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1.
Psychiatr Danub ; 32(3-4): 373-379, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33370735

RESUMO

BACKGROUND: Regular practice of physical activity is associated with better quality of life and functioning in people with bipolar disorder, schizophrenia and depression. However, to the best of our knowledge, there is no evidence of the association between physical activity and quality of life and global functioning among people in the initial stages of psychosis. The aim to explore the association of the level of physical activity with quality of life and global functioning among patients in early stages of psychosis. SUBJECTS AND METHODS: Cross-sectional study carried out in an early intervention program in 2016. The socio-demographic and clinical variables were assessed via a form; the adherence through the Measurement of Treatment Adherence; the global functioning through the Global Assessment of Functioning (GAF) scale; the level of physical activity through the International Physical Activity Questionnaire (IPAQ) and quality of life through the Medical Outcomes Study 36-Item Short Form Health Survey (SF-36). The Mann-Whitney test was used for analysis. RESULTS: A total of eighty-five participants (mean age=32, 57.6% were men) were assessed. Of the 85, 46 (54.1%) were classified as physically active. The physically active patients presented higher values, on average (standard deviation), in relation to the SF-36 domain of physical functioning (active patients: 87.1 (20.9) vs. inactive patients 80.1 (20.5) inactive; p=0.016), and global functioning when compared to the physically inactive group (active patients: 71.5 (17.6) vs. inactive patients 60.1 (20.9); p=0.011). CONCLUSION: Higher levels of physical activity are associated with better quality of life and higher global functioning in patients in early stages of psychosis.


Assuntos
Transtorno Bipolar/fisiopatologia , Depressão/fisiopatologia , Exercício Físico , Qualidade de Vida , Esquizofrenia/fisiopatologia , Adulto , Estudos Transversais , Feminino , Humanos , Masculino
2.
J Clin Psychiatry ; 81(6)2020 11 03.
Artigo em Inglês | MEDLINE | ID: mdl-33147655

RESUMO

OBJECTIVE: The aim of this study was to identify predisposing factors and clinical features at baseline that might help predict diagnosis of bipolar disorder vs schizophrenia in a first-episode psychosis (FEP) cohort. METHODS: In this prospective, naturalistic study, we evaluated a cohort of 335 subjects with FEP recruited from April 2009 to April 2012. Baseline features were compared between subjects with a final DSM-IV diagnosis of bipolar disorder and schizophrenia at 12-month follow-up. A binary logistic regression model was used to assess predictors of diagnosis of bipolar disorder at follow-up. RESULTS: At 12-month follow-up, 47 of the 335 subjects included in the study received the diagnosis of bipolar disorder and 105, of schizophrenia. Subjects with a final diagnosis of bipolar disorder had a higher prevalence of family history of mood disorders (38.2% vs 18.0%, P = .02), better baseline premorbid adjustment (Premorbid Adjustment Scale [PAS]: 38.4 vs 50.6, P < .01) and psychosocial functioning (Functional Assessment Short Test [FAST]: 23.6 vs 33.7, P = .001), better cognitive flexibility (number of perseverative errors on the Wisconsin Card Sorting Test [WCST]: 14.2 vs 19.7, P = .01), more manic symptoms (Young Mania Rating Scale [YMRS]: 14.1 vs 7.3, P < .01), lesser negative symptoms (Positive and Negative Syndrome Scale negative scale [PANSS-N]: 15.0 vs 22.3, P < .001), and shorter duration of untreated psychosis (144.2 vs 194.7 days, P < .01) than subjects with a schizophrenia diagnosis. Binary logistic regression model revealed that lower FAST scores (odds ratio [OR] = 0.956; P = .015), lower PANSS-N scores (OR = 0.93; P = .048), and lower number of perseverative errors on the WCST (OR = 0.946; P = .035) were significantly related to diagnosis of bipolar disorder at follow-up. CONCLUSIONS: In our FEP cohort, better psychosocial functioning, lesser negative symptoms, and better cognitive flexibility were related to diagnosis of bipolar disorder at 12-month follow-up.


