scholarly journals Depression treatment in women and men with bipolar affective disorder: a comparative study

2021 ◽  
Vol 13 (3) ◽  
pp. 59-66
Author(s):  
N. A. Tyuvina ◽  
A. E. Stolyarova ◽  
V. V. Balabanova ◽  
K. M. Bunkova ◽  
E. N. Efremova
Keyword(s):  
Affective Disorder ◽  
Clinical Global Impression ◽  
Treatment Efficacy ◽  
Rating Scale ◽  
Bipolar Affective Disorder ◽  
Severe Depression ◽  
Severity Of Illness ◽  
Depression Treatment ◽  
Significant Treatment ◽  
Men And Women

Objective: to compare depression treatment efficacy with and without antidepressants (ADs) in men and women with bipolar affective disorder (BAD).Patients and methods. We enrolled 100 patients with BAD (F31.3–F31.5 according to ICD-10), including 50 women aged 33.0 [23.0; 50.2] years and 50 men aged 37.5 [29.5; 47.2] years using prospective and retrospective methods. Various antidepressants, normothymics, antipsychotics combinations were used to treat depression. We performed a comparative analysis of treatment efficacy with and without antidepressants in men and women subgroups. Clinical assessment at the baseline and the end of 1, 2, 4, 6-th week of therapy (or at discharge) included a specially developed clinical examination chart and the following psychometric scales: Montgomery-Asberg Depression Rating Scale (MADRS), Clinical Global Impression – Severity of illness (CGI-S), Clinical Global Impression – Improvement (CGI-I).Results and discussion. Women tended to have a slower improvement in the condition compared to men. Maximum reduction in MADRS score and a CGI-I, CGI-S higher frequency of clinical improvement and remission was observed in men and women who did not receive antidepressants than patients who did not receive antidepressants. When BAD type was included in the analysis, in patients treated with antidepressants, transient symptoms of the opposite pole occurred in 24.7% of patients of both sexes with bipolar affective I disorder (BAD I) and in 16.8% with bipolar affective II disorder (BAD II). There were no significant gender differences in patients with BAD I, while women predominated in BAD II group (22.5% compared to 7.8% men). No significant treatment-emergent affective switch was observed with tricyclic antidepressants and selective serotonin and norepinephrine reuptake inhibitors in both groups (21; 16.7; 16.7% in men and 28; 21.8; 12.5% in women, respectively). The assessment of intermission revealed that women were significantly more likely to have shorter periods between phases (42% compared to 22% in men). In addition, women were significantly more likely to have shorter periods between phases (42% compared to 22% in men) when the intermission duration was included in the analysis. In some patients with severe depression and infective first-line therapy (anticonvulsants and atypical antipsychotics), antidepressants prescription can increase treatment effectiveness. However, several factors should be considered, such as BAD type and variant, depression severity, treatment-emergent affective switch in history, and gender.Conclusion. A decision about antidepressants' dosage and treatment duration requires a dynamic follow-up of the patient in order to discontinue the antidepressants as fast as possible and decrease the risk of treatment-emergent affective switch and shortening of remission period.

scholarly journals Features of depressive and anxiety manifestations in the first episode of bipolar affective disorder

2019 ◽  
Vol 25 (3) ◽  
pp. 142-146
Author(s):  
Yu. I. Mysula
Keyword(s):  
Affective Disorder ◽  
Bipolar Affective Disorder ◽  
First Episode ◽  
Depression And Anxiety ◽  
Men And Women ◽  
Treatment And Prevention ◽  
The Mean ◽  
Gender Factor ◽  
The Impact ◽  
Mixed Variant

Background. The study of depression and anxiety in the first episode of BAR is important for the timely detection, treatment and prevention of poor diagnosis of the disease. Objective – the study of the features of depressive and anxiety symptoms of the first episode of bipolar affective disorder, taking into account the gender factor and the clinical type. Materials and methods. We have clinically examined 65 men and 88 women diagnosed with first episode (FE) of bipolar affective disorder (BAD). Results. In patients with depressive FE of BAD, all indicators, with the exception of the undifferentiated depression indicator, in men are slightly higher than in women: the overall indicator (respectively 22.55±3.61 points and 22.16±3.03 points); adynamic depression (17.41±2.62 points and 16.76±2.48 points); pervasive depression (9.75±3.13 points and 9.69±2.66 points); depression with fear (9.34±2.55 points and 9.51±2.27 points); undifferentiated depression (4.89±0.95 points and 5.01±1.22 points); in patients with the mixed variant are not significantly different: accordingly 15,83±2,64 points and 17,00±3,32 points; 11.00±1.67 points and 11.80±1.64 points; 6.67±1.63 points and 6.60±2.07 points; 7.33±1.21 points and 8.00±1.87 points; 3.67±1.03 points and 3.40±1.14 points; in patients with a manic type there are no signs of depression. The indicators of anxiety in men and women do not differ significantly: in the depressive variant, the total indicator was accordingly 21.41±7.01 points and 23.36±7.01 points; psychic anxiety – 13.25±3.86 points and 14.35±3.87 points; somatic anxiety – 8.16±4.05 points and 9.01±4.10 points; when mixed, accordingly, 20,00±4,52 points and 22,00±4,90 points; 13.33±3.27 points and 15.20±2.39 points; 6.67±3.27 points and 6.80±3.70 points; the manic variant showed no signs of anxiety. The mean Zung score for the depressed variant was 68.82±8.30 points and 65.97±8.41 points, accordingly, for the mixed one, 44.00±5.55 points and 50.40±5.32 points, accordingly, at a manic variant 2.13±1.64 points and 2.50±1.60 points. Conclusions. Differences in manifestations of depression and anxiety in the first episode of bipolar affective disorder are determined by the clinical option; the impact of gender on these manifestations is insignificant.

