bluuebunny/crossref_metadata_2025_split huggingface dataset:
Group-based trajectory modeling a good model to explore sub-groups of recovery during acute bipolar mood episodes
Authors: M’bailara K. , Cosnefroy O. , Desage A. , Gard S. , Zanouy L. , Minois I. , Henry C. 
Published: May 2011

Group-based trajectory modeling (GBTM) is a statistical method created to explore the heterogeneity of clinical groups based on their longitudinal outcomes by identifying distinct trajectories of change. This model can be applied to assess heterogeneity in responses to treatment. This pilot study explored the relevance of the GBTM associated with the dimensional evaluation of mood (MATHYS) to define trajectory of recovery in acute bipolar mood episodes on a short period of time during a naturalistic study.MethodThe sample consisted in 118 bipolar patients and all patients were recruited during an acute phase: 56% had a major depressive episode, 26% a manic or hypomanic episode, and 18% a mixed state using the DSM-IV criteria. Patients were assessed four times with MATHYS during a three weeks follow-up period. It is an observational study and treatment was prescribed as usual. We applied the GBTM method and MATHYS total score to define trajectories of recovery.ResultsThis method allows identifying 4 trajectories of recovery. At Baseline, two of them started with a score of inhibition but with quite different evolutive profiles (stable inhibition versus improvement). The two others trajectories started with a score of activation (mild versus moderate) and showed a linear improvement of symptoms but with a more rapid recovery for the patients with the higher activation at baseline.ConclusionWhen considering the diagnosis of patients belonging in each trajectory, there model seems particular relevant to explore the high heterogeneity in response to treatment in bipolar patients during an acute depressive episode.
Treatment non-adherence amongst schizoaffective bipolar patients: An unsolved question
Authors: Murru A. , Bonnin C.M. , Nivoli A.M. , Pacchiarotti I. , Vieta E. , Colom F. 
Published: May 2011

IntroductionNon adherence to treatment is especially common in patients with chronic relapsing disorders. Schizoaffective disorder is a chronic, severe and disabling illness consisting of the concurrent presentation of symptoms of schizophrenia and affective disorders. Its course and prognosis has been found to be intermediate to those two conditions.ObjectivesTo evaluate treatment adherence in a schizoaffective sample and to which demographical and clinical variables it may be associated.MethodsAdherence to treatment and its clinical correlates were assessed in 69 patients meeting DSM-IV-TR diagnosis of schizoaffective disorder, bipolar type, by means of adherence-focused interviews, measurements of plasma concentrations of mood stabilizers.Adherent and poorly adherent patients were compared with respect to several clinical and treatment variables.ResultsPoorly adherent patients were 40% of the total sample. Demographic variables (i.e.: gender, marital status, cultural level, employment) were not associated to treatment adherence, nor were clinical variables (age at onset, polarity of the first episode, lifetime history of seasonal pattern, rapid cycling, atypical depression, melancholia, catatonia) or family history for generic psychiatric, affective disorders and suicide. No pharmacological treatment (atypical antipsychotic, mood stabilizer and antidepressant) was associated to adherence in our sample.ConclusionsClinical and demographical factors are not related to medication adherence in our sample. Coherently with the general severity of this condition, and since there does not seem to be any clinical predictor of poor adherence, in clinical practice all schizoaffective patients should be monitored and treated as potentially non-adherent.
Lithium and valproate combination: Therapeutic strategies in a sample of patients with bipolar disorder
Authors: Muti M. , Pergentini I. , Corsi M. , Viaggi C. , Caramelli A. , Musetti L. , Corsini G.U. , Dell’Osso L. 
Published: May 2011

