A systematic review of the evidence on the treatment of rapid cycling bipolar disorder

Fountoulakis KN, Kontis D, Gonda X, Yatham LN. A systematic review of the evidence on the treatment of rapid cycling bipolar disorder. Bipolar Disord 2013: 15: 115-137. (c) 2013 John Wiley & Sons A/S.Published by Blackwell Publishing Ltd. Objective: Rapid cycling is associated with longer illness duration and greater illness severity in bipolar disorder. The aim of the present study was to review the existing published randomized trials investigating the effect of treatment on patients with rapid cycling bipolar disorder. Methods: A MEDLINE search was conducted using combinations of the following key words: bipolar and rapid or rapid-cycling or rapid cycling and randomized. The search was conducted through July 16, 2011, and no conference proceedings were included. Results: The search returned 206 papers and ultimately 25 papers were selected for review. Only six randomized, controlled trials specifically designed to study a rapid cycling population were found. Most data were derived from post hoc analyses of trials that had included rapid cyclers. The literature suggested that: (i) rapid cycling patients perform worse in the follow-up period; (ii) lithium and anticonvulsants have comparable efficacies; (iii) there is inconclusive evidence on the comparative acute or prophylactic efficacy of the combination of anticonvulsants versus anticonvulsant monotherapy; (iv) aripiprazole, olanzapine, and quetiapine are effective against acute bipolar episodes; (v) olanzapine and quetiapine appear to be equally effective to anticonvulsants during acute treatment; (vi) aripiprazole and olanzapine appear promising for the maintenance of response of rapid cyclers; and (vii) there might be an association between antidepressant use and the presence of rapid cycling. Conclusion: The literature examining the pharmacological treatment of rapid cycling is still sparse and therefore there is no clear consensus with respect to its optimal pharmacological management. Clinical trials specifically studying rapid cycling are needed in order to unravel the appropriate management of rapid cycling bipolar disorder

Le burnout sportif comparé au syndrome de surentraînement : une entité clinique à part entière ?

Notre pratique au sein du CAPS nous amène à rencontrer des sportifs en situation de difficultés psychologiques. Dans ce cadre, nous avons été confrontés à des tableaux cliniques singuliers, dont certains ne se superposent pas exactement aux descriptions nosographiques classiques du champ de la psychiatrie et par conséquent nous questionnent sur la notion de spécificité sportive. Dans le contexte des pratiques sportives compétitives, l'entité clinique associant chute prolongée des performances, fatigue chronique et éléments dépressifs est consensuellement appelée syndrome de surentraînement. Dans la littérature, il est souvent mal délimité, et confondu notamment avec le concept de burnout sportif, parfois traduit par le terme d’ « épuisement » ou « grillage ».En s'appuyant sur notre travail de terrain, nous tentons ici de préciser la notion de « burnout sportif » sur le plan clinique et d'impact sur la vie des sportifs. Avant d'aborder sa description, nous reviendrons sur la définition de l'état de surentraînement, issue des données récentes émanant d'experts. Pour éclairer notre propos, et tenter de différentier plus clairement le burnout du surentraînement nous nous appuierons ensuite sur la description de deux cas de sportifs rencontrés au CAPS. Le but est de favoriser la reconnaissance de ce concept clinique afin d’optimiser la réactivité et l’efficacité de la prise en charge tout en tenant compte de l’identité sportive

The Prevalence of Myopia in Children in Spain: An Updated Study in 2020

Background: In recent years, there was a significant increase in myopia incidence worldwide. However, it is still not clear how it affects Spanish children. Since 2016, this research team analyzed myopia prevalence and risk in 9668 children aged between 5 and 7 years. It was shown that the prevalence rates increased from 16.8% in 2016 to 20.4% in 2019. The objective of this study is to update the prevalence rate of myopia in Spain in 2020 and analyze the risk and prevention factors of myopia. Methods: The participants underwent an optometric examination, and a questionnaire on their lifestyle, family history, and geographical origin was carried out. Finally, data were analyzed using the SPSS version 27 program. Results: 1601 children from various Autonomous Communities of Spain were examined. In 2020 the myopia rates did not increase compared to 2019 (p < 0.05), although the number of hyperopes decreased and the number of emmetropes increased. Regarding age, the prevalence of myopia increased progressively over the years (p < 0.001). There was no association between gender and myopia (p > 0.05). There was a link between the time spent in near vision and family history with the prevalence of myopia (p < 0.05). Conclusions: The prevalence of myopia in Spain in children between 5 and 7 years old increased significantly between 2016 and 2020

