Neurodevelopmental antecedents of early-onset bipolar affective disorder

1999 ◽  
Vol 174 (2) ◽  
pp. 121-127 ◽  
Author(s):  
Engilbert Sigurdsson ◽  
Eric Fombonne ◽  
Kapil Sayal ◽  
Stuart Checkley
Keyword(s):  
Affective Disorder ◽  
Motor Development ◽  
Early Onset ◽  
Bipolar Affective Disorder ◽  
Manic Episode ◽  
Unipolar Depression ◽  
Psychotic Symptoms ◽  
Affective Symptoms ◽  
Icd 10 ◽  
Psychotic Features

BackgroundDevelopmental impairments have been identified as a risk factor for early-onset schizophrenia. Affective symptoms are more common in children and adolescents with disordered neurodevelopment than in healthy controls.AimsTo test the hypothesis that severe early-onset mood disorders are associated with developmental antecedents.MethodWe retrospectively identified 38 adolescent cases (15 female, 23 male; mean age 14.4 years, range 11–18) who met ICD–10 Research Diagnostic Criteria for a manic episode, bipolar affective disorder or psychotic depression, and 41 controls (25 female, 16 male, mean age 14.2 years, range 11–18) with depression but without psychotic features.ResultsCases were significantly more likely to have experienced delayed language, social or motor development (OR 5.5, 95% CI=1.4–21.6, P=0.01). in particular those who develop psychotic symptoms (OR 7.2, 95% CI=1.8–28.6, P=0.003).ConclusionsCompared to early-onset unipolar depression, neurodevelopmental antecedents are over-represented in early-onset bipolar disorder. The validity of this finding was supported by contemporaneous IQ scores that are not subject to the same potential biases as case-note ratings.

Electroconvulsive Therapy and Depression with Psychotic Symptoms: a Case Report

2011 ◽  
Vol 26 (S2) ◽  
pp. 1136-1136
Author(s):  
A. Castillo ◽  
M. Lloret ◽  
M. Harto ◽  
A. Tatay ◽  
C. Almonacid ◽  
...  
Keyword(s):  
Major Depression ◽  
Electroconvulsive Therapy ◽  
Bipolar Affective Disorder ◽  
Manic Episode ◽  
Antipsychotic Agents ◽  
Pharmacological Therapy ◽  
Psychotic Symptoms ◽  
Antipsychotic Treatment ◽  
Psychotic Features ◽  
Depressive Episodes

IntroductionPsychotic symptoms in depression are indicators of severity and poor prognosis. It usually requires psychopharmacotherapy with antidepressants and antipsychotic agents and it may even require electroconvulsive therapy (ECT).Aims, methodologyTo review the indications of ECT in major depression through the study of a clinical case of a patient admitted in an indoor psychiatric unit.ResultsA 64-year-old woman diagnosed as bipolar affective disorder 20 years ago. Her first manic episode required hospitalization. Afterwards, she remained clinically stable for 18 years with pharmacotherapy with lithium. Lately she was admitted due to a major depressive episode with psychotic features (injury delusions, ruin and catastrophe). Antidepressant and antipsychotic treatment was added, improving her symptoms. However, she had to be readmitted two months later with severe psychotic symptoms that did not improve with pharmacological treatment. ECT was added to her treatment. She improved after a few sessions. During the last years, she has presented depressive episodes with psychotic symptoms at least once a year, and all of them have required ECT.ConclusionsECT is an alternative to pharmacological therapy in depression with psychotic symptoms in patients with no response to drugs. According to studies and clinical practice, ETC has been effective as we see in this case. Therefore, ECT is a technique to consider in major depression, not only in patients who do not respond to drug therapy but also in those who do not tolerate psychopharmacological, who suffer from severe or psychotic symptoms, suicide thoughts or those, psychomotor agitation or stupor.

Mania with Bupropion: A Dose-Related Phenomenon?

2000 ◽  
Vol 34 (5) ◽  
pp. 619-621 ◽  
Author(s):  
Jessica L Goren ◽  
Gary M Levin
Keyword(s):  
Affective Disorder ◽  
Bipolar Depression ◽  
Bipolar Affective Disorder ◽  
Antidepressant Drug ◽  
Manic Episode ◽  
Total Daily Dose ◽  
High Dose ◽  
Related Phenomenon ◽  
Increased Risk ◽  
Daily Dose

