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1.
Psiquiatr. biol. (Internet) ; 27(3): 130-133, sept.-dic. 2020. ilus
Artigo em Espanhol | IBECS | ID: ibc-198681

RESUMO

OBJETIVO: Describir un caso clínico de arteriopatía cerebral autosómica dominante con infartos subcorticales y leucoencefalopatía (CADASIL), un trastorno monogénico que causa ataques isquémicos transitorios recurrentes, accidentes cerebrovasculares lacunares, deterioro cognitivo, trastornos psiquiátricos, epilepsia y migrañas, diagnóstico que se pudo considerar tras la presencia de síntomas maniformes. CASO CLÍNICO: Describimos el caso clínico de un paciente varón de 57 años que fue diagnosticado inicialmente con trastorno bipolar tras iniciar con sintomatología maniforme. Sin embargo, al analizar los antecedentes personales médicos y apoyados en la prueba de neuroimagen, se consideró el diagnóstico de CADASIL. RESULTADOS: En las pruebas de neuroimagen se observaron las lesiones características del CADASIL, lo que, unido a los antecedentes personales y familiares, orientó el diagnóstico. CONCLUSIONES: En pacientes con sintomatología afectiva de inicio tardío, leucoencefalopatía en pruebas de neuroimagen, antecedentes familiares de accidente cerebrovascular, migraña o deterioro cognitivo se debería considerar el diagnóstico diferencial con CADASIL


OBJECTIVE: To describe a clinical case of autosomal dominant cerebral arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL), a monogenic disorder that causes recurrent transient ischemic attacks, lacunar stroke, cognitive impairment, psychiatric disorders, epilepsy and migraines; a diagnosis that could be considered after the presence of symptoms of mania. CLINICAL CASE: We describe the case of a 57-year-old male patient who was initially diagnosed with bipolar disorder after debuting with manic symptoms. However, after analyzing his medical history and supported by neuroimaging, the diagnosis of CADASIL was considered. RESULTS: In neuroimaging, the characteristic lesions of CADASIL were observed, which, together with the personal and family history, guided the diagnosis. CONCLUSIONS: In patients with late-onset affective symptoms, leukoencephalopathy in neuroimaging, family history of stroke, migraine or cognitive impairment, the differential diagnosis with CADASIL should be considered


Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Transtorno Bipolar/etiologia , CADASIL/diagnóstico por imagem , CADASIL/complicações , Imagem por Ressonância Magnética
2.
Riv Psichiatr ; 55(5): 319-321, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33078024

RESUMO

CoViD-19 pandemic has created a global concern in the whole population. The psychiatric and social impact of the viral infection is recorded differently by the community. However, more vulnerable individuals with negative psychiatric history are presenting to mental health hospitals for admission, assessment and treatment due to abnormal reactions to CoViD-19 pandemic. The current study reports six clinical cases of first psychiatric presentation that were characterised by sudden onset of symptoms, manic and psychotic symptoms, adverse response to stress, psychomotor agitation and behaviours out of character. The presentation was short-lived and responded to typical antipsychotics and antidepressants. The posed diagnoses were acute and transient psychotic disorder and acute stress reaction.


Assuntos
Betacoronavirus , Transtorno Bipolar/etiologia , Infecções por Coronavirus/psicologia , Depressão/etiologia , Pneumonia Viral/psicologia , Transtornos Psicóticos/etiologia , Adulto , Infecções por Coronavirus/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/epidemiologia
3.
J Affect Disord ; 277: 337-340, 2020 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-32858315

RESUMO

BACKGROUND: In December 2019, the novel coronavirus (SARS-CoV-2) infection was first reported in Wuhan city, central China, which has spread rapidly. The common clinical features of patients with SARS-CoV-2 infection included fever, fatigue, and damage to the respiratory or digestive system. However, it is still unclear whether SARS-CoV-2 infection could cause damage to the central nervous system (CNS) inducing psychiatric symptoms. CASE REPORT: Herein, we present the first case of SARS-CoV-2 infection with manic-like symptoms and describe the diagnosis, clinical course, and treatment of the case, focusing on the identifications of SARS-CoV-2 in the specimen of cerebrospinal fluid (CSF). The patient developed manic-like symptoms when his vital signs recovered on illness day 17. After manic-like attack, the detection of SARS-CoV-2 specific IgG antibody in CSF was positive, while the reverse transcriptase-polymerase chain reaction (RT-PCR) on CSF for the SARS-CoV-2 was negative. The patient received Olanzapine for treatment and his mood problems concurrently improved as indicated by scores of Young Manic Rating Scale (YMRS). LIMITATION: This is a single case report only, and the RT-PCR test for SARS-CoV-2 in CSF was not performed simultaneously when SARS-CoV-2 was positive in samples of sputum and stool. CONCLUSION: This first case of COVID-19 patient with manic-like symptoms highlights the importance of evaluation of mental health status and may contribute to our understanding of potential risk of CNS impairments by SARS-CoV-2 infection.


