1,720,962 research outputs found
Do euthymic bipolar patients have normal cognitive functioning?
No full textPurpose of review Research on the neurocognitive functions of bipolar patients has yielded inconsistent results over recent years. There is a growing need for clarification regarding the magnitude, clinical relevance and confounding variables of cognitive impairment in bipolar patients. Recent findings Current findings of studies investigating executive functions, psychomotor speed and memory functions suggest heterogeneous cognitive functioning in patients. A significant amount of variance can be attributed to treatment factors or interactions of those factors with the course of illness and individual characteristics. Furthermore, cognitive domains are presumably inter-related. The impact of bipolar illness on cognition can be influenced by age of onset, pharmaceutical treatment approaches, individual response, familial risk factors, and clinical features. Although brain activation patterns appear to be altered, these alternations do not necessarily correlate with impairment in cognitive performance. Without carefully controlling for confounding variables, the actual effect of bipolar disorder on cognitive performance scores cannot be evaluated. Summary Cognitive deficits of clinical relevance are documented for a substantial proportion, but not the majority, of bipolar patients. Yet, available data are inconclusive with respect to the origin of these deficits. Future studies on cognitive deficits in bipolar patients need to deliver detailed descriptions of drug treatment and clinical features
Academic Procrastination in Clients of a Psychotherapeutic Student Counselling Center
No full textThe start of university education is the beginning of a new phase of life for young adults, which requires significant psychosocial adjustments. Sociobiographical data, clinical symptoms, characteristics of education, work attitude, and career perspectives were gathered from 152 clients by a psychotherapeutic student counselling center to evaluate characteristics of students with and without academic procrastination. The procrastination group comprised heightened numbers of students who had changed universities, and people with suboptimal career prospects and career targets. These subjects were more often male and showed increased incidences of drug-and alcohol problems, as well as a lack of planning of the future. Furthermore, they had larger amounts of their study self-financed. On the basis of these results, concrete recommendations for preventive measures to improve on-time completion of study, and to prevent student drop-out are presented
Does antipsychotic treatment impair neurocognitive functions in euthymic bipolar patients?
No full textAnxiety- and novelty seeking-related personality traits and serotonin transporter gene polymorphisms
No full textThe affection of human personality by the promoter and the intron 2 polymorphism in the serotonin transporter gene (SERT) is inconsistently reported. We aimed to. clarify this situation by gender-specific haplotype-phenotype association. 98 women and 97 men completed the personality inventories NEO-PI-R and TPQ. The subjects were genotyped for the two SERT polymorphisms and the haplotypes were calculated. The short (S) and long (L) promoter alleles and the 12 and 10 repeat intron 2 alleles formed the haplotypes S 12, S 10, L 12 and L 10. In men, scores in the anxiety-related dimensions were higher in S 12 than in L 12 carriers. Opposite in direction, scores tended to be lower in S 10 than in L 10 carriers. In the novelty seeking-related dimensions, scores were higher in S 10 than in S 12 carriers. No association was observed in women. In conclusion, anxiety- and novelty seeking-related personality dimensions are differentially associated with different SERT haplotypes; the consistent restriction to men suggests common androgen regulation. Opposite trends with haplotypes including the same promoter alleles suggest contribution of group stratification to earlier inconsistent findings and call to further differentiate the molecular function and clinical implications of the SERT promoter polymorphism. (c) 2005 Elsevier Ltd. All rights reserved
Anxiety- and novelty seeking-related personality traits and serotonin transporter gene polymorphisms (vol 40, pg 568, 2006)
No full textDoes antipsychotic treatment impair neurocognitive functions in euthymic bipolar patients?
