Comorbidity of bipolar disorder and bulimia nervosa

1994 ◽  
Vol 9 (6) ◽  
pp. 315-317
Author(s):  
H Verdoux ◽  
M Mury ◽  
M Bourgeois
Keyword(s):  
Bipolar Disorder ◽  
Eating Disorders ◽  
Bulimia Nervosa ◽  
Bipolar Disorders ◽  
Unipolar Depression ◽  
Epidemiological Studies ◽  
Increased Risk ◽  
Bipolar Ii

SummaryThe association of eating disorders and bipolar disorders is less documented than the well-established association of eating disorders and unipolar depression. However, epidemiological studies have demonstrated an increased risk for bipolar disorders, especially bipolar II, in bulimic patients. We report the case of a patient displaying such a morbid association.

Migraine headache and bipolar disorder comorbidity: A systematic review of the literature and clinical implications

2016 ◽  
Vol 11 (1) ◽  
pp. 136-145 ◽  
Author(s):  
Raphael J. Leo ◽  
Joshna Singh
Keyword(s):  
Systematic Review ◽  
Bipolar Disorder ◽  
Migraine Headache ◽  
Unipolar Depression ◽  
Epidemiological Studies ◽  
Prevalence Rates ◽  
Review Of The Literature ◽  
Weighted Mean ◽  
Bipolar Ii Disorder ◽  
Bipolar Ii

AbstractBackground and aimsPsychiatric disorders, e.g., depression, are often comorbid with, and can complicate the treatment of, patients with migraine headache. Although empirical work has increasingly focused on the association between migraine and bipolar disorder, this topic has received little attention in the pain literature. Bipolar disorder is a chronic and recurrent mood disorder characterized by cyclic occurrence of elevated (i.e., manic or hypomanic) and depressed mood states. Bipolar I disorder is diagnosed when patients present with at least one abnormally and persistently elevated manic episode; bipolar II disorder is characterized by the presence of hypomanic episodes. Bipolar disorder warrants attention as depressive phases of the disorder can prevail and are often misconstrued by the unwary clinician as unipolar depression. However, treatment for bipolar disorder is distinct from that of unipolar depression and use of antidepressants, which are often invoked in migraine prophylaxis as well as the treatment of depression, may precipitate significant mood changes among bipolar disorder patients. A systematic review of the literature addressing the co-occurrence of bipolar disorder and migraine was conducted. The treatment of dually affected patients is also discussed.MethodsIn order to review the literature to date on migraine and bipolar disorder co-occurrence, a comprehensive search of MEDLINE, EMBASE, PubMed, PsycINFO, Web of Science, and CINAHL for clinic-based and epidemiological studies was conducted using terms related to migraine and bipolar disorder. Studies were selected for review if they included subjects meeting validated diagnostic criteria for bipolar disorder as well as migraine headache and if a quantitative description of prevalence rates of comorbid bipolar disorder and migraine were reported. Weighted means of the prevalence rates were calculated to compare with general epidemiological prevalence trends for migraine and bipolar disorder, respectively.ResultsEleven studies met inclusion criteria. Although findings were constrained by methodological limitations and several low quality studies, clinic- and epidemiological cross-sectional investigations demonstrated a high rate of comorbidity between bipolar disorder and migraine. The weighted mean prevalence rate for migraine headache among bipolar disorder patients was 30.7%; for bipolar disorder among migraineurs, the weighted mean prevalence rates were 9% and 5.9% in clinic-based and epidemiological studies, respectively. The association between bipolar disorder and migraine was most notable among women and patients with the bipolar II disorder subtype.ConclusionsHigh rates of comorbidity exist between migraine and bipolar disorder, exceeding estimated prevalence rates for those conditions in the general population. Comorbidity may portend a more serious clinical course for dually afflicted individuals.ImplicationsClinicians need to structure treatment approaches to address concurrent migraine and bipolar disorder in dually afflicted individuals. Although further evidence-based investigation is warranted to inform optimal treatment approaches for both conditions concurrently, anticonvulsants (e.g., valproate, lamotrigine and topiramate); atypical antipsychotics (e.g., olanzapine or quetiapine); and calcium channel blockers (e.g., verapamil) may be considered.

