128 research outputs found
THE CAMBRIDGE-PERUGIA INVENTORY FOR ASSESSMENT OF BIPOLAR DISORDER
It is well known that Bipolar Disorder is a condition which is often under diagnosed or misdiagnosed. We propose an inventory
of questions which will help assess the longitutinal history of the patient’s illness, and to evaluate the presence of mixed affective
states, rapid cycling, and comorbidities, all of which have an important bearing on prognosis
CAN METABOLIC SIDE EFFECTS OF ANTIPSYCHOTICS BE REVERSED BY LIFESTYLE CHANGES?
Introduction: Antipsychotics, particularly atypical antipsychotics, are known to have metabolic side effects such as; weight gain,
hyperlipidaemia and insulin resistance. This is problematic as metabolic syndrome can be a precursor to many diseases, including
type II diabetes and coronary heart disease. In an attempt to overcome these side-effects, lifestyle changes have been recommended
in tandem with commencement of atypical antipsychotics, but is this effective at halting metabolic syndrome?
Results: There is some evidence suggesting that lifestyle changes can reduce weight gain caused by atypical antipsychotics.
However, there seems to be a paucity of evidence about whether this correlates with correction of metabolic dysregulation.
Moreover, there is a lack of research into the precise mechanism of metabolic syndrome as caused by atypical antipsychotics,as well
as a lack of evidence into how exercise remedies this. Furthermore, there is research to suggest that the pathophysiology of
psychosis may lead to metabolic dysregulation independently of treatment.
Conclusion: Lifestyle changes should still be part of a treatment as they seem to partially reverse metabolic changes seen with
atypical antipsychotics. However, more research is needed to identify weight independent mechanisms for metabolic dysregulation
seen in those taking atypical antipsychotics in order to solve this pressing issue
THE DEVELOPMENTAL STAGES OF BIPOLAR DISORDER: A CASE REPORT
Bipolar disorder is a developing disorder; its early stages are sometimes misdiagnosed as anxiety or depressive disorders. At the
same time, these disorders are often in comorbidity with bipolar disorder. This complex symptomatology can lead to
misinterpretation and underdiagnosis of bipolar disorders, mainly at the earliest stages. Consequently, one of the most important
challenges for clinicians is to recognize the non specific early symptoms with the aid of clinical information, for example a family
history of bipolar disorder. Furthermore, it is well-known that comorbid anxiety disorders can lead to a worse prognosis in bipolar
patients but it is not exactly clear to what extent. A deeper understanding of the relationship between these comorbidities and their
stage of development will hopefully lead to better care of patients with bipolar disorder from a younger age
RESILIENCE AND DEPRESSIVE DISORDERS
Introduction: There is considerable variability in the response of individuals to adverse environmental conditions, while some
develop psychiatric illnesses like depression, others seem very capable of dealing with it. It is in this observation that the concepts of
vulnerability and resilience are rooted.
Methods: We conducted a review of the literature by inserting in PubMed the keywords resilience, vulnerability and depressive
disorders.
Discussion and conclusions: Freud formerly used the so-called crystal-principle to describe the concept of vulnerability:
according to this, the different psychopathologies would arise depending on the different psychological weaknesses, just like a
crystal thrown to the ground shatters along its lines of cleavage intrinsic to it, albeit invisible. The term resilience has been borrowed
from physics where it is used to describe the ability of a material to withstand impact without cracking. In psychology, the term
resilience refers to a complex and dynamic multidimensional construct, which derives from the interaction of neurobiological, social
and personal factors and indicates the ability to adaptively cope with stress and adversity, preserving a normal physical and
psychological functioning. Resilience has proven to be a protective factor against the development of psychiatric disorders such as
depression. Making a conceptual leap, the concepts of vulnerability and resilience can be related to the psychodynamic classification
of depression postulated by Gaetano Benedetti, who distinguished four kinds of depression: the first due to the failure of the ego, the
second to the perversion of the superego, the third to the inhibition of the Id and the fourth to the collapse of the ego ideal.
It is possible to improve the resilience of depressed subjects through pharmacological and psychotherapeutic interventions
MIXED STATES: A “NEW” NOSOGRAPHIC ENTITY
Objective: Mixed states represent a controversial topic in the current psychiatry. The definitions and the diagnostic criteria have
changed over the past years. The new DSM-5 classification will have a substantial impact in several fields: epidemiology, diagnosis,
treatment, research, education, and regulations.
Methods: We reviewed the latest literature by using the key words “mixed states” and “agitated depression” on the PubMed.
Results: Although there is a great expectation about the validity of the new DSM-5 mixed states diagnosis, little is known about
its application on large population study but the formulation of less restrictive and more specific criteria for the diagnosis of mixed
states represent a starting point for future researches, mainly in consideration of the fact that previous classifications consider the
MS a superposition of manic and depressive symptoms, underestimating the clinical complexity and the wider phenomenologic
variability of these conditions.
Conclusions: Clinical trials need to address treatment effects according to the presence or absence of mixed features in
consideration of the fact that replacing in the bipolar spectrum patients that traditionally are considered to be affected by unipolar
depression, represent a topical research hypothesis and has a practical remarkable importance in the appropriate therapeutic choice
RESILIENCE AND DEPRESSIVE DISORDERS
Introduction: There is considerable variability in the response of individuals to adverse environmental conditions, while some
develop psychiatric illnesses like depression, others seem very capable of dealing with it. It is in this observation that the concepts of
vulnerability and resilience are rooted.
Methods: We conducted a review of the literature by inserting in PubMed the keywords resilience, vulnerability and depressive
disorders.
Discussion and conclusions: Freud formerly used the so-called crystal-principle to describe the concept of vulnerability:
according to this, the different psychopathologies would arise depending on the different psychological weaknesses, just like a
crystal thrown to the ground shatters along its lines of cleavage intrinsic to it, albeit invisible. The term resilience has been borrowed
from physics where it is used to describe the ability of a material to withstand impact without cracking. In psychology, the term
resilience refers to a complex and dynamic multidimensional construct, which derives from the interaction of neurobiological, social
and personal factors and indicates the ability to adaptively cope with stress and adversity, preserving a normal physical and
psychological functioning. Resilience has proven to be a protective factor against the development of psychiatric disorders such as
depression. Making a conceptual leap, the concepts of vulnerability and resilience can be related to the psychodynamic classification
of depression postulated by Gaetano Benedetti, who distinguished four kinds of depression: the first due to the failure of the ego, the
second to the perversion of the superego, the third to the inhibition of the Id and the fourth to the collapse of the ego ideal.
It is possible to improve the resilience of depressed subjects through pharmacological and psychotherapeutic interventions
THE COMORBIDITY BETWEEN BIPOLAR DISORDER AND ADHD IN A YOUNG ADULT: A FOCUS ON IMPULSIVITY
Impulsivity is a complex behavioural feature of many psychiatric disorders, in particular of risk-taking behaviour, and is an
important determinant of personality. Both ADHD and bipolar disorder express features of impulsivity. The concept of having two or
more simultaneous psychiatric conditions is an increasingly recognised concept in the field of psychiatry, and is important clinically
for management and prognosis. Consequently, the aim of this case presentation is to report about a young patient with both bipolar
II and ADHD, in order to better understand which of the possible clinical phenotypes of these psychiatric conditions exist in
comorbidity, mainly focusing on impulsive features because of the relevant challenge that this psychological aspect can represent in
the clinical treatment of these patients
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