The Dual-System Theory of Bipolar Spectrum Disorders: A Meta-Analysis

Bipolar spectrum disorders are characterized by alternating intervals of extreme positive and negative affect. We performed a meta-analysis to test the hypothesis that such disorders would be related to dysregulated reinforcement sensitivity. First, we reviewed 23 studies that reported the correlation between self-report measures of (hypo)manic personality and measures of reinforcement sensitivity. A large relationship was found between (hypo)manic personality and BAS sensitivity (g = .74), but not with BIS sensitivity (g = -.08). This stands in contrast to self-reported depression which has a small, negative relationship with BAS sensitivity and a large positive one with BIS sensitivity (Katz et al., 2020). Next, we reviewed 33 studies that compared reinforcement sensitivity between euthymic, bipolar participants and healthy controls. There, bipolar disorder had a small, positive relationship with BAS sensitivity (g = .20) and a medium, positive relationship with BIS sensitivity (g = .64). These findings support a dual-system theory of bipolar disorders, wherein BAS sensitivity is more closely related to mania and BIS sensitivity more closely to bipolar depression. Bipolar disorders show diatheses for both states with euthymic participants being BAS- and BIS- hypersensitive. Implications for further theory and research practice are expounded upon in the discussion.

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The Dual-System Hypothesis of Bipolar Spectrum Disorders: A Meta-Analysis

10.31234/osf.io/ja6wd ◽

2020 ◽

Author(s):

Benjamin A Katz ◽

Cognition and Psychopathology Lab - Iftah Yovel

Keyword(s):

Positive Relationship ◽

Meta Analysis ◽

Bipolar Disorders ◽

Dual System ◽

Reward Sensitivity ◽

Bipolar Spectrum ◽

Bipolar Spectrum Disorders ◽

Reinforcement Sensitivity ◽

Punishment Sensitivity ◽

Spectrum Disorders

Bipolar spectrum disorders are characterized by alternating intervals of extreme positive and negative affect. We performed a meta-analysis to test the hypothesis that such disorders would be related to dysregulated reinforcement sensitivity. First, we reviewed 22 studies that reported the correlation be-tween self-report measures of (hypo)mania and measures of reinforcement sensitivity. A large relation-ship was found between (hypo)mania and reward sensitivity (g = .75), but not with punishment sensi-tivity (g = -.05). This stands in contrast to self-reported depression which was found to have a small, negative relationship with reward sensitivity and a large positive one with punishment sensitivity (Katz et al., 2020). Next, we reviewed 32 studies that compared reinforcement sensitivity between euthymic, bipolar participants and healthy controls. There, bipolar disorder had a small, positive relationship with reward sensitivity (g = .19) and a medium, positive relationship with punishment sensitivity (g = .64). These findings support a dual-system theory of bipolar disorders, wherein reward sensitivity is more closely related to mania and punishment sensitivity more closely to bipolar depression. Bipolar disorders show diatheses for both states with euthymic participants being hypersensitive to both rewards and punishments. Implications for further theory and research practice are expounded upon in the discussion.

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The dual-system theory of bipolar spectrum disorders: A meta-analysis

Clinical Psychology Review ◽

10.1016/j.cpr.2020.101945 ◽

2021 ◽

Vol 83 ◽

pp. 101945

Author(s):

Benjamin A. Katz ◽

Hadar Naftalovich ◽

Kathryn Matanky ◽

Iftah Yovel

Keyword(s):

System Theory ◽

Meta Analysis ◽

Dual System ◽

Bipolar Spectrum ◽

Bipolar Spectrum Disorders ◽

Spectrum Disorders

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Validity of the Brazilian Portuguese version of the bipolar spectrum diagnostic scale

Jornal Brasileiro de Psiquiatria ◽

10.1590/s0047-20852010000400001 ◽

2010 ◽

Vol 59 (4) ◽

pp. 266-270 ◽

Cited By ~ 1

Author(s):

Milena S. Castelo ◽

Eduardo R. Carvalho ◽

Emília S. Gerhard ◽

Danielle Silveira Macêdo ◽

Eduardo D. Ferreira ◽

...

