Affective Lability Research Articles

25.4 41032: Neural Predictors of Mood Dysregulation in Youth at Familial and Symptomatic Risk of Bipolar Disorder

Biomarkers of bipolar disorder are needed to aid in early diagnosis, and identifying neural markers of known prodromal behaviors is a step toward that goal. Mood dysregulation factors within affective lability scales are recognized as prodromal to the development of bipolar disorder. We identified neural and behavioral markers of future affective lability in at-risk youth from the Pittsburgh Bipolar Offspring Study (BIOS) and validated these in an independent sample of youth from the Longitudinal Assessment of Manic Symptoms (LAMS) study.

3.3 What Makes Irritability a Transdiagnostic Factor? Associations With Psychopathology Dimensions and Functional Impairment

Irritability is an important domain in child and adolescent mental health, is a strong marker of dysregulation, and is characterized by temper outbursts, low frustration tolerance, and affective lability. In this study, we examined irritability’s role in the structure and comorbidity of psychopathology and its unique effect on functional impairment in childhood and adolescence, which are critical periods for the emergence of mental health difficulties.

Patient-Reported Symptoms in the Global Multiple System Atrophy Registry.

The Global Multiple System Atrophy Registry (GLOMSAR) was established in 2013. It is an online patient-reported contact registry open and free that relies on self-reported diagnosis by the patient or caregiver. To report the demographics of patients enrolled in GLOMSAR and the results of an ancillary online symptom questionnaire. Patients enrolled in GLOMSAR were invited to complete a custom-designed online questionnaire about disease onset and symptom prevalence. At the time of writing, there were 1083 participants in GLOMSAR, of which 33% (365) completed the questionnaire. The onset and frequency of most symptoms was similar to those reported in the literature in physician-reported studies. Some were understudied or not typically associated with multiple system atrophy (MSA), including reduced female sexual sensation (55%), forgetfulness (60%), pseudobulbar affect (37%), olfactory changes (36%), and visual hallucinations (21%). Patient-reported studies and ancillary online questionnaires are valid, underused research tools useful to advance our knowledge on understudied MSA features and highlight the patients' voice.

Bipolar disorder predicted shorter and borderline personality disorder symptoms longer time to remission – A prospective cohort study of major depressive patients

BackgroundMajor depressive episodes (MDEs) of major depressive (MDD) or bipolar disorders (BD) are frequently complicated by features of borderline personality disorder (BPD). Mixed features are a hallmark of BD and affective lability of BPD, and both may markedly influence illness course. However, direct comparisons of outcome of depression in MDD, BD, and BPD are scarce. MethodsIn a cohort study based on stratified sampling, we diagnosed psychiatric MDE patients with SCID-I/P and SCID-II interviews and examined mixed symptoms using the Mix-MDE scale and borderline symptoms using the Borderline Personality Disorder Severity Index. During a six-month prospective follow-up, the MDE patients with MDD (n = 39), BD (n = 33), or BPD (n = 23) completed biweekly online assessments. Using life chart methodology, we divided the follow-up period into qualitatively different mood state periods. We investigated durations of mood episodes, times to first full symptomatic remission, and their predictors. ResultsRemission rates were similar in MDD, MDE/BD, and MDE/BPD patients. MDE/BD patients experienced more numerous and shorter distinct mood state periods during follow-up than the others. MDE/BD was associated with shorter (HR = 2.44, 95 % CI = 1.27–4.67) and dimensionally assessed BPD severity with longer time to first remission (HR = 0.95, 95 % CI = 0.91–1.00). LimitationsModerate sample size and follow-up duration. ConclusionsCourse of illness over six months differs between the three depressive groups. Bipolar depressive patients have the most alternating course and the shortest time to first period of remission. Dimensionally assessed severity of BPD may predict longer time to remission from depression.

The relationship between stress, anxiety, and depression levels and pseudobulbar affect in patients with multiple sclerosis

