bluuebunny/crossref_metadata_2025_split huggingface dataset:
Is MAO-B Activity in Platelets Associated with the Occurrence of Suicidality and Behavioural Personality Traits in Depressed Patients?
Authors: Lewitzka U. , Müller-Oerlinghausen B. , Felber W. , Lauterbach E. , Ising M. , Bronisch T. 
Published: March 2009

Objective:Low platelet MAO-B activity has been associated with various forms of impulsive behaviour and suicidality. The present study investigated the relationship between MAO-B activity in platelets and aspects of suicidality in depressed patients and controls.Method:In 87 patients with affective spectrum disorders (58% suffering from a Major Depressive Episode - MDE) the potential association between platelet MAO-B activity and suicidality was examined. 59 of the patients had committed suicide attempt recently (SA - “suicide attempters”), 28 patients were acutely depressed without having shown suicidal thoughts or suicidal behaviour in the past (NA - “non suicide attempters”).Results:SA and NA were comparable as to their diagnoses and general demographic and psychopathological parameters. MAO-B activity did not differ between SA and NA. No systematic correlations existed between MAO-B activity and any dimensions of suicidal behaviour or psychopathology. As a single finding only a weak positive association of higher MAO-B activity in SA with a fatal intention of the suicide attempt was observed.Conclusion:Our findings do not support a consistent association of platelet MAO-B activity and suicidal behaviour in general, but specific facts of suicidality might be associated.
The Serotonin System, Stressful Life Events, and Risk of Suicidal Behaviour
Authors: Saiz P. 
Published: March 2009

There is robust evidence that stressful life events (SLE) are associated with an increase in risk of developing depression. However, humans display wide variation in response to adversity. Recently, Caspi et al (2003) reported that a functional length polymorphism (5-HTTLPR) in the promoter of the serotonin transporter gene moderated the influence of SLE on depressive symptoms, major depression, and suicidality, suggesting evidences of a gene-by-environment interaction.Neuroimage data from healthy, non-depressed, s allele carriers of the 5-HTTLPR show an exaggerated amygdale response to threatening visual stimuli as well as reduced gray matter volume in limbic regions critical for processing of negative emotion compared with individuals with the LL genotype. These data suggest a potent modulatory effect of the 5-HTTLPR on amygdala reactivity to environmental threat.In recent years, a growing number of molecular genetic studies have focused on the serotonin system, suggesting that this system may be involved in the pathogenesis of suicidal behaviour. Meta-analytic evidences support a link between the s allele of the 5-HTTLPR and the risk of suicidal behaviour. However, several case-control association studies show an association between the short allele and the violence, the number, and the medical lethality of the attempts.In this presentation we discuss data regarding the complex relationship between the serotonin functionality, stress, and suicidal behaviour.
Bipolar Affective Disorders: Diagnostic and Treatment Situation in Lithuania
Authors: Adomaitiene V. , Kunigeliene A. , Dambrauskiene K. , Danileviciute V. 
Published: March 2009

Introduction:Bipolar disorder is one of the most important psychiatric diseases. This is a lifelong illness which increases disability, bad social, employment, and functional outcomes. Bipolar disorder causes dramatic mood swings - from overly “high” and irritable to sad and hopeless, often with periods of normal mood between. Bipolar I disorder is characterized by a history of at least one manic episode, with or without depressive symptoms. Bipolar II disorder is characterized by the presence of both depressive symptoms and a less severe form of mania.Objective:To review diagnostic and treatment situation of bipolar affective disorders in Lithuania.Method:A review of bipolar affective disorders in Lithuania: the prevalence of bipolar disorders, the differences between genders, the clinical features between genders.Results:Studies have suggested, that the prevalence of bipolar disorder in Lithuania is 1 % of population. The rates of bipolar disorder: in 2003 was 1131 cases, in 2004 - 1133 cases, in 2005 - 1147 cases, in 2006 - 1255 cases, in 2007 - 1257 cases. Distribution of bipolar disorders between males and females: males - 35,88 %, females - 64,12 %.Conclusion:The rates of Bipolar I disorder are equal between female and male population, but bipolar II disorder is more frequent in female population (bipolar depression, mixed manic disorder). Bipolar disorder with alcohol and drug abuse are very common among male population. Bipolar disorders are very common with somatic disease (thyroid disease, migraine, obesity of medication), anxiety disorders are more frequent in female population.
Suicidal Attempts Among Bipolar Patients: Correlation with Affective Temperaments and Life Events
Authors: Amara G. , Ben Salah N. , Ben Nasr S. , Ben Hadj Ali B. 
Published: March 2009