No full textDimensions of personality - Relationship between DSM-IV personality disorder symptoms, the five-factor model, and the biosocial model of personality
No full textDimensional approaches regard personality disorders as extreme or maladaptive variants of traits that are commonly used to describe normal personality. Previous clinical and nonclinical studies identified four factors interpreted as Antisocial, Asocial, Asthenic, and Anankastic. To investigate the validity of this four-factor structure in healthy volunteers, 97 male and 98 female students completed versions of the NEO-PI-R and TPQ. Symptoms of personality disorders were assessed using the ADP-IV questionnaire. A factor analysis of the personality and symptom scales revealed a four-factor solution accounting for 71.55% of the total variance. These factors resembling the "four A's" were labelled Asthenic, Sociable vs. Asocial, Antisocial, and Disorderly vs. An- ankastic. The results of this study support the presence of four factors in the description of adaptive as well as maladaptive personality traits
Neurocognitive functions in euthymic bipolar patients
No full textMeta-analytic findings support the hypothesis of specific neurocognitive deficits for bipolar patients in the domains of attention, processing speed, memory and executive functions. This study aims to show neurocognitive impairment in euthymic patients with bipolar I disorder compared with healthy controls while detailing the impact of medication side-effects or illness characteristics on neuropsychological test performance. Forty euthymic patients with bipolar I disorder were compared with 40 healthy controls in a cross-sectional design. Clinical features and neuropsychological measures of IQ, psychomotor speed, verbal fluency, learning and memory, executive functions and attention were assessed. Patients without antipsychotic drug use did not differ significantly from healthy controls in any neuropsychological measure. Yet patients treated with antipsychotics showed significant underperformance in the domains of semantic fluency, verbal learning and recognition memory as well as executive functions related to planning abilities, even when clinical features were controlled for. The impact of antipsychotic medication needs to be further clarified for euthymic bipolar patients and should be considered when neuropsychological test performance is interpreted
S100B and homocysteine in the acute alcohol withdrawal syndrome
No full textElevations of serum homocysteine levels are a consistent finding in alcohol addiction. Serum S100B levels are altered in different neuropsychiatric disorders but not well investigated in alcohol withdrawal syndromes. Because of the close connection of S100B to ACTH and glutamate secretion that both are involved in neurodegeneration and symptoms of alcoholism the relationship of S100B and homocysteine to acute withdrawal variables has been examined. A total of 22 male and 9 female inpatients (mean age 46.9 +/- A 9.7 years) with an ICD-10 diagnosis of alcohol addiction without relevant affective comorbidity were examined on admission and after 24, 48, and 120 h during withdrawal. S100B and homocysteine levels in serum were collected, and severity of withdrawal symptoms (AWS-scale), applied withdrawal medication, initial serum ethanol levels and duration of addiction were recorded. Serum S100B and homocysteine levels declined significantly (P < .05) over time. Both levels declined with withdrawal syndrome severity. Females showed a trend to a more intense decline in serum S100B levels compared to males at day 5 (P = .06). Homocysteine levels displayed a negative relationship to applied amount of clomethiazole (P < .05) and correlated with age of onset of addiction. No withdrawal seizures were recorded during the trial. As it is known for homocysteine, S100B revealed to decline rapidly over withdrawal treatment in alcoholism. This effect is more pronounced in female patients. S100B could be of relevance in the neurobiology of alcohol withdrawal syndromes. It may be indirectly related to the level of stress level or glutamatergic activity during alcohol withdrawal
Neurocognitive functions in euthymic patients with bipolar I disorder
No full textDie vorliegende Dissertationsschrift beschäftigt sich mit dem Ausmaß kognitiver Leistungsdefizite während der euthymen Phase einer Bipolar I Erkrankung und mit Faktoren, die das Leistungsniveau der Betroffen beeinflussen können. Es werden zunächst Befunde einer empirischen Arbeit vorgestellt, die 40 euthyme Bipolar I Patienten und 40 gesunde Kontrollprobanden im Hinblick auf ihre neuropsychologische Testleistung in verschiedenen Funktionsbereichen miteinander vergleicht. Die Ergebnisse dieser Studie zeigen nur für einen Teil der Patientenstichprobe signifikant geringere Testleistungen. Die Patientengruppe mit geringerer Testleistung unterscheidet sich von den Patienten ohne kognitive Leistungseinbußen nicht im Hinblick auf klinische Verlaufsmerkmale, sondern vielmehr im Hinblick auf ihre medikamentöse Behandlung. Die für bipolare Patienten wiederholt beschriebenen Einbußen in verbalen und exekutiven Fähigkeiten sind in dieser Untersuchung nur bei Patienten nachweisbar, die zusätzlich mit Antipsychotika behandelt werden. Diese Ergebnisse bilden den Grundstein für ein qualitatives Review der aktuellen Literatur zum Forschungsgebiet der