PERIPHERAL NON_ ENZYMATIC ANTIOXIDANTS LEVELS IN SCHIZOPHRENIA AND BIPOLAR ILLNESS A COMPARATIVE CROSS-SECTIONAL STUDY

Background: Nervous tissue is extremely sensitive to oxidative damage Recent studies show an elevated level of oxidative stress indicators in Schizophrenia. Current studies on oxidative stress in Schizophrenia mainly focus on enzymatic antioxidants, while limited studies have been carried out on non-enzymatic antioxidants Some studies discovered that plasma non-enzymatic antioxidants (uric acid, bilirubin, and albumin) in Schizophrenia are lower than those of healthy controls. Aim: To compare levels of nonenzymatic antioxidants in Schizophrenia and bipolar illness. Material and Methods: The present study is a hospital_ based cross-sectional study conducted among 100 patients with Schizophrenia and Bipolar Affective disorder included as per inclusion and exclusion criteria and undergone psychiatric assessment as per diagnostic criteria. Results: S. albumin, S.bilirubin, S.uric acid were found to be low in Schizophrenia but statistically, the significant difference was evaluated for S.uric acid. Conclusion: S. uric acid lower significant levels in Schizophrenia as compared to bipolar affective disorder shows the more impaired peripheral antioxidant scavenging system in Schizophrenia. However, pure peripheral antioxidant system dysfunction could not be ascertained in Schizophrenia through this study. Keywords: nonenzymatic antioxidants, Schizophrenia, bipolar illness.

The Impact of Bipolar Disorder on Couple Functioning: Implications for Care and Treatment. A Systematic Review

If there is an abundant literature on the impact of bipolar illness on the family and/or caregivers of patients, few studies have addressed its impact on marital relationship and couple functioning. Uncovering information relating specifically to this topic may be particularly relevant due to the unusually high divorce rate among individuals with bipolar disorder. We therefore conducted a systematic literature search to evaluate the existing data on bipolar disorder and marital issues, with a special focus on the help and support that can be provided by mental health professionals in this regard. We identified quantitative studies with pre-defined outcomes as well as qualitative investigations trying to understand the experiences of partners. A total of 27 articles were included in the review. The literature was found to capture the impact of bipolar disorder on partners as well as on the marital relationship itself or the children. Bipolar illness has a negative impact on the lives of partners including self-sacrifice, caregiver burden, emotional impact, and health problems. This negative impact can be aggravated by a lack of care and a lack of information from health personnel. The negative impact on the relationship includes volatility in the relationship, stigmatization, dissatisfaction with sexual life, and lower rates of childbearing. Negative impacts are likely to favor disease relapses for the patient. Children may also be negatively impacted. However, the illness may sometimes have positive impacts such as personal evolution, strengthening relationship, or new hope and perspectives. Based on these findings, the interventions of mental health professionals should be aimed at minimizing the negative impacts while favoring the positive ones.

Ketogenic diet as a metabolic therapy for bipolar disorder: Clinical developments

Background: Bipolar disorder is a neurodevelopmental illness characterized by severe biphasic changes in mood, energy, or thought. Key underlying metabolic pathologies thought to play a role include dysfunction in energy metabolism. The purpose of this article is to review the findings to date of the effects of a low carbohydrate ketogenic diet (KD) on mood symptoms in preclinical and clinical models of bipolar illness. The review highlights the underlying metabolic pathologies of bipolar disorder (BD) and potential therapeutic effects of the KD on these pathologies. The article also explores the potential effects of a KD on metabolic health in BD, including proposed mechanisms of action.Summary: Recent findings support the idea that bipolar disorder, along with other psychiatric disease, may have roots of metabolic dysfunction: cerebral glucose hypometabolism, oxidative stress, as well as mitochondrial and neurotransmitter dysfunction which has downstream effects on synapse connections. A KD provides alternative fuel to the brain aside from glucose and is believed to contain beneficial neuroprotective effects, including stabilization of brain networks, reduction of inflammation and oxidative stress. Several beneficial metabolic effects on insulin resistance, weight, and lipids have been shown. Based on its effectiveness in treating epilepsy, the KD has garnered recent interest in its application for mood disorders as it may imitate the pharmacological effects of mood stabilizers, commonly prescribed agents in the treatment of both BD and epilepsy. Additionally, it may improve metabolic dysfunction often seen in BD and repair deficits in energy metabolism. Limited case studies on KD treatment in BD have been reported; however, studies addressing the potential therapeutic effects of KD on metabolic abnormalities in mental illness are promising. Literature of plausible mechanisms and reports of improvements in psychosis, cognition and mood symptoms have been increasing.Conclusions: Preliminary findings support further testing of a low carbohydrate KD as a potential therapeutic tool in repairing energy metabolism in bipolar illness. Further research and clinical trials are needed to evaluate the efficacy of a KD as a supplemental or co-treatment of bipolar illness and the first open-label trial testing the diet in bipolar illness is currently underway at Stanford.

