7 dengan ketuntasan 55% menjadi 74,5 dengan ketuntasan mencapai 88% atau terjadi peningkatan sebesar 33% dari siklus I.

  2. Bipolar affective disorder and Parkinson's disease: a rare, insidious and often unrecognized association.

    Science.gov (United States)

    Cannas, A; Spissu, A; Floris, G L; Congia, S; Saddi, M V; Melis, M; Mascia, M M; Pinna, F; Tuveri, A; Solla, P; Milia, A; Giagheddu, M; Tacconi, P

    2002-09-01

    Five patients (4 women) with Parkinson's disease (PD) and primary major psychiatric disorder (PMPD) meeting DSM-IV criteria for the diagnosis of bipolar affective disorder (BAD) were studied. Four patients had early onset PD. Four developed a severe psychiatric disorder a few years after starting dopaminergic therapy in presence of a mild motor disability and a mild cognitive impairment, with no evidence of cerebral atrophy at CT or MRI. Two patients developed a clear manic episode; the other three presented a severe depressive episode (in one case featuring a Cotard syndrome). None showed previous signs of long term L-dopa treatment syndrome (LTS), hallucinosis or other minor psychiatric disorders. The two manic episodes occurred shortly after an increase of dopaminergic therapy and in one case rapid cyclic mood fluctuations were observed. At the onset of psychiatric symptoms, all patients had an unspecific diagnosis of chronic delusional hallucinatory psychosis (CDHP).

  3. 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.

  4. Theory of mind performance using a story comprehension task in bipolar mania compared to schizophrenia and healthy controls.

    Science.gov (United States)

    Rossell, Susan L; Van Rheenen, Tamsyn E

    2013-01-01

    Theory of mind (ToM) refers to the ability to understand the mental state of self and others. There is limited research into this topic in bipolar disorder (BD), with no previous study examining ToM in a BD group within a psychotic manic phase. Twenty-eight psychotic manic BD patients were compared with 30 schizophrenia (SCZ) patients and 29 healthy controls (HC). Participants performed a ToM story comprehension task that compared ToM stories and non-ToM stories (which we relabelled non-ToM "semantic" stories). Performance was examined by answering comprehension questions. Both patient groups were equally impaired on their scores for ToM stories (scores BD = 10/24, SCZ = 9/24, HC = 14/24, p psychotic symptoms. Patient performance was also impaired on the control condition (i.e., non-ToM semantic stories) supporting an additional deficit in semantic processing.

  5. Comorbidity of Bipolar Disorder and Multiple Sclerosis: A Case Report

    Directory of Open Access Journals (Sweden)

    Necla Keskin

    2013-08-01

    Full Text Available Multiple sclerosis is a chronic demyelinating disease of a central nervous system. Neuropsychiatric symptoms are common in multiple sclerosis and bipolar disorder is one of the most common psychiatric disorders that coexist with multiple sclerosis. Manic episodes may be the first presenting symptom of multiple sclerosis as comorbid pathology or as an adverse effect of pharmacotherapies used in multiple sclerosis. The comorbidity of bipolar disorder and multiple sclerosis is well-proven but its etiology is not known and investigated accurately. Recent studies support a common genetic susceptibility. Management of bipolar disorder in multiple sclerosis is based on evidence provided by case reports and treatment should be individualized. In this report, the association between bipolar disorder and multiple sclerosis, epidemiology, ethiology and treatment is discussed through a case had diagnosed as multiple sclerosis and had a manic episode with psychotic features. [Cukurova Med J 2013; 38(4.000: 832-836

  6. Haloperidol plasma levels in relation to antimanic effect

    DEFF Research Database (Denmark)

    Gjerris, Annette; Bech, P.; Christensen, Christian Broen

    2016-01-01

    n the treatment of mania, lithium (Li) has been found in several controlled studies as clearly superior to placebo, but haloperidol, when compared to Li, seems to be faster acting, at least with regard to motor activity (Shopsin et al., 1975). Hence, haloperidol has increasingly been recommended...... as the antimanic drug of choice (Shaw, 1979). However, the recommended dose of haloperidol for mania varies extremely, from 4 mg to 100 mg daily (Hollister, 1978). The haloperidol dose required obviously depends on the severity of the manic state, but might also depend on the metabolism of the drug, which varies...... in different patients (Forsman, 1977). To our knowledge the relationship between plasma levels of haloperidol and antimanic effect has not been evaluated. In the present study we have measured plasma levels of haloperidol in manic patients treated with a fixed haloperidol dose and examined the relationship...

  7. Diagnosis and Treatment of Comorbidities of Tourette's Syndrome and Bipolar Disorder in A 10-Year-Old Boy

    Directory of Open Access Journals (Sweden)

    Peng-Wei Wang

    2009-11-01

    Full Text Available Changes in moods are one of the comorbid psychiatric manifestations that frequently occur in patients with Tourette's syndrome. The assessment of a manic episode in children with Tourette's syndrome is challenging. Furthermore, the treatment of children with comorbid mania and Tourette's syndrome has not been extensively studied. We present a 10-year-old boy who suffered from both Tourette's syndrome and mania, whose symptoms improved after using lithium and risperidone. The child was diagnosed with Tourette's syndrome at 7 years of age when he suffered from tics and experienced his first manic episode. He received monotherapy, including haloperidol, risperidone and aripiprazole, and the response was poor. When the combination of lithium and risperidone was used, the tics and mania subsided. It is important to assess individuals with Tourette's syndrome for associated bipolar disorder. The treatment of children with both disorders is a major clinical issue, and our case may serve as an example for successful treatment strategies.

  8. Clinical characteristics and legal consequences of violent behavior: a case of bipolar disorder.

    Science.gov (United States)

    Gómez-Durán, E L; Carrión, M I; Xifró, A; Martin-Fumadó, C

    2010-01-01

    The main subject of criminal proceedings is that of criminal responsibility, from this point of view bipolar disorders sometimes seem to be a neglected subject in legal scholarship. Yet they may affect decision-making across the spectrum of the law, especially when manic and psychotic symptoms are implicated. This case studies a 37-year-old woman, diagnosed with bipolar affective in disorder, who attacked the neighbour of her ex-husband during a manic episode with psychotic symptoms. Two groups of those psychotic symptoms are especially remarkable: delusions and experiences of influences playing on her body and thought insertion (threat/control–override symptoms). Hostility against her ex-husband was also implicated in the attack. Researchers have pointed all those symptoms as important predictors of violence, and they have determinant legal correlates.

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

    DEFF Research Database (Denmark)

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

    2016-01-01

    features with automatically generated objective smartphone data on behavioral activities (for example, number of text messages and phone calls per day) and electronic self-monitored data (mood) on illness activity would increase the accuracy as a marker of affective states. Using smartphones, voice...... features, automatically generated objective smartphone data on behavioral activities and electronic self-monitored data were collected from 28 outpatients with bipolar disorder in naturalistic settings on a daily basis during a period of 12 weeks. Depressive and manic symptoms were assessed using...... to be more accurate, sensitive and specific in the classification of manic or mixed states with an area under the curve (AUC)=0.89 compared with an AUC=0.78 for the classification of depressive states. Combining voice features with automatically generated objective smartphone data on behavioral activities...

  10. Glycogen synthase kinase-3β in patients with bipolar I disorder

    DEFF Research Database (Denmark)

    Jacoby, Anne S; Munkholm, Klaus; Vinberg, Maj

    2016-01-01

    OBJECTIVES: The enzyme glycogen synthase kinase-3β (GSK3β) is involved in the mechanisms of action of lithium and may play a role in relation to affective states in bipolar disorder. The objectives of the present study were to compare the activity of GSK-3β (measured as levels of phosphorylated GSK......-3β [p-GSK-3β]) between patients with bipolar disorder in the euthymic state and healthy control subjects, and to investigate whether GSK-3β activity varies with affective states in patients with bipolar I disorder. METHODS: In a prospective 6-12-month follow-up study, we investigated state......-specific, intraindividual alterations in the activity of GSK-3β in 60 patients with bipolar I disorder with an acute severe manic index episode and in subsequent euthymic, depressive and manic states and compared this with repeated measurements in healthy control subjects. Data were analyzed using linear mixed...

  11. Predictors of switching from mania to depression in a large observational study across Europe (EMBLEM)

    DEFF Research Database (Denmark)

    Vieta, Eduard; Angst, Jules; Reed, Catherine

    2009-01-01

    BACKGROUND: The risk of switching from mania to depression in bipolar disorder has been poorly studied. Large observational studies may be useful in identifying variables that predict switch to depression after mania and provide data on medication use and outcomes in "real world" patients. METHOD...... Depression Rating Scale. Switching was defined using CGI-BP mania and depression such that patients changed from manic and not depressed to depressed but not manic over two consecutive observations within the first 12 weeks of follow-up. Cox proportional hazards models identified baseline variables...... independently associated with switch to depression. RESULTS: Of 2390 patients who participated in the maintenance phase (i.e. up to 24 months), 120 (5.0%) switched to depression within the first 12 weeks. Factors associated with greater switching to depression include previous depressive episodes, substance...

  12. Gender differences in the phenomenology of bipolar disorder

    DEFF Research Database (Denmark)

    Kessing, Lars Vedel

    2004-01-01

    OBJECTIVES: To investigate gender differences in the phenomenology of episodes in bipolar disorder as according to ICD-10. METHODS: All patients who got a diagnosis of a manic episode/bipolar disorder in a period from 1994 to 2002 at the first outpatient treatment ever or at the first discharge...... episodes (mild/moderate/severe without psychosis/severe with psychosis) did not differ between genders. The prevalence of psychotic symptoms at first contact was the same for both genders. Among patients treated in outpatient settings more men than women presented with comorbid substance abuse and among...... patients treated during hospitalization more women than men presented with mixed episodes. CONCLUSIONS: Besides differences in the prevalence of mixed episodes and comorbid substance abuse few gender differences are found among patients presenting with a manic episode/bipolar disorder at first contact...

  13. Thought Suppression in Patients With Bipolar Disorder

    OpenAIRE

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

    2010-01-01

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

  14. Quantifying over-activity in bipolar and schizophrenia patients in a human open field Paradigm

    OpenAIRE

    Perry, William; Minassian, Arpi; Henry, Brook; Kincaid, Meegin; Young, Jared W.; Geyer, Mark A.

    2010-01-01

    It has been suggested that a cardinal symptom of mania is over-activity and exaggerated goal-directed behavior. Nevertheless, few attempts have been made to quantify this behavior objectively in a laboratory environment. Having a methodology to assess over-activity reliably might be useful in distinguishing manic bipolar disorder (BD) from schizophrenia (SCZ) during highly activated states. In the current study, quantifiable measures of object-interaction were assessed using a multivariate ...

  15. Mixed-state bipolar I and II depression: time to remission and clinical characteristics.

    Science.gov (United States)

    Shim, In Hee; Woo, Young Sup; Jun, Tae-Youn; Bahk, Won-Myong

    2014-01-01

    We compared the time to achieve remission and the clinical characteristics of patients with bipolar depressive mixed state and those with bipolar depressive non-mixed state. The subjects (N=131) were inpatients diagnosed between 2006 and 2012 with bipolar I or II disorder, depression and were classified into the following three groups: "pure depressive state" (PD, n=70), "sub-threshold mixed state" (SMX, n=38), and "depressive mixed state" (DMX, n=23). Diagnosis of a DMX was in accordance with Benazzi's definition: three or more manic symptoms in a depressive episode. The subjects' charts were retrospectively reviewed to ascertain the time to achieve remission from the index episode and to identify other factors, such as demographic and clinical characteristics, specific manic symptoms, and pharmacological treatment, that may have contributed to remission. The time to achieve remission was significantly longer in the DMX (p=0.022) and SMX (p=0.035) groups than in the PD group. Adjustment for covariates using a Cox proportional hazards model did not change these results. Clinically, subjects with a DMX were more likely to have manic symptoms in the index episode, especially inflated self-esteem and psychomotor agitation than those in the PD. We investigated only inpatients and therefore could not comment on outpatients. These findings showed that sub-syndromal manic symptoms in bipolar depression had different clinical characteristics and a more severe illness course, including a longer time to achieve remission, than did a pure depressive state. © 2013 Elsevier B.V. All rights reserved.

  16. 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

  17. Calcium metabolism in lithium-treated patients

    International Nuclear Information System (INIS)

    Baastrup, P.C.; Transboel, I.

    1978-01-01

    The bone mineral content (BMC) together with biochemical indices of calcium metabolism were measured in 83 manic-depressive patients on long-term lithium therapy. The patients were diagnosed and divided into a unipolar and a bipolar group according to strict symptomatic course criteria. The patients with bipolar course had a significantly decreased BMC (88% of normal, P < 0.001), while the unipolar patients had normal BMC. Both groups had biochemical changes consistent with primary hyperparathyroidism. (author)

  18. Markers of neuroinflammation and neuronal injury in bipolar disorder: Relation to prospective clinical outcomes.

    Science.gov (United States)

    Isgren, Anniella; Sellgren, Carl; Ekman, Carl-Johan; Holmén-Larsson, Jessica; Blennow, Kaj; Zetterberg, Henrik; Jakobsson, Joel; Landén, Mikael

    2017-10-01

    Neuroimmune mechanisms have been linked to the pathophysiology of bipolar disorder based on studies of biomarkers in plasma, cerebrospinal fluid (CSF), and postmortem brain tissue. There are, however, no longitudinal studies investigating if CSF markers of neuroinflammation and neuronal injury predict clinical outcomes in patients with bipolar disorder. We have in previous studies found higher CSF concentrations of interleukin-8 (IL-8), monocyte chemoattractant protein 1 (MCP-1/CCL-2), chitinase-3-like protein 1 (CHI3L1/YKL-40), and neurofilament light chain (NF-L) in euthymic patients with bipolar disorder compared with controls. Here, we investigated the relationship of these CSF markers of neuroinflammation and neuronal injury with clinical outcomes in a prospective study. 77 patients with CSF analyzed at baseline were followed for 6-7years. Associations of baseline biomarkers with clinical outcomes (manic/hypomanic and depressive episodes, suicide attempts, psychotic symptoms, inpatient care, GAF score change) were investigated. Baseline MCP-1 concentrations were positively associated with manic/hypomanic episodes and inpatient care during follow-up. YKL-40 concentrations were negatively associated with manic/hypomanic episodes and with occurrence of psychotic symptoms. The prospective negative association between YKL-40 and manic/hypomanic episodes survived multiple testing correction. Concentrations of IL-8 and NF-L were not associated with clinical outcomes. High concentrations of these selected CSF markers of neuroinflammation and neuronal injury at baseline were not consistently associated with poor clinical outcomes in this prospective study. The assessed proteins may be involved in adaptive immune processes or reflect a state of vulnerability for bipolar disorder rather than being of predictive value for disease progression. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. Effectiveness and Patient Acceptability of Stellate Ganglion Block (SGB) for Treatment of Posttraumatic Stress Disorder (PTSD) Symptoms Among Active Duty Military Members

    Science.gov (United States)

    2016-03-01

    you were manic-depressive or had bipolar disorder ?* ○ No ○ Yes 9. Have you received therapy for PTS/PTSD in the past month?* ○ No [Go to Question...Posttraumatic Stress Disorder (PTSD) Symptoms among Active Duty Military Members PRINCIPAL INVESTIGATOR: Bradford B. Walters, MD, PhD CONTRACTING...of Posttraumatic Stress Disorder (PTSD) Symptoms among Active Duty Military Members 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER 5e

  20. Hamlet and psychiatry intertwined.

    Science.gov (United States)

    Rotstein, Sarah

    2018-05-01

    This article considers selected landmarks in the history of psychiatry and their impact on Hamlet productions, including Burton's Anatomy of Melancholia, Emil Kraepelin's manic-depression, Freud's oedipal complex and R.D. Laing's 'divided self'. Additionally, this article considers the way Shakespeare's Hamlet has influenced the course of psychiatry. The linkages between psychiatry and Hamlet have existed since the 17th century, and perhaps Shakespeare's Hamlet should have a place on every psychiatrist's shelf.

  1. Religion, culture and mental health

    National Research Council Canada - National Science Library

    Loewenthal, Kate

    2007-01-01

    ... psychiatric conditions such as schizophrenia, manic disorders, depression, anxiety, somatisation and dissociation as well as positive states of mind, and analyses the religious and cultural influences on each.   is Professor of Psychology at Royal Holloway, University of London. She has published numerous articles and spoken at internatio...

  2. 檀一雄の病跡学的研究 : 躁的防衛,抑うつポジション,移行対象の視点から

    OpenAIRE

    真鍋, 守栄; Morie, Manabe; 茨城キリスト教大学社会・自然科学; Ibaraki Christian University, Social and Natural Sciences

    2002-01-01

    Kazuo Dan is considered as a ruinous type of writer. He had difficulties in his background, for instance, his mother left home when he was 9 years old. I can see a vitality and will to live behind his dissapation for destruction. It seems like a home environment had a deep effect on his behavior later on. In this paper, I have tried to understand his life through the psychoanalytic viewpoints of Manic Defences, Depressive Position and Transitional Object.

  3. Smartphone based treatment in bipolar disorder

    DEFF Research Database (Denmark)

    Faurholt-Jepsen, M; Frost, M.; Bardram, J.E.

    2016-01-01

    During this symposium, results from a randomized controlled trial investigating the effect of smartphone based electronic self-monitoring on the severity of depressive and manic symptoms will be presented and discussed.Further, we will present and discuss the use of automatically generated...... objective smartphone data on behavioral activities (eg social activities, mobility and physical activity) as electronic biomarkers of illness activity in bipolar disorder....

  4. A Case of Mania Presenting with Hypersexual Behavior and Gender Dysphoria that Resolved with Valproic Acid

    OpenAIRE

    Heare, Michelle R.; Barsky, Maria; Faziola, Lawrence R.

    2016-01-01

    Hypersexuality and gender dysphoria have both been described in the literature as symptoms of mania. Hypersexuality is listed in the Diagnostic and Statistical Manual of Mental Disorders 5 as part of the diagnostic criteria for bipolar disorder. Gender dysphoria is less often described and its relation to mania remains unclear. This case report describes a young homosexual man presenting in a manic episode with co-morbid amphetamine abuse whose mania was marked by hypersexuality and the new o...

  5. Design and rationale of a 16-week adjunctive randomized placebo-controlled trial of mitochondrial agents for the treatment of bipolar depression

    OpenAIRE

    Olivia M. Dean; Alyna Turner; Gin S. Malhi; Chee Ng; Sue M. Cotton; Seetal Dodd; Jerome Sarris; Yuval Samuni; Michelle Tanious; Nathan Dowling; Astrid Waterdrinker; Deidre Smith; Michael Berk

    2015-01-01

    Objective: Bipolar disorder places a significant burden on individuals, caregivers and family, and the broader community. Current treatments are believed to be more effective against manic symptoms, leaving a shortfall in recovery during the depressive phase of the illness. The current study draws on recent evidence suggesting that, in addition to increased oxidative load, alterations in mitochondrial function occur in bipolar disorder. Methods: This 16-week study aims to explore the potentia...

  6. The Bipolar Illness Onset study: research protocol for the BIO cohort study

    DEFF Research Database (Denmark)

    Kessing, Lars Vedel; Munkholm, Klaus; Faurholt-Jepsen, Maria

    2017-01-01

    Bipolar disorder is an often disabling mental illness with a lifetime prevalence of 1%-2%, a high risk of recurrence of manic and depressive episodes, a lifelong elevated risk of suicide and a substantial heritability. The course of illness is frequently characterised by progressive shortening of...... conferences and meetings including conferences for the International Society for Bipolar Disorders and the World Federation of Societies for Biological Psychiatry and in scientific peer-reviewed papers. NCT02888262....

  7. Clouds and silver linings: positive experiences associated with primary affective disorders.

    Science.gov (United States)

    Jamison, K R; Gerner, R H; Hammen, C; Padesky, C

    1980-02-01

    Clinical psychiatry has focused almost entirely on the psychopathology of the affective disorders. The authors studied responses of 61 patients (35 bipolar. 26 unipolar) to questions about perceived short- and long-term benefits (increased sensitivity, sexuality, productivity, creativity, and social outgoingness) they attributed to their affective illness. Bipolar patients strongly indicated positive experiences associated with manic-depressive illness; few unipolar patients perceived their disorder in such a way. Significant sex differences emerged in the attributions made by bipolar patients.

  8. Psykose ved affektive lidelser

    DEFF Research Database (Denmark)

    Kessing, Lars Vedel

    2008-01-01

    Psychosis in affective disorder is prevalent as 15-20% of depressive patients and approximately 50% of manic patients present with psychotic features. Psychosis in conjunction with affective disorder has a poor prognosis. It is particularly so for depression where psychosis is associated...... with an increased risk of recurrence, development of bipolar disorder and suicide. It is still being debated whether these conditions reflect independent illness entities and their relationship to schizoaffective disorder and schizophrenia is also unresolved....

  9. Stemcell Information: SKIP000870 [SKIP Stemcell Database[Archive

    Lifescience Database Archive (English)

    Full Text Available asts of a patient with manic type I bipolar disorder responsive to lithium treatment 1型双極性障害患者由来iPS細胞、患者はリチウ...80 ... 心的外傷後ストレス障害 F431 post traumatic stress disorder ... 59 50-59 Male ... No No iPS cell derived from fibrobl

  10. Physical and Sexual Abuse and Early-Onset Bipolar Disorder in Youths Receiving Outpatient Services: Frequent, but Not Specific

    Science.gov (United States)

    Youngstrom, Eric A.; Martinez, Maria; KogosYoungstrom, Jennifer; Scovil, Kelly; Ross, Jody; Feeny, Norah C.; Findling, Robert L.

    2014-01-01

    The objective of this study was to determine if physical and sexual abuse showed relationships to early-onset bipolar spectrum disorders (BPSD) consistent with findings from adult retrospective data. Participants (N=829, M= 10.9 years old ±3.4 SD, 60 % male, 69 % African American, and 18 % with BPSD), primarily from a low socio-economic status, presented to an urban community mental health center and a university research center. Physical abuse was reported in 21 %, sexual abuse in 20 %, and both physical and sexual abuse in 11 % of youths with BPSD. For youths without BPSD, physical abuse was reported in 16 %, sexual abuse in 15 %, and both physical and sexual abuse in 5 % of youths. Among youth with BPSD, physical abuse was significantly associated with a worse global family environment, more severe depressive and manic symptoms, a greater number of sub-threshold manic/hypomanic symptoms, a greater likelihood of suicidality, a greater likelihood of being diagnosed with PTSD, and more self-reports of alcohol or drug use. Among youth with BPSD, sexual abuse was significantly associated with a worse global family environment, more severe manic symptoms, a greater number of sub-threshold manic/hypomanic symptoms, greater mood swings, more frequent episodes, more reports of past hospitalizations, and a greater number of current and past comorbid Axis I diagnoses. These findings suggest that if physical and/or sexual abuse is reported, clinicians should note that abuse appears to be related to increased severity of symptoms, substance use, greater co-morbidity, suicidality, and a worse family environment. PMID:25118660

  11. Subacute sclerosing panencephalitis presenting as mania

    Directory of Open Access Journals (Sweden)

    Aggarwal Ashish

    2011-01-01

    Full Text Available Subacute sclerosing panencephalitis (SSPE is a rare, invariably fatal degenerative disease of the central nervous system developing after measles infection. Besides neurological symptoms as initial presenting symptoms, rare reports of its presentation with pure psychiatric symptoms have been reported. We here report a case of 14 year old male who initially presented with manic symptoms and then subsequently diagnosed to be suffering from SSPE. Improtance of ruling our organic conditions is emphasized.

  12. Soren Kierkegaard (1813-55): a bicentennial pathographical review.

    Science.gov (United States)

    Schioldann, Johan; Søgaard, Ib

    2013-12-01

    Researchers in the fields of psychology, psychiatry, medicine and theology have made exhaustive efforts to shed light on the elusive biography/pathography of the great Danish philosopher Søren Kierkegaard (1813-55). This 'bicentennial' article reviews his main pathographical diagnoses of, respectively, possible manic-depressive [bipolar] disease, epilepsy, complex partial seizure disorder, Landry-Guillain-Barré's acute ascending paralysis, acute intermittent porphyria with possible psychiatric manifestations, and syphilidophobia.

  13. Early effects of modern electroconvulsive therapy on subjective memory in patients with mania or depression

    OpenAIRE

    Bag, Sevda; Canbek, Ozge; Atagun, Ilhan Murat; Kutlar, Tarik Mehmet

    2016-01-01

    Context: Although electroconvulsive therapy (ECT) is considered a very effective tool for the treatment of psychiatric diseases, memory disturbances are among the most important adverse effects. Aims: This study aimed to assess prospectively early subjective memory complaints in depressive and manic patients due to bilateral, brief-pulse ECT, at different stages of the treatment, compare the associations between psychiatric diagnosis, sociodemographic characteristics, and ECT characteristics....

  14. 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.

  15. Speech graphs provide a quantitative measure of thought disorder in psychosis.

    Science.gov (United States)

    Mota, Natalia B; Vasconcelos, Nivaldo A P; Lemos, Nathalia; Pieretti, Ana C; Kinouchi, Osame; Cecchi, Guillermo A; Copelli, Mauro; Ribeiro, Sidarta

    2012-01-01

    Psychosis has various causes, including mania and schizophrenia. Since the differential diagnosis of psychosis is exclusively based on subjective assessments of oral interviews with patients, an objective quantification of the speech disturbances that characterize mania and schizophrenia is in order. In principle, such quantification could be achieved by the analysis of speech graphs. A graph represents a network with nodes connected by edges; in speech graphs, nodes correspond to words and edges correspond to semantic and grammatical relationships. To quantify speech differences related to psychosis, interviews with schizophrenics, manics and normal subjects were recorded and represented as graphs. Manics scored significantly higher than schizophrenics in ten graph measures. Psychopathological symptoms such as logorrhea, poor speech, and flight of thoughts were grasped by the analysis even when verbosity differences were discounted. Binary classifiers based on speech graph measures sorted schizophrenics from manics with up to 93.8% of sensitivity and 93.7% of specificity. In contrast, sorting based on the scores of two standard psychiatric scales (BPRS and PANSS) reached only 62.5% of sensitivity and specificity. The results demonstrate that alterations of the thought process manifested in the speech of psychotic patients can be objectively measured using graph-theoretical tools, developed to capture specific features of the normal and dysfunctional flow of thought, such as divergence and recurrence. The quantitative analysis of speech graphs is not redundant with standard psychometric scales but rather complementary, as it yields a very accurate sorting of schizophrenics and manics. Overall, the results point to automated psychiatric diagnosis based not on what is said, but on how it is said.

  16. Speech graphs provide a quantitative measure of thought disorder in psychosis.

    Directory of Open Access Journals (Sweden)

    Natalia B Mota

    Full Text Available BACKGROUND: Psychosis has various causes, including mania and schizophrenia. Since the differential diagnosis of psychosis is exclusively based on subjective assessments of oral interviews with patients, an objective quantification of the speech disturbances that characterize mania and schizophrenia is in order. In principle, such quantification could be achieved by the analysis of speech graphs. A graph represents a network with nodes connected by edges; in speech graphs, nodes correspond to words and edges correspond to semantic and grammatical relationships. METHODOLOGY/PRINCIPAL FINDINGS: To quantify speech differences related to psychosis, interviews with schizophrenics, manics and normal subjects were recorded and represented as graphs. Manics scored significantly higher than schizophrenics in ten graph measures. Psychopathological symptoms such as logorrhea, poor speech, and flight of thoughts were grasped by the analysis even when verbosity differences were discounted. Binary classifiers based on speech graph measures sorted schizophrenics from manics with up to 93.8% of sensitivity and 93.7% of specificity. In contrast, sorting based on the scores of two standard psychiatric scales (BPRS and PANSS reached only 62.5% of sensitivity and specificity. CONCLUSIONS/SIGNIFICANCE: The results demonstrate that alterations of the thought process manifested in the speech of psychotic patients can be objectively measured using graph-theoretical tools, developed to capture specific features of the normal and dysfunctional flow of thought, such as divergence and recurrence. The quantitative analysis of speech graphs is not redundant with standard psychometric scales but rather complementary, as it yields a very accurate sorting of schizophrenics and manics. Overall, the results point to automated psychiatric diagnosis based not on what is said, but on how it is said.

  17. Affective cycling in thyroid disease

    International Nuclear Information System (INIS)

    Tapp, A.

    1988-01-01

    Depression in an elderly man with primary recurrent unipolar depression responded to radioactive iodine treatment of a thyrotoxic nodule, without the addition of psychotropic medications. Two months later, manic symptoms developed concomitant with the termination of the hyperthyroid state secondary to the radioactive iodine treatment. Clinical implications of these findings in relation to the possible mechanism of action of thyroid hormones on affective cycling are discussed

  18. Rapid onset of treatment effects on psychosis, depression, and mania in patients with acute exacerbation of schizoaffective disorder following treatment with oral extended-release paliperidone.

    Science.gov (United States)

    Fu, Dong-Jing; Turkoz, Ibrahim; Bossie, Cynthia A; Patel, Hiren; Alphs, Larry

    2016-03-15

    Patients with schizoaffective disorder (SCA) experience complicated interplays of psychotic, depressive, and manic symptoms. Paliperidone extended-release (pali ER) tablets have been shown to be efficacious in these patients, but treatment response has not been studied relative to the onset of effects for these symptom domains. In a pooled analysis of data from two 6-week, randomized, placebo-controlled studies, the onset of treatment effects with oral pali ER was evaluated by symptom domain (psychosis, depression, mania) in patients with an acute SCA exacerbation. Subjects were categorized as having prominent psychotic (Positive and Negative Syndrome Scale score >70), depressive (Hamilton Rating Scale for Depression-21 score ≥16), or manic (Young Mania Rating Scale score ≥16) symptoms at baseline. Of the 614 patients in these analyses, 597 (97.2%), 411 (66.9%), and 488 (79.5%) had prominent psychotic, depressive, and manic symptoms at baseline, respectively. Pali ER treatment was associated with rapid and significant improvement of all three symptom domains versus placebo within 1 week of initiation, regardless of whether treatment was given as monotherapy or in combination with mood stabilizers and/or antidepressants. Adverse events were similar to those reported in the original published studies. This post hoc analysis of two phase 3 trials requires confirmation in prospective studies. This pooled analysis suggests that treatment with pali ER is associated with rapid control of psychotic, depressive, and manic symptoms in patients with SCA. Its findings support the benefit of pali ER as a primary treatment for the management of SCA. Copyright © 2015 The Authors. Published by Elsevier B.V. All rights reserved.

  19. A TWIN STUDY OF SCHIZOAFFECTIVE-MANIA, SCHIZOAFFECTIVE-DEPRESSION AND OTHER PSYCHOTIC SYNDROMES

    OpenAIRE

    Cardno, Alastair G; Rijsdijk, Frühling V; West, Robert M; Gottesman, Irving I; Craddock, Nick; Murray, Robin M; McGuffin, Peter

    2011-01-01

    The nosological status of schizoaffective disorders remains controversial. Twin studies are potentially valuable for investigating relationships between schizoaffective-mania, schizoaffective-depression and other psychotic syndromes, but no such study has yet been reported. We ascertained 224 probandwise twin pairs (106 monozygotic, 118 same-sex dizygotic), where probands had psychotic or manic symptoms, from the Maudsley Twin Register in London (1948–1993). We investigated Research Diagnosti...

  20. Relationship between the clinical global impression of severity for schizoaffective disorder scale and established mood scales for mania and depression.

    Science.gov (United States)

    Turkoz, Ibrahim; Fu, Dong-Jing; Bossie, Cynthia A; Sheehan, John J; Alphs, Larry

    2013-08-15

    This analysis explored the relationship between ratings on HAM-D-17 or YMRS and those on the depressive or manic subscale of CGI-S for schizoaffective disorder (CGI-S-SCA). This post hoc analysis used the database (N=614) from two 6-week, randomized, placebo-controlled studies of paliperidone ER versus placebo in symptomatic subjects with schizoaffective disorder assessed using HAM-D-17, YMRS, and CGI-S-SCA scales. Parametric and nonparametric regression models explored the relationships between ratings on YMRS and HAM-D-17 and on depressive and manic domains of the CGI-S-SCA from baseline to the 6-week end point. A clinically meaningful improvement was defined as a change of 1 point in the CGI-S-SCA score. No adjustment was made for multiplicity. Multiple linear regression models suggested that a 1-point change in the depressive domain of CGI-S-SCA corresponded to an average 3.6-point (SE=0.2) change in HAM-D-17 score. Similarly, a 1-point change in the manic domain of CGI-S-SCA corresponded to an average 5.8-point (SE=0.2) change in YMRS score. Results were confirmed using local and cumulative logistic regression models in addition to equipercentile linking. Lack of subjects scoring over the complete range of possible scores may limit broad application of the analyses. Clinically meaningful score changes in depressive and manic domains of CGI-S-SCA corresponded to approximately 4- and 6-point score changes on HAM-D-17 and YMRS, respectively, in symptomatic subjects with schizoaffective disorder. Copyright © 2013 Elsevier B.V. All rights reserved.

  1. Quantitative measurement of Nerve Growth Factor in rat brain after acute and chronic application of lithium and carbamazepine

    OpenAIRE

    Nagel, Michael

    2010-01-01

    Bipolar affective disorder is a frequent, recurring affective disease with a high rate of mortality and co-morbidity. Manic as well as depressive episodes occur in its course. There are some indicators, that patients with bipolar affective disorder show a decrease in volume and metabolism of certain areas of the brain. This is accompanied by neuronal atrophy or loss of neurons. This assumption is supported by radiological as well as neuropathological findings of this patient group. A possi...

  2. Implication de la protéine kinase C dans les troubles bipolaires : vers de nouvelles cibles thérapeutiques

    OpenAIRE

    Abrial , Erika

    2013-01-01

    Bipolar disorder is a devastating long-term disease characterized by alternate episodes of mania and depression. Despite extensive research, the molecular and cellular underpinnings of bipolar disorder remain to be fully elucidated. Protein kinase C (PKC) has emerged as a potential molecular target for the treatment of bipolar disorder. The present study investigated the role of PKC in manic- and depressive-like behaviors. Our results showed that PKC inhibition produced an antimanic-like effe...

  3. The Mood Spectrum and Temperamental Instability in Unipolar and Bipolar Disorder

    OpenAIRE

    Kumar, Manish; Saha, Pradeep Kumar; Mondal, Anwesha

    2017-01-01

    Background: The current categorical split of mood disorders in bipolar (BP) disorders and depressive disorders has recently been questioned. The presence of a significant number of manic/hypomanic symptoms in patients with recurrent unipolar depression seems to challenge the traditional dichotomy of unipolar-BP disorder. Two highly unstable personality features, i.e., the cyclothymic temperament (CT) and borderline personality disorder, have been found to be more common in BP disorder than in...

  4. State-dependent alterations of lipid profiles in patients with bipolar disorder.

    Science.gov (United States)

    Huang, Yu-Jui; Tsai, Shang-Ying; Chung, Kuo-Hsuan; Chen, Pao-Huan; Huang, Shou-Hung; Kuo, Chian-Jue

    2018-07-01

    Objective Serum lipid levels may be associated with the affective severity of bipolar disorder, but data on lipid profiles in Asian patients with bipolar disorder and the lipid alterations in different states of opposite polarities are scant. We investigated the lipid profiles of patients in the acute affective, partial, and full remission state in bipolar mania and depression. Methods The physically healthy patients aged between 18 and 45 years with bipolar I disorder, as well as age-matched healthy normal controls were enrolled. We compared the fasting blood levels of glucose, cholesterol, triglyceride, low-density lipoprotein, and high-density lipoprotein of manic or depressed patients in the acute phase and subsequent partial and full remission with those of their normal controls. Results A total of 32 bipolar manic patients (12 women and 20 men), 32 bipolar depressed participants (18 women and 14 men), and 64 healthy control participants took part in this study. The mean cholesterol level in acute mania was significantly lower than that in acute depression (p bipolar mania. Conclusion Circulating lipid profiles may be easily affected by affective states. The acute manic state may be accompanied by state-dependent lower cholesterol and triglyceride levels relative to that in other mood states.

