Disorders - Bipolar Disorders
Zhang, Q., Yasen, A.
Background. Mania is a common psychological disease, which is often treated with drugs in clinical practice, but the effect of conventional
nursing intervention is not significant. Therefore, this study tries to intervene manic students through predictive nursing and psychological
education. Subjects and Methods. From March 2020 to March 2021, 116 manic students who entered our hospital for treatment were selected as research
subjects. They were randomly divided into a routine intervention group and a joint intervention group, each containing 58 manic students. The routine
intervention group was given routine nursing care in the psychiatric department of our hospital. The joint intervention group was intervened through
predictive nursing and psychological education. The intervention effect was evaluated by the Bech Rafaelsdn Mania Rating Scale (BRMS) and the Global
Assessment Scale (GAS). Results. Before the intervention, there was no significant difference in BRMS and GAS scores between the two groups (P >
0.01). After the intervention, the BRMS score of the joint intervention group was significantly lower than that of the control group, and the GAS
score was significantly higher than that of the control group, and the difference was statistically significant (P < 0.01). Table 1 shows the
comparison of BRMS and GAS scores between the two groups ofmanic students before and after the intervention. Conclusions. This study proved that the
intervention effect of predictive nursing combined with psychological education on manic students was significant. This therapy can effectively
reduce the onset of mania and improve the treatment compliance of patients by changing students' psychological cognition. This study is of great
significance to the psychological intervention of manic students.
CNS Spectrums, 28(Supplement 1) : S15
- Year: 2023
- Problem: Bipolar Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Psychoeducation, Other service delivery and improvement
interventions
Weintraub, M. J., Denenny, D., Ichinose, M. C., Zinberg, J., Morgan-Fleming, G., Done, M., Brown, R. D., Bearden, C. E., Miklowitz, D. J.
OBJECTIVES: There is substantial evidence that cognitive behavioral therapy (CBT) and mindfulness-based cognitive therapy (MBCT)
improve symptoms and functioning in adults with mood and psychotic disorders. There has been little work directly comparing these treatments among
adolescents with early-onset mood or psychosis symptoms.\rMETHOD: We conducted a randomized controlled trial comparing remotely administered group
CBT to group MBCT for adolescents (ages 13-17) with a mood disorder or attenuated psychosis symptoms. Adolescents attended nine sessions over 2
months; their parents attended parallel groups focused on the same skill practices. Participants were assessed for psychiatric symptoms and
functioning at posttreatment and 3 months posttreatment.\rRESULTS: Sixty-six youth (Mage = 15.1 years, SD = 1.4; 44 females [66.7%])
initiated the trial (32 in CBT and 34 in MBCT), with 54 retained at posttreatment and 53 at the 3-month follow-up. The treatments were associated
with comparable improvements in adolescents' mood, anxiety, attenuated psychosis symptoms, and psychosocial functioning over 5 months. CBT was
associated with greater improvements than MBCT in emotion regulation and well-being during the posttreatment period. MBCT (compared to CBT) was
associated with greater improvements in social functioning among adolescents with greater childhood adversity. Both treatments had comparable rates
of retention, but youth and parents reported more satisfaction with CBT than MBCT.\rCONCLUSIONS: The beneficial effect of both treatments in a group
telehealth format is encouraging. Due to our limited sample, future research should investigate whether adolescents' history of adversity and
treatment preferences replicate as treatment moderators for youth with mood or psychosis symptoms. (PsycInfo Database Record (c) 2023 APA, all rights
reserved).
Journal
of Consulting & Clinical Psychology, 91(4) : 234-241
- Year: 2023
- Problem: Anxiety Disorders (any), Bipolar Disorders, Depressive Disorders, Psychosis Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention), Disorder established (diagnosed disorder)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Mindfulness based
therapy, Technology, interventions delivered using technology (e.g. online, SMS)
Wang, Z., Zhang, D., Du, Y., Wang, Y., Huang, T., Ng, C. H., Huang, H., Pan, Y., Lai, J., Hu, S.
