Associations Between Self-Report of Emotional State and the EEG Patterns in Affective Disorders Patients

2010 ◽  
Vol 24 (1) ◽  
pp. 33-40 ◽  
Author(s):  
Miroslaw Wyczesany ◽  
Jan Kaiser ◽  
Anton M. L. Coenen
Keyword(s):  
State Energy ◽  
Emotional State ◽  
Spectral Power ◽  
Bipolar Affective Disorder ◽  
Affective State ◽  
Manic Episode ◽  
High Energy ◽  
Self Report ◽  
Major Depressive ◽  
High Tension

The study determines the associations between self-report of ongoing emotional state and EEG patterns. A group of 31 hospitalized patients were enrolled with three types of diagnosis: major depressive disorder, manic episode of bipolar affective disorder, and nonaffective patients. The Thayer ADACL checklist, which yields two subjective dimensions, was used for the assessment of affective state: Energy Tiredness (ET) and Tension Calmness (TC). Quantitative analysis of EEG was based on EEG spectral power and laterality coefficient (LC). Only the ET scale showed relationships with the laterality coefficient. The high-energy group showed right shift of activity in frontocentral and posterior areas visible in alpha and beta range, respectively. No effect of ET estimation on prefrontal asymmetry was observed. For the TC scale, an estimation of high tension was related to right prefrontal dominance and right posterior activation in beta1 band. Also, decrease of alpha2 power together with increase of beta2 power was observed over the entire scalp.

scholarly journals Mood self-assessment in bipolar disorder: a comparison between patients in mania, depression, and euthymia

2013 ◽  
Vol 35 (2) ◽  
pp. 141-145 ◽  
Author(s):  
Rafael de Assis da Silva ◽  
Daniel C. Mograbi ◽  
Luciana Angélica Silva Silveira ◽  
Ana Letícia Santos Nunes ◽  
Fernanda Demôro Novis ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Affective State ◽  
Manic Episode ◽  
Self Report ◽  
Type I ◽  
Global Assessment Of Functioning ◽  
Self Assessment ◽  
Syndrome Scale ◽  
Mood Scale ◽  
Negative Syndrome

BACKGROUND: Some studies indicate that mood self-assessment is more severely impaired in patients with bipolar disorder in a manic episode than in depression. OBJECTIVES: To investigate variations in mood self-assessment in relation to current affective state in a group of individuals with bipolar disorder. METHODS: A total of 165 patients with a diagnosis of bipolar disorder type I or type II had their affective state assessed using the Clinical Global Impressions Scale for use in bipolar illness (CGI-BP), the Positive and Negative Syndrome Scale (PANSS), and the Global Assessment of Functioning (GAF). In addition, participants completed a self-report visual analog mood scale (VAMS). Patients were divided into three groups (euthymia, mania, and depression) and compared with regard to VAMS results. RESULTS: Manic patients rated their mood similarly to patients in euthymia in 14 out of 16 items in the VAMS. By contrast, depressed patients rated only two items similarly to euthymic patients. CONCLUSION: Patients with bipolar disorder in mania, but not those in depression, poorly evaluate their affective state, reinforcing the occurrence of insight impairment in the manic syndrome.

scholarly journals The Symptom Structure of Postdisaster Major Depression: Convergence of Evidence from 11 Disaster Studies Using Consistent Methods

2021 ◽  
Vol 11 (1) ◽  
pp. 8
Author(s):  
Carol S. North ◽  
David Baron
Keyword(s):  
Major Depressive Disorder ◽  
Major Depression ◽  
Depressive Disorder ◽  
Diagnostic Assessment ◽  
Self Report ◽  
Depression Symptoms ◽  
Symptom Scale ◽  
Major Depressive ◽  
Report Symptom ◽  
Symptom Patterns