Comparison of the Hypomania Check List-32 scale with the Mood Disorder Questionnaire on Spanish Sample

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
E. Vieta ◽  
A. Martinez-Aran ◽  
J. Sanchez-Moreno
Keyword(s):  
Bipolar Disorder ◽  
Internal Consistency ◽  
Psychiatric Patients ◽  
Correct Diagnosis ◽  
Bipolar Disorders ◽  
Unipolar Depression ◽  
Cross Sectional ◽  
Bipolar Ii ◽  
Psychiatric Syndrome ◽  
The Right

Hypomania is perhaps the most difficult psychiatric syndrome to rule out retrospectively. However, the retrospective detection of hypomania is crucial for a correct diagnosis of bipolar disorder, and particularly bipolar II, and for the implementation of the right pharmacological treatment. Unfortunatelly, still nowadays, the misdiagnosis of bipolar II disorder as unipolar depression is very frequent, and may carry serious consequences for the patients. The availability of a good screening tool for past hypomania episodes would be extremely helpful.The psychometric study of the development of the HCL-32 scale in Spain exhibits high internal consistency and similar stability over time, in comparison with other instruments such as the MDQ and suggests that this scale may be very useful for the detection of bipolar disorder and past hypomania.The results of our study suggest the usefulness of the HCL-32 to screen out previous hypomanic symptoms in psychiatric patients, thus leading to better detection results than with the MDQ, although with the possibility of obtaining more false positives. HCL-32 has been shown to be a useful instrument for the detection of hypomania in patients with an affective disorder. The Spanish version exhibits good psychometric properties in relation to sensitivity and specificity. Given the difficulties involved in both the retrospective and cross-sectional diagnosis of hypomania, a key aspect of appropriate management of bipolar disorders, this questionnaire represents a potential improvement in clinicians’ ability to detect and correctly treat bipolar disorder, and in some aspects such as internal consistency, obtains better results than the MDQ.

scholarly journals Deficits in explicit emotion regulation in bipolar disorder: a systematic review

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Marcel Kurtz ◽  
Pia Mohring ◽  
Katharina Förster ◽  
Michael Bauer ◽  
Philipp Kanske
Keyword(s):  
At Risk ◽  
Bipolar Disorder ◽  
Emotion Regulation ◽  
Mood State ◽  
Bipolar Disorders ◽  
Protective Measure ◽  
Behavioral Measures ◽  
Increased Risk ◽  
Regulation Strategies ◽  
Depressive Episodes

Abstract Background This study aimed to compile and synthesize studies investigating explicit emotion regulation in patients with bipolar disorder and individuals at risk of developing bipolar disorder. The importance of explicit emotion regulation arises from its potential role as a marker for bipolar disorders in individuals at risk and its potent role in therapy for bipolar disorder patients. Methods To obtain an exhaustive compilation of studies dealing specifically with explicit emotion regulation in bipolar disorder, we conducted a systematic literature search in four databases. In the 15 studies we included in our review, the emotion-regulation strategies maintenance, distraction, and reappraisal (self-focused and situation-focused) were investigated partly on a purely behavioral level and partly in conjunction with neural measures. The samples used in the identified studies included individuals at increased risk of bipolar disorder, patients with current affective episodes, and patients with euthymic mood state. Results In summary, the reviewed studies' results indicate impairments in explicit emotion regulation in individuals at risk for bipolar disorder, patients with manic and depressive episodes, and euthymic patients. These deficits manifest in subjective behavioral measures as well as in neural aberrations. Further, our review reveals a discrepancy between behavioral and neural findings regarding explicit emotion regulation in individuals at risk for bipolar disorders and euthymic patients. While these groups often do not differ significantly in behavioral measures from healthy and low-risk individuals, neural differences are mainly found in frontostriatal networks. Conclusion We conclude that these neural aberrations are a potentially sensitive measure of the probability of occurrence and recurrence of symptoms of bipolar disorders and that strengthening this frontostriatal route is a potentially protective measure for individuals at risk and patients who have bipolar disorders.

scholarly journals Hypomanic Symptoms in Female Undergraduate Students Diagnosed with Unipolar Depression Based on Scores on the Hypomania Checklist

2009 ◽  
Vol 5 (1) ◽  
pp. 22-25 ◽  
Author(s):  
Thomas Richardson ◽  
Hugh Garavan
Keyword(s):  
Bipolar Disorder ◽  
Undergraduate Students ◽  
Unipolar Depression ◽  
Female Undergraduate ◽  
Bipolar Ii Disorder ◽  
Bipolar Ii