Assuntos
Adaptação Psicológica/fisiologia , Transtorno Bipolar/diagnóstico , Disfunção Cognitiva/diagnóstico , Esquizofrenia/diagnóstico , Esquizofrenia/fisiopatologia , Adolescente , Adulto , Transtorno Bipolar/complicações , Transtorno Bipolar/fisiopatologia , Disfunção Cognitiva/etiologia , Disfunção Cognitiva/fisiopatologia , Suscetibilidade a Doenças , Feminino , Seguimentos , Humanos , Masculino , Prognóstico , Esquizofrenia/complicações , Fatores de Tempo , Adulto Jovem
3.
J Clin Psychiatry ; 81(6)2020 10 27.
Artigo em Inglês | MEDLINE | ID: mdl-33113597

RESUMO

OBJECTIVE: Despite substantial literature on sex differences in adults with bipolar disorder (BD), little is known about this topic in youth; this study examines sex differences in mood symptomatology and psychiatric comorbidity in prospectively followed youth with BD. METHODS: A subsample of the Course and Outcome of Bipolar Youth study (N = 370; female n = 199, male n = 171) enrolled October 2000-July 2006 (age at intake = 7-17.11 years) who met DSM-IV criteria for bipolar I disorder (BD-I; n = 221), bipolar II disorder (BD-II; n = 26), or operationalized BD not otherwise specified (BD-NOS; n = 123) with ≥ 4 years follow-up was included. Analyses examined sex differences at intake and, prospectively, in mood symptomatology and psychiatric comorbidity for a mean ± SD follow-up of 10.5 ± 1.72 years. RESULTS: Females were older than males at intake (mean ± SD age = 13.33 ± 3.32 vs 12.04 ± 3.16 years; P = .0002) and at age at mood onset (9.33 ± 4.22 vs 7.53 ± 3.74 years; P < .0001). After adjustment for confounders, males spent more time with syndromal ADHD (Padjusted = .001) and females spent more time with syndromal anxiety (Padjusted = .02). There were trends toward males spending more time with substance use disorder and females having more non-suicidal self-injurious behavior (Padjusted = .07 and .09, respectively). There were no sex differences on outcome variables, including rate of or time to recovery and recurrence. CONCLUSIONS: Contrasting with adult literature, this study identified minimal sex differences in the course of youth with BD. Longer-term studies are needed to clarify if youth-onset BD remains a "sex neutral" subtype of BD or diverges according to sex in adulthood.


Assuntos
Transtornos de Ansiedade/fisiopatologia , Transtorno do Deficit de Atenção com Hiperatividade/fisiopatologia , Transtorno Bipolar/fisiopatologia , Progressão da Doença , Comportamento Autodestrutivo/fisiopatologia , Transtornos Relacionados ao Uso de Substâncias/fisiopatologia , Adolescente , Adulto , Idade de Início , Transtornos de Ansiedade/epidemiologia , Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Transtorno Bipolar/epidemiologia , Criança , Feminino , Humanos , Estudos Longitudinais , Masculino , Comportamento Autodestrutivo/epidemiologia , Fatores Sexuais , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Adulto Jovem
4.
Epidemiol Psychiatr Sci ; 29: e166, 2020 Sep 08.
Artigo em Inglês | MEDLINE | ID: mdl-32895076

RESUMO

Since its discovery in 1997, the default mode network (DMN) and its components have been extensively studied in both healthy individuals and psychiatric patients. Several studies have investigated possible DMN alterations in specific mental conditions such as bipolar disorder (BD). In this review, we describe current evidence from resting-state functional magnetic resonance imaging studies with the aim to understand possible changes in the functioning of the DMN in BD. Overall, several types of analyses including seed-based and independent component have been conducted on heterogeneous groups of patients highlighting different results. Despite the differences, findings seem to indicate that BD is associated with alterations in both frontal and posterior DMN structures, mainly in the prefrontal, posterior cingulate and inferior parietal cortices. We conclude this review by suggesting possible future research directions.


Assuntos
Transtorno Bipolar/diagnóstico por imagem , Mapeamento Encefálico/métodos , Encéfalo/diagnóstico por imagem , Imagem por Ressonância Magnética/métodos , Rede Nervosa/fisiologia , Vias Neurais/diagnóstico por imagem , Transtorno Bipolar/fisiopatologia , Humanos
5.
PLoS One ; 15(9): e0238726, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32915846