Aims:In this study, we focused on the correlations between life events, affective temperaments and suicidal attempts among patients with bipolar disorder.Methods:Patients with DSM IV diagnosis of bipolar I or bipolar II disorders were recruited from psychiatric consultation of the Farhat Hached Hospital in Sousse. All bipolar patients were in remission for at least four weeks. Suicidal attempts were checked by interrogating patients and consulting medical observations. Affective temperament dimensions were determined by using the Arabic version of TEMPS-A. The assessment of life events was based on the Paykel scale.Results:A total of 57 patients (47 with bipolar I disorder and 10 with bipolar II disorder) have participated in the study, with a mean age of 41,8 ± 11,3 years and a gender ratio of 2,29. Suicidal attempt number was positively correlated with depressive (p=0,021) and anxious (p=0,015) temperament, early orphanage (p=0,008) and the total number of life events (p=0,011). It was also correlated with the global negative impact of these events (p=0,036).Conclusion:According to our findings, life events and their negative impact, early parental loss and anxious and depressive temperaments predispose to suicidal attempts among patients with bipolar disorder. Further prospective studies are required to confirm these results.
Phenotypic and Genotypic Analysis in a Large Turkish Bipolar Family
Authors: Arisoy O. , Akarsu A.N. , Oral T. 
Published: March 2009

Objective:To document the phenotypic and genotypic characteristics of a three generational large family loaded with affective disorders.Method:Linkage analysis is done in a large three generational Turkish family loaded with affective disorders. 8 patients and 17 relatives are examined with SCID-I and the clinical characteristics of the patients are documented. Blood is drawn from all family members to isolate DNA but only the patients DNA are included in the molecular analysis and these patients are screened for five susceptibility regions implicated for both schizophrenia and bipolar disorder (10p12, 13q32, 18p11.2, 22q11 ve 20 p12-q12).Results:Clinical assesment of the patients revealed that, the depressive episodes of the patients are likely to be melancoholic and suicidal in nature and the manic episodes are usually associated with mood-congruent psychotic symptoms. No linkage could be detected for the screened regions in molecular analysis. Only a loss of heterozygosity could be detected in 18p11.2 region.Conclusion:The allelic loss from the maternal allele in this region did not seem to segregate with the disorder and this maternal allele loss could not be explained by an imprinting mechanism, since there was no parental transmission of the disorder in this pedigree. This region must be screened with multiple markers and sitogenetic analysis should be done in order to be able to understand whether there is a real loss of in this part of the chromosome.
Meta-analysis of Magnetic Resonance Imaging Studies in Bipolar Disorder and Schizophrenia [P01-175]
Authors: Arnone D. , Cavanagh J. , Gerber D. , Lawrie S.M. , Ebmeier K.P. , Mcintosh A.M. 
Published: March 2009

Introduction:Several MRI studies have identified structural abnormalities in association with bipolar disorder. The literature is however heterogeneous and there is remaining uncertainty about the brain areas pivotal to the pathogenesis of the condition. The aim of this study was to identify, appraise and summarise volumetric MRI studies of brain regions comparing bipolar disorder with an unrelated control group and/or patients with schizophrenia.Methods:A systematic review and random-effects meta-analysis was carried out to identify key areas of structural abnormality in bipolar disorder and whether the pattern of affected areas separated bipolar disorder from schizophrenia. Excessive variability was explored using meta-regression analyses.Results:Seventy two reports met inclusion criteria. Subjects with bipolar disorder showed significant whole brain and prefrontal lobe volume reductions, and also increases in the volume of the globus pallidus. Enlargement of the lateral ventricles in bipolar disorder was confirmed, although the magnitude of enlargement was smaller than in schizophrenia. Subjects with schizophrenia, but not bipolar disorder, showed significant reductions in right amygdala volumes. Heterogeneity was statistically significant for many of the analyses and could amongst others be explained by age, duration of illness and year of publication.Conclusion:There appear to be robust changes in brain volume in bipolar disorder compared with healthy volunteers. Age and duration of illness appear to be key issues in determining the magnitude of observed effect sizes.
Severely Mood-disordered Youth Respond Less Well to Treatment in a Community Clinic than Youth with Bipolar Disorder
Authors: Bastiaens L. , Bastiaens J. 
Published: March 2009

