Temporal Stability of the dex/CRH Test in Patients with Rapid-Cycling Bipolar I Disorder: A Pilot Study

2005 ◽  
Vol 39 (4) ◽  
pp. 244-248 ◽  
Author(s):  
Stuart Watson ◽  
Jill M. Thompson ◽  
Navdeep Malik ◽  
I. Nicol Ferrier ◽  
Allan H. Young
Keyword(s):  
Bipolar Disorder ◽  
Pilot Study ◽  
Hpa Axis ◽  
Mood State ◽  
Temporal Stability ◽  
Cortisol Response ◽  
Rapid Cycling ◽  
Corticotropin Releasing Hormone ◽  
Hypothalamic Pituitary Adrenal ◽  
Over Time

Objective: To examine the hypothesis that hypothalamic-pituitary-adrenal (HPA) axis function is a trait abnormality in bipolar disorder. Method: We examined HPA axis function in a pilot study of five patients with rapid-cycling bipolar disorder in both relapse and remission using the dexamethasone/corticotropin releasing hormone (dex/CRH) test. Results: The cortisol response to the dex/CRH test correlated significantly between the 2 tests (r = 0.997; p < 0.0005). Conclusion: The data suggests that the cortisol response to the dex/CRH test is stable over time and independent of mood state.

scholarly journals Hypothalamic-pituitary-adrenal axis function in patients with bipolar disorder

2004 ◽  
Vol 184 (6) ◽  
pp. 496-502 ◽  
Author(s):  
Stuart Watson ◽  
Peter Gallagher ◽  
James C. Ritchie ◽  
I. Nicol Ferrier ◽  
Allan H. Young
Keyword(s):  
Bipolar Disorder ◽  
Hpa Axis ◽  
Cortisol Response ◽  
Hypothalamic Pituitary Adrenal ◽  
The Core ◽  
Basal Cortisol ◽  
Suppression Test ◽  
Cortisol Levels ◽  
Dexamethasone Suppression ◽  
Pituitary Adrenal Axis

BackgroundHypothalamic-pituitary-adrenal (HPA) axis function, as variously measured by the responses to the combined dexamethasone/ corticotrophin-releasing hormone (dex/ CRH) test, the dexamethasone suppression test (DST) and basal cortisol levels, has been reported to be abnormal in bipolar disorder.AimsTo test the hypothesis that HPA axis dysfunction persists in patients in remission from bipolar disorder.MethodSalivary cortisol levels and the plasma cortisol response to the DST and dex/CRH test were examined in 53 patients with bipolar disorder, 27 of whom fulfilled stringent criteria for remission, and in 28 healthy controls. Serum dexamethasone levels were measured.ResultsPatients with bipolar disorder demonstrated an enhanced cortisol response to the dex/CRH test compared with controls (P=0.001). This response did not differ significantly between remitted and non-remitted patients. These findings were present after the potentially confounding effects of dexamethasone levels were accounted for.ConclusionsThe dex/CRH test is abnormal in both remitted and non-remitted patients with bipolar disorder. Thismeasure of HP Aaxis dysfunction is a potential trait marker in bipolar disorder and thus possibly indicative of the core pathophysiological process in this illness.

Consistent Reduction of ACTH responses to stimulation with CRH, Vasopressin and Hypoglycaemia in Patients with Major Depression

1989 ◽  
Vol 155 (4) ◽  
pp. 468-478 ◽  
Author(s):  
Roger G. Kathol ◽  
Richard S. Jaeckle ◽  
Juan F. Lopez ◽  
William H. Meller
Keyword(s):  
Major Depression ◽  
Hpa Axis ◽  
Negative Correlation ◽  
Arginine Vasopressin ◽  
Corticotropin Releasing Hormone ◽  
Hypothalamic Pituitary Adrenal ◽  
Releasing Hormone ◽  
Control Subjects ◽  
Basal Cortisol ◽  
Cortisol Responses

Eleven patients with major depression and 12 control subjects were administered corticotropin-releasing hormone (CRH), aqueous arginine vasopressin (AVP), and insulin hypoglycaemia (IH) to test for differences in hypothalamic–pituitary–adrenal (HPA) axis function. Patients with major depression demonstrated lower ACTH responses to CRH when compared with controls, and a trend toward such after administration of AVP. Despite lower ACTH responses in patients with depression, there were no differences in Cortisol responses to these stimuli. In the CRH and AVP tests, there was no correlation between the basal Cortisol and ACTH responses in either controls or patients, but in the IH test there was a negative correlation between these responses for both groups. The ACTH responses to CRH and AVP were positively correlated in controls and patients. Cortisol responses to all three provocative stimuli were positively correlated in both subject groups. These findings are consistent with the hypothesis that hypothalamic or supra-hypothalamic overactivity may be involved in the development of HPA-axis abnormalities in patients with depression.

