Manic Phase Research Articles

External Genitalia Trauma Following the First Manic Episode in an Elderly Woman With Sexual Disinhibition

Introduction: Late onset bipolar disorder is not common. In addition, bipolar disorder with a dominancy over sexual behaviors is very rare. Hence, traumatic and vigorous sexual behavior, such as masturbation and self-mutilation, are odd and rare occurrences. Case Presentation: An elderly woman in a manic phase of bipolar disorder without a previous history of psychiatric disorders was concomitant with problematic sexual over stimulation in the context of hyper sexuality. She had traumatized her genitals and underwent surgery for their repair. Following her admission and psychopharmacologic therapy, she recovered. Conclusions: The presentation of bipolar disorder in the elderly can be seen in sexual behaviors and self-mutilation that can lead to the need for reparative surgery. In each case, with trauma to the external genitalia, psychiatric problems should be considered.

Contrasting variability patterns in the default mode and sensorimotor networks balance in bipolar depression and mania

Depressive and manic phases in bipolar disorder show opposite constellations of affective, cognitive, and psychomotor symptoms. At a neural level, these may be related to topographical disbalance between large-scale networks, such as the default mode network (DMN) and sensorimotor network (SMN). We investigated topographical patterns of variability in the resting-state signal-measured by fractional SD (fSD) of the BOLD signal-of the DMN and SMN (and other networks) in two frequency bands (Slow5 and Slow4) with their ratio and clinical correlations in depressed (n = 20), manic (n = 20), euthymic (n = 20) patients, and healthy controls (n = 40). After controlling for global signal changes, the topographical balance between the DMN and SMN, specifically in the lowest frequency band, as calculated by the Slow5 fSD DMN/SMN ratio, was significantly increased in depression, whereas the same ratio was significantly decreased in mania. Additionally, Slow5 variability was increased in the DMN and decreased in the SMN in depressed patients, whereas the opposite topographical pattern was observed in mania. Finally, the Slow5 fSD DMN/SMN ratio correlated positively with clinical scores of depressive symptoms and negatively with those of mania. Results were replicated in a smaller independent bipolar disorder sample. We demonstrated topographical abnormalities in frequency-specific resting-state variability in the balance between DMN and SMN with opposing patterns in depression and mania. The Slow5 DMN/SMN ratio was tilted toward the DMN in depression but was shifted toward the SMN in mania. The Slow5 fSD DMN/SMN pattern could constitute a state-biomarker in diagnosis and therapy.

The manic phase of Bipolar disorder significantly impairs theory of mind decoding

Bipolar disorder is associated with significant deficits in the decoding of others’ mental states in comparison to healthy participants. However, differences in theory of mind decoding ability among patients in manic, depressed, and euthymic phases of bipolar disorder is currently unknown. Fifty-nine patients with bipolar I or II disorder (13 manic, 25 depressed, 20 euthymic) completed the “Reading the Mind in the Eyes” Task (Eyes task) and the Animals Task developed to control for non-mentalistic response demands of the Eyes Task. Patients also completed self-report and clinician-rated measures of depression, mania, and anxiety symptoms. Patients in the manic phase were significantly less accurate than those in the depressed and euthymic phases at decoding mental states in the Eyes task, and this effect was strongest for eyes of a positive or neutral valence. Further Eyes task performance was negatively correlated with the symptoms of language/thought disorder, pressured speech, and disorganized thoughts and appearance. These effects held when controlling for accuracy on the Animals task, response times, and relevant demographic and clinical covariates. Results suggest that the state of mania, and particularly psychotic symptoms that may overlap with the schizophrenia spectrum, are most strongly related to social cognitive deficits in bipolar disorder.

Performance of Bipolar Disorder Patients in Attention Testing: Comparison with Normal Controls and Among Manic, Depressive, and Euthymic Phases.