  5. A novel scale for measuring mixed states in bipolar disorder.

    Science.gov (United States)

    Cavanagh, Jonathan; Schwannauer, Matthias; Power, Mick; Goodwin, Guy M

    2009-01-01

    Conventional descriptions of bipolar disorder tend to treat the mixed state as something of an afterthought. There is no scale that specifically measures the phenomena of the mixed state. This study aimed to test a novel scale for mixed state in a clinical and community population of bipolar patients. The scale included clinically relevant symptoms of both mania and depression in a bivariate scale. Recovered respondents were asked to recall their last manic episode. The scale allowed endorsement of one or more of the manic and depressive symptoms. Internal consistency analyses were carried out using Cronbach alpha. Factor analysis was carried out using a standard Principal Components Analysis followed by Varimax Rotation. A confirmatory factor analytic method was used to validate the scale structure in a representative clinical sample. The reliability analysis gave a Cronbach alpha value of 0.950, with a range of corrected-item-total-scale correlations from 0.546 (weight change) to 0.830 (mood). The factor analysis revealed a two-factor solution for the manic and depressed items which accounted for 61.2% of the variance in the data. Factor 1 represented physical activity, verbal activity, thought processes and mood. Factor 2 represented eating habits, weight change, passage of time and pain sensitivity. This novel scale appears to capture the key features of mixed states. The two-factor solution fits well with previous models of bipolar disorder and concurs with the view that mixed states may be more than the sum of their parts.

  6. 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.

  7. Reduced concentrations of N-acetylaspartate (NAA) and the NAA-creatine ratio in the basal ganglia in bipolar disorder: a study using 3-Tesla proton magnetic resonance spectroscopy.

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    Frye, Mark A; Thomas, M Albert; Yue, Kenneth; Binesh, Nader; Davanzo, Pablo; Ventura, Joseph; O'Neill, Joseph; Guze, Barry; Curran, John G; Mintz, Jim

    2007-04-15

    The N-acetylaspartate (NAA) peak is prominent in the proton magnetic resonance spectrum and is thought to reflect neuron loss or dysfunction. This study was conducted to explore NAA biochemistry and its clinical correlates in mania. Subjects comprised 16 manic patients and 17 controls who underwent a structured diagnostic interview and (1)H magnetic resonance spectroscopy (MRS) acquisition. STEAM (1)H MRS (TR/TE/TM=2000/20/8 ms) was acquired at 3 Tesla from 2 x 2 x 2 cm(3) voxels in anterior cingulate (AC), right basal ganglia (BG), and left occipital-parietal white matter (OP). Absolute metabolite concentrations and ratios to creatine were calculated using the LC Model. The mean absolute concentrations of NAA and NAA-creatine ratio in the BG were significantly lower in manic subjects than in controls. There was a significant inverse correlation between NAA in the BG and the number of prior hospitalizations for mania. These data suggest BG pathology in mania and that NAA decrements may mark prior manic episode burden. Limitations of this study include small sample size and lack of tissue segmentation. Further study is encouraged to clarify state vs. trait aspects of NAA in bipolar disorder.

  8. Update on quetiapine in the treatment of bipolar disorder: results from the BOLDER studies

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    Prashant Gajwani

    2007-01-01

    Full Text Available Prashant Gajwani1, David J Muzina2, David E Kemp3, Keming Gao1, Joseph R Calabrese11Case Western Reserve University (CWRU School of Medicine, 2Cleveland Clinic Lerner College of Medicine of CWRU, 3Case Western Reserve University, Cleveland OH, USAAbstract: The essential features of bipolar affective disorder involve the cyclical occurrence of high (manic or hypomanic episodes and low mood states. Depressive episodes in both bipolar I and II disorder are more numerous and last for longer duration than either manic or hypomanic episodes. In addition depressive episodes are associated with higher morbidity and mortality. While multiple agents, including all 5 atypical antipsychotics, have demonstrated efficacy and earned US FDA indication for manic phase of bipolar illness, the acute treatment of bipolar depression is less well-studied. The first treatment approved by the US FDA for acute bipolar depression was the combination of the atypical antipsychotic olanzapine and the antidepressant fluoxetine. Recently, quetiapine monotherapy has demonstrated efficacy in the treatment of depressive episodes associated with both bipolar I and II disorder and has earned US FDA indication for the same.Keywords: bipolar disorder, quetiapine, BOLDER studies

  9. Bipolar disorder diagnosis: challenges and future directions

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    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

  10. Diagnosis, Epidemiology and Management of Mixed States in Bipolar Disorder.

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    Fagiolini, Andrea; Coluccia, Anna; Maina, Giuseppe; Forgione, Rocco N; Goracci, Arianna; Cuomo, Alessandro; Young, Allan H

    2015-09-01

    Approximately 40% of patients with bipolar disorder experience mixed episodes, defined as a manic state with depressive features, or manic symptoms in a patient with bipolar depression. Compared with bipolar patients without mixed features, patients with bipolar mixed states generally have more severe symptomatology, more lifetime episodes of illness, worse clinical outcomes and higher rates of comorbidities, and thus present a significant clinical challenge. Most clinical trials have investigated second-generation neuroleptic monotherapy, monotherapy with anticonvulsants or lithium, combination therapy, and electroconvulsive therapy (ECT). Neuroleptic drugs are often used alone or in combination with anticonvulsants or lithium for preventive treatment, and ECT is an effective treatment for mixed manic episodes in situations where medication fails or cannot be used. Common antidepressants have been shown to worsen mania symptoms during mixed episodes without necessarily improving depressive symptoms; thus, they are not recommended during mixed episodes. A greater understanding of pathophysiological processes in bipolar disorder is now required to provide a more accurate diagnosis and new personalised treatment approaches. Targeted, specific treatments developed through a greater understanding of bipolar disorder pathophysiology, capable of affecting the underlying disease processes, could well prove to be more effective, faster acting, and better tolerated than existing therapies, therefore providing better outcomes for individuals affected by bipolar disorder. Until such time as targeted agents are available, second-generation neuroleptics are emerging as the treatment of choice in the management of mixed states in bipolar disorder.

  11. Epidemiological and clinical variables related with the predominant polarity on bipolar disorder: A systematic review.

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    García-Jiménez, Jesús; Álvarez-Fernández, Marisol; Aguado-Bailón, Lidia; Gutiérrez-Rojas, Luis

    2017-08-14

    Current classification of bipolar disorder (BD) in type i or type ii, however useful, may be insufficient to provide relevant clinical information in some patients. As a result, complementary classifications are being proposed, like the predominant polarity (PP) based, which is defined as a clear tendency in the patient to present relapses in the manic or depressive poles. We carried out a search in PubMed and Web of Science databases, following the Preferred Items for Reporting of Systematic Reviews and Meta-Analyses -PRISMA- guidelines, to identify studies about BD reporting PP. The search is updated to June 2016. Initial search revealed 907 articles, of which 16 met inclusion criteria. Manic PP was found to be associated with manic onset, drug consumption prior to onset and a better response to atypical antipsychotics and mood stabilisers. Depressive PP showed an association with depressive onset, more relapses, prolonged acute episodes, a greater suicide risk and a later diagnosis of BD. Depressive PP was also associated with anxiety disorders, mixed symptoms, melancholic symptoms and a wider use of quetiapine and lamotrigine. Few prospective studies. Variability in some results. PP may be useful as a supplement to current BD classifications. We have found consistent data on a great number of studies, but there is also contradictory information regarding PP. Further studies are needed, ideally of a prospective design and with a unified methodology. Copyright © 2017 SEP y SEPB. Publicado por Elsevier España, S.L.U. All rights reserved.

  12. [Comparison of Inflammatory Biomarkers Between Bipolar Disorder I Patients and Control Subjects].

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    Palacio, Juan David; Guzman, Sandra; Vargas, Cristian; Díaz-Zuluaga, Ana María; López-Jaramillo, Carlos

    2016-01-01

    Inflammatory changes have been described in different affective episodes, as well as in the euthymic phase of Bipolar I Disease. These changes have been proposed as possible peripheral markers of the disease. For this reason well-designed studies are needed to explore this hypothesis. Quantify and compare the serum levels of interleukins (IL) and tumour necrosis factor (TNF) in bipolar I patients and healthy subjects, including the comparison between the affective episodes of the disease. Cross-sectional study including 41 bipolar I patients and 11 healthy control subjects. Serum levels of IL-1B, IL-RA, IL-2, IL-4, IL-6, IL-7, IL-8, IL-10, IL-12, and TNF were measured during the euthymic, depressive, and manic phases and were compared with the serum levels of the healthy subjects. Manic phase patients had low education and high number of hospitalisations. Depressive phase patients showed high number of depressive episodes throughout life. No statistically significant differences were found in IL and TNF levels between bipolar I patients and healthy controls, or between the bipolar I subgroups (euthymic, manic and depressive states). An increase in the size of the sample is necessary in future studies, in order to enhance the statistical value of the results, and explore the inflammatory hypothesis of the bipolar disease. Copyright © 2015 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  13. Strain-specific battery of tests for domains of mania: effects of valproate, lithium and imipramine

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    Shlomit Flaisher-Grinberg

    2010-04-01

    Full Text Available The lack of efficient animal models for bipolar disorder (BPD, especially for the manic pole, is a major factor hindering the research of its pathophysiology and the development of improved drug treatments. The present study was designed to identify an appropriate mouse strain for modeling some behavioral domains of mania and to evaluate the effects of drugs using this strain. The study compared the behavior of four strains: Black Swiss, C57Bl/6, CBA/J and A/J mice in a battery of tests that included spontaneous activity; sweet solution preference; light/dark box; resident-intruder; forced-swim and amphetamine-induced hyperactivity. Based on the ‘manic-like’ behavior demonstrated by the Black Swiss strain, the study evaluated the effects of the mood stabilizers valproate and lithium and of the antidepressant imipramine in the same tests using this strain. Results indicated that lithium and valproate attenuate the ‘manic-like’ behavior of Black Swiss mice whereas imipramine had no effects. These findings suggest that Black Swiss mice might be a good choice for modeling several domains of mania and distinguishing the effects of drugs on these specific domains. However, the relevance of the behavioral phenotype of Black Swiss mice to the biology of BPD is unknown at this time and future studies will investigate molecular differences between Black Swiss mice and other strains and asess the interaction between strain and mood stabilizing treatment.

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

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    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.

  15. Abnormal functional-structural cingulum connectivity in mania: combined functional magnetic resonance imaging-diffusion tensor imaging investigation in different phases of bipolar disorder.

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    Martino, M; Magioncalda, P; Saiote, C; Conio, B; Escelsior, A; Rocchi, G; Piaggio, N; Marozzi, V; Huang, Z; Ferri, F; Amore, M; Inglese, M; Northoff, G

    2016-10-01

    The objective of the study was to investigate the relationship between structural connectivity (SC) and functional connectivity (FC) in the cingulum in bipolar disorder (BD) and its various phases. We combined resting-state functional magnetic resonance imaging and probabilistic tractographic diffusion tensor imaging to investigate FC and SC of the cingulum and its portions, the SC-FC relationship, and their correlations with clinical and neurocognitive measures on sustained attention in manic (n = 21), depressed (n = 20), and euthymic (n = 20) bipolar patients and healthy controls (HC) (n = 42). First, we found decreased FC between the anterior and posterior parts of the cingulum in manic patients when compared to depressed patients and HC. Second, we observed decreased SC of the cingulum bundle, particularly in its anterior part, in manic patients when compared to HC. Finally, alterations in the cingulum FC (but not SC) correlated with clinical severity scores while changes in the cingulum SC (but not FC) were related with neurocognitive deficits in sustained attention in BD. We demonstrate for the first time a reduction in FC and concomitantly in SC of the cingulum in mania, which correlated with psychopathological and neurocognitive parameters, respectively, in BD. This supports the central role of cingulum connectivity specifically in mania. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  16. [Bipolar disorders in DSM-5].

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    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.

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

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    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.

  18. The influence of current mood state, number of previous affective episodes and predominant polarity on insight in bipolar disorder.

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    de Assis da Silva, Rafael; Mograbi, Daniel C; Camelo, Evelyn Vieira Miranda; Peixoto, Ursula; Santana, Cristina Maria Teixeira; Landeira-Fernandez, Jesus; Morris, Robin G; Cheniaux, Elie

    2017-11-01

    Although many studies have explored the effect of current affective episodes on insight into bipolar disorder, the potential interaction between current mood state and previous affective episodes has not been consistently investigated. To explore the influence of dominant polarity, number of previous affective episodes and current affective state on insight in bipolar disorder patients in euthymia or mania. A total of 101 patients with bipolar disorder were recruited for the study, including 58 patients in euthymia (30 with no defined predominant polarity and 28 with manic predominant polarity) and 43 in mania (26 with no defined predominant polarity and 17 with manic predominant polarity). Patients underwent a clinical assessment and insight was evaluated through the Insight Scale for Affective Disorders. Bipolar disorder patients in mania had worse insight than those in euthymia, with no effect of dominant polarity. In addition, positive psychotic symptoms showed a significant effect on insight and its inclusion as a covariate eliminated differences related to mood state. Finally, the number of previous manic or depressive episodes did not correlate with insight level. Mania is a predictor of loss of insight into bipolar disorder. However, it is possible that its contribution is linked to the more frequent presence of psychotic symptoms in this state. Dominant polarity and number/type of previous affective episodes have a limited impact on insight.

  19. Sodium butyrate has an antimanic effect and protects the brain against oxidative stress in an animal model of mania induced by ouabain.

    Science.gov (United States)

    Valvassori, Samira S; Dal-Pont, Gustavo C; Steckert, Amanda V; Varela, Roger B; Lopes-Borges, Jéssica; Mariot, Edemilson; Resende, Wilson R; Arent, Camila O; Carvalho, André F; Quevedo, João

    2016-01-30

    Studies have consistently reported the participation of oxidative stress in bipolar disorder (BD). Evidence indicates that epigenetic regulations have been implicated in the pathophysiology of mood disorders. Considering these evidences, the present study aimed to investigate the effects of sodium butyrate (SB), a histone deacetylase (HDAC)inhibitor, on manic-like behavior and oxidative stress parameters (TBARS and protein carbonyl content and SOD and CAT activities) in frontal cortex and hippocampus of rats subjected to the animal model of mania induced by intracerebroventricular (ICV) ouabain administration.The results showed that SB reversed ouabain-induced hyperactivity, which represents a manic-like behavior in rats. In addition, the ouabain ICV administration induced oxidative damage to lipid and protein and alters antioxidant enzymes activity in all brain structures analyzed. The treatment with SB was able to reversesboth behavioral and oxidative stress parameters alteration induced by ouabain.In conclusion, we suggest that SB can be considered a potential new mood stabilizer by acts on manic-like behavior and regulatesthe antioxidant enzyme activities, protecting the brain against oxidative damage. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  20. Childhood IQ and risk of bipolar disorder in adulthood: prospective birth cohort study.

    Science.gov (United States)

    Smith, Daniel J; Anderson, Jana; Zammit, Stanley; Meyer, Thomas D; Pell, Jill P; Mackay, Daniel

    2015-06-01

    Intellectual ability may be an endophenotypic marker for bipolar disorder. Within a large birth cohort, we aimed to assess whether childhood IQ (including both verbal IQ (VIQ) and performance IQ (PIQ) subscales) was predictive of lifetime features of bipolar disorder assessed in young adulthood. We used data from the Avon Longitudinal Study of Parents and Children (ALSPAC), a large UK birth cohort, to test for an association between measures of childhood IQ at age 8 years and lifetime manic features assessed at age 22-23 years using the Hypomania Checklist-32 (HCL-32; n =1881 individuals). An ordinary least squares linear regression model was used, with normal childhood IQ (range 90-109) as the referent group. We adjusted analyses for confounding factors, including gender, ethnicity, handedness, maternal social class at recruitment, maternal age, maternal history of depression and maternal education. There was a positive association between IQ at age 8 years and lifetime manic features at age 22-23 years (Pearson's correlation coefficient 0.159 (95% CI 0.120-0.198), P >0.001). Individuals in the lowest decile of manic features had a mean full-scale IQ (FSIQ) which was almost 10 points lower than those in the highest decile of manic features: mean FSIQ 100.71 (95% CI 98.74-102.6) v . 110.14 (95% CI 107.79-112.50), P >0.001. The association between IQ and manic features was present for FSIQ, VIQ and for PIQ but was strongest for VIQ. A higher childhood IQ score, and high VIQ in particular, may represent a marker of risk for the later development of bipolar disorder. This finding has implications for understanding of how liability to bipolar disorder may have been selected through generations. It will also inform future genetic studies at the interface of intelligence, creativity and bipolar disorder and is relevant to the developmental trajectory of bipolar disorder. It may also improve approaches to earlier detection and treatment of bipolar disorder in adolescents

  1. Evaluating depressive symptoms in mania: a naturalistic study of patients with bipolar disorder

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    Young AH

    2015-04-01

    Full Text Available Allan H Young,1 Jonas Eberhard1,21Institute of Psychiatry, King’s College London, London, UK; 2Corporate Medical Affairs, H. Lundbeck A/S, Copenhagen, DenmarkObjective: This study aimed to evaluate patients with bipolar I disorder (BD-I who have mania with depressive symptoms and who meet the new “with mixed features” specifier of the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5.Method: This prospective, multinational, naturalistic study surveyed psychiatrists and their patients with BD-I from October 2013 to March 2014. Eligible patients had BD-I, had a (current manic episode, and had experienced onset of a manic episode within the previous 3 months. Psychiatrists provided patient information on depressive symptoms (DSM-5 criteria; symptoms of anxiety, irritability, and agitation; suicide attempts; and physician satisfaction with treatment response. Data were stratified according to whether patients met the criteria for the BD-I “with mixed features” specifier of DSM-5 (≥3 depressive symptoms or not, and characteristics were compared between the two subgroups. Patients also self-reported on depressive symptoms using the Mini-International Neuropsychiatric Interview module questionnaire.Results: Overall, 34% of 1,035 patients met the criteria for BD-I “with mixed features,” exhibiting ≥3 depressive symptoms during their current manic episode. This correlated with the matched patient self-reports of depressive symptoms. During their current manic episode, BD-I patients “with mixed features” had more severe symptoms of anxiety, irritability, and agitation (average composite severity score of 4.1 vs 3.4, a higher incidence of suicide attempts (38% vs 9%, and more physician dissatisfaction with treatment response (22% vs 14%, compared to patients with 0–2 depressive symptoms (all P<0.05.Conclusion: This study found that patients with BD-I “with mixed features” (ie, ≥3 depressive symptoms

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

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

    2016-01-06

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

  3. Development of an integrated model of personality, personality disorders and severe axis I disorders, with special reference to major affective disorders.

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    von Zerssen, Detlev

    2002-04-01

    A unidimensional model of the relationships between normal temperament, psychopathic variants of it and the two main forms of so-called endogenous psychoses (major affective disorders and schizophrenia) was derived from Kretschmer's constitutional typology. It was, however, not confirmed by means of a biometric approach nor was Kretschmer's broad concept of cyclothymia as a correlate of physical stoutness on the one hand and major affective disorders on the other supported by empirical data. Yet the concept of the 'melancholic type' of personality of patients with severe unipolar major depression (melancholia) which resembles descriptions by psychoanalysts could be corroborated. This was also true for the 'manic type' of personality as a (premorbid) correlate of predominantly manic forms of a bipolar I disorder. As predicted from a spectrum concept of major affective disorders, the ratio of traits of either type co-varied with the ratio of the depressive and the manic components in the long-term course of such a disorder. The two types of premorbid personality and a rare variant of the 'manic type', named 'relaxed, easy-going type', were conceived as 'affective types' dominating in major affective disorders. They are opposed to three 'neurotoid types' prevailing in so-called neurotic disorders as well as in schizophrenic psychoses. The similarity among the types can be visualized as spatial relationships in a circular, i.e. a two-dimensional, model (circumplex). Personality disorders as maladapted extreme variants of personality are, by definition, located outside the circle, mainly along its 'neurotoid' side. However, due to their transitional nature, axis I disorders cannot be represented adequately within the plane which represents (adapted as well as maladapted) forms of habitual behaviour (personality types and disorders, respectively). To integrate them into the spatial model of similarity interrelations, a dimension of actual psychopathology has to be added

  4. Pengembangan Perangkat Pembelajaran Matematika Sekolah Menengah Pertama dengan Sistem Character Based Integrated Learning

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    Dian Kurniati

    2013-12-01

    Full Text Available AbstrakFokus dari penelitian ini adalah mengembangkan suatu perangkat pembelajaran matematika SMP dengan menerapkan sistem Character Based Integrated Learning yang valid, praktis, dan efektif. Perangkat pembelajaran tersebut meliputi RPP, LKS, Buku Siswa dan Instru-men Penilaian. Pada sistem Character Based Integrated Learning, kegiatan belajar meng-ajar mengacu pada 9 pilar karakter anak. Prosedur pengembangan perangkat pembelajaran yang digunakan dalam penelitian ini adalah tahap pendefinisian (define, perancangan (de-sign, dan pengembangan (develop dengan mengacu pada kriteria kevalidan, kepraktisan dan keefektifan. RPP, LKS, dan Buku Siswa yang dihasilkan pada penelitian ini memenuhi kriteria kevalidan dengan skor validasi berturut-turut adalah 3.73, 4, dan 4 dengan skala 1-4. Selain itu, perangkat pembelajaran tersebut juga memenuhi kriteria kepraktisan karena  85% siswa dan guru menyatakan bahwa perangkat pembelajaran praktis digunakan ketika uji keterbacaan. Serta memenuhi kriteria keefektifan karena terdapat 90% siswa tuntas terhadap hasil belajar dan 80% siswa berkarakter baik. Kata Kunci: Pengembangan Perangkat Pembelajaran Matematika, Sistem Character Based Integrated Learning  AbstractThe focus of this research is to develop a set of mathematical learning SMP system by implementing Character -Based Integrated Learning valid, practical, and effective. The learning device includes lesson plans, worksheets, Student Book and Instrument. In Character Based Integrated Learning systems, learning activities refer to the 9 pillars of character kids. Learning software development procedures used in this study is the definition phase (define, design (design, and development (develop with reference to the criteria of validity, practicality and effectiveness. Lesson plans, worksheets, and books produced by students in this study meets the criteria for the validity of the validation scores are respectively 3.73, 4, and 4. In addition, the

  5. PENGEMBANGAN PERANGKAT PEMBELAJARAN MODEL PROBLEM BASED LEARNING UNTUK MENINGKATKAN KEMAMPUAN BERPIKIR KREATIF

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    Ali Muntaha

    2013-03-01

    Full Text Available Penelitian ini bertujuan untuk : (1 Mengetahui proses pengembangan perangkat pembelajaran dengan model PBL berbantuan CD Pembelajaran untuk meningkatkan kemampuan berpikir kreatif siswa, (2 Menghasilkan perangkat pembelajaran dengan model PBL berbantuan CD Pembelajaran yang valid, (3 Menghasilkan perangkat pembelajaran dengan model PBL berbantuan CD Pembelajaran yang efektif. Penelitian ini merupakan penelitian pengembangan. Pengembangan yang dilakukan dalam penelitian ini meliputi Silabus, Rencana Pelaksanaan Pembelajaran (RPP,  Buku Siswa, Lembar Kegiatan Siswa (LKS,    dan Tes Kemampuan Berpikir Kreatif Siswa. Data penelitian diperoleh melalui  observasi dan tes kemampuan kognitif. Analisis statistik menggunakan uji ketuntasan (KKM hasil belajar dengan uji One sample t test, uji beda menggunakan independen sample t test, uji normalitas dan uji peningkatan kemampuan menggunakan N-gain. Hasil penelitian menunjukkan: (1 Proses pengembangan perangkat pembelajaran dilakukan melalui empat tahapan yaitu define (pendefinisian /penetapan, design (perancangan, develop (pengembangan, dan disseminate (penyebaran, (2 Hasil pengembangan perangkat pembelajaran dalam penelitian ini valid, (3 Hasil pengembangan perangkat pembelajaran dalam penelitian ini efektif untuk meningkatkan kemampuan berpikir kreatif siswa. This study aims to: (1 Knowing the software development process model of PBL assisted learning with Learning CD to enhance students’ creative thinking skills, (2 Generate the model of learning with Learning CD-assisted PBL valid, (3 Generate the model of learning with PBL CD-assisted learning effective. This research is a research development. Development conducted in this study include syllabus, lesson plan (RPP, Student Book, Student Activity Sheet (LKS, and Student Creative Thinking Ability Test. Data were obtained through observation and tests of cognitive ability. Statistical analysis using the mastery test (KKM learning outcomes to test

  6. PENGEMBANGAN MODEL PEMBELAJARAN BERBASIS MASALAH BERMAIN PERAN UNTUK PENINGKATKAN RASA CINTA TANAH AIR SISWA KELAS V PADA MATERI PROKLAMASI KEMERDEKAAN

    Directory of Open Access Journals (Sweden)

    Rosnawati -

    2015-06-01

    Full Text Available Penelitian berfokus pada pengembangan model pembelajaran berbasis masalah-bermain peran untuk meningkatkan rasa cinta tanah air siswa. Tujuan  penelitian ini untuk mendapatkan model pembelajaran yang valid, efektif dan praktis. Metode penelitian ini adalah penelitian pengembangan. Sistem pendukung model pembelajaran yang dikembangkan antara lain silabus pembelajaran, Rencana Pelaksanaan Pembelajaran (RPP, Bahan Ajar dilengkapi dengan Lembar Kerja Siswa (LKS, serta instrumen pembelajaran yang terdiri dari Lembar observasi, lembar angket pengukuran rasa cinta tanah air, dan lembar soal. Penelitian dilakukan pada siswa kelas V SDN Muktiharjo Lor Genuk kota Semarang. Model pembelajaran yang dikembangkan tergolong valid. Respon positif siswa terhadap pembelajaran 80% dan guru memberi komentar yang baik, sehingga model pembelajaran yang dikembangkan praktis digunakan. Rasa cinta tanah air siswa pada kelas eksperimen berada pada kategori sangat tinggi, sedangkan pada kelas pembanding hanya mencapai kategori tinggi. Hasil belajar meningkat dengan kualitas peningkatan tinggi pada kelas eksperimen sedangkan pada kelas pembanding meningkat dengan kualitas peningkatan pada kategori sedang. The research focuses on the development of problembased learning-role playing model to enhance the students' patriotism. The purpose of this study was to obtain a valid learning model, effective and practical. The method is research and development. Support system of learning model developed include syllabus (planning for learning, Learning Implementation Plan (RPP, equipped with Instructional Materials Student Worksheet (LKS, as well as learning an instrument consisting of a sheet of observation, measurement questionnaire sheet of the students' patriotism, and the booklet. The study was conducted in fifth grade in SDN Muktiharjo Lor Genuk Semarang. Learning model developed relatively valid. The positive response of 80% of students towards learning and teachers gave

  7. Pengembangan Lembar Kerja Anak Dengan Menggunakan Pendekatan Konstruktivistik Untuk Meningkatkan Kemampuan Sains Anak Usia Dini

    Directory of Open Access Journals (Sweden)

    Hardiyanti Pratiwi

    2017-01-01

    Full Text Available Penelitian ini bertujuan untuk mendeskripsikan pengembangan perangkat CTL di kelas IV sekolah dasar, mendeskripsikan hasil validasi dan hasil belajar dari implementasi perangkat pembelajaran dengan menggunakan model pengembangan 4-D yang direduksi menjadi 3-D, yaitu define, design, dan develop. Perangkat pembelajaran yang dikembangkan meliput rencana pelaksanaan pembelajaran (RPP, lembar kerja siswa (LKS, dan tes hasil belajar (THB yang diujicobakan pada kelas IV B sebagai eksperimen terdiri atas 30 siswa, dan kelas IV A sebagai kelas control terdiri atas 30 siswa di SD GMIT Ende. Uji coba perangkat pada penelitian ini menggunakan pre-tes dan post tes dengan teknik analisis statistik. Instrument penelitian terdiri atas lembar pengamatan keterlaksanaan pembelajaran, lembar aktifitas siswa, lembar angket respon siswa, dan lembar tes hasil belajar siswa serta lembar kendala-kendala. Pengumpulan data dilakukan dengan teknik observasi, tes, dan angket. Analisis hasil penelitian diperoleh fakta bahwa penggunaan perangkat pembelajaran dengan pendekatan CTL dapat meningkatkan hasil belajar siswa 43,33% (pada pre-tes sementara pada post tes menjadi 100%. Hasil belajar siswa tergolong sangat baik dengan rata-rata jawaban benar 87,66 untuk tes hasil belajar. Kata kunci: Perangkat Pembelajaran, Stretegi CTL, Hasil belajar   This study aims to describe the development of CTL in the fourth grade of primary school, describe the results of the validation and implementation of the learning material through 4-D model of development which is reduced to 3-D, namely define, design, and develop. The materials covers the lesson plan (RPP, students’ worksheet (LKS, and the test results (THB taken from the fourth grade (Class IV B as the experiment consisted of 30 students, and class IV A as the control class consists of 30 students in  SD GMIT Ende. Testing device in this study uses pre-test and post-test with statistical analysis techniques. Moreover, research

  8. KEMAMPUAN PEMECAHAN MASALAH MATEMATIKA PADA PEMBELAJARAN TERPADU MODEL INTEGRATED BERMUATAN PENDIDIKAN KARAKTER

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    E. D. Hastuti

    2014-02-01

    Full Text Available AbstrakTujuan penelitian ini untuk mendapatkan perangkat pembelajaran terpadu modelintegrated bermuatan pendidikan karakter untuk meningkatkan kemampuanpemecahan masalah siswa yang valid, praktis, dan efektif. Pengembangan perangkatpembelajaran pada penelitian ini menggunakan modofikasi model Thiagarajan.Data TKPM diolah menggunakan t test, uji proporsi z, regresi sederhana, danuji Gain. Pengembangan perangkat menghasilkan: (1 Perangkat valid diperolehskor rata-rata silabus 3,80; RPP 3,87; buku siswa 3,64; LKS 3,58; dan TKPM 3,39dan keseluruhannya dalam kategori “valid”. (2 Perangkat praktis yang dilihatdari pengamatan pengelolaan pembelajaran 3,83 (baik, dan respon siswa 86,21%(sangat positif, (3 pembelajaran efektif  (a TKPM 76,94 melampaui KKM 70dan mencapai ketuntasan klasikal lebih dari 80%, (b Rata-rata hasil TKPMmodel integrated lebih dari rata-rata hasil TKPM dengan metode konvensional, (cAktivitas peserta didik berpengaruh positif  terhadap TKPM sebesar 89,8%, dan (dAda peningkatan yang cukup signifikan pretest 42,18 dan posttest 76,94.AbstractThe purpose of  this study to obtain the integrated learning model of  integrated chargedcharacter education to enhance students’ problem solving abilities are valid, practical, andeffective. The development of  learning tools in this study using a modification of  the modelThiagarajan. TKPM data processed using t-test, z test of  proportion, simple regression, andtest Gain. Software development produces: (1 a valid device obtained an average score of  3.80syllabus; RPP 3.87; BSS 3.64; LKS 3.58, and 3.39 and its overall TKPM in the categoryof  “valid”. (2 practical tools in the observation of  the learning management 3.83 (good,and 86.21% student response (very positive, (3 effective learning (a 76.94 TKPM exceed70 KKM and achieve mastery over classical of  80%, (b Average results TKPM integratedmodel more than the average TKPM results with conventional methods, (c Activities

  9. PENGELOLAAN LAYANAN PEMBELAJARAN ANAK JALANAN DI LEMBAGA PPAP SEROJA SURAKARTA

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    Nur Aprilia Rochimah

    2016-08-01

    Full Text Available The purpose of research to describe the learning plan of street children in Seroja PPAP Institute Surakarta, describe the lesson in Surakarta Seroja PPAP Institute, describes the evaluation and follow-up study of Street Children in Institutions PPAP Lotus Surakarta. This study uses descriptive qualitative case study research design. The data used primary and secondary data. Data source informant, events or activities with resource informant. Data collection techniques with interview, observation, and document analysis. The validity of the data with data triangulation technique, triangulation methods and reviews informant. Analysis of data using data analysis interactive model of data collection, data reduction, data display and conclusion. Based on these results it can be concluded that the Planning Institute of Education for Street Children in Surakarta using Seroja PPAP Curriculum SBC 2006, do not use the syllabus and do not write lesson plans. The lesson begins with a prayer. Learning methods used mentoring, modeling, lectures, private and project base learning. Media and learning resources are used in the form of books diktat, LKS and white boards. Activities cover, ended by giving homework. Attitudes and skills assessment carried out by observation. Evaluation of learning has not been successful because the value has not reached the standard KKM. Follow-up for the provision of remedial, then to the attitude with mentoring and counseling.

  10. Pengawasan Islam dalam Operasional Lembaga Keuangan Syariah

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    Neneng Nurhasanah

    2013-06-01

    Full Text Available State has a role and responsibility in managing and monitoring the implementation principles of Shariah in society. In addition, each individual is required to participate in society as well as overseeing the form of “da’wa fil haq wa shabr” and “amr ma’ruf nahi munkar” with based on the general principles of Islamic law, namely: the principle of tawhid, ‘adalah (justice, amr ma’ruf nahi munkar, al-huriyyah wa al-mas’uliyyah (responsible freedom, al-musawah (equality, al-Ta’awun (the principle of mutual help and tasa’muh (tolerance Shariah Supervisory Board (DPS which is charged with overseeing the financial institutions practice of Shari’ah (LKS to conform with the principles of Shari’ah, its implementation has not been optimized to prevent the occurrence of irregularities, so requires strengthening the regulatory aspects of the worksheet other than banks and aspects of quality of human resources in the banking Shariah Supervisory Board.

  11. "We do as well as we can". The experiences of staff assisting disabled people in community residential homes "Við gerum bara eins og við getum" - Þjónusta við fólk með fjölþættar skerðingar

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    Guðný Jónsdóttir

    2013-06-01

    Full Text Available Staff supporting young people and adults with complex and severe neurological impairments are the key to their communication, quality of life and participation. This study reports the knowledge and experiences of staff members supporting disabled people living in community residential homes, as well as their perceived needs for information and support. Furthermore, the study aimed to reveal staff´s views on their possibilities to support service users´ wellbeing, participation and quality of life. Participants were twelve experienced staff members. Qualitative methods were used and data were collected through semi-structured interviews. The results of the study reveal that services provided in community residential homes for people with complex and severe impairments are not in line with human rights treaties, including the right to health. Further, it does not mirror the social approach to disability which today is the focus of policy frameworks. The staff were positive toward service users, tried to do their best but lacked resources. Their knowledge of service user´s health-related needs was scarce and little was done to prevent further impairments or increasing health problems. Staff reported lack of human resources, high staff turnover and lack of information, training and support. Recent governmental changes, provide possibilities for revised emphasis in the service provided, on cooperation between different sectors as well as for the development of transdisciplinary services.Aðstoðarfólk á heimilum fólks með fjölþættar skerðingar er mikilvægur hlekkur í lífi þess og lykill að samskiptum, lífsgæðum og þátttöku. Rannsóknin varpar ljósi á sýn þessa starfsfólks á megináherslur í þjónustu við fólk með flóknar stuðningsþarfir og þörf fyrir fræðslu og stuðning í starfi. Ennfremur var leitað eftir skilningi á heilsutengdum þörfum þjónustunotenda og möguleikum til að styðja við velferð

  12. PERANGKAT PEMBELAJARAN PROBLEM BASED LEARNING BERORIENTASI GREEN CHEMISTRY MATERI HIDROLISIS GARAM UNTUK MENGEMBANGKAN SOFT SKILL KONSERVASI SISWA

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    A. Rosita

    2014-10-01

    Full Text Available Penelitian ini bertujuan untuk mengembangkan perangkat pembelajaran problem based learning berorientasi green chemistry pada materi hidrolisis garam untuk mengembangkan soft skill konservasi siswa SMA. Metode penelitian ini adalah research and development (R&D. Hasil penelitian menunjukkan LKS yang dikembangkan sangat layak untuk digunakan dalam pembelajaran kimia. Perangkat pembelajaran dapat meningkatkan pemahaman konsep siswa materi hidrolisis garam dengan N-gain sebesar 0,63 (sedang. Peningkatan soft skill konservasi siswa yang berkriteria tinggi sebanyak 35,48 % sedangkan yang berkriteria sedang 64,52 %. This research has aim to developt teaching and learning instrument application on problem based learning which oriented on green chemistry on salt hydrolisys for developing conservation soft skill for student. The method of this research is research and development (R&D. The results showed a very worthy worksheets developed for use in teaching chemistry. Teaching instrument can improve the understanding of student concept of salt hydrolysis matery can get N-gain 0,63 (medium. The improving soft skill of student conservation has high criteria 35,48%. For medium has 64,52%.

