Bipolar Affective Disorder Research Articles

Causes and Treatment of Bipolar Disorder

Bipolar disorder is a psychological illness that is directly associated to suicide and is marked by episodes of manic or hypomanic periods and depressed. Suicidal conduct in people with bipolar illness has a highly complicated pathophysiological basis and closely related to psychosocial factors, genes, environment, etc. This article examines the influencing factors of physiology and psychology and the common psychotherapeutic approaches used to treat bipolar disorder, comprising psycho-educational interventions, interpersonal and social rhythm therapy, and family therapy, and cognitive behavioral therapy. The present urges people with bipolar disorder require psychosocial counseling in addition to pharmacological therapy. Several bipolar illness therapies have both advantages and disadvantages, which are currently debatable, and it is challenging to come to reliable conclusions from pertinent research. There is still a need for further future evidence-based medical research to support drug and psychotherapy treatments for bipolar disorder. Large sample studies in natural scenarios may be one of the future research directions.

Bipolar Disorder and Antidepressant Associated Hypomania

The impact of antidepressant associated hypomania on monomanic depression and its relationship to bipolar disorder. This review attempts to investigate and review current research on bipolar disorder diagnosis, the neurobiological mechanisms of antidepressant-associated hypomania, risk factors, and how to manage the occurrence of this condition. Bipolar disorder is a widespread, debilitating, recurrent, variable-severity mental health condition in which the patient exhibits two different states and unpredictable mood switching. Mania, hypomania, mixed states, depression, and depression interspersed with moments of relative health are the stages of the disorder. Early identification of bipolar disorder can improve prognosis. Patients with monophasic episodes are uncommon, as the clinical manifestation of bipolar illness is unpredictable. Throughout their lives, individuals with bipolar disorder alternate between episodes of mania or hypomania and depression. Depressive episodes in bipolar disorder are referred to as bipolar depression, and the underlying core symptom is depressed mood, which are essentially identical to the diagnostic criteria and clinical symptoms of uniphasic depression, so there is a high risk of misdiagnosis during the initial visit. Patients often choose to seek specialist help during depressive episodes, and this can lead to a tendency to overlook whether a patient has bipolar disorder. Antidepressant monotherapy is contraindicated for hypomanic episodes. Antidepressants tend to induce hypomanic and manic episodes, a phenomenon known as antidepressant-associated hypomania (AAH). All antidepressant drugs may cause mania. One is drug induced mania; The other is considered a potential bipolar disorder. There is a high co-occurrence of psychiatric disorders, but only bipolar disorder, monophasic depression, and antidepressant-induced hypomanic episodes are discussed here.

A Review of the Impact of Bipolar Disorder on Working Performance

While the symptoms of bipolar disorder (BD) have been recognized for centuries, only recently has attention been directed towards comprehensively understanding the conditions impact on everyday functioning, especially the research on bipolar patients real-life application in working environment are limited. Despite its significance, the effect of BD on work performance is frequently disregarded or inadequately quantified. Work functioning encompasses an individuals ability to acquire and maintain paid employment as well as engage in meaningful work that aligns with their educational background, skills, aspirations, and expectations. The quality of life in terms of ones health, ones ability to function physically and socially, ones ability to get employment, and ones ability to produce at work are all known to be significantly impacted by BD. Our study aimed to investigate how a specific aspect of executive functioning (EF) in individuals with BD influences work efficiency. The Result demonstrates that Bipolar illness significantly impairs functional abilities as well as work-related outcomes like productivity and job success. BD has a more significant negative impact on outcomes linked to the workplace than depression alone. It is crucial to remember that BD can also be linked to good qualities like creativity, resiliency, and high levels of energy.

Beyond Bipolar Disease: Primary Hyperparathyroidism in a Bipolar Patient

Primary hyperparathyroidism consists of a dysregulated production of parathyroid hormone that results in abnormal calcium homeostasis. It is mostly detected in the asymptomatic phase; however, presentation may include a broad spectrum of clinical manifestations. We describe the case of a 67-year-old female patient with a previous history of bipolar disorder and several vascular risk factors who presented with generalized muscular weakness, anorexia and weight loss, polydipsia, nausea, constipation and mental confusion with behavioural change. Mental and behaviour changes were previously considered a cognitive deficit. Blood tests revealed severe acute renal injury, severe hypercalcemia and frankly increased parathyroid hormone. During hypercalcaemia study, cervical ultrasound identified a nodule compatible with parathyroid adenoma, coincident with hypercaptant focus on the sestamibi scintigraphy. Patient underwent treatment with zolendronic acid and posterior parathyroidectomy with gradual symptomatic and analytical improvement. The authors report this case recalling that psychiatric pathologies can delay the diagnosis of physical conditions.