Introduction:Bipolar disorder diagnoses in youth have significantly increased in the past decade. To help establish proper diagnostic practices, four different phenotypes have been proposed, ranging from meeting full DSM-IV criteria to “severely mood disordered” conditions (Leibenluft et al, 2003). So far, not much is known about these phenotypes and their response to treatment in the community.Objective:To identify youth diagnosed with bipolar disorder versus mood disorder NOS and evaluate their response to treatment in a community clinic.Methods:A retrospective chart review identified 19 children with bipolar disorder and 22 with mood disorder NOS and “followed back” these patients for eight months. Pre- and post-treatment Global Assessment of Functioning (GAF) and Clinical Global Improvement (CGI) scales were collected.Results:There were no differences between the two groups in terms of gender, number of diagnoses, family history of bipolar disorder, initial GAF, level of care needed, or number of medications needed. Youth with bipolar disorder were older, had more risk factors for suicidality, more past medication trials, and more hospitalizations. Severely mood disordered patients had more ADHD.After eight months, bipolar disorder youth improved significantly more than severely mood disordered patients: Change in GAF (+10.4 vs +5.3), endpoint GAF (56.9 vs 50.3), and CGI (2.6 vs 3.1).Conclusion:Even though bipolar disorder youth look more like adults with bipolar disorder (older age, more suicidality, more hospitalizations), severely mood disordered youth respond much less to treatment in a community clinic.
Bipolar Disorder and Suicide: 10 Years Follow-up /Retrospective Survey/
Authors: Breznoscakova D. , Palova E. , Dragasek J. , Losonciova K. , Uhrin J. 
Published: March 2009

Introduction:Bipolar disorder (BD) is chronic psychiatric disorder by mood swings, symptoms of BD are serious and life-threating. Suicide risk in patients with BD is 25-50%, more frequent during depressive episode (Compton,2000) but with adequate treatment suicide risk can be presented in nearby 50% of patients only (Goodwin, Jamison,2006). Despite these facts data about the changes of treatment habits over the longer period of time under naturalistic condition are lacking.The aim of study:To assess presence of suicidal thoughts and attempts in inpatients with BD and follow-up changes of treatment with lithium over the period of time.Patients and methods:It was retrospective survey of in-patient's files hospitalized at the 1st Dept. of Psychiatry, UPJS, Kosice (1997-2007) with typical limitations for retrospective case survey. All patients had diagnosis of BD (DSM-IV), n=125 (67% of women and 33% of men). We discovered changes in suicidal behaviour with/without treatment of lithium.Results:The first episode was depressive in 62% of patients, average number of episodes: 8,2. There was trend of decrease in use of lithium over the time (68% vs 84% in men, 29% vs 60% in women). The suicidal thoughts were more frequent during depressive episode (in 50% of women and 18% of men). Suicidal thoughts and attempts were 3 times more frequent in women vs men with BD. Suicidal attempts were 4 times more frequent in women with treatment with lithium vs without lithium.
Does psychoeducatioanal Approach Could Reach the Target Patients with Bipolar Disorder?
Authors: Cakir S. , Bensusan R. , Akca Z. , Yazici O. 
Published: March 2009

The recurrent nature of bipolar disorder needs an optimum compliance with long term pharmacotherapy, however the poor adherence is common. Adjunctive psychoeducation seems favorable effects on adherence during the long term pharmacotherapy. Even strong benefits were showed, setting a psychoeducation in clinical practice is still novel and recruiting the patients with long history of bipolar disorder may not be feasible. In literature, recruitment rate, motivation and attitudes of patients for participation in psychoeducation is not studied. The present study was conducted to clarify the intends of patients with bipolar disorder to participate in psychoeducation and the factors that contribute.The euthymic patients with diagnosis of bipolar disorder I or II, were invited to the 6 week psychoeducation program in prospective study. The demographic and clinical data were obtained from life charts and updated with a clinical interview. The blood levels of mood stabilizers, adherence, response to prophylactic treatment, relapses and hospitalization rates between the participants and non-participants were compared.84 patients were attended the program, 71 patients were considered as unwilling to attend. The motivation of patients to attend a psychoeducation is limited. The participation rate was only 54.2%. The patients who refused attending to this program have fewer adherences to medication and irregular follow up visits, insufficient blood levels of mood stabilizers, poor response to long term treatment, more likely have mood episodes. Education level between attendees and non-attendees were not different.Optimum methods are required for recruitment of bipolar patients to a psychoeducation program.
Mania in Old Age: A Case Report
Authors: Castro L.C. 
Published: March 2009

