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Bipolar Disorders Nov 2023This article describes the development and psychometric evaluation of the Manic Thought Inventory (MTI), a patient-driven self-report inventory to assess the presence of...
OBJECTIVE
This article describes the development and psychometric evaluation of the Manic Thought Inventory (MTI), a patient-driven self-report inventory to assess the presence of typical (hypo)manic cognitions.
METHODS
The initial item pool was generated by patients with bipolar disorder (BD) type I and assessed for suitability by five psychiatrists specialized in treating BD. Study 1 describes the item analysis and exploratory factor structure of the MTI in a sample of 251 patients with BD type I. In study 2, the factor structure was validated with confirmatory factor analysis, and convergent and divergent validity were assessed in an independent sample of 201 patients with BD type I.
RESULTS
Study 1 resulted in a 50-item version of the MTI measuring one underlying factor. Study 2 confirmed the essentially unidimensional underlying construct in a 47-item version of the MTI. Internal consistency of the 47-item version of the MTI was excellent (α = 0.97). The MTI showed moderate to large positive correlations with other measures related to mania. It was not correlated with measures of depression.
CONCLUSION
The MTI showed good psychometric properties and can be useful in research and clinical practice. Patients could use the MTI to select items that they recognize as being characteristic of their (hypo)manic episodes. By monitoring and challenging these items, the MTI could augment current psychological interventions for BD.
Topics: Humans; Bipolar Disorder; Mania; Reproducibility of Results; Psychometrics; Self Report
PubMed: 36840434
DOI: 10.1111/bdi.13311 -
Psychotherapy and Psychosomatics 2015Affective disturbances involving alterations of mood, anxiety and irritability may be early symptoms of medical illnesses. The aim of this paper was to provide a... (Review)
Review
BACKGROUND
Affective disturbances involving alterations of mood, anxiety and irritability may be early symptoms of medical illnesses. The aim of this paper was to provide a systematic review of the literature with qualitative data synthesis.
METHODS
MEDLINE, PsycINFO, EMBASE, Cochrane, and ISI Web of Science were systematically searched from inception to February 2014. Search terms were 'prodrome/early symptom', combined using the Boolean 'AND' operator with 'anxiety/depression/mania/hypomania/irritability/irritable mood/hostility', combined with the Boolean 'AND' operator with 'medical illness/medical disorder'. PRISMA guidelines were followed.
RESULTS
A total of 21 studies met the inclusion criteria and were analyzed. Depression was found to be the most common affective prodrome of medical disorders and was consistently reported in Cushing's syndrome, hypothyroidism, hyperparathyroidism, pancreatic and lung cancer, myocardial infarction, Wilson's disease, and AIDS. Mania, anxiety and irritability were less frequent.
CONCLUSIONS
Physicians may not pursue medical workup of cases that appear to be psychiatric in nature. They should be alerted that disturbances in mood, anxiety and irritability may antedate the appearance of a medical disorder.
Topics: Affect; Anxiety; Bipolar Disorder; Depression; Disease; Humans; Irritable Mood
PubMed: 25547421
DOI: 10.1159/000367913 -
European Neuropsychopharmacology : the... 2012Impairments in cognitive performance and inability to function in everyday life situations are present, in various degrees, in many severe mental illnesses, including... (Review)
Review
Impairments in cognitive performance and inability to function in everyday life situations are present, in various degrees, in many severe mental illnesses, including major depressive disorder, bipolar disorder, and schizophrenia. Persistent mood symptoms (e.g., depression and mania) are associated with functional deficits in major depression and bipolar disorder, but also in conditions where mood symptoms are not the primary markers of the illness, such as in schizophrenia. While mood symptoms impact cognitive performance, both mood symptoms and cognitive deficits have a significant - and to some extent independent - impact on psychosocial functioning in psychiatric patients. Improved control of mood symptoms may represent an important strategy leading to improved functional outcomes. However, cognitive impairment may be an important independent dimension of many psychiatric disorders and such symptoms should also be considered a potential target of treatments aiming to reduce functional deficits.
Topics: Affect; Bipolar Disorder; Cognition; Depressive Disorder; Humans; Neuropsychological Tests; Schizophrenic Psychology; Social Behavior
PubMed: 22959115
DOI: 10.1016/j.euroneuro.2012.08.002 -
The British Journal of Clinical... Mar 2024In order to understand the working mechanisms of mania, it is necessary to perform studies during the onset of manic (-like) mood states. However, clinical mania is...
OBJECTIVES
In order to understand the working mechanisms of mania, it is necessary to perform studies during the onset of manic (-like) mood states. However, clinical mania is difficult to examine experimentally. A viable method to study manic mood like states is mood induction, but mood induction tasks thus far show variable effectiveness.
METHODS
In this pilot study, a new paradigm to induce mood through virtual reality (VR) is examined. Both state characteristics, namely changes in emotion, and trait characteristics, such as high and low scores on the hypomanic personality scale (HPS), were measured in 65 students. These students participated in either a neutral VR mood induction or an activating VR mood induction in which excitement, goal directedness, and tension (being aspects of mania) were induced. All participants performed a risk-taking behavioural task, Balloon Analogue Risk Task (BART).