Background: A number of studies have documented high levels of hypomanic symptoms in those diagnosed with depression, suggesting a potential misdiagnosis of bipolar disorder as unipolar depression. Research suggests that undergraduate students have high levels of depression, but whether such misdiagnosis occurs in this population has not been examined. The aim of this study was therefore to examine levels of hypomania in undergraduate students reporting diagnosed depression. Methods: An international sample of undergraduate students completed the 32-item Hypomania Checklist (HCL-32). A cohort was analysed for this study, consisting of female undergraduate students reporting a formal diagnosis of depression (n=28). Results: Participants scored high on the HCL-32, with a mean total score of 19.9 (SD=5.4) out of 32. Overall, 85.7% (n=24) scored equal to or above the original cut off point of 14 suggested for bipolar II disorder. Conclusions: Two possible conclusions are suggested by this study. Firstly, there are high levels of hypomanic symptoms in undergraduate students diagnosed with depression, suggesting that a formal diagnosis of bipolar disorder should be pursued in those with high scores. Alternatively, the cut-off points previously suggested for the HCL-32 may not be accurate for use with undergraduate students.

scholarly journals Psychotic symptoms in bipolar disorder: Two years’ retrospective study

2017 ◽  
Vol 13 (1) ◽  
pp. 49-57
Author(s):  
Baikuntha Raj Adhikari ◽  
S Mishra ◽  
S Nepal ◽  
N Sapkota
Keyword(s):  
Bipolar Disorder ◽  
Retrospective Study ◽  
Bipolar Depression ◽  
Bipolar Disorders ◽  
Unipolar Depression ◽  
Common Type ◽  
Psychotic Symptoms ◽  
Mixed Episode ◽  
Auditory Verbal Hallucinations ◽  
Primary Substance

Background: Psychosis in bipolar disorder is common but still not well understood. There is paucity of literature from our country and none from this institute which serves the eastern part of Nepal.Objective: To describe the hallucinations and delusions in bipolar disorders in our place.Methods: Patients-record files of bipolar disorders with psychosis discharged in two years’ time from 2012 to 2014 were analysed. Patients with unipolar depression, recurrent depressive disorder, serious organic illness, and primary substance use disorders were excluded. Information was collected in a structured performa. Association of delusion and hallucination was observed.Results: During the study period, ninety-five patients with bipolardisorder had psychosis. Hallucination was present in 29 (30.5%) cases, and out of these 23 (79.3%) were cases of mania. In 26 (89.7%) patients, the hallucinations were mood congruent. The median duration of appearance of hallucination was 10 days and appeared early in mania. Among hallucinations, auditory verbal hallucinations were present in all 29 patients. Delusions were present in 77 (81.1%) of patients, and grandiose delusions were the most common. Grandiose delusions tended to occur even in the absence of hallucinations. Conclusion: Psychosis is common in bipolar disorder. Grandiose delusions are the most common delusion and are relatively independent of hallucination. The auditory verbal hallucinations are the most common type of hallucination. Hallucinations in mania tend to manifest earlier than in bipolar depression and mixed episode, and most of the hallucinations in bipolar disorder are mood congruent. Health Renaissance 2015;13 (1): 49-57

Magnetic resonance spectroscopic measurement of cerebral gamma-aminobutyric acid concentrations in patients with bipolar disorders

2006 ◽  
Vol 18 (2) ◽  
pp. 120-126 ◽  
Author(s):  
Po W. Wang ◽  
Napapon Sailasuta ◽  
Rebecca A. Chandler ◽  
Terence A. Ketter
Keyword(s):  
Bipolar Disorder ◽  
Magnetic Resonance ◽  
Mood Disorders ◽  
Bipolar Disorders ◽  
Occipital Lobe ◽  
Gabaergic Neurotransmission ◽  
Control Subjects ◽  
Bipolar Ii ◽  
Healthy Control ◽  
Cr Concentration

