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1.
Acta Med Port ; 33(1): 76, 2020 01 03.
Artigo em Inglês | MEDLINE | ID: mdl-31928607
2.
Adv Exp Med Biol ; 1180: 19-57, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31784956

RESUMO

Major depressive disorder (MDD) and bipolar disorder (BPD) are both chronic, severe mood disorder with high misdiagnosis rate, leading to substantial health and economic burdens to patients around the world. There is a high misdiagnosis rate of bipolar depression (BD) just based on symptomology in depressed patients whose previous manic or mixed episodes have not been well recognized. Therefore, it is important for psychiatrists to identify these two major psychiatric disorders. Recently, with the accumulation of clinical sample sizes and the advances of methodology and technology, certain progress in the genetics of major depression and bipolar disorder has been made. This article reviews the candidate genes for MDD and BD, genetic variation loci, chromosome structural variation, new technologies, and new methods.


Assuntos
Transtorno Bipolar/genética , Transtorno Depressivo Maior/genética , Humanos
4.
J Opioid Manag ; 15(5): 362-366, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31849027

RESUMO

OBJECTIVE: To assess the efficacy of buprenorphine augmentation in treatment of psychotic symptoms in bipolar disorder type I. DESIGN: Bipolar type I patients with manic or depressive episodes and psychotic feature and with opioid dependency comorbidity were randomly included and allocated. Both groups of buprenorphine (4 or 6 mg/d) and placebo were also treated with enough dosages of sodium valproate and risperidone. Psychosis as primary outcome and depressive and manic symptoms as secondary outcome were assessed at baseline and after 1 and 2 weeks. Data were analyzed through t test and repeated measure ANOVA. RESULTS: Twenty-four patients remained in each group. Both groups displayed significant reduction in psychotic, depressive, and manic symptoms during the 2 weeks of study, although there was not any significant difference between them. CONCLUSIONS: Buprenorphine did not add any efficacy to usual treatment of psychotic episodes of bipolar, although did not aggravate psychiatric symptoms.


Assuntos
Antipsicóticos , Transtorno Bipolar , Buprenorfina , Transtornos Psicóticos , Analgésicos Opioides , Antipsicóticos/uso terapêutico , Transtorno Bipolar/tratamento farmacológico , Buprenorfina/uso terapêutico , Método Duplo-Cego , Humanos , Transtornos Psicóticos/tratamento farmacológico , Resultado do Tratamento
5.
Adv Exp Med Biol ; 1192: 159-195, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31705495

RESUMO

This chapter presents an overview of accumulating neuroimaging data with emphasis on translational potential. The subject will be described in the context of three disease states, i.e., schizophrenia, bipolar disorder, and major depressive disorder, and for three clinical goals, i.e., disease risk assessment, subtyping, and treatment decision.


Assuntos
Transtorno Bipolar/diagnóstico por imagem , Encéfalo/diagnóstico por imagem , Transtorno Depressivo Maior/diagnóstico por imagem , Neuroimagem , Psiquiatria , Esquizofrenia/diagnóstico por imagem , Biomarcadores , Tomada de Decisão Clínica , Humanos , Imagem por Ressonância Magnética , Medição de Risco
6.
Adv Exp Med Biol ; 1192: 251-261, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31705498

RESUMO

Mood disorders include all types of depression and bipolar disorder, and mood disorders are sometimes called affective disorders. We will discuss newly developing two issues in affective disorders in children and adolescents. Those are the new diagnostic challenges using neuroimaging techniques in affective disorders and the introduction of disruptive mood dysregulation disorder (DMDD). During the 1980s, mental health professionals began to recognize symptoms of mood disorders in children and adolescents, as well as adults. However, children and adolescents do not necessarily have or exhibit the same symptoms as adults. It is more difficult to diagnose mood disorders in children, especially because children are not always able to express how they feel. Child mental health professionals believe that mood disorders in children and adolescents remain one of the most underdiagnosed mental health problems. We are currently trying to introduce the new diagnostic technique-machine learning in children and adolescents with MDD. We will discuss the current progress in the clinical application of machine learning for MDD. After that, we would also discuss a new challenging diagnosis-DMDD. We are still suffering from a lack of evidence when trying to treat the patients with DMDD. In addition, there are some debates about the diagnostic validity of DMDD. We will explain the current situation of DMDD studies and the future directions in the study of DMDD.


