History Of Affective Disorder Research Articles

Reducing default mode network connectivity with mindfulness-based fMRI neurofeedback: a pilot study among adolescents with affective disorder history

Adolescents experience alarmingly high rates of major depressive disorder (MDD), however, gold-standard treatments are only effective for ~50% of youth. Accordingly, there is a critical need to develop novel interventions, particularly ones that target neural mechanisms believed to potentiate depressive symptoms. Directly addressing this gap, we developed mindfulness-based fMRI neurofeedback (mbNF) for adolescents that aims to reduce default mode network (DMN) hyperconnectivity, which has been implicated in the onset and maintenance of MDD. In this proof-of-concept study, adolescents (n = 9) with a lifetime history of depression and/or anxiety were administered clinical interviews and self-report questionnaires, and each participant’s DMN and central executive network (CEN) were personalized using a resting state fMRI localizer. After the localizer scan, adolescents completed a brief mindfulness training followed by a mbNF session in the scanner wherein they were instructed to volitionally reduce DMN relative to CEN activation by practicing mindfulness meditation. Several promising findings emerged. First, mbNF successfully engaged the target brain state during neurofeedback; participants spent more time in the target state with DMN activation lower than CEN activation. Second, in each of the nine adolescents, mbNF led to significantly reduced within-DMN connectivity, which correlated with post-mbNF increases in state mindfulness. Last, a reduction of within-DMN connectivity mediated the association between better mbNF performance and increased state mindfulness. These findings demonstrate that personalized mbNF can effectively and non-invasively modulate the intrinsic networks associated with the emergence and persistence of depressive symptoms during adolescence.

The Outcome of Psychiatric Rehabilitation Treatment Depends on Affective State at the Time of Admission.

In Austria, new approaches of rehabilitation programs focus on the prevention of mental illness and offer treatment not only for acute psychiatric patients, but also for those who are at risk of developing a mental disorder or have recovered from one.The aim of this study was to determine the effects of a psychiatric rehabilitation program on individuals with different mood states. 600 patients with a history of affective disorder were tested at the time of admission to an Austrian inpatient psychiatric rehabilitation center. Data of extreme groups - patients who were depressed (n=59; BDI-II<9 and HAMD<8) or euthymic (n=59; BDI<18 and HAMD>19) at the time of therapy start - were analyzed. The participants completed the Maslach Burnout Inventory - General Survey, the Symptom Checklist - Revised and the Stress Coping Questionnaire at the beginning and the end of the 6-weeks rehabilitation program. After 6 weeks, both groups showed significantly less psychiatric symptoms (BDI-II, HAMD, SCL-90, and negative coping strategies (SVF). Importantly, work-related stress symptoms ("burnout" symptoms) improved significantly in the euthymic group. Euthymic patients seem to be able to focus on work-related stress symptoms including reduced emotional exhaustion through treatment, while currently depressed patients primarily benefit by an improvement in general psychiatric symptomatology. The results indicate the crucial role of mood state validated with standardized psychological questionnaires BDI-II and HAMD at time of admission to such programs. These findings could have implications on treatment decisions for psychiatric patients and assist in making a forecast concerning ability to recover and treatment prognosis.

Behavioral and Emotional Reactions of the Russian Population to the Beginning of the COVID-19 Pandemic: An On-Line Survey Results.

The study aimed to identify the patterns of adaptive and behavioral strategies in different population groups, also to evaluate their association with the infection prevention strategies and the distress during the COVID-19 pandemic. The data were obtained from the on-line survey of 1958 respondents (mean age 31±12 years) from March 30, 2020 to April 5, 2020. 578 respondents reported a history of affective disorders; 884 respondents - a history of somatic disease. The level of anxiety distress was evaluated with the Psychological Stress Measure (PSM-25). The analysis of variance was used for statistics. p<0.05 was considered significant. The effect sizes (ES) were evaluated according to Cohen's d and Cramer's V criteria. The average PSM-25 score corresponded to moderate stress intensity. An increased level of psychological stress was associated with the young age of the respondents, the history of affective disorders and somatic diseases, the compliance with self-isolation, the practice of social distancing, and the use of sanitizer. Concerns about the availability of protective equipment were specifically associated with the self-isolation compliance (ES=0.1); the combination of concerns about the contagiousness of the virus (ES=0.12) and the inaccessibility of daily medications (ES=0.11) - with the principles of social distance. Moreover, the concerns about the lack of specific treatment, the danger to one's own life, the contagiousness of the virus, and the lack of protective equipment were associated with the protective behavior resulting in increased hand hygiene. The history of affective disorders was rarely associated with wearing masks and gloves, but more often - with the use of self-isolation strategies. The psychological reactions of the population during the COVID-19 pandemic are specifically associated with adaptive behavior in the process of anti-epidemic measures. Respondents with affective disorders experienced specific patterns of anxiety about coronavirus infection in combination with high rates of psychological stress.