IntroductionLithium is the agent that has shown more efficacy for the treatment of Bipolar Disorder (BD), anyway a single agent isn’t effective to control all aspects of the syndrome.The mood-stabilizer frequently used, in combination with Lithium, is Valproate which presents different methabolism and side effects. Further both molecules are glycogen synthase kinase-3 (GSK-3b) inhibitors and have synergistic neuroprotective action.ObjectivesWe underline the need to better investigate Lithium and Valproate combination therapy in BD.AimsObservation of Lithium and Valproate combination therapy in a sample of patients with BD, considering doses and serum levels.Methods56 patients with BD (mean age 38 ± 0,02), followed at the day hospital of the Psychiatric Clinic, University of Pisa, were studied. Serum levels evaluated at the Section of Pharmacology, Department of Neuroscience, University of Pisa.ResultsWe identified 5 comparison groups depending on the dose intake of Lithium (11 subjects: 300 mg /die, 9: 450 mg/die, 19: 600 mg/die, 7: 750 mg/die, 10: 900 mg/die) with increased serum levels of the medication (0.27 mEq/l, 0.37 mEq/l, 0.50 mEq/l, 0.52 mEq/l, 0,70 mEq/l). There are not significant differences between groups related to both, the mean dose intake of Valproate (772 mg/die, 744.4 mg/die, 867.5 mg/die, 821.4 mg/die, 845 mg/die) and its serum levels (45.2 mg/L, 46.6 mg/L, 53.2 mg/L, 47.4 mg/L, 48.4 mg/L).ConclusionsThis study aims to identify the effective dose of Lithium in combination with Valproate able to determine the prevention of relapse in BD patients. The use of the lower dose of Lithium maintaining therapeutic effectivness, means reducing side effects, toxicity and the need for constant monitoring.
Bipolar disorder and heroin addiction-case report
Authors: Nikic M. , Alcaz S. , Vucetic-Arsic S. , Popadic G. 
Published: May 2011

BackgroundIt was estimated that in general adult population represented in 2–3% co-occurring mental and substance use disorders.In our case we represented the patient who is a long-time heroin addict with a dual diagnosis of bipolar disorder. Special attention was payed to influence of the primary psychiatric disorder to a course and treatment of substance abuse.MethodsPatient is observed during the five years from March 2005 to March 2010. In the evaluation of the case we used History of illness, MINI, HAMD. and psychological tests battery (MMPI 202, Drawing Human Figure, EGO Perception and EGO Ideal Test).ResultsDuring the observation we have noticed that the patient was started treatment in periods of depression decompensation, because of heroin relapse. In that moment HAMD score was between 20 and 24 points. After detoxification, the patient was experiencing a switch in hippomanic state, which resulted in drop-out in the first month of treatment. This course of disease was repeated five times during our observation. Because the patient retained in treatment, we were able to progress. Now, the patient has been in abstinence for eight months, and he is in acceptable affective stability.ConclusionBipolar Disorder is increased risk for frequent heroin relapses and continuity in the therapeutic treatment. This influence may involve direct effects of drugs on the initiation of affective symptoms and indirect effects on treatment compliance. When symptoms are controlled through these psychiatric medications, patients will benefit from therapeutic treatment of their substance abuse.
Lithium therapy and the risk of acute hemolysis in G6PD deficient bipolar patients
Authors: Olari M. , Bourgeois V. , Haouzir S. , Guillin O. 
Published: May 2011

IntroductionGlucose-6-phosphate dehydrogenase (G6PD) deficiency is the most common enzyme deficiency worldwide. In this condition acute hemolysis is caused by exposure to an oxidative stressor in the form of an oxidative drug, an infection or aliments. G6PD deficiency can be associated to different psychiatric conditions, but little is known about the risk of acute hemolysis in G6PD deficient patients that are treated with antipsychotics and mood stabilizers.AimsA clinical description is presented in order to illustrate the possible risk of acute hemolysis with Lithium therapy in a G6PD patient.MethodsA 33 years old male of hispanic origin and a G6PD enzyme deficiency was admitted presenting a first episode of mania. Lithium treatment was initiated.The patient was clinically examined daily. Extensive laboratory evaluation was performed, including complete blood cell count, liver, renal and thyroid function tests, serum electrolytes and glucose levels, urinalysis, lithium blood dosage. Neuroimaging studies were also performed excluding secondary causes of mania.ResultsAt J7 of lithium therapy the patient presented with jaundice and a blood count revealed a drop in the number of red blood cell (from 3,42 T/L to 2,42 T/L) with an increase of bilirubin (87,2 umol/l) which revealed an episode of acute hemolysis. Lithium therapy was discontinued immediately. Red blood cell count continued to drop for another 7 days and returned to normal after 2 weeks of discontinuation of Lihium therapy.ConclusionsLithium might be a trigger of acute hemolysis in bipolar patients with G6PD deficiency associated.
The effects of childhood trauma on psychotic symptoms in bipolar disorder
Authors: Ozkose M.M. , Guclu O. , Guloksuz S. , Karaca O. , Yildirim B. , Ince B. , Erkmen H. 
Published: May 2011

