scholarly journals Mood versus energy/activity symptoms in bipolar disorder: which cluster of Hamilton Depression Rating Scale better distinguishes between mania, depression, and euthymia?

2019 ◽  
Vol 41 (4) ◽  
pp. 401-408
Author(s):  
Elie Cheniaux ◽  
Rafael de Assis da Silva ◽  
Cristina M. T. Santana ◽  
Antonio Egidio Nardi ◽  
Alberto Filgueiras
Keyword(s):  
Bipolar Disorder ◽  
Rating Scale ◽  
Latent Trait ◽  
Clinical Criteria ◽  
Clinical Scales ◽  
Hamilton Depression Rating Scale ◽  
Motor Retardation ◽  
Cardinal Symptoms ◽  
Activity Cluster

Abstract Introduction Although bipolar disorder (BD) is traditionally included among mood disorders, some authors believe that changes in energy and motor activity, rather than mood changes, represent the true cardinal symptoms in mania and depression. The aim of the current study was to identify which cluster of the Hamilton Depression Rating Scale (HAM-D) better distinguishes between mania, depression and euthymia. Method A group of 106 patients with BD were followed for 13 years and repeatedly assessed with the HAM-D as well as with other clinical scales. To perform a comparison, HAM-D items were classified according to clinical criteria into three clusters: energy/activity symptoms, mood symptoms, and other symptoms. Item response theory (IRT) analyses were performed to provide a test information curve for those three clusters. We measured the prevalence of one cluster of symptoms over the other two throughout the latent trait. Results Considering HAM-D items individually, the IRT analysis revealed that there was a mixture of mood and energy/activity symptoms among the most discriminative items, both in depression and in euthymia. However, in mania, only energy/activity symptoms – i.e., general somatic symptoms and retardation – were among the most informative items. Considering the classification of items, both in depression as in mania, the energy/activity cluster was more informative than the mood cluster according to the IRT analysis. Conclusion Our data reinforce the view of hyperactivity and motor retardation as cardinal changes of mania and depression, respectively.

scholarly journals The Bruton tyrosine kinase inhibitor ibrutinib improves anti-MAG antibody polyneuropathy

2020 ◽  
Vol 7 (4) ◽  
pp. e720 ◽  
Author(s):  
Francesca Castellani ◽  
Andrea Visentin ◽  
Marta Campagnolo ◽  
Alessandro Salvalaggio ◽  
Mario Cacciavillani ◽  
...  
Keyword(s):  
Tyrosine Kinase ◽  
Rating Scale ◽  
Kinase Inhibitor ◽  
Disability Score ◽  
Clinical Scales ◽  
Sum Score ◽  
Inflammatory Neuropathy ◽  
Bruton Tyrosine Kinase

ObjectiveTo assess whether neuropathy with anti-myelin-associated glycoprotein (MAG) antibody may improve after treatment with ibrutinib, an oral inhibitor of Bruton tyrosine kinase, we prospectively treated with ibrutinib a cohort of 3 patients with anti-MAG neuropathy and Waldenström macroglobulinemia (WM).MethodsAll 3 patients underwent bone marrow biopsy showing WM, with MYD88L265P mutated and CXCR4S338X wild type, and were started on ibrutinib 420 mg/die. Patients were assessed at baseline, at 3-6-9 months, and at 12 months in 2 patients with a longer follow-up, using Inflammatory Neuropathy Cause and Treatment (INCAT) Disability Score, INCAT sensory sum score, and Medical Research Council sum score. The modified International Cooperative Ataxia Rating Scale was performed in 2 patients, whereas it was not used in the patient with Parkinson disease as a major comorbidity. Responders were considered the patients improving by at least one point in 2 clinical scales.ResultsAll the patients reported an early and subjective benefit, consistent with the objective improvement, especially of the sensory symptoms as shown by clinical scales. Treatment was well tolerated.ConclusionThese preliminary data point to a possible efficacy of ibrutinib in anti-MAG antibody neuropathy, which is the most common disabling paraproteinemic neuropathy, where active treatment is eagerly needed.Classification of evidenceThis study provides Class IV evidence that for patients with anti-MAG antibody neuropathy, ibrutinib improves neuropathy symptoms.