scholarly journals Impulsivity in adolescent bipolar disorder

2011 ◽  
Vol 23 (2) ◽  
pp. 57-61 ◽  
Author(s):  
Kirsten E. Gilbert ◽  
Jessica H. Kalmar ◽  
Fay Y. Womer ◽  
Philip J. Markovich ◽  
Brian Pittman ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Mood State ◽  
The Self ◽  
Self Report ◽  
Rapid Cycling ◽  
Mood Symptoms ◽  
Barratt Impulsiveness Scale ◽  
Course Features ◽  
Report Measure ◽  
Motor Subscale

Objective: Increased impulsivity has been shown to be a trait feature of adults with bipolar disorder (BD), yet impulsivity has received little study in adolescents with BD. Thus, it is unknown whether it is a trait feature that is present early in the course of the disorder. We tested the hypotheses that self-reported impulsiveness is increased in adolescents with BD, and that it is present during euthymia, supporting impulsiveness as an early trait feature of the disorder.Methods: Impulsiveness was assessed in 23 adolescents with BD and 23 healthy comparison (HC) adolescents using the self-report measure of impulsivity, the Barratt Impulsiveness Scale (BIS), comprised by attentional, motor and non-planning subscale scores. Effects of subscale scores and associations of scores with mood state and course features were explored.Results: Total and subscale BIS scores were significantly higher in adolescents with BD than HC adolescents. Total, attentional and motor subscale BIS scores were also significantly higher in the subset of adolescents with BD who were euthymic, compared to HC adolescents. Adolescents with BD with rapid-cycling and chronic mood symptoms had significantly higher total and motor subscale BIS scores than adolescents with BD without these course features.Conclusion: These results suggest increased self-reported impulsiveness is a trait feature of adolescents with BD. Elevated impulsivity may be especially prominent in adolescents with rapid-cycling and chronic symptoms.

scholarly journals Real-world clinical predictors of manic/hypomanic episodes among outpatients with bipolar disorder

PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0262129
Author(s):  
Keita Tokumitsu ◽  
Yasui-Furukori Norio ◽  
Naoto Adachi ◽  
Yukihisa Kubota ◽  
Yoichiro Watanabe ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Substance Abuse ◽  
Clinical Practice ◽  
Personality Disorder ◽  
Real World ◽  
Mood State ◽  
Rapid Cycling ◽  
Bipolar I Disorder ◽  
Antidepressant Prescription ◽  
One Year

Background Bipolar disorder is a mental illness in which manic and depressive states are repeated, causing psychosocial dysfunction. Manic/hypomanic episodes cause problems with interpersonal, social and financial activities, but there is limited evidence regarding the predictors of manic/hypomanic episodes in real-world clinical practice. Methods The multicenter treatment survey on bipolar disorder (MUSUBI) in Japanese psychiatric clinics was administered in an observational study that was conducted to accumulate evidence regarding bipolar disorder in real-world clinical practice. Psychiatrists were asked to complete a questionnaire about patients with bipolar disorder who visited 176 member clinics of the Japanese Association of Neuro-Psychiatric Clinics by conducting a retrospective medical record survey. Our study extracted baseline patient characteristics from September to October 2016, including comorbidities, mental status, duration of treatment, Global Assessment of Functioning (GAF) score, and pharmacological treatment details. We investigated the presence or absence of manic/hypomanic episodes over the course of one year from baseline to September-October 2017. Results In total, 2231 participants were included in our study, 29.1% of whom had manic/hypomanic episodes over the course of one year from baseline. Binomial logistic regression analysis revealed that the presence of manic/hypomanic episodes was correlated with lower baseline GAF scores, rapid cycling, personality disorder, bipolar I disorder, and a mood state with manic or mixed features. Substance abuse was also a risk factor for manic episodes. There was no significant association between a baseline antidepressant prescription and manic/hypomanic episodes. Conclusions In Japan, 29.1% of outpatients with bipolar disorder had manic/hypomanic episodes over the course of one year. Our study suggested that a low GAF score, rapid cycling, personality disorder, bipolar I disorder, substance abuse, and baseline mood state could be predictors of manic/hypomanic episodes. Based on our findings, an antidepressant prescription is not a predictor of manic/hypomanic episodes.