The use of a low carbohydrate, ketogenic diet in bipolar disorder: systematic review

Background: Bipolar disorder is a neurodevelopmental illness characterized by severe biphasic changes in mood, energy, or thought. Key underlying metabolic pathologies thought to play a role include dysfunction in energy metabolism. The purpose of this article is to review the findings to date of the effects of a low carbohydrate ketogenic diet (KD) on mood symptoms in preclinical and clinical models of bipolar illness. The review highlights the underlying metabolic pathologies of bipolar disorder (BD) and potential therapeutic effects of the KD on these pathologies. The article also explores the potential effects of a KD on metabolic health in BD, including proposed mechanisms of action.Summary: Recent findings support the idea that bipolar disorder, along with other psychiatric disease, may have roots of metabolic dysfunction: cerebral glucose hypometabolism, oxidative stress, as well as mitochondrial and neurotransmitter dysfunction which has downstream effects on synapse connections. A KD provides alternative fuel to the brain aside from glucose and is believed to contain beneficial neuroprotective effects, including stabilization of brain networks, reduction of inflammation and oxidative stress. Several beneficial metabolic effects on insulin resistance, weight, and lipids have been shown. Based on its effectiveness in treating epilepsy, the KD has garnered recent interest in its application for mood disorders as it may imitate the pharmacological effects of mood stabilizers, commonly prescribed agents in the treatment of both BD and epilepsy. Additionally, it may improve metabolic dysfunction often seen in BD and repair deficits in energy metabolism. Limited case studies on KD treatment in BD have been reported; however, studies addressing the potential therapeutic effects of KD on metabolic abnormalities in mental illness are promising. Literature of plausible mechanisms and reports of improvements in psychosis, cognition and mood symptoms have been increasing.Conclusions: Preliminary findings support further testing of a low carbohydrate KD as a potential therapeutic tool in repairing energy metabolism in bipolar illness. Further research and clinical trials are needed to evaluate the efficacy of a KD as a supplemental or co-treatment of bipolar illness and the first open-label trial testing the diet in bipolar illness is currently underway at Stanford.

Psychopharmacological Treatments for Bipolar Disorder

The discovery of lithium in 1946 led to a revolution in the management of bipolar disorder as well as other psychiatric conditions. Since that time and especially in the past 20 years, treatment options for bipolar disorder have progressively advanced such that a modern practitioner has a number of evidence-based options to manage the illness. However, the evidence is strongest in adults for acute mania and weakens in other mood states and in youth. Nonetheless, based on the available evidence, this chapter provides recommendations for first-, second-, and third-line pharmacological treatments for bipolar illness to guide clinicians. Additionally, specific considerations for the various medications are reviewed. Suggestions are provided for both adults and youth.

Diagnosis, classification, and differential diagnosis of mood disorders

This chapter discusses DSM and non-DSM definitions and approaches to mood illness. Before 1980, the concept of manic–depressive illness (MDI) meant both bipolar illness and recurrent unipolar depression. Evidence on diagnostic validators since 1980 has not strengthened that claim and may be interpreted to support the original MDI concept, that is, that bipolar illness and unipolar depression are part of the same overall disease (MDI). As a corollary, the concept of major depressive disorder (MDD) may represent a spectrum of different depressive subtypes: mixed (depression with manic symptoms), melancholic, pure, vascular, and neurotic depression. Each subtype differs from the other, based on diagnostic validators of course, genetics, and biological aspects and/or treatment effects. The scientific evidence for this heterogeneity of MDD appears to weaken the claim dating to DSM-III in 1980 that this condition is a different diagnosis/illness from bipolar disorder. The differential diagnosis of mood conditions is described.

Psychiatric Illness Co-occurring with a Substance Use Problem

The combination of an SUD and a psychiatric disorder is called dual or co-occurring disorders (CODs). Rates of SUDs are especially high among individuals with antisocial or borderline personality disorders, bipolar illness, and schizophrenia. Having one disorder raises the risk of having the other. Psychiatric illness can affect how quickly a substance problem develops and response to treatment. It can also affect relapse to substance use. The effects of alcohol or other drugs can cause or worsen psychiatric symptoms. Suggestions are given for handling psychiatric emergencies, including suicide threats. An overview of the treatment options for patients with dual disorders is given.