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https://www.readbyqxmd.com/read/28098427/emergence-of-mania-in-two-middle-aged-patients-with-a-history-of-unipolar-treatment-refractory-depression-receiving-vagus-nerve-stimulation
#1
Naji C Salloum, Marie C Walker, Sunil Gangwani, Charles R Conway
OBJECTIVES: We report on two patients who experienced emergence of full manic symptoms while receiving vagal nerve stimulation (VNS). METHODS: Two patients, both with a well-documented and verified history of longstanding unipolar depression, were initiated on VNS for treatment of their severe major depressive episodes. RESULTS: The two patients had emergence of full manic symptoms after 8 and 9 months of VNS, respectively. Manic symptoms were adequately managed with standard treatments (mood stabilizer and electroconvulsive therapy) and VNS was continued in the two subjects for up to 5 years without any further occurrences of manic/hypomanic episodes...
January 18, 2017: Bipolar Disorders
https://www.readbyqxmd.com/read/28096676/aripiprazole-augmentation-in-managing-comorbid-obsessive-compulsive-disorder-and-bipolar-disorder-a-case-with-suicidal-attempts
#2
Jianbo Lai, Qiaoqiao Lu, Peng Zhang, Tingting Xu, Yi Xu, Shaohua Hu
Comorbid obsessive-compulsive disorder (OCD) and bipolar disorder (BD) have long been an intractable problem in clinical practice. The increased risk of manic/hypomanic switch hinders the use of antidepressants for managing coexisting OCD symptoms in BD patients. We herein present a case of a patient with BD-OCD comorbidity, who was successfully treated with mood stabilizers and aripiprazole augmentation. The young female patient reported recurrent depressive episodes and aggravating compulsive behaviors before hospitalization...
2017: Neuropsychiatric Disease and Treatment
https://www.readbyqxmd.com/read/28094461/comparison-of-the-32-item-hypomania-checklist-hcl-32-the-33-item-hypomania-checklist-hcl-33-and-the-mood-disorders-questionnaire-mdq-for-bipolar-disorder
#3
Yuan Feng, Yuan-Yuan Wang, Wei Huang, Gabor S Ungvari, Chee H Ng, Gang Wang, Zhen Yuan, Yu-Tao Xiang
AIM: Bipolar disorder (BD) is frequently misdiagnosed as major depression and hence reliable and culturally appropriate screening tools are needed. This study compared the 32-item Hypomania Checklist (HCL-32), the 33-item Hypomania Checklist (HCL-33), and the Mood Disorders Questionnaire (MDQ) for BD. METHODS: Altogether, 350 depressed patients were included. The HCL-32, the HCL-33 and the MDQ were completed by patients to identify manic and/or hypomanic symptoms...
January 17, 2017: Psychiatry and Clinical Neurosciences
https://www.readbyqxmd.com/read/28091342/childhood-interleukin-6-c-reactive-protein-and-atopic-disorders-as-risk-factors-for-hypomanic-symptoms-in-young-adulthood-a-longitudinal-birth-cohort-study
#4
J F Hayes, G M Khandaker, J Anderson, D Mackay, S Zammit, G Lewis, D J Smith, D P J Osborn
No abstract text is available yet for this article.
January 16, 2017: Psychological Medicine
https://www.readbyqxmd.com/read/28079488/association-analysis-of-ank3-variants-with-bipolar-disorder-in-the-korean-population
#5
Chul-Hyun Cho, Soojin Kim, Dongho Geum, Heon-Jeong Lee
BACKGROUND: Bipolar disorder (BD) is a major psychiatric disorder characterized by alternating mood episodes, including major depressive, hypomanic, and manic episodes. Previous genetic studies of BD have reported several genes as potentially associated with BD. The ANK3 gene has been identified as a possible BD susceptibility gene in genome-wide association analyses. AIMS: The goal of the present study was to evaluate the association of ANK3 variants with BD in the Korean population...
