No abstract

Within the limitations of the study, the results suggest that ongoing mood-stabilizing treatment may have a prophylactic effect against premenstrual symptom changes in women with treatment-responsive BD.

OBJECTIVES: We aimed to compare altered infl ammatory status between patients with bipolar manic and mixed episodes through neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and monocyte-tolymphocyte ratio (MLR) levels. BACKGROUND: NLR, PLR, and MLR are systemic infl ammation biomarkers that have recently studied in bipolar disorder (BD) manic and depressive episodes. Immunological biomarker signature of mixed episodes and MLR levels in BD have less been studied. DESIGN AND SETTING: Our study included 48 bipolar patients in a mood episode (28 manic, 20 mixed) and 32 controls. Study-specifi c form including sociodemographic and clinical variables with laboratory fi ndings were fi lled for all participants. METHODS: Red cell distribution width (RDW), mean platelet volume (MPV) neutrophil, lymphocyte and platelet count, NLR, PLR, and MLR were recorded. RESULTS: PLR and MLR were found signifi cantly higher in bipolar patients compared to controls while NLR and MLR were signifi cantly higher in manic patients than in mixed patients. RDW was found higher in mixed episode compared to controls. CONCLUSIONS: One can interpret these fi ndings as MLR would be considered as a novel state biomarker for bipolar mood episodes and greater infl ammatory activation may be involved in mania rather than mixed episode (Tab. 2, Fig. 1, Ref. 35).

The aim was to evaluate the clinical profile and effectiveness of ECT in women. A retrospective chart review was carried out to identify female patients who had received ECT during the period September 2013-February 2015. Details regarding their sociodemographic, clinical, and treatment data were extracted from these records for the present study. The total number of patients, admitted to our psychiatry inpatient clinic during the survey period, was 802. During this period, 26 (3.24 %) female patients received ECT. Patients who received ECT were mostly in age group of 25-44 years (76.9 %). Twenty percent of patients were in the postpartum period. Psychotic disorders (46.1 %) was the most common diagnosis for which ECT was used, followed by bipolar affective disorder, current episode manic (19.2 %). At the end of ECT courses, 70 % of the patients showed good response with a CGI-I of 1 or 2, and 30 % showed minimal response with a CGI-I score of 3. The most common side effects were post-ECT confusion (15.4 %) and prolonged seizure (11.5 %). This rate of prolonged seizure was higher the rates reported in the literature. The bronchospasm related with remifentanil, post-ECT bradycardia, hypertensive crisis and oligohydramnios were also reported in one case each. ECT is a safe and effective treatment option in women with severe psychiatric disorders and disorders in the perinatal/postpartum period are a major area of ECT use. The female gender may be a contributing factor for the higher rates of prolonged seizure.