Bipolar Affective Disorder Minus Left Prefrontal Cortex Equals Schizophrenia

1996 ◽  
Vol 168 (5) ◽  
pp. 647-650 ◽  
Author(s):  
Alfred Pang ◽  
Shôn W. Lewis
Keyword(s):  
Prefrontal Cortex ◽  
Affective Disorder ◽  
Past History ◽  
Single Case ◽  
Bipolar Affective Disorder ◽  
Specific Pattern ◽  
Left Temporal Lobe ◽  
Single Case Report ◽  
History Of ◽  
The Relationship

BackgroundAn investigation of the relationship between bipolar affective disorder and schizophrenia, following a severe head injury and removal of the left prefrontal cortex.MethodA single case report.ResultsAn individual with past history of bipolar affective disorder suffered traumatic damages to the left prefrontal cortex with a second lesion in the left temporal lobe. The patient developed typical schizophrenia nine months later. The relevance of his brain lesions in determining the schizophrenic symptoms is discussed.ConclusionWe propose that the specific pattern of brain injury in this patient was sufficient to change the phenotype from bipolar affective disorder to schizophrenia.

scholarly journals Cigarette smoking and psychotic symptoms in bipolar affective disorder

2001 ◽  
Vol 179 (1) ◽  
pp. 35-38 ◽  
Author(s):  
Aiden Corvin ◽  
Ed O'Mahony ◽  
Myra O'Regan ◽  
Claire Comerford ◽  
Robert O'Connell ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Affective Disorder ◽  
Bipolar Affective Disorder ◽  
Psychotic Symptoms ◽  
Heavy Smoking ◽  
Ordinal Logistic Regression Analysis ◽  
History Of ◽  
Categorical Diagnosis ◽  
The Relationship

BackgroundAn association exists between smoking and schizophrenia, independent of other factors and related to psychotic symptomatology.AimsTo determine whether smoking is associated with psychosis in bipolar affective disorder.MethodSmoking data were collected from 92 unrelated patients with bipolar affective disorder. An ordinal logistic regression analysis tested the relationship between smoking severity and psychotic symptomatology, allowing for potential confounders.ResultsA significant relationship was detected between smoking/heavy smoking and history of psychosis (68.7%, n=44). Smoking was less prevalent in patients who were less symptomatic (56.5%, n=13) than in patients with a more severe psychosis (75.7%, n=31). Prevalence and severity of smoking predicted severity of psychotic symptoms (P=0.001), a relationship independent of other variables (P=0.0272).ConclusionA link between smoking and psychosis exists in bipolar affective disorder and may be independent of categorical diagnosis.

Masked Bereavement Presenting as Agoraphobia

1994 ◽  
Vol 22 (2) ◽  
pp. 177-180
Author(s):  
Barbara Sahakian ◽  
Georgina Charlesworth
Keyword(s):  
Affective Disorder ◽  
Case History ◽  
Psychological Assessment ◽  
Past History ◽  
Single Case ◽  
Adult Life ◽  
Single Session ◽  
Presenting Symptoms ◽  
Behavioural Approach ◽  
History Of

This single case history highlights the importance of a complete psychological assessment to establish a client's past history rather than simply implementing a behavioural approach for the presenting symptoms. A single session of bereavement work was effective in treating agoraphobia in an elderly lady with a history of affective disorder throughout her adult life.

A Comparison of Alcoholics with and without Coexisting Affective Disorder

1983 ◽  
Vol 143 (2) ◽  
pp. 133-138 ◽  
Author(s):  
K. O'Sullivan ◽  
P. Whillans ◽  
M. Daly ◽  
B. Carroll ◽  
A. Clare ◽  
...  
Keyword(s):  
Family History ◽  
Affective Disorder ◽  
Diagnostic Criteria ◽  
Past History ◽  
History Of ◽  
Relationship Of ◽  
The Relationship

SummaryThree hundred male Irish alcoholics were selected from 508 consecutive alcoholic admissions to hospital. Using well defined diagnostic criteria, they were divided into three subgroups (1) primary alcoholics, (2) alcoholics with secondary affective disorder and (3) those with primary affective disorder and secondary alcoholism. Although the three groups reported differences in past history and family history of affective disorder and in time spent in hospital for both alcoholism and affective disorder, there was little to distinguish them in behaviour associated with alcoholism or in family history of alcoholism. The implications of these findings and their significance for the relationship of affective disorder and alcoholism are discussed.

