scholarly journals Do the Trajectories of Bipolar Disorder and Schizophrenia Follow a Universal Staging Model?

2016 ◽  
Vol 62 (2) ◽  
pp. 115-122 ◽  
Author(s):  
Anne Duffy ◽  
Gin S. Malhi ◽  
Paul Grof
Keyword(s):  
Bipolar Disorder ◽  
Psychiatric Disorders ◽  
Psychotic Disorders ◽  
Risk Indicators ◽  
Empirical Literature ◽  
Future Research ◽  
Diagnostic Categories ◽  
Staging Model ◽  
Robust Evidence ◽  
Illness Progression

Objective: The purpose of this study is to address the question of whether a universal staging model of severe psychiatric disorders is a viable direction for future research by examining the extant literature. Method: A narrative review was conducted of the relevant historical, conceptual, and empirical literature pertaining to the clinical trajectory of bipolar disorder and schizophrenia and issues relevant to staging. Results: There is substantive evidence that classic recurrent bipolar disorder is separable from schizophrenia on the basis of family history, developmental and clinical course, treatment response, and neurobiological findings. However, because of the intrinsic heterogeneity of diagnostic categories that has been amplified by recent changes in psychiatric taxonomy, key distinctions between the groups have become obfuscated. While mapping risk and illness markers to emerging psychopathology is a logical approach and may be of value for some psychiatric disorders and/or their clinical subtypes, robust evidence supporting identifiable stages per se is still lacking. Presently, even rudimentary stages such as prodromes cannot be meaningfully applied across different disorders and no commonalities can be found for the basis of universal staging. Conclusions: Advances in the prediction of risk, accurate early illness detection, and tailored intervention will require mapping biomarkers and other risk indicators to reliable clinical phases of illness progression. Given the capricious nature of mood and psychotic disorders, this task is likely to yield success only if conducted in narrowly defined subgroups of individuals at high risk for specific illnesses. This approach is diametrically opposite to that being promulgated by proponents of a universal staging model.

DSM-III criteria for affective disorders and schizophrenia : A preliminary appraisal using family interview findings

1988 ◽  
Vol 3 (3) ◽  
pp. 159-169
Author(s):  
H.G. Pope ◽  
B.M. Cohen ◽  
J.F. Lipinski ◽  
D. Yurgelun-Todd
Keyword(s):  
Bipolar Disorder ◽  
Affective Disorder ◽  
Schizoaffective Disorder ◽  
Psychotic Disorders ◽  
Diagnostic Interview ◽  
Diagnostic Categories ◽  
Family Interview ◽  
Small Test ◽  
Test Retest Reliability ◽  
Interview Studies

SummaryWe performed a blind family interview study of 226 first-degree relatives of 63 probands meeting DSM-III criteria for schizophrenia, schizoaffective disorder, and bipolar disorder, as diagnosed by the National Institute ot Mental Health Diagnostic Interview Schedule (DIS). A small test-retest reliability study demonstrated good agreement between the proband interviewer and the principal family interviewer for the major diagnostic categories of psychotic disorders. Excellent compliance was obtained, with 85% of living relatives interviewed personally.Three principal findings emerged front the study. First, as expected, bipolar disorder, as defined by DSM-III, displayed a strong familial comportent, comparable to that found by many studies using criteria other than those of DSM-III. Second, patients meeting DSM-III criteria for schizophrenia and schizoaffective disorder displayed a low familial prevalence of schizophrenia. Although initially suprising, this finding is in agreement with the results of several other recent lantily studies of schizophrenia. Upon comparing our results with those of other recent family studies of schizophrenia, it appears that the familial component in schizophrenia tnay be less than was estimated by earlier studies using older and “broader” definitions of schizophrenia.Third, we found that patients meeting DSM-III criteria for schizophrenia appeared genetically heterogeneous. Those who had displayed a superimposed full affective syndrome at some tinte in the course of their illness, together with those probands meeting DSM-III criteria for schizoaffective disorder, displayed a high familial prevalence of major affective disorder, similar to that found in the families of the bipolar probands. On the other hand, “pure” DSM-III schizophrenie probands, who had never experienced a superimposed full affective syndrome, displayed a low familial prevalence of major affective disorder, similar to that found in the general population. These findings favor the possibility that probands meeting DSM-III criteria for schizophrenia, but displaying a superimposed full affective syndrome, may in sonie cases have a disorder genetically relatcd to major affective disorder.Further prospective family interview studies, using DSM-III criteria and larger samples, will be necessary to test these preliminary impressions.

