Mood disorders

Psychiatry ◽  
2019 ◽  
Author(s):  
Rebecca McKnight ◽  
Jonathan Price ◽  
John Geddes
Keyword(s):  
Bipolar Disorder ◽  
Depressive Disorder ◽  
Mood Disorder ◽  
Psychiatric Disorders ◽  
Mood Disorders ◽  
Diagnostic Criteria ◽  
Current Approach ◽  
Self Report ◽  
Chronic Instability ◽  
Low Mood

Variations in mood are part of normal experience; we all have our ‘good’ and ‘bad’ days and different ways of managing these. Sadness is a natural re­sponse to loss, adversity, stress, or other negative life experiences and is not necessarily abnormal. The main difference between normal sadness and a mood disorder is that normal sadness is usually a temporary state strongly relating to the person’s current situation, whereas mood disorder is a more persistent pervasive change in mood which affects social and occupational functioning. Primary mood (or ‘affective’) disorders are very common, and are also seen in most other psychiatric disorders or co-morbid to a physical illness. The distribution of mood variation in the general population is probably continuous, producing a spec­trum of severity (see Fig. 21.1). As with all psychiatric disorders, classification is descriptive and based on clinical characteristics. The most useful current approach to classification is based on the clinical course. Fundamental elements of this approach include: … ● classifying an illness as a single episode, recurrent, or persistent; ● distinguishing between people who have only low mood (unipolar depression) and those who also have elated mood (bipolar disorder); ● classifying episodes of illness according to severity: depressive episodes are mild, moderate, or severe; elated mood is hypomanic or manic (Table 21.1). … The classification includes two categories for less severe and more chronic illnesses: … ● Dysthymia: chronic mildly low mood which lasts at least several years but does not meet criteria for a recurrent depressive disorder. ● Cyclothymia: chronic instability of mood with periods of mild depressive and elation, none of which are severe enough to meet criteria for bipolar disorder or recurrent depressive disorder. It is often seen in relatives of those who have bipolar disorder, and some patients may eventually meet criteria for bipolar disorder themselves. The prevalence of mood disorders is hard to accurately ascertain, as many patients with low mood do not seek professional help. This is especially common in men. However, data from research studies (which tend to use structured diagnostic criteria) and large national sur­veys (self- report) give very similar results, outlined in Table 21.2. Bipolar disorder epidemiology is well cap­tured, as patients tend to seek help and the diagnostic criteria are well defined.

Attention-deficit/hyperactivity disorder and other neurodevelopmental disorders in offspring of parents with depression and bipolar disorder

2021 ◽  
pp. 1-8
Author(s):  
L. Propper ◽  
A. Sandstrom ◽  
S. Rempel ◽  
E. Howes Vallis ◽  
S. Abidi ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Attention Deficit Hyperactivity Disorder ◽  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Mood Disorder ◽  
Attention Deficit ◽  
Neurodevelopmental Disorders ◽  
Autism Spectrum ◽  
Major Depressive ◽  
Hyperactivity Disorder

Abstract Background Offspring of parents with major mood disorders (MDDs) are at increased risk for early psychopathology. We aim to compare the rates of neurodevelopmental disorders in offspring of parents with bipolar disorder, major depressive disorder, and controls. Method We established a lifetime diagnosis of neurodevelopmental disorders [attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder, communication disorders, intellectual disabilities, specific learning disorders, and motor disorders] using the Kiddie Schedule for Affective Disorders and Schizophrenia, Present and Lifetime Version in 400 participants (mean age 11.3 + s.d. 3.9 years), including 93 offspring of parents with bipolar disorder, 182 offspring of parents with major depressive disorder, and 125 control offspring of parents with no mood disorder. Results Neurodevelopmental disorders were elevated in offspring of parents with bipolar disorder [odds ratio (OR) 2.34, 95% confidence interval (CI) 1.23–4.47, p = 0.010] and major depressive disorder (OR 1.87, 95% CI 1.03–3.39, p = 0.035) compared to controls. This difference was driven by the rates of ADHD, which were highest among offspring of parents with bipolar disorder (30.1%), intermediate in offspring of parents with major depressive disorder (24.2%), and lowest in controls (14.4%). There were no significant differences in frequencies of other neurodevelopmental disorders between the three groups. Chronic course of mood disorder in parents was associated with higher rates of any neurodevelopmental disorder and higher rates of ADHD in offspring. Conclusions Our findings suggest monitoring for ADHD and other neurodevelopmental disorders in offspring of parents with MDDs may be indicated to improve early diagnosis and treatment.