IntroductionAlthough history of childhood trauma is present in nearly 50% of bipolar patients, the effects of childhood trauma on the course of bipolar disorder are rarely investigated. Thus, we aimed to investigate the effects of childhood trauma on psychotic symptoms seen in patients with bipolar disorder.MethodsOne-hundred DSM-IV-TR diagnosed bipolar patients who were either manic or depressive were recruited from inpatient units of Bakirkoy Research and Training Hospital for Psychiatry, Neurology and Neurosurgery. Patients were initially evaluated by Young Mania Rating Scale (YMRS), Montgomery-Asperg Depression Rating Scale (MADRS), Scales for Assessment of Positive Symptoms. Patients were also evaluated by Childhood Trauma Questionnaire (CTQ) and Dissociative Experiences Scale in euthymia which was defined by scores of < 7 in YMRS, < 4 in MADRASResultsThere were no differences between the patients with and without a history of psychotic episode in terms of age at onset, duration of illness and episode characteristics. Patients with a history of psychotic episode were hospitalized more. CTQ physical abuse scores were higher in male comparing to female. CTQ sexual abuse scores were higher in female comparing to male. CTQ emotional abuse, physical neglect, physical abuse and total scores were higher in patients who had at least one psychotic episode in lifetime than in patients without a history of psychotic episode.ConclusionThe history of childhood trauma should be investigated and therapeutic interventions for childhood trauma should be added to the standard treatment plan of bipolar patients.
Pharmacological treatment prescribed to the hospitable discharge in the patients with diagnosis of two-pole disorder, current maniacal episode con/without psychotic symptoms
Authors: Paez M.I.N. 
Published: May 2011

IntroductionThe two-pole disorder is one of the diagnoses more prevalent to the hospitable revenue of the patients in the UHSM-HUSC. Nowadays there is scanty the knowledge of the pat physiology of this disease. Therefore, in the last years an advance has taken place in the different pharmacological therapies used for this disorder, being variable the current available evidence.AimsTo analyze the prescription to the hospitable discharge of lithium, anti-epileptic, antipsychotic atypical medicaments and antipsychotic typical in patients.MethodsWe realize a descriptive retrospective study of the prescribed treatments. The different alternatives of treatment analyzed are: antipsychotic atypical medicament, antipsychotic typical medicament, lithium and anti-epileptic in monotherapy or mixed. We use as sample all the patients’ income that have the criteria of two-pole Disorder, current maniacal episode con/without psychotic symptoms according to the CIE-10 that have taken place in the triennium in the UHSM-HUSC of Granada. The obtained information was submitted to statistical analysis(SPSS v.16.0)ResultsThe medicaments prescribed with more frequency are the lithium in monotherapy or partner to antipsychotic atypical being the trend the use of the acid valproico in monotherapy or from concomitant form to antipsychotic atypical. The medicaments fewer employees are the acid valproico and the antipsychotic atypical ones in monotherapy.ConclusionsIt was prescribed as treatment to the hospitable discharge in patients during the triennium principally lithium or acid valproico partners to antipsychotic atypical being the trend the use of acid valproico associated to antipsychotic atypical. The use of antipsychotic typical was more limited.
Bipolar disorder in childhood and adolescence
Authors: Paixão L. , Avelino M.J. , Barroso C. 
Published: May 2011

IntroductionThe diagnosis of Bipolar Disorder (BD) is still controversial in the early stages of life, not only because of its difficulty, but also because of the precaution of professionals with this diagnosis, since it is a chronic illness.AimsTo review and synthesize available information about paediatric BD.MethodsThe authors consulted, selected and reviewed information concerning the theme, mainly searched on-line articles.ResultsIt is difficult to diagnose BD in youths, considering the fewer specific symptoms and the high co-morbidity.ConclusionsDespite some disagreement on this diagnosis, BD is a valid clinical entity in children and adolescents.
P01-244-Mood-dependent changes of serum lithium concentration in a rapid cycling patient maintained on stable doses of lithium carbonate
Authors: Rittmannsberger H. , Malsiner-Walli G. 
Published: May 2011

