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

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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Mothers with and without bipolar disorder and their infants: group differences in mother-infant interaction patterns at three months postpartum

BMC Psychiatry ◽

10.1186/s12888-019-2275-4 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 1

Author(s):

Teija M. S. Anke ◽

Kari Slinning ◽

Vibeke Moe ◽

Cathrine Brunborg ◽

Torill S. Siqveland ◽

...

Keyword(s):

Bipolar Disorder ◽

Rating Scale ◽

Depressive Symptomatology ◽

Group Differences ◽

Maternal Behaviour ◽

Interaction Patterns ◽

Young Mania ◽

Significant Group ◽

Interaction Quality ◽

Affective Symptoms

Abstract Background Women with bipolar disorder (BD) have a high risk of illness relapse postpartum. The risk coincides with the period when mother-infant interactions are evolving. We compared mother-infant interactions in dyads where the mothers have BD with dyads where the mothers have no mental disorder. The association between concurrent affective symptoms of BD mothers and interaction quality was investigated. Methods Twenty-six women with BD and 30 comparison women with infants were included. The Parent-Child Early Relational Assessment (PCERA) was used to assess maternal behaviour, infant behaviour and dyadic coordination in interactions at 3 months postpartum. The Inventory of Depressive Symptomatology and Young Mania Rating Scale were used to assess affective symptoms of BD mothers at the time of interaction. Results There were significant group differences with medium to large effect sizes (0.73–1.32) on five of six subscales within the three interactional domains. Most interactional concerns were identified in dyadic coordination. No significant associations were found between maternal symptom load and interaction quality within the BD sample. Forty-six percent of the BD mothers experienced a mood episode within 0–3 months postpartum. Conclusions The present study identified challenges for mothers with BD and their infants in “finding” each other in interaction at 3 months postpartum. If sustained, this interaction pattern may have a long-term impact on children’s development. We suggest interventions specifically focusing on sensitising and supporting mothers to read infants’ cues on a micro-level. This may help them to respond contingently and improve dyadic coordination and synchronicity.

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Role of Age at Onset in the Clinical Presentation of Bipolar Disorder

JOURNAL FOR CLINICAL AND DIAGNOSTIC RESEARCH ◽

10.7860/jcdr/2021/24770.14692 ◽

2021 ◽

Author(s):

Ajitabh Soni ◽

Paramjeet Singh ◽

Raghav Shah ◽

Sunil Kumar ◽

Lalit Batra

Keyword(s):

Bipolar Disorder ◽

Family History ◽

Rating Scale ◽

Clinical Presentation ◽

Late Onset ◽

Age At Onset ◽

P Value ◽

Young Mania ◽

Thought Disorders ◽

History Of

Introduction: There is considerable evidence to suggest that the clinical expression of Bipolar Disorder (BD) differs according to Age at Onset (AAO) that has therefore been identified as a potential specifier of interest. Aim: To compare the clinical presentation of BD and also to compare the presence of family history of illness in three subgroups made on the basis of AAO. Materials and Methods: A cross-sectional hospital based observational study was carried out on 162 patients having a diagnosis of BD current episode manic. Three subgroups were made according to AAO viz., Early Onset Bipolar Disorder (EOBD; AAO ≤21 years; 67 patients), Intermediate Onset Bipolar Disorder (IOBD; AAO=22-34 years; 59 patients) and Late Onset Bipolar Disorder (LOBD; AAO ≥35 years; 36 patients). The subgroups were compared on clinical variables, items of the Young Mania Rating Scale (YMRS), Hamilton Depression Rating Scale (HAM-D) and Scale for Assessment of Positive Symptoms (SAPS) scales and family history of illness. Results: The EOBD subgroup had significantly more episodes per year (p-value <0.001 and partial eta squared value=0.17) than IOBD and LOBD subgroups (mean episodes per year, respectively in EOBD, IOBD and LOBD were 1.8, 0.8 and 0.6). The prevalence of family history of mood disorder was also significantly higher in the EOBD (present in 35 out of 67; χ2 value=22.8 and p-value <0.001) than both the other subgroups (present in 10 out of 59 in IOBD and 6 out of 36 in LOBD). Significant differences were found on different items of YMRS, HAM-D and SAPS scales among the subgroups EOBD subgroup had higher rating on irritability, motor activity energy, sexual interest, depressed mood, delusions, thought disorders, while LOBD subgroup had higher rating on elevated mood. Conclusion: EOBD subgroup can be considered as a specific phenotype of BD patients, which is more homogenous, severe and heritable form of illness.