Background:Animal models of depression and psychopharmacological mechanisms of action suggest the importance of the gamma-amino butyric acid (GABA) system in the pathophysiology of mood disorders. Mood stabilizers have overlapping effects on GABAergic neurotransmission, and antidepressant use has been associated with alterations in GABAB receptor function. Magnetic resonance spectroscopy (MRS) provides an opportunity to noninvasively assess cerebral GABA concentrations in anterior paralimbic circuits that have been implicated in mood disorders.Methods:In bipolar disorder patients and healthy control subjects, we used MRS with a modified GABA-edited point resolved spectroscopy sequence (TE 68 ms, TR 1500 ms, 512 averages, total scan time 26 min) to assess GABA in an 18-cm3 occipital voxel. In addition, in another cohort of bipolar disorder patients and healthy control subjects, we similarly assessed GABA in a 12.5-cm3 medial prefrontal/anterior cingulate (MPF/AC) voxel. The concentration of GABA was referenced to creatine (Cr) from unedited spectra.Results:In bipolar patients and controls, we consistently detected 3.0 p.p.m. GABA peaks in occipital lobe and MPF/AC. In 16 bipolar (nine bipolar I and seven bipolar II) disorder patients, compared with six healthy control subjects, mean occipital GABA/Cr concentration was 61% higher. In addition, in 15 bipolar (five bipolar I, nine bipolar II, and one bipolar not otherwise specified) disorder patients, compared with six healthy control subjects, mean MPF/AC GABA/Cr concentration tended to be 41% higher.Conclusions:Patients with bipolar disorders may have increased cerebral GABA concentrations. Although this was more evident in the occipital lobe, MPC/AC GABA disturbance may be of greater potential interest in view the more established role of MPF/AC in affective processing. Additional studies are warranted to assess changes in GABAergic neurotransmission and the influences of diagnosis, mood state, and medication status in bipolar disorder patients.

scholarly journals Comorbidity Between ADHD and Symptoms of Bipolar Disorder in a Community Sample of Children and Adolescents

2005 ◽  
Vol 8 (5) ◽  
pp. 459-466 ◽  
Author(s):  
Wendy Reich ◽  
Rosalind J. Neuman ◽  
Heather E. Volk ◽  
Cynthia A. Joyner ◽  
Richard D. Todd
Keyword(s):  
Bipolar Disorder ◽  
Children And Adolescents ◽  
Latent Class ◽  
Community Sample ◽  
Control Sample ◽  
Bipolar Disorders ◽  
Adhd Subtypes ◽  
Population Prevalence ◽  
Increased Risk ◽  
Dsm Iv

AbstractThe prevalence and frequency of comorbidity of possible bipolar disorder was examined with attention-deficit hyperactivity disorder (ADHD) in a nonreferred population of twins. Children and adolescents aged 7 to 18 years with a history of manic symptoms were identified from a population-based twin sample obtained from state birth records (n = 1610). The sample was enriched for ADHD; however, there was also a random control sample (n = 466), which allowed a look at the population prevalence of the disorder. Juveniles with threshold or below threshold manic episodes were further assessed for comorbidity with Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV; American Psychiatric Association, 1994) and population-defined ADHD subtypes (from latent class analysis) using Fisher's exact test. Nine juveniles who exhibited DSM-IV manic (n = 1), hypomanic (n = 2) or below threshold episodes (n = 6) were identified. The population prevalence of broadly defined mania in the random sample was 0.2%. The possible manic episodes showed significant comorbidity with population-defined severe combined and talkative ADHD subtypes. It can be concluded that there is a significant association of bipolar symptoms with two population-defined subtypes of ADHD. Episodes of possible bipolar disorders as defined by DSM-IV are uncommon in this nonreferred sample. Children and adolescents with ADHD appear to be only modestly at increased risk for bipolar disorders.

scholarly journals Artistic creativity and risk for schizophrenia, bipolar disorder and unipolar depression: a Swedish population-based case–control study and sib-pair analysis

2018 ◽  
Vol 212 (6) ◽  
pp. 370-376 ◽  
Author(s):  
J. H. MacCabe ◽  
A. Sariaslan ◽  
C. Almqvist ◽  
P. Lichtenstein ◽  
H. Larsson ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Mental Disorder ◽  
Odds Ratio ◽  
Case Control Study ◽  
Tertiary Education ◽  
Unipolar Depression ◽  
Population Based ◽  
Case Control ◽  
Increased Risk ◽  
Control Study

