scholarly journals Dysfunctional cognition in individuals with an increased risk for mania

2021 ◽  
Vol 3 (1) ◽  
Author(s):  
Raphaela Ulrich ◽  
Thomas D. Meyer ◽  
Sylke Andreas ◽  
Claudia Lex
Keyword(s):  
At Risk ◽  
Bipolar Disorder ◽  
Cognitive Style ◽  
Online Survey ◽  
Internal State ◽  
Attitude Scale ◽  
Hierarchical Regression ◽  
Increased Risk ◽  
Hypomanic Personality Scale ◽  
The University

Background There is still a lack of knowledge about attitudes and cognitions that are related to bipolar disorder. Theoretically, it was proposed that exaggerated beliefs about the self, relationships, the need for excitement, and goal-related activities might lead to mania in vulnerable individuals, however, the few studies that examined this hypothesis provided mixed results. One of the unresolved issues is if such a cognitive style is associated with current mood symptoms or with different stages of the illness, i.e. at-risk versus diagnosed bipolar disorder. Therefore, the present study aimed at evaluating depression and mania-related cognitive style in individuals at-risk for mania. Method In an online survey, we collected data of 255 students of the University of Klagenfurt, Austria. All participants completed the Hypomanic Personality Scale (HPS), the Cognition Checklist for Mania – Revised (CCL-M-R), the Dysfunctional Attitude Scale (DAS), the Beck Depression Inventory (BDI), and the Internal State Scale (ISS). Results In a hierarchical regression, HPS was positively related to scores of all subscales of the CCL-M-R. The HPS did not significantly predict scores of the DAS. Current manic and depressive symptoms significantly contributed to the models. Conclusion The present results suggest that a trait-like risk for mania is associated with mania-related but not depression-related cognitions.

scholarly journals Deficits in explicit emotion regulation in bipolar disorder: a systematic review

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Marcel Kurtz ◽  
Pia Mohring ◽  
Katharina Förster ◽  
Michael Bauer ◽  
Philipp Kanske
Keyword(s):  
At Risk ◽  
Bipolar Disorder ◽  
Emotion Regulation ◽  
Mood State ◽  
Bipolar Disorders ◽  
Protective Measure ◽  
Behavioral Measures ◽  
Increased Risk ◽  
Regulation Strategies ◽  
Depressive Episodes

Abstract Background This study aimed to compile and synthesize studies investigating explicit emotion regulation in patients with bipolar disorder and individuals at risk of developing bipolar disorder. The importance of explicit emotion regulation arises from its potential role as a marker for bipolar disorders in individuals at risk and its potent role in therapy for bipolar disorder patients. Methods To obtain an exhaustive compilation of studies dealing specifically with explicit emotion regulation in bipolar disorder, we conducted a systematic literature search in four databases. In the 15 studies we included in our review, the emotion-regulation strategies maintenance, distraction, and reappraisal (self-focused and situation-focused) were investigated partly on a purely behavioral level and partly in conjunction with neural measures. The samples used in the identified studies included individuals at increased risk of bipolar disorder, patients with current affective episodes, and patients with euthymic mood state. Results In summary, the reviewed studies' results indicate impairments in explicit emotion regulation in individuals at risk for bipolar disorder, patients with manic and depressive episodes, and euthymic patients. These deficits manifest in subjective behavioral measures as well as in neural aberrations. Further, our review reveals a discrepancy between behavioral and neural findings regarding explicit emotion regulation in individuals at risk for bipolar disorders and euthymic patients. While these groups often do not differ significantly in behavioral measures from healthy and low-risk individuals, neural differences are mainly found in frontostriatal networks. Conclusion We conclude that these neural aberrations are a potentially sensitive measure of the probability of occurrence and recurrence of symptoms of bipolar disorders and that strengthening this frontostriatal route is a potentially protective measure for individuals at risk and patients who have bipolar disorders.

scholarly journals Progressive cortical thinning might identify children at risk of developing psychotic spectrum symptoms

2021 ◽  
Keyword(s):  
At Risk ◽  
Bipolar Disorder ◽  
Brain Structure ◽  
Familial Risk ◽  
Low Risk ◽  
Children At Risk ◽  
Long Term Outcomes ◽  
Cortical Thinning ◽  
Increased Risk

Offspring of patients with schizophrenia or bipolar disorder have an increased risk of developing these conditions. However, our capacity to predict the long-term outcomes of these at-risk individuals is limited. Now, researchers have investigated whether longitudinal changes in brain structure differ in individuals at high familial risk who develop psychotic spectrum symptoms, compared to those who do not and to low-risk controls.

