scholarly journals Insight in bipolar disorder: a comparison between mania, depression and euthymia using the Insight Scale for Affective Disorders

2015 ◽  
Vol 37 (3) ◽  
pp. 152-156 ◽  
Author(s):  
Rafael de Assis da Silva ◽  
Daniel C. Mograbi ◽  
Evelyn V. M. Camelo ◽  
Jaqueline Bifano ◽  
Mayra Wainstok ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Clinical Management ◽  
Affective Disorders ◽  
Rating Scale ◽  
Mood State ◽  
Depression Scale ◽  
Treatment Compliance ◽  
Hamilton Depression Scale ◽  
Young Mania ◽  
Insight Into

Objective: To evaluate whether having general insight into bipolar disorder and its symptoms is affected by the mood state of the patient, using the Insight Scale for Affective Disorders, a hetero-application scale for people with mood disorders.Methods: Ninety-five patients with bipolar disorder were evaluated and divided into different groups according to the mood state presented during assessment (i.e., euthymia, mania and depression). Sociodemographic and clinical data (Hamilton Depression Scale, Young Mania Rating Scale, and Clinical Global Impressions Scale) were recorded. Insight was evaluated using the Insight Scale for Affective Disorders.Results: Patients with bipolar disorder in mania show less insight about their condition than patients in depression or euthymia, and less insight about their symptoms than patients with depression, with the exception of awareness of weight change.Conclusions: Loss of insight during mania may have important implications for treatment compliance and adherence and needs to be taken into account in the clinical management of people with bipolar disorder.

scholarly journals Reduced Plasma Dopamine-β-Hydroxylase Activity Is Associated With the Severity of Bipolar Disorder: A Pilot Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Zuoli Sun ◽  
Qijing Bo ◽  
Zhen Mao ◽  
Feng Li ◽  
Fan He ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Rating Scale ◽  
Bipolar Depression ◽  
Depression Scale ◽  
Hamilton Depression Scale ◽  
Cognitive Assessments ◽  
Young Mania ◽  
Neuropsychological Status ◽  
Patient Health ◽  
Depressive Episodes

Dopamine-β-hydroxylase (DβH) is an enzyme converting dopamine to norepinephrine, a key neurotransmitter in mood disorders, such as major depressive disorder (MDD) and bipolar disorder (BD). Due to overlapping symptomology of unipolar and bipolar depression, the present study attempted to explorer if the plasma DβH activity could discriminate the depressive episodes of BD from MDD. The aim of this study was to compare the plasma DβH activity among MDD patients (n = 104), BD patients (n = 101), and healthy controls (n = 160). Clinical characteristics and cognitive function were assessed using the Young Mania Rating Scale (YMRS), Hamilton Depression Scale (HAM-D), Hamilton Anxiety Scale (HAM-A), Patient Health Questionnaire-9 (PHQ-9), and Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Our data showed a lower plasma DβH activity in patients with BD, not MDD, than that in controls. For the BD patients, the plasma DβH activities were negatively correlated with HAM-D scores and HAM-A scores. However, there was no significant correlation between plasma DβH activity and severity of depressive symptoms in MDD patients. No significant correlation between DβH activities and cognitive assessments neither in BD nor in MDD patients. The present study provides evidence that BD is associated with decreased circulating DβH activity.

Adaptation and validation of the Korean Version of the Bipolar Depression Rating Scale (K-BDRS)

2016 ◽  
Vol 33 (S1) ◽  
pp. s236-s237
Author(s):  
W.M. Bahk ◽  
M.D. Kim ◽  
Y.E. Jung ◽  
Y.S. Woo ◽  
J. Lee ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Depressive Symptoms ◽  
Psychometric Properties ◽  
Rating Scale ◽  
Bipolar Depression ◽  
Depression Scale ◽  
Reliability And Validity ◽  
Hamilton Depression Scale ◽  
Young Mania ◽  
Korean Version