Platelet and Plasmatic Lipidic Profile as Potential Marker of Bipolar Disorders: Preliminary Findings

2017 ◽  
Vol 41 (S1) ◽  
pp. S210-S211
Author(s):  
L. Sideli ◽  
A. Mule’ ◽  
F. Damiani ◽  
M. Corso ◽  
S. Montana ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Arachidonic Acid ◽  
Mood Disorders ◽  
Rating Scale ◽  
Bipolar Disorders ◽  
University Hospital ◽  
Psychotic Symptoms ◽  
Alpha Linolenic Acid ◽  
Clinical Criteria ◽  
Potential Marker

IntroductionAlthough the diagnosis of bipolar disorder is currently based on clinical criteria, preliminary studies showed that palmitic and arachidonic acid levels are able to discriminate adult patients with major depressive disorder (MDD) from those with bipolar disorder (BD).ObjectivesTo replicate and to expand previous findings by investigating the relation between mood disorders and platelet and plasmatic fatty levels.AimsTo compare the lipidic profile of individuals with different mood disorder (MDD vs. BD) and to investigate the relation with specific clinical features (duration of illness, attempted suicide, psychotic symptoms).MethodsPotential participants were recruited from the outpatient and inpatient psychiatric units of the university hospital of Palermo (Italy). Diagnosis of DSM IV mood disorders was made using the MINI. Symptom severity was assessed using the HAM-D rating scale and the YMRS. Fatty acid profile was analyzed using mass spectrometry.ResultsPreliminary analyses were performed on 8 patients with MDD and 6 with BD. Groups were similar in terms of demographic variables. Patients with MDD showed highest levels of platelet palmitic acid, stearic acid, and arachidonic acid. Furthermore, plasmatic docosahexaenoic acid was negatively related with manic symptoms severity (Rho = –0.697; P = 0.025) and platelet alpha linolenic acid was positively related with illness duration (Rho = 0.845; P = 0.040).ConclusionsThese preliminary findings suggest that platelet fatty acids may be possible biological markers to improve the diagnosis of BD.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Disturbance of Oxidative Stress Parameters in Treatment-Resistant Bipolar Disorder and Their Association With Electroconvulsive Therapy Response

2020 ◽  
Vol 23 (4) ◽  
pp. 207-216 ◽  
Author(s):  
Qinyu Lv ◽  
Qiongyue Hu ◽  
Wenzhong Zhang ◽  
Xinxin Huang ◽  
Minghuan Zhu ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Bipolar Disorder ◽  
Electroconvulsive Therapy ◽  
Rating Scale ◽  
Enzyme Linked Immunosorbent Assay ◽  
Treatment Resistant ◽  
Young Mania ◽  
Hamilton Depression Rating Scale ◽  
Oxidative Stress Parameters ◽  
Stress Parameters

Abstract Objective Electroconvulsive therapy (ECT) is an effective option for treatment-resistant bipolar disorder (trBD). However, the mechanisms of its effect are unknown. Oxidative stress is thought to be involved in the underpinnings of BD. Our study is the first, to our knowledge, to report the association between notable oxidative stress parameters (superoxide dismutase [SOD], glutathione peroxidase [GSH-Px], catalase [CAT], and malondialdehyde [MDA]) levels and ECT response in trBD patients. Methods A total 28 trBD patients and 49 controls were recruited. Six-week ECT and naturalistic follow-up were conducted. SOD, GSH-Px, CAT, and MDA levels were measured by enzyme-linked immunosorbent assay, and the 17-item Hamilton Depression Rating Scale and Young Mania Rating Scale were administered at baseline and the end of the 6th week. MANCOVA, ANCOVA, 2 × 2 ANCOVA, and a multiple regression model were conducted. Results SOD levels were lower in both trBD mania and depression (P = .001; P = .001), while GSH-Px (P = .01; P = .001) and MDA (P = .001; P = .001) were higher in both trBD mania and depression compared with controls. CAT levels were positively associated with 17-item Hamilton Depression Rating Scale scores in trBD depression (radjusted  = 0.83, P = .005). MDA levels in trBD decreased after 6 weeks of ECT (P = .001). Interestingly, MDA levels decreased in responders (P = .001) but not in nonresponders (P > .05). Conclusions Our study indicates that decreased SOD could be a trait rather than a state in trBD. Oxidative stress levels are associated with illness severity and ECT response. This suggests that the mechanism of oxidative stress plays a crucial role in the pathophysiology of trBD.

