Social adjustment of remitted bipolar and unipolar out-patients: a comparison with age- and sex-matched controls

Article Abstract:

The interpersonal relationships and social characteristics of patients with depressive disorders have received increasing attention. In the face of severe life events, certain interpersonal and social characteristics, such as joblessness or having no one to confide in, may increase the likelihood of depression. In the present investigation, 51 depressive patients (27 bipolar and 24 unipolar) and 26 controls, who were matched for age and sex, were studied for differences in social adjustment during remission, the relationship between sociodemographic variables and social adjustment, differences in adjustment between unipolar and bipolar patients, and the relationship between the course of illness and social adjustment during remission. Remission was defined as being symptom-free for at least six months. Subjects were rated on social adjustment using standard rating scales and were interviewed for sociodemographic data. Overall, patients had significantly worse scores for adjustment than controls, but the adjustment deficiency was mild. Contact with friends was particularly poor in bipolar patients and social interactions were severely diminished for unipolar patients. Leisure-time activities were not significantly affected the two patient groups, but they did report having difficulty making friends. Unipolar patients also showed some impairment in sexual functioning. Adjustment for these patients was independent of factors such as age at onset, residual symptoms, and average number of episodes per year. For bipolars, there was a mild effect of these factors in the course of illness. (Consumer Summary produced by Reliance Medical Information, Inc.)

Social aspects, Evaluation, Prognosis, Depression, Mental, Depression (Mood disorder), Social adjustment

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Sleep loss as a possible mediator of diverse causes of mania

Article Abstract:

It has been hypothesized that factors that disrupt sleep might trigger mania, which is ironically characterized, in part, by a reduced need for sleep. This has been suggested by research showing that mania is often induced in bipolar (manic-depressive) patients who are deprived of sleep by many psychological, situational, and medical factors that disrupt sleep. Prevention of sleep loss, therefore, might be one way to help prevent mania if this speculation is valid. A case is presented of a 59-year-old woman who was observed for 16 weeks in a research hospital. During her time there she experienced five episodes of mania. The first three episodes were spontaneous, while the fourth and fifth were experimentally induced by sleep deprivation for one night. In both cases the patient became manic on the day following sleep deprivation, supporting the hypothesis that sleep deprivation is one trigger of manic episodes in bipolar patients. Conversely, recovery of sleep triggered the alternate state, depression. During the course of observation, three types of situations seemed to trigger this patient's manic episodes: hospital admission preceded the first (representative of a life event met with strong emotional reaction), sedative-hypnotic drugs, which preceded the second and third episodes, and sleep deprivation. (Consumer Summary produced by Reliance Medical Information, Inc.)

Psychological aspects, Risk factors, Sleep deprivation, Mania

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Regional cerebral blood flow in patients with affective disorders

Article Abstract:

To document the physiological correlates of mental dysfunction, a number of studies have been conducted to measure the degree to which brain hemisphere lateralization can be associated with certain disorders. However, much previous research of regional cerebral blood flow (as an indicator of normal function) has produced conflicting results. Seventeen men and 21 women diagnosed with depression and who were free of substance dependency were subjected to single-photon emission computed tomography (SPECT) to obtain images of the blood flow in various regions of their brains. Sixteen normal controls underwent the same procedure. The only remarkable finding was that blood flow was asymmetrical (with greater perfusion of the right hemisphere) in patients with bipolar disorder (manic-depressives), compared with either the depressives or the normal subjects. This asymmetry held for right-handed patients only, suggesting that the dominant hemisphere in bipolar depressives may be receiving inadequate blood flow. (Consumer Summary produced by Reliance Medical Information, Inc.)

Cerebral circulation, Brain

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