scholarly journals Associations between mood instability and emotional processing in a large cohort of bipolar patients

2016 ◽  
Vol 46 (15) ◽  
pp. 3151-3160 ◽  
Author(s):  
A. C. Bilderbeck ◽  
Z. E. Reed ◽  
H. C. McMahon ◽  
L. Z. Atkinson ◽  
J. Price ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Emotional Processing ◽  
Memory Task ◽  
Large Cohort ◽  
Mood Variability ◽  
Manic Symptoms ◽  
Mood Instability ◽  
Current Medication ◽  
Emotional Bias ◽  
Bipolar Patients

BackgroundAberrant emotional biases have been reported in bipolar disorder (BD), but results are inconsistent. Despite the clinical relevance of chronic mood variability in BD, there is no previous research investigating how the extent of symptom fluctuations in bipolar disorder might relate to emotional biases. This exploratory study investigated, in a large cohort of bipolar patients, whether instability in weekly mood episode symptoms and other clinical and demographic factors were related to emotional bias as measured in a simple laboratory task.MethodParticipants (N = 271, BDI = 206, BDII = 121) completed an ‘emotional categorization and memory’ task. Weekly self-reported symptoms of depression and mania were collected prospectively. In linear regression analyses, associations between cognitive bias and mood variability were explored together with the influence of demographic and clinical factors, including current medication.ResultsGreater accuracy in the classification of negative words relative to positive words was associated with greater instability in depressive symptoms. Furthermore, greater negative bias in free recall was associated with higher instability in manic symptoms. Participants diagnosed with BDII, compared with BDI, showed overall better word recognition and recall. Current antipsychotic use was associated with reduced instability in manic symptoms but this did not impact on emotional processing performance.ConclusionsEmotional processing biases in bipolar disorder are related to instability in mood. These findings prompt further investigation into the underpinnings as well as clinical significance of mood instability.

Dissociable mechanisms for memory impairment in bipolar disorder and schizophrenia

2006 ◽  
Vol 36 (8) ◽  
pp. 1085-1095 ◽  
Author(s):  
DAVID C. GLAHN ◽  
JENNIFER BARRETT ◽  
CARRIE E. BEARDEN ◽  
JIM MINTZ ◽  
MICHAEL F. GREEN ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Verbal Memory ◽  
Memory Task ◽  
Cognitive Remediation ◽  
Memory Deficits ◽  
Absolute Level ◽  
Memory Impairments ◽  
Remediation Strategies ◽  
Organizational Dysfunction ◽  
Bipolar Patients

Background. Although memory deficits are consistently reported in schizophrenia and bipolar disorder, the mechanisms underlying these impairments are poorly understood. Clarifying the nature and degree of overlap in memory deficits between the two illnesses could help to distinguish brain systems disrupted in these illnesses, and indicate cognitive remediation strategies to improve patient outcomes.Method. We examined performance on a non-verbal memory task in clinically stable out-patients with bipolar disorder (n=40), schizophrenia (n=40), and healthy comparison subjects (n=40). This task includes conditions in which distinct mnemonic strategies – namely, using context to organize familiar stimuli or using holistic representation of novel stimuli – facilitate performance.Result. When compared to a reference condition, bipolar patients had deficits consistent with organizational dysfunction and poor detection of novel information. Although patients with schizophrenia performed worse than the other groups, they were only differentially impaired when organizational demands were significant. Task performance was not correlated with severity of clinical symptomatology.Conclusions. This pattern of distinct memory impairments implies disturbances in partially overlapping neural systems in bipolar disorder and schizophrenia. Evidence of impairment in detection of novel stimuli that is unique to bipolar disorder suggests that, while the absolute level of cognitive dysfunction is less severe in bipolar disorder as compared to schizophrenia, subtle disruptions in memory are present. These findings can be used to plan targeted cognitive remediation programs by helping patients to capitalize on intact functions and to learn new strategies that they do not employ without training.

scholarly journals Chronic stressors and trauma: prospective influences on the course of bipolar disorder

2013 ◽  
Vol 43 (12) ◽  
pp. 2583-2592 ◽  
Author(s):  
A. Gershon ◽  
S. L. Johnson ◽  
I. Miller
Keyword(s):  
Bipolar Disorder ◽  
Support Groups ◽  
Life Stress ◽  
Bipolar I Disorder ◽  
Course Of Illness ◽  
College Life ◽  
Manic Symptoms ◽  
Chronic Stressors ◽  
Bipolar Patients ◽  
Exposure To Trauma

