scholarly journals Autobiographical Memory and Episodic Specificity Across Different Affective States in Bipolar Disorder

2021 ◽  
Vol 12 ◽  
Author(s):  
Rafael de Assis da Silva ◽  
Marcelo Baggi Tancini ◽  
Renata Lage ◽  
Rodrigo L. Nascimento ◽  
Cristina M. T. Santana ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Autobiographical Memory ◽  
Sense Of Self ◽  
Time Integration ◽  
Unipolar Depression ◽  
Mood States ◽  
Affective States ◽  
Psychiatric Interview ◽  
Self Identity ◽  
Bipolar Patients

Autobiographical memory is essential to ground a sense of self-identity, contributing to social functioning and the development of future plans, and being an essential source for the psychiatric interview. Previous studies have suggested loss of autobiographical episodic specificity in unipolar depression, but relatively fewer investigations have been conducted in bipolar disorder (BD) patients, particularly across different mood states. Similarly, there is a scarcity of systematic investigations about mood-congruent and mood-dependent memory in relation to autobiographical memory in BD. Considering this, a total of 74 patients with BD (24 in euthymia, 26 in mania, and 24 in depression) responded with autobiographical memories to cue words belonging to four categories: mania, depression, BD, and neutral. Episodic specificity was scored according to the Autobiographical Interview, with high intra- and inter-rater reliability. Results indicated that patients in mania generally re-experience more episodic details than those in depression. Depressed bipolar patients reported fewer details of perception and less time integration of memories than those in euthymia or mania. Words linked to depression and BD induced greater episodic re-experiencing than neutral words, just as words about BD provided greater episodic re-experiencing and more details of emotion/thoughts than words about mania. Words linked to depression provoked more time details about the recalled episodes than words on BD or neutral themes. No mood-congruent or mood-dependent effects were observed. Current findings may improve the ability of clinicians to conduct psychiatric interviews and the diagnosis of BD, with special attention to how memory details are generated across different mood states of the condition. Additionally, interventions to foster autobiographical recollection in BD may be developed, similar to what has already been done in the context of schizophrenia.

Prevalence of Bipolar Depression

CNS Spectrums ◽  
2003 ◽  
Vol 8 (S12) ◽  
pp. 2-3
Author(s):  
Robert M. Post
Keyword(s):  
Bipolar Disorder ◽  
Bipolar Depression ◽  
Unipolar Depression ◽  
The United States ◽  
Mood Stabilizers ◽  
Positive Screen ◽  
Specificity And Sensitivity ◽  
Academic Settings ◽  
Mood Disorder Questionnaire ◽  
Bipolar Patients

Recent data indicate that bipolar illness is underdiagnosed and therefore undertreated in the community (Slide 1). A recent survey of >85,000 households in the United States found a 3.7% positive screen for prominent bipolar symptomatology. Using the Mood Disorder Questionnaire, which has good specificity and sensitivity in outpatient clinics, the study also found that the prevalence was higher, 9.3%, among patients 18–24 years of age. However, most disappointing was that only 20% of the positive screens were diagnosed as bipolar, and among those, most were not treated with mood stabilizers. In addition, 31% of patients had been diagnosed with unipolar depression. Several studies have shown that approximately 20% to 40% of presumptively unipolar patients actually have bipolar II or bipolar disorder not otherwise specified. Combined, the data show that bipolar disorder, bipolar depression in particular, is highly prevalent and often misdiagnosed or unrecognized.Two recent studies found virtually the same data showing that depression is the predominant problem in naturalistically treated bipolar outpatients. Judd and colleagues found that depression was three times more prevalent than mania in bipolar patients. This is exactly what was found in the Stanley Foundation bipolar outpatient follow-up study, which rated the study's first 258 patients every day for 1 year (Slide 2). The study found that patients were ill almost 50% of the time; they were depressed 33% of the days in the year, and hypomanic or manic 10.8% of the days. This occurred despite aggressive treatment with a variety of agents, such as mood stabilizers, antidepressants, and benzodiazepines in 50% of the patients, and typical or atypical neuroleptics in almost 50% of the patients. Thus, even bipolar patients who are intensively treated in academic settings have a very substantial degree of morbidity, particularly depression.

