Possible association between haplotypes of the FKBP5 gene and suicidal bipolar disorder, but not with melancholic depression and psychotic features, in the course of bipolar disorder

Aims:The catecholamine hypothesis of affective disorders suggests that depression is associated with a functional decrease of catecholamines. There is consistent evidence that COMT gene would be a candidate gene for studies of bipolar disorder.Methods:The study was performed on patients with bipolar disorder n=298 (male n=126, female n=172). Control subjects were blood donors n=336 (male n=130, female n=206), who were not psychiatrically assessed. The subgroup of patients with psychotic features not congruent with mood contained n=88 patients, males n=41, females n=47. The subgroup of patients with psychotic features congruent with mood contained n=89 patients, males n=47, females n=42. The subgroup of patients with melancholic depression contained n=197 patients, males n=76, females n= 121. A polymorphism was analysed by PCR-RFLP method.Results:There were no differences in the frequency of genotypes, alleles between patients and controls in the whole group (p=0,286 for genotypes, p= 0,652 for alleles). Dividing the patients according to the gender, no differences in the frequency of either genotypes or alleles were found (p=0,298 for genotype males, p=0,456 for genotypes females). We did not find the association in the subgroup of patients with psychotic features congruent (p=0,828 for genotypes, p= 0,866 for alleles), or not congruent with mood (p=0,116 for genotypes, p= 0,673 for alleles) and with the subgroup of patients with depression with melancholic features (p= 0,758 for genotypes, p= 0,849 for alleles).Conclusion:Results of our study suggest that the polymorphism of COMT gene is not associated with the susceptibility to bipolar disorder.

Download Full-text

Narcolepsy: Differential Diagnosis or Etiology in Some Cases of Bipolar Disorder and Schizophrenia?

CNS Spectrums ◽

10.1017/s1092852900018344 ◽

2003 ◽

Vol 8 (2) ◽

pp. 120-126 ◽

Cited By ~ 25

Author(s):

Alan B. Douglass

Keyword(s):

Bipolar Disorder ◽

Differential Diagnosis ◽

Psychiatric Patients ◽

Human Leukocyte ◽

Sleep Paralysis ◽

Leukocyte Antigen ◽

Psychotic Features ◽

Hypnagogic Hallucinations ◽

Rule Out

AbstractDoes narcolepsy, a neurological disease, need to be considered when diagnosing major mental illness? Clinicians have reported cases of narcolepsy with prominent hypnagogic hallucinations that were mistakenly diagnosed as schizophrenia. In some bipolar disorder patients with narcolepsy, the HH resulted in their receiving a more severe diagnosis (ie, bipolar disorder with psychotic features or schizoaffective disorder). The role of narcolepsy in psychiatric patients has remained obscure and problematic, and it may be more prevalent than commonly believed. Classical narcolepsy patients display the clinical “tetrad”—cataplexy, hypnagogic hallucinations, daytime sleep attacks, and sleep paralysis. Over 85% also display the human leukocyte antigen marker DQB10602 (subset of DQ6). Since 1998, discoveries in neuroanatomy and neurophysiology have greatly advanced the understanding of narcolepsy, which involves a nearly total loss of the recently discovered orexin/hypocretin (hypocretin) neurons of the hypothalamus, likely by an autoimmune mechanism. Hypocretin neurons normally supply excitatory signals to brainstem nuclei producing norepinephrine, serotonin, histamine, and dopamine, with resultant suppression of sleep. They also project to basal forebrain areas and cortex. A literature review regarding the differential diagnosis of narcolepsy, affective disorder, and schizophrenia is presented. Furthermore, it is now possible to rule out classical narcolepsy in difficult psychiatric cases. Surprisingly, psychotic patients with narcolepsy will likely require stimulants to fully recover. Many conventional antipsychotic drugs would worsen their symptoms and make them appear to become a “chronic psychotic,” while in fact they can now be properly diagnosed and treated.

Download Full-text

Who Responds to Prophylactic Lithium Therapy?

The British Journal of Psychiatry ◽

10.1192/s0007125000292441 ◽

1993 ◽

Vol 163 (S21) ◽

pp. 20-26 ◽

Cited By ~ 24

Author(s):

M. T. Abou-Saleh

Keyword(s):

Bipolar Disorder ◽

Family History ◽

Bipolar Affective Disorder ◽

Positive Family History ◽

Specific Treatment ◽

Predictors Of Outcome ◽

Powerful Predictor ◽

Bipolar Illness ◽

History Of ◽

Psychotic Features

The search for predictors of outcome has not been particularly rewarding, and the use of lithium remains empirical: a trial of lithium is the most powerful predictor of outcome. However, lithium is a highly specific treatment for bipolar disorder. In non-bipolar affective disorder, factors of interest are correlates of bipolar disorder: mood-congruent psychotic features, retarded-endogenous profile, cyclothymic personality, positive family history of bipolar illness, periodicity, and normality between episodes of illness.