ObjectivesThe Bipolar Depression Rating Scale (BDRS) is a scale for assessment of the clinical characteristics of bipolar depression. The primary aims of this study were to describe the development of the Korean version of the BDRS (K-BDRS) and to establish more firmly its psychometric properties in terms of reliability and validity.MethodsThe study included 141 patients (62 male and 79 female) who had been diagnosed with bipolar disorder, were currently experiencing symptoms of depression, and were interviewed using the K-BDRS. Other measures included the Montgomery and Asberg Depression Scale (MADRS), the 17-item Hamilton Depression Scale (HAMD), and the Young Mania Rating Scale (YMRS). Additionally, the internal consistency, concurrent validity, inter-rater reliability, and test-retest reliability of the K-BDRS were evaluated.ResultsThe Cronbach's α-coefficient for the K-BDRS was 0.866, the K-BDRS exhibited strong correlations with the HAMD (r = 0.788) and MADRS (r = 0.877), and the mixed symptoms score of the K-BDRS was significantly correlated with the YMRS (r = 0.611). An exploratory factor analysis revealed three factors that corresponded to psychological depressive symptoms, somatic depressive symptoms, and mixed symptoms.ConclusionsThe present findings suggest that the K-BDRS has good psychometric properties and is a valid and reliable tool for assessing depressive symptoms in patients with bipolar disorder.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Depressive Mixed States: Symptomatology, Prevalence and Principles of Treatment

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
W. Drozdz ◽  
A. Borkowska
Keyword(s):  
Affective Disorders ◽  
Rating Scale ◽  
Depressive Symptomatology ◽  
Depression Scale ◽  
Assessment Tools ◽  
The Other ◽  
Mood Stabilizers ◽  
Hamilton Depression Scale ◽  
Principles Of Treatment ◽  
Bipolar Patients

Current diagnostic systems (DSM-IV-TR and ICD-10) do not include depressive mixed state (DMS) as a separate category. However, both historical descriptions and data from recent research clearly indicate that cooccurrence of (hypo)maniacal and depressive symptoms is standard in clinical picture of affective disorders. Most frequently employed criterion for DMS is the presence of at least three symptoms of (hypo)mania for 7 days during a major depressive episode. Not only formal diagnostic criteria for DMS are lacking but also psychometric assessment tools (for example the Hamilton Depression Scale or the MADRS) were designed around the features of “classical” depression. The other obstacles to recognize DMS could be lack of insight into the (hypo)maniacal symptoms in patients and cognitive dysfunctions present during an episode. On the other hand, newly created instrument, the Bipolar Depression Rating Scale, may assist clinical evaluation of DMS. Despite predominating depressive symptomatology, the principles of treatment of DMS suggest avoidance of antidepressant monotherapy in favor of mood stabilizers' administration. Actually DMS may emerge as a complication of antidepressant monotherapy in some bipolar patients or may be induced with interferon-alpha treatment in some chronic hepatitis C patients. Important consequences of both spontaneous and drug-induced DMS could be the roughening of affective symptomatology, resistance to antidepressants and the increase of suicidality. Thorough appraisal of symptoms seen in patients with affective disorders for indicators of DMS could have critical consequences for functional outcomes.

Differences in Kynurenine Metabolism During Depressive, Manic, and Euthymic Phases of Bipolar Affective Disorder

2020 ◽  
Vol 20 (15) ◽  
pp. 1344-1352 ◽  
Author(s):  
Alexander Maget ◽  
Martina Platzer ◽  
Susanne A. Bengesser ◽  
Frederike T. Fellendorf ◽  
Armin Birner ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Kynurenic Acid ◽  
Rating Scale ◽  
Depression Scale ◽  
Hamilton Depression Scale ◽  
Monooxygenase Activity ◽  
Kynurenine Aminotransferase ◽  
Mood Symptoms ◽  
Kynurenine Metabolism ◽  
Current Mood

