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The British Journal of Psychiatry : the... Aug 2023The long-awaited 11th revision of the International Classification of Diseases (ICD-11) makes important advances but simultaneously compromises on some aspects, which...
The long-awaited 11th revision of the International Classification of Diseases (ICD-11) makes important advances but simultaneously compromises on some aspects, which may have a negative impact on clinical practice. This editorial illustrates the double-edged nature of some of the changes in ICD-11, focusing on mood disorders and specifically the subtyping of bipolar disorder.
Topics: Humans; Bipolar Disorder; International Classification of Diseases; Mood Disorders
PubMed: 37525999
DOI: 10.1192/bjp.2023.66 -
European Archives of Psychiatry and... Mar 2018Major depressive disorder (MDD) remains the most prevalent mental disorder and a leading cause of disability, affecting approximately 100 million adults worldwide. The... (Review)
Review
Major depressive disorder (MDD) remains the most prevalent mental disorder and a leading cause of disability, affecting approximately 100 million adults worldwide. The disorder is characterized by a constellation of symptoms affecting mood, anxiety, neurochemical balance, sleep patterns, and circadian and/or seasonal rhythm entrainment. However, the mechanisms underlying the association between chronobiological parameters and depression remain unknown. A PubMed search was conducted to review articles from 1979 to the present, using the following search terms: "chronobiology," "mood," "sleep," and "circadian rhythms." We aimed to synthesize the literature investigating chronobiological theories of mood disorders. Current treatments primarily include tricyclic antidepressants and selective serotonin reuptake inhibitors, which are known to increase extracellular concentrations of monoamine neurotransmitters. However, these antidepressants do not treat the sleep disturbances or circadian and/or seasonal rhythm dysfunctions associated with depressive disorders. Several theories associating sleep and circadian rhythm disturbances with depression have been proposed. Current evidence supports the existence of associations between these, but the direction of causality remains elusive. Given the existence of chronobiological disturbances in depression and evidence regarding their treatment in improving depression, a chronobiological approach, including timely use of light and melatonin agonists, could complement the treatment of MDD.
Topics: Antipsychotic Agents; Chronobiology Disorders; Chronobiology Phenomena; Humans; Mood Disorders; PubMed
PubMed: 28894915
DOI: 10.1007/s00406-017-0835-5 -
Current Opinion in Psychology Aug 2020Women experience increased vulnerability for both mood and sleep disorders, and the female menstrual cycle represents one fundamental mechanism related to risk. This... (Review)
Review
Women experience increased vulnerability for both mood and sleep disorders, and the female menstrual cycle represents one fundamental mechanism related to risk. This review evaluates recent literature integrating female reproduction, sleep, and mood. For as many as one third of women, sleep is disrupted premenstrually, and sleep disturbances are particularly prevalent in those with premenstrual mood disorders. Variation in sleep patterns, circadian rhythm alterations, and decreased melatonin secretions due to hormonal fluctuations during the premenstrual phase of the menstrual cycle could explain sleep complaints and have been linked to menstrual irregularity. Menstrual irregularity is also independently associated with increased risk of mood complaints and poor sleep. Therefore, there is growing evidence for the interactional relationships between poor sleep, circadian rhythm disruption, and mood in reproductive-age women, although further research relating to specific mechanisms of risk are needed.
Topics: Circadian Rhythm; Female; Humans; Menstrual Cycle; Mood Disorders; Sleep; Women's Health
PubMed: 31610482
DOI: 10.1016/j.copsyc.2019.09.003 -
Psychiatria Polska 2015This paper looks at some recent developments in the official diagnostic definitions (DSM-5) and in the research domain. The spectrum concept of mood disorders consists... (Review)
Review
This paper looks at some recent developments in the official diagnostic definitions (DSM-5) and in the research domain. The spectrum concept of mood disorders consists of the components of depression and mania, alone or in combination, on a continuum. Its international operational classification changes regularly, being based on symptoms, their duration and consequences. Causation is as yet unknown. DSM-5 excludes unipolar mania and mania with mild depression as separate diagnoses (they come under bipolar I and bipolar II disorders) and introduces a new hierarchy of manic symptoms, placing energy/activity above mood (elated, irritable). This is shown to be problematic on the basis of recent data. The validity of the duration criteria for mania (1 week), hypomania (4 days) and depression (2 weeks) is also seriously questioned. Shorter episodes are clinically very relevant. The definition of mania/hypomania is a persistent problem, contributing to frequent un- derdiagnosis of bipolar disorder in depressed patients. Other contributory factors include that patients often do not feel ill or seek treatment for the consequences of their high mood, and that hypomania can be hidden by substance use disorders (SUD). Hidden hypomanic syndromes are important because associated with treatment resistance, high comorbidity with anxiety/panic and SUD, psychotic and cognitive symptoms, dementia and higher mortality. Anxiety, too, is doubtless a mood disorder but there is still no concept which integrates anxiety with bipolar disorder and depression.
