Assessment of social cognition in bipolar disorder

Background: Impairment in social cognition may contribute to deficits in social functioning in patients with bipolar disorder (BD). In this study, a complex social cognition task was administered during a neuroimaging session. The behavioral and neural correlates of social cogniton in patients with BD were compared to healthy comparison (HC) subjects. Methods: The task was administered to 25 HC and 25 patients with depression scores ranging from euthymic to depressed at the time of assessment. The task required participants to evaluate situations that were “enhancing” or “threatening” to self-esteem, directed at both oneself, and at other people. For instance, self-esteem enhancing scenarios involved vignettes of activities such as receiving praise during a sports game, while a threatening scenario involved, for example, receiving criticism at a party. Participants were then required to evaluate characters in the scenarios on the basis of positive (“kind”) or negative (“mean”) descriptors. Evaluations were classified from extremely negative to extremely positive. The frequencies of behavioral responses were analyzed using chi-square tests and fMRI data were analyzed using Statistical Parametric Mapping software. Results: Patients differed significantly from HCs in their evaluation of threatening scenarios, directed at both oneself and at other people (p<0.001). Patients had a lower proportion of responses in the neutral category, and more responses in the positive and negative categories, relative to HCs. Neuroimaging results reveal differential patterns of prefrontal-cortical and limbic-subcortical activation in BDs throughout the task [p<0.05 (unc.)]. Conclusions: Findings will contribute to understanding difficulty in interpersonal functioning in patients with BD.

Internet use by patients with bipolar disorder:results from an international multisite survey

There is considerable international interest in online education of patients with bipolar disorder, yet little understanding of how patients use the Internet and other sources to seek information. 1171 patients with bipolar disorder diagnosis in 17 countries completed a paper-based, anonymous survey. 81% of the patients used the Internet, a percentage similar to the general public. Older age, less education, and challenges in country telecommunications infrastructure and demographics decreased the odds of using the Internet. About 78% of the Internet users looked online for information on bipolar disorder or 63% of the total sample. More years of education in relation to the country mean, and feeling very confident about managing life decreased the odds of seeking information on bipolar disorder online, while having attended support groups increased the odds. Patients who looked online for information on bipolar disorder consulted medical professionals plus a mean of 2.3 other information sources such as books, physician handouts, and others with bipolar disorder. Patients not using the Internet consulted medical professionals plus a mean of 1.6 other information sources. The percentage of patients with bipolar disorder who use the Internet is about the same as the general public. Other information sources remain important.

Trastorno de estrés postraumático y crecimiento postraumático en niños y adolescentes afectados por el terremoto del año 2016 en Chile

Se estima que los niños y adolescentes se encuentran entre las personas más vulnerables a los efectos negativos de los desastres naturales. Los estudios de seguimiento de cohortes muestran que entre el 25% y el 60% de los niños ha sufrido un evento traumático significativo antes de llegar a la adultez. Siendo una de las mayores consecuencias, la sintomatología de Trastorno de Estrés postraumático (TEPT), (Osofsky et al., 2009; Yelland et al., 2010). Otra de las respuestas que puede surgir frente a la adversidad, es el Crecimiento Postraumático (CPT), el cual alude a un cambio positivo como resultado de un proceso de lucha a partir de un suceso traumático (Calhoun & Tedeschi, 1999; Cryder et al., 2006; Kilmer, 2009). Este estudio examina la sintomatología de Trastorno de Estrés Postraumático y Crecimiento Postraumático en niños y adolescentes expuestos a un terremoto (uno de los diez más grandes del mundo) y tsunami ocurrido en Chile el año 2010, respecto a un grupo de comparación, 12 meses y 24 meses después del desastre...

