A 2‐year naturalistic study on cognitive functioning in bipolar disorder

Arts B, Jabben N, Krabbendam L, van Os J. A 2‐year naturalistic study on cognitive functioning in bipolar disorder. Objective: Cognitive alterations in bipolar disorder may reflect genetic influence. However, to what degree mood, medication, thyroid function and other factors impact on longitudinal cognitive functioning remains unclear. Method: A group of patients with bipolar (spectrum) disorder (n = 76) underwent two monthly cognitive assessments over a 2‐year period in a prospective, repeated measures design. Regression models were used to investigate associations with predictors, corrected for multiple testing. Results: Patients with bipolar disorder performed worse than healthy controls (n = 61) on all cognitive domains tested. Effect sizes were small, with a maximum of −0.36 for sustained attention. However, cognitive performance varied substantially over the 2‐ year follow‐up, co‐varying with subjective cognitive complaints and impacting on functioning. Alterations in sustained attention and motor speed were the only impairments that were invariant over time. Predictors had very limited explanatory power on temporal variation in cognition. Use of second‐generation antipsychotics was associated with the largest negative effects on cognition, which were evident in the areas of motor speed and basic information processing (−0.35 < β < −0.5). Conclusion: Cognitive function in bipolar disorder varies significantly over time, largely independent of clinical factors. The temporal stability of sustained attention is the exception, suggesting it may represent a possible candidate intermediary phenotype.     

电灼术联合聚甲酚磺醛治疗化脓性肉芽肿疗效观察

目的:评价电灼术联合聚甲酚磺醛治疗化脓性肉芽肿的临床疗效。方法:选择77例化脓性肉芽肿患者电灼治疗,术后给予聚甲酚磺醛止血、抗感染。结果:手术时间1~10 min,出血量0~0.5 mL。随访3个月,一次性治愈74例(96.1%),显效3例(3.9%)。结论:电灼法联合聚甲酚磺醛治疗化脓性肉芽肿效果显著,手术时间短,操作简单易行,止血效果好。     

Bipolar disorder comorbidity in patients with a primary diagnosis of OCD

Objective: Bipolar disorder (BD) is considered to be a common comorbid condition in subjects with obsessive-compulsive disorder (OCD), but there is limited literature on the prevalence of BD and its clinical correlates in those with a primary diagnosis of OCD.

Methods: We studied the prevalence of BD in a sample of consecutively registered outpatients attending a specialty OCD clinic in India over a period of 13 months. One hundred and seventy-one patients with a primary diagnosis of OCD were assessed systematically using structured and semi-structured instruments.

Results: The prevalence of lifetime BD in OCD was 4%. The OCD?+?BD group had an episodic course of OCD and higher rate of lifetime suicide attempts.

Conclusions: BD may not be as highly prevalent in OCD as reported in literature. Those with OCD seem to have only a marginally higher risk for developing BD than the general population. A diagnosis of BD seems to have a pathoplastic effect on the course of OCD. Patients with OCD-BD comorbidity have to be specifically assessed for suicide risk.     

Psychiatric Drug Discovery and Development

This new conference on Psychiatric Drug Research was organised by the Strategic Research Institute and was chaired by P McGonigle (Wyeth Research, USA) and D Schoepp (Eli Lilly, USA). The 2-day meeting featured presentations from an international assembly of industrial and academic experts who have significantly contributed to the current body of knowledge in the field of psychotherapeutics. D Weinberger (NIMH, USA) gave an elegant keynote lecture on the application of genomics in psychopharmacology. Other presentations covered the latest technological advances, animal models and mechanistic approaches utilised in drug discovery for neuropsychiatric disorders and reviewed the current status of numerous novel targets resulting from these strategies.     

The Montgomery Asberg Depression Rating Scale in bipolar II and unipolar out-patients: A 405-patient case study

The aim of the present study was to find if the Montgomery Asberg Depression Rating Scale (MADRS) can identify symptom differences between bipolar II and unipolar depression. Four hundred and five consecutive bipolar II and unipolar depressed out-patients were interviewed with the Comprehensive Assessment of Symptoms and History structured interview, following DSM-IV criteria, the MADRS, and the Global Assessment of Functioning Scale. The Montgomery Asberg Depression Rating Scale items were not significantly different between bipolar II and unipolar patients. Comparisons among atypical and non-atypical bipolar II and unipolar patients showed that only MADRS items of 'reduced sleep' and 'reduced appetite' were significantly different between atypical and non-atypical patients.