scholarly journals Reliability and validity of a Brazilian version of the Hypomania Checklist (HCL-32) compared to the Mood Disorder Questionnaire (MDQ)

2010 ◽  
Vol 32 (4) ◽  
pp. 416-423 ◽  
Author(s):  
Odeilton Tadeu Soares ◽  
Doris Hupfeld Moreno ◽  
Eduardo Calmon de Moura ◽  
Jules Angst ◽  
Ricardo Alberto Moreno
Keyword(s):  
Bipolar Disorder ◽  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Mood Disorder ◽  
Psychometric Properties ◽  
Internal Consistency ◽  
Major Depressive ◽  
Brazilian Version ◽  
Diagnostic Certainty ◽  
Mood Disorder Questionnaire

OBJECTIVE: Bipolar disorders are often not recognized and undertreated. The diagnosis of current or past episodes of hypomania is of importance in order to increase diagnostic certainty. The Hypomania Checklist-32 is a self-applied questionnaire aimed at recognizing these episodes. As part of the international collaborative effort to develop multi-lingual versions of the Hypomania Checklist-32, we aimed to validate the Brazilian version and to compare its psychometric properties with those of the Mood Disorder Questionnaire. METHOD: Adult outpatients with bipolar disorder I (n = 37), bipolar disorder II (n = 44) and major depressive disorder (n = 42) of a specialized mood disorder unit were diagnosed according to DSM-IV-TR using a modified version of the SCID. We analyzed the internal consistency and discriminative ability of the Hypomania Checklist-32 Brazilian version in relation to the Mood Disorder Questionnaire. RESULTS: The internal consistency of the Brazilian Hypomania Checklist-32, analyzed using Cronbach's alpha coefficient, was 0.86. A score of 18 or higher in the Hypomania Checklist-32 Brazilian version distinguished between bipolar disorder and major depressive disorder, with a sensitivity of 0.75 and a specificity of 0.58, compared to 0.70 and 0.58, respectively, for the Mood Disorder Questionnaire (score > 7). The Hypomania Checklist-32 Brazilian version showed a dual factor structure characterized by "active/elated" and "risk-taking/irritable" items. Hence, the Hypomania Checklist-32 Brazilian version was found to have a higher sensitivity but the same specificity as the Mood Disorder Questionnaire. CONCLUSION: The Brazilian version of the Hypomania Checklist-32 has adequate psychometric properties and helps discriminating bipolar disorder from major depressive disorder (but not bipolar disorder I from bipolar disorder II) with good sensitivity and specificity indices, similar to those of the Mood Disorder Questionnaire.

scholarly journals Highly Predictive Transdiagnostic Features Shared across Schizophrenia, Bipolar Disorder, and ADHD Identified Using a Machine Learning Based Approach

2018 ◽  
Author(s):  
Yuelu Liu ◽  
Monika S. Mellem ◽  
Humberto Gonzalez ◽  
Matthew Kollada ◽  
Atul R. Mahableshwarkar ◽  
...  
Keyword(s):  
Machine Learning ◽  
Bipolar Disorder ◽  
Psychiatric Disorders ◽  
Patient Group ◽  
Attention Deficit ◽  
The United States ◽  
Self Report ◽  
Healthy Controls ◽  
Cohen’S D ◽  
Cohen's D

AbstractThe Diagnostic and Statistical Manual of Mental Disorders (DSM) is the standard for diagnosing psychiatric disorders in the United States. However, evidence has suggested that symptoms in psychiatric disorders are not restricted to the boundaries between DSM categories, implying an underlying latent transdiagnostic structure of psychopathology. Here, we applied an importance-guided machine learning technique for model selection to item-level data from self-reported instruments contained within the Consortium for Neuropsychiatric Phenomics dataset. From 578 questionnaire items, we identified a set of features which consisted of 85 items that were shared across diagnoses of schizophrenia (SCZ), bipolar disorder (BD), and attention deficit/hyperactivity disorder (ADHD). A classifier trained on the transdiagnostic features reliably distinguished the patient group as a whole from healthy controls (classification AUC = 0.95) and only 10 items were needed to attain the performance level of AUC being 0.90. A sum score created from the items produced high separability between patients and healthy controls (Cohen’s d = 2.85), and it outperformed predefined sum scores and sub-scores within the instruments (Cohen’s d ranging between 0.13 and 1.21). The transdiagnostic features comprised both symptom domains (e.g. dysregulated mood, attention deficit, and anhedonia) and personality traits (e.g. neuroticism, impulsivity, and extraversion). Moreover, by comparing the features that were common across the three patient groups with those that were most predictive of a single patient category, we can describe the unique features for each patient group superimposed on the transdiagnostic feature structure. Overall, our results reveal a latent transdiagnostic symptom/behavioral phenotypic structure shared across SCZ, BD, and ADHD and present a new perspective to understand insights offered by self-report psychiatric instruments.