RESUMO

BACKGROUND: There are no reliable and validated objective biomarkers for the assessment of depression severity. We aimed to investigate the association between depression severity and timing-related speech features using speech recognition technology. METHOD: Patients with major depressive disorder (MDD), those with bipolar disorder (BP), and healthy controls (HC) were asked to engage in a non-structured interview with research psychologists. Using automated speech recognition technology, we measured three timing-related speech features: speech rate, pause time, and response time. The severity of depression was assessed using the Hamilton Depression Rating Scale 17-item version (HAMD-17). We conducted the current study to answer the following questions: 1) Are there differences in speech features among MDD, BP, and HC? 2) Do speech features correlate with depression severity? 3) Do changes in speech features correlate with within-subject changes in depression severity? RESULTS: We collected 1058 data sets from 241 individuals for the study (97 MDD, 68 BP, and 76 HC). There were significant differences in speech features among groups; depressed patients showed slower speech rate, longer pause time, and longer response time than HC. All timing-related speech features showed significant associations with HAMD-17 total scores. Longitudinal changes in speech rate correlated with changes in HAMD-17 total scores. CONCLUSIONS: Depressed individuals showed longer response time, longer pause time, and slower speech rate than healthy individuals, all of which were suggestive of psychomotor retardation. Our study suggests that speech features could be used as objective biomarkers for the assessment of depression severity.


Assuntos
Transtorno Bipolar/fisiopatologia , Transtorno Depressivo Maior/fisiopatologia , Fala , Inteligência Artificial , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Tempo
6.
Psiquiatr. biol. (Internet) ; 27(2): 54-60, mayo-ago. 2020. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-193247

RESUMO

En los pacientes con trastorno bipolar existe una elevada prevalencia de consumo de drogas, siendo el cannabis una de las principales. El consumo puede modificar las manifestaciones clínicas y la evolución del trastorno. El objetivo del presente trabajo es estudiar la influencia del consumo de cannabis sobre la evolución del trastorno bipolar. Se ha realizado una revisión sistemática realizando una búsqueda de artículos en Medline. Se han obtenido 5 artículos sobre cohortes de sujetos bipolares que estudian el efecto de dicho consumo. El consumo de cannabis se presenta como un factor pronóstico negativo, con menor recuperación clínica, peor funcionamiento global, más tiempo en episodios afectivos y, posiblemente, mayor frecuencia de ciclos rápidos y episodios maníacos o mixtos. El cese del consumo mejora la evolución. El consumo de otras drogas es frecuente entre los consumidores de cannabis y se asocia a una evolución negativa


Bipolar disorder patients have a high prevalence of drug use, being cannabis one of the main drugs involved. Cannabis use can modify clinical characteristics and outcome of this disorder. The aim of the current work is to evaluate from longitudinal studies the influence of cannabis use in the outcome of bipolar disorder. A systematic review was carried out through a Medline searching. 5 papers were found on bipolar patients cohorts that study this effect. Cannabis use is a negative prognostic factor, it was associated with less sucessful clinical recovery, worse global functioning, more time in affective episodes, and probably, more often rapid cycling and manic/mixed episodes. Bipolar patients who stop using cannabis show a better outcome. Alcohol and other drugs use are common between cannabis users and are associated with a negative outcome


Assuntos
Humanos , Masculino , Feminino , Abuso de Maconha/complicações , Transtorno Bipolar/induzido quimicamente , Transtorno Bipolar/fisiopatologia
7.
Sci Rep ; 10(1): 13731, 2020 08 13.
Artigo em Inglês | MEDLINE | ID: mdl-32792642

RESUMO

There is a need to better understand key factors that impact sleep and circadian function for young adults of differing races and sexes. Sex and race are common factors contributing to disparities in health outcomes; however, the influence of these variables on sleep and circadian patterns for young adults are not well known. Multiple objective and self-report facets of sleep and circadian function were assessed (melatonin onset, actigraphy, and sleep diaries) in an ecological momentary assessment study of 150 emerging adults (Mage = 21.8 years; 58.7% female; 56% White, 22.7% Black, 21.3% Other ethnicity) at high or low risk for bipolar spectrum disorder (BSD). Controlling for BSD risk status, sex and race were significant predictors of objective and self-reported sleep and circadian rhythm measures. Males self-reported better sleep efficiency and exhibited later dim light melatonin onset phase than females, whereas females exhibited more actigraphy-measured sleep periods. White participants exhibited more actigraphy-measured total sleep time (TST), better sleep efficiency, and fewer sleep periods, and more self-reported TST and better sleep efficiency than Black participants. Our findings enhance the literature by utilizing robust measurement of sleep and circadian parameters to extend previous findings to a young adult sample at high or low risk for BSD.


