Depressive Phase Research Articles

A novel and rapid method to detect chlorpromazine hydrochloride in biological sample based on SERS

Chlorpromazine hydrochloride (CPZ) is a phenothiazine antipsychotic drug, which can effectively relieve the symptoms of chronic or severe mental disorders and reduce the manic phase of manic depression. However, excessive CPZ (more than 2 g per day) can cause serious harm to the health of the body, such as cholestatic jaundice, leukopenia, orthostatic hypotension, extrapyramidal effects and contact dermatitis. Therefore, a simple, fast, and accurate method to detect and identify CPZ is very important, especially for the detection of biological samples. In this study, based on the principle of inorganic salt inducing nanoparticle agglomeration, we synthesized silver colloids (AgNPs) with plasmon resonance effect. And we introduced inorganic salt MgBr2 to induce self-limiting aggregation of AgNPs, resulting in a large number of “hot spots” in the nanoparticle gap. Thereby significantly enhancing the SERS intensity. The surface-enhanced Raman spectroscopy (SERS) method proposed in this paper can achieve real-time rapid detection of chlorpromazine hydrochloride in the field, with a linear range of 0.1–100 ppm (R2 = 0.992). The calculated detection limit was 0.048 ppm. This strategy enables high stability and good repeatability of the SERS spectra. The application of established method can achieve the rapid and accurate determination of CPZ in pig urine. The recovery of standard addition was 87.50–107.70% and the RSD was between 2.87% and 7.42%. Therefore, the SERS detection technology in this study provides a new insight for the rapid, effective and accurate determination and identification of CPZ in pig urine.

Low peripheral mitochondrial DNA copy number during manic episodes of bipolar disorders is associated with disease severity and inflammation

Mitochondria (Mt) are intra-cellular components essential for cellular energy processes whose dysfunction may induce premature cellular senescence and/or inflammation, both observed in bipolar disorders (BD). We investigated mitochondrial DNA copy number (mtDNAcn) levels in patients with BD being in manic, depressive or euthymic phase and in healthy controls (HC) both characterized for the levels of blood-based inflammatory markers and stigma of pathogens.312 patients with BD were compared to 180 HC. mtDNAcn were measured using a digital droplet PCR. Serum levels of 14 inflammatory molecules and 3 anti-infectious IgG stigma were respectively evaluated by electro-chemiluminescence, ELISA and dedicated immunoassays. The statistical analyses were performed using Spearman’s correlation, Wilcoxon signed-rank and Kruskal-Wallis rank sum tests. P-values were adjusted for multiple testing with Benjamini-Hochberg method.We found low levels of mtDNAcn in BD patients as compared to HC (P = 0.008) especially during manic episodes (P = 0.0002). We also observed that low levels of mtDNAcn are negatively correlated with mood and psychotic scales (PANSS, YMRS and CGI) (adjusted P (Adj P) = 0.02, 0.003 and 0.05 respectively) and positively with the GAF severity scale (Adj P = 0.002). They were also correlated with high levels of both intercellular adhesion molecule (ICAM)-1 and vascular cell adhesion molecule (VCAM)-1 (Adj P = 0.003 and 0.001) along with a trend toward increased IL-2, IL-10 and B2M circulating levels (Adj P = 0.05).Here, we report correlations between marker of mitochondria functioning and both clinical scales and inflammatory markers in BD patients experiencing manic episodes. If replicated, these finding might allow to predict transition between disease phases and to design accurate therapeutic options.

Sudden Cognitive Decline in Bipolar Mood Disorder Patient with Underlying Severe Tardive Dyskinesia After the Failure of His Deep Brain Stimulation Device Battery

Bipolar disorder (BD) is a chronic mood disorder associated with multiple comorbidities. Structural and functional abnormalities in these subjects’ brains have been related to cognitive deficits correlated with the severity of the mood symptoms. These deficits are also present in euthymic states, indicating a trait characteristic. Bipolar subjects would risk developing tardive dyskinesia due to being exposed to long periods of antipsychotic treatment. Unfortunately, the presence of tardive dyskinesia is also associated with worsening cognition. One treatment option for severe tardive dyskinesia is deep brain stimulation that has also been implicated with cognitive decline. We present a case of Bipolar disorder with underlying cognitive impairment, who had a deep brain stimulation device inserted for severe tardive dyskinesia. He was admitted to a depressive phase and was noted to have a sudden worsening of cognitive impairment following his deep brain stimulation device battery running low. Possible explanations discussed for this unexpected observation are attributed to a further deterioration of his tardive dyskinesia following the device failure and depressive episode, which causes added pseudo-cognitive deficit signs.