Sex Differences Among Older Adults With Bipolar Disorder: Results From the Global Aging & Geriatric Experiments in Bipolar Disorder (GAGE-BD) Project

ObjectiveSex-specific research in adult bipolar disorder (BD) is sparse and even more so among those with older age bipolar disorder (OABD). Knowledge about sex differences across the bipolar lifespan is urgently needed to target and improve treatment. To address this gap, the current study examined sex differences in the domains of clinical presentation, general functioning, and mood symptoms among individuals with OABD. MethodsThis Global Aging & Geriatric Experiments in Bipolar Disorder (GAGE-BD) study used data from 19 international studies including BD patients aged ≥50 years (N = 1,185: 645 women, 540 men).A comparison of mood symptoms between women and men was conducted initially using two-tailed t tests and then accounting for systematic differences between the contributing cohorts by performing generalized linear mixed models (GLMMs). Associations between sex and other clinical characteristics were examined using GLMM including: age, BD subtype, rapid cycling, psychiatric hospitalization, lifetime psychiatric comorbidity, and physical health comorbidity, with study cohort as a random intercept. ResultsRegarding depressive mood symptoms, women had higher scores on anxiety and hypochondriasis items. Female sex was associated with more psychiatric hospitalizations and male sex with lifetime substance abuse disorders. ConclusionOur findings show important clinical sex differences and provide support that older age women experience a more severe course of BD, with higher rates of psychiatric hospitalization. The reasons for this may be biological, psychological, or social. These differences as well as underlying mechanisms should be a focus for healthcare professionals and need to be studied further.

Type 2 diabetes mellitus is associated with manic morbidity in elderly patients with mood disorders.

The association between mood disorders, especially bipolar disorder (BD), and metabolic disorders, is long known. However, to which extent metabolic disorders affect the course of mood disorders in late life is still open to inquiring. To assess the impact of type 2 diabetes mellitus (T2DM) on late-life mood disorders a retrospective chart review was performed. Elderly depressive patients (≥ 65 years) diagnosed with Major Depressive Disorder (N = 57) or BD (N = 43) and followed up for at least 18 months were included and subdivided according to the presence of T2DM comorbidity. Vascular encephalopathy (39.1% vs. 15.6%, P = 0.021) and neurocognitive disorders (21.7% vs. 5.2%, P = 0.028), were more frequently reported in patients with T2DM than in those without. Patients with T2DM showed a greater percentage of follow-up time in manic episodes (r = -0.23, P = 0.020) and a higher rate of manic episode(s) during follow-up (21.7% vs. 5.2%, P = 0.028) than those without. When restricting longitudinal analyses to patients with bipolar spectrum disorders, results were confirmed. In line with the well-known connection between BD and metabolic disorders, our data support an association between T2DM and unfavorable course of illness in the elderly with BD.

Chronic mild stress leads to anxiety-like behavior and decreased p70 S6K1 activity in the hippocampus of male mice

Major affective disorders are highly prevalent, however, current treatments are limited in their effectiveness due to a lack of understanding of underlying molecular mechanisms. Recent studies have shown that reduced activity of p70 S6 kinase 1 (S6K1), a downstream target of the mechanistic target of rapamycin complex 1 (mTORC1), is linked to anxiety-like behavior in both humans and rodents. The purpose of this study was to investigate the relationship between S6K1 and anxiety-like behavior following chronic mild stress (CMS) and drug-induced inhibition of S6K1. Following CMS, anxiety-like behavior was evaluated using an open field (OF) and elevated plus maze (EPM) in adult male C57/Bl6 mice. After behavior analysis, samples of the hippocampus were harvested for quantification of S6K1, S6 ribosomal protein, glycogen synthase kinase-3 β (GSK3β), and beta tubulin via western blot. Our results demonstrate that CMS mice exhibit anxiety-like behavior in the OF and EPM and reduced activity of S6K1 in the hippocampus (HPC). We measured phosphorylation levels of GSK3β and found that GSK3β phosphorylation was also reduced following CMS compared to control mice. Furthermore, pharmacological inhibition of S6K1 with PF-4708671 in male mice was sufficient to produce anxiety-like behavior in the OF and EPM. These results further support the significant role of S6K1 in the pathogenesis of anxiety and affective disorders.

