Desynchronization of Diurnal Rhythms in Bipolar Disorder and Borderline Personality Disorder

It has long been proposed that diurnal rhythms are disturbed in bipolar disorder (BD). Such changes are obvious in episodes of mania or depression. However, detailed study of patients between episodes has been rare and comparison with other psychiatric disorders rarer still. Our hypothesis was that evidence for desynchronization of diurnal rhythms would be evident in BD and that we could test the specificity of any effect by studying borderline personality disorder (BPD). Individuals with BD (n = 36), BPD (n = 22) and healthy volunteers (HC, n = 25) wore a portable heart rate and actigraphy device and used a smart-phone to record self-assessed mood scores 10 times per day for 1 week. Average diurnal patterns of heart rate (HR), activity and sleep were compared within and across groups. Desynchronization in the phase of diurnal rhythms of HR compared with activity were found in BPD (+3 h) and BD (+1 h), but not in HC. A clear diurnal pattern for positive mood was found in all subject groups. The coherence between negative and irritable mood and HR showed a four-cycle per day component in BD and BPD, which was not present in HC. The findings highlight marked de-synchronisation of measured diurnal function in both BD but particularly BPD and suggest an increased association with negative and irritable mood at ultradian frequencies. These findings enhance our understanding of the underlying physiological changes associated with BPD and BD, and suggest objective markers for monitoring and potential treatment targets. Improved mood stabilisation is a translational objective for management of both patient groups

An investigation of the mechanics of wire drawing with the superposition of an oscillatory drawing stress

A number of investigators have studied the application of oscillatory energy to a metal undergoing plastic deformation. Their results have shown that oscillatory stresses reduce both the stress required to initiate plastic deformation and the friction forces between the tool and workpiece. The first two sections in this thesis discuss historically and technically the devolopment of the use of oscillatory energy techniques to aid metal forming with particular reference to wire drawing. The remainder of the thesis discusses the research undertaken to study the effect of applying longitudinal oscillations to wire drawing. Oscillations were supplied from an electric hydraulic vibrator at frequencies in the range 25 to 500 c/s., and drawing tests were performed at drawing speeds up to 50 ft/m. on a 2000 lbf. bull-block. Equipment was designed to measure the drawing force, drawing torque, amplitude of die and drum oscillation and drawing speed. Reasons are given for selecting mild steel, pure and hard aluminium, stainless steel and hard copper as the materials to be drawn, and the experimental procedure and calibration of measuring equipment arc described. Results show that when oscillatory stresses are applied at frequencies within the range investigated : (a) There is no reduction in the maximum drawing load. (b) Using sodium stearate lubricant there is a negligible reduction in the coefficient of friction between the die and wire. (c) Pure aluminium does not absorb sufficient oscillatory energy to ease the movement of dislocations. (d) Hard aluminium is not softened by oscillatory energy accelerating the diffusion process. (e) Hard copper is not cyclically softened. A vibration analysis of the bull-block and wire showed that oscillatory drawiing in this frequency range, is a mechanical process of straining; and unstraining the drawn wire, and is dependent upon the stiffness of the material being drawn and the drawing machine. Directions which further work should take are suggested

Cannabis use and mania symptoms: A systematic review and meta-analysis

Background Whilst cannabis use appears to be a causal risk factor for the development of schizophrenia-related psychosis, associations with mania remain relatively unknown. This review aimed to examine the impact of cannabis use on the incidence of manic symptoms and on their occurrence in those with pre-existing bipolar disorder. Methods A systematic review of the scientific literature using the PRISMA guidelines. PsychINFO, Cochrane, Scopus, Embase and MEDLINE databases were searched for prospective studies. Results Six articles met inclusion criteria. These sampled 2391 individuals who had experienced mania symptoms. The mean length of follow up was 3.9 years. Studies support an association between cannabis use and the exacerbation of manic symptoms in those with previously diagnosed bipolar disorder. Furthermore, a meta-analysis of two studies suggests that cannabis use is associated with an approximately 3-fold (Odds Ratio: 2.97; 95% CI: 1.80-4.90) increased risk for the new onset of manic symptoms. Limitations We were only able to identify a small number of studies of variable quality, thus our conclusions remain preliminary. Conclusions Our findings whilst tentative, suggest that cannabis use may worsen the occurrence of manic symptoms in those diagnosed with bipolar disorder, and may also act as a causal risk factor in the incidence of manic symptoms. This underscores the importance of discouraging cannabis use among youth and those with bipolar disorder to help prevent chronic psychiatric morbidity. More high quality prospective studies are required to fully elucidate how cannabis use may contribute to the development of mania over time