Keyword(s):

Predictive Value ◽

Bipolar Disorders ◽

Psychiatric Clinic ◽

Bipolar Spectrum ◽

Bipolar Spectrum Disorders ◽

Brazilian Version ◽

Valid Instrument ◽

Dsm Iv ◽

Spectrum Disorders ◽

Development And Validation

OBJECTIVE: Bipolar spectrum disorders (BSDs) are prevalent and frequently unrecognized and undertreated. This report describes the development and validation of the Brazilian version of the bipolar spectrum diagnostic scale (B-BSDS), a screening instrument for bipolar disorders, in an adult psychiatric population. METHOD: 114 consecutive patients attending an outpatient psychiatric clinic completed the B-BSDS. A research psychiatrist, blind to the B-BSDS scores, interviewed patients by means of a modified version of the mood module of the Structured Clinical Interview for DSM-IV ("gold standard"). Subthreshold bipolar disorders were defined as recurrent hypomania without a major depressive episode or with fewer symptoms than those required for threshold hypomania. RESULTS: The internal consistency of the B-BSDS evaluated with Cronbach's alpha coefficient was 0.89 (95% CI; 0.86-0.91). On the basis of the modified SCID, 70 patients (61.4%) of the sample received a diagnosis of BSDs. A B-BSDS screening score of 16 or more items yielded: sensitivity of 0.79 (95% CI; 0.72-0.85), specificity of 0.77 (95% CI; 0.70-0.83), a positive predictive value of 0.85 (95% CI; 0.78-0.91) and a negative predictive value of 0.70 (95% CI; 0.63-0.75). CONCLUSION: The present data demonstrate that the B-BSDS is a valid instrument for the screening of BSDs.

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Mood Stabilizers in the Treatment of Substance Use Disorders

CNS Spectrums ◽

10.1017/s1092852900027346 ◽

2010 ◽

Vol 15 (2) ◽

pp. 95-109 ◽

Cited By ~ 13

Author(s):

Icro Maremmani ◽

Matteo Pacini ◽

Francesco Lamanna ◽

Pier Paolo Pani ◽

Giulio Perugi ◽

...

Keyword(s):

Substance Use ◽

Dual Diagnosis ◽

Substance Abusers ◽

Bipolar Disorders ◽

Preliminary Evidence ◽

Mood Stabilizers ◽

Bipolar Spectrum ◽

Bipolar Spectrum Disorders ◽

Spectrum Disorders

ABSTRACTIndividuals suffering from drug addiction may also manifest features of bipolar spectrum disorders. Hyperthymic and cyclothymic temperaments may render individuals vulnerable to later development of substance abuse. Bipolar disorders themselves may be altered or precipitated by substance use, most notably by stimulants (amphetamines), alcohol, and cannabinoids.The clinical usefulness of mood stabilizers, particularly antiepileptics, has been established as safe and effective in substance abusers with and without comorbid mood disorders. Most studies on this issue have been of short duration and focused on the resolution of a currently manifest period of illness. Few studies have been conducted on the usefulness of these drugs on the long-term longitudinal course of these diseases, such as frequently encountered recurrent relapses into states of agitation, impulsivity, and/or dissatisfaction. As opposed to the clinical experience with traditional antidepressants and neuroleptics, antiepileptics do not induce counter-polar states (depressed patients abruptly turning manic or hypomanic; nor patients currently hypomanic or manic turning abruptly depressed). Many clinicians consider antiepileptic mood stabilizers to be the preferred category of medications for the treatment of such patients. Valproate appears to be a potentially fruitful medication to study in these dual diagnosis patients due to preliminary evidence demonstrating its anticraving efficacy.