IntroductionSerum concentration of lithium may change according to mood states in bipolar patients, leading to reduced serum levels of lithium during manic periods.Objective/aimsDocumentation of mood states and serum lithium levels in a rapid cycling patientMethodsWe report about a 58 year old female patient with rapid cycling disorder whose mood altered every 20 to 30 days. No treatment has been effective until now. The patient is treated with a stable combination of clozapine 200mg, valproate 1500mg and lithium carbonate 450mg. Noncompliance can be ruled out since intake of medication is supervised. For 13 months a mood diary was performed by a relative using a simple scale for mood which rated neutral mood with 0, mania with +1, +2 and +3 (highest mania) and depression from -1 to -3 (deepest depression). Lithium levels were obtained first on a monthly, later on a weekly to two-weekly basis.ResultsOver a period of 13 months 7 depressive and 6 manic phases could be observed. The patient spent 230 (48%) days in depression (8 lithium samples obtained), 137 (29%) in mania (11 samples) and was euthymic on 68 (16%) days (2 samples). Mean lithium serum levels were 0.68mmol/l in depressive states, 0.37 mmol/l in manic states (p = .001, t-test). The lowest value was 0.13 mmol/l (in mania) and the highest 0.93 mmol/l (in depression).ConclusionsIn this patient mood-dependent changes of serum lithium levels during constant medication could be demonstrated. The reasons for this phenomenon are yet to be elucidated.
P01-245-Substance related disorder among bipolar patients
Authors: Samimi Ardestani S.M. , Razjouyan K. , Ramezani F. 
Published: May 2011

IntroductionBipolar disorder (BPD) is a common, severe, and persistent psychiatric illness affecting 1.3% to 1.7% of the population. Substance use disorders (SUDs) are also common. A community-based study found a lifetime prevalence of 17% for alcohol abuse or dependence and 6% for other substances. BPD and SUDs occur together more frequently than would be expected by chance alone.ObjectivesThis study was conducted to determine the pattern of substance abuse among Iranian bipolar disorder inpatients.AimsWe reviewed the history of patients who admitted with bipolar diagnosis in any phase to determine types of substance usage.Methods and materialsThis descriptive-analytical cross-sectional study on existing data, conducted among 322 patients with bipolar disorder attending to Imam-Hossein Hospital. The clinical records of each patient was assessed for any type of substance or alcohol related disorders.Results84 patients (26.1%) had substance use disorders. 40.5% were using opioids, 6% mood-elevators, 7.1% alcohol, and 46.4% were using multiple substances. The mean duration of substance abuse was 104 months plus 23 days.ConclusionsTotally, it may be concluded that substance abuse frequency among patients with bipolar disorder is high and may lead to deteriorated prognosis. Substances can also distort the clinical feature and course of the disorder and may create difficulties in correct diagnosis
P01-249-Weight change and metabolic effects of asenapine in placebo- or olanzapine-controlled studies
Authors: Zhao J. , Cazorla P. , Schoemaker J. , Mackle M. , Panagides J. , Karson C. , Szegedi A. 
Published: May 2011

IntroductionWeight change and metabolic effects of atypical antipsychotics vary considerably.ObjectiveAssess weight and metabolic effects of asenapine in adults.AimDemonstrate that asenapine marketed doses are well tolerated compared with placebo or olanzapine.MethodsData were from pooled asenapine trials that used placebo (1748 patients; duration: 1−6 wk) and/or olanzapine (3430 patients; duration, 3−>100 wk) controls. Asenapine doses were 5 or 10 mg BID (2–20 mg BID in 2 studies); olanzapine doses were 5–20 mg QD. Post hoc inferential analyses based on ANOVA assessed change from baseline weight, body mass index, and fasting lipid and glucose levels.ResultsTable 1 summarizes the results.[Change From Baseline Weight and Metabolic Paramete]DiscussionThese post hoc pooled analyses support published reports and suggest asenapine was associated with moderate weight gain and increased fasting triglyceride and glucose levels vs placebo, but lower propensity for weight gain or increased serum lipids (ie, triglycerides, low-density lipoprotein, and cholesterol) vs olanzapine.
Meta-analyses of the efficacy of asenapine vs placebo in bipolar I disorder as monotherapy and adjunct therapy compared with other atypical antipsychotics
Authors: Fennema H. , Slaap B. , Karson C. , Szegedi A. 
Published: May 2011