Depression during the COVID-19 pandemic (analysis of clinical cases)

Currently, in various world regions, the prevalence of depressive and anxiety disorders due to the impact of coronavirus infection is repeatedly increased compared to that in previous years. Among the predictors of their development during the pandemic, there are COVID-19 symptoms, a history of mental disorders, as well as restrictive measures, and financial losses.The paper describes three clinical cases of depressive disorders during the COVID-19 pandemic, with the depiction of the anamnesis, somatic and mental status, the patholopsychogical qualification of the condition, and the justification of a therapy regimen. The multifactorial stressor effect of the COVID-19 pandemic has provoked an exacerbation of depression in a male patient with a history of affective disorder; the development of a nosogenic depressive reaction of demoralization in a female patient with coronavirus pneumonia; the worsening of somatization dysthymia in a female patient of involutional age. The timely recognition of depression and its treatment with currently available antidepressants have contributed to the achievement of high-quality remission, the increase of stress resistance, and the improvement of quality of life in the patients.

Cognitive processing of infant stimuli in pregnant women with and without affective disorders and the association to postpartum depression

Pregnancy and childbirth are among the strongest risk factors for depression but the neurocognitive mechanisms underlying this enhanced risk are unknown. This study investigated emotional and non-emotional cognition in 57 pregnant women with or without an affective disorder during their third trimester, and the association between cognitive biases and subsequent postpartum depression (PPD). Of the pregnant women, 22 had a diagnosis of unipolar disorder (UD) and seven of bipolar disorder (BD) in full or partial remission, while 28 had no history of affective disorder. We included a control group of 29 healthy non-pregnant women. First, participants were interviewed, completed non-emotional and emotional cognitive tests and lastly filled out questionnaires. The participants were assessed two times after birth: at a home visit shortly after birth, and with a telephone interview to assess PPD in the first six months after birth. Healthy pregnant women rated infant cries less negatively than non-pregnant women, possibly reflecting preparation for motherhood. Pregnant women with UD exhibited a negative bias in ratings of infant cries, whereas pregnant women with BD showed a positive bias in ratings of infant happy faces and recognition of adult facial expressions. Across all pregnant women, more negative ratings of infant cries were associated with enhanced risk of PPD. Negatively biased perception of infant cries during pregnancy may thus signal vulnerability toward PPD.

Use of social media and online dating among individuals with a history of affective disorder.

To investigate how individuals with a history of affective disorder use and perceive their use of social media and online dating. A questionnaire focusing on affective disorders and the use of social media and online dating was handed out to outpatients from unipolar depression and bipolar disorder clinics and general practice patients with or without a history of affective disorders (latter as controls). The association between affective disorders and use of social media and online dating was analysed using linear/logistic regression. A total of 194 individuals with a history of unipolar depression, 124 individuals with a history of bipolar disorder and 196 controls were included in the analysis. Having a history of unipolar depression or bipolar disorder was not associated with the time spent on social media compared with controls. Using the controls as reference, having a history bipolar disorder was associated with use of online dating (adjusted odds ratio: 2.2 (95% CI: 1.3; 3.7)). The use of social media and online dating had a mood-congruent pattern with decreased and more passive use during depressive episodes, and increased and more active use during hypomanic/manic episodes. Among the respondents with a history of affective disorder, 51% reported that social media use had an aggravating effect on symptoms during mood episodes, while 10% reported a beneficial effect. For online dating, the equivalent proportions were 49% (aggravation) and 20% (benefit), respectively. The use of social media and online dating seems related to symptom deterioration among individuals with affective disorder.