Assuntos
Transtorno Bipolar/etiologia , Infecções por Coronavirus/complicações , Pneumonia Viral/complicações , Anticorpos Antivirais/líquido cefalorraquidiano , Antipsicóticos/uso terapêutico , Antivirais/uso terapêutico , Betacoronavirus , Transtorno Bipolar/líquido cefalorraquidiano , Transtorno Bipolar/diagnóstico , Transtorno Bipolar/tratamento farmacológico , Encéfalo/diagnóstico por imagem , Dor no Peito , China , Técnicas de Laboratório Clínico , Cobicistat/uso terapêutico , Infecções por Coronavirus/líquido cefalorraquidiano , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/terapia , Darunavir/uso terapêutico , Dispneia , Febre , Glucocorticoides/uso terapêutico , Humanos , Indóis/uso terapêutico , Imagem por Ressonância Magnética , Masculino , Metilprednisolona/uso terapêutico , Pessoa de Meia-Idade , Moxifloxacina/uso terapêutico , Olanzapina/uso terapêutico , Pandemias , Faringite , Pneumonia Viral/líquido cefalorraquidiano , Pneumonia Viral/diagnóstico , Pneumonia Viral/terapia , Reação em Cadeia da Polimerase Via Transcriptase Reversa
4.
PLoS One ; 15(5): e0232842, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32384131

RESUMO

OBJECTIVE: The risk of complications of nonsurgical hypoparathyroidism in Asia is unclear. We estimated the prevalence and risk of complications in patients with nonsurgical hypoparathyroidism. METHODS: We performed a retrospective cohort study using a nationwide claims database from 2005 to 2016. Among the entire Korean population, we identified 897 patients diagnosed with nonsurgical hypoparathyroidism during 2005-2015. We selected 210 patients with nonsurgical hypoparathyroidism during 2005-2008 who had no complications at baseline and followed them to 2016. Control subjects (n = 2075) were matched using propensity scores based on age, sex, and comorbid disease with a 1:10 ratio and monitored until 2016. RESULTS: The age-standardized prevalence of nonsurgical hypoparathyroidism was 0.2 cases per 100,000 persons in 2005. During a mean follow-up period of 9.5 years, patients with nonsurgical hypoparathyroidism had a higher risk of cardiovascular disease, especially arrhythmia (hazard ratio [HR], 2.03; 95% confidence interval [CI], 1.11-3.70) and heart failure (HR, 2.43; 95% CI, 1.22-4.83). The risk of vertebral fracture was higher in patients than in controls (HR, 2.27; 95% CI, 1.09-4.72). Patients had a significantly increased risk of renal disease (HR, 2.57; 95% CI, 1.56-4.21), seizure (HR, 5.74; 95% CI, 3.34-9.86), depression and bipolar disease (HR, 1.82; 95% CI, 1.30-2.56), and cataract (HR, 1.90; 95% CI, 1.30-2.79) compared with controls. CONCLUSIONS: The prevalence of nonsurgical hypoparathyroidism was very low in Korea but was associated with a higher risk of incident cardiovascular disease and vertebral fracture as well as known complications including renal disease, seizure, and cataract.


Assuntos
Hipoparatireoidismo/epidemiologia , Adulto , Doenças Autoimunes/epidemiologia , Transtorno Bipolar/epidemiologia , Transtorno Bipolar/etiologia , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/etiologia , Estudos de Casos e Controles , Catarata/epidemiologia , Catarata/etiologia , Comorbidade , Transtorno Depressivo/epidemiologia , Transtorno Depressivo/etiologia , Feminino , Fraturas Espontâneas/epidemiologia , Fraturas Espontâneas/etiologia , Humanos , Hipoparatireoidismo/complicações , Masculino , Síndrome Metabólica/epidemiologia , Pessoa de Meia-Idade , Prevalência , Pontuação de Propensão , República da Coreia/epidemiologia , Convulsões/epidemiologia , Convulsões/etiologia , Fraturas da Coluna Vertebral/epidemiologia , Fraturas da Coluna Vertebral/etiologia , Cálculos Urinários/epidemiologia , Cálculos Urinários/etiologia , Adulto Jovem
6.
J Neuroimmunol ; 343: 577238, 2020 06 15.
Artigo em Inglês | MEDLINE | ID: mdl-32305000

