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International Review of Psychiatry... May 2020Though a decade of research led to the creation of disruptive mood dysregulation disorder (DMDD), it was not until the 2013 publication of the DSM-5 that DMDD became an... (Review)
Review
Though a decade of research led to the creation of disruptive mood dysregulation disorder (DMDD), it was not until the 2013 publication of the DSM-5 that DMDD became an official diagnosis. The conception of DMDD was largely due to increasing rates of paediatric bipolar disorder (PBD) diagnoses, which significantly impacted treatment for these youth. The core symptoms of DMDD include persistent irritability and recurrent outbursts; the absence of a previous diagnostic category for youth experiencing these symptoms may have led to the over diagnosis of PBD. Due to the chronicity of symptoms, these youth are impaired in multiple areas of functioning. This article will present background information about DMDD, discuss clinical assessment strategies including scales for measuring irritability and aggression, and review pharmacologic and psychosocial treatments for youth with DMDD and clinical phenotypes similar to DMDD.
Topics: Aggression; Child; Child Behavior Disorders; Humans; Irritable Mood; Mood Disorders; Psychosocial Intervention
PubMed: 31775528
DOI: 10.1080/09540261.2019.1688260 -
Annals of Clinical Psychiatry :... Feb 2012Patients with bipolar disorder (BD) and major depressive disorder (MDD) experience adult attention-deficit/hyperactivity disorder (ADHD) at rates substantially greater... (Review)
Review
The Canadian Network for Mood and Anxiety Treatments (CANMAT) task force recommendations for the management of patients with mood disorders and comorbid attention-deficit/hyperactivity disorder.
BACKGROUND
Patients with bipolar disorder (BD) and major depressive disorder (MDD) experience adult attention-deficit/hyperactivity disorder (ADHD) at rates substantially greater than the general population. Nonetheless, ADHD frequently goes untreated in this population.
METHODS
We reviewed the literature regarding the management of adult ADHD in patients with mood disorders. Because a limited number of studies have been conducted in adults, our treatment recommendations also are partly informed by research in children and adolescents with BD+ADHD or MDD+ADHD, adults with ADHD, and our clinical experience.
RESULTS
In individuals with mood disorders, ADHD is best diagnosed when typical symptoms persist during periods of sustained euthymia. Individuals with BD+ADHD, particularly those with bipolar I disorder (BD I), are at risk for mood destabilization with many ADHD treatments, and should be prescribed mood-stabilizing medications before initiating ADHD therapies. Bupropion is a reasonable first-line treatment for BD+ADHD, while mixed amphetamine salts and methylphenidate also may be considered in patients determined to be at low risk for manic switch. Modafinil and cognitive-behavioral therapy (CBT) are second-line choices. In patients with MDD+ADHD and moderate to severe depression, MDD should be the treatment priority, whereas in mildly depressed or euthymic patients the order may be reversed. First-line treatments for MDD+ADHD include bupropion, an antidepressant plus a long-acting stimulant, or an antidepressant plus CBT. Desipramine, nortriptyline, and venlafaxine are second-line options.
CONCLUSIONS
Clinicians should be vigilant in screening for comorbid ADHD in mood disorder patients. ADHD symptoms can respond to appropriately chosen treatments.
Topics: Adult; Advisory Committees; Antidepressive Agents; Attention Deficit Disorder with Hyperactivity; Bipolar Disorder; Canada; Central Nervous System Stimulants; Cognitive Behavioral Therapy; Comorbidity; Depressive Disorder, Major; Humans; Lithium Compounds; Mood Disorders
PubMed: 22303520
DOI: No ID Found -
World Journal of Gastroenterology Jan 2016The hypothesis of an important role of gut microbiota in the maintenance of physiological state into the gastrointestinal (GI) system is supported by several studies... (Review)
Review
The hypothesis of an important role of gut microbiota in the maintenance of physiological state into the gastrointestinal (GI) system is supported by several studies that have shown a qualitative and quantitative alteration of the intestinal flora in a number of gastrointestinal and extra-gastrointestinal diseases. In the last few years, the importance of gut microbiota impairment in the etiopathogenesis of pathology such as autism, dementia and mood disorder, has been raised. The evidence of the inflammatory state alteration, highlighted in disorders such as schizophrenia, major depressive disorder and bipolar disorder, strongly recalls the microbiota alteration, highly suggesting an important role of the alteration of GI system also in neuropsychiatric disorders. Up to now, available evidences display that the impairment of gut microbiota plays a key role in the development of autism and mood disorders. The application of therapeutic modulators of gut microbiota to autism and mood disorders has been experienced only in experimental settings to date, with few but promising results. A deeper assessment of the role of gut microbiota in the development of autism spectrum disorder (ASD), as well as the advancement of the therapeutic armamentarium for the modulation of gut microbiota is warranted for a better management of ASD and mood disorders.