  13. Depletion of STAT5 blocks TEL–SYK-induced APMF-type leukemia with myelofibrosis and myelodysplasia in mice

    International Nuclear Information System (INIS)

    Sprissler, C; Belenki, D; Maurer, H; Aumann, K; Pfeifer, D; Klein, C; Müller, T A; Kissel, S; Hülsdünker, J; Alexandrovski, J; Brummer, T; Jumaa, H; Duyster, J; Dierks, C

    2014-01-01

    The spleen tyrosine kinase (SYK) was identified as an oncogenic driver in a broad spectrum of hematologic malignancies. The in vivo comparison of three SYK containing oncogenes, SYK wt , TEL–SYK and IL-2-inducible T-cell kinase (ITK)-SYK revealed a general myeloexpansion and the establishment of three different hematologic (pre)diseases. SYK wt enhanced the myeloid and T-cell compartment, without leukemia/lymphoma development. ITK–SYK caused lethal T-cell lymphomas and the cytoplasmic TEL–SYK fusion induced an acute panmyelosis with myelofibrosis-type acute myeloid leukemia (AML) with up to 50% immature megakaryoblasts infiltrating bone marrow, spleen and liver, additional MPN features (myelofibrosis and granulocyte expansion) and MDS stigmata with megakaryocytic and erythroid dysplasia. LKS cells were reduced and all subsets (LT/ST/MPP) showed reduced proliferation rates. SYK inhibitor treatment (R788) of diseased TEL–SYK mice reduced leukocytosis, spleen and liver infiltration, enhanced the hematocrit and prolonged survival time, but could not significantly reduce myelofibrosis. Stat5 was identified as a major downstream mediator of TEL–SYK in vitro as well as in vivo. Consequently, targeted deletion of Stat5 in vivo completely abrogated TEL–SYK-induced AML and myelofibrosis development, proving Stat5 as a major driver of SYK-induced transformation. Our experiments highlight the important role of SYK in AML and myelofibrosis and prove SYK and STAT5 inhibitors as potent treatment options for those diseases

  14. SOLUSI PROBLEM PENGHAPUSAN BUNGA DENGAN PENDEKATAN PRODUK BAI‘ BITSAMAN ĀJIL DALAM UPAYA MEWUJUDKAN LEMBAGA KEUANGAN LĀ-RIBA (Studi Kasus di BMT Damar dan BMT-KJKS IAIN Walisongo Semarang

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    Siti Mujibatun

    2016-05-01

    Full Text Available Mudhārabah practices as an icon rather than LKS (Sharia Financial Institution is still raise unresolved polemic associated with akunting system and balance, especially in the domain of financing, so that the stigma of people who think that the operating system is the same as the system of financial calculating interest only the different’s name has been continues. When examined in detail, there are other products that legitimized the contract either by the arguments Syara agreed by the majority of scholars and schools of jurisprudence, namely the contract of Ba‘i Bitsaman Ājil (BBA or purchase by way of pay gradually. This article concludes; First, offers a BBA in finance BMT Damar and BMT-KJKS IAIN Walisongo experiencing significant growth, in addition to a simple transaction models are not complex, almost the akunting system likes fixed rate (fixed rate so that customers become more familiar because the system is not much different from the credit money. Second, BBA financing acounting system can be separated from other products offered by BMT and not to be come one system with murābahah financing. Third, although the BBA acounting system similar to the system of interest and somewhat complicated because managers have the purchase to be come representer for wakālah contract to goods of customers, but offers and akunting BBA financing is more flexible and is not affected by rising interest rates as the often occurs in LKK Conventional Financial Institutional

  15. Development of Thermal Radiation Experiments Kit Based on Data Logger for Physics Learning Media

    Science.gov (United States)

    Permana, H.; Iswanto, B. H.

    2018-04-01

    Thermal Radiation Experiments Kit (TREK) based on data logger for physics learning media was developed. TREK will be used as a learning medium on the subject of Temperature and Heat to explain the concept of emissivity of a material in grade XI so that it can add variations of experiments which are commonly done such as thermal expansion, transfer of thermal energy (conduction, convection, and radiation), and specific heat capacity. DHT11 sensor is used to measure temperature and microcontroller Arduino-uno used as data logger. The object tested are in the form of coated glass thin films and aluminum with different colors. TREK comes with a user manual and student worksheet (LKS) to make it easier for teachers and students to use. TREK was developed using the ADDIE Development Model (Analyze, Design, Development, Implementation, and Evaluation). And validated by experts, physics teachers, and students. Validation instrument is a questionnaire with a five-item Likert response scale with reviewed aspect coverage: appropriate content and concepts, design, and user friendly. The results showed that TREK was excellent (experts 88.13%, science teachers 95.68%, and students 85.77%).

  16. MODEL PEMBELAJARAN ASAM BASA BERBASIS SCS (SCIENCE PROCESS SKILLS MELALUI KEGIATAN LABORATORIUM SEBAGAI WAHANA PENDIDIKAN SAINS SISWA MTS

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    malikhatul hidayah

    2016-03-01

    Full Text Available Tujuan  penelitian  ini  adalah  untuk    memperkenal- kan dan mengetahui efektivitas Model Pembelajaran SCS ( Science Process Skills melalui kegiatan Laboratorium Sebagai Wahana Pendidikan Sains yang cocok bagi siswa MTs agar meningkatkan: penguasaan konsep kimia, ke- mampuan berpikir kreatif, dan keterampilan  sains siswa. Metode yang digunakan adalah metode penelitian kelas, dan difokuskan pada pokok bahasan asam basa. Penelitian ini dilakukan di salah satu MTs Negeri di kota Semarang dengan subyek sebanyak 40 siswa kelas III. Instrumen yang digunakan dalam penelitian ini meliputi model pembelaja- ran, soal-soal tes, pedoman wawancara, pedoman obser- vasi dan angket, sedang LKS digunakan pada saat kegiatan laboratorium. Dalam model pembelajaran dikembangkan empat jenis konsep yaitu konsep kongkret, konsep yang menyatakan sifat, konsep yang melibatkan penggambaran simbol, dan konsep berdasarkan prinsip. Model pembela- jaran ini dapat meningkatkan pemahaman konsep pada setiap kelompok kemampuan siswa, mengembangkan ke- mampuan berpikir kreatif dengan hasil tertinggi pada as- pek membangun konsep di atas pengetahuan yang telah ada pada diri siswa dan terendah pada aspek memilih hal- hal yang mungkin tidak relevan, serta keterampilan sains mengatasi kurangnya waktu pembelajaran, bagian-bagian pembelajaran tertentu dapat dilaksanakan di luar jam ke- las.

  17. PENGEMBANGAN PERANGKAT PEMBELAJARAN IPA TERPADU BERKARAKTER MENGGUNAKAN PENDEKATAN HUMANISTIK BERBANTU ALAT PERAGA MURAH

    Directory of Open Access Journals (Sweden)

    A. Widiyatmoko

    2013-04-01

    Full Text Available Tujuan dari penelitian adalah menghasilkan perangkat pembelajaran IPA terpadu yang dapat memfasilitasi siswa untuk mengembangkan kemampuan yang dimiliki secara menyeluruh sehingga memiliki daya saing yang unggul, mampu mengikuti perkembangan IPTEK, dan memiliki karakter yang bersumber pada nilai-nilai pancasila. Dari hasil penelitian dan pembahasan maka dapat disimpulkan bahwa pengembangan perangkat pembelajaran IPA terpadu berkarakter menggunakan pendekatan humanistik berbantu alat peraga murah di sekolah menengah berupa silabus, RPP, alat peraga, LKS, dan modul yang dihasilkan melalui alur Four-D model, yaitu definition (pendefinisian, design (perancangan, development (pengembangan dan disseminate (penyebaran yang telah melalui tahap validasi dan revisi. The purpose of the research is to produce an integrated science learning tools that can facilitate learners to develop the capabilities of the whole so that it has a superior competitive, able to follow the development of science and technology, and has a character which is based on the values of Pancasila. From the results of research and discussion, it can be concluded that the development of the integrated science learning character humanistic approach berbantu cheap props in the form of school syllabi, lesson plans, visual aids, worksheets, and the modules produced by Four-D flow model, the definition (defining, design (design, development (development and disseminate (spread that have gone through the validation and revision.

  18. MATH INSTRUCTIONAL MEDIA DESIGN USING COMPUTER FOR COMPLETION OF TWO-VARIABLES LINEAR EQUATION SYSTEM BY ELIMINATION METHOD

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    Nurbaiti

    2017-03-01

    Full Text Available Science and technology have been rapidly evolved in some fields of knowledge, including mathematics. Such development can contribute to improvements on the learning process that encourage students and teachers to enhance their abilities and performances. In delivering the material on the linear equation system with two variables (SPLDV, the conventional teaching method where teachers become the center of the learning process is still well-practiced. This method would cause the students get bored and have difficulties to understand the concepts they are learning. Therefore, in order to the learning of SPLDV easy, an interesting, interactive media that the students and teachers can apply is necessary. This media is designed using GUI MATLAB and named as students’ electronic worksheets (e-LKS. This program is intended to help students in finding and understanding the SPLDV concepts more easily. This program is also expected to improve students’ motivation and creativity in learning the material. Based on the test using the System Usability Scale (SUS, the design of interactive mathematics learning media of the linear equation system with Two Variables (SPLDV gets grade B (excellent, meaning that this learning media is proper to be used for Junior High School students of grade VIII.

  19. PENERAPAN MODEL PEMBELAJARAN BAKULIKAN UNTUK MENINGKATKAN KEMAMPUAN BERSIKAP ILMIAH PADA KONSEP PEMANTULAN CAHAYA KELAS VIII

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    N. A. Shofiah

    2012-01-01

    Full Text Available Penelitian tindakan kelas yang bertujuan untuk meningkatkan kemampuan bersikap ilmiah, telah dilakukan di kelas VIII semester IIpada sub pokok bahasan pemantulan cahaya. Untuk meningkatkan kemampuan bersikap ilmiah diterapkan model pembelajaranbakulikan. Penelitian tindakan kelas ini terdiri dari tiga sikus, dengan masing-masing siklus terdiri dari empat tahapan yaituperencanaan, pelaksanaan, observasi dan refleksi. Data sikap ilmiah siswa diambil dari lembar angket dan lembar observasi. Datahasil belajar kognitif diambil dari evaluasi yang ada di LKS tiap akhir siklus dan data hasil belajar psikomotorik diambil dari lembarobservasi tiap akhir siklus. Hasil penelitian menyatakan bahwa sikap ilmiah siswa mengalami peningkatan walaupun tidaksignifikan. Hasil belajar kognitif dan keterampilan psikomotorik siswa mengalami peningkatan tiap siklus dan mencapai ketuntasanpada siklus III. A classroom action research aimed to improve scientific attitude skill had been done in second semester of grade VIII MTs on thesubtopic light reflection. The 'bakulikan' learning model was chosen for improving the scientific attitude skills of the students. Thisaction research consisted of three cycles, and each cycle has four stages, namely, planning, conducting, observation andreflection. The data obtained through questionnaire and observation sheets. The cognitive achievement drawn from the evaluationon each worksheet at the end of each cycle, and the psychometrics recorded from observation sheet. The study concludes that thescientific attitude skill improved significantly. The achievement on cognitive and psychometrics increase gradually on each cycleand get mastery at the end of the last cycle.Keywords: bakulikan; classroom action research; scientific attitude

  20. An Instructional Media using Comics on the Systems of Linear Equation

    Science.gov (United States)

    Widyastuti, P. D.; Mardiyana, M.; Saputro, D. R. S.

    2017-09-01

    Comic is one of the frequently used media in our daily life. This media has been familiar for the community. Comic is mostly used as entertainment facilities. Along with the current development, comics are not only functioned as a means of entertainment, but also used in the field of education. There were some problems in a classroom which encouraged the researchers to use comics as a solution for those problems. This article aims at discussing on comics as an instructional media which is appropriate for students. This research uses research and development (R and D) method. The results obtained from this study are based on the students’ responses of the questionnaires and validation to help them understanding the system of linear equations material. Results show that comics can be used to replace LKS (student worksheet). Feedbacks from students and validators also show that comic is an attractive medium. It is said so since comics link the concrete into abstract things so that it is easily understood by the students.

  1. Pengembangan lembar kerja siswa berbasis kontekstual berorientasi penalaran saintifik

    Directory of Open Access Journals (Sweden)

    Yulia Florenty Lamapaha

    2017-06-01

    Abstrack This research aims to develop a contextual-based student worksheet empowerment oriented student scientific reasoning. The study was conducted using the method of model development research. Learning tools developed in this study are the syllabus, lesson plans; worksheets based contextual, attitude assessment instruments and scientific reasoning of students. The device was developed in the context of learning materials rocky shore ecosystems. The results found that the contextual-based Student worksheet is considered good in all indicators of assessment conducted by the validator (learning media expert, expert learning materials, biology teachers and peers. Student worksheet ecosystem-based contextual material rocky shore ecosystems that meet the criteria on the basis of its constituent components increased the students' scientific reasoning for using contextual syntax right, looks at the value of students who have increased in terms of the scores of pre-test and post-test before and after use student worksheet developed contextually based, and there are significant differences in the data post-test results of students in the experimental class and the control class. Kata Kunci: LKS, CTL, Scientific Reasoning

  2. PENGEMBANGAN LEMBAR KEGIATAN SISWA MATERI LUAS BANGUN DATAR BERBASIS METODE PEMBELAJARAN DISCOVERY UNTUK SISWA SEKOLAH MENENGAH PERTAMA

    Directory of Open Access Journals (Sweden)

    Rohman Rohman

    2015-12-01

    Full Text Available This research aims to develop the student activity sheet material broad flat wake discovery based learning methods for secondary school students are valid and practical and how the potential effect of the use of student activity sheet based discovery learning method for junior high school students. The method used is a method of research and development (development research. Stages of development research done of the preliminary phase which includes the analysis and prototyping stage (designing and evalution formative stages which include self evalution, expert reviews, one to one, small group, and a field test. Based on the results of the analysis of the product, obtained LKS discovery based learning methods are valid and praktis.Valid seen from the results of expert assessment is based on content, construct, and languages. Practical seen from the observations of the trial small group where students can complete a given student activity sheet. Based on the results and final grades on students' ability test VII.1 SMP Negeri 3 Palembang done individually than 35 students that there were 15 (42.85% of students categorized as very good and 20 (57.14% students including both categories. Overall average grade student ability VII.1 is 78.85 which means that the learning outcomes of students belonging to either category. Based on the analysis of student learning outcomes, it can be concluded that student activity sheets that have been developed have potent

  3. Clinical outcomes associated with comorbid posttraumatic stress disorder among patients with bipolar disorder.

    Science.gov (United States)

    Passos, Ives C; Jansen, Karen; Cardoso, Taiane de A; Colpo, Gabriela D; Zeni, Cristian P; Quevedo, Joao; Kauer-Sant'Anna, Márcia; Zunta-Soares, Giovanna; Soares, Jair C; Kapczinski, Flavio

    2016-05-01

    To assess clinical outcomes associated with the presence of a lifetime history of comorbid posttraumatic stress disorder in subjects with bipolar disorder. This cross-sectional study of 284 subjects with bipolar disorder (DSM-IV) assessed the association between lifetime comorbid posttraumatic stress disorder (DSM-IV) and clinical characteristics. Participants were included from January 2006 to June 2009. We assessed age at onset, number of mood episodes, presence of rapid cycling, first drug use, suicide attempts, hospitalizations, functional impairment, and quality of life. Diagnostic, clinical, and functional assessments were carried out using the Structured Clinical Interview for DSM-IV Axis I Disorders, patient edition (SCID-I/P), the Functioning Assessment Short Test, and the World Health Organization Quality of Life scale. The number of manic episodes as assessed by SCID-I/P was the primary outcome. The prevalence of lifetime comorbid posttraumatic stress disorder was 19.7% (56 subjects). Subjects with bipolar disorder and posttraumatic stress disorder had an accelerated course of illness, with a lower age at onset of manic/hypomanic episodes (P = .009) and earlier initiation of illicit drug use (P = .008). In addition, they were more likely to be younger when they received the diagnosis of bipolar disorder (P = .036) and had a higher number of manic/hypomanic episodes (P = .01). Quality of life was worse in all domains among subjects who presented the comorbidity, and rates of functional impairment were higher. Comorbid posttraumatic stress disorder was associated with increased morbidity and accelerated illness progression among subjects with bipolar disorder. © Copyright 2016 Physicians Postgraduate Press, Inc.

  4. Alterations of the cerebellum and basal ganglia in bipolar disorder mood states detected by quantitative T1ρ mapping.

    Science.gov (United States)

    Johnson, Casey P; Christensen, Gary E; Fiedorowicz, Jess G; Mani, Merry; Shaffer, Joseph J; Magnotta, Vincent A; Wemmie, John A

    2018-01-07

    Quantitative mapping of T1 relaxation in the rotating frame (T1ρ) is a magnetic resonance imaging technique sensitive to pH and other cellular and microstructural factors, and is a potentially valuable tool for identifying brain alterations in bipolar disorder. Recently, this technique identified differences in the cerebellum and cerebral white matter of euthymic patients vs healthy controls that were consistent with reduced pH in these regions, suggesting an underlying metabolic abnormality. The current study built upon this prior work to investigate brain T1ρ differences across euthymic, depressed, and manic mood states of bipolar disorder. Forty participants with bipolar I disorder and 29 healthy control participants matched for age and gender were enrolled. Participants with bipolar disorder were imaged in one or more mood states, yielding 27, 12, and 13 imaging sessions in euthymic, depressed, and manic mood states, respectively. Three-dimensional, whole-brain anatomical images and T1ρ maps were acquired for all participants, enabling voxel-wise evaluation of T1ρ differences between bipolar mood state and healthy control groups. All three mood state groups had increased T1ρ relaxation times in the cerebellum compared to the healthy control group. Additionally, the depressed and manic groups had reduced T1ρ relaxation times in and around the basal ganglia compared to the control and euthymic groups. The study implicated the cerebellum and basal ganglia in the pathophysiology of bipolar disorder and its mood states, the roles of which are relatively unexplored. These findings motivate further investigation of the underlying cause of the abnormalities, and the potential role of altered metabolic activity in these regions. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  5. Does recent mania affect response to antidepressants in bipolar disorder? A re-analysis of STEP-BD data.

    Science.gov (United States)

    Mousavi, Zahra; Johnson, Sheri; Li, Descartes

    2018-08-15

    One previous study suggested that the presence of a manic episode before bipolar depression is related to worse response to antidepressants. To examine this effect in a larger sample, we used data from the large, multi-site STEP-BD study. We hypothesized that among persons treated with antidepressants for bipolar depression, manic or mixed episodes before depression onset (as compared to euthymia) would predict lower rate of recovery, more sustained depressive symptoms and higher rate of switching into mania/hypomania after antidepressant treatment of bipolar depression. 320 participants were available for analyses (140 male) diagnosed with bipolar I, bipolar II, cyclothymia, bipolar disorder not otherwise specified, or schizoaffective disorder bipolar subtype. Patients were randomly assigned to 3 treatment randomization strata (placebo, bupropion, and paroxetine) as adjuncts to mood stabilizers. Analyses were conducted to examine the effect of episode status before the depressive episode on the degree of change in depressive symptoms at 3 and 6 months, the likelihood of depression recovery and the likelihood of anti-depressant induced switching. Presence of a manic episode before depression in patients with bipolar disorder did not significantly predict response to antidepressants. The study was limited by a high rate of attrition, and consideration of only two antidepressant medications. Our findings are in agreement with other past studies suggesting that mania and depression may operate separately for those with bipolar disorder, with differential predictors of the onset and offset of mania versus depression. Future directions may consider vulnerability for these episodes separately. Copyright © 2018 Elsevier B.V. All rights reserved.

  6. The World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for the Biological Treatment of Bipolar Disorders: Acute and long-term treatment of mixed states in bipolar disorder.

    Science.gov (United States)

    Grunze, Heinz; Vieta, Eduard; Goodwin, Guy M; Bowden, Charles; Licht, Rasmus W; Azorin, Jean-Michel; Yatham, Lakshmi; Mosolov, Sergey; Möller, Hans-Jürgen; Kasper, Siegfried

    2018-02-01

    Although clinically highly relevant, the recognition and treatment of bipolar mixed states has played only an underpart in recent guidelines. This WFSBP guideline has been developed to supply a systematic overview of all scientific evidence pertaining to the acute and long-term treatment of bipolar mixed states in adults. Material used for these guidelines is based on a systematic literature search using various data bases. Their scientific rigour was categorised into six levels of evidence (A-F), and different grades of recommendation to ensure practicability were assigned. We examined data pertaining to the acute treatment of manic and depressive symptoms in bipolar mixed patients, as well as data pertaining to the prevention of mixed recurrences after an index episode of any type, or recurrence of any type after a mixed index episode. Manic symptoms in bipolar mixed states appeared responsive to treatment with several atypical antipsychotics, the best evidence resting with olanzapine. For depressive symptoms, addition of ziprasidone to treatment as usual may be beneficial; however, the evidence base is much more limited than for the treatment of manic symptoms. Besides olanzapine and quetiapine, valproate and lithium should also be considered for recurrence prevention. The concept of mixed states changed over time, and recently became much more comprehensive with the release of DSM-5. As a consequence, studies in bipolar mixed patients targeted slightly different bipolar subpopulations. In addition, trial designs in acute and maintenance treatment also advanced in recent years in response to regulatory demands. Current treatment recommendations are still based on limited evidence, and there is a clear demand for confirmative studies adopting the DSM-5 specifier with mixed features concept.

  7. Influence of valproate on the required dose of propofol for anesthesia during electroconvulsive therapy of bipolar affective disorder patients

    Directory of Open Access Journals (Sweden)

    Hızlı Sayar G

    2014-03-01

    Full Text Available Gökben Hizli Sayar, Gül Eryilmaz, Siban Şemieoğlu, Eylem Özten, Işil Göğcegöz Gül Uskudar University, Neuropsychiatry Istanbul Hospital, Istanbul, Turkey Background: Propofol is often used as an anesthetic agent for electroconvulsive therapy (ECT. In recent studies, propofol was shown to possess significant seizure-shortening properties during ECT. "Valproate" is a mood stabilizer used mainly in the treatment of bipolar affective disorder. It is reported that valproate, being an anticonvulsant, raises the seizure threshold, thus decreases the efficacy of ECT treatment. Aim: The purpose of our study was to compare the dose of propofol in valproate-using patients and valproate-free patients. Methods: In an open design, 17 patients with bipolar affective disorder manic episodes who were to be treated with valproate and ECT in combination, were compared with 16 manic-episode patients who were to be treated with ECT but not valproate. The two groups were compared on the basis of electroencephalography-registered seizure duration and the propofol dosage required to induce anesthesia. Results: Valproate, compared with no valproate treatment, results in a decrease in the propofol dose required to induce anesthesia. In the valproate group of study participants, seizure duration was significantly shorter than in the valproate-free group. Conclusion: The results suggest that valproate reduces the dose of propofol required for anesthesia during ECT treatment in patients with bipolar affective disorder manic episodes. Although propofol is a safe and efficacious anesthetic for ECT treatment, lower doses of propofol should be used to induce anesthesia for patients under valproate treatment. When the clinician needs to prolong seizure duration in patients treated with valproate, interruption of the valproate treatment or an anesthetic agent other than propofol should be considered. Keywords: bipolar affective disorder, ECT, anticonvulsant, mood

  8. A comparison of the neutrophil-lymphocyte, platelet-lymphocyte and monocyte-lymphocyte ratios in schizophrenia and bipolar disorder patients - a retrospective file review.

    Science.gov (United States)

    Özdin, Selçuk; Sarisoy, Gökhan; Böke, Ömer

    2017-10-01

    Neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR) and monocyte-lymphocyte ratio (MLR) have recently been used as indicators of inflammation. Higher MLR and PLR values have been determined in the euthymic and manic periods in patients with bipolar disorder compared to a control group. High NLR values were determined in the only study investigating this ratio in schizophrenia patients. The purpose of this study was to compare NLR, PLR and MLR values and complete blood count elements in patients receiving treatment and hospitalized due to schizophrenic psychotic episode and bipolar disorder manic episode. All patients meeting the inclusion criteria among subjects receiving treatment and hospitalized due to schizophrenia-psychotic episode and bipolar affective disorder-manic episode at the Ondokuz Mayıs University Medical Faculty Psychiatry Department, Turkey, in 2012-2016 were included in our study. A total of 157 healthy donors were included as a control group. White blood cell (WBC), neutrophil, lymphocyte, platelet and monocyte numbers were noted retrospectively from complete blood counts at time of admission, and NLR, PLR and MLR were calculated from these. NLR, PLR and MLR values and platelet numbers in this study were higher and lymphocyte numbers were lower in bipolar disorder patients compared to the controls. Elevation in NLR, MLR and PLR values and neutrophil numbers and lower lymphocyte numbers were determined in schizophrenia patients compared to the controls. Higher NLR and MLR values were found in schizophrenia patients compared to bipolar disorder. Findings of our study supported the inflammation hypothesis for schizophrenia and bipolar disorder.

  9. Antipsychotic adjunctive therapy to mood stabilizers and 1-year rehospitalization rates in bipolar disorder: A cohort study.

    Science.gov (United States)

    Hochman, Eldar; Krivoy, Amir; Schaffer, Ayal; Weizman, Abraham; Valevski, Avi

    2016-12-01

    Antipsychotic adjunctive therapy to mood stabilizers (MSs) may improve relapse prevention; however, only a few naturalistic studies, reflecting more generalizable bipolar disorder (BD) samples, support this notion. We compared the 1-year rehospitalization rates of manic patients with bipolar I disorder (BD-I) who were discharged with MS (lithium or valproate) monotherapy or with adjunctive atypical or typical antipsychotic therapy. A total of 201 patients with BD-I who were hospitalized with manic episodes between 2005 and 2013 were retrospectively followed for 1-year rehospitalization rates according to treatment at discharge: MS monotherapy, MS with atypical antipsychotics, and MS with typical antipsychotics. Additionally, time to rehospitalization during the 1-year period after discharge was compared between treatment groups. Multivariable survival analyses adjusted for covariates known to influence rehospitalization were conducted. Rehospitalization rates within 1 year were significantly lower in the MS with atypical antipsychotics group (6.3%) compared to the MS monotherapy group (24.3%, P=.008) and to the MS with typical antipsychotics group (20.6%, P=.02). Time to rehospitalization was significantly longer for the MS with atypical antipsychotics group (345.5 days) compared to the MS monotherapy group (315.1 days, P=.006) and to the MS with typical antipsychotics group (334.1 days, P=.02). The MS with atypical antipsychotics group had a significantly reduced adjusted risk of rehospitalization (hazard ratio=0.17, 95% confidence interval: 0.05-0.61, P=.007) compared to the MS monotherapy group. Atypical antipsychotic adjunctive therapy to MSs may be more effective than MS monotherapy in preventing rehospitalization during the 1-year period after a BD manic episode. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  10. Meta-analysis of Theory of Mind (ToM) impairment in bipolar disorder.

    Science.gov (United States)

    Bora, E; Bartholomeusz, C; Pantelis, C

    2016-01-01

    Theory of mind (ToM) dysfunction is prominent in a number of psychiatric disorders, in particular, autism and schizophrenia, and can play a significant role in poor functioning. There is now emerging evidence suggesting that ToM abilities are also impaired in bipolar disorder (BP); however, the relationship between ToM deficits and mood state is not clear. We conducted a meta-analysis of ToM studies in BP. Thirty-four studies comparing 1214 patients with BP and 1097 healthy controls were included. BP groups included remitted (18 samples, 545 BP patients), subsyndromal (12 samples, 510 BP patients), and acute (manic and/or depressed) (10 samples, 159 BP patients) patients. ToM performance was significantly impaired in BP compared to controls. This impairment was evident across different types of ToM tasks (including affective/cognitive and verbal/visual) and was also evident in strictly euthymic patients with BP (d = 0.50). There were no significant differences between remitted and subsyndromal samples. However, ToM deficit was significantly more severe during acute episodes (d = 1.23). ToM impairment was significantly associated with neurocognitive and particularly with manic symptoms. Significant but modest sized ToM dysfunction is evident in remitted and subsyndromal BP. Acute episodes are associated with more robust ToM deficits. Exacerbation of ToM deficits may contribute to the more significant interpersonal problems observed in patients with acute or subsyndromal manic symptoms. There is a need for longitudinal studies comparing the developmental trajectory of ToM deficits across the course of the illness.

  11. A new mouse model for mania shares genetic correlates with human bipolar disorder.

    Directory of Open Access Journals (Sweden)

    Michael C Saul

    Full Text Available Bipolar disorder (BPD is a debilitating heritable psychiatric disorder. Contemporary rodent models for the manic pole of BPD have primarily utilized either single locus transgenics or treatment with psychostimulants. Our lab recently characterized a mouse strain termed Madison (MSN that naturally displays a manic phenotype, exhibiting elevated locomotor activity, increased sexual behavior, and higher forced swimming relative to control strains. Lithium chloride and olanzapine treatments attenuate this phenotype. In this study, we replicated our locomotor activity experiment, showing that MSN mice display generationally-stable mania relative to their outbred ancestral strain, hsd:ICR (ICR. We then performed a gene expression microarray experiment to compare hippocampus of MSN and ICR mice. We found dysregulation of multiple transcripts whose human orthologs are associated with BPD and other psychiatric disorders including schizophrenia and ADHD, including: Epor, Smarca4, Cmklr1, Cat, Tac1, Npsr1, Fhit, and P2rx7. RT-qPCR confirmed dysregulation for all of seven transcripts tested. Using a novel genome enrichment algorithm, we found enrichment in genome regions homologous to human loci implicated in BPD in replicated linkage studies including homologs of human cytobands 1p36, 3p14, 3q29, 6p21-22, 12q24, 16q24, and 17q25. Using a functional network analysis, we found dysregulation of a gene system related to chromatin packaging, a result convergent with recent human findings on BPD. Our findings suggest that MSN mice represent a polygenic model for the manic pole of BPD showing much of the genetic systems complexity of the corresponding human disorder. Further, the high degree of convergence between our findings and the human literature on BPD brings up novel questions about evolution by analogy in mammalian genomes.

  12. Diagnosis of obsessive-compulsive disorder in the course of bipolar disorder

    Directory of Open Access Journals (Sweden)

    Maciej Żerdziński

    2016-06-01

    Full Text Available Aim: The aim of this study was to evaluate the coexistence of obsessive-compulsive symptoms with bipolar disorder (during the manic phase, depressive phase and remission. Method: The subjects were 70 patients previously diagnosed with and treated for bipolar disorder. For the purposes of this study, three subgroups were created: patients in the manic phase, depressive phase and in remission. The Hamilton Depression Rating Scale, Young Mania Rating Scale and Yale-Brown Obsessive Compulsive Scale were diagnostic tools used for the evaluation of patients’ mental health. Results: The data indicate high likelihood of co-occurrence of obsessive-compulsive disorder (28.6% and obsessive-compulsive syndromes (32.8% with bipolar disorder. Obsessions and compulsions were observed irrespectively of the type of bipolar disorder (type 1 and 2 and phase of the illness (depression, mania, remission. The results in the three subgroups were similar. The severity of anankastic symptoms depended both on the severity of depression and mania. The subjects confirmed the presence of obsessive-compulsive symptoms in the interview, although they were usually undiagnosed and untreated. Conclusions: Obsessive-compulsive disorder symptoms often coexist with bipolar disorder, both in its two phases and in remission. The severity of obsessive-compulsive symptoms in the course of bipolar condition varies, ranging from mild to extremely severe forms. The obsessive-compulsive disorder presentation in the course of bipolar disorder increases with the severity of depressive and manic symptoms. Obsessive-compulsive disorder can be primary to bipolar disorder. Obsessive-compulsive disorder coexisting with bipolar disorder is not diagnosed or treated properly.

  13. A twin study of schizoaffective-mania, schizoaffective-depression, and other psychotic syndromes.

    Science.gov (United States)

    Cardno, Alastair G; Rijsdijk, Frühling V; West, Robert M; Gottesman, Irving I; Craddock, Nick; Murray, Robin M; McGuffin, Peter

    2012-03-01

    The nosological status of schizoaffective disorders remains controversial. Twin studies are potentially valuable for investigating relationships between schizoaffective-mania, schizoaffective-depression, and other psychotic syndromes, but no such study has yet been reported. We ascertained 224 probandwise twin pairs [106 monozygotic (MZ), 118 same-sex dizygotic (DZ)], where probands had psychotic or manic symptoms, from the Maudsley Twin Register in London (1948-1993). We investigated Research Diagnostic Criteria schizoaffective-mania, schizoaffective-depression, schizophrenia, mania and depressive psychosis primarily using a non-hierarchical classification, and additionally using hierarchical and data-derived classifications, and a classification featuring broad schizophrenic and manic syndromes without separate schizoaffective syndromes. We investigated inter-rater reliability and co-occurrence of syndromes within twin probands and twin pairs. The schizoaffective syndromes showed only moderate inter-rater reliability. There was general significant co-occurrence between syndromes within twin probands and MZ pairs, and a trend for schizoaffective-mania and mania to have the greatest co-occurrence. Schizoaffective syndromes in MZ probands were associated with relatively high risk of a psychotic syndrome occurring in their co-twins. The classification of broad schizophrenic and manic syndromes without separate schizoaffective syndromes showed improved inter-rater reliability, but high genetic and environmental correlations between the two broad syndromes. The results are consistent with regarding schizoaffective-mania as due to co-occurring elevated liability to schizophrenia, mania, and depression; and schizoaffective-depression as due to co-occurring elevated liability to schizophrenia and depression, but with less elevation of liability to mania. If in due course schizoaffective syndromes show satisfactory inter-rater reliability and some specific etiological

  14. Lithium in the treatment of aggression.

    Science.gov (United States)

    Sheard, M H

    1975-02-01

    Lithium has become a widely accepted treatment for manic-depressive psychosis. It is dramatically effective for many cases of mania and is useful in the prevention of manic and depressive episodes. Hyperaggressiveness and hypersexuality are frequent components of manic-depressive illness and abate under the influence of lithium. A brief review is presented of the behavioral and biochemical pharmacology of lithium. This documents the inhibitory role which lithium can play in several examples of animal aggressive behavior including pain-elicited aggression, mouse killing in rats, isolation-induced aggression in mice, p-chlorophenylalanine-induced aggression in rats, and hypothalamically induced aggression in cats. The use of lithium to control human aggressive behavior has resulted in controversial findings. In epileptic conditions, improvement has been reported in interseizure aggressivity, but other reports indicate the possibility of increased seizures. Improvement in aggressive behavior in childhood has occasionally been reported as well as in emotionally unstable character disorders in young female patients. Te was a single blind study and the other a large but uncontrolled study. Both studies reported an improvement in aggressiveness as indicated by fewer recorded reports (tickets) for fighting. The final study reported is a study of 12 male delinquents age 16 to 23. They received lithium or placebo for 4 months inside an institution and then a trial of lithium for 1 to 12 months on an outpatient basis. Analysis of results in terms of the number of aggressive antisocial acts showed fewer serious aggressive episodes when the lithium level was between 0.6 and 1 meq/liter than when it was between 0.0 and 0.6 meq/liter. These results must be viewed with caution and are only suggestive since the study was not double blind.