Subthreshold Manifestations of Bipolar Disorders as Health Care’s tool

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
M. Mazza ◽  
D. Harnic ◽  
G. Marano ◽  
V. Catalano ◽  
L. Janiri ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Bipolar Disorder ◽  
Bipolar Disorders ◽  
Unipolar Depression ◽  
Response To Treatment ◽  
Type I ◽  
Male Patients ◽  
Bipolar Patients ◽  
Disorder Type

Introdution:Our study represents a pilot evaluation about how the MOOD-SR recognizes subthreshold manifestations that may be associated with clinical symptomatology in a group of bipolar patients.Methods:At Day Hospital of Psychiatry, Policlinico “A. Gemelli”, Bipolar Disorders Unit, it has been conducted an experimental study on a heterogeneous sample of 24 patients with a diagnosis of Bipolar Disorder type I. Patients have been assessed with the MOOD-SR, a clinical self-reported interview, that is specific for the spectrum of subthreshold pathology, and with the Quality of Life (QoL), that investigates the patient's quality of life.Results:We have found that 16 patients on 24 report a score higher than 60 (68,4%). Among these, 10 female patients on 15 have a total score higer than 61 (68.75%) while 6 male patients on 9 obtain a total score higher than 60 (62,5%). However, these results have only preliminary value, further studies are needed in order to obtain a deeper evaluation.Conclusion:Spectrum manifestations are both indicator of course and response to treatment and predictive for relapse. This finding may represent an important preventive instrument for maniacal relapse in patients with Bipolar Disorder, that is often underdiagnosed or confused for Unipolar Depression. By adequately recognizing the problem we will be able to refine diagnosis and individualize therapy.

Cognitive vulnerability in patients with bipolar disorder

2000 ◽  
Vol 30 (2) ◽  
pp. 467-472 ◽  
Author(s):  
J. SCOTT ◽  
B. STANTON ◽  
A. GARLAND ◽  
I. N. FERRIER
Keyword(s):  
Bipolar Disorder ◽  
Problem Solving ◽  
Autobiographical Memory ◽  
Rating Scale ◽  
Cognitive Vulnerability ◽  
Social Problem Solving ◽  
Memory Test ◽  
Dysfunctional Attitudes ◽  
Control Subjects ◽  
Bipolar Patients

Background. No study has simultaneously explored key components of Beck's model of cognitive vulnerability to depression in people with bipolar disorders.Methods. We compared 41 euthymic bipolar patients with 20 healthy control subjects. All subjects were assessed on the Hamilton Rating Scale for Depression, the Autobiographical Memory Test and the Mean Ends Problem-Solving procedure and also completed the Beck Depression Inventory, the Dysfunctional Attitude Scale, the Sociotropy Autonomy Scale and the Rosenberg Self-Esteem Questionnaire.Results. In comparison to control subjects, patients with bipolar disorder demonstrated significantly higher levels of dysfunctional attitudes (particularly perfectionism and need for approval) and sociotropy, significantly greater over-general recall on an autobiographical memory test and significantly less ability to generate solutions to social problem-solving tasks. These between group differences remained significant when age, intelligence, latency to respond to autobiographical memory test cue words, and subjective mood ratings were included as co-variates in the statistical analysis. Within the patient group, cognitive dysfunction was significantly correlated with level of morbidity (as measured by number of previous illness episodes).Conclusions. This study suggests that cognitive vulnerability in patients with bipolar disorder is similar to that described in unipolar disorders. It is not clear whether this dysfunction is a cause or an effect of repeated episodes of bipolar disorder. However, the findings may have implications for clinical treatment as well as suggesting a number of important new avenues of research into psychological models of affective disorder.

scholarly journals Appraisals of Internal States and their Consequences: Relationship to Adolescent Analogue Bipolar Symptoms

