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Most Recent Articles Published on Bipolar Disorder:

Implementation of the thinking skills for work program in a psychosocial clubhouse.

Psychiatr Rehabil J. 2010;33(3):190-9

Authors: McGurk SR, Schiano D, Mueser KT, Wolfe R

OBJECTIVE: Cognitive remediation programs aimed at improving role functioning have been implemented in a variety of different mental health treatment settings, but not in psychosocial clubhouses. This study sought to determine the feasibility and preliminary outcomes of providing a cognitive remediation program (the Thinking Skills for Work program), developed and previously implemented in supported employment programs at mental health agencies, in a psychosocial club-house. METHODS: Twenty-three members with a history of difficulties getting or keeping jobs, who were participating in a supported employment program at a psychosocial clubhouse, were enrolled in the Thinking Skills for Work program. A neurocognitive battery was administered at baseline and 3 months later after completion of the computer cognitive training component of the program. Hours of competitive work were tracked for the 2 years before enrollment and 2 years following enrollment. Other work-related activities (school, volunteer) were also tracked for 2 years following enrollment. RESULTS: Twenty-one members (91%) completed 6 or more computer cognitive training sessions. Participants demonstrated significant improvements on neurocognitive measures of processing speed, verbal learning and memory, and executive functions. Sixty percent of the members obtained a competitive job during the 2-year follow-up, and 74% were involved in some type of work-related activity. Participants worked significantly more competitive hours over the 2 years after joining the Thinking Skills for Work program than before. CONCLUSIONS: The findings support the feasibility and promise of implementing the Thinking Skills for Work program in the context of supported employment provided at psychosocial clubhouses.

PMID: 20061255 [PubMed - indexed for MEDLINE]

Atypical antipsychotics for acute manic and mixed episodes in children and adolescents with bipolar disorder: efficacy and tolerability.

Drugs. 2010 Mar 5;70(4):433-42

Authors: Singh MK, Ketter TA, Chang KD

The diagnosis of bipolar disorder (BD) in children is increasing, and often requires a comprehensive treatment plan to address a complex array of symptoms and associated morbidities. Pharmacotherapy, in combination with psychotherapeutic interventions, is essential for the treatment and stabilization of disrupted mood. Current evidence collectively demonstrates, by randomized controlled design, that atypical antipsychotics have efficacy for the treatment of acute manic or mixed symptoms in children and adolescents with BD. Additional longitudinal and biological studies are warranted to characterize the effects of atypical antipsychotics on all phases and stages of bipolar illness development in children and adolescents.

PMID: 20205485 [PubMed - in process]

Personality Disorders and Mood Disorders: Phenomenological Resemblances vs. Pathogenetic Pathways.

J Pers Disord. 2010 Feb;24(1):3-13

Authors: Paris J

Diagnosis in psychiatry is currently based on phenomenology, because etiology and pathogenesis are largely unknown, and because biological markers for disease have not been identified. The unitary model of depression and the model of a bipolar spectrum are based on resemblances in phenomenology between symptoms whose pathogenetic pathways are likely to differ. Both models have sometimes considered the diagnosis of personality disorder as an affective variant, even when patients present with qualitatively distinct mood features. Biological reductionism lies behind a concept of mood as the primary driver of psychopathology, a view that may be detrimental to treatment.

PMID: 20205495 [PubMed - in process]

Association between dopaminergic polymorphisms and borderline personality traits among at-risk young adults and psychiatric inpatients.