January 12, 2017: Nordic Journal of Psychiatry
https://www.readbyqxmd.com/read/28077190/measures-of-the-dsm-5-mixed-features-specifier-of-major-depressive-disorder
#6
Mark Zimmerman
During the past two decades, a number of studies have found that depressed patients frequently have manic symptoms intermixed with depressive symptoms. While the frequency of mixed syndromes are more common in bipolar than in unipolar depressives, mixed states are also common in patients with major depressive disorder. The admixture of symptoms may be evident when depressed patients present for treatment, or they may emerge during ongoing treatment. In some patients, treatment with antidepressant medication might precipitate the emergence of mixed states...
January 12, 2017: CNS Spectrums
https://www.readbyqxmd.com/read/28073041/major-depressive-disorder-with-subthreshold-hypomanic-mixed-features-a-real-world-assessment-of-treatment-patterns-and-economic-burden
#7
Roger S McIntyre, Daisy Ng-Mak, Chien-Chia Chuang, Rachel Halpern, Pankaj A Patel, Krithika Rajagopalan, Antony Loebel
BACKGROUND: To compare outcomes for individuals with major depressive disorder (MDD) with or without subthreshold hypomania (mixed features) in naturalistic settings. METHODS: Using the Optum Research Database (1/1/2009─10/31/2014), a retrospective analysis of individuals newly diagnosed with MDD was conducted. Continuous enrollment for 12-months before and after the initial MDD diagnosis was required. MDD with subthreshold hypomania (mixed features) (MDD-MF) was defined based on ≥1 hypomania diagnosis within 30 days after an MDD diagnosis during the one-year follow-up period, in the absence of bipolar I diagnoses...
December 23, 2016: Journal of Affective Disorders
https://www.readbyqxmd.com/read/28072644/use-of-an-analog-scale-in-the-treatment-of-patients-with-bipolar-disorder-to-optimize-assessment-and-clinical-outcome
#8
Sheldon H Preskorn
This column explains how a clinician can use an analog scale for patients with bipolar disorder: (1) to elucidate the course of the illness in a specific patient and (2) to assess response to treatment. This scale complements other standardized rating scales, such as the Young Mania Rating Scale, because its anchors are tailored to each specific patient in terms of the worst depressive or hypomanic/manic episode (ie, a -10 or +10, respectively) the person has ever experienced. The scale also allows clinicians to track how the individual patient's episodes have responded to treatment in the past, including whether the patient ever has achieved a full remission (ie, score of 0) following the initial onset of the disorder...
January 2017: Journal of Psychiatric Practice
https://www.readbyqxmd.com/read/28061921/bipolar-disorder-in-aviation-medicine
#9
Alpo Vuorio, Tanja Laukkala, Pooshan Navathe, Bruce Budowle, Robert Bor, Antti Sajantila
BACKGROUND: One of the most difficult challenges in aviation medicine is to diagnose, as early as possible, pilots with psychiatric disorders that may impair pilot performance and increase the risk of incidents and accidents. This diagnosis applies particularly to bipolar disorder (BD), where return to flying duty is not an option in the majority of cases. BD is a long-term mental disorder presenting remittent depressive, hypomanic, manic, or mixed episodes between low symptomatic or asymptomatic intermediate periods...
January 1, 2017: Aerospace Medicine and Human Performance
https://www.readbyqxmd.com/read/28044944/a-pragmatic-approach-to-the-diagnosis-and-treatment-of-mixed-features-in-adults-with-mood-disorders
#10
Roger S McIntyre, Yena Lee, Rodrigo B Mansur
Mixed features specifier (MFS) is a new nosological entity defined and operationalized in the Diagnostic and Statistical Manual of Mental Disorders (DSM), 5th Edition. The impetus to introduce the MFS and supplant mixed states was protean, including the lack of ecological validity, high rates of misdiagnosis, and guideline discordant treatment for mixed states. Mixed features specifier identifies a phenotype in psychiatry with greater illness burden, as evidenced by earlier age at onset, higher episode frequency and chronicity, psychiatric and medical comorbidity, suicidality, and suboptimal response to conventional antidepressants...
