Abnormal Thoughts Research Articles

Role of brain renin-angiotensin system in depression: A new perspective.

Depression is a mood disorder characterized by abnormal thoughts. The pathophysiology of depression is related to the deficiency of serotonin (5HT), which is derived from tryptophan (Trp). Mitochondrial dysfunction, oxidative stress, and neuroinflammation are involved in the pathogenesis of depression. Notably, the renin-angiotensin system (RAS) is involved in the pathogenesis of depression, and different findings revealed that angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) may be effective in depression. However, the underlying mechanism for the role of dysregulated brain RAS-induced depression remains speculative. Therefore, this review aimed to revise the conceivable role of ACEIs and ARBs and how these agents ameliorate the pathophysiology of depression. Dysregulation of brain RAS triggers the development and progression of depression through the reduction of brain 5HT and expression of brain-derived neurotrophic factor (BDNF) and the induction of mitochondrial dysfunction, oxidative stress, and neuroinflammation. Therefore, inhibition of central classical RAS by ARBS and ACEIs and activation of non-classical RAS prevent the development of depression by regulating 5HT, BDNF, mitochondrial dysfunction, oxidative stress, and neuroinflammation.

Genome Sequencing of Consanguineous Family Implicates Ubiquitin-Specific Protease 53 (USP53) Variant in Psychosis/Schizophrenia: Wild-Type Expression in Murine Hippocampal CA 1-3 and Granular Dentate with AMPA Synapse Interactions.

Psychosis is a severe mental disorder characterized by abnormal thoughts and perceptions (e.g., hallucinations) occurring quintessentially in schizophrenia and in several other neuropsychiatric disorders. Schizophrenia is widely considered as a neurodevelopmental disorder that onsets during teenage/early adulthood. A multiplex consanguineous Pakistani family was afflicted with severe psychosis and apparent autosomal recessive transmission. The first-cousin parents and five children were healthy, whereas two teenage daughters were severely affected. Structured interviews confirmed the diagnosis of DSM-V schizophrenia. Probands and father underwent next-generation sequencing. All available relatives were subjected to confirmatory Sanger sequencing. Homozygosity mapping and directed a priori filtering identified only one rare variant [MAF < 5(10)-5] at a residue conserved across vertebrates. The variant was a non-catalytic deubiquitinase, USP53 (p.Cys228Arg), predicted in silico as damaging. Genome sequencing did not identify any other potentially pathogenic single nucleotide variant or structural variant. Since the literature on USP53 lacked relevance to mental illness or CNS expression, studies were conducted which revealed USP53 localization in regions of the hippocampus (CA 1-3) and granular dentate. The staining pattern was like that seen with GRIA2/GluA2 and GRIP2 antibodies. All three proteins coimmunoprecipitated. These findings support the glutamate hypothesis of schizophrenia as part of the AMPA-R interactome. If confirmed, USP53 appears to be one of the few Mendelian variants potentially causal to a common-appearing mental disorder that is a rare genetic form of schizophrenia.

Actualización clínica y terapéutica de las urgencias en psiquiatría

A psychiatric emergency is any abnormal thoughts, feelings, or behaviors that require an immediate treatment intervention. The most common reasons for a psychiatric emergency consultation are anxiety, depressive symptoms, self-harming behavior or ideation, psychotic phenomena, and psychomotor agitation. All can be manifestations of an underlying psychiatric disease, though they may also emerge in the context of an organic disease. Therefore, faced with these healthcare needs, it is necessary to perform a differential diagnosis among the potential somatic, toxic, and psychiatric causes. To do so, it is recommended to take a full case history, conduct a physical and psychopathological examination, take vital signs, and perform basic additional tests: a blood test (biochemistry, complete blood count) and urine toxicology test. Occasionally, more specific tests may be necessary based on the diagnostic suspicion (electrocardiogram, computed tomography scan of the head, thyroid hormones, etc.). Its management is urgent and treatment will be for symptoms and for the underlying organic or psychiatric cause. Later, it would be necessary to evaluate referral to a psychiatry specialist on either an emergency or outpatient basis.