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The assessment and management of suicide risk in bipolar disorder

10.1093/med/9780198748625.003.0016 ◽

2017 ◽

Cited By ~ 1

Author(s):

Zoltán Rihmer ◽

Xénia Gonda ◽

Péter Döme

Keyword(s):

Bipolar Disorder ◽

Suicide Risk ◽

Bipolar Disorders ◽

Evidence Based ◽

Bipolar Spectrum ◽

Bipolar Spectrum Disorders ◽

Spectrum Disorders ◽

Bipolar Patients ◽

Routine Assessment ◽

Commit Suicide

Bipolar spectrum disorders are among the most frequent psychiatric ailments associated with a considerable risk of suicidal behaviour. Approximately 4–19% of (mostly untreated) patients with bipolar disorders ultimately commit suicide, and about 20–60% of them make at least one suicide attempt in their lifetime. Compared with the general population, the risk of committing suicide is about 10–30 times higher in patients with bipolar disorder. However, the majority of bipolar patients never attempt or commit suicide. Therefore, the routine assessment of several risk factors for suicide in clinical practice may aid in the recognition of those patients who are at the highest risk. This chapter summarizes the clinically most relevant suicide risk and protective factors in bipolar disorders. In addition, we review evidence-based strategies for suicide prevention in bipolar disorder.

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Screening for bipolar spectrum disorders: A comprehensive meta-analysis of accuracy studies

Journal of Affective Disorders ◽

10.1016/j.jad.2014.10.024 ◽

2015 ◽

Vol 172 ◽

pp. 337-346 ◽

Cited By ~ 45

Author(s):

André F. Carvalho ◽

Yemisi Takwoingi ◽

Paulo Marcelo G. Sales ◽

Joanna K. Soczynska ◽

Cristiano A. Köhler ◽

...

Keyword(s):

Meta Analysis ◽

Bipolar Spectrum ◽

Bipolar Spectrum Disorders ◽

Spectrum Disorders

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Validity of the Mood Disorder Questionnaire in a Brazilian psychiatric population

Brazilian Journal of Psychiatry ◽

10.1590/s1516-44462010005000024 ◽

2010 ◽

Vol 32 (4) ◽

pp. 424-428 ◽

Cited By ~ 6

Author(s):

Milena S. Castelo ◽

Eduardo R. Carvalho ◽

Emília S. Gerhard ◽

Carlos Maurício C. Costa ◽

Eduardo D. Ferreira ◽

...

Keyword(s):

Mood Disorder ◽

Predictive Value ◽

Bipolar Disorders ◽

Psychiatric Clinic ◽

Bipolar Spectrum ◽

Bipolar Spectrum Disorders ◽

Brazilian Version ◽

Mood Disorder Questionnaire ◽

Psychiatric Population ◽

Spectrum Disorders

OBJECTIVE: Bipolar spectrum disorders are prevalent and frequently underdiagnosed and undertreated. This report describes the development and validation of the Brazilian version of the Mood Disorder Questionnaire, a screening instrument for bipolar spectrum disorders, in an adult psychiatric population. METHOD: A total of 114 consecutive patients attending an outpatient psychiatric clinic completed the Brazilian version of the Mood Disorder Questionnaire. A research psychiatrist, blind to the Mood Disorder Questionnaire results, interviewed patients by means of the mood module of the Structured Clinical Interview for DSM-IV ('gold standard'). RESULTS: The internal consistency of the Brazilian Mood Disorder Questionnaire, evaluated with Cronbach's alpha coefficient was 0.76 (95% CI; 0.69-0.92). Principal component analysis with varimax rotation indicated an 'irritability-racing thoughts' factor and 'energized-activity' factor, which explained 39.1% of variance. On the basis of the SCID, 69 (60.5%) individuals received a diagnosis of bipolar disorders. A Brazilian Mood Disorder Questionnaire screening score of 8 or more items yielded sensitivity of 0.91 (95% CI; 0.85-0.98), specificity of 0.70 (95% CI; 0.62-0.75), a positive predictive value of 0.82 (95% CI; 0.75-0.88) and a negative predictive value of 0.84 (95% CI; 0.77-0.90). CONCLUSION: The present data demonstrate that the Brazilian Mood Disorder Questionnaire is a valid instrument for the screening of bipolar disorders. The instrument needs to be validated in other settings (e.g., in general practice).

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