The 40-Hz auditory steady-state response in bipolar disorder: A meta-analysis
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Magnetoencephalography
Bipolar I disorder
The diagnosis of bipolar disorder has received increasing attention during the past decade. Several research reports have suggested that bipolar disorder is under-recognized, and that many patients, particularly those with major depressive disorder, have, in fact, bipolar disorder. More recently, some reports have suggested that bipolar disorder is also overdiagnosed at times. There are several possible reasons for bipolar disorder overdiagnosis. In the present study, we examined whether secondary gain associated with receiving disability payments might be partially responsible for bipolar disorder overdiagnosis. A total of 82 psychiatric outpatients reported having been previously diagnosed with bipolar disorder, which was not confirmed when interviewed with the Structured Clinical Interview for DSM-IV. The percentage of patients receiving disability payments and the duration of disability payments were compared in these 82 patients and 528 patients who were not diagnosed with bipolar disorder. Compared with the patients who had never been diagnosed with bipolar disorder, the patients overdiagnosed with bipolar disorder were significantly more likely to have received disability payments at some point during the past 5 years, and were receiving disability payments for significantly more weeks. We conducted a regression analysis controlling for the number of lifetime diagnoses, and overdiagnosis of bipolar disorder was a significant predictor of disability status (OR = 3.8; 95% CI, 1.6–8.8). Thus, an unconfirmed diagnosis of bipolar disorder was significantly associated with receiving disability benefits.
Overdiagnosis
Bipolar I disorder
Bipolar II disorder
Spectrum disorder
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Abstract Although magnetoencephalography (MEG) and electroencephalography (EEG) have been available for decades, their relative merits are still debated. We examined regional differences in signal‐to‐noise‐ratios (SNRs) of cortical sources in MEG and EEG. Data from four subjects were used to simulate focal and extended sources located on the cortical surface reconstructed from high‐resolution magnetic resonance images. The SNR maps for MEG and EEG were found to be complementary. The SNR of deep sources was larger in EEG than in MEG, whereas the opposite was typically the case for superficial sources. Overall, the SNR maps were more uniform for EEG than for MEG. When using a noise model based on uniformly distributed random sources on the cortex, the SNR in MEG was found to be underestimated, compared with the maps obtained with noise estimated from actual recorded MEG and EEG data. With extended sources, the total area of cortex in which the SNR was higher in EEG than in MEG was larger than with focal sources. Clinically, SNR maps in a patient explained differential sensitivity of MEG and EEG in detecting epileptic activity. Our results emphasize the benefits of recording MEG and EEG simultaneously. Hum Brain Mapp 2009. © 2008 Wiley‐Liss, Inc.
Magnetoencephalography
EEG-fMRI
SIGNAL (programming language)
Brain mapping
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Objective To explore the clinical features and pharmacotherapy of outpatients with bipolar disorder.Methods Outpatients with bipolar disorder according to DSM-IV were included and were assessed with self-made questionnaires.Results ① Two hundred and three cases of patients were enrolled.Among which 163 cases(80.3%)were diagnosed as bipolar disorder Ⅰ and 40 cases(19.7%)bipolar disorder Ⅱ.② The most important medicine was mood-stabilizations(70.4%)and the second antipsychotic(63%).③ More cases with bipolar disorder Ⅰ were treated with mood-stabilizations,antipsychotic and benzodiazepines than ones with bipolar disorder Ⅱ.While more cases with bipolar disorder Ⅱ were treated with antidepressants than ones with bipolar disorder Ⅰ were.④ 72.4% patients were receiving two or more than two kinds of drugs.⑤80.5% bipolar disorder patients were in stable condition.Conclusion There were more outpatients with bipolar disorder Ⅰ than ones with bipolar disorder Ⅱ.Patients with bipolar disorder Ⅱ were easy to be missed.The present medications have been already accommodated with the guidelines of pharmacotherapy in bipolar disorder both in China and abroad.Many patients were receiving more than one drug.Most patients received good effects.
Pharmacotherapy
Bipolar I disorder
Bipolar II disorder
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Bipolar I disorder
Norepinephrine transporter
SNP
Bipolar II disorder
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Magnetoencephalography
Beta Rhythm
Alpha (finance)
EEG-fMRI
BETA (programming language)
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A growing body of evidence suggests that people with bipolar disorder are highly goal-oriented. Compared to other persons, they expend more effort to attain rewards and view goal pursuit as more important to their self-worth. Persons at risk for mania and those diagnosed with bipolar spectrum disorders have been shown to endorse highly ambitious life goals, such as becoming a multimillionaire or achieving fame. This study is the first examination of whether such elevated goals characterize persons diagnosed with bipolar I disorder. We also examined whether elevated ambitions predicted symptom change over time. Ninety-two persons with bipolar I disorder and 81 age- and sex-matched controls completed the Willingly Approached Set of Statistically Unlikely Pursuits, a measure of extremely high life ambitions. A subset of the bipolar participants completed a 3-month follow-up interview. Participants with bipolar disorder endorsed higher ambitions for popular fame than did controls; moreover, heightened ambitions for popular fame and financial success predicted increases in manic symptoms in those with bipolar disorder over the next three months. Discussion focuses on goal regulation in bipolar disorder.
