scholarly journals Neuropsychological status of bipolar I disorder: impact of psychosis

2009 ◽  
Vol 194 (3) ◽  
pp. 243-251 ◽  
Author(s):  
Jonathan Savitz ◽  
Lize van der Merwe ◽  
Dan J. Stein ◽  
Mark Solms ◽  
Rajkumar Ramesar
Keyword(s):  
Bipolar Disorder ◽  
Personality Traits ◽  
Childhood Trauma ◽  
Declarative Memory ◽  
Type I ◽  
Schizotypal Personality ◽  
Neuropsychological Status ◽  
History Of ◽  
Psychotic Features ◽  
The Impact

BackgroundThe presence of schizotypal personality traits in some people with bipolar disorder, together with reports of greater cognitive dysfunction in patients with a history of psychotic features compared with patients without such a history, raises questions about the nosological relationship between bipolar disorder with psychotic features and bipolar disorder without psychotic features.AimsTo test the impact of a history of DSM–IV-defined psychosis on the neuropsychological status of participants with bipolar disorder while statistically controlling for confounding factors such as mood, medication, alcohol misuse/dependence and childhood abuse, and to evaluate the impact of schizotypal personality traits (and thus potential vulnerability to psychotic illness) on the cognitive performance of people with bipolar disorder and their healthy relatives.MethodNeuropsychological data were obtained for 25 participants with type I bipolar disorder and a history of psychosis, 24 with type I bipolar disorder but no history of psychosis and 61 unaffected relatives. Schizotypal traits were measured with the Schizotypal Personality Scale (STA). Childhood trauma was measured with the Childhood Trauma Questionnaire.ResultsThe group with a history of psychosis performed significantly worse than the healthy relatives on measures of verbal working memory, cognitive flexibility and declarative memory. Nevertheless, the two bipolar disorder groups did not differ significantly from each other on any cognitive measure. Scores on the STA were negatively associated with verbal working and declarative memory, but positively associated with visual recall memory.Conclusions‘Psychotic’ and ‘non-psychotic’ subtypes of bipolar disorder may lie on a nosological continuum that is most clearly defined by verbal memory impairment.

The characteristics of psychotic features in bipolar disorder

2018 ◽  
Vol 49 (12) ◽  
pp. 2036-2048 ◽  
Author(s):  
Annet H. van Bergen ◽  
Sanne Verkooijen ◽  
Annabel Vreeker ◽  
Lucija Abramovic ◽  
Manon H. Hillegers ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Childhood Maltreatment ◽  
Linear Models ◽  
Disease Onset ◽  
Cross Sectional Study ◽  
Psychotic Symptoms ◽  
Type I ◽  
Cross Sectional ◽  
History Of ◽  
Psychotic Features

AbstractBackgroundIn a large and comprehensively assessed sample of patients with bipolar disorder type I (BDI), we investigated the prevalence of psychotic features and their relationship with life course, demographic, clinical, and cognitive characteristics. We hypothesized that groups of psychotic symptoms (Schneiderian, mood incongruent, thought disorder, delusions, and hallucinations) have distinct relations to risk factors.MethodsIn a cross-sectional study of 1342 BDI patients, comprehensive demographical and clinical characteristics were assessed using the Structured Clinical Interview for DSM-IV (SCID-I) interview. In addition, levels of childhood maltreatment and intelligence quotient (IQ) were assessed. The relationships between these characteristics and psychotic symptoms were analyzed using multiple general linear models.ResultsA lifetime history of psychotic symptoms was present in 73.8% of BDI patients and included delusions in 68.9% of patients and hallucinations in 42.6%. Patients with psychotic symptoms showed a significant younger age of disease onset (β = −0.09, t = −3.38, p = 0.001) and a higher number of hospitalizations for manic episodes (F11 338 = 56.53, p < 0.001). Total IQ was comparable between groups. Patients with hallucinations had significant higher levels of childhood maltreatment (β = 0.09, t = 3.04, p = 0.002).ConclusionsIn this large cohort of BDI patients, the vast majority of patients had experienced psychotic symptoms. Psychotic symptoms in BDI were associated with an earlier disease onset and more frequent hospitalizations particularly for manic episodes. The study emphasizes the strength of the relation between childhood maltreatment and hallucinations but did not identify distinct subgroups based on psychotic features and instead reported of a large heterogeneity of psychotic symptoms in BD.

Who Responds to Prophylactic Lithium Therapy?

