Diagnosis and characterization of mania: Quantifying increased energy and activity in the human behavioral pattern monitor

Abstract

Increased energy or activity is now an essential feature of the mania of Bipolar Disorder (BD) according to DSM-5. This study examined whether objective measures of increased energy can differentiate manic BD individuals and provide greater diagnostic accuracy compared to rating scales, extending the work of previous studies with smaller samples. We also tested the relationship between objective measures of energy and rating scales. 50 hospitalized manic BD patients were compared to healthy subjects (HCS, n=39) in the human Behavioral Pattern Monitor (hBPM) which quantifies motor activity and goal-directed behavior in an environment containing novel stimuli. Archival hBPM data from 17 schizophrenia patients were used in sensitivity and specificity analyses. Manic BD patients exhibited higher motor activity than HCS and higher novel object interactions. hBPM activity measures were not correlated with observer-rated symptoms, and hBPM activity was more sensitive in accurately classifying hospitalized BD subjects than observer ratings. Although the findings can only be generalized to inpatient populations, they suggest that increased energy, particularly specific and goal-directed exploration, is a distinguishing feature of BD mania and is best quantified by objective measures of motor activity. A better understanding is needed of the biological underpinnings of this cardinal feature.

Periodontal condition and levels of bacteria associated with periodontitis in individuals with bipolar affective disorders: A case‐control study

“…A significant association between periodontitis and depression was previously demonstrated, 10,[13][14][15][16] noted that the criteria used to define periodontitis may influence the prevalence presented in different studies. 1 In the present study, the Findings from the present study showed no significant differences in the occurrence of known risk variables for periodontitis (e. g. smoking, diabetes, gender, and family income) between individuals with and without BAPD. A possible explanation can be the homogeneity of the sample groups.…”

“…Periodontitis is highly prevalent with varying patterns in different populations. However, it should be noted that the criteria used to define periodontitis may influence the prevalence presented in different studies . In the present study, the use of the criteria by Gomes‐Filho et al to the detriment of the current criteria proposed by the CDC/AAP was motivated by the fact that the first also includes BOP and by the high occurrence of CAL in our sample (which does not necessarily indicate periodontitis).…”

“…One recurrent and serious mental health condition is the bipolar affective disorder (BPAD). Individuals with BAPD have what is called episodes or phases of extreme mania followed by long periods of depression . BPAD is estimated to have a worldwide prevalence rate of 2%‐5% .…”

The COMT Val158Met Polymorphism and Exploratory Behavior in Bipolar Mania

“…Twenty-six (16 male, 10 female, 22 Caucasian) acutely hospitalized inpatients with SCID (Structured Clinical Interview for DSM-IV)-diagnosed “DSM-IV Bipolar Disorder, Current Episode Manic” provided informed consent and participated in this study. Reports of hBPM differences between manic BD patients and healthy comparison participants can be found in our previously published work [14,17,18]; the participants in the current study were a subsample for which we had COMT genotypes available. Participants were between the ages of 18 and 55 years (mean age = 35.2, standard deviation = 13.0).…”

Association between Bipolar Affective Disorder and Periodontal Diseases

“…When the oscillations of mood are very marked with alternation of cycles, and go from great happiness to profound sadness, it is called cyclothymia. The alternation phases of depression with phases of mania characterize the BPAD, even though higher predominance and chronicity on stages of depression are observed [18,19] (Figure 3).…”