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ABSTRACT: BACKGROUND: Studies on mixed depression have been conducted so far on the basis of DSM-IV manic symptoms, i.e., a list of 7 symptoms which may provide limited information on the subsyndromal features associated with a full depressive episode. METHODS: As part of the EPIDEP National Multisite French Study of 493 consecutive DSM-IV major depressive patients evaluated in at least two semi-structured interviews 1 month apart, 102 (23.8%) were classified as mixed depressives (≥3 hypomanic symptoms), and 146 (34%) as pure depressives (0 hypomanic symptom), after exclusion of bipolar I patients; hypomanic symptoms were assessed with the Multiple Visual Analog Scales of Bipolarity (MVAS-BP, 26 items) of Ahearn-Carroll in a self assessment format. A narrower definition of mixed depression, resting on those MVAS-BP items referring to DSM-IV hypomanic symptoms was also tested, as a sensitivity analysis. RESULTS: Compared to pure depressives, mixed depressive patients had more psychotic symptoms, atypical features and suicide attempts during their index episode; their illness course was characterized by early age at onset, frequent episodes, rapid cycling, and comorbidities. Mixed depressive patients were more frequently bipolar with a family history of bipolar disorder, alcohol abuse, and suicide. A dose-response relationship was found between intradepression hypomania and several clinical features, including temperament measures. The following independent variables were associated with mixed depression: hyperthymic temperament, cyclothymic temperament, irritable temperament, and alcohol abuse. Using the narrower definition of mixed depression missed risk factors such as suicidality and comorbidities. LIMITATIONS: The following are the limitations of this study: retrospective design, recall bias, lack of sample homogeneity, no cross-validation of findings by hetero-evaluation of hypomanic symptoms. CONCLUSIONS: EPIDEP data showed the feasibility and face validity of self-assessment of intradepressive hypomania. They replicated previous findings on the severity and high suicidal risk of mixed depression profile. They confirmed, for mixed depression, that mixed states occur when mood episodes are superimposed upon temperaments of opposite polarity. They finally suggested that a definition of mixed depression only based on DSM-IV-TR hypomanic symptoms may not allow to identify the most unstable subforms of the entity.
Journal of affective disorders 07/2012; · 3.76 Impact Factor
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ABSTRACT: BackgroundKnowledge about psychopathologic presentations of mania in current clinical practice has to be refined in order to improve
diagnosis and treatment.
MethodsOne thousand ninety manic patients included in the French National Study EPIMAN-II Mille were submitted to a cluster analysis
on the basis of multiple variables related to the history of bipolar illness and symptoms of the current episode.
ResultsFour clusters were identified: “classic mania” (29.3% of patients) with less severe mania; “psychotic mania” (22.7%) with
psychotic symptoms, more severe mania, younger age and social impairment; “depressive mania” (30.4%) characterized by female
gender, suicide attempts, high number of previous episodes and residual symptoms; and “dual mania” (17.6%) characterized by
male gender, substance use, earlier onset and poor compliance. Patients groups also differed in manic symptoms, marital status,
stressors preceding illness onset, prior diagnoses, first episode polarity and temperamental characteristics.
LimitationsCross-sectional assessment of patients.
ConclusionsIn comparing our findings with those of four prior cluster analytic studies, we integrate clinical characteristics of mania
subtypes found in this very large representative French sample in contemporary practice, we suggest how such convergence of
data may help improve earlier recognition, differential response to different treatments, and prevention of these subtypes.
We finally suggest that such subtyping might provide clues to phenotype delineation suitable for pharmacogenetic investigations.
