Bipolar Disorders: Mixed States, Rapid Cycling and Atypical Forms

Cover......Page 1
Half-title......Page 3
Title......Page 5
Copyright......Page 6
Contents......Page 7
Contributors......Page 9
Preface......Page 13
Introduction: knowledge from the past, goals for the future......Page 15
The ancient times......Page 16
From Heinroth to the psychopharmacological revolution......Page 20
The renaissance of mixed states......Page 29
Phenomenology......Page 34
Onset, course, and outcome......Page 35
Comorbidity......Page 36
Future perspectives on mixed states......Page 37
Rapid cycling......Page 38
Comorbidity......Page 42
Bipolar schizoaffective mixed states......Page 43
Atypical depressions......Page 47
Polymorphic psychotic disorders as a possible atypical bipolar disorder......Page 50
REFERENCES......Page 51
Definition of bipolar mixed states......Page 59
Dysphoric mania......Page 61
Toward a broader definition of mixed mania......Page 63
Depressive mixed states......Page 65
Bipolar II and unipolar depressive mixed states......Page 66
Long-term aspects of mixed states......Page 67
Conclusions......Page 71
REFERENCES......Page 72
Introduction......Page 75
Family genetics......Page 76
Pathophysiology......Page 77
Epidemiology, phenomenology, and comorbidity......Page 79
Treatment recommendations......Page 83
Lamotrigine......Page 85
Clinical response......Page 89
Lithium......Page 91
Olanzapine......Page 93
Combination therapy......Page 94
REFERENCES......Page 97
Introduction......Page 102
Age at onset......Page 104
Clinical course and outcome......Page 105
Family studies and genetics......Page 109
Neuroimage......Page 110
Neurophysiology......Page 112
Treatment......Page 113
REFERENCES......Page 115
Bipolar spectrum......Page 123
Recurrent brief psychiatric syndromes......Page 125
Interviews......Page 126
Recurrent brief psychiatric syndromes......Page 127
Personality......Page 128
Recurrent brief psychiatric syndromes and their overlap......Page 129
The value of RBD, RBM, and hypomanic symptoms as a predictor of BP-II disorder......Page 130
Clinical characteristics......Page 131
Personality......Page 135
Discussion......Page 136
Risk of suicide attempts......Page 137
What is the nature of RBD?......Page 138
Treatment of RBD and CD......Page 139
Acknowledgment......Page 140
REFERENCES......Page 141
Introduction: the relationship of atypical depression to bipolar II disorder......Page 145
Recent literature review......Page 146
Is AD more common in BP-II versus UP?......Page 148
Is AD frequency still higher in BP-II versus UP when BP-II had a short hypomania?......Page 149
Is there a link between BP-II and UP AD?......Page 150
Are there differences between AD and non-AD?......Page 151
Are females more common in AD versus non-AD?......Page 152
Is there a link between female gender and AD in depressive mixed state?......Page 153
What is the relationship between AD and menopause?......Page 154
Patients and interview......Page 155
Results......Page 158
Conclusions......Page 160
REFERENCES......Page 165
Introduction......Page 171
Melancholia agitata......Page 172
Mixed affective states and agitated depression......Page 175
The parallelism between drive, mood, and thought......Page 179
Clinical picture of agitated depression......Page 180
Minor agitated depression......Page 181
Flight of ideas, racing and crowded thoughts......Page 183
Restlessness, inner agitation, and anxiety......Page 185
Role of temperament......Page 187
The nature and definition of agitated depression......Page 188
Patients and method......Page 190
Spontaneous and induced agitated depression......Page 191
Treatment......Page 193
Agitated depression followed by simple depression......Page 194
REFERENCES......Page 196
Introduction......Page 201
Developments of the definition of schizoaffective disorders......Page 202
Schizoaffective mixed states in the Cologne study......Page 206
Characteristics of episodes......Page 208
Duration of episodes......Page 210
Frequency of patients having mixed episodes......Page 212
Initial episode and first manifestation of a mixed episode......Page 213
Disability pensions......Page 214
Conclusions......Page 216
REFERENCES......Page 217
Definitions of acute and transient psychotic disorders......Page 221
Acute stress......Page 222
The predecessors of the acute and transient psychotic disorders......Page 225
Cycloid psychoses......Page 226