The Importance of α-Klotho in Depression and Cognitive Impairment and Its Connection to Glutamate Neurotransmission-An Up-to-Date Review.

Depression is a serious neuropsychiatric disease affecting an increasing number of people worldwide. Cognitive deficits (including inattention, poor memory, and decision-making difficulties) are common in the clinical picture of depression. Cognitive impairment has been hypothesized to be one of the most important components of major depressive disorder (MDD; referred to as clinical depression), although typical cognitive symptoms are less frequent in people with depression than in people with schizophrenia or bipolar disorder (BD; sometimes referred to as manic-depressive disorder). The importance of α-Klotho in the aging process has been well-documented. Growing evidence points to the role of α-Klotho in regulating other biological functions, including responses to oxidative stress and the modulation of synaptic plasticity. It has been proven that a Klotho deficit may contribute to the development of various nervous system pathologies, such as behavioral disorders or neurodegeneration. Given the growing evidence of the role of α-Klotho in depression and cognitive impairment, it is assumed that this protein may be a molecular link between them. Here, we provide a research review of the role of α-Klotho in depression and cognitive impairment. Furthermore, we propose potential mechanisms (related to oxidative stress and glutamatergic transmission) that may be important in α-Klotho-mediated regulation of mental and cognitive function.

Reward sensitivity and social rhythms during goal-striving: An ecological momentary assessment investigation of bipolar spectrum disorders

BackgroundThe reward/circadian rhythm model of bipolar spectrum disorders (BSDs) posits that when individuals with hypersensitive reward systems encounter reward-relevant events, they experience social and circadian rhythm disruption, leading to mood symptoms. The aim of the current study is to test an element of this theoretical model by investigating changes in social rhythms during and after an ecologically-valid reward-relevant event and evaluating whether the strength of these associations differ by trait reward sensitivity and BSD diagnostic group. MethodsYoung adults from three groups (low BSD risk with moderate reward sensitivity [MRew], high BSD risk with high reward sensitivity [HRew], and high reward sensitivity with BSD [HRew+BSD]) completed a reward responsiveness task and 20-day ecological momentary assessment study structured around a participant-specific goal occurring on day 15. Social rhythm disruption (SRD) and social rhythm regularity (SRR) were assessed daily. Multilevel models examined whether reward sensitivity and group moderated associations between study phase (baseline [days 1–5], goal-striving [days 16–20], or outcome [days 16–20]) and social rhythms. ResultsParticipants experienced greater SRD after the goal-striving event during the outcome phase, compared to the baseline phase. The HRew+BSD group had significant decreases in SRR during the outcome phase, and this pattern differed significantly from the low-risk and high-risk groups. Greater task reward responsiveness also was associated with significant decreases in SRR during the outcome phase. LimitationsThis study did not test whether social rhythm irregularity was associated with subsequent mood change. ConclusionsParticipants exhibited social rhythm changes over the course of this ecologically valid goal-striving period, providing evidence for the interplay between reward-activating events and social rhythms. The HRew+BSD group showed a distinct pattern in which their social rhythms were more irregular after completing reward-relevant goal-striving that was not observed for the low-BSD risk or high-BSD risk groups. These findings provide additional support for Interpersonal and Social Rhythms Therapy.

Depression Symptoms on The Dialogues of Laney Brooks in I Smile Back Movie

This qualitative research aims to find out and analyze depression symptoms of Laney Brooks on dialog I Smile Back movie. This research focus on analyzing one of four type bipolar disease episodes it called depression on the main character named Laney Brooks. The research methods used in this research are descriptive qualitative methods and library research methods and also observation method was used to get the data for this study by watching I Smile Back Movie and also using a note-taking technique to identify, and classify the data contains depression symptoms of Laney Brooks on dialog. NAMI (National Alliance Mental Illness) and Analyze Fiction by Kenney, W. P. (1966) theory has been applied in this research. The final result shows that Laney Brooks' depression symptoms are indicated by symptoms such as changes in appetite or weight, concentration and memory problems, irritability, and feelings of worthless or guilt. The symptoms of depression are shown by Laney through her dialogue.
 Keywords: Bipolar disorder, Depression, Dialogue, Movie.