Several studies on cognition in bipolar disorder (BD) have been developed on the last decade. Neuropsychological evaluation of attention in BD patients is fundamental since alterations in attention affect other cognitive functions. Evaluate if performance of BD patients in attention tests varies according to each phase of the disease and verify if there are differences in attention when comparing BD patients with normal controls. The study included 101 BD patients, with ages between 18 and 65years, being 52 euthymic, 22 manic and 27 depressive, besides 30 normal controls. All subjects were evaluated though Hamilton Depression Scale, Young Mania Rating Scale and Global Assessment of Functioning, bipolar version (CGI-BP). Attention was evaluated through a neuropsychological battery. Normal controls had a better performance in selective attention tests than BD patients. No differences were found among manic, depressive and euthymic phases. Attention is markedly impaired in BD. Nevertheless, the results of this study do not imply that the severity of the attention deficit in BD patients varies according to decease phase.

Presenting a Spatial-Geometric EEG Feature to Classify BMD and Schizophrenic Patients

Schizophrenia (SZ) and bipolar mood disorder (BMD) patients demonstrate some similar signs and symptoms; therefore, distinguishing those using qualitative criteria is not an easy task especially when these patients experience manic or hallucination phases. This study is aimed at classifying these patients by spatial analysis of their electroencephalogram (EEG) signals. In this way, 22-channels EEG signals were recorded from 52 patients (26 patients with SZ and 26 patients with BMD). No stimulus has been used during the signal recording in order to investigate whether background EEGs of these patients in the idle state contain discriminative information or not. The EEG signals of all channels were segmented into stationary intervals called “frame” and the covariance matrix of each frame is separately represented in manifold space. Exploiting Riemannian metrics in the manifold space, the classification of sample covariance matrices is carried out by a simple nearest neighbor classifier. To evaluate our method, leave one patient out cross validation approach has been used. The achieved results imply that the difference in the spatial information between the patients along with control subjects is meaningful. Nevertheless, to enhance the diagnosis rate, a new algorithm is introduced in the manifold space to select those frames which are less deviated around the mean as the most probable noise free frames. The classification accuracy is highly improved up to 98.95% compared to the conventional methods. The achieved result is promising and the computational complexity is also suitable for real time processing.

Omega-3 fatty acids combined with aripiprazole and lithium modulates activity of mitochondrial enzymes and acetylcholinesterase in methylphenidate-induced animal model of mania

Many studies have shown the alterations of mitochondrial complexes in bipolar disorder (BD) patients. However, changes in the Krebs cycle enzymes have been little studied.The animal model of mania induced by psychostimulants like amphetamine and methylphenidate (MPD) has been widely used to study the manic phase of bipolar disorder. The aim of the present study is to assess the changes in the activity of Krebs cycle enzymes and acetylcholinesterase (AChE) in an animal model of mania induced by MPD. wiss albino mice were first administered intraperitonially with MPD (5mg/kg) or saline for 14 days, upon changes in the behavioral activity, animals were treated with lithium (50mg/kg), omega-3 fatty acids (1.5ml/kg) given orally and aripiprazole administered intraperitonially (1.5mg/kg) from 8th day onwards. Activity of Krebs cycle enzymes and AChE were measured in brain. Administration of MPD inhibited the activity of Krebs cycle enzymes and AChE in brain. Treatment with lithium, aripiprazole and omega-3 fatty acids significantly reversed MPD induced mitochondrial dysfunction and AChE activity. This finding suggest that lithium, aripiprazole and omega-3 fatty acids exert protective effect against MPD induced impairment of Krebs cycle enzymes in brain of mice; further supporting the hypothesis that mitochondrial dysfunction may be associated with the pathophysiology of BD.

