-
Psychiatria Danubina Sep 2012Mood disorders are common in people with epilepsy (PWE) with prevalence rates ranging from 11% to 62%. The variation in epidemiological data results probably from the... (Review)
Review
BACKGROUND
Mood disorders are common in people with epilepsy (PWE) with prevalence rates ranging from 11% to 62%. The variation in epidemiological data results probably from the diversity of methodologies employed and selection of the populations across the studies. Moreover, the symptomathology of mood disorders in epilepsy is often atypical, intermittent and pleomorphic and fails to meet DSM-IV-TR categories. Several studies suggested the existence of distinct interictal dysphoric disorder (IDD) in patients with epilepsy. The majority of research studies in mood disorders in epilepsy were based on screening instruments in the diagnosis of mood disorders in PWE. However, the results in validity and reliability in detecting major depression in epilepsy using self-report inventories of mood symptoms is vague. The aim of this study was to review studies on mood disorders in epilepsy with particular focus on diagnostic methods.
SUBJECTS AND METHODS
The focus of this Review was on patient studies on mood disorders in epilepsy (2000-2012). We searched PubMed using the following search terms (effective date: 20th May 2012): (epilepsy (Title/Abstract) OR seizure (Title/Abstract)) AND depression (Title/Abstract) OR Dysthymia OR mania OR bipolar disorder OR affective disorder OR Interictal Dysphoric Disorder OR AND (humans (MeSH Terms) AND English (lang) AND (2000/01/01(PDAT): 2012/04/31(PDAT)).
RESULTS
Depression is the most frequent comorbid psychiatric disorder in epilepsy. Recent studies pointed out that bipolar disorders are not rare in epilepsy. Most of the research in PWE did not rely on standardized psychiatric measures and only about 18% of studies were based on diagnostic psychiatric interviews (mainly MINI and SCID-I). Mood disorders in epilepsy excluding the ictal or periictal symptoms can be categorized using standardized measures.
CONCLUSIONS
Common self-report depression measures may be used to screen for depression in clinical settings. The use of screening instruments in epilepsy must be followed by structured psychiatric interviews designed to establish a DSM-IV-TR diagnoses. Standardized psychiatric interview procedures based on DSM criteria like SCID-I or MINI provide a comprehensive way to diagnose mood disorders in patients with epilepsy.
Topics: Bipolar Disorder; Comorbidity; Cross-Sectional Studies; Depressive Disorder, Major; Diagnostic and Statistical Manual of Mental Disorders; Dysthymic Disorder; Epilepsy; Humans; International Classification of Diseases
PubMed: 22945186
DOI: No ID Found -
Pharmacological Reports : PR 2013Affective disorders are a medical condition with a complex biological pattern of etiology, involving genetic and epigenetic factors, along with different environmental... (Review)
Review
Affective disorders are a medical condition with a complex biological pattern of etiology, involving genetic and epigenetic factors, along with different environmental stressors. Increasing numbers of studies indicate that induction of oxidative and nitrosative stress (O&NS) pathways, which is accompanied by immune-inflammatory response, might play an important role in the pathogenic mechanisms underlying many major psychiatric disorders, including depression and bipolar disorder. Reactive oxygen and nitrogen species have been shown to impair the brain function by modulating activity of principal neurotransmitter (e.g., glutamatergic) systems involved in the neurobiology of depression. Both preclinical and clinical studies revealed that depression is associated with altered levels of oxidative stress markers and typically reduced concentrations of several endogenous antioxidant compounds, such as glutathione, vitamin E, zinc and coenzyme Q10, or enzymes, including glutathione peroxidase, and with an impairment of the total antioxidant status. These oxidative stress parameters can be normalized by successful antidepressant therapy. On the other hand, some antioxidants (zinc, N-acetylcysteine, omega-3 free fatty acids) may exhibit antidepressant properties or enhance standard antidepressant therapy. These observations introduce new potential targets for the development of therapeutic interventions based on antioxidant compounds. The present paper reviews selected animal and human studies providing evidence that oxidative stress is implicated in the pathophysiology and treatment of depression and bipolar disorder.