scholarly journals Alcohol Use Disorder Is Differently Associated With Psychotic Symptoms According To Underlying Psychiatric Disorders: A General Population Study

2019 ◽  
Author(s):  
Baptiste Pignon ◽  
Guillaume Sescousse ◽  
Ali Amad ◽  
Imane Benradia ◽  
Guillaume Vaiva ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
General Population ◽  
Anxiety Disorders ◽  
Psychiatric Disorders ◽  
Alcohol Use Disorder ◽  
Psychotic Disorders ◽  
Auditory Hallucinations ◽  
Psychotic Symptoms ◽  
Depression And Anxiety ◽  
General Population Study

Abstract Aims Psychotic symptoms can occur in the general population, and alcohol use disorder (AUD) is an identified vulnerability factor. However, it remains unclear how AUD is associated with psychotic symptoms, depending on the underlying psychiatric condition. We aimed to compare the prevalence of psychotic symptoms among subjects with different types of psychiatric disorders, i.e. unipolar or bipolar disorders, anxiety disorders, psychotic disorders or no psychiatric disorder, depending on whether or not there was an underlying AUD. Methods In a 38,694-subject general population study, we compared the likelihood of occurrence of seven types of psychotic symptoms, depending on the AUD status and the underlying psychiatric disorders, after adjustment for age, sex, marital status, education and income levels. Results In unipolar depression and anxiety disorders, almost all types of psychotic symptoms were found associated with AUD (odds ratios (ORs) between 1.98 and 2.19). In contrast, in bipolar disorder, only auditory hallucinations were associated with AUD (OR = 2.50). In psychotic disorders, only thought broadcasting was more frequent among subjects with AUD (OR = 1.78). Conclusion Our findings in depression and anxiety disorders are in line with the ‘dual diagnosis’ concept, which posits that comorbid psychiatric/addictive disorders form distinctive entities that are more frequently associated with non-specific severity factors, here psychotic symptoms. The co-occurrence of AUD in bipolar/psychotic disorders was not associated with a generalized increased occurrence of psychotic symptoms but altered their manifestations with an increased risk of auditory hallucinations for bipolar disorder and thought broadcasting for psychotic disorders.

The Co-Occurrence of Mania with Medical and other Psychiatric Disorders

1994 ◽  
Vol 24 (4) ◽  
pp. 305-328 ◽  
Author(s):  
Stephen M. Strakowski ◽  
Susan L. McElroy ◽  
Paul W. Keck ◽  
Scott A. West
Keyword(s):  
Bipolar Disorder ◽  
Psychiatric Disorders ◽  
Brain Structures ◽  
Future Research ◽  
Medical Illness ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Medical Disorders ◽  
Current State ◽  
Secondary Mania

Objective: The co-occurrence of mania with other medical and psychiatric disorders has been little studied. The authors reviewed the literature in order to clarify the current state of knowledge of this subject and to identify possible areas of future research. Methods: Published articles which specifically addressed associations of mania with medical disorders and other psychiatric syndromes were identified using the Paperchase® medical literature search system and by cross-referencing from other published work. The articles were then organized into three categories: 1) medical disorders associated with secondary mania; 2) medical comorbidity in bipolar disorder; and 3) psychiatric comorbidity in bipolar disorder. Results: The review of medical illness and secondary mania supports the hypothesis that injuries involving right-side and mid-line brain structures are associated with so-called secondary mania. Additionally, an association between bipolar disorder and migraine is identified. Several psychiatric disorders appear to occur with mania at rates higher than expected including obsessive-compulsive disorder, bulimia nervosa, panic disorder, impulse control disorders, and substance abuse. Conclusions: The authors discuss the potential implications of these findings and suggest research approaches to further examine the relationships between mania and other medical and psychiatric syndromes.

