Search

Environmental variables can regulate behavior in healthy subjects. Recently, some authors investigated the role of meteorological variables in bipolar patients with an impact on both the onset and course of bipolar disorder (BD). The aim of this study was to investigate the impact of meteorological variables and other indexes in bipolar hospitalized patients. We examined all patients admitted to the Psychiatric Inpatient Unit of San Luigi Gonzaga Hospital, Orbassano (Turin, Italy) from September 2013 to August 2015, collecting several socio-demographic and clinical characteristics. Seven hundred and thirty patients were included. Compared to the day of admission of control individuals, patients with BD were admitted on a day that presented higher minimum, medium, and maximum temperature, higher maximum humidity, higher solar radiation, and higher hours of sunshine. After logistic regression analysis, admissions to the emergency psychiatric ward due to a primary diagnosis of BD were associated with maximum temperature and solar radiation. The current study provides a novel perspective on the question surrounding seasonal mood patterns in patients with BD. A greater awareness of all possible precipitating factors is needed to inform self-management and psycho-educational programs as well as to improve resilience regarding affective recurrences in the clinical practice.

Major affective conditions including both unipolar (UD) and bipolar disorders (BD) are associated with significant disability throughout the life course. We aimed to investigate the most relevant socio-demographic/clinical differences between UD and BD subjects. Our sample included 180 inpatients, of which 82 (45.5%) participants were diagnosed with UD and 98 (54.5%) with BD. Relative to UD patients, BD individuals were more likely to report prior psychoactive medications, lifetime psychotic symptoms, nicotine abuse, a reduced ability to provide to their needs, gambling behavior, and fewer nonsuicidal self-harm episodes. Moreover, BD patients were more likely to report severe side effects related to medications, a younger age at illness onset and first hospitalization, higher illness episodes, and longer illness duration in years than UD subjects. In a multivariate logistic analysis accounting for age, gender, and socio-demographic characteristics, a significant positive contribution to bipolarity was found only for higher lifetime psychotic symptoms (β = 1.178; p ≤ .05) and number of illness episodes (β = .155; p ≤ .05). The present findings suggest that specific clinical factors may be used in order to better distinguish between UD and BD subgroups. Further studies are required to replicate these findings in larger samples., (Copyright © 2018 Elsevier B.V. All rights reserved.)

Introduction: Sensory processing patterns have been proposed as a stable dimension able to characterize individuals with major affective disorders, but to what extent specific impairments in sensory processing may be involved in the pathophysiology of these conditions is poorly understood. We aimed to explore which sensory profiles may better respond to psychoactive medications, with particular regard to antidepressants, according to depression, alexithymia, and hopelessness levels., Methods: A total of 402 outpatients who received maintenance treatment and were in stable psychopathological conditions were recruited and completed the Adolescent/Adult Sensory Profile (AASP), Toronto Alexithymia Scale (TAS-20), second version of the Beck Depression Inventory (BDI-II), and Beck Hopelessness Scale (BHS) according to a longitudinal prospective study design including three time points of measurements., Results: Subjects with abnormally reduced sensory seeking, hypersensitivity, enhanced sensory avoidance, and lower ability to register information better responded to antidepressant medications according to their reduced depression levels. Similarly, participants with lower registration better responded to antidepressants as reported by lower hopelessness levels. Regression analyses revealed that the use of antidepressants was the first variable able to predict depression, hopelessness, and alexithymia levels at baseline, and after three and six months of treatment, respectively, but the pattern of sensory sensitivity contribute to the prediction of depression and hopelessness. This pattern together with low registration predicted changes in alexithymia levels., Limitations: The study was limited by the modest sample size at the follow-up assessment points., Discussion: Exploring sensory processing patterns may provide intriguing insights into specific illness characteristics and treatment response., (Copyright © 2018. Published by Elsevier B.V.)

Purpose: Affective temperaments, hopelessness, alexithymia, and anxiety/agitation symptoms may play a significant role in the psychopathological characteristics of bipolar disorder (BD). Here, we aimed to investigate the eventual association between the mentioned explanatory variables and anxiety/agitation symptoms in BD., Materials and Methods: We recruited at the Section of Psychiatry, Department of Neuroscience, University of Genoa (Italy), 92 BD inpatients having a mean age of 52 (±13.8) years. Participants were assessed using specific psychometric instruments. Anxiety/agitation symptoms have been evaluated using the 11-item of the Beck Depression Inventory II (BDI-II)., Results: Overall, 53.8% of participants presented with anxiety/agitation symptoms and 46.2% without. The two groups significantly differed about socio-economic status, lifetime psychotic symptoms, and residual depressive symptoms between episodes. Anxiety/agitation symptoms significantly correlated with irritable affective temperament (r = 0.407; p = .01), hopelessness (r = 0.541; p ≤ .001), difficulty identifying feelings (r = 0.440; p ≤ .001), difficulty describing feelings (r = 0.437; p ≤ .001), and externally oriented-thinking (r = 0.393; p ≤ .001). After multivariate analyses, irritable affective temperament (OR = 2.457, p ≤ .01) and less lifetime psychotic symptoms (OR = 0.007, p ≤ .05) remained the only significant variables associated with anxiety/agitation symptoms., Conclusions: The generalization of the main findings is limited by the small sample size and cross-sectional study design. Nevertheless, our results suggest that the careful assessment of affective temperaments and psychotic symptoms may help to early identify BD patients suffering from anxiety/agitation symptoms and may allow to perform targeted interventions in the clinical practice.