RESUMO

Antiphospholipid syndrome (APS), an autoantibody mediated disease, is characterized by presence of antibodies against the proteins bound to the phospholipid membranes. The antibodies are predominantly formed against beta-2-glycoprotein I (b2GPI) which is considered pathogenic, but presence of lupus anticoagulant is a predictor of thrombotic events. The thrombotic events in APS may manifest as venous or arterial or small vessel thrombosis in any tissue or organ and pregnancy related complications namely, recurrent (three or more) and early spontaneous miscarriages before 10 weeks of gestation or unexplained deaths of normal fetus at or beyond 10 weeks, eclampsia or severe pre-eclampsia, intra-uterine growth retardation and pre-term births. However, lately its role as an etiological mechanism in causation of certain neuro-psychiatric disorders has been put forth. It has been suggested that one should suspect APS in psychiatric manifestations which are atypical, resistant to treatment, associated with cognitive decline and dementia, abnormal involuntary movements, livedo reticularis, migraine, thrombotic events like stroke or transient ischemic attacks, obstetrical complications. In this brief communication, we describe the case of young male who has been suffering from treatment resistant and difficult to manage bipolar affective disorder (BPAD) with fluctuating thrombocytopenia and neurological findings with positive lupus anticoagulant. We propose it to be a consequence of an atypical presentation of APS.


Assuntos
Síndrome Antifosfolipídica/complicações , Transtorno Bipolar/etiologia , Trombocitopenia/etiologia , Adulto , Humanos , Masculino
8.
Neuropsychiatr ; 34(2): 85-87, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32048183

RESUMO

In the literature, several cases of an association between hyponatremia and psychotic symptoms have been reported. We present the case of a young Caucasian male presenting with rapid, incoherent speech, religious and megalomanic delusions, and emotional lability. The patient was described by his relatives as being healthy until a few days before admission. He had no significant medical or psychiatric history, except a short drug-induced psychotic episode a few years earlier. Somatic workup showed moderate hyponatremia, but no other abnormalities. Tests for narcotics, in particular, were also negative. Antipsychotic treatment with risperidone was initiated. After normalization of sodium levels using intravenous saline, the patient remitted within a few days and risperidone was discontinued on day 3. He was discharged by day 13 without further pharmacological treatment.Dysfunction of voltage-gated ion channels, particularly sodium and calcium channels, has been implicated in the pathogenesis of bipolar disorder. We therefore assume a causal relationship between hyponatremia and manic-psychotic symptoms in our patient. Hyponatremia was most likely induced by excessive water intake during a period of fasting in the context of a wellness practice.


Assuntos
Antipsicóticos , Transtorno Bipolar , Hiponatremia , Transtornos Psicóticos , Adulto , Transtorno Bipolar/etiologia , Delusões , Humanos , Hiponatremia/complicações , Masculino , Transtornos Psicóticos/etiologia
9.
BMJ Case Rep ; 13(2)2020 Feb 26.
Artigo em Inglês | MEDLINE | ID: mdl-32107258

RESUMO

Episodes of mania typically occur in the context of bipolar disorder, with an average age of onset of 25 years. A condition with identical symptoms, known as secondary mania, generally occurs in isolation in older adults and has an identifiable organic etiology. Here, we report a 57-year-old man who presented to the emergency department with a 3 weeks history of sudden onset mania with psychotic symptoms. He had no previous psychiatric history, and his presentation coincided with the initiation of a course of steroids. Despite the absence of physical symptoms, investigations revealed a previously undetected adrenocorticotropic hormone-releasing small cell lung carcinoma that led to his death within months. This case highlights the complexity of distinguishing primary from secondary mania when it occurs after the peak incidence period of early adulthood. Undertaking a comprehensive medical workup is generally recommended.


