bluuebunny/crossref_metadata_2025_split huggingface dataset:
Euthymic bipolar disorder: Are there cognitive dysfunctions?
Authors: Da Ponte G. , Neves T. , Lobo M. 
Published: May 2011

IntroductionThe presence of cognitive dysfunction in bipolar disorder is well established, but in the euthymic phase appear a few studies that point to the absence of cognitive deficits.ObjectivesAlert to cases of euthymic bipolar disorder with no cognitive dysfunction.MethodsReview of relevant literature and description of a clinical case with psychological tests that assess memory and executive functions.ResultsDescription of a clinical case: FP is a middle age woman, early retired, with a bipolar disorder type 2, which begins at age 30.Her disease has several depressive episodes, and in the last 10 years, she spent most of the days lying in bed and repeatedly resorted to the emergency department for excessive voluntary drug intoxication or simply because she “wanted” to be hospitalized; her husband could not stand this situation. In September of 2009, in addition to the medical and psychological consultations, she starts attending group therapy; over the next 6 months her medication was changed and finally her disease goes into remission.The psychological tests, made at euthymic phase, show’s no significant deficits in verbal memory and executive functions.ConclusionsThis patient has a disease with prolonged course and multiple hospitalizations and drug treatments, but don’t present relevant cognitive deficits, which may point to the fact that cognitive impairment is determined by biological factors.
Antiepileptics as mood stabilizers
Authors: Danevski G. 
Published: May 2011

The field of bipolar affective disorders research now immence methodological challenges, some of which have only recently become obvious.It has become more clear that bipolar affective disorder should be viewed longitudinally rather than in terms of individual episodes. As result of these methodological challenges, more have been far a few mood stabilizers approwed for use in bipolar disorder. Lithium was the gold standard of treatment for bipolar disorder, but a number of studies over the past several decades shown that many drugs with antiepileptic properties are effective in the treatment of some patients with bipolar affective disorder, especially for those whose disorder inadequately responds to lithium, and those who are intolerant of treatment with lithium. These antiepileptic agents include two generations of drugs: cabamazepin and valproate as first generation, and lamotrigine, gabapentine and topiramate as second generation of mood stabilising antiepileptic agents. In this article are rewiew the pharmacological properties and their efficacy in the treatment of bipolar disorder.A series of 32 patients with bipolar affective disorder was reported. All patients were supervized in the Emergency psychiatry service in Psychiatric Hospital Skopje, as the greatest and most important psychiatric institution in Macedonia. We also summarise use of these agents in combination with other psychotropics.
Selective DNA methylation of BDNF promoter and nociceptin gene in bipolar disorder
Authors: dell’Osso B. , d’Addario C. , Palazzo M. , Cattaneo E. , Galimberti D. , Scarpini E. , Bresolin N. , Arosio B. , Bergamaschini L. , Candeletti S. , Romualdi P. , Altamura A.C. 
Published: May 2011

IntroductionThe etiology of bipolar disorder (BD) is still poorly understood and it has been proposed that altered expression of multiple mRNAs, affecting neurotransmission, in psychotic subjects may be due to epigenetic mechanisms (e.g., DNA methylation or histone modification).AimsThe present collaborative study was aimed to investigate, in subjects with BD, dysregulation of DNA methylation, in the brain-derived neurotrophic factor (BDNF), previously associated with psychosis and linked to epigenetic changes at promoter regions, and in the nociceptin gene (N/OFQ), a new proposed target in psychiatric disorders.MethodsDNA was isolated from blood of patients diagnosed with BD (either type I [n = 19] or II [n = 20]) according to DSM-IV criteria, and from healthy controls (n = 20) and, thereafter, bisulfite conversion was performed. Real-Time Methylation Specific PCR (MSP) was used for the quantification of the methylated promoters in all samples.ResultsA hypermethylation of BDNF promoter region was observed in BD II patients (but not in BD I) compared to controls (CONT: 19.0 ± 3.2%; BD I: 27.2 ± 4.0%; BD II: 36.3 ± 6.2% * P = 0.0167; ANOVA F = 3.464; P = 0.0384; Bonferroni’s post hoc test). No significant differences were found for DNA methylation of N/OFQ promoter.ConclusionsPresent preliminary findings suggest selective changes in DNA methylation of BDNF promoter in type II bipolar patients and highlight the importance of epigenetic factors in mediating the onset and/or susceptibility to BD, providing new insight into the mechanisms of gene expression.
P01-200-Validation of the french version of the affective disorder evaluation (ADE)
Authors: Delmas C. , Bourgeois V. , Haouzir S. , Bretel F. , Campion D. , Guillin O. 
Published: May 2011