Introduction: Extreme sensory processing patterns may contribute to the pathophysiology of major affective disorders. We aimed to examine whether significant correlations exist between sensory profiles, hypomania, self-reported depression, and hopelessness and whether sensory profiles may be potential mediators of the association between hypomania and depression/hopelessness., Methods: The sample consisted of 488 euthymic affective disorder patients of which 283 diagnosed with unipolar and 162 with bipolar disorder with an age ranging from 18 to 65 years (mean = 47.82 ± 11.67)., Results: Lower registration of sensory input and sensory sensitivity significantly correlated with elevated self-reported depression, hopelessness, and irritable/risk-taking hypomania while sensation seeking and avoiding significantly correlated with elevated depression and hopelessness but not with irritable/risk-taking hypomania. Moreover, individuals with lower ability to register sensory input and higher hypomania showed higher self-reported depression than those with good registration of sensory information. According to SEM analyses, there was both a direct/indirect effect of irritable/risk-taking on depression-hopelessness with the mediation model explaining 48% of the variance in depression-hopelessness., Limitations: The relatively small sample size and the cross-sectional nature of the study design do not allow the generalization of the main findings., Conclusion: Low registration was associated with enhanced depressed mood and hopelessness while sensory seeking may be considered a resilient factor., (Copyright © 2017 Elsevier B.V. All rights reserved.)

Introduction: The involvement of extreme sensory processing patterns, impulsivity, alexithymia, and hopelessness was hypothesized to contribute to the complex pathophysiology of major depression and bipolar disorder. However, the nature of the relation between these variables has not been thoroughly investigated., Aims: This study aimed to explore the association between extreme sensory processing patterns, impulsivity, alexithymia, depression, and hopelessness., Methods: We recruited 281 euthymic participants (mean age=47.4±12.1) of which 62.3% with unipolar major depression and 37.7% with bipolar disorder. All participants completed the Adolescent/Adult Sensory Profile (AASP), Toronto Alexithymia Scale (TAS-20), second version of the Beck Depression Inventory (BDI-II), Barratt Impulsivity Scale (BIS), and Beck Hopelessness Scale (BHS)., Results: Lower registration of sensory input showed a significant correlation with depression, impulsivity, attentional/motor impulsivity, and alexithymia. It was significantly more frequent among participants with elevated hopelessness, and accounted for 22% of the variance in depression severity, 15% in greater impulsivity, 36% in alexithymia, and 3% in hopelessness. Elevated sensory seeking correlated with enhanced motor impulsivity and decreased non-planning impulsivity. Higher sensory sensitivity and sensory avoiding correlated with depression, impulsivity, and alexithymia., Limitations: The study was limited by the relatively small sample size and cross-sectional nature of the study. Furthermore, only self-report measures that may be potentially biased by social desirability were used., Conclusion: Extreme sensory processing patterns, impulsivity, alexithymia, depression, and hopelessness may show a characteristic pattern in patients with major affective disorders. The careful assessment of sensory profiles may help in developing targeted interventions and improve functional/adaptive strategies., (Copyright © 2016 Elsevier B.V. All rights reserved.)

Introduction: Differential characteristics related to first illness episode in bipolar disorder (BD) have been identified based on the current literature; however, evidence are currently inconsistent across studies. Objectives: Thus, this study aimed to identify whether first depressive episode (FDE) was associated with specific clinical correlates in a large sample of BD outpatients. Methods: The sample included 364 euthymic bipolar outpatients (mean age= 53.9±16.05) of which 229 (62.9%) with FDE and 135 (37.1%) with first non-depressive episode (FNDE). A detailed data collection was performed and illness histories were retraced through clinical files and lifetime computerized medical records. Results: Compared to patients with FNDE, those with FDE significantly differ regarding age (p ≤.001), educational level (p ≤.05), working status (p ≤.01), and body mass index (p ≤.05). They were also more likely to have a older age at illness onset (p ≤.005) and first treatment (p≤.001), recent melancholic characteristics (p≤.05) and more lifetime suicide attempts (p ≤.05), use of non psychiatric medications in the past (p ≤.05), and have experienced a recent manic episode (p ≤.05). After logistic regression analysis adjusting for age, educational level, and working status, FDE was associated with recent melancholic features (OR≤.065, p≤.01), and lifetime suicide attempts (OR≤8.334, p≤.05). Conclusions: The identification of early targets for treatment may be very useful in the stratification of different BD phenotypes in the clinical practice. The presence of FDE seems to identify a specific subgroup of BD outpatients exhibiting differential clinical characteristics. [ABSTRACT FROM AUTHOR]