Bipolar I disorder
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Objectives Analyses of seasonal variation of manic and depressive symptoms in bipolar disorder in retrospective studies examining admission data have yielded conflicting results. We examined seasonal variation of mood symptoms in a prospective cohort with long‐term follow‐up: the Collaborative Depression Study ( CDS ). Methods The CDS included participants from five academic centers with a prospective diagnosis of bipolar I or II disorder. The sample was limited to those who were followed for at least 10 years of annual or semi‐annual assessments. Time series analyses and autoregressive integrated moving average ( ARIMA ) models were used to assess seasonal patterns of manic and depressive symptoms. Results A total of 314 individuals were analyzed (bipolar I disorder, n = 202; bipolar II disorder, n = 112), with both disorders exhibiting the lowest frequency of depressive symptoms in summer and the highest around the winter solstice, though the winter peak in symptoms was statistically significant only with bipolar I disorder. Variation of manic symptoms was more pronounced in bipolar II disorder, with a significant peak in hypomanic symptomatology in the months surrounding the fall equinox. Conclusions Significant seasonal variation exists in bipolar disorder, with manic/hypomanic symptoms peaking around the fall equinox and depressive symptoms peaking in the months surrounding the winter solstice in bipolar I disorder.
Bipolar I disorder
Solstice
Bipolar II disorder
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Objectives The aim of the present study was to determine the rate of, and risk factors for, a change in diagnosis from major depressive disorder to bipolar disorder, and from bipolar II disorder to bipolar I disorder in pregnancy and postpartum. Methods Patients with a prior history of major depressive disorder or bipolar II disorder were recruited between 24 and 28 weeks' gestation and followed through to one year postpartum. Diagnostic interviews were conducted using the Structured Clinical Interview for DSM ‐ IV at study intake and repeated using the Mini‐International Psychiatric Interview at one, three, six, and 12 months after childbirth. Fisher's exact test was used to assess the association between various risk factors and diagnostic switch. Results A total of 146 participants completed the intake interview and at least one follow‐up interview postpartum. Of these, 92 were diagnosed with major depressive disorder and 54 with bipolar II disorder at intake. Six women (6.52%) experienced a diagnostic change from major depressive disorder to bipolar II disorder during the first six months after childbirth. There were no cases of switching to bipolar I disorder, but in one participant the diagnosis changed from bipolar II disorder to bipolar I disorder during the three months after childbirth. Bipolar switch was associated with a family history of bipolar disorder. Conclusions The postpartum period appears to be a time of high risk for a new onset of hypomania in women with major depressive disorder. Our rate of diagnostic switching to bipolar II disorder (6.52%) is at least 11‐ to 18‐fold higher than the rates of switching in similar studies conducted in both men and women.
Hypomania
Bipolar II disorder
Bipolar I disorder
Research Diagnostic Criteria
Spectrum disorder
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Bipolar II disorder
Bipolar I disorder
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Both magnetoencephalography and stereo-electroencephalography are used in presurgical epilepsy assessment, with contrasting advantages and limitations. It is not known whether simultaneous stereo-electroencephalography-magnetoencephalography recording confers an advantage over both individual modalities, in particular whether magnetoencephalography can provide spatial context to epileptiform activity seen on stereo-electroencephalography. Twenty-four adult and paediatric patients who underwent stereo-electroencephalography study for pre-surgical evaluation of drug-resistant focal epilepsy, were recorded using simultaneous stereo-electroencephalography-magnetoencephalography, of which 14 had abnormal interictal activity during recording. The 14 patients were divided into two groups; those with detected superficial (n = 7) and deep (n = 7) brain interictal activity. Interictal spikes were independently identified in stereo-electroencephalography and magnetoencephalography. Magnetoencephalography dipoles were derived using a distributed inverse method. There was no significant difference between stereo-electroencephalography and magnetoencephalography in detecting superficial spikes (P = 0.135) and stereo-electroencephalography was significantly better at detecting deep spikes (P = 0.002). Mean distance across patients between stereo-electroencephalography channel with highest average spike amplitude and magnetoencephalography dipole was 20.7 ± 4.4 mm. for superficial sources, and 17.8 ± 3.7 mm. for deep sources, even though for some of the latter (n = 4) no magnetoencephalography spikes were detected and magnetoencephalography dipole was fitted to a stereo-electroencephalography interictal activity triggered average. Removal of magnetoencephalography dipole was associated with 1 year seizure freedom in 6/7 patients with superficial source, and 5/6 patients with deep source. Although stereo-electroencephalography has greater sensitivity in identifying interictal activity from deeper sources, a magnetoencephalography source can be localized using stereo-electroencephalography information, thereby providing useful whole brain context to stereo-electroencephalography and potential role in epilepsy surgery planning.
Magnetoencephalography
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