Assuntos
Transtorno Bipolar/etiologia , Transtorno Bipolar/fisiopatologia , Ritmo Circadiano/fisiologia , Sono/fisiologia , Actigrafia/métodos , Adolescente , Adulto , Transtorno Bipolar/metabolismo , Grupos de Populações Continentais , Feminino , Humanos , Masculino , Melatonina/metabolismo , Polissonografia/métodos , Estudos Prospectivos , Autorrelato , Fatores Sexuais , Fatores de Tempo , Adulto Jovem
8.
J Abnorm Psychol ; 129(6): 570-580, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32757601

RESUMO

Mismatch negativity (MMN) amplitude has been widely shown to be diminished in schizophrenia and, more recently, in other psychotic disorders. Although there is considerable evidence linking MMN reduction to cognitive and functional deficits in schizophrenia, there is little evidence of associations with specific psychotic symptoms. Further, it is unclear if MMN reductions relate to specific symptoms, cognitive, and functional deficits transdiagnostically across different psychotic disorders. The present study examines MMN amplitude in a large cohort of cases diagnosed with psychotic disorders including schizophrenia and schizoaffective disorder (N = 116); bipolar disorder and major depressive disorder (N = 75); and other psychotic disorders (N = 25), as well as individuals with no psychotic disorder diagnoses (N = 248). Furthermore, we examined the association of MMN with symptoms, cognitive functioning, and real-world functioning to determine whether these relationships differ by diagnosis. Results showed that MMN amplitude was reduced in cases overall compared to never-psychotic individuals, with no differences between psychotic disorders. Furthermore, there were transdiagnostic associations of reduced duration MMN (MMN-D) with worse auditory hallucinations (r = .14) and disorganization (r = .14), frequency MMN (MMN-F) with real-word functioning (r = .20) and episodic memory (r = -.22), and both components with executive functioning (MMN-D: r = -.17; MMN-F: r = -.15). Our findings relating MMN reductions with cognitive and real-world functioning replicate earlier research in schizophrenia and extend these relationships to other psychotic disorders. Furthermore, our correlations with MMN-D are consistent with computational modeling research and theoretical proposals that view MMN reduction, cognitive dysfunction, and psychotic symptoms as reflecting underlying predictive coding deficits. However, differences in relationships with MMN-F suggest that additional work is warranted on this topic. (PsycInfo Database Record (c) 2020 APA, all rights reserved).


Assuntos
Transtorno Bipolar/fisiopatologia , Potenciais Evocados Auditivos/fisiologia , Transtornos Psicóticos/fisiopatologia , Esquizofrenia/fisiopatologia , Estimulação Acústica , Adulto , Estudos de Casos e Controles , Eletroencefalografia , Função Executiva/fisiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
9.
Psychiatry Res Neuroimaging ; 304: 111149, 2020 10 30.
Artigo em Inglês | MEDLINE | ID: mdl-32738725

RESUMO

Notwithstanding being the object of a growing field of clinical research, the investigation of the dynamic resting-state functional connectivity alterations in psychiatric illnesses is still in its early days. Current research on major depressive disorder (MDD) and bipolar disorder (BD) has evidenced abnormal resting-state functional connectivity (rsFC), especially in regions subserving emotional processing and regulation such as the amygdala. However, dynamic changes in functional connectivity within the amygdalar subregions in distinguishing BD and MDD has not yet been fully understood. In this paper, we aim at analyzing the patterns characterizing dynamic FC (dFC) in the right amygdala to investigate the differences between similarly depressed BD and MDD. A number of 40 BD patients, 61 MDD patients and 63 healthy controls (HCs) underwent functional magnetic resonance imaging (fMRI) at rest. Using the right-amygdala as seed region, we compared the dFC within three subdivisions, namely, laterobasal (LB), centromedial (CM) and superficial (SF) between all the groups. To do so, one-way ANOVA followed by post-hoc t-tests were employed. Compared to HCs, patients with BD had a decreased dFC between right LB and the left postcentral gyrus as well as an increased dFC between right CM and the right cerebellum.Compared to BD patients, patients with MDD showed a decreased dFC between right CM and the cerebellum and an increased dFC between right LB and the left postcentral gyrus. These findings present initial evidence that abnormal patterns of the right-amygdalar subregions shared by BD and MDD supports the differential pathophysiology of these disorders.


