bipolar affective disorder
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2022 ◽  
Author(s):  
Caroline Wyatt

Bipolar disorder, like many neuropsychiatric conditions, can be studied from a number of perspectives; from observation of behaviour, to study of cognitive dysfunction, through to changes at the molecular and genetic level. A consequence of this way of working is that there is inadequate communication between different levels of analysis, such that insufficient thought is given to whether a theoretical model derived from behavioural work fits with neurobiological data, and vice versa. Such limitations represent a key limiting factor in successful translation. Therefore, this paper takes a dominant theoretical model of bipolar disorder, based on that by Gray (1994) and developed by Alloy et al., (2015) as a basis to propose that the foundational pathology in bipolar is reward hypersensitivity, and to review how recent diverse neurobiological, cognitive and behavioural findings fit with this understanding. Executive Function deficits, partially derived from heritable structural changes are suggested as a foundation through which reward hypersensitivity develops to disorder, and CANA1C polymorphism-induced hyperactivity, further serves to drive the system towards reward seeking goals, through interaction with dopaminergic systems. This action is supplemented by a genetic predisposition for cognitive regulatory dysfunction, leading to improper modulation of emotive and reward networks. Specifically, deficits in top-down limbic modulation leads to behaviours disproportionally driven by limbic and reward circuitry; this pathology strengths over time through use. This therefore eventually results in substantial regional disconnect, reflected in epigenetic changes to neurotransmitters and observable histological changes.


Psychiatry ◽  
2021 ◽  
Vol 19 (4) ◽  
pp. 34-41
Author(s):  
O. K. Savushkina ◽  
E. B. Tereshkina ◽  
T. A. Prokhorova ◽  
I. S. Boksha ◽  
T. P. Safarova ◽  
...  

The aim of the study is to evaluate the activity of platelet glutamate dehydrogenase (GDH) in late-life depression compared to the healthy control group and to reveal possible correlations with clinical data. Patients and methods: 42 elderly patients (60–86 years old) with depressive episodes of different nosological categories according to ICD-10 were examined: a single depressive episode (F32.0, F32.1), a depressive episode in recurrent depressive disorder (RDD — F33.0, F33.1) and a depressive episode in bipolar affective disorder (BD — F31.3). The activity of GDH and the severity of depression (using the Hamilton depressive scale, HAMD-17, and the Hamilton scale for assessing anxiety, HARS) were evaluated twice: before the starting the course of antidepressant therapy (day 0) and on the 28th day of the treatment course. Results: patients showed a significant decrease in the activity of GDH compared to the control group (p < 0.0008). Before the treatment, GDH activity was significantly reduced compared to the control in both RDD and BD (p < 0.002 and p < 0.004), whereas after the treatment, the decreased GDH activity was observed only in patients with BD (p < 0.002). When compared with the control group, male patients showed a significant decrease in GDH activity both before and after the treatment course (p < 0.017 and p < 0.027), whereas women patients showed the decrease only before the treatment (p < 0.014). Conclusion: the decreased platelet GDH activity in elderly depressions may indicate an impairment of glutamate metabolism. Gender differences were revealed in the reversal of GDH activity level after the therapy: in men, the level of GDH activity did not recover to control values after the treatment course. An elevation in the level of GDH to control values over a 28-day course of therapy occurred only in patients with RDD, but not in patients with BD.


2021 ◽  
Vol 34 (6) ◽  
pp. e100663
Author(s):  
Surbhi Batra ◽  
Sumit Kumar ◽  
Lokesh Singh Shekhawat

Neurocysticercosis is the most common neuro-parasitosis caused by the larval stage of Taenia solium. The most common manifestations include seizures and hydrocephalus. Psychiatric abnormalities are relatively rare but depressive symptoms are frequent in patients with neurocysticercosis. However, mania as a presentation is relatively rare. Pregnancy and the postpartum period are relatively vulnerable times and they can lead to reactivation of existing neurocysterci lesions. We are discussing the case of a 23-year-old female patient with neurocysticercosis leading to the reactivation of lesions in the peripartum and postpartum period leading to bipolar affective disorder. Improvement in the patient was seen with a combination of antipsychotics, antihelmintics, antiepileptics and steroids, along with improved radiological signs of neurocysterci lesions. Although neurocysticercosis is a common illness, its prevalence presenting as a manic episode is merely 2.6% and, hence, missed easily. Therefore, it is important to rule out organic aetiology in patients even with a classic presentation of bipolar affective disorder and those having any other neurological symptoms and signs.


2021 ◽  
Vol 14 (11) ◽  
pp. e244757
Author(s):  
Ami Mehul Mehta ◽  
Mukhyaprana Prabhu ◽  
Gokul Krishnan

Adrenoleukodystrophy (ALD) is an X linked recessive genetic disorder caused by an abnormality in the ABCD1 gene on the X chromosome, that affects 1 in 20 000 people. In X linked adrenoleukodystrophy (X-ALD), a defect in lignoceroyl-coenzyme A ligase causes pathognomonic tissue accumulation of very long chain fatty acids (VLCFA) in the adrenal cortex and nervous system. The phenotypic variability ranges from cerebral inflammatory demyelination of childhood onset, leading to death within 5 years, to adults remaining presymptomatic through more than five decades. Our case is that of a man who was previously diagnosed with bipolar affective disorder presented with dystonic posturing. During transit, he had an episode of generalised convulsive status epilepticus. He presented with spasticity and exaggerated reflexes. Three important signs of adrenal insufficiency were observed: hypotension, hyperpigmentation and comatose state. The diagnosis of X-ALD should be considered in young men presenting with gradually progressive unexplained cognitive and behavioural problems, a strong family history, adrenal insufficiency, bilateral upper motor signs with absent ankle reflexes.