Effective pharmacotherapy of bipolar depression with mixed
features defined by DSM-5 remains unclear in clinical treatment guidelines. Quetiapine (QTP) and valproate have potential treatment utility but are
often inadequate as monotherapy. Meanwhile, the efficacy of combination therapies of QTP plus valproate or lithium have yet to be verified. Hence, we
conducted a randomized controlled pilot study to evaluate the efficacy of QTP monotherapy in patients with bipolar depression with mixed features
defined by DSM-5 and compared the combination therapy of QTP plus valproate (QTP + V) versus QTP plus lithium (QTP + L) for those patients who
responded insufficiently to QTP monotherapy. Data was analyzed according to the intent-to-treat population. Generalized linear mixed model was
performed by using \"nlme\" package in R software. A total 56 patients were enrolled, among which, 35 patients responded to QTP alone, and 11 and 10
patients were randomly assigned to QTP + V and QTP + L group, respectively. Nearly 60% enrolled patients responded to QTP monotherapy at the first
two weeks treatment. No statistically significant difference in efficacy between QTP + V and QTP + L was observed. In conclusion, QTP monotherapy
appeared to be efficacious in patients with bipolar depression with mixed features, and for those who responded insufficiently to QTP, combining with
either valproate or lithium appeared to have positive effects. Copyright © 2023 by the authors.
, 16(2) (no
pagination) :
- Year: 2023
- Problem: Bipolar Disorders
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any), Atypical Antipsychotics (second
generation), Anticonvulsants/mood stabilisers (excl. lithium), Lithium
Wang, D., Tang, L., Xi, C., Luo, D., Liang, Y., Huang, Q., Wang, Z., Chen, J., Zhao, X., Zhou, H., Wang, F., Hu, S.
A more effective and better-tolerated site for repetitive
transcranial magnetic stimulation (rTMS) for treating cognitive dysfunction in patients with bipolar disorder (BD) is needed. The primary visual
cortex (V1) may represent a suitable site. To investigate the use of the V1, which is functionally linked to the dorsolateral prefrontal cortex
(DLPFC) and anterior cingulate cortex (ACC), as a potential site for improving cognitive function in BD. Seed-based functional connectivity (FC)
analysis was used to locate targets in the V1 that had significant FC with the DLPFC and ACC. Subjects were randomly assigned to 4 groups, namely,
the DLPFC active-sham rTMS (A1), DLPFC sham-active rTMS (A2), ACC active-sham rTMS (B1), and ACC sham-active rTMS groups (B2). The intervention
included the rTMS treatment once daily, with five treatments a week for four weeks. The A1 and B1 groups received 10 days of active rTMS treatment
followed by 10 days of sham rTMS treatment. The A2 and B2 groups received the opposite. The primary outcomes were changes in the scores of five tests
in the THINC-integrated tool (THINC-it) at week 2 (W2) and week 4 (W4). The secondary outcomes were changes in the FC between the DLPFC/ACC and the
whole brain at W2 and W4. Of the original 93 patients with BD recruited, 86 were finally included, and 73 finished the trial. Significant
interactions between time and intervention type (Active/Sham) were observed in the scores of the accuracy of the Symbol Check in the THINC-it tests
at baseline (W0) and W2 in groups B1 and B2 (F = 4.736, p = 0.037) using a repeated-measures analysis of covariance approach. Group B1 scored higher
in the accuracy of Symbol Check at W2 compared with W0 (p < 0.001), while the scores of group B2 did not differ significantly between W0 and W2. No
significant interactions between time and intervention mode were seen between groups A1 and A2, nor was any within-group significance of FC between
DLPFC/ACC and the whole brain observed between baseline (W0) and W2/W4 in any group. One participant in group B1 experienced disease progression
after 10 active and 2 sham rTMS sessions. The present study demonstrated that V1, functionally correlated with ACC, is a potentially effective rTMS
stimulation target for improving neurocognitive function in BD patients. Further investigation using larger samples is required to confirm the
clinical efficacy of TVCS. Copyright © 2023, The Author(s).
