Bipolar Affective Disorder Research Articles

Assessing theory of mind abilities in schizophrenia and bipolar disorder: A psychometric study of the Faux Pas Recognition test in Serbian

Theory of Mind (ToM) is a social-cognitive ability to understand the mental states of others. ToM functions are compromised in the case of mental disorders characterized by cognitive impairments. The Faux Pas Recognition test (FPRT) is considered a good measure of verbal aspects of ToM as it measures social adaptation through the adequate interpretation of potentially sensitive and awkward social situations. However, data on FPRT psychometric properties is somewhat limited. The aim of the present study is the psychometric evaluation of the FPRT in Serbian population. The adapted version in Serbian has been administered to 268 healthy participants, 30 patients with schizophrenia and 31 with bipolar affective disorder. The results show a high internal consistencies of Faux Pas stories (? = .954), Control stories (? = .929) and overall test (? = .936). Both Horn?s parallel analysis and confirmatory factor analysis indicated that a single-factor solution is optimal, supporting the premise of a general ToM ability underlying performance across test. The Faux Pas test showed good discriminative power in differentiation between individuals from healthy and clinical populations making it a useful clinical instrument.

Ketamine modulates disrupted in schizophrenia-1/glycogen synthase kinase-3β interaction.

Disrupted in schizophrenia-1 (DISC1) is a scaffolding protein whose mutated form has been linked to schizophrenia, bipolar affective disorders, and recurrent major depression. DISC1 regulates multiple signaling pathways involved in neurite outgrowth and cortical development and binds directly to glycogen synthase kinase-3β (GSK-3β). Since ketamine activates GSK-3β, we examined the impact of ketamine on DISC1 and GSK-3β expression. Postnatal day 7 rat pups were treated with ketamine with and without the non-specific GSK-3β antagonist, lithium. Cleaved-caspase-3, GSK-3β and DISC1 levels were measured by immunoblots and DISC1 co-localization in neurons by immunofluorescence. Binding of DISC1 to GSK-3β was determined by co-immunoprecipitation. Neurite outgrowth was determined by measuring dendrite and axon length in primary neuronal cell cultures treated with ketamine and lithium. Ketamine decreased DISC1 in a dose and time-dependent manner. This corresponded to decreases in phosphorylated GSK-3β, which implicates increased GSK-3β activity. Lithium significantly attenuated ketamine-induced decrease in DISC1 levels. Ketamine decreased co-immunoprecipitation of DISC1 with GSK-3β and axonal length. These findings confirmed that acute administration of ketamine decreases in DISC1 levels and axonal growth. Lithium reversed this effect. This interaction provides a link between DISC1 and ketamine-induced neurodegeneration.

Subjective attitude of pharmacophilia versus pharmacophobia in psychiatry patients: A cross-sectional, comparative study

Background: With the rise in the prevalence of mental illness and disabilities associated with them, medication non-adherence is also increasing. Negative attitude toward psychotropics is one of the important factors in medication nonadherence. Based on attitude, patient can either be pharmacophilic or pharmacophobic, which in turn may be influenced by various sociodemographic factors. Aims and Objectives: The aims and objectives of the study are to assess and compare the attitude of patients with various psychiatric diagnoses toward medication and its relation to other sociodemographic factors. Materials and Methods: The study was designed in the East Nimar region of Central India at a tertiary care center over 10-month period after approval from the Institution Ethical Committee. Participants were recruited by convenience sampling as per DSM-5 criteria of schizophrenia, bipolar affective disorder, major depressive disorder, insomnia, substance use disorder, anxiety, and obsessive-compulsive disorder. The attitude was measured using the self-report attitude toward psychotropic medications questionnaire. Statistical analysis was done by Kruskal–Wallis test for comparison between groups. Results: The study included total 246 patients from various disorders. Age-wise distribution varied among disorders but there was no statistically significant difference. Positive and negative score were also not statistically different when compared among different diagnoses. However, there was a significant difference in some responses of the questionnaire. Conclusion: There is no difference in the attitude of psychiatric patients with different diagnoses toward psychotropics.