Assuntos
Corticosteroides/efeitos adversos , Transtorno Bipolar/etiologia , Carcinoma Neuroendócrino/secundário , Neoplasias Hepáticas/secundário , Neoplasias Pulmonares/patologia , Carcinoma de Pequenas Células do Pulmão/patologia , Hormônio Adrenocorticotrópico/metabolismo , Evolução Fatal , Humanos , Masculino , Pessoa de Meia-Idade
10.
Int J Psychiatry Med ; 55(2): 74-81, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-31698993

RESUMO

Objective: Meningioma is the most common type of primary central nervous system and intracranial tumor, and psychiatric changes attributed to meningioma include depression, apathy, psychosis, and personality changes. We present a case of a 59-year-old man with right parietal meningioma who developed mania with psychotic features throughout multiple hospitalizations. Method: Single-case report. Results: The patient originally presented with headache and bilateral lower extremity weakness. He was found to have a large medial sphenoidal wing meningioma and a small right parietal meningioma. The sphenoidal wing meningioma was removed via craniotomy, but the right parietal meningioma was not resected. In the following years, the patient developed symptoms of mania and psychosis which coincided with an increase in size of the right parietal meningioma. Conclusions: Previous studies have linked right parietal meningioma to psychosis, but this case is one of the first to suggest that right parietal meningioma may be associated with the development of mania along with psychotic features.


Assuntos
Transtorno Bipolar/etiologia , Neoplasias Meníngeas/complicações , Meningioma/complicações , Lobo Parietal/diagnóstico por imagem , Transtornos Psicóticos/etiologia , Transtorno Bipolar/diagnóstico por imagem , Humanos , Imagem por Ressonância Magnética , Masculino , Neoplasias Meníngeas/diagnóstico por imagem , Meningioma/diagnóstico por imagem , Pessoa de Meia-Idade , Transtornos Psicóticos/diagnóstico por imagem
11.
PLoS One ; 14(12): e0226135, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31830059

RESUMO

A recently developed risk calculator for bipolar disorder (BD) accounts for clinical and parental psychopathology. Yet, it is understood that both familial predisposition and early life adversity contribute to the development of BD. How the interplay between these two factors influence emotion and reward processing networks in youth at risk for BD remains unclear. In this exploratory analysis, offspring of BD parents performed emotion and reward processing tasks while undergoing a fMRI scan. Risk calculator score was used to assess risk for developing BD in the next 5 years. Environmental risk was tabulated using the Stressful Life Events Schedule (SLES). Emotion and reward processing networks were investigated for genetic and/or environment interactions. Interaction effects were found between risk calculator scores, negative SLES score and activity in right amygdala and bilateral fusiform gyri during the emotion processing task, as well as activity in the fronto-, striatal, and parietal regions during the reward processing task. Our findings are preliminary; however, they support the unique and interactive contributions of both familial and environmental risk factors on emotion and reward processing within OBP. They also identify potential neural targets to guide development of interventions for youth at greatest risk for psychiatric disorders.


Assuntos
Experiências Adversas da Infância/estatística & dados numéricos , Transtorno Bipolar/fisiopatologia , Emoções , Predisposição Genética para Doença , Vias Neurais , Recompensa , Estresse Psicológico/complicações , Adolescente , Transtorno Bipolar/etiologia , Criança , Feminino , Humanos , Processamento de Imagem Assistida por Computador , Imagem por Ressonância Magnética , Masculino
12.
BMC Psychiatry ; 19(1): 378, 2019 12 02.
Artigo em Inglês | MEDLINE | ID: mdl-31791284

RESUMO

BACKGROUND: Conclusions regarding the association between antithyroid antibodies or thyroid dysfunction and rapid cycling bipolar disorder (RCBD) have been conflicting. Previous studies suggest that the impact of antithyroid antibodies on mental wellbeing seems to be independent of thyroid function. Here, we investigated their independent association with RCBD in a large, well-defined population of bipolar disorder (BD). METHODS: Fast serum levels of free thyroxine (FT4), free triiodothyronine (FT3), thyroid Stimulating Hormone (TSH), TPO-abs and Tg-abs were simultaneously measured in 352 patients with BD. Clinical features of BD were collected through semi-structural interview conducted by trained interviewers with background of psychiatric education. RESULTS: Neither hypothyroidism nor hyperthyroidism was significantly associated with RCBD. Both TPO-abs and Tg-abs were significantly related to RCBD, even after controlling for gender, age, marriage status, education, antidepressants treatment, comorbidity of thyroid diseases, and thyroid function (serum levels of FT3, FT4 and TSH). Although TPO-abs and Tg-abs were highly correlated with each other, binary logistic regression with forward LR selected TPO-abs, instead of Tg-abs, to be associated with RCBD. TPO-abs was significantly, independently of Tg-abs, associated with hyperthyroidism, while Tg-abs was marginally significantly related to hypothyroidism at the presence of TPO-abs. CONCLUSION: TPO-abs might be treated as a biomarker of RCBD. Further exploring the underlying mechanism might help understand the nature of RCBD and find out new treatment target for it.