ObjectiveDespite the number of rating scales for mood disorder and semi-structured interview in psychiatry, they are few evaluations focused on bipolar disorder. Here, we report the validation of the French version of the ADE used in STEP-BD (Systematic Treatment Enhancement Program for Bipolar Disorder) studies.MethodA total of 63 bipolar patients completed the ADE and French version of the DIGS (Diagnostic Interview for Genetic Studies). We compared the results between the two evaluations.ResultsThere was a very good concordance between the two interview for the diagnosis of the type of bipolar diagnosis (κ = 1) and non-significative difference between the age at onset. The concordance coefficient was weak for addictions: alcohol (κ = 0.22) and cannabis (κ = 0.16), for anxiety disorder: panic attacks (κ = 0.35), phobia (κ = 0.36), obsessive-compulsive disorder (κ = 0) and anorexia (κ = 0.04), but stronger for psychosis: delusion (κ = 0.78), hallucinations (κ = 0.69), suicidal attempts (κ = 0.97), violence (κ = 0.47) and bulimia (κ = 0.47).ConclusionsThe affective disorder evaluation seems to be a useful instrument in clinical practice and in psychopharmacological studies, but not when the diagnosis of comorbities is necessary.
P01-202-Assessement of relationship between affective temperaments, trait impusivity and emotional response inhibition in euthymic state of bipolar disorder
Authors: Novak T. , Dolenc B. , Sprah L. , Dernovsek M. 
Published: May 2011

IntroductionSeveral cognitive and behavioural disturbances persist in interepisodic bipolar disorder (BD). Affective temperaments may influence impairments as they contribute to the predisposition to BD and may share a common neurobiological basis with elevated trait impulsivity.AimsWe aimed to assess a relationship between temperamental traits and impulsivity as a trait and state dependent behaviour among euthymic bipolar outpatients and healthy volunteers.Methods38 euthymic bipolar outpatients and 24 healthy volunteers completed TEMPS-A and BIS-11. Computerised picture- based affective go/no-go task was applied to examine emotional response inhibition as an indicator of state dependent impulsivity.ResultsClinical group scored significantly higher than healthy volunteers on trait impulsivity and affective temperaments scales, and displayed poorer control of emotional response inhibition (Table 1). Correlation patterns were similar in both groups, with strong associations between the majority of affective temperaments and trait impulsivity components, while correlations between state dependent impulsivity measures appeared weak.ConclusionsDuring euthymia, distinctive temperament profile, elevated trait impulsivity and impaired emotional inhibition, prevailed among bipolar outpatients. This is consistent with data suggesting persistent abnormalities within specific areas of the prefrontal cortex and limbic structures which may underlie the emotional, cognitive and behavioural disturbances observed in all phases of BD.
P01-203-Motivational systems and trait impulsivity in euthymic outpatients with bipolar mood disorder and healthy volunteers
Authors: Dolenc B. , Sprah L. , Dernovsek M. 
Published: May 2011

ObjectivesAlthough previous studies have suggested that bipolar disorder symptoms could result from increased impulsivity and vulnerability of the Behavioural Activation System (BAS), the association of the Behavioural Inhibition System (BIS) with the disorder remains unclear.AimsGiven that motivational systems, especially BAS, and impulsivity are closely intertwined, we aimed to assess the associations between BIS and BAS and impulsivity among healthy volunteers and remitted bipolar outpatients.Methods70 euthymic bipolar outpatients and 70 healthy controls were self assessed with the BIS/BAS Scale and the Barratt Impulsivity Scale.ResultsOur data revealed elevated BIS and BAS sensitivity (Figure 1a) as well as impulsivity (Figure 1b) in the group of bipolar outpatients. Both motivational systems seem to be unrelated to the trait impulsivity.ConclusionsOur results indicate that BIS/BAS sensitivity and impulsivity represent a distinct trait. Furthermore, elevated BIS and BAS sensitivity and impulsivity in the euthymic phase of the disorder could represent an indicator of relatively stable personal traits which persist throughout all phases of the illness, thus signifying a vulnerability factor that could be relevant in the early diagnostic picture of affective disorders.
P01-204-Predictors of recurrence of bipolar disorder during pregnancy and postpartum period in a sample of egyptian women
Authors: Abd El-Hay M.A. , El Sawy H.F. , Badawy A.A. 
Published: May 2011