Prevalence of substance use disorder among bipolar affective disorder

IntroductionHigh rates of substance abuse have been reported in the general population and users of mental health services. In our environment, relationship between substance abuse and manic phase has not been well characterized.AimsDetermining the prevalence of active substance abuse among patients admitted to acute mental health unit at Virgen de la Victoria Hospital at Malaga, diagnosed with mania or hipomanía.MethodsWe analysed urine and blood seeking for ethanol, cannabis and other 11 substances in 140 patients previously diagnosed with bipolar disorder prior to their admission at the Hospital for mania or hipomanía phase.ResultsThirty-seven percent of the patients were positive for drugs. Eighteen percent were positive for two or more drugs. Males had higher rates of abuse than females, except in MDMA and amphetamines. By subtypes, cannabis (37.2%) and ethanol (29.62%) were the most consumed drugs. In young age cohorts had higher rates of active substance abuse. Dual patients had longer average stays at hospital (2.6 days more) (Fig. 1).ConclusionsSubstance abuse is a major comorbidity in bipolar patients with manic phase. The active consumption of cannabis and ethanol especially emphasizes in men younger than 35 years.We believe priority should be given to recognition and multidisclipinary approach to substance use disorders in bipolar patients. Bipolar patients with comorbid substance abuse may have a more severe course, and may be a preventable factor of new relapses. This rate could increase healthcare costs and worse quality of life of these patients.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Psychiatric symptoms paraneoplastic and legal obligation to combination therapy

Women 49-year-old with a history of left mastectomy for breast Ca. The patient is brought to the emergency by his family for disorderly conduct compatible with manic phase and psychotic symptoms by delirious speech mystical-religious content refusal of the patient to be evaluated by any medical decision and abandoned chemotherapy. Initial screening is performed from the emergency department of organic pathology (TAC without findings and normalcy in other PC). At the beginning of involuntary admission income that is corroborated by the commission judicial, a request of the family and given the history of abandonment IC Oncology treatment is performed as a result of which it is found that the onset of the psychiatric clinic communicates matches the decision to abandon treatment; after reassessment of the clinical status of the patient and recommendation by her oncologist to resume treatment with RT to court new authorization for further diagnosis and initiation of treatment after assessment by forensic and judge is granted a week tests requested. After screening of limbic encephalitis but positive AC. SD income it is maintained and combined treatment is performed. At discharge, the patient is stable DP vs. psychopathology with good controls over concomitant breast disease.ResultsThe need for medical treatment in organic pathology is justified even against the will of the patient in the context of represenDisclosure of interestThe authors have not supplied their declaration of competing interest.

Treatment of bipolar patients in manic phase: A comparison between asenapine and aripiprazole

IntroductionAgitation is the most evident symptom in an acute manic episode. It can be defined as excessive motor or verbal activity that can degenerate into aggressive behaviour. Both aripiprazole and asenapine are indicated for the treatment of agitation in patients with manic episode.AimsTo retrospectively evaluate the acute effects of drug therapy on psychomotor agitation rated with the PANSS-EC, the change in manic symptoms through the YMRS, the QoL with the SF-36v2 and the cardiometabolic effects of the new oral APS.MethodsWe administered the following tests to 13 patients with DBI at T0 (baseline), T1 (after 1 week), T2 (after 4 weeks), T3 (after 12 weeks) and T4 (after 24 weeks): PANSS-EC, YMRS, SF-36v2, CGI-BD, CGI-S, HAM-D, BPRS. We also considered weight, height, BMI, ECG and complete blood count.ResultsPatients recruitment and statistical analyses are still in progress. Our preliminary results suggest that there is not a marked difference between the two drugs. We highlighted that there has been a noticeable decrease in results at PANSS as well as at YMRS from T0 to T4 and patients showed an improvement in QoL. Only one patient treated with asenapine showed an increase in the results of HAM-D.ConclusionsResults suggest the efficacy of the two new APS but further recruitment and data collection are needed to better understand their impact on agitation and QoL, including the metabolic profile, with the aim to help clinicians to make a more accurate choice of drug for each specific patient.Disclosure of interestThe authors have not supplied their declaration of competing interest.