  15. The impact of depressive and bipolar symptoms on socioeconomic status, core symptoms, function and severity of fibromyalgia.

    Science.gov (United States)

    Gota, Carmen E; Kaouk, Sahar; Wilke, William S

    2017-03-01

    To evaluate the prevalence of depressive and bipolar symptoms in a cohort of consecutive fibromyalgia (FM) patients seen in a tertiary care center and to determine the relationship between depressive and manic symptoms with FM symptoms, socioeconomic status, severity and function. Three hundred and five FM patients were enrolled; demographic, clinical and questionnaire data were collected. Depressive symptoms were measured by the Patient Health Questionnaire (PHQ-9), manic symptoms by the Mood Disorders Questionnaire (MDQ). The FM cohort had the following characteristics: age 43.53 (11.7) years; 86.5% white; 82.7% female; PHQ-9 ≥ 10, 59.7%, mean 11.9 (7.3); no depression 11.4%, mild 29.1%, moderate 27.5%, moderate severe 17.7%, severe 14%; anxiety 41.6%; 21.3% had either an MDQ score ≥ 7 and/or reported a past diagnosis of bipolar disorder (BD). Increasing levels of depression severity, as well as a positive screen for BD were significantly associated with increasing prevalence and severity of FM symptoms, longer duration of morning stiffness, and increased severity of FM. Increasing levels of depression were significantly associated with increase in prevalence of reported past sexual abuse, and a decline in socioeconomic status, including higher disability and unemployment rates. Patients with severe FM disease activity, high load of symptoms, prolonged morning stiffness, increased disability, lower socioeconomic status and those who take a lot of medications for FM should be evaluated for depressive and manic symptoms. © 2015 Asia Pacific League of Associations for Rheumatology and Wiley Publishing Asia Pty Ltd.

  16. Temperament and personality in bipolar I patients with and without mixed episodes.

    Science.gov (United States)

    Röttig, Dörthe; Röttig, Stephan; Brieger, Peter; Marneros, Andreas

    2007-12-01

    Personality and temperament are supposed to have an impact on the clinical expression and course of an affective disorder. There is some indication, that mixed episodes result from an admixture of inverse temperamental factors to a manic syndrome. In a preliminary report [Brieger, P., Roettig, S., Ehrt, U., Wenzel, A., Bloink, R., Marneros, A., 2003. TEMPS-a scale in 'mixed' and 'pure' manic episodes: new data and methodological considerations on the relevance of joint anxious-depressive temperament traits. J. Affect. Disord. 73, 99-104] we reported support for this assumption. The present study completes the preliminary results and compares patients with and without mixed episodes with respect to personality and personality disorders in addition. Patients who had been hospitalized for bipolar I disorder were reassessed after 4.8 years. We examined temperament (TEMPS-A), personality (NEO-FFI) and frequency of personality disorders (SCID-II). Furthermore, illness-related parameters like age at first treatment, depressive and manic symptomatology, frequency and type of episodes and level of functioning were obtained and patients with and without mixed episodes were compared. Patients with (n=49) and without mixed episodes (n=86) did not differ significantly with regard to the illness-related parameters and personality dimensions. The frequency of personality disorders was significantly higher in patients with prior mixed episodes. With respect to temperament, scores of the depressive, cyclothymic, irritable and anxious temperament were significantly higher in patients with mixed episodes. We were not able to assess premorbid temperament and premorbid personality. The findings of the present study support the assumption of Akiskal [Akiskal, H.S., 1992b. The distinctive mixed states of bipolar I, II, and III. Clin. Neuropharmacol. 15 Suppl 1 Pt A, 632-633.] that mixed episodes are more frequent in subjects with inverse temperament.

  17. The Mood Spectrum and Temperamental Instability in Unipolar and Bipolar Disorder.

    Science.gov (United States)

    Kumar, Manish; Saha, Pradeep Kumar; Mondal, Anwesha

    2017-01-01

    The current categorical split of mood disorders in bipolar (BP) disorders and depressive disorders has recently been questioned. The presence of a significant number of manic/hypomanic symptoms in patients with recurrent unipolar depression seems to challenge the traditional dichotomy of unipolar-BP disorder. Two highly unstable personality features, i.e., the cyclothymic temperament (CT) and borderline personality disorder, have been found to be more common in BP disorder than in major depressive disorder. The aim was to assess the distributions of the number of mood spectrum, CT, and borderline personality items between two groups. Finding no bimodal distribution (a "zone of rarity") of these items would support a continuity between the two disorders. Forty euthymic BP disorder patients and forty unipolar depression patients were administered the Structured Clinical Interview for the Mood Spectrum, which assesses lifetime symptoms, traits, and lifestyles that characterize threshold and subthreshold mood episodes. CT was assessed using Temperament Evaluation of Memphis, Pisa, Paris and San Diego-A relative to CT and borderline personality trait (BPT) was assessed using Structured Clinical Interview for DSM Disorders II personality questionnaire relative to BPT. The distribution of the number of CT and BPT items was studied by Kernel density estimate. Patient with recurrent depression endorsed manic/hypomanic items though less than BP group. However, the Kernel density estimates distributions of the number of hypomanic/manic items, CT and BPT items in the entire sample had a normal-like shape (i.e. no bimodality). Normal-like curves in the distributions of mood symptoms, number of CT and BPT items in the entire sample, suggest significant amount of overlap of these characteristic in both the groups. Using the bimodality approach, continuity between BP and major depressive disorder (MDD) seems to be supported, questioning the current categorical splitting of BP and

  18. Predictors of switching from mania to depression in a large observational study across Europe (EMBLEM).

    Science.gov (United States)

    Vieta, Eduard; Angst, Jules; Reed, Catherine; Bertsch, Jordan; Haro, Josep Maria

    2009-11-01

    The risk of switching from mania to depression in bipolar disorder has been poorly studied. Large observational studies may be useful in identifying variables that predict switch to depression after mania and provide data on medication use and outcomes in "real world" patients. EMBLEM (European Mania in Bipolar Longitudinal Evaluation of Medication) is a 2-year, prospective, observational study of patients with a manic/mixed episode. Symptom severity measures included Clinical Global Impression-Bipolar Disorder scale (CGI-BP), Young Mania Rating Scale (YMRS) and 5-item Hamilton Depression Rating Scale. Switching was defined using CGI-BP mania and depression such that patients changed from manic and not depressed to depressed but not manic over two consecutive observations within the first 12 weeks of follow-up. Cox proportional hazards models identified baseline variables independently associated with switch to depression. Of 2390 patients who participated in the maintenance phase (i.e. up to 24 months), 120 (5.0%) switched to depression within the first 12 weeks. Factors associated with greater switching to depression include previous depressive episodes, substance abuse, greater CGI-BP overall severity and benzodiazepine use. Factors associated with lower switching rates were greater CGI-BP depression, lower YMRS severity and atypical antipsychotic use. The definition of switching biased against patients with mixed episodes being likely to switch. Strictly defined, switch to depression from mania occurs in a small proportion of bipolar patients. Clinical history, illness severity, co-morbidities and treatment patterns are associated with switching to depression. Atypical antipsychotics may protect against switch to depression.

  19. Lithium neurotoxicity.

    Science.gov (United States)

    Suraya, Y; Yoong, K Y

    2001-09-01

    Inspite of the advent of newer antimanic drugs, lithium carbonate remains widely used in the treatment and prevention of manic-depressive illness. However care has to be exercised due to its low therapeutic index. The central nervous system and renal system are predominantly affected in acute lithium intoxication and is potentially lethal. The more common side effect involves the central nervous system. It occurs early and is preventable. We describe three cases of lithium toxicity admitted to Johor Bahru Hospital, with emphasis on its neurological preponderance.

  20. Recurrence in affective disorder. I. Case register study

    DEFF Research Database (Denmark)

    Kessing, L V; Andersen, P K; Mortensen, P B

    1998-01-01

    hospital admissions with primary affective disorder in Denmark during 1971-1993. A total of 20,350 first-admission patients were discharged with a diagnosis of affective disorder, depressive or manic/cyclic type. RESULTS: The rate of recurrence increased with the number of previous episodes in both...... unipolar and bipolar disorder. Initially, the two types of disorders followed markedly different courses, but later in the course of the illness the rate of recurrence was the same for the two disorders. CONCLUSIONS: The course of severe unipolar and bipolar disorder seems to be progressive in nature...

  1. A Lithium-Sensitive and Sodium-Tolerant 3′-Phosphoadenosine-5′-Phosphatase Encoded by halA from the Cyanobacterium Arthrospira platensis Is Closely Related to Its Counterparts from Yeasts and Plants

    OpenAIRE

    Zhang, Ju-Yuan; Zou, Jie; Bao, Qiyu; Chen, Wen-Li; Wang, Li; Yang, Huanming; Zhang, Cheng-Cai

    2006-01-01

    3′-Phosphoadenosine-5′-phosphatase (PAPase) is required for the removal of toxic 3′-phosphoadenosine-5′-phosphate (PAP) produced during sulfur assimilation in various eukaryotic organisms. This enzyme is a well-known target of lithium and sodium toxicity and has been used for the production of salt-resistant transgenic plants. In addition, PAPase has also been proposed as a target in the treatment of manic-depressive patients. One gene, halA, which could encode a protein closely related to th...

  2. [Homicide is strongly correlated to depression and not to mania].

    Science.gov (United States)

    Bénézech, M; Bourgeois, M

    1992-01-01

    Typical manic episodes could be the cause of penal infractions, usually benign. In contrast, forensic studies show a close relationship between depression, suicide and homicide. Killers (16-28%) are often depressed when they commit a crime. In the UK and USA, 4-35% of killers commit suicide immediately after their crime. Assessment of a depressed patient must include an evaluation of the risk of homicide as well as the risk of suicide. The past history of depression and suicidal attempts, the presence of depressive symptoms and suicidal ideas, are good predictors of impending danger of aggression and sometimes of homicide.

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

    Directory of Open Access Journals (Sweden)

    João Pedro Ribeiro

    2013-12-01

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

  4. Co-occurrence of Marfan syndrome and bipolar disorder: A fifteen year follow up.

    Science.gov (United States)

    Jha, Vijendra Nath; Kumar, Manoj; Tarwani, Jatin

    2016-12-01

    Marfan syndrome, a chromosomal disorder, has been commonly associated with schizophrenia but no association with Bipolar affective disorder has been reported in the scientific literature. This case depicts the occurrence of Bipolar affective disorder in a previously undiagnosed case of Marfan syndrome. In this case patient had all manic episodes without any depressive or schizophrenia-like episodes, suggesting a diagnostic stability over a long period of over fifteen years. Studies and research are needed in this regard to look for any possible potential association between the two illnesses. Copyright © 2016 Elsevier B.V. All rights reserved.

  5. Effect of the new antiepileptic drug retigabine in a rodent model of mania

    DEFF Research Database (Denmark)

    Dencker, Ditte; Dias, Rebecca; Pedersen, Mette Lund

    2008-01-01

    Bipolar spectrum disorders are severe chronic mood disorders that are characterized by episodes of mania or hypomania and depression. Because patients with manic symptoms often experience clinical benefit from treatment with anticonvulsant drugs, it was hypothesized that retigabine, a novel...... compound with anticonvulsant efficacy, may also possess antimanic activity. The amphetamine (AMPH)+chlordiazepoxide (CDP)-induced hyperactivity model has been proposed as a suitable model for studying antimanic-like activity of novel compounds in mice and rats. The aims of the present study in rats were...

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

    Science.gov (United States)

    Findling, Robert L

    2016-01-01

    Pharmacotherapy is an important component of treatment for children and adolescents with bipolar disorder. The body of evidence supporting safe and effective treatments in this population is growing. Available data provide information on the risks and benefits of pharmacologic agents used for acute manic, mixed, and depressive episodes as well as for maintenance treatment. Lithium, anticonvulsants, and antipsychotics comprise the armamentarium for treating pediatric bipolar disorder. When selecting treatment, clinicians must consider the efficacy and side effect profile of potential pharmacotherapies, as well as the patient's history, including the presence of comorbidities, in order to develop a treatment plan that will ensure optimal outcomes. © Copyright 2016 Physicians Postgraduate Press, Inc.

  7. Late Onset Bipolar Disorder: Case Report

    Directory of Open Access Journals (Sweden)

    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.

  8. The influence of genes and environment on the development of bipolar disorder: A twin study

    OpenAIRE

    Vonk, Ronald

    2016-01-01

    Bipolar disorder (or manic-depressive disorder) is a severe mood disorder in which episodes of (hypo) mania (e.g. elevated mood en hyperactivity) and depression (e.g. decreased mood and reduced activity) alternate with periods of normal mood and functioning. Genetic factors as well as environmental factors play a role in the development of bipolar disorder. A serious problem for bipolar disorder is a delay of several years between the first mood episode(s) and the diagnosis. Afterwards it can...

  9. America Y2K: The Obsolescence of Educational Reforms

    Directory of Open Access Journals (Sweden)

    Sherman Dorn

    2000-01-01

    Full Text Available The passing of the deadline for fulfillment of the national education goals in the United States (the beginning of 2000 reflects the frequently hyperbolic statements of objectives and the manic pace of school reform efforts over the past two decades. The domination by schools of child and family life has combined with a longstanding reliance on schools to solve social problems to make school reform a politically opportune as well as visible issue. Thus, even if the phrasing of national education goals in the U.S. changes to reflect the passing of the nominal deadline, those pressures will remain.

  10. Self-reported creativity in bipolar disorder: prevalence, types and associated outcomes in mania versus hypomania.

    Science.gov (United States)

    McCraw, Stacey; Parker, Gordon; Fletcher, Kathryn; Friend, Paul

    2013-12-01

    Bipolar (BP) disorder has been linked to creativity following investigation of prominent artists and controlled trials of creativity in BP disorder patients. However, it is unclear whether creativity is differentially expressed across the BP I and BP II subtypes. 219 patients (aged 19-63 years) diagnosed with BP disorder by clinical interview and DSM-IV criteria were asked whether they tended to be more creative during hypo/manic episodes, and answered five questions about personality styles associated with creativity. Qualitative analyses were performed on a smaller subset of 69 BP patients (n=19 BP I, n=50 BP II) who provided written responses of the types of creative activities engaged in when hypo/manic and any perceived advantages or disadvantages of their creative pursuits. 82% of BP patients affirmed being creative when hypo/manic, with comparable results for the BP I and BP II subtypes (84% and 81% respectively). Both BP subtypes engaged mostly in writing, painting, work or business ideas and 'other' forms of art; however BP II patients were more likely to draw and be musical. Both subgroups reported the consequences of feeling good, being productive or quitting their project. BP I patients were more likely to overspend during their creative highs while BP II patients were more likely to experience improved focus and clarity. BP patients affirming creative highs were significantly more likely to report creative personality styles more generally outside of a mood episode. BP patients' self-reported creative activities were not retrospectively judged for quality or originality and so may reflect common creative abilities rather than exceptional quality. The impact of depressive episodes on creativity was not assessed. Uneven sample sizes in the BP I and BP II subgroups may have compromised statistical power. Creativity during hypo/manic episodes was extremely common in both BP subtypes. While some nuances in activity type and outcomes were observed, no

  11. The effect of lithium on thyroid function in patients with bipolar disorder

    OpenAIRE

    Kraszewska, Agnieszka; Abramowicz, Maria; Chłopocka-Woźniak, Maria; Sowiński, Jerzy; Rybakowski, Janusz

    2014-01-01

    Since 1963 lithium treatment has been the best proven long-term pharmacotherapy for bipolar disorder (BD), both in the prevention of depressive and manic episodes, along with the reduction of the suicide risk. Thyroid gland and the hypothalamic-pituitary-thyroid (HPT) axis play a role in the pathophysiology, clinical course and treatment of BD. The influence of lithium on the thyroid gland is one of the key side effects in the long-term therapy with this drug. Lithium is accumulated in the th...

  12. Diagnostic stability in pediatric bipolar disorder

    DEFF Research Database (Denmark)

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

    2015-01-01

    disorder (14.8%) and behavioral and emotional disorders with onset during childhood or adolescents (10.9%). Prevalence rates of schizophrenia, personality disorders, anxiety disorder or hyperkinetic disorders (ADHD) were low.LIMITATIONS: Data concern patients who get contact to hospital psychiatry only.......CONCLUSIONS: Clinicians should be more observant on manic symptoms in children and adolescents who at first glance present with transient psychosis, reaction to stress/adjustment disorder or with behavioral and emotional disorders with onset during childhood or adolescents (F90-98) and follow these patients more closely...

  13. Age of Onset of Mood Disorders and Complexity of Personality Traits

    OpenAIRE

    Ostacoli, L.; Zuffranieri, M.; Cavallo, M.; Zennaro, A.; Rainero, I.; Pinessi, L.; Pacchiana Parravicini, M. V.; Ladisa, E.; Furlan, P. M.; Picci, R. L.

    2013-01-01

    Objective. The aim of the present study is to evaluate the link between the age of onset of mood disorders and the complexity of the personality traits. Methods. 209 patients with major depressive or manic/hypomanic episodes were assessed using the Structured Clinical Interview for DSM Axis I diagnoses and the Millon Clinical Multiaxial Inventory-III (MCMI-III). Results. 17.2% of the patients had no elevated MCMI-III scores, 45.9% had one peak, and 36.9% had a complex personality disorder wit...

  14. 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

  15. Hyperosmolar nonketotic coma precipitated by lithium-induced nephrogenic diabetes insipidus.

    Science.gov (United States)

    Azam, H.; Newton, R. W.; Morris, A. D.; Thompson, C. J.

    1998-01-01

    A 45-year-old man, with a 10-year history of manic depression treated with lithium, was admitted with hyperosmolar, nonketotic coma. He gave a five-year history of polyuria and polydipsia, during which time urinalysis had been negative for glucose. After recovery from hyperglycaemia, he remained polyuric despite normal blood glucose concentrations; water deprivation testing indicated nephrogenic diabetes insipidus, likely to be lithium-induced. We hypothesize that when this man developed type 2 diabetes, chronic polyuria due to nephrogenic diabetes insipidus was sufficient to precipitate hyperosmolar dehydration. PMID:9538487

  16. In vivo 7Li and 19F NMR studies of drugs in the brain

    International Nuclear Information System (INIS)

    Komoroski, Richard A.

    1999-01-01

    For various reasons, it is advantageous to measure the concentration of a psychoactive drug in the brain in vivo. Many drugs contain the element fluorine. Using 19 F NMR spectroscopy, we have studied the psychoactive drugs trifluoperazine and fluoxetine in the brain in vivo. Using 7 Li NMR, it is possible to detect lithium ion, used to treat manic depressive illness. We have measured the concentration and distribution of lithium in both human and rat brain in vivo. Measurement of drug levels in the human brain may provide a measure of therapeutic or toxic effects, as well as insight into drug metabolism and mechanism of action. (author)

  17. Behavioral activities collected through smartphones and the association with illness activity in bipolar disorder

    DEFF Research Database (Denmark)

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

    2016-01-01

    with symptom severity. The more severe the depressive symptoms (1) the longer the smartphone’s screen was “on”/day, (2) more received incoming calls/day, (3) fewer outgoing calls/day were made, (4) less answered incoming calls/day, (5) the patients moved less between cell towers IDs/day. Conversely, the more...... severe the manic symptoms (1) more outgoing text messages/day sent, (2) the phone calls/day were longer, (3) the fewer number of characters in incoming text messages/day, (4) the lower duration of outgoing calls/day, (5) the patients moved more between cell towers IDs/day. Further, objective smartphone...

  18. Reduced mRNA expression of PTGDS in peripheral blood mononuclear cells of rapid-cycling bipolar disorder patients compared with healthy control subjects

    DEFF Research Database (Denmark)

    Munkholm, Klaus; Peijs, Lone; Kessing, Lars Vedel

    2015-01-01

    was measured in 37 rapid-cycling bipolar disorder patients and 40 age- and gender-matched healthy control subjects using reverse transcription quantitative real-time polymerase chain reaction. Repeated measurements of PTGDS and AKR1C3 mRNA expression were obtained in various affective states during 6-12 months...... and compared with repeated measurements in healthy control subjects. RESULTS: Adjusted for age and gender, PTGDS mRNA expression was down-regulated in rapid-cycling bipolar disorder patients in a euthymic, depressive, and manic/hypomanic state compared with healthy control subjects. No difference in PTGDS m...

  19. Psykose ved affektive lidelser

    DEFF Research Database (Denmark)

    Kessing, Lars Vedel

    2008-01-01

    Psychosis in affective disorder is prevalent as 15-20% of depressive patients and approximately 50% of manic patients present with psychotic features. Psychosis in conjunction with affective disorder has a poor prognosis. It is particularly so for depression where psychosis is associated with an ...... with an increased risk of recurrence, development of bipolar disorder and suicide. It is still being debated whether these conditions reflect independent illness entities and their relationship to schizoaffective disorder and schizophrenia is also unresolved Udgivelsesdato: 2008/11/10...

  20. Delusional Themes Across Affective and Non-Affective Psychoses

    Directory of Open Access Journals (Sweden)

    Angelo Picardi

    2018-04-01

    Full Text Available The current debate about the diagnostic significance of delusion revolves around two positions. The neurocognitive position conceives delusion as a non-specific, though polymorphic, symptom. The psychopathological position views features of delusion such as content and structure as having meaningful connections with diagnostic entities. This study aims at contributing to this debate by examining the association between delusional themes and diagnosis in a sample of 830 adult psychotic patients. All diagnoses were made by experienced psychiatrists according to DSM-IV or ICD-10 criteria, and in 348 patients were established with the SCID-I. All patients were administered the Brief Psychiatric Rating Scale (BPRS. In each patient, the presence of somatic delusions and delusions of guilt, grandiosity, and persecution was determined by examining the scores on relevant BPRS items. Delusions of guilt were almost pathognomonic for a psychotic depressive condition (psychotic major depression 40%; psychotic bipolar depression 30%; depressed schizoaffective disorder 8%; bipolar and schizoaffective mixed states 6 and 7%, respectively. Only 1% of patients with schizophrenia and no patient with delusional disorder or bipolar or schizoaffective manic state showed such delusions. The difference between unipolar and bipolar depression and the other diagnostic groups was highly significant. Delusions of grandiosity characterized mostly patients with manic symptoms (bipolar mania 20%; bipolar mixed states 19%; manic schizoaffective disorder 10%. They were observed significantly more often in bipolar mania than in schizophrenia (7%. Persecutory delusions were broadly distributed across diagnostic categories. However, they were significantly more frequent among patients with schizophrenia and delusional disorder compared with depressed and manic patients. Somatic delusions were also observed in all diagnostic groups, with no group standing out as distinct from the

  1. Hydrotherapy in state mental hospitals in the mid-twentieth century.

    Science.gov (United States)

    Harmon, Rebecca Bouterie

    2009-08-01

    This research describes nurses' experiences in administering "the water cure," hot or cold wet sheet packs, and continuous tub baths in state mental hospitals during the early twentieth century. Student and graduate nurses were required to demonstrate competence in hydrotherapy treatments used to calm agitated or manic patients in the era before neuroleptics. The nurses interviewed for this study indicated that, although labor intensive, hydrotherapy worked, at least temporarily. Although no longer used in state hospitals, hydrotherapy is regaining popularity with the general public and may serve as an adjunct to pharmacological treatments to calm hospitalized patients in the future.

  2. Is There Such a Diagnosis as an Early Onset Unipolar Depression?

    Directory of Open Access Journals (Sweden)

    Berta Ferreira

    2014-10-01

    Full Text Available According to Kraepelin, melancholia was part of manic-depressive psychosis. In the 60s however, other authors (Angst, 1966; Perris, 1966; Winokur, 1967 questioned this concept by considering unipolar depression a clinical entity, separated from bipolar disorders. Using strict bipolar disorders criteria, some prospective studies have shown a diagnosis switch from unipolar to bipolar disorders in up to 50% of the cases (Caryell, 1995; Goldberg, 2001; Angst, 2005. The existence of unipolar depression as a clinical entity is discussed, taking in consideration the “minor” bipolar symptoms that occur during the course of affective disorders.

  3. Sexual violence, mood disorders and suicide risk: a population-based study

    Directory of Open Access Journals (Sweden)

    Thaíse Campos Mondin

    2016-03-01

    Full Text Available Abstract This article seeks to analyze the association between sexual violence, manic and depressive episodes, and suicide risk among young adults. This is a cross-sectional population-based study carried out with young people between 18 and 24 years of age in a town in southern Brazil. The sample was selected through clusters. The prevalence of sexual violence, manic, depressive and mixed episodes and suicide risk were evaluated, as well as the association between them. The chi-square test and Poisson regression were used for statistical analysis. The study sample comprised 1,560 subjects. Among these, 3.1% had suffered sexual violence at some point in their life. The prevalence of depressive, mixed episodes, and (hypomanic episodes were 10%, 2.4% and 2.3%, respectively. Suicide risk had a prevalence of 8.6% in the total sample. Young people who have suffered sexual violence are more likely to be subject to mood changes or suicide risk than those who have not (p < 0.05, except for the occurrence of (hypomanic episodes. These results revealed a strong association between sexual violence and depressive and mixed episodes and suicide risk.

  4. Psychiatric and clinical correlates of rapid cycling bipolar disorder: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Alexandre D. Gigante

    2016-01-01

    Full Text Available Objective: Rapid cycling (RC is a feature of bipolar disorder (BD that has been associated with worse outcome and more severe disability. Our goal was to investigate the association of demographic and clinical factors with RC. Methods: We compared RC and non-rapid cycling (NRC BD patients from the Brazilian Research Network in Bipolar Disorder (BRN-BD regarding age at onset of BD; total number of episodes; previous number of manic, depressive, mixed, and hypomanic episodes; polarity of the first episode; gender; number of suicide attempts; number of lifetime hospitalizations and lifetime history of at least one hospitalization; family history of mood disorder; clinical comorbidities such as hypothyroidism, hyperthyroidism, seizures; and current use of medications such as lithium, anticonvulsants, antipsychotics, and antidepressants. Results: We studied 577 patients and found that 100 (17.3% met the criteria for RC in the year before the investigation. RC patients had earlier age at onset, longer duration of disease, more lifetime depressive and manic episodes, higher number of suicide attempts, and higher rate antidepressant use. Conclusion: The presence of RC in the previous year was associated with specific clinical characteristics closely related to worse outcome in the course of BD.

  5. Feeling and time: the phenomenology of mood disorders, depressive realism, and existential psychotherapy.

    Science.gov (United States)

    Ghaemi, S Nassir

    2007-01-01

    Phenomenological research suggests that pure manic and depressive states are less common than mixtures of the two and that the two poles of mood are characterized by opposite ways of experiencing time. In mania, the subjective experience of time is sped up and in depression it is slowed down, perhaps reflecting differences in circadian pathophysiology. The two classic mood states are also quite different in their effect on subjective awareness: manic patients lack insight into their excitation, while depressed patients are quite insightful into their unhappiness. Consequently, insight plays a major role in overdiagnosis of unipolar depression and misdiagnosis of bipolar disorder. The phenomenology of depression also is relevant to types of psychotherapies used to treat it. The depressive realism (DR) model, in contrast to the cognitive distortion model, appears to better apply to many persons with mild to moderate depressive syndromes. I suggest that existential psychotherapy is the necessary corollary of the DR model in those cases. Further, some depressive morbidities may in fact prove, after phenomenological study, to involve other mental states instead of depression. The chronic sub-syndromal depression that is often the long-term consequence of treated bipolar disorder may in fact represent existential despair, rather than depression proper, again suggesting intervention with existential psychotherapeutic methods.

  6. Early risk factors for suicide in an epidemiological first episode psychosis cohort.

    Science.gov (United States)

    Dutta, Rina; Murray, Robin M; Allardyce, Judith; Jones, Peter B; Boydell, Jane

    2011-03-01

    Much remains unknown about whether there are early risk factors for suicide in psychosis. The aim of the study was to determine whether there are any identifiable early symptom clusters, aetiological factors or illness course markers for suicide in first episode psychosis. A total of 2132 patients with first episode psychosis presenting to secondary care services in London (1965-2004; n=1474), Nottingham (1997-1999; n=195) and Dumfries and Galloway (1979-1998; n=463) were traced after up to 40 years (mean 13 years) following first presentation. Risk factors were identified from the Operational Checklist for Psychotic Disorders rated for the first year following presentation. Overall, there were 51 suicides and 373 deaths from other causes. Male gender (RR 2.84, 95% CI 1.20-6.69, p=0.02) and a cumulative threshold effect of symptoms early in the illness (RR 6.81, 95% CI 2.33-19.85, p<0.001) were associated with a higher propensity for later completed suicide. There was also a suggestion that early manic symptoms might increase the risk of later suicide irrespective of initial diagnosis. Suicide risk was associated with a cumulative threshold effect of symptoms and manic symptoms. As suicide is a relatively rare event in psychotic disorders, general population-based prevention strategies may have more impact in this vulnerable group as well as the wider population. Copyright © 2010 Elsevier B.V. All rights reserved.

  7. Amygdalar, hippocampal, and thalamic volumes in youth at high risk for development of bipolar disorder.

    Science.gov (United States)

    Karchemskiy, Asya; Garrett, Amy; Howe, Meghan; Adleman, Nancy; Simeonova, Diana I; Alegria, Dylan; Reiss, Allan; Chang, Kiki

    2011-12-30

    Children of parents with bipolar disorder (BD), especially those with attention deficit hyperactivity disorder (ADHD) and symptoms of depression or mania, are at significantly high risk for developing BD. As we have previously shown amygdalar reductions in pediatric BD, the current study examined amygdalar volumes in offspring of parents (BD offspring) who have not yet developed a full manic episode. Youth participating in the study included 22 BD offspring and 22 healthy controls of comparable age, gender, handedness, and IQ. Subjects had no history of a manic episode, but met criteria for ADHD and moderate mood symptoms. MRI was performed on a 3T GE scanner, using a 3D volumetric spoiled gradient echo series. Amygdalae were manually traced using BrainImage Java software on positionally normalized brain stacks. Bipolar offspring had similar amygdalar volumes compared to the control group. Exploratory analyses yielded no differences in hippocampal or thalamic volumes. Bipolar offspring do not show decreased amygdalar volume, possibly because these abnormalities occur after more prolonged illness rather than as a preexisting risk factor. Longitudinal studies are needed to determine whether amygdalar volumes change during and after the development of BD. 2011 Elsevier Ireland Ltd. All rights reserved.

  8. Multifactorial inheritance, rates of maturation and psychiatry's taxonomic dilemma: on Saugstad's "radical proposition" for two extremes of brain function and structure.

    Science.gov (United States)

    deVries, Marten W

    2008-06-01

    This paper reviews aspects of Letten F. Saugstad's Maturation Theory in relation to the Kraepelinian dichotomy and psychiatric classification. The maturation theory is based on existing neuroscience, cross-national and mental health case register data and offers an innovative alternative to current etiological formulations. The maturational theory holds (1) that manic depressive illness relates to early maturation and (2) the schizophrenic syndrome relates to late maturation. The foundation of these processes lies in cerebral pruning of excitatory synapses particularly at puberty but also at a number of earlier crucial periods in development. The process of synaptic pruning has by puberty eliminated some 40% of the synapses, leading to the disappearance of glutematergic excitatory synapses without apparently appreciably influencing inhibitory GABAergic neurons. As a consequence, early maturation is related to the manic-depressive syndrome and characterized by increased neural excitability. Conversely, late maturation is related to schizophrenia characterized by diminished neural activity. Saugstad demonstrates using cross-national and neuroscience studies the multifactoral and environmental influences on rates of maturation and thereby mental illness. Using these data Saugstad reasons her agreement with the Kraepelinian dichotomy based on the existence of two extremes in brain structure and function developed through interactions between the person and the environment.

  9. Neither bipolar nor obsessive-compulsive disorder: compulsive buyers are impulsive acquirers.

    Science.gov (United States)

    Filomensky, Tatiana Zambrano; Almeida, Karla Mathias; Castro Nogueira, Marcelo Campos; Diniz, Juliana Belo; Lafer, Beny; Borcato, Sonia; Tavares, Hermano

    2012-07-01

    Compulsive buying (CB) is currently classified as an impulse control disorder (ICD) not otherwise classified. Compulsive buying prevalence is estimated at around 5% of the general population. There is controversy about whether CB should be classified as an ICD, a subsyndromal bipolar disorder (BD), or an obsessive-compulsive disorder (OCD) akin to a hoarding syndrome. To further investigate the appropriate classification of CB, we compared patients with CB, BD, and OCD for impulsivity, affective instability, hoarding, and other OCD symptoms. Eighty outpatients (24 CB, 21 BD, and 35 OCD) who were neither manic nor hypomanic were asked to fill out self-report questionnaires. Compulsive buying patients scored significantly higher on all impulsivity measures and on acquisition but not on the hoarding subdimensions of clutter and "difficulty discarding." Patients with BD scored higher on the mania dimension from the Structured Clinical Interview for Mood Spectrum scale. Patients with OCD scored higher on obsessive-compulsive symptoms and, particularly, higher on the contamination/washing and checking dimensions from the Padua Inventory; however, they did not score higher on any hoarding dimension. A discriminant model built with these variables correctly classified patients with CB (79%), BD (71%), and OCD (77%). Patients with CB came out as impulsive acquirers, resembling ICD- rather than BD- or OCD-related disorders. Manic symptoms were distinctive of patients with BD. Hoarding symptoms other than acquisition were not particularly associated with any diagnostic group. Copyright © 2012 Elsevier Inc. All rights reserved.

  10. Risk factors predicting onset and persistence of subthreshold expression of bipolar psychopathology among youth from the community.

    Science.gov (United States)

    Tijssen, M J A; Van Os, J; Wittchen, H U; Lieb, R; Beesdo, K; Wichers, Marieke

    2010-09-01

    To examine factors increasing the risk for onset and persistence of subthreshold mania and depression. In a prospective cohort community study, the association between risk factors [a family history of mood disorders, trauma, substance use, attention-deficit/hyperactivity disorder (ADHD) and temperamental/personality traits] and onset of manic/depressive symptoms was determined in 705 adolescents. The interaction between baseline risk factors and baseline symptoms in predicting 8-year follow-up symptoms was used to model the impact of risk factors on persistence. Onset of manic symptoms was associated with cannabis use and novelty seeking (NS), but NS predicted a transitory course. Onset of depressive symptoms was associated with a family history of depression. ADHD and harm avoidance (HA) were associated with persistence of depressive symptoms, while trauma and a family history of depression predicted a transitory course. Different risk factors may operate during onset and persistence of subthreshold mania and depression. The differential associations found for mania and depression dimensions suggest partly different underlying mechanisms.

  11. Personality Pathology Predicts Outcomes in a Treatment-Seeking Sample with Bipolar I Disorder

    Directory of Open Access Journals (Sweden)

    Susan J. Wenze

    2014-01-01

    Full Text Available We conducted a secondary analysis of data from a clinical trial to explore the relationship between degree of personality disorder (PD pathology (i.e., number of subthreshold and threshold PD symptoms and mood and functioning outcomes in Bipolar I Disorder (BD-I. Ninety-two participants completed baseline mood and functioning assessments and then underwent 4 months of treatment for an index manic, mixed, or depressed phase acute episode. Additional assessments occurred over a 28-month follow-up period. PD pathology did not predict psychosocial functioning or manic symptoms at 4 or 28 months. However, it did predict depressive symptoms at both timepoints, as well as percent time symptomatic. Clusters A and C pathology were most strongly associated with depression. Our findings fit with the literature highlighting the negative repercussions of PD pathology on a range of outcomes in mood disorders. This study builds upon previous research, which has largely focused on major depression and which has primarily taken a categorical approach to examining PD pathology in BD.

