2.3 Prospective Risk of Developing Bipolar Disorder: Diagnostic Evolution in the Longitudinal Assessment of Manic Symptoms Cohort

2016 ◽  
Vol 55 (10) ◽  
pp. S260
Author(s):  
Eric Youngstrom ◽  
Boris Birmaher ◽  
Sarah M. Horwitz ◽  
Robert L. Findling ◽  
Mary A. Fristad ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Longitudinal Assessment ◽  
Manic Symptoms ◽  
Prospective Risk

scholarly journals Does the course of manic symptoms in pediatric bipolar disorder impact the course of conduct disorder? Findings from four prospective datasets

2018 ◽  
Vol 238 ◽  
pp. 244-249 ◽  
Author(s):  
Joseph Biederman ◽  
Maura Fitzgerald ◽  
K. Yvonne Woodworth ◽  
Amy Yule ◽  
Elizabeth Noyes ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Conduct Disorder ◽  
Pediatric Bipolar Disorder ◽  
Manic Symptoms

Mood Disorders

2017 ◽  
Author(s):  
Hasan A Baloch ◽  
Jair C. Soares
Keyword(s):  
Bipolar Disorder ◽  
Mood Disorders ◽  
Gray Matter ◽  
Affective Disorders ◽  
Unipolar Depression ◽  
Diagnosis And Treatment ◽  
Bipolar Spectrum ◽  
Manic Symptoms ◽  
Lifetime History ◽  
History Of

Affective disorders are among the most common disorders in psychiatry. They are generally classified according to the persistence and extent of symptoms and by the polarity of these symptoms. The two poles of the affective spectrum are mania and depression. Bipolar disorder is characterized by the presence of the mania or hypomania and often depression. Unipolar depression is defined by depression in the absence of a lifetime history of mania or hypomania. These differences are not merely categorical but have important implications for the prognosis and treatment of these conditions. Bipolar disorder, for example, is better treated using mood-stabilizing medication, whereas unipolar depression responds optimally to antidepressant medications. In addition, prognostically, unipolar depression may sometimes be limited to one episode in a lifetime, whereas bipolar disorder is typically a lifelong condition. The course of both conditions, however, is often chronic, and frequently patients can present with unipolar depression only to later develop manic symptoms. A thorough understanding of both conditions is therefore required to treat patients presenting with affective symptomatology. This chapter discusses the epidemiology, etiology and genetics, pathogenesis, diagnosis, and treatment of unipolar depression and bipolar disorder. Figures illustrate gray matter differences with lithium use and the bipolar spectrum. Tables list the pharmacokinetics of commonly used antidepressants and medications commonly used in the treatment of bipolar disorder. This review contains 2 figures, 2 tables, and 136 references.

scholarly journals Thought and language disturbance in bipolar disorder quantified via process-oriented verbal fluency measures

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Luisa Weiner ◽  
Nadège Doignon-Camus ◽  
Gilles Bertschy ◽  
Anne Giersch
Keyword(s):  
Bipolar Disorder ◽  
Verbal Fluency ◽  
Clinical Symptoms ◽  
Three Dimensional ◽  
Semantic Retrieval ◽  
Mixed States ◽  
Manic Symptoms ◽  
History Of ◽  
Process Oriented ◽  
Error Count

Abstract Bipolar disorder (BD) is characterized by speech abnormalities, reflected by symptoms such as pressure of speech in mania and poverty of speech in depression. Here we aimed at investigating speech abnormalities in different episodes of BD, including mixed episodes, via process-oriented measures of verbal fluency performance – i.e., word and error count, semantic and phonological clustering measures, and number of switches–, and their relation to neurocognitive mechanisms and clinical symptoms. 93 patients with BD – i.e., 25 manic, 12 mixed manic, 19 mixed depression, 17 depressed, and 20 euthymic–and 31 healthy controls were administered three verbal fluency tasks – free, letter, semantic–and a clinical and neuropsychological assessment. Compared to depression and euthymia, switching and clustering abnormalities were found in manic and mixed states, mimicking symptoms like flight of ideas. Moreover, the neuropsychological results, as well as the fact that error count did not increase whereas phonological associations did, showed that impaired inhibition abilities and distractibility could not account for the results in patients with manic symptoms. Rather, semantic overactivation in patients with manic symptoms, including mixed depression, may compensate for trait-like deficient semantic retrieval/access found in euthymia. “For those who are manic, or those who have a history of mania, words move about in all directions possible, in a three-dimensional ‘soup’, making retrieval more fluid, less predictable.” Kay Redfield Jamison (2017, p. 279).