Background & Objectives: The kynurenine pathway is involved in inflammatory diseases. Alterations of this pathway were shown in psychiatric entities as well. The aim of this study was to determine whether specific changes in kynurenine metabolism are associated with current mood symptoms in bipolar disorder. Methods: Sum scores of the Hamilton Depression Scale, Beck Depression Inventory, and Young Mania Rating Scale were collected from 156 bipolar individuals to build groups of depressive, manic and euthymic subjects according to predefined cut-off scores. Severity of current mood symptoms was correlated with activities of the enzymes kynurenine 3-monooxygenase (ratio of 3-hydroxykynurenine/ kynurenine), kynurenine aminotransferase (ratio of kynurenic acid/ kynurenine) and kynureninase (ratio of 3-hydroxyanthranilic acid/ 3-hydroxykynurenine), proxied by ratios of serum concentrations. Results: Individuals with manic symptoms showed a shift towards higher kynurenine 3-monooxygenase activity (χ2 = 7.14, Df = 2, p = .028), compared to euthymic as well as depressed individuals. There were no differences between groups regarding activity of kynurenine aminotransferase and kynureninase. Within the group of depressed patients, Hamilton Depression Scale and kynurenine aminotransferase showed a significant negative correlation (r = -0.41, p = .036), displaying lower metabolism in the direction of kynurenic acid. Conclusion: Depression severity in bipolar disorder seems to be associated with a decreased synthesis of putative neuroprotective kynurenic acid. Furthermore, higher kynurenine 3-monooxygenase activity in currently manic individuals indicates an increased inflammatory state within bipolar disorder with more severe inflammation during manic episodes. The underlying pathophysiological mechanisms of the different affective episodes could represent parallel mechanisms rather than opposed processes.

scholarly journals Melanopsin-mediated pupillary responses in bipolar disorder—a cross-sectional pupillometric investigation

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Helle Østergaard Madsen ◽  
Shakoor Ba-Ali ◽  
Steffen Heegaard ◽  
Ida Hageman ◽  
Ulla Knorr ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Blue Light ◽  
Rating Scale ◽  
Ganglion Cells ◽  
Mood State ◽  
Young Mania ◽  
Cross Sectional ◽  
Illness Duration ◽  
Pupillary Responses ◽  
Blue Range

Abstract Background Visible light, predominantly in the blue range, affects mood and circadian rhythm partly by activation of the melanopsin-containing intrinsically photosensitive retinal ganglion cells (ipRGCs). The light-induced responses of these ganglion cells can be evaluated by pupillometry. The study aimed to assess the blue light induced pupil constriction in patients with bipolar disorder (BD). Methods We investigated the pupillary responses to blue light by chromatic pupillometry in 31 patients with newly diagnosed bipolar disorder, 22 of their unaffected relatives and 35 healthy controls. Mood state was evaluated by interview-based ratings of depressive symptoms (Hamilton Depression Rating Scale) and (hypo-)manic symptoms (Young Mania Rating Scale). Results The ipRGC-mediated pupillary responses did not differ across the three groups, but subgroup analyses showed that patients in remission had reduced ipRGC-mediated responses compared with controls (9%, p = 0.04). Longer illness duration was associated with more pronounced ipRGC-responses (7% increase/10-year illness duration, p = 0.02). Conclusions The ipRGC-mediated pupil response to blue light was reduced in euthymic patients compared with controls and increased with longer disease duration. Longitudinal studies are needed to corroborate these potential associations with illness state and/or progression.

Emotional Schemas: A New Cognitive Perspective for the Distinction Between Unipolar Depression and Bipolar Disorder

2017 ◽  
Vol 41 (S1) ◽  
pp. S243-S243 ◽  
Author(s):  
O. Onur
Keyword(s):  
Bipolar Disorder ◽  
Rating Scale ◽  
Depression Scale ◽  
Unipolar Depression ◽  
Group Differences ◽  
Young Mania ◽  
Exploratory Investigation ◽  
General Activation ◽  
Dsm Iv ◽  
Competing Interest

IntroductionClinicians need to make the differential diagnosis between unipolar depression and bipolar disorder to guide their treatment choices. Looking at the differences observed in the emotional schemas might help with this differentiation. This study is an exploratory investigation of schema theory's Leahy's emotional schemas among individuals diagnosed with bipolar disorder and unipolar depression.MethodsThree groups of subjects 56 unipolar depression in the remission period, 70 bipolar eutimic and 58 healthy controls were asked to fill out the Leahy Emotional Schema Scale (LESS). The clinicians diagnosed the participants according to the criteria of DSM-IV-TR with SCID-I, and rated the moods of the subjects with the Beck Depression Scale, and the Young Mania Rating Scale (YMRS). Statistical analyses were undertaken to identify the group differences on LESS.ResultsThe bipolar eutimic and unipolar depression patients’ scores on the LESS dimensions were significantly different from the healthy participants in the areas of control, consensus, acceptance of feelings, dissimilarity and simplistic view of emotions.ConclusionsThese results suggest that the metacognitive model of unipolar depression might be extrapolated for patients with bipolar disorder. Bipolar disorder may be associated with a general activation of the emotional schemas.Disclosure of interestThe author has not supplied his/her declaration of competing interest.