IntroductionPregnancy and the postpartum are times of increased risk for women with bipolar disorder to develop new episodes.ObjectiveTo evaluate factors that are supposed to be associated with recurrence of bipolar I disorder among euthymic women with a history of bipolar I disorder, which could be used as a predictors of bipolar I disorder in that period.MethodEighty-three pregnant women with history of bipolar I disorder were followed through pregnancy and post-partum periods for possible recurrence of a new episode. All women were assessed using the MINI International Neuropsychiatric Interview. Factors that may contribute to recurrence were assessed prospectively; these included age of patients, age of onset of bipolar disorder, duration of illness, number of previous attacks, number of previous pregnancies, prior episodes in pregnancy or postpartum, complications during pregnancy and labor, pregnancy type, prior hospitalization, prior suicidal attempts, time since last episode in months, and continuation of medications.ResultsSixty five % of euthymic bipolar females had recurrence of a new episode, either during pregnancy (33.73%) or 4 weeks postpartum (31.32%). Discontinuation of medications, longer duration of illness, more number of previous attacks, more number of previous pregnancies, more prior episodes in pregnancy, more complication during pregnancy, more complication during labor, unplanned pregnancy type, prior hospitalization, were associated with recurrence of bipolar disorder during pregnancy and postpartum.ConclusionsMultiple factors were associated with risk of recurrence of bipolar I disorder during pregnancy and postpartum, which should be while planning treatment for such women.
P01-205-Standing in the shoulders of kraeplin's excited depression: evidences that suport “treating” depressive mixed state(s) as an official nosologic entity
Authors: Fernandes J.L. , Jorge J.C. 
Published: May 2011

IntroductionKraepelin described in “manic-depressive insanity” (1899/1913) co-ocurrence of opposite polarity symptoms in mania, hypomania, and depression. A full opposite polarity syndrome was not required to diagnose mixed state(s). Actually, mixed state(s) in the official nosology - ICD-1o and DSM-IV - is essentially limited to fullblown mixed state(s) with concomitant syndromal mania and depression. Nevertheless in the past 35 years contributions of Akiskal, Benazzi, and others followed a time of opposition to Krapelin's concept of mixed states - on the part of proeminent psychiatrists, namely: Karl Jaspers and Kurt Scheneider.ObjectiveTo review knowledge about depressive mixed state(s) and its importance in clinical practice.AimTo emphasize recent evidence supporting clinical and treatment implications of depressive mixed state(s) in both unipolar and bipolar depressed patients.MethodsSciencedirect and Pubmed search of English-language papers published between January 2000 e September 2010 using and cross-listing key words: bipolar mixed states, depressive mixed state/s, mixed depression, excited depression, agitated depression and suicide.DiscussionRecently depressive mixed state(s) was “redefined” and validated as a major depressive episode with some concurrent hypomanic symptoms, its diagnostic validity supported by familiar history and its utility supported by treatment response (negative effects of antidepressants).No response, worsening and suicidality observed in some depressed patients on antidepressants may reflect the inadequacy of our current oficial nosology which fails to recognize patients for whom antidepressant therapy unprotected by mood stabilizing agents and/or atypical antipsychotics appears to be inappropriate.
P01-206-Validation of two scales of depression in mixed mania
Authors: Fernandez M. , Ugarte A. , Ruiz de Azua S. , Saenz M. , Karim Haidar M. , Ron S. , Besga A. , Gonzalez-Pinto A.M. 
Published: May 2011