An approach to neuroleptic malignant syndrome from a clinical case

IntroductionNeuroleptic malignant syndrome (NMS) takes place in patients in treatment with neuroleptics and it is potentially lethal, being important an early diagnostic and therapeutic approach.ObjectivesTo analyze from a clinical case the clinical and epidemiological features, and therapeutical approach to NMS.MethodReview of some articles in Mental Health journals and analysis of the following clinical case: 68-year-old woman with bipolar disorder, hospitalized in manic phase. Usual treatment: lithium, trazodone, quetiapine and asenapine. During the admission to hospital, the patient started presenting hyperthermia, sweating, electrolyte disturbances, limb rigidity, and elevation of CPK levels. The suspicion was NMS, so neuroleptics were stopped and fluids and dantrolene were initiated, with favorable evolution.ResultsThe discharge diagnosis was NMS. Neuroleptics were gradually reintroduced under vigilance. The patient is stable and has not had new complications. NMS is an uncommon (0.02% to 3% among patients taking neuroleptic agents), but life-threatening condition. Its symptoms are hyperthermia, autonomic nervous system dysfunction, limb rigidity, altered consciousness… The attendant infections, consume of lithium, dehydration, iron deficiency and sharp changes in neuroleptic treatment are predisposing factors. The withdrawal of neuroleptics is the key of the treatment. Benzodiazepines can improve the prognosis, and electroconvulsive therapy can be necessary if there is no response to previous measures.ConclusionsNeuroleptic malignant syndrome is a life-threatening medical complication we should try to avoid by a correct and careful use of neuroleptics. Additionally, it is important the early treatment, taking withdrawal of neuroleptics as the key starting point.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Clinical Characteristics of Pediatric Bipolar Disorder by Subtype in a Korean Inpatient Sample

Objectives：We compared the clinical presentations of manic and depressive episodes and the treatment response among children and adolescents with bipolar disorder (BD) types I and II and BD not otherwise specified (NOS). Methods：The sample consisted of 66 patients, aged between 6 and 18 years, who were admitted for BD to a 20-bed child and adolescent psychiatric ward in a university hospital located in Seoul, Korea. Results：Patients with BD type I were more likely to have lower intelligence quotients and exhibit violent behaviors during manic episodes than patients with BD type II or BD NOS and to show better treatment responses during manic episodes than patients with BD NOS. Patients with BD NOS were more likely to have an irritable mood rather than a euphoric mood during the manic phase than patients with BD type I or II and to exhibit violent behaviors during the depressive phase and chronic course than patients with BD type II. Conclusion：Pediatric BD patients are heterogeneous with respect to their clinical characteristics. Implications for the usefulness of the current diagnostic subtype categories should be investigated in future studies.

Patterns of microstructural white matter abnormalities and their impact on cognitive dysfunction in the various phases of type I bipolar disorder

BackgroundIn recent years, diffusion tensor imaging (DTI) studies have detected subtle microstructural abnormalities of white matter (WM) in type I bipolar disorder (BD). However, WM alterations in the different phases of BD remain to be explored. The aims of this study is to investigate the WM alterations in the various phases of illness and their correlations with clinical and neurocognitive features. MethodsWe investigated the DTI-derived fractional anisotropy (FA), mean diffusivity (MD), radial diffusivity (RD) and axial diffusivity (AD) in patients with type I BD (n=61) subdivided in manic (n=21), depressive (n=20) and euthymic phases (n=20) vs. healthy controls (n=42), using a tract-based spatial statistics (TBSS) approach. Then, we investigated whether the subgroups of patients in the various phases of illness present different patterns of WM abnormalities. Finally we studied the correlations between WM alterations and clinical-cognitive parameters. ResultsWe found a widespread alteration in WM microstructure (decrease in FA and increase in MD and RD) in BD when compared to controls. The various subgroups of BD showed different spatial patterns of WM alterations. A gradient of increasing WM abnormalities from the euthymic (low degree and localized WM alterations mainly in the midline structures) to the manic (more diffuse WM alterations affecting both midline and lateral structures) and, finally, to the depressive phase (high degree and widespread WM alterations), was found. Furthermore, the WM diffuse alterations correlated with cognitive deficits in BD, such as decreased fluency prompted by letter and decreased hits and increased omission errors at the continuous performance test. LimitationsPatients under treatment. ConclusionsThe WM alterations in type I BD showed different spatial patterns in the various phases of illness, mainly affecting the active phases, and correlated with some cognitive deficits. This suggests a complex trait- and state-dependent pathogenesis of WM abnormalities in BD.