1993 ◽  
Vol 163 (S21) ◽  
pp. 20-26 ◽  
Author(s):  
M. T. Abou-Saleh
Keyword(s):  
Bipolar Disorder ◽  
Family History ◽  
Bipolar Affective Disorder ◽  
Positive Family History ◽  
Specific Treatment ◽  
Predictors Of Outcome ◽  
Powerful Predictor ◽  
Bipolar Illness ◽  
History Of ◽  
Psychotic Features

The search for predictors of outcome has not been particularly rewarding, and the use of lithium remains empirical: a trial of lithium is the most powerful predictor of outcome. However, lithium is a highly specific treatment for bipolar disorder. In non-bipolar affective disorder, factors of interest are correlates of bipolar disorder: mood-congruent psychotic features, retarded-endogenous profile, cyclothymic personality, positive family history of bipolar illness, periodicity, and normality between episodes of illness.

scholarly journals The impact of schizotypy on pragmatics

2020 ◽  
Vol 62 ◽  
pp. e020014
Author(s):  
Monica de Freitas Frias Chaves ◽  
Cilene Rodrigues
Keyword(s):  
Personality Traits ◽  
Contextual Information ◽  
Brazilian Portuguese ◽  
Schizophrenia Spectrum Disorders ◽  
Semantic Meaning ◽  
General Hypothesis ◽  
Schizotypal Personality ◽  
Schizophrenia Spectrum ◽  
Spectrum Disorders ◽  
The Impact

High levels of linguistic referential failures are associated with liability to develop schizophrenia-spectrum disorders, and it has been shown that these failures can differentiate healthy subjects, high-schizotypal and schizophrenics groups. Nevertheless, few investigations have focused on whether or not schizotypal traits in nonclinical populations can also impact linguistic reference. In Brazilian Portuguese, only one previous study (acceptability judgements task) had been conducted, and its results suggest association between schizotypal traits and a more rigid preference for assignment of specific readings to definite singular DPs. Here, we present another experimental study in Brazilian Portuguese,  a comprehension task designed to examine possible effects of schizotypal personality traits on the interpretation of definite singular DPs. The findings, in line with the previous results, support the conclusion that schizotypy does affect the interpretation of definite singular DPs in Brazilian Portuguese. Together, these two experiments suggest that schizotypal personality traits impact the integration of linguistic contextual information into the semantic meaning of definite DPs. This is  consistent with the general hypothesis that schizotypy, similarly to schizophrenia, is associated with pragmatic difficulties. Yet, our results emphasize that the impact of schizotypal traits on pragmatics can be observed even in healthy (nonclinical) speakers.

scholarly journals Study of Risk Factors Associated with Suicide Attempt in Patients with Bipolar Disorder Type I

2020 ◽  
Vol 11 (02) ◽  
pp. 291-298
Author(s):  
Karthick Subramanian ◽  
Vikas Menon ◽  
Siddharth Sarkar ◽  
Vigneshvar Chandrasekaran ◽  
Nivedhitha Selvakumar
Keyword(s):  
Risk Factors ◽  
Bipolar Disorder ◽  
Logistic Regression ◽  
Family History ◽  
Suicide Attempt ◽  
Coping Strategies ◽  
Binary Logistic Regression ◽  
Type I ◽  
Factors Associated ◽  
History Of

Abstract Background Suicide is the leading contributor to mortality in bipolar disorder (BD). A history of suicidal attempt is a robust predictive marker for future suicide attempts. Personality profiles and coping strategies are the areas of contemporary research in bipolar suicides apart from clinical and demographic risk factors. However, similar research in developing countries is rarer. Objectives The present study aimed to identify the risk factors associated with suicidal attempts in BD type I (BD-I). Materials and Methods Patients with BD-I currently in clinical remission (N = 102) were recruited. Sociodemographic details and the clinical data were collected using a semistructured pro forma. The psychiatric diagnoses were confirmed using the Mini-International Neuropsychiatric Interview 5.0. The National Institute of Mental Health–Life Chart Methodology Clinician Retrospective Chart was used to chart the illness course. Presumptive Stressful Life Events Scale, Coping Strategies Inventory Short Form, Buss–Perry aggression questionnaire, Past Feelings and Acts of Violence, and Barratt Impulsivity scale were used to assess the patient’s stress scores, coping skills, aggression, violence, and impulsivity, respectively. Statistical Analysis Descriptive statistics were used for demographic details and characteristics of the illness course. Binary logistic regression analyses were performed to identify the predictors for lifetime suicide attempt in BD-I. Results A total of 102 patients (males = 49 and females = 53) with BD-I were included. Thirty-seven subjects (36.3%) had a history of suicide attempt. The illness course in suicide attempters more frequently had an index episode of depression, was encumbered with frequent mood episodes, especially in depression, and had a higher propensity for psychiatric comorbidities. On binary logistic regression analysis, the odds ratios (ORs) for predicting a suicide attempt were highest for positive family history of suicide (OR: 13.65, 95% confidence interval [CI]: 1.28–145.38, p = 0.030), followed by the presence of an index depressive episode (OR: 6.88, 95% CI: 1.70–27.91, p = 0.007), and lower scores on problem-focused disengagement (OR: 0.72, 95% CI: 0.56–0.92, p = 0.009). Conclusion BD-I patients with lifetime suicide attempt differ from non-attempters on various course-related and temperamental factors. However, an index episode depression, family history of suicide, and lower problem-focused engagement can predict lifetime suicide attempt in patients with BD-I.