Assuntos
Aprendizado de Máquina , Transtornos do Humor/psicologia , Adolescente , Adulto , Transtornos de Deficit da Atenção e do Comportamento Disruptivo , Transtorno Bipolar/diagnóstico , Transtorno Bipolar/psicologia , Criança , Depressão , Emoções , Humanos , Transtornos do Humor/diagnóstico , Neuroimagem
7.
Medicine (Baltimore) ; 98(46): e17687, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31725611

RESUMO

To analyze the factors that affecting the help-seeking behavior of bipolar disorder (BD) patients by conducting interviews BD individuals in Hunan province of China.In 2015, 72,999 people from 123 counties of Hunan province of China were interviewed through multistage stratified random sampling. Twelve items of general health questionnaire (GHQ-12) and abnormal behavioral clue questionnaire were used as screening tools. The Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) (SCID) was used as a diagnostic tool.Among the 75 BD patients, 36% (27/75) sought help. Compared with help-seekers, non-help-seekers were more likely to be older, divorced, or widowed, mostly illiterate or elementary education, family monthly income at least 3000 ¥, more physically consulted in the past year, able to effective work or study, at a stable illness status. 70.4% help-seekers firstly sought help from a medical institution. The main reasons that patients did not seek help were economic problem, did not know where to seek help, unsatisfied with medical services, afraid of mental health stigma, and other problems, such as traffic inconvenience.Non-help-seekers were faced with more difficulties in their social functions and social interactions.


Assuntos
Transtorno Bipolar/psicologia , Comportamento de Busca de Ajuda , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Adulto , Idoso , China , Análise por Conglomerados , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
8.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde, LIS-bvsms | ID: lis-LISBR1.1-46833

RESUMO

Founded in 1979, the Anxiety and Depression Association of America (ADAA) is an international nonprofit organization dedicated to the prevention, treatment, and cure of anxiety, depression, OCD, PTSD, and co-occurring disorders through education, practice, and research.


Assuntos
Ansiedade , Depressão , Transtorno de Pânico , Suicídio , Transtornos Dismórficos Corporais , Transtornos da Alimentação e da Ingestão de Alimentos , Transtorno Obsessivo-Compulsivo , Transtornos de Estresse Pós-Traumáticos , Transtorno Bipolar , Agorafobia , Mutismo , Transtornos do Sono-Vigília , Fobia Social , Transtornos Fóbicos
10.
J Opioid Manag ; 15(4): 342-344, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31637686

RESUMO

A 49-year-old male with major depressive disorder well-managed with venlafaxine [serotonin and norepinephrine reuptake inhibitor (SNRI)] and no history of manic episodes developed his first manic episode following use of tramadol. Tramadol-induced mania has been described with selective serotonin reuptake inhibitors but not SNRIs. In addition, mania is not listed as a potential clinical side effect-further illustrating this relative rarity. Due to tramadol's SNRI activity, there is definitive risk for mood lability in individuals managed with tramadol and other serotonergic medications as seen in this patient. The authors findings suggest the need for greater risk consideration when prescribing tramadol with other related agents such as venlafaxine.


Assuntos
Transtorno Bipolar , Transtorno Depressivo Maior , Tramadol , Cloridrato de Venlafaxina , Analgésicos Opioides , Transtorno Bipolar/induzido quimicamente , Transtorno Depressivo Maior/tratamento farmacológico , Humanos , Masculino , Pessoa de Meia-Idade , Inibidores de Captação de Serotonina/efeitos adversos , Tramadol/efeitos adversos , Tramadol/uso terapêutico , Cloridrato de Venlafaxina/efeitos adversos , Cloridrato de Venlafaxina/uso terapêutico
12.
Psychiatr Danub ; 31(Suppl 3): 434-437, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31488767

RESUMO

The notion of "mixity" of the dysphoric phases of the bipolarity includes the most insidious symptoms of the bipolar spectrum of mood disorders: the overlapping between depression-restlessness-irritability-grief-tension-anxiety can cause worsening of the mood disorders and in the most acute phases may cause increased risk of major behavioural disruption including murder and suicide. The early utilization of the rating scale on mixed states, "GT-MSRS", which can demonstrate the level of "mixity" of the mood disorder, can prevent this.