Background Pseudobulbar affect (PBA) has recently been added to the list of mental disorders commonly observed in patients with Multiple Sclerosis (MS). The emotional changes experienced by MS patients may be associated with other mental problems and adversely affect disease prognosis. However, there are limited studies in the international and national literature on this subject. Aim This study aimed to evaluate the relationship between PBA and stress, anxiety, and depression levels in patients with MS. Design This is a descriptive, relational, and cross-sectional study. Methods A total of 442 MS patients followed in the neurology outpatient clinic of a hospital and registered with the MS Society in Turkey participated in this study. Data were collected using a personal information form, the Turkish version of the Center for Neurologic Study–Lability Scale (CNS-LS), and the Depression Anxiety Stress Scale (DASS). Results In this study, 63.3% of the patients had PBA, 21% had extremely severe depression, 41.6% had extremely severe anxiety, and 24.9% had severe stress. Correlation analysis revealed weak positive correlations between CNS-LS total score and DASS subscale and total scores. Depression, anxiety, and stress levels accounted for 22.5% of the variation in CNS-LS total score. Conclusion The results of this study indicate that a majority of MS patients in Turkey experience PBA, depression, anxiety, and stress, and that PBA is positively associated with depression, anxiety, and stress. Impact statement This study, indicates that should be increased consultation-liaison psychiatry services in Turkey, and MS patients should benefit from comprehensive psychiatric services.

Estradiol, stress reactivity, and daily affective experiences in trauma-exposed women.

Women experience higher risk for PTSD following trauma compared with men. Fluctuations in ovarian hormones might contribute to this greater vulnerability, given that estradiol is associated with affect and stress reactivity. Our objective was to test the relations between menstrual cycle-related changes in estradiol, affect, stress reactivity, and trauma-related symptoms. We assessed trauma-related symptoms in ethnically diverse naturally cycling women with a history of trauma during a clinical interview. Participants also completed a 10-day ecological momentary assessment (EMA) that included lower- and higher-estradiol phases. We tested associations between estradiol and PTSD symptoms and stress reactivity to a trauma reminder using Spearman correlation and Wilcoxon rank-sum tests. We tested the effect of menstrual cycle day on daily affect using multilevel modeling. Estradiol was negatively associated with symptom severity (rs = -.36), and participants in low- versus high-estradiol cycle phases at interview had higher sympathetic (r = .35) and lower hypothalamic-pituitary-adrenal axis (r = .41) reactivity. Across the EMA period, participants showed a decrease in daily PTSD symptoms (b = -.39), negative (b = -.11) and positive (b = -.24) affect, and variability in daily valence (b = -.07) and arousal (b = -.08), from the low- to high-estradiol phase. Consistent with prior evidence of more aversive affective experiences in low-estradiol states, lower estradiol was associated with higher trauma-related symptoms. In addition, trauma-exposed women showed a discordant pattern of stress reactivity to a trauma reminder, higher daily symptoms, and greater affective lability in a low-estradiol phase. Given that our sample consisted of high-functioning trauma-exposed women, these results should be replicated in women with PTSD. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

IMPACT OF MINDFULNESS ON INTOLERANCE OF UNCERTAINTY AND AFFECTIVE LABILITY AMONG INDIVIDUALS WITH HISTRIONIC PERSONALITY FEATURES

Objectives: The study investigated interrelationship among mindfulness, intolerance of uncertainty and affective lability among individuals with histrionic personality features and to investigate the moderating impact of mindfulness between intolerance of uncertainty and affective lability.Study Design: Correlational Study.Method: The sample of N = 300 individuals with features of histrionic personality was selected by using convenient purposive sampling technique. Four scales; Brief Histrionic Personality Scale (BPHS), Mindfulness Attention Awareness Scale (MAAS), Intolerance of Uncertainty Scale-12 (IUS-12) and Affective Lability Scale (ALS) were used to collect the data.Results: The results showed that mindfulness has significant negative correlation with intolerance of uncertainty and affective lability. Intolerance of uncertainty has significant positive association with affective lability. The results also indicated that mindfulness is significant negative moderator in the association between intolerance of uncertainty and affective lability among individuals with histrionic features. Keywords: Intolerance of uncertainty; mindfulness; affective lability.

The Psychiatric Manifestations of Multiple Sclerosis and their Treatment

Multiple sclerosis (MS) is a potentially disabling disease of the central nervous system (CNS). It could be manifested by physical and psychological symptoms. The historical background, etiology, diagnosis and treatment of MS with disease-modifying therapies are briefly summarized. The psychiatric manifestations of MS and their treatment are reviewed and include major depression, bipolar disorder, psychosis, anxiety, insomnia, personality changes, cognitive impairment, pseudobulbar affect and substance use disorders

SCHIZOPHRENIA AND PSEUDOBULBAR AFFECT DISORDER IN THE FILM SCRIPT JOKER

This study deals with schizophrenia, pseudobulbar affect (PBA) and negative responses of the community experienced by the main character of the Joker 2019 film, Arthur Fleck and the public's response to his illness. schizophrenia is a condition in which a person cannot distinguish between the real world and the world of fantasy or hallucination; while pseudobulbar affect (PBA) is a condition characterized by uncontrollable laughing or crying.Descriptive qualitative method to reveal the social features is applied to get relevant and precise data concerning the discussion based on the clinical psychology theory. Cinematography by listening to every scene in the film, showing Arthur Fleck's illness and the public's response to his illness is then used for the data collection procedures. The results show that the main character has got schizophrenia in the form of hallucination and pseudobulbar affect (PBA) in the form of inability to control his laughter and at the same time it is also found that the community gives negative responses upon the mental illness of the main character.