Translational
Psychiatry, 13(1) (no pagination) :
- Year: 2023
- Problem: Bipolar Disorders
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any), Transcranial magnetic stimulation
(TMS)
Lei, D., Li, W., Qin, K., Ai, Y., Tallman, M. J., Patino, L. R., Welge, J. A., Blom,
T. J., Klein, C. C., Fleck, D. E., Gong, Q., Adler, C. M., Strawn, J. R., Sweeney, J. A., DelBello, M. P.
Disruptions in the limbic system, and in emotion regulation circuitry that supports affect
modulation, have been reported during acute manic episodes of bipolar disorder (BD). The impact of pharmacological treatment on these deficits,
especially in youth, remains poorly characterized. 107 youths with acute manic or mixed episodes of bipolar I disorder and 60 group-matched healthy
controls were recruited. Youth with bipolar disorder were randomized to double-blind treatment with quetiapine or lithium and assessed weekly. Task-
based fMRI studies were performed using an identical pairs continuous performance task (CPT-IP) at pre-treatment baseline and post-treatment weeks
one and six. Region of interest analyses focused on the limbic system and ventral PFC - basal ganglia - thalamocortical loop structures known to be
involved in emotion regulation. Changes in regional activation were compared between the two treatment groups, and pretreatment regional activation
was used to predict treatment outcome. Mania treatment scores improved more rapidly in the quetiapine than lithium treated group, as did significant
normalization of neural activation toward that of healthy individuals in left amygdala (p = 0.007), right putamen (p < 0.001), and right globus
pallidus (p = 0.003). Activation changes in the right putamen were correlated with reduction of mania symptoms. The limbic and emotion regulation
system activation at baseline and week one predicted treatment outcome in youth with bipolar disorder with significant accuracy (up to 87.5%). Our
findings document more rapid functional brain changes associated with quetiapine than lithium treatment in youth with bipolar disorder, with most
notable changes in the limbic system and emotion regulation circuitry. Pretreatment alterations in these regions predicted treatment response. These
findings advance understanding of regional brain alterations in youth with bipolar disorder, and show that fMRI data can predict treatment outcome
before it can be determined clinically, highlighting the potential utility of fMRI biomarkers for early prediction of treatment outcomes in bipolar
disorder.Clinical Trials Registration: Name: Multimodal Neuroimaging of Treatment Effects in Adolescent Mania. URL: https://clinicaltrials.gov/ .
Registration number: NCT00893581.
Neuropsychopharmacology, 48(4) : 615-622
- Year: 2023
- Problem: Bipolar Disorders
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any), Atypical Antipsychotics (second
generation), Lithium
Janiri, D., Moccia, L., Montanari, S., Zani, V., Prinari, C., Monti, L., Chieffo, D., Mazza, M., Simonetti, A., Kotzalidis, G. D., Janiri, L.
BACKGROUND: Lithium is
the standard treatment for bipolar disorders (BD) in adults. There is a dearth of data on its use in the pediatric age. This review aimed to
investigate the use of lithium in pediatric bipolar disorder (BD) and other externalizing childhood-related disorders.\rMETHODS: We applied the
Preferred Reporting Items for Systematic Reviews and Meta-analyses criteria (PRISMA) to identify randomized controlled trials evaluating the use of
lithium in pediatric (BD), conduct disorder (CD), attention deficit hyperactivity disorder, oppositional defiant disorder, and disruptive mood
dysregulation disorder. The primary outcome of our study was to evaluate the efficacy of lithium compared to a placebo or other pharmacological
agents. The secondary outcomes were acceptability and tolerability.\rRESULTS: Twelve studies were eligible, 8 on BD and 4 on CD. Overall, 857
patients were treated with lithium. No studies for externalizing disorder diagnoses were identified. Regarding BD patients (n = 673), efficacy
results suggested that lithium was superior to placebo in manic/mixed episodes but inferior to antipsychotics. Lithium efficacy ranged from 32% to
82.4%. Results on maintenance need to be expanded. Comorbidity rates with other externalizing disorders were extremely high, up to 98.6%. Results in
CD patients (n= 184) suggested the efficacy of lithium, especially for aggressive behaviors. No severe adverse events directly related to lithium
were reported in BD and CD; common side effects were similar to adults.\rCONCLUSION: This systematic review supports the use of lithium in BD and CD
as an efficacious and generally well-tolerated treatment in the pediatric age. However, evidence is limited due to the paucity of available data.
Current Neuropharmacology, 21(6) : 1329-
1342
- Year: 2023
- Problem: Bipolar Disorders
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any), Lithium
Delbello, M. P., Bruns, K. M., Bloom, T., Patino Duran, L. R., Strawn, J., Adler, C., Welge, J.
