scholarly journals Complexity and Variability Analyses of Motor Activity Distinguish Mood States in Bipolar Disorder

2021 ◽  
Author(s):  
Petter Jakobsen ◽  
Andrea Stautland ◽  
Michael A. Riegler ◽  
Ulysse Cote-Allard ◽  
Zahra Sepasdar ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Motor Activity ◽  
Graph Algorithm ◽  
Sample Entropy ◽  
Connected Components ◽  
Circadian Cycle ◽  
Manic State ◽  
Similarity Graph ◽  
Core Symptoms ◽  
Manic Patients

Aims Changes in motor activity are core symptoms of mood episodes in bipolar disorder. The manic state is characterized by increased variance, augmented complexity and irregular circadian rhythmicity when compared to healthy controls. The aim was to characterize differences in motor activity when comparing manic patients to their euthymic selves. Methods Motor activity was collected from 14 bipolar inpatients in mania and remission. 24-h recordings and 2-h time series in the morning and evening were analyzed for mean activity, variability and complexity. Lastly, the recordings were analyzed with the similarity graph algorithm and graph theory concepts such as edges, bridges, connected components and cliques. Results When compared to euthymia, over the duration of approximately one circadian cycle, the manic state presented reduced variability, displayed by decreased standard deviation (p = 0.013) and augmented complexity shown by increased sample entropy (p = 0.025). During mania there were also fewer edges (p = 0.039) and more bridges (p = 0.026). Similar changes in variability and complexity were observed in the 2-h morning and evening sequences, mainly in the estimates of the similarity graph algorithm. A comparison of morning and evening sequences within states revealed no significant change in estimates for mania. Contrarily, the euthymic state showed significant evening differences in variance and complexity, displayed by fewer edges (p = 0.010) and an increased number of connected components (p = 0.009). Conclusion The motor activity of mania is characterized by altered complexity, variability, and circadian rhythms when compared within-subject to euthymia.

Manic-depressive illness — II: treatment outcome in bipolar disorder subtypes

1992 ◽  
Vol 9 (1) ◽  
pp. 9-12 ◽  
Author(s):  
Patrick McKeon ◽  
Patrick Manley ◽  
Gregory Swanwick
Keyword(s):  
Bipolar Disorder ◽  
Treatment Outcome ◽  
Antidepressant Drugs ◽  
Depressive Illness ◽  
Tricyclic Antidepressant ◽  
Rapid Cycling ◽  
Manic Depressive Illness ◽  
Mood Changes ◽  
Manic Depressive ◽  
Manic Patients

AbstractThe treatment outcome of 100 bipolar disorder patients (B.P.) was examined retrospectively to determine whether bipolar subtypes had a differential prophylactic response to lithium, carbamazepine, neuroleptics and antidepressant drugs when these treatments were given in a predetermined sequence. Sixty-eight per cent of 53 B.P.-I patients with a mania-depression-normothymic-interval (M.D.I.) sequence of mood changes had a good response to lithium, and all but one of the remainder responded with the addition of carbamazepine or an antidepressant. While only 17% of 12 unipolar manic patients achieved prophylaxis with lithium and a further 17% when carbamazepine was added, the other 66% remained normothymic when a neuroleptic was prescribed with lithium. Of the seven rapid cycling patients where depression preceded mania, 28% had a good prophylactic effect with lithium, a further 28% when a tricyclic antidepressant was added and 14% with lithium and carbamazepine. None of the 18 rapid cycling M.D.I. group had a good response to lithium, but 39% stabilised when carbamazepine was added to lithium. Twenty-eight per cent of this group failed completely to respond to any of the treatments used. Neuroleptics increased the severity and duration of depressive phases for all subtypes except the unipolar mania group.

Manic Mood Disorders

2010 ◽  
Author(s):  
Max Fink MD
Keyword(s):  
Bipolar Disorder ◽  
Severity Of Illness ◽  
Bipolar Disorders ◽  
Manic Episode ◽  
Depressive Illness ◽  
Manic Depressive Illness ◽  
Sleep Difficulty ◽  
Manic Depressive ◽  
Loss Of Appetite ◽  
Manic Patients

