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1.
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
2.
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
3.
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
4.
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
6.
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
7.
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
8.
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
9.
Psychiatr Hung ; 34(2): 214-236, 2019.
Artigo em Húngaro | MEDLINE | ID: mdl-31417009

RESUMO

To clarify the relationship between literature and psychiatry we can call on the help of the American-English writer Sylvia Plath, who was given electroconvulsive therapy and psychotherapy on a number of occasions for psychiatric illness and later took her own life. This study seeks an answer to five questions. Did Sylvia Plath suffer from psychiatric illness? Did she show signs of the bipolar triad (bipolar affective disorder, trait aggression, substance or behavioural dependence)? Did her activity as a writer have a therapeutic effect? What was the nature of her "confessionalism"? To what extent does her oeuvre reflect her life? Sylvia Plath very probably suffered from a psychiatric illness, namely bipolar 2 affective disorder. The unsuitable treatment of her illness and the interruption of intensive psychotherapy could have contributed to her early death. Together with the bipolar affective disorder, she was also characterised by serious dispositional aggression and emotional dependence. For her, writing was both a source of stress, because her dysthymia intensified her inhibitions, and at the same time self-healing and a self-fulfilling prophecy. The roots of her confessionalism can be found in her personality development suspended in the stage of becoming an adult, and the failure to work through her traumas. Unlike Goethe and Salinger who killed their heroes, having them commit suicide in The Sorrows of Young Werther and A Perfect Day for Bananafish, while both writers recovered from their crisis, Sylvia Plath described a positive development in The Bell Jar and in Ariel, her verse cycle, then put her head in the gas oven. Would she have stayed alive if she had followed the patterns of Goethe and Salinger?


Assuntos
Ira , Pessoas Famosas , Imaginação , Literatura Moderna/história , Suicídio/história , Suicídio/psicologia , Transtorno Bipolar/psicologia , Transtorno Bipolar/terapia , Feminino , História do Século XX , Humanos , Psicoterapia , Redação/história
10.
Medicine (Baltimore) ; 98(33): e16851, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31415415

RESUMO

BACKGROUND: Studies aimed at understanding the higher risk profiles for self-inflicted violence in individuals with BD become essential as a possible predictive risk measure for the presence of suicidal behavior, corroborating the expressive reduction of suicide deaths in young people who are in psychic suffering. METHODS: The protocol was constructed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyzes (PRISMA-P) and the research question was constructed using guidelines from the Population Intervention Comparator Outcome Setting (PICOS) strategy. A third reviewer will be contacted, and two studies will be included in the selection, analysis and inclusion phases of the articles, in case of divergence, a third reviewer will be contacted. (1) methodological design studies of cohorts, case-control and cross-sectional; (2) Diagnosis of Bipolar disorder according to Diagnostic and statistical Manual of mental disorders V; (3) Studies with adult population and (4) Studies that consider at least one type of self-inflicted violence as a variable. The articles considered eligible will be analyzed by New Castle - Ottawa quality assessment scale/cross section studies (NOS) to evaluate the quality of the studies. RESULTS: The identification of the characteristics of self-harm may subsidize professionals who work in the treatment of bipolar disorder with greater attention to these practices and monitoring of possible suicidal behaviors. CONCLUSION: This study may represent one of the initial measures of evaluation on these correlations, which will allow to protocol the guidelines in the field of practice and contribute to improvements in public health indexes.


Assuntos
Transtorno Bipolar/psicologia , Ideação Suicida , Tentativa de Suicídio/psicologia , Humanos , Medição de Risco , Revisão Sistemática como Assunto
11.
Tijdschr Psychiatr ; 61(6): 384-391, 2019.
Artigo em Holandês | MEDLINE | ID: mdl-31243748

RESUMO

BACKGROUND: There is an average 10-year delay in diagnosing bipolar disorder, hampering the application of effective therapeutic interventions.
AIM: To investigate factors contributing to early recognition.
METHOD: We give a stage-oriented overview of the opportunities for early recognition.
RESULTS: Recognition in stage 0 (at-risk) and stage 1 (prodromal) is yet impossible. In stage 2 (syndromal) there are opportunities for better recognition in patients presenting with depression by conducting a thorough (collateral) psychiatric assessment, family history and by applying additional screening tools. CONCLUSIONS There are opportunities for better recognition of bipolar disorder in the syndromal stage.