Features of cognitive impairment in bipolar affective disorder

The study of cognitive impairment in bipolar disorder (BD) combined with anxiety-phobic disorders, as the most common comorbid pathology, is a new, little-studied and relevant direction for further research on BD, promising for clarifying the neurobiological mechanisms of the disease and improving the quality of the diagnostic process. By searching for combinations of the keywords «bipolar disorder», «anxiety disorders», «cognitive impairment», «cognitive dysfunction», «meta-analysis» and «review» in the databases «PubMed» and «Google Scholar», meta-analyses, analytical, review and original relevant research articles were identified. A generalization of the information accumulated in the literature indicates a) the presence in BD of both phase-dependent and persistent cognitive impairments that also occur during the period of euthymia, b) different structure and severity of neurocognitive disorders in cases of «pure» BD and anxiety-phobic disorders, c) the unique structure of cognitive impairment in BD with comorbid anxiety-phobic disorders, which incorporates the features of neurocognitive impairments that are characteristic of both disorders and have the greatest severity compared to them. The results of this review are of interest for planning further empirical studies of this topic on the Russian patient population.

Unveiling the Unseen: Exploring the Lived Experiences of Family Caregivers of Young Adults with Chronic Mental Disorders: A Qualitative Phenomenological Study

Introduction: One of India’s most valuable resources is its young people, and this generation needs to be nurtured for the bright future of the nation. However, when the young generation is affected by chronic mental disorders, families find it difficult to take care of them and are burdened with the responsibility for several years. Aim: To explore the lived experiences of Family Caregivers (FCGs) of young adults with chronic mental disorders. Materials and Methods: This qualitative study was conducted at the selected mental inpatient and outpatient Department of a selected mental health facility in Urban Bangaluru, Karnataka, India from April 2021 to December 2021. The authors used a phenomenological qualitative study to explore the lived experiences of family caregivers of young adults with chronic mental disorders {mania, depression, Bipolar Affective Disorder (BPAD), schizophrenia} aged between 18-40 years. The Family Caregivers of young adults undergoing treatment were approached for written informed consent and recruited through purposive sampling. Data were collected using face-to-face, indepth, semi-structured interviews. Each interview lasted around 45 minutes to one hour, and data saturation was achieved with 15 samples. Interviews were conducted over a period of nine months. The audio-recorded interviews were transcribed, interpreted, and investigated using Colaizzi’s data analysis framework. Baseline variables were analysed using descriptive statistics. Results: In the present, the family caregivers’ ages ranged from 28 to 60 years, with the majority (67%) being females and employed. One of the family members was affected by a mental disorder. A rehabilitation facility was unavailable to the majority (67%) of them near their residence. Regarding the young adults with chronic mental disorders, the majority (74%) were unemployed and diagnosed with affective disorders. The maximum duration of illness was 20 years, with onset typically at the age of 17-21 years. From the analysis, six main themes and 36 subthemes emerged. The main themes were as follows: family caregivers experience difficulty in identifying the responsible person and support system, providing physical care, tackling emergencies, problems with medication and early identification of relapse, problems with indecent behaviour, and knowledge deficit related to mental disorders and their management. Conclusion: The study concludes that family caregivers of young adults with chronic mental disorders experience various psychosocial and economic issues and problems while caring for a young adult with chronic mental disorders. The knowledge generated from the present study can be utilised by mental health professionals to plan home-based care strategies to improve the quality of life and reduce the burden of care for FCGs.

A comparative study of internalized stigma and quality of life among patients of schizophrenia and bipolar affective disorder under remission, visiting a tertiary care center