Behav Brain Funct. 2010;6:4

Authors: Nemoda Z, Lyons-Ruth K, Szekely A, Bertha E, Faludi G, Sasvari-Szekely M

ABSTRACT: BACKGROUND: In the development of borderline personality disorder (BPD) both genetic and environmental factors have important roles. The characteristic affective disturbance and impulsive aggression are linked to imbalances in the central serotonin system, and most of the genetic association studies focused on serotonergic candidate genes. However, the efficacy of dopamine D2 receptor (DRD2) blocking antipsychotic drugs in BPD treatment also suggests involvement of the dopamine system in the neurobiology of BPD. METHODS: In the present study we tested the dopamine dysfunction hypothesis of impulsive self- and other-damaging behaviors: borderline and antisocial traits were assessed by Structured Clinical Interview for Diagnosis (SCID) for DSM-IV in a community-based US sample of 99 young adults from low-to-moderate income families. For the BPD trait analyses a second, independent group was used consisting of 136 Hungarian patients with bipolar or major depressive disorder filling out self-report SCID-II Screen questionnaire. In the genetic association analyses the previously indicated polymorphisms of the catechol-O-methyl-transferase (COMT Val158Met) and dopamine transporter (DAT1 40 bp VNTR) were studied. In addition, candidate polymorphisms of the DRD2 and DRD4 dopamine receptor genes were selected from the impulsive behavior literature. RESULTS: The DRD2 TaqI B1-allele and A1-allele were associated with borderline traits in the young adult sample (p = 0.001, and p = 0.005, respectively). Also, the DRD4 -616 CC genotype appeared as a risk factor (p = 0.02). With severity of abuse accounted for in the model, genetic effects of the DRD2 and DRD4 polymorphisms were still significant (DRD2 TaqIB: p = 0.001, DRD2 TaqIA: p = 0.008, DRD4 -616 C/G: p = 0.002). Only the DRD4 promoter finding was replicated in the independent sample of psychiatric inpatients (p = 0.007). No association was found with the COMT and DAT1 polymorphisms. CONCLUSIONS: Our results of the two independent samples suggest a possible involvement of the DRD4 -616 C/G promoter variant in the development of BPD traits. In addition, an association of the DRD2 genetic polymorphisms with impulsive self-damaging behaviors was also demonstrated.

PMID: 20205808 [PubMed - in process]

Increased uric acid levels in drug-naïve subjects with bipolar disorder during a first manic episode.

Prog Neuropsychopharmacol Biol Psychiatry. 2010 Mar 2;

Authors: Salvadore G, Viale CI, Luckenbaugh DA, Zanatto VC, Portela LW, Souza DO, Zarate CA, Machado-Vieira R

Recent evidence suggests that purinergic system dysfunction may play a role in the pathophysiology and therapeutics of bipolar disorder (BPD). Uric acid is a key nitrogenous end product of purine metabolism. In addition to being a potential marker of treatment response, high levels of uric acid may represent a state marker during mania. In this study, we assessed the presence of purinergic dysfunction in 25 treatment-naïve first-episode patients with BPD who were experiencing a manic episode. Patients were matched with 24 healthy controls. Plasma levels of uric acid were measured and correlated with severity of symptoms. We found that acutely manic patients had significantly higher levels of plasma uric acid (4.85+/-1.60mg/dL) compared to healthy controls (2.96+/-0.63mg/dL, p<0.001; F=28.1). No association with severity of manic symptoms was observed. These results support the role of purinergic system dysfunction in BPD early in the course of illness, and suggest that this phenomenon is not solely the result of chronicity or medication exposure. Overall, our findings suggest a novel mechanism in the pathophysiology of BPD.

PMID: 20206224 [PubMed - as supplied by publisher]

Feasibility and diagnostic validity of the m-3 checklist: a brief, self-rated screen for depressive, bipolar, anxiety, and post-traumatic stress disorders in primary care.

