Olfactory Memory in Depression: State and Trait Differences between Bipolar and Unipolar Disorders

Background: Changes in olfactory recognition memory may constitute sensory markers in depression. Significant differences may exist between unipolar and bipolar depression. Our study compares olfactory memory between control, unipolar, and bipolar patients in depressed and euthymic states in order to identify potential markers of depression. Methods: 176 participants were recruited in 5 groups: depressed bipolar (DB), euthymic bipolar (EB), depressed unipolar (DU), euthymic unipolar (EU), and controls (HC). The participants had a standardized clinical and olfactory assessment (olfactory memory, evaluation of pleasantness, intensity, familiarity, and emotional aspect of smells). Results: DU, DB, and EU patients had a deficit in olfactory memory compared to HC. DB patients had lower capacity to recognize new odors. DB and DU patients had more limited detection of unfamiliar odors than HC. DB patients rated odors as less pleasant compared to the other groups. All groups had lower hedonic ratings than HC. DB patients had lower emotional ratings than EU patients. Conclusions: Olfactory memory is impaired in depressive states, thus constituting a state marker of depression. Impairments in olfactory memory persist after remission of bipolar depression, thus constituting a possible trait marker of bipolarity. Hedonic rating differentiates unipolar from bipolar depression. This is the first study that identifies a sensory marker differentiating between unipolar and bipolar depression.

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Case Studies in Bipolar Depression: Best Practices for the Outpatient

CNS Spectrums ◽

10.1017/s1092852900015893 ◽

2007 ◽

Vol 12 (S20) ◽

pp. 4-13

Author(s):

Paul E. Keck ◽

Roger S. McIntyre ◽

Richard C. Shelton

Keyword(s):

Best Practices ◽

Bipolar Depression ◽

Preventive Treatment ◽

Term Treatment ◽

Case Examples ◽

Long Term Treatment ◽

Bipolar Patients ◽

Term Management ◽

Depressive States

Clinicians are fairly comfortable with the management of acute mania because of the abundance of research studies available. However, there are several important aspects of bipolar disorder that the field has been far less successful with, including management of acute and preventive treatment of bipolar depression, comorbid illnesses, and break-through depression in the context of long-term treatment. There is tremendous complexity in the various symptoms and behavioral dimensions associated with bipolar depression. To facilitate understanding of bipolar depression, this article focuses on treating and managing the bipolar outpatient at risk for a depressive relapse. The discussion poses several challenges associated with bipolar depression and addresses the morbidity of depressive states as well as acute and long-term management of this disorder. The best practices for the varying clinical states of bipolar depressive disorder will be demonstrated through two case examples of patients struggling with disturbances common in bipolar patients.

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Is There a Seasonal Pattern of Relapse in Bipolar Affective Disorders? a Dual Northern and Southern Hemisphere Cohort Study

The British Journal of Psychiatry ◽

10.1192/bjp.167.1.58 ◽

1995 ◽

Vol 167 (1) ◽

pp. 58-60 ◽

Cited By ~ 43

Author(s):

Trevor Silverstone ◽

Sarah Romans ◽

Neil Hunt ◽

Heather McPherson

Keyword(s):

Cohort Study ◽

New Zealand ◽

Affective Disorders ◽

Bipolar Depression ◽

Seasonal Pattern ◽

The Other ◽

Seasonal Factors ◽

Bipolar Patients ◽

Bipolar Affective Disorders ◽

Depressive Episodes

BackgroundAdmission statistics for mania frequently show an increase in the summer. The present two-centre study was designed to test the hypothesis, in a representative sample of bipolar patients, that manic and depressive relapses show a seasonal pattern.MethodTwo cohorts of bipolar I patients, one in London, England (n = 86), the other in Dunedin, New Zealand (n = 58), were tracked retrospectively during 1985–88 and prospectively during 1989–91, with the onset of all relapses being carefully dated.ResultsIn the London cohort there were 221 episodes of mania and 76 of depression; in the Dunedin cohort there were 201 of mania and 61 of depression. No consistent seasonal pattern of mania was detected in either centre. There was an autumn preponderance of depressive episodes in both centres.ConclusionsRelapse of bipolar depression, but not of mania, appears to be determined in part by seasonal factors.