  12. Capacity to consent to research among patients with bipolar disorder.

    Science.gov (United States)

    Misra, Sahana; Ganzini, Linda

    2004-06-01

    Experts have debated the influence of mental illness on decision-making capacity. This paper reviews concepts of decision-making capacity and existing research on the influence of mental illness on capacity to consent to research. We propose how bipolar disorder, especially mania, may have an effect on consent capacity. The current conceptualization of capacity utilizes legal standards of 'choice', 'understanding', 'appreciation' and 'rational reasoning', as well as voluntarism, or the assurance that the patient is free to agree or to decline to participate in research. Studies of patients with schizophrenia suggest impaired cognition influences 'understanding' and is more important than severity of psychosis in affecting decision-making abilities. There are no studies of sources and extent of impairment to consent to research among manic patients. Mania may influence a patient's understanding of the research protocol, but also alter the patient's views, values and level of insight, thus impairing decision-making abilities at the 'appreciation' standard even when the patient understands the relevant information. Mania may impact freedom to decide, yet paradoxically, manic patients may be less influenced by others and less vulnerable to coercion, undue influence and undue incentives compared to patients without mental illness. We suggest that in patients with mood disorders, the legal standard of appreciation be thoroughly probed during the consent procedure. Studies of the effect of mania and depression on consent capacity and voluntarism are needed in order to develop processes that increase safeguards in the informed consent process.

  13. Low social rhythm regularity predicts first onset of bipolar spectrum disorders among at-risk individuals with reward hypersensitivity.

    Science.gov (United States)

    Alloy, Lauren B; Boland, Elaine M; Ng, Tommy H; Whitehouse, Wayne G; Abramson, Lyn Y

    2015-11-01

    The social zeitgeber model (Ehlers, Frank, & Kupfer, 1988) suggests that irregular daily schedules or social rhythms provide vulnerability to bipolar spectrum disorders. This study tested whether social rhythm regularity prospectively predicted first lifetime onset of bipolar spectrum disorders in adolescents already at risk for bipolar disorder based on exhibiting reward hypersensitivity. Adolescents (ages 14-19 years) previously screened to have high (n = 138) or moderate (n = 95) reward sensitivity, but no lifetime history of bipolar spectrum disorder, completed measures of depressive and manic symptoms, family history of bipolar disorder, and the Social Rhythm Metric. They were followed prospectively with semistructured diagnostic interviews every 6 months for an average of 31.7 (SD = 20.1) months. Hierarchical logistic regression indicated that low social rhythm regularity at baseline predicted greater likelihood of first onset of bipolar spectrum disorder over follow-up among high-reward-sensitivity adolescents but not moderate-reward-sensitivity adolescents, controlling for follow-up time, gender, age, family history of bipolar disorder, and initial manic and depressive symptoms (β = -.150, Wald = 4.365, p = .037, odds ratio = .861, 95% confidence interval [.748, .991]). Consistent with the social zeitgeber theory, low social rhythm regularity provides vulnerability to first onset of bipolar spectrum disorder among at-risk adolescents. It may be possible to identify adolescents at risk for developing a bipolar spectrum disorder based on exhibiting both reward hypersensitivity and social rhythm irregularity before onset occurs. (c) 2015 APA, all rights reserved).

  14. Use of asenapine as add-on therapy in the treatment of bipolar disorder: a comprehensive review and case series.

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    Dell'Osso, Bernardo; Cremaschi, Laura; Palazzo, Maria Carlotta; Spagnolin, Gregorio; Cattaneo, Alma; Grancini, Benedetta; Maggi, Matteo; Altamura, Alfredo Carlo

    2014-09-01

    Several randomized controlled trials (RCTs), conducted in schizophrenic and bipolar patients, have documented the efficacy and tolerability of asenapine as monotherapy both for short- and long-term treatment. However, evidence on its augmentative use is more limited and related to the manic/mixed phase of bipolar disorder (BD). The present article reviews augmentative asenapine efficacy and safety/tolerability in the treatment of BD. It also includes some original cases of bipolar patients treated with add-on asenapine in the short- and long-term. To date, only a single RCT with manic/mixed patients with partial response to mood-stabilizer monotherapy supports the efficacy and safety/tolerability of augmentative asenapine to lithium/valproate, both in acute and long-term treatment. Additionally, two case reports confirm the overall effectiveness of augmentative asenapine to clozapine and valproate. Our case series, consisting of 4 bipolar patients treated with adjunctive asenapine to mood stabilizers and atypical antipsychotics - with treatment duration ranging from 1 to 14 months - provided clinical results that are consistent with literature data. Taken as a whole, available evidence seems to support the efficacy and safety of adjunctive asenapine in bipolar patients, though additional studies with active comparators are requested to confirm the current body of evidence.

  15. Role of extended release quetiapine in the management of bipolar disorders

    Directory of Open Access Journals (Sweden)

    Rayan K Al Jurdi

    2010-02-01

    Full Text Available Rayan K Al Jurdi1,2, Lena A Dixit1, Martha Sajatovic3 1Baylor College of Medicine, Department of Psychiatry, Houston, Texas, USA; 2South Central Mental Illness Research and Clinical Core, Department of Veterans Affairs, Houston, Texas; 3Department of Psychiatry, Case Western Reserve University School of Medicine, Cleveland, Ohio, USAAbstract: Atypical antipsychotics have become a widely utilized component of the bipolar disorder treatment armamentarium, with approximately 45% of bipolar patients prescribed atypicals. Over the last decade all atypical drugs except for clozapine have received a Food and Drug Administration (FDA bipolar indication. In October 2008, the FDA approved quetiapine XR monotherapy for the treatment of acute depressive episodes of bipolar disorder and acute manic or mixed episodes in bipolar I disorder based on two placebo-control trials. Quetiapine was also approved as adjunct therapy with lithium and divalproex for the treatment of acute manic or mixed episodes as well as maintenance of bipolar I disorder. In contrast to immediate release quetiapine which may require a twice-daily regimen, the XR formulation is intended for once-daily administration. This drug profile of quetiapine XR will address chemistry, pharmacodynamics, pharmacokinetics, metabolism, safety and tolerability and clinical trials in bipolar disorder.Keywords: quetiapine XR, bipolar disorder

  16. The Influence of Comorbid Disorders on the Episodicity of Bipolar Disorder in Youth

    Science.gov (United States)

    Yen, Shirley; Stout, Robert; Hower, Heather; Killam, Matthew A.; Weinstock, Lauren M.; Topor, David R.; Dickstein, Daniel P.; Hunt, Jeffrey I.; Gill, Mary Kay; Goldstein, Tina R.; Goldstein, Benjamin I.; Ryan, Neal D.; Strober, Michael; Sala, Regina; Axelson, David A.; Birmaher, Boris; Keller, Martin B.

    2015-01-01

    Objective Bipolar Disorder (BP) frequently co-occurs with other psychiatric disorders. We examine whether course of anxiety disorders (ANX), attention deficit hyperactivity disorder (ADHD), disruptive behavior disorders (DBD), and substance use disorders (SUD) influence likelihood of recovery and recurrence of depression and mania in BP youth. Method Weekly ratings of psychiatric disorder intensity were obtained from 413 participants of the Course and Outcome of BP Youth project, followed for an average of 7.75 years. Multiple-event Cox proportional hazards regression analyses examined worsening of comorbid disorders as predictors of mood episode recovery and recurrence. Results Increased severity in ANX and SUD predicted longer time to recovery and less time to next depressive episode, and less time to next manic episode. Multivariate models with ANX and SUD found that significant effects of ANX remained, but SUD only predicted longer time to depression recovery. Increased severity of ADHD and DBD predicted shorter time to recurrence for depressive and manic episodes. Conclusion There are significant time-varying relationships between the course of comorbid disorders and episodicity of depression and mania in BP youth. Worsening of comorbid conditions may present as a precursor to mood episode recurrence or warn of mood episode protraction. PMID:26475572

  17. An evolutionary approach to mania studying Sardinian immigrants to Argentina.

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    Carta, Mauro G; Perra, Alessandra; Atzeni, Michela; D'Oca, Silvia; Moro, Maria F; Kurotschka, Peter K; Moro, Daniela; Sancassiani, Federica; Minerba, Luigi; Brasesco, Maria V; Mausel, Gustavo; Nardi, Antonio E; Tondo, Leonardo

    2017-01-01

    To ascertain lifetime prevalence of positivity to a screening questionnaire for bipolar disorders (BD) in Sardinian immigrants to Argentina and residents of Sardinia and assess whether such positivity affects quality of life (QoL) in either group. Our hypothesis is that screen positivity for BD may be more frequent in immigrants. Observational study. Subjects were randomly selected from the membership lists of associations of Sardinian immigrants in Argentina. A study carried out in Sardinia using the same methodology was used for comparison. The Mood Disorder Questionnaire was used to screen for mania/hypomania and the Short-Form Health Survey-12 to measure QoL. A higher prevalence of manic/hypomanic episodes was found in Sardinian immigrants to Argentina (p immigrants to Argentina and in residents of Sardinia. To the best of our knowledge, this is the first study to show a higher lifetime prevalence of manic/hypomanic episodes in a general-population sample of individuals who migrated to a foreign country. Our results are in agreement with the hypothesis that hyperactive/novelty-seeking features may represent an adaptive substrate in certain conditions of social change.

  18. Psychiatric and physical comorbidities and their impact on the course of bipolar disorder: A prospective, naturalistic 4-year follow-up study.

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    Amann, Benedikt L; Radua, Joaquim; Wunsch, Christian; König, Barbara; Simhandl, Christian

    2017-05-01

    The aim of the present study was to increase the available evidence on how physical and psychiatric comorbidities influence the long-term outcome in bipolar I and II disorder. We examined the prevalence of comorbid physical (metabolic, cardiovascular, thyroid, and neurological) diseases and psychiatric (neurotic, stress-related, somatoform, and personality) disorders and their impact on the risk of relapse in bipolar disorder. A total of 284 consecutively admitted patients with ICD-10 bipolar I (n=161) and II (n=123) disorder were followed up naturalistically over a period of 4 years. Globally, 22.0% patients had metabolic, 18.8% cardiovascular, 18.8% thyroid, and 7.6% neurological diseases; 15.5% had neurotic, stress-related, and somatoform disorders; 12.0% had personality disorders; and 52.9% had nicotine dependence. We did not find any effect of comorbid metabolic, cardiovascular or neurological diseases or psychiatric disorders on the relapse risk. However, the presence of thyroid diseases, and especially hypothyroidism, was associated with an increased risk of manic relapse in bipolar disorder I (thyroid disease: hazard ratio [HR]=2.7; P=.003; hypothyroidism: HR=3.7;, Pbipolar disorder with more manic episodes, and the importance of its detection and treatment. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  19. [Concordance between hospital prescriptions and recommendations in the treatment of mania].

    Science.gov (United States)

    Laforgue, Edouard-Jules; Bulteau, Samuel; Cholet, Jennyfer; Victorri-Vigneau, Caroline; Guitteny, Marie; Mauduit, Nicolas; Vanelle, Jean-Marie; Sauvaget, Anne

    2017-06-01

    There are differences between recommendations and practice in the pharmacological treatment of acute mania. The objective was to assess conformity of the anti-manic prescription between national recommendations (Haute Autorité de santé [French health authority, HAS] and "résumé des caractéristiques du produit" [product characteristics, RCP]) and clinical practice. We observed the drug prescriptions of in-patients for a manic episode. The main outcome measure was the concordance rate with the recommendations of the drugs prescriptions at the 48th hour. The secondary outcome repeated the same process with the hospital discharge statement of switches, associations, the presence of symptomatic and antidepressant treatments. Sixty-six episodes were included, 40 patients (60%) had a prescription complies with RCP recommendations H48 and 46 patients (70%) to HAS. These rates fall at hospital discharge. Off-label prescriptions, drug combinations and choices of not listed molecules are the most common reasons for non-conformity. Copyright © 2016 Société française de pharmacologie et de thérapeutique. Published by Elsevier Masson SAS. All rights reserved.

  20. Olanzapine-Induced Mania in Bipolar Spectrum Disorder:A Case Report

    Directory of Open Access Journals (Sweden)

    Mehrdad Eftekhar

    2006-07-01

    Full Text Available Objective: To report the case of a 46-year old male with major depressive disorder, who represented manic symptoms, when olanzapine was added to his treatment. Method: A 46-year old female, with a diagnosis of treatment resistant depression was referred to the authors. He had past history of depression for more than 20 years. The symptoms were present nearly every day since 1981, without any distinct period of remission, nor any noticeable fluctuation. His irritability had been disruptive to his family all these years. His doctor had prescribed maprotiline 25 mg/day, and lorazepam, 2mg/day, in addition to fluoxetine for the last 5 months. He is also a father of two children with methylphenidateresistant and sodium valproate-responsive attention-deficit hyperactivity disorder. Considering the antidepressant effects of olanzapine and its positive effects on irritability, the authors added olanzapine, to the patient’s previous medications. Results: After one week, he showed new problems such as talkativeness and beginning to smoke for the first time in his life, elevated mood, grandiosity about his intelligence and abilities, talkativeness, and shopping sprees. The score on the mania rating scale was 14. Fluoxetine was discontinued and sodium valproate, were prescribed. It took around 2 months to completely control the manic symptoms. Conclusions: In the patients with depression who show bipolar spectrum disorder features, adding mood stabilizers may be preferred to the drugs as olanzapine which could induce mania.

  1. Validation of the bipolar disorder etiology scale based on psychological behaviorism theory and factors related to the onset of bipolar disorder.

    Directory of Open Access Journals (Sweden)

    Jae Woo Park

    Full Text Available OBJECTIVES: The aim of this study was to identify psychosocial factors related to the onset of bipolar I disorder (BD. To do so, the Bipolar Disorder Etiology Scale (BDES, based on psychological behaviorism, was developed and validated. Using the BDES, common factors related to both major depressive disorder (MDD and BD and specific factors related only to BD were investigated. METHOD: The BDES, which measures 17 factors based on psychological behaviorism hypotheses, was developed and validated. This scale was administered to 113 non-clinical control subjects, 30 subjects with MDD, and 32 people with BD. ANOVA and post hoc analyses were conducted. Subscales on which MDD and BD groups scored higher than controls were classified as common factors, while those on which the BD group scored higher than MDD and control groups were classified as specific factors. RESULTS: The BDES has acceptable reliability and validity. Twelve common factors influence both MDD and BD and one specific factor influences only BD. Common factors include the following: learning grandiose self-labeling, learning dangerous behavior, reinforcing impulsive behavior, exposure to irritability, punishment of negative emotional expression, lack of support, sleep problems, antidepressant problems, positive arousal to threat, lack of social skills, and pursuit of short-term pleasure. The specific factor is manic emotional response. CONCLUSIONS: Manic emotional response was identified as a specific factor related to the onset of BD, while parents' grandiose labeling is a candidate for a specific factor. Many factors are related to the onset of both MDD and BD.

  2. Validation of the bipolar disorder etiology scale based on psychological behaviorism theory and factors related to the onset of bipolar disorder.

    Science.gov (United States)

    Park, Jae Woo; Park, Kee Hwan

    2014-01-01

    The aim of this study was to identify psychosocial factors related to the onset of bipolar I disorder (BD). To do so, the Bipolar Disorder Etiology Scale (BDES), based on psychological behaviorism, was developed and validated. Using the BDES, common factors related to both major depressive disorder (MDD) and BD and specific factors related only to BD were investigated. The BDES, which measures 17 factors based on psychological behaviorism hypotheses, was developed and validated. This scale was administered to 113 non-clinical control subjects, 30 subjects with MDD, and 32 people with BD. ANOVA and post hoc analyses were conducted. Subscales on which MDD and BD groups scored higher than controls were classified as common factors, while those on which the BD group scored higher than MDD and control groups were classified as specific factors. The BDES has acceptable reliability and validity. Twelve common factors influence both MDD and BD and one specific factor influences only BD. Common factors include the following: learning grandiose self-labeling, learning dangerous behavior, reinforcing impulsive behavior, exposure to irritability, punishment of negative emotional expression, lack of support, sleep problems, antidepressant problems, positive arousal to threat, lack of social skills, and pursuit of short-term pleasure. The specific factor is manic emotional response. Manic emotional response was identified as a specific factor related to the onset of BD, while parents' grandiose labeling is a candidate for a specific factor. Many factors are related to the onset of both MDD and BD.

  3. Antidepressant Treatment for Acute Bipolar Depression: An Update

    Directory of Open Access Journals (Sweden)

    Ben H. Amit

    2012-01-01

    Full Text Available While studies in the past have focused more on treatment of the manic phase of bipolar disorder (BD, recent findings demonstrate the depressive phase to be at least as debilitating. However, in contrast to unipolar depression, depression in bipolar patients exhibits a varying response to antidepressants, raising questions regarding their efficacy and tolerability. Methods. We conducted a MEDLINE and Cochrane Collaboration Library search for papers published between 2005 and 2011 on the subject of antidepressant treatment of bipolar depression. Sixty-eight articles were included in the present review. Results. While a few studies did advocate the use of antidepressants, most well-controlled studies failed to show a robust effect of antidepressants in bipolar depression, regardless of antidepressant class or bipolar subtype. There was no significant increase in the rate of manic/hypomanic switch, especially with concurrent use of mood stabilizers. Prescribing guidelines published in recent years rely more on atypical antipsychotics, especially quetiapine, as a first-line therapy. Conclusions. Antidepressants probably have no substantial role in acute bipolar depression. However, in light of conflicting results between studies, more well-designed trials are warranted.

  4. FUNCTIONAL IMPLICATIONS OF THE CLOCK 3111T/C SINGLE-NUCLEOTIDE POLYMORPHISM

    Directory of Open Access Journals (Sweden)

    Angela Renee Ozburn

    2016-04-01

    Full Text Available Circadian rhythm disruptions are prominently associated with Bipolar Disorder (BD. Circadian rhythms are regulated by the molecular clock, a family of proteins that function together in a transcriptional-translational feedback loop. The CLOCK protein is a key transcription factor of this feedback loop, and previous studies have found that manipulations of the Clock gene are sufficient to produce manic-like behavior in mice (Roybal et al., 2007. The Clock 3111T/C single-nucleotide polymorphism (SNP; rs1801260 is a genetic variation of the human Clock gene that is significantly associated with increased frequency of manic episodes in BD patients (Benedetti et al., 2003. The 3111T/C SNP is located in the 3’ untranslated region of the Clock gene. In this study, we sought to examine the functional implications of the human Clock 3111T/C SNP by transfecting a mammalian cell line (mouse embryonic fibroblasts isolated from Clock -/- knockout mice with pcDNA plasmids containing the human Clock gene with either the T or C SNP at position 3111. We then measured circadian gene expression over a 24 hour time period. We found that the Clock3111C SNP resulted in higher mRNA levels than the Clock 3111T SNP. Further, we found that Per2, a transcriptional target of CLOCK, was also more highly expressed with Clock 3111C expression, indicating the 3’UTR SNP affects the expression, function and stability of Clock mRNA.

  5. Neuroprotective and antioxidant effects of curcumin in a ketamine-induced model of mania in rats.

    Science.gov (United States)

    Gazal, Marta; Valente, Matheus R; Acosta, Bruna A; Kaufmann, Fernanda N; Braganhol, Elizandra; Lencina, Claiton L; Stefanello, Francieli M; Ghisleni, Gabriele; Kaster, Manuella P

    2014-02-05

    Bipolar disorder (BD) is a chronic and debilitating illness characterized by recurrent manic and depressive episodes. Our research investigates the protective effects of curcumin, the main curcuminoid of the Indian spice turmeric, in a model of mania induced by ketamine administration in rats. Our results indicated that ketamine treatment (25 mg/kg, for 8 days) induced hyperlocomotion in the open-field test and oxidative damage in prefrontal cortex (PFC) and hippocampus (HP), evaluated by increased lipid peroxidation and decreased total thiol content. Moreover, ketamine treatment reduced the activity of the antioxidant enzymes superoxide dismutase and catalase in the HP. Pretreatment of rats with curcumin (20 and 50 mg/kg, for 14 days) or with lithium chloride (45 mg/kg, positive control) prevented behavioral and pro-oxidant effects induced by ketamine. These findings suggest that curcumin might be a good compound for preventive intervention in BD, reducing the episode relapse and the oxidative damage associated with the manic phase of this disorder. Copyright © 2013 Elsevier B.V. All rights reserved.

  6. [Role of associations in bipolar patients].

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    Attar-Lévy, D; Gay, C

    1997-01-01

    Providing information to the patients and their families represents one of today's new conditions in the management of the depressed. It will help their adaptation to the illness and its effects. It will maintain a good therapeutic alliance among patients and practitioners, and will enhance their treatment adherence thus improving their quality of life. Several aspects are essential in the transmission of this information: it must be available to every patient, easily accessible, concise, repeated and revised as necessary, discouraging self-diagnosis and self-prescription. This education must be given personally by the physicians and the pharmacists. Depressed patients may also have an access to complementary sources: books, magazines and more rarely scientific journals. Patients' associations provide another potential source of information, offering a comprehensive approach to the patient and the illness. France-Déxpression is a depressive and manic-depressive patients association. Its goals are to provide information and support to the patients and their families, promoting a better understanding and recognition of depressive and manic-depressive illness.

  7. The misdiagnosis of bipolar disorder as a psychotic disorder: some of its causes and their influence on therapy.

    Science.gov (United States)

    Meyer, Friederike; Meyer, Thomas D

    2009-01-01

    Looking at chart records bipolar disorder is often misdiagnosed as a psychotic disorder but no study has ever systematically looked into the reasons. One reason for misdiagnoses could be that clinicians use heuristics like the prototype approach in routine practice instead of strictly adhering to the diagnostic criteria. Using an experimental approach we investigated if the use of heuristics can explain when a diagnosis of psychotic disorder is given instead of bipolar disorder. We systematically varied information about the presence or absence of specific symptoms, i.e. hallucinations and decreased need for sleep during a manic episode. Experimentally varied case vignettes were randomly sent to psychiatrists in Southern Germany. The four versions of the case vignette all described the same person in a manic state and differed only in two aspects: the presence or absence of auditory hallucinations and of decreased need for sleep. The psychiatrists were asked to make a diagnosis, to rate their confidence in their diagnosis, and to recommend treatments. Almost half of the 142 psychiatrists (45%) did not diagnose bipolar disorder. Mentioning hallucinations decreased the likelihood of diagnosing bipolar disorder. The information about decreased need for sleep only affected the diagnosis significantly, if schizoaffective disorder was considered a bipolar disorder. Our results suggest that clinicians indeed use heuristics when making diagnostic decisions instead of strictly adhering to diagnostic criteria. More research is needed to better understand diagnostic decision making, especially under real life settings, and this might also be of interest when revising diagnostic manuals such as DSM.

  8. Resting State Brain Network Disturbances Related to Hypomania and Depression in Medication-Free Bipolar Disorder.

    Science.gov (United States)

    Spielberg, Jeffrey M; Beall, Erik B; Hulvershorn, Leslie A; Altinay, Murat; Karne, Harish; Anand, Amit

    2016-12-01

    Research on resting functional brain networks in bipolar disorder (BP) has been unable to differentiate between disturbances related to mania or depression, which is necessary to understand the mechanisms leading to each state. Past research has also been unable to elucidate the impact of BP-related network disturbances on the organizational properties of the brain (eg, communication efficiency). Thus, the present work sought to isolate network disturbances related to BP, fractionate these into components associated with manic and depressive symptoms, and characterize the impact of disturbances on network function. Graph theory was used to analyze resting functional magnetic resonance imaging data from 60 medication-free patients meeting the criteria for BP and either a current hypomanic (n=30) or depressed (n=30) episode and 30 closely age/sex-matched healthy controls. Correction for multiple comparisons was carried out. Compared with controls, BP patients evidenced hyperconnectivity in a network involving right amygdala. Fractionation revealed that (hypo)manic symptoms were associated with hyperconnectivity in an overlapping network and disruptions in the brain's 'small-world' network organization. Depressive symptoms predicted hyperconnectivity in a network involving orbitofrontal cortex along with a less resilient global network organization. Findings provide deeper insight into the differential pathophysiological processes associated with hypomania and depression, along with the particular impact these differential processes have on network function.

  9. [Epistemic and historical elucidation of the borderline personality disorder].

    Science.gov (United States)

    Londoño Paredes, Diego Enrique

    2015-01-01

    The particularities of those that have been considered "hard cases" in the clinical field, and their relationship with personality disorders, are discussed together with their quintessential conceptual and diagnostic model: the borderline personalities. The aim of the study is to historically and epistemologically rebuild their origins within psychiatry and psychoanalysis. From a classical epistemological and historical study, a brief tour is made through the nineteenth century alienism and the postulate of "partial insanity". Next, a passage is spawned through the concepts that emerged from this postulate: "monomania" and "moral insanity", up to mid-century Kraepelin and the "fundamental states" of manic-depressive insanity as pathological constitutional forms or characters, and reaching the twentieth century with characterology and psychopathic personalities. Finally, psychoanalysis is analyzed as the main source of borderline personality disorders arising from the problems encountered in analytical treatments and the development of the notion of "character neurosis". Borderline personality disorders are the result of the conjunction of a number of factors, heirs of the notion of "partial insanity", of the fundamental states of manic-depression insanity, of characterology, of the idea of constitutions and pathological personalities, together with the emerging concerns of psychoanalysis in the early twentieth century. Copyright © 2014 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  10. Familial Depressive Symptoms and Delinquency: Separate Self-Reports From Mothers and Their Offspring.

    Science.gov (United States)

    Ellis, Lee; Hoskin, Anthony

    2018-04-01

    Research has documented that both unipolar and bipolar depression are positively correlated with involvement in delinquency and crime. The present study sought to broaden the understanding of these relationships by looking for links between offending and family histories of depressive symptoms in relationship to offspring delinquency. More than 6,000 college students and their mothers provided self-reported information regarding feelings of depression. Students provided self-reports of involvement in various categories of offending and drug use from ages 10 through 18. Numerous significant positive correlations were found between general feelings of depression and of manic depression and involvement in delinquency. The depression-delinquency relationships were strongest when considering offspring themselves, although maternal depression symptoms were also associated with various forms of offspring delinquency and drug use. To help assess the causal chains that might be involved, multiple regression and mediation analysis revealed that parental depression enhanced the probability of offspring feeling depressed and may have thereby contributed to offspring being delinquent, particularly in the case of manic depression. This study reconfirmed the well-established relationship between depression and involvement in delinquency and drug use, and suggests that it extends back to parental forms of depression, especially by the mother.

  11. [Temperament and affective disorders--historical basis of current discussion].

    Science.gov (United States)

    Ehrt, U; Brieger, P; Marneros, A

    2003-06-01

    The history of the temperament concept begins in ancient Greece. The humoral theory remained influential over the centuries. At the beginning of the 20 th century, both Wilhelm Wundt and his pupil Emil Kraepelin formulated new aspects. Wundt described two dimensions: "speed of variability of emotions" and "intensity of emotions". Kraepelin observed four fundamental states (depressive, manic, irritable and cyclothymic), which he linked to manic-depressive illness. Since then different lines of temperament research have evolved: (1) psychiatric-psychopathological theories (e. g. Ewald, Kretschmer and Sheldon), which tend to see temperament as a dilution of full-blown affective disorders; (2) neurobiological theories (e. g. Pavlov, Eysenck and Gray), which understand temperament as determined by underlying neurobiological processes - especially levels of arousal; and (3) developmental theories (e. g. Chess & Thomas, Rothbart and Kagan), which derived their temperament concept from early childhood observations. Recent theories (e. g. those of Cloninger or Akiskal) combine different aspects. After reviewing the historical temperament concepts we present underlying factors which are linked to affective disorders (such as emotional reactivity, cyclicity or trait affectivity). Finally, we illustrate the importance of temperament concepts for research in affective disorders.

  12. Stressful life events predict delayed functional recovery following treatment for mania in bipolar disorder.

    Science.gov (United States)

    Yan-Meier, Leslie; Eberhart, Nicole K; Hammen, Constance L; Gitlin, Michael; Sokolski, Kenneth; Altshuler, Lori

    2011-04-30

    Identifying predictors of functional recovery in bipolar disorder is critical to treatment efforts to help patients re-establish premorbid levels of role adjustment following an acute manic episode. The current study examined the role of stressful life events as potential obstacles to recovery of functioning in various roles. 65 patients with bipolar I disorder participated in a longitudinal study of functional recovery following clinical recovery from a manic episode. Stressful life events were assessed as predictors of concurrent vs. delayed recovery of role functioning in 4 domains (friends, family, home duties, work/school). Despite clinical recovery, a subset of patients experienced delayed functional recovery in various role domains. Moreover, delayed functional recovery was significantly associated with presence of one or more stressors in the prior 3 months, even after controlling for mood symptoms. Presence of a stressor predicted longer time to functional recovery in life domains, up to 112 days in work/school. Interventions that provide monitoring, support, and problem-solving may be needed to help prevent or mitigate the effects of stress on functional recovery. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  13. Clinical predictors of conversion to bipolar disorder in a prospective longitudinal familial high-risk sample: focus on depressive features.

    Science.gov (United States)

    Frankland, Andrew; Roberts, Gloria; Holmes-Preston, Ellen; Perich, Tania; Levy, Florence; Lenroot, Rhoshel; Hadzi-Pavlovic, Dusan; Breakspear, Michael; Mitchell, Philip B

    2017-11-07

    Identifying clinical features that predict conversion to bipolar disorder (BD) in those at high familial risk (HR) would assist in identifying a more focused population for early intervention. In total 287 participants aged 12-30 (163 HR with a first-degree relative with BD and 124 controls (CONs)) were followed annually for a median of 5 years. We used the baseline presence of DSM-IV depressive, anxiety, behavioural and substance use disorders, as well as a constellation of specific depressive symptoms (as identified by the Probabilistic Approach to Bipolar Depression) to predict the subsequent development of hypo/manic episodes. At baseline, HR participants were significantly more likely to report ⩾4 Probabilistic features (40.4%) when depressed than CONs (6.7%; p conversion' to threshold BD (hazard ratio = 6.9, p conversion were psychomotor retardation and ⩾5 MDEs. Behavioural disorders only predicted conversion to subthreshold BD (hazard ratio = 5.23, p disorders did not predict either threshold or subthreshold hypo/mania. This study suggests that specific depressive characteristics substantially increase the risk of young people at familial risk of BD going on to develop future hypo/manic episodes and may identify a more targeted HR population for the development of early intervention programs.

  14. Assessing the contribution of borderline personality disorder and features to suicide risk in psychiatric inpatients with bipolar disorder, major depression and schizoaffective disorder.

    Science.gov (United States)

    Zeng, Ruifan; Cohen, Lisa J; Tanis, Thachell; Qizilbash, Azra; Lopatyuk, Yana; Yaseen, Zimri S; Galynker, Igor

    2015-03-30

    Suicidal behavior often accompanies both borderline personality disorder (BPD) and severe mood disorders, and comorbidity between the two appears to further increase suicide risk. The current study aims to quantify the risk of suicidality conferred by comorbid BPD diagnosis or features in three affective disorders: major depressive disorder (MDD), bipolar disorder (BP) and schizoaffective disorder. One hundred forty-nine (149) psychiatric inpatients were assessed by SCID I and II, and the Columbia Suicide Severity Rating Scale. Logistic regression analyses investigated the associations between previous suicide attempt and BPD diagnosis or features in patients with MDD, BP, and schizoaffective disorder, as well as a history of manic or major depressive episodes, and psychotic symptoms. Comorbid BPD diagnosis significantly increased suicide risk in the whole sample, and in those with MDD, BP, and history of depressive episode or psychotic symptoms. Each additional borderline feature also increased risk of past suicide attempt in these same groups (excepting BP) and in those with a previous manic episode. Of the BPD criteria, only unstable relationships and impulsivity independently predicted past suicide attempt. Overall, among patients with severe mood disorders, the presence of comorbid BPD features or disorder appears to substantially increase the risk of suicide attempts. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  15. Issues on the diagnosis and etiopathogenesis of mood disorders: reconsidering DSM-5.

    Science.gov (United States)

    Ogasawara, Kazuyoshi; Nakamura, Yukako; Kimura, Hiroyuki; Aleksic, Branko; Ozaki, Norio

    2018-02-01

    The authors present a narrative review from the diagnostic and nosologic viewpoints of mood disorders (bipolar and depressive ones) by revisiting the revision from the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders, Text Revision to DSM-5, including the following: the separation of the bipolar and depressive sections; the addition of increased energy and continuation of symptoms to the hypo/manic criteria; the elimination of mixed episodes; the creation of new categories and specifiers ("other specified bipolar and related disorder", "disruptive mood dysregulation disorder", "with anxious distress", "with mixed features", "with peripartum onset"); the categorization of hypo/manic episodes during antidepressant treatment into bipolar disorder; the elimination of the "bereavement exclusion"; the ambiguous separation between bipolar I and II; the insufficient distinction between "other specified bipolar and related disorders" and major depressive disorder; the differentiation regarding borderline personality disorder; agitation; premenstrual dysphoric disorder; and society and psychiatry. Through this analysis, we point out both the achievements and limitations of DSM-5. In addition, to examine the future direction of psychiatry, we introduce our cohort study regarding maternal depression and an outline of the National Institute of Mental Health's Research Domain Criteria project in the US. Finally, we advocate the importance of elucidating etiopathogeneses by starting from or going beyond the DSM operational diagnostic system, which has shown great efficacy.

  16. The influence of comorbid disorders on the episodicity of bipolar disorder in youth.

    Science.gov (United States)

    Yen, S; Stout, R; Hower, H; Killam, M A; Weinstock, L M; Topor, D R; Dickstein, D P; Hunt, J I; Gill, M K; Goldstein, T R; Goldstein, B I; Ryan, N D; Strober, M; Sala, R; Axelson, D A; Birmaher, B; Keller, M B

    2016-04-01

    Bipolar disorder (BP) frequently co-occurs with other psychiatric disorders. We examine whether course of anxiety disorders (ANX), attention deficit hyperactivity disorder (ADHD), disruptive behavior disorders (DBD), and substance use disorders (SUD) influence likelihood of recovery and recurrence of depression and mania in BP youth. Weekly ratings of psychiatric disorder intensity were obtained from 413 participants of the Course and Outcome of BP Youth project, followed for an average of 7.75 years. Multiple-event Cox proportional hazards regression analyses examined worsening of comorbid disorders as predictors of mood episode recovery and recurrence. Increased severity in ANX and SUD predicted longer time to recovery and less time to next depressive episode, and less time to next manic episode. Multivariate models with ANX and SUD found that significant effects of ANX remained, but SUD only predicted longer time to depression recovery. Increased severity of ADHD and DBD predicted shorter time to recurrence for depressive and manic episodes. There are significant time-varying relationships between the course of comorbid disorders and episodicity of depression and mania in BP youth. Worsening of comorbid conditions may present as a precursor to mood episode recurrence or warn of mood episode protraction. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  17. A 6 week randomized double-blind placebo-controlled trial of ziprasidone for the acute depressive mixed state.

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    Ashwin Patkar

    Full Text Available OBJECTIVE: To examine the efficacy of ziprasidone vs. placebo for the depressive mixed state in patients with bipolar disorder type II or major depressive disorder (MDD. METHODS: 73 patients were randomized in a double-blinded, placebo-controlled study to ziprasidone (40-160 mg/d or placebo for 6 weeks. They met DSM-IV criteria for a major depressive episode (MDE, while also meeting 2 or 3 (but not more nor less DSM-IV manic criteria. They did not meet DSM-IV criteria for a mixed or manic episode. Baseline psychotropic drugs were continued unchanged. The primary endpoint measured was Montgomery-Åsberg Depression Rating Scale (MADRS scores over time. The mean dose of ziprasidone was 129.7±45.3 mg/day and 126.1±47.1 mg/day for placebo. RESULTS: The primary outcome analysis indicated efficacy of ziprasidone versus placebo (p = 0.0038. Efficacy was more pronounced in type II bipolar disorder than in MDD (p = 0.036. Overall ziprasidone was well tolerated, without notable worsening of weight or extrapyramidal symptoms. CONCLUSIONS: There was a statistically significant benefit with ziprasidone versus placebo in this first RCT of any medication for the provisional diagnostic concept of the depressive mixed state. TRIAL REGISTRATION: Clinicaltrials.gov NCT00490542.

