Cognitive impairment in remission in bipolar affective disorder

2000 ◽  
Vol 30 (5) ◽  
pp. 1025-1036 ◽  
Author(s):  
J. S. RUBINSZTEIN ◽  
A. MICHAEL ◽  
E. S. PAYKEL ◽  
B. J. SAHAKIAN
Keyword(s):  
Executive Function ◽  
Affective Disorder ◽  
Response Latency ◽  
Substance Dependence ◽  
Bipolar Affective Disorder ◽  
Unipolar Depression ◽  
Social Adaptation ◽  
Cortical Function ◽  
Clinical Criteria ◽  
Bipolar Patients

Background. Although the traditional view of bipolar affective disorder is that the majority of patients have full remission between episodes, recent evidence suggests that residual cognitive deficits are present. The aim of this study was to determine whether memory and executive deficits were present in a well-defined clinically remitted group of patients.Methods. This was a case–control study of bipolar patients in remission (N = 18). Subjects had to fulfil stringent clinical criteria for inclusion into the study and had to have been in remission for at least 4 months. Subjects also had no history of substance dependence. The cognitive battery examined memory and executive function.Results. Patients in excellent clinical remission and who reported good social adaptation showed impairment on tests of visuospatial recognition memory. Accuracy on four tests of executive function was not impaired in patients in remission compared with controls, although response latency on these executive tests was still impaired.Conclusions. As our group and others have shown, patients with mania and unipolar depression show generalized impairment on tests of memory and executive function. In comparison, this study has demonstrated that patients in remission show a relatively specific impairment in memory with recovery of accuracy measures on executive function task. The increased response latency on the executive tasks suggests a possible small residual impairment. These findings suggest that in neuroanatomical terms, more posterior cortical function (temporal lobe) has not improved but there is at least some recovery of frontal lobe function in remission.

scholarly journals Altered Magnetic Resonance White-Matter T1 Values in Patients with Affective Disorder

1990 ◽  
Vol 157 (1) ◽  
pp. 107-110 ◽  
Author(s):  
R. J. Dolan ◽  
A. M. Poynton ◽  
P. K. Bridges ◽  
M. R. Trimble
Keyword(s):  
White Matter ◽  
Affective Disorder ◽  
Bipolar Affective Disorder ◽  
Normal Control Group ◽  
Proton Relaxation ◽  
Control Group ◽  
Frontal Lobe Dysfunction ◽  
Unipolar Disorder ◽  
Frontal White Matter ◽  
Bipolar Patients

The MRI T1 proton relaxation values were assessed in 14 patients with bipolar affective disorder and 10 with a unipolar disorder and a matched normal control group. The T1 values in the frontal white matter of patients significantly exceeded those of the controls. This difference was accounted for by an increase in T1 values in the frontal white matter of unipolar patients: the values for bipolar patients alone did not differ from those for controls. These preliminary findings support a hypothesis of frontal lobe dysfunction mediating pathological changes in mood.

scholarly journals Mental imagery in bipolar affective disorder versus unipolar depression: Investigating cognitions at times of ‘positive’ mood

2014 ◽  
Vol 166 ◽  
pp. 234-242 ◽  
Author(s):  
Annabel Ivins ◽  
Martina Di Simplicio ◽  
Helen Close ◽  
Guy M. Goodwin ◽  
Emily Holmes
Keyword(s):  
Affective Disorder ◽  
Mental Imagery ◽  
Bipolar Affective Disorder ◽  
Unipolar Depression ◽  
Positive Mood

Bipolar Affective Disorder in Old Age

1980 ◽  
Vol 136 (1) ◽  
pp. 26-32 ◽  
Author(s):  
Kenneth Shulman ◽  
Felix Post
Keyword(s):  
Retrospective Study ◽  
Affective Disorder ◽  
Old Age ◽  
Bipolar Affective Disorder ◽  
Bipolar Disorders ◽  
Long Period ◽  
Bipolar Patients ◽  
Depressive Episodes ◽  
Recurrent Nature

SummaryIn a retrospective study of 67 elderly bipolar patients the first manic attack occurred at about age 60, often after a long period from the time of the first affective episode, after which further depressive episodes occurred. This calls into question Perris’ criteria for unipolar diagnosis. Among the men, a preponderance of cerebral-organic disorders was found. The evidence for sub-classification of bipolar disorders into secondary or symptomatic manias is discussed. The recurrent nature of the illness in old age stresses the need for further evaluation of lithium prophylaxis.

scholarly journals DEMOGRAPHIC VARIABLES ASSOCIATED WITH DRUG USE IN BIPOLAR PATIENTS

