The use of topiramate in mood stabilization

OBJECTIVE: To review data on the effectiveness of topiramate as a mood stabilizer. DATA SOURCES: Clinical literature accessed through MEDLINE (1985-September 2001) and the manufacturer. Key search terms included topiramate, mania, mood stabilizer, and bipolar disorder. DATA SYNTHESIS: The traditional standard therapy for bipolar disorder has been lithium. Other mood stabilizers are increasingly being used to manage this complex disorder. Studies that used topiramate in bipolar disorders were evaluated. CONCLUSIONS: The present data from open trials suggest that topiramate may possibly possess antimanic properties. Controlled, double-blind studies are required to confirm this efficacy

Intentional forgetting in dysphoria:investigating the inhibitory effects of thought substitution using independent cues

Background Individuals with clinical and subclinical depression (dysphoria) exhibit problems intentionally forgetting unwanted memories on the think/no-think (TNT) paradigm (Anderson & Green, 2001). However, providing substitute words to think about instead of the to-be-forgotten targets can improve forgetting in depressed patients. Objectives To determine if thought substitution can enhance forgetting in dysphoric participants and to examine the potential mechanisms (blocking or inhibition) that might underpin successful forgetting. Methods Thirty-six dysphoric and 36 non-dysphoric participants learned neutral word-pairs and then practiced responding with the targets to some cues (think trials) and suppressing responses to others (no think trials). Half the participants were provided with substitute words to recall instead of the original targets (aided suppression) and half were simply told to avoid thinking about the targets (unaided suppression). Finally, participants completed two recall tests for the targets; one cued with the original probes and one with independent probes. Results Regardless of suppression condition (aided or unaided), dysphoric participants exhibited impaired forgetting, relative to their non-dysphoric counterparts, but only when cued with the original probes. Furthermore, higher depression scores were associated with poorer forgetting. In the aided condition, successful forgetting was observed on both the original and independent probe tasks, which supports the inhibitory account of thought substitution. Limitations Non-clinical status of the dysphoric participants was not confirmed using a validated measure. Conclusions Findings do not support the utility of thought substitution as a method of improving the forgetting in depressed participants, but do support the inhibition account of thought substitution.

Examining the impact of thought substitution on intentional forgetting in induced and naturally occurring dysphoria

Two experiments were conducted to determine if natural and induced dysphoria is associated with impaired forgetting and, whether a thought-substitution strategy would ameliorate any observed deficits. Study 1: 36 dysphoric & 36 non-dysphoric participants learnt a series of emotional word pairs. Participants were subsequently presented with some of the cues and were asked to recall the targets or prevent the targets from coming to mind. Half of the participants were provided with substitute words to recall instead of the original targets (aided suppression). At final memory testing, participants were asked to recall the targets to all cues. Dysphoric participants exhibited impaired forgetting, even when using a thought substitution strategy. Non-dysphoric participants, however, were able to use substitutes to suppress words. Study 2: 50 healthy participants initially completed the aided condition of the forgetting task. Participants were then given a positive or negative mood-induction, followed by another version of the forgetting task. Although all participants showed a forgetting effect prior to the mood-induction, only the positive group was successful at forgetting after the mood induction. Taken together, these findings do not support the utility of thought-substitution as an aid to forgetting in individuals in a naturally or induced dysphoric mood.

Buborékok és legendák. Válságok és válságmagyarázatok - II/1. rész. A Déltengeri Társaság (Bubbles and myths crises and explanations II/1.: the South Sea bubble)