RESULTS
The experimental VR task induced excitement and tension. In participants with higher sensitivity to hypomanic personality (HPS), irritation increased in response to activation whereas it decreased in the low HPS group, and excitement increased more steeply in the low HPS group. There were no effects on the behavioural task.
CONCLUSIONS
The VR task is effective in inducing relevant state aspects of hypomania and is suitable as a paradigm for future experimental studies. Activation of dual affective states (excitement and tension) is an essential aspect in manic-like mood induction paradigms.
Topics: Humans; Mania; Bipolar Disorder; Pilot Projects; Emotions; Virtual Reality
PubMed: 37975324
DOI: 10.1111/bjc.12445 -
Praxis 2020
Topics: Attention Deficit Disorder with Hyperactivity; Bipolar Disorder; Humans; Mania; Methylphenidate; Mood Disorders
PubMed: 33292002
DOI: 10.1024/1661-8157/a003603 -
International Clinical... Sep 2023Antidepressant (AD)- emergent mood switch (AEMS) is a common complication of bipolar depression. This study aimed to investigate the prevalence and clinical correlates...
Antidepressant (AD)- emergent mood switch (AEMS) is a common complication of bipolar depression. This study aimed to investigate the prevalence and clinical correlates of subthreshold AEMS (i.e. not fulfilling DSM criteria for hypomanic episodes) in major depressive disorder (MDD) and, prognostically, its impact on AD treatment outcome and suicidality. The study involved 425 outpatients with MDD followed during the acute phase (12 weeks) and continuation (weeks 13-28) AD treatment. AEMS was assessed through the Altman Self-Rating Mania scale (ASRM ≥ 6). Several clinical features differentiated individuals with or without subthreshold AEMS (n = 204 vs. 221): negative self-perception [odds ratio (OR) 1.017-1.565]; panic disorder (OR 1.000-1.091); subthreshold hypomanic episodes (OR 1.466-13.352); childhood emotional abuse (OR 1.053-2.447); lifetime suicidal behaviour (OR 1.027-1.236); AD-related remission (χ 2 = 22.903 P < 0.0001) and suicide ideation (χ 2 = 16.701 P < 0.0001). In AEMS earlier onset showed a strong correlation with bipolar spectrum disorder (overall score: P = 0.0053; mixed depression: P = 0.0154; subthreshold hypomania: P = 0.0150) whereas late-onset was associated with more severe suicidal behaviour ( P < 0.001). In conclusion, our results demonstrate that subthreshold mood switches occur frequently in unipolar depression during acute AD treatment as well as in continuation phase. Time of switch onset seems to have the greatest diagnostic and prognostic value.
Topics: Humans; Child; Depressive Disorder, Major; Suicidal Ideation; Mania; Suicide; Antidepressive Agents
PubMed: 37351585
DOI: 10.1097/YIC.0000000000000479 -
Psychopharmacology Jul 2024Rapid-eye movement (REM) sleep deprivation (SD) can induce manic-like behaviors in rodents. On the other hand, lithium, as one of the oldest drugs used in...
BACKGROUND
Rapid-eye movement (REM) sleep deprivation (SD) can induce manic-like behaviors in rodents. On the other hand, lithium, as one of the oldest drugs used in neuropsychiatric disorders, is still one of the best drugs for the treatment and control of bipolar disorder. In this study, we aimed to investigate the role of chronic short-term REM SD in the induction of manic-like behaviors in female rats.
METHODS
The rats were exposed to REM SD for 14 days (6 hours/day). Lithium was intraperitoneally injected at the doses of 10, 50, and 100 mg/kg.
RESULTS
REM SD induced hyperactivity and OCD-like behavior, and decreased anxiety, depressive-like behavior, and pain subthreshold. REM SD also impaired passive avoidance memory and decreased hippocampal brain-derived neurotrophic factor (BDNF) expression level. Lithium at the doses of 50 and 100 mg/kg partly and completely abolished these effects, respectively. However, lithium (100 mg/kg) increased BDNF expression level in control and sham REM SD rats with no significant changes in behavior.
CONCLUSIONS
Chronic short-term REM SD may induce a mania-like model and lead to OCD-like behavior and irritability. In the present study, we demonstrated a putative rodent model of mania induced by chronic REM SD in female rats. We suggest that future studies should examine behavioral and mood changes following chronic REM SD in both sexes. Furthermore, the relationship between manic-like behaviors and chronic REM SD should be investigated.