OBJECTIVE: To report a case in which bipolar depression was resistant to usual therapies, requiring dosages of bupropion >450 mg/d and to review the literature on mania associated with bupropion and propose a potential theory of a dose-related threshold associated with bupropion and mania. CASE SUMMARY: A 44-year-old white man with a 25-year history of bipolar affective disorder presented with depression resistant to usual therapies. Bupropion therapy was initiated and the dosage was titrated to 600 mg/d. After exceeding the maximum recommended daily dose (450 mg/d), he experienced a manic episode attrib uted to high-dose bupropion. DISCUSSION: Due to increased risk of seizures, current prescribing guidelines state that the total daily dose of bupropion is not to exceed 450 mg/d. Since bupropion is the agent least likely to cause a manic switch in bipolar disorder, this agent seemed a logical choice to treat the patient's depression. Due to a lack of response, the bupropion dosage was titrated to a maximum of 600 mg/d. Since the patient did not switch into mania until the dosage exceeded 450 mg/d, we speculate that this adverse reaction is a dose-related phenomenon. Scientific literature supports this theory. CONCLUSIONS: A switch into mania is a potential risk associated with antidepressant drug use in bipolar affective disorder. Bupropion is believed to be associated with a decreased risk compared with other antidepressant therapies. However, our case report as well as others support the theory that this decreased risk may be due to dosages not exceeding the recommended daily dose (450 mg/d). Doses of bupropion >450 mg/d should be used with caution in depressed patients with bipolar affective disorder.

Lithium use in a patient on haemodialysis with bipolar affective disorder and lithium-induced nephropathy

2021 ◽  
Vol 14 (7) ◽  
pp. e242841
Author(s):  
Sam Topp ◽  
Emma Salisbury
Keyword(s):  
Affective Disorder ◽  
Bipolar Affective Disorder ◽  
Manic Episode ◽  
Dose Titration ◽  
Dialysis Session ◽  
Treatment Resistant ◽  
History Of ◽  
End Stage ◽  
Level Monitoring

Lithium is an effective mood stabiliser used to treat bipolar affective disorder (BPAD); however, it can also adversely affect the kidneys, causing acute toxic effects, nephrogenic diabetes insipidus, chronic renal dysfunction and end-stage kidney disease (ESKD) in a minority of patients. We describe the case of a man with a 34-year history of BPAD type-1 and a 2-year history of ESKD secondary to lithium-induced nephropathy who experienced a manic relapse. He previously responded well to lithium but, following a deterioration in kidney function, was switched to olanzapine and sodium valproate. This precipitated a period of instability, which culminated in a treatment-resistant manic episode requiring hospital admission. After a multidisciplinary team discussion, lithium therapy was restarted and provided remission. This was achieved safely through a reduced dosing schedule of three times a week post dialysis, slow dose titration and blood level monitoring prior to each dialysis session.

scholarly journals Neurocysticercosis presenting as bipolar disorder: a case report

2021 ◽  
Vol 34 (6) ◽  
pp. e100663
Author(s):  
Surbhi Batra ◽  
Sumit Kumar ◽  
Lokesh Singh Shekhawat
Keyword(s):  
Bipolar Disorder ◽  
Case Report ◽  
Depressive Symptoms ◽  
Affective Disorder ◽  
Postpartum Period ◽  
Bipolar Affective Disorder ◽  
Taenia Solium ◽  
Manic Episode ◽  
Symptoms And Signs ◽  
Rule Out

Neurocysticercosis is the most common neuro-parasitosis caused by the larval stage of Taenia solium. The most common manifestations include seizures and hydrocephalus. Psychiatric abnormalities are relatively rare but depressive symptoms are frequent in patients with neurocysticercosis. However, mania as a presentation is relatively rare. Pregnancy and the postpartum period are relatively vulnerable times and they can lead to reactivation of existing neurocysterci lesions. We are discussing the case of a 23-year-old female patient with neurocysticercosis leading to the reactivation of lesions in the peripartum and postpartum period leading to bipolar affective disorder. Improvement in the patient was seen with a combination of antipsychotics, antihelmintics, antiepileptics and steroids, along with improved radiological signs of neurocysterci lesions. Although neurocysticercosis is a common illness, its prevalence presenting as a manic episode is merely 2.6% and, hence, missed easily. Therefore, it is important to rule out organic aetiology in patients even with a classic presentation of bipolar affective disorder and those having any other neurological symptoms and signs.

Bipolar illness

2013 ◽  
pp. 301-350
Keyword(s):  
Affective Disorder ◽  
Historical Perspective ◽  
Bipolar Affective Disorder ◽  
Manic Episode ◽  
Spectrum Disorder ◽  
Bipolar Illness ◽  
Clinical Notes ◽  
Bipolar Spectrum Disorder ◽  
Hypomanic Episode ◽  
Depressive Episodes

Introduction Historical perspective Mania/manic episode Hypomania/hypomanic episode Bipolar spectrum disorder Bipolar (affective) disorder 1: classification Bipolar (affective) disorder 2: clinical notes Bipolar (affective) disorder 3: aetiology Bipolar (affective) disorder 4: management principles Other issues affecting management decisions Treatment of acute manic episodes Treatment of depressive episodes...

scholarly journals Cigarette smoking and psychotic symptoms in bipolar affective disorder

