Patterns of changes in bipolar depressive symptoms revealed by trajectory analysis among 482 patients with bipolar disorder

Objective: Poorer mother–infant interaction quality has been identified among women with major depression; however, there is a dearth of research examining the impact of bipolar disorder. This study sought to compare mother–infant emotional availability at 6 months postpartum among women with perinatal major depressive disorder, bipolar disorder and no disorder (control). Methods: Data were obtained for 127 mother–infant dyads from an Australian pregnancy cohort. The Structured Clinical Interview for the DSM-5 was used to diagnose major depressive disorder ( n = 60) and bipolar disorder ( n = 12) in early pregnancy (less than 20 weeks) and review diagnosis at 6 months postpartum. Prenatal and postnatal depressive symptoms were measured using the Edinburgh Postnatal Depression Scale, along with self-report psychotropic medication use. Mother and infant’s interaction quality was measured using the Emotional Availability Scales when infants reached 6 months of age. Multivariate analyses of covariance examining the effects of major depressive disorder and bipolar disorder on maternal emotional availability (sensitivity, structuring, non-intrusiveness, non-hostility) and child emotional availability (responsiveness, involvement) were conducted. Results: After controlling for maternal age and postpartum depressive symptoms, perinatal disorder (major depressive disorder, bipolar disorder) accounted for 17% of the variance in maternal and child emotional availability combined. Compared to women with major depressive disorder and their infants, women with bipolar disorder and their infants displayed lower ratings across all maternal and child emotional availability qualities, with the greatest mean difference seen in non-intrusiveness scores. Conclusions: Findings suggest that perinatal bipolar disorder may be associated with additional risk, beyond major depressive disorder alone, to a mother and her offspring’s emotional availability at 6 months postpartum, particularly in maternal intrusiveness.

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Evaluating depressive symptoms in mania: a naturalistic study of patients with bipolar disorder

Neuropsychiatric Disease and Treatment ◽

10.2147/ndt.s82532 ◽

2015 ◽

pp. 1137 ◽

Cited By ~ 17

Author(s):

Allan Young ◽

Jonas Eberhard

Keyword(s):

Bipolar Disorder ◽

Depressive Symptoms ◽

Naturalistic Study

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Associations between residual depressive symptoms, cognition, and functioning in patients with euthymic bipolar disorder: results from the FACE-BD cohort

The British Journal of Psychiatry ◽

10.1192/bjp.bp.117.201335 ◽

2017 ◽

Vol 211 (6) ◽

pp. 381-387 ◽

Cited By ~ 18

Author(s):

Paul Roux ◽

Aurélie Raust ◽

Anne-Sophie Cannavo ◽

Valérie Aubin ◽

Bruno Aouizerate ◽

...

Keyword(s):

Bipolar Disorder ◽

Depressive Symptoms ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Cognitive Component ◽

Cognitive Components ◽

The Face ◽

Sources Of Variation ◽

The Relationship

BackgroundThe relationship between residual depressive symptoms, cognition and functioning in patients with euthymic bipolar disorder is a subject of debate.AimsTo assess whether cognition mediates the association between residual depressive symptoms and functioning in patients with bipolar disorder who were euthymic.MethodWe included 241 adults with euthymic bipolar disorder in a multicentre cross-sectional study. We used a battery of tests to assess six cognition domains. A path analysis was then used to perform a mediation analysis of the relationship between residual depressive symptoms, cognitive components and functioning.ResultsOnly verbal and working memory were significantly associated with better functioning. Residual depressive symptoms were associated with poorer functioning. No significant relationship was found between residual depressive symptoms and any cognitive component.ConclusionsCognition and residual depressive symptoms appear to be two independent sources of variation in the functioning of people with euthymic bipolar disorder.

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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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Neurocysticercosis presenting as bipolar disorder: a case report

General Psychiatry ◽

10.1136/gpsych-2021-100663 ◽

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.

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Living With Bipolar Disorder in the Time of Covid-19: Biorhythms During the Severe Lockdown in Cagliari, Italy, and the Moderate Lockdown in Tunis, Tunisia

Frontiers in Psychiatry ◽

10.3389/fpsyt.2021.634765 ◽

2021 ◽

Vol 12 ◽

Author(s):

Mauro Giovanni Carta ◽

Uta Ouali ◽

Alessandra Perra ◽

Azza Ben Cheikh Ahmed ◽

Laura Boe ◽

...

Keyword(s):

