Background. Research on mood disorders has progressively focused on the study of seasons and on the mood in association with them during depressive or manic episodes yet few studies have focused on the seasonal fluctuation that characterizes the patient's clinical course both during an illness episode and during euthymic periods. Methods. 113 euthymic outpatients 46 affected by major recurrent depression and 67 affected by bipolar disorder were recruited. We evaluated the impact of clinical &#x201c;rhythmical&#x201d; factors: seasonality, sleep disturbance, and chronotype. Patients completed the SPAQ<svg style="vertical-align:-0.51414pt;width:10.825px;" id="M1" height="9.3125" version="1.1" viewBox="0 0 10.825 9.3125" width="10.825" xmlns="http://www.w3.org/2000/svg">
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</svg> questionnaire, the MEQ questionnaire, and the medical outcomes study (MOS) sleep scale. We used t-test analyses to compare differences of clinical &#x201c;rhythmical&#x201d; and sociodemographic variables and of differences in the assessment scales among the diagnostic groups. Results. Patients reporting a family history for mood disorders have higher fluctuations throughout seasons. Sleep disturbance is more problematic in unipolars when compared to bipolars. Conclusions. Sleep, light, and seasonality seem to be three interconnected features that lie at the basis of chronobiology that, when altered, have an important effect both on the psychopathology and on the treatment of mood disorders.

Chiara Brambilla

Chiara Gavinelli

Dario Delmonte

Mara Cigala Fulgosi

Barbara Barbini

Cristina Colombo

Enrico Smeraldi

Seasonality and Sleep: A Clinical Study on Euthymic Mood Disorder Patients

The present study examined simultaneously the relations between cognitive reactivity to success and failure, on the one hand, and depression, manic, and bipolar tendencies, on the other hand. Participants (161 students) completed measures of success and failure reactivity, current manic and depressive symptoms, and tendencies towards depression, mania, and bipolarity. Results showed that respondents with a greater tendency towards depression evidenced greater (negative) reactivity to failure, whereas those with a greater tendency toward mania evidenced greater (positive) reactivity to success. Depression vulnerability was unrelated to success reactivity, and manic vulnerability was unrelated to failure reactivity. Tendencies toward bipolarity correlated significantly with both failure and success reactivity in a negative and positive manner, respectively. These findings add to the growing body of literature, suggesting that different features or cognitive tendencies are related to depression vulnerability versus manic vulnerability and imply that these &#8220;mirrored&#8221; cognitive features both form part of vulnerability to bipolar disorder.

Filip Raes

Ine Ghesqui&#232;re

Dinska Van Gucht

Cognitive Reactivity to Success and Failure Relate Uniquely to Manic and Depression Tendencies and Combine in Bipolar Tendencies

Background. Despite controversy, bipolar disorder (BD) is being increasingly diagnosed in under 18s. There is scant information regarding its treatment and uncertainty regarding the status of “severe mood dysregulation (SMD)” and how it overlaps with BD. This article collates available research on treatment of BD in under 18s and explores the status of SMD. Methods. Literature on treatment of BD in under 18s and on SMD were identified using major search engines; these were then collated and reviewed. Results. Some markers have been proposed to differentiate BD from disruptive behaviour disorders (DBD) in children. Pharmacotherapy restricted to short-term trials of mood-stabilizers and atypical-antipsychotics show mixed results. Data on maintenance treatment and non-pharmacological interventions are scant. It is unclear whether SMD is an independent disorder or an early manifestation of another disorder. Conclusions. Valproate, lithium, risperidone, olanzapine, aripiprazole and quetiapine remain first line treatments for acute episodes in the under 18s with BD. Their efficacy in maintenance treatment remains unclear. There is no validated treatment for SMD. It is likely that some children who are currently diagnosed with BD and DBD and possibly most children currently diagnosed with SMD will be subsumed under the proposed category in the DSM V of disruptive mood dysregulation disorder with dysphoria.

Rajeev Jairam

Mukesh Prabhuswamy

Pravin Dullur

Do We Really Know How to Treat a Child with Bipolar Disorder or One with Severe Mood Dysregulation? Is There a Magic Bullet?