New Hypothesis Unifies Previous Theories of Psychopathology and Identifies Core Biological Abnormality in Psychiatric Disorders

Despite millennia of philosophical debate and the enormous strides that have been made in neuroscience over the last century, the pathophysiology of psychiatric disorders remains unclear. Although the monoamine hypothesis has, for more than fifty years, provided a strong basis of support for the use of antidepressants in the treatment of depression, the overall success rate with antidepressants has been disappointingly low. Coincidingly, the monoamine hypothesis has come under increasing scrutiny for failing to explain all of the phenomena that characterize mood disorders. Consequently, mental health researchers, in an effort to find new molecular targets for treatment, have been searching for a more comprehensive explanation of the means by which psychiatric symptoms develop. Recently, several new models of depression have been proposed, including the immune, the endocrine, the glutamatergic, the GABAergic, the mitochondrial, and the neuroplastic; but none of them integrate the workings of the mind with the workings of the brain, and none of them explain how abnormalities in brain function actually translate into abnormalities in thought and emotion. However, an emerging hypothesis—one that reconceptualizes the anatomy of the cognitive-emotional system and unifies previous psychological and biological theories of psychopathology—posits that psychiatric symptoms are induced by a vicious cycle of mutual overstimulation between the mind and the brain. According to the Multi-Circuit Neuronal Hyperexcitability Hypothesis of Psychiatric Disorders, the mind, when under stress, overstimulates the associated neurons and circuits. The associated neurons and circuits, in turn, overstimulate the mind, particularly if the neurological system is inherently hyperexcitable. The result is an abnormal increase in the intensity and the duration of the associated thoughts and emotions, a change that distinguishes functionally abnormal thoughts and emotions from normal ones. A more detailed understanding of the mechanism by which psychiatric symptoms develop and perpetuate has important implications for treatment, as it would allow psychotherapists to better visualize what is happening in the cognitive-emotional system; it would allow psychiatrists to better visualize the target for medical interventions; and, by reducing the stigma of mental illness, it would allow patients to be more willing to seek and follow through with mental health care.

NEGATIVE IMPACTS OF PSYCHOLOGICAL PROBLEMS ON THE PROTAGONIST IN FAYE BIRD’S NOVEL MY SECOND LIFE

The objective of this study is to find out the psychological problems on the protagonist and the negative impacts caused by the psychological problems in Faye Bird’s novel My Second Life published in 2014. Psychological problem are disorders of cognitive, volition, affective, and psychomotor generating to psychological disorders characterized by abnormal thoughts, feelings, and behaviors. The two aspects of the problems are in reality get into the corridor of psychology, a study about human’s soul or mind, either about its symptoms, processes, or its background. As literature is a reflection of society, all the characters are also members of literary community leading to a concept that psychology and literature are closely related. This novel is about a teenager who experiences various psychological problems after finding out that in her first life she has been the cause of someone’s death. This study is conducted to give an overview to all people about the negative impacts of psychological problems experienced by the protagonist. This study applies qualitative method going through social phenomena and the data are collected from the novel. The results show the psychological problems are depression, anxiety and trauma causing negative impacts in the forms of insomnia, lack of concentration and truancy.

The Association Between Diabetes Mellitus and Mild Behavioral Impairment Among Mild Cognitive Impairment: Findings from Singapore.

Mild behavioral impairment (MBI) describes persistent behavioral changes in later life as an at-risk state for dementia. While cardiovascular risk factors (CVRFs) are linked to dementia, it is uncertain how CVRFs are associated with MBI. To determine the prevalence of MBI and its association with CVRFs among cognitively normal (CN) and mild cognitive impairment (MCI) individuals in Singapore. 172 individuals (79 CN and 93 MCI) completed the MBI-checklist (MBI-C). The prevalence of MBI and MBI-C sub-domain characteristics among CN and MCI were examined. Regression models evaluated the relationships between MBI-C sub-domain scores with CVRFs. The prevalence of MBI and mean MBI-C total score were significantly higher among MCI than CN (34.4%versus 20.3%, p = 0.022 and 7.01 versus 4.12, p = 0.04). The highest and lowest-rated sub-domains among CN and MCI were impulse dyscontrol and abnormal thoughts and perception respectively. Within the MCI cohort, a higher proportion of individuals with diabetes mellitus (DM) had MBI compared to individuals without DM (28.1%versus 10.4%, p = 0.025). The interaction of DM and MCI cohort resulted in significantly higher mean MBI-C total, decreased motivation, emotional dysregulation, impulse dyscontrol, and abnormal thoughts and perception sub-domain scores. The prevalence of MBI is higher among a Singapore cohort compared to Caucasian cohorts. The associations of DM with both the presence and severity of MBI among MCI suggest that DM may be a risk factor for MBI. The optimization of DM may be a potential therapeutic approach to improve clinical outcomes among MCI with MBI.

