Cognitive Impairment in Early and Late Bipolar Disorder

Schouws, Sigfried; Comijs, Hannie C.; Stek, Max L.; Dekker, J.M.; Oostervink, Frits; Naarding, Paul; Velde, Iet van der; Beekman, Aartjan T.F.

doi:10.1097/jgp.0b013e31819e2d50

Cited by 121 publications

(111 citation statements)

References 24 publications

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“…In mice, brain regions showing paternal influence are abundant in the hypothalamus and septum areas, which mediate instinctual behavior, such as feeding, mating, and social aggression (Keverne et al 1996a, b). Maternal influence is observed in areas related to development of higher order cognition, which is interesting given that cognition is impaired in BPD and schizophrenia patients (Barrett et al 2009;Schouws et al 2009). Furthermore, imprinting syndromes often exhibit psychiatric comorbidities.…”

Section: Parent-of-origin Effectsmentioning

confidence: 97%

Understanding Bipolar Disorder: The Epigenetic Perspective

Khare

Pal

Petronis

2010

Behavioral Neurobiology of Bipolar Disorder and Its Treatment

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Bipolar disease (BPD) is a complex major psychiatric disorder that affects between 1% and 2% of the population and exhibits ?85% heritability. This has made BPD an appealing target for genetic studies yet, despite numerous attempts, the genetic basis of this disease remains elusive. Recently, it has come to light that epigenetic factors may also influence the development of BPD. These factors act via stable but reversible modifications of DNA and chromatin structure. In this chapter, we revisit the epidemiological, clinical, and molecular findings in BPD and reanalyze them from the perspective of inherited and acquired epigenetic misregulation. Epigenetic research has great potential to enhance our understanding of the molecular basis of BPD.

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Section: Parent-of-origin Effectsmentioning

confidence: 97%

Understanding Bipolar Disorder: The Epigenetic Perspective

Khare

Pal

Petronis

2010

Behavioral Neurobiology of Bipolar Disorder and Its Treatment

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“…A study (23) This aspect may be related, among other thing, to the polypharmacotherapy, to the disorder and to the age range studied, because elderly patients with BAD tend to present cognitive impairments hindering the recognition and retention of the medication administration schedules (23)(24) . For the elderly people with BAD who have limitations for the self-administration of medication it is crucial to involve the family in the provision of help.…”

Section: Discussionmentioning

confidence: 99%

Medication therapy: adherence, knowledge and difficulties of elderly people from bipolar disorder

Cruz

Miranda²,

Vedana

et al. 2011

Rev. Latino-Am. Enfermagem

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This study aimed to verify the adherence, knowledge and the difficulties of elderly patients with Bipolar Affective Disorder (BAD) in relation to the prescribed pharmacological therapy for the control of this disorder. The study included 17 elderly patients with BAD treated at a Mental Health Center. Semi-structured interviews were conducted and scales were applied. The data were analyzed using a quali-quantitative approach. A low level of adherence to the pharmacological treatment and a deficit in knowledge in relation to the medication were identified, especially regarding the dose and frequency of administration. Among the difficulties inherent to the pharmacotherapy, the obligation of polypharmacotherapy, the desire to quit the pharmacological treatment, limitations in the self-administration of the medication, collateral effects, and doubts about the need for the medication were related. Investment is needed in educational activities and in the promotion of adherence that address the difficulties experienced by elderly people with BAD in the following of the pharmacotherapy in order to ensure safety in the medication therapy.Descriptors: Bipolar Disorder; Medication Adherence; Aged. Identificou-se baixo grau de adesão ao tratamento farmacológico e déficit no conhecimento sobre os medicamentos, especialmente sobre as doses e frequência de administração.Entre as dificuldades inerentes à farmacoterapia relataram-se: a obrigatoriedade da polifarmacoterapia, o desejo de encerrar o tratamento farmacológico, limitações na autoadministração dos fármacos, efeitos colaterais e dúvidas sobre a necessidade dos medicamentos. São necessários investimentos em ações educativas e de promoção da adesão que contemplem as dificuldades vivenciadas pelos idosos com TAB, no seguimento da farmacoterapia, para garantia de segurança na terapêutica medicamentosa.Descritores: Transtorno Bipolar; Adesão à Medicação; Idoso. Terapéutica medicamentosa: adhesión, conocimiento y dificultades de personas ancianas portadoras de trastorno bipolarEste estudio tuvo como objetivo verificar la adhesión, el conocimiento y las dificultades de ancianos con Trastorno Afectivo Bipolar (TAB) en relación a la terapéutica medicamentosa prescrita para control del referido trastorno. Participaron del estudio 17 ancianos con TAB atendidos en un Núcleo de Salud Mental. Fueron realizadas entrevistas semiestructuradas y aplicación de escalas. Los datos fueron analizados con abordaje cualitativo-cuantitativo. Se identificó bajo grado de adhesión al tratamiento farmacológico y déficit en el conocimiento sobre los medicamentos, especialmente sobre las dosis y frecuencia de administración. Entre las dificultades inherentes a la fármacoterapia fueron relatadas la obligatoriedad de la polifármacoterapia, el deseo de terminar el tratamiento farmacológico, las limitaciones en la auto-administración de los fármacos, los efectos colaterales y las dudas sobre la necesidad de los medicamentos. Se concluye que son necesarias inversiones en acciones educativas y de promoción...