Agreement has not been achieved across symptom factor studies of major depressive disorder, and no studies have identified characteristic postdisaster depressive symptom structures. This study examined the symptom structure of major depression across two databases of 1181 survivors of 11 disasters studied using consistent research methods and full diagnostic assessment, addressing limitations of prior self-report symptom-scale studies. The sample included 808 directly-exposed survivors of 10 disasters assessed 1–6 months post disaster and 373 employees of 8 organizations affected by the September 11, 2001 terrorist attacks assessed nearly 3 years after the attacks. Consistent symptom patterns identifying postdisaster major depression were not found across the 2 databases, and database factor analyses suggested a cohesive grouping of depression symptoms. In conclusion, this study did not find symptom clusters identifying postdisaster major depression to guide the construction and validation of screeners for this disorder. A full diagnostic assessment for identification of postdisaster major depressive disorder remains necessary.

Mania with Bupropion: A Dose-Related Phenomenon?

2000 ◽  
Vol 34 (5) ◽  
pp. 619-621 ◽  
Author(s):  
Jessica L Goren ◽  
Gary M Levin
Keyword(s):  
Affective Disorder ◽  
Bipolar Depression ◽  
Bipolar Affective Disorder ◽  
Antidepressant Drug ◽  
Manic Episode ◽  
Total Daily Dose ◽  
High Dose ◽  
Related Phenomenon ◽  
Increased Risk ◽  
Daily Dose

OBJECTIVE: To report a case in which bipolar depression was resistant to usual therapies, requiring dosages of bupropion >450 mg/d and to review the literature on mania associated with bupropion and propose a potential theory of a dose-related threshold associated with bupropion and mania. CASE SUMMARY: A 44-year-old white man with a 25-year history of bipolar affective disorder presented with depression resistant to usual therapies. Bupropion therapy was initiated and the dosage was titrated to 600 mg/d. After exceeding the maximum recommended daily dose (450 mg/d), he experienced a manic episode attrib uted to high-dose bupropion. DISCUSSION: Due to increased risk of seizures, current prescribing guidelines state that the total daily dose of bupropion is not to exceed 450 mg/d. Since bupropion is the agent least likely to cause a manic switch in bipolar disorder, this agent seemed a logical choice to treat the patient's depression. Due to a lack of response, the bupropion dosage was titrated to a maximum of 600 mg/d. Since the patient did not switch into mania until the dosage exceeded 450 mg/d, we speculate that this adverse reaction is a dose-related phenomenon. Scientific literature supports this theory. CONCLUSIONS: A switch into mania is a potential risk associated with antidepressant drug use in bipolar affective disorder. Bupropion is believed to be associated with a decreased risk compared with other antidepressant therapies. However, our case report as well as others support the theory that this decreased risk may be due to dosages not exceeding the recommended daily dose (450 mg/d). Doses of bupropion >450 mg/d should be used with caution in depressed patients with bipolar affective disorder.

Lithium use in a patient on haemodialysis with bipolar affective disorder and lithium-induced nephropathy

2021 ◽  
Vol 14 (7) ◽  
pp. e242841
Author(s):  
Sam Topp ◽  
Emma Salisbury
Keyword(s):  
Affective Disorder ◽  
Bipolar Affective Disorder ◽  
Manic Episode ◽  
Dose Titration ◽  
Dialysis Session ◽  
Treatment Resistant ◽  
History Of ◽  
End Stage ◽  
Level Monitoring

Lithium is an effective mood stabiliser used to treat bipolar affective disorder (BPAD); however, it can also adversely affect the kidneys, causing acute toxic effects, nephrogenic diabetes insipidus, chronic renal dysfunction and end-stage kidney disease (ESKD) in a minority of patients. We describe the case of a man with a 34-year history of BPAD type-1 and a 2-year history of ESKD secondary to lithium-induced nephropathy who experienced a manic relapse. He previously responded well to lithium but, following a deterioration in kidney function, was switched to olanzapine and sodium valproate. This precipitated a period of instability, which culminated in a treatment-resistant manic episode requiring hospital admission. After a multidisciplinary team discussion, lithium therapy was restarted and provided remission. This was achieved safely through a reduced dosing schedule of three times a week post dialysis, slow dose titration and blood level monitoring prior to each dialysis session.