Prevalence and Pattern of Olanzapine Emergent Obsessive–Compulsive Symptoms: A Cross-sectional Study

Objective: Olanzapine is an atypical antipsychotic medication and known for metabolic side effects but olanzapine-induced obsessive–compulsive symptoms are another important behavioral side effects which are less studied and only a few case reports reported these side effects. This study aims to estimate the prevalence and pattern of olanzapine-induced obsessive–compulsive symptoms in schizophrenia and bipolar affective disorders (BPADs). Methods: Subjects were recruited from psychiatry outpatient department. Subjects with schizophrenia ( n = 41) and BPAD ( n = 18) taking olanzapine at least more than 6 months were evaluated for clinical profile and the presence of obsession and compulsion symptoms by means of Yale-Brown Obsessive–Compulsive Symptom (YBOCS) checklist scale and data were collected on the structured format. Results: Eighteen (30.5%) of the 59 patients met YBOCS checklist scale for both obsessive–compulsive symptoms among subjects with schizophrenia and BPAD subjects. The mean duration of olanzapine intake was 2 years and the mean dose of olanzapine was 12.5 ± 5.21 mg in obsessive–compulsive symptoms (OCSs) present subjects and the mean dose was 13.78 ± 5.21 mg in subjects not having OCSs. Contamination was the most common obsession and checking was the most common compulsion. Conclusions: These findings suggest that obsessive–compulsive symptoms occur in a substantial percentage of patients taking olanzapine in schizophrenia and BPAD and most of the subjects had more than one OCS.

A STUDY ON BIPOLAR AFFECTIVE DISORDER SUBJECTS UNDER REMISSION – QUALITY OF SLEEP AND QUALITY OF LIFE

Aims and Objectives: People affected with bipolar disorder experience sleep disturbances which precedes an episode of depression or mania. The aim of the present study was to assess the quality of sleep and quality of life (QOL) in subjects with euthymic bipolar disorder. Methods: This was a case–control study conducted between April 2015 and September 2015. All subjects in the age of 18–60 years with bipolar affective disorder (BPAD) under remission for at least 6 months were included as cases and healthy volunteers as controls. Mini-international neuropsychiatric interview plus brief interview, Hamilton depression rating scale and young mania rating scale were used to quantify remission. Pittsburgh sleep quality index (PSQI) and Epworth sleepiness scale were used to assess quality of sleep and the WHO quality of life brief version (WHOQOL-BREF) scale was used to assess QOL. Descriptive data were given in summary statistics, Student’s t-test to compare means, one-way ANOVA to compare means with variables, Pearson’s test for correlation and Chi-square test for qualitative variables were used. p<0.05 was considered significant. Results: Fifty patients and 51 volunteers were included in the study. The mean age was 39.62±11.68 years, males and females were equal, most were married (82.17%), 34.65% had completed high school, 47.52% were unskilled workers and 73.27% were in upper lower socioeconomic status. About 95.05% did not had family history of psychiatric illness. Euthymic BPAD patients were more unmarried (p=0.033), more unemployed (p=0.0003), less full-time employees (p=0.0001), had more PSQI global score (p=0.0003) and more Epworth sleepiness scale (p=0.0004) than controls. As the duration of remission increased, sleep dysfunction improved (p=0.009). WHOQOL scores were lower in BPAD patients and overall perception of health was lower (p=0.044). BPAD patients had poor sleep hygiene and watched more television in bed, had more cigarettes and had more coffee than tea. Conclusion: Patients with BPAD even when in remission had significant sleep disturbances. Sleep hygiene factors have to be modified to improve sleep dysfunction. Psychosocial interventions are needed to achieve better QOL.

Mental health outcomes of encephalitis: An international web-based study.

