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Is increased libido an atypical symptom of bipolar depression? An interesting case

Mahadevan R, Nik Jaafar NR, Sidi H, Midin M, Das S

J Sex Med, 2013 Mar;10(3):883-6.
PMID: 23036068 DOI: 10.1111/j.1743-6109.2012.02949.x

Decreased libido is recognized as one of the vegetative symptoms of depression. Increased libido has not been acknowledged as one of its symptoms, neither has it been reported, particularly in depressed bipolar patients.

Matched MeSH terms: Bipolar Disorder/psychology*
Internet use by patients with bipolar disorder: Results from an international multisite survey

Bauer R, Conell J, Glenn T, Alda M, Ardau R, Baune BT, et al.

Psychiatry Res, 2016 08 30;242:388-394.
PMID: 27391371 DOI: 10.1016/j.psychres.2016.05.055

There is considerable international interest in online education of patients with bipolar disorder, yet little understanding of how patients use the Internet and other sources to seek information. 1171 patients with a diagnosis of bipolar disorder in 17 countries completed a paper-based, anonymous survey. 81% of the patients used the Internet, a percentage similar to the general public. Older age, less education, and challenges in country telecommunications infrastructure and demographics decreased the odds of using the Internet. About 78% of the Internet users looked online for information on bipolar disorder or 63% of the total sample. More years of education in relation to the country mean, and feeling very confident about managing life decreased the odds of seeking information on bipolar disorder online, while having attended support groups increased the odds. Patients who looked online for information on bipolar disorder consulted medical professionals plus a mean of 2.3 other information sources such as books, physician handouts, and others with bipolar disorder. Patients not using the Internet consulted medical professionals plus a mean of 1.6 other information sources. The percentage of patients with bipolar disorder who use the Internet is about the same as the general public. Other information sources remain important.

Matched MeSH terms: Bipolar Disorder/psychology*
International multi-site survey on the use of online support groups in bipolar disorder

Bauer R, Conell J, Glenn T, Alda M, Ardau R, Baune BT, et al.

Nord J Psychiatry, 2017 Aug;71(6):473-476.
PMID: 28696841 DOI: 10.1080/08039488.2017.1334819

BACKGROUND: Peer support is an established component of recovery from bipolar disorder, and online support groups may offer opportunities to expand the use of peer support at the patient's convenience. Prior research in bipolar disorder has reported value from online support groups.
AIMS: To understand the use of online support groups by patients with bipolar disorder as part of a larger project about information seeking.
METHODS: The results are based on a one-time, paper-based anonymous survey about information seeking by patients with bipolar disorder, which was translated into 12 languages. The survey was completed between March 2014 and January 2016 and included questions on the use of online support groups. All patients were diagnosed by a psychiatrist. Analysis included descriptive statistics and general estimating equations to account for correlated data.
RESULTS AND CONCLUSIONS: The survey was completed by 1222 patients in 17 countries. The patients used the Internet at a percentage similar to the general public. Of the Internet users who looked online for information about bipolar disorder, only 21.0% read or participated in support groups, chats, or forums for bipolar disorder (12.8% of the total sample). Given the benefits reported in prior research, clarification of the role of online support groups in bipolar disorder is needed. With only a minority of patients using online support groups, there are analytical challenges for future studies.

Matched MeSH terms: Bipolar Disorder/psychology*
Fulltext Executive function and attention span in euthymic patients with bipolar 1 disorder

Normala I, Abdul HA, Azlin B, Nik Ruzyanei NJ, Hazli Z, Shah SA

Med J Malaysia, 2010 Sep;65(3):199-203.
PMID: 21939168

This is a cross sectional comparison study to assess executive function and attention span in euthymic patients with bipolar 1 disorder. It compares the performance of these two cognitive domains in 40 patients with bipolar 1 disorder to that of 40 healthy normal subjects using Trail Making (TMT), Digit Span (Forward and Backward) and Verbal Fluency (VF) tests. The association between demographic, clinical characteristics and performance in all tests were examined. Patients with bipolar illness showed significant impairment with moderate to large effect sizes (VF = 0.67, TMT A = 0.52, TMT B = 0.81, Digit Forward = 0.97, Digit backward = 1.10) in all tasks of executive and attention functioning. These impairments are observed in the absence of active mood symptoms while duration and severity of illness are not found to have an effect on both cognitive domains. Medications received by patients with bipolar disorder have significant association with performance on executive tasks. The results of this study add on to the existing global evidence of cognitive impairment in bipolar illness despite its cross cultural differences. Its presence in the absence of mania, depression or mixed episode indicates that cognitive impairment is stable even after symptoms recovery.

Matched MeSH terms: Bipolar Disorder/psychology
Disability in schizophrenia and mood disorders in a developing country

Rahman MB, Indran SK

Soc Psychiatry Psychiatr Epidemiol, 1997 Oct;32(7):387-90.
PMID: 9383969

The aim of this study was to investigate how the prevalence and severity of psychiatric disabilities in patients with chronic schizophrenia compares with that in patients with chronic mood disorders. A total of 128 patients, 80 with chronic schizophrenia and 48 with chronic mood disorders as confirmed by DSM-III-R, were examined using the World Health Organization Psychiatric Disability Assessment Schedule (WHO/ DAS). There were no significant differences in the prevalence and severity of disabilities between the two disorders. Two-thirds of the patients with chronic schizophrenia and over half the patients with chronic mood disorders had dysfunctional behaviour and experienced significant disabilities. The prevalence of disabilities among these Malaysian patients was not markedly different from that seen in developed countries, suggesting that the prognosis in developing countries may not be as favourable as previously thought.

