A 20-year multi-follow-up of hallucinations in schizophrenia, other psychotic, and mood disorders

Background:Mood disorders are related to considerable morbidity and mortality, and although there is little doubt that they are brain-based disorders, their neural correlates still remain elusive. A neuro-anatomic model of mood regulation comprising the prefrontal cortex, amygdala-hippocampus complex, thalamus, basal ganglia, and connections among these areas has been proposed.Objective:We reviewed the evidence for regional brain abnormalities in bipolar disorder, and attempted to integrate available findings into a comprehensive pathophysiological model of illness.Methods:A computerized Medline Ovid search was conducted for the period 1966–2002, and complemented by a manual search of bibliographical references from recent reviews. Articles meeting specified criteria were included.Results:Hyperintense lesions in cortical and subcortical regions are the most consistently reported and widely studied structural abnormalities. Smaller prefrontal cortical volume is a common finding in bipolar disorder and unipolar depression. Enlarged amygdala (in bipolar disorder) and smaller hippocampus (in unipolar depression) have been reported by several groups. Decreased volumes (in unipolar depression) and increased or unaltered volumes (in bipolar disorder) of striatal structures have been reported.Conclusions:Bipolar and unipolar mood disorders are associated with detectable structural brain abnormalities. The histopathology underlying such anatomical changes remains to be elucidated. To reach more definitive conclusions about neuroanatomical changes that take place during the course of mood disorders, prospective longitudinal studies are needed. Also, integration with functional imaging is necessary in order to elucidate the relevance of identified structural abnormalities.

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Mood Disorders

10.2310/fm.1021 ◽

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.

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Brain mechanisms in manic depression

Clinical Chemistry ◽

10.1093/clinchem/40.2.303 ◽

1994 ◽

Vol 40 (2) ◽

pp. 303-308 ◽

Cited By ~ 20

Author(s):

B J Carroll

Keyword(s):

Bipolar Disorder ◽

Mood Disorders ◽

Unipolar Depression ◽

Depressive Illness ◽

Manic Depression ◽

Manic Depressive Illness ◽

Manic Depressive ◽

Clinical Presentations ◽

Genetic Mechanisms ◽

Activity Information

Abstract Manic depressive illness (bipolar disorder) is the mood disorder classically considered to have a strong biological basis. During manic depressive cycles, patients show dramatic fluctuations of mood, energy, activity, information processing, and behaviors. Theories of brain function and mood disorders must deal with the case of bipolar disorder, not simply unipolar depression. Shifts in the nosologic concepts of how manic depression is related to other mood disorders are discussed in this overview, and the renewed adoption of the Kraepelinian "spectrum" concept is recommended. The variable clinical presentations of manic depressive illness are emphasized. New genetic mechanisms that must be considered as candidate factors in relation to this phenotypic heterogeneity are discussed. Finally, the correlation of clinical symptom clusters with brain systems is considered in the context of a three-component model of manic depression.

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Novel therapeutic targets for bipolar disorder

10.1093/med/9780198748625.003.0030 ◽

2017 ◽

Author(s):

Ioline D. Henter ◽

Rodrigo Machado-Vieira

Keyword(s):

Bipolar Disorder ◽

Mood Disorders ◽

Bipolar Depression ◽

Nmda Antagonist ◽

Excitatory Neurotransmitter ◽

Residual Symptoms ◽

Antidepressant Effects ◽

The Central Nervous System ◽

Depressive Episodes

The long-term course of bipolar disorder (BD) comprises recurrent depressive episodes and persistent residual symptoms for which standard therapeutic options are scarce and often ineffective. Glutamate is the major excitatory neurotransmitter in the central nervous system, and glutamate and its cognate receptors have consistently been implicated in the pathophysiology of mood disorders and in the development of novel therapeutics for these disorders. Since the rapid and robust antidepressant effects of the N-methyl-D-aspartate (NMDA) antagonist ketamine were first observed in 2000, other NMDA receptor antagonists have been studied in major depressive disorder (MDD) and BD. This chapter reviews the clinical evidence supporting the use of novel glutamate receptor modulators for treating BD—particularly bipolar depression. We also discuss other promising, non-glutamatergic targets for potential rapid antidepressant effects in mood disorders, including the cholinergic system, the melatonergic system, the glucocorticoid system, the arachidonic acid (AA) cascade, and oxidative stress and bioenergetics.

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Specificity and Continuity of Schizophrenia and Bipolar Disorder: Relation to Biomarkers

Current Pharmaceutical Design ◽

10.2174/1381612825666191216153508 ◽

2020 ◽

Vol 26 (2) ◽

pp. 191-200 ◽

Cited By ~ 1

Author(s):

Yuji Yamada ◽

Madoka Matsumoto ◽

Kazuki Iijima ◽

Tomiki Sumiyoshi

Keyword(s):

Bipolar Disorder ◽

Mood Disorders ◽

Schizoaffective Disorder ◽

Unmet Needs ◽

Risk Genes ◽

Clinical Phenomenology ◽

Psychiatric Conditions ◽

Familial Patterns ◽

New Treatments ◽

The Continuum

Schizophrenia and bipolar disorder overlap considerably in terms of symptoms, familial patterns, risk genes, outcome, and treatment response. This article provides an overview of the specificity and continuity of schizophrenia and mood disorders on the basis of biomarkers, such as genes, molecules, cells, circuits, physiology and clinical phenomenology. Overall, the discussions herein provided support for the view that schizophrenia, schizoaffective disorder and bipolar disorder are in the continuum of severity of impairment, with bipolar disorder closer to normality and schizophrenia at the most severe end. This approach is based on the concept that examining biomarkers in several modalities across these diseases from the dimensional perspective would be meaningful. These considerations are expected to help develop new treatments for unmet needs, such as cognitive dysfunction, in psychiatric conditions.

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The Diagnoses of Schizophrenia, Schizoaffective Disorder, Bipolar Disorder and Unipolar Depression: Interrater Reliability and Congruence between DSM-IV and ICD-10

Psychopathology ◽

10.1159/000228838 ◽

2009 ◽

Vol 42 (5) ◽

pp. 293-298 ◽

Cited By ~ 39

Author(s):

Elie Cheniaux ◽

J. Landeira-Fernandez ◽

Marcio Versiani

Keyword(s):

Bipolar Disorder ◽

Schizoaffective Disorder ◽

Interrater Reliability ◽

Unipolar Depression ◽

Icd 10 ◽

Dsm Iv

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Mood Disorders

10.2310/neuro.1021 ◽

2010 ◽

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 135 references.

Download Full-text