PERBEDAAN TINGKAT DEPRESI MASA MENOPAUSE ANTARA IBU BEKERJA DAN IBU TIDAK BEKERJA DI RT 13-15 DESA TAMBAK BAYAAN YOGYAKARTA

Background: Menopause is a significant physiology change for woman who has reach age of 40 – 65. Menopause is a phase in a woman life cycle which begins when woman stops menstruating permanently. One of the symptoms is that woman experiencing menopause becomes depressed. Objective: To find out the difference of depression phase during menopause between employed and unemployed wife in RT 13 – 15 Desa Tambak Bayan Yogyakarta. Methods: This research uses comparative descriptive non experimental quantitative with cross sectional approach. Total sample is 50 people. Sampling uses purposive sampling technique. Result: The depression phase during menopause of 14 employed women (28%) belongs to minor category, while 9 unemployed women (18%) are categorized as major, with significant 0,119>0,05. Conclusion Research result shows that there is no difference of depression level during menopause between employed and unemployed wife in RT13 – 15 Desa Tambak Bayan Yogyakarta.

A Systematic Review of the Clinical Use of Gabapentin and Pregabalin in Bipolar Disorder

Despite its prevalence and disease burden, several chasms still exist with regard to the pharmacotherapy of bipolar disorder (BD). Polypharmacy is commonly encountered as a significant proportion of patients remain symptomatic, and the management of the depressive phase of the illness is a particular challenge. Gabapentin and pregabalin have often been prescribed off-label in spite of a paucity of evidence and clinical practice guidelines to support its use. This systematic review aimed to synthesize the available human clinical trials and inform evidence-based pharmacological approaches to BD management. A total of six randomized, controlled trials (RCTs) and 13 open-label trials involving the use of gabapentin and pregabalin in BD patients were reviewed. Overall, the studies show that gabapentin and its related drug pregabalin do not have significant clinical efficacy as either monotherapy or adjunctive therapy for BD. Gabapentin and pregabalin are probably ineffective for acute mania based on the findings of RCT, with only small open-label trials to support its potential adjunctive role. However, its effects on the long-term outcomes of BD remain to be elucidated. The evidence base was significantly limited by the generally small sample sizes and the trials also had heterogeneous designs and generally high risk of bias.

Abstracts

Abstracts

A Successful ART Treatment of Advanced Maternal Age Pregnancy with HRT Along with Donor Oocytes: A Case Study at Wardha Test Tube Baby Centre

Introduction: This case report refers to 54 years old infertile woman who visit ACHARYA VINOBABHAVE RURAL HOSPITAL for her ARTHRITIS PROBLEM with her husband (age 61-year-old). During her treatment, she got to know about IVF/ART procedures. As she belongs to a rural area and is not so educated, she was not aware of this and start investigating it and found it interesting. After knowing about all these procedures, a new ray of hope was awakened in her that, she can also give birth to her baby after so much waiting and facing so much criticism by society as a barren woman. In the 36th week of gestation, one healthy baby girl has been delivered by Cesarean section. In this way, the faith between patient and doctor was built-up and inevitably, we can appreciate this case of postmenopausal gestation (Geriatric Pregnancy) As A Therapeutic Victory For Wardha Test Tube Baby Centre and for the patient as well. This infertile couple was not that financially strong and even this all procedure is too much unaffordable to them still after all these, their urge to having a baby is so high that, they invest financially as well as emotionally and also mother put her health in peril while going through IVF/ART procedure. Being an infertile woman, she has to face a lot, and in such conditions, women go through psychological torture, and from this depressive phase, many health issues arise.
 Main Symptoms and/or Important Clinical Findings: Menopausal woman, qualitative analysis of AMH show 0 ng/ml, means diminished ovarian reserve (DOR).
 The Main Diagnoses, Therapeutic Interventions, and Outcomes: The woman is pinpointed with primary infertility for 26 years. The couple suggested going for IVF/ICSI treatment with donor oocytes(frozen) and self-sperm sample, ICSI is performed and sequential embryo transfer is done and gets conceived in the first cycle of ART. As being a menopausal woman, the dose of oral intake of estrogen hormone tablets doubles as an HRT treatment.
 Conclusion: Intake of the double dose of estrogen orally (hormone replacement therapy, HRT) than the normal women whose age is not much and who is not menopausal, increases the endometrium thickness and its receptivity which helps the woman to conceive in the first cycle through ART.

