Normal levels of prepulse inhibition in the euthymic phase of bipolar disorder

Background. Deficits in prepulse inhibition (PPI) of the acoustic startle response have been suggested as a potentially useful endophenotype for schizophrenia spectrum disorders and may explain certain symptoms and cognitive deficits observed in the psychoses. PPI deficits have also been found in mania, but it remains to be confirmed whether this dysfunction is present in the euthymic phase of bipolar disorder.Method. Twenty-three adult patients with DSM-IV bipolar disorder were compared to 20 controls on tests of acoustic startle reactivity and PPI of the startle response. Sociodemographic and treatment variables were recorded and symptom scores assessed using the Hamilton Depression Inventory and the Young Mania Rating Scale.Results. Overall, the patient and control groups demonstrated similar levels of startle reactivity and PPI, although there was a trend for the inter-stimulus interval to differentially affect levels of PPI in the two groups.Conclusions. In contrast to bipolar patients experiencing a manic episode, general levels of PPI were normal in this euthymic sample. Further studies are required to confirm this finding and to determine the mechanisms by which this potential disruption/normalization occurs. It is suggested that an examination of PPI in a high-risk group is required to fully discount dysfunctional PPI as a potentially useful endophenotype for bipolar disorder.

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Early Schizophrenia and Bipolar Disorder Patients Display Reduced Neural Prepulse Inhibition

Brain Sciences ◽

10.3390/brainsci12010093 ◽

2022 ◽

Vol 12 (1) ◽

pp. 93

Author(s):

Rodrigo San-Martin ◽

Maria Zimiani ◽

Milton de Ávila ◽

Rosana Shuhama ◽

Cristina Del-Ben ◽

...

Keyword(s):

Bipolar Disorder ◽

Prepulse Inhibition ◽

Rating Scale ◽

Acoustic Startle ◽

Acoustic Startle Response ◽

Population Based ◽

Simultaneous Recording ◽

First Episode ◽

Control Group ◽

Young Mania

Background: Altered sensorimotor gating has been demonstrated by Prepulse Inhibition (PPI) tests in patients with psychosis. Recent advances in signal processing methods allow assessment of neural PPI through electroencephalogram (EEG) recording during acoustic startle response measures (classic muscular PPI). Simultaneous measurements of muscular (eye-blink) and neural gating phenomena during PPI test may help to better understand sensorial processing dysfunctions in psychosis. In this study, we aimed to assess simultaneously muscular and neural PPI in early bipolar disorder and schizophrenia patients. Method: Participants were recruited from a population-based case-control study of first episode psychosis. PPI was measured using electromyography (EMG) and EEG in pulse alone and prepulse + pulse with intervals of 30, 60, and 120 ms in early bipolar disorder (n = 18) and schizophrenia (n = 11) patients. As control group, 15 socio-economically matched healthy subjects were recruited. All subjects were evaluated with Rating Scale, Hamilton Rating Scale for Depression, and Young Mania Rating Scale questionnaires at recruitment and just before PPI test. Wilcoxon ranked sum tests were used to compare PPI test results between groups. Results: In comparison to healthy participants, neural PPI was significantly reduced in PPI 30 and PPI60 among bipolar and schizophrenia patients, while muscular PPI was reduced in PPI60 and PPI120 intervals only among patients with schizophrenia. Conclusion: The combination of muscular and neural PPI evaluations suggested distinct impairment patterns among schizophrenia and bipolar disorder patients. Simultaneous recording may contribute with novel information in sensory gating investigations.