Fiberoptic laryngoscopic neurological examination of amyotrophic lateral sclerosis patients with bulbar symptoms

ObjectiveBulbar symptoms in amyotrophic lateral sclerosis (ALS) are variable, reflecting bulbar and pseudobulbar palsy. The current study sought to characterize the pharyngeal findings in ALS using a fiberoptic laryngoscope and compare them with the findings of general neurological examination. MethodsWe enrolled ALS patients with bulbar symptoms who were admitted between 2014 and 2020. All participants were evaluated on salivary status, velopharyngeal movement during speech and swallowing, pharyngeal constriction, and vocal cord movement using fiberoptic laryngoscopy. The laryngoscopic findings were compared with general neurological examination results. ResultsA total of 50 patients (31 men; median age: 69 years) were enrolled. Salivary residue in the hypopharynx was the most common abnormal finding on laryngoscopy (40 patients; 80%). Twenty-three patients (46%) exhibited velopharyngeal insufficiency, 18 of which exhibited good velopharyngeal closure in swallowing and poor velopharyngeal closure in speech. Thus, these patients presented speech-swallow dissociation (SSD) in velopharyngeal closure. Five patients (10%) exhibited unilateral weakness of the pharyngeal constrictor muscles in phonation. Compared with general neurological examinations, emotional incontinence was more frequent in patients who presented with SSD in velopharyngeal movement, compared with those who did not. None of the five patients with unilateral weakness of pharyngeal constriction showed curtain movement on examination via the mouth. ConclusionThe specific findings of laryngoscopy in ALS patients, such as SSD in velopharyngeal closure and laterality in pharyngeal constriction, could not be evaluated by general neurological examination via the mouth.

Pseudobulbar affect as an early manifestation of HIV-related toxoplasmosis

IntroductionPseudobulbar affect (PBA) is an emotional disorder characterized by uncontrollable outbursts of laughing and/or crying. It is caused by lesions that damage pathways in the frontal lobe and descending to the brain stem, basis pontis and cerebellum. The main causes are neurodegenerative diseases.ObjectivesTo present a case of PBA secondary to cerebral toxoplasmosis.MethodsThe present study is a case report of a patient admitted for HIV-related toxoplasmosis to our hospital. We also researched previous case reports of PBA secondary to CNS infection using a pubmed query.ResultsMr. JA is a 38-year-old male, with no prior psychiatric or medical history. He reported having had same-sex sexual encounters previously. He was admitted for ataxia and dysarthria in a medical unit, and diagnosed of HIV infection, with a CD4 count of 19 cells/μL. The MRI showed a lesion of 22x19x18mm with ring enhancement predominantly in basis pontis, compatible with toxoplasmosis(Image1). Treatment with sulfadiazine, pyrimethamine and dexamethasone was initiated. After five days of hospitalization he was referred to Consultation-Liaison Psychiatry for involuntary and uncontrollable outbursts of laughing and crying, insomnia, but no other psychopathological symptoms. Therefore, citalopram 20mg per day was started, with reduction on the frequency of outbursts.ConclusionsThe clinical presentation suggested the diagnosis of PBA due to cerebral toxoplasmosis. Although we found no previous reports of PBA related to HIV infection or toxoplasmosis, the location of the toxoplasmosis lesion is congruent with the typical damaged pathways in PBA. To our knowledge, this is the first report about PBA secondary to HIV-related toxoplasmosis.DisclosureNo significant relationships.

