A follow-up linkage study supports evidence for a bipolar affective disorder locus on chromosome 21q22

BackgroundA few recent linkage studies have shown a possible locus for bipolar disorder on chromosome 18. Cytogenetic studies may assist in the further localisation of susceptibility loci on this chromosome.MethodA search was made for abnormalities of chromosome 18 in two separate large cytogenetic databases. In Denmark detection of mental illness in subjects with chromosome abnormalities was done by cross-linking the two separate register of psychiatric and chromosome disorders. In Scotland the Cytogenetic Registry of the MRC Human Genetics Unit undertakes long-term clinical follow-up of all cases with chromosome abnormalities.ResultsCross-linking the two Danish register's revealed a family with the rare karyotype abnormality inv(18) (p11.3;q21.1) with one inversion carrier who also suffered from bipolar disorder. In this family there were two other cases of bipolar disorder, but the karyotype of these cases could not be established. One family in Scotland showed a case of schizophrenia in a carrier of inv(18) with the same breakpoints as the Danish family.ConclusionsWe suggest further studies of the 18p11.3 and 18q21.1 regions in order to identify genes involved in bipolar affective disorder and schizophrenia.

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Thyrotoxicosis followed by hypothyroidism in a patient on lithium

Mental Illness ◽

10.1108/mi.2014.5415 ◽

2014 ◽

Vol 6 (2) ◽

pp. 38-39 ◽

Cited By ~ 1

Author(s):

Nilamadhab Kar ◽

Surabhi R. Hullumane ◽

Carol Williams

Keyword(s):

Maintenance Therapy ◽

Affective Disorder ◽

Female Patient ◽

Thyroid Dysfunction ◽

Bipolar Affective Disorder ◽

Clinical Impact

While hypothyroidism is common in lithium-treated patients, thyrotoxicosis is rarely reported. We present a female patient on lithium for maintenance therapy of bipolar affective disorder, who developed thyrotoxicosis for few months which was followed by hypothyroidism which continued. There was no further thyrotoxicosis episode during a five year follow up period. While she was treated for thyroid dysfunction, lithium was continued. There was no clinical impact on the maintenance of the bipolar affective disorder during the follow up period; she was maintained well in the community.

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Lithium and recurrence in a long-term follow-up of bipolar affective disorder

Psychological Medicine ◽

10.1017/s0033291796004461 ◽

1997 ◽

Vol 27 (2) ◽

pp. 281-289 ◽

Cited By ~ 29

Author(s):

W. CORYELL ◽

G. WINOKUR ◽

D. SOLOMON ◽

T. SHEA ◽

A. LEON ◽

...

Keyword(s):

Affective Disorder ◽

Bipolar Affective Disorder ◽

Treatment Decisions ◽

First Year ◽

Drug Status ◽

Prophylactic Effect ◽

Long Term Follow Up ◽

Physiological Differences

Background. Though previous studies have clearly shown that lithium affords prophylaxis in bipolar affective disorder, these studies have not demonstrated the persistence of this prophylactic effect beyond the first year of recovery.Methods. One hundred and eighty-one patients with bipolar affective disorder recovered during 5 years of semi-annual follow-up. After 8 weeks of recovery, 139 were taking lithium prophylaxis and 42 were not. Analyses used drug status (lithium v. no-lithium) as a censoring variable to compare these two groups by interval-specific probabilities of recurrence.Results. Recurrence was initially less likely in the lithium group but interval-specific probabilities of recurrence did not consistently favour either group after the first 32 weeks of recovery.Conclusions. Biases in treatment decisions may have both reduced the size and altered the specificity of the lithium effects seen here. Nevertheless, the apparent transience of lithium prophylactic effects is unexplained and may reflect important, physiological differences between relapse and recurrence. This possibility invites a controlled lithium discontinuation study, with gradual taper, of patients who have had at least 8 months of sustained euthymia.

