scholarly journals Bipolar disorder and multiple sclerosis

2007 ◽  
Vol 65 (4b) ◽  
pp. 1177-1180 ◽  
Author(s):  
Mariana Inés Ybarra ◽  
Marcos Aurélio Moreira ◽  
Carolina Reis Araújo ◽  
Marco Aurélio Lana-Peixoto ◽  
Antonio Lucio Teixeira
Keyword(s):  
Multiple Sclerosis ◽  
Bipolar Disorder ◽  
Adverse Reaction ◽  
Mood Disorders ◽  
Psychiatric Symptoms ◽  
Biological Factors ◽  
Demyelinating Lesions

Bipolar disorder may be overrepresented in multiple sclerosis (MS) patients. Although research in this area is limited, studies assessing the nature of this association have focused on genetic aspects, adverse reaction to drugs and brain demyelinating lesions. Herein we report three patients with MS that also presented bipolar disorder. The coexistence of neurological and psychiatric symptoms in most MS relapses highlights the relevance of biological factors in the emergence of mood disorders in these patients.

scholarly journals Familial Multiple Sclerosis with Repetitive Relapses of Manic Psychosis in Two Patients (Mother and Daughter)

2000 ◽  
Vol 12 (4) ◽  
pp. 175-179 ◽  
Author(s):  
Pedro J. Modrego ◽  
Jaime Ferrández
Keyword(s):  
Multiple Sclerosis ◽  
Bipolar Disorder ◽  
Psychiatric Symptoms ◽  
Brain Magnetic Resonance Imaging ◽  
Hla Alleles ◽  
Mother And Daughter ◽  
Magnetic Resonance Imaging Mri ◽  
Similar Class ◽  
The Right ◽  
Psychiatric Manifestations

The clinical presentation of multiple sclerosis (MS) with psychiatric symptoms is uncommon but it is believed that MS patients are twice as likely to be afflicted with bipolar disorder as the general population. We report two cases (mother and daughter) of MS presenting with bipolar disorder in the form of recurrent manic psychosis and whose outcome was favourable with neuroleptics and corticosteroids. In both cases we found multiple hypersignal lesions on brain magnetic resonance imaging (MRI), especially in the right frontal lobe where we observed signs of activity. Apart from clinical and radiological concordance, the patients exhibited similar class I HLA alleles and identical class II HLA alleles. We focused discussion on whether there may be a common genetic susceptibility to both illnesses or whether MS caused psychiatric manifestations. The coincidence of psychiatric and neurological symptoms in most relapses supports the second hypothesis.

scholarly journals Bipolar Disorder and Multiple Sclerosis: A Case Series

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Youssef Sidhom ◽  
Mouna Ben Djebara ◽  
Yosr Hizem ◽  
Istabrak Abdelkefi ◽  
Imen Kacem ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Bipolar Disorder ◽  
Interferon Beta ◽  
Psychiatric Symptoms ◽  
Treatment Options ◽  
Case Series ◽  
Psychotic Symptoms ◽  
Antipsychotic Treatment ◽  
High Dose ◽  
Psychiatric Disturbance

Background.The prevalence of psychiatric disturbance for patients with multiple sclerosis (MS) is higher than that observed in other chronic health conditions. We report three cases of MS and bipolar disorder and we discuss the possible etiological hypothesis and treatment options.Observations.All patients fulfilled the McDonald criteria for MS. Two patients were followed up in psychiatry for manic or depressive symptoms before developing MS. A third patient was diagnosed with MS and developed deferred psychotic symptoms. Some clinical and radiological features are highlighted in our patients: one manic episode induced by high dose corticosteroids and one case of a new orbitofrontal MRI lesion concomitant with the emergence of psychiatric symptoms. All patients needed antipsychotic treatment with almost good tolerance for high dose corticosteroids and interferon beta treatment.Conclusions.MRI lesions suggest the possible implication of local MS-related brain damage in development of pure “psychiatric fits” in MS. Genetic susceptibility is another hypothesis for this association. We have noticed that interferon beta treatments were well tolerated while high dose corticosteroids may induce manic fits.