Download Full-text

Procedural memory consolidation after a night of sleep in bipolar disorder with psychotic features

Schizophrenia Research ◽

10.1016/j.schres.2018.12.044 ◽

2019 ◽

Vol 210 ◽

pp. 299-300

Author(s):

Ann K. Shinn ◽

Cagri Yuksel ◽

Grace Masters ◽

Danielle Pfaff ◽

Erin Wamsley ◽

...

Keyword(s):

Bipolar Disorder ◽

Memory Consolidation ◽

Procedural Memory ◽

Psychotic Features

Download Full-text

Association between catechol-O-methyltransferase Val(108/158)Met polymorphism and psychotic features of bipolar disorder

Journal of Affective Disorders ◽

10.1016/j.jad.2010.01.005 ◽

2010 ◽

Vol 125 (1-3) ◽

pp. 341-344 ◽

Cited By ~ 18

Author(s):

Francesco Benedetti ◽

Sara Dallaspezia ◽

Cristina Colombo ◽

Cristina Lorenzi ◽

Adele Pirovano ◽

...

Keyword(s):

Bipolar Disorder ◽

Psychotic Features

Download Full-text

The Neurobiology and Treatment of Bipolar Disorder

10.1093/med/9780190681425.003.0020 ◽

2017 ◽

Author(s):

Katherine E. Burdick ◽

Luz H. Ospina ◽

Stephen J. Haggarty ◽

Roy H. Perlis

Keyword(s):

Bipolar Disorder ◽

High Risk ◽

Genetic Risk ◽

Biological Models ◽

Increased Risk ◽

Psychotic Features ◽

Prodromal Syndrome ◽

Abnormal Sleep ◽

Epigenetic Processes ◽

High Risk Children

Bipolar disorder (BPD) is a severe mood disorder that often has psychotic features. Its most severe forms are more common and significantly more likely to cause disability than originally thought. Studies of high-risk children have found them to be at increased risk for a variety of symptoms and neurobiological abnormalities. In contrast to schizophrenia, there is no formal prodromal syndrome that has been identified, and cognitive abnormalities do not precede the onset of the disorder. Abnormal sleep and circadian rhythms are prominent and have led to intriguing biological models. Neurobiological experiments have primarily focused on candidate pathways and include circadian abnormalities, epigenetic processes including histone modification, WNT/GSK3 signaling, other modulators of neuroplasticity, and mitochondrial dysfunction. Recent data suggest that BPD is a highly polygenic disease and that integration of prior modeling and data with the wide variety of new genetic risk loci will be productive in the future.

Download Full-text

Bipolar disorder with and without a history of psychotic features: fMRI correlates of sustained attention

Progress in Neuro-Psychopharmacology and Biological Psychiatry ◽

10.1016/j.pnpbp.2019.109817 ◽

2020 ◽

Vol 98 ◽

pp. 109817 ◽

Cited By ~ 1

Author(s):

Gianna Sepede ◽

Piero Chiacchiaretta ◽

Francesco Gambi ◽

Giuseppe Di Iorio ◽

Domenico De Berardis ◽

...

Keyword(s):

Bipolar Disorder ◽

Sustained Attention ◽

History Of ◽

Psychotic Features

Download Full-text

Risk of bipolar disorder and psychotic features in patients initially hospitalised with severe depression

Acta Neuropsychiatrica ◽

10.1017/neu.2014.42 ◽

2014 ◽

Vol 27 (2) ◽

pp. 113-118 ◽

Cited By ~ 9

Author(s):

Kimiya Nakamura ◽

Junichi Iga ◽

Naoki Matsumoto ◽

Tetsuro Ohmori

Keyword(s):