scholarly journals The relationship between cognitive functioning and psychopathology in patients with psychiatric disorders: a transdiagnostic network analysis

2021 ◽  
pp. 1-10
Author(s):  
UnYoung Chavez-Baldini ◽  
Dorien H. Nieman ◽  
Amos Keestra ◽  
Anja Lok ◽  
Roel J. T. Mocking ◽  
...  
Keyword(s):  
Network Analysis ◽  
Visual Attention ◽  
Cognitive Functioning ◽  
Psychiatric Disorders ◽  
Verbal Memory ◽  
Depressive Disorders ◽  
Psychotic Disorders ◽  
Future Research ◽  
Cognitive Domains ◽  
Network Analyses

Abstract Background Patients with psychiatric disorders often experience cognitive dysfunction, but the precise relationship between cognitive deficits and psychopathology remains unclear. We investigated the relationships between domains of cognitive functioning and psychopathology in a transdiagnostic sample using a data-driven approach. Methods Cross-sectional network analyses were conducted to investigate the relationships between domains of psychopathology and cognitive functioning and detect clusters in the network. This naturalistic transdiagnostic sample consists of 1016 psychiatric patients who have a variety of psychiatric diagnoses, such as depressive disorders, anxiety disorders, obsessive−compulsive and related disorders, and schizophrenia spectrum and other psychotic disorders. Psychopathology symptoms were assessed using various questionnaires. Core cognitive domains were assessed with a battery of automated tests. Results Network analysis detected three clusters that we labelled: general psychopathology, substance use, and cognition. Depressive and anxiety symptoms, verbal memory, and visual attention were the most central nodes in the network. Most associations between cognitive functioning and symptoms were negative, i.e. increased symptom severity was associated with worse cognitive functioning. Cannabis use, (subclinical) psychotic experiences, and anhedonia had the strongest total negative relationships with cognitive variables. Conclusions Cognitive functioning and psychopathology are independent but related dimensions, which interact in a transdiagnostic manner. Depression, anxiety, verbal memory, and visual attention are especially relevant in this network and can be considered independent transdiagnostic targets for research and treatment in psychiatry. Moreover, future research on cognitive functioning in psychopathology should take a transdiagnostic approach, focusing on symptom-specific interactions with cognitive domains rather than investigating cognitive functioning within diagnostic categories.

Genetics of bipolar disorder

2020 ◽  
pp. 735-743
Author(s):  
Francis J. McMahon ◽  
Sevilla Detera-Wadleigh
Keyword(s):  
Bipolar Disorder ◽  
Psychiatric Disorders ◽  
Molecular Genetics ◽  
Genetic Epidemiology ◽  
Clinical Care ◽  
Future Research ◽  
Research Directions ◽  
Modelling Studies ◽  
Future Research Directions ◽  
Genetic Modelling

Bipolar disorder represents one of the most highly heritable group of common psychiatric disorders, but the complex genetic basis of these disorders has only recently begun to reveal itself. This chapter reviews the genetic epidemiology, molecular genetics, and genetic modelling studies of bipolar disorder. The chapter concludes with a glimpse of anticipated developments of relevance to clinical care and anticipates some future research directions.

Intervening early in bipolar disorder in young people: a review of the clinical staging model

2015 ◽  
Vol 32 (1) ◽  
pp. 31-43
Author(s):  
P. Power
Keyword(s):  
Bipolar Disorder ◽  
Early Intervention ◽  
Young People ◽  
Psychotic Disorders ◽  
Early Adulthood ◽  
General Medicine ◽  
Developmental Trajectory ◽  
Clinical Staging ◽  
Co Morbidity ◽  
Staging Model

Bipolar disorder (BPD) essentially has its onset during adolescence and early adulthood. It has the capacity to be highly disruptive, dislocating individuals from their normal developmental trajectory and potentially causing significant long-term co-morbidity and chronicity. At a societal level the burden created is greater than schizophrenia. This is not helped by the very substantial delays in its diagnosis and appropriate treatment. Thus, there is a clear rationale for intervening earlier and at a younger age. However, the field of early intervention in BPD is in its infancy. One approach that conceptually provides a basis for early intervention is the Clinical Staging Model (used widely in general medicine). This article outlines how this model helps in an understanding of the emerging stages of BPD. It also summarises the interventions that might be appropriately introduced if a person progresses from an early to a late stage of the illness. Early intervention has a well-established record in psychotic disorders. If it can be realised for BPDs, then it may hold out hope of better outcomes for the next generation of young people at risk.