SYMPTOMS OF POISONING LYMNAEA (MOLLUSCA, GASTROPODA, LYMNAEIDAE) WITH WATER MEDIUM CHROME SULFATE

Problem. Cr (III) ions are dangerously toxic for the hydrobionts of water system of the Dnieper River basin. The ions have not been previously studied in relation to their effect on a number of pond snail species. Aim. Hence, the aim of this work is to determine the range of concentrations of Cr (III) in aquatic environment that cause each of the subsequent phases of pathological process in pond snails: poisoning by the aforementioned toxicant, and presence of the complexes of symptoms of the pathological or adaptive nature that are typical for each phase. Methods.The study was conducted in 2018 in the laboratory of zoology of invertebrates of Zhytomyr Ivan Franko State University on 344 individuals of pond snails of the species Lymnaea atra, L. callomphala and L. turricula. The toxicological experiment was performed according to the technique of V. A. Alekseyev, the rate of heartbeat by D. A. Vyskushenko, the rate of branchial respiration by V. I. Zhadin, the mean daily food intake by A. P. Sushkina, the trematode (Trematoda) infection rates and morphological examination by T. A. Ginetsinskaya. Main results. Cr (III) ions are water-soluble endogenic, highly poisonous toxicant, which locally affects the respiratory branchial epithelium and skin epithelium of pond snails. The depression, and later the termination of aerobic respiration lead to their death from asphyxia. The course of poisoning is five-phase. At 0.5 MPC Cr (III) all vital functions of pond snails are carried out at the normal level (indifference phase). At concentrations of 1-2 MPC, Cr (III) ions cause an increase in their heart rate, intensity of branchial respiration, nutrition and digestion, locomotion (muscle) activity (stimulation phase). At 3 MPC of Cr (III) ions, the depression phase of intoxication develops, with the complex of symptoms including bradycardia, a sharp weakening of respiratory and trophic functions and muscle activity, with increasing degrees of hydremia, pastosity, necrosis of the respiratory epithelium and underlying tissues, and the occurrence of bleeding and hemorrhage (depressive, sublethal and lethal phases). Conclusions. The studied species of pond snails are highly sensitive to the action of Cr (III) ions and can be suggested for use as test objects in the system of hydroecological monitoring of terrestrial waters of Ukraine.

Understanding of “Feeling” and “Self-Consciousness” on the Border of the XIX–XX Centuries and M. Loewy’s Concept of Depersonalization

The aimwas to review the understanding of the phenomena of “feeling” and “self-consciousness” in the concepts of the leading European scientists at the second half of XIX — beginning of the XX centuries.Method:H.R. Lotze, I.M. Sechenov, A. Bain, W. Wundt, G. Stoerring, Th. Lipps, K. Oesterreich, E. Kraepelin and some others are analyzed.Conclusion:while Th. Lipps, H.R. Lotze, W. Wundt and K. Oesterreich were striving for strict differentiation of the notions of “sensations” and “feelings”, A. Bain, I.M. Sechenov, G. Stoerring were not following an effi cient distinction of these phenomena. H.R. Lotze, I.M. Sechenov, A. Bain distinguished in the consciousness and self-consciousness the affective and intellectual components; Th. Lipps considered as the core of self-consciousness the feelings that were very manifold and accompanied different mental acts including the act of perception: “perceptions feeling”. G. Stoerring paid attention to the lack of the feeling of activity by depersonalization, and the Austrian psychiatrist and neurologist M. Loewy elaborated the concept of “ubiquitous” “action feelings” (Actionsgefuehle) that exist outside of “pleasure — displeasure” modality. According to M. Loewy’s concept every mental act is accompanied normally by two “feelings of act”: general and specifi c, in the abnormal case one or both of them may disappear. The clinical description of weakening or loss of the action feelings: impulse feeling, perception feeling of vital sensation, perception feelings of sensations from organs of sense, “feelings of the feeling process”, “thinking feeling”, M. Loewy accomplished by “personalizing” approach to the account of one of his patient, Russian female student. M. Loewy considered the depersonalization disorders in this case as a symbolic neurosis according to S. Freud and as a psychasthenia according to P. Janet. Although E. Kraepelin defi ned selfconsciousness as merely cognitive phenomenon he interpreted depersonalization as a kind of emotional disturbance including the disorders on the level of sensations in the frames of light depressive phase of the manic-depressive illness. The M. Loewy’s concept of the “action feelings” can be applied not only for the understanding of “neurotic” depersonalization but also for depersonalization cases on the ground of depressive and mixed phase affective states.