Patterns and predictors of fatigue following living donor nephrectomy: Findings from the KDOC Study.

This study sought to identify the prevalence, pattern, and predictors of clinical fatigue in 193 living kidney donors (LKDs) and 20 healthy controls (HCs) assessed at predonation and 1, 6, 12, and 24monthspostdonation. Relative to HCs, LKDs had significantly higher fatigue severity (P=.01), interference (P=.03), frequency (P=.002), and intensity (P=.01), and lower vitality (P<.001), at 1-month postdonation. Using published criteria, significantly more LKDs experienced clinical fatigue at 1 monthpostdonation, compared to HCs, on both the Fatigue Symptom Inventory (60% vs. 37%, P<.001) and SF-36 Vitality scale (67% vs. 16%, P<.001). No differences in fatigue scores or clinical prevalence were observed at other time points. Nearly half (47%) reported persistent clinical fatigue from 1 to 6months postdonation. Multivariable analyses demonstrated that LKDs presenting for evaluation with a history of affective disorder and low vitality, those with clinical mood disturbance and anxiety about future kidney failure after donation, and those with less physical activity engagement were at highest risk for persistent clinical fatigue 6monthspostdonation. Findings confirm inclusion of fatigue risk in existing OPTN informed consent requirements, have important clinical implications in the care of LKDs, and underscore the need for further scientific examination in this population.

Antidepressant use during pregnancy and risk of autism spectrum disorder and attention deficit hyperactivity disorder: systematic review of observational studies and methodological considerations

BackgroundAntidepressant exposure during pregnancy has been associated with an increased risk of autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) in several observational studies. We performed a systematic review of these studies to highlight the effect that important methodological limitations have on such analyses and to consider approaches to the conduct, reporting and interpretation of future studies.MethodsA review of MEDLINE and EMBASE identified case–control, cohort and sibling studies assessing the risk of ASD and ADHD with antidepressant use during pregnancy. Approaches to confounding adjustment were described. Crude and adjusted effect estimates for comparisons between antidepressant exposure during pregnancy vs. all unexposed women were first meta-analysed using a generic inverse variance method of analysis, followed by effect estimates for alternative pre-selected comparison groups.ResultsA total of 15 studies measuring ASD as an outcome (involving 3,585,686 children and 40,585 cases) and seven studies measuring ADHD as an outcome (involving 2,765,723 patients and 52,313 cases) were identified. Variation in confounding adjustment existed between studies. Updated effect estimates for the association between maternal antidepressant exposure during pregnancy vs. all unexposed women remained statistically significant for ASD (adjusted random-effects risk ratio [RaRR] 1.53, 95% confidence interval [CI] 1.31–1.78). Similar significant associations were observed using pre-pregnancy maternal antidepressant exposure (RaRR 1.48, 95% CI 1.29–1.71) and paternal antidepressant exposure during pregnancy (1.29, 95% CI 1.08–1.53), but analyses restricted to using women with a history of affective disorder (1.18, 95% CI 0.91–1.52) and sibling studies (0.96, 95% CI 0.65–1.42) were not statistically significant. Corresponding associations for risk of ADHD with exposure were: RaRR 1.38, 95% CI 1.13–1.69 (during pregnancy), RaRR 1.38, 95% CI 1.14–1.69 (during pre-pregnancy), RaRR 1.71, 95% CI 1.31–2.23 (paternal exposure), RaRR 0.98, 95% CI 0.77–1.24 (women with a history of affective disorder) and RaRR 0.88, 95% CI 0.70–1.11 (sibling studies).ConclusionsExisting observational studies measuring the risk of ASD and ADHD with antidepressant exposure are heterogeneous in their design. Classical comparisons between exposed and unexposed women during pregnancy are at high risk of residual confounding. Alternative comparisons and sibling designs may aid the interpretation of causality and their utility requires further evaluation, including understanding potential limitations of undertaking meta-analyses with such data.

Risk for affective disorders is associated with greater prefrontal gray matter volumes: A prospective longitudinal study.

