The Staging of Major Mood Disorders: Clinical and Neurobiological Correlates

Muneer, Ather; Mazommil, Rana

doi:10.30773/pi.2018.05.26

Cited by 7 publications

(7 citation statements)

References 68 publications

(65 reference statements)

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“…Results confirm studies ( 26 ) showing that patients in both diagnostic groups with more severe baseline depressive symptoms do not appear to make significant progress ( 6 , 28 ) with a 20-week psychological intervention concurrent with pharmacotherapy. Similar to Sabass et al.’s findings, this study also finds that patients with a moderate level of depression severity at baseline and therefore fewer problems with social functioning also tend to perceive benefits gained from group therapy.…”

Section: Discussionsupporting

confidence: 83%

“…Other studies have shown that functional impairment predicts clinical outcome in unipolar depression ( 67 ) and has been used as an outcome measure to classify a sample of bipolar remitted patients into good versus poor functional outcome and then comparing individual characteristics of each group ( 68 ). These results also support research on staging of mood disorders pointing to deteriorating social functioning as a contributor to illness progression ( 26 ).…”

Section: Discussionsupporting

confidence: 83%

“…Perhaps bipolar patients have been excluded from CBASP treatment due to concerns that patients may switch unexpectedly into hypomania during treatment or to concerns that patients may have cognitive difficulties that make it difficult for them to benefit from cognitive restructuring exercises. The rationale behind staging models for psychiatric disorders sometimes suggests that Bipolar Disorders are more difficult to treat or require different therapeutic interventions or models in relation to the progressive nature of the illness ( 26 – 28 ) Therefore, it remains unknown whether group CBASP can also be beneficial for bipolar depression, a mood state that is often more long-lasting than hypomanic states.…”

Section: Introductionmentioning

confidence: 99%

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Group Cognitive Behavioral Analysis System of Psychotherapy (CBASP): A Pilot Study for Bipolar Depression

et al. 2020

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Objectives Cognitive Behavioral Analysis System of Psychotherapy (CBASP) is an individually administered treatment model designed specifically for Persistent Depression however bipolar patients have traditionally been excluded from CBASP studies. There is a perception that bipolar depression will be harder to treat and requires a unique psychological approach. This pilot study reports on the feasibility of administering the same 20-week manualized group CBASP therapy with bipolar patients currently in a depressive episode. Methods This non-randomized, single-arm prospective pilot study, reports on an a posteriori exploration of benefits to bipolar depressed patients (n=26) of the same 20-week group CBASP intervention administered to unipolar depressed patients (n=81). The clinical trial for the initial phase examining benefits of the manualized 20-week group CBASP intervention with unipolar patients was registered with the ISRCTN registry, study ID: ISRCTN95149444. Results reported here include mixed ANOVA analyses, across group treatment models and diagnostic categories. Changes over time in self-reported depressive symptoms (Inventory of Depressive Symptoms -IDS-SR), self-reported social functioning, interpersonal problems and interpersonal dispositions are documented for all patients. An exploratory longitudinal latent class analysis was used to examine patients’ trajectories of improvement in depressive symptoms. Finally, the best predictors of change in reported depressive symptoms were explored with a logistic regression for all patients. Results Improvements in depressive symptoms and in social functioning over time were significant for all patients with bipolar patients trending towards a greater improvement in depressive symptoms after controlling for baseline differences. An exploratory Latent Class Analysis identified two different treatment trajectories for the entire sample: 1) moderate to severely depressed patients who improved significantly (49%) and 2) severely depressed patients who did not improve (51%). The best predictors of non-response to group therapy include high baseline problems in social functioning and low rates of self-reported Perceived Improvements in overall health. Conclusion Bipolar patients in a depressive episode appear to benefit from the same 20-week group CBASP model designed originally for the treatment of Persistent Depressive Disorder. Bipolar patients seem more easily mobilized both during and outside of group therapy sessions and report more interpersonal confidence and more agency than unipolar depressed patients.

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Section: Discussionsupporting

confidence: 83%

Section: Discussionsupporting

confidence: 83%

Section: Introductionmentioning

confidence: 99%

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Group Cognitive Behavioral Analysis System of Psychotherapy (CBASP): A Pilot Study for Bipolar Depression

et al. 2020

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“…BD is a spectrum disorder and classical presentation with recurrent manic and depressive episodes is seen in only 25% of the cases. 3 Commonly the patients have vague manifestations like mixed symptoms, anxiety spectrum disorders, psychotic features, subthreshold symptoms and rapid cycling. 4 In the youth, the clinical picture is further obscured by such externalizing disorders as attention deficit hyperactivity disorder, conduct disorder, and drug misuse.…”

Section: Introductionmentioning

confidence: 99%

The Discovery of Clinically Applicable Biomarkers for Bipolar Disorder: A Review of Candidate and Proteomic Approaches

Muneer

2020

Chonnam Med J

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Bipolar disorder (BD) is a severe psychiatric condition which affects innumerable people across the globe. The etiopathogenesis of BD is multi-faceted with genetic, environmental and psychosocial factors playing a role. Hitherto, the diagnosis and management of BD are purely on empirical grounds as we lack confirmed biomarkers for this condition. In this regard, hypothesis-driven investigations have been unable to identify clinically applicable biomarkers, steering the field towards newer technologies. Innovative, state-of-the-art techniques like multiplex immunoassays and mass spectrometry can potentially investigate the entire proteome. By detecting up or down regulated proteins, novel biomarkers are identified and new postulates about the etiopathogenesis of BD are specified. Hence, biological pathways are uncovered which are involved in the initiation and advancement of the disease and new therapeutic targets are identified. In this manuscript, the extant literature is thoroughly reviewed and the latest findings on candidate BD biomarkers are provided, followed by an overview of the proteomic approaches. It was found that due to the heterogeneous nature of BD no single biomarker is feasible, instead a panel of tests is more likely to be useful. With the application of latest technologies, it is expected that validated biomarkers will be discovered which will be useful as diagnostic tools and help in the delivery of individually tailored therapies to the patients.

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“…In the previous issue, Muneer and Mazommi systematically reviewed clinical staging models of major mood disorders and their associated clinical and neurobiological correlates [ 3 ]. Several assumptions must be made to create a useful staging model for a particular disease.…”

mentioning

confidence: 99%

Prerequisites for Appropriate Clinical Staging of Major Psychiatric Disorders

Kim

2018

Psychiatry Investig

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The Staging of Major Mood Disorders: Clinical and Neurobiological Correlates

Cited by 7 publications

References 68 publications

Group Cognitive Behavioral Analysis System of Psychotherapy (CBASP): A Pilot Study for Bipolar Depression

Group Cognitive Behavioral Analysis System of Psychotherapy (CBASP): A Pilot Study for Bipolar Depression

The Discovery of Clinically Applicable Biomarkers for Bipolar Disorder: A Review of Candidate and Proteomic Approaches

Prerequisites for Appropriate Clinical Staging of Major Psychiatric Disorders

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