Matched MeSH terms: Bipolar Disorder/psychology
Tarantism, dancing mania and demonopathy: the anthro-political aspects of 'mass psychogenic illness'

Bartholomew RE

Psychol Med, 1994 May;24(2):281-306.
PMID: 8084927

This study questions the widely held assumption that the phenomenon known as mass psychogenic illness (MPI) exists per se in nature as a psychiatric disorder. Most MPI studies are problematical, being descriptive, retrospective investigations of specific incidents which conform to a set of pre-existing symptom criteria that are used to determine the presence of collective psychosomatic illness. Diagnoses are based upon subjective, ambiguous categories that reflect stereotypes of female normality which assume the presence of a transcultural disease or disorder entity, underemphasizing or ignoring the significance of episodes as culturally conditioned roles of social action. Examples of this bias include the mislabelling of dancing manias, tarantism and demonopathy in Europe since the Middle Ages as culture-specific variants of MPI. While 'victims' are typified as mentally disturbed females possessing abnormal personality characteristics who are exhibiting cathartic reactions to stress, it is argued that episodes may involve normal, rational people who possess unfamiliar conduct codes, world-views and political agendas that differ significantly from those of Western-trained investigators who often judge these illness behaviours independent of their local context and meanings.

Matched MeSH terms: Bipolar Disorder/psychology*
Association between solar insolation and a history of suicide attempts in bipolar I disorder

Bauer M, Glenn T, Alda M, Andreassen OA, Angelopoulos E, Ardau R, et al.

J Psychiatr Res, 2019 06;113:1-9.
PMID: 30878786 DOI: 10.1016/j.jpsychires.2019.03.001

In many international studies, rates of completed suicide and suicide attempts have a seasonal pattern that peaks in spring or summer. This exploratory study investigated the association between solar insolation and a history of suicide attempt in patients with bipolar I disorder. Solar insolation is the amount of electromagnetic energy from the Sun striking a surface area on Earth. Data were collected previously from 5536 patients with bipolar I disorder at 50 collection sites in 32 countries at a wide range of latitudes in both hemispheres. Suicide related data were available for 3365 patients from 310 onset locations in 51 countries. 1047 (31.1%) had a history of suicide attempt. There was a significant inverse association between a history of suicide attempt and the ratio of mean winter solar insolation/mean summer solar insolation. This ratio is smallest near the poles where the winter insolation is very small compared to the summer insolation. This ratio is largest near the equator where there is relatively little variation in the insolation over the year. Other variables in the model that were positively associated with suicide attempt were being female, a history of alcohol or substance abuse, and being in a younger birth cohort. Living in a country with a state-sponsored religion decreased the association. (All estimated coefficients p bipolar disorder. Further investigation of the impacts of solar insolation on the course of bipolar disorder is needed.

Matched MeSH terms: Bipolar Disorder/psychology*
Fulltext Seasonality shows evidence for polygenic architecture and genetic correlation with schizophrenia and bipolar disorder

Byrne EM, Psychiatric Genetics Consortium Major Depressive Disorder Working Group, Raheja UK, Stephens SH, Heath AC, Madden PA, et al.

J Clin Psychiatry, 2015 Feb;76(2):128-34.
PMID: 25562672 DOI: 10.4088/JCP.14m08981

OBJECTIVE: To test common genetic variants for association with seasonality (seasonal changes in mood and behavior) and to investigate whether there are shared genetic risk factors between psychiatric disorders and seasonality.
METHOD: Genome-wide association studies (GWASs) were conducted in Australian (between 1988 and 1990 and between 2010 and 2013) and Amish (between May 2010 and December 2011) samples in whom the Seasonal Pattern Assessment Questionnaire (SPAQ) had been administered, and the results were meta-analyzed in a total sample of 4,156 individuals. Genetic risk scores based on results from prior large GWAS studies of bipolar disorder, major depressive disorder (MDD), and schizophrenia were calculated to test for overlap in risk between psychiatric disorders and seasonality.
RESULTS: The most significant association was with rs11825064 (P = 1.7 × 10⁻⁶, β = 0.64, standard error = 0.13), an intergenic single nucleotide polymorphism (SNP) found on chromosome 11. The evidence for overlap in risk factors was strongest for schizophrenia and seasonality, with the schizophrenia genetic profile scores explaining 3% of the variance in log-transformed global seasonality scores. Bipolar disorder genetic profile scores were also associated with seasonality, although at much weaker levels (minimum P value = 3.4 × 10⁻³), and no evidence for overlap in risk was detected between MDD and seasonality.
CONCLUSIONS: Common SNPs of large effect most likely do not exist for seasonality in the populations examined. As expected, there were overlapping genetic risk factors for bipolar disorder (but not MDD) with seasonality. Unexpectedly, the risk for schizophrenia and seasonality had the largest overlap, an unprecedented finding that requires replication in other populations and has potential clinical implications considering overlapping cognitive deficits in seasonal affective disorders and schizophrenia.

Matched MeSH terms: Bipolar Disorder/psychology