BackgroundMany studies have addressed the question of whether mental disorder is associated with creativity, but high-quality epidemiological evidence has been lacking.AimsTo test for an association between studying a creative subject at high school or university and later mental disorder.MethodIn a case–control study using linked population-based registries in Sweden (N = 4 454 763), we tested for associations between tertiary education in an artistic field and hospital admission with schizophrenia (N = 20 333), bipolar disorder (N = 28 293) or unipolar depression (N = 148 365).ResultsCompared with the general population, individuals with an artistic education had increased odds of developing schizophrenia (odds ratio = 1.90, 95% CI = [1.69; 2.12]) bipolar disorder (odds ratio = 1.62 [1.50; 1.75]) and unipolar depression (odds ratio = 1.39 [1.34; 1.44]. The results remained after adjustment for IQ and other potential confounders.ConclusionsStudents of artistic subjects at university are at increased risk of developing schizophrenia, bipolar disorder and unipolar depression in adulthood.Declaration of interestNone.

Subthreshold Manifestations of Bipolar Disorders as Health Care’s tool

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
M. Mazza ◽  
D. Harnic ◽  
G. Marano ◽  
V. Catalano ◽  
L. Janiri ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Bipolar Disorder ◽  
Bipolar Disorders ◽  
Unipolar Depression ◽  
Response To Treatment ◽  
Type I ◽  
Male Patients ◽  
Bipolar Patients ◽  
Disorder Type

Introdution:Our study represents a pilot evaluation about how the MOOD-SR recognizes subthreshold manifestations that may be associated with clinical symptomatology in a group of bipolar patients.Methods:At Day Hospital of Psychiatry, Policlinico “A. Gemelli”, Bipolar Disorders Unit, it has been conducted an experimental study on a heterogeneous sample of 24 patients with a diagnosis of Bipolar Disorder type I. Patients have been assessed with the MOOD-SR, a clinical self-reported interview, that is specific for the spectrum of subthreshold pathology, and with the Quality of Life (QoL), that investigates the patient's quality of life.Results:We have found that 16 patients on 24 report a score higher than 60 (68,4%). Among these, 10 female patients on 15 have a total score higer than 61 (68.75%) while 6 male patients on 9 obtain a total score higher than 60 (62,5%). However, these results have only preliminary value, further studies are needed in order to obtain a deeper evaluation.Conclusion:Spectrum manifestations are both indicator of course and response to treatment and predictive for relapse. This finding may represent an important preventive instrument for maniacal relapse in patients with Bipolar Disorder, that is often underdiagnosed or confused for Unipolar Depression. By adequately recognizing the problem we will be able to refine diagnosis and individualize therapy.

scholarly journals Regional lithium prescription rates and recurrence in bipolar disorder

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Martin Sköld ◽  
Sindre Rolstad ◽  
Erik Joas ◽  
Mathias Kardell ◽  
Erik Pålsson ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Bipolar Disorders ◽  
Population Level ◽  
Bipolar I Disorder ◽  
Not Otherwise Specified ◽  
Number Of Patients ◽  
Bipolar Ii ◽  
National Quality ◽  
Prescription Rates ◽  
Depressive Episodes

Abstract Background Lithium is the best documented maintenance treatment in bipolar disorder, but its use varies considerably across and within countries. It is not known whether regional differences in lithium prescription rates translate to differing regional outcomes. Aims To estimate associations between county specific lithium prescription rates and county specific recurrence odds of bipolar disorder in Sweden. Method Data from 14,616 patients with bipolar I disorder, bipolar II disorder, or bipolar disorder not otherwise specified were extracted from the Swedish national quality assurance register for bipolar disorders (BipoläR). Lithium prescription frequencies were calculated for 21 counties. Logistic regression analyses were run adjusted for confounders, with any type of recurrence as primary outcome, and incident elated and depressive episodes as secondary outcomes. Subsets of patients with bipolar I, II and not otherwise specified disorder were also analysed separately. Results Lithium prescription rates for populations with all bipolar subtypes ranged across counties from 37.7 to 84.9% (mean 52.4%). Higher regional prescription rates were significantly associated with lower rate of any type of recurrence. The association was stronger when bipolar I disorder was analysed separately. Conclusions The advantages for lithium use long acknowledged for bipolar I disorder are also seen for the rest of the bipolar spectrum. Results suggest that population level outcomes of bipolar disorder could be improved by increasing the number of patients using lithium.

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