BackgroundMajor depression and bipolar disorders aggregates in families and are linked with a wide range of neurobiological abnormalities including cortical gray matter (GM) alterations. Prospective studies of individuals at familial risk may expose the neural mechanisms underlying risk transmission.MethodsWe used voxel based morphometry to investigate changes in regional GM brain volume, over a seven-year period, in 37 initially healthy individuals having a mono- or di-zygotic twin diagnosed with major depression or bipolar disorder (high-risk group; mean age 41.6 yrs.) as compared to 36 individuals with no history of affective disorders in the index twin and first-degree relatives (low-risk group; mean age 38.5 yrs.).ResultsGroups did not differ in regional GM volume changes over time. However, independent of time, high-risk twins had significantly greater GM volumes in bilateral dorsal anterior cingulate, inferior frontal gyrus and temporoparietal regions as compared to low-risk twins. Further, individuals who developed an affective disorder at follow-up (n = 12), had relatively the largest GM volumes, both at baseline and follow-up, in the right dorsal anterior cingulate cortex and right inferior frontal cortex compared to high- and low-risk twins who remained well at follow-up.ConclusionThis pattern of apparently stable grater regional GM volume may constitute a neural marker of an increased risk for developing an affective disorder in individuals at familial risk.

Bipolar versus schizoaffective disorder: Clinical profiles

IntroductionDifferentiating between bipolar (BD) and schizoaffective disorder (SAD) can be challenging, especially during early stages of the illness.ObjectivesComparing clinical profiles and socio-demographic characteristics of patients diagnosed with BD and SAD.MethodsThe study, conducted between 2014–2016, included 67 inpatients from the Timisoara Psychiatric Clinic, diagnosed with either BD (n = 35) or SAD (n = 32), according to ICD-10 criteria. The following parameters were analyzed: number of episodes, number of times hospitalized, onset age, frequency and nature of psychotic symptoms, family history of psychiatric disorders and socio-demographic characteristics (age, sex, marital status). Data were obtained by direct interview and patient files. Symptom severity was measured with Brief Psychiatric Rating Scale (BPRS).ResultsThere were no significant differences between the two samples regarding age or sex distribution. Schizoaffective patients were more frequent unmarried (P = 0.007). Onset age was significantly lower in SAD patients (22.41 years for SAD, 28.36 years for BD). SAD patients had the highest number of episodes and needed more frequent hospitalization. Bipolar patients had higher percentage of family history of affective disorders when compared to schizoaffective patients (41% versus 36%). Hallucinations were more frequently found in schizoaffective patients than in bipolar patients (P = 0.004). We found no significant differences between the two samples regarding the presence or the type of delusions. The SAD sample had significantly higher BPRS total scores than bipolar patients (P = 0.035).ConclusionsAlthough this study revealed numerous similarities between BD and SAD, it also identified differences that may be helpful in establishing the correct diagnosis.Disclosure of interestThe authors have not supplied their declaration of competing interest.

The SAINT: A Guided Self-Help Approach for People With Intellectual Disabilities

ABSTRACTIntroduction: This article introduces the SAINT (Self-Assessment and INTervention), a guided self-help intervention for the treatment of mild depression in people with intellectual disabilities. Method: The study used a single-case experimental design and adopted quality frameworks specific to the approach to describe the participants and to standardize the study. The aim was to examine the acceptability and effectiveness of the SAINT on reducing symptoms of anxiety and depression. Semi-structured interviews were conducted to record user experiences and a framework-analysis approach was used. Attendance at sessions was also monitored. Results: Nine people receiving guided self-help using SAINT demonstrated a decrease in symptoms for both intervention phases for either depression or anxiety, with four showing a decrease in mean symptom scores in both intervention phases for both depression and anxiety. Those with a history of affective disorders and those with moderate intellectual disabilities showed improved symptom scores during both intervention phases. Summary and Conclusion: The idea that the SAINT can be feasibly implemented in routine clinical practice was broadly supported, with the positive outcomes relating to symptom reduction and acceptability. From the feedback received, the SAINT is tolerated well by participants and viewed positively by those using it and those who have supported people in its use.