A cikk a tulipánmániával foglalkozó tanulmány folytatása (Madarász [2009]). A Déltengeri Társaság 1720-as fellendülése és kipukkadása mindmáig egyike a pénzügyi történelem leghíresebb és leggyakrabban emlegetett buborékainak. A közgazdaságtanban a buborék sokáig nem volt fontos téma, de az utóbbi időben ismét divatba jött. A tanulmány először a buborékmetafora néhány irodalmi példáját mutatja be, majd összefoglalja az angol államadósság kialakulását, a korai modern fiskális-militarista állam létrejöttét és a pénzügyi forradalom különböző interpretációit. A Déltengeri Társaság történetének, az adósság-részvény csere lebonyolításának és a korabeli vélemények spektrumának ismertetése után áttekintést ad arról, milyen módon és céllal használták fel az 1720-as eseményeket közgazdászok és történészek saját magyarázataikban. Ezek skálája a tudatos csalástól a befektetők irracionális mániáján át a racionális buborék kialakulásáig terjed. / === / The first part of the study (published here in 2009) was devoted to "tulipmania". This article continues the account of early bubbles and crises with the 1720 boom and bust of the South Sea Company, which is to this day one of the best known and most cited examples in history. For several decades, bubbles were not seen as an important issue in economic and financial theory, but recent events have focused attention on them again. The author introduces some historical examples of the bubble metaphor in literature, before giving an account of the emergence of British public debt and the fiscal-military state, and summarizing various interpretations of the financial revolution. An account of the South Sea Bubble, a detailed description of the debt-equity swap, and citations from some contemporary investors and observers are followed by an overview of the way the events of 1720 were used subsequently by various economists and historians in their own theorizing and explanations. The interpretations placed on it range from deliberate fraud, through irrational investment mania, to the emergence of a rational bubble.

Buborékok és legendák. Válságok és válságmagyarázatok II/2. rész. A Déltengeri Társaság (Bubbles and myths crises and explanations II/2.: the South Sea bubble)

A cikk a tulipánmániával foglalkozó tanulmány folytatása (Madarász [2009]). A Déltengeri Társaság 1720-as fellendülése és kipukkadása mindmáig egyike a pénzügyi történelem leghíresebb és leggyakrabban emlegetett buborékainak. A közgazdaságtanban a buborék sokáig nem volt fontos téma, de az utóbbi időben ismét divatba jött. A tanulmány először a buborékmetafora néhány irodalmi példáját mutatja be, majd összefoglalja az angol államadósság kialakulását, a korai modern fiskális-militarista állam létrejöttét és a pénzügyi forradalom különböző interpretációit. A Déltengeri Társaság történetének, az adósság-részvény csere lebonyolításának és a korabeli vélemények spektrumának ismertetése után áttekintést ad arról, milyen módon és céllal használták fel az 1720-as eseményeket közgazdászok és történészek saját magyarázataikban. Ezek skálája a tudatos csalástól a befektetők irracionális mániáján át a racionális buborék kialakulásáig terjed. / === / The first part of the study (published here in 2009) was devoted to "tulip-mania". This article continues the account of early bubbles and crises with the 1720 boom and bust of the South Sea Company, which remains to this day one of the best known and most cited examples in history. For several decades, bubbles were not seen as an important issue in economic and financial theory, but recent events have focused attention on them again. The author introduces some historical examples of the bubble metaphor in literature, before describing the emergence of British public debt and the fiscal/military state, and summarizing various interpretations of the financial revolution. An account of the South Sea Bubble, a detailed description of the debt-equity swap, and citations from some contemporary investors and observers are followed by an overview of how the events of 1720 were used subsequently by various economists and historians in their theorizing and explanations. Such interpretations range from deliberate fraud, through irrational investment mania, to the emergence of a rational bubble.

Using the Big -Five personality factors in the Minnesota Multiphasic Personality Inventory, California Psychological Inventory, and Inwald Personality Inventory to predict police performance

The purpose of this study was to determine the degree to which the Big-Five personality taxonomy, as represented by the Minnesota Multiphasic Personality Inventory (MMPI), California Psychological Inventory (CPI), and Inwald Personality Inventory (IPI) scales, predicted a variety of police officer job performance criteria. Data were collected archivally for 270 sworn police officers from a large Southeastern municipality. Predictive data consisted of scores on the MMPI, CPI, and IPI scales as grouped in terms of the Big-Five factors. The overall score on the Wonderlic was included in order to assess criterion variance accounted for by cognitive ability. Additionally, a psychologist's overall rating of predicted job fit was utilized to assess the variance accounted for by a psychological interview. Criterion data consisted of supervisory ratings of overall job performance, State Examination scores, police academy grades, and termination. Based on the literature, it was hypothesized that officers who are higher on Extroversion, Conscientiousness, Agreeableness, Openness to Experience, and lower on Neuroticism, otherwise known as the Big-Five factors, would outperform their peers across a variety of job performance criteria. Additionally, it was hypothesized that police officers who are higher in cognitive ability and masculinity, and lower in mania would also outperform their counterparts. Results indicated that many of the Big-Five factors, namely, Neuroticism, Conscientiousness, Agreeableness, and Openness to Experience, were predictive of several of the job performance criteria. Such findings imply that the Big-Five is a useful predictor of police officer job performance. Study limitations and implications for future research are discussed. ^

