Bipolar spectrum: Relevant psychological and biological factors

The bipolar spectrum is a concept which bridges bipolar Ⅰ disorder and unipolar depression. As Kraepelin described, there may be continuity across mood disorders. If this is the case, why should we discriminate for drug choice? For example, it is generally accepted that mood stabilizers should be used for the bipolar spectrum, whereas antidepressants are for unipolar depression. If these disorders are diagnostically continuous, it is possible that the same drug could be effective in treating both bipolar Ⅰ disorder/spectrum and unipolar depression. To resolve this question, I would like to propose my hypothesis that there is an inflexion point which constitutes the boundary between the bipolar spectrum and unipolar depression. It is likely that this inflexion point consists of temperaments as, reportedly, there are many significant differences in the presence of various temperaments between the bipolar spectrum(bipolar Ⅱ, Ⅱ1/2 and Ⅳ) and unipolar depression. These findings suggest that temperaments could draw a boundary between the bipolar spectrum and unipolar depression. Moreover, it has been shown that certain temperaments may be associated with several biological factors and may be associated with drug response. As such, whilst the concept of the bipolar spectrum emphasizes continuity, it is the proposed inflexion point that discriminates drug responses between the bipolar spectrum and unipolar depression. At the moment, although hypothetical, I consider this idea worthy of further research.     

Antidepressants for bipolar disorder——A meta-analysis of randomized,double-blind,controlled trials

OBJECTIVE： To examine the efficacy and safety of short-term and long-term use of antidepres- sants in the treatment of bipolar disorder. DATA SOURCES： A literature search of randomized, double-blind, controlled trials published until December 2012 was performed using the PubMed, ISI Web of Science, Medline and Cochrane Central Register of Controlled Trials databases. The keywords ＂bipolar disorder, bipolar I disorder, bipolar II disorder, bipolar mania, bipolar depression, cyclothymia, mixed mania and depression, rapid cycling and bipolar disorder＂, AND ＂antidepressant agent, antidepressive agents second- generation, antidepressive agents tricyclic, monoamine oxidase inhibitor, noradrenaline uptake in- hibitor, serotonin uptake inhibitor, and tricyclic antidepressant agent＂ were used. The studies that were listed in the reference list of the published papers but were not retrieved in the above-mentioned databases were supplemented. STUDY SELECTION： Studies selected were double-blind randomized controlled trials assessing the efficacy and safety of antidepressants in patients with bipolar disorder. All participants were aged 18 years or older, and were diagnosed as having primary bipolar disorder. Antidepressants or antidepressants combined with mood stabilizers were used in experimental interventions. Placebos, mood stabilizers, antipsychotics and other antide pressants were used in the control interventions. Studies that were quasi-randomized studies, or used antidepressants in combination with antipsy- chotics in the experimental group were excluded. All analyses were conducted using Review Man- ager 5.1 provided by the Cochrane Collaboration.     

Grey matter volume abnormalities in patients with bipolar I depressive disorder and unipolar depressive disorder:a voxelbased morphometry study

Bipolar disorder and unipolar depressive disorder(UD) may be different in brain structure. In the present study,we performed voxel-based morphometry(VBM) to quantify the grey matter volumes in 23 patients with bipolar I depressive disorder(BP1) and 23 patients with UD,and 23 age-,gender-,and educationmatched healthy controls(HCs) using magnetic resonance imaging. We found that compared with the HC and UD groups,the BP1 group showed reduced grey matter volumes in the right inferior frontal gyrus and middle cingulate gyrus,while the UD group showed reduced volume in the right inferior frontal gyrus compared to HCs. In addition,correlation analyses revealed that the grey matter volumes of these regions were negatively correlated with the Hamilton depression rating scores. Taken together,the results of our study suggest that decreased grey matter volume of the right inferior frontal gyrus is a common abnormality in BP1 and UD,and decreasedgrey matter volume in the right middle cingulate gyrus may be specifi c to BP1.     