BackgroundExposure to life stress is known to adversely impact the course of bipolar disorder. Few studies have disentangled the effects of multiple types of stressors on the longitudinal course of bipolar I disorder. This study examines whether severity of chronic stressors and exposure to trauma are prospectively associated with course of illness among bipolar patients.MethodOne hundred and thirty-one participants diagnosed with bipolar I disorder were recruited through treatment centers, support groups and community advertisements. Severity of chronic stressors and exposure to trauma were assessed at study entry with in-person interviews using the Bedford College Life Event and Difficulty Schedule (LEDS). Course of illness was assessed by monthly interviews conducted over the course of 24 months (over 3000 assessments).ResultsTrauma exposure was related to more severe interpersonal chronic stressors. Multiple regression models provided evidence that severity of overall chronic stressors predicted depressive but not manic symptoms, accounting for 7.5% of explained variance.ConclusionsOverall chronic stressors seem to be an important determinant of depressive symptoms within bipolar disorder, highlighting the importance of studying multiple forms of life stress.

Telemedicine and bipolar disorder

2016 ◽  
Vol 33 (S1) ◽  
pp. S121-S121
Author(s):  
A. García-Alocén ◽  
C. Bermudez-Ampudia ◽  
M. Martínez-Cengotitabengoa ◽  
I. González-Ortega ◽  
S. Ruiz de Azua ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Psychoeducational Intervention ◽  
Treatment As Usual ◽  
Patient Functioning ◽  
Manic Symptoms ◽  
Intervention Treatment ◽  
Competing Interest ◽  
Additional Support ◽  
Bipolar Patients ◽  
Web Platform

Show the efficacy of an innovate telemedicine psyeducational invention based on a psychoeducational intervention treatment with a group of bipolar patients.ObjetivesTo assess the efficacy of an innovate telemedicine psyeducational treatment (TPT) based on a psychoeducational intervention (21 sessions) with an additional support through telemedicine which has 12 videos versus treatment as usual (TAU) based on psychiatry reviews. Specifically, the objective was to evaluate patients’ efficacy of psyeducational treatment with telemedicine (TPT) in the fuctionalitity, depressive symptoms and manic symptoms.MethodsThirty-eight patients with bipolar disorder were included in the study and randomly distributed in the two groups. The telemedine treatment is performed through a www.puedoser.es web platform provided by Astra Zeneca. In the web platform is available forums, emails and digital-course with the sessions worked as a reminder. In order to assess the effectiveness of treatments, FAST scale was administered at baseline and 6 months after the intervention. To obtain the results we used coparative data analysis.ResultsIn patients, we found a low daily functionality. The main issues were: interpersonal cognitive area (t = –2.611; P = 0.014) and interpersonal-area (t = –2.617; P = 0.014). We found, at baseline, that TPT group had worse overall results in daily functionality (t = –2.876; P = 0.008). After intervention, there is an improvement in the daily functionality of the TPT group. This improvement occurred in cognitive area (z = –3.24; P < 0.001), leisure area (z = –1.85; P = 0.065) and interpersonal area (z = –1.72; P = 0.086).ConclusionsThe psychoeducational program combined with telemedicine shows to be more effective than TAU in the improvement of general patient functioning in bipolar disorder patients.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals The effect of positive mood induction on emotional processing in euthymic individuals with bipolar disorder and controls

2008 ◽  
Vol 39 (5) ◽  
pp. 785-791 ◽  
Author(s):  
J. Roiser ◽  
A. Farmer ◽  
D. Lam ◽  
A. Burke ◽  
N. O'Neill ◽  
...  
Keyword(s):  
Decision Making ◽  
Bipolar Disorder ◽  
Emotional Processing ◽  
Mood Induction ◽  
Emotional State ◽  
Negative Mood ◽  
Positive Mood ◽  
Attentional Biases ◽  
Novel Technique ◽  
Emotional Bias

BackgroundMany studies have used negative mood induction techniques to investigate the effect of emotional state on cognitive performance but positive mood induction paradigms have been used less frequently. The objective of this study was to investigate the effect of positive mood induction on emotional processing in euthymic individuals with bipolar disorder (BD) and controls.MethodPreviously, we reported that positive mood induction using a novel technique based on feedback produced a longer-lasting effect in euthymic individuals with BD than controls (Farmer et al.2006). Here we report the effect of mood induction on two tests of emotional processing, the Affective Go/No-go test (AGNG) and the Cambridge Gamble task (CGT), on which BD patients in the manic phase differ in their performance from controls.ResultsFollowing positive mood induction, bipolar cases exhibited a positive emotional bias on the AGNG and performed more slowly than controls on the CGT, particularly when making more difficult decisions.ConclusionsThese data confirm that positive mood induction is more effective in individuals with BD than controls. They also suggest that alterations in decision making and attentional biases occur even with transient and subtle changes in mood in bipolar disorder.