Assuntos
Tonsila do Cerebelo/fisiopatologia , Transtorno Bipolar/fisiopatologia , Transtorno Depressivo Maior/fisiopatologia , Adulto , Tonsila do Cerebelo/diagnóstico por imagem , Transtorno Bipolar/diagnóstico por imagem , Cerebelo/diagnóstico por imagem , Cerebelo/fisiopatologia , Transtorno Depressivo Maior/diagnóstico por imagem , Feminino , Humanos , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Córtex Somatossensorial/diagnóstico por imagem , Córtex Somatossensorial/fisiopatologia
10.
J Fr Ophtalmol ; 43(7): 586-597, 2020 Sep.
Artigo em Francês | MEDLINE | ID: mdl-32631695

RESUMO

Major depressive disorder, bipolar disorder and schizophrenia are currently among the most common psychiatric disorders, known to constitute a serious public health issue in terms of morbidity, mortality and functional handicap. Their pathophysiology is still unclear, but there is now increasing evidence supporting the existence of abnormalities of neurotransmission. As the retina is an extension of the central nervous system, it may be an interesting site of study which might provide a better understanding of the pathophysiology of psychiatric disorders. Several studies have demonstrated retinal abnormalities, with abnormal cone and rod responses on electroretinography (ERG), suggesting a process of functional neuronal loss, structurally supported by a decrease in the retinal nerve fiber layer thickness (RNFL) on optical coherence tomography (OCT), which suggests involvement of the molecular signal pathways of neurotransmission. These tests could be useful tools for diagnosing and monitoring psychiatric disorders. This article is an overview of the literature on retinal abnormalities observed in patients with major depressive disorder, bipolar disorder or schizophrenia, and discusses how they could be pathophysiologic markers.


Assuntos
Transtorno Bipolar/fisiopatologia , Transtorno Depressivo Maior/fisiopatologia , Retina/diagnóstico por imagem , Retina/fisiologia , Esquizofrenia/fisiopatologia , Acuidade Visual/fisiologia , Transtorno Bipolar/complicações , Transtorno Bipolar/diagnóstico , Transtorno Bipolar/patologia , Transtorno Depressivo Maior/complicações , Transtorno Depressivo Maior/diagnóstico , Transtorno Depressivo Maior/patologia , Eletrorretinografia , Humanos , Fibras Nervosas/patologia , Fibras Nervosas/fisiologia , Retina/patologia , Células Fotorreceptoras Retinianas Cones/patologia , Células Fotorreceptoras Retinianas Cones/fisiologia , Células Ganglionares da Retina/patologia , Células Ganglionares da Retina/fisiologia , Esquizofrenia/complicações , Esquizofrenia/diagnóstico , Esquizofrenia/patologia , Tomografia de Coerência Óptica
11.
Psychiatry Res Neuroimaging ; 303: 111139, 2020 09 30.
Artigo em Inglês | MEDLINE | ID: mdl-32707490

RESUMO

Given the emerging evidence in support of parietal brain stimulation to treat speech disorder in psychosis, we investigated structural and functional parietal dysconnectivity in schizophrenia (n = 34) and bipolar disorder with psychotic symptoms (n = 16). We found that both patient groups demonstrated reduced left parietal structural connectivity compared to healthy controls (n = 32). The three groups also differed significantly on the variability of left and right parietal dynamic functional connectivity. In patients with schizophrenia, parietal dysconnectivity predicted the severity of disorganisation symptoms. These findings suggest that dysconnectivity between the parietal lobe and the rest of the brain plays a key role in disorganisation symptoms of schizophrenia.


Assuntos
Transtorno Bipolar/diagnóstico por imagem , Imagem por Ressonância Magnética/métodos , Rede Nervosa/diagnóstico por imagem , Lobo Parietal/diagnóstico por imagem , Transtornos Psicóticos/diagnóstico por imagem , Esquizofrenia Hebefrênica/diagnóstico por imagem , Adulto , Transtorno Bipolar/fisiopatologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Rede Nervosa/fisiopatologia , Lobo Parietal/fisiopatologia , Transtornos Psicóticos/fisiopatologia , Esquizofrenia/diagnóstico por imagem , Esquizofrenia/fisiopatologia , Esquizofrenia Hebefrênica/fisiopatologia
12.
Psychiatry Res ; 291: 113227, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32593852

RESUMO

INTRODUCTION: Almost a third of the offspring of parents diagnosed with schizophrenia or bipolar disorder could develop a mental disorder or related symptoms. The objectives of this study were to test the existence of two distinct subgroups of youth at-risk, according to their retinal response to luminance measured with electroretinography (ERG), and to relate the resulting cluster memberships with the cognitive clusters previously reported. METHODOLOGY: A clustering analysis was performed with ERG measurements in 107 at-risk offspring. Each subgroup was compared to a healthy control group of 203 individuals. The ERG subgroup memberships were then associated with the cognitive clusters. RESULTS: A two-cluster solution was obtained: HR-Cluster1 (n=53) showed a control-like ERG profile and HR-Cluster2 (n=54) showed reduced rod amplitudes and prolonged cone latencies of the b-wave. Subjects in the HR-Cluster2 were 2.7 times more likely to belong to the most detrimental cognitive subgroup than subjects in the HR-Cluster1 (49% Vs 18%). CONCLUSION: At-risk offspring showed two distinct ERG profiles: a control-like and an altered profile. A higher risk of impaired cognitive function was observed in subjects with the altered ERG profile, suggesting the ERG as a potential biomarker of susceptibility to mental illness among youth at risk.


