scholarly journals Altered Risk-Taking Behavior in Early-Stage Bipolar Disorder With a History of Psychosis

2021 ◽  
Vol 12 ◽  
Author(s):  
Sandra Chi Yiu Wong ◽  
Mary Chung Mun Ng ◽  
Joe Kwun Nam Chan ◽  
Martha Sin Ki Luk ◽  
Simon Sai Yu Lui ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Risk Aversion ◽  
Risk Taking ◽  
Cognitive Functions ◽  
Early Stage ◽  
First Episode ◽  
Increased Risk ◽  
Significant Difference ◽  
History Of ◽  
Risk Taking Behavior

Altered risk-taking propensity is an important determinant of functional impairment in bipolar disorder. However, prior studies primarily assessed patients with chronic illness, and risk-taking has not been evaluated in the early illness course. This study investigated risk-taking behavior in 39 euthymic early-stage bipolar disorder patients aged 16–40 years who were treated within 3 years from their first-episode mania with psychotic features and 36 demographically-matched healthy controls using the Balloon Analog Risk Task (BART), a well-validated risk-taking performance-based paradigm requiring participants to make responses for cumulative gain at increasing risk of loss. Relationships of risk-taking indices with symptoms, self-reported impulsivity, cognitive functions, and treatment characteristics were also assessed. Our results showed that patients exhibited significantly lower adjusted scores (i.e., average balloon pumps in unexploded trials) (p = 0.001), lower explosion rate (p = 0.007) and lower cumulative scores (p = 0.003) than controls on BART, indicating their suboptimal risk-taking performance with increased propensity for risk aversion. Risk-taking indices were not correlated with any symptom dimensions, self-reported impulsivity, cognitive functions or antipsychotic dose. No significant difference was observed between patients with and without antipsychotic medications on self-reported impulsivity or any of the BART performance indices. This is the first study to examine risk-taking behavior in early-stage bipolar disorder with history of psychosis and indicates that patients displayed altered risk-taking with increased risk aversion compared with controls. Further research is needed to clarify longitudinal trajectory of risk-taking propensity and its relationships with psychosis and functional outcome in the early stage of bipolar disorder.

FC07-01 - Cognitive functions in first episode psychosis

2011 ◽  
Vol 26 (S2) ◽  
pp. 1846-1846
Author(s):  
H.F. Elsawy ◽  
M.A. Abd Elhay ◽  
A.B. Abd Elkrem
Keyword(s):  
Bipolar Disorder ◽  
Schizoaffective Disorder ◽  
Cognitive Functions ◽  
Wisconsin Card Sorting Test ◽  
First Episode ◽  
Psychotic Episode ◽  
Control Group ◽  
Early Stages ◽  
First Psychotic Episode ◽  
Significant Difference

BackgroundCognitive impairment is recognized as an important feature of psychosis in its early stages and is a determinant of prognosis and management of these disorders.Aim of the studyTo test the cognitive functions in first psychotic episode in patients with disorders of schizophrenia, schizoaffective disorder, bipolar disorder and depression with psychotic disorder and to compare them to controls.Subjects and methodsThe study included 254 patients diagnosed according to Diagnostic and Statistical criteria of Mental disorders, 4th edition (91 schizophrenics, 21 with schizoaffective disorder, 107 with bipolar disorder and 31 with psychotic depression) and experiencing their first psychotic episode. Seventy healthy volunteers matched as regards age and sex with patients were used as controls. All are subjected to cognitive evaluation by Trail Making Test, part B, Wisconsin card sorting test 128, Benton Visual Retention Test and Wechsler Adult Intelligence Test.ResultsAll patients showed significant cognitive deterioration in all tests compared to control group. On comparing patients to each other, there was no significant difference between schizophrenics and patients with bipolar disorder, but both showed marked deterioration in comparison to depressive group.ConclusionCognitive impairments are present in early stages of psychosis and need careful assessment and management.

scholarly journals Can Risk-Taking Be an Endophenotype for Bipolar Disorder? A Study on Patients with Bipolar Disorder Type I and Their First-Degree Relatives

2013 ◽  
Vol 19 (4) ◽  
pp. 474-482 ◽  
Author(s):  
Ceren Hıdıroğlu ◽  
Özlem Demirci Esen ◽  
Zeliha Tunca ◽  
Şehnaz Neslihan Gűrz Yalçìn ◽  
Lauren Lombardo ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Risk Taking ◽  
Outcome Measure ◽  
Bipolar Disorders ◽  
Type I ◽  
Balloon Analogue Risk Task ◽  
First Degree Relatives ◽  
Risk Taking Behavior ◽  
Disorder Type ◽  
Core Features