Topics: Animals; Female; Brain-Derived Neurotrophic Factor; Hippocampus; Sleep Deprivation; Rats; Mania; Rats, Sprague-Dawley; Obsessive-Compulsive Disorder; Disease Models, Animal; Behavior, Animal; Dose-Response Relationship, Drug; Sleep, REM
PubMed: 38430395
DOI: 10.1007/s00213-024-06566-0 -
Psychiatric Genetics Feb 2021Bipolar disorder (BD) is a chronic, disabling disease characterised by alternate mood episodes, switching through depressive and manic/hypomanic phases. Mood... (Review)
Review
INTRODUCTION
Bipolar disorder (BD) is a chronic, disabling disease characterised by alternate mood episodes, switching through depressive and manic/hypomanic phases. Mood stabilizers, in particular lithium salts, constitute the cornerstone of the treatment in the acute phase as well as for the prevention of recurrences. The pathophysiology of BD and the mechanisms of action of mood stabilizers remain largely unknown but several pieces of evidence point to gene x environment interactions. Epigenetics, defined as the regulation of gene expression without genetic changes, could be the molecular substrate of these interactions. In this literature review, we summarize the main epigenetic findings associated with BD and response to mood stabilizers.
METHODS
We searched PubMed, and Embase databases and classified the articles depending on the epigenetic mechanisms (DNA methylation, histone modifications and non-coding RNAs).
RESULTS
We present the different epigenetic modifications associated with BD or with mood-stabilizers. The major reported mechanisms were DNA methylation, histone methylation and acetylation, and non-coding RNAs. Overall, the assessments are poorly harmonized and the results are more limited than in other psychiatric disorders (e.g. schizophrenia). However, the nature of BD and its treatment offer excellent opportunities for epigenetic research: clear impact of environmental factors, clinical variation between manic or depressive episodes resulting in possible identification of state and traits biomarkers, documented impact of mood-stabilizers on the epigenome.
CONCLUSION
Epigenetic is a growing and promising field in BD that may shed light on its pathophysiology or be useful as biomarkers of response to mood-stabilizer.
Topics: Adult Survivors of Child Adverse Events; Affect; Bipolar Disorder; DNA Methylation; Epidemiologic Research Design; Epigenesis, Genetic; Female; Gene-Environment Interaction; Genetic Association Studies; Histone Code; Humans; Male; Organ Specificity; Psychotropic Drugs; RNA, Untranslated
PubMed: 33290382
DOI: 10.1097/YPG.0000000000000267 -
The Annals of Pharmacotherapy 1999To review the literature regarding the use of lamotrigine as a mood stabilizer, and to discuss its efficacy in treating this condition. (Review)
Review
OBJECTIVE
To review the literature regarding the use of lamotrigine as a mood stabilizer, and to discuss its efficacy in treating this condition.
DATA SOURCES
Data were obtained from MEDLINE, Micromedex, and Cochrane collaboration searches from January 1985 to July 1998.
DATA SUMMARY
There are insufficient data to confirm that lamotrigine is an effective mood stabilizer. There are no controlled studies, and the current evidence is from case studies and open trials. Furthermore, only one study shows any evidence of effectiveness in the manic phase, although this may be because the data tend to relate to a treatment-refractory population.
CONCLUSIONS
From the current evidence, lamotrigine cannot be recommended as a mood stabilizer except when conventional therapies have failed.
Topics: Affect; Anticonvulsants; Antidepressive Agents; Antimanic Agents; Bipolar Disorder; Humans; Lamotrigine; Triazines
PubMed: 10466917
DOI: 10.1345/aph.18388 -
Journal of Affective Disorders Mar 2021Irritability is a common symptom in youth that is thought to be predictive of mood disorders. Its effects on mood are likely to be age-dependent, with direct and...
BACKGROUND
Irritability is a common symptom in youth that is thought to be predictive of mood disorders. Its effects on mood are likely to be age-dependent, with direct and indirect mediators. We assessed age-related effects and mediators of irritability in adolescent girls with subthreshold depressive and manic symptoms.
METHODS
We analysed the irritability item from the Mood Disorder Questionnaire in 3 cohorts of girls aged 12-18years (N=229); 12-13years (N=82); 14-15years (N=68); and 16-18years (N=79). They also completed mood, anxiety and emotion regulation questionnaires. MANOVA, correlations and bootstrapped mediation analyses were performed with SPSS®v25 and Hayes Processv3.5®.
RESULTS
Overall, irritable girls had higher depressive and manic symptoms, trait anxiety and emotion dysregulation than those who were not irritable. Significantly higher rates of irritability were observed in mid-adolescents (aged 14-15years; p = 0.001). Notably, irritability exerted effects on depressive symptoms via trait anxiety, non-acceptance of emotions and dysregulation in emotion clarity throughout adolescence. However, irritability directly exerted effects on manic symptoms in mid-adolescence but in older adolescents, their relationship was indirect via impulse control dysregulation.
LIMITATIONS
The cross-sectional design and non-clinical sample limit generalisability of our findings.
CONCLUSIONS
Irritability is involved in subthreshold depressive symptoms, via trait anxiety and perceptual emotion dysregulation. On the other hand, irritability is directly and indirectly associated with subthreshold manic symptoms via dysregulated impulse control depending on age. Therefore, screening for irritability, trait anxiety and emotion dysregulation throughout adolescence may facilitate the early detection of subthreshold depressive and manic symptoms, and the implementation of preventive strategies.
Topics: Adolescent; Anxiety; Anxiety Disorders; Child; Cross-Sectional Studies; Female; Humans; Irritable Mood; Mood Disorders
PubMed: 33601692
DOI: 10.1016/j.jad.2020.12.173