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“…Older adults with BD have been shown to have greater levels of cognitive dysfunction than age-matched mentally healthy control subjects (272)(273)(274)(275). Among older patients with BD, a greater burden from vascular risk factors has been associated with poorer outcomes on some cognitive measures (276,277).…”

Section: Issues In the Management Of Bd In Older Patientsmentioning

confidence: 99%

Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) collaborative update of CANMAT guidelines for the management of patients with bipolar disorder: update 2013

et al. 2012

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Yatham LN, Kennedy SH, Parikh SV, Schaffer A, Beaulieu S, Alda M, O’Donovan C, MacQueen G, McIntyre RS, Sharma V, Ravindran A, Young LT, Milev R, Bond DJ, Frey BN, Goldstein BI, Lafer B, Birmaher B, Ha K, Nolen WA, Berk M.  Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) collaborative update of CANMAT guidelines for the management of patients with bipolar disorder: update 2013.  Bipolar Disord 2012: 00: 000–000. © 2012 John Wiley & Sons A/S.Published by Blackwell Publishing Ltd.The Canadian Network for Mood and Anxiety Treatments published guidelines for the management of bipolar disorder in 2005, with updates in 2007 and 2009. This third update, in conjunction with the International Society for Bipolar Disorders, reviews new evidence and is designed to be used in conjunction with the previous publications.The recommendations for the management of acute mania remain largely unchanged. Lithium, valproate, and several atypical antipsychotic agents continue to be first‐line treatments for acute mania. Monotherapy with asenapine, paliperidone extended release (ER), and divalproex ER, as well as adjunctive asenapine, have been added as first‐line options.For the management of bipolar depression, lithium, lamotrigine, and quetiapine monotherapy, as well as olanzapine plus selective serotonin reuptake inhibitor (SSRI), and lithium or divalproex plus SSRI/bupropion remain first‐line options. Lurasidone monotherapy and the combination of lurasidone or lamotrigine plus lithium or divalproex have been added as a second‐line options. Ziprasidone alone or as adjunctive therapy, and adjunctive levetiracetam have been added as not‐recommended options for the treatment of bipolar depression. Lithium, lamotrigine, valproate, olanzapine, quetiapine, aripiprazole, risperidone long‐acting injection, and adjunctive ziprasidone continue to be first‐line options for maintenance treatment of bipolar disorder. Asenapine alone or as adjunctive therapy have been added as third‐line options.

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Cognitive Impairment in Early and Late Bipolar Disorder

Cited by 121 publications

References 24 publications

Understanding Bipolar Disorder: The Epigenetic Perspective

Understanding Bipolar Disorder: The Epigenetic Perspective

Medication therapy: adherence, knowledge and difficulties of elderly people from bipolar disorder

Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) collaborative update of CANMAT guidelines for the management of patients with bipolar disorder: update 2013

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