Coping strategies in an euthymic phase for major depressed patients

Background and objectivesThe present study aimed to explore for a better understanding of the dysfunctional coping styles in patients with major depression, making a comparison between an acute and an euthymic phase. MethodsA longitudinal study included 65 patients diagnosed with recurrent major depressive disorder who were twice evaluated, clinically and for coping mechanisms, for the first time during an acute depressive episode and for the second time after 6 months of euthymia. Coping mechanisms were assessed with the Brief COPE scale and the severity of depression was evaluated by the Hamilton Depression Rating Scale — 17 items. For both phases of the illness, depression and euthymia, the results were compared with 35 healthy controls. ResultsEuthymic patients, in comparison with healthy individuals, displayed significant statistical differences (p < 0.05) showing greater use of self-distraction, disengagement, and substance use coping styles. For most of the dysfunctional coping tests applied the scores were found similar for depressed patients and euthymic ones. Also, no significant statistical associations were found between the use of dysfunctional coping mechanisms for the two phases of the examination. ConclusionsEuthymic patients, when compared with healthy controls, showed significant statistical differences in the use of dysfunctional coping strategies. No statistically significant differences were found between the two phases of depression, the use of dysfunctional coping mechanisms being the same.

Dynamics of amygdala connectivity in bipolar disorders: a longitudinal study across mood states

Alterations in activity and connectivity of brain circuits implicated in emotion processing and emotion regulation have been observed during resting-state for different clinical phases of bipolar disorders (BD), but longitudinal investigations across different mood states in the same patients are still rare. Furthermore, measuring dynamics of functional connectivity patterns offers a powerful method to explore changes in the brain’s intrinsic functional organization across mood states. We used a novel co-activation pattern (CAP) analysis to explore the dynamics of amygdala connectivity at rest in a cohort of 20 BD patients prospectively followed-up and scanned across distinct mood states: euthymia (20 patients; 39 sessions), depression (12 patients; 18 sessions), or mania/hypomania (14 patients; 18 sessions). We compared them to 41 healthy controls scanned once or twice (55 sessions). We characterized temporal aspects of dynamic fluctuations in amygdala connectivity over the whole brain as a function of current mood. We identified six distinct networks describing amygdala connectivity, among which an interoceptive-sensorimotor CAP exhibited more frequent occurrences during hypomania compared to other mood states, and predicted more severe symptoms of irritability and motor agitation. In contrast, a default-mode CAP exhibited more frequent occurrences during depression compared to other mood states and compared to controls, with a positive association with depression severity. Our results reveal distinctive interactions between amygdala and distributed brain networks in different mood states, and foster research on interoception and default-mode systems especially during the manic and depressive phase, respectively. Our study also demonstrates the benefits of assessing brain dynamics in BD.

Gender differences in the clinical course of depression in bipolar disorder

Objective: to investigate gender differences in patients with depression and bipolar disorder (BD) and their impact on the clinical course of the disease. Patients and methods . 50 women and 50 men with bipolar disorder (BD) (F31 according to the International Classification of Diseases, 10 th revision – ICD-10) were examined using a specially developed survey. Patients symptoms was assessed in accordance with the diagnostic criteria of affective disorders according to ICD-10 and DSM-V, MADRS (Montgomery-Asberg Depression Rating Scale) and Q-LES-Q-SF (Scoring the Quality of Life Enjoyment and Satisfaction Questionnaire). Results and discussion . Gender differences in the clinical course of BP were revealed. In men the disease usually starts with a mania phase followed by a marked mood increase in BD- I, a shorter period before the first mania (hypomania) if the onset is with the depression phase, mood swings and substance use disorders in puberty, which makes the diagnosis easier. In women BD diagnosis may be harder due to higher frequency of BD-II, clinical presentation with depression, longer period before the first mania (hypomania). Therefore the most important clinical markers of BD in women include the early onset of the disease, its association with neurohormonal factors, history of affective variability, substance use disorders, schizophrenia, hereditary or comorbid eating disorder in puberty or later in life. The most common clinical features during the depression phase in men include: seasonal fluctuation (worsening of symptoms in autumn and winter) and diurnal variations (improvement of symptoms in the evening), numbed emotions, depersonalization-derealization syndrome, decreased libido, difficulty in falling asleep and increased appetite and/or body mass, comorbid depression, panic attacks and alcohol and substance abuse. The depression in women with BD is characterized by a higher prevalence of apathy, tearfulness, self-harm, body dysmorphic disorder, decreased appetite. Both male and female patients with depression and BD have a high level of anxiety, presence of psychomotor retardation, self-accusation and irritancy, 10% had atypical features according to the DSM-V criteria. Women have a higher proportion of depressive episodes (including rapid cycling BD) and a higher risk of suicidal behavior, and men, due to a higher frequency of manic phases, change partners and have a history of divorce significantly more often. Conclusion. The revealed features of psychopathological symptoms, comorbid disorders, the course of the disease and correlations between individual characteristics and factors due to gender differences, can be used as markers of bipolarity, which will allow to diagnose BD earlier and more accurately and prescribe adequate therapy.