AbstractRisk-taking behavior and impulsivity are core features of bipolar disorder. Whether they are part of the inherited aspect of the illness is not clear. We aimed to evaluate risk-taking behavior as a potential endophenotype for bipolar disorders, and its relationship with impulsivity and illness features. The Balloon Analogue Risk Task (BART) and Barratt Impulsiveness Scale-11 (BIS-11) were used to assess risk-taking behavior and impulsivity respectively in 30 euthymic bipolar I patients (BD), their 25 asymptomatic first-degree relatives (BD-R), and 30 healthy controls (HC). The primary BART outcome measure was the behavioral adjustment score (number of pumps after trials where the balloon did not pop minus the number of pumps after trials where the balloon popped). BD (p< .001) and BD-R (p= .001) had similar and significantly lower adjustment scores than HC. Only BD scored significantly higher on BIS-11 total (p= .01) and motor (p= .04) subscales than HC. Neither the BART, nor impulsivity scores associated with illness features. A limitation of this study is medicated patients and a heterogeneous BD-R were included. Riskiness may be a candidate endophenotype for bipolar disorder as it appears independently from illness features, presents similarly in BD and BD-R groups and differs from impulsivity. (JINS, 2013,19, 1–9)

Equity-Based Incentives, Risk Aversion, and Merger-Related Risk-Taking Behavior

2014 ◽  
Vol 49 (1) ◽  
pp. 117-148 ◽  
Author(s):  
Bradley W. Benson ◽  
Jung Chul Park ◽  
Wallace N. Davidson
Keyword(s):  
Risk Aversion ◽  
Risk Taking ◽  
Related Risk ◽  
Risk Taking Behavior

scholarly journals Market shocks and professionals' investment behavior – Evidence from the COVID-19 crash

2020 ◽  
Author(s):  
Christoph Huber ◽  
Juergen Huber ◽  
Michael Kirchler
Keyword(s):  
Stock Market ◽  
Risk Aversion ◽  
Risk Taking ◽  
Investment Behavior ◽  
Controlled Experiments ◽  
Price Expectations ◽  
Market Crashes ◽  
Changes In Risk ◽  
Risk Taking Behavior ◽  
Market Shocks

We investigate how the experience of stock market shocks, such as the COVID-19 crash, influences risk-taking behavior. To isolate changes in risk taking from other factors during stock market crashes, we ran controlled experiments with finance professionals in December 2019 and March 2020. We observe that their investments in the experiment were 12 percent lower in March 2020 than in December 2019, although their price expectations had not changed, and although they considered the experimental asset less risky during the crash than before. Thus, lower investments are driven by higher risk aversion, not by changes in beliefs.

scholarly journals Device complications with addition of defibrillation to cardiac resynchronisation therapy for primary prevention

Heart ◽  
2018 ◽  
Vol 104 (18) ◽  
pp. 1529-1535 ◽  
Author(s):  
Sérgio Barra ◽  
Rui Providência ◽  
Serge Boveda ◽  
Rudolf Duehmke ◽  
Kumar Narayanan ◽  
...  
Keyword(s):  
Primary Prevention ◽  
Cardiac Resynchronisation Therapy ◽  
Late Complications ◽  
Increased Risk ◽  
Significant Difference ◽  
Cardiac Resynchronisation ◽  
Acute Complications ◽  
Resynchronisation Therapy ◽  
History Of

ObjectiveIn patients indicated for cardiac resynchronisation therapy (CRT), the choice between a CRT-pacemaker (CRT-P) versus defibrillator (CRT-D) remains controversial and indications in this setting have not been well delineated. Apart from inappropriate therapies, which are inherent to the presence of a defibrillator, whether adding defibrillator to CRT in the primary prevention setting impacts risk of other acute and late device-related complications has not been well studied and may bear relevance for device selection.MethodsObservational multicentre European cohort study of 3008 consecutive patients with ischaemic or non-ischaemic dilated cardiomyopathy and no history of sustained ventricular arrhythmias, undergoing CRT implantation with (CRT-D, n=1785) or without (CRT-P, n=1223) defibrillator. Using propensity score and competing risk analyses, we assessed the risk of significant device-related complications requiring surgical reintervention. Inappropriate shocks were not considered except those due to lead malfunction requiring lead revision.ResultsAcute complications occurred in 148 patients (4.9%), without significant difference between groups, even after considering potential confounders (OR=1.20, 95% CI 0.72 to 2.00, p=0.47). During a mean follow-up of 41.4±29 months, late complications occurred in 475 patients, giving an annual incidence rate of 26 (95% CI 9 to 43) and 15 (95% CI 6 to 24) per 1000 patient-years in CRT-D and CRT-P patients, respectively. CRT-D was independently associated with increased occurrence of late complications (HR=1.68, 95% CI 1.27 to 2.23, p=0.001). In particular, when compared with CRT-P, CRT-D was associated with an increased risk of device-related infection (HR 2.10, 95% CI 1.18 to 3.45, p=0.004). Acute complications did not predict overall late complications, but predicted device-related infection (HR 2.85, 95% CI 1.71 to 4.56, p<0.001).ConclusionsCompared with CRT-P, CRT-D is associated with a similar risk of periprocedural complications but increased risk of long-term complications, mainly infection. This needs to be considered in the decision of implanting CRT with or without a defibrillator.