Ann Fam Med. 2010 Mar-Apr;8(2):160-9

Authors: Gaynes BN, Deveaugh-Geiss J, Weir S, Gu H, Macpherson C, Schulberg HC, Culpepper L, Rubinow DR

PURPOSE: Mood and anxiety disorders are the most common psychiatric conditions seen in primary care, yet they remain underdetected and undertreated. Screening tools can improve detection, but available instruments are limited by the number of disorders assessed. We wanted to assess the feasibility and diagnostic validity of the My Mood Monitor (M-3) checklist, a new, 1-page, patient-rated, 27-item tool developed to screen for multiple psychiatric disorders in primary care. METHODS: We enrolled a sample of 647 consecutive participants aged 18 years and older who were seeking primary care at an academic family medicine clinic between July 2007 and February 2008. We used a 2-step scoring procedure to make screening more efficient. The main outcomes measured were the sensitivity and specificity of the M-3 for major depression, bipolar disorder, any anxiety disorder, and post-traumatic stress disorder (PTSD), a specific type of anxiety disorder. Using a split sample technique, analysis proceeded from determination of optimal screening thresholds to assessment of the psychometric properties of the self-report instrument using the determined thresholds. We used the Mini International Neuropsychiatric Interview as the diagnostic standard. Feasibility was assessed with patient and physician exit questionnaires. RESULTS: The depression module had a sensitivity of 0.84 and a specificity of 0.80. The bipolar module had a sensitivity of 0.88, and a specificity of 0.70. The anxiety module had a sensitivity of 0.82 and a specificity of 0.78, and the PTSD module had a sensitivity of 0.88 and a specificity of 0.76. As a screen for any psychiatric disorder, sensitivity was 0.83 and specificity was 0.76. Patients took less than 5 minutes to complete the M-3 in the waiting room, and less than 1% reported not having time to complete it. Eighty-three percent of clinicians reviewed the checklist in 30 or fewer seconds, and 80% thought it was helpful in reviewing patients' emotional health. CONCLUSIONS: The M-3 demonstrates utility as a valid, efficient, and feasible tool for screening multiple common psychiatric illnesses, including bipolar disorder and PTSD, in primary care. Its diagnostic accuracy equals that of currently used single-disorder screens and has the additional benefit of being combined into a 1-page tool. The M-3 potentially can reduce missed psychiatric diagnoses and facilitate proper treatment of identified cases.

PMID: 20212303 [PubMed - in process]

Aripiprazole: a drug with a novel mechanism of action and possible efficacy for alcohol dependence.

CNS Neurol Disord Drug Targets. 2010 Mar 1;9(1):50-4

Authors: Vergne DE, Anton RF

Alcohol dependence is a costly and socially devastating illness. The dopamine system has received increased attention due to the consensus that dopaminergic dysfunction is at the core of the addiction process. Agents that modulate this system might be beneficial in reducing craving, reward, and relapse. Aripiprazole is a 3(rd) generation atypical antipsychotic U.S. Food and Drug Administration-approved for the treatment of schizophrenia, bipolar disorder, and treatment-resistant major depression. Its principal mechanism of action appears to be associated with partial agonism at the D(2) dopamine receptor. Nevertheless, relatively recent pre-clinical data shows that aripiprazole might exert its action by way of agonism, partial agonism, and antagonism at both dopamine and serotonin receptors. In animal models of alcoholism aripiprazole produced an overall decrease in drinking behavior. Clinical trials with aripiprazole in alcoholics have shown some positive, but inconsistent, results. Given aripiprazole's putative activity on frontal-subcortical circuits subserving reward/craving and impulsive behavior, it might prove to be beneficial for neuropsychiatric conditions in which dysregulation of reward and impulsivity, among them alcoholism, are at the core of the syndrome. This article proposes a potential role for aripiprazole in alcoholism treatment, and suggests that more randomized controlled trials should be designed at appropriate doses to better understand aripiprazole's potential role as a treatment option. More options are needed to treat alcoholics that fall into different subgroups (e.g., those with impulsive disorders), or non-responsive to available treatments. Early results with aripiprazole are promising and warrant further exploration.

PMID: 20201815 [PubMed - in process]

TRPC Channels and their Implication in Neurological Diseases.