2015 ◽  
Vol 44 (2) ◽  
pp. 214-224 ◽  
Author(s):  
Rebecca E. Kelly ◽  
Patrick Smith ◽  
Eleanor Leigh ◽  
Warren Mansell
Keyword(s):  
Bipolar Disorder ◽  
Clinical Sample ◽  
Unipolar Depression ◽  
Mood States ◽  
Clinical Implications ◽  
Moderate Risk ◽  
Mood Symptoms ◽  
Internal States ◽  
Adolescent Sample ◽  
Negative Appraisals

Background: Extreme appraisals of internal states correlate with and prospectively predict mood symptoms in adults, and discriminate individuals with bipolar disorder from individuals with unipolar depression and non-clinical controls. Aims: These findings required replication in adolescents. This study sought to investigate the relationships between appraisals of internal states, mood symptoms and risk for bipolar disorder in an adolescent sample. Method: A non-clinical sample (n = 98) of adolescents completed measures of mood symptoms, appraisals, and mania risk, alongside covariates. Results: Appraisals of internal states were associated with analogue bipolar symptoms, independently of impulsivity and responses to positive affect. Positive appraisals of activated mood states were uniquely associated with hypomania, whilst negative appraisals were uniquely associated with depression and irritability symptoms. Individuals who appraised activated states as both extremely positive and extremely negative were more likely to score at high or moderate risk for future mania. Conclusions: This study is the first to demonstrate associations between appraisals of internal states, analogue mood symptoms and mania risk in adolescents. Clinical implications are discussed.

Clinical differences between unipolar and bipolar depression

2017 ◽  
Vol 41 (S1) ◽  
pp. S428-S428
Author(s):  
S. Smaoui ◽  
N. Charfi ◽  
M. Maâlej Bouali ◽  
L. Zouari ◽  
N. Zouari ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Rating Scale ◽  
Bipolar Depression ◽  
Unipolar Depression ◽  
Total Sample ◽  
Epidemiological Studies ◽  
University Hospital ◽  
Median Score ◽  
Depressed Patients ◽  
Bipolar Patients

IntroductionEpidemiological studies indicate that the majority of patients with bipolar disorder are diagnosed many years later. Unipolar depression represents the most frequent misdiagnosis.ObjectivesThis study aimed to examine the symptom profiles of depressed patients in order to identify clinical specificities of bipolar depression.MethodsA total of 31 depressed patients were recruited from psychiatry outpatient department of Hedi Chaker university hospital in Sfax (Tunisia), during October and November 2016. Unipolar and bipolar patients were compared on a broad range of parameters, including sociodemographic and clinical characteristics. Depressive symptoms were rated using the Montgomery Asberg Depression Rating Scale (MADRS) and Bipolar Depression Rating Scale (BDRS).ResultsThe total sample comprised 31 patients with 16 men and 15 women. It involved 20 with unipolar depression and 11 with bipolar depression. Patients with bipolar depression had more family history of bipolar disorder (P = 0.037) and a triggering factor had been identified less often (P = 0.03). MADRS scores were similar in bipolar and unipolar patient (median score 28.22 versus 28.36; P = 0.964). BDRS scores were significantly higher in bipolar depressed patients (median score 33 versus 25; P = 0.01). The mixed subscale (item 16 to 20) scores were particularly higher (median 6 vs. 1.2; P ≤ 0.01) especially concerning irritability (P = 0.001). Increased motor drive (P = 0.004) and agitation (P = 0.008).ConclusionOur findings suggest that the presence of mixed symptoms is very important to recognize depressed patients as having a bipolar disorder. We also recommend routine use of the BDRS for patients presenting for treatment of depression.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Anomalies of Autobiographical Memory

2019 ◽  
Vol 25 (10) ◽  
pp. 1061-1075 ◽  
Author(s):  
Michael D. Kopelman
Keyword(s):  
Autobiographical Memory ◽  
Past History ◽  
Case Reports ◽  
Sense Of Self ◽  
Illustrative Case ◽  
Control Mechanisms ◽  
Autobiographical Memories ◽  
Self Identity ◽  
Reminiscence Bump ◽  
Temporal Function