2001 ◽  
Vol 179 (1) ◽  
pp. 35-38 ◽  
Author(s):  
Aiden Corvin ◽  
Ed O'Mahony ◽  
Myra O'Regan ◽  
Claire Comerford ◽  
Robert O'Connell ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Affective Disorder ◽  
Bipolar Affective Disorder ◽  
Psychotic Symptoms ◽  
Heavy Smoking ◽  
Ordinal Logistic Regression Analysis ◽  
History Of ◽  
Categorical Diagnosis ◽  
The Relationship

BackgroundAn association exists between smoking and schizophrenia, independent of other factors and related to psychotic symptomatology.AimsTo determine whether smoking is associated with psychosis in bipolar affective disorder.MethodSmoking data were collected from 92 unrelated patients with bipolar affective disorder. An ordinal logistic regression analysis tested the relationship between smoking severity and psychotic symptomatology, allowing for potential confounders.ResultsA significant relationship was detected between smoking/heavy smoking and history of psychosis (68.7%, n=44). Smoking was less prevalent in patients who were less symptomatic (56.5%, n=13) than in patients with a more severe psychosis (75.7%, n=31). Prevalence and severity of smoking predicted severity of psychotic symptoms (P=0.001), a relationship independent of other variables (P=0.0272).ConclusionA link between smoking and psychosis exists in bipolar affective disorder and may be independent of categorical diagnosis.

Risk of bipolar disorder and psychotic features in patients initially hospitalised with severe depression

2014 ◽  
Vol 27 (2) ◽  
pp. 113-118 ◽  
Author(s):  
Kimiya Nakamura ◽  
Junichi Iga ◽  
Naoki Matsumoto ◽  
Tetsuro Ohmori
Keyword(s):  
Bipolar Disorder ◽  
Severe Depression ◽  
Psychotic Symptoms ◽  
Primary Disorder ◽  
Icd 10 ◽  
History Of ◽  
Physical Diseases ◽  
The Stability ◽  
Psychotic Features ◽  
Depressive Episodes

ObjectiveSevere depression may be a risk factor for diagnostic conversion into bipolar disorder (BD), and psychotic depression (PD) has been consistently associated with BD. The aims of the present study were to investigate the stability of the diagnosis of severe depression and the differences between PD and non-psychotic severe depression (non-PD), as well as to assess the effectiveness of electroconvulsive therapy (ECT).MethodsPatients who were hospitalised for severe depression (diagnosed according to ICD-10) both with and without psychotic symptoms (n=89; mean age=55.6 years, SD=13.9) from 2001 to 2010 were retrospectively assessed.ResultsBy the 75th month of follow-up assessments, 11(12.4%) patients had developed BD. Among these 11 converters, nine had developed BD within 1 year after admission. Only sub-threshold hypomanic symptoms were significantly related to developing BD. The number of depressive episodes and history of physical diseases were significantly increased in non-PD compared with PD patients, whereas ECT was significantly increased in PD compared with non-PD patients. There was a significant association between length of stay at the hospital and the number of days between admission and ECT.ConclusionSub-threshold hypomanic symptoms may represent a prodrome of BD or an indicator of an already manifest phenotype, especially in older patients, which suggests cautious use of antidepressants. In severe depression, non-PD may often occur secondary to physical diseases and patients may experience increased recurrences compared with PD patients, which may be a more ‘primary’ disorder and often requires ECT treatments. ECT is effective for severe depression regardless of the presence of any psychotic feature; the earlier ECT is introduced, the better the expected treatment outcome.

Misdiagnosis of Bipolar Affective Disorder as Personality Disorder

1993 ◽  
Vol 38 (9) ◽  
pp. 587-589 ◽  
Author(s):  
Stephen P. Tyrer ◽  
Andrew D. Brittlebank
Keyword(s):  
Personality Disorder ◽  
Affective Disorder ◽  
Interpersonal Relationships ◽  
Bipolar Affective Disorder ◽  
Behavioural Disturbance ◽  
The Past ◽  
Affective Symptoms ◽  
Personality Disturbance

Patients with longstanding recurrent behavioural disturbance, unstable interpersonal relationships and periodic affective symptoms are often diagnosed as having a cluster B personality disturbance using DSM-III-R criteria. Two women are described who were diagnosed as having a personality disorder on several admissions to hospital, but in whom closer inquiry revealed evidence of bipolar affective disorder. Since treatment with lithium and adjunctive mood-stabilizing drugs neither patient has required further admissions to hospital within the past five years.

scholarly journals Mental imagery in bipolar affective disorder versus unipolar depression: Investigating cognitions at times of ‘positive’ mood

2014 ◽  
Vol 166 ◽  
pp. 234-242 ◽  
Author(s):  
Annabel Ivins ◽  
Martina Di Simplicio ◽  
Helen Close ◽  
Guy M. Goodwin ◽  
Emily Holmes
Keyword(s):  
Affective Disorder ◽  
Mental Imagery ◽  
Bipolar Affective Disorder ◽  
Unipolar Depression ◽  
Positive Mood
Sign in / Sign up

Export Citation Format

Share Document