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Prepulse inhibition in euthymic bipolar disorder patients in comparison with control subjects

European Psychiatry ◽

10.1016/j.eurpsy.2016.01.170 ◽

2016 ◽

Vol 33 (S1) ◽

pp. S126-S126

Author(s):

J.L. Santos ◽

J. Mateo ◽

A. Aparicio ◽

E.M. Sánchez-Morla

Keyword(s):

Bipolar Disorder ◽

Social Cognition ◽

Prepulse Inhibition ◽

Rating Scale ◽

Smoking Status ◽

Sensorimotor Gating ◽

Cognitive Measures ◽

Young Mania ◽

Control Subjects ◽

Bipolar Patients

IntroductionDeficient prepulse inhibition (PPI) of the startle response, indicating sensorimotor gating deficits, has been reported in schizophrenia and other neuropsychiatric disorders.Objectives and aimsThe present study aimed to assess sensorimotor gating deficits in euthymic bipolar patients. Furthermore, we analysed the relationships between PPI and clinical and cognitive measures.MethodPPI was measured in 64 euthymic bipolar patients and in 64 control subjects matched for age, gender, education level and smoking status. Clinical characteristics and level of functioning were assessed in all participants using the Hamilton Depression Rating Scale (HDRS), Young Mania Rating Scale (YMRS) and Functioning Assessment Short Test (FAST). Cognition was evaluated using the MATRICS Consensus Cognitive Battery (MCCB) and the Stroop Test as an additional measure of executive function.ResultsCompared with controls, patients with bipolar disorder exhibited PPI deficits at 60- and 120-milliseconds prepulse-pulse intervals. Among patients with bipolar disorder, PPI was correlated with the social cognition domain of the MCCB. PPI was not significantly correlated with other clinical or neurocognitive variables in either group.ConclusionsOur data suggest that PPI deficit is a neurobiological marker in euthymic bipolar disorder, which is associated with social cognition but not with other clinical, functional or cognitive measures.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Sensorimotor Gating in Depressed and Euthymic Patients with Bipolar Disorder: Analysis on Prepulse Inhibition of Acoustic Startle Response Stratified by Gender and State

Frontiers in Psychiatry ◽

10.3389/fpsyt.2018.00123 ◽

2018 ◽

Vol 9 ◽

Cited By ~ 7

Author(s):

Junko Matsuo ◽

Miho Ota ◽

Shinsuke Hidese ◽

Toshiya Teraishi ◽

Hiroaki Hori ◽

...

Keyword(s):

Bipolar Disorder ◽

Prepulse Inhibition ◽

Startle Response ◽

Acoustic Startle ◽

Acoustic Startle Response ◽

Sensorimotor Gating

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Psychosocial function in schizophrenia and bipolar disorder: Relationship to neurocognition and clinical symptoms

Journal of the International Neuropsychological Society ◽

10.1017/s1355617710000573 ◽

2010 ◽

Vol 16 (5) ◽

pp. 771-783 ◽

Cited By ~ 43

Author(s):

CARMEN SIMONSEN ◽

KJETIL SUNDET ◽

ANJA VASKINN ◽

TORILL UELAND ◽

KRISTIN LIE ROMM ◽

...

Keyword(s):

Bipolar Disorder ◽

Psychosocial Functioning ◽

Rating Scale ◽

Depressive Symptomatology ◽

Clinical Symptoms ◽

Schizophrenia Spectrum Disorders ◽

Young Mania ◽

Psychosocial Function ◽

History Of ◽

Spectrum Disorders

AbstractIn line with a dimensional approach to psychopathology, we examined whether psychosocial function and its relationship to neurocognition and clinical symptoms differ across schizophrenia and bipolar disorder subgroups with and without a history of affective or psychotic episodes. From the TOP study, a heterogeneous sample of individuals with schizophrenia spectrum disorders without (n = 60) and with a history of affective episodes (n = 54); individuals with bipolar spectrum disorders with (n = 64) and without a history of psychosis (n = 56) and healthy controls (n = 268) participated. Psychosocial functioning was measured with the Social Functioning Scale (self-rated) and the Global Assessment of Functioning Scale (clinician-rated), neurocognition with a comprehensive neuropsychological test battery, and symptoms with Inventory of Depressive Symptomatology, Young Mania Rating Scale, and Positive and Negative Syndrome Scale. Clinician-rated functioning was poorer in schizophrenia groups than in bipolar groups, but self-rated functioning was similar across all clinical groups and poorer than in controls. Neurocognition and current clinical symptoms were associated with psychosocial function in bivariate analyses, but current symptoms had a greater independent contribution to functioning than neurocognition across clinical groups in multivariate analyses. Despite differences in neurocognition and psychosocial function, groups showed the same pattern in prediction of functioning irrespective of DSM-IV or clinical definition. (JINS, 2010, 16, 771–783.)