343 A benefit-risk assessment of daridorexant for the treatment of insomnia using patient preference data from two phase 3 trials

Abstract Introduction The efficacy and safety of daridorexant, a dual orexin receptor antagonist intended to treat insomnia, was demonstrated in two placebo-controlled phase III trials. Both pivotal trials included instruments for eliciting treatment preferences of enrolled patients, to interpret the trial findings from their perspective using a patient-centered benefit-risk assessment (pBRA). Methods Digital ethnographies and qualitative interviews with insomnia patients informed the design of a discrete choice experiment (DCE). The DCE was pre-tested in qualitative and quantitative pilots before inclusion in the trials. Within the DCE, patients were asked to make trade-offs between seven outcomes (“time to fall asleep,” “total time asleep,” “daytime functioning,” “likelihood of daytime dizziness/grogginess,” “likelihood of abnormal thoughts and behavioural changes,” “likelihood of falls in the night,” and “treatment withdrawal”). The preference data were analysed using a mixed logit (MXL) model that accounted for preference heterogeneity. Relative attribute importance (RAI) and maximum acceptable risk (MAR) of abnormal thoughts and behavioral changes were obtained from the MXL. A pBRA combined elicited preferences with collected clinical trial data to predict preferences for daridorexant over placebo. Sensitivity analysis accounted for uncertainty in both clinical outcomes and preferences. Results Patients valued all seven outcomes (p &amp;lt; 0.05), but considered improving daytime functioning (RAI = 33.7%) and avoiding treatment withdrawal (RAI = 27.5%) as most important. Patients were also willing to accept an additional 18.8% risk (p-value &amp;lt; 0.001) of abnormal thoughts and behavioral changes for an improvement in daytime functioning from difficulty functioning to restricted functioning. The pBRA suggested that both daridorexant 50 mg and 25 mg were significantly preferred (p-value &amp;lt; 0.001) over placebo, and 50 mg was significantly preferred (p-value &amp;lt; 0.001) over 25 mg, even after accounting for uncertainty in clinical outcomes and preferences. Conclusion All seven outcomes included in the DCE were valued by patients, but improving daytime functioning and avoiding severe treatment withdrawal was considered as most important. Daridorexant 50 mg and 25 mg were found to be significantly preferred over placebo, suggesting a positive benefit-risk balance of both doses. Overall, the preference data allowed for an innovative interpretation of the trial data from patients’ perspective. Support (if any):

Mild Behaviour Impairment Checklist (MBI‐C): Is there a difference in ratings between patient and close informant?

AbstractBackgroundMild Behavioural Impairment‐Checklist (MBI‐C) is a validated questionnaire that measures sustained later‐life emergent neuropsychiatric symptoms among people with prodromal dementia. Using this checklist as a MBI case ascertainment instrument, the prevalence of MBI was found to be 5.8% in subjective cognitive decline (SCD) and 14.2% in mild cognitive impairment (MCI). While the MBI‐C can be self‐administered or administered through a close informant via face‐to‐face or phone interviews, it is unknown whether patients and close‐informants differentially report on the MBI‐C. Here, we aim to examine the differences in self‐administered and close‐informant administered MBI‐C scores in a specialty clinic population.Method87 (25 SCD and 62 MCI) patients from the Singapore National Neuroscience Institute memory clinic completed the MBI‐C and Geriatric Depression Scale (GDS)4. Close‐informants completed the MBI‐C and Zarit caregiver burden scale (Zarit)5. The MBI‐C is a 34‐item questionnaire organized into five domains; 1) motivation, 2) emotional regulation, 3) impulse control, 4) social cognition, and 5) abnormal thoughts. MBI is defined by an MBI‐C total score of &gt;6.5 in MCI 3 and a &gt;8.5 total score in SCI2. Paired sample T‐test evaluated the difference in MBI‐C scores between patients and close‐informants. Pearson correlation test evaluated the associations between MBI‐C with GDS and Zarit scores.ResultOut of 87 participants (Mage= 67.62, SD=9.08), 29 participants were diagnosed with MBI. The frequency of MBI did not differ between SCI and MCI (40% in SCI and 30% in MCI). We found that MBI‐C domain scores did not differ significantly between patients and close‐informants (p&gt;0.05). GDS scores positively correlated with MBI total score (p&lt;0.01), motivation (p&lt;0.01), emotional regulation (p&lt;0.01), impulse control (p&lt;0.01), social cognition (p=0.001) and abnormal thoughts (p=0.018). Zarit scores positively correlated with MBI total score (p=0.017) and impulse control (p=0.009).ConclusionMBI is common in our Asian clinic population with preclinical prodromal dementia diagnosed using the MBI‐C and was associated with greater caregiver burden and depressive symptoms. Importantly, we found that patients and their close‐informants do not report differently on the MBI‐C. Our findings suggest that both patients and close‐informants may provide reliable measures of the patient’s neuropsychiatric symptoms using the MBI‐C.