Topics: Animals; Antidepressive Agents; Biomarkers; Humans; Mood Disorders; Oxidative Stress
PubMed: 24553004
DOI: 10.1016/s1734-1140(13)71517-2 -
International Journal of Molecular... Oct 2023Recent studies have reported positive effects of Intermittent Fasting (IF) on metabolic parameters, cognition, and mood. However, regarding depressive symptoms, the... (Review)
Review
Recent studies have reported positive effects of Intermittent Fasting (IF) on metabolic parameters, cognition, and mood. However, regarding depressive symptoms, the effect of IF is not clear. The purpose of this review was to assess the available evidence on IF interventions for depression in both clinical and preclinical studies. Of the 23 included studies, 15 were performed on humans and 8 on animal models. The studies on rodents suggested that IF acts as a circadian regulator, improving neurotransmitter availability and increasing the levels of neurotrophic factors in the brain. However, the investigations on humans mainly evaluated healthy volunteers and showed a great heterogeneity regarding both the IF regimen studied and the observed effects on mood. Most available clinical trials have specific limitations, such as small sample sizes and uncontrolled designs. A comprehensive systematic review was conducted on five databases, PubMed, Cochrane, the Central Register of Controlled Trials, Web of Science databases, BVS and Scopus, identifying 23 relevant studies up to 6 October 2022. IF has potentially relevant physiological effects for the treatment of mood disorders, but better designed studies and controlled evaluations are needed to evaluate its efficiency in the treatment of major depression.
Topics: Humans; Depressive Disorder, Major; Depression; Intermittent Fasting; Mood Disorders; Brain
PubMed: 37958535
DOI: 10.3390/ijms242115551 -
JMIR MHealth and UHealth Sep 2021Mood disorders are commonly underrecognized and undertreated, as diagnosis is reliant on self-reporting and clinical assessments that are often not timely. Speech... (Review)
Review
BACKGROUND
Mood disorders are commonly underrecognized and undertreated, as diagnosis is reliant on self-reporting and clinical assessments that are often not timely. Speech characteristics of those with mood disorders differs from healthy individuals. With the wide use of smartphones, and the emergence of machine learning approaches, smartphones can be used to monitor speech patterns to help the diagnosis and monitoring of mood disorders.
OBJECTIVE
The aim of this review is to synthesize research on using speech patterns from smartphones to diagnose and monitor mood disorders.
METHODS
Literature searches of major databases, Medline, PsycInfo, EMBASE, and CINAHL, initially identified 832 relevant articles using the search terms "mood disorders", "smartphone", "voice analysis", and their variants. Only 13 studies met inclusion criteria: use of a smartphone for capturing voice data, focus on diagnosing or monitoring a mood disorder(s), clinical populations recruited prospectively, and in the English language only. Articles were assessed by 2 reviewers, and data extracted included data type, classifiers used, methods of capture, and study results. Studies were analyzed using a narrative synthesis approach.
RESULTS
Studies showed that voice data alone had reasonable accuracy in predicting mood states and mood fluctuations based on objectively monitored speech patterns. While a fusion of different sensor modalities revealed the highest accuracy (97.4%), nearly 80% of included studies were pilot trials or feasibility studies without control groups and had small sample sizes ranging from 1 to 73 participants. Studies were also carried out over short or varying timeframes and had significant heterogeneity of methods in terms of the types of audio data captured, environmental contexts, classifiers, and measures to control for privacy and ambient noise.
CONCLUSIONS
Approaches that allow smartphone-based monitoring of speech patterns in mood disorders are rapidly growing. The current body of evidence supports the value of speech patterns to monitor, classify, and predict mood states in real time. However, many challenges remain around the robustness, cost-effectiveness, and acceptability of such an approach and further work is required to build on current research and reduce heterogeneity of methodologies as well as clinical evaluation of the benefits and risks of such approaches.
Topics: Acoustics; Humans; Monitoring, Physiologic; Mood Disorders; Smartphone; Speech
PubMed: 34533465
DOI: 10.2196/24352 -
Psychiatria Danubina Oct 2023Depression is a major burden for society. While most mood disorders are treated on an outpatient basis, specific indications warrant hospitalization. Besides progresses...
Depression is a major burden for society. While most mood disorders are treated on an outpatient basis, specific indications warrant hospitalization. Besides progresses in pharmacology, psychotherapy, or interventional procedures, we suggest that the hospital setting could also be used as a tool to address specific aspects of the mood disorder problem. Hospitalizations may present some iatrogenic effects and participate to the chronicization of some inpatients. In this paper, we propose a split hospitalization model for the treatment of mood disorders, where the stay in the hospital is split by a period of return to home, to test their ability to find own solutions to their mood difficulties. This split model could offset some of the negative effects inherent in long-term or repeated hospitalization, and chronicization. This model, where patients are treated as actors of their recovery supports the self-efficacy dimension by deconstructing a self-fulfilling prophecy based on the idea that the main function of the hospital is to serve as an asylum where the patient seeks protection against own self-destructive tendencies. This article outlines how the system was set up, described the expected therapeutic prospects, and presents a critical discussion of the main issues at stake.