  18. Feeling and Time: The Phenomenology of Mood Disorders, Depressive Realism, and Existential Psychotherapy

    Science.gov (United States)

    Ghaemi, S. Nassir

    2007-01-01

    Phenomenological research suggests that pure manic and depressive states are less common than mixtures of the two and that the two poles of mood are characterized by opposite ways of experiencing time. In mania, the subjective experience of time is sped up and in depression it is slowed down, perhaps reflecting differences in circadian pathophysiology. The two classic mood states are also quite different in their effect on subjective awareness: manic patients lack insight into their excitation, while depressed patients are quite insightful into their unhappiness. Consequently, insight plays a major role in overdiagnosis of unipolar depression and misdiagnosis of bipolar disorder. The phenomenology of depression also is relevant to types of psychotherapies used to treat it. The depressive realism (DR) model, in contrast to the cognitive distortion model, appears to better apply to many persons with mild to moderate depressive syndromes. I suggest that existential psychotherapy is the necessary corollary of the DR model in those cases. Further, some depressive morbidities may in fact prove, after phenomenological study, to involve other mental states instead of depression. The chronic subsyndromal depression that is often the long-term consequence of treated bipolar disorder may in fact represent existential despair, rather than depression proper, again suggesting intervention with existential psychotherapeutic methods. PMID:17122410

  19. 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

  20. Penerapan Pendekatan Saintifik Untuk Meningkatkan Kreativitas Dan Hasil Belajar Siswa Dalam Mata Pelajaran IPA

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    Nur Alamsyah

    2017-01-01

    Full Text Available Abstrak Penelitian ini bertujuan untuk mendeskripsikan penerapan pendekatan saintifik untuk meningkatkan kreativitas dan hasil belajar siswa dalam mata pelajaran IPA kelas V SD Negeri 12/30 Kanaungan Kabupaten Pangkep . dengan penerapan pendekatan saintifik maka kreativitas dan hasil belajar siswa dapat meningkat. Penelitian ini merupakan Penelitian Tindakan Kelas (PTK yang dilaksanakan tiap siklus pembelajaran terdiri atas (1 Perencanaan (2 Pelaksanaan (3 Observasi dan (4 Refleksi. Perangkat pembelajaran yang digunakan meliputi silabus, rencana pelaksanaan pembelajaran (RPP, lembar kerja siswa (LKS, buku siswa, lembar evaluasi. Instrumen meliputi Lembar Pengamatan keterlaksanaan guru mengelola pembelajaran, Lembar aktivitas siswa mengikuti pembelajaran serta angket respon siswa terhadap pembelajaran yang diikutinya. Kurikulum yang digunakan dalam penelitian ini adalah kurikulum tingkat satuan pendidikan (KTSP tahun 2006 dengan materi pokok bumi dan alam semesta. Adapun data yang dianalisis sebagai hasil penelitian meliputi: (1 Keterlaksanaan guru dalam mengelola pembelajaran dan aktivitas siswa mengikuti pembelajaran (2 Kreativitas siswa (3, Hasil belajar siswa (4, Respon siswa terhadap pembelajaran yang diikutinya. Dari hasil analisis data selama tiga siklus menunjukkan bahwa: (1 keterlaksanaan guru dalam mengelola pembelajaran mencapai tingkat persentase ketercapaian 84% atau ada pada kategori “sangat baik (2 aktivitas siswa mengikuti pembelajaran mencapai kategori “efektif”,(3 kreativitas siswa menunjukkan 100% siswa kreatif, (4 hasil belajar siswa ranah kognitif dengan rata-rata kelas 84 ranah sikap dengan rata-rata 88, dan ranah psikomotor dengan rata-rata 81 dengan kategori tuntas, dan ketuntasan individu mencapai 92% dengan kategori “tuntas”, (5 Respon siswa dalam mengikuti pembelajaran mencapai tingkat “positif” atau pada kategori (Senang, Baru, Menarik, dan Ya. Berdasarkan pembahasan hasil penelitian dan analisis data

  1. KEEFEKTIFAN PEMBELAJARAN SNOWBALL THROWING BERBANTUAN LEMBAR KEGIATAN SISWA

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    Gallant Alim Purbowo

    2012-06-01

    Full Text Available Abstract Tujuan penelitian ini adalah untuk mengetahui keefektifan pembelajaran Snowball Throwing berbantuan LKS terhadap hasil belajar siswa kelas VIII SMP Negeri 1 Kaliori pada materi lingkaran tahun ajaran 2011/2012. Populasi dalam penelitian ini adalah semua siswa kelas VIII SMP Negeri 1 Kaliori tahun ajaran 2011/2012. Sampel dalam penelitian ini diambil secara cluster random sampling. Data hasil penelitian diperoleh dengan metode tes yang dianalisis dengan menggunakan uji proporsi, uji rata-rata, uji kesamaan dua proporsi, dan uji perbedaan dua rata-rata untuk menguji hipotesis. Hasil penelitian menunjukkan: (1 zhitung =0,5>-(z(0,5-? =-1,64, artinya siswa yang tuntas terhadap hasil belajar pada kelas eksperimen dapat mencapai persentase ketuntasan minimal siswa, (2 thitung=3,9001 >t(1-? =1,69 artinya rata-rata hasil belajar siswa pada kelas eksperimen dapat mencapai KKM, (3 zhitung=2,335>z(0.5-? =1,64, artinya siswa yang tuntas pada kelas eksperimen lebih besar dari kelas kontrol, (4 thitung=2,0194 ? 1,668, artinya rata-rata hasil belajar siswa pada kelas eksperimen lebih dari kelas kontrol. Berdasarkan hasil penelitian tersebut dapat disimpulkan bahwa penerapan Pembelajaran Snowball Throwing berbantuan LKS efektif terhadap hasil belajar siswa kelas VIII SMP Negeri 1 Kaliori pada materi lingkaran. The purpose of this study was to determine the effectiveness of Snowball Throwing learning assisted students worksheets to learning outcomes of VIII grade in SMP Negeri 1 Kaliori in circle material of the school year 2011/2012. The population in this study were all students in VIII grade SMP Negeri 1 Kaliori academic year 2011/2012. The sample in this study were drawn by cluster random sampling. Research data obtained with the test method were analyzed using the proportion test, test averages, test the equality of two proportions, and test the average difference in the two hypotheses. The results showed: (1 zcount = 0.5> - z(0,5-? = -1.64, meaning

  2. MODEL DISCOVERY LEARNING DENGAN PENDEKATAN SAINTIFIK BERMUATAN KARAKTER UNTUK MENINGKATKAN KEMAMPUAN BERPIKIR KREATIF

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    Hendra Erik Rudyanto

    2016-11-01

    Full Text Available This Study aims to produce a model learning device discovery learning with scientific approach to improve the character charged valid creative thinking, practical and effective. The model refers to a model of learning development includes activities Plomp initial investigation, design, realization/contruction, testing, evaluation and revision. The results showed that (1 learning tools developed valid; syllabus ehit an average of 3,3 (very good; RPP with an average of 3,2 (good; LKS with an average of 3,2 (good; textbook student with an average of 3,3 (very good; and TKBK with an average of 3,5 (good.; (2 the stated learning practical , namely: 1 the activity of student on both criteria, an average score 74,1%; 2 the activity of the teacher are very good on the criterion, the average score of 98,25; 3 positive teacher response, a score of 97,14; 4 positive students response, average 89,73.; (3 the learning of mathematics is declared effective the indicator 1 traffic to think creatively achieve mastery with the average value of 71,55 and a classical completeness reaches 90%; 2 the average grade of creative thinking ability model of discovery learning with scientific approachis better than ekspositori class; 3 the character of the curiosity and skills to communicate a positive influence on the ability to think creatively; and 4 an increase in the ability to think creatively in class models discovery learning with scientific approach.   Keywords: discovery learning, scientific approach, creative thinking ability.

  3. Pengembangan Perangkat Pembelajaran Ekosistem Dan Pencemaran Lingkungan Berbasis Inkuiri Serta Pengaruhnya Terhadap Kemampuan Berpikir Kritis, Pemahaman Konsep, Dan Sikap Siswa Kelas X SMA

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    Dody Kurniawan

    2015-09-01

    Full Text Available Abstract: The objectives of this research are to design a valid inquiry-based learning material about ecosystem and environmental pollution for grade X of Senior High School 3 Malang and to discover its effect towards critical thinking ability, conceptual comprehension, and attitude of grade X of Senior High School 3 Malang students. This research was conducted in two phases. The first phase is making the learning material including syllable, course outline, handout, student worksheet, and scoring instrument. The second phase is a quasi-experiment. Two sample groups are given different treatment to see the effect for critical thinking skills, conceptual comprehension, and student attitude. The results of the study showed that the learning material based on inquiry learning is valid and could be used for grade X students of Senior High School 3 Malang and there is a significant effect of the learning material towards the students critical thinking ability, conceptual comprehension, and attitude. Key Words: developing learning material, ecosystem and enviromental pollution, inquiry, critical thinking ability, conceptual comprehensension, attitude Abstrak: Tujuan penelitian ini adalah mengembangkan perangkat pembelajaran berbasis inkuiri pada materi ekosistem dan pencemaran lingkungan untuk siswa kelas X SMAN 3 Malang dan mengetahui pengaruhnya terhadap kemampuan berpikir kritis, pemahaman konsep, dan sikap siswa kelas X SMAN 3 Malang. Penelitian ini dilakukan dalam dua tahap. Tahap pertama adalah perancangan perangkat pembelajaran seperti silabus, RPP, handout, LKS, dan instrumen penilaian. Tahap kedua adalah eksperimen quasi. Pada tahap ini, dua sampel kelompok diberikan perlakuan yang berbeda untuk melihat pengaruh terhadap kemampuan berpikir kritis, pemahaman konsep, dan sikap siswa. Hasil dari penelitian ini menyatakan bahwa perangkat pembelajaran berbasis inkuiri valid dan dapat digunakan pada siswa kelas X SMAN 3 Malang dan terdapat pengaruh

  4. JAK and MPL mutations in myeloid malignancies.

    Science.gov (United States)

    Tefferi, Ayalew

    2008-03-01

    The Janus family of non-receptor tyrosine kinases (JAK1, JAK2, JAK3 and tyrosine kinase 2) transduces signals downstream of type I and II cytokine receptors via signal transducers and activators of transcription (STATs). JAK3 is important in lymphoid and JAK2 in myeloid cell proliferation and differentiation. The thrombopoietin receptor MPL is one of several JAK2 cognate receptors and is essential for myelopoiesis in general and megakaryopoiesis in particular. Germline loss-of-function (LOF) JAK3 and MPL mutations cause severe combined immunodeficiency and congenital amegakaryocytic thrombocytopenia, respectively. Germline gain-of-function (GOF) MPL mutation (MPLS505N) causes familial thrombocytosis. Somatic JAK3 (e.g. JAK3A572V, JAK3V722I, JAK3P132T) and fusion JAK2 (e.g. ETV6-JAK2, PCM1-JAK2, BCR-JAK2) mutations have respectively been described in acute megakaryocytic leukemia and acute leukemia/chronic myeloid malignancies. However, current attention is focused on JAK2 (e.g. JAK2V617F, JAK2 exon 12 mutations) and MPL (e.g. MPLW515L/K/S, MPLS505N) mutations associated with myeloproliferative neoplasms (MPNs). A JAK2 mutation, primarily JAK2V617F, is invariably associated with polycythemia vera (PV). The latter mutation also occurs in the majority of patients with essential thrombocythemia (ET) or primary myelofibrosis (PMF). MPL mutational frequency in MPNs is substantially less (<10%). In general, despite a certain degree of genotype - phenotype correlations, the prognostic relevance of harbouring one of these mutations, or their allele burden when present, remains dubious. Regardless, based on the logical assumption that amplified JAK-STAT signalling is central to the pathogenesis of PV, ET and PMF, several anti-JAK2 tyrosine kinase inhibitors have been developed and are currently being tested in humans with these disorders.

  5. MODEL PEMBELAJARAN JIGSAW DENGAN STRATEGI METAKOGNITIF UNTUK MENINGKATKAN SELF-EFFICACY DAN KEMAMPUAN PEMECAHAN MASALAH

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    Purtiana Septi Alfurofika

    2013-12-01

    Full Text Available Tujuan penelitian ini untuk menghasilkan perangkat pembelajaran matematika model Jigsaw strategi Metakognitif untuk meningkatkan self-efficacy terhadap kemampuan pemecahan masalah dengan materi segi empat kelas VII valid, praktis dan efektif. Penelitian ini merupakan penelitian pengembangan modifikasi Plomp. Jenis perangkat pembelajaran yang dikembangkan adalah silabus, RPP, bahan ajar, LKS, media pembelajaran, Tes Kemampuan Pemecahan Masalah. Teknik pengambilan data menggunakan lembar validasi, lembar pengamatan self-efficacy dan aktifitas, Lembar angket, dan Tes Kemampuan Pemecahan Masalah. Hasil penelitian menunjukkan: (1 perangkat yang dikembangkan valid; (2 pembelajaran praktis ditandai dengan respon positif siswa dan kemampuan guru baik; (3 Efektifitas ditandai dengan (a kemampuan pemecahan masalah mencapai KKM yaitu 83,4 dan ketuntasan klasikal sebesar 90,3%; (b self-efficacy dan aktifitas siswa secara bersama – sama berpengaruh positif terhadap kemampuan pemecahan masalah sebesar 71,9%; dan (c self-efficacy dan aktivitas siswa mengalami peningkatan. Berdasarkan hasil penelitian dapat disimpulkan tujuan pengembangan perangkat tercapai. The aim of this research to produce mathematics’ learning device the Jigsaw model with Metacognitive strategies for increasing self-efficacy towards problem solving ability to quadrilateral of class VII valid, practical and effective. This research is development of modifications Plomp. Kinds of learning devices are developed syllabi, lesson plans, teaching materials, worksheets, instructional media, and problem solving ability test. Technique of data collection by using validation sheet, observation sheet student’s self-efficacy and activity, questionnaire, and problem solving ability test. The results showed: (1 device developed valid; (2 practical learning is characterized by the positive response of students and good teachers ability; (3 effectiveness characterized by (a the ability of problem

  6. UPAYA MENINGKATKAN HASIL BELAJAR IPS MELALUI METODE MIND MAP DENGAN MEDIA POWERPOINT

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    Anisa Fatmawati

    2017-09-01

    Full Text Available The low learning outcomes were caused by the lecture method, question and answer and discussion based on the students’ worksheet as well as the unoptimum media of teaching. The research was aimed to improve students’ learning outcome of social science on the topic of economic activities related to the natural resources in their areas through Mind Map method and Powerpoint media for the fourth graders SDN Pasir Wetan. This classroom action research consisted of two cycles and it had 2 meetings and each cycle. The procedure was planning, acting, observing and reflecting. The data were obtained through student’ worksheet (LKS, evaluation test (at the end of the cycle, scoring sheet of teacher activities, observation sheet of students’ activity in their cognitive, affective and psychomotor aspect and there were field notes and interview. The research and discussion that the use Mind Map methode and Powerpoint media could improve students’ cognitive aspect proven by mean of first cycle 72,57 (good criteria and 71,65% level of achievement (good enough while second cycle 80,31 (very good criteria and 92,26% level of achievement (very good. The affevtive mean score showed 3,08 (good criteria in the first cycle and the mean score 8,66 was in the second cycle (very good. The psychomotor aspect showed with mean score that 3,25 was in the first cycle (good criteria and 3,4 was in the second cycle (very good. It could be drawn that Mind Map methode and Powerpoint media could improve students’ learning outcomes off social science for the fourth graders.

  7. Rotational malalignment after closed intramedullary nailing of femoral shaft fractures and its influence on daily life.

    Science.gov (United States)

    Karaman, Ozgur; Ayhan, Egemen; Kesmezacar, Hayrettin; Seker, Ali; Unlu, Mehmet Can; Aydingoz, Onder

    2014-10-01

    Any intraoperative rotational malalignment during intramedullary nailing (IMN) of femoral shaft fractures will become permanent. We hypothesized that rotational malalignment of the femur and its compensatory biomechanics may induce problems in the hip, knee, patellofemoral and ankle joints. We purposed to clarify the influence of a femoral rotational malalignment of ≥10° on daily activities. Twenty-four femoral shaft fracture patients treated with closed antegrade IMN were included. At last follow-up, to reveal any rotational malalignment, computerized tomography (CT) scans of both femurs (injured and uninjured sides) were examined. The patient groups with or without CT-detected true rotational malalignment ≥10° were compared with respect to the activity scores. Ten of the 24 patients (41.7%) had a CT-detected true rotational malalignment of ≥10° compared with the unaffected side. The AOFAS scores were 100.00 for all of the patients. LKS, WOMAC knee, and WOMAC hip scores were significantly decreased in the patients with rotational malalignment compared to those without. Patients without rotational malalignment tolerated climbing stairs significantly better than those with rotational malalignment. Patients who could not tolerate climbing stairs were consistently complaining of anterior knee pain. A femoral rotational malalignment of ≥10° is symptomatic for the patients, and the hip, knee, and patellofemoral joints were affected. Because of the possibly altered joint loadings and biomechanics, these could render patients prone to degenerative joint disease. In addition, due to the high rates of rotational malalignment after femoral shaft fracture and consequent malpractice claims, it is important for surgeons to be more aware of rotational alignment during surgery.

  8. Suppression of cytochrome p450 reductase enhances long-term hematopoietic stem cell repopulation efficiency in mice.

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    Yan Zhang

    Full Text Available BACKGROUND: Bone marrow microenvironment (niche plays essential roles in the fate of hematopoietic stem cells (HSCs. Intracellular and extracellular redox metabolic microenvironment is one of the critical factors for the maintenance of the niche. Cytochrome P450 reductase (CPR is an obligate electron donor to all microsomal cytochrome P450 enzymes (P450 or CYP, and contributes to the redox metabolic process. However, its role in maintaining HSCs is unknown. OBJECTIVE: To examine the effects of low CPR expression on HSCs function using a mouse model of globally suppressed Cpr gene expression (Cpr Low, CL mice. METHODS: Hematopoietic cell subpopulations in bone marrow (BM and peripheral blood (PB from WT and CL mice were examined for their repopulation and differentiation ability upon BM competitive transplantation and enriched HSC (LKS(+ transplantation. Effects of low CPR expression on hematopoiesis were examined by transplanting normal BM cells into CL recipients. Reactive oxygen species (ROS, cell cycle, and apoptosis in CL mice were analyzed by flow cytometry for DCF-DA fluorescence intensity, Ki67 protein, and Annexin-V, respectively. RESULTS: The levels of ROS in BM cells, HPCs and HSCs were comparable between CL and WT mice. In comparison to WT mice, the number of LT-HSCs or ST-HSCs was lower in CL mice while CMPs, GMPs and MEPs in CL mice were higher than that in WT control. Competitive transplantation assay revealed enhanced repopulation capacity of HSCs with low CPR expression, but no difference in differentiation potential upon in vitro experiments. Furthermore, lymphoid differentiation of donor cells decreased while their myeloid differentiation increased under CL microenvironment although the overall level of donor hematopoietic repopulation was not significantly altered. CONCLUSIONS: Our studies demonstrate that suppressing CPR expression enhances the repopulation efficiency of HSCs and a low CPR expression microenvironment favors

  9. KEEFEKTIFAN PEMBELAJARAN BENCANA ALAM BERVISI SETS TERINTEGRASI DALAM IPA DENGAN MEDIA ANIMASI DAN LEMBAR PERTANYAAN

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    F. Ferawati*

    2012-07-01

    Full Text Available Penelitian ini bertujuan untuk menentukan keefektifan pembelajaran bencana alam banjir bervisi SETS terintegrasi dalam materi IPA pokok bahasan Perubahan Lingkungan Fisik dengan media animasi dan lembar pertanyaan sebagai solusi alternatif mengatasi rendahnya pemahaman masyarakat terhadap bencana alam banjir melalui pembelajaran formal sejak dini. Desain penelitian ini adalah penelitian eksperimen Pretest-Posttest Control Group Design dengan objek siswa kelas IV SD Tahun Ajaran 2010/2011. Hasil belajar siswa pada materi IPA, bencana alam banjir dan ketuntasan belajar dianalisis dengan uji signifikansi gain. Hasil analisis data menunjukkan siswa yang dikenai pembelajaran bencana alam banjir bervisi SETS terintegrasi dalam materi IPA dengan media animasi dan lembar pertanyaan lebih baik daripada siswa yang dikenai pembelajaran bencana alam banjir bervisi SETS terintegrasi dalam materi IPA dengan media LKS dan pertanyaan mandiri. Dengan demikian dapat disimpulkan bahwa pembelajaran bencana alam banjir bervisi SETS yang terintegrasi dalam materi IPA pokok bahasan Perubahan Lingkungan Fisik dengan media animasi dan lembar pertanyaan lebih efektif dalam meningkatkan pemahaman konsep bencana alam dan IPA.This study aims to determine the effectiveness of flood natural disasters learning based on SETS vision integrated to Science subject: Physical Environment Changes applying animation media and the question sheet as an alternative solution to overcome the lack of earlier understanding of society to flood natural disasters. Experimental research design: Control Group Pretest-posttest was used with fourth grade students of elementary school of Bandarharjo 02 academic year 2010/2011 used as the research object. Students’ learning outcomes of science: flood natural disasters topic and students’ achievement were analysed through the use of significance gain test. The results of the analysis of experimental data showed the experiment class

  10. PENERAPAN PEMBELAJARAN DENGAN PENDIDIKAN MATEMATIKA REALISTIK (PMR SECARA BERKELOMPOK UNTUK MENINGKATKAN KEMAMPUAN PEMECAHAN MASALAH MATEMATIS SISWA DI KELAS X SMA

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    Atik Krismiati

    2013-09-01

    Full Text Available Tujuan dari penelitian ini adalah untuk mengetahui peningkatan kemampuan pemecahan masalah matematis serta kinerja siswa. Subyek populasi dalam penelitian ini adalah siswa SMA Aloysius Bandung. Pendekatan yang digunakan dengan PMR. Instrumen yang digunakan terdiri dari: tes kemampuan pemecahan masalah dan aktivitas siswa selama pembelajaran. Secara keseluruhan siswa yang pembelajaran pemecahan masalah dengan metode PMR lebih baik dalam meningkatkan kemampuan pemecahan masalah, yaitu terlihat dengan adanya peningkatan dari siklus I ke siklus II. Kesulitan siswa terutama pada permasalahan dengan aspek argumentasi dan keakuratan. Selain itu kelebihan dari metode ini siswa lebih terlihat menyukai yaitu terlihat dengan antusiasnya mengerjakan tugas-tugas dari guru serta memberi alasan secara geometri, kreativitas, dan generalisasi yang sebagian besar perwujudannya dilakukan oleh siswa sendiri. Berdasarkan respon dan hasil akhir LKS menunjukkan aktivitas, dan kinerja yang lebih meningkatkan untuk setiap siklusnya Kata Kunci : Pendidikan Matematika Realistik, Pemecahan Masalah Matematis     The purpose of this study is to determine the increase in mathematical problem-solving skills as the well as student performance. The population subjects in this study are the high school students Aloysius Bandung . The approach applied is PMR . The used instruments consisted of : problem solving ability testing and students activities during the learning process. Overall, the students who are applying PMR method is better, which is seen from the increasing cycle I to cycle II. The primary students difficulties are on problems with aspects of argumentation and accuracy. However the advantages of this method the students look more enthusiastic in doing the tasks given are by the teachers, and they are also able to give geometrical and creative reasons. Which most of its manifestations are generally made by the students themselves. Based on the response and the

  11. Poverty, disability and welfare Fátækt,fötlun og velferð

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    James G. Rice

    2011-12-01

    ð fyrirliggjandi gögn sýni að fatlað fólk sé líklegra en ófatlað til að vera fátækt hafa fáar rannsóknir beinst að samspili fötlunar og fátæktar. Markmið rannsóknanna sem hér er greint frá var að afla þekkingar á félagslegum og fjárhagslegum aðstæðum fatlaðs fólks og öryrkja með áherslu á að öðlast skilning á daglegri reynslu og sjónarhorni fólksins sjálfs. Beitt var eigindlegum aðferðum, einstaklingsviðtölum og rýnihópaviðtölum. Þátttakendur voru alls um 80, fjölbreyttur hópur með tilliti til aldurs, skerðingar, fjölskylduaðstæðna, búsetu, menntunar og fleiri þátta. Niðurstöður sýna að þátttakendur bjuggu við þröngan kost, margir áttu erfitt með að uppfylla brýnustu þarfir sínar og fjölskyldunnar og börðust við að falla ekki í fátækt. Fólk sýndi mikla útsjónarsemi við að lifa af á örorkubótum. Þrátt fyrir það var erfitt eða ómögulegt fyrir flesta að leggja fyrir til að eiga varasjóð en það er lykilatriði til að takast á við óvænt áföll og útgjöld. Þegar í harðbakka sló leituðu þátttakendur aðstoðar í félagslegu tengslaneti sínu, oftast til fjölskyldu, og ljóst er að gagnkvæm stuðningstengsl gátu skipt miklu um afkomu fólks. Þær erfiðu fjárhagslegu og félagslegu aðstæður sem flestir bjuggu við sköpuðu álag, kvíða og streitu sem höfðu neikvæð áhrif á líðan og heilsufar. Mikilvægt er að aðgerðir stjórnvalda til að sporna við fátækt byggist á þekkingu á aðstæðum fólks og þeim flóknu ferlum sem eru að verki þar sem fátækt og fötlun mætast.

  12. Mean platelet volume in bipolar disorder: the search for an ideal biomarker

    Directory of Open Access Journals (Sweden)

    Mert DG

    2016-08-01

    Full Text Available Derya Guliz Mert,1 Hatice Terzi2 1Department of Psychiatry, 2Department of Hematology, Faculty of Medicine, Cumhuriyet University, Sivas, Turkey Background: The pathophysiology of bipolar disorder (BD remains a mystery. In this context, interest in the role of the immune and inflammatory systems in BD has been increasing. We aimed to compare the routine hemogram values of BD patients with those of the participants in the healthy control group, to assess the inflammation levels of the two groups. Mean platelet volume (MPV can be obtained as routine hemogram parameters and may aid in the detection of systemic inflammation. Subjects and methods: This study was conducted with BD (manic episode inpatients (n=132 and healthy controls (n=135. Abnormally distributed variables (ie, neutrophil–lymphocyte ratio [NLR], platelet–lymphocyte ratio [PLR], neutrophils, lymphocytes, hemoglobin, hematocrit [HCT], mean corpuscular volume [MCV], mean corpuscular hemoglobin [MCH], mean corpuscular hemoglobin concentration [MCHC], red cell distribution width [RDW], MPV, and plateletcrit [PCT] were compared using the Mann–Whitney U-test. Student’s t-test was used to compare the mean ages and white blood cell, red blood cell, and platelet counts of the patients with BD against those of the participants in the control group. Results: The comparisons revealed that while the mean WBC and the median NLR, PLR, neutrophil, lymphocyte, MPV, and PCT values were significantly higher in the patients with BD (P<0.05, the median hemoglobin, RBC, HCT, and MCHC values were significantly higher in the control group (P<0.05. Conclusion: Comparisons of hemogram values of patients with BD against those of the healthy control group revealed that inflammatory cells (absolute neutrophil count, platelet count, PCT, and MPV and ratios (NLR, PLR seem to be altered during manic episodes. These findings support the hypothesis that inflammatory activation occurs in BD during manic

  13. Mixed states vs. pure mania in the french sample of the EMBLEM study: results at baseline and 24 months – European mania in bipolar longitudinal evaluation of medication

    Directory of Open Access Journals (Sweden)

    Azorin Jean-Michel

    2009-06-01

    Full Text Available Abstract Background To describe the clinical course and treatment patterns over 24 months of patients experiencing an acute manic/mixed episode within the standard course of care. Methods EMBLEM was a 2-year European prospective, observational study on outcomes of patients experiencing a manic/mixed episode. Adults with bipolar disorder were enrolled within the standard course of care as in/outpatients if they initiated or changed oral medication for treatment of acute mania. After completing 12 weeks of acute phase, patients were assessed every 3–6 months during the maintenance phase. We present the 24 month results, with subgroup analysis for mixed states (MS and pure mania (PM. These subgroup analyses are driven by the high proportion of antidepressants prescribed in this cohort. Results In France, 771 patients were eligible for the maintenance phase. 69% of patients completed the follow up over 24 months. The mean age was 45.5 years (sd = 13.6 with 57% of women. 504 (66% patients were experiencing a PM and 262 (34% a MS at baseline. The main significant differences in MS vs. PM at baseline were: a higher rate of women, and in the previous 12 months, a higher frequency of episodes (manic/mixed and depressive, more suicide attempts, more rapid cycling, fewer social activities and more work impairment. Over the 24 months of follow-up the MS group had a significantly lower recovery than PM (36% vs. 46%, p = 0.006. Overall, 42% of all patients were started on monotherapy and 58% on combination therapy; of those 35% and 30% respectively remained on their initial medication throughout the 24 months. At baseline, 36% were treated with an antidepressant, this proportion remains high throughout the follow-up period, with a significantly higher rate for MS vs. PM at 24 months (55% vs. 27%, p Conclusion In this large sample, MS occur frequently (34%, they are more severe at baseline and have a worse functional prognosis than PM. Although

  14. The prevalence and illness characteristics of DSM-5-defined "mixed feature specifier" in adults with major depressive disorder and bipolar disorder: Results from the International Mood Disorders Collaborative Project.

    Science.gov (United States)

    McIntyre, Roger S; Soczynska, Joanna K; Cha, Danielle S; Woldeyohannes, Hanna O; Dale, Roman S; Alsuwaidan, Mohammad T; Gallaugher, Laura Ashley; Mansur, Rodrigo B; Muzina, David J; Carvalho, Andre; Kennedy, Sidney H

    2015-02-01

    A substantial proportion of individuals with mood disorders present with sub-syndromal hypo/manic features. The objective of this analysis was to evaluate the prevalence and illness characteristics of the Diagnostic and Statistical Manual Version-5 (DSM-5) - defined mixed features specifier (MFS) in adults with major depressive disorder (MDD) and bipolar disorder (BD). Data from participants who met criteria for a current mood episode as part of MDD (n=506) or BD (BD-I: n=216, BD-II: n=130) were included in this post-hoc analysis. All participants were enrolled in the International Mood Disorders Collaborative Project (IMDCP): a collaborative research platform at the Mood Disorders Psychopharmacology Unit, University of Toronto and the Cleveland Clinic, Cleveland, Ohio. Mixed features specifier was operationalized as a score ≥ 1 on 3 or more select items on the Young Mania Rating Scale (YMRS) or ≥ 1 on 3 select items of the Montgomery Åsberg Depression Rating Scale (MADRS) or Hamilton Depression Rating Scale (HAMD-17) during an index major depressive episode (MDE) or hypo/manic episode, respectively. A total of 26.0% (n=149), 34.0% (n=65), and 33.8% (n=49) of individuals met criteria for MFS during an index MDE as part of MDD, BD-I and BD-II, respectively. Mixed features specifier during a hypo/manic episode was identified in 20.4% (n=52) and 5.1% (n=8) in BD-I and BD-II participants, respectively. Individuals with MDE-MFS as part of BD or MDD exhibited a more severe depressive phenotype (p=0.0002 and pdefined MFS is common during an MDE as part of MDD and BD. The presence of MFS identifies a subgroup of individuals with greater illness complexity and possibly a higher rate of cardiovascular comorbidity. The results herein underscore the common occurrence of MFS in adults with either BD or MDD. Moreover, the results of our analysis indicate that adults with mood disorders and MFS have distinct clinical characteristics and comorbidity patterns. Copyright

  15. Desenvolvimento da versão em português da Escala de Avaliação de Mania de Bech-Rafaelsen (EAM-BR Desarrollo de la versión en portugués de la Escala de Evaluación de la Manía de Bech-Rafaelsen (EAM-BR Development of the Portuguese version of the Bech-Rafaelsen Mania Rating Scale (BRMaS

    Directory of Open Access Journals (Sweden)

    Flávio Shansis

    2004-04-01

    Full Text Available No presente artigo, é apresentado o desenvolvimento da versão em português da Bech-Rafaelsen Mania Rating Scale (BRMaS de Bech e colaboradores intitulada: Escala de Avaliação de Mania de Bech-Rafaelsen (EAM-BR. A EAM-BR foi desenvolvida para ser aplicada na forma de uma entrevista semi-estruturada breve conduzida pelo clínico. Ela investiga a presença versus a ausência de sintomas maníacos, sua severidade e sua mudança em resposta ao tratamento. São descritas as qualidades psicométricas da escala original. Com este artigo, a comunidade científica passa a dispor em português de mais um importante instrumento para avaliação do estado maníaco.En este artículo se presenta el desarrollo de la versión en portugués de la Bech-Rafaelsen Mania Rating Scale (BRMaS de Bech y colaboradores titulada: Escala de la Evaluación de Manía de Bech-Rafaelsen (EAM-BR. La EAM-BR fue desarrollada para ser aplicada en la forma de entrevista semi-estructurada breve conduzida por el clínico. Ella investiga la presencia versus la ausencia de síntomas maníacos, su severidad y su mudanza en respuesta al tratamiento. Son descriptas las cualidades psicométricas de la escala original. Con este artículo la comunidad científica dispone, en portugués, de un importante instrumento a más para la evaluación del estado maníaco.In this article the authors present the development of the Portuguese-language version of a scale intended to evaluate the manic state: Bech-Rafaelsen Mania Rating Scale (BRMaS. The BRMaS was created in order to assist the clinician to evaluate a manic patient in a semi-structured interview. This article provides the scientific community with an important instrument to rate manic presentations in native speakers of Portuguese.

  16. Reassessing carbamazepine in the treatment of bipolar disorder: clinical implications of new data.

    Science.gov (United States)

    Akiskal, Hagop S; Fuller, Matthew A; Hirschfeld, Robert M A; Keck, Paul E; Ketter, Terence A; Weisler, Richard H

    2005-06-01

    This monograph summarizes the proceedings of a roundtable meeting convened to discuss the role of carbamazepine in the treatment of bipolar disorder, in light of new data and the recent indication of carbamazepine extended-release capsules (CBZ ERC) for use in the treatment of acute manic and mixed episodes. Two lectures were presented, followed by a panel discussion among all 6 participants. A summary of the two pivotal trials of CBZ ERC and their pooled data along with other relevant data is presented first. Next, historical trends of carbamazepine and the agent's use in acute mania, bipolar depression, and maintenance are reviewed, emphasizing clinical implications of efficacy, safety, tolerability, and drug interactions. Finally, the panel discussion provides recommendations for the use of carbamazepine in different phases of the illness, taking into account adverse effects and drug-drug interactions. Panel discussants agree that current data confirm the utility of CBZ ERC as an effective treatment for acute manic and mixed episodes in bipolar disorder. Carbamazepine may also prove to be an option for maintenance treatment. Tolerability of the drug is related to dose and titration, and overall safety limitations regarding carbamazepine usage are comparable to other medications. For some patients, the main challenges to use of carbamazepine may be common drug-drug interactions and increased side effects related to aggressive introduction during treatment of acute manic and mixed episodes. Thus, carbamazepine may be a lower priority option for patients who are taking multiple medications, such as elderly individuals with medical comorbidity, due to the potential for drug interactions. Important benefits of carbamazepine include the low propensity toward weight gain and evidence of good tolerability with long-term treatment. (At present there are no available data from long-term, placebo-controlled studies evaluating the effects of carbamazepine or CBZ ERC on

  17. Genome-wide association study of borderline personality disorder reveals genetic overlap with bipolar disorder, major depression and schizophrenia

    DEFF Research Database (Denmark)

    Witt, S H; Streit, F; Jungkunz, M

    2017-01-01

    Borderline personality disorder (BOR) is determined by environmental and genetic factors, and characterized by affective instability and impulsivity, diagnostic symptoms also observed in manic phases of bipolar disorder (BIP). Up to 20% of BIP patients show comorbidity with BOR. This report...... describes the first case-control genome-wide association study (GWAS) of BOR, performed in one of the largest BOR patient samples worldwide. The focus of our analysis was (i) to detect genes and gene sets involved in BOR and (ii) to investigate the genetic overlap with BIP. As there is considerable genetic...... overlap between BIP, major depression (MDD) and schizophrenia (SCZ) and a high comorbidity of BOR and MDD, we also analyzed the genetic overlap of BOR with SCZ and MDD. GWAS, gene-based tests and gene-set analyses were performed in 998 BOR patients and 1545 controls. Linkage disequilibrium score...

