Some patients with bipolar disorder have traumatic experience, sleep disturbance, and emotional variations, which are related to nightmare reports in clinics. We hypothesized that the nightmare experience might present some uniqueness in different types of bipolar disorder. We invited 200 healthy volunteers and 141 bipolar disorder I (BD I) and 78 bipolar disorder II (BD II) patients who had at least one nightmare lifelong to undergo tests of the Nightmare Experience Questionnaire (NEQ) and the questionnaires measuring mania, hypomania, and depression. Compared with healthy controls, both BD I and BD II patients displayed their abnormal affective states and scored significantly higher on NEQ Meaning Interpretation; BD I patients, in addition, scored higher on NEQ Horrible Stimulation. Hypomania was correlated with Horrible Simulation in BD II patients, and depression was correlated with Physical Effect and Horrible Stimulation in healthy controls. We found some NEQ scales were elevated in bipolar disorder, but these abnormalities failed to differentiate BD I from BD II.
Hypersexuality is related to functions of personality and emotion and is a salient symptom of bipolar I disorder especially during manic episode. However, it is uncertain whether bipolar I disorder with (BW) and without (BO) hypersexuality exhibits different cerebral activations under external emotion stimuli. In 54 healthy volunteers, 27 BW and 26 BO patients, we administered the visual oddball event-related potentials (ERPs) under external emotions of Disgust, Erotica, Fear, Happiness, Neutral, and Sadness. Participants’ concurrent states of mania, hypomania, and depression were also evaluated. The N1 latencies under Erotica and Happiness were prolonged, and the P3b amplitudes under Fear and Sadness were decreased in BW; the P3b amplitudes under Fear were increased in BO. The parietal, frontal, and occipital activations were found in BW, and the frontal and temporal activations in BO under different external emotional stimuli, respectively. Some ERP components were correlated with the concurrent affective states in three groups of participants. The primary perception under Erotica and Happiness, and voluntary attention under Fear and Sadness, were impaired in BW, while the voluntary attention under Fear was impaired in BO. Our study indicates different patterns of visual attentional deficits under different external emotions in BW and BO.
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