Peningkatan Kualitas Hidup Orang Dengan Gangguan Jiwa Dengan Self Help Group Di Kota Surakarta

Introduction: People who experience mental disorders who experience various problems, with different symptoms, generally they have characteristics with some combination of abnormal thoughts, emotions, behavior and relationships with other people that manifest in the form of a series of symptoms and / or changes in behavior which is meaningful and can cause suffering and obstacles in carrying out people's functions as humans (UU Kesehatan no 18 tahun 2014; WHO, 2017; &amp; WHO, 2018). This is a serious health problem, which usually has problems with poor quality of life. They are associated with feelings of distress, lack of control over symptoms and life in general, negative perceptions of self, stigmatization and rejection, reduced activity and difficulty with daily functioning, and negative outlook. (Connell, J, Brazier, J, O'Cathain, A, Jones, M.L. &amp; Paisley, S., 2012). Group interventions carried out by nurses such as group activity therapy, supportive therapy and self-help groups to help individuals improvement in their quality of life. Group therapy, one of the self help group, is a group where each member has the same desire to overcome mental disorders or increase the level of cognitive or emotional well-being among group members (Sulistyowati., E.C. &amp; Sulistyowati D, 2018). Self Help Group aims to develop empathy among fellow group members where fellow group members provide mutual reinforcement which has an impact on improving the quality of life. This study aims to determine the improvement of the quality of life of people with mental disorders (ODGJ) with the self help group in the city of Surakarta. Methods: This was a quasi-experimental study with a pre-post test control group design. Data were taken before and after giving the intervention of self-help groups of schizophrenia patients in the intervention group. The total sample was 160 clients divided into 2 groups, namely 80 respondents for group 1 at Griya PMI and 80 respondents for group 2 at RSJD Dr Arif Z Surakarta, each group consisting of 40 respondents for intervention and 40 respondents for the control group. This study measures the quality of life with a research instrument using a life quality questionnaire. Data were analyzed using Paired t-test, Wilcoxon signed ranks test, independent t-test and Mann Whitney-test. Results: The study proved that there was a statistically significant difference in the quality of life before and after giving the self help group (p value, 0.000) between the intervention group and the control group, both at Griya PMI with a mean difference of 20.23 and at RSJD Dr. Arif Z. self help group with a mean difference of 10.85. Conclusion: self help group which is used for intervention is considered effective to improve quality of life. Suggestion: self help group is used as a mental nursing group intervention in caring for mentally ill patients.

Autophagy and Schizophrenia.

Schizophrenia (SCZ) is characterized by abnormal thoughts, behaviors and speech, along with a decreased perception of reality that can included visual or auditory hallucinations, withdrawal of social activity and lack of motivation, etc. Many hypotheses related to the causes of SCZ have been proposed, but the underlying neuropathological mechanism remains unclear. Recent studies have suggested that there is an association between autophagy and SCZ. The strongest evidence for this comes from the expression of ATGs in the BA22 of postmortem samples from SCZ patients, coinciding with some of the brain imaging studies and certain hypotheses about SCZ in interpreting the positive symptoms. Autophagy dysfunction in the hippocampus, especially in the CA2 region, may relate to deficits of social communication and interaction in SCZ patients. mTOR regulation of autophagy is also potentially a piece of strong supporting evidence for the autophagic neuropathogenesis of SCZ. In vitro studies show that antipsychotics often induce autophagy through distinct mechanisms of drug action, but they may all share common features as autophagy inducers and antagonists of dopamine receptors.