European Archives of Psychiatry and Clinical Neuroscience 04/2012; 258(8):497-504. · 3.49 Impact Factor
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ABSTRACT: In parallel to considerable progress in understanding and treatment of bipolarity and despite growing interest in old age psychiatry, late-onset bipolar illness (LOBI) has remained relatively understudied so far, probably in reason of its complexity. To update available data, a systematic review was conducted, focusing on the main issues addressed in literature in regard to this topic. In addition to data on epidemiology, clinical features and treatment, five main issues could be identified: LOBI as secondary disorder, LOBI as expression of a lower vulnerability to the disease, LOBI as subform of pseudodementia, LOBI as risk factor for developing dementia, and LOBI as bipolar type VI (bipolarity in the context of dementia like processes). Levels of available evidence were found to vary according to the addressed issue. Although the concept of bipolar type VI could be criticized for subsuming under one single heading all the four other issues, this concept may be of pragmatic value in helping clinicians to orientate both diagnosis process and treatment decisions. Among others, the question as to whether some forms of bipolar type VI could constitute a special risk factor for developing dementia deserves further investigation. More studies are also needed to better disentangle the effects of age at onset from those of age itself.
CNS Neuroscience & Therapeutics 06/2011; 18(3):208-13. · 4.44 Impact Factor
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Marc Adida,
Fabrice Jollant,
Luke Clark,
Nathalie Besnier,
Sébastien Guillaume, Arthur Kaladjian,
Pascale Mazzola-Pomietto,
Régine Jeanningros,
Guy M Goodwin,
Jean-Michel Azorin,
Philippe Courtet
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ABSTRACT: In bipolar disorder (BD), little is known about how deficits in neurocognitive functions such as decision-making are related to phase of illness. We predicted that manic, depressed, and euthymic bipolar patients (BPs) would display impaired decision-making, and we tested whether clinical characteristics could predict patients' decision-making performance.
Subjects (N = 317; age range: 18-65 years) including 167 BPs (45 manic and 32 depressed inpatients, and 90 euthymic outpatients) and 150 age-, IQ-, and gender-matched healthy control (HC) participants, were included within three university psychiatric hospitals using a cross-sectional design. The relationship between predictor variables and decision-making was assessed by one-step multivariate analysis. The main outcome measures were overall decision-making ability on the Iowa Gambling Task (IGT) and an index of sensitivity to punishment frequency.
Manic, depressed, and euthymic BPs selected significantly more cards from the risky decks than HCs (p < .001, p < .01, and p < .05, respectively), with no significant differences between the three BD groups. However, like HCs, BPs preferred decks that yielded infrequent penalties over those yielding frequent penalties. In multivariate analysis, decision-making impairment was significantly (p < .001) predicted by low level of education, high depressive scores, family history of BD, use of benzodiazepines, and nonuse of serotonin and norepinephrine reuptake inhibitor (SNRI) antidepressants.
BPs have a trait-related impairment in decision-making that does not vary across illness phase. However, some subtle differences between the BD groups in the individual deck analyses may point to subtle state influences on reinforcement mechanisms, in addition to a more fundamental trait impairment in risk-sensitive decision making.
Biological psychiatry 03/2011; 70(4):357-65. · 8.93 Impact Factor
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ABSTRACT: As only a few studies so far systematically reported on bipolar patients subtyped according to first-episode polarity, we took the opportunity of having at disposal a large sample of bipolar I patients to specify the characteristics of patients included in these subtypes, with a special focus on temperament and triggering events.
A total of 1089 consecutive DSM-IV bipolar I manic inpatients were subtyped in manic onset (MO), depressive onset (DO) and mixed onset (MXO), and assessed for demographic, illness course, clinical, psychometric, comorbidity and temperament characteristics.
The main characteristics of MO patients were a hyperthymic temperamental predisposition, a first episode triggered by substance abuse and an illness course with pure, severe and psychotic mania. In comparison, DO patients had more depressive temperaments, a first episode triggered by stress and alcohol, an illness course with more episodes, cyclicity, suicide attempts, anxious comorbidity and residual symptoms. Although sharing characteristics with either MO or DO, MXO patients had more mixed episodes and cyclothymic temperament.
The following are the limitations of this study: retrospective design, bias toward preferential enrolment of MO patients, and lack of information on the number and polarity of lifetime episodes.