THE HYPOTHALAMIC-PITUITARY-ADRENAL (HPA) AXIS OF PATIENTS WITH SEVERE SEPSIS: ALTERED RESPONSE TO CORTICOTROPIN-RELEASING HORMONE (CRH)

1999 ◽  
Vol 27 (Supplement) ◽  
pp. A144
Author(s):  
Stefan Schroeder ◽  
Maria Wichers ◽  
Lutz E Lehmann ◽  
Christian Putensen ◽  
Andreas Hoeft ◽  
...  
Keyword(s):  
Severe Sepsis ◽  
Hpa Axis ◽  
Corticotropin Releasing Hormone ◽  
Hypothalamic Pituitary Adrenal ◽  
Releasing Hormone ◽  
Altered Response

Effects of Cloprednol and other Corticosteroids on Hypothalamic-Pituitary-Adrenal Axis Function

1976 ◽  
Vol 4 (5) ◽  
pp. 326-337 ◽  
Author(s):  
Eduardo Ortega ◽  
Consuelo Rodriguez ◽  
L James Strand ◽  
Eugene Segre
Keyword(s):  
Oral Dose ◽  
Single Oral Dose ◽  
Hpa Axis ◽  
Healthy Subjects ◽  
Plasma Cortisol ◽  
Cortisol Response ◽  
Hypothalamic Pituitary Adrenal ◽  
Adrenal Axis ◽  
Pituitary Adrenal Axis ◽  
Hpa Function

The effects of cloprednol and other synthetic corticosteroids on hypothalamic-pituitary-adrenal (HPA) function were studied in healthy subjects after administration of a single oral dose of corticosteroid at 6 a.m. or 6 p.m., and after daily 6 a.m. administration of corticosteroids at various doses for seven days. The degree of HPA suppression was assessed by metyrapone tests (METP), insulin hypoglycaemia tests (IHT) and 6 a.m. fasting plasma Cortisol concentrations. Regardless of the corticosteroid tested, 6 p.m. dosing was at least four-fold more suppressive of METP response than 6 a.m. administration. At therapeutically equivalent doses, single doses of triamcinolone and dexamethasone were more suppressive of HPA-axis function than cloprednol, hydrocortisone or prednisolone. After 6 a.m. administration for seven days, 12·5 mg of cloprednol did not impair the Cortisol response to IHT or interfere with the METP response. The clinically equivalent dose of prednisolone (25 mg) resulted in slightly greater HPA-axis suppression. All doses of dexamethasone (0·5, 3·75 and 6·0 mg) and of betamethasone (2·0, 4·0 and 6·5 mg) were more suppressive of HPA-axis function than either cloprednol or prednisolone. These results suggest that at equipotent anti-inflammatory doses, cloprednol is slightly less suppressive of HPA-axis function than prednisolone, and both cloprednol and prednisolone are much less suppressive than dexamethasone or betamethasone.

Emotional vulnerability and cognitive control in patients with bipolar disorder and their healthy siblings: a pilot study

2010 ◽  
Vol 22 (2) ◽  
pp. 54-62 ◽  
Author(s):  
Kathrin Houshmand ◽  
Peter Bräunig ◽  
Siegfried Gauggel ◽  
Katrin Kliesow ◽  
Rahul Sarkar ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Pilot Study ◽  
Cognitive Control ◽  
Response Inhibition ◽  
Emotional Regulation ◽  
Mood State ◽  
Emotional Arousal ◽  
Healthy Controls ◽  
Healthy Siblings ◽  
Emotional Vulnerability

Scheuch K, Bräunig P, Gauggel S, Kliesow K, Sarkar R, Krüger S. Emotional vulnerability and cognitive control in patients with bipolar disorder and their healthy siblings: a pilot study.Objective:There is evidence that, even in remission, patients with bipolar disorder (BD) have deficits in cognitive function and emotional regulation. Siblings of patients with BD are also reported to exhibit minor dysfunction in neuropsychological domains. In this study, we examined the interference of acute mood state with reaction time (RT) and response inhibition in euthymic patients with BD, in their healthy siblings and in healthy controls.Methods:A total of 34 patients with bipolar I disorder, 22 healthy siblings and 33 healthy controls performed a stop-signal paradigm after induction of a transient intense sadness and a relaxed mood state. The differences in RT and the response inhibition were compared between the groups.Results:Euthymic patients with BD displayed a higher emotional reactivity compared with their siblings and with controls. Compared with controls, patients with BD showed longer RTs in a relaxed mood state and a delay in response inhibition during emotional activation.Conclusions:The present study provides evidence for the clinical observation that patients with BD have shorter RTs when in a state of emotional arousal rather than in a relaxed state. Inhibitory deficits in these patients may be because of a too strong emotional arousal. The results show that in patients with BD, relaxation and emotional arousal are inversely associated with performance in a neuropsychological task. This is in contrast to findings in healthy individuals suggesting a dysbalance in emotional regulation in these patients.

Sign in / Sign up

Export Citation Format

Share Document