Bipolar disorder correlated to shorter remission latency and borderline personality disorder symptom severity to longer in depression – a prospective cohort study of major depressive patients

IntroductionMajor depressive episodes (MDE) occur in major depressive (MDD) and bipolar disorders (BD), and are frequently complicated by borderline personality disorder (BPD). Mixed affective symptomatology is a hallmark of BD, and affective lability of BPD; both may markedly influence illness course. However, direct comparisons of outcome of depression in MDD, BD and BPD are scarce.ObjectivesTo investigate course of illness and outcome of depression in MDD, bipolar and borderline patients.MethodsIn this six-month, prospective cohort study of secondary-level psychiatric MDE patients (n = 95), after initial assessment, the patients (N = 95) completed biweekly online assessments of mood symptoms. We divided the follow up period into qualitatively different mood state periods based on multiple prospective information sources. We examined mixed affective symptoms and borderline symptom severity dimensionally. Outcomes assessed included clinical course, time to first full symptomatic remission, and factors predicting these.ResultsRemission rates according to DSM-5 were similar in MDD, MDE/BD and MDE/BPD patients. Bipolar patients experienced more shorter qualitatively distinct mood state periods during follow-up than the others. Bipolar disorder was associated with shorter (HR = 2.44, 95% CI = 1.27–4.67, see fig. 1) and dimensionally assessed BPD severity with longer time to first remission (HR = 0.95 per point., CI = 0.91–1.00).ConclusionsCourse of illness differs between the three depressive groups in the medium term. Bipolar depressive patients have the most alternating course and the shortest time to first remission. Dimensionally assessed severity of BPD may be prognostic of longer depressive remission latency.DisclosureI am employed by a psychiatric treatment provider, treating e.g. patients suffering from depression, bipolar disorder and borderline personality disorder.

The Transdiagnostic Self-Injury Interview: A Feasibility Study

IntroductionNon-suicidal self-injury (NSSI) is associated with emotional distress and mental disorders. In clinical samples NSSI is reported by 21% to 60% of all psychiatric patients. Developed NSSI instruments are not suitable for clinical settings because they are too time-consuming or lack validation across psychiatric diagnoses.The Transdiagnostic Self-Injury Interview (TSI) is semi-structured interview that accesses onset, frequency, methods, and severity of NSSI. It is transdiagnostic and developed for clinical settings.ObjectivesThe purpose of the study is to evaluate the feasibility of a TSI validation study. The study will also provide preliminary validation of the instrument.MethodsThe feasibility study will recruit participants at in- and outpatient units from a university hospital. Participants can be included in the study if they are 18 years old and admitted to a psychiatric in- or outpatient unit.Instruments: The Deliberate Self-Harm Inventory will be used to test concurrent validity. Convergent validity will be tested with the Columbia Suicidality Severity Rating Scale, the Personal and Social Performance scale, the Affective Lability Scale-short, and the Brief Trauma Questionnaire. Interrater reliability will be evaluated in groups of medical doctors, psychologist, and other clinical professionals.Feasibility are measured by inclusion of participants per week, the time each participant takes to complete the study instruments, and number of dropouts.ResultsRecruitment of participants will start in the fall of 2021. We aim to recruit 50 participants.ConclusionsWhen TSI has been validated, it can be used to assess prevalence and severity of NSSI and clarify the need for treatment and supervision.DisclosureNo significant relationships.

Ventral Attention Network Correlates With High Traits of Emotion Dysregulation in Community Women - A Resting-State EEG Study.

In recent years, many studies have focused on resting-state brain activity, and especially on functional connectivity (FC), an approach that typically describes the statistical interdependence of activity in distant brain regions through specific networks. Our aim was to study the neurophysiological correlates of emotion dysregulation. Therefore, we expected that both the Default Mode Network (DMN), and the Ventral Attention Network (VAN) would have been involved. Indeed, the latter plays a role in the automatic orienting of attention towards biologically salient stimuli and includes key regions for emotion control and modulation. Starting from a community sample of 422 female students, we selected 25 women with high traits of emotion dysregulation (HD group) and 25 with low traits (LD group). They underwent a 64-channel EEG recording during a five-minute resting state with eyes open. Seed-based FC was computed on the EEG Alpha band (8–13 Hz) as a control band, and on EEG Gamma power (30–50 Hz) as the relevant measure. The power within each network and inter-network connectivity (Inter-NC) was also calculated. Analysis of the EEG Gamma band revealed, in the HD group, higher levels of Inter-NC between the VAN and all other resting-state networks as compared with the LD group, while no differences emerged in the Alpha band. Concerning correlations, Alpha power in the VAN was negatively correlated in the HD group with affective lability (ALS-18 questionnaire), both for total score (ρ = –0.52, pFDR < 0.01) and the Depression/Elation subscale) ρ = −0.45, pFDR < 0.05). Consistent with this, in the Gamma band, a positive correlation was found between VAN spectral power and the Depression/Elation subscale of ALS-18, again in the HD group only (ρ = 0.47, pFDR < 0.05). In conclusion, both resting state FC and network power in the VAN were found to be related to high emotion dysregulation, even in our non-clinical sample with high traits. Emotion dysregulation was characterized, in the EEG gamma band, by a VAN strongly connected to all other networks, a result that points, in women prone to emotion dysregulation, to a strong automatic orienting of attention towards their internal state, bodily sensations, and emotionally intense related thoughts.