CNS Neurol Disord Drug Targets. 2010 Mar 1;9(1):94-104

Authors: Selvaraj S, Sun Y, Singh BB

Calcium is an essential intracellular messenger and serves critical cellular functions in both excitable and non-excitable cells. Most of the physiological functions in these cells are uniquely regulated by changes in cytosolic Ca(2+) levels ([Ca(2+)](i)), which are achieved via various mechanisms. One of these mechanism(s) is activated by the release of Ca(2+) from the endoplasmic reticulum (ER), followed by Ca(2+) influx across the plasma membrane (PM). Activation of PM Ca(2+) channel is essential for not only refilling of the ER Ca(2+) stores, but is also critical for maintaining [Ca(2+)](i) that regulates biological functions, such as neurosecretion, sensation, long term potentiation, synaptic plasticity, gene regulation, as well as cellular growth and differentiation. Alterations in Ca(2+) homeostasis have been suggested in the onset/progression of neurological diseases, such as Parkinson's, Alzheimer's, bipolar disorder, and Huntington's. Available data on transient receptor potential conical (TRPC) protein indicate that these proteins initiate Ca(2+) entry pathways and are essential in maintaining cytosolic, ER, and mitochondrial Ca(2+) levels. A number of biological functions have been assigned to these TRPC proteins. Silencing of TRPC1 and TRPC3 has been shown to inhibit neuronal proliferation and loss of TRPC1 is implicated in neurodegeneration. Thus, TRPC channels not only contribute towards normal physiological processes, but are also implicated in several human pathological conditions. Overall, it is suggested that these channels could be used as potential therapeutic targets for many of these neurological diseases. Thus, in this review we have focused on the functional implication of TRPC channels in neuronal cells along with the elucidation of their role in neurodegeneration.

PMID: 20201820 [PubMed - in process]

The strong relationship between bipolar and substance-use disorder.

Ann N Y Acad Sci. 2010 Feb;1187:276-93

Authors: Swann AC

Bipolar disorder and substance-use disorders commonly occur in the same individual. In fact, bipolar disorder has a higher prevalence of substance-use disorders than any other psychiatric illness. Individuals with both disorders have a more severe course of bipolar disorder, including earlier onset, more frequent episodes, and more complications, including anxiety- and stress-related disorders, aggressive behavior, legal problems, and suicide. Bipolar and substance-use disorders share common mechanisms, including impulsivity, poor modulation of motivation and responses to rewarding stimuli, and susceptibility to behavioral sensitization. Studies of potential treatments for bipolar substance-use disorder have paid scant attention to the combined disorders. The most promising treatment strategies are those that address their shared mechanisms.

PMID: 20201858 [PubMed - in process]

Is perseveration uniquely characteristic of schizophrenia?

Schizophr Res. 2010 Mar 1;

Authors: Waford RN, Lewine R

Evidence for the existence of categorically distinct disorders such as schizophrenia, bipolar disorder, and major depression is mixed: neuropsychological impairments may be similar in schizophrenia and bipolar disorder; schizophrenia and major depression show similar neuropsychological and frontal lobe disturbances; and overlap in biochemical anomalies among the disorders has also been reported. Interestingly, there are very few studies that directly compare all diagnoses. The present study compares cognitive perseveration in these three diagnostic groups using the Wisconsin Card Sorting Task (WCST) to examine performance across patients with schizophrenia (n=143), bipolar disorder (n=25) and major depression (n=21). Individuals used in this sample were 18-45years old at time of testing to eliminate confounds of aging. Sex ratios within each diagnostic group are comparable to those of the national population. Univariate analyses examining diagnostic group and percent perseverative error revealed no significant differences in WCST performance across the diagnostic groups. Examination of clinical variables in the sample of individuals with schizophrenia revealed that perseveration is related to negative symptoms and depressive symptoms in young adults.

PMID: 20202795 [PubMed - as supplied by publisher]

Proxy and patients ratings on quality of life in patients with schizophrenia and bipolar disorder in Korea.