Assuntos
Autoanticorpos/sangue , Transtorno Bipolar/sangue , Hormônios Tireóideos/imunologia , Tireotropina/imunologia , Adulto , Autoanticorpos/imunologia , Biomarcadores/sangue , Transtorno Bipolar/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Testes de Função Tireóidea , Hormônios Tireóideos/sangue , Tireotropina/sangue , Tiroxina/sangue , Tiroxina/imunologia , Tri-Iodotironina/sangue , Tri-Iodotironina/imunologia
13.
J Psychiatr Res ; 119: 76-83, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31574363

RESUMO

The present study aimed to evaluate the effects of treatment with lithium (Li) and valproate (VPA) on behaviors and brain BDNF, NGF, NT-3, NT-4 and GDNF levels in mice submitted to paradoxical sleep deprivation (PSD), which induces an animal model of mania. Male C57BL/6J mice received an intraperitoneal (i.p.) injection of saline solution (NaCl 0.09%, 1 ml/kg), Li (47.3 mg/kg, 1 ml/kg) or VPA (200 mg/kg, 1 ml/kg) once a day for seven days. Animals were randomly distributed into six groups (n = 10 per group): (1) Control + Sal; (2) Control + Li; (3) Control + VPA; (4) PSD + Sal; (5) PSD + Li; or (6) PSD + VPA. Animals were submitted to 36 h of PSD, and then, they were submitted to the open field test. The frontal cortex and hippocampus were dissected from the brain. The manic-like behaviors in the mice were analyzed. Treatment with Li and VPA reversed the behavioral alterations induced by PSD. PSD decreased BDNF, NGF, and GDNF levels in the frontal cortex and hippocampus of mice. The administration of Li and VPA protected the brain against the damage induced by PSD. However, PSD and the administration of Li and VPA did not affect the levels of NT-3 and NT-4 in either brain structure evaluated. In conclusion, the PSD protocol induced manic-like behavior in rats and induced alterations in neurotrophic factor levels. It seems that neurotrophic factors and sleep are essential targets to treat BD.


Assuntos
Antimaníacos/farmacologia , Comportamento Animal/efeitos dos fármacos , Transtorno Bipolar/tratamento farmacológico , Lobo Frontal/efeitos dos fármacos , Hipocampo/efeitos dos fármacos , Compostos de Lítio/farmacologia , Fatores de Crescimento Neural/efeitos dos fármacos , Privação do Sono/complicações , Ácido Valproico/farmacologia , Animais , Antimaníacos/administração & dosagem , Transtorno Bipolar/etiologia , Fator Neurotrófico Derivado do Encéfalo/efeitos dos fármacos , Modelos Animais de Doenças , Fator Neurotrófico Derivado de Linhagem de Célula Glial/efeitos dos fármacos , Compostos de Lítio/administração & dosagem , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Fator de Crescimento Neural/efeitos dos fármacos , Sono REM/fisiologia , Ácido Valproico/administração & dosagem
14.
Psychiatry Res ; 282: 112484, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31331636

RESUMO

The current study was conducted with the aim to investigate the relationship between rheumatoid arthritis (RA) and bipolar disorder (BD). Potentially eligible studies were identified from Medline and EMBASE databases from inception to May 2019. Eligible cohort studies must include patients with RA and comparators without RA, follow them for incident BD and report the relative risk, hazard risk ratio or standardized incidence ratio and associated 95% confidence intervals (CI) comparing the incidence of BD between the two groups. Eligible case-control studies must include cases with BD and controls without BD, explore prior history of RA and report the odds ratio and associated 95% CI for this association. Point estimates with standard errors were extracted from individual study and were combined together using random-effect model, generic inverse variance method. A total of six studies fulfilled the inclusion criteria and were included into the meta-analysis. The risk of developing BD was significantly higher among patients with RA than individuals without RA with the pooled relative risk of 2.06 (95% CI, 1.34-3.17; I2 86%). Chronic inflammation is a potential mechanism and could be a modifiable risk factor of BD. However, further studies are still required to confirm this.