Epidemiology of psychotic-like experiences by subtypes and their relationship with emotional regulation and affective lability among Chinese college students

Although psychotic-like experiences (PLEs) are transient and not pathognomonic for psychiatric disorders, they may increase the risk of concurrent and future psychiatric disorders. However, the prevalence of PLEs and the different effects of PLE subtypes on mood outcomes are still unclear. Thus, this study seeks to investigate the prevalence of PLE subtypes and explore their relationship with the use of specific emotion regulation strategies and the level of affective lability among college students. The history of PLEs, the level of affective lability, and the use of specific emotion regulation strategies were assessed via self-reported questionnaires, and 1905 college students and 1812 college students were included in separate analyses. This study found that 14.44% of college students reported ever experiencing any of the five PLEs, with males reporting more PLE symptoms and a higher number of PLEs than females. Different PLE subtypes had different effects on the use of specific emotion regulation strategies (cognitive reappraisal or suppression) and the level of affective lability and also showed gender differences. Cognitive reappraisal and suppression differently predicted affective lability in males and females, and cognitive reappraisal mediated the relationship between hearing voices in PLEs and affective lability in males. In conclusion, PLEs were common in Chinese college students and gender differences were revealed in the prevalence of PLE subtypes. PLEs were associated with the use of specific emotion regulation strategies and the level of affective lability. Cognitive reappraisal may be a promising target for intervention aimed at relieving the effect of PLEs in non-clinical individuals.

Comorbid Eating Disorders in a Sample of Youth With Bipolar Disorder: Elevated Burden of Dimensional and Categorical Psychopathology.

Objective: There is growing recognition of the importance of comorbid eating disorders (ED) among individuals with bipolar disorder (BD). However, most studies on this topic have focused on adult samples, and little is known regarding comorbid ED among youth with BD.Methods: The sample included 197 youth with DSM-IV BD (BD-I, BD-II, or BD-NOS [not otherwise specified]), aged 13-20 years and recruited from a subspecialized clinic within a tertiary academic health sciences center from 2009 to 2017. Univariate analyses examined demographic and clinical variables among participants with versus without lifetime DSM-IV ED. Variables significant at P < .10 were entered into a backward stepwise regression.Results: Fifty-six participants (28.4%) had lifetime DSM-IV ED (3.6% anorexia nervosa, 8.1% bulimia nervosa, 16.8% ED not otherwise specified). Significant correlates of lifetime ED were female sex (P < .001), BD-II subtype (P = .03), suicidal ideation (P = .006), suicide attempts (P = .004), non-suicidal self-injury (P < .001), sexual abuse (P = .02), cigarette smoking (P = .001), anxiety disorders (P = .004), posttraumatic stress disorder (P = .004), substance use disorders (P = .006), history of individual therapy (P = .01), and family history of anxiety (P = .01). Significant correlates of no lifetime ED were BD-I subtype (P < .001) and lifetime lithium use (P = .01). The ED group had significantly more severe lifetime depression (P < .001) and significantly more self-reported affective lability (P < .001) and borderline personality traits (P < .001). In multivariate analysis, the most robust predictors of lifetime ED were female sex (odds ratio [OR] = 4.61, P = .004), BD-I subtype (OR = 0.21, P = .03), cigarette smoking (OR = 2.78, P = .02), individual therapy (OR = 3.92, P = .03), family history of anxiety (OR = 2.86, P = .02), and borderline personality traits (OR = 1.01, P = .009).Conclusions: ED are common among youth with BD and associated with adverse clinical characteristics, many of which converge with prior adult literature. Future studies evaluating specific ED subtypes are warranted, as are treatment studies targeting comorbid ED in youth with BD.