AbstractObjectives:In this paper, I review three ‘anomalies’ or disorders in autobiographical memory: neurological retrograde amnesia (RA), spontaneous confabulation, and psychogenic amnesia.Methods:Existing theories are reviewed, their limitations considered, some of my own empirical findings briefly described, and possible interpretations proposed and interspersed with illustrative case-reports.Results:In RA, there may be an important retrieval component to the deficit, and factors at encoding may give rise to the relative preservation of early memories (and the reminiscence bump) which manifests as a temporal gradient. Spontaneous confabulation appears to be associated with a damaged ‘filter’ in orbitofrontal and ventromedial frontal regions. Consistent with this, an empirical study has shown that both the initial severity of confabulation and its subsequent decline are associated with changes in the executive function (especially in cognitive estimate errors) and inversely with the quantity of accurate autobiographical memories retrieved. Psychogenic amnesia can be ‘global’ or ‘situation-specific’. The former is associated with a precipitating stress, depressed mood, and (often) a past history of a transient neurological amnesia. In these circumstances, frontal control mechanisms can inhibit retrieval of autobiographical memories, and even the sense of ‘self’ (identity), while compromised medial temporal function prevents subsequent retrieval of what occurred during a ‘fugue’. An empirical investigation of psychogenic amnesia and some recent imaging studies have provided findings consistent with this view.Conclusions:Taken together, these various observations point to the importance of frontal ‘control’ systems (in interaction with medial temporal/hippocampal systems) in the retrieval and, more particularly, the disrupted retrieval of ‘old’ memories.

Moral Disability, Moral Injury, and the Flight from Vulnerability

2018 ◽  
Author(s):  
Virginia L. Warren
Keyword(s):  
Sense Of Self ◽  
Well Being ◽  
Moral Injury ◽  
Controversial Issues ◽  
Moral Reflection ◽  
Moral Value ◽  
Self Identity ◽  
Moral Conviction ◽  
Moral Importance

This chapter explores the concept of moral disability, identifying two types. The first type involves disabling conditions that distort one’s process of moral reflection. Examples include the incapacity to consider the long-term future, to feel empathy for others, and to be honest with oneself. A noteworthy example of self-deception is systematically denying one’s own—and humanity’s—vulnerability to the power of others, to accidents, and to having one’s well-being linked to that of others and the eco-system. Acknowledging vulnerability often requires a new sense of self. The second type includes incapacities directly resulting from ‘moral injury’—debilitating, self-inflicted harms when one violates a deeply held moral conviction, even if trying to remain true to another moral value. Examining moral disabilities highlights the moral importance of self-identity. More progress may be made on controversial issues if we discuss who we are, how we connect, and how we can heal.

scholarly journals Patients’ adherence to smartphone apps in the management of bipolar disorder: a systematic review

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Marie-Camille Patoz ◽  
Diego Hidalgo-Mazzei ◽  
Bruno Pereira ◽  
Olivier Blanc ◽  
Ingrid de Chazeron ◽  
...  
Keyword(s):  
Systematic Review ◽  
Bipolar Disorder ◽  
Mobile Health ◽  
Smartphone Apps ◽  
Exclusion Criteria ◽  
Future Studies ◽  
Health Apps ◽  
Definition Of ◽  
Bipolar Patients ◽  
Digital Or

Abstract Background Despite an increasing number of available mental health apps in the bipolar disorder field, these tools remain scarcely implemented in everyday practice and are quickly discontinued by patients after downloading. The aim of this study is to explore adherence characteristics of bipolar disorder patients to dedicated smartphone interventions in research studies. Methods A systematic review following PRISMA guidelines was conducted. Three databases (EMBASE, PsychInfo and MEDLINE) were searched using the following keywords: "bipolar disorder" or "mood disorder" or “bipolar” combined with “digital” or “mobile” or “phone” or “smartphone” or “mHealth” or “ehealth” or "mobile health" or “app” or “mobile-health”. Results Thirteen articles remained in the review after exclusion criteria were applied. Of the 118 eligible studies, 39 did not provide adherence characteristics. Among the selected papers, study length, sample size and definition of measures of adherence were strongly heterogeneous. Activity rates ranged from 58 to 91.6%. Conclusion The adherence of bipolar patients to apps is understudied. Standardised measures of adherence should be defined and systematically evaluated in future studies dedicated to these tools.

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