Objective: To conduct a pilot study to examine topiramate for the
treatment of weight gain associated with olanzapine in manic adolescents with bipolar disorder. Method(s): We conducted a 12-week double-blind
randomized placebo-controlled pilot study of topiramate (300-400 mg/day) versus placebo in manic youth (ages 10-18 years) with bipolar disorder who
were treated with olanzapine (10-20 mg/day). The primary outcome measure was gender- and weight-normed change in body mass index (BMI z-score).
Result(s): Thirty manic adolescents were treated with olanzapine and were randomized to either topiramate (n = 16) or placebo (n = 14). There was a
significantly greater increase in BMI z-scores in the placebo group (0.28 standard deviations [SDs]) compared with the topiramate group (0.10 SDs)
when analyzed by longitudinal regression (p = 0.049). The placebo group had greater increases in raw BMI and weight (2.25 kg/m2 and 6.9 kg,
respectively) compared with the topiramate (0.99 kg/m2 and 2.9 kg) group (p = 0.011 for BMI, p = 0.016 for weight). The most common adverse events in
the topiramate group were headache (n = 7, 44%), gastrointestinal upset (n = 3, 19%), and muscle stiffness (n = 3, 19%). Conclusion(s): Topiramate
may minimize the weight gain associated with olanzapine treatment in adolescents with bipolar disorder. Moreover, topiramate in combination with
olanzapine was well tolerated. Larger studies that are adequately powered are necessary to determine the efficacy of topiramate for second-generation
antipsychotic-related weight gain. Copyright © 2023, Mary Ann Liebert, Inc.
Journal of Child and Adolescent Psychopharmacology, 33(4) : 126-
133
- Year: 2023
- Problem: Bipolar Disorders
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any), Atypical Antipsychotics (second
generation), Anticonvulsants/mood stabilisers (excl. lithium)
Zhuo,
C., Chen, G., Chen, J., Tian, H., Ma, X., Li, Q., Yang, L., Zhang, Q., Li, R., Song, X., Huang, C.
Lithium monotherapy
has been proposed to have antidepressant and antimanic effects in patients with bipolar disorder (BP). However, so far, it is lack of evidence to
support this proposition. The main aim of this study was to test the hypothesis that lithium bidirectionally regulates depression- and mania-related
brain functional abnormalities in patients with BP. We also assessed the effects of lithium, alone and in combination with other pharmacological
treatments, on patients' cognitive performance. We enrolled 149 drug-naive patients with BP; 99 patients experiencing first depressive episodes were
allocated randomly to four treatment groups [lithium (DP/Li), lithium with lamotrigine (LTG; DP/Li+LTG), LTG (DP/LTG), and valproate (VPA) with LTG
(DP/VPA+LTG)], and 50 experiencing first hypo-manic episodes were allocated to two treatment groups (MA/Li and MA/VPA). For comparative analysis, 60
age-matched healthy individuals were also recruited. Whole-brain global and regional resting-state cerebral blood flow (rs-CBF) and cognitive
alterations were examined before and after 12-week treatment. We have the following findings: DP/Li+LTG, and to a lesser extent DP/Li, alleviated the
depression-related reduction in rs-CBF. MA/VPA and MA/Li reversed the mania-related elevation of rs-CBF completely and partially, respectively.
Lithium alone improved cognitive performance during depressive and manic episodes; other tested treatments have no such effect or worsened cognitive
ability. Our results showed that lithium bidirectionally regulates depression- and mania-associated brain functional abnormalities in patients with
BP. Lithium monotherapy has a better antimanic effect than VPA, is superior to other tested treatments in improving cognition during the course of
BP, and has satisfactory antidepressant effects in patients with BP. Copyright © 2022 Zhuo, Chen, Chen, Tian, Ma, Li, Yang, Zhang, Li, Song and
Huang.
Frontiers in Psychiatry, 13 (no
pagination) :
- Year: 2022
- Problem: Bipolar Disorders
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any), Anticonvulsants/mood stabilisers (excl. lithium), Lithium
Zeng, C., Qiu, Y., Li, S., Teng, Z., Xiang, H., Chen, J., Wu, X., Cao, T., Zhang, S., Chen, Q., Wu, H., Cai,
H.