Background: Patients with schizophrenia and bipolar affective disorder (BPAD) diagnosis often experience high levels of internalized stigma, where they internalize negative societal views about mental illness. This can profoundly impact their quality of life (QOL), help-seeking behavior, adherence to treatment, increased disability, and increase the economic burden. This study was taken up to determine and compare internalized stigma in remitted patients of schizophrenia and bipolar disorder and correlate the association between internalized stigma and QOL. Methodology: A cross-sectional comparative hospital-based study with a sample size of 100 (48 patients of schizophrenia and 52 patients of bipolar disorder in remission) was taken for the study as per the International Classification of Diseases-10 criteria. Basic demographic data were collected using a semi-structured questionnaire. Remission was assessed by the Clinical Global Impressions-Severity Scale. Stigma was assessed using the Internalized Stigma of Mental Illness Scale and quality of life (QOL) was assessed using the World Health Organization Quality of Life Brief version (WHOQOL BREF), insight grading as per Comprehensive Textbook of Psychiatry 10th Edition. The level of significance was set at 0.05 for all statistical analyses. Results: A total of 100 subjects participated in the study, of which 48 belong to the schizophrenia group and 52 belong to the BPAD group. Prevalence of internalized stigma among subjects with schizophrenia is 54% and BPAD is 50%. There was a statistically significant association between diagnosis and self-stigma. Self-stigma was found to be more among female gender (P = 0.001), single (0.014), and unemployed (P = 0.010). There was a statistically significant negative correlation between internalized stigma scores and QOL. Conclusion: The current study found a strong negative correlation between internal stigma and QOL, suggesting that internal stigma may have a negative impact on social relationships, community participation, and physical and psychological well-being of the individual. Considering this, psychiatrist should formulate strategies to address internal stigma along with clinical manifestations.

Efficacy of ketamine and thiopentone sodium with modified electroconvulsive therapy in depressive disorder: An observational study

Background: The first-line treatment for people with acute mania, mood disorders, severe depression, and catatonia is electroconvulsive therapy (ECT). The goal of anesthesia during ECT is to cause unconsciousness, and the drugs administered should not have any effect on seizures. Because all anesthetics have some ability to change seizures, the kind of anesthetic used in modified ECT becomes crucial. This study aimed to assess the hemodynamic profile during modified ECT and the effects of ketamine and thiopentone sodium on seizure duration. Aims and Objectives: The aim of the study was to compare the outcome of ECT, such as hemodynamics, improvement in depression, and duration of seizure, with ketamine versus thiopentone sodium in depressive disorder. Materials and Methods: A prospective observational study was conducted with 50 randomly selected depression patients after obtaining permission from the Institutional Ethics Committee and consent from the patients and attendants from June 2021 to November 2022. All 50 cases were equally divided into group K and group T. To obtain the data, a predesigned, semi-structured questionnaire was used along with the Hamilton rating scale for depression and ECT. The Chi-square test was used to measure the association between two categorical variables. A P < 0.05 was considered statistically significant. Results: The mean heart rate, systolic blood pressure, diastolic blood pressure, mean arterial pressure, and saturation of peripheral oxygen are higher in group K than in group T, and the mean difference was significant between group K and group T. Groups had a statistically significant association with increased secretions, nausea and vomiting, and headache, but not with gender, ASA grade, and number of ECT sessions. Conclusion: Compared to ketamine, thiopentone sodium was found to have minimal hemodynamic derangements, a decrease in seizure duration, and side effects.

Projection of Bipolarity to Mitochondria: GABA Shunt is related with Self pathology and Medical Comorbidity in Bipolar Disorder

The nature of the relationship with the self-object is the source of mental energy. At this point, the self is a spatiotemporal formation. The self has been found to be associated with the GAD enzyme activity responsible for GABA production at the molecular level. GABA is a metabolite of Krebs. Bipolar disorder is a biphasic state of energy dysregulation as a circadian rithms. Phasic nature of mitochondria to produce ATP may be crucial to the switching of affective states in bipolar disorder. The GABA shunt is an alternative energy production pathway that is activated in response to stress. The GABA shunt plays an important role in preventing the accumulation of reactive oxygen intermediates and cell death. On the other hand, GABA shunt impairs phosphorylation processes. Mitochondrial dysfunction is reflected in glucose, lipid and protein metabolism. A bipolar spectrum is possible at this point, including physical illnesses. A classification of mood disorders based on entropy levels is framed by medical comorbidity.

The Effect of Omega-3 Supplementation on Serum Levels of Antioxidant Status in Patients With Bipolar Disease: A Randomized Double-blind Controlled Clinical Trial.