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Recognition memory for infant faces: An analog of the other-race effect

Bulletin of the Psychonomic Society ◽

10.3758/bf03330133 ◽

1986 ◽

Vol 24 (4) ◽

pp. 257-260 ◽

Cited By ~ 9

Author(s):

June E. Chance ◽

Alvin G. Goldstein ◽

Blake Andersen

Keyword(s):

Recognition Memory ◽

The Other ◽

Race Effect ◽

Infant Faces

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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)

Psychological Medicine ◽

10.1017/s0033291714000804 ◽

2014 ◽

Vol 44 (16) ◽

pp. 3455-3467 ◽

Cited By ~ 17

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.

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Semantic Congruency Improves Recognition Memory Performance for Both Audiovisual and Visual Stimuli

Multisensory Research ◽

10.1163/22134808-00002595 ◽

2017 ◽

Vol 30 (7-8) ◽

pp. 763-781 ◽

Cited By ~ 1

Author(s):

Jenni Heikkilä ◽

Kimmo Alho ◽

Kaisa Tiippana

Keyword(s):

Recognition Memory ◽

Congruency Effect ◽

Memory Performance ◽

Visual Stimuli ◽

The Other ◽

Memory Encoding ◽

Semantic Congruency ◽

Recognition Memory Performance ◽

Visual Encoding ◽

Per Se

Audiovisual semantic congruency during memory encoding has been shown to facilitate later recognition memory performance. However, it is still unclear whether this improvement is due to multisensory semantic congruency or just semantic congruencyper se. We investigated whether dual visual encoding facilitates recognition memory in the same way as audiovisual encoding. The participants memorized auditory or visual stimuli paired with a semantically congruent, incongruent or non-semantic stimulus in the same modality or in the other modality during encoding. Subsequent recognition memory performance was better when the stimulus was initially paired with a semantically congruent stimulus than when it was paired with a non-semantic stimulus. This congruency effect was observed with both audiovisual and dual visual stimuli. The present results indicate that not only multisensory but also unisensory semantically congruent stimuli can improve memory performance. Thus, the semantic congruency effect is not solely a multisensory phenomenon, as has been suggested previously.

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Memory for non-painful auditory items is influenced by whether they are experienced in a context involving painful electrical stimulation

10.1101/341891 ◽

2018 ◽

Author(s):

Keith M. Vogt ◽

Caroline M. Norton ◽

Lauren E. Speer ◽

Joshua J. Tremel ◽

James W. Ibinson ◽

...

Keyword(s):

Electrical Stimulation ◽

Recognition Memory ◽

Response Times ◽

The Other ◽

Experimental Context ◽

Word Lists

AbstractIn this study, we sought to examine the effect of pain on memory. Subjects heard a series of words and made categorization decisions in two different contexts. One context included painful shocks administered just after presentation of some of the words; the other context involved no shocks. For the context that included painful stimulations, every other word was followed by a shock and subjects were informed to expect this pattern. Word lists were repeated three times within each context in randomized order, with different category judgments but consistent pain-word pairings. After a brief delay, recognition memory was assessed. Non-pain words from the pain context were less strongly encoded than non-pain words from the completely pain-free context. An important accompanying finding is that response times to repeated experimental items were slower for non-pain words from the pain context, compared to non-pain words from the completely pain-free context. This demonstrates that the effect of pain on memory may generalize to non-pain items experienced in the same experimental context.

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Depressive Mixed States: Symptomatology, Prevalence and Principles of Treatment

European Psychiatry ◽

10.1016/s0924-9338(09)70808-9 ◽

2009 ◽

Vol 24 (S1) ◽

pp. 1-1

Author(s):

W. Drozdz ◽

A. Borkowska

Keyword(s):