IntroductionSuperiority of asenapine vs placebo, as monotherapy or adjunctive therapy to lithium or valproate, for acute bipolar mania has previously been reported.ObjectivePresent meta-analyses of asenapine compared with atypical antipsychotics based on placebo-controlled trials.AimFurther demonstrate the efficacy of asenapine for acute bipolar mania.MethodsThe primary endpoint was change from baseline vs placebo on Young Mania Rating Scale (YMRS) total score at treatment week 3. Data for asenapine (5 or 10 mg BID) and comparators were obtained from all monotherapy (n = 20) or adjunctive treatment trials in patients showing incomplete response to lithium or valproate monotherapy (n = 10) published at the time of the analysis. Meta-analyses used a random-effects model described by DerSimonian and Laird (Control Clin Trials 1986;7:177–188).ResultsTreatment effects varied substantially across agents and for individual agents across trials. For monotherapy, the change from baseline in YMRS total score with asenapine exceeded placebo by 4.5 points (95% CI, 2.5–6.4; p < 0.0001); this was comparable to the treatment effect of all comparators vs placebo (4.9 points; 95% CI, 3.8–6.0). The treatment effect for adjunctive asenapine exceeded placebo by 2.4 points (95% CI, 0.5–4.3); this was also comparable to the overall treatment effect for the combined comparators (2.7 points; 95% CI, 2.0–3.3).DiscussionThese meta-analyses demonstrate statistical superiority of asenapine over placebo, as monotherapy or adjunctive therapy, for acute bipolar mania. Further, they reveal that the efficacy of asenapine is similar to that of other atypical antipsychotics used as monotherapy or adjunctive therapy.
The temperaments: Its knowledge is a crucial way in early diagnosis of bipolar disorders
Authors: Tavormina G.T. 
Published: May 2011

BackgroundAn observational study of the diagnosis of 300 consecutive new patients in a period of four years led to the main observation of a high percentage of bipolar spectrum diagnosis (4), followed to a new classification of “the bipolar spectrum” (ten sub-types of bipolar spectrum mood).Inside these sub-types also the temperaments have been inserted, even if they are only sub-clinical aspects of the bipolar spectrum (sub-threshold forms).MethodsWith the same method (the diagnostic method was based on an analysis of clinical interviews and personal history of the illness) and with the same aims, others 123 consecutive new patients have been valued for the other subsequential two years; then, all the 423 patients of the six years evaluation have been revalued to put in evidence the presence of their temperaments, emerging from their personal anamnesis.ResultsIt appears clear that significantly more patients within the series appear to have a soft bipolar illness than a major unipolar depression; the depressive episodes are now considered as only one phase of bipolar spectrum. Besides, every patient with bipolar spectrum disorder already presented in their personal history of the illness a sub-clinical evidence of one temperament (hyperthymic temper.: 35%; cyclothymic temper.: 49%; depressive temper.: 16%).ConclusionsThe subthreshold presence of the temperaments in the history of the patients with bipolar spectrum disorders allow us to consider this crucial way for early diagnosis of bipolar spectrum mood disorders.
Screening of bipolarity in a depressed population
Authors: Touhami M. , Ouriaghli F. , Manoudi F. , Asri F. 
Published: May 2011

IntroductionIt's not always evident to diagnose a bipolar disorder.The difficulties of diagnosis have been demonstrated by several studies, some of which have shown that one out of two bipolars consulted at least three health professionals before receiving a proper diagnosis, with an average period of 10 years evolution prior to diagnosis. hypomania is often experienced by patients as a pleasant experience and not a pathological one, rarely have they reported this phenomenon spontaneously. Thus, the diagnosis of hypomania or BP-II disorder is not established in 50% of cases.Aimsto find the prevalence of bipolar disorder type II in a population of depressed people in order to highlight the role of scales in the early identification of this disease often under-diagnosed.Methodsa prospective study of screening for a history of hypomania in a population of patients hospitalized for consultants or major depressive episode or recurrent depressive disorder; over a period of three monthsThe diagnoses of MDE and RDD were prepared according to the DSM-IV.TR.The screening tool is the Hypomania Checklist (HCL French version) which was completed by patients or by the psychiatrist of illiterate patients after its translation into Arabic dialectResults:Sample of 35 patients: 20 women and 15 men, average age: 34 years; Composed of 25 RDD and 10 MED15 patients answered “yes” to 10 or more items of the HCL-20, hypomanic history was confirmed by a clinical interview in 13 of them