A study of the relationships between sport practice and health issues among college students: Effects of gender on eating disorders and substance use

A number of previous studies have focused on the effect of sport practice on eating disorders and substance use. Most of these studies suggest that among students sport practice is related to low levels of health issues like eating disorders and substance use. However, there is a relative dearth of evidence for these relationships and previous findings are based on comparisons between people involved in sport practice and physical activity and sedentary or largely inactive people. The present study aims to test the effects of frequency of sport practice on college students' eating disorders and substance use when also controlling for gender effects. Methods: One thousand and seventy-three first year college students (35.6% boys, 64.4% girls) volunteered to participate in the study. Participants were divided into three groups according to the frequency of their sport practice: students who rarely participated in sport practice (less than one hour a week and not every week; 406 students, 26.4% boys vs 73.6% girls), students who frequently participated in sport practice (every week but less than eight hours a week; 173 students, 33.5% boys vs 66.5% girls), and students who had intensive sport practice (eight hours a week or more; 494 students, 43.9% boys vs 56.1% girls). Alcohol, tobacco and cannabis use were assessed using the Alcohol Smoking and Substance Involvement Screening Test (ASSIST). Three different categories of eating disorders (Dieting, Bulimia, Oral control) were assessed using the EAT-26 inventory. ANOVAs were computed to test for gender differences across the three sport practice groups. Results: Results of univariate ANOVAs revealed main effects for gender and sport practice on some of the substance use and eating disorder variables, ANOVA with multiple comparisons (Tamhan T Test) revealed a significant interaction effect of sport practice and gender on oral control and tobacco use. For girls, oral control and tobacco use do not vary within the three groups of sport practice whereas for boys the more frequent the sport practice, the lower their scores on oral control and tobacco use. For oral control, boys reported significantly higher scores than girls only when sport practice was rare. For tobacco use, boys reported significantly higher scores than girls when sport practice was rare and lower scores when sport practice was intensive. Conclusion: These results suggest that the positive effects of sport practice vary by gender and that the campaigns for promotion of physical activity might assist in the prevention of health issues amongst students but should be adapted according to the gender of the participants. © 2014

Neurobiology of bipolar disorder

Bipolar disorder is one of the most severely debilitating of all medical illnesses. It can lead to significant suffering for patients and their families, limit functioning and workplace productivity, and with its risks of increased morbidity and mortality, it is increasingly recognized as a major public health problem. For a large number of patients, outcomes are poor. Patients with bipolar disorder generally experience high rates of relapse, a chronic recurrent course, lingering residual symptoms, functional impairment, psychosocial disability and diminished well-being. Despite this, little is known about the specific pathophysiology of bipolar disorder. A better understanding of the neurobiological underpinnings of this condition, informed by preclinical and clinical research, will be essential for the future development of specific targeted therapies that are more effective, achieve their effects more quickly and are better tolerated than currently available treatments. An abundance of research has implicated specific neuroendocrine, neurotransmitter and intracellular signaling systems in the pathophysiology and treatment of this illness. More recently, genetic association studies have identified numerous genes that confer vulnerability to the disorder, many of which are known to function in the signaling pathways previously identified as relevant to the etiology of the illness. In this article, we will review current knowledge regarding the neurotransmitter systems, signaling networks, neuroendocrine systems and genetics of bipolar disorder; all of these allow insight into the mechanism of illness and thus offer potential novel directions for the development of novel therapeutics