New Ways to Classify Bipolar Disorders: Going from Categorical Groups to Symptom Clusters or Dimensions

Henry, Chantal; Étain, Bruno

doi:10.1007/s11920-010-0156-0

Cited by 51 publications

(39 citation statements)

References 49 publications

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“…BD with psychotic features has been suggested to be a subtype of BD [8] with specific personality characteristics; in the prodromal phase, increased energy/goal–directed activity was found more frequently in patients with subsequent psychotic BD than in patients with non-psychotic BD [9]. Psychotic symptoms have been associated with brain dopaminergic activity [10].…”

Section: Introductionmentioning

confidence: 99%

The Influence of the Val158Met Catechol-O-Methyltransferase Polymorphism on the Personality Traits of Bipolar Patients

Dávila¹,

Basterreche

Arrúe³

et al. 2013

PLoS ONE

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IntroductionCertain personality traits and genetic polymorphisms are contributing factors to bipolar disorder and its symptomatology, and in turn, this syndrome influences personality. The aim of the present study is to compare the personality traits of euthymic bipolar patients with healthy controls and to investigate the effect of the catechol-O-methyltransferase (COMT) Val158Met genotype on those traits. We recruited thirty seven bipolar I patients in euthymic state following a manic episode and thirty healthy controls and evaluated their personality by means of the Cloninger’s Temperament and Character Inventory (version TCI-R-140). We assessed the influence of the polymorphism Val158Met in the COMT gene on the personality of these patients. The patients scored higher than controls in harm avoidance (61.3±12.5 vs. 55.3±8.1) and self-transcendence (45.3±12.8 vs. 32.7±8.2) and scored lower than controls in self-directedness (68.8±13.3 vs. 79.3±8.1), cooperativeness (77.1±9.1 vs. 83.9±6.5) and persistence (60.4±15.1 vs. 67.1±8.9). The novelty seeking dimension associates with the Val158Met COMT genotype; patients with the low catabolic activity genotype, Met/Met, show a higher score than those with the high catabolic activity genotype, Val/Val.ConclusionsSuffering from bipolar disorder could have an impact on personality. A greater value in harm avoidance may be a genetic marker for a vulnerability to the development of a psychiatric disorder, but not bipolar disorder particularly, while a low value in persistence may characterize affective disorders or a subgroup of bipolar patients. The association between novelty seeking scores and COMT genotype may be linked with the role dopamine plays in the brain’s reward circuits.

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Section: Introductionmentioning

confidence: 99%

The Influence of the Val158Met Catechol-O-Methyltransferase Polymorphism on the Personality Traits of Bipolar Patients

Dávila¹,

Basterreche

Arrúe³

et al. 2013

PLoS ONE

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“…Previous research has focused on early versus late onset, but recent large multisite studies have identified three potential age at onset‐based subgroups with different clinical presentation, across different cultural settings and birth cohorts : i.e., early onset (mean age at onset ≈ 17 years), intermediate onset (mean age at onset ≈ 26 years), and late onset (mean age at onset ≈ 42 years). The characteristics of the disorder may vary with the age at onset , and those with an early onset appear as a separate subgroup with specific clinical manifestations including higher recurrence rates of mood episodes, more elevated episodes at least in BD‐I , more often depressive onsets , more suicide attempts , higher risk for comorbid borderline personality disorder , higher rates of psychotic symptoms , more frequent neurocognitive impairment , more BD‐I than BD‐II , and more often a family history of BD compared to patients with later onsets.…”

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confidence: 99%

Neurocognitive features in subgroups of bipolar disorder

et al. 2013

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ObjectiveTo examine which subgroups of DSM-IV bipolar disorder (BD) [BD type I (BD-I) or BD type II (BD-II), and subgroups based on history of psychosis, presenting polarity, and age at onset] differentiate best regarding neurocognitive measures.MethodsA total of 199 patients with BD were characterized by clinical and neurocognitive features. The distribution of subgroups in this sample was: BD-I, 64% and BD-II, 36%; 60% had a history of psychosis; 57% had depression as the presenting polarity; 61% had an early onset of BD, 25% had a mid onset, and 14% had a late onset. We used multivariate regression analyses to assess relationships between neurocognitive variables and clinical subgroups.ResultsBoth BD-I diagnosis and elevated presenting polarity were related to impairments in verbal memory, with elevated presenting polarity explaining more of the variance in this cognitive domain (22.5%). History of psychosis and BD-I diagnosis were both related to impairment in semantic fluency, with history of psychosis explaining more of the variance (11.6%).ConclusionPoor performance in verbal memory appears to be associated with an elevated presenting polarity, and poor performance in semantic fluency appears to be associated with a lifetime history of psychosis.

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“…In contrast, if ICD-11 and DSM-V introduce a dimensional diagnostic approach, as suggested by several authors [33,34], adjustment disorder will disappear from the psychiatric nomenclature. As a result, reactions to stressful life events could be described by using psychopathological syndrome scores for dimensions such as depression or anxiety.…”

Section: Discussionmentioning

confidence: 99%

Diagnosis of Adjustment Disorder: Reliability of Its Clinical Use and Long-Term Stability

Jäger¹,

Burger²,

Becker³

et al. 2012

Psychopathology

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Background: Adjustment disorder is a common diagnosis in mental health services. However, the diagnostic reliability and stability of this nosological construct are unclear. Sampling and Methods: Clinical chart records of patients who had been discharged with a clinical diagnosis of adjustment disorder were re-evaluated by two independent raters using ICD-10 criteria. On the basis of the chart material, the frequency of readmissions and diagnostic changes were recorded. Results: Of 142 patients with a clinical diagnosis of adjustment disorder, only 91 (64.1%) retrospectively met ICD-10 criteria for this diagnosis. Eighteen of these 91 patients (19.8%) were readmitted to a mental health hospital within a 5-year period and 9 (9.9%) showed a diagnostic change at readmission, 5 of them to substance use disorders (5.5%). Conclusions: The dramatic divergence between the clinical diagnosis and ICD-10 criteria challenges the validity and usefulness of the current nosological concept of adjustment disorder.

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New Ways to Classify Bipolar Disorders: Going from Categorical Groups to Symptom Clusters or Dimensions

Cited by 51 publications

References 49 publications

The Influence of the Val158Met Catechol-O-Methyltransferase Polymorphism on the Personality Traits of Bipolar Patients

The Influence of the Val158Met Catechol-O-Methyltransferase Polymorphism on the Personality Traits of Bipolar Patients

Neurocognitive features in subgroups of bipolar disorder

Diagnosis of Adjustment Disorder: Reliability of Its Clinical Use and Long-Term Stability

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