抑郁、焦虑对癫(癎)患者健康相关生存质量的影响

Objective To assess health-related quality of life and the mood disorder in adults with epilepsy,and to evaluate factors contributing to the quality of life.Methods Quality of life was measured by the Quality of Life in Epilepsy Inventory(QOLIE-31)and the World Health Organization Quality of Life Assessment-Bref(WHOQOL-BREF).Psychotic conditions were evaluated by Self-rating Depressive Scale (SDS)and Self-rating Anxious Seale(SAS).The multivariate analysis was used to assess the determinant factors.Results The study included 141 epilepsy patients in the teat group and 59 sex,age,and education matched normal controls. WHOQOL-BREF scores in the physical and psychological aspects were significantly lower in epilepsy patients(12.7 ±1.8 and 12.4±1.9,respectively)than those in the normal controls(15.1 ±2.3 and 13.9 ±1.9,respectively,t value were 11.75 and 8.625.both P<0.05).The survey reported that 57.4 % of the epilepsy patients suffered with depression.and 39.7 % anxiety.The patients with both anxiety and depression scored lower in all aspects in QOLIE survey except medical effect.Multivariate analysis showed that factors that effect the overall quality of life in order were anxiety.depression and disease duration.Conclusion Our results support that complications of anxiety and depression and long disease duration are key factors affecting the quality of life in epilepsy patients.     

抑郁、焦虑对癫(癎)患者健康相关生存质量的影响

Objective To assess health-related quality of life and the mood disorder in adults with epilepsy,and to evaluate factors contributing to the quality of life.Methods Quality of life was measured by the Quality of Life in Epilepsy Inventory(QOLIE-31)and the World Health Organization Quality of Life Assessment-Bref(WHOQOL-BREF).Psychotic conditions were evaluated by Self-rating Depressive Scale (SDS)and Self-rating Anxious Seale(SAS).The multivariate analysis was used to assess the determinant factors.Results The study included 141 epilepsy patients in the teat group and 59 sex,age,and education matched normal controls. WHOQOL-BREF scores in the physical and psychological aspects were significantly lower in epilepsy patients(12.7 ±1.8 and 12.4±1.9,respectively)than those in the normal controls(15.1 ±2.3 and 13.9 ±1.9,respectively,t value were 11.75 and 8.625.both P<0.05).The survey reported that 57.4 % of the epilepsy patients suffered with depression.and 39.7 % anxiety.The patients with both anxiety and depression scored lower in all aspects in QOLIE survey except medical effect.Multivariate analysis showed that factors that effect the overall quality of life in order were anxiety.depression and disease duration.Conclusion Our results support that complications of anxiety and depression and long disease duration are key factors affecting the quality of life in epilepsy patients.     

抑郁、焦虑对癫(癎)患者健康相关生存质量的影响

Objective To assess health-related quality of life and the mood disorder in adults with epilepsy,and to evaluate factors contributing to the quality of life.Methods Quality of life was measured by the Quality of Life in Epilepsy Inventory(QOLIE-31)and the World Health Organization Quality of Life Assessment-Bref(WHOQOL-BREF).Psychotic conditions were evaluated by Self-rating Depressive Scale (SDS)and Self-rating Anxious Seale(SAS).The multivariate analysis was used to assess the determinant factors.Results The study included 141 epilepsy patients in the teat group and 59 sex,age,and education matched normal controls. WHOQOL-BREF scores in the physical and psychological aspects were significantly lower in epilepsy patients(12.7 ±1.8 and 12.4±1.9,respectively)than those in the normal controls(15.1 ±2.3 and 13.9 ±1.9,respectively,t value were 11.75 and 8.625.both P<0.05).The survey reported that 57.4 % of the epilepsy patients suffered with depression.and 39.7 % anxiety.The patients with both anxiety and depression scored lower in all aspects in QOLIE survey except medical effect.Multivariate analysis showed that factors that effect the overall quality of life in order were anxiety.depression and disease duration.Conclusion Our results support that complications of anxiety and depression and long disease duration are key factors affecting the quality of life in epilepsy patients.     

