A case series on the hypothesized connection between dementia and bipolar spectrum disorders: Bipolar type VI?

Ng, Bernardo; Camacho, Álvaro Sicilia; Lara, Diogo R.; Brunstein, Miriam Garcia; Pinto, Olavo; Akiskal, Hagop S.

doi:10.1016/j.jad.2007.08.018

Cited by 68 publications

(71 citation statements)

References 32 publications

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“…Coexistence of temperaments or intrusion of a mood episode on a temperament of the opposite polarity also produces complex clinical manifestations and might lead to poor outcome. Often this poor outcome does not reflect inherent properties of the illness, but instead reflects the inability of the therapist to understand the illness and adequately plan treatment 72,[110][111][112][113][114][115][116][117]123,124,[129][130][131]133 . Temperament assessment could be especially helpful in understanding gender differences and planning treatment accordingly 128,136,140,141 .…”

Section: Discussionmentioning

confidence: 99%

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The Role of Temperament in the Etiopathogenesis of Bipolar Spectrum Illness

Fountoulakis

Gonda

Koufaki

et al. 2016

Harvard Review of Psychiatry

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Bipolar disorder constitutes a challenge for clinicians in everyday clinical practice. Our knowledge concerning this clinical entity is incomplete and contemporary classification systems are unable to reflect the complexity of this disorder.. The concept of temperament which for the first time was described during antiquity constitutes a reasonable vehicle to synthesize our knowledge on how the human body works and what determines human behavior. Although it originally included philosophical and sociocultural approaches, today the biomedical model is dominant. It is possible that specific temperaments might constitute vulnerability factors, determine the clinical picture or constitute illness course modifiers and even act as a bridge between genes and clinical manifestations, thus giving birth to the concept of the bipolar spectrum with major implications for all aspects of mental health research and providing of care. More specifically it has been reported that the hyperthymic and the depressive temperaments are related to the more 'classic' bipolar disorder, while cyclothymic, anxious and irritable temperaments are related to more complex manifestations and might predict poor response to treatment, violent or suicidal behavior and high comorbidity. It seems reasonable to assume that the incorporating of the concept of temperament and the bipolar spectrum in the standard training of psychiatric residents might result in an improvement of everyday clinical practice.3

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Section: Discussionmentioning

confidence: 99%

“…Today we know that this prototypical bipolar disorder (BD) corresponds only to bipolar type I (BD-I). A summary of BD types and their definitions is shown in table 1 [3][4][5] .…”

Section: Introductionmentioning

confidence: 99%

The Role of Temperament in the Etiopathogenesis of Bipolar Spectrum Illness

Fountoulakis

Gonda

Koufaki

et al. 2016

Harvard Review of Psychiatry

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“…Çalışmamızda, ailede psikiyatrik hastalık öyküsü-nün, geç başlangıçlı olan ve olmayan iki uçlu olgular arasında farklı bulunmaması; erken başlangıçlı olgularda sıklıkla bulunduğundan yola çıkarak, pozitif aile öyküsü-nün geç başlangıçlı olgularda daha nadir olabileceğini öngören Todd'un (23) düşüncesinden çok, öyle olmadı-ğını ileri süren Akiskal'ınkiyle (1) uyumludur (24). Kuşkusuz, aile öyküsünün, geç başlangıçlı olgular arasında farklı bir alt tip yordayanı olarak değerlendirilip değerlendirilemeyeceğini söyleyebilmek için, daha fazla hastayı içeren, geniş kapsamlı yeni çalışmalara ihtiyaç vardır.…”

Section: Discussionunclassified

Geç başlangıçlı olan ve olmayan iki uçlu bozukluk hastalarının karşılaştırılması / Comparison of bipolar patients with and without late onset