A theoretical approach for therapeutic artificial supplementary lighting in elderly living spaces

Depression is a leading cause of disability and death worldwide. Due to physiological and psychological degeneration, the elderly suffer from an increased risk and incidence of depression. Light therapy (LT), a non-intrusive approach for treating depression, exerts powerful effects on emotional and cognitive disorders, and can thus be installed in elderly living spaces (ELSs) in order to provide daily intervention that prevents the occurrence of the early phase of depression, delays its development, and promotes rehabilitation over its entire course. LT requires specific thresholds of light intensity, exposure duration, exposure time, and spectrum. The high incidence of seasonal affective disorder (SAD) triggered by daylight deprivation (caused by seasonal solar variation) suggests that daylight is insufficient for stable LT. Thus, custom-designed supplementary artificial lighting is needed.In this work, based on literature review and a synthesis of the light patterns related to antidepressant efficacy, visual comfort, and visual characteristics of the elderly, we recommended a set of a priori technical thresholds for light therapy installations in ELSs. Accordingly, using Radiance with Chengdu as a study case, we calculated the quantity and distribution of daylight and compared supplementary artificial lighting from the ceiling (horizontal lighting) and walls (vertical lighting), finding that vertical lighting is more advantageous in terms of both uniformity and energy efficiency for creating a lighting environment for daily light intervention in ELSs. This study introduces a theoretical approach for therapeutic lighting design, and the conclusions can provide technical guidance for applying light therapy in ELSs.

A unified model of the pathophysiology of bipolar disorder.

This work provides an overview of the most consistent alterations in bipolar disorder (BD), attempting to unify them in an internally coherent working model of the pathophysiology of BD. Data on immune-inflammatory changes, structural brain abnormalities (in gray and white matter), and functional brain alterations (from neurotransmitter signaling to intrinsic brain activity) in BD were reviewed. Based on the reported data, (1) we hypothesized that the core pathological alteration in BD is a damage of the limbic network that results in alterations of neurotransmitter signaling. Although heterogeneous conditions can lead to such damage, we supposed that the main pathophysiological mechanism is traceable to an immune/inflammatory-mediated alteration of white matter involving the limbic network connections, which destabilizes the neurotransmitter signaling, such as dopamine and serotonin signaling. Then, (2) we suggested that changes in such neurotransmitter signaling (potentially triggered by heterogeneous stressors onto a structurally-damaged limbic network) lead to phasic (and often recurrent) reconfigurations of intrinsic brain activity, from abnormal subcortical-cortical coupling to changes in network activity. We suggested that the resulting dysbalance between networks, such as sensorimotor networks, salience network, and default-mode network, clinically manifest in combined alterations of psychomotricity, affectivity, and thought during the manic and depressive phases of BD. Finally, (3) we supposed that an additional contribution of gray matter alterations and related cognitive deterioration characterize a clinical-biological subgroup of BD. This model may provide a general framework for integrating the current data on BD and suggests novel specific hypotheses, prompting for a better understanding of the pathophysiology of BD.