2021 ◽  
Vol 5 (2) ◽  
pp. 569
Author(s):  
Ivana Jessline ◽  
Monty P. Satiadarma ◽  
Rita Markus Idulfilastri

Bipolar affective disorder (bipolar) is a multicomponent disease involving episodes of severe mood disorders, neuropsychological deficits, immunological and physiological changes, and impairments in functioning.In addition to being characterized by episodes of mania, hypomania, depression, and a mixed state of the three, often followed by high rates of comorbidity with other mental illnesses.One of the therapeutic alternatives offered is with psychotherapy with cognitive behavior therapy (CBT). CBT is best form of psychoteraphy choosen that is used to treat anxiety in people with bipolar disorder. Nevertheless, the results obtained are still not consistent and can be generalized. The purpose of this study was to determine the overall difference in anxiety disorders in bipolar patients after being given CBT and the significance effect. The research method is a meta-analysis. The articles used are searched from various databases and selected using PRISMA. The results of the synthesis and processing of data showed that there were differences in symptoms of anxiety disorders after being given CBT and the overall point effect size estimate was 0.89 with p<0.05 indicating a high effect, thus giving a conclusion that CBT was effective for use as a therapy to overcome anxiety in bipolar disorder. Limitations and suggestions for further research, especially control of sampling. Strengths, limitations, and the need for future research are discussed. Gangguan afektif bipolar (bipolar) adalah penyakit multikomponen yang melibatkan episode gangguan mood yang parah, defisit neuropsikologis, perubahan imunologis dan fisiologis, dan gangguan dalam keberfungsian. Selain ditandai dengan adanya episode mania, hipomania, depresi, serta keadaan campuran dari ketiganya, seringkali diikuti oleh tingginya angka komorbiditas dengan penyakit mental lainnya. Salah satu alternatif terapi yang ditawarkan adalah dengan psikoterapi dengan cognitive behavior therapy (CBT). CBT menjadi salah satu pilihan psikoterapi yang digunakan untuk mengatasi kecemasan pada penderita bipolar. Namun demikian, hasil yang didapatkan masih belum konsisten dan dapat digeneralisasi. Tujuan dari penelitian ini adalah untuk mengetahui secara keseluruhan perbedaan gangguan kecemasan pada pasien bipolar setelah diberikan CBT dan seberapa besar efeknya. Metode penelitian adalah meta analisis. Artikel yang digunakan dicari dari berbagai database dan dipilih dengan menggunakan PRISMA. Hasil sintesis dan pengolahan data menunjukan ada perbedaan gejala gangguan kecemasan setelah diberi CBT. Hasil statistik menunjukan signifikansi yang tinggi dan estimasi poin effect size menyeluruh adalah 0,89 dengan signifikansi p<0.05 mengindikasikan efek yang tinggi, sehingga memberi kesimpulan CBT efektif untuk digunakan sebagai terapi mengatasi kecemasan pada bipolar. Keterbatasan dan saran untuk penelitian selanjutnya yaitu control yang dilakukan pada saat melakukan sampling. Kekuatan, keterbatasan, dan kebutuhan untuk penelitian masa depan juga dibahas.


Author(s):  
María Luisa Fernández-Rocha ◽  
Mariano García-Izquierdo ◽  
María Isabel Ríos-Rísquez

BACKGROUND: Patients with bipolar affective disorder (BPAD) have a suicide risk of up to 30 times higher than the general population. There is increasing interest in analyzing the effects of resilience in psychiatric diseases and its relationship to other factors such as suicide risk. AIM: The main objective of this study was to analyze the relationship between psychological resilience and suicide attempts, along with other relevant clinical and sociodemographic variables in euthymic patients with BPAD. METHODS: Eighty six outpatients, more than 18 years old, mostly men (60.5%) with BPAD type 1, 2, mixed, and unspecified, in euthymic phase receiving antidepressant and/or euthimizing treatment, participated in the study. Sociodemographic and clinical variables were assessed by means of a questionnaire and psychological resilience by means of Connor-Davidson’s 10-item Resilience Scale. RESULTS: Patients with previous autolytic attempts scored significantly lower in resilience than those who had not attempted suicide ( T = 3.30; p ≤ .001; 20.61 ± 6.58 vs. 26.52 ± 7.29). Patients diagnosed with BPAD scored significantly lower than other samples of university participants, workers, and the unemployed. The number of depressive episodes experienced was negatively and significantly associated with resilience scores ( r = −.28; p < .01). CONCLUSIONS: Patients diagnosed with BPAD who had made autolytic attempts had lower resilience scores than those who had not made them and lower scores than other general nonpsychiatric samples. The promotion of resilience in patients diagnosed with BPAD would facilitate a more adaptive and positive coping with the disease and their recovery process.


2021 ◽  
pp. 1-3
Author(s):  
Polina A. Sobolevskaia ◽  
Boris V. Andreev ◽  
Leonid P. Churilov ◽  
Tamara V. Fedotkina ◽  
Boris Gilburd ◽  
...  

A kind of autoimmune encephalitis with positive autoantibodies toward the B1 subunit of the gamma-aminobutyric acid-type B receptor is known as anti-GABABR encephalitis. It is an autoimmune brain disorder with typical manifestations of a limbic encephalitis. It can coexist with positive anti-thyroid autoantibodies. We described a 57-year-old woman who was diagnosed with a bipolar affective disorder. The patient had high titers of anti-thyroid peroxidase antibodies, and she also was positive for anti-GABABR antibodies. There is a question, if this case is a kind of comorbidity of anti-thyroid and anti-brain autoimmunity or is it a single nosological entity – a kind of Hashimoto’s encephalopathy?


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