Assuntos
Transtorno Bipolar/diagnóstico , Transtorno Depressivo Maior/diagnóstico , Transtorno Bipolar/psicologia , Transtorno Depressivo Maior/psicologia , Diagnóstico Diferencial , Manual Diagnóstico e Estatístico de Transtornos Mentais , Humanos , Escalas de Graduação Psiquiátrica
12.
Nord J Psychiatry ; 73(4-5): 264-272, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31134834

RESUMO

Aim: Posttraumatic stress disorder (PTSD) in parents can have severe consequences also for their children. Prevalence of PTSD is high among refugees. Refugee children have been reported to perform poorly in school. The aim of this study was to investigate the impact of PTSD in refugee and native Swedish parents on children's school performance and to compare the impact of PTSD with that of other major psychiatric disorders. Methods: Register study where multiple regression models were used to analyse school performance in 15-16-year-olds in a national cohort (n = 703,813). PTSD and other major psychiatric disorders (bipolar, depression and/or psychotic disorders) were identified from out- and in-patient hospital care. Results: Maternal and paternal PTSD were associated with lower grades, with adjusted effects of 0.30-0.37 SD in refugee and 0.46-0.50 SD in native Swedish families. Impact of PTSD was greater than that of other psychiatric disorders and comorbidity to PTSD did not increase this impact. Although the impact of PTSD on grades was greater in children in native Swedish families, consequences with regard to eligibility to secondary education were greater for children in refugee families, where 35% of these children were ineligible. Conclusions: Parental PTSD has major consequences for children's school performance and contributes to the lower school performance in children in refugee families in Sweden. Identification and treatment of PTSD in refugee parents is important for offspring educational achievement. Psychiatric clinics and treatment centres need to have a strategy for support, including educational support, to the offspring of their patients with PTSD.


Assuntos
Desempenho Acadêmico/psicologia , Filho de Pais Incapacitados/psicologia , Pais/psicologia , Refugiados/psicologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Adolescente , Transtorno Bipolar/epidemiologia , Transtorno Bipolar/psicologia , Estudos de Coortes , Feminino , Humanos , Masculino , Prevalência , Transtornos Psicóticos/epidemiologia , Transtornos Psicóticos/psicologia , Sistema de Registros , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Suécia/epidemiologia
13.
Am J Psychother ; 72(2): 47-57, 2019 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-31070452

RESUMO

Bipolar II disorder causes significant suffering among patients and their families, some of which may be alleviated by psychotherapy alone or as an adjunct to pharmacotherapy. Psychotherapies may be more effective if modified to meet the specific needs of patients with bipolar II disorder.


Assuntos
Transtorno Bipolar/psicologia , Transtorno Bipolar/terapia , Psicoterapia/métodos , Humanos
14.
Dev Psychopathol ; 31(3): 1037-1052, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31064610