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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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Odour identification impairment is a trait but not a disease-specific marker for bipolar disorders: Comparisons of bipolar disorder with different episodes, major depressive disorder and schizophrenia

Australian & New Zealand Journal of Psychiatry ◽

10.1177/0004867421998774 ◽

2021 ◽

pp. 000486742199877

Author(s):

Shu-bin Li ◽

Ze-tian Li ◽

Zhi-hong Lyu ◽

Xiao-yuan Zhang ◽

Lai-quan Zou

Keyword(s):

Bipolar Disorder ◽

Major Depressive Disorder ◽

Depressive Disorder ◽

Acute Phase ◽

Rating Scale ◽

Clinical Symptoms ◽

Olfactory Function ◽

Specific Marker ◽

Young Mania ◽

Major Depressive

Objective: Olfactory deficits have been reported in bipolar disorder, but this finding is controversial. This study investigated whether olfactory deficit can serve as a specific marker for bipolar disorder by comparing olfactory function in different mood episodes of bipolar disorder. We also compared olfactory function in bipolar disorder and other mental disorders – namely, major depressive disorder and schizophrenia. Methods: The study consisted of two experiments. Experiment 1 enrolled 175 bipolar disorder patients (70 depressed subgroup, 70 manic subgroup and 35 euthymic subgroup) and 47 controls. Experiment 2 enrolled the participants from Experiment 1, along with 85 major depressive disorder and 90 schizophrenia patients. The Sniffin’ Sticks test was used to evaluate odour identification ability and odour threshold (as a measure of odour sensitivity). The Hamilton Depression Rating Scale and Young Mania Rating Scale were used to assess depressive symptoms in all subjects and manic symptoms in bipolar disorder patients, respectively. We also used the Positive and Negative Syndrome Scale to assess clinical symptoms in schizophrenia patients. Results: All three bipolar disorder patient subgroups (depressed, manic and euthymic subgroup) showed reduced odour identification ability compared to controls; however, only patients in the acute phase of a mood episode (depressed, and manic subgroup) showed impaired odour sensitivity. Clinical symptoms were negatively correlated with odour sensitivity but not odour identification ability. Bipolar disorder and major depressive disorder patients showed less odour identification and sensitivity impairment than schizophrenia patients. Conclusion: Odour sensitivity is a potential dopaminergic marker for distinguishing between bipolar disorder patients in acute phase vs remission, while odour identification is a trait but a nonspecific marker of bipolar disorder.

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

Psychological Medicine ◽

10.1017/s0033291705005702 ◽

2005 ◽

Vol 35 (12) ◽

pp. 1737-1746 ◽

Cited By ~ 28

Author(s):

SUZANNE LUCIA BARRETT ◽

CHRISTOPHER KELLY ◽

DAVID ROBERT WATSON ◽

ROBERT BELL ◽

DAVID JOHN KING

Keyword(s):

Bipolar Disorder ◽

Prepulse Inhibition ◽

Startle Response ◽

Rating Scale ◽

Acoustic Startle ◽

High Risk Group ◽

Schizophrenia Spectrum Disorders ◽

Young Mania ◽

Stimulus Interval ◽

Bipolar Patients

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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Eye Movements and Cognitive Functioning in Patients With Schizophrenia Spectrum Disorders: Network Analysis

Frontiers in Psychiatry ◽

10.3389/fpsyt.2021.736228 ◽

2021 ◽

Vol 12 ◽

Author(s):

Alexander Shmukler ◽

Alexander V. Latanov ◽

Maria Karyakina ◽

Victor N. Anisimov ◽

Marina A. Churikova ◽

...

Keyword(s):