抑郁、焦虑对癫(癎)患者健康相关生存质量的影响

Objective To assess health-related quality of life and the mood disorder in adults with epilepsy,and to evaluate factors contributing to the quality of life.Methods Quality of life was measured by the Quality of Life in Epilepsy Inventory(QOLIE-31)and the World Health Organization Quality of Life Assessment-Bref(WHOQOL-BREF).Psychotic conditions were evaluated by Self-rating Depressive Scale (SDS)and Self-rating Anxious Seale(SAS).The multivariate analysis was used to assess the determinant factors.Results The study included 141 epilepsy patients in the teat group and 59 sex,age,and education matched normal controls. WHOQOL-BREF scores in the physical and psychological aspects were significantly lower in epilepsy patients(12.7 ±1.8 and 12.4±1.9,respectively)than those in the normal controls(15.1 ±2.3 and 13.9 ±1.9,respectively,t value were 11.75 and 8.625.both P<0.05).The survey reported that 57.4 % of the epilepsy patients suffered with depression.and 39.7 % anxiety.The patients with both anxiety and depression scored lower in all aspects in QOLIE survey except medical effect.Multivariate analysis showed that factors that effect the overall quality of life in order were anxiety.depression and disease duration.Conclusion Our results support that complications of anxiety and depression and long disease duration are key factors affecting the quality of life in epilepsy patients.     

抑郁、焦虑对癫(癎)患者健康相关生存质量的影响

Objective To assess health-related quality of life and the mood disorder in adults with epilepsy,and to evaluate factors contributing to the quality of life.Methods Quality of life was measured by the Quality of Life in Epilepsy Inventory(QOLIE-31)and the World Health Organization Quality of Life Assessment-Bref(WHOQOL-BREF).Psychotic conditions were evaluated by Self-rating Depressive Scale (SDS)and Self-rating Anxious Seale(SAS).The multivariate analysis was used to assess the determinant factors.Results The study included 141 epilepsy patients in the teat group and 59 sex,age,and education matched normal controls. WHOQOL-BREF scores in the physical and psychological aspects were significantly lower in epilepsy patients(12.7 ±1.8 and 12.4±1.9,respectively)than those in the normal controls(15.1 ±2.3 and 13.9 ±1.9,respectively,t value were 11.75 and 8.625.both P<0.05).The survey reported that 57.4 % of the epilepsy patients suffered with depression.and 39.7 % anxiety.The patients with both anxiety and depression scored lower in all aspects in QOLIE survey except medical effect.Multivariate analysis showed that factors that effect the overall quality of life in order were anxiety.depression and disease duration.Conclusion Our results support that complications of anxiety and depression and long disease duration are key factors affecting the quality of life in epilepsy patients.     

抑郁、焦虑对癫(癎)患者健康相关生存质量的影响

Objective To assess health-related quality of life and the mood disorder in adults with epilepsy,and to evaluate factors contributing to the quality of life.Methods Quality of life was measured by the Quality of Life in Epilepsy Inventory(QOLIE-31)and the World Health Organization Quality of Life Assessment-Bref(WHOQOL-BREF).Psychotic conditions were evaluated by Self-rating Depressive Scale (SDS)and Self-rating Anxious Seale(SAS).The multivariate analysis was used to assess the determinant factors.Results The study included 141 epilepsy patients in the teat group and 59 sex,age,and education matched normal controls. WHOQOL-BREF scores in the physical and psychological aspects were significantly lower in epilepsy patients(12.7 ±1.8 and 12.4±1.9,respectively)than those in the normal controls(15.1 ±2.3 and 13.9 ±1.9,respectively,t value were 11.75 and 8.625.both P<0.05).The survey reported that 57.4 % of the epilepsy patients suffered with depression.and 39.7 % anxiety.The patients with both anxiety and depression scored lower in all aspects in QOLIE survey except medical effect.Multivariate analysis showed that factors that effect the overall quality of life in order were anxiety.depression and disease duration.Conclusion Our results support that complications of anxiety and depression and long disease duration are key factors affecting the quality of life in epilepsy patients.     