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Recent findings in bipolar affective disorder

Psychological Medicine ◽

10.1017/s0033291704002855 ◽

2004 ◽

Vol 34 (5) ◽

pp. 767-776 ◽

Cited By ~ 3

Author(s):

PAUL BEBBINGTON

Keyword(s):

Bipolar Disorder ◽

Affective Disorder ◽

Psychotic Disorders ◽

Attempted Suicide ◽

Bipolar Affective Disorder ◽

Unipolar Depression ◽

Natural Mortality ◽

Affective Psychosis ◽

Great Excess

Goodwin (2000) famously argued that bipolar disorder was the Cinderella of psychiatry. It certainly should not be: there is no doubt of the anguish caused by the condition, in particular the excess of natural mortality and the great excess of death by suicide (Ösby et al. 2001). In this issue, Mitchell et al. (2004) report that 26% of their cases of bipolar disorder had attempted suicide at some point. This reflects the sheer persistence of personal suffering: Judd and colleagues (2002, 2003) demonstrated in a long and detailed follow-up that patients with bipolar disorder were symptomatic at least half the time. The Australian National Survey of Psychotic Disorders found levels of disability in affective psychosis equal to those of schizophrenia (Jablensky et al. 2000), and bipolar cases are more likely to score highly on measures of disability than unipolar cases (Mitchell et al. 2004). People with bipolar disorder are more likely to be single, widowed or divorced than both the general populace and those with unipolar depression (Mitchell et al. 2004).

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Resistant Bipolar Affective Disorder Treated by Stereotactic Subcaudate Tractotomy

The British Journal of Psychiatry ◽

10.1192/bjp.152.3.354 ◽

1988 ◽

Vol 152 (3) ◽

pp. 354-358 ◽

Cited By ~ 23

Author(s):

A. Poynton ◽

P. K. Bridges ◽

J. R. Bartlett

Keyword(s):

Affective Disorder ◽

Single Case ◽

Bipolar Affective Disorder ◽

Unipolar Depression ◽

Substantial Improvement ◽

Single Case Study ◽

Bipolar Affective Disorders ◽

Depressive Episodes

The results of stereotactic subcaudate tractotomy in nine patients with resistant bipolar affective disorder are presented in the form of a single case study with a summary of the other eight cases. Follow-up studies at 2–4 years showed substantial improvement in five patients and amelioration of symptoms in a further four patients, with a tendency for a greater improvement in the manic than in the depressive episodes. These preliminary results suggest that there is a place for this operation in the management of severe bipolar affective disorders which are not responding to any other treatment, although decisive recovery occurs less often than with unipolar depression.

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Course and outcome in bipolar affective disorder: a longitudinal follow- up study

American Journal of Psychiatry ◽

10.1176/ajp.152.3.379 ◽

1995 ◽

Vol 152 (3) ◽

pp. 379-384 ◽

Cited By ~ 227

Keyword(s):

Affective Disorder ◽

Bipolar Affective Disorder ◽

Follow Up Study

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Linkage of bipolar affective disorder on chromosome 8q24: follow-up and parametric analysis

Molecular Psychiatry ◽

10.1038/sj.mp.4001388 ◽

2004 ◽

Vol 9 (2) ◽

pp. 191-196 ◽

Cited By ~ 27

Author(s):

D Avramopoulos ◽

V L Willour ◽

P P Zandi ◽

Y Huo ◽

D F MacKinnon ◽

...

Keyword(s):

Affective Disorder ◽

Parametric Analysis ◽

Bipolar Affective Disorder ◽

Chromosome 8Q24

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Mortality in Patients with Primary Unipolar Depression, Secondary Unipolar Depression, and Bipolar Affective Disorder: A Comparison with General Population Mortality

The International Journal of Psychiatry in Medicine ◽

10.2190/vl1b-7yee-91j5-mwra ◽

1988 ◽

Vol 17 (4) ◽

pp. 351-360 ◽

Cited By ~ 14

Author(s):

Donald W. Black ◽

George Winokur ◽

Amelia Nasrallah

Keyword(s):

Affective Disorder ◽

Bipolar Affective Disorder ◽

Tertiary Care ◽

Geographical Area ◽

Care Facility ◽

Unipolar Depression ◽

Mortality Data ◽

Initial Portion ◽

Tertiary Care Facility

Mortality data are presented from a two to fourteen year follow-up of 705 primary unipolar depressives, 302 secondary unipolar depressives, and 586 patients with bipolar affective disorder (BAD) hospitalized at a tertiary care facility. Death ascertainment was made through a record-linkage process. Using sex- and age-standardized mortality ratios (SMRs), the mortality experience of the study population was compared with that of Iowa, the geographical area served by the admitting medical facility for this study group. Results show that risk for all-cause mortality was most pronounced during the first two years following hospital discharge, although secondary unipolar depressives continued to show a significant excess of deaths throughout the entire follow-up period. Deaths occurring from natural causes were significantly excessive only during the initial portion of the follow-up. Deaths from unnatural causes were significantly excessive throughout follow-up except for patients with bipolar affective disorder.

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