Rapid amelioration of severe manic episodes with right unilateral ultrabrief pulse ECT: a case series of four patients

2016 ◽  
Vol 25 (1) ◽  
pp. 10-12 ◽  
Author(s):  
Alexey Sidorov ◽  
Prashanth Mayur
Keyword(s):  
Electroconvulsive Therapy ◽  
Clinical Global Impression ◽  
Treatment Efficacy ◽  
Rating Scale ◽  
Case Series ◽  
Inadequate Response ◽  
Young Mania ◽  
Dramatic Decrease ◽  
Current Case ◽  
Significant Clinical Improvement

Objective: The aim of this small case series is to describe four cases of severe mania, where ultrabrief pulse electroconvulsive therapy (ECT) was used as a primary mode of treatment. Methods: A retrospective file review was undertaken of four patients identified as having received ultrabrief pulse ECT for severe mania. The outcome measures for treatment efficacy were the Young Mania Rating Scale (YMRS) and Clinical Global Impression (CGI). Results: All the patients showed significant clinical improvement. A comparison of pre- and post-treatment YMRS and CGI scores showed a dramatic decrease in all four cases. However, one patient was shifted to brief pulse ECT due to inadequate response. Conclusions: Ultrabrief pulse ECT may be an effective treatment in cases of severe mania. Due to the very small number of cases in the current case series, no specific conclusions regarding efficacy may be drawn; however, larger, controlled studies would be indicated.

scholarly journals Features of dyssomnyas in primary episode of bipolar affective disorder

2019 ◽  
Vol 23 (3) ◽  
pp. 393-396
Author(s):  
Yu.I. Mysula ◽  
O.P. Wenger
Keyword(s):  
Sleep Disturbance ◽  
Sleep Disorders ◽  
Affective Disorder ◽  
Sleep Disturbances ◽  
Bipolar Affective Disorder ◽  
The Other ◽  
Men And Women ◽  
Falling Asleep ◽  
Wide Range ◽  
Mixed Variant

Bipolar affective disorder (BAD) is one of the actual problems in modern psychiatry. The aim of the study is to investigate dyssomnia in patients with primary episode of BAD, taking into account, the sex and clinical features of the diseases debut. We have clinically examined 65 men and 88 women diagnosed with bipolar affective disorder in the period 2015–2019. It was found that dyssomnia is present in 98.3% of all patients, in 97.7% of men and in 98.7% of women with depressive variant of the primary episode of BAD, accordingly in 30.4%, 26.7% and 37.5% of patients with manic variant and at 100,0% of patients with mixed variant. The structure of sleep disorders varies significantly depending on the variant of the primary episode: with depressive, prevail night and early awakenings (100.0%), sleep disturbance (75.6%, 70.5%, and 78.7%), unstable sleep (47.9%, 59.1% and 41.3%, p<0.05), nightmares (12.6%, 13.6% and 12.0%); at manic — unstable sleep (73.9%, 73.3% and 75.0%), sleep disturbance (17.4%, 13.3% and 25.0%) and frequent night awakenings (13.0%, 13.3% and 12.0%), in the mixed variant — falling asleep (72.7%, 66.7% and 80.0%), unstable sleep (72.7%, 83.3% and 60.0%), frequent night awakenings (54.5%, 66.7%, and 40.0%), early awakening (36.4%, 50.0%, and 20.0%) and nightmares (27.3%, 16.7% and 40.0%). Thus, the primary episode of bipolar affective disorder is accompanied by a wide range of dyssomnias, among which the leading are disorders of depth and stability of sleep. Manifestations of dyssomnia vary depending on the clinical type of the primary episode of BAD: with the depressive variant, prevail night awakenings, early awakenings and sleep disturbances, with unstable sleep, and with mixed sleep disturbance and unstable sleep. Dyssomnia prevalence is highest for mixed and lowest for manic variants. In depressive men, unstable sleep was more common, and the other disorders of sleep in men and women were not significantly different.