Qual Life Res. 2010 Mar 4;

Authors: Kim EJ, Song DH, Kim SJ, Park JY, Lee E, Seok JH, Jon DI, Cho HS

PURPOSE: This study aimed to assess the agreement between patient and proxy ratings of Quality of life (QoL) in patients with psychotic mental illnesses. METHODS: The abbreviated version of the WHO quality of life scale (WHOQOL-BREF) and 36-item short-form health survey (SF-36) were administered to patient-family proxy pairs of 81 schizophrenia patients with mild symptoms and 50 euthymic bipolar disorder patients. Paired t-tests and the intraclass correlation coefficient (ICC) were used to evaluate the level of agreement between patient and proxy ratings of QoL. RESULTS: At the group level, small standardized differences (0.0-0.3 for schizophrenia, 0.0-0.5 for bipolar disorder) between patient and proxy mean scores were found for most domains in both QoL measures. At the individual level, moderate to good agreement (ICC) was found (schizophrenia: ICC 0.4-0.7 on WHOQOL-BREF; 0.4-0.7 on SF-36; bipolar disorder: ICC 0.4-0.7 on WHOQOL-BREF; 0.6-0.7 on SF-36). The reported agreement was higher than that reported for similar measures in the psychiatric population. These results may be due to the fact that our subjects had mild clinical symptoms and frequent family interaction. CONCLUSION: These findings suggest that family proxy rating of patients' QoL can be used as a reasonable estimate of the patients' QoL for stable schizophrenia and bipolar patients in Korea.

PMID: 20204707 [PubMed - as supplied by publisher]

[Valproate induced hypoactive delirium in a bipolar disorder patient with psychotic features.]

Turk Psikiyatri Derg. 2010;21(1):79-84

Authors: Ozen S, Bülbül I, Soyuçok E

Delirium may present with hyperactive, hypoactive or mixed clinical pictures. The signs of hypoactive delirium are lethargy, confusion, apathy, hypersomnia, muttering, difficulty in maintaining attention, and difficulty in understanding and performing commands. Valproate is commonly used for the treatment of epilepsy and bipolar disorders. It is also used for the management of alcohol withdrawal delirium and agitative-aggressive deliriums. However, few reports are available about the valproate-induced delirium. In this report, we present a 46 years-old woman with bipolar disorder for 14 years. During her last two hospital admissions, she had been diagnosed with manic episode with psychotic features and she had received valproate. She experienced three hypoactive delirium episodes lasting 2-3 days throughout the treatment period of first week. The patient predominantly had the following signs; vomiting, hypersalivation, confusion, drowsiness, dysphasia, and hypoactivity. At the first day of delirium episode, serum valproate level was found to be within the therapeutic range (98.4, 117.1, and 65.6 mug/ml; respectively). In addition, she had normal results of cranial MRI, complete blood count, urine analysis, electrocardiogram, ALT, AST, albumin, bilirubin, BUN, creatinine and electrolytes. The serum ammonia level of the patient could not been measured due to limitations of laboratory facilities. The patient's consciousness improved dramatically 2-3 days after cessation of valproate. In conclusion, valproate can induce delirium at therapeutic blood levels in some patients via various mechanisms and this side effect has to be considered during valproate use.

PMID: 20204907 [PubMed - in process]

Quetiapine Improves Sleep Disturbance in Acute Bipolar Disorder: A Case Series.

Pharmacopsychiatry. 2010 Mar 4;

Authors: Cohrs S, Gade K, Meier A, Jordan W, Falkai P, Rüther E, Rodenbeck A

PMID: 20205075 [PubMed - as supplied by publisher]

Clinical and medial temporal features in a family with mood disorders.

Neurosci Lett. 2010 Jan 4;468(2):93-7

Authors: Boccardi M, Almici M, Bresciani L, Caroli A, Bonetti M, Monchieri S, Gennarelli M, Frisoni GB

It is debated whether non-affected relatives of patients with affective disorders share a specific brain structure endophenotype. Aim of this work is to explore the medial temporal morphology in affected and non-affected members of a family with mood disorders. Hippocampi and amygdalae were manually traced from the 3D magnetic resonance imaging of five affected family members, 10 non-affected relatives, and 15 unrelated matched controls. Affected and non-affected relatives were characterized by larger left amygdalae (18%, p=0.030), smaller right hippocampus (up to 18%, p<0.0005), and reduced hippocampal asymmetry (p<0.001) than controls. Abnormal, albeit non significant, positive correlations of MTL volumes with age were observed, with the exception of smaller volume of the left hippocampus with advancing age (r=-0.76) in the affected relatives. These data add to the evidence that abnormal medial temporal structures may constitute an endophenotype for affective disorders.