Assuntos
Transtorno Bipolar/fisiopatologia , Disfunção Cognitiva/fisiopatologia , Eletrorretinografia/métodos , Retina/fisiopatologia , Esquizofrenia/fisiopatologia , Adolescente , Adulto , Transtorno Bipolar/diagnóstico , Transtorno Bipolar/psicologia , Criança , Disfunção Cognitiva/diagnóstico , Disfunção Cognitiva/psicologia , Estudos de Coortes , Feminino , Humanos , Masculino , Fatores de Risco , Esquizofrenia/diagnóstico , Psicologia do Esquizofrênico , Adulto Jovem
13.
Psychiatry Res Neuroimaging ; 302: 111110, 2020 08 30.
Artigo em Inglês | MEDLINE | ID: mdl-32505904

RESUMO

It is still unclear whether the structural abnormalities in Bipolar disorder (BD) are static or progressive. We aimed to compare differences in cortical thickness, surface area, and volume between patients with BD and healthy volunteers (HV) and to examine whether there are differences between patients who have had a single manic episode and those with multiple episodes. We recruited 30 patients with Type I BD and 30 age and sex matched HV. All participants underwent structural magnetic resonance imaging. Cortical volume, thickness, and surface area were measured using the QDEC tool from the Freesurfer software with age and intracranial volume as covariates. Study groups were comparable across age, sex distribution, and intracranial volume. Patients had significantly lower surface area in bilateral cuneus, right postcentral gyrus, and rostral middle frontal gyri; and lower cortical volume in the left middle temporal gyrus, right postcentral gyrus, and right cuneus. BD patients with multiple episodes had lower cortical measures while those with single episode had cortical measures comparable to HV. Findings indicate that the pathophysiological processes in BD are possibly progressive in nature. Our findings underscore the potential importance of early diagnosis and intervention in preventing deterioration and improving functional recovery.


Assuntos
Transtorno Bipolar/diagnóstico por imagem , Lobo Frontal/diagnóstico por imagem , Lobo Occipital/diagnóstico por imagem , Lobo Temporal/diagnóstico por imagem , Adolescente , Adulto , Transtorno Bipolar/patologia , Transtorno Bipolar/fisiopatologia , Transtorno Bipolar/psicologia , Estudos de Casos e Controles , Córtex Cerebral/diagnóstico por imagem , Córtex Cerebral/patologia , Feminino , Lobo Frontal/patologia , Humanos , Imagem por Ressonância Magnética/métodos , Masculino , Lobo Occipital/patologia , Tamanho do Órgão , Recidiva , Lobo Temporal/patologia , Adulto Jovem
15.
Eur Psychiatry ; 63(1): e49, 2020 05 14.
Artigo em Inglês | MEDLINE | ID: mdl-32406349

RESUMO

BACKGROUND: Patients with schizophrenia display experiential anomalies in their feelings and cognitions arising in the domain of their lived body. These abnormal bodily phenomena (ABP) are not part of diagnostic criteria for schizophrenia. One of the reasons is the difficulty to assess specific ABP for schizophrenia spectrum disorders. The present study aimed to explore the presence in patients with schizophrenia of specific ABP. METHODS: We used a semistructured interview-the Abnormal Bodily Phenomena questionnaire (ABPq), an instrument devised to detect and measure ABP specific to patients with schizophrenia. Fifty-one outpatients affected by schizophrenia and 28 euthymic outpatients affected by bipolar disorder type I with psychotic features (BD-pf-e) were recruited. Before assessing the specificity for schizophrenia of the observed ABP, we tested the internal consistency and the convergent validity of the ABPq in patients with schizophrenia. Specificity was assessed by examining potential differences in ABPq among the patients with schizophrenia in remission (SCZ-r) and BD-pf-e. RESULTS: The ABPq shows strong internal consistency and convergent validity. As to the specificity, ABP measured by ABPq were more frequent and severe in SCZ-r than in BD-pf-e. In particular, all ABPq dimensions, except "Coherence," had at least mild severity in over 50% of SCZ-r, while dimensions with at least mild severity were observed in 5-10% of the BD-pf-e. CONCLUSIONS: These findings can contribute to establish more precise phenomenal boundaries between schizophrenia and bipolar disorder, to explore the borders between nonpsychotic and psychotic forms of ABP, between ABP and negative and disorganized symptoms, and to enlighten core aspects of schizophrenia.