Bipolar Disorder ◽

Depressive Symptoms ◽

Rating Scale ◽

Biological Rhythms ◽

Short Term ◽

Female Age ◽

Future Studies ◽

Restrictive Measures ◽

Depressive Episodes ◽

Hamilton Rating Scale

Background: Restrictions during Covid-19 pandemic lockdown, in which rhythms of life have been compromised, can influence the course of bipolar disorder (BD). This study follows patients with bipolar disorder living in two geographically close cities (Cagliari and Tunis), but with different lockdown conditions: less severe in Tunis.Methods: Two cohorts were evaluated during lockdown (April 2020, t0) and 2 months later with lockdown lifted for a month (t1). Individuals were: over 18 years old without gender exclusion, BD I or II, in care for at least 1 year, received a clinical interview in the month before the start of the lockdown, stable clinically before the lockdown. The assessment was conducted by telephone by a psychiatrist or psychologist with good knowledge of patients. Diagnoses were made according to DSM-5 criteria. Depressive symptoms were collected through the Hamilton Rating Scale for Depression; cut-off 14 indicative of depressive episode. Circadian rhythms were measured using the BRIAN scale.Results: Forty individuals in Cagliari (70%female, age 48.57 ± 11.64) and 30 in Tunis (53.3% Female, age 41.8 ± 13.22) were recruited. In Cagliari at t0 45% had depressive episodes against none in Tunis, a similar difference appeared at t1. At t0 and t1 the Cagliari sample had more dysfunctional scores in the overall BRIAN scale and in the areas of sleep, activities and social rhythms; no differences were found in nutrition, both samples had predominantly nocturnal rhythm. In Cagliari at t0 and t1, the depressive sub-group showed more dysfunctional scores in the BRIAN areas sleep, activity, and nutrition. However, the differences in biological rhythms resulted, through ANCOVA analysis, independent of the co-presence of depressive symptoms.Discussion: A rigid lockdown could expose people with BD to depressive relapse through dysregulation of biological rhythms. The return to more functional rhythms did not appear 1 month after lockdown. The rekindling of the pandemic and the restoration of new restrictive measures will prevent, at least in the short term, the beneficial effect of a return to normality of the two cohorts.This was a limited exploratory study; future studies with larger samples and longer observational time are needed to verify the hypothesis.

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Polygenic scores for major depressive disorder and depressive symptoms predict response to lithium in patients with bipolar disorder

10.1101/449363 ◽

2018 ◽

Cited By ~ 1

Author(s):

Azmeraw T. Amare ◽

Klaus Oliver Schubert ◽

Liping Hou ◽

Scott R. Clark ◽

Sergi Papiol ◽

...

Keyword(s):

Bipolar Disorder ◽

Major Depressive Disorder ◽

Depressive Symptoms ◽

Depressive Disorder ◽

Treatment Response ◽

Lithium Treatment ◽

Mapk Signaling ◽

Genome Wide Association Studies ◽

Major Depressive ◽

Polygenic Scores

AbstractBackgroundLithium is a first-line medication for bipolar disorder (BD), but only ~30% of patients respond optimally to the drug. Since genetic factors are known to mediate lithium treatment response, we hypothesized whether polygenic susceptibility to the spectrum of depression traits is associated with treatment outcomes in patients with BD. In addition, we explored the potential molecular underpinnings of this relationship.MethodsWeighted polygenic scores (PGSs) were computed for major depressive disorder (MDD) and depressive symptoms (DS) in BD patients from the Consortium on Lithium Genetics (ConLi+Gen; n=2,586) who received lithium treatment. Lithium treatment outcome was assessed using the ALDA scale. Summary statistics from genome-wide association studies (GWAS) in MDD (130,664 cases and 330,470 controls) and DS (n=161,460) were used for PGS weighting. Associations between PGSs of depression traits and lithium treatment response were assessed by binary logistic regression. We also performed a cross-trait meta-GWAS, followed by Ingenuity® Pathway Analysis.OutcomesBD patients with a low polygenic load for depressive traits were more likely to respond well to lithium, compared to patients with high polygenic load (MDD: OR =1.64 [95%CI: 1.26-2.15], lowest vs highest PGS quartiles; DS: OR=1.53 [95%CI: 1.18-2.00]). Associations were significant for type 1, but not type 2 BD. Cross-trait GWAS and functional characterization implicated voltage-gated potassium channels, insulin-related pathways, mitogen-activated protein-kinase (MAPK) signaling, and miRNA expression.InterpretationGenetic loading to depression traits in BD patients lower their odds of responding optimally to lithium. Our findings support the emerging concept of a lithium-responsive biotype in BD.FundingSee attached details

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Effects of Marijuana Use on Brain Circuitry and Depressive Symptoms in Adolescents With Bipolar Disorder

Journal of the American Academy of Child & Adolescent Psychiatry ◽

10.1016/j.jaac.2019.09.016 ◽

2019 ◽

Vol 58 (10) ◽

pp. S299

Author(s):

Adina S. Fischer

Keyword(s):

Bipolar Disorder ◽

Depressive Symptoms ◽

Marijuana Use ◽

Brain Circuitry

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‘Bipolarity’ in bipolar disorder: Distribution of manic and depressive symptoms in a treated population

The British Journal of Psychiatry ◽

10.1192/bjp.187.1.87 ◽

2005 ◽

Vol 187 (1) ◽

pp. 87-88 ◽

Cited By ~ 52

Author(s):

Mark S. Bauer ◽

Gregory E. Simon ◽

Evette Ludman ◽

Jurgen Unützer

Keyword(s):

Bipolar Disorder ◽

Depressive Symptoms ◽

Health Maintenance Organisation ◽

Cross Sectional ◽

Health Maintenance ◽

Manic Symptoms ◽

Clinically Significant ◽

Sectional Analysis ◽

Depressive And Manic Symptoms

SummaryCross-sectional analysis of 441 individuals with bipolar disorder treated at a US health maintenance organisation investigated the distribution of manic and depressive symptoms in that illness. Clinically significant depressive symptoms occurred in 94.1% of those with (hypo)mania, while70.1% inadepressive episode had clinically significant manic symptoms. DSM-unrecognised depression-plus-hypomania was over twice as prevalent as DSM-recognised mixed episodes. Depressive symptoms were unimodally distributed in (hypo)mania. Depressive and manic symptoms were positively, not inversely correlated, and their co-occurrence was associated with worse quality of life. Implications for the DSM and ICD nosological systems are discussed.

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