scholarly journals Mood Disorders in Late Life: A Population-based Analysis of Prevalence, Risk Factors, and Consequences in Community-dwelling Older Adults in Ontario: Troubles de l’humeur en âge avancé : Une analyse dans la population de la prévalence, des facteurs de risque et des conséquences chez des adultes âgés vivant en milieu communautaire en Ontario

2020 ◽  
Vol 65 (9) ◽  
pp. 630-640
Author(s):  
Rachel Strauss ◽  
Paul Kurdyak ◽  
Richard H. Glazier
Keyword(s):  
Risk Factors ◽  
Mood Disorder ◽  
Mood Disorders ◽  
Potential Risk ◽  
Late Life ◽  
Population Based ◽  
Community Dwelling ◽  
Self Report ◽  
Term Care ◽  
Potential Risk Factors

Objective: Mental health issues in late life are a growing public health challenge as the population aged 65 and older rapidly increases worldwide. An updated understanding of the causes of mood disorders and their consequences in late life could guide interventions for this underrecognized and undertreated problem. We undertook a population-based analysis to quantify the prevalence of mood disorders in late life in Ontario, Canada, and to identify potential risk factors and consequences. Method: Individuals aged 65 or older participating in 4 cycles of a nationally representative survey were included. Self-report of a diagnosed mood disorder was used as the outcome measure. Using linked administrative data, we quantified associations between mood disorder and potential risk factors such as demographic/socioeconomic factors, substance use, and comorbidity. We also determined associations between mood disorders and 5-year outcomes including health service utilization and mortality. Results: The prevalence of mood disorders was 6.1% (4.9% among males, 7.1% among females). Statistically significant associations with mood disorders included younger age, female sex, food insecurity, chronic opioid use, smoking, and morbidity. Individuals with mood disorders had increased odds of all consequences examined, including placement in long-term care (adjusted odds ratio [OR] =2.28; 95% confidence interval [CI], 1.71 to 3.02) and death (adjusted OR = 1.35; 95% CI, 1.13 to 1.63). Conclusions: Mood disorders in late life were strongly correlated with demographic and social/behavioral factors, health care use, institutionalization, and mortality. Understanding these relationships provides a basis for potential interventions to reduce the occurrence of mood disorders in late life and their consequences.

scholarly journals 62 Predictors of Tardive Dyskinesia in Psychiatric Patients Taking Concomitant Antipsychotics

CNS Spectrums ◽  
2019 ◽  
Vol 24 (1) ◽  
pp. 207-208 ◽  
Author(s):  
Oscar Patterson-Lomba ◽  
Rajeev Ayyagari ◽  
Benjamin Carroll
Keyword(s):  
Quality Of Life ◽  
New York ◽  
Bipolar Disorder ◽  
Depressive Disorder ◽  
Prediction Model ◽  
Psychiatric Disorders ◽  
Index Date ◽  
Atypical Antipsychotics ◽  
Increased Risk

AbstractBackgroundTardive dyskinesia (TD) is typically caused by exposure to antipsychotics, is often irreversible, and can be debilitating. TD symptoms can increase the social stigma of patients with comorbid psychiatric disorders, negatively impact quality of life, and potentially increase medical morbidity and mortality. An increased risk of developing TD has been associated with factors such as older age, female sex, underlying mental illness, and long-term use and higher doses of antipsychotics. The association of TD with the use of typical versus atypical antipsychotics has also been evaluated, with mixed results. To date, predictive models assessing the joint effect of clinical characteristics on TD risk have not been developed and validated in the US population.Study ObjectiveTo develop a prediction model to identify patient and treatment characteristics associated with the occurrence of TD among patients with psychiatric disorders taking antipsychotic medications, using a retrospective database analysis.MethodsAdult patients with schizophrenia, major depressive disorder, or bipolar disorder who were taking oral antipsychotics, and who had 6months of data prior to the index date were identified from Medicaid claims from six US states. The index date was defined as the date of the first claim for an antipsychotic drug after a claim for the underlying disorder but before TD diagnosis. A multivariate Cox prediction model was developed using a cross-validated version of the least absolute shrinkage and selection operator (LASSO) regression method to improve prediction accuracy and interpretability of the model. The predictive performance was assessed in a separate validation set via model discrimination (concordance) and calibration.ResultsA total of 189,415 patients were identified: 66,723 with bipolar disorder, 68,573 with depressive disorder, and 54,119 with schizophrenia. The selected prediction model had a clinically meaningful concordance of 70% and was well calibrated (P=0.46 for Hosmer–Leme show goodness-of-fit test). Patient’s age at index date (hazard ratio [HR]: 1.03), diagnosis of schizophrenia (HR: 1.73), dosage of antipsychotic at index date (up to 100mg/day chlorpromazine equivalent; HR: 1.40), and presence of bipolar and related disorders (HR: 1.16) were significantly associated with an increased risk of TD diagnosis. Use of atypical antipsychotics at index date was associated with a modest reduction in the risk of TD (HR=0.94).ConclusionsThis study identified a group of factors associated with the development of TD among patients with psychiatric disorders treated with antipsychotics. This may allow physicians to better monitor their patients receiving antipsychotics, allowing for the prompt identification and treatment of TD to help maintain quality of life.Presented at: American Psychiatric Association Annual Meeting; May 5–9, 2018, New York, New York, USAFunding Acknowledgements: This study was supported by Teva Pharmaceuticals, Petach Tikva, Israel.