Integrative network analysis identifies differential regulation of neuroimmune system in Schizophrenia and Bipolar disorder

BackgroundNeuropsychiatric disorders such as Schizophrenia (SCZ) and Bipolar disorder (BPD) pose a broad range of problems with different symptoms mainly characterized by some combination of abnormal thoughts, emotions, behaviour, etc. However, in depth molecular and pathophysiological mechanisms among different neuropsychiatric disorders have not been clearly understood yet. We have used RNA-seq data to investigate unique and overlapping molecular signatures between SCZ and BPD using an integrative network biology approach. MethodsRNA-seq count data were collected from NCBI-GEO database generated on post-mortem brain tissues of controls (n = 24) and patients of BPD (n = 24) and SCZ (n = 24). Differentially expressed genes (DEGs) were identified using the consensus of DESeq2 and edgeR tools and used for downstream analysis. Weighted gene correlation networks were constructed to find non-preserved (NP) modules for SCZ, BPD and control conditions. Topological analysis and functional enrichment analysis were performed on NP modules to identify unique and overlapping expression signatures during SCZ and BPD conditions. ResultsWe have identified four NP modules from the DEGs of BPD and SCZ. Eleven overlapping genes have been identified between SCZ and BPD networks, and they were found to be highly enriched in inflammatory responses. Among these eleven genes, TNIP2, TNFRSF1A and AC005840.1 had higher sum of connectivity exclusively in BPD network. In addition, we observed that top five genes of NP module from SCZ network were downregulated which may be a key factor for SCZ disorder. ConclusionsDifferential activation of the immune system components and pathways may drive the common and unique pathogenesis of the BPD and SCZ.

Profile of mild behavioral impairment and factor structure of the Mild Behavioral Impairment Checklist in cognitively normal older adults.

In this large population study, we set out to examine the profile of mild behavioral impairment (MBI) by using the Mild Behavioral Impairment Checklist (MBI-C) and to explore its factor structure when employed as a self-reported and informant-rated tool. This was a population-based cohort study. Participants were recruited from the Platform for Research Online to Investigate Genetics and Cognition in Aging study (https://www.protect-exeter.org.uk). A total of 5,742 participant-informant dyads participated in the study. Both participants and informants completed the MBI-C. The factor structure of the MBI-C was evaluated by exploratory factor analysis. The most common MBI-C items, as rated by self-reported and informants, related to affective dysregulation (mood/anxiety symptoms), being present in 34% and 38% of the sample, respectively. The least common items were those relating to abnormal thoughts and perception (psychotic symptoms) (present in 3% and 6% of the sample, respectively). Only weak correlations were observed between self-reported and informant-reported MBI-C responses. Exploratory factor analysis for both sets of respondent answers indicated that a five-factor solution for the MBI-C was appropriate, reflecting the hypothesized structure of the MBI-C. This is the largest and most detailed report on the frequency of MBI symptoms in a nondementia sample. The full spectrum of MBI symptoms was present in our sample, whether rated by self-reported or informant report. However, we show that the MBI-C performs differently in self-reported versus informant-reported situations, which may have important implications for the use of the questionnaire in clinic and research.

꿈과 언어 - 비논리적인 꿈, 비정상적인 사고와 언어의 관계에 관한 연구

꿈과 언어 - 비논리적인 꿈, 비정상적인 사고와 언어의 관계에 관한 연구

Awareness and Perception of Drug Trials among Patients with Mental Disorders

Mental disorders are generally characterized by abnormal thoughts, perceptions and emotions. These abnormalities may make an informed consent more difficult to obtain from psychiatric patients. The implementation of drug trials is being threatened by the decline in its overall frequency generally, especially in Psychiatry. This foretells a dearth of major breakthroughs in pharmacotherapy for psychiatric patients if they are unwilling to present themselves for drug trials. Insight into patient’s awareness and perception of drug trials will enhance the planning, design and implementation of drug trials among this vulnerable subpopulation. This was a cross-sectional study of one hundred patients attending the follow-up clinic of a tertiary psychiatric hospital. A proforma questionnaire to assess awareness and perception of drug trials was administered to participants. About half (51%) were aware of drug trials and 50% of the participants were not willing to participate in a drug trial. Sixty-five percent considered it highly risky to participate. Females were more likely to be unsure whether informed consent will be needed for drug trials. The married were more likely to be unaware of drug trials in clinical research. The unmarried were more likely to be informed about drug trials through the media. Findings are likely to have been influenced by the socio-cultural environment of this study setting. Drug trials among this population require an approach that will create an initial drug trial disorder—sensitive awareness and a design that will ensure that the consent process will take into cognizance the vulnerability of these patients; especially among females.

