scholarly journals Cognitive impact in bipolar disorder

2019 ◽  
pp. 052-058
Author(s):  
Bourin Michel
Keyword(s):  
Bipolar Disorder ◽  
Verbal Memory ◽  
Visual Memory ◽  
Age Of Onset ◽  
Cognitive Difficulties ◽  
Speed Of Information Processing ◽  
History Of ◽  
Bipolar Patients ◽  
Disability Severity ◽  
Depressive Episodes

It appears that bipolar patients suffer from cognitive difficulties whereas they are in period of thymic stability. These intercritical cognitive difficulties are fairly stable and their severity is correlated with the functional outcome of patients. Nevertheless, the profile of cognitive impairment varies significantly from study to study quantitatively and qualitatively. According to the studies, the authors find difficulties in terms of learning, verbal memory, visual memory, working memory, sustained attention, speed of information processing, functions executive. On the other hand, deficits of general intelligence, motor functions, selective attention, and language are not usually found. One of the reasons for the heterogeneity of results is the difficulty of exploring cognition in bipolar disorder. Many factors must be taken into account, such as the presence of residual mood symptoms, the longitudinal history of the disorder (age of onset, number of episodes due, among others, the neurotoxic impact of depressive episodes and deleterious cognitive effects). (length of hospitalization), level of disability severity, comorbidities (particularly addictive).

Manic-depressive illness — I: clinical characteristics of bipolar disorder subtypes

1992 ◽  
Vol 9 (1) ◽  
pp. 6-9 ◽  
Author(s):  
Patrick McKeon ◽  
Patrick Manley ◽  
Gregory Swanwick
Keyword(s):  
Bipolar Disorder ◽  
Family History ◽  
Age Of Onset ◽  
Rapid Cycling ◽  
Manic Depressive Illness ◽  
Bipolar Ii ◽  
History Of ◽  
Bipolar Patients ◽  
Depressive Episodes ◽  
Manic Patients

AbstractThe clinical and demographic features of 100 bipolar disorder patients, who were categorised into bipolar I, bipolar II, unipolar mania and rapid cycling groups, and who were further classified on the basis of the sequence of occurrence of the manic and depressive episodes within each cycle, are compared. Bipolar I (including unipolar manic) patients, 77% of whom had a sequence of moods where mania preceded depression (Mania-Depression – normothymic Interval: M.D.I.) constituted 69% of the total sample. Six per cent were classified as bipolar II and 25% has a rapid cycling disorder. Patients who had an M.D.I. sequence of moods, whether rapid or non-rapid cycling, had a younger age of onset, a higher male:female ratio and a stronger family history of bipolar disorder than patients whose depression preceded mania (D.M.I.). Unipolar manic patients, 12% of the sample, had a comparable age of onset, a greater family history of bipolarity and more frequent hospitalisations than the bipolar I-M.D.I. group. Rapid cycling patients had a lower mean serum thyroxine concentration than the non-rapid cycling bipolar disorder patients. This study supports the rationale for distinguishing bipolar patients with an M.D.I, sequence from those with a D.M.I, pattern and rapid cyclers from non-rapid cyclers.

scholarly journals Psychosocial and clinical factors of cognitive functioning of patients with coronary heart disease after coronary stent

2015 ◽  
Vol 8 (3) ◽  
pp. 156-172 ◽  
Author(s):  
O.Yu. Schyolkova ◽  
D.A. Eremina
Keyword(s):  
Verbal Memory ◽  
Visual Memory ◽  
Age Of Onset ◽  
Empirical Studies ◽  
Epileptiform Activity ◽  
Memory Disorders ◽  
Short Term ◽  
Cerebral Pathology ◽  
History Of ◽  
Sick Children

Memory disorders are a common pathology in children with convulsive paroxysms. The present study tested the hypothesis that the pathology of memory in children with paroxysmal states have quantitative and qualitative specificity. The study involved 107 children aged 6–10 years. 59 people had a history of paroxysmal state, 12 people with epileptiform activity on EEG without seizures in history. A comparison group comprised 36 people with residual cerebral pathology without a history of seizures. The study used experimental psychological and neuropsychological research methods memory. The results of empirical studies have shown that increasing importance in the picture of violations mnestic activity in children with convulsive paroxysms addition to short-term verbal memory disorders have impaired short-term visual memory, the phenomenon of amnestic aphasia and modal-nonspecific memory disorders. The degree of short-term verbal memory disorders correlates with the age of onset of seizures, visual memory - with the number of attacks in history. Consideration of the results will allow to organize the process of providing psychological assistance to sick children more effectively.