Findings from this study tend to confirm most of the differences previously evidenced among patients subtyped according to first-episode polarity. Differences found in temperamental predisposition and illness onset triggering events are worth noting and may help target early preventive interventions as well as orientate the search for specific genetic risk factors.
Journal of affective disorders 03/2011; 129(1-3):39-46. · 3.76 Impact Factor
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ABSTRACT: Despite considerable progress in the pharmacological treatment of schizophrenia, unmet needs remain concerning refractory patients, as well as improvement of negative symptoms, cognition, quality of life, adherence and tolerability. Sertindole, a second-generation antipsychotic with high affinity for dopamine D₂, serotonin 5-HT₂(A), 5-HT₂(C), and α₁-adrenergic receptors, is the first phenylindole-derived antipsychotic agent.
Pharmacodynamics, pharmacokinetics, clinical efficacy, safety and cost-effectiveness of sertindole are covered based on a literature review (PubMed) from 1990 to 2010. Pivotal as well as supportive randomized controlled trials are reviewed along with observational and/or naturalistic safety studies.
This review of sertindole will allow the reader to determine the place for sertindole in the schizophrenia treatment landscape.
Studies conducted so far suggest a beneficial effect of sertindole on positive and negative symptoms as well as on cognition, relapse prevention and quality of life. There is also some evidence for the treatment of refractory patients. Sertindole induces moderate weight gain, with few extrapyramidal symptoms and metabolic changes. More head-to-head comparisons with other second-generation antipsychotics are, however, still needed as well as further clarification on cardiac safety.
Expert Opinion on Pharmacotherapy 12/2010; 11(18):3053-64. · 3.20 Impact Factor
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ABSTRACT: Studies on emotional biases towards threat-related stimuli in schizophrenia and bipolar disorder have provided, so far, inconsistent results. The aim of the present study was to investigate emotional interference in acute schizophrenic and manic patients and its clinical correlates by using a card version of the Emotional Stroop Task designed with neutral, paranoid, depressive and manic words.
Thirty paranoid schizophrenia patients, 30 manic patients and 60 healthy controls were compared on the Emotional Stroop Test. Response times (RT) were collected for each card. Interference indices were calculated by subtracting the RT for the neutral card from the RT for the depressive, paranoid and manic cards.
The schizophrenic and manic patient groups showed an increased interference effect when the emotional valence was relating to the disorder-specific psychopathology. In addition, the paranoid interference index correlated with positive symptoms in schizophrenic patients. By contrast, no correlation was evidenced between interference indices and mood symptoms in the manic group.
Among schizophrenic patients, paranoid interference might be a state-related emotional abnormality associated with persecutory delusions. In mania, we suggest that emotional biases towards depressive as well as manic information might be trait features of the emotional hyperreactivity involved in the vulnerability to bipolar disorder.
Psychopathology 10/2010; 44(1):1-11. · 1.82 Impact Factor
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ABSTRACT: To evaluate the impact of a pharmacoeducation module both on hospital stay and on clinical and functional state in a French patient population with schizophrenic and schizoaffective disorders.
After inclusion, 82 patients were randomly distributed in 2 groups, one group receiving the pharmacoeducation module and the other to be a control group. Data on the number of hospital stays and emergency visits, and the type of medication received, were compiled. Patients were evaluated with the Positive and Negative Syndrome Scale, Clinical Global Impression Scale, Barnes Akathisia Scale, Simpson-Angus Scale, Quality of Life Scale, and Global Assessment of Functioning; data were gathered at baseline, then each year for 2 years.
Among the 72 analyzed patients, those receiving pharmacoeducation had significantly lower total hospital stays, forced hospital stays, and emergency visits, compared with the control group patients. They also had more improvement in their symptomatology, autonomy, and quality of life. They presented less akathisia and less medication intake.
Pharmacoeducation can reduce the hospital stays of patients with schizophrenia and schizoaffective disorders, as well as improve their clinical and functional state, likely through better compliance.