抑郁、焦虑对癫(癎)患者健康相关生存质量的影响

Objective To assess health-related quality of life and the mood disorder in adults with epilepsy,and to evaluate factors contributing to the quality of life.Methods Quality of life was measured by the Quality of Life in Epilepsy Inventory(QOLIE-31)and the World Health Organization Quality of Life Assessment-Bref(WHOQOL-BREF).Psychotic conditions were evaluated by Self-rating Depressive Scale (SDS)and Self-rating Anxious Seale(SAS).The multivariate analysis was used to assess the determinant factors.Results The study included 141 epilepsy patients in the teat group and 59 sex,age,and education matched normal controls. WHOQOL-BREF scores in the physical and psychological aspects were significantly lower in epilepsy patients(12.7 ±1.8 and 12.4±1.9,respectively)than those in the normal controls(15.1 ±2.3 and 13.9 ±1.9,respectively,t value were 11.75 and 8.625.both P<0.05).The survey reported that 57.4 % of the epilepsy patients suffered with depression.and 39.7 % anxiety.The patients with both anxiety and depression scored lower in all aspects in QOLIE survey except medical effect.Multivariate analysis showed that factors that effect the overall quality of life in order were anxiety.depression and disease duration.Conclusion Our results support that complications of anxiety and depression and long disease duration are key factors affecting the quality of life in epilepsy patients.     

抑郁障碍患者的关联性负变化研究

目的探索关联性负变化（ CNV）在抑郁障碍患者中的应用价值。方法应用事件相关电位工作站的相关检测技术，检测29例抑郁障碍患者（抑郁障碍组）和28名健康成人（正常对照组）的CNV。结果检查发现抑郁障碍组的CNV波形不规则， FZ和CZ部位的命令信号后负变化（PINV）复合波波幅低于正常对照组（P＜0.05），PZ部位的O波和E波潜伏期较正常对照组延长（ P＜0.05）。结论抑郁障碍患者的PINV复合波波幅及O波和E波潜伏期改变诸特点，对临床诊断有帮助，值得进一步研究。     

情感性障碍患者关联性负变改变初探

目的 探讨情感性障碍与正常成人在关联性负变(CNV)检测中的不同表现。方法 应用光和声两种成对刺激,对29例情感性障碍患者和22例正常成人的CNV作了检测。结果 躁狂相组患者波幅B增高,抑郁相组患者A-S＇_2面积缩小,并且躁狂相组波幅B较抑郁相组(单相)高,抑郁相单相组或双相组A-S＇_2面积均较躁狂相缩小。结论 CNV和指令信号后负变化等指标有助于鉴别躁狂相与抑郁相。     

精神分裂症患者的关联性负变异常变化及临床随访

目的了解精神分裂症患者关联性负变（ＣＮＶ）的特征以及治疗缓解后ＣＮＶ的变化。方法使用美国ＣＡ１０００型电生理仪及光、声两种成对刺激方法,对３１例精神分裂症患者（患者组）和３８名健康人（对照组）作ＣＮＶ测定,并对患者组中２５例作ＣＮＶ随访。结果患者组在潜伏期ＣＮＶ起点（Ａ点）及命令信号后负变化上延迟（Ｐ＜０．０１或＜０．０５）,命令信号前负相期待波面积小于对照组（Ｐ＜０．０１）。患者康复时的ＣＮＶ波形较发病期稳定,潜伏期Ａ点缩短（Ｐ＜０．０５）,波幅Ｂ增高（Ｐ＜０．０５）。结论精神分裂症患者的ＣＮＶ变化为状态标志。     

首发精神分裂症人面孔彩照诱发关联性负变的初步研究

目的 研究熟悉人和陌生人面孔彩色照片与短声组成不同的刺激序列诱发关联性负变(CNV)在精神分裂症中的应用.方法 应用中国广州三甲J-1脑电生理仪,检测30例首发精神分裂症患者和29名正常对照的CNV,进行横断面的病例对照研究.结果 精神分裂症组波形不规则.对照组A点潜伏期为(320±57)ms,精神分裂症组为(373±61)ms,精神分裂症患者CNV潜伏期A点延迟(t=4.59,P＝0.007),对照组波幅B(16±5)μV,精神分裂症组为(9±6)μV,精神分裂症患者波幅B降低(t=4.51,P＝0.008 ).结论 首发精神分裂症患者面孔照片诱发CNV A点潜伏期延迟,波幅B降低,CNV变化有待进一步探讨.     