Topics: Animals; Anti-Bacterial Agents; Autism Spectrum Disorder; Autistic Disorder; Fecal Microbiota Transplantation; Gastrointestinal Microbiome; Humans; Mood Disorders; Probiotics
PubMed: 26755882
DOI: 10.3748/wjg.v22.i1.361 -
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 -
Journal of Psychiatric and Mental... Jun 2023WHAT IS KNOWN ON THE SUBJECT?: People with mood disorders often use substances. There are several clinician-driven hypotheses explaining the relationship. WHAT THE PAPER... (Review)
Review
WHAT IS KNOWN ON THE SUBJECT?: People with mood disorders often use substances. There are several clinician-driven hypotheses explaining the relationship. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: The paper draws together the existing research on the perceptions of those with lived experience of mood disorders on the reasons for using substances. The participants in the studies identified using substances to manage their mood when treatment to manage their mood was not effective or acceptable, and as an escape from trauma and hardship. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Mental health nurses need an understanding of why people with mood disorders may use substances and the impact of this on their treatment. Mental health nurses need to provide trauma-informed care that emphasizes harm reduction for those who have mood disorders and substance use. ABSTRACT: Introduction Substance use is highly prevalent among people with mood disorders. Effective treatment for these people requires a better understanding of the relationship between both mood and substance use from the perspectives of those with lived experience. Question What are the reasons those with lived experience of mood disorders give for substance use? Method An integrative review was conducted. The Joanna Briggs Institute suite of critical appraisal tools was used to evaluate the quality of individual studies. Data relevant to the review question were extracted, and the results were synthesized into themes. Results Eighteen papers met the eligibility criteria. Three themes were identified across the included studies: Managing my mood, More Effective than prescribed medication, and Escape from trauma and hardship. Discussion This integrative review identified that people with a mood disorder who use substances described choosing to take substances to manage their mood, as an alternative to prescribed medications, and to cope with trauma and social hardships. Implications for Practice Mental health nurses need to provide care that recognizes why people use substances. They need to understand these reasons to provide a harm reduction and trauma-informed model of care. Evidence-based non-pharmacological interventions for mood disorders need to be available as an alternative to medications or as a supplement.
Topics: Humans; Substance-Related Disorders; Mood Disorders
PubMed: 36177991
DOI: 10.1111/jpm.12876 -
Schizophrenia Research Oct 2013Characterization of patients with both psychotic and mood symptoms, either concurrently or at different points during their illness, has always posed a nosological...
Characterization of patients with both psychotic and mood symptoms, either concurrently or at different points during their illness, has always posed a nosological challenge and this is reflected in the poor reliability, low diagnostic stability, and questionable validity of DSM-IV Schizoaffective Disorder. The clinical reality of the frequent co-occurrence of psychosis and Mood Episodes has also resulted in over-utilization of a diagnostic category that was originally intended to only rarely be needed. In the Diagnostic and Statistical Manual of Mental Disorders, fifth edition, an effort is made to improve reliability of this condition by providing more specific criteria and the concept of Schizoaffective Disorder shifts from an episode diagnosis in DSM-IV to a life-course of the illness in DSM-5. When psychotic symptoms occur exclusively during a Mood Episode, DSM-5 indicates that the diagnosis is the appropriate Mood Disorder with Psychotic Features, but when such a psychotic condition includes at least a two-week period of psychosis without prominent mood symptoms, the diagnosis may be either Schizoaffective Disorder or Schizophrenia. In the DSM-5, the diagnosis of Schizoaffective Disorder can be made only if full Mood Disorder episodes have been present for the majority of the total active and residual course of illness, from the onset of psychotic symptoms up until the current diagnosis. In earlier DSM versions the boundary between Schizophrenia and Schizoaffective Disorder was only qualitatively defined, leading to poor reliability. This change will provide a clearer separation between Schizophrenia with mood symptoms from Schizoaffective Disorder and will also likely reduce rates of diagnosis of Schizoaffective Disorder while increasing the stability of this diagnosis once made.
Topics: Diagnostic and Statistical Manual of Mental Disorders; Humans; Mood Disorders; Psychotic Disorders
PubMed: 23707642
DOI: 10.1016/j.schres.2013.04.026 -
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 -
Epilepsy & Behavior : E&B Aug 2023Mood disorders are the most frequent comorbidities in people with epilepsy. The term Interictal Dysphoric Disorder (IDD) has been used to describe a condition where at... (Review)
Review
INTRODUCTION
Mood disorders are the most frequent comorbidities in people with epilepsy. The term Interictal Dysphoric Disorder (IDD) has been used to describe a condition where at least three out of eight symptoms must be present for diagnosis. Symptoms are grouped into three symptom clusters of four "labile depressive" symptoms (anergia, depressed mood, insomnia, and pain), two "labile affective" symptoms (anxiety and fear), and two specific symptoms (euphoric moods and paroxysmal irritability), which are described and can be present in people with epilepsy. There is debate about whether IDD is a distinct disease, or if it is simply a special manifestation of mood disorders in epilepsy. For instance, it may represent an atypical presentation of depression in this population.