From labelling to social aid for immigrants in the 21st Century

Migration is as old as humanity, but since the 1990s migration flows in Western Europe have led to societies that are not just multicultural but so-called «super-diverse». As a result, Western towns now have very complex social structures, with amongst others large amounts of small immigrant communities that are in constant change. In this paper we argue that for social workers to be able to offer adequate professional help to non-native residents in town, they will need balanced view of ‘culture’ and of the role culture plays in social aid. Culture is never static, but is continually changing. By teaching social workers about how to look at cultural backgrounds of immigrant groups and about the limitations of then role that culture plays in communication, they will be better equipped to provide adequate aid and will contribute to making various groups grow towards each other and to avoid people thinking in terms of ‘out-group-homogeneity’. Nowadays, inclusion is a priority in social work that almost every social worker supports. Social workers should have an open attitude to allow them to approach every individual as a unique person. They will see the other person as the person they are, and not as a part of a specific cultural group. Knowledge about the others makes them see the cultural heterogeneity in every group. The social sector, though, must be aware not to fall into the trap of the ‘inclusion mania’! This will cause the social deprivation of a particular group to be forgotten. An inclusive policy requires an inclusive society. Otherwise, this could result in even more deprivation of other groups, already discriminated against. Emancipation of deprived people demands a certain target-group policymaking. Categorized aid will raise efficiency of working with immigrants and of acknowledging the cultural identity of the non-natives group. It will also create the possibility to work on fighting social deprivation, in which most immigrants can be found.

A meditation on boredom: Re-appraising its value through introspective phenomenology

Boredom is almost universally regarded as a dysphoric mental state, characterised by features such as disengagement and low arousal. However, in certain quarters (e.g., Zen Buddhism), boredom is seen as potentially having great value and even importance. The current study sought to explore boredom through a case study involving introspective phenomenology. The author created conditions in which he would experience boredom for an hour, and recorded his experience in real-time using a variant of the Experiencing Sampling Method. The data were analysed using an adaptation of Interpretative Phenomenological Analysis. The results indicated that the state of boredom contained three main sources of value: (a) altered perception of time; (b) awakened curiosity about the environment; and (c) exploration of self. Consequently, the paper offers a re-appraisal of boredom, suggesting that rather than necessarily being a negative state, if engaged with, boredom has the potential to be a positive and rewarding experience.

Autistic and Schizotypal Traits and Global Functioning in Bipolar I Disorder

Objective: To determine the expression of autistic and positive schizotypal traits in a large sample of adults with bipolar I disorder (BD-I), and the effect of co-occurring autistic and positive schizotypal traits on global functioning in BD-I. Method: Autistic and positive schizotypal traits were self-assessed in 797 individuals with BD-I recruited by the Bipolar Disorder Research Network. Differences in global functioning (rated using the Global Assessment Scale) during lifetime worst depressive and manic episodes (GASD and GASM respectively) were calculated in groups with high/low autistic and positive schizotypal traits. Regression analyses assessed the interactive effect of autistic and positive schizotypal traits on global functioning. Results: 47.2% (CI=43.7-50.7%) showed clinically significant levels of autistic traits, and 23.22% (95% CI=20.29-26.14) showed clinically significant levels of positive schizotypal traits. In the worst episode of mania, the high autistic, high positive schizotypal group had better global functioning compared to the other groups. Individual differences analyses showed that high levels of co-occurring traits were associated with better global functioning in both mood states. Limitations: Autistic and schizotypal traits were assessed using self-rated questionnaires. Conclusions: Expression of autistic and schizotypal traits in adults with BD-I is prevalent, and may be important to predict illness aetiology, prognosis, and diagnostic practices in this population. Future work should focus on replicating these findings in independent samples, and on the biological and/or psychosocial mechanisms underlying better global functioning in those who have high levels of both autistic and positive schizotypal traits.