2021 ◽  
Vol 30 (03) ◽  
pp. 114-119
Author(s):  
Aysha Rashid ◽  
Mariam Haroon ◽  
Sumira Qambar Bokhari ◽  
Aysha Butt ◽  
Nauman Mazhar ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Drug Abuse ◽  
Drug Use ◽  
Affective Disorder ◽  
Bipolar Affective Disorder ◽  
Treatment Compliance ◽  
Bipolar Patient ◽  
Cross Sectional ◽  
The Mean ◽  
Bipolar Patients

Background: Substance Use is highly associated with bipolar affective disorder, however the reason for the co-occurrence is unknown. It was evident that if a bipolar patient use  drug of abuse his outcome will be poor. Either it can directly trigger the affective symptoms, or may affect the treatment compliance indirectly. Aims: The objective of this study was to study the demographic correlates of drug abuse in patients with bi-polar affective disorder. Method: Cross-Sectional research design and non-probability consecutive sampling was used to collect data from a private clinic in Lahore. Data was comprised of 368 patients of bipolar disorder. Results: Out of a total of 368 bipolar patients, drug abuse was found in 147 patients that is 39.9%. The results showed that the mean age of the patients was 31.03 ±5.837; mean monthly income was 229597.82 ±164626.77 PKR. The mean duration of illness was 6.54 ±5.157. The mean number of drugs used was 2 ±0.875. The mean cost of drug was 29945.7 ±19068.8 PKR. The mean number of hospitalization was 2.47 ±1.694. Association  between drug use and  occupation of  bipolar patients (0.006), factors leading to initiation of drug use (0.000), family history of drug use (0.001), current episode (0.000) and the type of drugs used (0.000)  was statistically significant. Conclusion: The cause and effect relationship between drug use and bipolar disorder cannot be clearly identified. However occupation of the patient, reasons of initiating drugs, drug abuse in family, current episode as well as  type of drugs used have  significant association  with drug abuse in bipolar patients .

scholarly journals Impulsivity as a Risk Factor for Suicide in Bipolar Disorder

2021 ◽  
Vol 12 ◽  
Author(s):  
Przemysław Zakowicz ◽  
Maria Skibińska ◽  
Karolina Wasicka-Przewoźna ◽  
Bartosz Skulimowski ◽  
Filip Waśniewski ◽  
...  
Keyword(s):  
Affective Disorder ◽  
Suicide Risk ◽  
Iowa Gambling Task ◽  
Strong Predictor ◽  
Bipolar Affective Disorder ◽  
Self Report ◽  
Continuous Performance Task ◽  
Character Inventory ◽  
The Difference ◽  
Bipolar Patients

The accurate assessment of suicide risk in psychiatric, especially affective disorder diagnosed patients, remains a crucial clinical need. In this study, we applied temperament and character inventory (TCI), Barratt impulsiveness scale 11 (BIS-11), PEBL simple reaction time (SRT) test, continuous performance task (CPT), and Iowa gambling task (IGT) to seek for variables linked with attempted suicide in bipolar affective disorder group (n = 60; attempters n = 17). The main findings were: strong correlations between self-report tool scores and objective parameters in CPT; the difference between attempters and non-attempters was found in the number of correctly responded trials in IGT; only one parameter differed between attempters and non-attempters in BPI diagnosis; and no significant differences between suicide attempters and non-attempters in TCI, BIS-11, and SRT were found. These justify the conclusion that impulsivity itself is not a strong predictor, and used as a single variable might not be sufficient to indicate the high suicide risk group among bipolar patients.

scholarly journals Quality of Life in Schizophrenia and Bipolar Affective Disorder

2015 ◽  
Vol 3 (1) ◽  
Author(s):  
Pratima
Keyword(s):  
Quality Of Life ◽  
Bipolar Disorder ◽  
Affective Disorder ◽  
Expressed Emotion ◽  
Bipolar Affective Disorder ◽  
Poor Quality ◽  
Living Environment ◽  
The Family ◽  
Bipolar Patients

Family caregivers of persons with bipolar disorder and schizophrenia experience high level of burden and compromised quality of life. A considerable amount of burden on the caregivers often leads to display of certain attitudes towards persons with severe mental illness called expressed emotion, which then leads to poor quality of patients as well. Although numerous studies dealing with these issues separately are present, but studies dealing with relationship, using mixed methodology, among these issues are scarce. The aim of the present study was to understand how actually the construct of quality of life in different demographic conditions affect life conditions of schizophrenic and bipolar patients and determining relapse. The present study was designed mainly to assess the quality of life on patients and the families of a particular group of patients namely those with schizophrenia and bipolar disorder. The objectives if the present research were to study: (i) the quality of life of patients with Schizophrenia and Bipolar Affective disorder. (ii) the quality of life of caregivers of patients with Schizophrenia and Bipolar Affective disorder. Patients with disorders such as schizophrenia and bipolar affective disorder are more likely to relapse when there is high expressed emotion present in their living environment. The stress from the remarks and attitudes of the family is overwhelming because they feel like the cause of the problems. The patient then falls into the cycle of relapse. The only way to escape this vortex for the family is to go through therapy together to prevent the relapse. But before that it becomes necessary to understand that what is the reason behind such attitude towards a family member who is mentally ill, what is the cause of burden and what all changes the caregivers’ and the patients’ quality of life come across.