METABOLIC EFFECT OF RISPERIDONE IN PSYCHIATRIC PATIENTS

Aim & Objective: This study was designed to evaluate the metabolic effects of risperidone in patients with psychiatric illness treated with risperidone. Method: Thirty non-diabetic patients with Psychiatric illness (e.g. schizophrenia, manic phase of bipolor disorder based on Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria) inducted in this study. These Patients did not receive any drug that would alter the blood sugar levels and also risperidone for at least four weeks prior to the initiation of the study. All the patients who were inducted in this study receive the mean dose of 4mg/day (range 2-8 mg) of risperidone for eight weeks, depending upon the clinical condition. The patients fasting, post prandial blood sugar and weight gain were evaluated at the baseline and then at four weeks and at eight weeks. Results: Thirty patients completed the study. The mean fasting blood sugar level was increased from 87.5mg/dL (baseline) to 101.7 mg/dL at week 8 (P<0.001).The mean post prandial blood sugar was increased from111.68 mg/dl to147.88 mg/dl at week 8 (p<0.001).There was also statistically significant weight gain with a increase in mean weight of59.16 kg to59.96 kg (p=0.001). The 8-week study showed that fasting blood sugar and postprandial blood sugar levels may increase in psychiatric patients receiving risperidone .There was also definite weight gain. No serious adverse events were reported. Conclusion: Measuring and monitoring fasting & postprandial blood sugar before the initiation and during the treatment with risperidone is suggested. Key Words: Metabolic effect, Risperidone , Blood glucose, psychiatric illness.

Treatment of Early-Age Mania: Outcomes for Partial and Nonresponders to Initial Treatment

The Treatment of Early Age Mania (TEAM) study evaluated lithium, risperidone, and divalproex sodium (divalproex) in children with bipolar I disorder who were naive to antimanic medication, or were partial or nonresponders to 1 of 3 study medications. This report evaluates the benefit of either an add-on or a switch of antimanic medications for an 8-week trial period in partial responders and nonresponders, respectively. TEAM is a randomized, controlled trial of individuals (N= 379) aged 6 to 15 years (mean ± SD= 10.2 ± 2.7 years) with DSM-IV bipolar I disorder (mixed or manic phase). Participants (n= 154) in this report were either nonresponders or partial responders to 1 of the 3study medications. Nonresponders (n= 89) were randomly assigned to 1 of the other 2 antimanic medications and cross-tapered. Partial responders (n= 65) were randomly assigned to 1 of 2 other antimanic medications as an add-on to their initial medication. Adverse event (AE) rates are reported only for the add-on group. Response rate for children switched to risperidone (47.6%) was higher than for those switched to eitherlithium (12.8%; p= .005; number needed to treat [NNT]= 3; 95% CI=1.71-9.09) or divalproex (17.2%; p=.03; NNT= 3; 95% CI= 1.79-20.10); response rate for partial responders who added risperidone (53.3%) was higher than for those who added divalproex (0%; p=.0002; NNT= 2; 95% CI= 1.27-3.56) and trended higher for lithium (26.7%; p= .07; NNT= 4). Reported AEs in the add-on group were largely consistent with the known AE profile for the second medication. Weight gain (kg) was observed for all add-on medications: lithium add-on (n=29 of 30)= 1.66 ± 1.97; risperidone add-on (n= 15 of 15)= 2.8 ± 1.34; divalproex add-on (n= 19 of 20)= 1.42 ± 1.96. There was no evidence at the 5% significance level that the average weight gain was different by study medication for partial responders (p=.07, 1-way analysis of variance). Risperidone appears to be more useful than lithium or divalproex for children with bipolar I disorder and other comorbid conditions who are nonresponders or partial responders to an initial antimanic medication trial. Clinical trial registration information-Study of Outcome and Safety of Lithium, Divalproex and Risperidone for Mania in Children and Adolescents (TEAM); http://clinicaltrials.gov/; NCT00057681.