  18. Neuropsychiatric complications associated with interferon - alpha -2b treatment of malignant melanoma.

    LENUS (Irish Health Repository)

    Enudi, W

    2012-02-01

    Several adverse effects have been associated with interferon alpha 2b treatment and neuropsychiatric effects have also been commonly reported. Psychosis and mood disorders have been described in the literature. This case report is of a 30 year old man with malignant melanoma stage 3a who was receiving adjuvant alpha 2b interferon and developed a manic episode two weeks post switching after one month of treatment on a high dose to a low dose. There was no previous psychiatric illness and no known family history of mental illness. This is in keeping with previous reports that mania has been observed in patients undergoing interferon treatment especially after significant dose-reduction or treatment breaks. Mania induced by interferon responds well to antimanic drugs .Since interferon alpha 2b is now commonly used in the treatment of malignant melanoma and other conditions, the need to be aware of its neuropsychiatric complications is essential.

  19. 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...

  20. Omega-3 fatty acid monotherapy for pediatric bipolar disorder: a prospective open-label trial.

    Science.gov (United States)

    Wozniak, Janet; Biederman, Joseph; Mick, Eric; Waxmonsky, James; Hantsoo, Liisa; Best, Catherine; Cluette-Brown, Joanne E; Laposata, Michael

    2007-01-01

    To test the effectiveness and safety of omega-3 fatty acids (Omegabrite(R) brand) in the treatment of pediatric bipolar disorder (BPD). Subjects (N=20) were outpatients of both sexes, 6 to 17 years of age, with a DSM-IV diagnosis of BPD and Young Mania Rating Scale (YMRS) score of >15 treated over an 8-week period in open-label trial with omega-3 fatty acids 1290 mg-4300 mg combined EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid). Subjects experienced a statistically significant but modest 8.9+/-2.9 point reduction in the YMRS scores (baseline YMRS=28.9+/-10.1; endpoint YMRS=19.1+/-2.6, pDHA increased in treated subjects. As only 35% of these subjects had a response by the usual accepted criteria of >50% decrease on the YMRS, omega-3 fatty acids treatment was associated with a very modest improvement in manic symptoms in children with BPD.

  1. Electroconvulsive Therapy: A Current Review

    Directory of Open Access Journals (Sweden)

    Gokben Hizli Sayar

    2014-06-01

    Full Text Available Most of the electroconvulsive therapy guidelines state that severe major depression with psychotic features, manic delirium, or catatonia are conditions where there is a clear consensus favoring early electroconvulsive therapy. The decision to administer electroconvulsive therapy is based on an evaluation of the risks and benefits for the individual patient and involves a combination of factors, including psychiatric diagnosis, type and severity of symptoms, prior treatment history and response, identification of possible alternative treatment options, and consumer preference. In this review history, mechanisms of action, side effects that have been referenced in the literature and clinical experience are discussed. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2014; 6(2.000: 107-125

  2. Examination of digestive enzyme distribution in gut tract and functions of intestinal caecum, in megascolecid earthworms (Oligochaeta: Megascolecidae) in Japan.

    Science.gov (United States)

    Nozaki, Mana; Ito, Katsutoshi; Miura, Chiemi; Miura, Takeshi

    2013-09-01

    Earthworms ingest various materials in addition to food items, such as soil particles. Most earthworms of the family Megascolecidae, a dominant family in Japan, have intestinal caeca connected directly to the intestinal tract. The function of the caeca has not been demonstrated, although it is thought to be associated with digestion. We investigated the activity of the digestive enzymes amylase, phosphatase, cellulase, and protease in different regions of the gut, including the intestinal caeca, in three species of megascolecid earthworms, Pheretima heteropoda, Pheretima hilgendorfi, and Pheretima sieboldi. Activities of several enzymes were high in the intestinal caeca; in particular, protease activity was higher in the caeca than that in the anterior gut, foregut, midgut, and hindgut in all three species. Moreover, the ratio of enzyme activities in the intestinal caeca to whole-gut tended to be higher in manicate intestinal caeca than in simple intestinal caeca. These results suggest that the digestive system of earthworms relies on the intestinal caeca.

  3. Antidepressant-Resistant Depression and Antidepressant-Associated Suicidal Behaviour: The Role of Underlying Bipolarity

    Directory of Open Access Journals (Sweden)

    Zoltan Rihmer

    2011-01-01

    Full Text Available The complex relationship between the use of antidepressants and suicidal behaviour is one of the hottest topics of our contemporary psychiatry. Based on the literature, this paper summarizes the author's view on antidepressant-resistant depression and antidepressant-associated suicidal behaviour. Antidepressant-resistance, antidepressant-induced worsening of depression, antidepressant-associated (hypomanic switches, mixed depressive episode, and antidepressant-associated suicidality among depressed patients are relatively most frequent in bipolar/bipolar spectrum depression and in children and adolescents. As early age at onset of major depressive episode and mixed depression are powerful clinical markers of bipolarity and the manic component of bipolar disorder (and possible its biological background shows a declining tendency with age antidepressant-resistance/worsening, antidepressant-induced (hypomanic switches and “suicide-inducing” potential of antidepressants seem to be related to the underlying bipolarity.

  4. ["Is it an animal inside? "Melanie Klein's unpublished Don Juan Paper (1939)].

    Science.gov (United States)

    Frank, Claudia

    2008-01-01

    Klein had been asked to contribute an article to the birthday number of the International Journal for Jones. The author outlines how she hurriedly wrote a text about Don Juan which, however, was rejected by the editor. Essential parts of it are presented in German translation. The manuscript is discussed in the context of Klein's published work as well as of the relevant contemporary literature. In Klein's view, Don Juan's genitality is determined by oral impulses and fears. By his manic acting out he attempts to ward off a depressive break-down. The paper ends with some reflections about why Klein--ontrary to her intention--failed to revise her manuscript for later publication.

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

    DEFF Research Database (Denmark)

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

    2016-01-01

    Changes in speech have been suggested as sensitive and valid measures of depression and mania in bipolar disorder. The present study aimed at investigating (1) voice features collected during phone calls as objective markers of affective states in bipolar disorder and (2) if combining voice...... features, automatically generated objective smartphone data on behavioral activities and electronic self-monitored data were collected from 28 outpatients with bipolar disorder in naturalistic settings on a daily basis during a period of 12 weeks. Depressive and manic symptoms were assessed using...... and electronic self-monitored data increased the accuracy, sensitivity and specificity of classification of affective states slightly. Voice features collected in naturalistic settings using smartphones may be used as objective state markers in patients with bipolar disorder....

  6. Pharmacological Approaches for Treatment-resistant Bipolar Disorder

    Science.gov (United States)

    Poon, Shi Hui; Sim, Kang; Baldessarini, Ross J.

    2015-01-01

    Bipolar disorder is prevalent, with high risks of disability, substance abuse and premature mortality. Treatment responses typically are incomplete, especially for depressive components, so that many cases can be considered “treatment resistant.” We reviewed reports on experimental treatments for such patients: there is a striking paucity of such research, mainly involving small incompletely controlled trials of add-on treatment, and findings remain preliminary. Encouraging results have been reported by adding aripiprazole, bupropion, clozapine, ketamine, memantine, pramipexole, pregabalin, and perhaps tri-iodothyronine in resistant manic or depressive phases. The urgency of incomplete responses in such a severe illness underscores the need for more systematic, simpler, and better controlled studies in more homogeneous samples of patients. PMID:26467409

  7. Bipolar disorder in the postpartum period: management strategies and future directions.

    Science.gov (United States)

    Pope, Carley J; Sharma, Verinder; Mazmanian, Dwight

    2014-07-01

    Bipolar I and II disorder are chronic and severe psychiatric illnesses that affect many women. Furthermore, women are at increased risk for mood episodes during the postpartum period compared with non-postpartum periods. Unfortunately, identification of clinically significant depressive or (hypo)manic episodes can be challenging. Delays in detection, as well as misdiagnosis, put women at risk of many negative consequences, such as symptom exacerbation and treatment refractoriness. Early and accurate detection of bipolar I or II disorder in the postpartum period is critical to improve prognosis. At this time, limited recommendations can be made due to a paucity of research. Further research on postpartum bipolar I or II disorder focusing on its identification, consequences and treatment is urgently needed to allow for empirically informed clinical decision-making.

  8. Bipolar Disorder after Stroke in an Elderly Patient

    Directory of Open Access Journals (Sweden)

    Raquel Calvão de Melo

    2014-01-01

    Full Text Available The onset of bipolar disorder (BD secondary to a stroke event is a rare clinical entity. Although it may be related to specific regions of the brain, several other factors have been linked to its expression such as subcortical atrophy or chronic vascular burden. While precise locations and cerebral circuits involved in the bipolarity expression after stroke still need to be determined, their investigation represents an opportunity to study brain function and BD etiopathogenesis. We present a BD secondary to multiple subcortical biparietal lacunar infarctions, a lacunar infarction in left putamen and an ischemic lesion at the cerebral trunk evolving the right median portion, in a 65-year-old male patient who experienced manic, hypomanic, and depressive episodes, after 6, 10, and 16 months, respectively, of the cerebrovascular events.

  9. Smartphone data as an electronic biomarker of illness activity in bipolar disorder

    DEFF Research Database (Denmark)

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

    2015-01-01

    Objectives Objective methods are lacking for continuous monitoring of illness activity in bipolar disorder. Smartphones offer unique opportunities for continuous monitoring and automatic collection of real-time data. The objectives of the paper were to test the hypotheses that (i) daily electronic...... self-monitored data and (ii) automatically generated objective data collected using smartphones correlate with clinical ratings of depressive and manic symptoms in patients with bipolar disorder. Methods Software for smartphones (the MONARCA I system) that collects automatically generated objective......-monitored data (i.e., mood and activity) and scores on the YMRS. Finally, the automatically generated objective data were able to discriminate between affective states. Conclusions Automatically generated objective data and self-monitored data collected using smartphones correlate with clinically rated...

  10. C-reactive protein and white blood cell levels in schizophrenia, bipolar disorders and depression - associations with mortality and psychiatric outcomes

    DEFF Research Database (Denmark)

    Horsdal, H T; Köhler-Forsberg, O; Benros, Michael E

    2017-01-01

    BACKGROUND: Mental disorders have been associated with increased levels of inflammatory markers, which can affect disease trajectories. We aimed to assess levels of C-reactive protein (CRP) and white blood cells (WBC) across individuals with schizophrenia, bipolar disorder, and depression......, and to investigate associations with subsequent psychiatric admission and mortality. METHODS: We identified all adults in the Central Denmark Region during 2000-2012 with a first diagnosis of schizophrenia, bipolar disorder, or depression and a baseline measurement of CRP and/or WBC count. We followed.......5mg/L) (particularly during manic states, 3.9mg/L), followed by schizophrenia (3.1mg/L), and depression (2.8mg/L), while baseline WBC count did not differ (median 7.1×10(9)/L). Elevated CRP levels were associated with increased all-cause mortality by adjusted HRs of 1.56 (95% CI: 1.02-2.38) for levels...

  11. A case of mania presenting with hypersexual behavior and gender dysphoria that resolved with valproic acid

    Directory of Open Access Journals (Sweden)

    Michelle R. Heare

    2016-11-01

    Full Text Available Hypersexuality and gender dysphoria have both been described in the literature as symptoms of mania. Hypersexuality is listed in the Diagnostic and Statistical Manual of Mental Disorders 5 as part of the diagnostic criteria for bipolar disorder. Gender dysphoria is less often described and its relation to mania remains unclear. This case report describes a young homosexual man presenting in a manic episode with co-morbid amphetamine abuse whose mania was marked by hypersexuality and the new onset desire to be a woman. Both of these symptoms resolved with the addition of valproic acid to antipsychotics. This case report presents the existing literature on hypersexuality and gender dysphoria in mania and describes a treatment option that has not been previously reported.

  12. [Delusional jealousy and obsessive love--causes and forms].

    Science.gov (United States)

    Bogerts, Bernhard

    2005-02-10

    Obsessive love and delusional jealousy as persistent mental disorders, are well-known but rare psychiatric conditions, the prevalence of which is estimated to be less than 0.1%. Delusional jealousy should not be confused with exaggerated "pathological" jealousy, which is characterized by excessive suspicion and possessiveness on the part of individuals who, as a rule, suffer from considerably disordered self-esteem. As a paranoid development, delusional jealousy occurs in particular among male chronic alcoholics. As in all delusional disorders, trivial events are evaluated with unshakeable certainty as proof of the correctness of the delusive notion. Obsessive love is seen predominantly in women. In the differential diagnosis, other mental disorders such as schizophrenia, manic or organic brain syndrome must be excluded.

  13. A Preclinical Study of Casein Glycomacropeptide as a Dietary Intervention for Acute Mania

    DEFF Research Database (Denmark)

    Liebenberg, Nico; Jensen, Erik; Larsen, Erik Roj

    2018-01-01

    Background: Casein glycomacropeptide is a peptide that lacks phenylalanine, tyrosine, and tryptophan. This profile may enable it to deplete phenylalanine, tyrosine, and tryptophan, and subsequently the synthesis of dopamine and serotonin in the brain. Dopamine- and serotonin-depleting amino acid...... mixtures have shown promise as acute antimanic treatments. In this study, we explore the depleting effects on amino acids, dopamine and serotonin as well as its actions on manic-like and other behavior in rats. Methods: Casein glycomacropeptide and a selection of amino acid mixtures were administered...... orally at 2, 4, or 8 h or for 1 week chronically. Amino acid and monoamine levels were measured in plasma and brain and behavior was assessed in the amphetamine-hyperlocomotion, forced swim, prepulse inhibition, and elevated plus maze tests. Results: Casein glycomacropeptide induced a time...

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

    Directory of Open Access Journals (Sweden)

    Dziwota Ewelina

    2015-06-01

    Full Text Available Normothymic, antidepressant and antipsychotic pharmaceutics are, in accordance with international guidelines, employed both in the therapy and the prevention of bipolar disorder (BD. Long-term studies on the mechanisms of action of such medications, as well as on the pathogenetic background of BD, have led to the discovery of effective, albeit unconventional pharmacotherapeutic approaches. These methods have the potential to successfully treat mania and depression, as well as to counter affective episode relapse. Allopurinol - commonly used to treat gout, secondary hyperuricemia and Lesch-Nyhan syndrome, acts by inhibiting the synthesis of uric acid, levels of which are often increased in manic patients. Due to this, an evaluation of the potential effect of allopurinol on the reduction of mania symptoms seems to be reasonable. Additionally, the numerable research papers coming out of research regarding the role of purine neurotransmitters in mood alterations, indicate that adenosine agonists act analogously to dopamine antagonists.

  15. Do personality traits predict first onset in depressive and bipolar disorder?

    DEFF Research Database (Denmark)

    Christensen, Maj Vinberg; Kessing, Lars Vedel

    2006-01-01

    The aim was to investigate whether personality traits predict onset of the first depressive or manic episode (the vulnerability hypothesis) and whether personality might be altered by the mood disorder (the scar hypothesis). A systematic review of population-based and high-risk studies concerning...... personality traits and affective disorder in adults was conducted. Nine cross-sectional high-risk studies, seven longitudinal high-risk studies and nine longitudinal population-based studies were found. Most studies support the vulnerability hypothesis and there is evidence that neuroticism is a premorbid...... risk factor for developing depressive disorder. The evidence for the scar hypothesis is sparse, but the studies with the strongest design showed evidence for both hypotheses. Only few studies of bipolar disorder were found and the association between personality traits and bipolar disorder is unclear...

  16. Saúde mental: reconstruindo saberes em enfermagem

    Directory of Open Access Journals (Sweden)

    Francisca Bezerra de Oliveira

    2003-02-01

    Full Text Available O manicômio, apesar de criticado, reformado ou mesmo negado, ainda é uma prática preponderante no cuidado às pessoas com transtornos mentais. Tal prática tem como princípio básico o isolamento do doente mental, contrariando todas as possibilidades de assistência centrada num humanismo ético. Este ensaio procura interpretar a institucionalização do asilo, da psiquiatria, da doença mental e o processo da reforma psiquiátrica, buscando contribuir para as reflexões acerca da desinstitucionalização e dos saberes e práticas de enfermagem em saúde mental.

  17. Catatonia from its creation to DSM-V: Considerations for ICD.

    Science.gov (United States)

    Fink, Max

    2011-07-01

    Catatonia was delineated only as a type of schizophrenia in the many American Psychiatric Association DSM classifications and revisions from 1952 until 1994 when "catatonia secondary to a medical condition" was added. Since the 1970s the diagnosis of catatonia has been clarified as a syndrome of rigidity, posturing, mutism, negativism, and other motor signs of acute onset. It is found in about 10% of psychiatric hospital admissions, in patients with depressed and manic mood states and in toxic states. It is quickly treatable to remission by benzodiazepines and by ECT. The DSM-V revision proposes catatonia in two major diagnostic classes, specifiers for 10 principal diagnoses, and deletion of the designation of schizophrenia, catatonic type. This complex recommendation serves no clinical or research purpose and confuses treatment options. Catatonia is best considered in the proposed ICD revision as a unique syndrome of multiple forms warranting a single unique defined class similar to that of delirium.

  18. Treatment in a specialised out-patient mood disorder clinic v. standard out-patient treatment in the early course of bipolar disorder

    DEFF Research Database (Denmark)

    Kessing, Lars Vedel; Hansen, Hanne Vibe; Hvenegaard, Anne

    2013-01-01

    BACKGROUND: Little is known about whether treatment in a specialised out-patient mood disorder clinic improves long-term prognosis for patients discharged from initial psychiatric hospital admissions for bipolar disorder. AIMS: To assess the effect of treatment in a specialised out-patient mood...... disorder clinic v. standard decentralised psychiatric treatment among patients discharged from one of their first three psychiatric hospital admissions for bipolar disorder. METHOD: Patients discharged from their first, second or third hospital admission with a single manic episode or bipolar disorder were...... randomised to treatment in a specialised out-patient mood disorder clinic or standard care (ClinicalTrials.gov: NCT00253071). The primary outcome measure was readmission to hospital, which was obtained from the Danish Psychiatric Central Register. RESULTS: A total of 158 patients with mania/bipolar disorder...

  19. Quality of web-based information on bipolar disorder.

    Science.gov (United States)

    Morel, Vincent; Chatton, Anne; Cochand, Sophie; Zullino, Daniele; Khazaal, Yasser

    2008-10-01

    To evaluate web-based information on bipolar disorder and to assess particular content quality indicators. Two keywords, "bipolar disorder" and "manic depressive illness" were entered into popular World Wide Web search engines. Websites were assessed with a standardized proforma designed to rate sites on the basis of accountability, presentation, interactivity, readability and content quality. "Health on the Net" (HON) quality label, and DISCERN scale scores were used to verify their efficiency as quality indicators. Of the 80 websites identified, 34 were included. Based on outcome measures, the content quality of the sites turned-out to be good. Content quality of web sites dealing with bipolar disorder is significantly explained by readability, accountability and interactivity as well as a global score. The overall content quality of the studied bipolar disorder websites is good.

  20. The relationship between the state and humanistic sciences in Serbia at the beginning of the 21st century. Citation metrics as an attempted murder of Serbian anthropology

    Directory of Open Access Journals (Sweden)

    Ivan Kovačević

    2016-03-01

    Full Text Available In Serbia, the influence of the society on humanistic sciences is mainly perpetrated through state funding of scientific projects. Such funding currently involves valuation of the results of a scientific work by applying citation metrics methods, which are not acknowledged in Europe. Citation metrics in the USA, where it was created, lead to caricature forms of scientific products, composed of several pages of text and a great number of cited (quoted titles. Citation metrical-citation manic procedure can lead to the elimination of the domestic humanistic sciences and the implementation of third rate quoteres, who, along with hollow articles filled with mutually intertwined citations, fulfill requirements, unconsciously(? set by the authorized Ministry and University.

  1. Palatal tremor after lithium and carbamazepine use: a case report

    Directory of Open Access Journals (Sweden)

    Kuruvilla Anju

    2010-06-01

    Full Text Available Abstract Introduction Palatal tremor, characterized by rhythmic contractions of the soft palate, can occur secondary to pathology in the dentato-rubro-olivary pathway, or in the absence of such structural lesions. Its pathogenesis is only partially understood. We describe a case of probable drug-induced palatal tremor. Case presentation A 27-year-old Indian man had taken carbamazepine and lithium for 7 years for the treatment of a manic episode. He presented with a one-year history of bilateral rhythmic oscillations of his soft palate and tremors of his tongue. There were no other abnormalities detected from his examination or after detailed investigation. Conclusion Palatal tremors may result from medication used in the treatment of psychiatric disorders.

  2. Psychopathology in a migrant population visiting a psychiatric outpatient clinic in Punjab, India

    Directory of Open Access Journals (Sweden)

    Navkiran S Mahajan

    2015-01-01

    Full Text Available Background: Migration is a risk factor for psychosis in international migrants. Objectives: We compared the psychiatric morbidity in first and second generation interstate migrants in India. Methods: Psychiatric morbidity was assessed in 18-64-year-old first and second generation migrants of both the gender using Mini International Neuropsychiatry Interview. Total 70 subjects were included in the study. Males and females of both the generation compared. Results: Mood disorders are found to be most common disorder in second generation migrants. Where females of second generation migrants have a major depressive episode with melancholic features, as compared to males who have manic episode significantly higher in second generation migrants. Conclusion: Migration is a risk factor for mood disorders especially in second generation migrants. As adversity of migration, discrimination, and acculturation faced from birth and early life leads to higher rates of psychiatry morbidity in second generation migrants.

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

    DEFF Research Database (Denmark)

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

    2014-01-01

    hormones, e.g. estrogen, are fluctuating and particularly postpartum there is a steep fall in the levels of serum estrogen. The role of estrogen in women with bipolar disorder is, however, not fully understood. Aim: The main objective of this review is to evaluate the possible relation between serum...... estrogen levels and women with bipolar disorder including studies of the anti manic effects of the selective estrogen receptor modulator tamoxifen. Method: A systematically literature search on PubMed was conducted: two studies regarding the connection between serum estrogen levels and women with bipolar...... tamoxifen studies found that tamoxifen was effective in producing antimanic effects. Conclusion: These results indicate that estrogen fluctuations may be an important factor in the etiology of bipolar disorder and it is obvious that more research on this topic is needed to clarify the role of estrogen...

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

    DEFF Research Database (Denmark)

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

    2014-01-01

    hormones, e.g. estrogen, are fluctuating and particularly postpartum there is a steep fall in the levels of serum estrogen. The role of estrogen in women with bipolar disorder is, however, not fully understood. AIM: The main objective of this review is to evaluate the possible relation between serum...... estrogen levels and women with bipolar disorder including studies of the anti manic effects of the selective estrogen receptor modulator tamoxifen. METHOD: A systematically literature search on PubMed was conducted: two studies regarding the connection between serum estrogen levels and women with bipolar...... tamoxifen studies found that tamoxifen was effective in producing antimanic effects. CONCLUSION: These results indicate that estrogen fluctuations may be an important factor in the etiology of bipolar disorder and it is obvious that more research on this topic is needed to clarify the role of estrogen...

  5. Cerebral metabolic rates for glucose in mood disorders. Studies with positron emission tomography and fluorodeoxyglucose F 18

    International Nuclear Information System (INIS)

    Baxter, L.R. Jr.; Phelps, M.E.; Mazziotta, J.C.; Schwartz, J.M.; Gerner, R.H.; Selin, C.E.; Sumida, R.M.

    1985-01-01

    Cerebral metabolic rates for glucose were examined in patients with unipolar depression (N = 11), bipolar depression (N = 5), mania (N = 5), bipolar mixed states (N = 3), and in normal controls (N = 9) using positron emission tomography and fluorodeoxyglucose F 18. All subjects were studied supine under ambient room conditions with eyes open. Bipolar depressed and mixed patients had supratentorial whole brain glucose metabolic rates that were significantly lower than those of the other comparison groups. The whole brain metabolic rates for patients with bipolar depression increased going from depression or a mixed state to a euthymic or manic state. Patients with unipolar depression showed a significantly lower ratio of the metabolic rate of the caudate nucleus, divided by that of the hemisphere as a whole, when compared with normal controls and patients with bipolar depression

  6. Differential diagnosis of depression: relevance of positron emission tomography

    International Nuclear Information System (INIS)

    Schwartz, J.M.; Baxter, L.R. Jr.; Mazziotta, J.C.; Gerner, R.H.; Phelps, M.E.

    1987-01-01

    The proper differential diagnosis of depression is important. A large body of research supports the division of depressive illness into bipolar and unipolar subtypes with respect to demographics, genetics, treatment response, and neurochemical mechanisms. Optimal treatment is different for unipolar and bipolar depressions. Treating a patient with bipolar depression as one would a unipolar patient may precipitate a serious manic episode or possibly even permanent rapid cycling disorder. The clinical distinction between these disorders, while sometimes difficult, can often be achieved through an increased diagnostic suspicion concerning a personal or family history of mania. Positron emission tomography and the FDG method, which allow in vivo study of the glucose metabolic rates for discrete cerebral structures, provide new evidence that bipolar and unipolar depression are two different disorders

  7. Dandy walker variant and bipolar I disorder with graphomania.

    Science.gov (United States)

    Can, Serdar Suleyman; Karakaş Uğurlu, Görkem; Cakmak, Selcen

    2014-07-01

    Cerebellum is known to play an important role in coordination and motor functions. In some resent studies it is also considered to be involved in modulation of mood, cognition and psychiatric disorders. Dandy Walker Malformation is a congenital malformation that is characterized by hypoplasia or aplasia of the cerebellar vermis, cystic dilatation of the fourth ventricle and enlargement of the posterior fossa. When the volume of posterior fossa is normal, the malformation is called Dandy Walker Variant. Case is a 32 year old male with a 12 year history of Bipolar I Disorder presented with manic and depresive symptoms, including dysphoric and depressive affect, anhedonia, suicidal thoughts and behaviours, thoughts of fear about future, overtalkativeness and graphomania, increased energy, irregular sleep, loss of appetite, increased immersion in projects, irritability, agressive behavior, impulsivity. Cranial Magnetic Resonance Imaging was compatible to the morphological features of Dandy Walker Variant.

  8. Use of Lithium and Anticonvulsants and the Rate of Chronic Kidney Disease

    DEFF Research Database (Denmark)

    Kessing, Lars Vedel; Gerds, Thomas Alexander; Feldt-Rasmussen, Bo

    2015-01-01

    -stage CKD among individuals exposed to successive prescriptions of lithium, anticonvulsants, or other drugs used for bipolar disorder. DESIGN, SETTING, AND PARTICIPANTS: This is a Danish nationwide population-based study of 2 cohorts. Cohort 1 comprised a randomly selected sample of 1.5 million individuals......IMPORTANCE: Lithium is the main mood stabilizing drug for bipolar disorder. However, it is controversial whether long-term maintenance treatment with lithium or other drugs for bipolar disorder causes chronic kidney disease (CKD). OBJECTIVE: To compare rates of CKD and in particular rates of end...... among all persons who were registered in Denmark on January 1, 1995, all patients with a diagnosis of a single manic episode or bipolar disorder between January 1, 1994, and December 31, 2012 (n =10 591), and all patients exposed to either lithium (n = 26 731) or anticonvulsants (n=420 959). Cohort 2...

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

    Science.gov (United States)

    Swann, Alan C

    2011-01-01

    SUMMARY Antisocial personality disorder (ASPD) and bipolar disorder are both characterized by impulsive behavior, increased incarceration or arrest, addictive disorders and suicidal behavior. These characteristics appear more severe in the combined disorders. Individuals with ASPD who also have bipolar disorder have higher rates of addictive disorders and suicidal behavior and are more impulsive, as measured by questionnaires or behavioral laboratory tests. Those with bipolar disorder who have ASPD have higher rates of addictive, criminal and suicidal behavior, earlier onset of bipolar disorder with a more recurrent and predominately manic course and increased laboratory-measured, but not questionnaire-rated, impulsivity. These characteristics may result in part from differential impulsivity mechanisms in the two disorders, with bipolar disorder driven more by excessive catecholamine sensitivity and ASPD by deficient serotonergic function. PMID:22235235

  10. [Atypical presentation of an induced hyperthyroidism].

    Science.gov (United States)

    Duque, María Del Pilar Velásquez; Miranda, Jaime Bernal

    2013-03-01

    We present the case of a person with baseline Bipolar Affective Disorder, who starts receiving medical treatment for subclinical Hypothyroidism, during this time the patient develops Hyperthyroidism. During the course of the latter, the patient started to exhibit depressed mood symptoms and worsening of her baseline disorder. Typically there are depressive symptoms in hypothyroidism and manic symptoms in hyperthyroidism, there have been a few cases of depressive symptoms (depressed mood, asthenia and apathy) reported in patients with hyperthyroidism. Up till now it's a fact that Hyperthyroidism constitutes itself as a risk factor for developing or precipitating depressive states, thus increasing hospital readmissions, and another important fact is that of manifesting or worsening affective symptoms due to the influence of thyroid hormones. We also present the well-known relationship between thyroid malfunction and affective disorders. Copyright © 2013 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  11. [Mania associated with Usher syndrome type II].

    Science.gov (United States)

    Praharaj, Samir Kumar; Acharya, Mahima; Sarvanan, Arul; Kongasseri, Sreejayan; Behere, Rishikesh V; Sharma, P S V N

    2012-01-01

    Usher syndrome (or Hallgren syndrome) is an autosomal recessive genetic disorder characterized by sensorineural deafness, retinitis pigmentosa, and variable vestibular deficit; Usher syndrome type II is the most common form. Various neuropsychiatric disorders have been reported to occur in those with Usher syndrome, including schizophrenia-like disorder, atypical psychosis, recurrent depressive illness, neurotic disorder, and mental retardation; however, bipolar disorder is not common in those with Usher syndrome. Herein we describe a 30-year-old male with Usher syndrome type II that developed features indicative of a probable manic episode. The patient had complete remission of symptoms in response to treatment with olanzapine 20 mg d-1. In persons with dual sensory impairment there are inherent problems with assessment and diagnosis is difficult due to their limited communication abilities. The diagnosis of Usher syndrome depends heavily on behavioral observation and disturbances in vegetative functions.

  12. A survey of the psycho-social aspects of murderers in Iran.

    Science.gov (United States)

    Roohanna, R S

    1982-01-01

    The psycho-social aspects of 72 murderers (one female, 71 males) were studied. The murderers came from the Khoozestan and the Lorestan provinces of Iran. One of them had been transferred from the north of Iran (probably on exile). The murderers were mostly from lower social classes and crowded homes. The majority of them had worked as unskilled labourers or farmers. A great number of them regretted their action but a few were proud of what they had done. They believed that they had saved the chastity of their family which is very important in Islam. None of them were epileptic nor had any history of it. Four claimed to be nervous. Eight were alcoholics and three were addicted to drugs. One of them was suspected of having manic-depressive psychosis and only one had paranoid schizophrenia. The female and four of the males were psychopaths.

  13. "On cyclic insanity" by Karl Ludwig Kahlbaum, MD: a translation and commentary.

    Science.gov (United States)

    Baethge, Christopher; Salvatore, Paola; Baldessarini, Ross J

    2003-01-01

    Karl Ludwig Kahlbaum (1828-1899) spent most of his professional career as director of a private psychiatric sanatorium in Germany. He remains influential for introducing his "clinical method" (based on considering the course of an illness as well as the signs and symptoms) of differential diagnosis of specific psychiatric syndromes and urging abandonment of the more unitary views of psychotic disorders favored by the leading German academic theorists of his time. Kahlbaum's approach to nosology, detailed in an 1863 monograph and other works, strongly influenced Kraepelin's views. However, remarkably few of the important writings of this keen clinical observer are available in English translation. His seminal lecture-essay "On Cyclic Insanity" [Uber cyklisches Irresein] of 1882 is translated into English here for the first time, with comments about its place in the history of the evolution of the concept of bipolar disorder, including its position as a link between Falret's folie circulaire and Kraepelin's manic-depressive insanity.

  14. Recognizing thyrotoxicosis in a patient with bipolar mania: a case report

    Directory of Open Access Journals (Sweden)

    Lee Catherine

    2008-02-01

    Full Text Available Abstract Background A thyroid stimulating hormone level is commonly measured in patients presenting with symptoms of mania in order to rule out an underlying general medical condition such as hyperthyroidism or thyrotoxicosis. Indeed, many cases have been reported in which a patient is initially treated for bipolar mania, but is later found to have a thyroid condition. Several case reports have noted the development of a thyroid condition in bipolar patients either on lithium maintenance treatment or recently on lithium treatment. Case presentation We review a case in which a patient with a long history of bipolar disorder presents with comorbid hyperthyroidism and bipolar mania after recent discontinuation of lithium treatment. Conclusion Physicians should consider a comorbid hyperthyroidism in bipolar manic patients only partially responsive to standard care treatment with a mood stabilizer and antipsychotic.

  15. Evidence of Premeditation in Skin Messages in Suicide.

    Science.gov (United States)

    Byard, Roger W

    2016-03-01

    A 34-year-old man with manic-depressive disorder was found dead sitting in a vehicle with a hose running from the exhaust pipe to the cabin. Numerous suicide notes were found inside his house. At autopsy, the decedent was wearing jeans and a long-sleeved windcheater. Upon removal of his clothes, a series of messages were also found written on the legs and forearm. Death was due to carbon monoxide toxicity with a blood level of carboxyhemoglobin of 84%. Skin messages represent a rare form of suicide note that may suggest that a suicide has not been planned, as the decedent may have used the nearest surface to write on. This case demonstrates, however, that skin messages may be more organized, being written prior to dressing and setting up the fatal episode. They also may compliment other notes and messages. © 2015 American Academy of Forensic Sciences.

  16. PPM-X: A new X-linked mental retardation syndrome with psychosis, pyramidal signs, and macroorchidism maps to Xq28

    Energy Technology Data Exchange (ETDEWEB)

    Lindsay, S.; Splitt, M.; Edney, S. [Univ. of Newcastle upon Tyne (United Kingdom)] [and others

    1996-06-01

    We report a three-generation family manifesting a previously undescribed X-linked mental retardation syndrome. Four of the six moderately retarded males have had episodes of manic-depressive psychosis. The phenotype also includes pyramidal signs, Parkinsonian features, and macroorchidism, but there are no characteristic dysmorphic facial features. Affected males do not show fragile sites at distal Xq on cytogenetic analysis, nor do they have expansions of the CGG repeats at the FRAXA, FRAXE, or FRAXF loci. Linkage analyses were undertaken, and a maximal LOD score of 3.311 at {theta} = .0 was observed with the microsatellite marker DXS1123 in Xq28. A recombination was detected in one of the affected males with DXS1691 (Xq28), which gives the proximal boundary of the localization. No distal recombination has been detected at any of the loci tested. 31 refs., 2 figs., 2 tabs.