Bipolar Disorder ◽

Severe Depression ◽

Psychotic Symptoms ◽

Primary Disorder ◽

Icd 10 ◽

History Of ◽

Physical Diseases ◽

The Stability ◽

Psychotic Features ◽

Depressive Episodes

ObjectiveSevere depression may be a risk factor for diagnostic conversion into bipolar disorder (BD), and psychotic depression (PD) has been consistently associated with BD. The aims of the present study were to investigate the stability of the diagnosis of severe depression and the differences between PD and non-psychotic severe depression (non-PD), as well as to assess the effectiveness of electroconvulsive therapy (ECT).MethodsPatients who were hospitalised for severe depression (diagnosed according to ICD-10) both with and without psychotic symptoms (n=89; mean age=55.6 years, SD=13.9) from 2001 to 2010 were retrospectively assessed.ResultsBy the 75th month of follow-up assessments, 11(12.4%) patients had developed BD. Among these 11 converters, nine had developed BD within 1 year after admission. Only sub-threshold hypomanic symptoms were significantly related to developing BD. The number of depressive episodes and history of physical diseases were significantly increased in non-PD compared with PD patients, whereas ECT was significantly increased in PD compared with non-PD patients. There was a significant association between length of stay at the hospital and the number of days between admission and ECT.ConclusionSub-threshold hypomanic symptoms may represent a prodrome of BD or an indicator of an already manifest phenotype, especially in older patients, which suggests cautious use of antidepressants. In severe depression, non-PD may often occur secondary to physical diseases and patients may experience increased recurrences compared with PD patients, which may be a more ‘primary’ disorder and often requires ECT treatments. ECT is effective for severe depression regardless of the presence of any psychotic feature; the earlier ECT is introduced, the better the expected treatment outcome.

Download Full-text

Bipolar disorder and co-occurring cannabis use disorders

European Psychiatry ◽

10.1016/j.eurpsy.2017.01.522 ◽

2017 ◽

Vol 41 (S1) ◽

pp. S466-S466

Author(s):

S. Ben Mustapha ◽

W. Homri ◽

L. Jouini ◽

R. Labbane

Keyword(s):

Bipolar Disorder ◽

Suicide Attempts ◽

Term Treatment ◽

Cannabis Use ◽

Family Dynamic ◽

Long Term Treatment ◽

Cannabis Use Disorders ◽

Competing Interest ◽

Bipolar Patients ◽

Psychotic Features

AimsAssess the prevalence of cannabis use disorders (CUD) in patients with bipolar disorder, describe the demographic and clinical profile socio bipolar patients with comorbid addictive and assess the implications of this comorbidity on prognosis and evolution of bipolar disorder.MethodsA case-control study, 100 euthymic patients treated for bipolar disorder, recruited in the department of psychiatry C of Razi hospital. Two groups were individualized by the presence or not of cannabis use disorders comorbidity. The two groups were compared for sociodemographic, clinical, therapeutic and historical characteristics.ResultsThe prevalence of CUD was 27.53% (n = 19) in our sample. Comparing bipolar patients according to the presence or absence of CUD, we found the following results with patients with CUD comorbidity: younger, mostly male, a disturbed family dynamic, low educational level, poor socio-economic conditions, more time abroad history, more suicide attempts in history, more criminal record, more psychiatric family history, an earlier onset of the disease, a longer duration of undiagnosed bipolar disorder, more personality disorder, more frequent presence of a triggering factor for bipolar disorder, more psychotic features during mood episodes, more need of antipsychotic long-term treatment.ConclusionsThe frequency of CUD in BD is higher than the prevalence in the general population and CUD is a factor in the evolution and prognosis of bipolar disorder and promotes the development of mood disorders in predisposed patients.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Download Full-text

The Maudsley bipolar disorder project Clinical characteristics of bipolar disorder I in a Catchment area treatment sample

European Psychiatry ◽

10.1016/s0924-9338(02)00009-3 ◽

2003 ◽

Vol 18 (1) ◽

pp. 13-17 ◽

Cited By ~ 29

Author(s):

Vanessa Raymont ◽

David Bettany ◽

Sophia Frangou

Keyword(s):

Bipolar Disorder ◽

Substance Abuse ◽

Catchment Area ◽

Clinical Characteristics ◽

Age Of Onset ◽

Psychiatric Service ◽

Male Gender ◽

Younger Age ◽

Male Patients ◽

Psychotic Features

AbstractThe clinical characteristics of bipolar I disorder (BD1) have prognostic and therapeutic importance. The aim of this study was to examine the effect of demographic and clinical variables on the course of BD1. We reviewed the case notes of all BD1 patients (n = 63) receiving treatment in a London psychiatric service during a 1-month period. Depressive and manic onsets were equally likely without any gender difference. The earlier the age of onset, the more likely it was for patients to experience psychotic features. Only depressive onsets predicted a higher number of episodes of the same polarity. Male gender and substance abuse were associated with younger age at first presentation, while women with co-morbid substance abuse had more manic episodes. Male patients were more likely than females to be unemployed or single.

Download Full-text