scholarly journals ‘Bipolarity’ in bipolar disorder: Distribution of manic and depressive symptoms in a treated population

2005 ◽  
Vol 187 (1) ◽  
pp. 87-88 ◽  
Author(s):  
Mark S. Bauer ◽  
Gregory E. Simon ◽  
Evette Ludman ◽  
Jurgen Unützer
Keyword(s):  
Bipolar Disorder ◽  
Depressive Symptoms ◽  
Health Maintenance Organisation ◽  
Cross Sectional ◽  
Health Maintenance ◽  
Manic Symptoms ◽  
Clinically Significant ◽  
Sectional Analysis ◽  
Depressive And Manic Symptoms

SummaryCross-sectional analysis of 441 individuals with bipolar disorder treated at a US health maintenance organisation investigated the distribution of manic and depressive symptoms in that illness. Clinically significant depressive symptoms occurred in 94.1% of those with (hypo)mania, while70.1% inadepressive episode had clinically significant manic symptoms. DSM-unrecognised depression-plus-hypomania was over twice as prevalent as DSM-recognised mixed episodes. Depressive symptoms were unimodally distributed in (hypo)mania. Depressive and manic symptoms were positively, not inversely correlated, and their co-occurrence was associated with worse quality of life. Implications for the DSM and ICD nosological systems are discussed.

scholarly journals Meta-analysis of Theory of Mind (ToM) impairment in bipolar disorder

2015 ◽  
Vol 46 (2) ◽  
pp. 253-264 ◽  
Author(s):  
E. Bora ◽  
C. Bartholomeusz ◽  
C. Pantelis
Keyword(s):  
Bipolar Disorder ◽  
Theory Of Mind ◽  
Mood State ◽  
Meta Analysis ◽  
Interpersonal Problems ◽  
Developmental Trajectory ◽  
Healthy Controls ◽  
Manic Symptoms ◽  
Different Types ◽  
The Relationship

BackgroundTheory of mind (ToM) dysfunction is prominent in a number of psychiatric disorders, in particular, autism and schizophrenia, and can play a significant role in poor functioning. There is now emerging evidence suggesting that ToM abilities are also impaired in bipolar disorder (BP); however, the relationship between ToM deficits and mood state is not clear.MethodWe conducted a meta-analysis of ToM studies in BP. Thirty-four studies comparing 1214 patients with BP and 1097 healthy controls were included. BP groups included remitted (18 samples, 545 BP patients), subsyndromal (12 samples, 510 BP patients), and acute (manic and/or depressed) (10 samples, 159 BP patients) patients.ResultsToM performance was significantly impaired in BP compared to controls. This impairment was evident across different types of ToM tasks (including affective/cognitive and verbal/visual) and was also evident in strictly euthymic patients with BP (d = 0.50). There were no significant differences between remitted and subsyndromal samples. However, ToM deficit was significantly more severe during acute episodes (d = 1.23). ToM impairment was significantly associated with neurocognitive and particularly with manic symptoms.ConclusionSignificant but modest sized ToM dysfunction is evident in remitted and subsyndromal BP. Acute episodes are associated with more robust ToM deficits. Exacerbation of ToM deficits may contribute to the more significant interpersonal problems observed in patients with acute or subsyndromal manic symptoms. There is a need for longitudinal studies comparing the developmental trajectory of ToM deficits across the course of the illness.