Topics: Humans; Mood Disorders; Hospitalization; Psychotherapy
PubMed: 37800209
DOI: No ID Found -
Journal of the American Academy of... Jun 2008To compare scores on autism spectrum disorder (ASD) symptom scales in healthy youths and youths with mood or anxiety disorders.
OBJECTIVE
To compare scores on autism spectrum disorder (ASD) symptom scales in healthy youths and youths with mood or anxiety disorders.
METHOD
A total of 352 youths were recruited (107 healthy participants, 88 with an anxiety disorder, 32 with major depressive disorder, 62 with bipolar disorder, and 63 with a mood disorder characterized by severe nonepisodic irritability). Participants received structured psychiatric interviews and parent ratings on at least one of three ASD symptom scales: Children's Communication Checklist, Social Communication Questionnaire, and Social Responsiveness Scale.
RESULTS
Relative to healthy youths, youths with mood or anxiety disorders exhibited higher scores on each ASD symptom scale. ASD symptom scale scores also showed an association with impairment severity and attention-deficit/hyperactivity disorder. Among patients with mood disorders but not those with anxiety disorders, consistent, statistically significant associations between diagnosis and ASD symptom scale scores remained even after controlling for potential confounders.
CONCLUSIONS
Patients with mood disorders exhibit higher scores on ASD symptom scales than healthy youths or youths with anxiety disorders. These data should alert clinicians to the importance of assessing ASD symptoms to identify social reciprocity and communication deficits as possible treatment targets in pediatric mood and anxiety disorders.
Topics: Adolescent; Anxiety Disorders; Autistic Disorder; Bipolar Disorder; Child; Depressive Disorder, Major; Diagnosis, Differential; Female; Humans; Irritable Mood; Male; Mood Disorders; Personality Assessment; Psychometrics; Reproducibility of Results
PubMed: 18434923
DOI: 10.1097/CHI.0b013e31816bffa5 -
Psychiatria Polska Oct 2018Brain morphological changes in affective disorders occur mainly in the fronto-limbic cortex, hippocampus and amygdala - the structures regulating emotional and cognitive... (Review)
Review
Brain morphological changes in affective disorders occur mainly in the fronto-limbic cortex, hippocampus and amygdala - the structures regulating emotional and cognitive functioning, as well as development of somatic symptoms in the course of disorders. The largest number of reports of structural changes in the cerebral cortex include the dorsolateral prefrontal cortex, the orbitofrontal cortex and the anterior cingulate cortex. The results of neuroimaging and sectional studies reveal changes in the volume of structures involved in the creation of neuronal circuits that affect development of mood disorders. Microscopic studies show changes in cell count, density, and morphology in these areas. Some of those changes are observed only in certain layers of the cerebral cortex. A valuable addition to this data are histochemical studies of neuronal survival markers, proinflammatory cytokines, trophic factors, and markers specific for particular cellular structures. The role of monoaminergic, GABA-ergic and glutamatergic neurotransmission is confirmed by the studies on concentration of neurotransmitters, their receptors and transporters. Some of the results correlate quantitatively with the type and severity of symptoms, duration of the disorder, as well as pharmacotherapy and nonpharmacological treatment.
Topics: Bipolar Disorder; Brain; Humans; Mood Disorders; Neuroimaging; Neurons; gamma-Aminobutyric Acid
PubMed: 30584814
DOI: 10.12740/PP/89553 -
Journal of Psychiatric Research Dec 2021Parents of a child with a mood disorder report significant levels of distress and burden from caregiving. This study examined whether maternal distress varies over time...
Parents of a child with a mood disorder report significant levels of distress and burden from caregiving. This study examined whether maternal distress varies over time with levels of mood symptoms in youth with mood disorders, and whether expressed emotion (EE) and family functioning moderate these associations. We recruited youth (ages 9-17 years) with mood disorders and familial risk for bipolar disorder (BD) for a randomized trial of family-focused therapy compared to standard psychoeducation. Participants were assessed every 4-6 months for up to 4 years. Using repeated-measures mixed effects modeling, we examined the longitudinal effects of youths' mood symptoms and maternal distress concurrently, as well as whether each variable predicted the other in successive study intervals. Secondary analyses examined the moderating effects of EE and ratings of family cohesion and adaptability on maternal distress. In sample of 118 youth-mother dyads, levels of self-reported parental distress decreased over time, with no differences between treatment conditions. Youths' depressive symptoms and, most strongly, mood lability were associated with greater maternal distress longitudinally; however, maternal distress did not predict youths' mood symptoms or lability. The effect of youth symptoms on maternal distress was greater among mothers who were high EE. Family cohesion was associated with reduced concurrent ratings of maternal distress, whereas family adaptability was associated with reduced maternal distress at successive follow-ups. While maternal distress decreases over time as youths' symptoms decrease, mothers of youth with mood disorders experience significant distress that is directly linked to the youths' depressive symptom severity and lability. Improved family functioning appears to be an important mechanism by which to intervene.