The effectiveness of intravenous ketamine in adults with treatment-resistant major depressive disorder and bipolar disorder presenting with prominent anxiety: Results from the Canadian Rapid Treatment Center of Excellence

2020 ◽  
pp. 026988112095404
Author(s):  
Roger S McIntyre ◽  
Nelson B Rodrigues ◽  
Orly Lipsitz ◽  
Flora Nasri ◽  
Hartej Gill ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Depressive Symptomatology ◽  
Rapid Onset ◽  
Anxiety Symptoms ◽  
Self Report ◽  
Treatment Center ◽  
Treatment Resistant ◽  
Major Depressive

Background: Individuals meeting criteria for treatment-resistant depression (TRD) are differentially affected by high levels of anxiety symptoms. Aims: There is a need to identify the efficacy of novel rapid-onset treatments in adults with mood disorders and comorbid anxious-distress. Methods: This study included patients with treatment-resistant major depressive disorder (MDD) or bipolar disorder (BD) who were receiving intravenous (IV) ketamine treatment at a community-based clinic.Anxious-distress was proxied using items from the Quick Inventory of Depressive Symptomatology–Self Report 16-item (QIDS-SR16) and Generalized Anxiety Disorder 7-item (GAD7) scales. The difference in QIDS-SR16 total score, QIDS-SR16 suicidal ideation (SI) item and GAD7 score were analyzed between groups. Results: A total of 209 adults with MDD ( n = 177) and BD ( n = 26) were included in this analysis. From this sample, 94 patients (mean = 45 ± 13.9 years) met the criteria for anxious-distress. Individuals meeting the criteria for anxious-distress exhibited a significantly greater reduction in QIDS-SR16 total score following four infusions ( p = 0.02) when compared with patients not meeting the anxious-distress criteria. Both anxious-distressed and low-anxiety patients exhibited a significant reduction in SI ( p < 0.0001) following four infusions.Finally, there was a significantly greater reduction in anxiety symptoms in the anxious-distress group compared with the non–anxious distress group following three ( p = 0.02) and four infusions ( p < 0.001). Conclusion: Patients with TRD and prominent anxiety receiving IV ketamine exhibited a significant reduction in depressive, SI and anxiety symptoms.

Fatty acid composition of the postmortem corpus callosum of patients with schizophrenia, bipolar disorder, or major depressive disorder

2017 ◽  
Vol 39 ◽  
pp. 51-56 ◽  
Author(s):  
K. Hamazaki ◽  
M. Maekawa ◽  
T. Toyota ◽  
B. Dean ◽  
T. Hamazaki ◽  
...  
Keyword(s):  
Fatty Acids ◽  
Bipolar Disorder ◽  
Major Depressive Disorder ◽  
Fatty Acid ◽  
White Matter ◽  
Corpus Callosum ◽  
Depressive Disorder ◽  
Psychiatric Disorders ◽  
Postmortem Brain ◽  
Major Depressive