Prefrontal cortex function in remitted major depressive disorder

2012 ◽  
Vol 43 (6) ◽  
pp. 1219-1230 ◽  
Author(s):  
N. L. Nixon ◽  
P. F. Liddle ◽  
G. Worwood ◽  
M. Liotti ◽  
E. Nixon
Keyword(s):  
Major Depressive Disorder ◽  
Prefrontal Cortex ◽  
Depressive Disorder ◽  
Negative Feedback ◽  
Affective State ◽  
Recurrence Risk ◽  
Anterior Cingulate ◽  
Major Depressive ◽  
Negative Experience

BackgroundRecent models of major depressive disorder (MDD) have proposed the rostral anterior cingulate (rACC) and dorsomedial prefrontal cortex (dmPFC) as nexus sites in the dysfunctional regulation of cognitive-affective state. Limited evidence from remitted-state MDD supports these theories by suggesting that aberrant neural activity proximal to the rACC and the dmPFC may play a role in vulnerability to recurrence/relapse within this disorder. Here we present a targeted analysis assessing functional activity within these two regions of interest (ROIs) for groups with identified vulnerability to MDD: first, remitted, high predicted recurrence-risk patients; and second, patients suffering observed 1-year recurrence.MethodBaseline T2* images sensitive to blood oxygen level-dependent (BOLD) contrast were acquired from patients and controls during a Go/No-Go (GNG) task incorporating negative feedback, with 1-year patient follow-up to identify recurrence. BOLD contrast data for error commission (EC) and visual negative feedback (VNF) were used in an ROI analysis based on rACC and dmPFC coordinates from the literature, comparing patientsversuscontrols and recurrenceversusnon-recurrenceversuscontrol groups.ResultsAnalysis of patients (n = 20)versuscontrols (n = 20) showed significant right dmPFC [Brodmann area (BA) 9] hypoactivity within the patient group, co-localized during EC and VNF, with additional significant rACC (BA 32) hypoactivity during EC. The results from the follow-up analysis were undermined by small groups and potential confounders but suggested persistent right dmPFC (BA 9) hypoactivity associated with 1-year recurrence.ConclusionsConvergent hypoactive right dmPFC (BA 9) processing of VNF and EC, possibly impairing adaptive reappraisal of negative experience, was associated most clearly with clinically predicted vulnerability to MDD.

scholarly journals Neurocysticercosis presenting as bipolar disorder: a case report

2021 ◽  
Vol 34 (6) ◽  
pp. e100663
Author(s):  
Surbhi Batra ◽  
Sumit Kumar ◽  
Lokesh Singh Shekhawat
Keyword(s):  
Bipolar Disorder ◽  
Case Report ◽  
Depressive Symptoms ◽  
Affective Disorder ◽  
Postpartum Period ◽  
Bipolar Affective Disorder ◽  
Taenia Solium ◽  
Manic Episode ◽  
Symptoms And Signs ◽  
Rule Out

Neurocysticercosis is the most common neuro-parasitosis caused by the larval stage of Taenia solium. The most common manifestations include seizures and hydrocephalus. Psychiatric abnormalities are relatively rare but depressive symptoms are frequent in patients with neurocysticercosis. However, mania as a presentation is relatively rare. Pregnancy and the postpartum period are relatively vulnerable times and they can lead to reactivation of existing neurocysterci lesions. We are discussing the case of a 23-year-old female patient with neurocysticercosis leading to the reactivation of lesions in the peripartum and postpartum period leading to bipolar affective disorder. Improvement in the patient was seen with a combination of antipsychotics, antihelmintics, antiepileptics and steroids, along with improved radiological signs of neurocysterci lesions. Although neurocysticercosis is a common illness, its prevalence presenting as a manic episode is merely 2.6% and, hence, missed easily. Therefore, it is important to rule out organic aetiology in patients even with a classic presentation of bipolar affective disorder and those having any other neurological symptoms and signs.