Assuntos
Transtorno Bipolar/fisiopatologia , Transtorno Ciclotímico/fisiopatologia , Alucinações/diagnóstico , Esquizofrenia/fisiopatologia , Autoimagem , Adulto , Cognição , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pacientes Ambulatoriais , Transtornos Psicóticos/fisiopatologia , Psicologia do Esquizofrênico , Inquéritos e Questionários
16.
J Fr Ophtalmol ; 43(5): e157-e166, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32381369

RESUMO

Major depressive disorder, bipolar disorder and schizophrenia are currently among the most common psychiatric disorders, known to constitute a serious public health issue in terms of morbidity, mortality and functional handicap. Their pathophysiology is still unclear, but there is now increasing evidence supporting the existence of abnormalities of neurotransmission. As the retina is an extension of the central nervous system, it may be an interesting site of study which might provide a better understanding of the pathophysiology of psychiatric disorders. Several studies have demonstrated retinal abnormalities, with abnormal cone and rod responses on electroretinography (ERG), suggesting a process of functional neuronal loss, structurally supported by a decrease in the retinal nerve fiber layer thickness (RNFL) on optical coherence tomography (OCT), which suggests involvement of the molecular signal pathways of neurotransmission. These tests could be useful tools for diagnosing and monitoring psychiatric disorders. This article is an overview of the literature on retinal abnormalities observed in patients with major depressive disorder, bipolar disorder or schizophrenia, and discusses how they could be pathophysiologic markers.


Assuntos
Transtorno Bipolar/fisiopatologia , Transtorno Depressivo Maior/fisiopatologia , Retina/diagnóstico por imagem , Retina/patologia , Retina/fisiopatologia , Esquizofrenia/fisiopatologia , Transtorno Bipolar/complicações , Transtorno Bipolar/diagnóstico , Transtorno Bipolar/psicologia , Transtorno Depressivo Maior/complicações , Transtorno Depressivo Maior/diagnóstico , Transtorno Depressivo Maior/psicologia , Eletrorretinografia , Humanos , Esquizofrenia/complicações , Esquizofrenia/diagnóstico , Psicologia do Esquizofrênico , Transmissão Sináptica/fisiologia , Tomografia de Coerência Óptica
17.
Psychiatry Res Neuroimaging ; 300: 111078, 2020 06 30.
Artigo em Inglês | MEDLINE | ID: mdl-32361172

RESUMO

The ability of the brain to reduce the amount of trivial or redundant sensory inputs is called gating function. Dysfunction of sensory gating may lead to cognitive fragmentation and poor real-world functioning. The auditory dual-click paradigm is a pertinent neurophysiological measure of sensory gating function. This meta-analysis aimed to examine the subcomponents of abnormal P50 waveforms in bipolar disorder and schizophrenia to assess P50 sensory gating deficits and examine effects of diagnoses, illness states (first-episode psychosis vs. schizophrenia, remission vs. episodes in bipolar disorder), and treatment status (medication-free vs. medicated). Literature search of PubMed between Jan 1st 1980 and March 31st 2019 identified 2091 records for schizophrenia, 362 for bipolar disorder. 115 studies in schizophrenia (4932 patients), 16 in bipolar disorder (975 patients) and 10 in first-degree relatives (848 subjects) met the inclusion criteria. P50 sensory gating ratio (S2/S1) and S1-S2 difference were significantly altered in schizophrenia, bipolar disorder and their first-degree relatives. First-episode psychosis did not differ from schizophrenia, however episodes altered P50 sensory gating in bipolar disorder. Medications improve P50 sensory gating alterations in schizophrenia significantly and at trend level in bipolar disorder. Future studies should examine longitudinal course of P50 sensory gating in schizophrenia and bipolar disorder.


Assuntos
Transtorno Bipolar/fisiopatologia , Eletroencefalografia , Potenciais Evocados Auditivos/fisiologia , Esquizofrenia/fisiopatologia , Filtro Sensorial/fisiologia , Adulto , Encéfalo/fisiopatologia , Feminino , Humanos , Masculino
18.
Schizophr Res ; 222: 541-542, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32404258

RESUMO

Delusional topics tend to rapidly incorporate popular hot topical issues. Thus, the current coronavirus COVID-19 pandemic has rapidly reached delusional themes in patients with psychiatric disorders. Here we present the clinical case of a Spanish woman with bipolar disorder that included coronavirus infection in her delusional themes even faster than the real infection reached mainland Spain.