Obesity and quality of life in bipolar disorder

2017 ◽  
Vol 41 (S1) ◽  
pp. S423-S424
Author(s):  
R. Jouini ◽  
H. Ben Ammar ◽  
G. Hamdi ◽  
N. Smari ◽  
A. Aissa ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Bipolar Disorder ◽  
Scale Score ◽  
Rating Scale ◽  
Short Form ◽  
Depression Scale ◽  
Overweight And Obesity ◽  
Hamilton Depression Scale ◽  
Bipolar Patients

IntroductionOverweight and obesity, despite their comorbidities and mortality, could deteriorate the quality of life of people with bipolar disorder.ObjectivesThe objective of this study is to evaluate the quality of life among patients with bipolar disorder and investigate a possible interaction between obesity and deterioration of the quality of life.AimsThis study aims to highlight the importance of preventing overweight and obesity in people with bipolar disorder to obtain an adequate quality of life subsequently an acceptable control of the illness.MethodsFifty euthymic bipolar patients (Hamilton Depression Scale score ≤ 8, and Young Mania Rating Scale score ≤ 6) received the Medical Outcomes Study 36-Item Short-Form Health Survey in Arabic validated version in order to investigate the quality of life.ResultsWe examined 50 euthymic bipolar patients (60% men, 40% women). The average age was 46, 5 years (23–70). Most patients (69%) were over weighted (BMI ≥ 25.0 kg/m2) (body mass index), of whom 40% were obese (BMI ≥ 30.0 kg/m2). Seventy-two percent of the investigated patients had an affected quality of life (score < 66.7). The mental items were deteriorated in 80% of the cases. An affected quality of life was correlated with obesity. The BMI was significantly and negatively correlated with the scores of dimensions D4 (mental health) and D8 (perceived health) (P < 0.01).ConclusionThe investigation of quality of life in people with mental disorder enables to reveal the social handicap caused by these illnesses consequently emphasizes health care in mental affections.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals The progression of 102 Brazilian patients with bipolar disorder: outcome of first 12 months of prospective follow-up

2014 ◽  
Vol 36 (1) ◽  
pp. 16-22 ◽  
Author(s):  
Fernanda Novis ◽  
Patricia Cirillo ◽  
Rafael Assis da Silva ◽  
Ana Letícia Santos ◽  
Luciana Angélica Silva Silveira ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Depressive Symptoms ◽  
Rating Scale ◽  
Depression Scale ◽  
First Episode ◽  
First Year ◽  
International Studies ◽  
Hamilton Depression Scale ◽  
Adequate Treatment ◽  
Depressive Episodes

INTRODUCTION: Prospective studies have shown that the course of bipolar disorder (BD) is characterized by the persistence of symptoms, predominantly depression, along most of the time. However, to our knowledge, no studies in Latin America have investigated it. OBJECTIVES: To replicate international studies using a Brazilian sample to prospectively analyze treatment outcomes in the first year and to determine potential chronicity factors. METHODS: We followed up 102 patients with BD for 12 months and evaluated the number of months with affective episodes and the intensity of manic and depressive symptoms using the Young Mania Rating Scale (YMRS) and the Hamilton Depression Scale (HAM-D17). Sociodemographic and retrospective clinical data were examined to determine possible predictors of outcome. RESULTS: Almost 50% of the patients had symptoms about half of the time, and there was a predominance of depressive episodes. Disease duration and number of depressive episodes were predictors of chronicity. Depressive polarity of the first episode and a higher number of depressive episodes predicted the occurrence of new depressive episodes. CONCLUSION: In general, BD outcome seems to be poor in the first year of monitoring, despite adequate treatment. There is a predominance of depressive symptoms, and previous depressive episodes are a predictor of new depressive episodes and worse outcome.