RESUMO

Aberrant face emotion processing has been demonstrated in youth with and at a familial risk for bipolar and major depressive disorders. However, the neurobiological factors related to emotion processing that underlie resilience from youth-onset mood disorders are not well understood. Functional magnetic resonance imaging data during an implicit emotion processing task were collected at baseline from a sample of 50 youth, ages 8-17, who were healthy but also familially at high risk for either bipolar disorder or major depressive disorder, and 24 healthy controls with no family history of psychopathology (HCL). Participants were reevaluated 3 years later and classified into three groups for analysis: high-risk youth who converted to a psychiatric diagnosis (CVT; N = 23), high-risk youth who were resilient from developing any psychopathology (RES; N = 27), and HCL youth (N = 24) who remained healthy at follow-up. For happy > calm faces, the CVT and RES groups had significantly lower activation in the left inferior parietal lobe (IPL), while the RES group had lower activation in the right supramarginal gyrus. For fear > calm faces, the RES group had lower activation in the right precuneus and inferior frontal gyrus (IFG) compared to the CVT group. Connectivity analyses revealed the RES group exhibited higher left IPL connectivity with visual cortical regions for happy > calm faces, and higher IFG connectivity with frontal, temporal, and limbic regions for fear > calm faces. These connectivities were correlated with improvements in prosocial behaviors and global functioning. Our findings suggest that differential activation and connectivity in the IPL, IFG, and precuneus in response to emotional stimuli may represent distinct resilience and risk markers for youth-onset mood disorders.


Assuntos
Transtorno Bipolar/diagnóstico por imagem , Encéfalo/diagnóstico por imagem , Transtorno Depressivo Maior/diagnóstico por imagem , Emoções/fisiologia , Expressão Facial , Resiliência Psicológica , Adolescente , Transtorno Bipolar/fisiopatologia , Transtorno Bipolar/psicologia , Encéfalo/fisiopatologia , Criança , Transtorno Depressivo Maior/fisiopatologia , Transtorno Depressivo Maior/psicologia , Feminino , Predisposição Genética para Doença , Humanos , Imagem por Ressonância Magnética/métodos , Masculino
15.
Zh Nevrol Psikhiatr Im S S Korsakova ; 119(1. Vyp. 2): 22-27, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31006787

RESUMO

AIM: To study clinical features of depressive episode with the onset in late adolescence associated with the risk of bipolar affective disorder (BAD). MATERIAL AND METHODS: Forty patients with BAD (ICD-10 F31), who experienced depressive state at the age of 15-18 years corresponding to the diagnostic criteria of 'Depressive episode' (F32), were examined. The duration of follow-up was from 3 to 5 years. Clinical-psychopathologic, follow-up, statistical methods were applied. RESULTS: Duration of depressive episodes did not exceed 6 months in 70% of patients with BAD. Characteristic clinical features included the frequent presence of psychomotor retardation, anergia, anhedonia, melancholy, irritability, affective instability with increased emotional reactivity, hypersomnia. Other 'atypical' depressive symptoms were less characteristic. There was a significant incidence of suicidal tendencies, comorbid psychopathic-like behavioral disorders and substance abuse. In most cases, the depressive state was accompanied by a deterioration in social functioning and led to educational maladaptation. CONCLUSION: Characteristic clinical features of bipolar depression manifested in late adolescence were a relatively short duration, the prevalence of typical depressive symptoms (melancholy, psychomotor retardation), irritability, increased emotional reactivity, hypersomnia, a significant incidence of suicidal tendencies.


Assuntos
Transtorno Bipolar , Transtorno Depressivo , Adolescente , Transtorno Bipolar/psicologia , Comorbidade , Depressão , Humanos , Classificação Internacional de Doenças
16.
Artigo em Inglês | MEDLINE | ID: mdl-30934957

RESUMO

Environmental variables can regulate behavior in healthy subjects. Recently, some authors investigated the role of meteorological variables in bipolar patients with an impact on both the onset and course of bipolar disorder (BD). The aim of this study was to investigate the impact of meteorological variables and other indexes in bipolar hospitalized patients. We examined all patients admitted to the Psychiatric Inpatient Unit of San Luigi Gonzaga Hospital, Orbassano (Turin, Italy) from September 2013 to August 2015, collecting several socio-demographic and clinical characteristics. Seven hundred and thirty patients were included. Compared to the day of admission of control individuals, patients with BD were admitted on a day that presented higher minimum, medium, and maximum temperature, higher maximum humidity, higher solar radiation, and higher hours of sunshine. After logistic regression analysis, admissions to the emergency psychiatric ward due to a primary diagnosis of BD were associated with maximum temperature and solar radiation. The current study provides a novel perspective on the question surrounding seasonal mood patterns in patients with BD. A greater awareness of all possible precipitating factors is needed to inform self-management and psycho-educational programs as well as to improve resilience regarding affective recurrences in the clinical practice.