Antioxidants prevent the progression of neuropsychiatric disorders, such as bipolar disorder (BD). Omega-3 fatty acid supplementation helps prevent lipid peroxidation and improve antioxidant status. This study aims to investigate the effect of omega-3 supplementation on serum levels of antioxidant status in patients with BD. In this study, 28 patients with BD received an omega-3 fatty acid supplement (2 g/daily) while the other 28 patients received edible paraffin oil (2 g/daily) for 60 days. The activities of superoxide dismutase (SOD), catalase (CAT), and total antioxidant capacity (TAC) were evaluated in pre-intervention and post-intervention. The results showed that omega-3 supplementation increased the activities of SOD (12.94±3.84 U/mL vs 17.72±3.59 U/mL) and CAT (5.08±1.61 nmol/min/mL vs 6.43±1.33 nmol/min/mL) in post-intervention compared to pre-intervention (P=0.001). The results also showed that omega-3 supplementation increased the activities of SOD (17.72±3.59 U/mL vs 13.79±3.12 U/mL) and CAT (6.43±1.33 nmol/min/mL vs 4.89±1.45 nmol/min/mL) compared to the control group in post-intervention (P=0.001). Omega-3 supplementation did not have significant effects on the serum concentration of TAC compared to pre-intervention (P=0.373) and control group (P=0.604). Omega-3 supplementation increased the activities of SOD and CAT and may decrease the progression of disease via increasing antioxidant status.

A Robust Method of Bipolar Mental Illness Detection from Facial Micro Expressions Using Machine Learning Methods

A Robust Method of Bipolar Mental Illness Detection from Facial Micro Expressions Using Machine Learning Methods

Postpartum Psychosis: A Proposed Treatment Algorithm.

Postpartum psychosis (PPP) is a psychiatric emergency that generally warrants acute inpatient care. PPP is marked by the sudden onset of affective and psychotic symptoms with a rapid deterioration in mental state. Evidence suggests that PPP is a discrete disorder on the bipolar disorder spectrum with a distinct treatment profile and prognosis. We conducted a PubMed database search for various terms involving PPP and its treatment and included peer-reviewed articles published in English. To provide a treatment algorithm for the management of PPP based on available evidence. Pharmacological therapy is the mainstay of PPP management in the acute phase. Evidence points to a combination of antipsychotics and lithium in the acute treatment of PPP. Electroconvulsive therapy can offer a rapid treatment response where required. Lithium appears to have the best evidence for relapse prevention and prophylaxis in PPP. Psychoeducation is essential and psychosocial interventions used in bipolar disorder may be effective in PPP. Early detection and prompt treatment with antipsychotics and lithium, followed by maintenance treatment with lithium, is associated with a favourable prognosis in PPP.Reprinted from J Psychopharmacol 2023; 37:960-970, with permission from Sage Journals. Copyright © 2023.

Atypical antipsychotics in the treatment of depression in affective disorders and schizophrenia (using the aripiprazole model)

The review discusses aspects of the use of atypical antipsychotics in the treatment of depression in affective disorders and schizophrenia using the model of aripiprazole, a partial agonist of dopamine receptors. According to numerous studies, aripiprazole is the drug of choice for augmentative therapy of major depressive disorder, as well as for relieving and long-term maintenance monotherapy and combination therapy of various affective episodes of bipolar affective disorder and depression in schizophrenia.

A Study of Oxytocin Levels in a Sample of Bipolar Affective Disorder

A Study of Oxytocin Levels in a Sample of Bipolar Affective Disorder

A case study of bipolar affective disorder treated with homoeopathy

A case study of bipolar affective disorder treated with homoeopathy

Psychopharmacotherapy of mixed affective states in bipolar disorder

On the example of a patient with a mixed affective episode within the framework of bipolar affective disorder, the clinical features of this psychopathological condition, the difficulties of diagnosis and selection of therapy in mixed states are presented. The use of the modern atypical antipsychotic ziprasidone in this category of patients is argued.

Lithium treatment for affective disorders in old age

Lithium is considered the gold standard for the treatment of bipolar affective disorder for the prevention of recurrence of manic and depressive episodes and for augmentation treatment in unipolar severe depressive episodes. The indications for treatment with lithium do not differ for older or younger patients. Nevertheless, there are anumber of aspects to be considered with respect to drug safety in the group of old patients. The aim was to give an overview of the current literature on lithium treatment in old age and from this to derive recommendations for action. Aselective literature review on lithium treatment in old age was conducted to answer questions on drug safety, monitoring (particularly with respect to comorbidities) and potential alternatives to lithium. Lithium is an effective and, if used correctly, safe drug also in old people; however, with respect to somatic comorbidities that increase with age, special caution is required when using lithium in order to prevent nephropathy and intoxication.