scholarly journals Nonlinear time-series approaches in characterizing mood stability and mood instability in bipolar disorder

2011 ◽  
Vol 279 (1730) ◽  
pp. 916-924 ◽  
Author(s):  
M. B. Bonsall ◽  
S. M. A. Wallace-Hadrill ◽  
J. R. Geddes ◽  
G. M. Goodwin ◽  
E. A. Holmes
Keyword(s):  
Bipolar Disorder ◽  
Time Series ◽  
Depressive Symptomatology ◽  
Nonlinear Time Series ◽  
Mood Variability ◽  
Mood Instability ◽  
Time Series Approach ◽  
Longitudinal Pattern ◽  
Patient Groups ◽  
Deterministic Processes

Bipolar disorder is a psychiatric condition characterized by episodes of elevated mood interspersed with episodes of depression. While treatment developments and understanding the disruptive nature of this illness have focused on these episodes, it is also evident that some patients may have chronic week-to-week mood instability. This is also a major morbidity. The longitudinal pattern of this mood instability is poorly understood as it has, until recently, been difficult to quantify. We propose that understanding this mood variability is critical for the development of cognitive neuroscience-based treatments. In this study, we develop a time-series approach to capture mood variability in two groups of patients with bipolar disorder who appear on the basis of clinical judgement to show relatively stable or unstable illness courses. Using weekly mood scores based on a self-rated scale (quick inventory of depressive symptomatology—self-rated; QIDS-SR) from 23 patients over a 220-week period, we show that the observed mood variability is nonlinear and that the stable and unstable patient groups are described by different nonlinear time-series processes. We emphasize the necessity in combining both appropriate measures of the underlying deterministic processes (the QIDS-SR score) and noise (uncharacterized temporal variation) in understanding dynamical patterns of mood variability associated with bipolar disorder.

scholarly journals Cognitive emotional processing across mood disorders

CNS Spectrums ◽  
2019 ◽  
Vol 24 (1) ◽  
pp. 54-63 ◽  
Author(s):  
Priyanka Panchal ◽  
Alexander Kaltenboeck ◽  
Catherine J. Harmer
Keyword(s):  
Bipolar Disorder ◽  
Mood Disorders ◽  
Emotional Processing ◽  
Reward Processing ◽  
Major Depressive ◽  
Cognitive Domains ◽  
Mood Instability ◽  
Attention Memory ◽  
Similarities And Differences ◽  
Distinct Features

While impairments in cognitive emotional processing are key to the experience of mood disorders, little is understood of their shared and distinct features across major depressive disorder (MDD) and bipolar disorder (BD). In this review, we discuss the similarities and differences in abnormal emotional processing associated with mood disorders across the cognitive domains of perception, attention, memory, and reward processing, with a particular focus on how these impairments relate to the clinical profile of the disorders. We consider behavioral and neuroimaging evidence, especially that of the growing consensus surrounding mood-congruent biases in cognition, in combination with state- and trait-related characteristics in an attempt to provide a more comprehensive and translational overview of mood disorders. Special consideration is given to the shared phenomenon of mood instability and its role as a potential transdiagnostic marker across the prodrome and maintenance of mood disorders.

P01-216-Frontopolar cortical inefficiency underpins both “hot” and “cold” cognitive dysfunction in bipolar disorder

2011 ◽  
Vol 26 (S2) ◽  
pp. 217-217
Author(s):  
J. Jogia ◽  
D. Dima ◽  
V. Kumari ◽  
S. Frangou
Keyword(s):  
Bipolar Disorder ◽  
Working Memory ◽  
Cognitive Processing ◽  
Emotional Processing ◽  
Iowa Gambling Task ◽  
Memory Task ◽  
Emotional Dysregulation ◽  
Anterior Cingulate ◽  
Group Differences ◽  
The Relationship