Neuropsychologie bei bipolaren Patienten. Die Auseinandersetzung mit den zwischen 2008 und 2009 erschienenen Studien untermauert die große Heterogenität der bisher veröffentlichten Befunde. Als Ursachen werden die noch heute fehlende einheitliche Definition der euthymen Krankheitsphase diskutiert, ebenso wie die uneinheitliche Interpretation von neuropsychologischen Testergebnissen und die mangelhafte Dokumentation der medikamentösen Behandlung. Bisherige Untersuchungen erlauben demzufolge kaum eine eindeutige Klärung des Einflusses der Diagnose auf die neuropsychologische Testleistung. Angesichts fehlender randomisierter Studien, die krankheitsbedingte Einbußen von Behandlungseffekten trennen könnten, wird zusätzlich eine Meta-Analyse aller verfügbaren Studien aus dem Zeitraum 1993 bis 2010 durchgeführt. Dabei wird durch den Einsatz von Meta-Regressionen der Einfluss einer Antipsychotikabehandlung und der Residualsymptomatik auf Leistungsunterschiede in den einzelnen neuropsychologischen Funktionsbereichen quantifiziert. Eine Behandlung mit Antipsychotika geht in dieser Studie mit größerer psychomotorischer Verlangsamung sowie mit größeren Einbußen im verbalen Gedächtnis, in der Wiedererkennensleistung und in der Arbeitsgedächtniskapazität einher. Zusätzlich sagen depressive Symptome einen bedeutsamen Teil der Unterschiede in Wortflüssigkeit und psychomotorischer Geschwindigkeit voraus. Stichproben mit höherer manischer Restsymptomatik zeigen darüber hinaus schlechtere Wiedererkennensleistungen. Die Testleistungen im verbalen Lernen sind in dieser Meta-Analyse nicht durch die untersuchten Einflussfaktoren vorhersagbar und könnten auf Dysfunktionen in Bereichen des Temporallappens hinweisen. Es wird im Rahmen der vorgestellten Befunde ein krankheitsspezifisches Defizit im phonologischen und semantischen Enkodieren verbaler Informationen bei bipolar Erkrankten diskutiert. In Stichproben mit einem höheren Anteil an antipsychotisch behandelten Patienten sind in dieser Untersuchung die verbalen Gedächtnisleistungen stärker beeinträchtigt. Unabhängig von einer antipsychotischen Behandlung ist jedoch ein Defizit in der Wortflüssigkeit, dem gezielten Abruf von Informationen aus dem Langzeitgedächtnis, bei bipolaren Patienten nachweisbar. Dieses, durch eine depressive Symptomatik mitbedingte, Abrufproblem bildet einen weiteren potenziellen Einflussfaktor auf verbale Gedächtnisleistungen von bipolaren Patienten.This dissertation investigates cognitive deficits during the euthymic phase of bipolar I disorder as well as factors that influence cognitive functioning in bipolar patients. First, the results of an empiric study comparing neuropsychological test results of 40 euthymic bipolar I patients and 40 healthy controls are presented. Findings support a significantly lower test performance only in a subgroup of bipolar patients. In this study, patients with and without lower test performance do not differ in terms of clinical features, but they differ with regard to their medical treatment. Deficits in verbal abilities and executive functions that have been described for bipolar patients in former studies are only confirmed for patients under antipsychotic treatment. These results provide a basis for a qualitative review of the prevailing literature on the neuropsychology of bipolar patients. The examination of studies published between 2008 and 2009 supports a large heterogeneity within the publicized results. Possible causes might be the lack of a consistent definition for the euthymic phase, inconsistent interpretation of test results, and incomplete reports of medical treatment. The previous literature therefore hardly allows a well-defined discrimination of the impact of treatment and diagnosis on neuropsychological test performance. Given the lack of randomized studies suitable to distinguish effects of diagnosis and treatment, a meta-analysis is conducted, including all available studies between 1993 and 2010. Meta-regression is applied to quantify the impact of antipsychotic medication and residual symptoms on test performance. According to the results of this meta-regression, antipsychotic treatment is associated with increased psychomotor slowing, and decreased verbal memory, recognition and working memory functions in patient samples. The presence of residual depressive symptoms accounts for a significant proportion of variance in effects for verbal fluency and psychomotor speed. Recognition memory is more impaired in patient samples reporting higher scores for residual manic symptoms. The performance deficits in verbal learning cannot be explained by any of the variables investigated in this meta-analysis and therefore, may provide evidence for a temporal lobe dysfunction in bipolar disorder. A specific deficit in phonological and semantic encoding of verbal material is discussed for bipolar patients. Yet, verbal memory functions are more impaired in patient samples with a higher amount of patients using antipsychotic medication. In this study, verbal fluency, a measure of directed retrieval of information, is impaired in bipolar patients independent of their medication status. However, the impairment in verbal fluency is increased in samples with higher depression scores. This deficit in retrieval can additionally influence verbal memory performance of patients with bipolar disorder
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