RESUMEN
Trichotillomania (TTM) is an intractable and chronic mental disorder that causes significant distress or functional impairments in various life domains. Most individuals with trichotillomania have other comorbid diagnoses. Bipolar disorder (BD) is one of the most common comorbid conditions. Up to date, no FDA-approved drugs for TTM are available, not to mention children and adolescent patients with TTM and BD. Here, we present a case of an 8-year-old child with a long history of episodic TTM and bipolar disorder who was effectively treated with topiramate in a 3-year follow-up.
Asunto(s)
Trastorno Bipolar , Trastorno Obsesivo Compulsivo , Tricotilomanía , Adolescente , Humanos , Niño , Tricotilomanía/complicaciones , Tricotilomanía/tratamiento farmacológico , Tricotilomanía/epidemiología , Trastorno Obsesivo Compulsivo/diagnóstico , Trastorno Obsesivo Compulsivo/epidemiología , Topiramato/uso terapéutico , Trastorno Bipolar/complicaciones , Trastorno Bipolar/tratamiento farmacológico , Estudios de Seguimiento , ComorbilidadRESUMEN
BACKGROUND: Metabolic syndrome (Mets) is commonly seen in bipolar disorder (BD). As the key component and early biological index of Mets, insulin resistance (IR) among BD has received more and more attention. However, little is known about the prevalence of IR and its associated factors in drug-naïve patients with (BD), especially among Han Chinese population. METHODS: A cross-sectional study was conducted on 125 drug-naïve patients with bipolar disorder (BD) and 85 healthy controls (HC). The Homeostatic Model Assessment of insulin resistance (HOMA-IR) was calculated, and IR was defined as HOMA-IR greater than the 75th percentile value for health controls (2.35). Clinical characteristics of BD were collected through semi-structural interview performed by a trained interviewer with background of psychiatric education. RESULTS: Among the measured anthropocentric variables including BMI, waist circumference, abdomen circumference, hipline, and hip-waist ratio, waist circumference was found to be the most closely related to IR (0R = 1.070, 95%CI = 1.031-1.110, P < 0.001). Male was another factor that was associated with IR (OR = 2.281, 95%CI = 1.107-4.702, P = 0.025). After adjusted for gender and waist circumference, the risk of IR was significantly higher in bipolar disorder than in healthy controls (OR = 2.66, 95%CI = 1.364-5.214, P = 0.004). No significant association was found between IR and any of the observed physical and mental comorbidities, any characteristic of illness course including age onset, number of mixed episodes, types of current state, duration of current episode, duration of illness course, rapid cycling, number of mood episodes, and subgroup of BD. Hypersomnia was the only symptomatic feature that was significantly associated with IR (OR = 0.316, 95%CI = 0.124-0.803, P = 0.016). CONCLUSIONS: Bipolar disorder increases two-to-three-fold risk of IR, both circumference and male are the risk factors of IR but hypersomnia act as a protective factor.
Asunto(s)
Trastorno Bipolar , Resistencia a la Insulina , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Adulto Joven , Trastorno Bipolar/epidemiología , Estudios de Casos y Controles , China/epidemiología , Estudios Transversales , Pueblos del Este de Asia , Resistencia a la Insulina/fisiología , Síndrome Metabólico/epidemiología , Prevalencia , Factores de Riesgo , Factores Sexuales , Circunferencia de la CinturaRESUMEN
Bipolar disorder (BD) is commonly comorbid with premenstrual syndrome (PMS) or premenstrual dysphoric disorder (PMDD). However, little is known about their relationship. This study aimed to assess the impact of comorbid PMS or PMDD on the clinical characteristics of BD. A cross-sectional study was conducted on 262 women with BD. PMS and PMDD were screened with the Premenstrual Symptoms Screening Tool (PSST). Symptomatic features were assessed with Hamilton Depression Scale (HAMD), Young Mania Rating Scale (YMRS), and atypical features by the depressive episode section of SCID-I/P. The rates of PMS and PMDD among BD were 57.6% and 20.6% according to PSST. No significant difference in the rates of PMS and PMDD was found between BD I, BD II, and BD-NOS. Compared to BD patients without PMS or PMDD, patients with comorbid BD and PMS or PMDD were younger, more educated, had a higher risk of OCD, had an earlier age of onset, scored higher on HAMD-17 and its sub-scale of anxiety/somatization, cognitive deficit, psychomotor retardation, and were more likely to have increased appetite and leaden paralysis. In addition, patients with comorbid BD and PMDD were less likely to experience traumatic life events, more likely to have family history of mental disorders and have inflammatory or autoimmune disease, scored higher on HMAD-17, particularly in its sub-scale of anxiety/somatization, cognitive deficit, psychomotor retardation, and sleep disturbance. Compared with BD without PMS or PMDD, BD with PMS or PMDD might be a specific subtype of BD characterized with earlier onset age, heavier genetic load, increased symptom severity, and atypical features.
Asunto(s)
Trastorno Bipolar , Trastorno Disfórico Premenstrual , Síndrome Premenstrual , Humanos , Femenino , Trastorno Disfórico Premenstrual/diagnóstico , Trastorno Bipolar/diagnóstico , Trastorno Bipolar/epidemiología , Estudios Transversales , Síndrome Premenstrual/diagnóstico , Síndrome Premenstrual/epidemiología , Síndrome Premenstrual/psicología , China/epidemiologíaRESUMEN
In order to achieve pesudocapacitive performance of single-wall carbon nanotube (SWCNT) electrodes, a high-efficient and reversible redox strategy utilizing a redox-mediated electrolyte for SWCNT-based supercapacitors is reported. In this novel redox-mediated electrolyte, the single-electrode specific capacitance of the supercapacitor is heightened four times, reaching C=162.66 F g(-1) at 1 A g(-1). The quick charge-discharge ability of the supercapacitor is also enhanced, and the relaxation time is as low as 0.58 s. Furthermore, the supercapacitor shows an excellent cycling performance of 96.51 % retention after 4000 cycles. The remarkable results presented here illustrate that the redox strategy is a facile and straightforward approach to improve the performances of SWCNT electrodes.