Association between flupenthixol treatment and emergence of manic symptoms

2002 ◽  
Vol 17 (6) ◽  
pp. 349-352 ◽  
Author(s):  
D. Becker ◽  
Y. Grinberg ◽  
A. Weizman ◽  
R. Mester
Keyword(s):  
Bipolar Disorder ◽  
Antipsychotic Drug ◽  
Manic Symptoms

SummaryBackground.Flupenthixol is an antipsychotic drug with known mood-elevating properties. Its propensity to induce manic symptoms has not been investigated.Methods and results.We describe six patients, four with schizophrenia and two with bipolar disorder, in whom flupenthixol treatment was associated with emergence of manic symptoms.Conclusions.Patients treated with flupenthixol should be carefully monitored for the emergence of manic symptoms.

Association of subthreshold manic symptoms and cognitive impairments in euthymic patients with bipolar disorder I

2019 ◽  
Vol 278 ◽  
pp. 303-308
Author(s):  
Xiaofei Zhang ◽  
Xiongchao Cheng ◽  
Jianshan Chen ◽  
Bin Zhang ◽  
Qiuxia Wu ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Cognitive Impairments ◽  
Manic Symptoms

scholarly journals What is the relationship between post-traumatic stress disorder, extreme appraisals of internal state and symptoms in bipolar disorder?

2019 ◽  
Vol 48 (1) ◽  
pp. 103-115
Author(s):  
Laura Frost ◽  
Warren Mansell ◽  
Filippo Varese ◽  
Sara Tai
Keyword(s):  
Bipolar Disorder ◽  
Depressive Symptoms ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Internal State ◽  
Cognitive Model ◽  
Post Traumatic Stress ◽  
Manic Symptoms ◽  
Co Morbidity ◽  
Post Traumatic

AbstractBackground:It is important to understand the factors associated with more severe mood symptoms in bipolar disorder. The integrative cognitive model of bipolar disorder proposes that extreme appraisals of changes to internal states maintain and exacerbate mood symptoms.Aims:The current study aimed to investigate if post-traumatic stress disorder (PTSD) is related to current depressive and manic bipolar symptoms, and whether this relationship is mediated by appraisals of internal state.Method:Participants with bipolar disorder (n = 82) from a randomized controlled trial of cognitive therapy for bipolar disorder (the TEAMS trial) completed self-reported questionnaires assessing appraisals of internal state, generalized anxiety symptoms, and self-reported and observer-rated depressive and manic symptoms. Clinical interviews assessed PTSD co-morbidity.Results:Participants with bipolar and co-morbid PTSD (n = 27) had higher depressive symptoms and more conflicting appraisals than those without PTSD. Regression analyses found PTSD to be associated with depressive symptoms but not manic symptoms. Conflicting appraisals were found to be associated only with manic symptoms meaning that the planned mediation analysis could not be completed.Conclusions:Findings provide partial support for the integrative cognitive model of bipolar disorder and highlight the need for transdiagnostic treatments in bipolar disorder due to the prevalence and impact of trauma and co-morbidity. Working on trauma experiences in therapy may impact on depressive symptoms for those with bipolar disorder and co-morbid PTSD.

scholarly journals 98 Dronabinol-Induced Hypomania: A Case Report and Literature Review

CNS Spectrums ◽  
2019 ◽  
Vol 24 (1) ◽  
pp. 223-224 ◽  
Author(s):  
Shirshendu Sinha ◽  
Audrey Umbreit ◽  
Charles Sieberg
Keyword(s):  
Bipolar Disorder ◽  
Sleep Disturbances ◽  
Illicit Drugs ◽  
Underlying Mechanism ◽  
Dopamine Synthesis ◽  
Manic Symptoms ◽  
Wasting Syndrome ◽  
Need To Evaluate ◽  
Other Substances ◽  
Synthetic Derivative