抑郁症患者人脸照片诱发的关联性负变研究

目的研究抑郁症患者和健康人的人脸照片诱发的事件相关电位关联性负变（CNV）的特点。方法应用脑电生理仪和反应时间技术,检测38例抑郁症患者的CNV,并与30名健康对照的CNV进行比较。结果抑郁症组CNV主要为延迟型（44.74%）,健康对照主要为正常型（66.67%）,CNV分型有统计学差异（χ2=21.32,P〈0.01）。抑郁症组A点潜伏期为（380±63）ms,健康对照组为（323±59）ms,有统计学差异（t=3.81,P=0.01）;抑郁症组波幅B为（9±6）μV,健康对照组为（16±5）μV,有统计学差异（t=5.13,P〈0.01）。结论抑郁症患者的CNV波形不规则,潜伏期A点延迟,波幅B降低。     

人面孔照片诱发伴随负变化的初步研究

目的　研究熟悉和陌生人面照片与短声组成不同的刺激序列诱发伴随负变化（ＣＮＶ）。方法　２０ 名１８～２６ 岁大学生为志愿受试者,完成４ 轮试验,Ａ 轮：Ｓ１ 和Ｓ２ 均为１ ５００ Ｈｚ 短声;Ｂ轮：Ｓ１为短声,Ｓ２ 为熟悉或陌生照片;Ｃ轮：熟悉或陌生照片为Ｓ１,短声为Ｓ２;Ｄ轮：序列编排同Ｃ轮。Ａ、Ｂ、Ｃ轮令受试者看到或听到Ｓ１,当Ｓ２ 呈现时迅速按键,Ｄ轮令受试者辨别Ｓ１ 是熟悉还是陌生照片,当Ｓ２呈现时分别按相应的键。试验中同时记录ＥＥＧ,分析ＣＮＶ的上升潜伏期、峰波潜伏期、峰波幅和波面积。结果　Ｃ、Ｄ轮ＣＮＶ的峰波幅和波面积显著小于Ａ轮和Ｂ轮,上升潜伏期和峰潜伏期则显著长于后者。Ｄ轮有面孔辨识任务与无辨识任务的Ｃ轮相比,ＣＮＶ 波面积和峰波幅减小,潜伏期则延长,辨别熟悉者照片时,ＣＮＶ波面积和波幅显著小于辨别陌生照片时,潜伏期则延长。ＣＮＶ较小时潜伏期相应延长,其前出现较大的Ｐ３ 波。结论　研究结果提示,反应注意、记忆、期待和准备等心理活动的ＣＮＶ,受到面孔辨别任务的影响,揭示了“分心效应”和复杂任务时ＣＮＶ减小的实质,即可能受认知过程（认知电位Ｐ３） 的影响。     

A New Method of Evaluating the Postimperative Negative Variation (PINV)

Abstract: The PINV has been widely applied to psychiatric investigations in which the definition of its abnormality depended on the visual evaluation without giving attention to its wave form. We have developed a new method of evaluating the PINV by applying the exponential regression correlation to raw and smoothed PINVs for the amplitude of the 15 points at the intervals of 70 msec. The significant correlation between the PINV wave form and the exponential curve was observed both in the raw and smoothed PINVs. Coefficient A was positively correlated with the PINV duration quantified by a visual measurement. Coefficients A and B had the negative and positive correlation with the CNV magnitude. The, findings obtained in 28 healthy subjects suggest that the PINV may correlate to the CNV magnitude.     

Benign (nonparoxysmal) familial chorea of early onset: an electroneurophysiological examination of two families

A nonparoxysmal nonprogressive autosomal dominant choreatic disorder of early onset is described in two families. Laboratory investigations of blood, urine and cerebrospinal fluid were normal. Extensive electroneurophysiological examinations did not reveal evident abnormalities. The contingent negative variation was also normal, except for a P500. These electroneurophysiological data are the opposite of what can be found in cases of Huntington's chorea.     

Autosomal dominant paroxysmal kinesigenic choreoathetosis: An electroneurophysiological study

A case of an 11-year-old boy with an autosomal dominant form of paroxysmal kinesigenic choreoathetosis is presented. Routine EEG, sleep EEG recording, and registration of visual evoked potentials and somatosensory evoked potentials were normal. EEG with videomonitoring and registration of event-related potentials, however, showed abnormalities, which are discussed in detail. Our data provide further arguments in support of the hypothesis that paroxysmal kinesigenic choreoathetosis is the expression of a dysbalance in the cortico-striopallidal-thalamic loop, and has an extrapyramidal genesis.