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Psychosocial functioning impairment in euthymic patients with bipolar disorder II: The role of clinical factors

European Psychiatry ◽

10.1016/j.eurpsy.2016.01.1164 ◽

2016 ◽

Vol 33 (S1) ◽

pp. S333-S333

Author(s):

R.S. Ilhan ◽

V. Senturk-Cankorur

Keyword(s):

Bipolar Disorder ◽

Psychosocial Functioning ◽

Rating Scale ◽

Healthy Individuals ◽

Young Mania ◽

Clinical Variables ◽

Hamilton Anxiety Rating Scale ◽

Short Test ◽

Competing Interest ◽

Bipolar Patients

IntroductionGrowing body of evidence have showed that euthymic bipolar patients have poor psychosocial functioning. Most of the studies have focused on the psychosocial functioning in euthymic bipolar disorder (BD)-I patients. On the contrary, there have been limited researches investigating psychosocial functioning in euthymic BD-II patients. Moreover, the factors associated with psychosocial functioning in euthymic patients with BD II have been also understudied.Objectives/aimsAim of our study was to investigate the association between clinical variables and poor psychosocial functioning in euthymic BD-II patients. Hypothesis of this study was that euthymic BD-II patients would have low level of psychosocial functioning compared with healthy individuals.MethodsBD-II (n = 37) and healthy subjects (n = 35) were compared in terms of their psychosocial functioning which were assessed by Functional Assessment Short Test (FAST). The euthymic state was confirmed by low scores both on the Hamilton Depression Rating Scale (HDRS) and the Young Mania Rating Scale (YMRS). Anxiety symptoms were also assessed by Hamilton Anxiety Rating Scale (HARS) in both groups. Clinical variables were taken as independent variables and FAST scores were taken as dependent variable in order to run correlation analysis in BD-II group.ResultsNo socio-demographic differences were found between two groups. Euthymic BD-II patients had significantly higher FAST, HARS, HDRS YMRS scores compared with healthy individuals. Only HDRS scores correlated with FAST scores of BD-II patients.ConclusionsThis study indicated that euthymic BD-II patients had poorer psychosocial functioning. And subclinical depressive symptoms were associated with poor psychosocial functioning.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Creatine kinase levels in patients with bipolar disorder: depressive, manic, and euthymic phases

Brazilian Journal of Psychiatry ◽

10.1590/s1516-44462011005000005 ◽

2011 ◽

Vol 33 (2) ◽

pp. 171-175 ◽

Cited By ~ 8

Author(s):

Gustavo Feier ◽

Samira S. Valvassori ◽

Gislaine T. Rezin ◽

Márcio Búrigo ◽

Emilio L. Streck ◽

...

Keyword(s):