IntroductionThere are manic disorders with depressive symptoms in mixed mania that do not reach the threshold for the diagnosis of mixed episode.Mania and hypomania are evaluated with scales that do not detect the depressive symptoms of patients in manic episode.ObjectivesTo determine the usefulness of HAMD-5 and MES depression scales in patients with bipolar disorder type I and II who have a manic or hypomanic episode with depressive symptoms. These scales were compared with the HAMD-21 and the MADRS scales respectively.Methods100 subjects between 18 and 65 years old were included. All patients met the DSM-IV-TR criteria for bipolar disorder with manic or hypomanic symptoms and major depression.All patients were evaluated at baseline and at 3 and 4 weeks during the follow-up.ResultsAt baseline the HAMD-5 and the MES had high reliability (α = 0.88 and α = 0,74 respectively)The test-retest reliability between the 3rd and the 4th week was great for both scales (HAMD-5: r = 0,89; p < 0,001; MES: r = 0,77; p < 0,001).The convergent validity had an acceptable level for the HAMD-5 (HAMD-21/HAMD-5 = 0,73; 95% CI 0,599–0,873) and for the MES (MADRS/MES = 0,79; 95% CI 0,766–0,894)Regarding the discriminant validity, the values for the HAMD-5 and MES were higher than for the HAMD-21 and MADRS respectively (HAM-5: AUC = 0,92, 95% CI: 0,892–0,980; MES: AUC = 0,86, 95% CI: 0,786–0,934).ConclusionsBoth scales showed an adequate correlation with the HAMD-21 and MADRS and a high capacity of detection of mixed, pure and other symptoms as their remission.
„Sms-the subjective mania scale“
Authors: Freidl M. , Friedrich F. , Kaiser G. , Wancata J. 
Published: May 2011

IntroductionNon-adherence of medication still is a major problem among patients suffering from bipolar disorders.ObjectivesPrevious studies focused mainly on possible side-effects, attitudes and subjective well-being. Most scales concerning this issue have been developed by psychiatric experts and based on their knowledge not on the patients points of view.AimsThe purpose of this study was to find out what kind of drug effects the patients themselves want.Methods2 focus-groups with 13 patients and In-depth interviews with 15 mania patients were conducted to collect information about subjective burden and symptoms of the illness. Content analyses of the transcriptions were performed and the results were used to develop a first draft of the questionnaire.ResultsThe final German test version consists of 32 items and is called “The Subjective Mania Scale”. The study of content-validity showed that all SMS items were considered to be important by more than 50% of the sample. Test-retest reliability and sensitivity to change were evaluated. All SMS-items showed a significant change between time-point 1 and 3.ConclusionThe SMS-rating scale is a feasible, reliable and valid instrument for clinical trials among mania patients.
P01-208-Prevalence of hypomania in patients with diagnosis of affective disorder
Authors: Garcia Del Castillo I. , Fernandez Mayo L. , Carmona Camacho R. , Martin Calvo M.J. , Serrano Drozdowskyj E. , Ovejero García S. , Baca García E. 
Published: May 2011

IntroductionRecent epidemiological studies suggest that the prevalence of bipolar disorder might be misdiagnosed initially as unipolar depression due to the difficulty to detect episodes of hypomania. The Hypomania Checklist (HCL-32), validated in Spanish, is a self-report questionnaire with 32 hypomania items designed to screen for hypomanic episodes.ObjectivesTo examine the prevalence of hypomania in patients with unipolar depression. Corroborate the efficacy of the HCL-32 to detect symptoms of hypomania.MethodsThe presence of hypomanic symptoms was assessed by the HCL-32 in a sample of 128 subjects diagnosed with bipolar I disorder (n = 30), bipolar II disorder (n = 1), unipolar depression (n = 57), and anxiety disorder (n = 15) according to DSM-IV-TR criteria. A control group of healthy subjects was selected (n = 25).ResultsThe discriminative capacity was analyzed by the ROC curve. The AUC was 0.65 which did not indicate a good capacity. The sensitivity (S), specificity (E) and prevalence (P) of hypomania in unipolar patients for the following cut-off points were :14: S = 81.6%,95%CI(69.8, 93.5); E = 30.1%,95%CI(19.7,40.6); P = 74.1%; 15: S = 77.6%,95%CI(64.9,90.3); E = 37.4%,95%CI(26.3,48.4); P = 67.2%; 16: S = 59.2%,95%CI(44.4,73.9); E = 55.4%,95%CI(44.1,74.0); P = 51.7%; 17: S = 55.1%,95%CI(40.2,70.1); E = 57.8%,95%CI(46.6,69.1); P = 48.3%.ConclusionsThe HCL-32 has a high sensitivity but a low specificity as screening instrument. This might explain the high proportion of hypomania found in this study. The difference with previous studies is that our sample was heterogeneous, unstable and serious. This suggests that the HCL-32 is not valid for any psychiatric sample. Future research should develop more specific instruments with better external validity.
P01-209-The comparison between manic and mixed episodes
Authors: Ghaffarinejad A. , Mirghiasi A. 
Published: May 2011