Assuntos
Transtorno Bipolar/diagnóstico , Transtorno Bipolar/psicologia , Transtornos do Humor/diagnóstico , Transtornos do Humor/psicologia , Ansiedade/psicologia , Depressão/psicologia , Pesar , Homicídio/psicologia , Humanos , Humor Irritável , Agitação Psicomotora/psicologia , Suicídio/psicologia
13.
Psychiatr Danub ; 31(Suppl 3): 490-496, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31488778

RESUMO

BACKGROUND: Differentiating Borderline Personality Disorder (BPD) from Bipolar Disorder (BD) represents a very difficult challenge for clinicians. Dysphoria could be a possible key to differentiate these disorders. We currently define dysphoria as a complex and disorganized emotional state with proteiform phenomenology, characterized by a multitude of symptoms. Among them irritability, discontent, interpersonal resentment and surrender prevail. These dimensions can be detected using the Neapen Dysphoria Scale - Italian version (NDS-I). Dysphoria role in BPD has been highlighted by the recent theorization of the Interpersonal Dysphoria Model, according to which dysphoria could represent the "psychopathological organizer" of the BPD. On the other side, dysphoria role in BD has not yet been established. This is simply considered as an aspect, and not fundamental, of the symptomatology characterizing BD, especially in mixed states patients. The phenomenological analysis of the dimensional spectrum of dysphoria within BPD and DB could provide a valuable aid in the differential diagnosis between BPD and BD. AIMS: The aim of this paper is to verify if the dimensional spectrum of dysphoria differs between Borderline Personality Disorder (BPD) and Bipolar Disorder Spectrum (BD) through an observational comparative study SUBJECTS AND METHODS: In this study, 65 adult patients, males and females between the ages of 18 and 65, were enrolled from the Psychiatric Service of the Santa Maria della Misericordia Hospital in Perugia (PG), Italy, from January 1st 2018 to April 30th 2019. We have formed 2 groups. A BPD group composed of 33 patients (19 female patients, representing approximately 57.6% of the sample) and a BD group composed of 32 patients (18 Female patients, representing approximately 56.2% of the sample). Patient's comorbid with BD and BPD have been excluded from the study. After a preliminary assessment to exclude organic and psychiatric comorbidity, and after at least 72 hours from hospitalization, we administered them the Neapen Dysphoria Scale - Italian Version (NDS-I), a specific dimensional test for dysphoria. Starting from the dataset, with the aid of the statistical program SPSS 20, we have carried out a comparison between disorders groups selected and their NDS-I total score and subscales (irritability, discontent, interpersonal resentment, surrender); For this we have used the Mann-Whitney U test, a nonparametric test with 2 independent samples, by setting a significance level p<0.05. CONCLUSIONS: This study allowed us to explore and analyze dysphoria dimensions expressions in BPD and BD. Despite the small sample analyzed, the results show a significant different dimensional spectrum expression of the dysphoria between the two disorders. In particular, Irritability and Interpersonal Resentment dimensions show greater interest in BPD than BD spectrum. Further studies with a larger and stratified sample are needed to confirm these results.


Assuntos
Transtorno Bipolar/diagnóstico , Transtorno Bipolar/psicologia , Transtorno da Personalidade Borderline/diagnóstico , Transtorno da Personalidade Borderline/psicologia , Pacientes Internados/psicologia , Adolescente , Adulto , Idoso , Feminino , Humanos , Itália , Masculino , Pessoa de Meia-Idade , Adulto Jovem
14.
Psychiatr Danub ; 31(Suppl 3): 554-560, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31488790

RESUMO

Bipolar depression (BD) is among the most severe psychiatric disorders. A significant number of patients do not achieve an entirely symptom-free state and experience residual sub-syndromal depression. Most of the treatment options approved for bipolar depression give no rapid symptom improvement. Ketamine is an anaesthetic medication that acts as an antagonist of the NMDA receptor and has antidepressant potential. Due to its unique way of action, ketamine seems to be crucial for the treatment of anhedonia. This review paper aims to provide an overview of the efficacy of ketamine infusions in bipolar depression with a focus on anhedonia Literature suggests that intravenous ketamine 0.5 mg/kg over 40 min weekly could be useful in the treatment of bipolar depression with prominent anhedonia, but there is still a small number of studies that examine the efficacy of ketamine infusions in BD. In conclusion, ketamine should be considered as a valuable treatment option for patients with BD and anhedonia.