Quality of parenting and vulnerability to depression: results from a family study

1998 ◽  
Vol 28 (1) ◽  
pp. 185-191 ◽  
Author(s):  
C. DUGGAN ◽  
P. SHAM ◽  
C. MINNE ◽  
A. LEE ◽  
R. MURRAY
Keyword(s):  
Mental Illness ◽  
Family Study ◽  
Past History ◽  
Familial Risk ◽  
Self Report ◽  
History Of ◽  
Quality Of Parenting ◽  
Independent Effects ◽  
The Relationship ◽  
History Of Depression

Background. We examined a group of subjects at familial risk of depression and explored the relationship between the perceptions of parents and a history of depression. We also investigated: (a) whether any difference in perceived parenting found between those with and without a past history of depression was an artefact of the depression; and (b) whether the relationship between parenting and depression was explained by neuroticism.Method. We took a sample of first-degree relatives selected from a family study in depression and subdivided them by their history of mental illness on the SADS-L, into those: (a) without a history of mental illness (N=43); and (b) those who had fully recovered from an episode of RDC major depression (N=34). We compared the perceptions of parenting, as measured by the Parental Bonding Instrument (PBI), in these two groups having adjusted for the effect of neuroticism and subsyndromal depressive symptoms. We also had informants report on parenting of their siblings, the latter being subdivided into those with and without a past history of depression.Results. Relatives with a past history of depression showed lower care scores for both mother and father combined compared with the never ill relatives. The presence of a history of depression was associated with a non-significant reduction in the self-report care scores compared to the siblings report. Vulnerable personality (as measured by high neuroticism) and low perceived care were both found to exert independent effects in discriminating between the scores of relatives with and without a history of depression and there was no interaction between them.Conclusion. This study confirmed that low perceived parental care was associated with a past history of depression, that it was not entirely an artefact of having been depressed, and suggested that this association was partially independent of neuroticism.

Lithium use in a patient on haemodialysis with bipolar affective disorder and lithium-induced nephropathy

2021 ◽  
Vol 14 (7) ◽  
pp. e242841
Author(s):  
Sam Topp ◽  
Emma Salisbury
Keyword(s):  
Affective Disorder ◽  
Bipolar Affective Disorder ◽  
Manic Episode ◽  
Dose Titration ◽  
Dialysis Session ◽  
Treatment Resistant ◽  
History Of ◽  
End Stage ◽  
Level Monitoring

Lithium is an effective mood stabiliser used to treat bipolar affective disorder (BPAD); however, it can also adversely affect the kidneys, causing acute toxic effects, nephrogenic diabetes insipidus, chronic renal dysfunction and end-stage kidney disease (ESKD) in a minority of patients. We describe the case of a man with a 34-year history of BPAD type-1 and a 2-year history of ESKD secondary to lithium-induced nephropathy who experienced a manic relapse. He previously responded well to lithium but, following a deterioration in kidney function, was switched to olanzapine and sodium valproate. This precipitated a period of instability, which culminated in a treatment-resistant manic episode requiring hospital admission. After a multidisciplinary team discussion, lithium therapy was restarted and provided remission. This was achieved safely through a reduced dosing schedule of three times a week post dialysis, slow dose titration and blood level monitoring prior to each dialysis session.

scholarly journals 098 A case of delayed post-hypoxic leukoencephalopathy complicating drug overdose

2019 ◽  
Vol 90 (e7) ◽  
pp. A32.1-A32
Author(s):  
Min Fong ◽  
Nicholas Rigby ◽  
Paul Pun ◽  
Roger Mitchell ◽  
Daniel Schweitzer ◽  
...  
Keyword(s):  
White Matter ◽  
Single Case ◽  
Neuropsychiatric Symptoms ◽  
Bipolar Affective Disorder ◽  
Cerebral White Matter ◽  
High Signal ◽  
White Matter Changes ◽  
Hypoxic Event ◽  
Diffusion Weighted Images ◽  
Single Case Report