Background:Geriatric bipolar disorder is associated with a significant morbidity, mortality and poor psychosocial outcomes. Bipolar affective disorder contributes substantially to geriatric mood disorders and to geriatric hospitalizations. Mania in late-life is often a tremendous treatment challenge because of frequent medical co-morbidity and age-related variations in response to therapeutics.Aim:To report a case of mania in late-life, in order to discuss the impact of bipolar disorder in the elderly, underlining treatment difficulties in the geriatric population.Methods:Case study and review of the literature.Results:A 70 year old woman was hospitalized in a geriatric service of a psychiatric hospital with a maniac episode. She had a history of bipolar disorder diagnosed during her adult life. She had several co-morbid medical conditions, including diabetes, hypertension, dyslipidemia and psoriasis. There was a successful multidisciplinary approach and intervention, allowing a significant improvement and reintegration in the community.Conclusions:Geriatric patients with bipolar disorder carry a substantial burden of general medical conditions. There are few studies and a lack of specific algorithms concerning bipolar management in the elderly. It is urgent the development of specific interventions that target medical burden in patients with bipolar disorder and further research on the treatment of bipolar disorder in old age. A multidisciplinary approach is essential to allow a holistic treatment and improvement of quality of life parameters in this population.
Neuropsychiatric Lupus in an Adolescent Presenting with Bipolar Disorder with Catatonic Features
Authors: Alao A. , Chung C. 
Published: March 2009

Case presentation:We describe a 15-year-old African American female with a family history positive for Bipolar I disorder and schizophrenia who presented with symptoms consistent with an affective disorder. The patient was diagnosed with Bipolar I disorder with catatonic features and required multiple hospitalizations for mood disturbance. Two years after her initial presentation, the patient was noted to have a malar rash and subsequently underwent a full rheumatologic workup, which revealed cerebral vasculitis. Neuropsychiatric lupus (NPSLE) was diagnosed and, following treatment with steroids, the patient improved substantially and no longer required further psychiatric medication or therapy.Conclusion:Neuropsychiatric manifestations of lupus (NPSLE) have been shown to occur in 80-91% of adults and up to 95% of pediatric patients with SLE. In the case we described, diagnosis was hindered by the patient's presentation of what appeared to be isolated psychiatric symptoms and her strong family history of psychiatric disease. Thus, given the especially high prevalence of NPSLE in pediatric patients with lupus, it is important for clinicians to recognize that neuropsychiatric symptoms in an adolescent may indeed be the initial manifestations of SLE.
Potential Misdiagnosis of Bipolar Disorder
Authors: Correia D. , Correia L. , Gandra T. , Silva F. 
Published: March 2009

Background:Several reports indicate that Bipolar Disorder (BD) is frequently underdiagnosedleading to overuse of antidepressants and underuse of mood stabilizers.Aims and methods:The aim is to review literature concerning this subject published since 2000.Results:BD seems to be frequently underdiagnosed. Several studies, as EPIDEP and NEMESIS, reveal insufficiencies on the diagnosis of this disorder, suggesting that clinicians miss this diagnosis about half of the times, and that about three quarters of these patients are not receiving appropriate treatment, respectively.BD is often misdiagnosed as Major Depression Disorder (MDD), with approximately 40% of BD patients being initially diagnosed as MDD. On the other hand, a large fraction of patients initially diagnosed as MDD will change diagnosis to BD during follow-up, with some authors presenting values as high as 67%. Studies comparing the depressive features of MDD and BD point to some strong clinical indicators of bipolarity in patients presenting with depression, such as family history, seasonal pattern, postpartum onset, psychotic symptoms, younger age, suicidal behaviours, among others.To a lesser extent, BD can also be misdiagnosed as: substance abuse, borderline personality, obsessive-compulsive disorder, among others.It is also important to consider that a large fraction of patients with BD diagnosis will change diagnosis during the follow-up period.Conclusion:BD patients with the diagnosis may represent only a fraction of the subjects with this disorder, and the true epidemiological extent of this problem needs further investigation.
Effectiveness of Extended-release Formulation of Quetiapine as Monotherapy for the Treatment of Acute Bipolar Mania (Trial D144CC00004)
Authors: Datto C. , Nordenhem A. , Minkwitz M. , Dettore B. , Acevedo L. , Darko D. , Cutler A. 
Published: March 2009