Bipolar Disorder ◽

Creatine Kinase ◽

Healthy Volunteers ◽

Rating Scale ◽

Serum Creatine Kinase ◽

Control Group ◽

Young Mania ◽

Potential Marker ◽

Significant Difference ◽

Bipolar Patients

OBJECTIVE: Bipolar disorder is a severe, recurrent, and often chronic psychiatric illness associated with significant functional impairment, morbidity, and mortality. Creatine kinase is an important enzyme, particularly for cells with high and fluctuating energy requirements, such as neurons, and is a potential marker of brain injury. The aim of the present study was to compare serum creatine kinase levels between bipolar disorder patients, in the various phases (depressive, manic, and euthymic), and healthy volunteers. METHOD: Forty-eight bipolar patients were recruited: 18 in the euthymic phase; 17 in the manic phase; and 13 in the depressive phase. The control group comprised 41 healthy volunteers. The phases of bipolar disorder were defined as follows: euthymic-not meeting the DSM-IV criteria for a mood episode and scoring < 8 on the Hamilton Depression Rating Scale (HDRS) and Young Mania Rating Scale (YMRS); manic-scoring < 7 on the HDRS and > 7 on the YMRS; depressive-scoring > 7 on the HDRS and < 7 on the YMRS. Patients in mixed phases were excluded. Blood samples were collected from all participants. RESULTS: Creatine kinase levels were higher in the manic patients than in the controls. However, we observed no significant difference between euthymic and depressive patients in terms of the creatine kinase level. CONCLUSION: Our results suggest that the clinical differences among the depressive, manic, and euthymic phases of bipolar disorder are paralleled by contrasting levels of creatine kinase. However, further studies are needed in order to understand the state-dependent differences observed in serum creatine kinase activity.

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Assessment of psychotic symptoms in bipolar disorder

European Psychiatry ◽

10.1016/j.eurpsy.2017.01.376 ◽

2017 ◽

Vol 41 (S1) ◽

pp. S419-S419

Author(s):

F. Cazan ◽

R. Paunescu ◽

A. Tamas

Keyword(s):

Bipolar Disorder ◽

Rating Scale ◽

Psychotic Symptoms ◽

Young Mania ◽

Affective Symptoms ◽

Number Of Patients ◽

General Functioning ◽

Competing Interest ◽

Bipolar Patients ◽

Manic Patients

IntroductionBipolar disorder is a disabling condition characterized by the presence of manic, depressive, hypomanic or mixed episodes, affective symptoms that may coexist with several types of psychotic features.ObjectivesThe purpose is to evaluate the frequency of psychotic symptoms among bipolar disorder.MethodThe study included 55 bipolar patients admitted in the Psychiatry Clinical Hospital from January 2012 until May 2013. Inclusion criteria were represented by diagnosis of bipolar disorder, manic or depressive episode, according to DSM-IV-TR and ICD 10 criteria. Clinical instruments used to assess the severity of the current affective episode were Young Mania Rating Scale (YMRS) for manic patients and Hamilton Depression Rating Scale-17 items – (HDRS) for the depressive ones. Psychotic symptoms were evaluated with the Brief Psychiatric Rating Scale-18 items – (BPRS).ResultsOut of the 55 patients, 32 had psychotic symptoms upon admission to the hospital. BPRS results showed delusions of guilt, inutility, hypochondriac and nihilistic delusions for the depressed patients. Delusions of grandiosity and megalomania accounted for most of psychotic symptoms in manic patients. A smaller number of patients showed delusions of invention and reform. Perception disturbances such as auditory hallucinations were present in both diagnosis categories but in a higher percentage in depressive bipolar patients.ConclusionsEven if less frequently than in schizophrenia or schizoaffective disorder, psychotic symptoms are present in bipolar disorder. They influence the general functioning and the outcome of patients diagnosed with this illness.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Impact of modification to DSM-5 criterion A for hypomania/mania in newly diagnosed bipolar patients: findings from the prospective BIO study

International Journal of Bipolar Disorders ◽

10.1186/s40345-020-00219-9 ◽

2021 ◽

Vol 9 (1) ◽

Author(s):

Mette U. Fredskild ◽

Sharleny Stanislaus ◽

Klara Coello ◽

Sigurd A. Melbye ◽

Hanne Lie Kjærstad ◽

...