Involuntary crying episodes with Susac\u2019s syndrome\u2014a rare presentation of a rare disease: a case report

BackgroundIn this case, we reported the pseudobulbar affect (PBA) in a patient with Susac’s syndrome—a rare condition that was caused by a rare syndrome. Previous case reports of Susac syndrome described psychiatric symptoms such as emotional disturbances or personality changes. Only a few case reports have reported psychiatric disorders in patients with Susac’s syndrome. There were no reported cases of Susac syndrome with PBA as an initial presentation.Case presentationOur patient was 56 years old and presented with involuntary crying, left-sided headache, left-sided hearing loss, and tinnitus. Brain MRI showed numerous areas of restricted diffusion and enhancement involving the corpus callosum, bilateral hemispheres, and brainstem. Ophthalmological evaluation showed bilateral branch retinal artery occlusion. She was diagnosed with Susac’s syndrome and PBA. She was treated with cyclophosphamide and dextromethorphan hydrobromide/quinidine sulfate with excellent recovery. This is a 2-year clinical course.Discussion and conclusionsRecognition of the clinical presentation of Susac’s syndrome and PBA with early diagnosis and treatment are the keys to preventing further disability and impact on patients and their families.

Evaluation of neuropsychiatric symptoms in patients with multiple sclerosis

Purpose: The aim of this study was to comprehensively assess the neurophyschiatric symptoms of multiple sclerosis (MS) such as apathy and pseudobulbar affect and their correlation with other concomitant factors.&#x0D; Materials and Methods: Montreal Cognitive Assessment (MoCA), Apathy Evaluation Scale (AES), Fatigue severity scale (FSS), Center for Neurologic Study-Lability Scale (CNS-LS), Beck Depression Inventory (BDI) are applied to 258 MS patients. Correlation and regression analysis are conducted between scales and other possible causers.&#x0D; Results: 53.6% of the patients have psuedobulbar affect, 76.2% of patient population have fatigue. Pseudobulbar affect had positive correlation with fatigue and also depression while apathy negatively correlate with pseudobulbar affect or fatigue. Additionally, apathy and depression correlated negatively. There was no relation between cognition and depression and/or disease duration and/or other scales’ scores. &#x0D; Conclusion: Pseudobulbar affect and apathy are quite common symptoms in MS patients, that are cross-cutting issues. Also, apathy may be an independent neuropyschiatric symptom of MS that need to be approached separately.

Chronic T Cell Encephalitis Responsive to Immunotherapy

Chronic encephalitis manifesting as an epilepsy syndrome most commonly presents as Rasmussen's syndrome, usually characterized by epilepsia partialis continua, hemiparesis, and progressive cortical deficits such as aphasia, hemianopia, and cognitive decline. It is characterized by progressive hemispheric cortical atrophy on imaging and is usually seen in childhood. Adult-onset of the syndrome is rare, and only a few cases have been reported with bilateral symptoms. We present a patient with pseudobulbar affect and frontal lobe dysfunction who developed multifocal myoclonic jerks, right hemibody focal motor seizures, and right hemiparesis with bilateral cerebellar signs. Magnetic resonance imaging showed progressive hemispheric atrophy and bilateral features in Positron emission tomography–computed tomography (PET CT). Brain biopsy revealed chronic T-cell infiltrate. We discuss this case as the patient had several features that were atypical for Rasmussen's encephalitis (or syndrome).

Evaluating the use of lamotrigine to reduce mood lability and impulsive behaviors in adults with chronic and severe eating disorders

BackgroundGold-standard psychological and pharmacological treatments for bulimic-spectrum eating disorders only result in remission for around 50% of patients; patients with affective lability and impulsivity represent a subgroup with particularly poor outcomes. Both dialectical behavior therapy (DBT), a treatment for emotion dysregulation, and lamotrigine, a mood stabilizer, have demonstrated promise for targeting affective lability and impulsivity; however, data exploring the combination of these interventions remain limited.ObjectiveWe followed a group of women with recurrent dysregulated eating behaviors (N = 62) throughout intensive DBT treatment and compared the symptom trajectory of those prescribed lamotrigine (n = 28) and those who were not (n = 34).MethodParticipants completed surveys every 2 weeks throughout treatment.ResultsGroup analyses suggested that all participants self-reported decreases in emotional reactivity, negative urgency, and symptoms of borderline personality disorder (BPD). The lamotrigine group reported greater elevations in BPD symptoms at baseline, but demonstrated steeper decreases in emotion and behavioral dysregulation than the non-matched comparison group. Within-subject analyses suggested that within the lamotrigine group, subjects reported greater decreases in symptoms following prescription of lamotrigine.ConclusionsFindings provide initial data suggesting that lamotrigine could be useful as an adjunctive treatment for patients with affective lability and impulsivity.Level of evidenceIV, time series without randomization.