Improving cancer pain control: Potential impact of CYP2D6 pharmacogenomic (PGx) testing in oncology (Onc) patients.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 12089-12089
Author(s):  
Natalie Reizine ◽  
Keith Danahey ◽  
Emily Schierer ◽  
Tien Truong ◽  
Mark J. Ratain ◽  
...  
Keyword(s):  
At Risk ◽  
Pain Control ◽  
Opioid Analgesics ◽  
P Value ◽  
Cyp2d6 Genotype ◽  
Oncology Patients ◽  
Increased Risk ◽  
Oncology Care ◽  
The University ◽  
Post Hoc

12089 Background: Several opioid analgesics have well-known germline PGx associations which may predict either inefficacy or exaggerated (toxic) responses, depending on the patient’s genotype. Despite this, germline PGx testing has not been routinely incorporated into oncology care. We hypothesized that CYP2D6 germline PGx profiling offers the potential to improve oncology patients’ pain control by identifying individuals at increased risk for inadequate analgesia with standard opioid dosing. Methods: We retrospectively analyzed the medication histories of over 81,000 adult oncology patients treated at the University of Chicago from 2012-2018 for exposure to opioids. CYP2D6 genotype (permitting assignment of metabolizer phenotype: normal metabolizer [NM], intermediate metabolizer [IM], or poor metabolizer [PM]) was determined post-hoc for 127 patients who were genotyped for other reasons unrelated to pain prescribing. The primary endpoint was the number of opioids required for pain control over the course of longitudinal care, comparing PM/IMs with NMs. The secondary endpoint was the number of hospitalizations for pain control. Results: Over 47,000 oncology patients were exposed to opioids, with an average of 2.67±1.6 different opioid medication exposures per patient. Thirteen percent of genotyped patients were IM/PM, who were at risk for inadequate analgesia. IM/PM patients demonstrated an increased number of different opioid exposures (4.5±2.1) compared to NM (2.7±2.1, P value = 0.002). IM/PM patients were also more likely to have a pain related hospitalization (OR 4.17, CI 1.3-13.2, P = 0.016). Conclusions: Based on population prevalence, we estimate that > 6000 oncology patients (1000 patients/year) who received opioids at our center were IM/PM and thus at risk for inadequate analgesia due to genetic predisposition. CYP2D6 germline PGx profiling offers the potential to improve oncology patients’ pain management.

scholarly journals Clinical presentation and need for treatment of a cohort of subjects accessing to a mental illness prevention service

2020 ◽  
Vol 23 (1) ◽  
Author(s):  
Marco Solmi ◽  
Mara Campeol ◽  
Federica Gentili ◽  
Angela Favaro ◽  
Carla Cremonese
Keyword(s):  
Mental Health ◽  
At Risk ◽  
Bipolar Disorder ◽  
Mental Illness ◽  
Family History ◽  
Mental State ◽  
Schizotypal Personality ◽  
Increased Risk ◽  
Prevention Service ◽  
At Risk Mental State

Outreaching activities decrease prognostic accuracy of at-risk mental state defining tools, over-attracting subjects who are not at increased risk of mental illness. The setting was a mental illness primary indicated prevention outpatients service embedded within the Psychiatry Unit of Padua University Hospital, Italy. Help-seeking patients accessing the service between January 2018 and December 2018 were evaluated with validated tools assessing functioning, at-risk mental state, schizotypal personality features, depressive and anxious symptoms, together with medical and family history collection. The primary outcome was the prevalence of drop in functioning at presentation according to the Social and Occupational Functioning Assessment Scale (SOFAS). Secondary outcomes were diagnoses according to DSM-5 criteria and meeting criteria for at-risk mental state. Fifty-nine patients accessed the service, mean age was 18.8 (2.12) years old, 54.2% were females. Virtually all subjects (97.7%) had a drop in functioning. Baseline primary diagnoses were depressive episode in 33%, anxiety disorder in 21%, personality disorder in 17%, adjustment disorder 9%, conduct disorder 7%, schizophrenia spectrum disorder 5%, bipolar disorder 5%, eating disorder in 1.7%, dissociative disorder 1.7%. Overall, 59.1% met at-risk mental state criteria. Lower functioning was associated with anxious symptoms (p=0.031), a family history of mental illness (p=0.045) and of suicide (p=0.042), and schizotypal personality traits (p=0.036). Subjects accessing a prevention service embedded within the mental health department already present a trans-diagnostic drop in functioning, mainly due to a non-psychotic mental disorder, with at-risk mental state in one patient out of two, and schizophrenia or bipolar disorder already present in only 10% of subjects. Prevention service within mental health facility setting appears to properly detect subjects in need of treatment with a drop in functioning, at risk of developing severe mental illness, without any outreaching activity in the general population.