IntroductionEmotional dysregulation in Bipolar Disorder (BD) is thought to be linked with prefrontal cortex (PFC) dysfunction associated with cognitive control coupled with increased or aberrant activation within regions associated with emotional processing.ObjectivesTo determine the common and distinct patterns of functional brain abnormalities during affective and emotionally neutral cognitive processing in BD.AimsCurrent models of BD emphasise the relationship between mood dysregulation and fronto-limbic dysfunction during affective or “hot” processing. However, they do not account for deficits in emotionally neutral or “cold” tasks of memory and executive function which are also present in BD. Therefore the purpose of this study was to examine the neural correlates of affective decision making and working memory in BD.MethodsParticipants were 36 euthymic BD patients and 37 healthy controls matched for age, gender and IQ. FMRI was conducted during the Iowa Gambling Task (IGT) and the n-back working memory task as respective exemplars of “hot” and “cold” processing.ResultsThere were no group differences in performance on either task. BD patients demonstrated a pattern of inefficient engagement within the ventral frontopolar PFC in both the IGT and n-back. These abnormalities showed task-related segregation along the medial-lateral dimension for “hot” and “cold” processing respectively. Patients also showed greater activation in the anterior cingulate cortex during the IGT and in the insula during the n-back. These regions are thought to respond to markers of autonomic arousal.ConclusionsThese data demonstrate ventral frontopolar PFC inefficiency as a shared abnormality underpinning both “hot” and “cold” processing deficits in BD.

scholarly journals Patients’ adherence to smartphone apps in the management of bipolar disorder: a systematic review

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Marie-Camille Patoz ◽  
Diego Hidalgo-Mazzei ◽  
Bruno Pereira ◽  
Olivier Blanc ◽  
Ingrid de Chazeron ◽  
...  
Keyword(s):  
Systematic Review ◽  
Bipolar Disorder ◽  
Mobile Health ◽  
Smartphone Apps ◽  
Exclusion Criteria ◽  
Future Studies ◽  
Health Apps ◽  
Definition Of ◽  
Bipolar Patients ◽  
Digital Or

Abstract Background Despite an increasing number of available mental health apps in the bipolar disorder field, these tools remain scarcely implemented in everyday practice and are quickly discontinued by patients after downloading. The aim of this study is to explore adherence characteristics of bipolar disorder patients to dedicated smartphone interventions in research studies. Methods A systematic review following PRISMA guidelines was conducted. Three databases (EMBASE, PsychInfo and MEDLINE) were searched using the following keywords: "bipolar disorder" or "mood disorder" or “bipolar” combined with “digital” or “mobile” or “phone” or “smartphone” or “mHealth” or “ehealth” or "mobile health" or “app” or “mobile-health”. Results Thirteen articles remained in the review after exclusion criteria were applied. Of the 118 eligible studies, 39 did not provide adherence characteristics. Among the selected papers, study length, sample size and definition of measures of adherence were strongly heterogeneous. Activity rates ranged from 58 to 91.6%. Conclusion The adherence of bipolar patients to apps is understudied. Standardised measures of adherence should be defined and systematically evaluated in future studies dedicated to these tools.

scholarly journals Response Processes to Looming Appetitive and Aversive Cues in Euthymic Bipolar Patients and Their First-Degree Relatives: An Exploratory Study

2020 ◽  
pp. 025371762097528
Author(s):  
Velprashanth Venkatesan ◽  
Christoday R J Khess ◽  
Umesh Shreekantiah ◽  
Nishant Goyal ◽  
K. K. Kshitiz
Keyword(s):  
Bipolar Disorder ◽  
Healthy Controls ◽  
Sensitivity To Reward ◽  
Bipolar Group ◽  
First Degree Relatives ◽  
Vulnerability Model ◽  
Increased Sensitivity ◽  
Appetitive Cues ◽  
Spectrum Disorders ◽  
Bipolar Patients

Background: Patients with bipolar disorder demonstrate increased sensitivity to appetitive/rewarding stimuli even during euthymia. On presentation of arousing pictures, they show a peculiar response, suggesting heightened vigilance. While responding to looming arousing cues, studies show subjects with anxiety spectrum disorders exhibit increased reaction time (RT), explained by the “looming-vulnerability model.” This study aimed to investigate the responses to looming arousing cues in euthymic bipolar patients and their first-degree relatives, as compared to healthy controls. Method: A looming appetitive and aversive cue paradigm was designed for assessing the RT of patients to process appetitive and aversive cues. The behavioral inhibition/activation and sensitivity to reward/punishment amongst the groups were also assessed. Results: The bipolar group showed significantly longer RT to process appetitive cues irrespective of the looming condition. Aversive cues elicited significantly longer RT in both the bipolar group and in first-degree relatives, but only when presented with the looming condition. Significant looming bias was elicited in the bipolar group which suggested a particular cognitive style to looming cues. A composite measure of RT along with sensitivity to reward/punishment distinguishes the bipolar group and their first-degree relatives from the healthy controls. Conclusion: The looming vulnerability model may provide important insights for future exploration of cognitive endophenotypes in bipolar disorder.

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