scholarly journals Machado-Joseph disease op azorean ancestry in Brazil: the Catarina kindred neurological, neuroimaging, psychiatric and neuropsychological findings in the largest known family, the «Catarina» kindred

1993 ◽  
Vol 51 (1) ◽  
pp. 21-30 ◽  
Author(s):  
J. Radvany ◽  
C.H.P. Camargo ◽  
Z.M. Costa ◽  
N.C. Fonseca ◽  
E.D. Nascimento
Keyword(s):  
At Risk ◽  
Verbal Memory ◽  
Visual Memory ◽  
Rating Scale ◽  
Age Of Onset ◽  
Quantitative Difference ◽  
Type I ◽  
History Of ◽  
The Moment ◽  
Fly Eye

At the moment 9 seemingly independent families with the clinical diagnosis of MJD are known in Brazil. The largest family tree of Azorean ancestry contatins 622 individuals in 9 generations. 236 were examined, 39 found to be affected by two examiners. Pheno-types I, II and III were expressed by 12, 23 and 4 patients with age of onset by phenotypea being 10-48, 14-54 and 30-55 respectively. Although clinically more severe, juvenile onset type I disease did not show as severe a ponto-mesencephialic atrophy on MRI as the father with type II disease of similar symptomatic duration. None of the 8 patients examined with MRI showed olivary atrophy or pallidal abnormalities. 12 affected and 23 at risk were evaluated with neuropsychological tests. Attention was normal in both groups. Verbal memory scores were below normal in the affected and there was greater decay with time than in the risk group. Both scored below normal in identifying silluettes and constructional praxis. Visual memory scores were well below normal for both, with many rotations but no omissions or confabulations. A peculiar pattern of multiplying internal details called «the fly-eye effect» was observed in 6 affected and 8 at risk. Defective color distinction when multiple colors presented close to each other, in face of proper naming of individual colors («color simultantagnosia»), was looked for in 29 people. 4/10 affected and 4/19 at risk showed this phenomenon. Cognitive dysfunctions in this MJD family are prominent in the sphere of vision. Whether they constitute an early manifestation in those at risk and thus serve as a clinical identifier of the illnes is yet to be established. Depression was looked for in the history of the family with DSM III-R criteria and an atempt at quantification with the Montgomery-Asberg Rating Scale. There was no significant quantitative difference between affected and at risk. Once undeniably symptomatic however, the patients had no, or less depression than themselves before or tat the early stages of the illness. Covert depression was appropriately excluded. Fully established MJD in this family seemed to exert a protective effect from depression.

The Effect of Gender on Neurocognitive Functioning in Bipolar Disorder

2017 ◽  
Vol 41 (S1) ◽  
pp. S213-S213 ◽  
Author(s):  
K. Tournikioti ◽  
P. Ferentinos ◽  
I. Michopoulos ◽  
D. Dikeos ◽  
C. Soldatos ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Executive Functions ◽  
Associative Learning ◽  
Verbal Memory ◽  
Visual Memory ◽  
Fixed Effects ◽  
Gender Effects ◽  
Analysis Of Covariance ◽  
Healthy Controls ◽  
Bipolar Patients