scholarly journals Postpartum psychosis in bipolar disorder: no evidence of association with personality traits, cognitive style or affective temperaments

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
A. Perry ◽  
K. Gordon-Smith ◽  
I. Webb ◽  
E. Fone ◽  
A. Di Florio ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Personality Traits ◽  
Cognitive Style ◽  
Cognitive Styles ◽  
Dysfunctional Attitudes ◽  
Postpartum Psychosis ◽  
Affective Temperaments ◽  
Increased Risk ◽  
Affective Temperament ◽  
History Of

Abstract Background Bipolar disorder has been associated with several personality traits, cognitive styles and affective temperaments. Women who have bipolar disorder are at increased risk of experiencing postpartum psychosis, however little research has investigated these traits and temperaments in relation to postpartum psychosis. The aim of this study is to establish whether aspects of personality, cognitive style and affective temperament that have been associated with bipolar disorder also confer vulnerability to postpartum psychosis over and above their known association with bipolar disorder. Methods Personality traits (neuroticism, extraversion, schizotypy and impulsivity), cognitive styles (low self-esteem and dysfunctional attitudes) and affective temperaments (including cyclothymic and depressive temperaments) were compared between two groups of parous women with DSM-IV bipolar I disorder: i) 284 with a lifetime history of postpartum psychosis within 6 weeks of delivery (PP group), ii) 268 without any history of mood episodes with onset during pregnancy or within 6 months of delivery (no perinatal mood episode, No PME group). Results After controlling for current mood state, and key demographic, clinical and pregnancy-related variables, there were no statistically significant differences between the PP and No PME groups on any of the personality, cognitive style or affective temperament measures. Conclusions Personality traits, cognitive styles and affective temperaments previously shown to be associated with bipolar disorder in general were not specifically associated with the occurrence of postpartum psychosis. These factors may not be relevant for predicting risk of postpartum psychosis in women with bipolar disorder.

scholarly journals Individuals at increased risk for development of bipolar disorder display structural alterations similar to people with manifest disease

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Pavol Mikolas ◽  
Kyra Bröckel ◽  
Christoph Vogelbacher ◽  
Dirk K. Müller ◽  
Michael Marxen ◽  
...  
Keyword(s):  
At Risk ◽  
Bipolar Disorder ◽  
High Risk ◽  
Help Seeking ◽  
Large Scale ◽  
Assessment Tool ◽  
Early Recognition ◽  
Structural Alterations ◽  
Populations At Risk ◽  
Increased Risk

AbstractIn psychiatry, there has been a growing focus on identifying at-risk populations. For schizophrenia, these efforts have led to the development of early recognition and intervention measures. Despite a similar disease burden, the populations at risk of bipolar disorder have not been sufficiently characterized. Within the BipoLife consortium, we used magnetic resonance imaging (MRI) data from a multicenter study to assess structural gray matter alterations in N = 263 help-seeking individuals from seven study sites. We defined the risk using the EPIbipolar assessment tool as no-risk, low-risk, and high-risk and used a region-of-interest approach (ROI) based on the results of two large-scale multicenter studies of bipolar disorder by the ENIGMA working group. We detected significant differences in the thickness of the left pars opercularis (Cohen’s d = 0.47, p = 0.024) between groups. The cortex was significantly thinner in high-risk individuals compared to those in the no-risk group (p = 0.011). We detected no differences in the hippocampal volume. Exploratory analyses revealed no significant differences in other cortical or subcortical regions. The thinner cortex in help-seeking individuals at risk of bipolar disorder is in line with previous findings in patients with the established disorder and corresponds to the region of the highest effect size in the ENIGMA study of cortical alterations. Structural alterations in prefrontal cortex might be a trait marker of bipolar risk. This is the largest structural MRI study of help-seeking individuals at increased risk of bipolar disorder.