Depression and Suicidality Outcomes in the Treatment of Early Age Mania Study

To assess the efficacy of mood-stabilizing medications for depression and suicidality in pediatric bipolar disorder. The Treatment of Early Age Mania (TEAM) studyis a multicenter, prospective, randomized, masked comparison of divalproex sodium (VAL), lithium carbonate (LI), and risperidone (RISP) in an 8-week parallel clinical trial. A total of 279 children and adolescents with DSM-IV diagnoses of bipolar I disorder, mixed or manic, aged 6 to 15years were enrolled. The primary outcome measure was improvement on the Clinical Global Impression scale for depression (CGI-BP-I-D). Secondary outcome measures included the Children's Depression Rating Scale (CDRS-R) and suicidality status. Statistics included longitudinal analysis of outcomes using generalized linear mixed models with random intercept both for the complete data set and by using last observation carried forward. CGI-BP-I-D ratings were better in the RISP group (60.7%) as compared to the LI (42.2%; p= .03) or VAL (35.0%; p= .003) groups from baseline to the end of the study. CDRS scores in all treatment groups improved equally by study end. In week 1, scores were lower with RISP compared to VAL (mean= 4.72, 95% CI= 2.67, 6.78), and compared to LI (mean= 3.63, 95% CI= 1.51, 5.74), although group differences were not present by the end of the study. Suicidality was infrequent, and there was no overall effect of treatment on suicidality ratings. Depressive symptoms, present in the acutely manic or mixed phase of pediatric bipolar disorder, improved with all 3 medications, though RISP appeared to yield more rapid improvement than LI or VAL and was superior using a global categorical outcome. Clinical trial registration information-Study of Outcome and Safety of Lithium, Divalproex and Risperidone for Mania in Children and Adolescents (TEAM); http://clinicaltrials.gov; NCT00057681.

Pharmacological Approaches for Treatment-resistant Bipolar Disorder.

Bipolar disorder is prevalent, with high risks of disability, substance abuse and premature mortality. Treatment responses typically are incomplete, especially for depressive components, so that many cases can be considered “treatment resistant.” We reviewed reports on experimental treatments for such patients: there is a striking paucity of such research, mainly involving small incompletely controlled trials of add-on treatment, and findings remain preliminary. Encouraging results have been reported by adding aripiprazole, bupropion, clozapine, ketamine, memantine, pramipexole, pregabalin, and perhaps tri-iodothyronine in resistant manic or depressive phases. The urgency of incomplete responses in such a severe illness underscores the need for more systematic, simpler, and better controlled studies in more homogeneous samples of patients.

C.01.03 How to use anxiety, irritability, and agitation (AIA) for diagnosing mania with depressive symptoms – patient cases

Hopelessness, a key risk factor for suicidal behaviour overall, has been studied little among bipolar disorder (BD) patients. For purposes of prevention, it is important to know whether it is predominantly a patient's permanent trait or merely reflects the highly variable illness states. We investigated the degree to which hopelessness is trait- or state-related during the course of BD.The Jorvi Bipolar Study (JoBS) is a naturalistic prospective study representing psychiatric in- and outpatients with DSM-IV BD I and II. Repeated measurements with the Beck Hopelessness Scale of 188 patients at baseline, 6 months and 18 months were analysed using a linear regression model with general estimation equations. Factors covarying with hopelessness during follow-up were investigated.Levels of hopelessness varied markedly between illness phases, being highest in depressive and mixed phases, and lowest in euthymia, hypomania or mania. Hopelessness was independently associated with concurrent severity of depression (estimate 0.231, p < 0.001), anxiety (0.105, p < 0.001), fewer manic symptoms (− 0.096, p = 0.001) and comorbid personality disorder (1.741, p = 0.001). However, the strongest predictor of degree of hopelessness during follow-up was previous hopelessness (0.403, p < 0.001).After baseline, relatively few patients had manic, hypomanic, mixed or depressive mixed phases. Hopelessness was measured at only three time-points.Level of hopelessness varies markedly between patients in different phases of BD, but is also, to a degree, a permanent feature. Among BD patients, hopelessness appears to be both a trait- and state-related characteristic.

