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Brain Sciences Feb 2023Previous research suggests that there is a link between perfectionism and symptoms of depression. This study aimed to see if different types of perfectionism are linked... (Review)
Review
BACKGROUND
Previous research suggests that there is a link between perfectionism and symptoms of depression. This study aimed to see if different types of perfectionism are linked differently to symptoms of depression in mood disorders and if there is a relationship between perfectionism and symptoms of mania in bipolar disorder.
METHODS
A systematic search was conducted in the databases PsycINFO, EMBASE, Web of Science, and PubMed to find papers which examined the relationship in clinical depression and bipolar disorder. A meta-analysis pooled the correlation effect sizes for mood symptoms severity and the severity of the perfectionism subtype.
RESULTS
Twelve papers were included in the review, with five of these being included in the meta-analysis. The meta-analysis found statistically significant positive correlations between greater severity of depression symptoms and more severe perfectionism for the following subtypes: concern over mistakes, doubts about actions, other-oriented perfectionism, parental criticism, self-oriented perfectionism, and socially prescribed perfectionism. There was no significant relationship between depression symptoms and perfectionism subtypes of organisation and personal standards. There were not enough studies reporting data for manic symptoms for the meta-analysis or for any firm conclusions to be drawn.
CONCLUSIONS
The relationship between depression and perfectionism differs depending on the particular type of perfectionism examined. Most studies were cross-sectional and correlational, so causation cannot be inferred, and future longitudinal studies are needed.
PubMed: 36979187
DOI: 10.3390/brainsci13030377 -
Clinical Psychological Science : a... Mar 2023Adolescence is critical period of neurocognitive development as well as increased prevalence of mood pathology. This cross-sectional study replicated developmental...
Adolescence is critical period of neurocognitive development as well as increased prevalence of mood pathology. This cross-sectional study replicated developmental patterns of neurocognition and tested whether mood symptoms moderated developmental effects. Participants were 419 adolescents (=246 with current mood disorders) who completed reward learning and executive functioning tasks, and reported on age, puberty, and mood symptoms. Structural equation modeling revealed a quadratic relationship between puberty and reward learning performance that was moderated by symptom severity: in early puberty, adolescents reporting higher manic symptoms exhibited heightened reward learning performance (better maximizing of rewards on learning tasks), whereas adolescents reporting elevated anhedonia showed blunted reward learning performance. Models also showed a linear relationship between age and executive functioning that was moderated by manic symptoms: adolescents reporting higher mania showed poorer executive functioning at older ages. Findings suggest neurocognitive development is altered in adolescents with mood pathology and suggest directions for longitudinal studies.
PubMed: 37309523
DOI: 10.1177/21677026221111389 -
British Journal of Pharmacology Sep 2022Rats emit 50-kHz ultrasonic vocalizations (USV) in appetitive situations, reflecting a positive affective state. Particularly high rates of 50-kHz USV are elicited by... (Review)
Review
Rats emit 50-kHz ultrasonic vocalizations (USV) in appetitive situations, reflecting a positive affective state. Particularly high rates of 50-kHz USV are elicited by the psychostimulant d-amphetamine. Exaggerated 50-kHz USV emission evoked by d-amphetamine is modulated by dopamine, noradrenaline and 5-hydroxytyrptamine receptor ligands and inhibited by the mood stabilizer lithium, the gold standard anti-manic drug for treating bipolar disorder. This indicates that exaggerated 50-kHz USV emission can serve as a reliable and valid measure for assessing mania-like elevated mood in rats with sufficient translational power for gaining a better understanding of relevant pathophysiological mechanisms and the identification of new therapeutic targets. The improved capacity to study the effects of anti-manic pharmacological interventions on a broader range of behaviours by including exaggerated 50-kHz USV emission as preclinical outcome measure complementary to locomotor hyperactivity will refine rodent models for mania. LINKED ARTICLES: This article is part of a themed issue on New discoveries and perspectives in mental and pain disorders. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v179.17/issuetoc.
Topics: Amphetamine; Animals; Antimanic Agents; Dextroamphetamine; Mania; Rats; Ultrasonics; Vocalization, Animal
PubMed: 33830495
DOI: 10.1111/bph.15487 -
Journal of Psychiatric Research Jun 2022Sleep disturbances are a key feature of bipolar disorder (BD), and poor sleep has been linked to mood symptoms. Recent use of ecological momentary assessment (EMA) has...
Sleep disturbances are a key feature of bipolar disorder (BD), and poor sleep has been linked to mood symptoms. Recent use of ecological momentary assessment (EMA) has allowed for nuanced exploration of the sleep-mood link; though, the scale and directionality of this relationship is still unclear. Using EMA, actigraphy, and self-reported sleep measures, this study examines the concurrent and predictive relationships between sleep and mood. Participants with BD (n = 56) wore actigraphy devices for up to 14 days and completed validated scales and daily EMA surveys about mood and sleep quality. Linear mixed models were used to examine overall and time-lagged relationships between sleep and mood variables. EMA mood ratings were correlated with validated rating scales for depression, mania, anxiety, and impulsivity. Poor self-reported sleep quality was associated with worse overall ratings of sadness and anger. Worse self-reported sleep quality was associated with greater sadness the following day. Higher daytime impulsivity was associated with worse sleep quality the following night. Exploratory analyses found relationships between worse and more variable mood (sadness, anger, and impulsivity) with worse and more variable sleep that evening (efficiency, WASO, and sleep onset time). The sample size was modest, fairly homogenous, and included mainly euthymic persons with BD. EMA-based assessments of mood and sleep are correlated with validated scale scores and provide novel insight into intra-individual variability. Further work on the complex two-way interactions between sleep and mood is needed to better understand how to improve outcomes in BD.