scholarly journals The Appalachia Mind Health Initiative (AMHI): A pragmatic clinical trial of adjunctive internet-based Cognitive Behavior Therapy for treating major depressive disorder among primary care patients

2021 ◽  
Author(s):  
Robert M. Bossarte ◽  
Ronald C. Kessler ◽  
Andrew A. Nierenberg ◽  
Pim Cuijpers ◽  
Angel Enrique ◽  
...  
Keyword(s):  
Treatment Effects ◽  
Remission Rate ◽  
Self Report ◽  
Cognitive Behavior ◽  
Major Depressive ◽  
Treatment Providers ◽  
Health Initiative ◽  
Heterogeneity Of Treatment Effects ◽  
Comparative Treatment

Abstract Background: Major Depressive Disorder (MDD) is a leading cause of disease morbidity. Combined treatment with antidepressant medication (ADM) plus psychotherapy yields a much higher MDD remission rate than ADM-only. But 77% of US MDD patients are nonetheless treated with ADM-only despite strong patient preferences for psychotherapy. This mismatch is due at least in part to a combination of cost considerations and limited availability of psychotherapists, although stigma and reluctance of PCPs to refer patients for psychotherapy are also involved. Internet-based Cognitive Behavior Therapy (i-CBT) addresses all of these problems. Methods: Enrolled patients (n=3,360) will be those who are beginning ADM-only treatment of MDD in primary care facilities throughout West Virginia, one of the poorest and most rural states in the country. Participating treatment providers and study staff at West Virginia University School of Medicine (WVU) will recruit patients and, after obtaining informed consent, administer a baseline self-report questionnaire (SRQ) and then randomize patients to 1 of 3 treatment arms with equal allocation: ADM-only, ADM + self-guided i-CBT, and ADM + guided i-CBT. Follow-up SRQs will be administered 2, 4, 8, 13, 16, 26, 39, and 52 weeks after randomization. The trial has two primary objectives: to evaluate aggregate comparative treatment effects across the 3 arms; and to estimate heterogeneity of treatment effects (HTE). The primary outcome will be episode remission based on a modified version of the patient-centered Remission from Depression Questionnaire (RDQ). The sample was powered to detect predictors of HTE that would increase the proportional remission rate by 20% by optimally assigning individuals as opposed to randomly assigning them into three treatment groups of equal size. Aggregate comparative treatment effects will be estimated using intent-to-treat analysis methods. Cumulative inverse probability weights will be used to deal with loss to follow-up. A wide range of self-report predictors of MDD heterogeneity of treatment effects based on previous studies will be included in the baseline SRQ. A state-of-the-art ensemble machine learning method will be used to estimate HTE.Discussion: The study is innovative in using a rich baseline assessment and in having a sample large enough to carry out a well-powered analysis of heterogeneity of treatment effects. We anticipate finding that self-guided and guided i-CBT will both improve outcomes compared to ADM-only. We also anticipate finding that the comparative advantages of adding i-CBT to ADM will vary significantly across patients. We hope to develop a stable individualized treatment rule that will allow patients and treatment providers to improve aggregate treatment outcomes by deciding collaboratively when ADM treatment should be augmented with i-CBT. Trial registration: The Appalachian Mind Health Initiative (AMHI; registry name) was prospectively registered on 10/9/19 (ClinicalTrials.gov Identifier: NCT04120285).

scholarly journals Kluver-Bucy Syndrome in a Patient with Bipolar Affective Disorder

2018 ◽  
Vol 6 (1) ◽  
pp. 36-40
Author(s):  
Madhur Basnet ◽  
Luna Paudel ◽  
Bikram Prasad Gajurel ◽  
Nidesh Sapkota ◽  
Raj Kumar Rauniyar
Keyword(s):  
Rhesus Monkeys ◽  
Dietary Habits ◽  
Bipolar Affective Disorder ◽  
Cerebral Atrophy ◽  
Manic Episode ◽  
Temporal Lobectomy ◽  
Bipolar Illness ◽  
Close Relatives ◽  
Increased Activity ◽  
Lobe Atrophy

