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Mood Disorders
Published in Vincenzo Berghella, Maternal-Fetal Evidence Based Guidelines, 2022
Madeleine A. Becker, Tal E. Weinberger, Leigh J. Ocker
Bipolar disorder is a psychiatric illness characterized by episodes of depression alternating with sustained episodes of elevated mood and/or irritability, which are classified as either “mania” or “hypomania.” Hypomania is an attenuated form of mania with no associated functional impairment. Both mania and hypomania are associated with increased energy, decreased need for sleep, rapid speech and/or thoughts, distractibility, impulsivity, mood lability, and grandiosity. “Mood swings” are not adequate for a diagnosis of bipolar disorder; rather, a patient must have a syndrome characterized by sustained symptoms lasting for several days to weeks.
Neurofeedback in Combination with Psychotherapy
Published in Hanno W. Kirk, Restoring the Brain, 2020
Bipolar disorder is a chronic relapsing and remitting disorder with progressive disability across the lifespan. The depressed state is characterized by sad or hopeless feelings, anger and frustration, as well as irritability in varying degrees of severity. There is also a noticeable change in sleep and appetite, tiredness, feelings of worthlessness, and loss of interest in pleasurable endeavors. The hypomanic phase involves an increase in grandiose thinking, talkativeness, decreased need for sleep, distractibility, and excessive need to indulge in activities that are likely to produce painful consequences. The manic phase is more severe and causes a marked impairment in functioning, and patients may require hospitalization. These individuals suffer from the loss of functional lives due to constant mood swings and disrupted personal relationships. Often, hospitalizations and re-hospitalizations are necessary and provide temporary relief of the symptoms.
Psychopharmacology EMIs
Published in Michael Reilly, Bangaru Raju, Extended Matching Items for the MRCPsych Part 1, 2018
D, H. Bupropion is used mainly in Great Britain and Ireland as an aid to smoking cessation. It is associated with a higher rate of seizures than most other antidepressants, and has been suggested anecdotally to be less likely to cause ‘switching’ into hypomania than other antidepressants. [W. p80–1]
Confirmatory Factor Analysis of the Affective Lability Scale-18 in a Community Sample of Pregnant and Postpartum Women
Published in Women's Reproductive Health, 2021
Hua Li, Alana Glecia, Lloyd Balbuena
We had expected that ALS depression/elation would relate positively to the Highs Scale. However, we observed an inverse relationship. This is probably due to the bi-phasic nature of depression/elation, whereas the Highs Scale focuses singularly on elation. One possible interpretation is that negative affect is predominant among healthy women experiencing shifts between depression and elation symptoms. This interpretation is supported by the higher prevalence of depression symptoms (24.3%) vs. hypomania symptoms (17.8%); however, this finding needs to be verified in larger samples. The women who experienced depressive and anxiety symptoms also reported a significantly elevated affective instability. This can be explained by the high comorbidity between depression and anxiety, as featured in the form of mood shifts between anxiety and depression and the nature of mood swings between depression and hypomania in perinatal women.
The Effect of Psychoeducation on Internalized Stigma of the Hospitalized Patients with Bipolar Disorder: A Quasi-Experimental Study
Published in Issues in Mental Health Nursing, 2020
Zinat Keshavarzpir, Naima Seyedfatemi, Marjan Mardani-Hamooleh, Nazanin Esmaeeli, Jennifer E. Boyd
The high prevalence of mental health problems of the public is a concern. Throughout the world, one out of every four persons experiences a mental health problem during their lifetime (Hanisch et al., 2016). Bipolar disorder is a chronic, recurrent mental illness with mood swings (Cardoso et al., 2014). An international meta-analysis estimated that the lifetime prevalence of this disorder was 1.06 − 1.57%, respectively, in the general adult population (Clemente et al., 2015). Bipolar disorder is described as a chronic and cyclical mood disorder involving periods of severe changes in mood and destructive behavior that are intertwined with periods of complete recovery or much improved function (Au et al., 2019). It is sometimes called manic-depressive disorder or manic depression. The main characteristic of this disorder is the experience of hypomania or mania. Mania is a distinct period during which the mood is abnormally and stubbornly high, expansive or irritable. Generally, this period lasts at least 1 week (unless the person is hospitalized and treated early). Hypomania is similar to mania but with less intensity and shorter duration (4 days) that does not impair a person’s ability to function. During depressive episode, an individual experiences a depressed mood or lack of enjoyment in all activities (Mason et al., 2016). Bipolar disorder causes significant changes in the social and professional life of a person and is considered a major health problem regarding its social, economic and quality of life problems (Grande et al., 2016).
Improving long term patient outcomes from deep brain stimulation for treatment-refractory obsessive-compulsive disorder
Published in Expert Review of Neurotherapeutics, 2020
Andrew Guzick, Patrick J. Hunt, Kelly R. Bijanki, Sophie C. Schneider, Sameer A. Sheth, Wayne K. Goodman, Eric A. Storch
The process of optimizing stimulation conditions typically takes 6–12 months. During post-operative programming visits, DBS stimulation parameters are adjusted by an experienced psychiatrist with expertise in both OCD and DBS programming. The device is programmed telemetrically using a hand-held tablet. As in DBS for movement disorders, the following stimulation parameters can be adjusted: selection of active contact(s) across the leads, amplitude, frequency, and pulse width. As the number of different possible permutations is enormous, programming algorithms built on prior clinical experience are followed to render this task more manageable. Initially, a monopolar survey is conducted with frequency typically set between 130–150 Hz at a constant pulse width of 90–150 microseconds. Amplitudes are gradually adjusted as tolerated and guided by bedside assessment of mood/affect, the ‘energy,’ or autonomic activation that the patient feels, and the patient’s anxiety. Acute induction of a mirth response is used to guide programming [36]. However, as noted, it is critical not to send the patient home on settings that produce hypomania. Future visits continue to modify stimulation settings while monitoring changes in OCD symptom severity as reflected by changes in Y-BOCS scores. Across time, the psychiatrist increases amplitude and voltage to the highest tolerated settings, as increased total energy output across time corresponds with optimal symptom reduction [24,54].