Topics: Actigraphy; Affect; Bipolar Disorder; Ecological Momentary Assessment; Humans; Sleep; Sleep Initiation and Maintenance Disorders
PubMed: 35405410
DOI: 10.1016/j.jpsychires.2022.03.055 -
Journal of Affective Disorders Feb 2022Impulsivity and sleep and circadian rhythm disturbance are core features of bipolar spectrum disorders (BSDs) that are antecedents to onset and persist even between mood...
Impulsivity and sleep and circadian rhythm disturbance predict next-day mood symptoms in a sample at high risk for or with recent-onset bipolar spectrum disorder: An ecological momentary assessment study.
BACKGROUND
Impulsivity and sleep and circadian rhythm disturbance are core features of bipolar spectrum disorders (BSDs) that are antecedents to onset and persist even between mood episodes; their pervasive presence in BSD suggests that they may be particularly relevant to understanding BSD onset and course. Considerable research demonstrates bidirectional associations between impulsivity and sleep disturbance in healthy individuals; thus, it is important to examine how these features interact to impact BSD symptomatology.
METHODS
Young adults (N = 107, 55% female, M age = 21.82 years) at high risk for developing BSD (based on high self-reported reward sensitivity) or with recent-onset BSD participated in ecological momentary assessment (EMA) to examine relationships between impulsivity, sleep and circadian rhythm alterations, and mood symptoms in everyday life. Impulsivity was measured via self-report/behavioral task, sleep was measured via actigraphy, circadian rhythms were measured via dim light melatonin onset (DLMO) time, and mood symptoms were measured three times daily via self-report.
RESULTS
Multi-level modeling revealed that less total sleep time predicted increased next-day mood symptoms. Moreover, DLMO, total sleep time, and sleep onset latency moderated the relationship between impulsivity and EMA-assessed mood symptoms. Fewer minutes of sleep and later DLMO strengthened the positive relationship between impulsivity and mood symptoms.
LIMITATIONS
Mood symptoms in our sample were mild; future studies should replicate findings in populations with more severe mood symptoms.
CONCLUSIONS
This multi-method assessment of dynamic relationships revealed novel associations between impulsivity, sleep and circadian rhythm disturbance, and symptoms within individuals at high-risk for or with recent-onset BSD.
Topics: Adult; Bipolar Disorder; Circadian Rhythm; Ecological Momentary Assessment; Female; Humans; Impulsive Behavior; Male; Melatonin; Sleep; Young Adult
PubMed: 34728283
DOI: 10.1016/j.jad.2021.08.155 -
Bipolar Disorders Dec 2021Bipolar disorder (BP) is commonly researched in digital settings. As a result, standardized digital tools are needed to measure mood. We sought to validate a new survey...
OBJECTIVES
Bipolar disorder (BP) is commonly researched in digital settings. As a result, standardized digital tools are needed to measure mood. We sought to validate a new survey that is brief, validated in digital form, and able to separately measure manic and depressive severity.
METHODS
We introduce a 6-item digital survey, called digiBP, for measuring mood in BP. It has three depressive items (depressed mood, fidgeting, fatigue), two manic items (increased energy, rapid speech), and one mixed item (irritability); and recovers two scores (m and d) to measure manic and depressive severity. In a secondary analysis of individuals with BP who monitored their symptoms over 6 weeks (n = 43), we perform a series of analyses to validate the digiBP survey internally, externally, and as a longitudinal measure.
RESULTS
We first verify a conceptual model for the survey in which items load onto two factors ("manic" and "depressive"). We then show weekly averages of m and d scores from digiBP can explain significant variation in weekly scores from the Young Mania Rating Scale (R = 0.47) and SIGH-D (R = 0.58). Lastly, we examine the utility of the survey as a longitudinal measure by predicting an individual's future m and d scores from their past m and d scores.
CONCLUSIONS
While further validation is warranted in larger, diverse populations, these validation analyses should encourage researchers to consider digiBP for their next digital study of BP.