A chronobiological approach to therapy for depression

In the modern world, the discrepancy between biological and social rhythms in the presence of the existing genetic predisposition increases a risk for the occurrence and chronicity of depression. To solve this problem, various approaches, including a chronobiological one, are applied. Objective: to explore the relationship between chronobiological characteristics and psychopharmacotherapy in patients with depression. Patients and methods Eighty patients with depression, among whom women (68.7%) predominated, were examined. The age of the patients was 18–75 years (47.6±15.6 years). Their chronotype was identified using the Morningness–Eveningness Questionnaire (MEQ) to determine the type of circadian rhythm. Changes in the patients' status were clinically assessed utilizing the psychometric indicators. Results. Sleep disorders were most pronounced in recurrent depression (4.1±1.1 scores) (Montgomery–Asberg Depression Rating Scale, MADRS, item 4). The inverted pattern of daily variations was more frequently observed in patients with a first depressive episode (p<0.05). According to MEQ scores, the investigators identified three groups of patients with morning (5%), intermediate (65%), and evening (30%) chronotypes. At the same type, the latter chronotype was clearly associated with the positive family history of affective disorders, earlier onset of depression, a larger number of experienced episodes, a higher average duration of an episode in the history, younger age, and severe condition when visiting a physician's office required additional psychopharmacotherapy. It was more effective to use antidepressants in the morning, if the patient had an evening chronotype, and in the evening, if he/she had a morning/intermediate chronotype. Conclusion. The patients with initially different chronotypes showed differences in the premorbid, onset, and course of the disease. The account of a chronotype can be considered as one of the approaches to optimize psychopharmacotherapy.

Markers of subsyndromal depression in very old persons

To investigate factors associated with subsyndromal depression (SSD) in very old persons, and to develop a model for prediction of SSD among very old persons. A cross-sectional, population-based study was undertaken on 85-year-old persons in Sweden. Data were collected from a postal questionnaire, assessments in the participants' homes and at reception visits. Depressiveness was screened with GDS-15 (Geriatric Depression Scale), and the results were classified into three outcome categories: non-depression (ND), SSD and syndromal depression. Data were analysed with binary logistic, ordinal logistic and linear regression. With univariate logistic regression 20 factors associated with SSD were identified in very old persons, and the four hypothesized domains--sociodemographic factors, declining physical functioning, neuropsychiatric factors and existential factors--significantly related to SSD. The multivariate logistic model included seven independent factors that increase the likelihood of SSD instead of ND (lower self-perceived health, life not meaningful, problems with self-care, use of tranquilizing medication, no contact with neighbours, history of affective disorder and history of stroke). The ordinal logistic and the linear regression models resulted in seven partly different factors for predicting SSD and depressiveness, in the very old. The identified markers may help clinicians with the detection, prevention and treatment of SSD in very old persons. The findings indicate the importance of a comprehensive functional approach to diagnosing and treating depressiveness in this population, and the findings might be interpreted as offering support for the coexistence of a dimensional and a categorical view on depressive disorders.

Profile of the Patients with Psychiatric Medication Abuse in a Mental Health Center.

Objectives There is an increasing demand for treatment for dependence on different psychiatric medication like benzodiazepines. The goal is to determine the user's profile that is attended in a mental health center. Material/Methods We obtained a sample of 30 users, divided into two groups: A) main drug benzodiazepines, B) primary drug others. Sociodemographic, psychiatric and drug use variables are collected, making a descriptive retrospective analysis, using means for quantitative variables and proportions for categorical variables. Results Group A is composed mainly of women (63.6%) of average age 46 years, and the group B of males (75%) with slightly higher average age (48 years). In group A and B the average level of education is primary/secondary education. Overall, they do not work and are single, having more pensioners and separated in group B. In both groups, more than half have a history of affective disorders, often followed by anxiety disorders, with higher prevalence in group A (54.6% vs 36.8%), and personality disorders (77.3% and 75%). In reference to group B, the primary drug of abuse is mostly alcohol. In general there is higher prevalence of nicotine dependence. Conclusion The profile of group A is a middle-aged woman who presents comorbidity with affective and personality disorders. The profile of group B is a middle-aged man, alcohol dependent, with earlier onset of use and with personality disorder.