Assuntos
Anedonia/efeitos dos fármacos , Transtorno Bipolar/tratamento farmacológico , Transtorno Bipolar/psicologia , Depressão/complicações , Depressão/tratamento farmacológico , Ketamina/farmacologia , Ketamina/uso terapêutico , Antidepressivos/farmacologia , Antidepressivos/uso terapêutico , Transtorno Bipolar/complicações , Humanos
15.
Psychiatr Danub ; 31(Suppl 3): 574-578, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31488793

RESUMO

Bipolar disorder is associated with the highest risk of completed suicide of all mental disorders. The suicide mortality of people with bipolar disorder is approximately 25 times higher than the general population. No approved pharmacological strategies for suicidality in bipolar disorder have been introduced so far. There is evidence for anti-suicidal effect of clozapine in schizophrenia. Clozapine with its unique pharmacology, anti-aggressive and anti-impulsive properties is potentially an effective strategy for suicidality in bipolar disorder.


Assuntos
Transtorno Bipolar/psicologia , Clozapina/farmacologia , Clozapina/uso terapêutico , Suicídio/prevenção & controle , Suicídio/psicologia , Transtorno Bipolar/mortalidade , Transtorno Bipolar/terapia , Humanos
16.
Psychiatr Danub ; 31(Suppl 3): 591-594, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31488796

RESUMO

Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy (CADASIL) is a rare monogenic disorder caused by mutations in the NOTCH3 gene. The clinical features are primarily neurological, which include recurrent transient ischaemic attacks, strokes, and migraines. However, psychiatric manifestations which mainly include mood disturbances have also been reported in CADASIL. Manic symptoms and bipolar disorders are rarely documented in CADASIL and existing reports generally lack detailed descriptions of the psychiatric evaluation. We discuss a case of Bipolar Affective Disorder (BD) in a British woman with a family history of CADASIL. This case provides insight into the diagnosis and management of BD as well as the possible underlying aetiologies that should be considered. The similarities between BD and CADASIL in terms of imaging, genetic, and therapeutic aspects raise the possibility of common dysfunctional pathways. BD in CADASIL may warrant greater consideration by both psychiatrists as well as non-psychiatric specialists and further studies are required to understand the pathological significance.


Assuntos
Transtorno Bipolar/complicações , CADASIL/complicações , Transtorno Bipolar/genética , Transtorno Bipolar/fisiopatologia , Transtorno Bipolar/psicologia , CADASIL/genética , CADASIL/fisiopatologia , CADASIL/psicologia , Feminino , Humanos , Transtornos de Enxaqueca/complicações , Transtornos do Humor/complicações , Mutação , Receptor Notch3/genética , Reino Unido
17.
Psychiatr Danub ; 31(Suppl 3): 595-603, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31488797

RESUMO

BACKGROUND: Bipolar disorder is a mental illness characterised by periods of elevated mood alternating with periods of depression. Long-term relapse prevention in bipolar disorder is challenging, with a significant number of patients relapsing following the initial stabilisation of mood. Initial treatment of the condition is complex and usually occurs in secondary care. Whilst there is no known cure for bipolar disorder, several therapies have been found to be effective in both managing acute episodes and sustaining long-term remission. The key pharmacological therapies in bipolar disorder are lithium salts, antiepileptics and antipsychotics and these will be the focus of this review. AIM: This review seeks to outline the key common pharmacological therapies used in the treatment and relapse prevention of this condition. METHODS: A MEDLINE search was performed, and the available literature was subsequently analysed, including meta-analyses, reviews and original clinical trials. RESULTS: Management strategies can be subdivided into treating acute presentations of mania and depression and maintaining long-term remission. The extensive side effect profile of several antipsychotics means that there are certain patient groups for whom they may be intolerable or contraindicated. Lithium emerges as a highly efficacious maintenance therapy but retains the burden of therapeutic drug monitoring. Antiepileptics play a crucial role in maintaining remission but are linked to serious, albeit rare, side effects. CONCLUSION: Despite the efficacy of the medications discussed in this article, their underlying mechanisms of action remain to be fully elucidated. Nonetheless, these key therapies continue to be essential tools in the management of bipolar disorder.


Assuntos
Anticonvulsivantes/uso terapêutico , Antipsicóticos/uso terapêutico , Transtorno Bipolar/tratamento farmacológico , Compostos de Lítio/uso terapêutico , Antimaníacos/uso terapêutico , Humanos
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