Psychiatric disorders and labour force activity

2015 ◽  
Vol 20 (1) ◽  
pp. 13-27 ◽  
Author(s):  
Annika Jonsdottir ◽  
Geoffrey Waghorn
Keyword(s):  
Vocational Rehabilitation ◽  
Psychiatric Disorders ◽  
Labour Force ◽  
Diagnostic Category ◽  
Future Research ◽  
Policy Makers ◽  
Content Type ◽  
Psychiatric Illnesses ◽  
Diagnostic Categories

Purpose – The purpose of this paper is to explore and review the range and quality of international epidemiological and observational studies reporting impacts of psychiatric disorders on labour force activity. This information is needed to explore the relative priority of different diagnostic groups for more intensive forms of vocational rehabilitation. Design/methodology/approach – The authors provide an overview of the current literature. A systematic review of papers measuring labour force variables and psychiatric disorders across a range of countries is conducted. These results are compared to OECD background unemployment rates during the same period. The results for each diagnostic category included are aggregated and compared to the other diagnostic categories. Findings – The proportions of people employed decreased with the more severe disorder categories, indicating that severe psychiatric illnesses are contributing to employment struggles for people with these illnesses, across countries. Research limitations/implications – This review is exploratory and shows that there is little consistency in reporting of labour force variables. Future research should endeavour to utilise internationally agreed definitions of labour force activity. Practical implications – This conclusion is relevant to matching community residents with psychiatric disorders to the more intensive and costly forms of vocational rehabilitation. Originality/value – To our knowledge, no previous review has examined diagnostic categories of psychiatric disorders by labour force activity internationally while taking into account background unemployment. This review found an employment gradient related to severity of diagnostic category that will be of interest to clinicians and policy makers.

Yogic Intervention in Sexual Dysfunction - A Review

2017 ◽  
Vol 2 (4) ◽  
Author(s):  
Rakshith K. R. ◽  
Shivakumar . ◽  
Kaushal Sinha ◽  
Vijeth Kumar L. A.
Keyword(s):  
Psychological Functioning ◽  
Empirical Studies ◽  
Empirical Literature ◽  
Future Research ◽  
Therapeutic Effects ◽  
Yoga Therapy ◽  
Cognitive Component ◽  
Beneficial Effects ◽  
Breathing Exercises ◽  
The Mind

Yoga is an ancient practice with Eastern roots that involves both physical postures (Asanas) and breathing techniques (Pranayamas). Yoga therapy for male sexual problems can effectively be treated through Yoga therapy, particularly with the help of Yoga poses and breathing exercises, Yoga has proven itself highly very effective in the treatment of a number of incurable and sometimes terminable diseases. Then again, Yoga's therapeutic effects are just a spin-off and supplementary. Yoga which has proved to be very effective in the treatment of many impossible and incurable diseases, the therapeutic effect of Yoga is only a by product and incidental. Problems related to sex can very well be handled with Yoga as most often these problems are more related to the mind than body. Either they are caused by lack of confidence or stress or fatigue or fear and very few times some physical cause is there. There is also a cognitive component focusing on meditation and concentration, which aids in achieving the goal of union between the self and the spiritual. Although numerous empirical studies have found a beneficial effect of Yoga on different aspects of physical and psychological functioning, claims of Yoga's beneficial effects on sexuality derive from a rich but no empirical literature. The goal of this article is to review the philosophy and forms of Yoga, to review the no empirical and (limited) empirical literatures linking Yoga with enhanced sexuality, and to propose some future research avenues focusing on Yoga as a treatment for sexual disorder.

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