Mitochondrial Involvement in Mental Disorders: Energy Metabolism and Genetic and Environmental Factors.

Mental disorders, such as major depressive disorder (MDD), bipolar disorder (BD), and schizophrenia (SZ), are generally characterized by a combination of abnormal thoughts, perceptions, emotions, behavior, and relationships with others. Multiple risk factors incorporating genetic and environmental susceptibility are associated with development of these disorders. Mitochondria have a central role in the energy metabolism, and the literature suggests energy metabolism abnormalities are widespread in the brains of subjects with MDD, BPD, and SZ. Numerous studies have shown altered expressions of mitochondria-related genes in these mental disorders. In addition, environmental factors for these disorders, such as stresses, have been suggested to induce mitochondrial abnormalities. Moreover, animal studies have suggested that interactions of altered expression of mitochondria-related genes and environmental factors might be involved in mental disorders. Further investigations into interactions of mitochondrial abnormalities with environmental factors are required to elucidate of the pathogenesis of these mental disorders.

Mitochondrial Involvement in Mental Disorders; Energy Metabolism, Genetic, and Environmental Factors.

Mental disorders such as major depressive disorder (MDD), bipolar disorder (BD), and schizophrenia (SZ) are generally characterized by a combination of abnormal thoughts, perceptions, emotions, behavior, and relationships with others. Multiple risk factors incorporating genetic and environmental susceptibility are associated with development of these disorders. Mitochondria have a central role in the energy metabolism, and the literature suggests energy metabolism abnormalities are widespread in the brains of subjects with MDD, BD, and SZ. Numerous studies have shown altered expressions of mitochondria-related genes in these mental disorders. In addition, environmental factors for these disorders, such as stresses, have been suggested to induce mitochondrial abnormalities. Moreover, animal studies have suggested that interactions of altered expression of mitochondria-related genes and environmental factors might be involved in mental disorders. Further investigations into interactions of mitochondrial abnormalities with environmental factors are required to elucidate of the pathogenesis of these mental disorders.

Studies of a Neuronal Cell Line as a Model of Psychiatric Disorders.

Mental disorders are generally characterized by a combination of abnormal thoughts, perceptions, emotions, behavior, and relationships with others. Although multiple risk factors, such as genetic and environmental factors and interaction of these factors, are suggested, the exact etiologies are not known. On the other hand, it has been strongly suggested that the dopaminergic system is impaired in a variety of mental disorders. In the described method, the SH-SY5Y neuroblastoma cell line is differentiated to neuronal cell which expresses NSE, neuronal marker, and dopamine transporter (DAT) by treatment with all-trans-retinoic acid. SH-SY5Y cells allow investigating neuronal phenotypes of mental disorders as an in vitro model of these disorders.

Impact of Psycho-Education on Burden and other Correlates of Caregivers of Patients Suffering from Bipolar Mood Disorder