Objectives:To evaluate the effectiveness of extended release quetiapine fumarate (quetiapine XR) as once-daily monotherapy for manic symptoms in bipolar I disorder.Methods:In this 3-week, randomized, parallel-group, double-blind study, adults with bipolar I disorder (most recent episode manic or mixed; with or without rapid cycling) were randomized to once-daily treatment with either quetiapine XR (n=149; Day 1, 300 mg; Day 2, 600 mg; Day 3 through Week 3, 400-800 mg flexibly dosed) or placebo (n=159). Primary outcome measure was change from baseline to Week 3 in Young Mania Rating Scale (YMRS) total score. Secondary outcome measures included YMRS response and remission and change in Clinical Global Impression-Bipolar (CGI-BP)-Severity of Illness and -Change scales. Change from baseline was compared between groups with analysis of covariance, using the last observation carried forward approach for missing data.Results:Once-daily quetiapine XR was associated with significant, sustained improvement in manic symptoms compared with placebo, beginning on Day 4 (P< 0.001) and continuing through Week 3 (mean change: -14.34 versus -10.52; P< 0.001). At Week 3, quetiapine XR-treated patients showed significantly greater response (P< 0.01) and remission (P< 0.01) rates and improvement in CGI-BP-associated scores than placebo-treated patients. Adverse events were mild to moderate in intensity, the most common being sedation, dry mouth, and somnolence for quetiapine XR.Conclusions:Once-daily quetiapine XR monotherapy (400-800 mg) was efficacious (from Day 4 through Week 3) and generally well tolerated in the treatment of manic episodes associated with bipolar I disorder.Supported by funding from AstraZeneca Pharmaceuticals LP.
Effectiveness of the New Extended-release Formulation of Quetiapine as Monotherapy for the Treatment of Acute Bipolar Depression (Trial D144CC00002)
Authors: Datto C. , Minkwitz M. , Nordenhem A. , Walker C. , Darko D. , Suppes T. 
Published: March 2009

Objectives:To evaluate the effectiveness of extended-release quetiapine fumarate (quetiapine XR) as once-daily monotherapy for bipolar depression.Method:Patients in this double-blind, placebo-controlled study were acutely depressed adults with bipolar I or II disorder (with or without rapid cycling), and were randomized to 8 weeks of once-daily treatment with quetiapine XR 300 mg (n=133) or placebo (n=137). The primary outcome measure was change from baseline to endpoint (Week 8) in Montgomery-Åsberg Depression Rating Scale (MADRS) total score. Secondary outcome measures included response (MADRS total score reduction ≥50%) and remission (MADRS total score ≤12) rates at endpoint, changes from baseline to endpoint in MADRS item scores, and Clinical Global Impressions-Bipolar (CGI-BP) severity of illness and change. Change from baseline was compared between groups with analysis of covariance using last observation carried forward approach.Results:Quetiapine XR 300 mg/d was significantly more effective than placebo in improving depressive symptoms, from first assessment (Week 1; P< 0.001) to endpoint (P< 0.001). Compared with placebo, quetiapine XR was associated with higher response (P< 0.001) and remission (P< 0.05) rates and greater improvements from baseline to endpoint in MADRS total score (-17.43 vs -11.92; P< 0.001), MADRS item scores for core symptoms of depression, and CGI-BP-related outcomes at Week 8. Most common adverse events with quetiapine XR were dry mouth, somnolence, and sedation.Conclusions:Quetiapine XR (300 mg) once-daily monotherapy was efficacious (from Weeks 1 through 8) compared with placebo and generally well tolerated in bipolar depression.Supported by funding from AstraZeneca Pharmaceuticals LP.