December 2016: CNS Spectrums
https://www.readbyqxmd.com/read/28031070/mixed-features-in-bipolar-disorder
#11
Eva Solé, Marina Garriga, Marc Valentí, Eduard Vieta
Mixed affective states, defined as the coexistence of depressive and manic symptoms, are complex presentations of manic-depressive illness that represent a challenge for clinicians at the levels of diagnosis, classification, and pharmacological treatment. The evidence shows that patients with bipolar disorder who have manic/hypomanic or depressive episodes with mixed features tend to have a more severe form of bipolar disorder along with a worse course of illness and higher rates of comorbid conditions than those with non-mixed presentations...
December 29, 2016: CNS Spectrums
https://www.readbyqxmd.com/read/28006664/the-high-burden-of-traumatic-brain-injury-and-comorbidities-amongst-homeless-adults-with-mental-illness
#12
Jane Topolovec-Vranic, Andree Schuler, Agnes Gozdzik, Julian Somers, Paul-Émile Bourque, C James Frankish, Jalila Jbilou, Sarah Pakzad, Luis Ivan Palma Lazgare, Stephen W Hwang
OBJECTIVE: characterize the prevalence of self-reported head injury with loss of consciousness (LOC) and associated demographic, clinical and service use factors in a sample of homeless adults with mental illness. METHOD: Participants in the At Home/Chez Soi study were interviewed at the time of study enrollment regarding their history of head injuries, mental and physical health diagnoses and justice system and healthcare interactions. Sociodemographic and clinical data were also collected...
December 3, 2016: Journal of Psychiatric Research
https://www.readbyqxmd.com/read/28004626/treating-mixed-mania-hypomania-a-review-and-synthesis-of-the-evidence
#13
Minoru Takeshima
The DSM-5 incorporates a broad concept of mixed states and captured ≥3 nonoverlapping symptoms of the opposite polarity using a "with mixed features" specifier to be applied to manic/hypomanic and major depressive episodes. Pharmacotherapy of mixed states is challenging because of the necessity to treat both manic/hypomanic and depressive symptoms concurrently. High-potency antipsychotics used to treat manic symptoms and antidepressants can potentially deteriorate symptoms of the opposite polarity. This review aimed to provide a synthesis of the current evidence for pharmacotherapy of mixed states with an emphasis on mixed mania/hypomania...
December 22, 2016: CNS Spectrums
https://www.readbyqxmd.com/read/27987053/protection-against-hormone-mediated-mood-symptoms
#14
Leah C Susser, Alison D Hermann
We present the case of a woman with bipolar I disorder with severe premenstrual mood instability, confusion, and psychosis resembling the clinical features of postpartum psychosis when estrogen levels are expected to be low, and hypomania when estrogen levels are expected to be elevated. While depressive symptoms across the menstrual cycle have been extensively documented in the literature, there is little information regarding manic and hypomanic symptoms. In addition, we describe the successful treatment of her menstrual-cycle related symptoms...
December 16, 2016: Archives of Women's Mental Health
https://www.readbyqxmd.com/read/27936451/onset-polarity-in-bipolar-disorder-a-strong-association-between-first-depressive-episode-and-suicide-attempts
#15
Laura Cremaschi, Bernardo Dell'Osso, Matteo Vismara, Cristina Dobrea, Massimiliano Buoli, Terence A Ketter, A Carlo Altamura
BACKGROUND: The role of onset polarity (OP) in patients with bipolar disorder (BD) has been increasingly investigated over the last few years, for its clinical, prognostic, and therapeutic implications. The present study sought to assess whether OP was associated with specific correlates, in particular with a differential suicidal risk in BD patients. METHODS: A sample of 362 recovered BD patients was dichotomized by OP: depressed (DO) or elevated onset (EO: hypomanic/manic/mixed)...