Acute encephalitis is associated with psychiatric symptoms. Despite this, the extent of mental health problems following encephalitis has not been systematically reported. We recruited adults who had been diagnosed with encephalitis of any aetiology to complete a web-based questionnaire. In total, 445 respondents from 31 countries (55.1% UK, 23.1% USA) responded. Infectious encephalitis constituted 65.4% of cases, autoimmune 29.7%. Mean age was 50.1 years, 65.8% were female, and median time since encephalitis diagnosis was 7 years. The most common self-reported psychiatric symptoms were anxiety (75.2%), sleep problems (64.4%), mood problems (62.2%), and unexpected crying (35.2%). Self-reported psychiatric diagnoses were common: anxiety (44.0%), depression (38.6%), panic disorder (15.7%), and posttraumatic stress disorder (PTSD; 21.3%). Severe mental illnesses such as psychosis (3.3%) and bipolar affective disorder (3.1%) were reported. Self-reported diagnosis rates were broadly consistent with results from the Psychiatric Diagnostic Screening Questionnaire. Many respondents also reported they had symptoms of anxiety (37.5%), depression (28.1%), PTSD (26.8%), or panic disorder (20.9%) that had not been diagnosed. Rates of psychiatric symptoms did not differ between autoimmune and infectious encephalitis. In total, 37.5% respondents had thought about suicide, and 4.4% had attempted suicide, since their encephalitis diagnosis. More than half of respondents (53.5%) reported they had no, or substandard, access to appropriate mental health care. High rates of sensory hypersensitivities (>75%) suggest a previously unreported association. This large international survey indicates that psychiatric symptoms following encephalitis are common and that mental health care provision may be inadequate. We highlight a need for proactive psychiatric input.

Identification of the role of immune-related genes in the diagnosis of bipolar disorder with metabolic syndrome through machine learning and comprehensive bioinformatics analysis.

Bipolar disorder and metabolic syndrome are both associated with the expression of immune disorders. The current study aims to find the effective diagnostic candidate genes for bipolar affective disorder with metabolic syndrome. A validation data set of bipolar disorder and metabolic syndrome was provided by the Gene Expression Omnibus (GEO) database. Differentially expressed genes (DEGs) were found utilizing the Limma package, followed by weighted gene co-expression network analysis (WGCNA). Further analyses were performed to identify the key immune-related center genes through function enrichment analysis, followed by machine learning-based techniques for the construction of protein-protein interaction (PPI) network and identification of the Least Absolute Shrinkage and Selection Operator (LASSO) and Random Forest (RF). The receiver operating characteristic (ROC) curve was plotted to diagnose bipolar affective disorder with metabolic syndrome. To investigate the immune cell imbalance in bipolar disorder, the infiltration of the immune cells was developed. There were 2,289 DEGs in bipolar disorder, and 691 module genes in metabolic syndrome were identified. The DEGs of bipolar disorder and metabolic syndrome module genes crossed into 129 genes, so a total of 5 candidate genes were finally selected through machine learning. The ROC curve results-based assessment of the diagnostic value was done. These results suggest that these candidate genes have high diagnostic value. Potential candidate genes for bipolar disorder with metabolic syndrome were found in 5 candidate genes (AP1G2, C1orf54, DMAC2L, RABEPK and ZFAND5), all of which have diagnostic significance.

Perturbation of 3D nuclear architecture, epigenomic aging and dysregulation, and cannabinoid synaptopathy reconfigures conceptualization of cannabinoid pathophysiology: part 2-Metabolome, immunome, synaptome.