Are Social Comparisons Detrimental for the Mood and Self-Esteem of Individuals with an Affective Disorder?

The current study tested whether experimentally induced social comparisons affect mood and self-esteem in euthymic unipolar and bipolar patients, compared to participants without any history of affective disorders. It was predicted that unfavourable upward comparisons with feedback that another person was performing better would have a negative effect on implicit self-esteem and explicit mood (positive and negative affect) in unipolar patients. We further predicted that favourable downward social comparisons with feedback that another person was performing worse will enhance mood and self-esteem, especially in bipolar patients. Participants were randomly assigned to upward or downward social comparison in a brainstorming task. As was expected, after upward comparison, negative affect increased, whereas positive affect decreased in all groups. After downward comparison, positive affect initially increased in unipolar and healthy subjects, while in bipolar patients no significant change in positive affect was observed. Implicit self-esteem generally showed an unexpected decrease regardless of the comparison condition and group. Remitted bipolar patients seemed to be less sensitive to positive feedback which may reflect ‘dampening’ of positive affect which has been observed before in bipolar patients.

Serum NGF, BDNF and IL-6 levels in postpartum mothers as predictors of infant development: the influence of affective disorders.

BackgroundEarly adverse experiences are associated with increased risk of developing psychiatric disorders, although little is known about the neurobiological mediators involved. The mechanisms by which early environmental influences may mediate vulnerability in the development of offspring await further investigation. The present study correlated the NGF, BDNF, IL-6 and cortisol levels of mothers with postpartum affective disorders (PPAD) with infant development.MethodsA longitudinal study was performed with 152 pregnant women and their infants. Between 60 and 120 days after delivery, women were interviewed and provided biological samples for biochemical analysis, and the infants were examined for neurobiological-motor development.ResultsOverall, the mothers' history of affective disorders, PPAD and anxiety disorder were associated with infant motor development. Using an adjusted linear regression analysis, PPAD (p = 0.049), maternal anxiety disorder (p = 0.043), NGF level (p = 0.034) and infant cortisol level (p = 0.013) were associated with infant motor development. Using a factorial analysis of primary components, two components were retained. The psychological factor was characterized by a positive loading of a history of affective disorder, PPAD and anxiety disorder. For the biological factor, infant cortisol adhered negatively with infant motor development, but NGF was positively associated. The psychological factor had a negative association, but the biological factor had a positive association with infant motor development.ConclusionsThere are few studies that have focused on the relationship of biomarkers and infant neurodevelopment. Our study points that psychological and biological factors are associated with infant motor development, however the causal relationship between these factors is still to be defined.

Brain Derived Neurotrophic Factor (BDNF) levels as a possible predictor of psychopathology in healthy twins at high and low risk for affective disorder

Brain Derived Neurotrophic Factor (BDNF) is a potential biomarker of affective disorder. However, longitudinal studies evaluating a potential predictive role of BDNF on subsequent psychopathology are lacking. The aim of this study was to investigate whether BDNF alone or in interaction with the BDNF Val66Met polymorphism predict onset of affective disorder in healthy individuals at heritable risk for affective disorder. In a high-risk study, we assessed whole blood levels of BDNF in 234 healthy monozygotic and dizygotic twins with or without a co-twin history of affective disorder (high and low risk twins, respectively). Participants were followed up longitudinally with questionnaires at 6-month intervals for mean seven years and then reassessed with a personal interview to obtain information about whether they had developed psychiatric illness. At follow-up 36 participants (15.4%) had developed psychiatric disorder. Cox regression analysis revealed that BDNF levels at baseline were not associated with onset of illness in this explorative study. Further, two-way interactions between BDNF levels and the Val66Met polymorphism or between familial risk and the Val66Met polymorphism did not predict illness onset.