PMID: 19874870 [PubMed - indexed for MEDLINE]

[Association between the tryptophan hydroxylase (TPH) gene polymorphic markers and endogenous psychoses]

Genetika. 2009 Dec;45(12):1668-73

Authors:

Tryptophan hydroxylase is one of the key enzymes involved in serotonergic metabolism. In many studies, an association between the TPH gene and human mentality, as well as mental disorder was demonstrated. This study was designed to analyze the association between three TPH gene polymorphisms (A218C, T3792A, and (CT)n(CA)n(CT)n) and endogenous psychoses. The patients included into investigation were represented by those with manic-depressive psychosis (93 individuals) and those with the schizophrenia spectrum disorders (307 individuals). An association between the A218C polymorphism with the disorders of the schizophrenia spectrum was demonstrated. These findings confirmed the data obtained earlier for other populations. In addition, an association between the (CT)n(CA)n(CT)n microsatellite repeats and bipolar disease was shown for the first time.

PMID: 20198979 [PubMed - in process]

Risk factors predicting onset and persistence of subthreshold expression of bipolar psychopathology among youth from the community.

Acta Psychiatr Scand. 2010 Feb 25;

Authors: Tijssen MJ, Van Os J, Wittchen HU, Lieb R, Beesdo K, Wichers M

Tijssen MJA, Van Os J, Wittchen HU, Lieb R, Beesdo K, Wichers M. Risk factors predicting onset and persistence of subthreshold expression of bipolar psychopathology among youth from the community Objective: To examine factors increasing the risk for onset and persistence of subthreshold mania and depression. Method: In a prospective cohort community study, the association between risk factors [a family history of mood disorders, trauma, substance use, attention-deficit/hyperactivity disorder (ADHD) and temperamental/personality traits] and onset of manic/depressive symptoms was determined in 705 adolescents. The interaction between baseline risk factors and baseline symptoms in predicting 8-year follow-up symptoms was used to model the impact of risk factors on persistence. Results: Onset of manic symptoms was associated with cannabis use and novelty seeking (NS), but NS predicted a transitory course. Onset of depressive symptoms was associated with a family history of depression. ADHD and harm avoidance (HA) were associated with persistence of depressive symptoms, while trauma and a family history of depression predicted a transitory course. Conclusion: Different risk factors may operate during onset and persistence of subthreshold mania and depression. The differential associations found for mania and depression dimensions suggest partly different underlying mechanisms.

PMID: 20199490 [PubMed - as supplied by publisher]

[Bipolar disorders as co-morbidity in childhood and adolescence - underdiagnosed or overinterpreted? Therapy of a 14-year-old boy with Hyperkinetic Conduct Disorder and hypomania.]

Z Kinder Jugendpsychiatr Psychother. 2010 Mar;38(2):123-30

Authors: Rothermel B, Poustka L, Banaschewski T, Becker K

Objective: Considerable debate exists regarding differing prevalence rates of co-morbid bipolar disorder in children and adolescents with ADHD in Germany as compared to the US. Methods: Described in this case report are the assessment of and treatment procedure for a 14-year old boy with hyperkinetic conduct disorder and co-morbid hypomanic episode, as well as different possible interpretations of symptoms. Conclusions: Further studies of children and adolescents with ADHD and coexisting impulsive-aggressive behaviour are needed. Important in practice is a precise differentiation of symptoms with regard to co-morbid bipolar disorder.