The second part of this paper builds upon and expands the epigenomic-aging perspective presented in Part 1 to describe the metabolomic and immunomic bases of the epigenomic-aging changes and then considers in some detail the application of these insights to neurotoxicity, neuronal epigenotoxicity, and synaptopathy. Cannabinoids are well-known to have bidirectional immunomodulatory activities on numerous parts of the immune system. Immune perturbations are well-known to impact the aging process, the epigenome, and intermediate metabolism. Cannabinoids also impact metabolism via many pathways. Metabolism directly impacts immune, genetic, and epigenetic processes. Synaptic activity, synaptic pruning, and, thus, the sculpting of neural circuits are based upon metabolic, immune, and epigenomic networks at the synapse, around the synapse, and in the cell body. Many neuropsychiatric disorders including depression, anxiety, schizophrenia, bipolar affective disorder, and autistic spectrum disorder have been linked with cannabis. Therefore, it is important to consider these features and their complex interrelationships in reaching a comprehensive understanding of cannabinoid dependence. Together these findings indicate that cannabinoid perturbations of the immunome and metabolome are important to consider alongside the well-recognized genomic and epigenomic perturbations and it is important to understand their interdependence and interconnectedness in reaching a comprehensive appreciation of the true nature of cannabinoid pathophysiology. For these reasons, a comprehensive appreciation of cannabinoid pathophysiology necessitates a coordinated multiomics investigation of cannabinoid genome-epigenome-transcriptome-metabolome-immunome, chromatin conformation, and 3D nuclear architecture which therefore form the proper mechanistic underpinning for major new and concerning epidemiological findings relating to cannabis exposure.

Application of asynchronous teaching method in the treatment of bipolar disorder

BackgroundBipolar affective disorder, as a common mental issue, is characterized by emotional abnormality and manic and depressive states. Traditional medicine has a long course of disease and generates slow poor therapeutic effects. The asynchronous teaching method takes the students’ self-consciousness as an observation perspective. It focuses on the intervention of students’ psychological conditions in a teaching situation of equality and mutual assistance. To explore the effect of asynchronous teaching method on students with bipolar disorder to help improve their mental health.Subjects and MethodsThe research took the students with bipolar affective disorder as the experiment object. The control group applied basic nursing, medication guidance and other conventional nursing approach, while the experimental group was treated with asynchronous teaching method intervention on the basis of the control group, that is, the teacher used a six-stage teaching process to guide students’ personalized development and improvement of their self-consciousness, and timely guided students to pay attention to and examine their own psychological conditions. The intervention time was 3 months. The aggressive behavior and psychological status of the students were evaluated with the Modified Overt Aggression Scale (MOAS) and the Self-reporting Inventory (SCL-90). SPSS22.0 statistical software was used for classification analysis. Measurement data was expressed as (x ± s), and P<0.05 was defined as statistically significant.ResultsAfter receiving nursing care, the students in the two groups all received improvement in their symptoms to varying degrees. The MOAS scores of the students in the experimental group after one month and three months of nursing care were (5.34 ± 0.83) and (0.31 ± 0.91), which were significantly better than those of the control group (5.42 ± 0.92) and the control group (2.08 ± 0.32), with statistical significance (P<0.05). After intervention, the SCL-90 scores of the two groups were significantly different (P<0.05).Conclusions Asynchronous teaching method intervenes students with bipolar affective disorder in a more equal way so that they can correctly and objectively view their own symptoms. The method proposed in this research has a better intervention effect on students’ psychological assessment and mental health status.

Prevalence and Factors Associated with Medication Nonadherence in Patients with Major Psychiatric Disorders in Southern India

Abstract Objectives: Historically, nonadherence to medication has been a major problem faced by health care workers while treating chronic illnesses. Nonadherence to psychotropic medications is known to be associated with poorer treatment outcomes, remarkable risk, and cost to the medical system in managing psychiatric illness. For care providers, partial compliance or discontinuation of medications represents the difficulty of maintaining treatment successes over time. In this study, we intended to assess medication adherence and to understand the reasons for nonadherence in patients with major psychiatric disorders in southern India. Methods: This is a cross-sectional observational study, done from January to June 2023. With the International Classification of Diseases 10th Revision diagnosis, we assessed patients with psychotic disorders, bipolar affective disorders, and major depressive disorder. The Medication Adherence Rating Scale (MARS) was used to assess medication adherence. The patients also completed copies of semi-structured questionnaire on their sociodemographic characteristics, their medications, and reasons for nonadherence. Results: A total of 147 subjects were assessed. We found that 68.0% of subjects were poorly adherent to the treatment based on MARS, and that only 32.0% of them were strictly adherent to the treatment. The reasons for poor adherences to the medication treatment were carelessness or forgetfulness (21.8%), adverse effects of the medications (16.3%), and the perception of the subject of feeling better (15.6%). Conclusion: More than two thirds of the subjects was found to be non-adherent to the medications. Assessing various reasons for medication adherence will help find strategies to improve medication adherence and thus outcome of the treatment.