Velocidad de anticipación y trastorno por déficit de atención e hiperactividad

Resulta innegable que la conducción de vehículos constituye, en sí, el ejercicio de una actividad multitarea compleja. De manera tal que, quien quisiera ejecutarla, deberá poseer determinadas aptitudes psíquicas y físicas que aseguren, en todo momento, el mantenimiento de óptimas condiciones de seguridad. Por un lado, los datos de investigación, así como las estadísticas de siniestralidad vial, indican que son varios factores los que inclinan la balanza hacia una mayor propensión de conductas de riesgo en la conducción por parte de los adolescentes: la combinación de inmadurez e inexperiencia, no utilizar el cinturón de seguridad, acelerar o conducir demasiado rápido, el alto consumo de tecnología mientras conducen, etc. Por otro lado, la distracción y la inatención son factores humanos concurrentes en los accidentes de tráfico. Se ha considerado abordar la distracción y la inatención como aspectos continuos e inherentes a la persona bajo el Trastorno por Déficit de Atención e Hiperactividad (TDAH). Catalogado como un trastorno que se manifiesta por presentar dificultades crónicas para mantener la concentración (déficit de atención), sobre todo en circunstancias que ofrecen baja estimulación, y la falta de inhibición/control sobre los impulsos asociada con frecuencia a inquietud motora (impulsividad-hiperactividad) y que interfieren, visiblemente, en el desarrollo del individuo y, con un papel muy notorio, en los ámbitos clínico, social, asistencial, académico y, por supuesto, seguridad vial. Apenas se conoce la sensibilidad/capacidad de la prueba psicotécnica, velocidad de anticipación, utilizada en los Centros de Reconocimiento de Conductores para la obtención o renovación del carné de conducir en España, como instrumento para detectar sujetos con TDAH. El objetivo del presente estudio es comparar el desempeño en la prueba psicotécnica que mide la velocidad de anticipación, a través del Test KCC, en una muestra de 173 sujetos, niños y adolescentes, de ambos sexos, entre los 7 y 16 años con y sin TDAH y, si otras variables, como el sexo, la edad, el índice de reflexividad/impulsividad (a través del Test de Stroop) y el potencial de aprendizaje (medido con el Test TONI-2) también influyen. Los resultados obtenidos muestran que no existen diferencias estadísticamente significativas entre niños y adolescentes con o sin TDAH para las variables de velocidad de anticipación, edad, sexo e índice de reflexividad/impulsividad. Sin embargo, si se encontraron diferencias estadísticamente significativas en relación al potencial de aprendizaje (CI) y la medida, velocidad de anticipación. Se recomienda efectuar estudios confirmatorios e investigaciones que repliquen y evalúen estas variables.

Online information seeking by patients with bipolar disorder:results from an international multisite survey

Background: Information seeking is an important coping mechanism for dealing with chronic illness. Despite a growing number of mental health websites, there is little understanding of how patients with bipolar disorder use the Internet to seek information. Methods: A 39 question, paper-based, anonymous survey, translated into 12 languages, was completed by 1222 patients in 17 countries as a convenience sample between March 2014 and January 2016. All patients had a diagnosis of bipolar disorder from a psychiatrist. Data were analyzed using descriptive statistics and generalized estimating equations to account for correlated data. Results: 976 (81 % of 1212 valid responses) of the patients used the Internet, and of these 750 (77 %) looked for information on bipolar disorder. When looking online for information, 89 % used a computer rather than a smartphone, and 79 % started with a general search engine. The primary reasons for searching were drug side effects (51 %), to learn anonymously (43 %), and for help coping (39 %). About 1/3 rated their search skills as expert, and 2/3 as basic or intermediate. 59 % preferred a website on mental illness and 33 % preferred Wikipedia. Only 20 % read or participated in online support groups. Most patients (62 %) searched a couple times a year. Online information seeking helped about 2/3 to cope (41 % of the entire sample). About 2/3 did not discuss Internet findings with their doctor. Conclusion: Online information seeking helps many patients to cope although alternative information sources remain important. Most patients do not discuss Internet findings with their doctor, and concern remains about the quality of online information especially related to prescription drugs. Patients may not rate search skills accurately, and may not understand limitations of online privacy. More patient education about online information searching is needed and physicians should recommend a few high quality websites.

Differential activation in temporal, cingulate and prefrontal cortices during response inhibition in bipolar disorder

Background: Increased impulsivity and aberrant response inhibition have been observed in bipolar disorder (BD). This study examined the functional abnormalities and underlying neural processes during response inhibition in BD, and its relationship to impulsivity. Methods: We assessed impulsivity using the Barratt Impulsiveness Scale (BIS) and, using functional magnetic resonance imaging (fMRI), measured neural activity in response to an Affective Go-NoGo Task, consisting of emotional facial stimuli (fear, happy, anger faces) and non-emotional control stimuli (neutral female and male faces) in euthymic BD (n=23) and healthy individuals (HI; n=25). Results: BD patients were significantly more impulsive, yet did not differ from HI on accuracy or reaction time on the emotional go/no-go task. Comparing neural patterns of activation when processing emotional Go versus emotional NoGo trials yielded increased activation in BD within temporal and cingulate cortices and within prefrontal-cortical regions in HI. Furthermore, higher BIS scores for BD were associated with slower reaction times, and indicative of compensatory cognitive strategies to counter increased impulsivity. Conclusions: These findings illustrate cognition-emotion interference in BD and the observed differences in neural activation indicate potentially altered emotion modulation. Increased activation in brain regions previously shown in emotion regulation and response inhibition tasks could represent a disease-specific marker for BD