PMID: 20200829 [PubMed - in process]

Functional polymorphism of matrix metalloproteinase-9 (MMP-9) gene in alcohol dependence: Family and case control study.

Brain Res. 2010 Feb 27;

Authors: Samochowiec A, Grzywacz A, Kaczmarek L, Bienkowski P, Samochowiec J, Mierzejewski P, Preuss UW, Grochans E, Ciechanowicz A

AIM: Matrix metalloproteinases (MMP) are extracellularly acting endopeptidases, whose substrates are extracellular matrix and adhesion proteins. In the gene polymorphism studies MMP-9 has been suggested to be involved in the pathogenesis of heart disease, cancer, bipolar disorder, and schizophrenia. In animal models MMP-9 has been shown to play a key role in a variety of neuronal plasticity phenomena, including learning and memory as well as drug addiction. METHOD: We studied 139 families, Caucasians, with no history of psychiatric disorder of ICD-10 other than alcohol or nicotine dependence. The control subjects were 136 unrelated individuals, matched for ethnicity and gender, with no mental disorder. Alcohol and family history of alcoholism were assessed by means of a structured interview, based on the Polish version of SSAGA (Semi-Structured Assessment on Genetics in Alcoholism). RESULTS: We found a statistically significant preferential transmission of the T allele (known to produce higher gene transcriptional activity) from parents to alcoholics (59%, p=0.046). In case-control study genotype TT and T alleles were significantly more frequent in the alcoholics than in the controls (OR=2.6). CONCLUSION: Our results suggest that the MMP-9 gene may play a role in the pathogenesis of alcohol dependence.

PMID: 20197064 [PubMed - as supplied by publisher]

Screening for bipolar disorder during pregnancy and the postpartum period.

Arch Womens Ment Health. 2010 Mar 3;

Authors: Chessick CA, Dimidjian S

Bipolar disorder is a significant mental health problem among perinatal women; however, little attention has been devoted to methods of screening for bipolar disorder during this phase of women's life cycle. There is a need for reliable and valid screening instruments for perinatal women. This paper presents a review of 11 self-report measures used to screen bipolar disorder in the general population and discusses their applicability to screening among perinatal women. Published psychometric data, including reliability, sensitivity, specificity, and positive predictive value of each self-report instrument, is presented and critiqued. We make recommendations for screening in clinical practice and highlights priorities for future research. The need for more research in this area is emphasized.

PMID: 20198393 [PubMed - as supplied by publisher]

Electroconvulsive therapy in a cochlear implant patient.

Otol Neurotol. 2010 Jan;31(1):64-6

Authors: Labadie RF, Clark NK, Cobb CM, Benningfield MM, Fuchs DC

OBJECTIVE: To report the first use of electroconvulsive therapy (ECT) in a patient with a cochlear implant (CI). STUDY DESIGN: Clinical Capsule Report. SETTING: University hospital. PATIENT:: A 17-year-old boy who underwent Nucleus 22 cochlear implantation in 1995 presented with delirious mania in 2009. Aggressive pharmacologic management was ineffective, and ECT was recommended due to the potentially lethal nature of his psychiatric illness. INTERVENTIONS: After careful consideration by a multidisciplinary team, unilateral ECT on the side opposite the CI without removal of the device was recommended. Electroconvulsive therapy was performed on hospital Days 20 and 21. Integrity testing of the CI was performed on hospital Day 38. MAIN OUTCOME MEASURES: Subjective and objective assessment of cochlear implant functioning and response to ECT. RESULTS: Electroconvulsive therapy was well tolerated and contributed to alleviation of presenting symptoms. The patient used his CI without subjective degradation of performance. Integrity testing of the CI after ECT confirmed proper functioning of the device. CONCLUSION: This is the first report of ECT in a patient with CI. Unilateral ECT was performed contralateral to the CI without subjective or objective decline in performance. This Clinical Report motivates further study regarding the use of ECT in CI patients.

PMID: 19816223 [PubMed - indexed for MEDLINE]