Assuntos
Transtorno Bipolar/epidemiologia , Serviço Hospitalar de Emergência/estatística & dados numéricos , Admissão do Paciente/estatística & dados numéricos , Unidade Hospitalar de Psiquiatria/estatística & dados numéricos , Luz Solar , Temperatura Ambiente , Adulto , Transtorno Bipolar/psicologia , Feminino , Humanos , Umidade , Itália/epidemiologia , Masculino , Pessoa de Meia-Idade , Energia Solar
17.
Metabolism ; 95: 65-76, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30954559

RESUMO

Changes of sphingolipid metabolism were suggested to contribute to the patho-etiology of major depression (MD) and bipolar disorder (BD). In a pilot study we assessed if lipid allostasis manifested in pathological plasma concentrations of bioactive lipids i.e. endocannabinoids, sphingolipids, ceramides, and lysophosphatidic acids. METHODS: Targeted and untargeted lipidomic analyses were performed according to GLP guidelines in 67 patients with unipolar or bipolar disorders (20-67 years, 36 male, 31 female) and 405 healthy controls (18-79 years, 142 m, 263 f), who were matched according to gender, age and body mass index. Multivariate analyses were used to identify major components, which accounted for the variance between groups and were able to predict group membership. RESULTS: Differences between MD and BP patients versus controls mainly originated from ceramides and their hexosyl-metabolites (C16Cer, C18Cer, C20Cer, C22Cer, C24Cer and C24:1Cer; C24:1GluCer, C24LacCer), which were strongly increased, particularly in male patients. Ceramide levels were neither associated with the current episode, nor with the therapeutic improvement of the Montgomery Åsberg Depression Rating Scale (MARDS). However, long-chain ceramides were linearly associated with age, stronger in patients than controls, and with high plasma levels of diacyl- and triacylglycerols. Patients receiving antidepressants had higher ceramide levels than patients not taking these drugs. There was no such association with lithium or antipsychotics except for olanzapine. CONCLUSION: Our data suggest that high plasma ceramides in patients with major depression and bipolar disorder are indicative of a high metabolic burden, likely aggravated by certain medications.


Assuntos
Transtorno Bipolar/metabolismo , Ceramidas/metabolismo , Transtorno Depressivo Maior/metabolismo , Metabolismo dos Lipídeos/genética , Adolescente , Adulto , Fatores Etários , Idoso , Antidepressivos/efeitos adversos , Antidepressivos/uso terapêutico , Antimaníacos/efeitos adversos , Antimaníacos/uso terapêutico , Antipsicóticos/efeitos adversos , Antipsicóticos/uso terapêutico , Transtorno Bipolar/tratamento farmacológico , Transtorno Bipolar/psicologia , Índice de Massa Corporal , Transtorno Depressivo Maior/tratamento farmacológico , Transtorno Depressivo Maior/psicologia , Diglicerídeos/metabolismo , Feminino , Humanos , Lítio/efeitos adversos , Lítio/uso terapêutico , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Escalas de Graduação Psiquiátrica , Caracteres Sexuais , Triglicerídeos/metabolismo , Adulto Jovem
18.
Psychiatr Danub ; 31(1): 37-42, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30948688

RESUMO

BACKGROUND: Body image concerns are associated with the poor prognosis of bipolar disorder, but it is unknown whether bipolar I (BD I) and II (BD II) types differ in these concerns and their associations with personality styles or affective states. SUBJECTS AND METHODS: We therefore invited 89 BD I, 91 BD II patients, and 159 healthy volunteers to undergo the tests of the Body Image Concern Scale (BICS), the Mood Disorder Questionnaire, the Hypomania Checklist - 32, the Plutchik - van Praag Depression Inventory, and the Parker Personality Measure. RESULTS: Both BD I and BD II displayed higher scores of ongoing affective states and of personality disorder functioning styles than healthy controls did. BD II scored higher on all six BICS scales than controls did, and higher on five than BD I did. The depressive measure predicted four, and Dependent style predicted three BICS scales in BD I; and the depressive measure predicted all six BICS scales, hypomanic measure predicted one, and Avoidant style predicted one in BD II. CONCLUSIONS: Body image concerns and their associations with the affective states and personality styles were different in BD I and BD II, suggesting different pathological mechanisms, clinical symptom severities and managements for the two types of bipolar disorder.