Polarised views about bipolar disorder(s): A critique of the 2020 College guidelines for mood disorders

2021 ◽  
pp. 000486742110200
Author(s):  
Gordon Parker
Keyword(s):  
Bipolar Disorder ◽  
Mood Disorders ◽  
International Classification Of Diseases ◽  
Bipolar Ii Disorder ◽  
Statistical Manual ◽  
Diagnostic And Statistical Manual ◽  
Bipolar Ii ◽  
Classification Of Diseases ◽  
Formal Status

The 2020 College guidelines for mood disorders banish bipolar II disorder – despite its formal status in Diagnostic and Statistical Manual of Mental Disorders and International Classification of Diseases manuals for more than two decades – and argue that there is no need to partition bipolar disorder into separate sub-types. Their single-entity model is seemingly based on opinion rather than any support from referenced scientific studies. The author challenges the Committee’s model of there being only one bipolar disorder and argues that it presents several clinical management risks, particularly of ‘over-treatment’.

827 Central Sleep Apnea in a patient with Multiple Sclerosis

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A322-A323
Author(s):  
Rahul Dasgupta ◽  
Sonja Schütz ◽  
Tiffany Braley
Keyword(s):  
Multiple Sclerosis ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Sleep Disordered Breathing ◽  
Central Sleep Apnea ◽  
Progressive Multiple Sclerosis ◽  
Obstructive Sleep ◽  
Increased Risk ◽  
Demyelinating Lesions ◽  
The Brain

Abstract Introduction Sleep-disordered breathing is common in persons with multiple sclerosis (PwMS), and may contribute to debilitating fatigue and other chronic MS symptoms. The majority of research to date on SDB in MS has focused on the prevalence and consequences of obstructive sleep apnea; however, PwMS may also be at increased risk for central sleep apnea (CSA), and the utility of methods to assess CSA in PwMS warrant further exploration. We present a patient with secondary progressive multiple sclerosis who was found to have severe central sleep apnea on WatchPAT testing. Report of case(s) A 61 year-old female with a past medical history of secondary progressive multiple sclerosis presented with complaints of fragmented sleep. MRI of the brain, cervical spine, and thoracic spine showed numerous demyelinating lesions in the brain, brainstem, cervical, and thoracic spinal cord. Upon presentation, the patient noted snoring, witnessed apneas, and daytime sleepiness. WatchPAT demonstrated severe sleep apnea, with a pAHI of 63.3, and a minimum oxygen saturation of 90%. The majority of the scored events were non-obstructive in nature (73.1% of all scored events), and occurred intermittently in a periodic fashion. Conclusion The differential diagnosis of fatigue in PwMS should include sleep-disordered breathing, including both obstructive and central forms of sleep apnea. Demyelinating lesions in the brainstem (which may contribute to impairment of motor and sensory networks that control airway patency and respiratory drive), and progressive forms of MS, have been linked to both OSA and CSA. The present data illustrate this relationship in a person with progressive MS, and offer support for the WatchPAT as a cost-effective means to evaluate for both OSA and CSA in PwMS, while reducing patient burden. PwMS may be at increased risk for CSA. Careful clinical consideration should be given to ordering appropriate sleep testing to differentiate central from obstructive sleep apnea in PwMS, particularly for patients with demyelinating lesions in the brainstem. Support (if any) 1. Braley TJ, Segal BM, Chervin RD. Obstructive sleep apnea and fatigue in patients with multiple sclerosis. J Clin Sleep Med. 2014 Feb 15;10(2):155–62. doi: 10.5664/jcsm.3442. PMID: 24532998; PMCID: PMC3899317.

scholarly journals Microglial Pruning: Relevance for Synaptic Dysfunction in Multiple Sclerosis and Related Experimental Models

