A cross-sectional comparative study of functioning in patients with bipolar depression and patients with unipolar depression

Author(s):  
Aftab Khan ◽  
Swapnil Agrawal ◽  
Savita Patel ◽  
Rahila Qureshi
2018 ◽  
Vol 18 (1) ◽  
Author(s):  
Nicolas A. Nuñez ◽  
Stefano Comai ◽  
Eduard Dumitrescu ◽  
Maykel F. Ghabrash ◽  
John Tabaka ◽  
...  

Author(s):  
Monika Kushwaha ◽  
Sanjeev Narang

Background: This study is cross-sectional, observational and comparative study, at Index Medical College, Hospital & Research Centre, Indore, Madhya Pradesh from July 2017 to July 2019 with sample size 100 placentae. Method: The placenta received was evaluated blinded of maternal pregnancy outcome. The pattern of morphology was evaluated both qualitatively (type of lesion) and quantitatively (number of lesions). Result: In Present study 79% of the deliveries were term deliveries and 21% were preterm deliveries. On placental macroscopy, placenta weight was significantly low among the neonates of preterm deliveries (370.00±60.49) as compared to term deliveries (440.89±55.22). Preterm placenta had higher number of abnormal placental lesion compared to term pregnancies. Conclusion: The uteroplacental insufficiency defined as placental infarct, fibrosis of chorionic villi, thickening of blood vessels, and poor vascularity of chorionic villi. Placental histopathological lesions are strongly associated with maternal under perfusion and uteroplacental insufficiency. These are the reasons for preterm birth. Thus, knowledge of the etiological factor can be use to reduce maternal and neonatal morbidity and mortility. Keywords: Placenta, Term & Preterm.


Author(s):  
Virginia Carter Leno ◽  
Emily Simonoff

Recent evidence suggests that individuals with autism spectrum disorder (ASD) experience depression at rates approximately four times greater than the general population. Co-occurring mood problems, including depressive and bipolar disorders, are associated with negative outcomes such as lower quality of life, increased adaptive behavior impairments, and greater service use. This chapter discusses what is known about the presentation of unipolar and bipolar depression in people with ASD and describes challenges to establishing sound prevalence estimates of mood disorders in ASD as they relate to methodological design issues and diagnostic assessment practices. It also provides an overview of potential vulnerability factors in the development of depression in this population; these areas of vulnerability include characteristics such as chronological age, cognitive ability, and ASD symptom severity, as well as those individual differences that may represent more direct mechanisms, for example, maladaptive coping styles, attentional biases, social reward profiles, and predisposition to rumination. The current research on interventions specifically designed to treat mood in people with ASD is very limited. However, promising treatments include adapted cognitive behavioral therapy and mindfulness-based approaches. Though most of this chapter focuses on unipolar depression in ASD as the more well-studied mood disorder, the chapter also summarizes the small research base on bipolar disorder in the context of ASD. It ends with a call for improved screening, assessment, and evidence-based treatment options to address this significant public health problem in this special population.


2021 ◽  
pp. 1-8
Author(s):  
Giada Benasi ◽  
Giovanni A. Fava ◽  
Jenny Guidi

<b><i>Introduction</i></b>: Appraisal of prodromal symptoms of unipolar depression may complement the traditional cross-sectional approach and provide a longitudinal perspective, according to a staging model of the illness. <b><i>Objective:</i></b> To provide an updated systematic review of clinical studies concerned with prodromal symptoms of unipolar depression, according to PRISMA guidelines. <b><i>Methods:</i></b> Keyword searches were conducted in PubMed, Scopus, and Web of Science. Longitudinal studies on prodromal symptoms and signs in adult patients primarily diagnosed with unipolar depression were selected. Findings were examined separately according to study design (i.e., retrospective or prospective). <b><i>Results:</i></b> Twenty-five studies met the criteria for inclusion in this systematic review. Findings indicate that a distinct prodromal symptomatology – commonly characterized by anxiety, tension, irritability, and somatic complaints – exists before the onset of unipolar depression. The duration of the prodromal phase was highly variable across studies, ranging from less than a month to several years. Prodromal symptoms profile and duration were consistent within individuals across depressive episodes. There was a close relationship between prodromal and residual symptoms of the same depressive episode. <b><i>Conclusions:</i></b> The present systematic review addresses an important, and yet relatively neglected, clinical issue that deserves further investigation and may be of immediate practical value. The findings provide challenging insights into the pathogenesis and course of unipolar depression, which may result in more timely and effective treatment of recurrences. The definition of a prodromal phase in depression would benefit from the joint use of symptom identification, biomarkers, and neuroimaging.


2021 ◽  
pp. 014556132110001
Author(s):  
Daniel J. Lee ◽  
Daniella Daliyot ◽  
Ri Wang ◽  
Joel Lockwood ◽  
Paul Das ◽  
...  