IntroductionDelayed post-hypoxic leukoencephalopathy (DPHL) is a syndrome characterised by neurological deterioration following a period of recovery after an initial hypoxic event with striking white-matter change on magnetic resonance imaging. We present a case characterised by insidious onset and a fluctuating course of cognitive and neuropsychiatric symptoms.MethodsSingle case report.ResultsA 61 year old lady, with a background history of previously well managed bipolar affective disorder, was found unresponsive following an intentional overdose of temazepam and tramadol. She was hypotensive, hypoxic and required ventilatory and inotropic support. Following extubation, the patient had residual left-sided weakness and MRI confirmed a right frontal watershed infarction. A three week period of clinical improvement was followed by marked deterioration firstly with fluctuating mood and other neuropsychiatric symptoms which progressed to severe impairment of cognition and alertness. There was generalised slowing on the EEG and the CSF was unremarkable. Repeat neuroimaging undertaken on day 41 of the admission, revealed new symmetric and confluent cerebral white matter changes with high signal on the Diffusion Weighted Images (DWI) and Fluid Attenuated Inversion Recovery (FLAIR) images. The patient was managed with supportive care and sustained a clinically significant recovery (MOCA 26/30), despite ongoing cognitive impairments including working memory and deficits in social cognition including mood instability and disinhibition. Repeat neuroimaging 3 months after initial presentation revealed partial resolution of the white matter changes.ConclusionA diagnosis of DPHL should be considered in patients with variable mood and cognition following initial improvement after a hypoxic event.

scholarly journals 59 “Lithium Damaged My Spine” Might not Be a Delusion After All

CNS Spectrums ◽  
2019 ◽  
Vol 24 (1) ◽  
pp. 206-207
Author(s):  
Muhammad Zaidi ◽  
Anurag Prabhu ◽  
Jose Perez Martell ◽  
Sakshi Dhir
Keyword(s):  
Affective Disorder ◽  
Schizoaffective Disorder ◽  
Patient Population ◽  
Bipolar Affective Disorder ◽  
Extensive Literature ◽  
Negative Effects ◽  
Mesh Terms ◽  
First Choice ◽  
History Of ◽  
Bipolar Affective Disorders

AbstractBackgroundLithium remains to be the drug of choice for treating BPAD for the past few decades. There is extensive literature showing the effectiveness of Lithium when used as a mood stabilizing agent in bipolar spectrum disorders. However significant number of articles show that a third of the patients who receive lithium for their symptomology not only do not show any response but also may show deterioration of their clinical symptoms. (However, research shows that Lithium may negatively affect a third of the patients depending on various factors). The side effect profile of Lithium and especially its neurotoxic effects were discussed in depth in literature over the last decade. Although Lithium remains first choice as maintenance treatment for bipolar affective disorder, about half of all individuals may stop their treatment at some point, despite its proven benefits concerning the prevention of severe affective episodes and suicide.MethodsThe authors performed a systematic literature review to recognize the significance of negative effects of Lithium in a minority of patient population and also comment on the factors influencing patient compliance. We ran a literature search on Pubmed using the following terms: “Lithium” AND (“schizoaffective disorder [MeSH terms]” OR “Bipolar Affective disorder [MeSH terms]” ). Our inclusion criteria were studies which have observed effects of Lithium in schizoaffective patient population or bipolar affective patient population. Studies with other concurrent diagnoses were excluded.Case presentationWe discuss a fifty nine year old male with a history of multiple admissions to a forensic hospital care setting. He initially endorsed a diagnosis of Psychotic disorder NOS which was later changed to schizoaffective disorder during his subsequent admissions. He presented with affective psychotic features where his mood was labile shifting from melancholic to euphoric and a concurrent history of auditory verbal hallucinations. He displayed paranoid non-bizarre persecutory delusions and also alleged that one of his doctors had hated him and put him on Lithium as a form of punishment. He claims that Lithium, as a result, has significantly affected him negatively and also damaged his nerves. This led the authors to explore the significance of use of Lithiumin people with schizoaffective disorders and also bipolar affective disorders. We also discuss the disease course in the patient and his clinical response to use of various psychotropic medications.ConclusionsThe case exemplifies the negative effects of Lithium when used as a mood stabilizer in patient population that is susceptible to its adverse effects due to various factors.