Keyword(s):

Rating Scale ◽

Newly Diagnosed ◽

Young Mania ◽

Dsm 5 ◽

Criterion A ◽

Number Of Patients ◽

Bipolar Type ◽

Dsm Iv ◽

Bipolar Patients

Abstract Background DSM-IV states that criterion A for diagnosing hypomania/mania is mood change. The revised DSM-5 now states that increased energy or activity must be present alongside mood changes to diagnose hypomania/mania, thus raising energy/activity to criterion A. We set out to investigate how the change in criterion A affects the diagnosis of hypomanic/manic visits in patients with a newly diagnosed bipolar disorder. Results In this prospective cohort study, 373 patients were included (median age = 32; IQR, 27–40). Women constituted 66% (n = 245) of the cohort and 68% of the cohort (n = 253) met criteria for bipolar type II, the remaining patients were diagnosed bipolar type I. Median number of contributed visits was 2 per subject (IQR, 1–3) and median follow-up time was 3 years (IQR, 2–4). During follow-up, 127 patients had at least one visit with fulfilled DSM-IV criterion A. Applying DSM-5 criterion A reduced the number of patients experiencing a hypomanic/manic visit by 62% at baseline and by 50% during longitudinal follow-up, compared with DSM-IV criterion A. Fulfilling DSM-5 criterion A during follow-up was associated with higher modified young mania rating scale score (OR = 1.51, CL [1.34, 1.71], p < 0.0001) and increased number of visits contributed (OR = 1.86, CL [1.52, 2.29], p < 0.0001). Conclusion Applying the stricter DSM-5 criterion A in a cohort of newly diagnosed bipolar patients reduced the number of patients experiencing a hypomanic/manic visit substantially, and was associated with higher overall young mania rating scale scores, compared with DSM-IV criterion A. Consequently, fewer hypomanic/manic visits may be detected in newly diagnosed bipolar patients with applied DSM-5 criterion A, and the upcoming ICD-11, which may possibly result in longer diagnostic delay of BD as compared with the DSM-IV.

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Driving ability in bipolar patients receiving lithium or lamotrigine

European Psychiatry ◽

10.1016/s0924-9338(11)71904-6 ◽

2011 ◽

Vol 26 (S2) ◽

pp. 194-194

Author(s):

A. Brunnauer ◽

F. Segmiller ◽

I. Hermisson ◽

F. Seemüller ◽

M. Riedel ◽

...

Keyword(s):

Visual Perception ◽

Stress Tolerance ◽

Traffic Safety ◽

Test Performance ◽

Rating Scale ◽

Safety Data ◽

Developed Countries ◽

Driving Ability ◽

Young Mania ◽

Bipolar Patients

ObjectivesDriving is a daily activity for most people in developed countries and is important in maintaining independence. Bipolar patients may have an impaired driving behavior because of the pathology itself, with psychomotor and cognitive disturbances. Additionally, adverse effects of pharmacologic treatment may be detrimental.Methods24 remitted bipolar outpatients diagnosed according to ICD-10 criteria were enrolled in the study, receiving either lithium (n = 12) or lamotrigine (n = 12). Participants were investigated under steady state plasma level conditions. According to the German Guidelines for road and traffic safety data were collected with the Wiener Testsystem (WTS) measuring visual perception, reactivity, stress tolerance, concentration and vigilance.Psychopathologic symptoms were rated with the Montgomery-Asberg Depression Rating Scale (MADRS) and the Young Mania Rating Scale - Clinician rated (YMRS-C).ResultsAbout 40% of patients were without clinically relevant psychomotor disturbances. In 40% of cases mild to moderate impairments could be seen, and 20% of the patients were considered as severely impaired. Data show that patients under lamotrigine had an altogether better test performance than patients treated with lithium. Especially in visual perception and stress tolerance differences were most pronounced.ConclusionsAbout 20% of remitted bipolar outpatients treated with lithium or lamotrigine must be considered unfit to drive. In 40% of the cases it seems justified to counsel patients individually, taking into account compensational factors. Analysis of our data point to an advantage for bipolar patients treated with lamotrigine when compared with lithium. However causal relationships can not be drawn from our data.

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