Topics: Behavioral Symptoms; Bipolar Disorder; Diagnostic Errors; Diagnostic and Statistical Manual of Mental Disorders; Humans; Medical History Taking; Prevalence
PubMed: 26488343
DOI: 10.12740/PP/58259 -
Current Opinion in Psychiatry Jan 2022The present review aims to examine, summarize and update information on the sociodemographic and cultural determinants of mood disorders. (Review)
Review
PURPOSE OF REVIEW
The present review aims to examine, summarize and update information on the sociodemographic and cultural determinants of mood disorders.
RECENT FINDINGS
Known sociodemographic and cultural determinants continue to be good predictors of the risk of developing a mood disorder over the lifetime. Polygenic risk scores do not appear to offer any advantages over these determinants at present. There is also new and emerging understanding of the role of lifestyle and environmental factors in mediating vulnerability to mood disorder. The influence of ethnicity and migration, on the other hand, is far more complex than initially envisaged.
SUMMARY
Recent evidence on sociodemographic determinants of mood disorders confirms associations derived from existing literature. There is also new and emerging evidence on how quality of sleep, diet and the environment influence risk of mood disorders. Culture and ethnicity, depending on context, may contribute to both vulnerability and resilience. Socioeconomic deprivation may be the final common pathway through which several sociodemographic and cultural determinants of mood disorders act.
Topics: Diet; Humans; Life Style; Mood Disorders
PubMed: 34812742
DOI: 10.1097/YCO.0000000000000766 -
Bipolar Disorders Nov 2018The treatment of mood disorders remains sub-optimal. A major reason for this is our lack of understanding of the underlying pathophysiology of depression and bipolar... (Review)
Review
OBJECTIVES
The treatment of mood disorders remains sub-optimal. A major reason for this is our lack of understanding of the underlying pathophysiology of depression and bipolar disorder. A core problem is the lack of specificity of our current diagnoses. This paper discusses the history of this problem and posits a solution in the form of a more sophisticated model.
METHOD
The authors review the notable historical works that laid the foundations of mood disorder nosology; discuss the more recent influences that shaped modern diagnoses; and examine the evidence that mood disorders are characterised by multidimensional and longitudinal symptom profiles.
RESULTS
The ACE model considers mood disorders as a combination of symptoms across three domains: Activity, Cognition, and Emotion; that vary over time. This multidimensional and longitudinal perspective is consistent with the prevalence of complex clinical presentations, such as mixed states, and highlights the importance of recurrence in mood disorders.
CONCLUSIONS
The ACE model encourages researchers to characterise patients from a number of equally important perspectives and, by doing so, add specificity to the treatment of mood disorders.
Topics: Adult; Anxiety Disorders; Bipolar Disorder; Cognition Disorders; Comorbidity; Depressive Disorder, Major; Diagnosis, Differential; Diagnostic and Statistical Manual of Mental Disorders; Female; Guideline Adherence; Humans; Male; Models, Psychological; Recurrence
PubMed: 30328224
DOI: 10.1111/bdi.12700 -
Vertex (Buenos Aires, Argentina) Dec 2021Bipolar disorder is a serious and chronic mood disorder, which in extreme forms can lead to psychosis, especially in manic states. In this sense, historically, the... (Review)
Review
Bipolar disorder is a serious and chronic mood disorder, which in extreme forms can lead to psychosis, especially in manic states. In this sense, historically, the differentiation from schizophrenia has represented a real clinical challenge and a nosological dilemma. Categorical diagnostic approaches have promoted progress in the generation of consensus and the facilitation of scientific communication, but many times, they have done so to the detriment of the complexity and richness of clinical presentations. As a counterpart, the notion of the bipolar spectrum proposes a dimensional perspective, a continuum of severity in whose maximum expression alterations in the content of thought or sensory perception can stand out. Schizotype, where these manifestations can be found, has long been pointed out as a series of personality characteristics linked to schizophrenia. But its presence can be verified in other areas of psychopathology, even outside it. Regarding its presence in mood disorders, schizotypal traits, instead of being a marker of a worse prognosis, could be related to positive aspects such as creativity. The objective of this work is to investigate, through a bibliographic review, the association between schizotypy and bipolar disorder, mainly its possible role in the creative processes associated with this pathology.