Cells ◽  
2021 ◽  
Vol 10 (3) ◽  
pp. 686
Author(s):  
Maria Concetta Geloso ◽  
Nadia D’Ambrosi
Keyword(s):  
Multiple Sclerosis ◽  
Neuronal Death ◽  
Environmental Changes ◽  
Experimental Models ◽  
Synaptic Dysfunction ◽  
Synapse Elimination ◽  
Neurodegenerative Process ◽  
Immune Mediated ◽  
Wide Range ◽  
Demyelinating Lesions

Microglia, besides being able to react rapidly to a wide range of environmental changes, are also involved in shaping neuronal wiring. Indeed, they actively participate in the modulation of neuronal function by regulating the elimination (or “pruning”) of weaker synapses in both physiologic and pathologic processes. Mounting evidence supports their crucial role in early synaptic loss, which is emerging as a hallmark of several neurodegenerative diseases, including multiple sclerosis (MS) and its preclinical models. MS is an inflammatory, immune-mediated pathology of the white matter in which demyelinating lesions may cause secondary neuronal death. Nevertheless, primitive grey matter (GM) damage is emerging as an important contributor to patients’ long-term disability, since it has been associated with early and progressive cognitive decline (CD), which seriously worsens the quality of life of MS patients. Widespread synapse loss even in the absence of demyelination, axon degeneration and neuronal death has been demonstrated in different GM structures, thus raising the possibility that synaptic dysfunction could be an early and possibly independent event in the neurodegenerative process associated with MS. This review provides an overview of microglial-dependent synapse elimination in the neuroinflammatory process that underlies MS and its experimental models.

scholarly journals Affective Temperaments and Illness Severity in Patients with Bipolar Disorder

Medicina ◽  
2021 ◽  
Vol 57 (1) ◽  
pp. 54
Author(s):  
Mario Luciano ◽  
Luca Steardo ◽  
Gaia Sampogna ◽  
Vito Caivano ◽  
Carmen Ciampi ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Bipolar Disorder ◽  
Protective Factor ◽  
Psychiatric Symptoms ◽  
Control Group ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Affective Temperaments

Background and objectives: Bipolar disorder (BD) is one of the most burdensome psychiatric illnesses, being associated with a negative long-term outcome and the highest suicide rate. Although affective temperaments can impact on BD long-term outcome, their role remains poorly investigated. The aims of the present study are to describe the clinical characteristics of patients with BD more frequently associated with the different affective temperaments and to assess the relation between affective temperaments and severity of clinical picture in a sample of patients with BD. Materials and Methods: A total of 199 patients have been recruited in the outpatients units of two university sites. Patients’ psychiatric symptoms, affective temperaments, and quality of life were investigated through validated assessment instruments. Results: Predominant cyclothymic and irritable temperaments are associated to higher number of relapses, poorer quality of life, higher rates of aggressive behaviors, and suicide attempts. Conversely, the predominant hyperthymic disposition was a protective factor for several outcome measures, including relapse rate, severity of anxiety, depressive and manic symptoms, suicidality, and earlier age at onset. One limitationo of the present study is that the recruitment took place in two university sites; therefore, our findings cannot be fully generalized to the whole community of BD patients. Other limitations are the lack of a control group and the cross-sectional design of the study. Conclusions: The early identification of affective temperaments can help clinicians to identify those BD patients who are more likely to show a poor long-term outcome. An early screening of affective temperaments can be useful to develop targeted integrated pharmacological and psychosocial interventions.