Assuntos
Artrite Reumatoide/psicologia , Transtorno Bipolar/epidemiologia , Transtorno Bipolar/etiologia , Adulto , Estudos de Casos e Controles , Estudos de Coortes , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Razão de Chances , Fatores de Risco
15.
Australas Psychiatry ; 27(5): 491-495, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31310153

RESUMO

OBJECTIVE: This article describes how the onset of bvFTD can be heralded by psychiatric symptoms. METHOD: Case reports are described with reference to the relevant literature review. RESULTS: Three patients were admitted with psychiatric symptoms, including depression, mania, psychosis and catatonia. Two had been previously diagnosed with a psychiatric disorder. All three were diagnosed with probable bvFTD. CONCLUSION: bvFTD is an important differential diagnosis to consider when patients present with atypical psychiatric symptoms.


Assuntos
Demência Frontotemporal/diagnóstico , Transtornos Mentais/diagnóstico , Idoso , Transtorno Bipolar/diagnóstico , Transtorno Bipolar/etiologia , Transtorno Bipolar/fisiopatologia , Catatonia/diagnóstico , Catatonia/etiologia , Catatonia/fisiopatologia , Depressão/diagnóstico , Depressão/etiologia , Depressão/fisiopatologia , Diagnóstico Diferencial , Feminino , Demência Frontotemporal/complicações , Demência Frontotemporal/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos Psicóticos/diagnóstico , Transtornos Psicóticos/etiologia , Transtornos Psicóticos/fisiopatologia
16.
Methods Mol Biol ; 2011: 61-77, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31273693

RESUMO

Characterized by the switch of manic and depressive phases, bipolar disorder was described as early as the fifth century BC. Nevertheless up to date, the underlying neurobiology is still largely unclear, assuming a multifactor genesis with both biological-genetic and psychosocial factors. Significant process has been achieved in recent years in researching the causes of bipolar disorder with modern molecular biological (e.g., genetic and epigenetic studies) and imaging techniques (e.g., positron emission tomography (PET) and functional magnetic resonance imaging (fMRI)). In this chapter we will first summarize our recent knowledge on the etiology of bipolar disorder. We then discuss how several factors observed to contribute to bipolar disorder in human patients can be manipulated to generate rodent models for bipolar disorder. Finally, we will give an overview on behavioral test that can be used to assess bipolar-disorder-like behavior in rodents.


Assuntos
Transtorno Bipolar/etiologia , Transtorno Bipolar/psicologia , Animais , Escala de Avaliação Comportamental , Transtorno Bipolar/diagnóstico , Gerenciamento Clínico , Modelos Animais de Doenças , Suscetibilidade a Doenças , Meio Ambiente , Predisposição Genética para Doença , Humanos , Roedores
17.
Neurosci Biobehav Rev ; 103: 21-28, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31195001

RESUMO

BACKGROUND: Several studies have shown cerebellar abnormalities during depressive and manic states, although the specific cerebellar role in mood fluctuations remains poorly defined. Therefore, the study of pathologies characterized by frequent mood swings, such as bipolar disorder, is of great interest to investigate the relationship between the cerebellum and mood alterations. METHODS: A systematic literature search on the occurrence of mood disorders in patients with cerebellar pathologies (1st research strategy) and on the presence of cerebellar alterations in mood disorders (2nd research strategy) was conducted using the PubMed electronic Internet database. For this systematic review all information was written based on the PRISMA-P statement. RESULTS: The results of the 1st research strategy generated 9 articles, and in one of these, a direct correlation between cerebellar damage and the onset of mood disorder was reported. The 2nd research strategy generated 14 articles that were grouped according to the patient's mood phase (manic or depressive) or diagnosis (bipolar I or bipolar II). CONCLUSIONS: The present review suggests that the cerebellum should be considered a key structure involved in the regulation of mood.