Polymer Light-Emitting Electrochemical Cells with Embedded Bipolar Electrodes: Visualizing Bipolar Electrochemistry in Solid State

The work presented in this thesis examines the properties of BPEs of various configurations and under different operating conditions in a large planar LEC system. Detailed analysis of time-lapsed fluorescence images allows us to calculate the doping propagation speed from the BPEs. By introducing a linear array of BPEs or dispersed ITO particles, multiple light-emitting junctions or a bulk homojunction have been demonstrated. In conclusion, it has been observed that both applied bias voltages and sizes of BPEs affected the electrochemical doping from the BPE. If the applied bias voltage was initially not sufficiently high enough, a delay in appearance of doping from the BPE would take place. Experiments of parallel BPEs with different sizes (large, medium, small) demonstrate that the potential difference across the BPEs has played a vital role in doping initiation. Also, the p-doping propagation distance from medium-sized BPE has displayed an exponential growth over the time-span of 70 seconds. Experiments with a linear array of BPEs with the same size demonstrate that the doping propagation speed of each floating BPE was the same regardless of its position between the driving electrodes. Probing experiments under high driving voltages further demonstrated the potential of having a much more efficient light emission from an LEC with multiple BPEs.

Terapia de aceptación y compromiso en un caso de tras¬torno mixto de ansiedad y depresión en una paciente con cáncer

This paper introduces the case of a woman with breast cancer who had developed a mixed depressive-anxiety disorder with avoidance behaviors. The patient presented depressive symptoms like listlessness, insomnia, weeping, food disorders and hopelessness though. Also, she exhibited physiological arousal and restlessness feelings. Additionally, the patient had an avoidance patron behavior in relation with all stimulus she believed could hurt her. Based on the Acceptance and Commitment Therapy (ACT) the intervention planted the following objectives: the patient will learn to accept her illness and the emotional distress that she was experiencing, also, the patient will recover the other areas of her life that she had abandoned. The treatment was developed in 14 sessions. The therapist used these techniques: creative hopelessness, disabling verbal functions, values clarification and loss of control over private events. In the results, it was observed a positive change in the behavior of the patient as well as a decrease in emotional distress that was his reason for initial consultation

Resolving conflict in bipolar societies: The fate of political settlements in Fiji and Northern Ireland

Ethnically divided societies that might be described as ‘balanced bicommunal’ (where there are two communities, each of which comes close to representing half of the population) pose a particular challenge to conventional principles of collective decision-making, and commonly threaten political stability. This article analyses the experience of two such societies – Northern Ireland and Fiji – with a view to exploring whether there are common processes in the route by which political stability has been pursued. We assess the manner in which a distinctive relationship with Great Britain and its political culture has interacted with local conditions to produce a highly competitive, bipolar party system. This leads to consideration of the devices that have been adopted in an effort to bridge the gap between the communities: the Fiji constitution as amended in 1997, and Northern Ireland’s Good Friday Agreement of 1998. We focus, in particular, on the use of unusual (preferential voting) formulas for the election of parliamentarians and of an inclusive principle in the selection of ministers, and consider the contribution of these institutional devices to the attainment of political stability. We find that, in both cases, the intervention of forces from outside the political system had a decisive impact, though in very different ways. In addition to being underpinned by solid institutional design, for political settlements to work effectively, some minimal level of trust between rival elites is required.

Transición a trastorno mental grave y consumo de sustancias en primeros episodios psicóticos