Introduction: Kluver and Bucy described a behavioral syndrome in rhesus monkeys following bilateral temporal lobectomy which included psychic blindness, hyperorality, hypermetamorphosis, hypersexuality, and emotional unresponsiveness. Case report: A 44 years old right handed male of Indo-aryan origin, blacksmith by profession, had presented in manic phase of bipolar illness. He had hypersexuality, hypermetamorphosis, hyperorality, and altered dietary habits along with amnesia and fleeting misrecognition of even his close relatives. MRI of the patient showed mild cerebral atrophy with right temporal lobe atrophy. The patient was treated with lithium and olanzapine along with benzodiazepines. The symptoms resolved gradually with resolution of the manic phase. Patient had similar features in the previous manic episode as well that resolved with resolution of mania. Conclusion: The symptoms of Kluver-Bucy syndrome like increased libido, increased activity might be confused with that of mania. Other features of Kluver-Bucy syndrome and the overt hypersexuality could help identify it even during manic phase of bipolar illness.

The Revised Child Anxiety and Depression Scale: A Psychometric Investigation with Australian Youth

2002 ◽  
Vol 19 (2) ◽  
pp. 90-101 ◽  
Author(s):  
Raelene L. de Ross ◽  
Eleonora Gullone ◽  
Bruce F. Chorpita
Keyword(s):  
Anxiety Disorder ◽  
Convergent Validity ◽  
Child Anxiety ◽  
Depression Scale ◽  
Separation Anxiety Disorder ◽  
Self Report ◽  
Anxiety And Depression ◽  
Normative Study ◽  
Major Depressive ◽  
Compulsive Disorder

AbstractThe Revised Child Anxiety and Depression Scale (RCADS) is a 47-item self-report measure intended to assess children's symptoms corresponding to selected DSM-IV anxiety and major depressive disorders. The scale comprises six subscales (e.g., Separation Anxiety Disorder; Social Phobia; Obsessive Compulsive Disorder; Panic Disorder; Generalised Anxiety Disorder; and Major Depressive Disorder). To date, only one normative study of youth has been published with results providing strong initial support for the reliability and validity of this new measure (Chorpita, Yim, Moffitt, Umemoto, & Francis, 2000). The present investigation provides additional psychometric data derived from an Australian sample comprising 405 youth aged 8 to 18 years. In general, the data were found to be consistent with those reported in the initial normative study. Internal consistency for the overall scale and its subscales was found to be adequate. Good convergent validity was demonstrated through moderate to strong correlations between the subscales of the RCADS with scores on the Revised Children's Manifest Anxiety Scale (RCMAS) and the Children's Depression Inventory (CDI). Confirmatory factor analysis suggested reasonable fit for the six-factor model by Chorpita et al. (2000). Notwithstanding the need for additional validation, it is concluded that the RCADS is a promising instrument for use in both clinical and research settings.

Bipolar illness

2013 ◽  
pp. 301-350
Keyword(s):  
Affective Disorder ◽  
Historical Perspective ◽  
Bipolar Affective Disorder ◽  
Manic Episode ◽  
Spectrum Disorder ◽  
Bipolar Illness ◽  
Clinical Notes ◽  
Bipolar Spectrum Disorder ◽  
Hypomanic Episode ◽  
Depressive Episodes

Introduction Historical perspective Mania/manic episode Hypomania/hypomanic episode Bipolar spectrum disorder Bipolar (affective) disorder 1: classification Bipolar (affective) disorder 2: clinical notes Bipolar (affective) disorder 3: aetiology Bipolar (affective) disorder 4: management principles Other issues affecting management decisions Treatment of acute manic episodes Treatment of depressive episodes...

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