Mood Disorders and Trauma: What are the Associations?

Objectives: Mood dysregulation in traumatized children may be misdiagnosed as bipolar disorder (BD) and conversely, the diagnosis of BD overlooked. Our aim is to characterize the relationship between trauma and mood dysregulation and pediatric BD. Methods: We are assessing youths ages 8-18 who present with mood symptoms and past trauma divided into two groups: 1. Trauma+Unmodified DSM-IV-TR BD (T+BD) and 2. Trauma+Mood Disorder NOS (T+MD). Differences in clinical variables between groups are analyzed using t-tests for continuous and chi-square tests for categorical variables (α= 0.05). Results: Age at onset of trauma for youth with T+BD (n=10) compared with T+MD (n=10) was similar (2.6±1.8 versus 3.3±1.9 years; p=0.4) as were types of trauma and number of incidents, and age at onset of mood symptoms (T+BD 7±2.5 versus T+MD 7.8±1.8 p=0.4). The T+BD group had higher scores on the sexual abuse subscale of the Childhood Trauma Questionnaire (p=0.04) and BPRS mania subscale (p=0.02), and higher total number of major depressive episodes (p=0.04) and manic episodes (p=0.03) per the KSCID. Youth with T+BD reported a trend toward higher rates of ideation to self-harm compared to youth with T+MD (p=0.08). Both groups had similar PTSD and ADHD symptoms, and similar number of psychotrophic medications (BD 3.6±2.9 MD 2.7±2.1 p=0.4). Finally, family history findings suggest a trend towards higher rates of any Axis I disorder in the T+BD families (p=0.07), and significantly higher rates of anxiety disorders (p=0.05), BD (p=0.04), and schizophrenia (p=0.02). Conclusions: Results suggest differences in clinical presentation and higher rates of BD and schizophrenia in the T+BD families. Taken together, these preliminary results suggest potential biological and genetic vulnerabilities which may predispose children to develop specific mood disorders under certain circumstances; the ability to identify these children early on could change their prognostic trajectory

Holevo's bound from a general quantum fluctuation theorem

We give a novel derivation of Holevo's bound using an important result from nonequilibrium statistical physics, the fluctuation theorem. To do so we develop a general formalism of quantum fluctuation theorems for two-time measurements, which explicitly accounts for the back action of quantum measurements as well as possibly non-unitary time evolution. For a specific choice of observables this fluctuation theorem yields a measurement-dependent correction to the Holevo bound, leading to a tighter inequality. We conclude by analyzing equality conditions for the improved bound.Comment: 5 page

Psychiatric Symptomatology, Mood Regulation, and Resting State Functional Connectivity of the Amygdala: Preliminary Findings in Youth With Mood Disorders and Childhood Trauma

Background: As mood dysregulation and hyperarousal are overlapping and prominent features of posttraumatic stress disorder (PTSD), and mood disorders (MD) including bipolar disorder (BD), we aimed to clarify the role of trauma and MD on the resting state functional connectivity (RSFC) of amygdala in MD youth with or without trauma exposure, and healthy controls (HC). Methods: Of 23 subjects, 21 completed the magnetic resonance imaging (MRI) protocol, 5 were excluded for subject motion, leaving final sample size of 16: nine subjects with MD (5/9 with trauma), and 7 HC. Youth were assessed with Schedule for Affective Disorders and Schizophrenia for School Aged Children-Present and Lifetime Version (K-SADS-PL), and other behavioral measures including Young Mania Rating Scale (YMRS). Imaging data were acquired using functional MRI in 3-T scanner. Imaging included T1-weighted structural MRI and 6-min resting state acquisition. Results: In between group analysis, the average correlation coefficients between left anterior cingulate cortex (Acc) and left insula cortex with left amygdala regions were significantly larger in HC compared to the patient population. Connectivity between left amygdala and left cingulate cortex shows a significant negative correlation with YMRS severity. Conclusions: In this preliminary study, MD with trauma youth had more manic symptoms and difficulties regulating anger. While MD youth showed reduced RSFC of left amygdala with left acc and left insula, no significant difference between the subgroups of children with MD was observed. However, when looking at both clinical groups together, we observed a significant correlation of RSFC of left amygdala to left acc, and YMRS scores