The association of breast cancer-related lymphedema after unilateral mastectomy with shoulder girdle kinematics and upper extremity function

The purpose of this study was to examine the association of breast cancer-related lymphedema on shoulder girdle kinematics and upper extremity function. The study included 67 breast cancer survivors with and without unilateral lymphedema. Individuals were divided into non-lymphedema, moderate and severe lymphedema groups according to the volumetric measurement difference between the affected and unaffected upper extremities. A three-dimensional motion monitor-electromagnetic system was used to analyze scapular movements during the elevation and depression phases of the upper extremity elevation in the scapular plane. Shoulder range of motion was assessed with a digital inclinometer. Upper extremity function was assessed with the ‘Disabilities of the Arm, Shoulder, and Hand Questionnaire–Short Form (Quick-DASH)’. The scapular upward rotation was lower for the severe lymphedema group than for the non-lymphedema group in the 90–60–30° depression phases of arm elevation (p < .05). The scapular anterior tilt was higher for the severe lymphedema group than for the non-lymphedema group in the 30° depression phase of arm elevation (p < .05). Shoulder abduction range of motion was the lowest in the severe lymphedema group (p < .05). The non-lymphedema group had the lowest quick-DASH score and the severe lymphedema group had the highest score (p < .05). There were statistically significant moderate associations between the quick-DASH scores and scapular movements in all groups (p < .05). The development, presence and/or severity of lymphedema were associated with impaired shoulder-girdle kinematics and decreased upper extremity function. However, a need exists for longitudinal studies comparing individuals with and without lymphedema and healthy controls.

Confirmatory evaluation of the bipolar depression rating scale (BDRS) in a large sample of female patients with bipolar depression

Objective The Bipolar Depression Rating Scale (BDRS) is a structured rating scale designed to assess depressive and mixed symptoms in bipolar disorder (BD). Previous studies evaluating the scale have been performed on small samples or on patients in a depressive phase, but not on patients in a mixed or manic phase. This study evaluated the Persian version of the BDRS regarding its factor structure, reliability, and validity in a large sample of Iranian women with BD in a depressive or mixed/manic phase. Methods Three-hundred and one female BD inpatients completed the BDRS, the Beck Depression Inventory-II (BDI-II), the Hamilton Depression Rating Scale (HDRS), the Montgomery-Åsberg Depression Rating Scale (MADRS), and the Young Mania Rating Scale (YMRS). Results The BDRS demonstrated a three-factor structure with good reliability. The BDRS and its psychological and somatic symptom clusters had stronger correlations with other measures of depressive symptoms than a measure of mania. The BDRS mixed symptom cluster also had a stronger correlation with a measure of mania than other measures of depression, supporting the scales’ convergent and discriminant validity. Conclusions The BDRS demonstrated psychometric validity in assessing depressive and mixed symptoms in Iranian women with BD in a depressive or mixed/manic phase. KEY POINTS The Bipolar Depression Rating Scale (BDRS) was validated in Iranian women with BD. The BDRS showed a three-factor structure, similar to the original validation. The BDRS had good reliability based on Omega and test-retest coefficients. The findings provided evidence for the convergent and discriminant validity of the BDRS.

That’s not my family: The undercover bipolar patient

IntroductionBipolar disorder is a serious psychiatric condition based on depressive, manic, and mixed phases. Bipolar disorder has been usually divided into type I (manic phases and depressive phases) and type II (hypomanic and depressive phases). Furthermore, subsequent classifications have been developed based on subtypes complexity.ObjectivesA case of a 52-year-old man is presented. The patient had suffered depressive symptoms and self-destructive ideation. He had sold his house to pay for drugs and prostitution, even though he was in quarantine for COVID-19. The patient had a history of depressive episodes with milder manic episodes which had been treated with antidepressants.MethodsAnalytical and imaging tests were performed without findings. Mood stabilizing treatment was started based on lithium salts. He became perplexed and suspicious of the medication. Auditory hallucinations appeared congruent with the mood and he began to think that his relatives were dead; the patient started to communicate via telephone with actors. A treatment based on olanzapine 30mg/d was started.ResultsThe clinic was resolved with antipsychotic treatment. The diagnosis of Bipolar Disorder has been made in youth; however, some patients symptoms could be camouflaged and allow a functional life. Depressive episodes could present with psychotic symptoms and predispose more to suicide attempts than manic phases.ConclusionsThe early-stage diagnosis should play a key role on bipolar disorder control. More public and clinic efforts are needed to prevent non-easily distinguishable cases which could derived on serious social and health problems.DisclosureNo significant relationships.