Elevated Level of Small Extracellular Vesicles in the Serum of Patients with Depression, Epilepsy and Epilepsy with Depression

Small extracellular vesicles (sEVs) properties and sEVs composition are far from being well-studied for now, especially in the context of mental disorders. To elucidate the role of sEVs in disease we performed a quantitative analysis of the blood sEV in patients with focal epilepsy and patients with focal epilepsy with depression, psychogenic non-epileptic seizures with depression, pure depression, and bipolar affective disorder with the current depressive episode (cDE). Small EVs were isolated from the serum by gel filtration or PEG precipitation, and both methods showed very similar results. Subsequently, we precipitated neuronal sEVs and quantified it with several methods. Activity of lysosomal enzymes was determined in the sEVs fraction. The concentration of the blood sEVs in patients with depression, focal epilepsy, or depression with focal epilepsy was higher than in healthy controls. No difference was found between patients and controls in terms of neuronal sEVs concentration. Another finding of our work is that sEVs in the serum of patients contains various lysosomal enzymes. We suppose that the concentration of the blood sEVs in patients with depression or epilepsy is higher due to the sEVs secretion by the immune cells. Finding sEVs in the blood of patients with depression and focal epilepsy grants validity for future attempts to use sEVs as diagnostic tools for these disorders.

Ayurvedic management of Bipolar affective disorder: A case report

Abstract: Bipolar Affective Disorder (BPAD) is a recurrent and chronic disorder that is characterized by episodes of depression and elevated mood with intervening periods of normal mood. This disorder is associated with severely debilitating symptoms that hamper the quality of life of both patients and their caregivers as well. Bipolar disorder typically begins in adolescence or early adulthood and can have life-long adverse effects on the patient’s mental and physical health, educational and occupational functioning, and also on interpersonal relationships. A 25-year-old female presented with primary concerns of frequent speech which was occasionally incoherent, elevated mood, wandering nature, increased social mingling, increased thoughts, increased anger, irritable nature and feeling that her mother is the “devil,” and thoughts of killing her repeatedly coming to her mind for six months. A detailed interview with her parents revealed the presence of similar symptoms and irritable nature most of the time. The observations were made in the level of affective and behavioral domains of BPAD I. In Ayurveda, the condition was diagnosed as Vatikonmada (~Vata predominant insanity) with Pittanubandha (~association of Pitta) based on the clinical symptoms. Shodhana (~purificatory therapies)-based treatment protocols including Virechana (~therapeutic purgation), Snehapana (~internal oleation), Vamana (~therapeutic emesis), Basti (~enema), and Nasya (~medication through nose) followed by Shamana (~palliative procedure) were planned and administered. Psychological supportive measures such as Satvavajaya (~psychotherapy) and Yoga therapy were also sought under the supervision of Manasa roga (~psychiatric disorder) experts and qualified yoga therapists, and the mental status of the patient was assessed using the Young Mania Rating Scale. The case showed considerable relief after the treatment with Shodhana and Shamana based therapies and the psychological supportive measures.

A Misalignment-Tolerant Hybrid Coupler for Electric Vehicle IPT Charging Systems

To solve the problems of output voltage and system efficiency sharply decreasing in the case of misalignment for the electric vehicle inductive power transfer (IPT) charging system, a universal hybrid coupler with high misalignment tolerance is proposed. The hybrid coupler consists of a four-coil bipolar (BP) coupler, the T-type network and a compensation capacitor, which effectively achieves high anti-misalignment for any compensation networks. The introduction of the T-type network makes the two overlapping coils in the same side of the BP coupler transmitter decouple effectively and simplifies the design. Although the two overlapping coils in the receiver side are still coupled with each other, the parameter design only needs to consider the cross-coupling to be small enough, which significantly reduces the design difficulty of the coupler without iteration and repetition. Finally, a 2-kW misalignment-tolerance hybrid IPT system is constructed based on the proposed hybrid IPT coupler. A configurable series-series (SS) and series/inductor-capacitor- capacitor(S/LCC) compensation topologies are used to implement constant current (CC) and constant voltage (CV) load-independent outputs in the face of conditions where the coupling coefficient and load change simultaneously. The experimental results validate the correctness of the theoretical analysis.