Canadian journal of psychiatry. Revue canadienne de psychiatrie 05/2010; 55(5):329-37. · 2.42 Impact Factor
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ABSTRACT: Reduced inhibition has been demonstrated in both schizophrenic and bipolar patients through the findings of increased interference on the Stroop Colour-Word Task (SCWT) and increased emotional interference on specific versions of the Emotional Stroop Task (EST). Despite previous findings of enhanced interference in unaffected relatives of schizophrenic and bipolar patients, it remains unclear whether interference might be a candidate endophenotype to both disorders. Moreover, data regarding emotional interference in unaffected relatives are critically lacking. In the present study, we aimed to compare unaffected relatives of patients with schizophrenia (SZ-rel, N = 30) and bipolar disorder (BD-rel, N= 30) with normal controls (N = 60) when performing the SCWT and an EST designed with neutral, depressive, paranoid and manic words. SZ-rel exhibited greater interference effect on both the SCWT and the EST as compared to either BD-rel or normal controls. BD-rel, and by contrast to SZ-rel and controls, showed increased emotional interference effect on the EST that was specifically associated to the disease-related words. The findings support the hypothesis of different markers of vulnerability to schizophrenic and bipolar disorders; impairment in cognitive inhibition could characterize high-risk individuals for schizophrenia whereas an emotional bias towards mood-related information could be a trait marker of bipolar disease.
The World Journal of Biological Psychiatry 09/2009; 10(4 Pt 3):809-18. · 2.38 Impact Factor
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ABSTRACT: Despite numerous studies on the comorbidity of bipolar and anxiety disorders, there is no satisfactory psychopathological model for their overlap.
1,090 hospitalized patients meeting DSM-IV criteria for a manic episode of bipolar I disorder were subtyped according to the presence or not of lifetime anxiety comorbidity and assessed for demographic, illness course, clinical, associated condition, temperament, and treatment characteristics.
Lifetime anxiety comorbidity, defined as presence of at least one anxiety disorder in lifetime, was found in 27.2% (n = 297) of the sample. Compared to patients without such a comorbidity (n = 793), those who had it experienced a higher number of mood episodes and suicide attempts in the previous year, more stressors, organic disorders and less free intervals; furthermore, they showed more temperaments with depressive features and complex treatment. At study entry, they also experienced manic episodes with higher levels of depression, psychosis and hostility. The following independent variables were associated with lifetime anxiety comorbidity: higher scores on the Montgomery-Asberg Depression Rating Scale, depressive temperament, irritable temperament, higher scores on the Scale for the Assessment of Positive Symptoms, episodes without free intervals and at least one stressor before the index episode.
Factors associated with lifetime anxiety comorbidity in bipolar I patients may be integrated into a comprehensive diathesis-stress model emphasizing the role of irritable temperament as a source of mood instability and stress, and interacting with other temperamental characteristics to trigger the outbreak of both anxiety and bipolar symptoms.
Psychopathology 09/2009; 42(6):380-6. · 1.82 Impact Factor
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ABSTRACT: Neuroimaging studies of bipolar disorder (BD) have provided evidence of brain functional abnormalities during both the states of mania and remission. However, the differences in brain function between these two states are still poorly known. In the current study, we aimed to use a longitudinal design to examine the functional changes associated with symptomatic remission from mania within the brain network underlying motor response inhibition.
Using event-related functional magnetic resonance imaging (fMRI), 10 BD patients and 10 healthy subjects were imaged twice while performing a Go/NoGo task. Patients were in a manic state when they underwent the first scan and fully remitted during the second scan. A mixed-effect ANOVA was used to identify brain regions showing differences in activation change over time between the two groups.
The left amygdala was the only brain region to show a time-dependent change in activation that was significantly different between BD patients and healthy subjects. Further analyses revealed that this difference arose from the patient group, in which amygdala activation was decreased between mania and subsequent remission.