Ethnic differences in the presentation of bipolar affective disorder

1999 ◽  
Vol 14 (4) ◽  
pp. 199-204 ◽  
Author(s):  
G. Kirov ◽  
R.M. Murray
Keyword(s):  
Affective Disorder ◽  
Ethnic Differences ◽  
Bipolar Affective Disorder ◽  
Unipolar Depression ◽  
Appropriate Treatment ◽  
Black Patients ◽  
Bipolar Ii ◽  
The Uk ◽  
Suicidal Ideas ◽  
White Patients

SummaryThere have been repeated reports that Afro-Caribbean people living in the UK are more prone than white people to be diagnosed as having schizophrenia and mania, along with some evidence that they are less likely to receive a diagnosis of depression. We attempted to replicate these findings in a population of patients on lithium prophylaxis. We therefore assessed the clinical characteristics of people under the age of 55 from three ethnic groups attending a lithium clinic in south London, those of (1) white British (n = 88); (2) Afro-Caribbean (n = 31); and, (3) African (n = 15) origin.Nineteen of the white patients met DSM-IV criteria for unipolar depression (UP) and eight met the criteria for bipolar II disorder (BP II); in contrast, only two black patients met the criteria for unipolar depression and none met the criteria for BP II. Among patients diagnosed as BP I, Africans were significantly more likely than whites to show exclusively or mainly manic presentations while Afro-Caribbeans were more likely to have had mood-incongruent delusions. On the other hand, white patients were significantly more likely than Afro-Caribbeans to have had suicidal ideas or actions, and showed a similar but not significant excess when compared with Africans.Our findings could reflect either genuine ethnic differences in the presentation of severe affective disorder or be produced by the failure of British doctors to detect depression and deliver appropriate treatment to their black patients. The frequency with which Afro-Caribbean patients with mania present mood-incongruent delusions probably contributes to the high rates of diagnosed schizophrenia in this population.

Stigma as a Barrier to Recovery: Adverse Effects of Perceived Stigma on Social Adaptation of Persons Diagnosed With Bipolar Affective Disorder

2001 ◽  
Vol 52 (12) ◽  
pp. 1627-1632 ◽  
Author(s):  
Deborah A. Perlick ◽  
Robert A. Rosenheck ◽  
John F. Clarkin ◽  
Jo Anne Sirey ◽  
Jamelah Salahi ◽  
...  
Keyword(s):  
Adverse Effects ◽  
Affective Disorder ◽  
Bipolar Affective Disorder ◽  
Social Adaptation ◽  
Perceived Stigma

A comparative study of the phenomenological features of bipolar depression versus unipolar major depression in chinese patients in a regional hospital in hong kong

2011 ◽  
Vol 26 (S2) ◽  
pp. 260-260
Author(s):  
S.M.Q. Wong
Keyword(s):  
Family History ◽  
Affective Disorder ◽  
Bipolar Depression ◽  
Conditional Logistic Regression ◽  
Bipolar Affective Disorder ◽  
Unipolar Depression ◽  
Chinese Patients ◽  
Time Interval ◽  
History Of ◽  
The Mean

ObjectivesTo determine the characteristics and time course of diagnostic conversion from unipolar depression to bipolar depression in a retrospective cohort of psychiatric outpatients, and to compare the clinical and sociodemographic profiles of the bipolar switch group against a matched group without conversion.MethodThis is a retrospective case-control study in which outpatients newly diagnosed of unipolar depression from 1st January 1994 to 31st December 1999 were reviewed. Those with conversion to bipolar depression were identified and controls were matched.Multivariate conditional logistic regression was carried out to identify predictors of bipolar switch.Results88 patients out of 823 were identified with bipolar switch. The mean age at switch was 37.58 years old. The mean time interval from presentation to conversion was 58.13 months. Sodium valproate was most commonly used after switch. Bipolar switch was associated with male sex (OR 2.601, 95% CI 1.279 – 5.291, p = 0.008), an earlier age at presentation of depression of < 37 years old (OR 2.238, 95% CI 1.136 – 4.409, p = 0.020), family history of bipolar affective disorder (OR 5.684, 95% CI 1.149 – 28.124, p = 0.033) and use of 3 or above different antidepressants in the first five years after presentation (OR 2.105, 95% CI 1.082 – 4.098, p = 0.028).ConclusionThe incidence of bipolar switch found in this study was 10.7%. Family history of bipolar affective disorder and frequent switch of antidepressants in depressive patients presenting at a young age can be helpful guidance for identification of those at high risk for a bipolar course.

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