Background: Currently no study has examined the effects of probiotic administration on the symptoms of anxiety, depression,
and mania, as well as their correlations with the biomarkers of oxidative stress in patients with bipolar disorder (BPD). The aim of this study is to
determine the effects of probiotic supplementation on plasma oxidative stress-related biomarkers and different domains of clinical symptom in
patients suffering from BPD. Method(s): Eighty first-episode drug-naive patients with BPD were recruited. The subjects were randomized to receive
psychotropic drugs supplementing with either probiotic or placebo and scheduled to evaluate with follow-ups for clinical symptom improvements and
changes in the oxidative stress biomarkers. The Hamilton Depression Rating Scale, Hamilton Anxiety Rating Scale, and Young Mania Rating Scale were
used to assess the clinical symptomatology. The panel of plasma oxidative stress biomarkers were determined by ultra-performance liquid
chromatography-mass spectrometry (UPLC-MS/MS) at baseline and for 3 months of follow-up, i.e., at post-treatment month 1, 2, and 3. Result(s): After
3 months of intervention, decreased levels of plasma lysophosphatidylcholines (LPCs) were found in both placebo and probiotic groups. However, six
other oxidative stress biomarkers (i.e., creatine, inosine, hypoxanthine, choline, uric acid, allantoic acid) increased in BPD patients after the two
types of therapies. In addition, a positive correlation between changes of LPC (18:0) and YMRS scale was found in BPD patients and this association
only existed in the probiotic group. Additionally, the mania symptom greatly alleviated (pretreatment-posttreatment, odds ratio = 0.09, 95%CI = 0.01,
0.64, p= 0.016) in patients who received probiotic supplements as compared with the placebo group. Conclusion(s): The changes in plasma biomarkers of
oxidative stress in patients with BPD have a potential to be trait-like markers, and serve as prognostic indexes for bipolar patients. Daily intakes
of probiotics have advantageous effects on BPD patients with certain clinical symptoms, especially manic symptoms. The treatment may be a promising
adjunctive therapeutic strategy for BPD patients in manic episode.Copyright © 2022 Zeng, Qiu, Li, Teng, Xiang, Chen, Wu, Cao, Zhang, Chen, Wu and
Cai.
Frontiers in Pharmacology, 13 : 829815
- Year: 2022
- Problem: Bipolar Disorders
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Vitamins and supplements
Yule, A. M., DiSalvo, M., Kramer, J., Woodward, D. W., Lyons, R. M., Wilens, T. E.
Objectives: The objective is to compare the efficacy of quetiapine on substance use and mood symptoms for the treatment of
youth with a co-occurring substance use disorder (SUD) and bipolar disorder. Method(s): Pilot 8-week, randomized, double-blind trial of adjuvant
quetiapine titrated up to 300 mg per day vs placebo for youth aged 15 to 24 years with a co-occurring SUD and bipolar disorder with symptoms of
severe mood dysregulation and current substance use. Outcome measures included proportion of past 28 days with substance use assessed by timeline
follow back, mania assessed on the Young Mania Rating Scale, depression assessed by the Beck Depression Inventory II (BDI-II), and the Global
Assessment of Functioning (GAF) rating scale. This was a modified intention-to-treat analysis defined by completing 1 week of study medication, and
outcome measures were analyzed using mixed-effects linear or Poisson regression models, depending on the distribution. Result(s): Nineteen subjects
completed 1 week of medication (quetiapine = 10, placebo = 9). Cannabis was the most common primary SUD identified by participants (79%), and 95% of
participants (N = 18) met criteria for bipolar disorder type 1. The mean age of subjects was 20.6 +/- 1.9 years, 63% were female, 63% were White, 79%
were not Hispanic/Latino, and there were no significant differences in baseline demographics between the groups (p's >.05). There were no
significant differences between groups in change in proportion of days with substance use or BDI-II score (p's >.05). However, when compared to
placebo, subjects randomized to quetiapine had a greater decrease in YMRS score (-8.8 +/- 8.1 vs -0.4 +/- 7.5, p =.005) and greater improvement in
GAF score (8.0 +/- 6.3 vs 0.8 +/- 4.5, p =.009). Conclusion(s): Despite a small sample size treatment with quetiapine resulted in greater
improvements in symptoms of mania and overall functioning among youth with co-occurring SUD and bipolar disorder. SUD, BRD, TREAT Copyright ©
2022
Journal of the American Academy of Child and Adolescent Psychiatry, 61(10
Supplement) : S271
- Year: 2022
- Problem: Bipolar Disorders, Substance Use Disorders (any)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any), Atypical Antipsychotics (second
generation)
Weintraub, M. J., Schneck, C. D., Posta, F., Merranko, J.