Comparación de biomarcadores inflamatorios en pacientes con trastorno afectivo bipolar tipo I y sujetos controles

IntroductionInflammatory changes have been described in different affective episodes, as well as in the euthymic phase of Bipolar I Disease. These changes have been proposed as possible peripheral markers of the disease. For this reason well-designed studies are needed to explore this hypothesis. ObjectiveQuantify and compare the serum levels of interleukins (IL) and tumour necrosis factor (TNF) in bipolar I patients and healthy subjects, including the comparison between the affective episodes of the disease. MethodsCross-sectional study including 41 bipolar I patients and 11 healthy control subjects. Serum levels of IL-1B, IL-RA, IL-2, IL-4, IL-6, IL-7, IL-8, IL-10, IL-12, and TNF were measured during the euthymic, depressive, and manic phases and were compared with the serum levels of the healthy subjects. ConclusionsManic phase patients had low education and high number of hospitalisations. Depressive phase patients showed high number of depressive episodes throughout life. No statistically significant differences were found in IL and TNF levels between bipolar I patients and healthy controls, or between the bipolar I subgroups (euthymic, manic and depressive states). An increase in the size of the sample is necessary in future studies, in order to enhance the statistical value of the results, and explore the inflammatory hypothesis of the bipolar disease.

Chronic treatment with mood stabilizer lithium inhibits amphetamine-induced risk-taking manic-like behaviors

A lack of behavioral tests and animal models for manic-depressive bipolar disorder is recognized as an important factor limiting development of novel pharmaceutical treatments for the disorder. Repeated amphetamine-induced hyperactivity is a commonly used animal model for mania. However, hyperactivity represents only one facet of mania and is also seen in other disorders. Increased engagement in risk taking behavior is frequently observed in the manic phase of bipolar disorder. In the present study, we analyzed the effect of the most commonly used mood stabilizer lithium on repeated amphetamine treatment-induced risk-taking behaviors in rats using elevated plus maze and wire-beam bridge tests. We found that repeated amphetamine treatment not only increased locomotor activity, but also increased risk taking behaviors in rats, and further that chronic lithium treatment inhibited the amphetamine-increased risk taking behavior. Our studies suggest that these tests may be useful tools to analyze the pharmacological validity of new and improved anti-manic drugs in animals.

A Comparative Study of the Ability of Facial Emotional Expression Recognition and its Relationship with Communication Skills in Iranian Patients with Mood Disorders

Background: Facial emotion recognition impairment in psychiatric patients such as those with mood disorders and impaired communication skills in these patients is one of the most important issues. The present study aims to evaluate and compare facial emotion recognition among patients with depression, bipolar disorder who experience manic phase and the subjects of the normal group without a diagnosis of a disorder. Moreover, the present study aims to evaluate and compare the relationship between facial emotion recognition ability and communication skills among these patients. Materials and Methods: Participants of this study included 30 patients with depression, 30 patients with bipolar disorder and 30 subjects from a normal group; a total of 90 subjects who were selected using convenience sampling method. PC version of Ekman’s facial emotion test (1976) and Queendom’s interpersonal communication skills test (2004) were used to collect data. Data were analyzed using statistical tests of correlation, one way analysis of variance and Tukey’s post hoc test. Results: The findings showed that there was a significant difference between facial emotion recognition in patients with mood disorder and the normal group. Moreover, there was a correlation between facial emotion recognition and communication skills among these patients. Conclusions: Based on the results of this study on facial emotion recognition impairment and its significant relationship with communication skills in patients with mood disorder, it can be said that paying attention to them is very important in treating these disorders and reducing the relapse of the disease.[GMJ. 2015;4(3):90-99]