An IRT Investigation of the Validity of Non-Patient Analogue Research Using the Beck Depression Inventory

1995 ◽  
Vol 11 (1) ◽  
pp. 14-20 ◽  
Author(s):  
Sean M. Hammond
Keyword(s):  
Differential Item Functioning ◽  
Beck Depression Inventory ◽  
Rating Scale ◽  
Latent Trait ◽  
Scale Model ◽  
Item Functioning ◽  
Two Samples ◽  
Patient Groups ◽  
Analogue Research ◽  
Rating Scale Model

This paper presents an IRT analysis of the Beck Depression Inventory which was carried out to assess the assumption of an underlying latent trait common to non-clinical and patient samples. A one parameter rating scale model was fitted to data drawn from a patient and non-patient sample. Findings suggest that while the BDI fits the model reasonably well for the two samples separately there is sufficient differential item functioning to raise serious duobts of the viability of using it analogously with patient and non-patient groups.

Manejo y comorbilidades de los trastornos bipolares en la infancia y adolescencia

2020 ◽  
Vol 63 (6) ◽  
pp. 40-50
Author(s):  
Hugo Enrique Hernández-Martínez ◽  
Marta Georgina Ochoa-Madrigal
Keyword(s):  
Bipolar Disorder ◽  
Key Words ◽  
Child Psychiatry ◽  
Affective Disorders ◽  
Age Of Onset ◽  
Bipolar Disorders ◽  
World Population ◽  
Key Words Bipolar Disorder ◽  
The World ◽  
Cardinal Symptoms

The diagnosis and treatment of bipolar disorders (BPD) in children is currently one of the biggest challenges and area of controversy in the field of child psychiatry. Bipolar disorders encompass several affective disorders that involve alterations in the degree of activity, content and form of thinking that are characterized by biphasic episodes of mood. This group of disorders affect approximately 1% of the world population and begin in youth (the average age of onset of ~20 years). However, in some studies a delay of 5 years has been observed since the presentation of symptoms at the beginning of the treatment. Currently, the diagnosis of TBP in children and adolescents should be based on the same set of symptoms applied to adults, as well as the general principles of the treatment. The research carried out around this disorder has resulted in changes in the conceptualization and approach of this pathology, now conceived as a group of disorders that share changes in mood and other cardinal symptoms, of a chronic and progressive nature that impacts in a negative way in those who suffer them. Key words: Bipolar disorder; childhood; mania; hypomania; depression.

scholarly journals The functional impairment of different subtypes and occupational states in euthymic patients with bipolar disorder

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xinyu Liu ◽  
Xiaojuan Ma ◽  
Wenchen Wang ◽  
Jian Zhang ◽  
Xia Sun ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Social Functioning ◽  
Rating Scale ◽  
Verbal Learning ◽  
Occupational Status ◽  
Learning Performance ◽  
Neurocognitive Functioning ◽  
Type I ◽  
Speed Of Processing ◽  
Occupational Functioning

Abstract Background The aim was to explore the associations between clinical symptoms, demographic variables, social and neurocognitive functioning in euthymic patients with bipolar disorder (BD) stratified by subgroups of DSM-IV BD (type I (BD-I) and type II (BD-II)) and occupational status (employed/unemployed), and to highlight the significance of occupational status when assessing social and neurocognitive functioning in euthymic BD patients. Methods A total of 81 euthymic BD patients were participated in the study. The severity of the depressive and manic/hypomanic symptoms was measured using the 17-item Hamilton Depression Rating Scale (HDRS-17) and the Young Mania Rating Scale (YMRS), respectively. Social functioning and neurocognitive functioning were evaluated by the Functioning Assessment Short Test (FAST) and neurocognitive measures, respectively. Results Employed BD patients displayed greater social functioning (autonomy, occupational functioning, interpersonal relationship domain) and better verbal learning performance and speed of processing than unemployed BD patients. The correlation between neurocognitive functioning and social functioning was stronger in the employed group than in the unemployed group. There were no significant differences in neurocognitive and social functioning between the BD-I and BD-II groups, and the correlation between neurocognitive functioning and social functioning was similar between the BD-I and BD-II groups. Conclusion Employed BD patients may present greater occupational functioning and interpersonal relationships, as well as better verbal learning performance and speed of processing.

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