Affective Disorders ◽

Rating Scale ◽

Depressive Symptomatology ◽

Depression Scale ◽

Assessment Tools ◽

The Other ◽

Mood Stabilizers ◽

Hamilton Depression Scale ◽

Principles Of Treatment ◽

Bipolar Patients

Current diagnostic systems (DSM-IV-TR and ICD-10) do not include depressive mixed state (DMS) as a separate category. However, both historical descriptions and data from recent research clearly indicate that cooccurrence of (hypo)maniacal and depressive symptoms is standard in clinical picture of affective disorders. Most frequently employed criterion for DMS is the presence of at least three symptoms of (hypo)mania for 7 days during a major depressive episode. Not only formal diagnostic criteria for DMS are lacking but also psychometric assessment tools (for example the Hamilton Depression Scale or the MADRS) were designed around the features of “classical” depression. The other obstacles to recognize DMS could be lack of insight into the (hypo)maniacal symptoms in patients and cognitive dysfunctions present during an episode. On the other hand, newly created instrument, the Bipolar Depression Rating Scale, may assist clinical evaluation of DMS. Despite predominating depressive symptomatology, the principles of treatment of DMS suggest avoidance of antidepressant monotherapy in favor of mood stabilizers' administration. Actually DMS may emerge as a complication of antidepressant monotherapy in some bipolar patients or may be induced with interferon-alpha treatment in some chronic hepatitis C patients. Important consequences of both spontaneous and drug-induced DMS could be the roughening of affective symptomatology, resistance to antidepressants and the increase of suicidality. Thorough appraisal of symptoms seen in patients with affective disorders for indicators of DMS could have critical consequences for functional outcomes.

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Reciprocal Stimulation of Decay Between Serotonergic Facilitation and Depression of Synaptic Transmission

Journal of Neurophysiology ◽

10.1152/jn.90267.2008 ◽

2008 ◽

Vol 100 (2) ◽

pp. 1113-1126 ◽

Cited By ~ 12

Author(s):

Sun Hee Cho Lee ◽

Karen Taylor ◽

Franklin B. Krasne

Keyword(s):

Protein Kinase ◽

Synaptic Transmission ◽

Protein Kinase A ◽

The Other ◽

Command Neurons ◽

Wide Range ◽

History Of ◽

Depressive States ◽

Kinase A ◽

Stimulation Of

Serotonin can produce multiple, contradictory modulatory effects on strength of synaptic transmission in both vertebrate and invertebrate nerve circuits. In crayfish, serotonin (5-HT) can both facilitate and depress transmission to lateral giant escape command neurons; however, which effect is manifest during application, as well as the sign and duration of effects that may continue long after 5-HT washout, may depend on history of application as well as on concentration. We report that protein kinase A (PKA) signaling is essential to the production of facilitation but depression is mediated by non-cAMP/PKA signaling pathways. However, we unexpectedly found that PKA activity is essential for the decay of depression when serotonin is washed out. This, and evidence from the effects of a variety of serotonin application regimens, suggest that facilitatory and depressive states coexist and compete and that the decay of each is dependent on stimulation by the other. A computational model that incorporates these assumptions can account for and rationalize the varied effects of a wide range of serotonin application regimens.

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Antidepressant Effect of Mood Stabilizers

CNS Spectrums ◽

10.1017/s1092852900028777 ◽

2003 ◽

Vol 8 (S12) ◽

pp. 4-5

Author(s):

Claudia F. Baldassano

Keyword(s):

American Psychiatric Association ◽

Bipolar Depression ◽

Mood Stabilizer ◽

Mood Stabilizers ◽

High Rate ◽

Study Endpoint ◽

Antidepressant Effect ◽

Medication Treatment ◽

Antidepressant Effects ◽

Bipolar Patients

Bipolar depression certainly poses the greatest challenge to clinicians treating bipolar patients. Having a widespread disability associated with it, bipolar depression is often chronic, is less responsive to medication treatment, and has a particularly high rate of suicide. There are currently no drugs approved by the Food and Drug Administration for the treatment of bipolar depression, although full trials have been conducted with lithium, the antipsychotic olan-zapine, and the antiepileptic (AED) lamotrigine. Data for the other AEDs are quite limited and not controlled. The American Psychiatric Association guidelines recommends maximizing the dose in patients who are already on a mood stabilizer and initiating lithium or lamotrigine in patients who are not on a mood stabilizer.Zornberg and Pope reviewed nine studies comparing lithium to placebo in bipolar depression. Among the 145 patients in these studies, there was detectable response in 79% and an unequivocal response in 36%. Although the studies varied in their methodological design and rigor, they argue quite strongly that lithium is an effective anti-depressant. In addition, six of the seven pre1990 studies evaluating lithium for bipolar depression indicated that the drug had significant antidepressant effects.The most recent study of lithium for bipolar depression randomly assigned 117 outpatients with acute bipolar depression to treatment with either placebo, Imipramine, or paroxetine. At the 10-week study endpoint, lithium monotherapy was as effective as the addition of an antidepressant, suggesting lithium's antidepressant properties.

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Prevalence of Bipolar Depression

CNS Spectrums ◽

10.1017/s1092852900028765 ◽

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.

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