Assuntos
Transtorno Bipolar , Imagem Corporal , Transtornos da Personalidade , Transtorno Bipolar/psicologia , Estudos de Casos e Controles , Emoções , Humanos , Personalidade , Transtornos da Personalidade/psicologia
19.
Psychiatr Danub ; 31(1): 54-61, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30948690

RESUMO

BACKGROUND: Some authors suggest that working memory may underlie most of cognitive deficits found in schizophrenia and contribute to the most salient features of the disorder. Many authors further believe that, despite the differences in magnitude, profile of cognitive impairment is quite similar across schizophrenia and affective psychosis. To test the hypothesis of profile similarity between SCZ and BPD compared to healthy individuals, we carried out a comparative study applying several working memory tasks. SUBJECTS AND METHODS: A total of 64 subjects participated in the study, 20 diagnosed with schizophrenia, 18 with bipolar affective disorder and 26 healthy controls. Groups were matched according to age, sex and education, and two clinical groups were also matched according to the number of hospitalizations. To measure working memory we applied se Wisconsin Card Sorting Test (WCST), STROOP task, Trail making test (TMT), Digit span forward and backward tasks. To test the size and profile similarities of the groups, we used ANOVA and Kruskal-Wallis tests on individual measures and on factor scores. RESULTS: Most indicators of the WCST did not differentiate between the groups, but all of the remaining indicators indicated weaker working memory of the two clinical groups compared to the healthy controls. All applied measures could be reduced to two latent constructs provisionally named WM Attention and WM Capacity. Both clinical groups scored lower on the capacity component than controls, whereas the three groups could not be distinguished according to the attention component. Results provided no evidence of difference in either size or profile of working memory impairment in patients with SCZ and BDP. CONCLUSIONS: The current study determined impairment of WM in patients diagnosed with SCZ and BPD compared to healthy controls. However, no difference was found regarding either the size or the profile of impairment between SCZ and BPD patients.


Assuntos
Transtorno Bipolar , Memória de Curto Prazo , Esquizofrenia , Psicologia do Esquizofrênico , Transtorno Bipolar/psicologia , Humanos , Transtornos do Humor , Testes Neuropsicológicos
20.
Psychiatr Danub ; 31(1): 106-110, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30948697

RESUMO

BACKGROUND: Both affective temperaments and seasonality impact on the illness course in bipolar disorder (BD). This exploratory study aims to investigate the link between seasonality and affective temperament in BD. SUBJECTS AND METHODS: Sixty-six euthymic patients with BD-I were recruited. The Seasonal Pattern Assessment Questionnaire (SPAQ) and Temperament Evaluation Memphis, Pisa, Paris and San Diego-Autoquestionnaire version scale (TEMPS-A) were applied. RESULTS: The seasonal BD rate was 39.4% (n=26). Depressive and anxious temperament scores were higher in patients with seasonality. The SPAQ total scores were also associated with depressive, cyclothymic, and anxious affective temperament scores. CONCLUSION: Our findings warrant further investigation to understanding the complex interaction between seasonality, mood regulation, and temperament collectively moderating illness course in BD. This study implies that affective temperament may have some value in discerning the link between seasonality and illness course in BD.


Assuntos
Transtorno Bipolar , Transtorno Ciclotímico , Temperamento , Afeto , Transtorno Bipolar/psicologia , Humanos , Inquéritos e Questionários
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