Kesebir¹,

Şayakçı²,

Süner³

2012

Dusunen Adam

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Kısa Araştırmalar / Brief Reports ÖZET Geç başlangıçlı olan ve olmayan iki uçlu bozukluk hastalarının karşılaştırılması Amaç: Bu çalışmanın amacı, geç başlangıçlı iki uçlu bozukluğu olan olguların, geç başlangıçlı olmayan olgulardan farklılaşıp farklılaşmadığının incelenmesidir. Yöntem: Bu çalışmada, DSM-IV ölçütlerine göre iki uçlu bozukluk tanılı ve polikliniğimizde izlenmekte olan 144 olgu değerlendirilmiştir. İki uçlu bozuklukta geç başlangıç sınırı olarak 40 yaş seçilmiştir. Geriye dönük olarak geç başlangıçlı olduğu saptanan 17 olgu, geç başlangıçlı olmayan 127 olgu ile karşılaştırılmıştır. Bulgular: Geç başlangıçlı olgularda psikotik bulgulu dönem, karma dönem, hızlı döngülülük, mevsimsellik ve antidepresan ile kayma daha sık, hipertimik mizaç puanları daha yüksek bulundu. Bedensel hastalık eştanısı geç başlangıçlı olgular arasında daha sıktı. Olguların %83'ünde hipertansiyon, %71'inde diyabet, %23'ünde ise serebrovasküler hastalık eştanısı belirlendi. Ailede bedensel hastalık öyküsü de geç başlangıçlı olgularda daha sıktı. Sonuç: İki uçlu bozuklukta başlangıç yaşı, farklı alttipleri belirlemede, hastalığın farklı klinik gidişlerini ve eştanıları öngörmede önemli bir belirleyici olarak değerlendirilmektedir. Özellikle, geç başlangıçlı olgularda daha sık bulunduğu saptanan vasküler patolojiler, bu olgularda dikkatle incelenmeli, ayrıntılı bir genel tıbbi durum değerlendirmesinin gerekliliği göz ardı edilmemelidir. Anahtar kelimeler: İki uçlu bozukluk, geç başlangıç, vasküler hastalık ABSTRACT Comparison of bipolar patients with and without late onsetObjective: The aim of this study was to find out if late onset bipolar patients were different from bipolar patients without late onset disorder. Methods: In this study, we evaluated 144 bipolar cases which met DSM IV diagnosis criteria. Our cut-off for late onset bipolar disorder was 40 years of age. Seventeen cases who were retrospectively determined as having late onset disease were compared with 127 non late onset cases. Results: Psychotic and mixed episodes, rapid cycling, seasonality and switch with antidepressants were more frequent and hyperthymic temperament scores were higher in patients with late onset disease. Comorbid diseases were more frequent in the late onset patient group: 83% had hypertension, 71% had diabetes mellitus and 23% had cerebrovascular disease. Family history for medical illness was more frequent among late onset patients also. Conclusions: In bipolar disorder, age of onset is accepted as an important marker in determining different subtypes and in predicting different clinical courses and comorbidity. Vascular pathologies which were determined more frequently, especially in late onset cases must be evaluated carefully and the necessity for a general medical examination must not be ignored.

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“…Βέβαια, υπάρχουν πολλά ερωτήματα τα οποία θα πρέπει να βρουν απαντήσεις: (α) Για πόσο χρονικό διάστημα θα πρέπει να συνεχιστεί η θεραπευτική παρέμβαση; (β) Σε ποιον βαθμό οι διάφορες θερα-πευτικές παρεμβάσεις γίνονται αποδεκτές από τους ασθενείς, την οικογένεια και το ευρύτερο κοινωνικό περιβάλλον; (γ) Με ποιον τρόπο θα αποφύγουμε τον στιγματισμό ατόμων που ενδεχομένως, ποτέ δεν θα μεταπέσουν σε ψύχωση; (δ) Υπάρχει δυνατότητα εντόπισης κλινικών ή/και βιολογικών παραγόντων που ενδεχομένως θα καθορίσουν τις ειδικές θερα-πευτικές παρεμβάσεις ή/και θα αποτρέψουν την εξέ-λιξη σε ψύχωση; 18,45,46,[66][67][68][69] In recent years an increasing number of studies focus on the issue of early diagnosis and intervention. At the same time, a large number of special service units for early psychosis have been established around the world especially in Australia, USA, UK, Germany etc.…”

Section: συμπεράσματα-προβληματισμοίunclassified

“…67 Η διαταραχή διάθεσης με όψιμη έ-ναρξη χαρακτηρίζεται από υπερθυμική, κυκλοθυμική και ευερέθιστη ιδιοσυγκρασία. 68 Συνοπτικά, η υπερθυμική ιδιοσυγκρασία σχετίζεται με ευφορία, μεγαλομανία και παρανοϊκό ιδεασμό, αντι-κοινωνική συμπεριφορά, αυξημένη ενέργεια και μειω-μένη ανάγκη ύπνου, καθώς και μεγαλύτερη συχνότητα μανιακών επεισοδίων και νοσηλειών. Η κυκλοθυμική ιδιοσυγκρασία συνδέεται με διπολική διαταραχή ΙΙ, διαταραχή πανικού, αγοραφοβία και διαταραχή κοινω-νικού άγχους, μη ψυχωτικά μικτά επεισόδια και αυτο-κτονικότητα.…”

Section: Hagop Akiskal 1998unclassified

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Psychiatriki

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A case series on the hypothesized connection between dementia and bipolar spectrum disorders: Bipolar type VI?

Cited by 68 publications

References 32 publications

The Role of Temperament in the Etiopathogenesis of Bipolar Spectrum Illness

The Role of Temperament in the Etiopathogenesis of Bipolar Spectrum Illness

Geç başlangıçlı olan ve olmayan iki uçlu bozukluk hastalarının karşılaştırılması / Comparison of bipolar patients with and without late onset

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