This finding suggests that a decrease in left amygdala responsiveness is a critical phenomenon associated with remission from mania. It emphasizes the relevance of longitudinal approaches for identifying neurofunctional modifications associated with mood changes in BD.
Bipolar Disorders 09/2009; 11(5):530-8. · 5.29 Impact Factor
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Olivier Blin,
Christine Audebert,
Séverine Pitel, Arthur Kaladjian,
Catherine Casse-Perrot,
Mohammed Zaim,
Joelle Micallef,
Jacky Tisne-Versailles,
Pierre Sokoloff,
Philippe Chopin,
Marc Marien
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ABSTRACT: Dimethylaminoethanol pyroglutamate (DMAE p-Glu) is a compound resulting from the reaction between dimethylaminoethanol (an indirect precursor of acetylcholine) and pyroglutamic acid (a cyclic derivative of glutamic acid having procholinergic properties and promnesic effects in both animals and man).
The present study undertook preclinical and clinical evaluations to test a potential therapeutic utility for DMAE p-Glu in cognitive impairments related to central cholinergic deficit.
In preclinical study, DMAE p-Glu was studied in rats by intracerebral microdialysis in conscious freely moving animals, on performance of rats in the Morris water maze test of spatial memory, and on the deficit in passive avoidance behavior induced by scopolamine. The clinical study examined the effect of DMAE p-Glu on cognitive deficits induced by an intravenous injection of scopolamine in healthy young male subjects.
In rat experiments, DMAE p-Glu increased the extracellular levels of choline and acetylcholine in the medial prefrontal cortex, as assessed by intracerebral microdialysis, improved performance in a test of spatial memory, and reduced scopolamine-induced memory deficit in passive avoidance behavior. Clinical study results show that scopolamine induced a memory deficit and that DMAE p-Glu produced a significant positive effect on scores in the Buschke test, as well as a slight but significant difference on choice reaction time.
These results indicate that DMAE p-Glu reduces the deleterious effect of scopolamine on long-term memory in healthy volunteers and suggest that DMAE p-Glu might be effective in reducing memory deficits in patients with cognitive impairment.
Psychopharmacologia 09/2009; 207(2):201-12. · 4.08 Impact Factor
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ABSTRACT: Deficits in inhibitory control have been reported in euthymic bipolar disorder patients. To date, data on the neuroanatomical correlates of these deficits are exclusively related to cognitive inhibition. This study aimed to examine the neural substrates of motor inhibitory control in euthymic bipolar patients. Groups of 20 patients with euthymic bipolar disorder and 20 demographically matched healthy subjects underwent event-related functional magnetic resonance imaging while performing a Go-NoGo task. Between-group differences in brain activation associated with motor response inhibition were assessed by using random-effects analyses. Although euthymic bipolar patients and healthy subjects performed similarly on the Go-NoGo task, they showed different patterns of brain activation associated with response inhibition. Specifically, patients exhibited significantly decreased activation in the left frontopolar cortex and bilateral dorsal amygdala compared with healthy subjects. There were no brain regions that were significantly more activated in patients than in healthy subjects. The findings suggest that euthymic bipolar patients have deficits in their ability to engage the left frontopolar cortex and bilateral dorsal amygdala during response inhibition. Further research should ascertain the role that such deficits may play in the emergence of impulsive behaviors that characterize bipolar disorder.
Psychiatry Research 06/2009; 173(1):45-51. · 2.52 Impact Factor
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ABSTRACT: Although depression accounts for a large part of the burden associated with bipolar disorder, its drug treatment has been under-studied.
To provide the best available evidence supporting the pharmacotherapy of bipolar depression.
A systematic review was conducted, focusing on randomized, controlled trials (RCTs) and meta-analyses.