Patients suffering from mania are overactive, intrusive, excited, and belligerent. They may believe that they have special powers, are related to public figures, and can read the minds of others. They spend money lavishly. Voices on the radio or television are sometimes understood as personal communications. They speak rapidly, with illogical and confused thoughts, move constantly, and write page after page of nonsense. They typically sleep and eat poorly, have little interest in work, friends, or family, and often require restraint or seclusion. Suicide is a perpetual threat. Some manic patients are likable, while others are angry and frightening. Psychosis is a frequent feature. Manic patients believe that their parents are not their real parents, asserting that they have royal blood. They believe that they can predict the future. They know that others are watching or talking about them, and they hear voices when no one is present. Delusional mania requires more intensive treatment and almost always hospital care. In older classifications of psychiatric illnesses, these patients were considered to be suffering from a manic-depressive illness. In modern classification, this term has been discarded and the illness is now conceived as bipolar disorder for patients with manic and depressive features and major depression for those with depressive symptoms only. Bipolar disorders, ranging from mild to severe, are divided into numerous subtypes. The variety of symptoms that admit the diagnosis of bipolar disorder has led to a virtual epidemic of diagnoses of the condition. Many patients so labeled do not exhibit the sleep difficulty, loss of appetite, and loss of weight, or the severity of illness, that were the criteria for manic-depressive illness. In manic-depressive illness, the manic episode persists for hours, days, weeks, or months and interferes with normal living. Once the episode resolves, it may suddenly recur; or manic episodes may alternate with periods of depression, or occur as simultaneous mixed episodes of depression and mania. When the shift in mood from mania to depression takes place within one or a few days, the condition is labeled rapid cycling, a particularly malignant form of the illness. In manic-depressive illness, the manic episode persists for hours, days, weeks, or months and interferes with normal living.

scholarly journals Sleep and Circadian Rhythm Disturbance in Remitted Schizophrenia and Bipolar Disorder: A Systematic Review and Meta-analysis

2020 ◽  
Vol 46 (5) ◽  
pp. 1126-1143 ◽  
Author(s):  
Nicholas Meyer ◽  
Sophie M Faulkner ◽  
Robert A McCutcheon ◽  
Toby Pillinger ◽  
Derk-Jan Dijk ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Circadian Rhythm ◽  
Motor Activity ◽  
Sleep Latency ◽  
Total Sleep Time ◽  
Sleep Time ◽  
Mean Difference ◽  
Effect Sizes ◽  
Time In Bed ◽  
Modifiable Factors

Abstract Background Sleep and circadian rhythm disturbances in schizophrenia are common, but incompletely characterized. We aimed to describe and compare the magnitude and heterogeneity of sleep-circadian alterations in remitted schizophrenia and compare them with those in interepisode bipolar disorder. Methods EMBASE, Medline, and PsycINFO were searched for case–control studies reporting actigraphic parameters in remitted schizophrenia or bipolar disorder. Standardized and absolute mean differences between patients and controls were quantified using Hedges’ g, and patient–control differences in variability were quantified using the mean-scaled coefficient of variation ratio (CVR). A wald-type test compared effect sizes between disorders. Results Thirty studies reporting on 967 patients and 803 controls were included. Compared with controls, both schizophrenia and bipolar groups had significantly longer total sleep time (mean difference [minutes] [95% confidence interval {CI}] = 99.9 [66.8, 133.1] and 31.1 [19.3, 42.9], respectively), time in bed (mean difference = 77.8 [13.7, 142.0] and 50.3 [20.3, 80.3]), but also greater sleep latency (16.5 [6.1, 27.0] and 2.6 [0.5, 4.6]) and reduced motor activity (standardized mean difference [95% CI] = −0.86 [−1.22, −0.51] and −0.75 [−1.20, −0.29]). Effect sizes were significantly greater in schizophrenia compared with the bipolar disorder group for total sleep time, sleep latency, and wake after sleep onset. CVR was significantly elevated in both diagnoses for total sleep time, time in bed, and relative amplitude. Conclusions In both disorders, longer overall sleep duration, but also disturbed initiation, continuity, and reduced motor activity were found. Common, modifiable factors may be associated with these sleep-circadian phenotypes and advocate for further development of transdiagnostic interventions that target them.

Cerebrospinal Fluid Lithium in Manic Illness

1966 ◽  
Vol 112 (483) ◽  
pp. 163-165 ◽  
Author(s):  
Max Alden Baker ◽  
George Winokur
Keyword(s):  
Cerebrospinal Fluid ◽  
Lithium Ion ◽  
Animal Experimentation ◽  
Therapeutic Use ◽  
Fourfold Increase ◽  
Manic State ◽  
Enzyme Systems ◽  
Clear Explanation ◽  
Two Phases ◽  
Manic Patients

The lithium ion has been found increasingly valuable in the treatment of manic illness (1, 2). In the therapeutic use of lithium there are two phases, stabilization and maintenance. These data have been reviewed by Gershon and Yuwiler (1), but a clear explanation of the pharmacodynamics involved is not evident. Animal experimentation has been used to study the behaviour of the lithium ion as compared with other cations. The lithium ion's behaviour resembles sodium in some tissues and enzyme systems but is more like potassium in others. These authors have reported a three- to fourfold increase in the tolerance for toxic symptoms due to lithium ion in manic patients as compared to normals. They found that this increased tolerance decreased to normal as the patient's manic state subsided.