Eye Movements ◽

Network Analysis ◽

Cognitive Functioning ◽

Rating Scale ◽

Central Element ◽

Depression Scale ◽

Schizophrenia Spectrum Disorders ◽

Young Mania ◽

Schizophrenia Spectrum ◽

Spectrum Disorders

Background: Eye movement parameters are often used during cognitive functioning assessments of patients with psychotic spectrum disorders. It is interesting to compare these oculomotor parameters with cognitive functions, as assessed using psychometric cognitive tests. A network analysis is preferable for understanding complex systems; therefore, the aim of this study was to determine the multidimensional relationships that exist between oculomotor reactions and neurocognition in patients with schizophrenia spectrum disorders.Materials and Methods: A total of 134 subjects (93 inpatients with schizophrenia spectrum disorders (ICD-10) and 41 healthy volunteers) participated in this study. Psychiatric symptom severity was assessed using the Positive and Negative Syndrome Scale, the Calgary Depression Scale for Schizophrenia, and the Young Mania Rating Scale. Extrapyramidal symptoms were assessed using the Simpson-Angus Scale, and akathisia was assessed using the Barnes Akathisia Rating Scale. Eye movements were recorded using an eye-tracker SMI RED 500, and cognitive function was assessed using the Brief Assessment of Cognition in Schizophrenia. The statistical analyses were conducted using Minitab 17 Statistical Software, version 17.2.1. Data visualization and additional analyses were performed in the R 4.0.3 environment, using RStudio V 1.3.1093 software.Results: A network model of neurocognitive and oculomotor functions was constructed for the patients. In the full network (which includes all correlations) the median antisaccade latency value is the central element of the oculomotor domain, and the Symbol Coding test, the Digit Sequencing test, and the Verbal Fluency test are central elements in the neurocognitive domain. Additionally, there were connections between other cognitive and oculomotor functions, except for the antisaccade error latency in the oculomotor domain and the Token Motor Task in the neurocognitive domain.Conclusion: Network analysis provides measurable criteria for the assessment of neurophysiological and neurocognitive abnormalities in patients with schizophrenic spectrum disorders and allows to select key targets for their management and cognitive remediation.

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Impulsivity, personality and bipolar disorder

European Psychiatry ◽

10.1016/j.eurpsy.2009.03.004 ◽

2009 ◽

Vol 24 (7) ◽

pp. 464-469 ◽

Cited By ~ 31

Author(s):

M. Lewis ◽

J. Scott ◽

S. Frangou

Keyword(s):

Bipolar Disorder ◽

Rating Scale ◽

Clinical Symptoms ◽

Clinical Status ◽

Diagnostic Feature ◽

Eysenck Personality Questionnaire ◽

Young Mania ◽

Personality Dimension ◽

Trait Impulsivity ◽

The Relationship

AbstractBackgroundIncreased impulsivity is a diagnostic feature of mania in bipolar disorder (BD). However it is unclear whether increased impulsivity is also a trait feature of BD and therefore present in remission. Trait impulsivity can also be construed as a personality dimension but the relationship between personality and impulsivity in BD has not been explored. The aim of this study was to examine the relationship of impulsivity to clinical status and personality characteristics in patients with BD.MethodsWe measured impulsivity using the Barratt Impulsiveness Scale (BIS-11) and personality dimensions using Eysenck Personality Questionnaire in 106 BD patients and demographically matched healthy volunteers. Clinical symptoms were assessed in all participants using the Clinical Global Impressions Scale, the Montgomery-Asberg Depression Rating Scale and the Young Mania Rating Scale. Based on their clinical status patients were divided in remitted (n = 36), subsyndromal (n = 25) and syndromal (n = 45).ResultsThere was no difference in BIS-11 and EPQ scores between remitted patients and healthy subjects. Impulsivity, Neuroticism and Psychoticism scores were increased in subsyndromal and syndromal patients. Within the BD group, total BIS-11 score was predicted mainly by symptoms severity followed by Psychoticism and Neuroticism scores.ConclusionsIncreased impulsivity may not be a trait feature of BD. Symptom severity is the most significant determinant of impulsivity measures even in subsyndromal patients.

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Lovastatin as an Adjuvant to Lithium for Treating Manic Phase of Bipolar Disorder: A 4-Week, Randomized, Double-Blind, Placebo-Controlled Clinical Trial

Depression Research and Treatment ◽

10.1155/2014/730505 ◽

2014 ◽

Vol 2014 ◽

pp. 1-6 ◽

Cited By ~ 3

Author(s):

Ahmad Ghanizadeh ◽

Motahhar OmraniSigaroodi ◽

Ali Javadpour ◽

Mohammad Hossein Dabbaghmanesh ◽

Sara Shafiee

Keyword(s):

Clinical Trial ◽

Bipolar Disorder ◽

Placebo Group ◽

Adverse Effects ◽

Rating Scale ◽

Clinical Symptoms ◽

Controlled Clinical Trial ◽

Young Mania ◽

Double Blind ◽

Significant Difference

Objectives. Many patients with bipolar disorder suffer from metabolic disorder. Lovastatin is effective for treating major depression. This double-blind randomized placebo controlled clinical trial investigates whether lovastatin is a useful adjuvant to lithium for treating mania.Methods. Fifty-four patients with bipolar disorder-manic phase were randomly allocated into lovastatin or placebo group. The clinical symptoms were assessed at baseline, week 2, and week 4 using Young Mania Rating Scale. Adverse effects were checked.Results. Forty-six out of 54 patients completed this trial. The mania score in the lovastatin group decreased from 40.6 (11.1) at baseline to 12.9 (8.7) and 4.1 (5.4) at weeks 2 and 4, respectively. The score in the placebo group decreased from 41.0 (11.2) at baseline to 12.8 (8.07) and 5.8 (4.6) at weeks 2 and 4, respectively. However, there was no significant difference between groups at week 2 and week 4. The adverse effects rates were comparable between the two groups. No serious adverse effect was found. Tremor and nausea were the most common adverse effects.Conclusions. Lovastatin neither exacerbated nor decreased the symptoms of mania in patients with bipolar disorder. Current results support that the combination of lovastatin with lithium is tolerated well in bipolar disorder. The trial was registered with the Iranian Clinical Trials Registry (IRCT201302203930N18).