AbstractPurposePresent a case of dronabinol-induced hypomania.BackgroundDronabinol is a synthetic derivative of cannabis that is commonly prescribed for chemotherapy-induced nausea and vomiting or cachexia due to HIV/AIDS. The safety in those with bipolar disorder warrants further investigation as previous studies suggest that the use of cannabis may be associated with exacerbation of manic symptoms. The risk of developing manic symptoms in patients with bipolar disorder who use dronabinol is largely unknown. Clinical Case: A 55-year-old Caucasian male, following with psychiatry since July of 2016 for substance use disorder (alcohol, cocaine and cannabis), bipolar I disorder, generalized anxiety, PTSD, and intermittent sleep disturbances, was prescribed dronabinol 2.5mg twice daily on 5/19/17 to treat wasting syndrome and significant weight loss due to underlying HIV. He has been abstinent from alcohol, tobacco, and illicit substances for more than a year. The patient’s relevant medication list includes: bupropion XL 150mg daily, quetiapine 300mg daily at bedtime, and trazodone 50–100mg at bedtime. At psychiatrist visit on 7/10/17, his bipolar disorder was noted to be stable. But, after his dose of dronabinol was increased on 7/21/17 to 5mg twice daily, the patient presented to psychiatrist on 8/1/2017 in a state of hypomania, with symptoms including: increased interest in sex, insomnia and increased animation. His judgment and impulse control were slightly impaired. Excluding the dronabinol dose increase, no other medication changes had taken place and the patient was not using alcohol or other substances. Quetiapine was discontinued and olanzapine 10mg at bedtime was started. Bupropion was discontinued, trazodone was tapered off, and dronabinol was discontinued. Upon follow up within a month, our patient’s hypomania symptoms resolved. He was also gaining weight with the olanzapine and reported improved sleep. He was continued on olanzapine 10mg at bedtime and continued off the trazodone, bupropion and dronabinol. He continues to remain abstinent from alcohol and illicit drugs.DiscussionThe underlying mechanism of dronabinol-induced manic symptoms in those with bipolar disorder remains unclear but may involve dopamine. Sensitization of the dopaminergic system by THC is thought to be associated with the development of manic symptoms in those that use cannabis. THC is associated with increased dopaminergic cell firing, dopamine synthesis, and dopamine release when used acutely.Other medications associated with causing manic symptoms include bupropion and trazodone, as relevant to our case. However, our patient was stable on these medications before the addition of dronabinol. Thus, it is reasonable to conclude that the dronabinol likely caused our patient’s hypomania symptoms.ConclusionThis case emphasizes the need to evaluate mental health conditions before prescribing cannabis derivatives such as dronabinol.

Prediction of transition from common adolescent bipolar experiences to bipolar disorder: 10-year study

2010 ◽  
Vol 196 (2) ◽  
pp. 102-108 ◽  
Author(s):  
Marijn J. A. Tijssen ◽  
Jim van Os ◽  
Hans-Ulrich Wittchen ◽  
Roselind Lieb ◽  
Katja Beesdo ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Cohort Study ◽  
Clinical Outcomes ◽  
Mental Healthcare ◽  
Dependent Manner ◽  
Manic Symptoms ◽  
The Poor ◽  
Affective Symptoms ◽  
Dsm Iv ◽  
Dose Dependent

BackgroundAlthough (hypo)manic symptoms are common in adolescence, transition to adult bipolar disorder is infrequent.AimsTo examine whether the risk of transition to bipolar disorder is conditional on the extent of persistence of subthreshold affective phenotypes.MethodIn a 10-year prospective community cohort study of 3021 adolescents and young adults, the association between persistence of affective symptoms over 3 years and the 10-year clinical outcomes of incident DSM–IV (hypo)manic episodes and incident use of mental healthcare was assessed.ResultsTransition to clinical outcome was associated with persistence of symptoms in a dose-dependent manner. Around 30–40% of clinical outcomes could be traced to prior persistence of affective symptoms.ConclusionsIn a substantial proportion of individuals, onset of clinical bipolar disorder may be seen as the poor outcome of a developmentally common and usually transitory non-clinical bipolar phenotype.

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