Reciprocal effects of stable and temporary components of neuroticism and affective disorders: results of a longitudinal cohort study

Cross-sectional studies show that neuroticism is strongly associated with affective disorders. We investigated whether neuroticism and affective disorders mutually reinforce each other over time, setting off a potential downward spiral. A total of 2981 adults aged 18-65 years, consisting of healthy controls, persons with a prior history of affective disorders and persons with a current affective disorder were assessed at baseline (T1) and 2 (T2) and 4 years (T3) later. At each wave, affective disorders according to DSM-IV criteria were assessed with the Composite Interview Diagnostic Instrument (CIDI) version 2.1 and neuroticism with the Neuroticism-Extraversion-Openness Five Factor Inventory (NEO-FFI). Using structural equation models the association of distress disorders (i.e. dysthymia, depressive disorder, generalized anxiety disorder) and fear disorders (i.e. social anxiety disorder, panic disorder, agoraphobia without panic) with neuroticism could be attributed to three components: (a) a strong correlation of the stable components of distress and fear disorders with the stable trait component of neuroticism; (b) a modest contemporaneous association of change in distress and fear disorders with change in neuroticism; (c) a small to modest delayed effect of change in distress and fear disorders on change in neuroticism. Moreover, neuroticism scores in participants newly affected at T2 but remitted at T3 did not differ from their pre-morbid scores at T1. Our results do not support a positive feedback cycle of changes in psychopathology and changes in neuroticism. In the context of a relative stability of neuroticism and affective disorders, only modest contemporaneous and small to modest delayed effects of psychopathology on neuroticism were observed.

Gender-related clinical and neurocognitive differences in individuals seeking treatment for pathological gambling

ObjectivesUnderstanding variations in disease presentation in men and women is clinically important as differences may reflect biological and sociocultural factors and have implications for selecting appropriate prevention and treatment strategies. The aim of this study was to investigate clinical and cognitive differences in treatment-seeking people with pathological gambling as a function of gender. Materials and methods501 adult subjects (n = 274 [54.7%] females) with DSM-IV pathological gambling presenting for various clinical research trials over a 9-year period were assessed in terms of sociodemographics and clinical characteristics. A subset (n = 77) had also undertaken neuropsychological assessment with the Stop-signal and set-shift tasks. ResultsPG in females was associated with significantly worse disease severity, elevated mood and anxiety scores, and history of affective disorders, later age of study presentation, later age of disease onset, and elevated risk of having a first-degree relative with gambling or alcohol problems. These findings were of small effect size (0.20–0.35). Additionally, PG in females was associated with proportionately more non-strategic gambling with medium effect size (0.61). In contrast, PG in males was associated with a significantly greater lifetime history of an alcohol use disorder and any substance use disorder (small effect sizes 0.22–0.38); and slower motoric reaction times (medium effect size, 0.50). Response inhibition and cognitive flexibility were similar between the groups. ConclusionsThese data suggest that important differences exist in the features of pathological gambling in women and men. Findings are of considerable relevance to clinicians and in terms of targeted treatments.

Investigation into activation of dysfunctional schemas in euthymic bipolar disorder following positive mood induction

OBJECTIVES. There are dysfunctional cognitions that may be characteristic of bipolar disorder (BD), and which may be mood-state dependent. However, it has been found that such cognitions may be resilient to minor positive mood increase. The aim of this study is to investigate whether positive mood-induction procedure has the effect of altering the availability of dysfunctional schemas in a group of individuals with BD. DESIGN. The sentence completion task was designed to assess the content of dysfunctional schemas: it was modified for use with positive mood-induction procedure in the current study so that more dysfunctional schematic models would lead to completion of sentence stems by negative constructs, whereas functional schematic models led to completion of sentence stems by positive constructs. METHODS. Using the modified sentence completion task, 30 participants with remitted bipolar I disorder were compared with 30 individuals with no history of affective disorder. Results. At baseline the bipolar group inserted significantly more dysfunctional completions than the control group. Following mood induction, the number of dysfunctional completions was reduced for both groups. The bipolar group still inserted significantly more dysfunctional completions relating to autonomy than the control group following mood induction. However, no significant group by time interactions were identified. CONCLUSIONS. As predicted, participants' reports of dysfunctional attitudes reduced following the mood-induction procedure, although no difference was identified between the groups in terms of the size of this reduction. The bipolar group continued to insert significantly more dysfunctional completions for the factor of autonomy, suggesting that this group has more access to autonomy schemas, regardless of change in mood. This finding may have implications in terms of focus of therapy and relapse prevention work.