History of Premenstrual Mood Change and Postpartum Episodes are Associated with Perimenopausal Episodes in Women with Bipolar Disorder

Background and Aims: Reproductive life events are potential triggers of mood episodes in women with bipolar disorder. We aimed to establish whether a history of premenstrual mood change and postpartum episodes are associated with perimenopausal episodes in women who have bipolar disorder. Methods: Participants were 339 post-menopausal women with DSM-IV bipolar disorder recruited into the Bipolar Disorder Research Network (www.bdrn.org). Women self-reported presence (N = 200) or absence (N = 139) of an illness episode during the perimenopausal period. History of premenstrual mood change was measured using the self-report Premenstrual Symptoms Screening Tool (PSST), and history of postpartum episodes was measured via semi-structured interview (Schedules for Clinical Assessment in Neuropsychiatry, SCAN) and inspection of case-notes. Results: History of a postpartum episode within 6 months of delivery (OR = 2.13, p = 0.03) and history of moderate/severe premenstrual syndrome (OR = 6.33, p < 0.001) were significant predictors of the presence of a perimenopausal episode, even after controlling for demographic factors. When we narrowed the definition of premenstrual mood change to premenstrual dysphoric disorder, it remained significant (OR = 2.68, p = 0.007). Conclusions: Some women who have bipolar disorder may be particularly sensitive to reproductive life events. Previous mood episodes in relation to the female reproductive lifecycle may help clinicians predict individual risk for women with bipolar disorder approaching the menopause. There is a need for prospective longitudinal studies of women with bipolar disorder providing frequent contemporaneous ratings of their mood to overcome the limitations of retrospective self-report data.

Autistic and Schizotypal Traits and Global Functioning in Bipolar Disorder

Background and Aims To determine the expression of autistic and positive schizotypal traits in a large sample of adults with bipolar disorder (BD), and the effect of co-occurring autistic and positive schizotypal traits on global functioning in BD. Methods Autistic and positive schizotypal traits were assessed in 797 individuals with BD recruited by the Bipolar Disorder Research Network (BDRN), using the Autism-Spectrum Quotient and Kings Schizotypy Questionnaire (KSQ), respectively. Differences in global functioning (rated using the Global Assessment Scale) during lifetime worst depressive and manic episodes (GASD and GASM respectively) were calculated in groups with high/low autistic and positive schizotypal traits. Regression analyses assessed the interactive effect of autistic and positive schizotypal traits on global functioning. Results 47.2% (CI = 43.7–50.7%) showed clinically significant levels of autistic traits. Mean of sample on the KSQ-Positive scale was 11.98 (95% CI: 11.33–12.62). In the worst episode of mania, the high autistic, high positive schizotypal group had better global functioning than the low autistic, low positive schizotypal group (mean difference = 3.72, p = 0.004). High levels of co-occurring traits were associated with better global functioning in both mood states in individuals with a history of psychosis (GASM: p < 0.001; GASD: p = 0.055). Conclusions Expression of autistic and schizotypal traits in adults with BD is prevalent, and may be important to predict course of illness, prognosis, and in devising individualised therapies. Future work should focus on replicating these findings in independent samples, and on the biological and/or psychosocial mechanisms underlying better global functioning in those who have high levels of both autistic and positive schizotypal traits.

Age at the time of exposure to trauma modulates the psychopathological profile in early psychosis patients