Socio-Cultural Parameters in Yoruba Nigerian Patients with Affective Disorders

1989 ◽  
Vol 155 (3) ◽  
pp. 337-340 ◽  
Author(s):  
Roger O. A. Makanjuola
Keyword(s):  
Bipolar Disorder ◽  
Depressive Disorder ◽  
Affective Disorders ◽  
Educational Status ◽  
Major Depressive ◽  
Manic Disorder ◽  
Younger Age ◽  
History Of ◽  
Bipolar Patients ◽  
Manic Patients

One hundred and ten consecutive new patients presenting with major affective disorders were divided into five categories according to pattern of presentation: recurrent manic disorder, recurrent depressive disorder, bipolar disorder, single episodes of manic disorder, and single episodes of major depressive disorder. Manic patients predominated, and recurrent manic disorder was much more frequent than either recurrent depressive or bipolar disorder. The manic and bipolar patients were younger. Females predominanted in all five groups of patients. The two manic groups were less likely to be married, but this was probably a reflection of their younger age. No differences were demonstrated with regard to educational status or occupation. There were no significant differences with regard to sibship position, family size, or polygamous/monogamous parents. Manic patients were more likely to have suffered permanent separation from one or both parents before the age of 12 years. A relatively low proportion of the patients had a positive history of mental disorder among first- or second-degree relatives. Manic and bipolar patients tended to present in hospital relatively early in their illness.

Motor activity patterns can distinguish between interepisode bipolar disorder patients and healthy controls

CNS Spectrums ◽  
2020 ◽  
pp. 1-11
Author(s):  
Jakub Schneider ◽  
Eduard Bakštein ◽  
Marian Kolenič ◽  
Pavel Vostatek ◽  
Christoph U. Correll ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Motor Activity ◽  
Employment Status ◽  
Rating Scale ◽  
Activity Patterns ◽  
Healthy Controls ◽  
Respective Group ◽  
Young Mania ◽  
Mean Values ◽  
Time Variations

Abstract Background Bipolar disorder (BD) is linked to circadian rhythm disruptions resulting in aberrant motor activity patterns. We aimed to explore whether motor activity alone, as assessed by longitudinal actigraphy, can be used to classify accurately BD patients and healthy controls (HCs) into their respective groups. Methods Ninety-day actigraphy records from 25 interepisode BD patients (ie, Montgomery–Asberg Depression Rating Scale (MADRS) and Young Mania Rating Scale (YMRS) < 15) and 25 sex- and age-matched HCs were used in order to identify latent actigraphic biomarkers capable of discriminating between BD patients and HCs. Mean values and time variations of a set of standard actigraphy features were analyzed and further validated using the random forest classifier. Results Using all actigraphy features, this method correctly assigned 88% (sensitivity = 85%, specificity = 91%) of BD patients and HCs to their respective group. The classification success may be confounded by differences in employment between BD patients and HCs. When motor activity features resistant to the employment status were used (the strongest feature being time variation of intradaily variability, Cohen’s d = 1.33), 79% of the subjects (sensitivity = 76%, specificity = 81%) were correctly classified. Conclusion A machine-learning actigraphy-based model was capable of distinguishing between interepisode BD patients and HCs solely on the basis of motor activity. The classification remained valid even when features influenced by employment status were omitted. The findings suggest that temporal variability of actigraphic parameters may provide discriminative power for differentiating between BD patients and HCs while being less affected by employment status.

Increased Affective Reactivity to Neutral Stimuli and Decreased Maintenance of Affective Responses in Bipolar Disorder

2015 ◽  
Vol 30 (7) ◽  
pp. 852-860 ◽  
Author(s):  
M. Lemaire ◽  
W. El-Hage ◽  
S. Frangou
Keyword(s):  
Bipolar Disorder ◽  
Affective Responses ◽  
Clinical State ◽  
Healthy Individuals ◽  
Affective Dysregulation ◽  
Affective Reactivity ◽  
Manic State ◽  
Multiple Processes ◽  
Passive Viewing ◽  
Key Dimensions

AbstractBackground:Affective dysregulation is a core feature of bipolar disorder (BD) and a significant predictor of clinical and functional outcome. Affective dysregulation can arise from abnormalities in multiple processes. This study addresses the knowledge gap regarding the precise nature of the processes that may be dysregulated in BD and their relationship to the clinical expression of the disorder.Methods:Patients with BD (n = 45) who were either in remission or in a depressive or manic state and healthy individuals (n = 101) were compared in terms of the intensity, duration and physiological response (measured using inter-beat intervals and skin conductance) to affective and neutral pictures during passive viewing and during experiential suppression.Results:Compared to healthy individuals, patients with BD evidenced increased affective reactivity to neutral pictures and reduced maintenance of subjective affective responses to all pictures. This pattern was present irrespective of clinical state but was more pronounced in symptomatic patients, regardless of polarity. Patients, regardless of symptomatic status, were comparable to healthy individuals in terms of physiological arousal and voluntary control of affective responses.Conclusion:Our study demonstrates that increased affective reactivity to neutral stimuli and decreased maintenance of affective responses are key dimensions of affective dysregulation in BD.

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