Assuntos
Transtorno Bipolar/etiologia , Doenças Cerebelares/complicações , Humanos
18.
Eur Psychiatry ; 60: 79-85, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31234011

RESUMO

BACKGROUND: Several observational studies have investigated the association of insomnia with psychiatric disorders. Such studies yielded mixed results, and whether these associations are causal remains unclear. Thus, we aimed to identify the causal relationships between insomnia and five major psychiatric disorders. METHODS: The analysis was implemented with six genome-wide association studies; one for insomnia and five for psychiatric disorders (attention-deficit/hyperactivity disorder, autism spectrum disorder, major depressive disorder, schizophrenia, and bipolar disorder). A heterogeneity in dependent instrument (HEIDI) approach was used to remove the pleiotropic instruments, Mendelian randomization (MR)-Egger regression was adopted to test the validity of the screened instruments, and bidirectional generalized summary data-based MR was performed to estimate the causal relationships between insomnia and these major psychiatric disorders. RESULTS: We observed significant causal effects of insomnia on the risk of autism spectrum disorder and bipolar disorder, with odds ratios of 1.739 (95% confidence interval: 1.217-2.486, p = 0.002) and 1.786 (95% confidence interval: 1.396-2.285, p = 4.02 × 10-6), respectively. There was no convincing evidence of reverse causality for insomnia with these two disorders (p = 0.945 and 0.546, respectively). When insomnia was considered as either the exposure or outcome variable, causal estimates for the remaining three psychiatric disorders were not significant. CONCLUSIONS: Our results suggest a causal role of insomnia in autism spectrum disorder and bipolar disorder. Future disease models should include insomnia as a factor for these two disorders to develop effective interventions. More detailed mechanism studies may also be inspired by this causal inference.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Transtorno do Espectro Autista , Transtorno Bipolar , Transtorno Depressivo Maior , Esquizofrenia , Distúrbios do Início e da Manutenção do Sono , Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Transtorno do Deficit de Atenção com Hiperatividade/etiologia , Transtorno do Espectro Autista/epidemiologia , Transtorno do Espectro Autista/etiologia , Transtorno Bipolar/epidemiologia , Transtorno Bipolar/etiologia , Causalidade , Transtorno Depressivo Maior/epidemiologia , Transtorno Depressivo Maior/etiologia , Predisposição Genética para Doença , Estudo de Associação Genômica Ampla , Humanos , Análise da Randomização Mendeliana , Razão de Chances , Esquizofrenia/epidemiologia , Esquizofrenia/etiologia , Distúrbios do Início e da Manutenção do Sono/epidemiologia , Distúrbios do Início e da Manutenção do Sono/etiologia
19.
Neuropsychopharmacol Rep ; 39(3): 203-208, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31240870

RESUMO

AIM: Clinical trials and meta-analyses have demonstrated the efficacy of high-frequency repetitive transcranial magnetic stimulation (rTMS) over the left prefrontal cortex in treatment-resistant depression. The aim of this study was to prospectively evaluate the effectiveness of the conventional 37.5-minute vs 18.75-minute rTMS protocol over the left prefrontal cortex in patients with treatment-resistant depressive episode. METHODS: Thirty patients with treatment-resistant depression or bipolar disorder depressive episode were randomized 1:1 to either 37.5-minute or 18.75-minute rTMS protocol groups. rTMS treatment was applied at 120% resting motor threshold with 10 Hz over the left prefrontal cortex. Treatment sessions were delivered for a total of 3000 pulses/d, 5 days a week, for 4-6 weeks. Patients received a 75 trains with "4 sec on and 26 sec off" for 37.5 minutes or a 75 trains with "4 sec on and 11 sec off" for 18.75 minutes. Severity of depression was rated with the Quick Inventory of Depressive Symptomatology (QIDS) and Patient Health Questionnaire (PHQ-9). Remission was defined as a total score of 5 or less on the QIDS. The primary outcome measure was to compare the remission rate between the both groups. RESULTS: Thirteen of 30 patients (43.3%) showed remission at week 6. There were no significant differences in the remission rate between the conventional 37.5- and 18.75-minute protocol groups (46.7% and 40.0%, respectively). No seizures or treatment-emergent mania/hypomania were occurred. CONCLUSION: These findings suggest that, compared with the conventional one, rTMS with 18.75-minute protocol might be equally effective and clinically beneficial in saving the treatment session length. Further well-designed studies are needed.


Assuntos
Transtorno Depressivo Resistente a Tratamento/terapia , Córtex Pré-Frontal/fisiopatologia , Estimulação Magnética Transcraniana/efeitos adversos , Adulto , Idoso , Transtorno Bipolar/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Convulsões/etiologia , Estimulação Magnética Transcraniana/métodos
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