Assuntos
Transtorno Bipolar/fisiopatologia , Infecções por Coronavirus , Delusões/fisiopatologia , Pandemias , Pneumonia Viral , Adulto , Transtorno Bipolar/complicações , Delusões/etiologia , Feminino , Humanos
19.
Arch Sex Behav ; 49(4): 1345-1354, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32133544

RESUMO

Hypersexuality is associated with psychiatric disorders such as mania; however, it remains unclear whether bipolar I disorder with (BW) or without (BO) hypersexuality demonstrates different responses to external emotional stimuli and their transitions that were composed of pictures and sounds of same domain. In 21 BW patients, 20 BO patients, and 41 healthy volunteers, we administered polygraph tests (electrocardiogram, electromyogram, electrooculogram, and galvanic skin response) to measure transitions from a primer emotion (i.e., external disgust, erotica, fear, happiness, neutral, and sadness) to a noncongruent emotion (out of the remaining five) and to the primer emotion again (repeat-primer). We also evaluated participants' concurrent states of mania, hypomania, and depression. With neutral as the noncongruent emotion, the heart rate difference in BW was greater than in controls when responses to the primer erotica were subtracted from responses to the repeat-primer erotica, or when to the primer sadness were subtracted from the repeat-primer sadness. The difference of the masseter electromyographic activity in BW was lower than in BO and controls when responses to the noncongruent happiness were subtracted from responses to the repeat-primer neutral, and was lower than in BO when to the noncongruent neutral were subtracted from the repeat-primer erotica. The eyeball movement difference was greater in BW than in BO and controls when responses to the noncongruent sadness were subtracted from responses to the repeat-primer neutral. The heart rate difference when responses to the primer happiness were subtracted from responses to the noncongruent neutral was negatively correlated with mania in BO. BW and BO patients behaved differently to external emotions and their transitions, particularly regarding erotica and sadness, which might characterize unique pathophysiological processes of the two bipolar I disorder subtypes.


Assuntos
Transtorno Bipolar/fisiopatologia , Emoções/fisiologia , Comportamento Sexual/psicologia , Adulto , Feminino , Voluntários Saudáveis , Humanos , Masculino
20.
Bipolar Disord ; 22(6): 593-601, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32212391

RESUMO

OBJECTIVES: Bipolar disorder (BD) is a psychiatric condition causing shifts in mood, energy and activity levels severely altering the quality of life of the patients even in the euthymic phase. Although widely accepted, the neurobiological bases of the disorder in the euthymic phase remain elusive. This study aims at characterizing resting state functional activity of the BD euthymic phase in order to better understand the pathogenesis of the disease and build future neurobiological models. METHODS: Fifteen euthymic BD patients (10 females; mean age 40.2; standard deviation 13.5; range 20-61) and 27 healthy controls (HC) (21 females; mean age 37; standard deviation 10.6; range 22-60) underwent a 3T functional MRI scan at rest. Resting state activity was extracted through independent component analysis (ICA) run with automatic dimensionality estimation. RESULTS: ICA identified 22 resting state networks (RSNs). Within-network analysis revealed decreased connectivity in the visual, temporal, motor and cerebellar RSNs of BD patients vs HC. Between-network analysis showed increased connectivity between motor area and the default mode network (DMN) partially overlapping with the fronto-parietal network (FPN) in BD patients. CONCLUSION: Within-network analysis confirmed existing evidence of altered cerebellar, temporal, motor and visual networks in BD. Increased connectivity between the DMN and the motor area network suggests the presence of alterations of the fronto-parietal regions, precuneus and cingulate cortex in the euthymic condition. These findings indicate that specific connectivity alterations might persist even in the euthymic state suggesting the importance of examining both within and between-network connectivity to achieve a global understanding of the BD euthymic condition.


Assuntos
Transtorno Bipolar/fisiopatologia , Transtorno Ciclotímico/fisiopatologia , Adulto , Encéfalo/fisiopatologia , Mapeamento Encefálico , Estudos de Casos e Controles , Cerebelo/fisiopatologia , Feminino , Giro do Cíngulo/fisiopatologia , Humanos , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Lobo Parietal/fisiopatologia , Qualidade de Vida , Adulto Jovem
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