Despite FDA approval of both the olanzapine-fluoxetine combination and quetiapine for the treatment of acute bipolar depression, independent RCTs (i.e., not trials conducted 'under the umbrella' of a drug company) have not found any drug to have antidepressant effects similar to those seen in unipolar depression. A practice-based suggestion, valuable for both short- and long-term treatment, might be to have a background of mood stabilizers and to add drugs, following one of several treatment options, trusting to find a drug with a degree of effectiveness by trial and error. The list of drugs that could be used would include all the current antidepressants, the olanzapine-fluoxetine combination and probably quetiapine too. Special features and situations might also influence treatment options.
Expert Opinion on Pharmacotherapy 03/2009; 10(2):161-72. · 3.20 Impact Factor
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ABSTRACT: The tendency to engage in risky behaviours is a core feature of the manic episodes of bipolar disorder. The aim of this study was to establish whether this characteristic can be quantified with a laboratory measure of decision making [the Iowa Gambling Task (IGT)] and to determine clinical correlates of the IGT performance in mania.
Inpatients with acute mania (n = 45) and healthy volunteers (n = 45) were assessed on the IGT. Affective symptomatology was assessed with the Young Mania Rating Scale and Hamilton Depression Rating Scale, and item scores were subjected to factor analysis. Multivariate regression was used to assess clinical predictors of impaired decision making in the manic patients.
On the IGT, manic patients selected more cards from the risky decks than healthy controls, and showed little capacity to learn from incurred losses. In a multivariate analysis, impaired decision making ability in the manic patients was significantly predicted by a symptom factor associated with lack of insight.
Manic patients clearly show defects in decision making, which are strongly related to their lack of insight. Neural circuitry supporting effective decision making, including the ventromedial prefrontal cortex and somatosensory cortex, may be implicated in the pathophysiology of acute mania.
Bipolar Disorders 12/2008; 10(7):829-37. · 5.29 Impact Factor
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ABSTRACT: Despite numerous explanatory hypotheses, few studies have involved a large national clinical sample examining risk factors in the occurrence of rapid cycling during the course of bipolar illness.
From 1,090 manic bipolar I disorder inpatients included in a multicenter national study in France, 958 could be classified as rapid or nonrapid cyclers and assessed for demographic, illness course, clinical, psychometric, temperament, comorbidity, and treatment characteristics.
Rapid cycling bipolar disorder occurred in 9% (n=86) of the study group. Compared to nonrapid cyclers (n=872), patients with rapid cycling experienced the onset of their illness at a younger age, a higher number of prior episodes, more depression during the first episode, and more suicide attempts. At study entry, they also experienced manic episodes with more depressive and anxious symptoms, but less psychotic features. The following independent variables were associated with rapid cycling: longer duration of illness, antidepressant treatment, episodes with no free intervals, cyclothymic temperament, lower scores on the Scale for Assessment of Positive Symptoms and presence of thyroid disorder. Retrospective study limited to bipolar I disorder inpatients; several factors previously associated with rapid cycling were not assessed.
Our findings may confirm previous descriptions, according to which rapid cycling develops later in the course of illness following a sensitization process triggered by antidepressant use or thyroid dysfunction, in patients with a depression-mania-free interval course, and cyclothymic temperament.
CNS spectrums 10/2008; 13(9):780-7. · 2.20 Impact Factor
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ABSTRACT: Knowledge about psychopathologic presentations of mania in current clinical practice has to be refined in order to improve diagnosis and treatment.
One thousand ninety manic patients included in the French National Study EPIMAN-II Mille were submitted to a cluster analysis on the basis of multiple variables related to the history of bipolar illness and symptoms of the current episode.
Four clusters were identified: "classic mania" (29.3% of patients) with less severe mania; "psychotic mania" (22.7%) with psychotic symptoms, more severe mania, younger age and social impairment; "depressive mania" (30.4%) characterized by female gender, suicide attempts, high number of previous episodes and residual symptoms; and "dual mania" (17.6%) characterized by male gender, substance use, earlier onset and poor compliance. Patients groups also differed in manic symptoms, marital status, stressors preceding illness onset, prior diagnoses, first episode polarity and temperamental characteristics.