February 2017: Journal of Affective Disorders
https://www.readbyqxmd.com/read/27914248/the-difficult-lives-of-individuals-with-bipolar-disorder-a-review-of-functional-outcomes-and-their-implications-for-treatment
#16
REVIEW
Michael J Gitlin, David J Miklowitz
BACKGROUND: Most longitudinal or treatment studies in bipolar disorder have used symptomatic or syndromal status as the primary outcome variable. More recently, psychosocial functioning has been highlighted as a key domain of outcome. Patients with bipolar disorder appear to be impaired in all functional domains, although the factors that cause impairment have not been clearly specified. METHODS: This paper reviews cross-sectional and longitudinal studies on functional impairment and its relationship to symptomatic, neurocognitive, personality, and stress variables in bipolar disorder; and the implications of these relationships for defining treatment targets...
February 2017: Journal of Affective Disorders
https://www.readbyqxmd.com/read/27867936/effects-of-lithium-monotherapy-for-bipolar-disorder-on-gene-expression-in-peripheral-lymphocytes
#17
Amit Anand, Jeanette N McClintick, Jill Murrell, Harish Karne, John I Nurnberger, Howard J Edenberg
BACKGROUND: This study investigated the effect of lithium monotherapy on peripheral lymphocyte gene expression in bipolar disorder (BD). METHOD: Twenty-two medication-free bipolar subjects (11 hypomanic, 11 depressed) were started on lithium monotherapy. Closely matched healthy subjects (n = 15) were included as controls but did not receive treatment. Blood RNA samples were collected at baseline and after 2 and 8 weeks of treatment. RNA expression was measured using the Affymetrix GeneChip® Human Gene 1...
October 2016: Molecular Neuropsychiatry
https://www.readbyqxmd.com/read/27862615/the-reciprocal-relationship-between-bipolar-disorder-and-social-interaction-a-qualitative-investigation
#18
Rebecca Owen, Patricia Gooding, Robert Dempsey, Steven Jones
BACKGROUND: Evidence suggests that social support can influence relapse rates, functioning and various clinical outcomes in people with bipolar disorder. Yet 'social support' is a poorly defined construct, and the mechanisms by which it affects illness course in bipolar disorder remain largely unknown. Key aims of this study were to ascertain which facets of social interaction affect mood management in bipolar disorder, and how symptoms of bipolar disorder can influence the level of support received...
November 13, 2016: Clinical Psychology & Psychotherapy
https://www.readbyqxmd.com/read/27831463/what-is-the-role-of-conventional-antidepressants-in-the-treatment-of-major-depressive-episodes-with-mixed-features-specifier
#19
Gianni L Faedda, Ciro Marangoni
The newly introduced Mixed Features Specifier of Major Depressive Episode and Disorder (MDE/MDD) is especially challenging in terms of pharmacological management. Prior to the publication of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, the symptoms of the mixed features specifier were intradepressive hypomanic symptoms, always and only associated with bipolar disorder (BD). Intradepressive hypomanic symptoms, mostly referred to as depressive mixed states (DMX), have been poorly characterized, and their treatment offers significant challenges...
November 10, 2016: CNS Spectrums
https://www.readbyqxmd.com/read/27813593/case-report-case-study-of-a-patient-presenting-both-type-ii-bipolar-affective-disorder-and-klinefelter-syndrome
#20
H Delavenne, J M Khoury, F Thibaut, F D Garcia
Klinefelter syndrome (KS) is the most common sex chromosomal disorder with an estimated prevalence of 1 in 500-1000. Increased incidences of anxiety, depression, substance abuse, psychotic and behavioral disorders, and sexual disorders have been reported in patients with KS. The aim of this case study was to report a case of a man with untreated KS who was also diagnosed with type II bipolar disorder. This case report raises awareness regarding psychiatric diagnoses that may be associated with such a highly prevalent condition...
October 17, 2016: Genetics and Molecular Research: GMR
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