POS-530 ANXIETY AND DEPRESSION IN HEMODIALYSIS PATIENTS DURING COVID-19

The current Coronavirus pandemic (COVID-19) presents a peculiar and unusual reality. It affects people certainly physically but also psychologically. Hemodialysis patients move to their center three times a week even during the confinement period.Indeed, in such context, they may experience reactions and phases of stress, anxiety and depression. Hence, it is important to study the psychological impact on them. A sample of hemodialysis patients in our unit completed a self-report survey while being treated. It included questions about current mental health and experiences with COVID-19 , refering to the Hospital Anxiety And Depression Scale HADS. We have twenty hemodialysis beds. We were able to isolate two beds for patients with covid-19. During the second wave, we dialyzed 45 patients tested positive for covid-19 in the circuit reserved. Forty patients participated in the study. They were equally divided by gender, with an average age of 49.45 [25-77]. The analysis revealed that only one patient had definite anxiety symptoms , which is an unempolyed married female hemodialysed since two years. Two others had questionable anxiety or depressive symptoms ; A married woman and a single smoker man ,also unemployed and have been on hemodialysis for less than 5 years. Meanwhile, 10% of the studied patients holding history of psychiatric illness had no psychological symptoms. To adapt to the psychological impact, 50% tend to reduce the number and duration of their hemodialysis sessions. Otherwise, all patients wear their surgical masks. Temperature measurementwas systematic at the entrance as well as the washing of hands. In the long term, this health crisis is expected to significantly improve our understanding of mental health risk factors in chronic hemodialysis patients facing the COVID-19 pandemic. Therefore, we would be able to implement effective prevention strategies to promote mental well-being .No need to stress if we respect the rules of hygiene and the wearing of masks for both patients and health care professionals .

Creativity and psychopathology – an interdisciplinary view

IntroductionSince ancient philosophy extraordinary creativity is associated with mental disorders, emotional and cognitive destabilization, and melancholia. We here summarize the results of empirical and narrative studies and analyze most prominent cases of highly creative persons who suffered from depression, bipolar and schizotypic disorders, drug- and alcohol addiction. Hereby, we focus on the interaction of creative processes with “bipolar” personality traits. Finally, we offer an interdisciplinary interpretation of the creative dialectics between order and chaos.ObjectivesAn interdisciplinary concept of the relationship between creativity and psychopathology is shown to be essential for reasonable psychopharmacological and psychotherapeutic treatment of creative individuals.MethodsOn the basis of empirical-statistical and biographical studies we offer a comprehensive concept of the interaction between creativity and psychopathology.ResultsThe exemplary cases of J. W. v. Goethe and Robert Schumann show a complex interaction of mood swings with creative achievements. Dysthymic and mild depressive phases were associated with creative efforts whereas severe depressive episodes inhibited their creativity. Mild mood swings and “bipolar personality traits” interacted constructively with their creative striving. With respect to the relationship of alcohol- and drug-abuse, we show on behalf of a detailed analysis of the life and work of prominent Pop-Icons that addiction mostly leads to psycho-social disintegration and destruction of creativity.ConclusionsAn interplay between cognitive coherence and incoherence, emotional stability and instability, order and chaos accompanies many creative processes. The interdisciplinary approach shows that psychopathology can motivate creative efforts. However, if expressed severely, mental disorders inhibit or even destroy creativity.DisclosureNo significant relationships.

Deficiency of Biogenic Amines Modulates the Activity of Hypoglossal Nerve in the Reserpine Model of Parkinson's Disease.

The underlying cause of respiratory impairments appearing in Parkinson’s disease (PD) is still far from being elucidated. To better understand the pathogenesis of respiratory disorders appearing in PD, we studied hypoglossal (HG) and phrenic (PHR) motoneuron dysfunction in a rat model evoked with reserpine administration. After reserpine, a decrease in the baseline amplitude and minute HG activity was noted, and no depressive phase of the hypoxic ventilatory response was observed. The pre-inspiratory time of HG activity along with the ratio of pre-inspiratory time to total respiratory cycle time and the ratio of pre-inspiratory to inspiratory amplitude were significantly reduced during normoxia, hypoxia, and recovery compared to sham rats. We suggest that the massive depletion of not only dopamine, but above all noradrenaline and serotonin in the brainstem observed in our study, has an impact on the pre-inspiratory activity of the HG. The shortening of the pre-inspiratory activity of the HG in the reserpine model may indicate a serious problem with maintaining the correct diameter of the upper airways in the preparation phase for inspiratory effort and explain the development of obstructive sleep apnea in some PD patients. Therapies involving the supplementation of amine depletion other than dopamine should be considered.