Topics: Affect; Bipolar Disorder; Humans; Irritable Mood; Psychiatric Status Rating Scales; Self Report; Surveys and Questionnaires
PubMed: 33587813
DOI: 10.1111/bdi.13058 -
Translational Psychiatry Apr 2022Manic episodes are a defining, frequent and dramatically disabling occurrence in the course of Bipolar Disorder type I. Current pharmacotherapy of mania lists a good... (Review)
Review
Manic episodes are a defining, frequent and dramatically disabling occurrence in the course of Bipolar Disorder type I. Current pharmacotherapy of mania lists a good number of agents, but differences in efficacy and safety profiles among these agents must be considered in order to tailor personalized therapies, especially when the long-term course of the illness is considered. There is wide room and need to ameliorate current pharmacological approaches to mania, but ongoing pharmacological research on the topic is scant. In this work we try to critically assess clinical factors and patients' characteristics that may influence the treatment choice for manic episodes. In addition, we conduct a narrative review on experimental pharmacology of bipolar mania and psychotic disorders, presenting a critical overview on agents which could represent treatment alternatives for a manic episode in the next future. Results show limited novel or ongoing research on agents acting as mood stabilizers (Ebselen, Valnoctamide and Eslicarbazepine did not reach statistical significance in demonstrating antimanic efficacy). As for the emerging experimental antipsychotic, some of them (including KarXT, SEP-363856, RO6889450, ALKS3831) have demonstrated good antipsychotic efficacy and a favorable safety profile, but little is known about their use in patients with bipolar disorder and specifically designed trials are needed. Lastly, some benefits for the treatment of mania could be expected to come in the next future from non-mood stabilizers/non-antipsychotic agents (especially PKC inhibitors like Endoxifen): long-term trials are needed to confirm positive results in terms of long-term efficacy and safety.
Topics: Anticonvulsants; Antimanic Agents; Antipsychotic Agents; Bipolar Disorder; Humans; Mania; Psychotic Disorders
PubMed: 35461339
DOI: 10.1038/s41398-022-01928-8 -
Frontiers in Immunology 2021Tryptophan catabolites (TRYCATs) are implicated in the pathophysiology of mood disorders by mediating immune-inflammation and neurodegenerative processes. We performed a... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
Tryptophan catabolites (TRYCATs) are implicated in the pathophysiology of mood disorders by mediating immune-inflammation and neurodegenerative processes. We performed a meta-analysis of TRYCAT levels in bipolar disorder (BD) patients compared to healthy controls.
METHODS
A systematic literature search in seven electronic databases (PubMed, Embase, Web of Science, Cochrane, Emcare, PsycINFO, Academic Search Premier) was conducted on TRYCAT levels in cerebrospinal fluid or peripheral blood according to the PRISMA statement. A minimum of three studies per TRYCAT was required for inclusion. Standardized mean differences (SMD) were computed using random effect models. Subgroup analyses were performed for BD patients in a different mood state (depressed, manic). The methodological quality of the studies was rated using the modified Newcastle-Ottawa Quality assessment Scale.
RESULTS
Twenty-one eligible studies were identified. Peripheral levels of tryptophan (SMD = -0.44; < 0.001), kynurenine (SMD = - 0.3; = 0.001) and kynurenic acid (SMD = -.45; = < 0.001) were lower in BD patients versus healthy controls. In the only three eligible studies investigating TRP in cerebrospinal fluid, tryptophan was not significantly different between BD and healthy controls. The methodological quality of the studies was moderate. Subgroup analyses revealed no significant difference in TRP and KYN values between manic and depressed BD patients, but these results were based on a limited number of studies.
CONCLUSION
The TRYCAT pathway appears to be downregulated in BD patients. There is a need for more and high-quality studies of peripheral and central TRYCAT levels, preferably using longitudinal designs.
Topics: Bipolar Disorder; Depression; Humans; Inflammation; Kynurenic Acid; Kynurenine; Tryptophan
PubMed: 34093561
DOI: 10.3389/fimmu.2021.667179 -
Journal of Psychiatric Research Sep 2021Many of the existing models of mood in bipolar disorder can largely be divided into two camps, tracking mood as either a discrete or continuous variable. Both groups...
Many of the existing models of mood in bipolar disorder can largely be divided into two camps, tracking mood as either a discrete or continuous variable. Both groups rely upon certain assumptions, with most considering only aggregate scores on clinical instruments. In this study, we propose a novel framework that combines elements from both discrete and continuous mood models, using a machine learning pipeline to detect subtle patterns across individuals. Latent factors are constructed from assessments at the item level, then clustered into groups referred to as microstates. Transitions between microstates are captured via a discrete-time Markov chain, allowing for characterization of mood's dynamic nature. Key findings include a factor mapping heavily onto irritability and aggression, as well as a hierarchical pattern of microstates within depression and mania. Validity of these results is confirmed by reproduction in an unseen data set from a separate subject cohort.
Topics: Affect; Aggression; Bipolar Disorder; Humans; Irritable Mood
PubMed: 34304043
DOI: 10.1016/j.jpsychires.2021.07.021 -
Cureus Jul 2021Lithium is a common mood-stabilizing drug for manic patients. We describe a case of sinoatrial node dysfunction in a patient with serum lithium levels within the...
Lithium is a common mood-stabilizing drug for manic patients. We describe a case of sinoatrial node dysfunction in a patient with serum lithium levels within the therapeutic range. Given the symptomology and severity of the patient's illness, after placing a permanent pacemaker, the patient was discharged on the preadmission dose of lithium.
PubMed: 34513385
DOI: 10.7759/cureus.16778