IntroductionBipolar disorder (BD) is frequently associated with cognitive deficits in attention, verbal memory and executive functions that have been related to various clinical characteristics of the disorder.ObjectivesHowever, few studies have examined the effect of gender on cognition despite its clinical relevance.AimsThe aim of our study was to investigate potential diagnosis-specific gender effects on visual memory/learning and executive functions in BD.MethodsCognitive performance of 60 bipolar-I patients and 30 healthy controls was evaluated by using CANTAB battery tasks targeting spatial memory (SRM), paired associative learning (PAL), executive functions (ID/ED, SOC). A multivariate analysis of covariance (MANCOVA) of neuropsychological parameters was performed with gender and diagnosis as fixed effects and age and education as covariates. Following univariate analyses of covariance (ANCOVA) were undertaken to examine the effect of gender on each neuropsychological task.ResultsBipolar patients showed significantly poorer performance in paired associative learning (PAL), set shifting (ID/ED) and planning (SOC). Moreover, a diagnosis specific gender effect was observed for cognitive functioning in BD (gender × diagnosis interaction P = 0.029). Specifically, male healthy controls outperformed healthy females in tasks of visual memory/learning but this pattern was not sustained (SRM) or was even reversed (PAL) in BD patients.ConclusionsThe present study is one of the few studies that have examined the effect of gender on neurocognitive function in BD. Our findings indicate that the gender-related variation observed in healthy subjects is disrupted in BD. Moreover, they suggest that gender may modulate the degree of frontotemporal dysregulation observed in BD.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals The relationship between affective temperament and suicide attempt, clinical history and current subclinical symptoms in bipolar disorder

2018 ◽  
Vol 9 (3) ◽  
pp. 65
Author(s):  
Rafael Assis Da Silva ◽  
Daniel Mograbi ◽  
Luiza Nogueira Amadeo ◽  
Cristina MT Santana ◽  
Jesus Landeira-Fernandez ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Suicide Attempt ◽  
Clinical Course ◽  
Depressive Mood ◽  
First Episode ◽  
Hamilton Depression Scale ◽  
Affective Temperament ◽  
History Of ◽  
Bipolar Patients ◽  
Depressive Episodes

Background: Affective temperament may strongly influence psychopathological characteristics in mood disorders such as clinical course of major or minor affective episodes, predominant polarity, clinical symptoms, long term clinical course, suicidality, and response/adherence to medication.Objective: The objective of this work is evaluate the association between affective temperament and clinical characteristics in bipolar disorder (BD) patients.Method: 88 euthymic bipolar patients were evaluated through Hamilton Depression Scale (HAM-D), Young Mania Rating Scale (YMRS), Clinical Global Impressions Scale for use in bipolar illness (CGI-BP), and TEMPS-Rio de Janeiro. Identification, sociodemographic data, and clinical information as age on disease onset, number of manic episodes, number of depressive episodes, polarity of first affective episode, and history of suicidal attempts, if any, from each patient were collected.Results: Our results founded that high scores in cyclothymic, irritable, depressive and anxious temperaments were associated with at least one suicide attempt. Higher scores of anxious temperament were associated with depressive polarity in the first episode of the disease as well as higher amount of manic episodes. Higher scores of hyperthymic temperament were associated with manic polarity in the first episode of the disease. Higher scores of depressive temperament were associated with higher scores in total HAM-D and specifically with higher scores in items 1 and 2 of HAM-D, i.e., depressive mood and guilt. No correlation was found between temperament and intensity of subsyndromal manic symptoms.Conclusion: We concluded that affective temperaments in BD are associated with history of suicide attempts, seem to influence polarity of first episode and that depressive temperament seems to relate to more intense subsyndromal depressive symptoms, especially depressive mood and guilt.

scholarly journals Pathology of memory in the structure of mental development disorders in children with convulsive paroxysms

2015 ◽  
Vol 8 (3) ◽  
pp. 145-155 ◽  
Author(s):  
N.G. Turovskaya
Keyword(s):  
Verbal Memory ◽  
Visual Memory ◽  
Age Of Onset ◽  
Empirical Studies ◽  
Epileptiform Activity ◽  
Memory Disorders ◽  
Short Term ◽  
Cerebral Pathology ◽  
History Of ◽  
Sick Children

Memory disorders are a common pathology in children with convulsive paroxysms. The present study tested the hypothesis that the pathology of memory in children with paroxysmal states have quantitative and qualitative specificity. The study involved 107 children aged 6-10 years. 59 people had a history of paroxysmal state, 12 people with epileptiform activity on EEG without seizures in history. A comparison group comprised 36 people with residual cerebral pathology without a history of seizures. The study used experimental psychological and neuropsychological research methods memory. The results of empirical studies have shown that increasing importance in the picture of violations mnestic activity in children with convulsive paroxysms addition to short-term verbal memory disorders have impaired short-term visual memory, the phenomenon of amnestic aphasia and modal-nonspecific memory disorders. The degree of short-term verbal memory disorders correlates with the age of onset of seizures, visual memory - with the number of attacks in history. Consideration of the results will allow to organize the process of providing psychological assistance to sick children more effectively.