Bipolar disorder with and without a history of psychotic features: fMRI correlates of sustained attention

2020 ◽  
Vol 98 ◽  
pp. 109817 ◽  
Author(s):  
Gianna Sepede ◽  
Piero Chiacchiaretta ◽  
Francesco Gambi ◽  
Giuseppe Di Iorio ◽  
Domenico De Berardis ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Sustained Attention ◽  
History Of ◽  
Psychotic Features

Lithium prevents grey matter atrophy in patients with bipolar disorder: an international multicenter study

2020 ◽  
pp. 1-10
Author(s):  
Franz Hozer ◽  
Samuel Sarrazin ◽  
Charles Laidi ◽  
Pauline Favre ◽  
Melissa Pauling ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Grey Matter ◽  
Brain Regions ◽  
Anterior Cingulate ◽  
Type I ◽  
Linear Regression Models ◽  
Neuroprotective Effects ◽  
History Of ◽  
International Multicenter Study ◽  
The Right

Abstract Background Lithium (Li) is the gold standard treatment for bipolar disorder (BD). However, its mechanisms of action remain unknown but include neurotrophic effects. We here investigated the influence of Li on cortical and local grey matter (GM) volumes in a large international sample of patients with BD and healthy controls (HC). Methods We analyzed high-resolution T1-weighted structural magnetic resonance imaging scans of 271 patients with BD type I (120 undergoing Li) and 316 HC. Cortical and local GM volumes were compared using voxel-wise approaches with voxel-based morphometry and SIENAX using FSL. We used multiple linear regression models to test the influence of Li on cortical and local GM volumes, taking into account potential confounding factors such as a history of alcohol misuse. Results Patients taking Li had greater cortical GM volume than patients without. Patients undergoing Li had greater regional GM volumes in the right middle frontal gyrus, the right anterior cingulate gyrus, and the left fusiform gyrus in comparison with patients not taking Li. Conclusions Our results in a large multicentric sample support the hypothesis that Li could exert neurotrophic and neuroprotective effects limiting pathological GM atrophy in key brain regions associated with BD.

Risk of bipolar disorder and psychotic features in patients initially hospitalised with severe depression

2014 ◽  
Vol 27 (2) ◽  
pp. 113-118 ◽  
Author(s):  
Kimiya Nakamura ◽  
Junichi Iga ◽  
Naoki Matsumoto ◽  
Tetsuro Ohmori
Keyword(s):  
Bipolar Disorder ◽  
Severe Depression ◽  
Psychotic Symptoms ◽  
Primary Disorder ◽  
Icd 10 ◽  
History Of ◽  
Physical Diseases ◽  
The Stability ◽  
Psychotic Features ◽  
Depressive Episodes

ObjectiveSevere depression may be a risk factor for diagnostic conversion into bipolar disorder (BD), and psychotic depression (PD) has been consistently associated with BD. The aims of the present study were to investigate the stability of the diagnosis of severe depression and the differences between PD and non-psychotic severe depression (non-PD), as well as to assess the effectiveness of electroconvulsive therapy (ECT).MethodsPatients who were hospitalised for severe depression (diagnosed according to ICD-10) both with and without psychotic symptoms (n=89; mean age=55.6 years, SD=13.9) from 2001 to 2010 were retrospectively assessed.ResultsBy the 75th month of follow-up assessments, 11(12.4%) patients had developed BD. Among these 11 converters, nine had developed BD within 1 year after admission. Only sub-threshold hypomanic symptoms were significantly related to developing BD. The number of depressive episodes and history of physical diseases were significantly increased in non-PD compared with PD patients, whereas ECT was significantly increased in PD compared with non-PD patients. There was a significant association between length of stay at the hospital and the number of days between admission and ECT.ConclusionSub-threshold hypomanic symptoms may represent a prodrome of BD or an indicator of an already manifest phenotype, especially in older patients, which suggests cautious use of antidepressants. In severe depression, non-PD may often occur secondary to physical diseases and patients may experience increased recurrences compared with PD patients, which may be a more ‘primary’ disorder and often requires ECT treatments. ECT is effective for severe depression regardless of the presence of any psychotic feature; the earlier ECT is introduced, the better the expected treatment outcome.