Topics: Bipolar Disorder; Humans; Mood Disorders; Psychotic Disorders; Schizophrenia; Schizotypal Personality Disorder
PubMed: 35041728
DOI: 10.53680/vertex.v32i154.110 -
Perspectives on Psychological Science :... Nov 2017Although the belief that creativity is related to psychopathology is prevalent, empirical evidence is limited. Research findings relating to mood disorder in particular... (Meta-Analysis)
Meta-Analysis Review
Although the belief that creativity is related to psychopathology is prevalent, empirical evidence is limited. Research findings relating to mood disorder in particular are mixed, possibly as a result of differing research approaches (e.g., assessing the creativity of individuals with versus without mood disorder opposed to the prevalence of mood disorder in creative versus noncreative individuals). Therefore, a systematic review and meta-analysis were conducted to investigate prior research examining the link between mood disorder and creativity from three distinct research approaches. Multilevel random effects models were used to calculate the overall effect size for studies that assessed (a) creativity in a clinical versus nonclinical sample ( k = 13), (b) mood disorder in a creative versus noncreative sample ( k = 10), and (c) the correlation between dimensional measures of creativity and mood disorder symptoms ( k = 15). Potential moderators were examined using meta-regression and subgroup analyses, as significant heterogeneity was detected among the effects in all three analyses. Results reveal a differential strength and pattern of effects across the three analyses, suggesting that the relationship between creativity and mood disorder differs according to the research approach. The theoretical implications of results and potential mechanisms responsible for the relationship between creativity and mood disorder are discussed.
Topics: Creativity; Humans; Mood Disorders
PubMed: 28934560
DOI: 10.1177/1745691617699653 -
The Psychiatric Clinics of North America Mar 2024This article reviews the literature on mood disorders and sleep disorders among children and adolescents. Research suggests that sleep plays an important role in the... (Review)
Review
This article reviews the literature on mood disorders and sleep disorders among children and adolescents. Research suggests that sleep plays an important role in the development, progression, and maintenance of mood disorder symptoms among children and adolescents. Sleep problems as early as maternal perinatal insomnia may predict and predate depression among youth. Children and adolescents who develop comorbid mood disorders and sleep problems represent a particularly high-risk group with more severe mood episode symptoms, higher rates of self-harm and suicidality, and less responsivity to treatment. Treatment research supports the idea that sleep problems can be improved through behavioral interventions.
Topics: Female; Pregnancy; Child; Humans; Adolescent; Mood Disorders; Sleep Initiation and Maintenance Disorders; Sleep; Sleep Wake Disorders; Suicidal Ideation
PubMed: 38302210
DOI: 10.1016/j.psc.2023.06.016 -
Advances in Experimental Medicine and... 2021Altered behavioral rhythms are a fundamental diagnostic feature of mood disorders. Patients report worse subjective sleep and objective measures confirm this,...
Altered behavioral rhythms are a fundamental diagnostic feature of mood disorders. Patients report worse subjective sleep and objective measures confirm this, implicating a role for circadian rhythm disruptions in mood disorder pathophysiology. Molecular clock gene mutations are associated with increased risk of mood disorder diagnosis and/or severity of symptoms, and mouse models of clock gene mutations have abnormal mood-related behaviors. The mechanism by which circadian rhythms contribute to mood disorders remains unknown, however, circadian rhythms regulate and are regulated by various biological systems that are abnormal in mood disorders and this interaction is theorized to be a key component of mood disorder pathophysiology. A growing body of evidence has begun defining how the interaction of circadian and neurotransmitter systems influences mood and behavior, including the role of current antidepressants and mood stabilizers. Additionally, the hypothalamus-pituitary-adrenal (HPA) axis interacts with both circadian and monoaminergic systems and may facilitate the contribution of environmental stressors to mood disorder pathophysiology. The central role of circadian rhythms in mood disorders has led to the development of chronotherapeutics, which are treatments designed specifically to target circadian rhythm regulators, such as sleep, light, and melatonin, to produce an antidepressant response.
Topics: Animals; Circadian Rhythm; Humans; Melatonin; Mice; Mood Disorders; Pituitary-Adrenal System; Sleep
PubMed: 34773231
DOI: 10.1007/978-3-030-81147-1_9