scholarly journals Age at onset, course of illness and response to psychotherapy in bipolar disorder: results from the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD)

2014 ◽  
Vol 44 (16) ◽  
pp. 3455-3467 ◽  
Author(s):  
A. Peters ◽  
L. G. Sylvia ◽  
P. V. da Silva Magalhães ◽  
D. J. Miklowitz ◽  
E. Frank ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Collaborative Care ◽  
Bipolar Depression ◽  
Age At Onset ◽  
Number Needed To Treat ◽  
Systematic Treatment ◽  
Illness Duration ◽  
Bipolar Patients ◽  
Depressive Episodes ◽  
Intensive Psychotherapy

Background.The course of bipolar disorder progressively worsens in some patients. Although responses to pharmacotherapy appear to diminish with greater chronicity, less is known about whether patients' prior courses of illness are related to responses to psychotherapy.Method.Embedded in the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD) was a randomized controlled trial of psychotherapy for bipolar depression comparing the efficacy of intensive psychotherapy with collaborative care (a three-session psycho-educational intervention). We assessed whether the number of previous mood episodes, age of illness onset, and illness duration predicted or moderated the likelihood of recovery and time until recovery from a depressive episode in patients in the two treatments.Results.Independently of treatment condition, participants with one to nine prior depressive episodes were more likely to recover and had faster time to recovery than those with 20 or more prior depressive episodes. Participants with fewer than 20 prior manic episodes had faster time to recovery than those with 20 or more episodes. Longer illness duration predicted a longer time to recovery. Participants were more likely to recover in intensive psychotherapy than collaborative care if they had 10–20 prior episodes of depression [number needed to treat (NNT) = 2.0], but equally likely to respond to psychotherapy and collaborative care if they had one to nine (NNT = 32.0) or >20 (NNT = 9.0) depressive episodes.Conclusions.Number of previous mood episodes and illness duration are associated with the likelihood and speed of recovery among bipolar patients receiving psychosocial treatments for depression.

Early and Late Onset Bipolar Disorders in Older Adults

2017 ◽  
Vol 41 (S1) ◽  
pp. S211-S211
Author(s):  
N. Smaoui ◽  
L. Zouari ◽  
N. Charfi ◽  
M. Maâlej-Bouali ◽  
N. Zouari ◽  
...  
Keyword(s):  
Older Adults ◽  
Bipolar Disorder ◽  
Early Onset ◽  
Age Of Onset ◽  
Late Onset ◽  
Age At Onset ◽  
Bipolar Disorders ◽  
Medical Diagnoses ◽  
The Mean ◽  
Bipolar Patients

IntroductionAge of onset of illness may be useful in explaining the heterogeneity among older bipolar patients.ObjectiveTo examine the relationship of age of onset with clinical, demographic and behavioral variables, in older patients with bipolar disorder.MethodsThis was a cross-sectional, descriptive and analytical study, including 24 patients suffering from bipolar disorders, aged 65 years or more and followed-up in outpatient psychiatry unit at Hedi Chaker university hospital in Sfax in Tunisia. We used a standardized questionnaire including socio-demographic, behavioral and clinical data. Age of onset was split at age 40 years into early-onset (< 40 years; n = 12) and late-onset (≥ 40 years; n = 12) groups.ResultsThe mean age for the entire sample was 68.95 years. The mean age of onset was 39.95 years. The majority (60%) of patients were diagnosed with bipolar I. Few meaningful differences emerged between early-onset and late-onset groups, except that tobacco use was significantly higher in the late-onset group (66.6% vs. 16.6%; P = 0.027). No significant differences between the early-onset and late-onset groups were seen on demographic variables, family history and number of medical diagnoses or presence of psychotic features.ConclusionOur study found few meaningful behavioral differences between early versus late age at onset in older adults with bipolar disorder.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Organizational Learning Strategies and Verbal Memory Deficits in Bipolar Disorder