A., Singh, M. K., Chang, K. D., Miklowitz, D. J.
Objectives: Family-focused
therapy (FFT) is associated with reduced rates of mood episodes among youth at high risk for bipolar disorder (BD). In a randomized trial of FFT
compared to a psychoeducation-only treatment (enhanced care, EC), we sought to determine if changes in psychosocial functioning mediate mood
improvements among high-risk youth. Method: 119 youths with active mood symptoms and a family history of BD were randomized to either 4 months of FFT
or EC. Participants were rated on mood symptom severity and provided self-ratings of psychosocial functioning across domains of family, social-
emotional, and school functioning. Repeated measures mixed modeling and bootstrapped mediational analyses evaluated the effects of treatment
conditions and psychosocial functioning on mood improvements immediately posttreatment and over 2 years of follow-up. Results: Youths in FFT reported
greater improvements in family functioning over 24 months compared to those in EC, F(5, 76.8) = 3.1, p < .05. Improvements in family functioning
partially mediated participants' improvements in depressive symptoms, B = -0.22, p < .01; 95% CI [-0.55, -0.02]. The effects of FFT versus EC on
family functioning were stronger among youth with comorbid anxiety and externalizing disorders than among youth without these comorbid disorders.
Conclusions: The findings suggest a temporal link between changes in youths' perceptions of family functioning and improvements in depressive
symptoms among high-risk youth in FFT. Family conflict and cohesion are important treatment targets for youth who present with early signs of BD.
Future studies should examine whether changes in observational measures of family interaction precede improvements in mood among high-risk youth.
(PsycInfo Database Record (c) 2022 APA, all rights reserved) Impact Statement What is the public health significance of this article?: This study
found that family-focused therapy leads to reductions in depressive symptoms via improvements in family functioning among youth who are at high risk
for bipolar disorder. These findings highlight the importance of intervening on the immediate family unit in order to improve mood symptoms among
these youth. (PsycInfo Database Record (c) 2022 APA, all rights reserved)
Journal of Consulting and Clinical
Psychology, 90(2) : 161-171
- Year: 2022
- Problem: Bipolar Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Family therapy, Psychoeducation
Vannucci, C., Bonsall, M. B., Di-Simplicio, M. Cairns,
A., Holmes, E. A., Burnett-Heyes, S.
Positive mood amplification is a hallmark of the bipolar disorder spectrum
(BPDS). We need better understanding of cognitive mechanisms contributing to such elevated mood. Generation of vivid, emotionally compelling mental
imagery is proposed to act as an 'emotional amplifier' in BPDS. We used a positive mental imagery generation paradigm to manipulate affect in a
subclinical BPDS-relevant sample reporting high (n = 31) vs. low (n = 30) hypomanic-like experiences on the Mood Disorder Questionnaire (MDQ).
Participants were randomized to an 'elated' or 'calm' mental imagery condition, rating their momentary affect four times across the experimental
session. We hypothesized greater affect increase in the high (vs. low) MDQ group assigned to the elated (vs. calm) imagery generation condition. We
further hypothesized that affect increase in the high MDQ group would be particularly apparent in the types of affect typically associated with
(hypo)mania, i.e., suggestive of high activity levels. Mixed model and time-series analysis showed that for the high MDQ group, affect increased
steeply and in a sustained manner over time in the 'elated' imagery condition, and more shallowly in 'calm'. The low-MDQ group did not show this
amplification effect. Analysis of affect clusters showed high-MDQ mood amplification in the 'elated' imagery condition was most pronounced for
active affective states. This experimental model of BPDS-relevant mood amplification shows evidence that positive mental imagery drives changes in
affect in the high MDQ group in a targeted manner. Findings inform cognitive mechanisms of mood amplification, and spotlight prevention strategies
targeting elated imagery, while potentially retaining calm imagery to preserve adaptive positive emotionality. Copyright © 2022, The Author(s).
Translational
Psychiatry, 12(1) (no pagination) :
- Year: 2022
- Problem: Bipolar Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions