Dissertations / Theses: 'Bipolar affective disorders'

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Maripuu, Martin. "Hypocortisolism in recurrent affective disorders." Doctoral thesis, Umeå universitet, Psykiatri, 2015. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-112824.

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Bipolar disorders and recurrent depressions are two common psychiatric disorders with a life time prevalence of approximately 1% and 8%, respectively. Despite treatment these patients suffer from affective symptoms up to 50% of the time, resulting in lower well-being. The average life length is also reduced with 10-15 years, mainly attributable to suicide and cardiovascular disease. Increased stress is one of many factors that have been shown to be linked to an increased risk for developing affective disorders and some comorbid somatic conditions such as metabolic disturbances and cardiovascular disease. An increased stress level is known to cause hyperactivity of the hypothalamic-pituitary-adrenal-axis (HPA-axis) with increased cortisol secretion. Hyperactivity of the HPA-axis (or hypercortisolism) is one of the most replicated neurobiological finding in depression. In other stress related disorders it has however been shown that prolonged stress over long periods of time can lead to a state of low HPA-axis activity, hypocortisolism. Since persons with recurrent affective disorders such as bipolar disorder and recurrent depression are exposed to a high degree of recurrent and chronic stress it could be expected that in addition to hypercortisolism, a state of hypocortisolism could also develop in these disorders, potentially exerting an influence upon the psychological and somatic wellbeing among these patients. The major aim of this thesis was to evaluate whether hypocortisolism is related to relevant psychiatric and somatic phenotypes in recurrent affective disorders. In bipolar disorder, individuals with hypocortisolism exhibited a higher degree of depression and low quality of life compared to patients with normal HPA-axis activity. In recurrent depression, individuals with hypocortisolism exhibited shorter leukocyte telomere length than patients with normal or high HPA-axis activity, which is an indication of an accelerated aging process. In a sample of both bipolar and recurrent depression patients, hypocortisolism was associated with an increased proportion of obesity, dyslipidemia and metabolic syndrome compared with patients with normal or high HPA-axis activity. Patients with recurrent depression showed a higher occurrence of hypocortisolism than the control sample representative of the general population. Patients with bipolar disorder showed a similar occurrence of hypocortisolism as the control sample. Among bipolar disorder patients with a low degree of lifetime with lithium prophylaxis, there was an inverse correlation between age and HPA-axis activity. In contrast, among patients with a higher degree of lifetime with lithium prophylaxis as well as among the controls, there was no correlation between age and HPA-axis activity. Accordingly, hypocortisolism was most common among older patients with a low degree of lifetime with lithium prophylaxis. In conclusion, hypocortisolism in both recurrent depression and bipolar disorder was associated with multiple clinically-relevant phenotypes. Additionally it was shown for bipolar disorder patients that increasing age was a risk factor for hypocortisolism and that prophylactic lithium treatment was a protective factor. It is argued that the protective effect of lithium towards the HPA-axis is attributable to its mood-stabilizing effect, which in turn reduces the chronic stress level. These results provide new insight into the role of hypocortisolism and chronic stress in recurrent affective disorders warranting further studies and hopefully providing clues to improved treatment strategies.

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Johnson, Lars. "Affective disorders in a stress-vulnerability perspective : a clinical, biological and psycho-social study /." Stockholm, 2002. http://diss.kib.ki.se/2002/91-7349-396-1/.

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Fekadu, Abebaw. "Studies on affective disorders in rural Ethiopia." Doctoral thesis, Umeå universitet, Psykiatri, 2010. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-37813.

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Background Affective disorders are poorly defined and studied in sub-Saharan Africa despite their substantial public health impact. Objectives Overall objective: To describe the epidemiology of selected affective disorders in rural Ethiopia. Specific objectives 1. To describe the validity and utility of the concept of minor depressive disorder (mD). 2. To describe the manifestation, prevalence and the short-term clinical and functional course and outcome of bipolar disorder. Subjects and methods Population: Zay community residents (age ≥16), and residents of Butajira (ages 15-49), in Southern Ethiopia. Study design: Population-based cross-sectional and longitudinal studies Case identification: For the identification of cases with bipolar disorder, a two stage process was employed. An initial screen used key informants and interview with the Composite International Diagnostic Interview (CIDI) to identify cases with probable bipolar disorder. A second confirmatory diagnostic assessment stage employed the Schedules for Clinical Assessment in Neuropsychiatry (SCAN). For the identification of cases with mD, data from the CIDI was used. Follow-up: 312 cases with bipolar disorder from Butajira were followed up for a mean of 2.5 years (ranging 1-4 years) through monthly clinical assessments and annual symptom and functional ratings. Results The CIDI was administered to 1714 adults among the Zay and to 68, 378 adults among the Butajira residents. The prevalence of mD among the Zay and Butajira was 20.5% and 2.2% respectively. Up to 80% of cases with mD had used services for their symptoms, while a third to a half of cases had thought about self harm. Up to a sixth of cases had attempted suicide. Age, marital status, education and somatic symptoms were independently associated with mD. The prevalence of bipolar disorder among the Zay was 1.8%. During a 2.5-year follow-up of 312 cases with bipolar disorder from Butajira, 65.9% relapsed (47.8% manic, 44.3% depressive and 7.7% mixed episodes) while 31.1% experienced persistent illness. Female gender predicted depressive relapse whereas male gender predicted manic relapse. Only being on psychotropic medication predicted remission (OR=3.42; 95% CI=1.82, 6.45). Disability was much worse among bipolar patients than in the general population and was predicted by symptom se3verity. Conclusions This is the largest study on mD and bipolar disorder in Africa. mD appears to have potential clinical utility in this setting given its association with service use and risk. The identified risk factors for mD also suggest potential aetiological continuity with major depression. The relatively high prevalence of bipolar disorder among the Zay may be related to genetic predisposition perhaps mediated through a founder effect, but other factors need exploring. In relation to the outcome of bipolar disorder, this study indicates that, contrary to previous assumptions, the course of bipolar disorder is characterised by both manic and depressive relapses in a relatively proportionate fashion. Bipolar disorder also leads to significant levels of disability. This is the only prospective outcome study of bipolar disorder in Africa where cases were monitored systematically at short assessment intervals. Therefore, findings are likely to be more robust than previous reports.

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Grobler, Christoffel. "A cross-sectional descriptive study of clinical features and course of illness in a South African population with bipolar disorder." Thesis, University of Pretoria, 2012. http://hdl.handle.net/2263/24414.

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There is generally a lack of studies examining prevalence and phenomenology of bipolar disorder in Africa. In literature, a unipolar manic course of illness in particular is reported to be rare. The purpose of this study was to investigate and describe the course of illness and clinical features in a cross-section of patients diagnosed with bipolar disorder attending public hospitals in Limpopo Province, South Africa and to determine the rate of a unipolar manic course in this sample of patients. This was a descriptive, cross-sectional study of patients presenting with a history of mania between October 2009 and April 2010, to three hospitals in Limpopo Province. A purposeful sample of 103 patients was recruited and interviewed using the Affective Disorders Evaluation. This study confirms that a unipolar manic course is indeed much more common than rates suggested in present day literature with57% of the study sample only ever experiencing manic episodes. The study also confirms the debilitating nature of bipolar disorder with more than two-thirds being unemployed in spite of a quarter of the study subjects having a tertiary education. The high rates of attempted suicide, history of violence and history of drug abuse all furthermore points to the devastating effects bipolar disorder has on individuals and their families. Treatment choice appeared to be a combination of a mood-stabilising agent in combination with an anti-psychotic. It was found that two-thirds of study subjects had consulted with faith- or traditional healers. Significant gender differences appeared in that females were more likely to suffer from comorbid anxiety disorders, have a history of sexual trauma, and be HIV positive whilst men were more likely to have a forensic- and substance-abuse history, experience hallucinations and receive clozapine. Patients presenting with a unipolar manic course of illness, as described in this thesis, may contribute to the search for an etiologically homogeneous sub-group which presents unique phenotype for genetic research and the search for genetic markers in mental illness. A unipolar manic course therefore needs to be considered as a specifier in diagnostic systems in order to heighten the awareness of such a course of illness in bipolar disorder, with a view to future research. Thesis (MD)--University of Pretoria, 2012. Psychiatry unrestricted

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Brocke, Burkhard, André Beauducel, Regina John, Stefan Debener, and Hubert Heilemann. "Sensation Seeking and Affective Disorders: Characteristics in the Intensity Dependence of Acoustic Evoked Potentials." Saechsische Landesbibliothek- Staats- und Universitaetsbibliothek Dresden, 2014. http://nbn-resolving.de/urn:nbn:de:bsz:14-qucosa-134689.

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Augmenting/reducing of the evoked potential has been shown to be related to sensation seeking (SS) and specific clinical disorders. Buchsbaum demonstrated that patients with bipolar affective disorders (BAD) tend to be augmenters, as is the case with sensation seekers, and patients with unipolar affective disorders (UPD) tend to be reducers. In addition, he reported that prophylactic medication reduced the tendency to augment in bipolar patients. However, evidence for these relations is restricted to a few studies. This study explores whether Buchsbaum’s initial findings can be found in a naturalistic clinical setting. Acoustic evoked potentials were recorded for six levels of intensity (59, 71, 79, 88, 92, 96 dB SPL) from 24 healthy adults, 21 unipolar depressed patients, and 21 patients with BAD. Participants also completed personality questionnaires, especially the Sensation Seeking Scales Form V. Results revealed a positive correlation between SS and augmenting/reducing in healthy controls, thereby replicating earlier findings. Bipolar depressed patients showed larger P1/N1 slopes than healthy controls, when medication was statistically controlled. Unipolar depressed patients showed smaller P2 slopes, but only when medication was not controlled. Implications of these results for further research on augmenting/reducing and affective disorders and their relationship to SS are discussed Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich

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Watson, Andrew. "Effect that the t(1;11) translocation and mental disorders have on glutamate and NAA levels in the prefrontal lobe, as measured by MRS." Thesis, University of Edinburgh, 2018. http://hdl.handle.net/1842/31362.

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1H-Magnetic Resonance Spectroscopy (MRS) is a MRI paradigm that allows the levels of specific metabolites to be estimated in vivo [1]. This means that insights into the biochemical changes associated with a rare genetic change that raises the risk of mental disorders, and the impact of having a mental disorder, can potentially be made. In this study the levels of glutamate and N-acetyl-aspartate (NAA) were measured at 3T field strength in three separate voxels: right dorsolateral prefrontal cortex (DLPFC), left DLPFC and the anterior cingulate cortex (ACC). This thesis reports that members of a family that carry a unique t(1;11)(q42.2;q14) translocation that affects DISC1 have a substantially raised risk of developing a range of mental disorders, including bipolar affective disorder, schizophrenia and depression. A genetic change that leads to an increase in the susceptibility to a range of mental disorders is in line with other genetic studies that have been recently reported [2, 3]. The translocation was associated with a significant reduction in right DLPFC glutamate (mean difference= -2.11, CI= -0.24: -3.98, p=0.029) and left DLPFC NAA (mean difference= -1.97, CI= -0.34: -3.61, p=0.020). Changes in these metabolites offer some support to studies in cells and rodents trying to understand the impact of the t(1;11) translocation. More specifically the results offer support to studies that have linked alterations in DISC1's molecular biology to changes in glutamate receptors and mitochondrial function [4-6]. The results need to be interpreted with some caution due to the small sample size and the lack of a significant effect in the bilateral DLPFCs. People with a major mental disorder were also found to have significantly lower levels of glutamate in the left DLPFC (F=3.16, p=0.047). When compared to controls the reductions were significant in the people with a diagnosis of schizophrenia (mean difference= -0.86, CI= -0.19: -1.51, p=0.012), but not in people with bipolar affective disorder. Glutamate levels were significantly correlated with negative symptoms in people with schizophrenia (SANS r= -0.44, CI= -0.07: - 0.70, p= 0.024). The effect of experiencing depressive symptoms was also evaluated due to support for a link in previous studies [7, 8]. Whist the participants were not recruited due their experience of depressive symptoms, metabolite levels were found to be significantly associated with depressive symptoms in all participants with a mental disorder (all three voxels, both NAA and glutamate p < 0.05). The experience of depressive symptoms is not the same experiencing a depressive episode though, and further work may offer more insights into the association between metabolite changes and experience of depression. These findings provide insights into the relationship between diagnosis, current psychopathology and genetic risk in major mental disorders. The thesis provides some support that MRS imaging can be used to try understand neurobiological changes that are associated a genetic change, which is in turn linked to range of mental disorders. Interpreting the results of MRS imaging studies in humans remains challenging due to the complexity of the molecular biology that underpins the estimated metabolite levels, but where there has been a wide range of translational study into a specific protein (or genetic change) MRS may offer further information to help understand any effect in vivo.

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Brocke, Burkhard, André Beauducel, Regina John, Stefan Debener, and Hubert Heilemann. "Sensation Seeking and Affective Disorders: Characteristics in the Intensity Dependence of Acoustic Evoked Potentials." Karger, 2000. https://tud.qucosa.de/id/qucosa%3A27588.

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Augmenting/reducing of the evoked potential has been shown to be related to sensation seeking (SS) and specific clinical disorders. Buchsbaum demonstrated that patients with bipolar affective disorders (BAD) tend to be augmenters, as is the case with sensation seekers, and patients with unipolar affective disorders (UPD) tend to be reducers. In addition, he reported that prophylactic medication reduced the tendency to augment in bipolar patients. However, evidence for these relations is restricted to a few studies. This study explores whether Buchsbaum’s initial findings can be found in a naturalistic clinical setting. Acoustic evoked potentials were recorded for six levels of intensity (59, 71, 79, 88, 92, 96 dB SPL) from 24 healthy adults, 21 unipolar depressed patients, and 21 patients with BAD. Participants also completed personality questionnaires, especially the Sensation Seeking Scales Form V. Results revealed a positive correlation between SS and augmenting/reducing in healthy controls, thereby replicating earlier findings. Bipolar depressed patients showed larger P1/N1 slopes than healthy controls, when medication was statistically controlled. Unipolar depressed patients showed smaller P2 slopes, but only when medication was not controlled. Implications of these results for further research on augmenting/reducing and affective disorders and their relationship to SS are discussed. Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich.

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Kwan, Hiu-fai, and 關曉暉. "Bipolar affective disorder and schizophrenia with first-episode psychosis : baseline and outcome study in Hong Kong." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2013. http://hdl.handle.net/10722/192964.

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Objective: The aim of the current study was to investigate the differences in baseline characteristics and three-year outcomes between two diagnostic categories with presentation of first-episode psychosis: bipolar affective disorder (mania with psychotic features) and schizophrenia. The comparison was based on pre-treatment characteristics, clinical presentation, symptomatic and functional outcomes, and engagement in risk behaviours. Methods:461 schizophrenic patients and 54 bipolar affective disorder (BAD) patients between the ages of 15 to 25 years from a local first-episode psychosis treatment program within the years2001 to 2003 were studied. Researchers collected detailed data on baseline and three-year follow up variables from systematic medical file review for statistical analyses. Results: At service entry, compared to schizophrenic patients, bipolar affective disorder(BAD)patients exhibited more prominent positive symptoms (p = 0.01), were younger at first presentation and had a higher unemployment rate (p < 0.01), were more likely to have acute onset of psychosis, shorter duration of untreated psychosis (DUP), a higher rate of hospital admission within first month after initial contact, and lower pre-treatment functioning (Social and Occupational Functioning Assessment Scale (SOFAS), p < 0.001). There was no significant difference in gender, education level, age of onset and pre-treatment risk taking behaviours. After applying univariate analysis of variance (ANCOVA)by controlling baseline variables that showed significant differences, the three year follow up reveals that schizophrenic patients displayed fewer numbers of hospitalization (p <0.01)with no difference in the total length (days) of hospitalization, more prominent positive symptoms(p < 0.01), poorer functioning at year 3 (p <0.05), and consistently significant lower employment rate at 12 month (p < 0.001), 24 month (p < 0.001) and 36 month (p < 0.01). Finally, more schizophrenic patients received social benefits (p < 0.05). Conclusion: The outstanding baseline poorer functioning level of bipolar affective disorder patients have progressively made a modest improvement in functional outcomes at the end of three-year follow up. BAD patients also displayed a marked improvement with fewer positive symptoms in the follow up. The results suggest a differentiation in symptomatology and the course of illness between bipolar affective disorder and schizophrenia with first-episode psychosis. In coherence with other scholastic literature, duration of untreated psychosis (DUP) associates with remission(Crumlish et al., 2009;Chang et al., 2012a), positive symptoms(Barnes et.al., 2008; Chang et.al., 2012b; Clarke et al., 2006; Crumlish et.al., 2009;), and functional outcomes(Barnes et al., 2008; Chang et al., 2012b; Clarke et.al., 2006; Crumlish et.al, 2009; Fusar-Poli et al., 2009). Moreover, further exploration about the diagnostic-specific therapeutic window for early intervention, symptoms management, and rehabilitation strategies in occupational training are in demand. published_or_final_version Psychological Medicine Master Master of Psychological Medicine

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Angelis, Geisa de. "Estudo comparativo entre a percepção da qualidade do sono, qualidade de vida, sintomas depressivos e de ansiedade em portadores de transtorno bipolar na fase eutímica." Universidade de São Paulo, 2009. http://www.teses.usp.br/teses/disponiveis/5/5138/tde-06052009-171637/.

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INTRODUÇÃO: O transtorno bipolar é caracterizado por episódios alternados e recorrentes de mania ou hipomania com depressão e períodos de eutimia, com prevalência entre 1% e 8% na população geral. Os transtornos mentais influenciam consideravelmente a qualidade de vida, prejudicando as relações familiares, sociais e ocupacionais. O sono que influi diretamente na qualidade de vida, também pode alterar-se no transtorno bipolar. OBJETIVOS: a) Verificar se existe diferença entre a percepção da qualidade de vida e qualidade do sono em portadores de transtorno bipolar quando comparados a um grupo-controle; b) verificar a associação entre qualidade de vida e qualidade do sono em cada grupo; c) avaliar a intensidade de sintomas depressivos e de ansiedade e verificar se essas variáveis são diferentes entre os grupos; d) investigar se existe associação dos sintomas depressivos e de ansiedade na qualidade de vida e na qualidade do sono; e) verificar se a latência, duração e eficiência do sono nos maus dormidores do grupo-estudo são diferentes dos maus dormidores do grupo-controle. MÉTODOS: A pesquisa foi do tipo caso-controle e a amostra foi caracterizada como não probabilística por conveniência. Grupoestudo (n=43) e grupo-controle (n=80). A seleção do grupo-estudo seguiu os seguintes critérios de inclusão: pessoas com transtorno bipolar na fase estabilizada que participavam do grupo de psicoeducação em um Hospital Dia Psiquiátrico, idade entre 25 e 60 anos, diagnóstico de transtorno bipolar tipo I ou II, de acordo com os critérios diagnósticos do Manual Diagnóstico e Estatístico de Transtornos Mentais IV-Revisão, em uso de estabilizador do humor e ausência de co-morbidade psiquiátrica. Foram excluídos os controles com quaisquer diagnósticos psiquiátricos do eixo I, do Manual Diagnóstico e Estatístico de Transtornos Mentais IV-Revisão. O projeto foi aprovado pelo Comitê de Ética do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo. Os instrumentos utilizados foram: Índice de Qualidade do Sono de Pittsburgh, Inventário de Depressão de Beck, Inventário de Ansiedade de Beck, Questionário de Qualidade de Vida da Organização Mundial da Saúde, Entrevista Clínica Estruturada para o Manual Diagnóstico e Estatístico de Transtornos Mentais IV-Revisão, Escala de Avaliação de Mania Modificada e o Critério de Classificação Econômica Brasil. RESULTADOS: Encontrou-se diferença significativa em relação à qualidade do sono (p=0,045). As diferenças não foram significativas para qualidade de vida (p=0,154), sintomas depressivos (p=0,480) e sintomas de ansiedade (p=0,484). As variáveis qualidade do sono e qualidade de vida apresentaram correlação significativa tanto para o grupo-estudo (p<0,001; r=0,534) quanto para o grupo-controle (p<0,001; r=0,382). Foram encontradas diferenças significativas na latência e duração do sono nos subgrupos de maus dormidores (p=0,026 e p=0,001; respectivamente). CONCLUSÃO: As pessoas com transtorno bipolar apresentaram percepção da qualidade de vida, intensidade de sintomas depressivos e de ansiedade semelhantes às de pessoas não afetadas por este transtorno, porém com pior qualidade do sono. Houve associação diretamente proporcional entre as variáveis: qualidade do sono e qualidade de vida. No subgrupo de maus dormidores do grupo-estudo, a latência e duração do sono estiveram aumentadas comparadas com o subgrupo de maus dormidores do grupo-controle. INTRODUCTION: The bipolar disorder is characterized by alternating and recurrent episodes of mania and hypomania with depression and periods of euthymia, with prevalence between 1 and 8% in the general population. The mental disorders influence the quality of life considerably, disturbing familiar, social and occupational relations. Sleep is also associated with the quality of life; moreover, it can be modified in bipolar disorder. OBJECTIVES: a) To verify if there is a difference between the perception of the quality of life and the quality of sleep in bipolar disorder when compared with a control-group; b) to verify the association between quality of life and quality of sleep in each group; c) to evaluate the intensity of depressive and anxiety symptoms and verify if these variables are different between the groups; d) to investigate possible association of depressive and anxiety symptoms in quality of life and quality of sleep; e) to verify if latency, duration and efficiency of sleep in the bad sleepers of the study-group are different from those of bad sleepers in the control-group. METHODS: The kind of research was case-control and the sample was characterized as a no-probability for convenience. Study-group (n=43) and control-group (n=80). The selection for the study-group had the following criteria of inclusion: patients with bipolar disorder in the stabilized phase who took part of the group of psychoeducation in a Psychiatric Hospital, age between 25 and 60, diagnostic of bipolar disorder, according to the criteria diagnostics of Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition, in use of stabilizer of mood and absence of psychiatric comorbidity. The project has been approved by the Committee of Ethic of Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto, da Universidade de São Paulo, Brazil. The instruments used in this process were: Pittsburgh Sleep Quality Index, Beck Depression Inventory, Beck Anxiety Inventory, World Health Organization Quality of Life Assessment, Clinical Interview Structuralized for the Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition, Modified Scale of Mania Evaluation and Brazilian Criteria of Economic Classification. RESULTS: a significant difference in the quality of sleep (p=0.045) has been found. The differences werent significant for the variables: quality of life (p=0.154), depressive symptoms (p=0.480) and anxiety symptoms (p=0.154). The variables quality of sleep and quality of life presented a significant correlation to both studygroup (p<0.001; r=0.534) and control-group (p<0.001: r=0.382). Significant differences in latency and duration of sleep in the subgroup of bad sleepers (p=0.026 and p=0.001, respectively) have been found. CONCLUSION: Patients with bipolar disorder presented perception of the quality of life, intensity of depressive and anxiety symptoms similar to those of subjects in the control-group not affected by this disorder. There has been a direct proportional association between the variables quality of sleep and quality of life. In the sub-group of bad sleepers in the study-group, the latency and duration of sleep had been increased compared to those in the sub-group of bad sleepers in the control-group.

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Schwannauer, Matthias. "Cognitive, interpersonal and psychsocial factors influencing vulnerability, treatment outcome and relapse in bipolar affective disorders : a clinical randomised controlled treatment trial." Thesis, University of Edinburgh, 2007. http://hdl.handle.net/1842/18603.

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Bipolar Affective Disorder is one of the most long-term recurrent mental health disorders. Despite the efforts in pharmacological management of bipolar disorder, relapse and residual symptoms remain a major factor in the development of illness chronicity, and long term social and occupational disability. For individuals themselves relapse is critical in the development of secondary psychological morbidity. On the basis of a review of the current literature on psychological treatments and the influence of psychological and psychosocial factors on the onset, course and outcome in bipolar disorder an integrated psychological intervention model for this clinical group is presented. This treatment approach will combine effective cognitive behavioural therapy elements and interpersonal psychotherapy components. The efficacy and effectiveness of this intervention is investigated through a clinical randomised controlled trial. The trial is comparing three conditions in an exploratory partially randomised design; a waiting list condition of treatment as usual (TAU), consisting of clinical management and psychiatric follow up, and the experimental groups of cognitive interpersonal intervention in a group and individual treatment format. Participants were randomised into the TAU or treatment group; in the treatment group participants' were offered a choice of group or individual therapy. Participants randomised to TAU were offered treatment after a six months waiting period. Those participants in the treatment group were assessed at the start of treatment, at mid-treatment, end of treatment, and at a six months and 18 months follow up using a variety of clinician rated and self rated assessments of clinical symptoms as well as relevant psychological and psychosocial factors. Clinical service data relating to service use and hospital admissions were collected for the entire group for pre and post intervention periods. Overall out of 258 referrals, 212 individuals were assessed for the study and 193 individuals started treatment, 174 participants completed the minimum number of treatment sessions, 134 were available for follow-up assessments at 6 months post treatment and 108 were available for follow-up at 18 months post treatment. The direct comparison of treatment and control group showed a large positive treatment effect of cognitive interpersonal therapy on the primary outcome, quality of life. Similarly medium to large treatment effects were shown for the secondary outcomes, indicators of bipolar symptoms, emotional distress and indicators of relapse and recurrence. Participants who completed treatment showed significant improvement in quality of life, psychiatric symptoms, and emotional distress'. Further, their relapse rates and hospital admissions as well as their use of emergency psychiatric services were significantly reduced. The analysis of psychological and psychosocial predictors established clear differential effects of psychological factors on therapeutic change and outcome in relation to depression and symptoms of mania respectively, demonstrating that the change in cognitive, interpersonal and psychosocial variables through the intervention is predictive of outcome indicators at end of treatment and follow up. The results of these analyses aid the development of a cognitive interpersonal model of bipolar affective disorder and support the development of an integrated psychological treatment aimed at this complex and chronic clinical group.

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Labalestra, Mélanie. "Les troubles formels de la pensée et de la mémoire sémantique : modèle de vulnérabilité au trouble bipolaire." Thesis, Reims, 2018. http://www.theses.fr/2018REIML012/document.

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La désorganisation du discours est couramment observée en phase maniaque du trouble bipolaire. Elle peut se manifester par un langage incompréhensible, des idées décousues ou illogiques. Les premières études qui ont exploré les processus cognitifs sous-tendant ces perturbations du langage et du cours de la pensée dans le trouble bipolaire semblent en faveur de perturbations sémantiques. Pour déterminer la nature de ces perturbations, nous avons réalisé plusieurs études portant sur deux processus spécifiques : la propagation automatique de l’activation sémantique et l’inhibition sémantique. Pour évaluer ces processus nous avons construit deux tâches de décision lexicale basées sur l’amorçage sémantique. Celles-ci sont proposées à 17 patients bipolaires euthymiques ainsi qu’à un groupe de 61 personnes issues de la population générale pour lesquelles les traits de personnalité hypomaniaque et les tempéraments affectifs sont évalués. Les résultats montrent une moindre efficacité pour les deux processus dans le trouble bipolaire. Ces perturbations sont associées aux troubles du cours de la pensée. Dans la population générale, les résultats montrent que seule l’atteinte de la propagation automatique de l’activation est associée aux tempéraments hyperthymique et irritable. Cette association n’est pas retrouvée pour le processus d’inhibition sémantique, suggérant la mise en place de stratégies cognitives compensatoires lorsque les processus sont contrôlés. Nos résultats, associés à ceux de la littérature, semblent en faveur d’une approche dimensionnelle du trouble bipolaire et soulignent l’intérêt d’investiguer davantage la cognition dans les formes atténuées du trouble Disorganization of speech is commonly observed in the manic phase of bipolar disorder as incomprehensible language, disjointed or illogical ideas. Recent studies had explored the cognitive processes that underlie these disturbances of language and formal thought disorders in bipolar trouble. These studies appear to be in favor of semantic abnormalities. To determine the nature of these disturbances, we carried out studies which focus on two specific processes: the automatic spreading activation and the semantic inhibition. To assess these processes, two lexical decision tasks based on semantic priming were built. These tasks are proposed to 17 euthymic bipolar patients as well as to a group of 61 people from the general population for whom hypomanic personality traits and affective temperaments are evaluated. The results show lower efficacy for both processes in bipolar disorder. These disturbances are associated with the disturbances of formal thought disorders. In the general population, the results show that only the dysfunction of the automatic spreading activation is associated with hyperthymic and irritable temperaments. This association is not found for semantic inhibition, suggesting the intervention of compensatory cognitive strategies when the processes are controlled. Our results, combined with those of the literature, seem to be in favor of a dimensional approach to bipolar disorder and underline the interest of investigating cognition in the attenuated forms of the disorder

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Jarbin, Håkan. "Long-term Outcome, Suicidal behaviour, Quality of Life and Expressed Emotion in Adolescent Onset Psychotic Disorders." Doctoral thesis, Uppsala University, Department of Neuroscience, 2003. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-3341.

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This study investigated a consecutive cohort of 88 youngsters with onset of a psychotic disorder at age 15.7 (sd 1.5) years and followed-up 10.6 (sd 3.6) years after first admission at the age of 26.5 (sd 3.7) years. A subsample of 15 subjects were assessed with the Five Minute Speech Sample for measuring Expressed Emotion and subsequent recording of relapses during a two year period.A diagnostic split between schizophrenia spectrum psychosis and affective psychotic disorder was usually stable over time. The main diagnostic shift was an influx to schizophrenia spectrum disorder of subjects with a better premorbid function and less insidious onset as compared to those with a stable schizophrenia diagnosis.Early onset schizophrenia spectrum disorder usually had a poor functional outcome. Most subjects needed support in the form of a disability pension. Early onset affective psychotic disorder usually had a good functional outcome. Most subjects worked and enjoyed regular friendships. The functional level before onset of illness was the best predictor of future functional level in psychotic disorders. A family history of non-affective psychosis predicted a worse function in schizophrenia. Frequent episodes and low intelligence predicted a worse function in affective disorders.Four men (4.5% of the sample) committed suicide. The risk of suicide was increased about 30 times. Almost a third of subjects attempted suicide. Females made more attempts. Suicide attempts were related to more depressive symptoms but less negative symptoms at first episode, to readmissions and to dependence on nicotine. Subjects with schizophrenia spectrum psychoses were less satisfied with life than those with affective psychotic disorder. Subjective satisfaction in schizophrenia was strongly associated to depressive mood while in affective disorders it was associated to degree of employment.Adolescents with psychosis in families rated high or borderline high in Expressed Emotion either during first episode or after discharge had an increased risk of relapse.

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Masters, Grace A. "Bipolar Disorder in the Perinatal Period: Understanding Gaps in Care to Improve Access and Patient Outcomes." eScholarship@UMMS, 2021. https://escholarship.umassmed.edu/gsbs_diss/1127.

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Background: Bipolar disorder (BD) is a significant cause of perinatal morbidity and mortality. Because BD is hard to detect and treat, these individuals often go without care. This dissertation was designed to: (1) identify the prevalence rates of BD and bipolar-spectrum mood episodes in perinatal individuals, (2) understand pertinent barriers to mental healthcare, and (3) elucidate how to bridge healthcare gaps. Methods: Data sources included: primary qualitative and quantitative data from obstetric clinicians, encounter data from Massachusetts Child Psychiatry Access Program (MCPAP) for Moms, a program aimed at helping clinicians to provide mental healthcare to perinatal patients. Analyses included: descriptive statistics, systematic review and meta-analysis, qualitative data analyses, longitudinal regression analyses, and group-based trajectory modeling. Results: The prevalence of BD in perinatal individuals was 2.6% (95% CI: 1.2 to 4.5%). Twenty to 54.9% were found to have a bipolar-spectrum mood episode. Barriers to mental healthcare for perinatal patients with BD included the paucity of psychiatric resources, difficulties in assessing BD, and stigma towards pharmacotherapy. Obstetric clinicians reported that MCPAP for Moms has helped them feel more comfortable in treating patients with BD. Longitudinal analyses of encounter data corroborated these findings - utilization of the program predicted increased clinician capacity to treat BD. Conclusion: Clinicians for perinatal individuals are being called upon and stepping up to care for complex illnesses like BD. Programs like MCPAP for Moms can help them feel more confident in this role, helping to bridge gaps in perinatal mental healthcare and ensuring that individuals with BD are able to receive appropriate care.

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El-Badri, Selim Mohamed. "Neurobiological changes in bipolar affective disorder." Thesis, University of Newcastle Upon Tyne, 1998. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.242439.

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Taka-Eilola, T. (Tiina). "Mental health problems in the adult offspring of antenatally depressed mothers in the Northern Finland 1966 Birth Cohort:relationship with parental severe mental disorder." Doctoral thesis, Oulun yliopisto, 2019. http://urn.fi/urn:isbn:9789526222455.

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Abstract Maternal depressed mood during pregnancy is common, but studies on the offspring of antenatally depressed mothers, with a long follow-up, are scarce. The aim was to study whether the adult offspring of antenatally depressed mothers are at an elevated risk of psychoses, depression, bipolar disorder, antisocial and borderline personality disorder, and schizotypal and affective traits. Parental severe mental disorder was considered as both a genetic and environmental risk factor for mental disorders. The data are based on the unselected, prospective, population-based Northern Finland 1966 Birth Cohort of 12,058 live-born children. The data were collected beginning from pregnancy and ending mid-adulthood. The mothers were asked about their mood during pregnancy at the antenatal clinic at 24–28 gestational weeks. Of the mothers, 13.9% rated themselves as depressed (11.8%) or very depressed (2.1%) during pregnancy. Parents’ severe, hospital-treated mental disorders, and the cohort members’ mental disorders were identified mainly by using the Finnish Care Register for Health Care. In this study, the adult offspring of antenatally depressed mothers had an increased risk of depression, and the male offspring for antisocial personality disorder, compared to cohort members without antenatally depressed mothers. The offspring with both maternal antenatal depressed mood and parental severe mental disorder had a markedly elevated risk of schizophrenia and depression, compared to cohort members without one or both of the risk factors. This is the first study where the offspring of antenatally depressed mothers were followed till mid-adulthood, also taking into account parental severe mental disorders. Based on the findings, the prevention of and early intervention in antenatal depression, especially in families with severe mental illness, might present an opportunity to reduce the risk of mental disorders in the offspring Tiivistelmä Äitien raskausajan masennus on yleistä, mutta pitkiä seurantatutkimuksia raskausaikana masentuneiden äitien lapsista on vähän. Tutkimuksen tavoitteena oli selvittää, onko raskausaikana masentuneiden äitien aikuisilla jälkeläisillä kohonnut riski sairastua skitsofreniaan, masennukseen, kaksisuuntaiseen mielialahäiriöön, epäsosiaaliseen tai epävakaaseen persoonallisuushäiriöön, ja ilmeneekö heillä enemmän skitsotyyppisiä tai affektiivisia piirteitä. Vanhempien vakavien mielenterveydenhäiriöiden katsottiin olevan sekä mahdollisia geneettisiä että ympäristöön liittyviä riskitekijöitä jälkeläisten mielenterveyshäiriöille. Tutkimus perustuu yleisväestöön pohjautuvaan, prospektiiviseen Pohjois-Suomen vuoden 1966 syntymäkohorttiin, johon kuuluu 12 058 elävänä syntynyttä lasta. Kohortin jäseniä on seurattu sikiöajalta keski-ikään, aina 49 ikävuoteen saakka. Äitien raskaudenaikaista mielialaa tiedusteltiin raskausviikoilla 24–28 neuvolassa. 13,9 % äideistä raportoi mielialansa masentuneeksi (11,8 %) tai hyvin masentuneeksi (2.1%) raskausaikana. Vanhempien vakavat mielenterveydenhäiriöt ja kohortin jäsenten mielenterveyshäiriöt selvitettiin pääosin hoitoilmoitusrekisteritiedoista. Tutkimuksessa raskaudenaikana masentuneiden äitien lapsilla havaittiin kohonnut depressioriski sekä kohonnut epäsosiaalisen persoonallisuushäiriön riski miehillä, verrattuna kohortin jäseniin, joiden äitien mieliala ei ollut masentunut raskausaikana. Kohortin jäsenillä, joiden äideillä oli raskausajan masennusta ja toisella vanhemmista vakava mielenterveyshäiriö, oli kohonnut riski sairastua skitsofreniaan ja depressioon, verrattuna heihin, joilla oli vain yksi tai ei kumpaakaan näistä riskitekijöistä. Tämä on ensimmäinen tutkimus, jossa raskausaikana masentuneiden äitien lapsia on seurattu keski-ikään saakka, huomioiden myös vanhempien vakavat mielenterveydenhäiriöt. Tutkimuksen tulosten perusteella äidin raskausajan masennusoireiden varhaisen tunnistamisen ja hoidon voitaisiin ajatella vähentävien jälkeläisten mielenterveysongelmien riskiä, etenkin perheissä, joissa on vakavia mielenterveysongelmia

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Sambrook, Suzanne. "A cognitive investigation of bipolar affective disorder." Thesis, University of Southampton, 1997. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.242667.

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Bunch, Kristin. "Risk taking behaviour in bipolar affective disorder." Thesis, University of Leeds, 2010. http://etheses.whiterose.ac.uk/1176/.

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This piece of research was designed to explore the nature of risk taking behaviour and impulsivity in bipolar affective disorder. Involvement in pleasurable activities that have a high potential, or risk, for unwanted consequences forms one of the DSM IV diagnostic criteria for (hypo)mania; however, little research has investigated the prevalence of risk taking behaviour in this population, nor the possible meaning of such behaviour. Furthermore, research has demonstrated that individuals diagnosed with bipolar disorder have elevated trait levels of impulsivity, as well as increased levels of state impulsivity during mood episodes. Much research has theoretically linked impulsivity with risk taking behaviour; however, little research has measured both constructs simultaneously. Therefore, this research was designed to measure both the propensity to engage in risk taking behaviour and levels of impulsivity via multiple methods in individuals diagnosed with bipolar disorder who were currently euthymic, to establish a baseline measure in the absence of clinically significant symptomatology. Two control groups were used; one was comprised of individuals with no history of psychiatric disorder and a group of individuals diagnosed with major depressive disorder, to establish the specificity of any findings to bipolar disorder rather than affective disorders in general. The bipolar group scored more highly on the behavioural measure of impulsivity and some aspects of the self-report measure than the two control groups, who did not differ significantly. the two clinical groups also reported higher levels of unhelpful coping strategies when experiencing depressed mood, including engaging in dangerous activities; however, there were no between groups differences on the behavioural risk taking task. The findings were discussed in relation to psychological models of bipolar disorders. Limitations of the research and ideas for future research were also discussed.

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Tkachev, Dmitri. "Expression profiling in schizophrenia and bipolar affective disorder." Thesis, University of Cambridge, 2005. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.614767.

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Albin, Melissa Cindy. "cAMP-dependent protein kinase activity in bipolar affective disorder." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2000. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape4/PQDD_0020/MQ54132.pdf.

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Giurgiu, Mariana. "Appraisals of, and responses to, hypomanic states in bipolar affective disorder." Thesis, University of East Anglia, 2011. https://ueaeprints.uea.ac.uk/48138/.

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There has been an increased interest in the last decade in studying the cognitive processes that could explain the development and maintenance of bipolar affective disorder. Further research is needed to understand the interpretations people with bipolar affective disorder make about their energetic, positive moods and the mechanisms used to regulate their mood states. This study investigates the presence of extreme, personalised beliefs about internal states and cognitive strategies of positive mood regulation amongst remitted clinical participants with a diagnosis of bipolar affective disorder. The inter-relation between positive and negative appraisals of energetic, agitated states on one hand and enhancing as well downregulating positive mood strategies on the other hand is also explored. Remitted bipolar participants (N= 30) were compared with healthy controls (N= 27) on measures of interpretations of hypomanic states (Hypomanic Attitudes and Positive Predictions Inventory, Mansell & Sadhani, 2007) and ruminative responses in regards to positive mood (Response to Positive Affect Questionnaire; Feldman, Joorman & Johnson, 2008). Levels of current mood at the time of data collection were assessed. Results indicated that people with a diagnosis of bipolar affective disorder, in a remitted phase, showed elevated levels of positive extreme beliefs about their hypomanic states as well as higher levels of catastrophic, self-and-other critical and loss of control beliefs than people with no history of mental health difficulties. It was found that remitted bipolar affective participants are ambivalent about positive mood states, engaging in both enhancing and down-regulating positive mood strategies. Tendency to dampen positive affect was positively correlated with catastrophic and self-and-other critical beliefs about activated states. A positive association was also found between selfactivating beliefs and positive rumination strategies. The findings bring further evidence for VIII the theory driven cognitive model developed by Mansell, Morrison, Reid, Lowens & Tai, (2007), highlighting the importance of focusing in clinical practice on the interpretations people with bipolar affective disorder make about their internal states and the need to incorporate emotion regulation techniques in the treatment of this client group.

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Ho, Kwo Wei David. "The genetic basis of seasonal affective disorder." Diss., University of Iowa, 2015. https://ir.uiowa.edu/etd/5505.

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Family and twin studies have shown a heritable component to seasonal affective disorder (SAD). While a few studies have examined individual genetic variants in SAD, many methodological issues exist in the current literature. First, most studies combined major depression (MDD) and bipolar (BD) cases in the genetic analysis of SAD. This makes it difficult to differentiate the effect from MDD and BD. Second, most studies adopted a candidate gene approach and used fairly small sample sizes. This does not allow for testing across a wide variety of genes, and it yields less robust P-values. Third, healthy controls have been used, but not case comparisons, which makes it difficult to differentiate the effects of seasonality from that of the primary illness (MDD and BD). To overcome these issues, seasonal MDD and BD cases were separated into two different studies in this thesis; sample sizes for both studies are the largest in the current SAD molecular genetics literature; GWAS was used to test for potential risk loci in a hypothesis-free fashion; case comparisons were incorporated to exclude potential genetic contributions related generally to the primary diseases themselves (MDD and BD). For MDD, we performed a GWAS with 562 seasonal MDD cases and 1,225 comparison cases with non-seasonal MDD. Subjects were drawn from two iterations of the Genetics of Recurrent Early Onset Depression (GenRED) study. Seasonal cases were those whose depressive episodes typically started in fall or winter. A mega-analysis of the two GWAS datasets was done using SNPTEST. We found that two single nucleotide polymorphisms (SNPs), rs149882931 and rs77073398, on chromosome 16p12.1 were associated with seasonal depression, at a genome-wide significant level (OR= 1.66, P= 3.59 x 10-8 and OR=1.62, 4.76 x 10-8, respectively). Since SAD is more prevalent in females, a female-specific analysis was carried out. The two variants were more significant in this analysis: P=2.18x10-9 (OR=1.89) and P=2.79x10-9 (OR=1.82), respectively, and a significant sex-by-SNP interaction was observed. These SNPs are located in a conserved intergenic region between the genes HS3ST4 and C16orf82. The protein product of HS3ST4 modifies the side chains of heparan sulfate proteoglycans. We therefore tested the hypothesis that the heparan sulfate biosynthesis pathway would be enriched in nominally significant SNPs using the SNP ratio test, and found evidence for such enrichment (P=0.008, SNP ratio test, P=0.027, SKAT). For BD, the GWAS analysis of 818 seasonal BD cases and 1,515 healthy controls showed that BD-S is most strongly associated with two SNPs within the ZBTB20 genes. BD subjects were drawn from NIMH Bipolar Genetics Study (BIGS), and seasonal cases were defined as those with depressive episodes starting in fall or winter. An association study was carried out with SNPTEST, and we found two single nucleotide polymorphisms (SNPs) in the intronic region of ZBTB20 gene to be associated with BD-S (rs7646282, OR=2.34, P= 7.23 x 10-8 and rs139459337, OR=2.37, 8.05 x 10-8). A similar case-only study was carried out with 818 BD-S cases and 1239 cases without seasonal depressive symptoms (non-BDS), though no SNP was found to be significantly associated in this analysis. rs7646282 is the strongest SNP in cis-association with ZBTB20 gene expression, and ZBTB20 has been shown to affect the neural development of the hippocampus, a brain region implicated in the pathophysiology of BD. Finally, we sought to determine whether there is a role for circadian rhythm genes in BD susceptibility. In this study, we used a discovery set of 189 exome-sequenced BD patients and 105 healthy controls to look for circadian genes associated with BD. We found the DRD2 gene to be the circadian gene most strongly associated with BD. Among the rare damaging variants in the DRD2 gene, the S311C variant was the predominant SNP. To test whether this variant segregates in family members with BD, we genotyped the family members of probands from the discovery sample. This data was used for a linkage and family-based association study. Even though the linkage analysis was only very weakly positive, the family-based association study showed significant segregation of the variant in family members with BD (P< 0.05). To follow up on this finding, we further genotyped 2,185 unrelated BD cases and 1,982 healthy controls. We found no support for the S311C variant in this replication dataset. Sub-phenotype study of psychotic features and mood-incongruence also did not show significant association. Meta-analysis with 2,994 BD cases and 3,661 controls, however, revealed no association between the S311C variant and BD.

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Lim, Lionel Chee-Chong. "Association and linkage studies of bipolar affective disorder : a candidate gene strategy." Thesis, King's College London (University of London), 1995. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.283825.

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Lee, Andrew J. "Allele sharing method for fine mapping linkage loci : application to bipolar affective disorder." Thesis, University of Edinburgh, 2009. http://hdl.handle.net/1842/4158.

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Large family studies of complex disorders can be used to detect a genomic region linked with a particular illness. Where multiple families are found with common regions of linkage, this could be due to an ancestral mutation common to these families. In this thesis, I describe a method for studying allele sharing in families that share a linkage region, to identify a common founder mutation, thus maximising the results of replicated linkage studies. The method tests the hypothesis that the evidence for shared linkage is derived from the sharing of a common affected ancestor. By comparing the allelic similarity of haplotypes across common linkage regions, it is possible to identify any regions that are identical by descent between the families. A method of permutation analysis followed by a nested permutation technique have been developed to assess the statistical significance of allele sharing scores. Chapter 3 describes the proof of principle of the method through its application to known cystic fibrosis mutations and through simulated datasets. This provides both a real dataset and a much more diverse range of simulated conditions on which to test the method. The range of simulated data was also used to develop a set of criteria for the effective us of the method. In Chapter 4, the allele sharing method was applied to two replicated linkage regions on chromosome 4p15-16 that segregate with bipolar affective disorder. This was done over two phases, first taking in markers covering the genic regions of the shared linkage region and then followed up with a complete coverage of the region. This analysis identified a 200kb region with significant confidence within the 8Mb of the two linkage regions. The study of this region presents a clear example of how replicated linkage results that are caused by some founder effect, can be examined, and refined using this allele sharing method to vastly reduce the region under investigation.

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Emamghoreishi, Masoumeh. "The G protein-calcium ion link in the pathophysiology of bipolar affective disorder." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1999. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape9/PQDD_0005/NQ41145.pdf.

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Lan, Martin Joseph Kean. "Molecular studies to further understand the pathophysiology and treatment of bipolar affective disorder." Thesis, University of Cambridge, 2008. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.612208.

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Cheema, Madiha. "Postpartum affective episodes in womenwith bipolar disorder – monitored by astructured follow-up method." Thesis, Örebro universitet, Institutionen för medicinska vetenskaper, 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-68992.

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Introduction Bipolar disorder (BD) is a psychiatric illness characterised by episodes of depression, hypomania and mania. The first choice of medication treatment for BD is mood stabilizers. However, psychotropic medication has not been approved for use during pregnancy because some drugs have teratogenic and adverse neurodevelopmental effects. However, up to 80 % of women with BD develop some form of postpartum affective episode. Therefore, it is of great interest to investigate the medication treatment for pregnant women with BD. Aim Describe the medication treatment for pregnant women with bipolar disorder and outcome of postpartum affective episodes. Methods This was an observational study, based on retrospective review of medical records of pregnant patients with BD. The patients have visited the clinic of affective disorders, Örebro University Hospital, between the years 2013-2017. The patients were followed during pregnancy and a period of at least 6 months postpartum. Results The rate of postpartum affective episodes in women with bipolar disorder was 8.7%. There was no significant difference (p = 0.36) in outcome between the groups. A greater number of patients with BD type II were included in our cohort. A statistically significant difference (p = 0.05) was observed between the BD type I and type II groups, regarding lithium treatment. Conclusion Our study showed that the rate of postpartum affective episodes was marked lower than expected. Furthermore, except for lithium treatment, there was no statistically significant difference in medication treatment or outcome of postpartum affective episodes between BD type I and II, when monitored by this structured follow-up method.

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Gadon, Lisa Alexandre. "Identification and management of prodromal symptoms in bipolar affective disorder : the role of individual, disorder, and treatment-related factors." Thesis, University of Edinburgh, 2011. http://hdl.handle.net/1842/5712.

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Background: Traditional psychosocial treatments have been adapted for use with individuals with bipolar affective disorders due to the limited prophylactic nature of pharmacotherapy and the recognition of the role of psychosocial factors in the course of this disorder. Psychosocial interventions that include a prodromal monitoring and management component have been empirically shown to be an effective adjunct to medication for the treatment of bipolar disorder. Aims: There is a deficit of quantitative research that examines the impact of individualrelated (e.g. age, self-efficacy), disorder-related (e.g. time since diagnosis, experience of prodromal symptoms) and treatment-related (e.g. level of psychosocial input) factors on individuals’ ability to manage this disorder via the use of prodromal monitoring. The current research aimed to investigate factors that are associated with the identification and management of prodromal symptoms. Method: Participants completed five self-report measures in order to provide information on their experience of prodromal symptoms, current mood state, general self-efficacy, view of social support from significant others, and demographic and clinical-related variables. The data were collected from 101 participants, 58 of whom were female. The sample consisted of individuals with a diagnosis of bipolar disorder type I and II. Results: Univariate and bivariate analyses were used to explore the relationship between individual, disorder, and treatment-related variables associated with participants’ experience of bipolar disorder. Variables that were significantly associated with participants’ perception of their ability to identify and manage prodromes were further investigated using ordinal logistic regression analyses. The results indicated that general self-efficacy and prodromal-specific help from significant others were associated with an increase in participants’ perception of their ability to identify manic and depressive prodromal symptoms. General self-efficacy was also associated with participants’ view of their ability to manage cognitive and behavioural prodromes. Experience of prodromal symptoms (e.g. consistency of symptoms experienced, type of prodrome experienced) was associated the participants’ perception of their ability to identify and manage prodromes. In general, disorder-related variables (e.g. time since diagnosis, mood state, diagnosis type, and number of episodes experienced) were not significantly associated with the participants’ view of their ability to identify and manage prodromal symptoms. Individual-related variables such as gender and age, however, were associated with prodromal identification. Conclusion: The results indicated the need to consider constructs such as general selfefficacy and experience of prodromal symptoms (e.g. consistency of symptoms, types of prodromes experienced, and ability to recognise prodromes when they first present) when helping patients to learn how to identify and manage prodromal symptoms. In addition gender differences and the role of help from significant others were highlighted as variables that should be considered when using prodromal monitoring approaches with patients with bipolar disorder. Limitations of the research are reviewed in relation to the methodology used. Clinical implications and directions for future research are considered.

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Swift, Anna Louise. "How time flies : the perception, perspective and experience of time in bipolar affective disorder." Thesis, University of East Anglia, 2005. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.426816.

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This study examined time perception, time experience and time perspective in bipolar disorder. In a cross-sectional, quasi-experimental design, 58 bipolar participants completed a clinical interview to assess mood and were assigned to one of three mood state groups; euthymic, depressed or mania. Furthermore, 20 health professionals without a diagnosis of bipolar disorder were recruited as a control group. Therefore, 78 participants in total completed a temporal generalisation computer task (Wearden, 1992), a visual analogue scale of time experience (Blewitt, 1992) and the Zimbardo Time Perspective Inventory (ZTPI, Zimbardo & Boyd, 1999). Results indicated that the manic group were significantly less accurate on the temporal generalisation task indicating a deficit in time perception. However, no significant differences in performance were found between the control, euthymic and depressed groups. Furthermore, in an unfilled duration, depressed participants rated the subjective passing of time as significantly slower than the other groups. Additionally, the manic group rated time as passing significantly faster than the other groups in an unfilled duration. However, when focussed upon a task (filled duration) this effect was reduced to the extent that no significant differences between the groups were found. Finally, significant differences were found between the group profiles on the ZTPI subscales indicating that different mood states were characterised by specific temporal perspectives. The results suggest that bipolar mood states are characterised by differences in temporal experience and this has direct implication for psychological interventions.

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Savitz, Jonathan. "The molecular genetics of bipolar affective disorder : South African populations, endophenotypes, and environmental influence." Doctoral thesis, University of Cape Town, 2006. http://hdl.handle.net/11427/7435.

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Includes bibliographical references. The identification of the genetic variants underpinning bipolar disorder (BPD) has been impeded by a complex pattern of inheritance that may include by genetic heterogeneity, genetic epistasis, gene-environment interactions, incomplete penetrance and variable expressivity. In this thesis three strategies were employed to ameliorate these confounding factors. The first strategy was to focus on a theoretically genetically-homogeneous population with BPD. A unique South African sample including 190 individuals of the relativity reproductively-isolated Afrikaner population yielded promising evidence of linkage to chromosome 1 q31-32 and weaker peaks at lOq23 and 13q32, regions previously implicated in the disorder. A family-based analysis suggested that the 3' variable number tandem repeat (VNTR) variant of the dopamine transporter gene (DAT) is associated with bipolar-spectrum illness in the 132-strong sample of British ancestry. The second strategy was to carry out genetic linkage and association analyses using quantitative traits (elldophenotypes) that were closely associated with BPD. As part of this process a variety of personality traits were evaluated in the cohort, and anxiety related, novelty-seeking, hyperthymic, and cyclothymic personality traits were found to aggregate in participants with BPD and to a lesser extent repeated unipolar illness (MDE-R). These traits were therefore used as quantitative markers or endophenotypes of BPD. The quantitative linkage analysis indicated that a variant in the region of 13q32 may influence the development of novelty-seeking-related traits in the largest Afrikaner pedigree, while the personality trait, ""Stability"", was weakly linked to 4p16 in the total sample. The catechol-o-methytransferase (COM1) Va1l58Mct and the Brain Derived Neurotrophic Factor (BDNF) Va1l66Met polymorphisms were associated with mood-labile-cyclothymic and hyperthymic·-novelty-seeking traits, respectively. the DA T VNTR and the Notch4 exonic repeat variants were associated with a broad range of ""pathological"" personality traits in the sa11lples of British and Afrikaner origin, respectively. The sample was also evaluated with a battery of neuropsychological tasks and the BPD 1 and MDE-R groups displayed both verbal and visual memory recall deficits while the BPD 1 sample also suffered from recognition memory deficits. The neurocognitive trait, ""Memory"" was therefore used as a second endophenotype generating potential linkage signals on IOq23 and 22q 11. The exonic 48bp VNTR polymorphism in the dopamine 4 receptor (DRD4) gene was associated with '""Memory"" performance. As a third strategy, a potentially important aetiological factor, childhood trauma, was measured, and used to test for gene-environment interactions between the various candidate genes and bipolar-illness or BPD-related endophenotypes in the cohort. BPD and M DE-R individuals displayed significantly higher levels of emotional and physical abuse, and the former variable was also associated with the development of anxiety-related and unstable personality traits. A functional variant of the COM1 gene was found to interact with abuse to predispose to anxiety-related, unstable cyclothymic and novelty-seeking related personality traits. The combination of childhood abuse and possession of low-activity MAO-A gene variants was also associated the development of more anxious and unstable personality traits. All interaction between sexual abuse and the B])NF gene modulated performance on verbal and visual memory tasks. A similar interaction between the ApoE gene and sexual abuse was observed. Although a number of theoretical obstacles remain to be resolved, the analyses of isolated populations coupled with the use of endophenotypes and the testing or gene environment interactions, holds out great promise for the eventual elucidation of the genetic basis of hi polar affective disorder.

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Macnamara, Joanna C. "Identity and acceptance of mental health problems and related disabilities in individuals with severe and enduring mental health problems." Thesis, n.p, 2001. http://ethos.bl.uk/.

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Andreopoulos, Stavroula. "Molecular mechanisms underlying G protein disturbances in bipolar affective disorder, the role of ADP-ribosylation processes." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2000. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape4/PQDD_0026/NQ50057.pdf.

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Lyon, Helen Michelle. "Social cognition and the manic defence : attributions, selective attention and self-schema in bipolar affective disorder." Thesis, Bangor University, 2000. https://research.bangor.ac.uk/portal/en/theses/social-cognition-and-the-manic-defence-attributions-selective-attention-and-selfschema-in-bipolar-affective-disorder(72447264-6a15-4ba9-8584-1f375c96c627).html.

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Psychological studies in bipolar affective disorder and analogue conditions suggest that mania may be the product of an abnormal defence against depression. In this study, currently manic bipolar individuals, currently depressed bipolar individuals, and normal controls were assessed using explicit and implicit measures of attributional style, an emotional Stroop test with euphoria-related and depression-related words and a recall measure of the selfschema. Manic individuals showed a normal self-serving bias on a version of the explicit attributional style questionnaire, attributing positive events more than negative events to self, in contrast to bipolar-depressed individuals who attributed negative events more than positive events to self. However, on an implicit test of attributional style, both manic and bipolar-depressed individuals attributed negative events more than positive events to self. Both bipolar-manic and bipolar-depressed individuals demonstrated slowed colour naming for depression-related but not euphoriarelated words on an emotional Stroop test. Manic individuals, like normal controls, endorsed primarily positive words as true to self on a self referent questionnaire, but like bipolar-depressed individuals, recalled primarily negative words in a surprise recall test afterwards. Findings from the implicit tests therefore indicate a common form of psychological organisation in manic and depressed individuals, whereas the contrasts between the scores on the implicit and explicit measures are in accord with the hypothesis of a manic-defence. Future avenues for research and implications for treatment are discussed.

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Bénard, Victoire. "Étude Multi-Échelles de Profils de Patients avec Risque de Suicide." Thesis, Lille 2, 2020. http://www.theses.fr/2020LIL2S010.

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Dans la littérature scientifique actuelle, des études ont mis en évidence par une approche transdiagnostique, l’implication de facteurs cliniques, biologiques et génétiques spécifiques des conduites suicidaires indépendamment d’un diagnostic de trouble psychiatrique de l’Axe I ou II du Manuel Diagnostique et Statistique des Troubles Mentaux (DSM) (1–3). De plus, l’existence d’un trouble psychiatrique n’apparaît pas être discriminante pour définir certains types de profils de patients à risque de suicide (4–6). En effet, le suicide peut toucher à la fois des personnes dites en situation de crise mais il est largement reconnu que les pathologies psychiatriques restent à haut risque de suicide, notamment les troubles de l’humeur tels que les troubles bipolaires et les dépressions unipolaires, et plus particulièrement avec caractéristiques psychotiques (7,8). De plus, des facteurs de risque spécifiques de suicide ont été retrouvés dans chacune de ces différentes populations (9,10). Ainsi, avec cette conception moderne du suicide, il semble pertinent d’étudier le risque suicidaire dans diverses populations de suicidants, souffrant ou non de troubles psychiatriques, et en utilisant une approche tant épidémiologique, dynamique avec l’actigraphie, et biologique (3,11,12). En me basant sur cette approche, mon projet de thèse s’articule en 3 axes décrits ci-après, et consiste à identifier des facteurs de risque de récidive de tentative de suicide ainsi qu’à définir des profils de patients suicidants dans des populations différentes. Pour cela, plusieurs études coordonnées permettront de réaliser une évaluation multi-échelles de la vulnérabilité suicidaire de façon transdiagnostique et de façon ciblée dans les troubles de l’humeur uni- et bi-polaires In the current scientific literature, the studies have been highlighted by a transdiagnostic approach, implementation of clinical, biological and genetic factors, suicidal behavior independent of a diagnosis of psychiatric disorder in Axis I or II of the Diagnostic and Statistical Manual. Mental Disorders (DSM) (1-3). In addition, the endurance of psychiatric disorder is not discriminating to define certain types of profiles of patients at risk of suicide (4-6). In fact, suicide can affect both people in crisis but it is widely recognized that psychiatric pathologies remain at high risk of suicide, including mood disorders such as bipolar disorder and unipolar depression, and especially with psychotics (7,8). In addition, specific suicide risk factors were found in these different populations (9,10). Thus, with this modern conception of suicide, it seems relevant to study suicidal risk in various suicidal populations, with or without psychiatric problems, and using an epidemiological approach, dynamic with actigraphy, and biological (3, 11 , 12).For this, there are several different assessments of vulnerability of suicide in a transdiagnostic and targeted way in the problems of the united and bi-polar moods

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Williamson, Vernell. "Using Next Generation Sequencing (NGS) to identify and predict microRNAs (miRNAs) potentially affecting Schizophrenia and Bipolar Disorder." VCU Scholars Compass, 2012. http://scholarscompass.vcu.edu/etd/2880.

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The last decade has seen considerable research focusing on understanding the factors underlying schizophrenia and bipolar disorder. A major challenge encountered in studying these disorders, however, has been the contribution of genetic, or etiological, heterogeneity to the so-called “missing heritability” [1-6]. Further, recent successes of large-scale genome-wide association studies (GWAS) have nonetheless seen only limited advancements in the delineation of the specific roles of implicated genes in disease pathophysiology. The study of microRNAs (miRNAs), given their ability to alter the transcription of hundreds of targeted genes, has the potential to expand our understanding of how certain genes relate to schizophrenia and bipolar disorder. Indeed, the strongest finding of one recent mega-analysis by the Psychiatric GWAS consortium (PGC) was for a miRNA, though little can be said presently about its particular role in the etiologies of schizophrenia and bipolar disorder [52]. Next generation sequencing (NGS) is a versatile technology that can be used to directly sequence either DNA or RNA, thus providing valuable information on variation in the genome and in the transcriptome. A variation of NGS, MicroSeq, focuses on small RNAs and can be used to detect novel, as well as known, miRNAs [26,125, 126]. The following thesis describes the role of miRNAs in schizophrenia and bipolar disorder in various experimental settings. As an index of the interaction between multiple genes and between the genome and the environment, miRNAs are great potential biomarkers for complex disorders such as schizophrenia and bipolar disorder.

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Wohl, Elizabeth C. "Creativity and Affective Traits Across the Life Span: Developmental Influences Among Adolescents and Older Adults." Thesis, University of North Texas, 2003. https://digital.library.unt.edu/ark:/67531/metadc4279/.

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In recent years, empirical research has consistently supported an association between susceptibility to affective illness and creativity at the level of eminent achievement and at the non-eminent, or "everyday creativity" level. Although this research has provided greater evidence for the existence of this link, it has simultaneously unearthed more questions about how and why such an association exists. The purpose of this research was twofold: first, to provide further analysis of the nature of the relationship between hypomanic traits and creativity by employing a longitudinal study to determine the extent to which inter-individual differences over time in creativity are predicted by hypomanic traits. Second, the purpose of the cross-sectional analysis in the present study was to further determine how developmental components such as age and expertise may help unravel the ways in which hypomanic traits contribute to creativity and to further describe inter-individual differences among these variables. The first hypothesis, which proposed that the direction of the relationship between hypomanic traits and creativity could be predicted, was not supported by these results. The second research hypothesis was partially supported: hypomanic traits predict creativity in the combined adolescent and older adult samples. However, upon further examination of the regression analyses, the data indicate that the relationship between hypomanic traits and creativity is also influenced by age and developmental factors. Furthermore, the way in which the relationship is influenced by these other factors depends on the way in which the creativity construct is measured (e.g., process or personality. The findings suggest that the antecedents of creativity may differ between adolescents and older adults. In adolescents, the hypomanic traits measure is the only variable that predicts creative personality and creative process, while expertise is the only variable to predict creative personality and creative process among the older adults in this study. It appears expertise significantly and uniquely contributes to at least two areas of creativity in older adults, while hypomanic traits significantly and uniquely contributes to the same two areas of creativity in adolescents. Implications of these findings and limitations to this study are discussed.

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Nicolas, Aude. "Recherche de gènes de vulnérabilité aux troubles bipolaires." Thesis, Paris Est, 2011. http://www.theses.fr/2011PEST0095/document.

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Affectant plus de 1% de la population, les troubles bipolaires constituent l'une des maladies mentales les plus fréquentes, sévères et dévastatrices. Ces troubles de l’humeur se caractérisent par une alternance d’épisodes maniaques (humeur exaltée, euphorie, irritabilité) et d’épisodes dépressifs, entrecoupés de phases de rémission. Malgré une composante génétique démontrée, les études génétiques peinent à identifier des gènes de vulnérabilité à cause de facteurs environnementaux et d’une hétérogénéité génétique, sous-tendue par une forte hétérogénéité clinique. Une analyse de liaison sur l’ensemble du génome de 87 paires de germains atteints de trouble bipolaire à début précoce, sous-groupe cliniquement homogène de patients, a révélé des liaisons suggestives avec les régions chromosomiques 3p14 et 20p12. Un variant fonctionnel dans le promoteur du gène SNAP25, situé en 20p12, est associé au trouble bipolaire à début précoce. Ce gène code une protéine essentielle à la libération de neurotransmetteurs. Nous avons étudié 2 gènes candidats à la vulnérabilité au trouble bipolaire à début précoce, localisés dans la région 3p14, SYNPR et CADPS, codant des partenaires de SNAP25. Nous avons identifié des mutations non-synonymes et une délétion dans CADPS, chez 4,5% des patients, suggérant son implication dans la vulnérabilité aux troubles bipolaires et suggérant une hétérogénéité génétique. Une recherche de micro-remaniements chromosomiques a identifié sept nouveaux gènes candidats aux troubles bipolaires : NRXN1, LINGO2, CDH8, ANKS1b, GPHN, PLCXD3 et GABARAPL1. Les protéines codées sont impliquées dans la transmission synaptique. Ces résultats font concevoir une modification de la fonction synaptique dans la vulnérabilité génétique des troubles bipolaires. Ces études permettront, à plus long terme, une meilleure compréhension de la physiopathologie des troubles bipolaires et peut-‐être d’identifier des biomarqueurs de ces troubles. Elles devraient également permettre d’ouvrir de nouvelles voies d’exploration pour les stratégies thérapeutiques Bipolar Affective Disorder (BPAD) is a common, severe and fatal psychiatric disease, affecting approximately 1% of general population. Despite a demonstrated genetic component, genetic studies have difficulties in identifying vulnerability genes, because of environnemental effects, clinic heterogenity and genetic heterogeneity. We performed a linkage study in 87 sib-‐pairs with early-‐onset bipolar affective disorder type I probands, which reported suggestive linkage in 3p14 and 20p12. Functional variant in SNAP25 promotor, located in 20p12 is associated with early-‐onset BPAD. This gene encodes essential protein implicated in neurotransmitters release. We studied two candidate genes for vulnerability to BPAD, SYNPR and CADPS, located in 3p14, encoding SNAP25 cellular partners. We reported patient-‐specific non-‐synonymous variants and a 9kb coding deletion in 4,5% of patients, for CADPS gene, suggesting its implication in vulnerability to BPAD. We enlarged these findings by genome wide search for Copy Number Variants. We choosed 7 variants affecting synaptic genes: NRXN1, LINGO2, CDH8, ANKS1b, GPHN, PLCXD3 and GABARAPL1 as new candidate genes for BPAD. These findings suggested a modified synaptic function in bipolar patients. These studies would allowed a better understanding of pathophysiology of bipolar affective disorder and could open new ways of diagnostic, preventive and therapeutic strategies

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Merz, Christina. "Die Geschwindigkeit des Depressionsbeginns bei unipolarer und bipolarer affektiver Störung." Doctoral thesis, Universitätsbibliothek Leipzig, 2014. http://nbn-resolving.de/urn:nbn:de:bsz:15-qucosa-142512.

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Die klinische Erfahrung zeigt, dass sich depressive Episoden sehr schnell innerhalb weniger Stunden bis Tage oder sehr langsam innerhalb mehrerer Wochen bis Monate entwickeln können. Hauptziel dieser Arbeit war es, die zeitliche Entwicklung depressiver Episoden bei Patienten mit einer unipolaren oder bipolaren affektiven Störung zu untersuchen. Mithilfe des dafür entwickelten und im Rahmen dieser Studie weiter modifizierten strukturierten Patienteninterview ODI (Onset of Depression Inventory) wurde die Geschwindigkeit des Depressionsbeginns bei 223 konsekutiven Patienten erfasst, von denen 129 in die Auswertung eingeschlossen werden konnten. Es zeigte sich, dass sich depressive Episoden bei Patienten mit bipolarer affektiver Störung signifikant schneller manifestieren als bei Patienten mit unipolarer affektiver Störung. Somit kann die Geschwindigkeit des Depressionsbeginns, gemessen mit dem ODI, als Differenzierungsmerkmal zwischen unipolarer und bipolarer affektiver Störung gewertet werden und im klinischen Alltag helfen, zwischen den beiden Störungsbildern zu unterscheiden.

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Sorge, Bernice. "An exploration of repetition as a factor in healing in art psychotherapy, is hope a feature of this healing? Case illustration, a man with bipolar affective disorder." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1999. http://www.collectionscanada.ca/obj/s4/f2/dsk2/ftp03/MQ39125.pdf.

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Isaac, Clemence. "Élaboration d’un programme de remédiation cognitive au profit des patients bipolaires : approche clinique et neuropsychologique." Thesis, Paris 8, 2018. http://www.theses.fr/2018PA080014/document.

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Introduction : Près de 60% des patients bipolaires stabilisés souffrent de déficits cognitifs associés à des troubles du fonctionnement psychosocial. En l’absence de traitement, ces troubles sont susceptibles de persister tout au long de la vie. Malgré cela, les déficits cognitifs ont longtemps été ignorés dans les troubles bipolaires et il n’existe que peu d’études à l’heure actuelle ciblant cette problématique. Méthodologie : Nous avons développé le programme individuel écologique de remédiation cognitive ECo, élaboré pour les troubles de l’humeur. Nous avons mené une série d’études empiriques afin d’explorer les corrélats psychologiques des troubles cognitifs, ainsi que l’amélioration cognitive, fonctionnelle et psychologique de patients bipolaires suite à une intervention en remédiation cognitive ou une psychothérapie individuelle.Résultats : Les troubles métacognitifs pourraient être associés à une augmentation de la fréquence des activités des patients et à une fragilisation sur le plan cognitif et émotionnel. La remédiation cognitive, et en particulier le programme ECo, a permis d’améliorer les capacités de résolution de problèmes dans notre population. Le programme ECo peut normaliser les fonctions cognitives déficitaires et la régulation métacognitive chez certains patients, mais peut également améliorer la résistance aux facteurs de stress, le contrôle émotionnel, l’ouverture aux relations et l’estime de soi.Conclusion : Un programme de remédiation cognitive écologique et individualisé, centré sur la métacognition et le sentiment d’efficacité personnelle, peut contribuer à améliorer des composantes de la santé fonctionnelle chez les patients bipolaires Background: Nearly sixty percent of stabilized bipolar patients suffer from important cognitive impairments that lead to significant functional disabilities. Without proper treatment, these impairments remain throughout lifespan. However, cognitive deficits in bipolar disorders have been overlooked and only a few studies investigated treatments to improve cognitive functioning for bipolar patients. Method: We developed ECo, an individual ecological cognitive remediation intervention that was designed for mood disorders. We conducted experimental studies to investigate psychological correlates of cognitive impairments, and the cognitive, functional and psychological improvements of bipolar patients after either cognitive remediation or individual psychotherapy.Results: Our results suggest that metacognitive impairments lead to an increased frequency of everyday life activities that can create a cognitive and emotional overload. We observed that cognitive remediation, and in particular the ECo program, can improve problem solving skills in our population. The ECo program can improve impaired cognitive functions and metacognitive regulation, as well as coping skills, emotional control, openness to relationships and self-esteem.Conclusion: An ecological, individualized cognitive remediation program, targeting metacognition and self-efficacy, can contribute to an improvement of functional health components in bipolar disorders

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Etain, Bruno. "Contribution à l'étude des facteurs génétiques et environnementaux de susceptibilité aux troubles bipolaires : études du trouble bipolaire à début précoce et des traumatismes affectifs de l’enfance." Thesis, Paris Est, 2009. http://www.theses.fr/2009PEST0048.

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Les troubles bipolaires (TB) sont des maladies psychiatriques dont le déterminisme complexe fait intervenir des facteurs génétiques et environnementaux de susceptibilité. Les efforts d’identification des facteurs génétiques ont produit des résultats discordants et les facteurs environnementaux restent mal connus. Notre équipe a contribué à identifier une forme à début précoce des TB (TB-DP), son caractère fortement familial en faisant un candidat pour faciliter l’identification de gènes de susceptibilité. Ainsi, nous avons réalisé un criblage systématique du génome dans le TB-DP suggérant une liaison avec les régions chromosomiques 2p21, 2q14, 3p14, 5q33, 7q36, 10q23, 16q23 et 20p12. Nous avons montré des associations entre le TB-DP et le gène SNAP25 (rôle dans les mécanismes d’exocytose, région 20p12) et entre les TB et le gène codant l’ASMT (rôle dans la synthèse de la mélatonine). Enfin, une étude d’association pangénomique suggère une association entre le TB-DP et deux gènes de la voie du phosphatidyl-inositol (PLEKHA5 et PLCXD3). Concernant les facteurs environnementaux, les traumatismes affectifs subis dans l’enfance (principalement les abus émotionnels) sont associés aux TB, influencent deux dimensions constitutives des TB (labilité affective et intensité des affects) et interagissent avec le 5HTTLPR pour moduler l’âge de début des troubles. Ces travaux illustrent la pertinence de se focaliser sur le TB-DP pour identifier des gènes de susceptibilité, la nécessité d’explorer plus finement les facteurs environnementaux (notamment les stress précoces) et de considérer les interactions gène-environnement afin de mieux appréhender le déterminisme complexe des TB Bipolar disorders (BD) are psychiatric diseases with a complex determinism in which genetic and environmental susceptibility factors are involved. Attempts to identify genetic factors have produced conflicting results and environmental factors remain unknown. Early-onset bipolar disorder (EO-BD) is a clinical entity that is characterized by a strong familial aggregation ; a specific focus on this subtype might facilitate the identification of susceptibility genes. A genome-wide scan in EO-BD has suggested eight regions of linkage (chromosomal regions 2p21, 2q14, 3p14, 5q33, 7q36, 10q23, 16q23 and 20p12). We have demonstrated an association between EO-BD and the SNAP25 gene (located at 20p12 and involved in exocytosis). We have demonstrated an association between BD and the ASMT gene (involved in the synthesis of melatonin). Finally, a genome-wide association study has suggested the involvement of two phosphatidyl-inositol pathway related genes in the susceptibility to EO-BD (PLEKHA5 et PLCXD3). Concerning environmental susceptibility factors, childhood affective traumatic events (mainly emotional abuse) are associated with BD, might influence two core dimensions of BD (affective lability and affect intensity) and might interact with the serotonin transporter genelinked polymorphic region to modulate the age of onset of the disorder. These studies illustrate the relevance of focusing on the early onset subgroup of the disease to identify susceptibility genes, the need to further explore early stressors as environmental factors associated with BD and to investigate the complex relationships between these two kinds of susceptibility factors

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Prefasi, Gomar Salvador. "Evaluación de la experiencia de usuario (UX) mediante la aplicación móvil e-terapia orientada al control de la sintomatología en personas con trastorno bipolar." Doctoral thesis, Universitat Politècnica de València, 2021. http://hdl.handle.net/10251/158556.

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[ES] La investigación de la presente tesis está motivada por el interés en conocer el impacto en el uso de las Tecnologías de la Información y la Comunicación (TIC's) en pacientes con una enfermedad mental grave y crónica, mediante la experimentación realizada con la aplicación web e-Terapia para el control y seguimiento de la sintomatología de pacientes con un Trastorno Bipolar. Esta aplicación ha sido desarrollada por el Servicio de Psiquiatría y Psicología Clínica del Hospital Universitario y Politécnico la Fe de Valencia y se emplea actualmente en el tratamiento psicosocial de pacientes que reúnen una serie de requisitos como estar en estado estable al inicio de la participación, el compromiso de seguir el programa psicoterapéutico programado por el Hospital, disponer de un dispositivo ubicuo inteligente y estar familiarizado con el uso de aplicaciones móviles. Los estudios previos realizados por el doctorando han intentado valorar por un lado, el grado de satisfacción de un grupo de pacientes con una enfermedad mental de carácter crónico al enfrentarse al manejo de herramientas digitales multimedia para su formación educacional, laboral y terapéutica, y por otro, valorar el grado de usabilidad y accesibilidad empleados en aplicaciones informáticas para evaluar y analizar las limitaciones concretas de este tipo de personas, con la finalidad de comprender mejor las barreras que potencian la Brecha Digital para estos colectivos, y buscarles una solución a través de los criterios de usabilidad y accesibilidad adaptados a las necesidades de personas con una enfermedad mental, que complementen las pautas generales de diseño y programación utilizados actualmente. Si bien es cierto que existen numerosas investigaciones en el ámbito médico y sanitario sobre las necesidades, adecuación e impacto de las TIC en colectivos con alguna discapacidad física, existe aún una importante carencia de estudios científicos que valoren y analicen la accesibilidad real en la utilización de las nuevas tecnologías en personas con algún tipo de discapacidad mental, y más concretamente en personas con una enfermedad mental grave y crónica como el Trastorno Bipolar. A nivel social, es muy importante desarrollar herramientas y aplicaciones interactivas que permitan el control directo y eficaz de las personas con trastornos relacionados con la Salud Mental. Estas herramientas o aplicaciones deben estar orientadas a cumplir con una serie de requisitos funcionales y estéticos de interfaz de comunicación hombre-máquina desde el punto de vista de la usabilidad, la accesibilidad y la Experiencia de Usuario (UX), proporcionando así una información valiosa tanto para diseñadores, ingenieros informáticos y programadores como para el personal sanitario involucrado en el desarrollo de nuevos instrumentos de ayuda y control. Mediante el presente trabajo de tesis, no solo se ha recopilado una serie de pautas a seguir para mejorar la Experiencia de Usuario (UX) con e-Terapia que se aplicarán en un futuro próximo para actualizar esta herramienta imprescindible para el tratamiento psicosocial de pacientes con Trastorno Bipolar. La importancia de aumentar la adherencia de los pacientes a dicha aplicación, repercute directamente en su estado mental y en su calidad de vida, lo que obliga a ir mejorando poco a poco este tipo de aplicaciones con la ayuda de los propios pacientes para conocer de primera mano, cómo se sienten al utilizarla. [CA] La investigació de la present tesi està motivada per l'interés a conéixer l'impacte en l'ús de les Tecnologies de la Informació i la Comunicació (TIC's) en pacients amb una malaltia mental greu i crònica, per mitjà de l'experimentació realitzada amb l'aplicació web e-Terapia per al control i seguiment de la simptomatologia de pacients amb un Trastorn Bipolar. Esta aplicació ha sigut desenvolupada pel Servei de Psiquiatria i Psicologia Clínica de l'Hospital Universitari i Politècnic la Fe de València i s'empra actualment en el tractament psicosocial de pacients que reunixen una sèrie de requisits com estar en estat estable a l'inici de la participació, el compromís de seguir el programa psicoterapèutic programat per l'Hospital, disposar d'un dispositiu intel·ligent i estar familiaritzat amb l'ús d'aplicacions mòbils. Els estudis previs realitzats pel doctorand han intentat valorar d'una banda, el grau de satisfacció d'un grup de pacients amb una malaltia mental de caràcter crònic a l'enfrontar-se al maneig de ferramentes digitals multimèdia per a la seua formació educacional, laboral i terapèutica, i d'un altre, valorar el grau d'usabilitat i accessibilitat empleats en aplicacions informàtiques per a avaluar i analitzar les limitacions concretes d'este tipus de persones, amb la finalitat de comprendre millor les barreres que potencien la Bretxa Digital per a estos col·lectius, i buscar una solució a través dels criteris d'usabilitat i accessibilitat adaptats a les necessitats de persones amb una malaltia mental, que complementen les pautes generals de disseny i programació utilitzats actualment. Si bé és cert que hi ha nombroses investigacions en l'àmbit mèdic i sanitari sobre les necessitats, adequació i impacte de les TIC en col·lectius amb alguna discapacitat física, existix encara una important carència d'estudis científics que valoren i analitzen l'accessibilitat real en la utilització de les noves tecnologies en persones amb algun tipus de discapacitat mental, i més concretament, en persones amb una malaltia mental greu i crònica com el Trastorn Bipolar. A nivell social, és molt important desenvolupar ferramentes i aplicacions interactives que permeten el control directe i eficaç de les persones amb trastorns relacionats amb la Salut Mental. Estes ferramentes o aplicacions han d'estar orientades a complir amb una sèrie de requisits funcionals i estètics d'interfaç de comunicació home-màquina des del punt de vista de la usabilitat, l'accessibilitat i l'Experiència d'Usuari (UX), proporcionant així una informació valuosa tant per a dissenyadors, enginyers informàtics i programadors com per al personal sanitari involucrat en el desenvolupament de nous instruments d'ajuda i control. Per mitjà del present treball de tesi, no sols s'ha recopilat una sèrie de pautes que s'han de seguir per a millorar l'Experiència d'Usuari (UX) amb e-Terapia que s'aplicaran en un futur pròxim per a actualitzar esta ferramenta imprescindible per al tractament psicosocial de pacients amb Trastorn Bipolar. La importància d'augmentar l'adherència dels pacients a la dita aplicació, repercutix directament en el seu estat mental i en la seua qualitat de vida, la qual cosa obliga a anar millorant a poc a poc este tipus d'aplicacions amb l'ajuda dels propis pacients per a conéixer de primera mà, com se senten a l'utilitzar-la. [EN] The research of this thesis is motivated by an interest in understanding the impact of the use of Information and Communication Technology (ICT) for patients with severe and chronic mental illness, through experimentation carried out with the web application e-Therapy for the control and monitoring of the symptoms of patients with Bipolar Disorder. This application was developed by the Psychiatry and Clinical Psychology Service of La Fe University and Polytechnic Hospital of Valencia, and is currently used in the psychosocial treatment of patients who meet a series of requirements such as being in a stable state at the beginning of participation, having the commitment to follow the psychotherapeutic program programmed by the Hospital, having unrestricted access to a smart device, and being familiar with the use of mobile applications. Previous studies carried out by the doctoral student have attempted to assess, on the one hand, the degree of satisfaction of a group of patients with chronic mental illness when facing the use of digital multimedia tools for their educational, occupational and therapeutic training, and on the other hand, the degree of usability and accessibility of computer applications used to evaluate and analyze the specific limitations of this type of person in order to better understand the barriers that increase the Digital Divide for these groups, and seek a solution through the usability and accessibility criteria adapted to the needs of people with mental illness, which complement the general design and programming guidelines currently in place. Although it is true that there are numerous investigations in the medical and health field on the needs, adequacy and impact of ICT in groups with some physical disability, there is still a significant lack of scientific studies that assess and analyze real accessibility in the use of new technologies in people with some type of mental disability, and more specifically in people with a severe and chronic mental illness such as Bipolar Disorder. At a social level, it is extremely important to develop interactive tools and applications that allow direct and effective control of people with disorders related to Mental Health. These tools or applications must be aimed at meeting a series of functional and aesthetic human-machine communication interface requirements from the point of view of usability, accessibility and User Experience (UX), thus providing valuable information both for designers, computer engineers and programmers as well as healthcare personnel involved in the development of new instruments for help and control. As a result of this thesis project, a series of guidelines has been compiled which can be followed to improve the User Experience (UX) with e-Therapy. These guidelines will be applied in the near future to update this essential tool for the psychosocial treatment of patients with Bipolar Disorder. The importance of increasing patients' adherence to this application has a direct impact on their mental state and quality of life, which means that this type of application is gradually improving with the help of the patients themselves by allowing researchers to get to know how patients feel when they are using it. Prefasi Gomar, S. (2020). Evaluación de la experiencia de usuario (UX) mediante la aplicación móvil e-terapia orientada al control de la sintomatología en personas con trastorno bipolar [Tesis doctoral]. Universitat Politècnica de València. https://doi.org/10.4995/Thesis/10251/158556 TESIS

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Hart, George Allan Desmond. "An Investigation into dopamine function in bipolar and unipolar primary affective disorders measuring prolactin when challenged by chlorpromazine and L-Dihydroxyphenylalanine." Thesis, 1986. http://hdl.handle.net/10413/2545.

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This work is the result of an investigation into aspects of prolactin and dopamine in primary affective disorders. It is introduced by a discussion on the need for obtaining good scientific data on the organic and psychosocial aspects of psychiatric illness, and in particular, primary affective disorders. A short perspective of the history of depressive illness preceeds the review of relevant scientific literature on primary affective disorder. The literature survey covers aspects which indicate organic causal factors as well as viewing numerous organic studies which are thought to be relevant to this investigation. The role of dopamine in motor behaviour is considered in some detail. Psychopharmacological evidence that the mesolimbic and nigrostriatal dopaminergic systems are involved in motor regulation is reviewed. The role of dopamine receptors in motor behaviour is important to the conceptual framework of this thesis. Dopamine D 2 and D 1 receptors are considered and the opposing roles of these receptors is thought to be significant. Drugs affecting manic and depressive phases of primary affective disorders are reviewed. Emphasis is placed on dopaminergic aspects of various drugs in primary affective disorders as with pimozide as an antimanic agent, and nomifensine as an antidepressant. The possible role of noradrenaline in learning and mood regulation and in the dialogue with dopamine is looked at from an experimental and clinical point of view. Dopaminergic control of prolactin is reviewed and in particular the nature of the D4 receptor. The fact that these receptors which are on the pituitary mammotrophs have similarities to the D2 receptors is relevant. Thus considerable commonality exists between the dopaminergic regulation of motor behaviour and regulation of prolactin. Prolactin is used as an index of dopamine function in patients with primary affective disorders. Motor behaviour is strongly influenced by affective disorders.The central theme of the study itself was to indirectly evaluate dopamine function in primary affective disorder by measuring prolactin levels. As strong tonic inhibition is exerted by dopamine on prolactin, a series of challenges to the dopamine system was decided upon in order to generate a number of serum prolactin values. A dopamine agonist L-dihydroxyphenylalanine (indirect) and an antagonist, chlorpromazine, were used to stress the system mildly. The procedure was carried out under standard conditions both in the illness phase and upon significant recovery. Both these investigations were conducted in a drug-free state. The data generated was subjected to statistical analysis. The results of the analysis suggests that prolactin levels are low in depressed patients, and increase upon recovery, while manic patients have elevated levels which decrease with recovery. The pattern of the curves obtained from the challenge procedure suggests a possible supersensitivity of dopamine receptors in the manic patients. Blunting of responses of depressed patients remains a possibility but a study against normal controls is required to further assess this aspect. Evidence is therefore found for altered prolactin levels in illness phases of primary affective disorders. This is thought to be due to an abnormality in the dopamine regulation of prolactin. A discussion on the possible mechanisms and significance of these changes involves Beta-endorphin in an attempt to tie motor changes to mood regulation. Shortcomings of the study and future implications and developments are considered. Thesis (M.D.)-University of Natal, Durban, 1986.

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Rambousková, Jana. "Farmakoterapie poruch nálady." Master's thesis, 2017. http://www.nusl.cz/ntk/nusl-370999.

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Charles University Faculty of Pharmacy in Hradec Králové Department of Pharmacology & Toxicology Student: Jana Rambousková Supervisor: Prof. MUDr. Radomír Hrdina, CSc. Title of diploma thesis: Pharmacotherapy of mood disorder This diploma thesis deals with the characterization of mood disorders concentrating especially on depression disorders. It presents the classification of mood disorders according to classification MKN-10. The diploma thesis presents patophysiology of depression disorders, their causes, symptoms and progress. It analyses the choice of pharmacotherapy in depression disorders and bipolar affective disorder. It describes individual groups of antidepressants and drugs used for treatement of bipolar affective disorder. It analyses their mechanism of action, indications, contraindications and adverse effects. At the end of diploma thesis states the other use of antidepressants in non- psychiatric indications.

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Pomahačová, Kateřina. "Metody sociální práce používané u klientů s duševními poruchami a jejich efektivita." Master's thesis, 2021. http://www.nusl.cz/ntk/nusl-448106.

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In thesis on the topic "Social work methods used in clients with mental disorders and their effectiveness" I focus on the terminology. I am going to learn basic information about selected mental disorders such as schizophrenia, affective disorders, specifically bipolar disorder, neurotic disorders, specifically obsessive-compulsive disorder and lastly personality disorders, namely borderline personality disorder. Next, I am going to focus on the treatment possibilities of mental disorders, where I speak about the prevention and social worker approach. I continue with social survey and treatment&care for people with mental disorders. Finally, I am going to write about social work methods. The main goal of my thesis was to find what methods of social work are used at work with clients suffering mental disorders. Also if in practice are any methods used and what kind of method is used most often. My next goal was to find out the effectiveness of the methods used in social work. I used survey by a questionnaire. The survey contains 11semi-open questions. After that I concluded that methods of social work are provided to clients with mental disorders and all methods of social work for the mentally ill are used. That means work with an individual, family, group, community, psychiatric rehabilitation,...

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Babakhani, Anet. "Cognitive vulnerability to manic and depressive symptoms in bipolar affective disorder." Thesis, 2011. http://hdl.handle.net/1959.13/1037322.

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Research Doctorate - PhD (Clinical Psychology) The overarching aim of this research was to ascertain why it is that individuals with bipolar affective disorder (BAD) sometimes have depressive episodes and at other times have manic episodes. Most of the existing research has considered the disorder in its entirety without considering the two poles of the disorder separately. Studies of cognitive styles among euthymic people with bipolar affective disorder (BAD) without use of mood induction (MI) techniques to access those cognitive styles give misleading impressions of the normality of those cognitions. The aim of the first study was to assess dysfunctional attitudes of participants with BAD, and control participants with no previous psychiatric histories, after mood inductions (MIs). Sad and happy moods were induced within 49 individuals with BAD and 37 healthy controls. Dysfunctional attitudes were measured following MIs using the Dysfunctional Attitude Scale – short form (DAS-24) which has three subscales of achievement, interpersonal, and goal attainment. It was hypothesized that within individuals with BAD the sad MI would help in accessing dysfunctional attitudes in all three domains relative to the happy MI. This was supported. It was also hypothesized that the MIs would not affect dysfunctional attitudes within controls. This was also supported. When diagnosis was entered as a between group variable, achievement dysfunctional attitudes were significantly higher in individuals with BAD compared to controls after a happy induction. Both sad and happy moods provoked higher levels of dysfunctional attitudes within individuals with BAD. Euphoria may be related to elevated achievement dysfunctional attitudes, raising the risk for mania. The aim of the second study was to investigate the congruency hypothesis, that exacerbations in manic and depressive symptoms are a function of the interaction of interpersonal or achievement dysfunctional attitudes with life events in congruent domains. The same 49 individuals with bipolar I (n = 40) and bipolar II (n = 9) disorders participated in a longitudinal study of life events, using the Life Events and Difficulties Schedule (LEDS; Brown & Harris, 1978). Data were obtained for 44 of the 49 individuals. LEDS was conducted at 6 and 12-months. Mixed models analysis with autoregressive correlation (AR1) was used. Internal State Scale (ISS) activation (ACT) score assessed monthly was the dependent variable; DAS-24 achievement dysfunctional attitudes and number of achievement life events were the independent variables. We hypothesized that after a happy mood induction, achievement dysfunctional attitudes in interaction with achievement life events would predict manic symptom increases (e.g., Lozano & Johnson, 2001; Scott & Pope, 2003). In support of our hypothesis we found, when predicting ACT, achievement DAS after happy induction in interaction with achievement life events lagging three months before the activation month, showed significant effects after inclusion of baseline ACT and medication compliance. At high levels of DAS achievement after happy induction, as the number of achievement life events lagging 3 months from the activation month increased, so did activation. This supported the congruency hypothesis. Further, we hypothesized that interpersonal dysfunctional attitudes, after a sad mood induction, would interact with interpersonal life events to predict manic symptom increases. Interpersonal DAS after sad induction in interaction with interpersonal life events lagging one month before the activation month showed significant effects when predicting ACT, after inclusion of baseline ACT and medication compliance. At high levels of interpersonal DAS after sad induction, as the number of negative interpersonal life events increased, so did ACT scores as predicted by congruency hypothesis. We also hypothesized that interpersonal DAS after sad induction would interact with interpersonal life events which would predict depressive symptoms. This hypothesis was not supported. Unexpectedly though, the interaction of interpersonal DAS after sad induction and number of achievement life events lagging one month from the BDI score was significant after inclusion of baseline BDI and compliance with medications. At high levels of interpersonal DAS after sad induction, as the number of negative achievement events increased, the BDI score decreased. The events however were non-congruent with the DAS. The results are discussed in light of theory, analyses employed and mood induction. We further compared individuals with BAD and a healthy control group on Rosenberg’s (1965) self-esteem scale and a measure of instability of self-esteem. It was found that individuals with BAD had lower self-esteem on Rosenberg’s positive, negative and total self-esteem scales than the healthy control group. In addition, on positive, negative and total SE instability, individuals with BAD had higher self-esteem instability score than the healthy control group. We then tested the buffering hypothesis of self-esteem. That is, self-esteem would buffer the individual against occurrence of life events. We found support for the buffering hypothesis, as individuals with high self-esteem, after experiencing negative life events in the interpersonal domain, had lower levels of BDI and ACT scores. In contrast individuals with low self-esteem had higher levels of BDI and ACT scores, after occurrence of interpersonal life events. More specifically, the number of negative events in the interpersonal domain was predictive of BDI scores in low self-esteem individuals. However, it was found that the long-term threat posed by negative interpersonal events, predicted ACT scores in low self-esteem individuals. Also, individuals with low self-esteem instability tended to respond to life events with increased depressive and manic symptoms as opposed to individuals with high SE instability. The results concerning self-esteem instability were contrary to expectations. We suggested that the interactive effect of trait self-esteem and self-esteem instability might provide reasons for the current results. In the last study, it was hypothesised that high social rhythm disruptive (SRD) life events would increase manic and depressive symptoms of the disorder through disruption of social rhythms as proposed by Ehlers et al. (1988). We did not directly test the above hypothesis. However, we found that maximum SRD interacted with the number of interpersonal events at Lag 3 months to predict BDI such that at higher levels of maximum SRD, once the number of interpersonal events at Lag 3 months increased, BDI score increased. Similarly, maximum SRD interacted with long-term threat for interpersonal events at Lag 4 months to predict ACT, such that at higher levels of maximum SRD, as the long-term threat for interpersonal events at Lag 4 months increased, the ACT score increased. Also, maximum SRD interacted with long-term threat for achievement events at Lag 4 months to predict ACT such that at high levels of maximum SRD, as long-term threat for achievement events at Lag 4 months increased the ACT score increased. The above results were aligned with predictions. However, we also found that at high levels of maximum SRD, as the long-term threat for achievement events at Lag 2 months increased, ACT score decreased, contrary to predictions. In light of the findings of this study, the theory of social rhythms may need to be modified to account for the interaction of SRD with achievement and interpersonal life events to cause symptom exacerbations in mania and depression. This research has contributed to an explanation why individuals with bipolar disorder have manic episodes at some times and depressive episodes at other times. A combination of variables, such as level of self-esteem, instability of self-esteem, dysfunctional attitudes, SRD, achievement and interpersonal life event occurrences, and participants’ mood at the time of event occurrence, decides whether an individual will have depressive or manic episodes.

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HUANG, WEN-XIANG, and 黃文翔. "The influence of life stress on the relapse of bipolar affective disorder." Thesis, 1988. http://ndltd.ncl.edu.tw/handle/94638015207354896028.

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Chi, Li-Chi, and 紀力齊. "Molecular genetic study of the human POU3F2 gene in bipolar affective disorder." Thesis, 2014. http://ndltd.ncl.edu.tw/handle/69727221814714031776.

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碩士 國立中興大學 生物醫學研究所 102 Abstract Bipolar affective disorder (BPD) is one of the most common and complex mood disorder, characterized by mood swinging back and forth between mania and depression episodes. Little is known about the pathophysiology of BPD. However, the previous twins, family, and adoption studies of BPD indicated that BPD has strong genetic components. Increased of amygdala volume, larger ventricles volume and deficit of GABAergic interneurons in cerebral cortex were observed in BPD patients in neuroimaging and postmortem studies. These findings imply some defect on neuronal development may contribute to BPD pathogenesis. POU3F2 is a transcriptional factor that most likely expressed in CNS, and plays an important role in regulating neuronal differentiation related gene expression, including cell fate decision of neuronal precursor cells, Schwann cell development, and so on. Although POU3F2 is involved in neuronal lineage determination, limited studies regarding POU3F2 gene and its effects on neuropsychiatric disorder have been reported. Here we aim to analyze the role of POU3F2 gene in etiology of BPD. Our team have systematically screened the POU3F2 locus, and identified twelve variants of POU3F2 gene. Here, we select six SNPs to perform BPD association study. Single locus association, linkage disequilibrium analysis, and haplotypic association study were applied to test the genetic association between POU3F2 and BPD. We found the different LD patterns of SNP g.-291G>A between BPD and controls. For studying the biological function of g.-291G>A, promoter reporter functional assay is done and find g.-291G>A of POU3F2 promoter will affect the gene expression in neuroblastoma cells. Results from our current study imply POU3F2 gene has a role in BPD.

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Lin, Yi-Mei, and 林宜玫. "The genetic and functional study of serotonin system in pathogenesis of bipolar affective disorder." Thesis, 2007. http://ndltd.ncl.edu.tw/handle/27187439550947873677.

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博士 國立成功大學 基礎醫學研究所 95 Bipolar affective disorder (BPD) characterized by manic and depressive episodes is a common and complex disease. Serotonin (5-hydroxytryptamine; 5-HT) is a key neurotransmitter in the central nervous system (CNS), and dysfunction of serotonin transmission in the CNS has been implicated in several psychiatric diseases including BPD. This study aimed to examine whether sequence variants of serotonergic genes, that impair proteins’ function and contribute to the dysfunction of serotonin transmission, lead to the development of BPD. The genetic and functional effects of serotonergic genes, including serotonin receptors (HTRs), neuronal tryptophan hydroxylase (TPH2), and monoamine oxidase A (MAOA), were demonstrated. Results from these studies combined with previous reports of tryptophan hydroxylase 1 (TPH1) and serotonin transporter (SLC6A4), which were done in our laboratory using the same dataset, successfully identified weak-to-strong associations between polymorphisms of these genes with BPD in single-locus or haplotype levels. Further functional analyses using reporter gene and enzyme-activity assays indicated that the alteration of sequence variants indeed affected the protein function. Finally the higher order interactions between polymorphisms of the TPH2 gene and between TPH2 and TPH1 have been demonstrated. Both the intra- and inter-gene interactions among variants of serotonin system were found and showed contribution to BPD etiology. Results from these studies support the hypothesis that the alteration in each single variant or serotonergic gene only contribute to partial effect. However, the synergic effect of interactions between variants and genes in the same pathway that co-contribute to influence serotonin neurotransmission is important in BPD etiology.

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Klempan, Timothy Arthur. "Transmission analysis of presynaptic and neurodevelopmental candidate gene variants in schizophrenia and bipolar affective disorder." 2004. http://link.library.utoronto.ca/eir/EIRdetail.cfm?Resources__ID=94769&T=F.

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Chen, Chia-Chun, and 陳佳君. "The caring experience and the coping process of the bipolar affective disorder patient''s spouse." Thesis, 2003. http://ndltd.ncl.edu.tw/handle/11793408567948975858.

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碩士 東吳大學 社會工作學系 91 The purpose of the study is to explore the caring experience and the coping process of the bipolar affective disorder patient’s spouse. What kind of difficulties do they have in the coping process？What kind of inner strengths do they have？ And what kind of resources do they use？ 9 spouses were interviewed. Results of the study indicated that patients’ spouses have difficulties in the patient’s unstable conditions, other family’s expectation and over-involvement. A few spouses mentioned that they lack of connection with other organization and people with the same problem. They have hurt feelings because of the stigma from the society. The inner strength they have including positive cognitions and interpretations of the disease, the difficulties, and their marriage. After years, the spouses have developed better problem-solving skills. Positive personalities also help them to overcome the difficulties. They can reframe and learn from the traumatic experiences. They know how to take care of themselves. They also get power and faith from their religion. The resources they use in the coping process are from the social welfare system, the medical system, the police agent and other organization in the community. The spouses also can get help and support from their families, their boss and colleagues, their friends and their neighborhood. The more strength the spouses have, the better coping process they have.

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Dissertations / Theses on the topic 'Bipolar affective disorders'

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