scholarly journals Features of changes in the cognitive sphere of patients with a primary episode of bipolar affective disorder

2019 ◽  
Vol 85 (4) ◽  
pp. 93-100
Author(s):  
Yu.I. Mysula
Keyword(s):  
Affective Disorder ◽  
Test Performance ◽  
Test Scores ◽  
Depressive Symptomatology ◽  
Bipolar Affective Disorder ◽  
Productive Activity ◽  
Rapid Phase ◽  
Men And Women ◽  
Manic Symptoms ◽  
Delayed Reproduction

153 patients with primary episode of bipolar affective disorder were divided to three groups: with prevalence of depressive symptomatology (44 men and 75 women), with prevalence of manic symptoms (15 men and 8 women) and with simultaneous presence of depressive and manic symptomatology or with rapid or severe manic symptoms (6 men and 5 women) and were examined using the Rey–Osterrieth test. It was found that they had impaired cognitive functioning whose structure and severity were related to the clinical type of the primary episode. In patients with depressive variant revealed approximately equal deterioration of test performance across all assessment vectors, while reproduction (immediate and delayed) observed synchronous deterioration of indicators, with the degree of deterioration of characteristics between copying and immediate and retarded reproduction. In the manic variant the performance of test is significantly different from the depressive variant. Patients with a manic variant showed the lowest indicators in the presence of individual elements of the figure, accuracy and diligence. At the same time, indicators for most estimation vectors are unstable, varying with immediate and delayed reproduction without some systematicity. Such features reflect on the cognitive functions of the maniac state with its acceleration of the speed of thinking, its chaos, instability of attention, difficulties of concentration and inability to productive activity. In patients with mixed episode, the Ray–Osterrieth test scores reflect complex contradictory tendencies of changes in the affective area, related to the rapid phase change and the presence of opposite affective manifestations. Quantitative values of indicators in patients of this group has an intermediate position between indicators of patients with depressive and manic variants. Common disorders inherent in patients of all groups were distortion of the integrity and symmetry of the figure, contamination of the elements of the figure and the omission of minor details. The differences in the structure and severity of cognitive impairment between men and women are not statistically significant.

scholarly journals A Comparative Personality Profile Study Between Bipolar-affective disorders (Mania) and Normal control group

2017 ◽  
Vol 5 (1) ◽  
pp. 37-42
Author(s):  
R. Kumar ◽  
A.R. Singh
Keyword(s):  
Affective Disorder ◽  
Normal Control ◽  
Rating Scale ◽  
Bipolar Affective Disorder ◽  
Normal Control Group ◽  
Personality Factor ◽  
Control Group ◽  
Normal Male ◽  
Personality Profile ◽  
Bipolar Affective Disorders

Introduction: Personality is the important core feature and identification of an individual. Some factors in personality may be vulnerable for psychiatric illness.Objective: To compare Personality profile of Bipolar Affective Dirosder with Normal control group.Method: 30 male patients diagnosed as Bipolar affective disorder (mania) and 30 normal male were included in the study, with the aim to determine the comparison of personality characteristic of Bipolar affective disorder (Mania) and Normal control group. Each individual was given the inform consent response than collected Socio demographic and Clinical data sheet after that Young mania rating scale and 16 personality factor was applied for data collection.Result: Present study explore that the Manic (BAD) groups of subject differ significantly on all the factors except Q4 from normal controls. Higher mean scores on factor Q4 means that manic (BAD) are tense, restless, fretful & driven, extremely high tension level was disrupt school and work performance.Conclusion: Both the groups differentiated significantly on all the factors except Q4. The mean score obtained by normal control has higher in comparison of BAD-manic category.

scholarly journals Efficacy of Sodium Valproate and Olanzapine in treating bipolar affective disorder 'mania' at a tertiary care hospital in Nepal: A comparative study

2017 ◽  
Vol 4 (1) ◽  
pp. 27-35
Author(s):  
Lokeshwar Chaurasia ◽  
Sunil Kumar Shah ◽  
Sudarshana Magham Chetty
Keyword(s):  
Affective Disorder ◽  
Sodium Valproate ◽  
Rating Scale ◽  
Tertiary Care Hospital ◽  
Bipolar Affective Disorder ◽  
Tertiary Care ◽  
Care Hospital ◽  
Medical Sciences ◽  
Significant Difference ◽  
The Mean