scholarly journals P747 Adherence to ECCO guidelines for cancer surveillance is associated to the detection of early cancer: A retrospective, single-centre, cohort study

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S598-S599
Author(s):  
T L PARIGI ◽  
G Roda PhD ◽  
M Allocca ◽  
F Furfaro ◽  
L Loy ◽  
...  
Keyword(s):  
Family History ◽  
Skin Cancer ◽  
Disease Duration ◽  
Early Cancer ◽  
Cancer Surveillance ◽  
Early Cancer Diagnosis ◽  
Increased Risk ◽  
Significant Difference ◽  
History Of ◽  
The Impact

Abstract Background Patients with inflammatory bowel disease (IBD), such as ulcerative colitis (UC) and Crohn’s disease (CD) are at increased risk of developing gastrointestinal (GI) malignancies. The aim of this study is to assess the risk of malignancies in IBD patients and the impact of cancer screening according to the ECCO guidelines in a tertiary referral centre. Methods We retrospectively analysed the electronic database of all IBD patients followed by the IBD Centre of Humanitas Research Hospital, Milan, from January 2010 to October 2019, and collected all new diagnoses of solid and haematological tumours since 2010. The annual standardised incidence rate (SIR), rate of mortality and early cancer diagnosis were calculated and a descriptive analysis of drug exposure, disease duration, family history of any cancer, smoking habits was made. Results We included 5239 patients, with a total 19820 patient-years follow-up. Eighty-four malignancies in 81 patients were retrieved, 71 were included in the final analysis (38 CD, 32 UC, 31 females). Average age at tumour diagnosis was 52.9 years (range 19–78). 64% of patients were former or active smokers, 31% had a family history of cancer or IBD. Sixty-two per cent of patients were previously exposed or had 5-ASA at the time of cancer, 40% azathioprine, 43% anti-TNF or vedolizumab. The annual SIR for all kinds of malignancy was 0.358%. GI malignancies were the most frequent (n = 17, 23.9%, 47% UC, 53% in CD). Six over 8 GI tract malignancies in UC patients were found in the colon or rectum (mean disease duration 22.5 years), whereas in CD patients 5/9 were in the small-bowel (mean disease duration 7.0 years). Melanoma and breast cancer (n = 8 each) were the most common non-GI cancers, followed by prostate (n = 7) and bladder (n = 6). No significant difference in incidence was found between CD or UC. Non-Hodgkin lymphomas and leukaemia (3 and 1, respectively) only occurred in CD patients. Other tumours included thyroid (n = 5), lungs (n = 4), testicle (n = 3), ovary (n = 2), kidney (n = 2), head-nose-throat (n = 2), pancreas (n = 1), brain (n = 1), and non-melanoma skin cancer (n = 1). Death occurred in 11% of patients, 8 of them for late stage cancer. Only 2 were related to the concomitant IBD (1 colo-rectal and 1 anal cancer). In patients regularly screened according to the ECCO Guidelines (GI cancer, haematological and skin cancer), there was a significantly higher number of detection of early cancer (28 vs. 1, p = 0.003), although no differences in mortality rates were reported in the two groups (2 vs. 2, p = 0.10). Conclusion The overall incidence of cancer in our cohort was not different from the current literature available. Adherence to the ECCO Guidelines for cancer surveillance improves the detection of early cancer in IBD patients.