scholarly journals Use of the Renal Artery Doppler to Identify Small for Gestational Age Fetuses at Risk for Adverse Neonatal Outcomes

2021 ◽  
Vol 10 (9) ◽  
pp. 1835
Author(s):  
Stephen Contag ◽  
Silvia Visentin ◽  
Katherine Goetzinger ◽  
Erich Cosmi
Keyword(s):  
At Risk ◽  
Renal Artery ◽  
Umbilical Artery ◽  
Neonatal Outcome ◽  
Receiver Operating Curve ◽  
Adverse Neonatal Outcome ◽  
Test Characteristics ◽  
Increased Risk ◽  
Umbilical Artery Doppler ◽  
The University

Objective: To measure the sensitivity and positive predictive value (PPV) for an adverse neonatal outcome among growth-restricted fetuses (FGR) comparing the cerebral–placental ratio (CPR) with the cerebral–renal ratio (CRR). Methods: Retrospective analysis of 92 women who underwent prenatal ultrasound at the University of Maryland and the University of Padua. Renal, middle cerebral and umbilical artery Doppler waveforms were recorded for all scans during the third trimester. The last scan prior to delivery was included for analysis. We calculated the test characteristics of the pulsatility indices (PI) of the umbilical and renal arteries in addition to the derived CPR and CRR to detect a composite adverse neonatal outcome. Results: The test characteristics of the four Doppler ratios to detect increased risk for the composite neonatal outcome demonstrated that the umbilical artery pulsatility index had the best test performance (sensitivity 64% (95% CI: 47–82%), PPV 24% (95% CI: 21–27), and positive likelihood ratio 2.7 (95% CI: 1.4–5.2)). There was no benefit to using the CRR compared with the CPR. The agreement between tests was moderate to poor (Kappa value CPR compared with CRR: 0.5 (95%CI 0.4–0.70), renal artery PI:−0.1 (95% CI −0.2–0.0), umbilical artery PI: 0.5 (95% CI 0.4–0.7)). Only the umbilical artery had an area under the receiver operating curve that was significantly better compared with the CPR as a reference (p-value < 0.01). Conclusions: The data that we present do not support the use of renal artery Doppler as a useful clinical test to identify a fetus at risk for an adverse neonatal outcome. Within the various indices applied to this population, umbilical artery Doppler performed the best in identifying the fetuses at risk for an adverse perinatal outcome.

scholarly journals Correlates of a University Counseling Center’s Perceived Service Promptness

2017 ◽  
Vol 7 (2) ◽  
pp. 24
Author(s):  
Gary Blau ◽  
Peter A DeMaria, Jr ◽  
John DiMino
Keyword(s):  
Undergraduate Students ◽  
Online Survey ◽  
Wait Time ◽  
Hierarchical Regression ◽  
Future Research ◽  
Counseling Services ◽  
University Counseling ◽  
Research Issues ◽  
Confirmatory Factor ◽  
The University

The overall goal of this study was to explore the usefulness of a Perceived Service Promptness (PSP) measure for University Counseling Centers (UCCs). As UCCs compete for university resources, helping a client as quickly as possible or PSP can help to support a UCC’s documented ability to meet increasing client demands. Since no prior empirical research was found measuring PSP at a UCC, a four-item measure, adapted from a more general quality of service scale, was used. From August 2014 to May 2016, one hundred and seventeen non-urgent undergraduate students seeking counseling services filled out an online survey measuring demographics, client perceptions, wait measures, PSP and recommending the university. Confirmatory factor analysis and scale reliability data psychometrically supported the PSP scale. Correlational analyses showed that both wait time and wait bother experience were each significantly negatively related to PSP. However, hierarchical regression analyses showed that wait bother experience, but not wait time, significantly explained PSP beyond prior controlled-for demographic and client perception variables. In addition, PSP positively explained recommending the university beyond demographic, client perception and wait measures. Research limitations and future research issues are discussed.

scholarly journals The role of family and personal psychiatric history in postconcussion syndrome following sport-related concussion: a story of compounding risk