The present study evaluated mitochondrial respiratory chain and creatine kinase activities after administration of harmine (5, 10, and 15&#x2009;mg/kg) and imipramine (10, 20, and 30&#x2009;mg/kg) in rat brain. After acute treatment occurred an increase of creatine kinase in the prefrontal with imipramine (20 and 30&#x2009;mg/kg) and harmine in all doses, in the striatum with imipramine (20 and 30&#x2009;mg/kg) and harmine (5 and 10&#x2009;mg/kg); harmine (15&#x2009;mg/kg) decreased creatine kinase. In the chronic treatment occurred an increase of creatine kinase with imipramine (20&#x2009;mg/kg), harmine (5&#x2009;mg/kg) in the prefrontal with imipramine (20 and 30&#x2009;mg/kg) and harmine (5 and 10&#x2009;mg/kg) in the striatum. In the acute treatment, the complex I increased in the prefrontal with harmine (15&#x2009;mg/kg) and in the striatum with harmine (10&#x2009;mg/kg); the complex II decreased with imipramine (20 and 30&#x2009;mg/kg) in the striatum; the complex IV increased with imipramine (30&#x2009;mg/kg) in the striatum. In the chronic treatment, the complex I increased with harmine (5&#x2009;mg/kg) in the prefrontal; the complex II increased with imipramine (20&#x2009;mg/kg) in the prefrontal; the complex IV increased with harmine (5&#x2009;mg/kg) in the striatum. Finally, these findings further support the hypothesis that harmine and imipramine could be involved in mitochondrial function.

Gislaine Z. R&#xe9;us

Roberto B. Stringari

Cinara L. Gon&#xe7;alves

Giselli Scaini

Milena Carvalho-Silva

Gabriela C. Jeremias

Isabela C. Jeremias

Gabriela K. Ferreira

Emílio L. Streck

Jaime E. Hallak

Antônio W. Zuardi

Jos&#xe9; A. Crippa

Jo&#xe3;o Quevedo

Administration of Harmine and Imipramine Alters Creatine Kinase and Mitochondrial Respiratory Chain Activities in the Rat Brain

Previous research on functional outcome in bipolar disorder (BD) has uncovered various factors that exacerbate psychosocial disability over the course of illness, including genetics, illness severity, stress, anxiety, and cognitive impairment. This paper presents an integrated view of these findings that accounts for the precipitous decline in psychosocial functioning after illness onset. The proposed model highlights a number of reciprocal pathways among previously studied factors that trap people in a powerful cycle of ailing forces. The paper discusses implications to patient care as well as the larger social changes required for shifting the functional trajectory of people with BD from psychosocial decline to growth.

Boaz Levy

Emily Manove

Functional Outcome in Bipolar Disorder: The Big Picture

Bipolar depression is often refractory to treatment and is frequently associated with anxiety symptoms and elevated suicide risk. There is a great need for adjunctive psychotherapeutic interventions. Treatments with effectiveness for depressive and anxiety symptoms as well as suicide-related thoughts and behaviors would be particularly beneficial. Mindfulness-based interventions hold promise, and studies of these approaches for bipolar disorder are warranted. The aim of this paper is to provide a conceptual background for such studies by reviewing key findings from diverse lines of investigation. Results of that review indicate that cortical midline structures (CMS) appear to link abnormal self-referential thinking to emotional dysregulation in mood disorders. Furthermore, CMS and striatal dysfunction may play a role in the neuropathology underlying suicide-related thoughts and behaviors. Thus, combining studies of mindfulness interventions targeting abnormal self-referential thinking with functional imaging of CMS and striatal function may help delineate the neurobiological mechanisms of action of these treatments.

William R. Marchand

Self-Referential Thinking, Suicide, and Function of the Cortical Midline Structures and Striatum in Mood Disorders: Possible Implications for Treatment Studies of Mindfulness-Based Interventions for Bipolar Depression

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Depression Research and Treatment publishes original research articles and review articles related to all aspects of depression

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Depression Research and Treatment publishes original research articles and review articles related to all aspects of depression

Depression Research and Treatment