Uma construção histórica do fenômeno da mania no campo psicopatoiógico

This study aims to shed light on the construction of the concept of mania in the field of psychopathology. The article addresses the historical evolution of mania, from manic-depressive illness to the diagnosis of bipolar and schizoaffective disorders. It was observed that the current concept of mania is a product of the second half of the 19th century, although it originates from the classical Greek period, when it was understood as a way of being, and then, throughout history, was reduced to a psychopathological symptom. Currently, mania is again being considered in a broader sense, as manic functioning, but without excluding its symptomatic condition. It is from this position that we situate it as a phenomenon, encompassing the symptom and the lived experience, from the perspective constructed from phenomenological psychopathology, which looks at the manic experience not by reducing it to a natural fact, but by understanding it as a historical-cultural phenomenon, constructed in the world of human relationships.

Female body-corporeal as both the aetiological site and the site of resistance: Conceptualizing manic depression in Jerry Pinto's Em and the BigHoom

The hegemonic discourse of normalcy perpetuates unfavourable portrayals of mental illness; it distorts our understanding of the sufferer's existential and affective experiences. However, mental illness is a multifaceted phenomenon; it necessitates a holistic understanding of how an individual's identity and personhood are emplaced at the intersection of the diverse sociocultural conditions. The article conceptualizes manic depression as a complex interplay of the corporeal, cognitive, and cultural factors in Jerry Pinto's critically acclaimed contemporary novel Em and the Big Hoom (2012). Jerry Pinto is a Mumbai-based Goanese Indian author who embarks on exploring the intricacies of psychological vulnerabilities and draws heavily from his personal experiences to write poignant, humane and empathetic stories. Em and the Big Hoom documents the narrator's reminiscences of his late mother, Em or Imelda's experiences of mood swings, paranoid delusions, freakish breakdowns, and psychiatric treatments. It scrutinizes extracts of Em's diary notes, letters, and past conversations to exhibit how a woman succumbs to abjection due to socio-cultural expectations of sex, pregnancy, and childbirth and eventually resorts to self-harm. The article projects the female body-corporeal as both the aetiological site and the site of resistance; while phallocentric cartography of the female body engenders abjection, manifestations of abjection at the corporeal level formulate tropes of resistance. The article challenges the phallocentric tendency to pathologize deviant body-behaviour motifs in women, contributing to the expanding corpus of phenomenological knowledge on pathologized female subjectivities.

Clinical Application of Machine Learning Methods in Psychiatric Disorders

Abstract: Psychiatric disorders, especially bipolar affective disorder, present a significant burden on national and global healthcare systems, warranting advanced clinical management methods. Machine learning (ML) has emerged as a reliable tool to advance diagnosis, treatment, and monitoring. This paper compiles insights from literature to confirm the applicability of ML models in the clinical setting. The findings indicate that ML can predict psychiatric disorder symptoms from speech and imaging data with up to 89% accuracy. Furthermore, individual responses to treatment and remission cases can be forecasted with accuracies exceeding 80%. ML can also predict prevailing symptoms after treatment with up to 91.26% accuracy.

A rare presentation of Rubinstein-Taybi syndrome

Objective. Taybi syndrome is a rare genetical disorder with the symptoms of small stature, broad thumbs and first toes, a moderate to severe intellectual handicap, and unique facial traits. The present case study aimed with diagnose and therapeutic management of pediatric patients having Rubinstein-Taybi syndrome. Study area. The case study was carried out in Jawaharlal Nehru Medical College, Acharya Vinoba Bhave Rural Hospital, Sawangi Meghe, Wardha, Maharashtra, in department of Pediatrics. The present study follows case of male child, diagnosed with different degrees of compliance, in which the therapeutic approach was determined by the severity of the patient’s conditions. Outcomes. Case study on 3 years old male child was carried out and observed with some behavioural changes like unstable mood, distractibility and impulsivity along with attention problem, aggressive nature and self-injurious behavior etc. As the syndrome does not have a particular treatment but some therapies are applied to address issues that are frequently connected to the illness. The thumbs or toes surgically repaired might enhance grip or ease pain. The study was performed as per the scientific way, based on research literatures study.