Bouffée délirante......Page 229
Other predecessors......Page 230
What are acute and transient psychotic disorders?......Page 231
Methods of the HASBAP......Page 233
ATPD versus bipolar affective mixed states versus bipolar schizoaffective mixed states......Page 234
Polymorphic subgroup of ATPD versus bipolar affective mixed versus bipolar schizoaffective mixed states......Page 235
Polymorphic subgroup versus all mixed (affective and schizoaffective)......Page 240
ATPD versus the groups of bipolar affective mixed, bipolar schizoaffective mixed, bipolar affective non-mixed, and non-mixed bipolar schizoaffective disorders......Page 241
Conclusions......Page 246
References......Page 247
Prevalence......Page 251
Clinical diagnoses......Page 252
Longitudinal course......Page 256
Top-down studies......Page 258
Treatment......Page 259
REFERENCES......Page 262
Atypical features......Page 266
Age of onset and clinical course......Page 267
Neurologic comorbidity......Page 269
Cognitive impairment......Page 270
Proposed subtypes......Page 271
Atypical treatment issues......Page 273
References......Page 274
Relevance of comorbidity......Page 277
Medical conditions and neuropsychiatric disorders......Page 278
Substance-abuse disorders......Page 280
Anxiety disorders......Page 281
Personality disorders......Page 282
Other psychiatric disorders......Page 283
Conclusions......Page 284
References......Page 285
Epidemiology of mood disorders......Page 291
Family studies......Page 292
Review of empirical evidence......Page 293
Relationship to the proband......Page 297
Sex of proband......Page 298
Twin studies of mood disorders......Page 299
Adoption studies of the mood disorders......Page 300
Family studies......Page 301
Twin studies......Page 302
Association studies of mood disorders......Page 303
Review of empirical evidence......Page 304
Linkage studies of mood disorders......Page 305
Review of empirical evidence......Page 306
Lack of direct correspondence between the genotype and phenotype......Page 310
Gene–environment interaction......Page 311
Future directions......Page 312
References......Page 314
Introduction......Page 325
Implications of catecholamines on mixed states and rapid cycling......Page 326
Implications of hormonal aberrations on mixed states and rapid cycling......Page 328
The impact of transmembranous ion fluxes on rapid cycling and mixed states......Page 329
How do antiepileptic drugs used in treating mixed states and rapid cycling potentially interfere with intracellular calcium signalling?......Page 330
Other mechanisms of mood stabilizers possibly related to rapid cycling and mixed states......Page 332
References......Page 333
Severe stage of mania......Page 338
Dysphoric mania......Page 339
Manic defense in depression......Page 340
Transition state during a cycle: MDI/DMI......Page 341
Mixed states in predominantly depressed bipolar patients (BP-II, Dm)......Page 342
Modified by substance misuse......Page 344
Modified by organic brain disease......Page 345
Ultrarapid cycling......Page 346
Clinical trials in mania and mixed states......Page 347
Treatment responses in different models of mixed states......Page 349
Cortisol levels during response to antipsychotics......Page 350
\"Manic defense,\" transitions, and treatment of mania......Page 351
Antipsychotics in prophylaxis of bipolar disorder......Page 352
Antidepressants in bipolar mixed states......Page 353
Resistance to treatment in mixed states......Page 355
Combining lithium and antidepressants in prophylaxis of mixed mania......Page 356
Conclusions......Page 357
References......Page 358
Introduction......Page 367
Controlled studies of atypical antipsychotic medications in bipolar disorder......Page 368
Method......Page 369
Risperidone......Page 370
Olanzapine......Page 372
Quetiapine......Page 377
Ziprasidone......Page 378
Use of atypical antipsychotic medications in mania: psychotic and non-psychotic patients......Page 379
References......Page 380
Difficulties in conducting clinical trials for atypical bipolar disorder......Page 383
Difficulties in conducting clinical trials for mixed episodes......Page 386
Difficulties in conducting clinical trials for rapid cycling......Page 387
What are the lessons from clinical trials for rapid cycling?......Page 389
Rapid cycling: clinical trial design issues......Page 393
Secondary rapid cycling......Page 396
References......Page 397
Index......Page 400