Cross-sectional assessment of patients.
In comparing our findings with those of four prior cluster analytic studies, we integrate clinical characteristics of mania subtypes found in this very large representative French sample in contemporary practice, we suggest how such convergence of data may help improve earlier recognition, differential response to different treatments, and prevention of these subtypes. We finally suggest that such subtyping might provide clues to phenotype delineation suitable for pharmacogenetic investigations.
Archiv f ur Psychiatrie und Nervenkrankheiten 07/2008; 258(8):497-504. · 2.75 Impact Factor
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ABSTRACT: Mania has been frequently associated with impaired inhibitory control. The present study aimed to identify brain functional abnormalities specifically related to motor response inhibition in mania by using event-related fMRI in combination with a Go/NoGo task designed to control for extraneous cognitive processes involved in task performance. Sixteen manic patients and 16 healthy subjects, group-matched for age and sex, were imaged while performing a warned equiprobable Go/NoGo task during event-related fMRI. Between-group differences in brain activation associated with motor response inhibition were assessed using analyses of covariance. Although no significant between-group differences in task performance accuracy were observed, patients showed significantly longer response times on Go trials. After controlling for covariates, the only brain region that differentiated the two groups during motor response inhibition was the ventrolateral prefrontal cortex (VLPFC), where activation was significantly decreased in both the right and left hemispheres in manic patients. Our data suggest that response inhibition in mania is associated with a lack of engagement of the bilateral VLPFC, which is known to play a primary role in the suppression of irrelevant responses. This result might give clues to understanding the pathophysiology of disinhibition and impulsivity that characterize mania.
Journal of Psychiatric Research 07/2008; 43(4):432-41. · 4.66 Impact Factor
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ABSTRACT: The emotional Stroop test evaluates the influence of the emotional valence of stimuli on cognitive inhibition processes. In subjects with psychiatric disorders, interference increases in this test when valence refers to their specific psychopathology. This study aims to develop a version of the emotional Stroop test adapted to paranoid schizophrenia and bipolar disorder.
The emotional valence and the number of times patients used 200 words related to schizophrenia and bipolar disorder psychopathology were assessed by 25 clinicians; then a principal component analysis was performed with an ascending hierarchical classification.
Words are distributed according to 2 factorial dimensions, emotionality and tonality, into 4 valence classifications: depressive, paranoid, manic, and neutral words. There were no differences in the lexical frequency of the words chosen to develop the test.
The statistical validation of the emotional valence of words allows for the development of an emotional Stroop test adapted to exploring emotional bias in paranoid schizophrenia and bipolar disorder.
Canadian journal of psychiatry. Revue canadienne de psychiatrie 04/2008; 53(3):177-88. · 2.42 Impact Factor
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ABSTRACT: Previous functional magnetic resonance imaging (fMRI) studies have reported abnormal brain activation in individuals with schizophrenia during performance of motor inhibition tasks. We aimed to clarify brain functional abnormalities related to motor response inhibition in schizophrenia by using event-related fMRI in combination with a Go-NoGo task designed to control for non-inhibitory cognitive processes involved in task performance.
We studied 21 schizophrenic patients and 21 healthy subjects, group-matched for age, sex, and performance accuracy on a Go-NoGo task during event-related fMRI. The task was designed so that Go and NoGo events were equally probable. Between-group activation differences were assessed using ANCOVAs with response time and IQ as covariates of non-interest.
Compared to healthy subjects, schizophrenic patients exhibited a significant decrease in activation during motor response inhibition in the right ventrolateral prefrontal cortex (VLPFC) only. There were no areas of increased brain activation in patients compared to healthy subjects.
Schizophrenic patients demonstrate a blunted activation in the right VLPFC, a region known to play a critical role in motor response inhibition. Further research should ascertain the contribution of the VLPFC dysfunction to the impulsive behavior observed in schizophrenia.
Schizophrenia Research 01/2008; 97(1-3):184-93. · 4.75 Impact Factor