Use of Novel Psychoactive Substances and Induced Psychiatric Symptoms: Outcomes From the Eivissa Project

2017 ◽  
Vol 41 (S1) ◽  
pp. S206-S206 ◽  
Author(s):  
G. Martinotti ◽  
C. Montemitro ◽  
M. Corbo ◽  
F. Sarchione ◽  
E. Cinosi ◽  
...  
Keyword(s):  
Negative Symptoms ◽  
Rating Scale ◽  
Psychiatric Symptoms ◽  
Depression Scale ◽  
New Psychoactive Substances ◽  
Psychiatric History ◽  
Hamilton Depression Scale ◽  
Psychoactive Substances ◽  
Young Mania ◽  
Polydrug Abuse

IntroductionPolydrug abuse seems to be especially popular in Ibiza, an important market for new psychoactive substances (NPS). The misuse of psychoactive substances can lead to serious psychiatric symptoms.AimsTo evaluate symptoms induced by NPSs and other club drugs, correlating with the main classes of drugs.MethodsNinety subjects (M/F 59/31) admitted in the Psychiatric Unit of Can Misses Hospital (Ibiza) referring a recent intake of substances were enrolled. The following scales were administered: TLFB (Timeline follow-back); Positive and Negative Symptoms Scale (PANSS); Symptom checklist-90 (SCL-90) ; Young Mania Rating Scale (YMRS) ; Hamilton Depression Scale (HAM-D); Hamilton Anxiety Scale (HAM-A); Modified Overt Aggression Scale (MOAS); Columbia Suicide Severity Rating Scale (C-SSRS).ResultsPolydrug abuse was reported by 67.4% of the sample; the sample was grouped by the main preferred substance in THC-, stimulants-, and depressors-users. The majority of patients reported a previous psychiatric history. Positive symptoms resulted to be higher among THC-users (P < .05). Anxiety evaluated by SCL-90 was prevalent in the group of Depressors-users (P < .05). The scores of MOAS and SCL-90 subscale for hostility/aggression resulted to be significantly (P < .01) greater in the THC-users group.ConclusionsSome specific psychiatric symptoms are characteristic of some classes of substances and may help to identify them when a urine sample is not available. The possibility to develop psychiatric symptoms after a recent drug use is more common in two situations: (1) patients with a previous psychiatric history; (2) subjects with a history of very strong substance use.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Assessment of Serum IL-4, 15d-PGJ2, PPAR Gamma Levels in Patients with Bipolar Disorder

2017 ◽  
Vol 41 (S1) ◽  
pp. S75-S75
Author(s):  
G. Erzin ◽  
Ç. aydemir ◽  
R. yüksel ◽  
E. tatlıdil ◽  
B. Çakır ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Demographic Data ◽  
Depression Scale ◽  
Ppar Gamma ◽  
Hamilton Depression Scale ◽  
Healthy Controls ◽  
Young Mania ◽  
Endogenous Factors ◽  
Anti Inflammatory ◽  
Competing Interest

IntroductionMany hypotheses have been proposed about development of bipolar disorder including inflammatory processes due to the external and endogenous factors. There are strong evidences that immunological dysfunction is present in bipolar disorder. In the pathophysiology of bipolar disorder, there are many data that support the inflammatory hypothesis.ObjectivesIn this study, to clarify the etiology of bipolar disorder, based on the inflammatory process hypothesis, it is aimed to measure and evaluate serum 15d-PGJ2 and PPARγ, anti-inflammatory cytokine IL-4 levels in patients with bipolar disorder.MethodsThis study was performed at Ankara Numune Training and Research Hospital. Ninety-five patients are included in the study that were in their mania or remission periods and meet the DSM-V criteria for bipolar disorder. Forty-four healthy volunteers are included in the study as well. Serum IL-4, 15d-PGJ2, PPARγ levels are measured in both groups. Young Mania Scale, Hamilton Depression Scale, demographic data form were given to patient group.ResultsIn our study, 15d-PGJ2, PPARγ levels were found statistically significantly lower in patients with bipolar disorder compared to healthy controls.ConclusionThere are differences in anti-inflammatory prostaglandin levels in patients with bipolar disorder who are in their mania period when compared to healthy controls and patients in their remission period. This does not show any significance according to smoking and gender. This implies that inflammation markers could be a good candidate to determine trait markers, which will provide an insight for preventing patient from mania period or prognosis after the diagnosis of bipolar disorder.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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