METHODS
We conducted a systematic review of the literature in 3 databases with the terms "Interictal Dysphoric Disorder" and "mood disorder". A total of 130 articles were selected and, after removing the duplicated applying eligibility criteria, 12 articles were included.
RESULTS
Six articles showed positive evidence for the validation of IDD as an independent nosological entity; in contrast, five articles reported inconclusive findings regarding the question; one explicitly questioned significant differences between IDD and mood disorders as nosological constructs. The data available and presented in this systematic review is insufficient to confirm IDD as a distinct diagnostic category. Nevertheless, it is worth noting other researchers have found some validity in this concept, highlighting the strong connection between mood disorders and epilepsy.
CONCLUSION
Further research in this area is needed, and additional systematic reviews focusing on other aspects of the construct, such as neurobiological mechanisms, may prove to be helpful.
Topics: Humans; Anxiety Disorders; Comorbidity; Epilepsy; Mood Disorders; Pain
PubMed: 37300908
DOI: 10.1016/j.yebeh.2023.109231 -
Expert Review of Pharmacoeconomics &... Jun 2017Co-occurring disorders (CODs) describe a Substance Use Disorder (SUD) accompanied by a comorbid psychiatric disorder. Attention-Deficit/Hyperactivity Disorder (ADHD) and... (Review)
Review
Co-occurring disorders (CODs) describe a Substance Use Disorder (SUD) accompanied by a comorbid psychiatric disorder. Attention-Deficit/Hyperactivity Disorder (ADHD) and mood disorders are common CODs with high prevalence rates in SUD populations. It is proposed that literature on a tri-condition presentation of ADHD, mood disorder and SUD is limited. Areas covered: A literature search was conducted using a keyword search on EBSCOhost. Initially 2 799 records were identified, however, only two articles included all three conditions occurring concurrently in individuals. CODs constitute a major concern due to their overarching burden on society as a whole. Diagnosis and treatment of such patients is challenging. There is evidence that dysfunction of dopamine in the brain reward circuitry impacts the development or symptomology of all three disorders. Disparity exists regarding whether ADHD or mood disorders are greater modifiers for increased SUD severity. However, it has been reported that poor functional capacity may have a greater influence than comorbidities on SUD development. Expert commentary: Challenges exist which confound the clear distinction of CODs, however, with greater emergence of adult ADHD its screening in SUD populations should become standard practice to establish data on multi-condition presentations with the ultimate goal of improving clinical outcomes.
Topics: Animals; Attention Deficit Disorder with Hyperactivity; Brain; Diagnosis, Dual (Psychiatry); Dopamine; Humans; Mood Disorders; Prevalence; Reward; Severity of Illness Index; Substance-Related Disorders
PubMed: 28686107
DOI: 10.1080/14737167.2017.1351878 -
Journal of Abnormal Psychology Apr 2019Drawing from the National Survey on Drug Use and Health (NSDUH; N = 611,880), a nationally representative survey of U.S. adolescents and adults, we assess age, period,...
Drawing from the National Survey on Drug Use and Health (NSDUH; N = 611,880), a nationally representative survey of U.S. adolescents and adults, we assess age, period, and cohort trends in mood disorders and suicide-related outcomes since the mid-2000s. Rates of major depressive episode in the last year increased 52% 2005-2017 (from 8.7% to 13.2%) among adolescents aged 12 to 17 and 63% 2009-2017 (from 8.1% to 13.2%) among young adults 18-25. Serious psychological distress in the last month and suicide-related outcomes (suicidal ideation, plans, attempts, and deaths by suicide) in the last year also increased among young adults 18-25 from 2008-2017 (with a 71% increase in serious psychological distress), with less consistent and weaker increases among adults ages 26 and over. Hierarchical linear modeling analyses separating the effects of age, period, and birth cohort suggest the trends among adults are primarily due to cohort, with a steady rise in mood disorder and suicide-related outcomes between cohorts born from the early 1980s (Millennials) to the late 1990s (iGen). Cultural trends contributing to an increase in mood disorders and suicidal thoughts and behaviors since the mid-2000s, including the rise of electronic communication and digital media and declines in sleep duration, may have had a larger impact on younger people, creating a cohort effect. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
Topics: Adolescent; Adult; Age Distribution; Aged; Cohort Studies; Depressive Disorder, Major; Female; Humans; Internet; Male; Middle Aged; Mood Disorders; Substance-Related Disorders; Suicidal Ideation; Suicide; Suicide, Attempted; United States; Young Adult
PubMed: 30869927
DOI: 10.1037/abn0000410