Mental illness is a condition that impacts a person's thinking, feeling or mood and may affect his or her ability to relate to others and function on a daily basis. According to the World Health Organization and Centers for Disease Control and Prevention (CDC), mental disorders are generally characterized by dysregulation of mood, some combinations of abnormal thoughts, emotions, behavior and relationship with others. According to the World Health Organization report in 2011, one out of seven people in India, i.e., 15 per cent of Indian population was depressed and in 2015, one out of five people in India i.e 20 per cent of Indian population is depressed that showcases an alarming increase in rates of depression by five per cent of the population injust a span of four years putting us all in grave situation (Weblink I). In classifications of mental disorder mood disorder comes under Axis I in Multi Axial System of DSM IV This disorder is one of biological psychiatry's greatest success stories. Pharmacotherapy is the first line offense against episodes of mania and depression. Nonetheless clinicians and researchers are increasingly recognizing the urgency of combining models of psychosocial interventions with pharmacotherapy.Nature of bipolar disorderMood disorders fall into the basic groups of elevated mood, such as mania or hypomania; depressed mood, of which the best-known and most researched is major depressive disorder (MDD) (commonly called clinical depression, unipolar depression, or major depression); and moods which cycle between mania and depression, known as bipolar disorder (BD) (formerly known as manic depression). There are several types of bipolar disorder; all involve episodes of depression and mania to a degree. They include bipolar I, bipolar II, cyclothymic disorder, mixed bipolar, and rapid-cycling bipolar disorder. A person affected by bipolar I disorder has had at least one manic episode in his or her life. A manic episode is a period of abnormally elevated mood, accompanied by abnormal behavior that disrupts life. Bipolar II is similar to bipolar I disorder, with moods cycling between high and low over time. However, in bipolar II disorder, the up moods never reach full-on mania. In rapid cycling, a person with bipolar disorder experiences four or more episodes of mania or depression in one year. With mixed bipolar disorder, a person experiences both mania and depression simultaneously or in rapid sequence. Cyclothymia (cyclothymic disorder) is a relatively mild mood disorder. People with cyclothymic disorder have milder symptoms than in full-blown bipolar disorder. During a manic phase, bipolar symptoms include heightened sense of self-importance, exaggerated positive outlook, significantly decreased need for sleep, poor appetite and weight loss, racing speech, flight of ideas, impulsiveness, ideas that move quickly from one subject to the next, poor concentration, easy distractibility, increased activity level, excessive involvement in pleasurable activities, poor financial choices, rash spending sprees, excessive irritability, aggressive behavior. During a depressed phase, bipolar symptoms include feelings of sadness or hopelessness, loss of interest in pleasurable or usual activities, difficulty sleeping; early-morning awakening, loss of energy and constant lethargy, sense of guilt or low self-esteem, difficulty concentrating, negative thoughts about the future, weight gain or weight loss, talk of suicide or death. About one percent of adults experience bipolar disorder at some point, usually starting during or after the teenage years. Men and women are equally likely to be affected. It causes significant distress, disability and marital problems, and is linked to abuse of alcohol, drugs and other substances. When people with bipolar disorder go through mood changes, they usually experience severe changes in their energy and activity levels, sleeping patterns, and other everyday behaviors. …

Somatic symptom disorder in dermatology

Somatic symptom disorder (SSD) is defined by the prominence of somatic symptoms associated with abnormal thoughts, feelings, and behaviors related to the symptoms, resulting in significant distress and impairment. Individuals with these disorders are more commonly encountered in primary care and other medical settings, including dermatology practice, than in psychiatric and other mental health settings. What defines the thoughts, feelings, and behaviors as abnormal is that they are excessive, that is, out of proportion to other patients with similar somatic symptoms, and that they result in significant distress and impairment. SSD may occur with or without the presence of a diagnosable dermatologic disorder. When a dermatologic disorder is present, SSD should be considered when the patient is worrying too much about his or her skin, spending too much time and energy on it, and especially if the patient complains of many nondermatologic symptoms in addition. The differential diagnosis includes other psychiatric disorders, including depression, anxiety disorders, delusions of parasitosis, and body dysmorphic disorder.This paper describes SSD and its applicability in dermatologic practice, with illustrative cases.

Pathophysiological Role of Neuroinflammation in Neurodegenerative Diseases and Psychiatric Disorders.

Brain diseases and disorders such as Alzheimer disease, Parkinson disease, depression, schizophrenia, autism, and addiction lead to reduced quality of daily life through abnormal thoughts, perceptions, emotional states, and behavior. While the underlying mechanisms remain poorly understood, human and animal studies have supported a role of neuroinflammation in the etiology of these diseases. In the central nervous system, an increased inflammatory response is capable of activating microglial cells, leading to the release of pro-inflammatory cytokines including interleukin (IL)-1β, IL-6, and tumor necrosis factor-α. In turn, the pro-inflammatory cytokines aggravate and propagate neuroinflammation, degenerating healthy neurons and impairing brain functions. Therefore, activated microglia may play a key role in neuroinflammatory processes contributing to the pathogenesis of psychiatric disorders and neurodegeneration.