The Duration of Undiagnosed Bipolar Disorder: Impact of Substance use Disorders co-morbidity

2017 ◽  
Vol 41 (S1) ◽  
pp. S132-S132
Author(s):  
S. Ben Mustapha ◽  
W. Homri ◽  
L. Jouini ◽  
R. Labbane
Keyword(s):  
Bipolar Disorder ◽  
Substance Use ◽  
Standard Deviation ◽  
Substance Use Disorders ◽  
Mood Stabilizer ◽  
Type I ◽  
Addictive Behaviour ◽  
Bipolar Disease ◽  
Co Morbidity ◽  
The Impact

AimsStudy the impact of substance use disorders (SUD) co-morbidity on the duration of undiagnosed bipolar disorder (DUBP).MethodsCase-control study during a period of six months from July 2015 to December 2015. One hundred euthymic patients with BD (type I, II or unspecified) were recruited in the department of psychiatry C Razi Hospital, during their follow-up. Two groups were individualized by the presence or not of a SUD co-morbidity. In our study DUBP was defined as the period between the first symptoms and the beginning of treatment by a mood stabilizer.ResultsThe beginning of addictive behaviour preceded the installation of bipolar disease in 32% of cases. Installation of bipolar disorder preceded the installation of addictive behaviour in 12% of cases. The beginning of addictive behaviour was concomitant with the installation of bipolar disease in 6% of cases. The average DUBP in the full sample was 4.80 years with a standard deviation of 8.04 and extremes ranging from 0.08 to 37.5.The average DUBP in patients with SUD co-morbidity was 5.91 years with a standard deviation of 8.16 and extremes ranging from 0.08 to 35, and 3.68 years with a standard deviation of 7.84 and extremes ranging from 0.08 to 37.5 in patients without SUD co-morbidity.ConclusionsAccording to studies over two thirds of patients with bipolar disorder received misdiagnoses before diagnosis of BD, and among the factors involved can report the presence of SUD co-morbidity. Hence, we should detect BD among patients with SUD.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Childhood Trauma in Bipolar Disorders: Familial and Individual Mediators for Predicting Occurrence and Outcome

2017 ◽  
Vol 41 (S1) ◽  
pp. S28-S28
Author(s):  
B. Etain
Keyword(s):  
Physical Abuse ◽  
Childhood Trauma ◽  
Emotional Abuse ◽  
Suicide Attempts ◽  
Bipolar Disorders ◽  
Affect Intensity ◽  
The Face ◽  
History Of ◽  
Competing Interest ◽  
Psychotic Features

Childhood trauma is highly prevalent in patients with bipolar disorder (BD) and has been associated to a more severe/complex expression of the disorder. Little is known about the familial and individual factors that can mediate the occurrence of trauma within families but also influence the outcomes of BD. We will present data from two independent samples of patients with BD in order to identify the potential mediators for occurrence and severity/complexity. In a first sample of 371 patients with BD, 256 relatives and 157 healthy controls, we will show that there is a familial resemblance for emotional and physical abuses. Patients’ level of physical abuse was associated with their parental levels of physical abuse, but also with their father's history of alcohol misuse (p < 0.05). Second, in a sub-sample of 270 normothymic patients, we have performed a path-analysis to demonstrate that emotional and physical abuses interacted with cannabis misuse to increase the frequency of psychotic features and delusional beliefs. Finally, in an independent sample of 485 euthymic patients from the FACE-BD cohort we used path-analytic models to show that emotional abuse increased all the assessed affective/impulsive dimensions (p < 0.001). In turn, affect intensity and attitudinal hostility were associated with high risk for suicide attempts (p < 0.001), whereas impulsivity was associated with a higher risk for presence of substance misuse (p < 0.001). These results illustrate that childhood trauma might derive from parental characteristics (own childhood trauma and psychopathology) and increase the severity/complexity of BD through individual dimensions of psychopathology.Disclosure of interestThe author has not supplied his declaration of competing interest.

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