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Comparisons of Narrative Psychotherapy to Conventional CBT for the Psychotherapy of Psychosis and Bipolar Disorder

European Psychiatry ◽

10.1016/j.eurpsy.2017.01.1480 ◽

2017 ◽

Vol 41 (S1) ◽

pp. s779-s779

Author(s):

L. Mehl-Madrona ◽

B. Mainguy

Keyword(s):

Bipolar Disorder ◽

Narrative Therapy ◽

Rating Scales ◽

Psychotic Disorders ◽

Rating Scale ◽

Therapy Group ◽

Well Being ◽

Outcome Data ◽

Symptom Scale ◽

Young Mania

IntroductionThere is ongoing debate about about both the value of psychotherapy in psychotic disorders and the best type of psychotherapy to use if necessary.MethodsWe conducted narrative psychotherapy with 18 adults, all diagnosed as having bipolar disorder with psychotic features and/or schizo-affective disorder. Outcome data consisted of the Positive and Negative Symptom Scale, the Clinical Global Impressions Scale, the Young Mania Rating Scale, the Hamilton Anxiety and Depression Scales, the My Medical Outcome Profile, Version 2(MYMOP2), and the Outcome Rating Scales of Duncan and Miller. We compare the outcomes of our patients to those of a matched comparison group receiving conventional psycho-education and cognitive behavioural therapy. Patients were seen for a minimum of 16 weeks over an average of 22 weeks. Average age was 31.5 years with a standard deviation of 8.1 years.ResultsThe narrative therapy group showed statistically significant reductions in all outcome measures compared to the conventional treatment group. They continued treatment significantly longer and had fewer re-hospitalizations. They were less distressed by voices.ConclusionsA narrative psychotherapy approach using dialogical theory and therapy ideas is a reasonable approach for the psychotherapy of psychosis. Review of psychotherapy notes showed that narrative approaches allowed the therapist to align with the patient as collaborator in considering the story presented and was therefore less productive of defensiveness and self-criticism than conventional approaches. The therapy included techniques for negotiating changes in illness narratives, identity narratives, and treatment narratives that were more conducive of well-being and recovery.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Recovery and its correlates among patients with bipolar disorder: A study from a tertiary care centre in North India

International Journal of Social Psychiatry ◽

10.1177/0020764016676214 ◽

2016 ◽

Vol 62 (8) ◽

pp. 726-736 ◽

Cited By ~ 5

Author(s):

Sandeep Grover ◽

Nandita Hazari ◽

Jitender Aneja ◽

Subho Chakrabarti ◽

Sunil Sharma ◽

...

Keyword(s):

Bipolar Disorder ◽

Mental Illness ◽

Depressive Symptoms ◽

Rating Scale ◽

Tertiary Care ◽

North India ◽

Personal Recovery ◽

Tertiary Care Centre ◽

Young Mania ◽

Level Of Functioning

Background and Aim: The goal of treatment in mental illness has evolved from a symptom-based approach to a personal recovery–based approach. The aim of this study was to evaluate the predictors of personal recovery among patients with bipolar disorder. Methodology: A total of 185 patients with bipolar disorder, currently in remission, were evaluated on Recovery Assessment Scale (RAS), Internalized Stigma of Mental Illness Scale (ISMIS), Brief Religious coping scale (RCOPE), Duke University Religiosity Index (DUREL), Religiousness Measures Scale, Hamilton depression rating scale (HDRS), Young Mania rating scale (YMRS) and Global Assessment of Functioning (GAF) scale. Results: The mean age of the sample was 40.5 (standard deviation (SD), 11.26) years. Majority of the participants were male, married, working, Hindu by religion and belonged to extended/joint families of urban background. In the regression analysis, RAS scores were predicted significantly by discrimination experience, stereotype endorsement and alienation domains of ISMIS, level of functioning as assessed by GAF, residual depressive symptoms as assessed by HDRS and occupational status. The level of variance explained for total RAS score and various RAS domains ranged from 36.2% to 46.9%. Conclusion: This study suggests that personal recovery among patients with bipolar disorder is affected by stigma, level of functioning, residual depressive symptoms and employment status of patients with bipolar disorder.

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