La fecha de publicación es la fecha de lectura

Adverse Childhood Life Events and Postpartum Psychosis in Bipolar Disorder

Background Women with bipolar disorder are at increased risk of postpartum psychosis. Adverse childhood life events have been associated with depression in the postpartum period, but have been little studied in relation to postpartum psychosis. In this study we investigated whether adverse childhood life events are associated with postpartum psychosis in a large sample of women with bipolar I disorder. Methods Participants were 432 parous women with DSM-IV bipolar I disorder recruited into the Bipolar Disorder Research Network (www.BDRN.org). Diagnoses and lifetime psychopathology, including perinatal episodes, were obtained via a semi-structured interview (Schedules for Clinical Assessment in Neuropsychiatry; Wing et al., 1990) and case-notes. Adverse childhood life events were assessed via self-report and case-notes, and compared between women with postpartum psychosis (n=208) and those without a lifetime history of perinatal mood episodes (n=224). Results There was no significant difference in the rate of any adverse childhood life event, including childhood sexual abuse, or in the total number of adverse childhood life events between women who experienced postpartum psychosis and those without a lifetime history of perinatal mood episodes, even after controlling for demographic and clinical differences between the groups. Limitations Adverse childhood life events were assessed in adulthood and therefore may be subject to recall errors. Conclusions We found no evidence for an association between adverse childhood life events and the occurrence of postpartum psychosis. Our data suggest that, unlike postpartum depression, childhood adversity does not play a significant role in the triggering of postpartum psychosis in women with bipolar disorder.

Medidas organizativas y educativas para facilitar la inclusión de estudiantes con trastorno del espectro autista en la universidad

La inclusión de las personas con necesidades específicas de apoyo educativo, relacionadas con los trastornos del espectro autista (TEA), en los centros educativos, se define bajo los principios de integración curricular, realizada sobre el mismo espacio regular. En la universidad existe actualmente un importante desarrollo normativo en base a la orientación psicopedagógica que trata de responder a la equidad de la educación de las personas con discapacidad, que acceden a realizar sus estudios de grado. Desde esta perspectiva, es necesario establecer los criterios básicos y las orientaciones educativas sobre los cuales ha de apoyarse el diseño de programas en el ámbito universitario. Esta investigación trata precisamente de responder a esta cuestión, con el objetivo principal de exponer las variables predictivas más significativas que faciliten las bases de dichos programas, así como establecer las pautas de intervención psicopedagógica correspondientes. En efecto, los resultados, hallados mediante un análisis de regresión lineal por pasos facilita la deducción de conclusiones acerca de la elaboración de un programa general de intervención, que luego tendría necesariamente que adaptarse a las necesidades particulares de cada situación.

El uso de la musicoterapia para la mejora de la comunicación de niños con Trastorno del Espectro Autista en Aulas Abiertas Especializadas

Los beneficios que aporta la musicoterapia en alumnos con Trastorno del Espectro Autista, han sido demostrados profusamente por los distintos autores, si bien carecemos de literatura suficiente sobre su utilización en las Aulas Abiertas Especializadas en colegios ordinarios (Aulas TEA). En este sentido, el objetivo del trabajo, ha consistido en analizar qué mejoras aporta la musicoterapia al desarrollo de la comunicación en los alumnos con Trastorno del Espectro Autista dentro de las Aulas Abiertas de los CEIPs de Castilla-La Mancha y la Comunidad Autónoma de Madrid. Para ello, se ha realizado una amplia revisión documental de fuentes de referencia y se ha entrevistado a los docentes responsables de las Aulas Abiertas Especializadas que utilizan actividades de musicoterapia como recurso en el aula. Se concluye el artículo manifestando, en primer lugar, la escasa integración de la musicoterapia en las aulas TEA (menos del 20% de los centros). En aquellas aulas que sí se programa con actividades de musicoterapia, los beneficios que ésta aporta se ven reflejados en un incremento claro de la intención comunicativa en los alumnos. Además, a la hora de planificar las actividades se tiene muy en cuenta conocer las preferencias y la historia musical del niño. No obstante, existen factores que impiden el aprovechamiento total de las posibilidades terapéuticas de la musicoterapia debido, especialmente a: a) una escasa formación del profesorado y b) un espacio inadecuado para poner en práctica una sesión de musicoterapia.

Prevalencia de alergias en niños entre 5 y 14 años con trastorno de déficit de atención e hiperactividad. Medellín, 2012

Las enfermedades alérgicas y el trastorno por déficit de atención son entidades frecuentes en la niñez. Alguno autores han sugerido una asociación entre estas. El objetivo de este trabajo es establecer la prevalencia de alergias en niños con déficit de atención y sus características clínicas y socio-demográficas en la consulta de neurología hecha por los autores.

Trastorno del espectro autista y función ejecutiva

Las alteraciones en la función ejecutiva, especialmente en flexibilidad cognoscitiva, planeación, control inhibitorio y memoria de trabajo constituyen un elemento cardinal dentro las manifestaciones del trastorno del espectro autista (TEA). El objetivo de este trabajo fue evaluar el desempeño de las pruebas de función ejecutiva en una población de pacientes con trastorno del espectro autista (TEA).