This study was designed for comparing between manic and mixed episodes and the relationship between these episodes and special scores were evaluated.This analytical - observational study was performed in Kerman Beheshti hospital / Kerman / Iran : one hundred and eighty six bipolar inpatients with diagnosis of manic and mixed episodes were included in study. They were assessed with the Young mania and Beck Depression Inventory.Frequency of pure mania was 22.6%. The mean of age of onsent was lower in mixed type (P = 0.02). Young score was higher in pure mania (p = 0.026).Spearman's correlation coefficient show strong relationship between duration of hospitalization and young score (p = 0.0001).These is significant relationship between Beck score and family history of bipolar disorder (p < 0.05). and there was significant relationship between Beck score and patient’s insight overlay,comorbidity of personality disorder was 26.3 was similar in both groups.There were significant relationships between age of onset of illness and positive familial history of bipolar disorder and major depressive disorder,and between suicidal attept and panic disorder and social phobia,however rapid cycling was higher in mixed patients significantly (p = 0.009).As far as we know This is the first study regarding relationship between bipolar subtypes and severity of mood disorders in Iran. This study is a part of a larger study including several provinces in Iran.We believed the prevalence of mixed state is not well known and in many cases it could be underdiagnosed.
P01-210-Bipolar affective disorder and dissociation – comparison with healthy controls
Authors: Latalova K. , Prasko J. , Kamaradova D. , Kovacsova A. , Grambal A. , Diveky T. , Jelenova D. , Mainerova B. , Vrbova K. 
Published: May 2011

IntroductionAccording to recent findings, certain clinical symptoms of the patients suffering from affective and anxiety disorder can be related to dissociation. The aim of our study is to examine if the level of dissociation in bipolar affective disorder differ from the level of dissociation in healthy volunteers.Methods41 patients suffering from bipolar disorder (51.2% females), and 198 healthy controls (71.2% females) were included in the study. The patients with bipolar affective disorder in remission of the illness were recruited from the Outpatient psychiatric department of Psychiatry Clinic of University hospital Olomouc. Patients were psychiatrically assessed and the state of the disorder was evaluated by experienced psychiatrist. Only patients in remission of the disorder, evaluated as 1 or 2 points of clinical global impression - severity scale, were included into the study. All participants were assessed with the Dissociative Experiences Scale (DES).ResultsThe groups didn’t differ in demographic variables like age, gender and education. Patients had significantly higher mean score on the DES and pathological DES than healthy controls.ConclusionOur results suggest that the level of psychological dissociation in bipolar affective patients is higher than in healthy controls.Supported by grant IGA MZ ČR NT11047
Incongruent psychosis in bipolar i disorder: heritability and importance for genetic association studies
Authors: Grigoroiu-Serbanescu M. , Elston R.C. 
Published: May 2011

IntroductionPhenotype homogeneity and heritability are important conditions for identifying the genetic basis of bipolar I disorder (BPI) in association studies. Our objective was to study the heritability of mood-incongruent psychosis (MIP) in BPI in a sample of 504 families ascertained through BPI probands (294 females; 210 males) recruited from consecutive hospital admissions.MethodThere were 402 families with a psychotic proband and 275 families with a proband with MIP. All probands were directly interviewed as well as 79.55% first-degree and 22.59% second-degree relatives. The narrow and the broad sense heritability (h2) of MIP and the effect of sex and age were estimated using S.A.G.E.v.6.01-software (2009).ResultsThere was no sex difference for the psychosis prevalence in probands but MIP was two times more frequent in females than in males. In families with MIP probands the narrow-sense h2 for MIP was 0.14 (SE = 0.02, P = 0.002) and the broad-sense h2 was 0.20 (SE = 0.014, P = 0.0000). Significant but lower heritabilities were found in families with a psychotic proband (narrow-sense h2 = 0.12; broad-sense h2 = 0.13). In the total sample the narrow-sense h2 was 0.06 (P < 0.005) and the broad-sense h2 was 0.10 (P < 0.00001). The female sex was more prone to incongruency (χ2 = 33.32, P = 0.0000).ConclusionThe heritability of MIP was significant but not high in families ascertained through BPI probands regardless of familial psychopathology. These finding is in line with GWAS-studies showing that the polygenic score fails to differentiate psychotic BPI from non-psychotic BPI. Is therefore incongruent psychosis a useful dimension for association studies?