  17. Orality disorders in melancholia: acedia as stagnation

    Directory of Open Access Journals (Sweden)

    Ana Cecília Magtaz

    2012-09-01

    Full Text Available In this article valuable contributions by Lasègue, Freud and Abraham are discussed, as they are all indispensible to the understanding of orality disorders in melancholia. Although none of the above authors used the exact term "orality disorders," their understandings of both hysteria and melancholia are important in the debate surrounding the clinical treatment of these difficulties. Sadness is a common denominator for the authors, but contributions on acedia, the "noonday demon" mentioned by Agamben, are also important. Acedia is defined as stagnation, a desperate lack of vigor when faced with a wearying and demanding situation. Those who suffer from chronic acedia feel great inertia and are unable to envision a future. They see their creativity wane away, especially due to the painful isolation caused by what might be called anguished sadness - a denial of sadness through manic action.

  18. Neuropsychiatric complications associated with interferon - alpha -2b treatment of malignant melanoma.

    LENUS (Irish Health Repository)

    Enudi, W

    2009-08-01

    Several adverse effects have been associated with interferon alpha 2b treatment and neuropsychiatric effects have also been commonly reported. Psychosis and mood disorders have been described in the literature. This case report is of a 30 year old man with malignant melanoma stage 3a who was receiving adjuvant alpha 2b interferon and developed a manic episode two weeks post switching after one month of treatment on a high dose to a low dose. There was no previous psychiatric illness and no known family history of mental illness. This is in keeping with previous reports that mania has been observed in patients undergoing interferon treatment especially after significant dose-reduction or treatment breaks. Mania induced by interferon responds well to antimanic drugs .Since interferon alpha 2b is now commonly used in the treatment of malignant melanoma and other conditions, the need to be aware of its neuropsychiatric complications is essential.

  19. Tell me your apps and I will tell you your mood: Correlation of apps usage with Bipolar Disorder State

    DEFF Research Database (Denmark)

    Alvarez-Lozano, Jorge; Frost, Mads; Osmani, Venet

    2014-01-01

    Bipolar Disorder is a disease that is manifested with cycling periods of polar episodes, namely mania and depression. Depressive episodes are manifested through disturbed mood, psychomotor retardation, behaviour change, decrease in energy levels and length of sleep. Manic episodes are manifested...... be captured through the analysis of smartphone usage. We have analysed changes in smartphone usage, specifically app usage and how these changes correlate with the self-reported patient state. We also used psychiatric evaluation scores provided by the clinic to understand correlation of the patient smartphone...... behaviour before the psychiatric evaluation and after the psychiatric evaluation. The results show that patients have strong correlation of patterns of app usage with different aspects of their self-reported state including mood, sleep and irritability. While, on the other hand, the patients’ application...

  20. Increased risk of developing stroke for patients with major affective disorder--a registry study

    DEFF Research Database (Denmark)

    Nilsson, Flemming M; Kessing, Lars V

    2004-01-01

    and cerebrovascular diseases in hospitalised patients. The main finding of this study was that patients with depression severe enough to be hospitalised, seem to be at an increased risk of developing cerebrovascular disease. The hazard ratio of getting a diagnosis of stroke after initially having been discharged......Only a few studies have evaluated depressive disorder as a risk factor for cerebrovascular disease. In a hospital discharge register with nation-wide coverage of all hospitals in Denmark we used linkage between the somatic and psychiatric registries to study comorbidity between affective disorders...... with a diagnosis of depression was found to be 1.22 (95% Confidence Interval: 1.06-1.41). In the group of patients with manic/bipolar disorder no association was found concerning development of stroke. In elderly with first time depression admitted to hospital, neurological disorders should be carefully evaluated...

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

    DEFF Research Database (Denmark)

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

    2014-01-01

    BACKGROUND: No study has investigated when preventive treatment with lithium should be initiated in bipolar disorder. AIMS: To compare response rates among patients with bipolar disorder starting treatment with lithium early v. late. METHOD: Nationwide registers were used to identify all patients...... with a diagnosis of bipolar disorder in psychiatric hospital settings who were prescribed lithium during the period 1995-2012 in Denmark (n = 4714). Lithium responders were defined as patients who, following a stabilisation lithium start-up period of 6 months, continued lithium monotherapy without being admitted...... to hospital. Early v. late intervention was defined in two ways: (a) start of lithium following first contact; and (b) start of lithium following a diagnosis of a single manic/mixed episode. RESULTS: Regardless of the definition used, patients who started lithium early had significantly decreased rates of non...

  2. Dialectical behavior therapy for adolescents with bipolar disorder: results from a pilot randomized trial.

    Science.gov (United States)

    Goldstein, Tina R; Fersch-Podrat, Rachael K; Rivera, Maribel; Axelson, David A; Merranko, John; Yu, Haifeng; Brent, David A; Birmaher, Boris

    2015-03-01

    The purpose of this study was to conduct a pilot randomized trial of dialectical behavior therapy (DBT) versus psychosocial treatment as usual (TAU) for adolescents diagnosed with bipolar disorder (BP). We recruited participants 12-18 years of age with a primary BP diagnosis (I, II, or operationalized not otherwise specified [NOS] criteria) from a pediatric specialty clinic. Eligible patients were assigned using a 2:1 randomization structure to either DBT (n=14) or psychosocial TAU (n=6). All patients received medication management from a study-affiliated psychiatrist. DBT included 36 sessions (18 individual, 18 family skills training) over 1 year. TAU was an eclectic psychotherapy approach consisting of psychoeducational, supportive, and cognitive behavioral techniques. An independent evaluator, blind to treatment condition, assessed outcomes including affective symptoms, suicidal ideation and behavior, nonsuicidal self-injurious behavior, and emotional dysregulation, quarterly over 1 year. Adolescents receiving DBT attended significantly more therapy sessions over 1 year than did adolescents receiving TAU, possibly reflecting greater engagement and retention; both treatments were rated as highly acceptable by adolescents and parents. As compared with adolescents receiving TAU, adolescents receiving DBT demonstrated significantly less severe depressive symptoms over follow-up, and were nearly three times more likely to demonstrate improvement in suicidal ideation. Models indicate a large effect size, for more weeks being euthymic, over follow-up among adolescents receiving DBT. Although there were no between-group differences in manic symptoms or emotional dysregulation with treatment, adolescents receiving DBT, but not those receiving TAU, evidenced improvement from pre- to posttreatment in both manic symptoms and emotional dysregulation. DBT may offer promise as an adjunct to pharmacotherapy in the treatment of depressive symptoms and suicidal ideation for

  3. The social and economic origins of genetic determinism: a case history of the American Eugenics Movement, 1900-1940 and its lessons for today.

    Science.gov (United States)

    Allen, G E

    1997-01-01

    Eugenics, the attempt to improve the genetic quality of the human species by 'better breeding', developed as a worldwide movement between 1900 and 1940. It was particularly prominent in the United States, Britain and Germany, and in those countries was based on the then-new science of Mendelian genetics. Eugenicists developed research programs to determine the degree in which traits such as Huntington's chorea, blindness, deafness, mental retardation (feeblemindedness), intelligence, alcoholism, schizophrenia, manic depression, rebelliousness, nomadism, prostitution and feeble inhibition were genetically determined. Eugenicists were also active in the political arena, lobbying in the United States for immigration restriction and compulsory sterilization laws for those deemed genetically unfit; in Britain they lobbied for incarceration of genetically unfit and in Germany for sterilization and eventually euthanasia. In all these countries one of the major arguments was that of efficiency: that it was inefficient to allow genetic defects to be multiplied and then have to try and deal with the consequences of state care for the offspring. National socialists called genetically defective individuals 'useless eaters' and argued for sterilization or euthanasia on economic grounds. Similar arguments appeared in the United States and Britain as well. At the present time (1997) much research and publicity is being given to claims about a genetic basis for all the same behaviors (alcoholism, manic depression, etc.), again in an economic context--care for people with such diseases is costing too much. There is an important lesson to learn from the past: genetic arguments are put forward to mask the true--social and economic--causes of human behavioral defects.

  4. Aripiprazole augmentation in managing comorbid obsessive–compulsive disorder and bipolar disorder: a case with suicidal attempts

    Directory of Open Access Journals (Sweden)

    Lai J

    2016-12-01

    Full Text Available Jianbo Lai,1,2 Qiaoqiao Lu,1 Peng Zhang,2,3 Tingting Xu,2,3 Yi Xu,1,2 Shaohua Hu1,2 1Department of Psychiatry, the First Affiliated Hospital, Zhejiang University School of Medicine, 2The Key Laboratory of Mental Disorder’s Management in Zhejiang Province, 3Department of Psychiatry, Mental Health Centre, Xiaoshan Hospital of Zhejiang Province, Hangzhou, Zhejiang, People’s Republic of China Abstract: Comorbid obsessive–compulsive disorder (OCD and bipolar disorder (BD have long been an intractable problem in clinical practice. The increased risk of manic/hypomanic switch hinders the use of antidepressants for managing coexisting OCD symptoms in BD patients. We herein present a case of a patient with BD–OCD comorbidity, who was successfully treated with mood stabilizers and aripiprazole augmentation. The young female patient reported recurrent depressive episodes and aggravating compulsive behaviors before hospitalization. Of note, the patient repetitively attempted suicide and reported dangerous driving because of intolerable mental sufferings. The preexisting depressive episode and OCD symptoms prompted the use of paroxetine, which consequently triggered the manic switching. Her diagnosis was revised into bipolar I disorder. Minimal response with mood stabilizers prompted the addition of aripiprazole (a daily dose of 10 mg, which helped to achieve significant remission in emotional and obsessive–compulsive symptoms. This case highlights the appealing efficacy of a small dose of aripiprazole augmentation for treating BD–OCD comorbidity. Well-designed clinical trials are warranted to verify the current findings. Keywords: aripiprazole, bipolar disorder, obsessive–compulsive disorder, suicide

  5. Three-year latent class trajectories of attention-deficit/hyperactivity disorder (ADHD) symptoms in a clinical sample not selected for ADHD.

    Science.gov (United States)

    Arnold, L Eugene; Ganocy, Stephen J; Mount, Katherine; Youngstrom, Eric A; Frazier, Thomas; Fristad, Mary; Horwitz, Sarah M; Birmaher, Boris; Findling, Robert; Kowatch, Robert A; Demeter, Christine; Axelson, David; Gill, Mary Kay; Marsh, Linda

    2014-07-01

    This study aims to examine trajectories of attention-deficit/hyperactivity disorder (ADHD) symptoms in the Longitudinal Assessment of Manic Symptoms (LAMS) sample. The LAMS study assessed 684 children aged 6 to 12 years with the Kiddie-Schedule for Affective Disorders and Schizophrenia (K-SADS) and rating scales semi-annually for 3 years. Although they were selected for elevated manic symptoms, 526 children had baseline ADHD diagnoses. With growth mixture modeling (GMM), we separately analyzed inattentive and hyperactive/impulsive symptoms, covarying baseline age. Multiple standard methods determined optimal fit. The χ(2) and Kruskal-Wallis analysis of variance compared resulting latent classes/trajectories on clinical characteristics and medication. Three latent class trajectories best described inattentive symptoms, and 4 classes best described hyperactive/impulsive symptoms. Inattentive trajectories maintained their relative position over time. Hyperactive/impulsive symptoms had 2 consistent trajectories (least and most severe). A third trajectory (4.5%) started mild, then escalated; and a fourth (14%) started severe but improved dramatically. The improving trajectory was associated with the highest rate of ADHD and lowest rate of bipolar diagnoses. Three-fourths of the mildest inattention class were also in the mildest hyperactive/impulsive class; 72% of the severest inattentive class were in the severest hyperactive/impulsive class, but the severest inattention class also included 62% of the improving hyperactive-impulsive class. An ADHD rather than bipolar diagnosis prognosticates a better course of hyperactive/impulsive, but not inattentive, symptoms. High overlap of relative severity between inattention and hyperactivity/impulsivity confirms the link between these symptom clusters. Hyperactive/impulsive symptoms wane more over time. Group means are insufficient to understand individual ADHD prognosis. A small subgroup deteriorates over time in

  6. Neuropsychological Impairments in Schizophrenia and Psychotic Bipolar Disorder: Findings from the Bipolar-Schizophrenia Network on Intermediate Phenotypes (B-SNIP) Study

    Science.gov (United States)

    Hill, S. Kristian; Reilly, James L.; Keefe, Richard S.E.; Gold, James M.; Bishop, Jeffrey R.; Gershon, Elliot S.; Tamminga, Carol A.; Pearlson, Godfrey D.; Keshavan, Matcheri S.; Sweeney, John A.

    2017-01-01

    Objective Familial neuropsychological deficits are well established in schizophrenia but remain less well characterized in other psychotic disorders. This study from the Bipolar-Schizophrenia Network on Intermediate Phenotypes (B-SNIP) consortium 1) compares cognitive impairment in schizophrenia and bipolar disorder with psychosis, 2) tests a continuum model of cognitive dysfunction in psychotic disorders, 3) reports familiality of cognitive impairments across psychotic disorders, and 4) evaluates cognitive impairment among nonpsychotic relatives with and without cluster A personality traits. Method Participants included probands with schizophrenia (N=293), psychotic bipolar disorder (N=227), schizoaffective disorder (manic, N=110; depressed, N=55), their first-degree relatives (N=316, N=259, N=133, and N=64, respectively), and healthy comparison subjects (N=295). All participants completed the Brief Assessment of Cognition in Schizophrenia (BACS) neuropsychological battery. Results Cognitive impairments among psychotic probands, compared to healthy comparison subjects, were progressively greater from bipolar disorder (z=−0.77) to schizoaffective disorder (manic z=−1.08; depressed z=−1.25) to schizophrenia (z=−1.42). Profiles across subtests of the BACS were similar across disorders. Familiality of deficits was significant and comparable in schizophrenia and bipolar disorder. Of particular interest were similar levels of neuropsychological deficits in relatives with elevated cluster A personality traits across proband diagnoses. Nonpsychotic relatives of schizophrenia probands without these personality traits exhibited significant cognitive impairments, while relatives of bipolar probands did not. Conclusions Robust cognitive deficits are present and familial in schizophrenia and psychotic bipolar disorder. Severity of cognitive impairments across psychotic disorders was consistent with a continuum model, in which more prominent affective features and less

  7. Identification of a Glycogen Synthase Kinase-3[beta] Inhibitor that Attenuates Hyperactivity in CLOCK Mutant Mice

    Energy Technology Data Exchange (ETDEWEB)

    Kozikowski, Alan P.; Gunosewoyo, Hendra; Guo, Songpo; Gaisina, Irina N.; Walter, Richard L.; Ketcherside, Ariel; McClung, Colleen A.; Mesecar, Andrew D.; Caldarone, Barbara (Psychogenics); (Purdue); (UIC); (UTSMC)

    2012-05-02

    Bipolar disorder is characterized by a cycle of mania and depression, which affects approximately 5 million people in the United States. Current treatment regimes include the so-called 'mood-stabilizing drugs', such as lithium and valproate that are relatively dated drugs with various known side effects. Glycogen synthase kinase-3{beta} (GSK-3{beta}) plays a central role in regulating circadian rhythms, and lithium is known to be a direct inhibitor of GSK-3{beta}. We designed a series of second generation benzofuran-3-yl-(indol-3-yl)maleimides containing a piperidine ring that possess IC{sub 50} values in the range of 4 to 680 nM against human GSK-3{beta}. One of these compounds exhibits reasonable kinase selectivity and promising preliminary absorption, distribution, metabolism, and excretion (ADME) data. The administration of this compound at doses of 10 to 25 mg kg{sup -1} resulted in the attenuation of hyperactivity in amphetamine/chlordiazepoxide-induced manic-like mice together with enhancement of prepulse inhibition, similar to the effects found for valproate (400 mg kg{sup -1}) and the antipsychotic haloperidol (1 mg kg{sup -1}). We also tested this compound in mice carrying a mutation in the central transcriptional activator of molecular rhythms, the CLOCK gene, and found that the same compound attenuates locomotor hyperactivity in response to novelty. This study further demonstrates the use of inhibitors of GSK-3{beta} in the treatment of manic episodes of bipolar/mood disorders, thus further validating GSK-3{beta} as a relevant therapeutic target in the identification of new therapies for bipolar patients.

  8. Residual symptoms and specific functional impairments in euthymic patients with bipolar disorder.

    Science.gov (United States)

    Samalin, Ludovic; de Chazeron, Ingrid; Vieta, Eduard; Bellivier, Frank; Llorca, Pierre-Michel

    2016-03-01

    The aims of the present study were to confirm the impact of residual symptoms on overall functioning in a large sample of euthymic patients with bipolar disorder in real-life conditions and to explore the relationship between residual symptoms and specific areas of functional impairment. This was a multicenter, cross-sectional, non-interventional study of euthymic outpatients with bipolar disorder. The Functioning Assessment Short Test was used to assess overall and specific domains of functioning (autonomy, occupational functioning, cognitive functioning, financial issues, interpersonal relationships, and leisure time). Various residual symptoms were assessed (residual mood symptoms, emotional dysregulation, sleep and sexual disorders, stigma, and perceived cognitive impairment). Logistic regression was used to determine the best model of association between functional domains and residual symptoms. Almost half of the 468 patients included (42%) had poor overall functioning. Residual depressive symptoms appeared to have an impact on overall functioning and in nearly all areas of functioning. In addition, specific residual symptoms had significantly more negative effects on some domains of functioning in euthymic patients with bipolar disorder (residual manic symptoms and occupational stigma on autonomy, emotional inhibition on occupational functioning, residual manic symptoms on financial issues, family stigma on interpersonal relationships, and sexual function and occupational stigma on leisure time). Our findings highlight the importance of evaluating overall functioning in clinical practice as well as functional domains. They also indicate that some residuals symptoms in patients with bipolar disorder should be targeted in personalized treatment plans, in order to improve functioning in the domains in which the patient is most impaired. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  9. Perceived treatment effectiveness, medication compliance, and complementary and alternative medicine use among veterans with bipolar disorder.

    Science.gov (United States)

    Jarman, Christopher N; Perron, Brian E; Kilbourne, Amy M; Teh, Carrie Farmer

    2010-03-01

    Recent research shows a high rate of complementary and alternative medicine (CAM) use among persons with mental disorders, although correlates and patterns of CAM use are relatively unknown. This study tested whether CAM use is associated with perceived effectiveness of conventional treatment (i.e., psychotropic medication and psychotherapy) and medication compliance among persons with bipolar disorder. Patients with bipolar disorder (n = 435) were included as part of a naturalistic cohort study. Measures of CAM utilization, medication compliance, and perceptions of the effectiveness of psychotropic medications and psychotherapy were based on previously established questionnaires. Associations were tested using bivariate and multivariate analyses. Bivariate analyses showed that patients who did not perceive psychotherapy as effective at improving social, family, or job functioning reported greater CAM use. However, medication compliance was not significantly associated with use of CAM. Patients who used oral (e.g., herbal therapies) or cognitive (e.g., meditation) CAM were more likely to report that their medications were not effective at relieving manic or depressive symptoms. Users of cognitive CAM were more likely to report that their medications did not help with social, job, or family functioning, and that they did not prevent recurrences of manic or depressive episodes. None of the bivariate associations remained significant in multivariate analyses. Prior research has suggested that persons who are dissatisfied with treatment for medical conditions are more likely to use CAM therapies. However, the results of this study do not show CAM therapies to be associated with perceived effectiveness of treatments for mental health problems among this sample of persons with serious mental illnesses. This suggests that motivations for CAM use may vary by population and condition. Because few correlates of CAM use among persons with serious mental illnesses are known

  10. Peripheral brain-derived neurotrophic factor (BDNF) as a biomarker in bipolar disorder: a meta-analysis of 52 studies.

    Science.gov (United States)

    Fernandes, Brisa S; Molendijk, Marc L; Köhler, Cristiano A; Soares, Jair C; Leite, Cláudio Manuel G S; Machado-Vieira, Rodrigo; Ribeiro, Thamara L; Silva, Jéssica C; Sales, Paulo M G; Quevedo, João; Oertel-Knöchel, Viola; Vieta, Eduard; González-Pinto, Ana; Berk, Michael; Carvalho, André F

    2015-11-30

    The neurotrophic hypothesis postulates that mood disorders such as bipolar disorder (BD) are associated with a lower expression of brain-derived neurotrophic factor (BDNF). However, its role in peripheral blood as a biomarker of disease activity and of stage for BD, transcending pathophysiology, is still disputed. In the last few years an increasing number of clinical studies assessing BDNF in serum and plasma have been published. Therefore, it is now possible to analyse the association between BDNF levels and the severity of affective symptoms in BD as well as the effects of acute drug treatment of mood episodes on BDNF levels. We conducted a systematic review and meta-analysis of all studies on serum and plasma BDNF levels in bipolar disorder. Through a series of meta-analyses including a total of 52 studies with 6,481 participants, we show that, compared to healthy controls, peripheral BDNF levels are reduced to the same extent in manic (Hedges' g = -0.57, P = 0.010) and depressive (Hedges' g = -0.93, P = 0.001) episodes, while BDNF levels are not significantly altered in euthymia. In meta-regression analyses, BDNF levels additionally negatively correlate with the severity of both manic and depressive symptoms. We found no evidence for a significant impact of illness duration on BDNF levels. In addition, in plasma, but not serum, peripheral BDNF levels increase after the successful treatment of an acute mania episode, but not of a depressive one. In summary, our data suggest that peripheral BDNF levels, more clearly in plasma than in serum, is a potential biomarker of disease activity in BD, but not a biomarker of stage. We suggest that peripheral BDNF may, in future, be used as a part of a blood protein composite measure to assess disease activity in BD.

  11. Alterations in BDNF (brain derived neurotrophic factor) and GDNF (glial cell line-derived neurotrophic factor) serum levels in bipolar disorder: The role of lithium.

    Science.gov (United States)

    Tunca, Zeliha; Ozerdem, Aysegul; Ceylan, Deniz; Yalçın, Yaprak; Can, Güneş; Resmi, Halil; Akan, Pınar; Ergör, Gül; Aydemir, Omer; Cengisiz, Cengiz; Kerim, Doyuran

    2014-09-01

    Brain-derived neurotrophic factor (BDNF) has been consistently reported to be decreased in mania or depression in bipolar disorders. Evidence suggests that Glial cell line-derived neurotrophic factor (GDNF) has a role in the pathogenesis of mood disorders. Whether GDNF and BDNF act in the same way across different episodes in bipolar disorders is unclear. BDNF and GDNF serum levels were measured simultaneously by enzyme-linked immunosorbent assay (ELISA) method in 96 patients diagnosed with bipolar disorder according to DSM-IV (37 euthymic, 33 manic, 26 depressed) in comparison to 61 healthy volunteers. SCID- I and SCID-non patient version were used for clinical evaluation of the patients and healthy volunteers respectively. Correlations between the two trophic factor levels, and medication dose, duration and serum levels of lithium or valproate were studied across different episodes of illness. Patients had significantly lower BDNF levels during mania and depression compared to euthymic patients and healthy controls. GDNF levels were not distinctive. However GDNF/BDNF ratio was higher in manic state compared to euthymia and healthy controls. Significant negative correlation was observed between BDNF and GDNF levels in euthymic patients. While BDNF levels correlated positively, GDNF levels correlated negatively with lithium levels. Regression analysis confirmed that lithium levels predicted only GDNF levels positively in mania, and negatively in euthymia. Small sample size in different episodes and drug-free patients was the limitation of thestudy. Current data suggests that lithium exerts its therapeutic action by an inverse effect on BDNF and GDNF levels, possibly by up-regulating BDNF and down-regulating GDNF to achieve euthymia. Copyright © 2014 Elsevier B.V. All rights reserved.

  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. 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. Update on extended release quetiapine fumarate in schizophrenia and bipolar disorders

    Directory of Open Access Journals (Sweden)

    El-Khalili N

    2012-11-01

    Full Text Available Nizar El-KhaliliAlpine Clinic, Lafayette, IN, USAAbstract: The atypical antipsychotic quetiapine fumarate is available both as an immediate release (IR and as an extended release (XR formulation allowing flexibility of dosing for individual patients. Approved uses of quetiapine XR include the treatment of schizophrenia (including maintenance therapy for prevention of relapse, the treatment of bipolar disorder (manic and depressive episodes, and the prevention of recurrence in patients with bipolar disorder who respond to quetiapine XR. This narrative review provides an update on quetiapine XR in these indications. The pharmacological profile of quetiapine, including a moderate affinity for dopamine D2 receptors and higher affinity for serotonin 5-hydroxytryptophan (5-HT2A receptors, may explain its broad efficacy and low propensity for extrapyramidal symptoms (EPS. The XR formulation has similar bioavailability but prolonged plasma levels compared with the IR formulation, allowing for less frequent (once-daily dosing. Clinical studies have confirmed the efficacy of quetiapine XR in relieving the acute symptoms of schizophrenia during short-term trials, and reducing the risk for relapse in long-term studies. Direct switching from the IR formulation to the same dose of the XR formulation did not reveal any loss of efficacy or tolerability issues, and switching patients to quetiapine XR from conventional or other atypical antipsychotics (for reasons of insufficient efficacy or tolerability also proved to be beneficial and generally well tolerated. In bipolar disorder, quetiapine XR has also proven effective in relieving acute depressive and manic symptoms. Adverse events with quetiapine XR in patients with either schizophrenia or bipolar disorder are similar to those associated with the IR formulation, the most common being sedation, dry mouth, somnolence, dizziness, and headache. The low propensity for EPS is maintained with the XR formulation

  15. Hydro-electric power project on the Toulnustouc River

    International Nuclear Information System (INIS)

    Rochon, Y.; Morneau, J.; Lefebvre, G.

    2001-01-01

    Hydro-Quebec has proposed the development of a hydro-electric power project on the Toulnustouc River, located between Saint-Anne Lake and Manic Reservoir. The work would involve the construction of a power generation plant of 526 MW, construction of a 77 m dam on the Toulnustouc River, 14 km downstream from the existing Lac-Saint-Anne dam, the creation of a new water expanse covering 22 square kilometers, the construction of an embankment, the strengthening of the existing Saint-Anne embankment, digging a 9.8 km gallery, and the construction of a flood spillway. This work would have consequences for three different sectors of the river: between the existing and the proposed dam, between the dam and the projected power plant, and between the power plant and the limit of the influence of the reservoir Manic-2. Hydro-Quebec would like the work to begin in July 2001, with the aim of having the plant in operation in 2005. The overall cost of the project is estimated at 600 million dollars. It is expected that the economic benefits for the region would be in the 211 million dollar range. An environmental assessment of the entire project was performed by Quebec Ministere de l'Environnement. The authors determined that the project was recognized as justified by the Ministere des Ressources Naturelles (Natural Resources Ministry) and concluded that the project was acceptable from an environmental point of view as long as six conditions were met. They touched on the construction of a flood spillway capable of evacuating 19 cubic meters per second at any time during the year, that water be evacuated downstream following a pre-determined debit that varies according to the time of year, monitoring of the brook trout population and its habitat, and environmental monitoring. 46 refs., 7 tabs., 2 figs., 1 annex

  16. Treatment Development and Feasibility Study of Family-Focused Treatment for Adolescents with Bipolar Disorder and Comorbid Substance Use Disorders

    Science.gov (United States)

    Goldstein, Benjamin I.; Goldstein, Tina R.; Collinger, Katelyn A.; Axelson, David A.; Bukstein, Oscar G.; Birmaher, Boris; Miklowitz, David J.

    2014-01-01

    Background Comorbid substance use disorders (SUD) are associated with increased illness severity and functional impairment among adolescents with bipolar disorder (BD). Previous psychosocial treatment studies have excluded adolescents with both BD and SUD. Studies suggest that integrated interventions are optimal for adults with BD and SUD. Methods We modified family-focused treatment for adolescents with BD (FFT-A) in order to explicitly target comorbid SUD (FFT-SUD). Ten adolescents with BD who had both SUD and an exacerbation of manic, depressed, or mixed symptoms within the last 3 months were enrolled. FFT-SUD was offered as an adjunct to pharmacotherapy, with a target of 21 sessions over 12 months of treatment. The FFT-SUD manual was iteratively modified to integrate a concurrent focus on SUD. Results Six subjects completed a mid-treatment 6-month assessment (after a mean of 16 sessions was completed). Of the 10 subjects, 3 dropped out early ( after ≤ 1 session); in the case of each of these subjects, the participating parent had active SUD. No other subjects in the study had a parent with active SUD. Preliminary findings suggested significant reductions in manic symptoms and depressive symptoms and improved global functioning. Reduction in cannabis use was modest and did not reach significance. Limitations Limitations included a small sample, open treatment, concurrent medications, and no control group. Conclusions These preliminary findings suggest that FFT-SUD is a feasible intervention, particularly for youth without parental SUD. FFT-SUD may be effective in treating mood symptoms, particularly depression, despite modest reductions in substance use. Integrating motivation enhancing strategies may augment the effect of this intervention on substance use. Additional strategies, such as targeting parental substance use, may prevent early attrition. PMID:24847999

  17. Atypical Antipsychotics in the Treatment of Acute Bipolar Depression with Mixed Features: A Systematic Review and Exploratory Meta-Analysis of Placebo-Controlled Clinical Trials

    Directory of Open Access Journals (Sweden)

    Michele Fornaro

    2016-02-01

    Full Text Available Evidence supporting the use of second generation antipsychotics (SGAs in the treatment of acute depression with mixed features (MFs associated with bipolar disorder (BD is scarce and equivocal. Therefore, we conducted a systematic review and preliminary meta-analysis investigating SGAs in the treatment of acute BD depression with MFs. Two authors independently searched major electronic databases from 1990 until September 2015 for randomized (placebo- controlled trials (RCTs or open-label clinical trials investigating the efficacy of SGAs in the treatment of acute bipolar depression with MFs. A random-effect meta-analysis calculating the standardized mean difference (SMD between SGA and placebo for the mean baseline to endpoint change in depression as well as manic symptoms score was computed based on 95% confidence intervals (CI. Six RCTs and one open-label placebo-controlled studies (including post-hoc reports representing 1023 patients were included. Participants received either ziprasidone, olanzapine, lurasidone, quetiapine or asenapine for an average of 6.5 weeks across the included studies. Meta-analysis with Duval and Tweedie adjustment for publication bias demonstrated that SGA resulted in significant improvements of (hypo-manic symptoms of bipolar mixed depression as assessed by the means of the total scores of the Young Mania Rating Scale (YMRS (SMD −0.74, 95% CI −1.20 to −0.28, n SGA = 907, control = 652. Meta-analysis demonstrated that participants in receipt of SGA (n = 979 experienced a large improvement in the Montgomery–Åsberg Depression Rating Scale (MADRS scores (SMD −1.08, 95% CI −1.35 to −0.81, p < 0.001 vs. placebo (n = 678. Publication and measurement biases and relative paucity of studies. Overall, SGAs appear to offer favorable improvements in MADRS and YMRS scores vs. placebo. Nevertheless, given the preliminary nature of the present report, additional original studies are required to allow more reliable

  18. Comparison of mania patients suitable for treatment trials versus clinical treatment.

    Science.gov (United States)

    Talamo, Alessandra; Baldessarini, Ross J; Centorrino, Franca

    2008-08-01

    It remains uncertain whether bipolar disorder (BPD) patients in randomized-controlled trials (RCTs) are sufficiently representative of clinically encountered patients as to guide clinical-therapeutic practice. We complied inclusion/exclusion criteria by frequency from reports of 21 RCTs for mania, and applied them in a pilot study of patients hospitalized for DSM-IV BPD manic/mixed states to compare characteristics and clinical responses of patients who did versus did not meet exclusion criteria. From 27 initially identified inclusion/exclusion criteria ranked by citation frequency, we derived six inclusion, and 10 non-redundant-exclusion factors. Of 67 consecutive patients meeting inclusion criteria, 15 (22.4%) potential "research subjects" met all 10 exclusion criteria. The remaining 52 "clinical patients" differed markedly on exclusion criteria, including more psychiatric co-morbidity, substance abuse, involuntary hospitalization, and suicide attempts or violence, but were otherwise similar. In both groups responses to clinically determined inpatient treatments were similar, including improvement in mania ratings. Based on applying reported inclusion/exclusion criteria for RCTs to a pilot sample of hospitalized-manic patients, those likely to be included in modern RCTs were similar to patients who would be excluded, most notably in short-term antimanic-treatment responses. The findings encourage further comparisons of subjects included/excluded from RCTs to test potential clinical generalizability of research findings. The pilot study is limited in numbers and exposure times with which to test for the minor differences between "research subjects" and "clinical patients." (c) 2008 John Wiley & Sons, Ltd.

  19. Level of response and safety of pharmacological monotherapy in the treatment of acute bipolar I disorder phases: a systematic review and meta-analysis

    Science.gov (United States)

    Tamayo, Jorge M.; Zarate, Carlos A.; Vieta, Eduard; Vázquez, Gustavo; Tohen, Mauricio

    2010-01-01

    In recent years, combinations of pharmacological treatments have become common for the treatment of bipolar disorder type I (BP I); however, this practice is usually not evidence-based and rarely considers monotherapy drug regimen (MDR) as an option in the treatment of acute phases of BP I. Therefore, we evaluated comparative data of commonly prescribed MDRs for both manic and depressive phases of BP I. Medline, PsycINFO, EMBASE, the Cochrane Library, the ClinicalStudyResults.org and other data sources were searched from 1949 to March 2009 for placebo and active controlled randomized clinical trials (RCTs). Risk ratios (RRs) for response, remission, and discontinuation rates due to adverse events (AEs), lack of efficacy, or discontinuation due to any cause, and the number needed to treat or harm (NNT or NNH) were calculated for each medication individually and for all evaluable trials combined. The authors included 31 RCTs in the analyses comparing a MDR with placebo or with active treatment for acute mania, and 9 RCTs comparing a MDR with placebo or with active treatment for bipolar depression. According to the collected evidence, most of the MDRs when compared to placebo showed significant response and remission rates in acute mania. In the case of bipolar depression only quetiapine and, to a lesser extent, olanzapine showed efficacy as MDR. Overall, MDRs were well tolerated with low discontinuation rates due to any cause or AE, although AE profiles differed among treatments. We concluded that most MDRs were efficacious and safe in the treatment of manic episodes, but very few MDRs have demonstrated being efficacious for bipolar depressive episodes. PMID:20128953

  20. The affective dimension of early-onset psychosis and its relationship with suicide.

    Science.gov (United States)

    Sanchez-Gistau, Vanessa; Baeza, Inmaculada; Arango, Celso; González-Pinto, Ana; de la Serna, Elena; Parellada, Mara; Graell, Montserrat; Paya, Beatriz; Llorente, Cloe; Castro-Fornieles, Josefina

    2015-07-01

    The affective dimension has scarcely been studied in early-onset psychosis. Our aims were to investigate the prevalence and type of affective symptoms in the prodromal and acute phases of early-onset psychosis and to examine their relationship with suicide. We also sought to establish whether the presence of premorbid antecedents or the presence of affective symptoms during the prodromal and acute phase might predict a later diagnosis of bipolar disorder (BP) or schizophrenia (SZ). Participants were 95 youths, aged 9-17 years, experiencing a first episode of a psychotic disorder (FEP) according to DSM-IV criteria. Prodromal affective symptoms in the year prior to the onset of full-blown psychosis were assessed by means of the K-SADS. Affective symptoms during the acute episode were evaluated using the Hamilton Depression Rating Scale and the Young Mania Rating Scale. Suicidality was assessed during the acute episode and at 6 and 12 months. Half of the patients experienced affective symptoms during the prodrome, with depressive symptoms being the most frequently reported. During the acute episode, 23.2% presented depressive, 41.4% mixed and 18.9% manic symptoms. After logistic regression analysis, only the presence of depressive symptoms was significantly associated with suicidality during the 12 months following the FEP. Neither early premorbid antecedents nor the prevalence or type of affective symptoms during the FEP predicted a diagnosis of BP or SZ at 12 months. However, both depressive and manic prodromal symptoms were associated with a later diagnosis of BP. The FEP of both SZ and BP is preceded by an identifiable prodromal phase. Early detection programs should target young people at clinical risk for the extended psychosis phenotype. The high prevalence of affective symptoms during the early phases of psychosis may encourage clinicians to identify and treat them in order to prevent suicide behaviour. © 2014 Association for Child and Adolescent Mental