Topics: Adolescent; Affect; Bipolar Disorder; Child; Family Therapy; Female; Humans; Mood Disorders; Mothers
PubMed: 34735839
DOI: 10.1016/j.jpsychires.2021.10.041 -
Bipolar Disorders Feb 2008To find, review, and critically evaluate evidence pertaining to the phenomenology of pediatric bipolar disorder and its validity as a diagnosis. (Review)
Review
OBJECTIVE
To find, review, and critically evaluate evidence pertaining to the phenomenology of pediatric bipolar disorder and its validity as a diagnosis.
METHODS
The present qualitative review summarizes and synthesizes available evidence about the phenomenology of bipolar disorder (BD) in youths, including description of the diagnostic sensitivity and specificity of symptoms, clarification about rates of cycling and mixed states, and discussion about chronic versus episodic presentations of mood dysregulation. The validity of the diagnosis of BD in youths is also evaluated based on traditional criteria including associated demographic characteristics, family environmental features, genetic bases, longitudinal studies of youths at risk of developing BD as well as youths already manifesting symptoms on the bipolar spectrum, treatment studies and pharmacologic dissection, neurobiological findings (including morphological and functional data), and other related laboratory findings. Additional sections review impairment and quality of life, personality and temperamental correlates, the clinical utility of a bipolar diagnosis in youths, and the dimensional versus categorical distinction as it applies to mood disorder in youths.
RESULTS
A schema for diagnosis of BD in youths is developed, including a review of different operational definitions of 'bipolar not otherwise specified.' Principal areas of disagreement appear to include the relative role of elated versus irritable mood in assessment, and also the limits of the extent of the bipolar spectrum--when do definitions become so broad that they are no longer describing 'bipolar' cases?
CONCLUSIONS
In spite of these areas of disagreement, considerable evidence has amassed supporting the validity of the bipolar diagnosis in children and adolescents.
Topics: Adolescent; Attention Deficit Disorder with Hyperactivity; Bipolar Disorder; Child; Comorbidity; Cross-Sectional Studies; Diagnosis, Differential; Diagnostic and Statistical Manual of Mental Disorders; Humans; International Classification of Diseases; Mood Disorders; Personality Assessment; Psychiatric Status Rating Scales; Risk Factors; Sensitivity and Specificity; Social Adjustment; Temperament
PubMed: 18199237
DOI: 10.1111/j.1399-5618.2007.00563.x -
Aging & Mental Health Jul 2006The association between widowhood and mental health problems, such as depressive symptomatology and anxiety, has been examined extensively. Few studies, however, have... (Review)
Review
The association between widowhood and mental health problems, such as depressive symptomatology and anxiety, has been examined extensively. Few studies, however, have explored the prevalence and incidence of mood and anxiety disorders based on diagnostic criteria after the loss of the partner. We conducted a systematic review, and searched major bibliographical databases for studies examining mood and anxiety disorders in widowhood. We included all studies examining the prevalence or incidence of mood and anxiety disorders in the widowed, according to diagnostic criteria as assessed with a structured diagnostic interview. Eleven studies were identified, exploring the prevalence and incidence of mood and anxiety disorders in 3,481 widowed individuals and 4,685 non-widowed controls. As expected, the prevalence of Major Depressive Disorder (MDD) and anxiety disorders were considerably elevated in widowed individuals, especially in the first year after the loss of a spouse. During the first year of bereavement, almost 22% of the widowed were diagnosed as having MDD; almost 12% met diagnostic criteria for Post Traumatic Stress Disorder; and there were higher risks of Panic Disorder and Generalized Anxiety Disorder. The incidence rate of MDD and several anxiety disorders ranged from 0.08-0.50. The relative risk of developing a mood or anxiety disorder ranged from 3.49-9.76, in the widowed, compared to control subjects.
Topics: Aged; Anxiety Disorders; Bereavement; Female; Humans; Incidence; Male; Middle Aged; Mood Disorders; Prevalence; Widowhood
PubMed: 16798624
DOI: 10.1080/13607860600638529