2017 ◽  
Vol 23 (4) ◽  
pp. 358-366 ◽  
Author(s):  
George C. Nitzburg ◽  
Armando Cuesta-Diaz ◽  
Luz H. Ospina ◽  
Manuela Russo ◽  
Megan Shanahan ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Learning Strategies ◽  
Verbal Memory ◽  
Verbal Learning ◽  
Diagnostic Category ◽  
Exact Nature ◽  
Organizational Strategies ◽  
Learning Differences ◽  
Mnemonic Devices ◽  
Bipolar Patients

AbstractBackground: Verbal memory (VM) impairment is prominent in bipolar disorder (BD) and is linked to functional outcomes. However, the intricacies of VM impairment have not yet been studied in a large sample of BD patients. Moreover, some have proposed VM deficits that may be mediated by organizational strategies, such as semantic or serial clustering. Thus, the exact nature of VM break-down in BD patients is not well understood, limiting remediation efforts. We investigated the intricacies of VM deficits in BD patients versus healthy controls (HCs) and examined whether verbal learning differences were mediated by use of clustering strategies. Methods: The California Verbal Learning Test (CVLT) was administered to 113 affectively stable BD patients and 106 HCs. We compared diagnostic groups on all CVLT indices and investigated whether group differences in verbal learning were mediated by clustering strategies. Results: Although BD patients showed significantly poorer attention, learning, and memory, these indices were only mildly impaired. However, BD patients evidenced poorer use of effective learning strategies and lower recall consistency, with these indices falling in the moderately impaired range. Moreover, relative reliance on semantic clustering fully mediated the relationship between diagnostic category and verbal learning, while reliance on serial clustering partially mediated this relationship. Conclusions: VM deficits in affectively stable bipolar patients were widespread but were generally mildly impaired. However, patients displayed inadequate use of organizational strategies with clear separation from HCs on semantic and serial clustering. Remediation efforts may benefit from education about mnemonic devices or “chunking” techniques to attenuate VM deficits in BD. (JINS, 2017, 23, 358–366)

Effects of In Utero Exposure to AEDs on Morphology and Neurodevelopment

CNS Spectrums ◽  
2006 ◽  
Vol 11 (S5) ◽  
pp. 9-10
Author(s):  
Martha J. Morrell
Keyword(s):  
Bipolar Disorder ◽  
Clinical Information ◽  
Mood Stabilizer ◽  
Mood Stabilizers ◽  
Antipsychotic Treatment ◽  
Close Monitoring ◽  
History Of ◽  
Major Congenital Malformations ◽  
Major Depressive Episodes ◽  
Depressive Episodes

AbstractThe presentations and clinical courses of patients with bipolar disorder differ greatly by gender. In addition, medical therapy must be tailored differently for men and women because of emerging safety concerns unique to the female reproductive system. In November 2005, these topics were explored by a panel of experts in psychiatry, neurology, and reproductive health at a closed roundtable meeting in Dallas, Texas. This clinical information monograph summarizes the highlights of that meeting.Compared to men with bipolar disorder, women have more pervasive depressive symptoms and experience more major depressive episodes. They are also at higher risk for obesity and certain other medical and psychiatric comorbidities. Mood changes across the menstrual cycle are common, although the severity, timing, and type of changes are variable. Bipolar disorder is frequently associated with menstrual abnormalities and ovarian dysfunction, including polycystic ovarian syndrome. Although some cases of menstrual disturbance precede the treatment of bipolar disorder, it is possible that valproate and/or antipsychotic treatment may play a contributory role in young women.Pregnancy does not protect against mood episodes in untreated women. Maintenance of euthymia during pregnancy is critical because relapse during this period strongly predicts a difficult postpartum course. Suspending therapy in the first months of pregnancy may be an option for some women with mild-to-moderate illness, or those with a long history of euthymia during pre-pregnancy treatment. However, a mood stabilizer should be reintroduced either in the later stages of pregnancy or in the immediate postpartum period. Preliminary data suggest that fetal exposure to some mood stabilizers may raise the risk of major congenital malformations and neurodevelopmental delays. For women planning to become pregnant, clinicians may consider switching to other drugs before conception. The value and drawbacks of breastfeeding during treatment must be considered in partnership with the patient, with close monitoring of nursing infants thereafter. The risks and benefits of medical treatment for women with bipolar disorder should be carefully reconsidered at each stage of their reproductive lives, with a flexible approach that is responsive to the changing needs of patients and their families.

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