2018 ◽  
Vol 22 (3) ◽  
pp. 238-243 ◽  
Author(s):  
Andrew D. Legarreta ◽  
Benjamin L. Brett ◽  
Gary S. Solomon ◽  
Scott L. Zuckerman
Keyword(s):  
High School ◽  
At Risk ◽  
Bipolar Disorder ◽  
Psychiatric History ◽  
Regression Analyses ◽  
High School Athletes ◽  
Postconcussion Syndrome ◽  
Increased Risk ◽  
Bivariate Regression

OBJECTIVESport-related concussion (SRC) has become a major public health concern. Prolonged recovery after SRC, named postconcussion syndrome (PCS), has been associated with several biopsychosocial factors, yet the role of both family and personal psychiatric histories requires investigation. In a cohort of concussed high school athletes, the authors examined the role(s) of family and personal psychiatric histories in the risk of developing PCS.METHODSA retrospective cohort study of 154 high school athletes with complete documentation of postconcussion symptom resolution or persistence at 6 weeks was conducted. PCS was defined as 3 or more symptoms present 6 weeks after SRC. Three groups were defined: 1) positive family psychiatric history and personal psychiatric history (FPH/PPH), 2) positive FPH only, and 3) negative family and personal psychiatric histories (controls). Three bivariate regression analyses were conducted: FPH/PPH to controls, FPH only to controls, and FPH/PPH to FPH. Post hoc bivariate regression analyses examined specific FPH pathologies and PCS.RESULTSAthletes with FPH/PPH compared with controls had an increased risk of PCS (χ2 = 8.90, p = 0.018; OR 5.06, 95% CI 1.71–14.99). Athletes with FPH only compared with controls also had an increased risk of PCS (χ2 = 6.04, p = 0.03; OR 2.52, 95% CI 1.20–5.30). Comparing athletes with FPH/PPH to athletes with FPH only, no added PCS risk was noted (χ2 = 1.64, p = 0.247; OR 2.01, 95% CI 0.68–5.94). Among various FPH diagnoses, anxiety (χ2 = 7.48, p = 0.021; OR 2.99, 95% CI 1.36–6.49) and bipolar disorder (χ2 = 5.13, p = 0.036; OR 2.74, 95% CI 1.14–6.67) were significantly associated with the presence of PCS.CONCLUSIONSConcussed high school athletes with FPH/PPH were greater than 5 times more likely to develop PCS than controls. Athletes with only FPH were over 2.5 times more likely to develop PCS than controls. Those with an FPH of anxiety or bipolar disorder are specifically at increased risk of PCS. These results suggest that not only are athletes with FPH/PPH at risk for slower recovery after SRC, but those with an FPH only—especially anxiety or bipolar disorder—may also be at risk. Overall, this study supports taking a detailed FPH and PPH in the management of SRC.

scholarly journals Looking on the bright side and seeing it vividly: interpretation bias and involuntary mental imagery are related to risk for bipolar disorder

2019 ◽  
Vol 48 (2) ◽  
pp. 203-215
Author(s):  
Andrew D. Peckham ◽  
Kiana Modavi ◽  
Sheri L. Johnson
Keyword(s):  
At Risk ◽  
Bipolar Disorder ◽  
Mental Imagery ◽  
Interpretation Bias ◽  
Ambiguous Information ◽  
Bright Side ◽  
Measures Of Risk ◽  
Hypomanic Personality Scale ◽  
Intrusive Imagery ◽  
Over Time

AbstractBackground:Involuntary mental imagery is elevated among people with bipolar disorder, and has been shown to shape biases in interpretation of ambiguous information. However, it is not clear whether biases in interpretation of ambiguous scenarios can be observed in those at risk for bipolar disorder, or whether involuntary imagery is related to such a bias.Aims:In the present study, we extended a prominent model of bipolar cognition to an at-risk sample. We specifically tested whether positive interpretation bias and involuntary mental imagery are linked to a greater risk of bipolar disorder.Method:Young adults (N = 169) completed measures of risk for bipolar disorder (the Hypomanic Personality Scale [HPS]), interpretation bias, and involuntary mental imagery.Results:Higher scores on the HPS were significantly correlated with more positive interpretations of ambiguous scenarios (β = 0.29, p <. 01) and more frequent involuntary mental imagery (β = 0.22, p < .01). There was no evidence of an interaction between interpretation bias and mental imagery in predicting HPS score, β = .04, p = .62.Conclusions:Further research is warranted to determine if intrusive imagery or interpretation bias influence the development of bipolar disorder over time in those at risk.

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