Sleep deprivation during late pregnancy produces hyperactivity and increased risk-taking behavior in offspring

2015 ◽  
Vol 1596 ◽  
pp. 88-98 ◽  
Author(s):  
Arathi Radhakrishnan ◽  
B.S. Aswathy ◽  
Velayudhan Mohan Kumar ◽  
Kamalesh K. Gulia
Keyword(s):  
Sleep Deprivation ◽  
Risk Taking ◽  
Late Pregnancy ◽  
Increased Risk ◽  
Risk Taking Behavior

scholarly journals Preservation of Gray Matter Volume in Early Stage of Bipolar Disorder: A Case for Early Intervention

2020 ◽  
pp. 070674372092782 ◽  
Author(s):  
Kamyar Keramatian ◽  
Wayne Su ◽  
Gayatri Saraf ◽  
Trisha Chakrabarty ◽  
Lakshmi N. Yatham
Keyword(s):  
Bipolar Disorder ◽  
Gray Matter ◽  
Early Stage ◽  
Gray Matter Volume ◽  
Volume Changes ◽  
Matter Volume ◽  
History Of ◽  
Bipolar Patients ◽  
Gray Matter Volumes ◽  
Healthy Participants

Objective: It has been proposed that different stages of the bipolar disorder might have distinct neurobiological changes. However, the evidence for this has not been consistent, as the studies in early stages of the illness are limited by small sample sizes. The purpose of this study was to investigate the gray matter volume changes in bipolar patients who recently recovered from their first episode of mania (FEM). Methods: Using a whole-brain voxel-based analysis, we compared the regional gray matter volumes of 61 bipolar patients who have recovered from their FEM in the past 3 months with 43 age- and gender-matched healthy participants. We also performed a series of subgroup analyses to determine the effects of hospitalization during the FEM, history of depressive episodes, and exposure to lithium. Results: No statistically significant difference was found between gray matter volumes of FEM patients and healthy participants, even at a more liberal threshold ( P < 0.001, uncorrected for multiple comparisons). Voxel-based subgroup analyses did not reveal significant gray matter differences except for a trend toward decreased gray matter volume in left lateral occipital cortex ( P < 0.001, uncorrected) in patients with a previous history of depression. Conclusion: This study represents the largest structural neuroimaging investigation of FEM published to date. Early stage of bipolar disorder was not found to be associated with significant gray matter volume changes. Our findings suggest that there might be a window of opportunity for early intervention strategies to prevent or delay neuroprogression in bipolar disorder.

scholarly journals Readmissions for Depression and Suicide Attempt following Stroke and Myocardial Infarction

2020 ◽  
Vol 10 (2) ◽  
pp. 94-104
Author(s):  
Laura K. Stein ◽  
Alana Kornspun ◽  
John Erdman ◽  
Mandip S. Dhamoon
Keyword(s):  
Myocardial Infarction ◽  
Suicide Attempt ◽  
Cox Regression ◽  
Vascular Events ◽  
Discharge Home ◽  
Increased Risk ◽  
Significant Difference ◽  
History Of ◽  
Nationally Representative ◽  
History Of Depression

Background and Purpose: Rates of depression after ischemic stroke (IS) and myocardial infarction (MI) are significantly higher than in the general population and associated with morbidity and mortality. There is a lack of nationally representative data comparing depression and suicide attempt (SA) after these distinct ischemic vascular events. Methods: The 2013 Nationwide Readmissions Database contains >14 million US admissions for all payers and the uninsured. Using International Classification of Disease, 9th Revision, Clinical Modification Codes, we identified index admission with IS (n = 434,495) or MI (n = 539,550) and readmission for depression or SA. We calculated weighted frequencies of readmission. We performed adjusted Cox regression to calculate hazard ratio (HR) for readmission for depression and SA up to 1 year following IS versus MI. Analyses were stratified by discharge home versus elsewhere. Results: Weighted depression readmission rates were higher at 30, 60, and 90 days in patients with IS versus MI (0.04%, 0.09%, 0.12% vs. 0.03%, 0.05%, 0.07%, respectively). There was no significant difference in SA readmissions between groups. The adjusted HR for readmission due to depression was 1.49 for IS versus MI (95% CI 1.25–1.79, p < 0.0001). History of depression (HR 3.70 [3.07–4.46]), alcoholism (2.04 [1.34–3.09]), and smoking (1.38 [1.15–1.64]) were associated with increased risk of depression readmission. Age >70 years (0.46 [0.37–0.56]) and discharge home (0.69 [0.57–0.83]) were associated with reduced hazards of readmission due to depression. Conclusions: IS was associated with greater hazard of readmission due to depression compared to MI. Patients with a history of depression, smoking, and alcoholism were more likely to be readmitted with depression, while advanced age and discharge home were protective. It is unclear to what extent differences in type of ischemic tissue damage and disability contribute, and further investigation is warranted.

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