Cognitive impairment, clinical course and treatment history in out-patients with bipolar affective disorder: relationship to tardive dyskinesia

1989 ◽  
Vol 19 (4) ◽  
pp. 897-902 ◽  
Author(s):  
John L. Waddington ◽  
Katherine Brown ◽  
Jane O'Neill ◽  
Patrick McKeon ◽  
Anthony Kinsella
Keyword(s):  
Tardive Dyskinesia ◽  
Affective Disorder ◽  
Cognitive Flexibility ◽  
Clinical Course ◽  
Bipolar Affective Disorder ◽  
Involuntary Movements ◽  
Impaired Performance ◽  
Treatment History ◽  
Individual Vulnerability ◽  
History Of

SYNOPSISClinical, neuropsychological and psychopharmacological characteristics were investigated for their ability to distinguish individuals with and without involuntary movements (tardive dyskinesia), among a population of 40 out-patients with bipolar affective disorder and a history of exposure to neuroleptics and lithium. Impaired performance on a test of cognitive flexibility bore the primary association with both the presence and the severity of involuntary movements. The additional relationships identified emphasized further that individual vulnerability to involuntary movements appeared to be associated not with greater duration or dosage of treatment, but with features of the bipolar illness, including number and type of affective episodes, for which that treatment was prescribed.

Takotsubo syndrome in bipolar affective disorder with alcohol withdrawal syndrome

2020 ◽  
Vol 13 (10) ◽  
pp. e236070
Author(s):  
Deshwinder Singh Sidhu ◽  
Richard Farrelly ◽  
John Lally
Keyword(s):  
Affective Disorder ◽  
Troponin I ◽  
Epigastric Pain ◽  
Bipolar Affective Disorder ◽  
Alcohol Withdrawal Syndrome ◽  
Takotsubo Syndrome ◽  
History Of ◽  
Alcohol Dependence Syndrome ◽  
Background History ◽  
St Elevation

A 40-year-old woman presented to the emergency department with epigastric pain and agitation. She recently separated from her husband and was consuming 30 units of alcohol daily for 5 days. She had a history of bipolar affective disorder, borderline personality disorder and alcohol dependence syndrome. Investigations revealed the following: elevated troponin I levels, ST elevation, early Q waves and prolonged QTc. Emergency angiogram confirmed Takotsubo’s appearance. Medications with QTc prolongation propensity were held. A multidisciplinary apporach was required. She was discharged 10 days later when medically stabilised. It was later discovered that she died unexpectedly the following month. Takotsubo syndrome is a rare but unique cause of cardiac failure. This case highlights the need to consider the differential of Takotsubo syndrome in people presenting with possible acute ischaemic events, particularly in those with a history of combined emotional and physical stressors and a background history of mood disorder.

scholarly journals A SINGLE CASE REPORT ON HYPERAMMONEMIA INDUCED BY VALPROATE MONOTHERAPY WITHOUT HEPATIC DYSFUNCTION

2017 ◽  
Vol 9 (4) ◽  
pp. 218 ◽  
Author(s):  
C. Prarthana Saraswathi ◽  
J. Anu Rita ◽  
S. Nambi
Keyword(s):  
Case Report ◽  
Mental Status ◽  
Hepatic Dysfunction ◽  
Single Case ◽  
Bipolar Affective Disorder ◽  
Mood Stabilizer ◽  
Altered Mental Status ◽  
Plasma Ammonia ◽  
Manic Symptoms ◽  
Single Case Report

Valproate is a commonly used mood stabilizer. One of the important and rare side effects of valproate is hyperammonemia leading to delirium and hepatic encephalopathy. Valproate-induced delirium is commonly mistaken for worsening of manic symptoms or psychosis. We hereby report a case of bipolar affective disorder who was on a therapeutic dose of valproate monotherapy developed altered mental status where we found elevated levels of plasma ammonia which decreased after the discontinuation of valproate and with normal levels of serum valproate, LFT’s, EEG and imagings. This case report emphasises on the need to consider plasma ammonia levels in patients with altered mental status receiving valproate in addition to other investigations.

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