Objective: To directly compare the prevalence of chemosensory dysfunction (smell and taste) in geographically distinct regions with the same questionnaires. Methods: A cross-sectional study was performed to evaluate the self-reported symptoms among adults (older than 18 years) who underwent COVID-19 testing at an ambulatory assessment center in Canada and at a hospital in Israel between March 16, 2020, and August 19, 2020. The primary outcome was the prevalence of self-reported chemosensory dysfunction (anosmia/hypomsia and dysgeusia/ageusia). Subgroup analysis was performed to evaluate the prevalence of chemosensory deficits among the outpatients. Results: We identified a total of 350 COVID-19–positive patients (138 Canadians and 212 Israelis). The overall prevalence of chemosensory dysfunction was 47.1%. There was a higher proportion of chemosensory deficits among Canadians compared to Israelis (66.7% vs 34.4%, P < .01). A subgroup analysis for outpatients (never hospitalized) still identified a higher prevalence of chemosensory dysfunction among Canadians compared to Israelis (68.2% vs 36.1%, P < 0.01). A majority of patients recovered their sense of smell after 4 weeks of symptom onset. Conclusion: Although the prevalence of chemosensory deficit in COVID-19 was found to be similar to previously published reports, the prevalence can vary significantly across different geographical regions. Therefore, it is important to obtain regionally specific data so that the symptom of anosmia/dysgeusia can be used as a guide for screening for the clinical diagnosis of COVID-19.


2019 ◽  
Vol 53 (5) ◽  
pp. 458-469 ◽  
Author(s):  
YC Janardhan Reddy ◽  
Venugopal Jhanwar ◽  
Rajesh Nagpal ◽  
MS Reddy ◽  
Nilesh Shah ◽  
...  

Objective: The treatment of bipolar disorder is challenging because of its clinical complexity and availability of multiple treatment options, none of which are ideal mood stabilizers. This survey studies prescription practices of psychiatrists in India and their adherence to guidelines. Method: In total, 500 psychiatrists randomly selected from the Indian Psychiatric Society membership directory were administered a face-to-face 22-item questionnaire pertaining to the management of bipolar disorder. Results: For acute mania, most practitioners preferred a combination of a mood stabilizer and an atypical antipsychotic to monotherapy. For acute depression, there was a preference for a combination of an antidepressant and a mood stabilizer over other alternatives. Electroconvulsive therapy was preferred in the treatment of severe episodes and to hasten the process of recovery. Approximately, 50% of psychiatrists prescribe maintenance treatment after the first bipolar episode, but maintenance therapy was rarely offered lifelong. While the majority (85%) of psychiatrists acknowledged referring to various clinical guidelines, their ultimate choice of treatment was also significantly determined by personal experience and reference to textbooks. Limitations: The study did not study actual prescriptions. Hence, the responses to queries in the survey are indirect measures from which we have tried to understand the actual practices, and of course, these are susceptible to self-report and social-desirability biases. This was a cross-sectional study; therefore, temporal changes in responses could not be considered. Conclusion: Overall, Indian psychiatrists seemed to broadly adhere to recommendations of clinical practice guidelines, but with some notable exceptions. The preference for antidepressants in treating depression is contrary to general restraint recommended by most guidelines. Therefore, the efficacy of antidepressants in treating bipolar depression in the context of Indian psychiatrists’ practice needs to be studied systematically. Not initiating maintenance treatment early in the course of illness may have serious implications on the long-term outcome of bipolar disorder.


2021 ◽  
Vol 6 (1) ◽  
pp. 1304-1309
Author(s):  
Bikash Khadka ◽  
Nil Raj Sharma

Introduction: Pain during the injection of anesthetic agents may be distressing and can reduce the acceptability of an otherwise useful agent such as propofol during daycare surgeries. Lidocaine and ketamine both are used as pre-treatment to decrease propofol induced pain. This study aims to compare the effectiveness of ketamine injection to decrease propofol-induced pain in comparison to lidocaine injection. Methodology: This is a prospective cross-sectional comparative study. Eighty-nine cases were divided into two groups where group K received ketamine 2 ml (0.2 mg/kg) whereas group L received lidocaine 2% 2ml (0.5 mg/kg) after venous occlusion with rubber tourniquet. One-fourth dose of propofol was injected 1 min after release of tourniquet and pain accessed at 0, 1, and 2 minutes of propofol injection with a verbal response and behavioral signs. Chi-square test and paired T-test were used and a p-value less than 0.05 was considered significant. Result: Regarding hemodynamic, oxygenation, and adverse effects there was no significant difference. Immediately after propofol injection, only 1 patient of the ketamine group had mild pain (2.22%) while 12 patients from the lignocaine group had mild pain (27.27%) with a p-value of 0.009. Also after 2 minutes of propofol injection, only 12 cases had mild pain i.e. 13.48% (1 from ketamine group i.e. 2.22% and 11 from lidocaine group i.e. 25%) with p-value of 0.002. Conclusion: Our study helps prove low-dose ketamine is more effective in reducing the incidence and severity of pain on injection of propofol in comparison to Lidocaine with better hemodynamic stability. 


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