PO10-TU-63 Case report: bipolar disorder, tension type headache and multiple sclerosis

2009 ◽  
Vol 285 ◽  
pp. S213
Author(s):  
A. Dzagnidze ◽  
M. Kukava ◽  
N. Lobjanidze ◽  
M. Janelidze ◽  
M. Shalikashvili
Keyword(s):  
Multiple Sclerosis ◽  
Bipolar Disorder ◽  
Case Report ◽  
Tension Type Headache ◽  
Type Headache

The Prevalence of Comorbid Anxiety in Schizophrenia, Schizoaffective Disorder and Bipolar Disorder

1998 ◽  
Vol 32 (1) ◽  
pp. 67-72 ◽  
Author(s):  
Susan J. Cosoff ◽  
R. Julian Hafner
Keyword(s):  
Bipolar Disorder ◽  
Anxiety Disorder ◽  
Anxiety Disorders ◽  
Schizoaffective Disorder ◽  
Psychiatric Symptoms ◽  
Psychotic Episode ◽  
Obsessive Compulsive ◽  
General Anxiety ◽  
Admission Rates ◽  
Clinical Benefits

Objective: The aim of this study to determine the prevalence of anxiety disorders in publically treated psychiatric inpatients with a DSM-IV diagnosis of schizophrenia, schizoaffective disorder or bipolar disorder. Method: Using the Structured Clinical Interview for DSM-III-R (SCID), 100 consecutive inpatients with a psychotic disorder were examined for the presence or absence of an anxiety disorder. Questionnaire measures of phobias, obsessive-compulsive and general anxiety symptoms were also applied. Results: The prevalences of social phobia (17%), obsessiv-ompulsive disorder (13%) and generalised anxiety disorder in schizophrenia were relatively high, as were prevalences of obsessive-compulsive (30%) and panic disorder (15%) in bipolar disorder. The proportion of subjects with an anxiety disorder (4345%) was almost identical across the three psychoses, with some evidence of gender differences. Although self-ratings of overall psychiatric symptoms were significantly elevated in those with anxiety disorders, hospital admission rates were not. Conclusions: Almost none of those with anxíeGty disorders were being treated for them, primarily because the severity of the acute psychotic illness required full diagnostic and therapeutic attention. Patients were generally discharged as soon as their psychotic episode was resolved, with little recognition of the presence of an anxiety disorder. Given that anxiety disorders are relatively responsive to treatment, greater awareness of their comorbidity with psychosis should yield worthwhile clinical benefits.

Cognitive reserve in neuropsychiatry

2006 ◽  
Vol 36 (8) ◽  
pp. 1053-1064 ◽  
Author(s):  
J. H. BARNETT ◽  
C. H. SALMOND ◽  
P. B. JONES ◽  
B. J. SAHAKIAN
Keyword(s):  
Bipolar Disorder ◽  
Cognitive Function ◽  
Head Injury ◽  
Cognitive Reserve ◽  
Protective Factor ◽  
Psychiatric Symptoms ◽  
Neuropsychiatric Disorders ◽  
Future Studies ◽  
Cognitive Failure ◽  
History Of

Background. The idea that superior cognitive function acts as a protective factor against dementia and the consequences of head injury is well established. Here we suggest the hypothesis that cognitive reserve is also important in neuropsychiatric disorders including schizophrenia, bipolar disorder and depression.Method. We review the history of passive and active models of reserve, and apply the concept to neuropsychiatric disorders. Schizophrenia is used as an exemplar because the effects of premorbid IQ and cognitive function in this disorder have been extensively studied.Results. Cognitive reserve may impact on neuropsychiatric disorders in three ways: by affecting the risk for developing the disorder, in the expression of symptoms within disorders, and in patients' functional outcome. Cognitive failure below a certain threshold may alone, or in combination with common psychiatric symptoms, produce neuropsychiatric syndromes.Conclusions. Consideration of cognitive reserve may considerably improve our understanding of individual differences in the causes and consequences of neuropsychiatric disorders. For these reasons, the concept of cognitive reserve should be incorporated in future studies of neuropsychiatric disorder. It may be possible to enhance cognitive reserve through pharmacological or non-pharmacological means, such as education, neurocognitive activation or other treatment programmes.

Sign in / Sign up

Export Citation Format

Share Document