Background and Objectives: Bipolar affective disorder, mania is the mood of an abnormally elevated arousal energy level or a state of heightened overall activation with enhanced affective expression together with lability of affect. The objective of the study was to compare the efficacy of sodium valproate and olanzapine in bipolar affective disorder, mania patients at a tertiary care hospital in NepalMaterial and Methods: A randomized observational prospective open label study was conducted for one and half year at College of Medical Sciences-Teaching Hospital (CMS-TH), Bharatpur, Nepal in the Psychiatry Department. Sixty patients diagnosed with bipolar affective disorder, mania were enrolled. 30 patients received sodium valproate and 30 patients received olanzapine. Patients were monitored and evaluated on baseline (day 0), day 7 and day 30 and compared to the baseline for the severity of illness using the 11-item Young Mania Rating Scale (YMRS).Results: The mean baseline YMRS score for all cases on sodium valproate (n=30) on day 0 was 38.87 ± 3.73, while it was reduced to 13.90 ± 1.95 (p < 0.001) on day 30. Similarly, the mean baseline YMRS score for all cases on olanzapine (n=30) on day 0was 40.83 ± 6.50, while it was reduced to 14.47 ± 2.83 (p < 0.001) on day 30.The mean decrease in YMRS score by sodium valproate was 64.24% and by olanzapine was 64.56%.Conclusion: Treatment with sodium valproate and olanzapine significantly improves the mean mania ratings score and there is no statistically significant difference in efficacy of both the drugs in patients diagnosed with bipolar affective disorder, mania.Janaki Medical College Journal of Medical Sciences (2016) Vol. 4(1): 27-35

P01-222-Prospective memory performance in Chinese patients with bipolar affective disorder

2011 ◽  
Vol 26 (S2) ◽  
pp. 223-223
Author(s):  
E. Lee ◽  
Y.T. Xiang ◽  
R.W.C. Au ◽  
D. Shum ◽  
W.K. Tang ◽  
...  
Keyword(s):  
Affective Disorder ◽  
Prospective Memory ◽  
Rating Scale ◽  
Memory Performance ◽  
Bipolar Affective Disorder ◽  
Memory Test ◽  
Event Based ◽  
Behavioral Memory ◽  
Hamilton Rating Scale ◽  
Prospective Memory Performance

IntroductionPersons suffering from bipolar affective disorder have a wide range of cognitive deficits, but there have been limited understanding of prospective memory performance. Time-based prospective memory is remembering to perform an action at a specific time, whereas event-based prospective memory is remembering to perform an action when an external cue appears.ObjectivesAssess the time-based and event-based prospective memory performance in Chinese persons diagnosed with bipolar affective disorder.AimsIdentify factors associated with prospective memory performance.MethodsA sample of 40 persons diagnosed with bipolar affective disorder were recruited from a psychiatric outpatient clinic. All participants completed the Cambridge Prospective Memory Test, Rivermead Behavioral Memory Test, Test of Nonverbal Intelligence - Third Edition, the Young Mania Rating Scale and Hamilton Rating Scale for Depression.ResultsThe mean total score of the Cambridge Prospective Memory Test of persons diagnosed with bipolar affective disorder was 24.4 ± 7.0. Time-based prospective memory performance was worse than event-based PM task. The Cambridge Prospective Memory Test total score was associated with the Hamilton Rating Scale for Depression score and Rivermead Behavioral Memory Test score. The performance of time-based prospective memory tasks was associated with the Hamilton Rating Scale for Depression score, and the performance of event-based prospective memory tasks was associated with the Rivermead Behavioral Memory Test total score.ConclusionsPersons diagnosed with bipolar affective disorder are found to have worse time-based than event-based prospective memory performance. The importance for everyday functioning and independent living needs to be explored in future studies.

scholarly journals Lithium and pregnancy

2000 ◽  
Vol 24 (6) ◽  
pp. 229-231 ◽  
Author(s):  
Kelwyn Williams ◽  
Sarah Oke
Keyword(s):  
Bipolar Disorder ◽  
Mental Illness ◽  
Affective Disorder ◽  
Serious Mental Illness ◽  
Bipolar Affective Disorder ◽  
Unborn Child ◽  
Men And Women ◽  
Child Bearing ◽  
In Pregnancy ◽  
Algorithmic Form

The lifetime prevalence of bipolar affective disorder is approximately 1% in both men and women (Reiger et al, 1998). In women the illness is most prevalent in the child-bearing years (Robins et al, 1984). While lithium for the treatment of bipolar disorder is a cornerstone of modern psychopharmacology (Llewellyn et al, 1998), there are inherent problems in treating this sizeable subgroup of patients, as lithium presents small, but significant, risks to a potential foetus. It is also becoming increasingly obvious that serious mental illness poses a risk to the unborn child. This paper reviews those risks, presents a protocol in algorithmic form for dealing with the prescription of lithium in pregnancy and discusses practical issues pertaining to dosage and lithium monitoring.

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