AbstractBackgroundStudies investigating the relationship between n-3 polyunsaturated fatty acid (PUFA) levels and psychiatric disorders have thus far focused mainly on analyzing gray matter, rather than white matter, in the postmortem brain. In this study, we investigated whether PUFA levels showed abnormalities in the corpus callosum, the largest area of white matter, in the postmortem brain tissue of patients with schizophrenia, bipolar disorder, or major depressive disorder.MethodsFatty acids in the phospholipids of the postmortem corpus callosum were evaluated by thin-layer chromatography and gas chromatography. Specimens were evaluated for patients with schizophrenia (n = 15), bipolar disorder (n = 15), or major depressive disorder (n = 15) and compared with unaffected controls (n = 15).ResultsIn contrast to some previous studies, no significant differences were found in the levels of PUFAs or other fatty acids in the corpus callosum between patients and controls. A subanalysis by sex gave the same results. No significant differences were found in any PUFAs between suicide completers and non-suicide cases regardless of psychiatric disorder diagnosis.ConclusionsPatients with psychiatric disorders did not exhibit n-3 PUFAs deficits in the postmortem corpus callosum relative to the unaffected controls, and the corpus callosum might not be involved in abnormalities of PUFA metabolism. This area of research is still at an early stage and requires further investigation.

Dysfunctional Cognitions among Offspring of Individuals with Bipolar Disorder

2013 ◽  
Vol 43 (4) ◽  
pp. 449-464 ◽  
Author(s):  
Camilo J. Ruggero ◽  
Kathleen M. Bain ◽  
Patrick M. Smith ◽  
Jared N. Kilmer
Keyword(s):  
Bipolar Disorder ◽  
Young Adult ◽  
Depressive Disorder ◽  
Mood Disorder ◽  
Cognitive Models ◽  
Mood States ◽  
Dysfunctional Beliefs ◽  
Structured Interviews ◽  
Major Depressive ◽  
Dysfunctional Cognitions

Background: Individuals with bipolar disorder often endorse dysfunctional beliefs consistent with cognitive models of bipolar disorder (Beck, 1976; Mansell, 2007). Aims: The present study sought to assess whether young adult offspring of those with bipolar disorder would also endorse these beliefs, independent of their own mood episode history. Method: Participants (N = 89) were young adult college students with a parent with bipolar disorder (n = 27), major depressive disorder (MDD; n = 30), or no mood disorder (n = 32). Semi-structured interviews of the offspring were used to assess diagnoses. Dysfunctional beliefs related to Beck and colleagues’ (2006) and Mansell's (2007) cognitive models were assessed. Results: Unlike offspring of parents with MDD or no mood disorder, those with a parent with bipolar disorder endorsed significantly more dysfunctional cognitions associated with extreme appraisal of mood states, even after controlling for their own mood diagnosis. Once affected by a bipolar or depressive disorder, offspring endorsed dysfunctional cognitions across measures. Conclusions: Dysfunctional cognitions, particularly those related to appraisals of mood states and their potential consequences, are evident in young adults with a parent who has bipolar disorder and may represent targets for psychotherapeutic intervention.

scholarly journals EEG Frontal Asymmetry in Dysthymia, Major Depressive Disorder and Euthymic Bipolar Disorder

Symmetry ◽  
2021 ◽  
Vol 13 (12) ◽  
pp. 2414
Author(s):  
Chiara Spironelli ◽  
Francesca Fusina ◽  
Marco Bortolomasi ◽  
Alessandro Angrilli
Keyword(s):  
Bipolar Disorder ◽  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Mood Disorders ◽  
Quantitative Eeg ◽  
Beta Activity ◽  
Major Depressive ◽  
Eeg Asymmetry ◽  
Frontal Asymmetry ◽  
Frontal Eeg Asymmetry

In the last few decades, the incidence of mood disorders skyrocketed worldwide and has brought an increasing human and economic burden. Depending on the main symptoms and their evolution across time, they can be classified in several clinical subgroups. A few psychobiological indices have been extensively investigated as promising markers of mood disorders. Among these, frontal asymmetry measured at rest with quantitative EEG has represented the main available marker in recent years. Only a few studies so far attempted to distinguish the features and differences among diagnostic types of mood disorders by using this index. The present study measured frontal EEG asymmetry during a 5-min resting state in three samples of patients with bipolar disorder in a Euthymic phase (EBD, n = 17), major depressive disorder (MDD, n = 25) and persistent depressive disorder (PDD, n = 21), once termed dysthymia. We aimed to test the hypothesis that MDD and PDD lack the typical leftward asymmetry exhibited by normal as well as EBD patients, and that PDD shows greater clinical and neurophysiological impairments than MDD. Clinical scales revealed no symptoms in EBD, and significant larger anxiety and depression scores in PDD than in MDD patients. Relative beta (i.e., beta/alpha ratio) EEG asymmetry was measured from lateral frontal sites and results revealed the typical greater left than right frontal beta activity in EBD, as well as a lack of asymmetry in both MDD and PDD. The last two groups also had lower bilateral frontal beta activity in comparison with the EBD group. Results concerning group differences were interpreted by taking into account both the clinical and the neurophysiological domains.

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