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3 results

  • Impact of psychotic features on morbidity and course of illness in patients with bipolar disorder

  • İ. Özyıldırım, S. Çakır, O. Yazıcı
  • Journal:
    European Psychiatry / Volume 25 / Issue 1 / January 2010
    Published online by Cambridge University Press:
    16 April 2020, pp. 47-51
  • Objective

    In this study, we aimed to compare the clinical features and response patterns to the long-term prophylaxis of bipolar patients with or without psychotic features.

    Method

    The life charts of patients with bipolar I disorder were evaluated. Two hundred and eighty-one patients who suffer with bipolar disorder for at least 4 years and who had at least three mood episodes were included to the study. The patients whose all episodes are psychotic (psychotic group) and the patients who never experienced psychotic episode (non-psychotic group) were assigned as comparison groups. The clinical features and the response to long-term prophylaxis were compared across the groups.

    Results

    The psychotic group consists of 43 patients; non-psychotic group consists of 54 patients. The history of bipolar disorder among the first-degree relatives was remarkably more prevalent in non-psychotic group (p = 0.032). The predominance of manic/hypomanic episodes was significantly higher in psychotic group than non-psychotic group; and the rate of depressive episodes were higher in non-psychotic group than psychotic group (p = 0.013). Episodes were more severe (p < 0.001) and hospitalization rates were higher (p = 0.023) in psychotic group. The response to lithium monotherapy was better in non-psychotic group (p < 0.001).

    Conclusion

    The well identified psychotic subtype of bipolar patients may give important predictions about long term course and prophylaxis of bipolar disorder.

  • Prolactin secretion in response to haloperidol challenge in delusional (psychotic) and non-delusional depression

  • L Lykouras, M Markianos, J Hatzimanolis, P Oulis, G.N Christodoulou
  • Journal:
    European Psychiatry / Volume 15 / Issue 8 / December 2000
    Published online by Cambridge University Press:
    16 April 2020, pp. 480-482

  • Certain studies on measures related to central neurotransmitter activity have demonstrated that in delusional (psychotic) depression there is a dopaminergic dysregulation which distinguishes it from non-psychotic depression. A neuroendocrinologic method to check the degree of DA receptor responsivity is by measuring the prolactin responses to acute intramuscular administration of haloperidol. We studied this possibility by applying the haloperidol test in seven delusional and ten non-delusional depressed patients. All patients met DSM-IV criteria for a major depressive episode, single or recurrent, with or without psychotic features. After a three-week washout period, 5 mg of haloperidol were injected i.m. and blood samples were taken at 0, 30, 60, 90 and 120 minutes. In both trials, significant time effects were observed (elevated prolactin levels, F = 11.36, P = 0.000). However, the prolactin responses to haloperidol did not differ significantly between the two patient groups (F = 0.12, P = 0.97). These data do not show a difference in D2 receptor responsivity, at least at the hypothalamus-pituitary level, between psychotic and non-psychotic depression.

  • Section I - Schizophrenia

  • Edited by Martha E. Shenton, Bruce I. Turetsky, University of Pennsylvania
  • Book:
    Understanding Neuropsychiatric Disorders
    Published online:
    10 January 2011
    Print publication:
    09 December 2010, pp -

  • Summary

    This chapter provides a review of the vast body of published research that has used either structural magnetic resonance imaging (MRI) or diffusion tensor imaging (DTI) to investigate for neuroanatomical abnormalities in schizophrenia (SZ) patients. If one thing is clear from the multitude of MRI and DTI studies reviewed in the chapter, it is that there is now a great deal of evidence indicating that SZ patients exhibit consistent (albeit subtle) and widespread abnormalities in both their gray matter (GM) and white matter (WM). An important question, then, is whether these GM and WM abnormalities have separate causes, or whether they share a common underlying pathology. A highly speculative theory is presented as to how a single mechanism could potentially underlie the GM abnormalities, WM abnormalities, hyperdopaminergia and psychotic features characteristic of SZ. This theory is extremely speculative and would benefit from a great deal more supporting empirical evidence.