Objective: To examine the potential differential impact of childhood trauma, according to the age at the time of exposure, on the psychopathological profile of patients with early psychosis treated in a specialized 3-year program during the early phase of the disease. Methods: 196 subjects with early psychosis aged 18-35 years were followed up prospectively over 36 months of treatment between 2004 and 2010. Patients who had faced at least 1 experience of abuse (physical, sexual, or emotional) or neglect (physical or emotional) were classified according to age at the time of the first exposure (early trauma: before 12 years of age; late trauma: from age 12 through 16 years) and then compared with unexposed patients (nontrauma). The level of symptoms was assessed using the Positive and Negative Syndrome Scale, the Young Mania Rating Scale, and the Montgomery-Asberg Depression Rating Scale. Results: Exposure to 1 or more forms of trauma before 16 years of age was present in 31.63% of patients. Comparisons over the 3 years of treatment with the nontrauma patients revealed that (1) patients with early trauma showed consistently higher levels of positive (P = .006), depressive (P = .001), manic (P = .006), and negative (P = .029) symptoms and (2) patients with late trauma showed only more negative symptoms (P = .029). Conclusions: These results suggest that the age at the time of exposure to trauma has a modulating effect on symptoms in patients with early psychosis. Various biological and psychological hypotheses can be proposed to explain this observation, and they need to be investigated in an experimental setting in order to develop therapeutic avenues.

O tratamento do doente bipolar na consulta de medicina dentária: um caso clínico

Dissertação para obtenção do grau de Mestre no Instituto Superior de Ciências da Saúde Egas Moniz

Prevalencia y factores asociados al trastorno disfórico premestrual en estudiantes del Colegio Nacional Manuela Garaicoa de Calderón, Cuenca 2015

ANTECEDENTES: El trastorno disfórico premenstrual (TDPM) es una afección en la cual la mujer que lo padece puede volverse lo suficientemente incapacitante para desempeñarse en su vida normal. Se basa en una combinación de síntomas somáticos y psíquicos que se presentan durante la fase lútea de la menstruación, afectando entre un 3 a un 8 % de las mujeres jóvenes iniciando en la adolescencia. (3)(18) OBJETIVO GENERAL: Determinar la Prevalencia y Factores asociados al Trastorno Disfórico Premenstrual en estudiantes del Colegio Manuela Garaicoa de Calderón, Cuenca 2015. METODOLOGÍA: Se realizó un estudio de tipo transversal. Área de estudio: Colegio Manuela Garaicoa de Calderón. Universo: 1703 estudiantes. Muestra: 440 estudiantes que se obtuvieron mediante el programa Epi Info 7, con un intervalo de confianza de 95%, con una frecuencia esperada más 3%, límite de confianza 5%, efectos del diseño 1%. La selección de la muestra se obtuvo del programa Epidat 3.1 mediante muestreo simple aleatorio. Para obtener los datos se aplicó una encuesta basada en los criterios del DSM V y sobre factores asociados. La tabulación de los datos se realizó en el programa SPSS versión 15.0. Para el análisis se utilizó frecuencias, porcentajes, razón de prevalencia, Índice de confianza al 95% y valor de p para determinar asociación estadística. Se elaboraron tablas de acuerdo a los objetivos, utilizando el programa Microsoft Excel 2010. RESULTADOS: Basado en los criterios del DSM V la prevalencia de Trastorno Disfórico Premenstrual encontrada fue de 8.41%. De los factores asociados estudiados se encontró que la herencia fue un factor de riesgo con una RP: 4.76 Valor de p: 0.02, la cual fue valorada subjetivamente. CONCLUSIONES: Las adolescentes con mayor riesgo de presentar TDPM en el colegio Manuela Garaicoa de Calderón son aquellas estudiantes que tienen relación en cuanto a herencia.

Bipolar disorder: a troubled diagnosis

Bipolar disorder is indeed a troubled diagnosis. Conceived from manic-depressive illness, bipolar disorder is a much narrower concept by virtue of the emphasis placed in modern psychiatric taxonomy on polarity rather than recurrence of mood episodes. At first, this "new diagnosis" floundered and received little attention, but once it established itself, it steadily gained interest throughout the "decade of the brain." By the beginning of the new millennium bipolar disorder was perfectly poised for a phenomenal expansion. Its rapid growth led to a proliferation of bipolar subtypes, each of which quickly gained disorder status, wrongly insinuating a disease entity. Prompted by the recent launch of DSM-5 and the imminent arrival of ICD-11, questions are being asked about this complex diagnosis, which has been so problematic, especially in children. This chapter discusses the evolution of bipolar disorder, in the hope that an understanding of its origins will shed light on why it remains such a troublesome diagnosis.