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Johnson R, Bhandary P R, Guddatu V, Kamath C, John S. Comparison of verbal fluency performance in Kannada-speaking adults with and without euthymic bipolar disorder type 1. Appl Neuropsychol Adult 2023:1-11. [PMID: 38117696 DOI: 10.1080/23279095.2023.2289550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2023]
Abstract
Individuals with euthymic bipolar disorder (BD) type I exhibit deficits in executive functions. Although less explored in the BD population, the tasks of verbal fluency (VF) have shown great potential in understanding semantic organization. This study provides an extensive exploration across the letter and semantic VF tasks in 27 demographically matched euthymic BD-I and healthy controls (HC). The groups were compared on measures of the total number of correct words (TNCW), temporal pattern analysis, number of clusters (NC), mean cluster size (MCS), number of switches (NS), and error pattern. An overall reduction in letter fluency scores (the TNCW, number of switches, and NC) as compared to semantic fluency scores was noted for both groups, with a significantly greater decrease in the BD-1 group. The MCS and temporal pattern were relatively similar across the two groups. The influence of education with no gender difference was observed between groups with error types prevalent in both groups. The study findings call attention toward assessing the VF performance in persons with BD in terms of error production and the strategies employed (clustering-switching).
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Affiliation(s)
- Rachel Johnson
- Department of Speech and Hearing, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, India
| | | | - Vasudeva Guddatu
- Department of Data Science, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, India
| | - Chinmayi Kamath
- Department of Speech and Hearing, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, India
| | - Sunila John
- Department of Speech and Hearing, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, India
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Abstract
Psychomotor slowing is a key feature of depressive disorders. Despite its great clinical importance, the pathophysiology and prevalence across different diagnoses and mood states are still poorly understood. Actigraphy allows unbiased, objective, and naturalistic assessment of physical activity as a marker of psychomotor slowing. Yet, the true effect-sizes remain unclear as recent, large systematic reviews are missing. We conducted a novel meta-analysis on actigraphically measured slowing in depression with strict inclusion and exclusion criteria for diagnosis ascertainment and sample duplications. Medline/PubMed and Web-of-Science were searched with terms combining mood-keywords and actigraphy-keywords until September 2021. Original research measuring actigraphy for ⩾24 h in at least two groups of depressed, remitted, or healthy participants and applying operationalized diagnosis was included. Studies in somatically ill patients, N < 10 participants/group, and studies using consumer-devices were excluded. Activity-levels between groups were compared using random-effects models with standardized-mean-differences and several moderators were examined. In total, 34 studies (n = 1804 patients) were included. Patients had lower activity than controls [standardized mean difference (s.m.d.) = -0.78, 95% confidence interval (CI) -0.99 to -0.57]. Compared to controls, patients with unipolar and bipolar disorder had lower activity than controls whether in depressed (unipolar: s.m.d. = -0.82, 95% CI -1.07 to -0.56; bipolar: s.m.d. = -0.94, 95% CI -1.41 to -0.46), or remitted/euthymic mood (unipolar: s.m.d. = -0.28, 95% CI -0.56 to 0.0; bipolar: s.m.d. = -0.92, 95% CI -1.36 to -0.47). None of the examined moderators had any significant effect. To date, this is the largest meta-analysis on actigraphically measured slowing in mood disorders. They are associated with lower activity, even in the remitted/euthymic mood-state. Studying objective motor behavior via actigraphy holds promise for informing screening and staging of affective disorders.
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Affiliation(s)
- Florian Wüthrich
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Carver B Nabb
- Department of Psychiatry and Behavioral Sciences, Northwestern University, Chicago, IL, USA
| | - Vijay A Mittal
- Department of Psychiatry and Behavioral Sciences, Northwestern University, Chicago, IL, USA
- Department of Psychology, Northwestern University, Evanston, IL, USA
- Institute for Innovations in Developmental Sciences, Northwestern University, Evanston/Chicago, IL, USA
- Institute for Policy Research, Northwestern University, Evanston, IL, USA
- Medical Social Sciences, Northwestern University, Chicago, IL, USA
| | - Stewart A Shankman
- Department of Psychiatry and Behavioral Sciences, Northwestern University, Chicago, IL, USA
- Department of Psychology, Northwestern University, Evanston, IL, USA
| | - Sebastian Walther
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
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Lee CN, Huang YL, Chang HH, Kuo CY, Lu TH, Hsieh YT, Chang WH, Yang YK, Chen PS, Tseng HH. Associations of emotion recognition, loneliness, and social functioning in euthymic patients with bipolar disorder. Kaohsiung J Med Sci 2022; 38:703-711. [PMID: 35394707 DOI: 10.1002/kjm2.12539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 02/11/2022] [Accepted: 03/07/2022] [Indexed: 11/05/2022] Open
Abstract
Emotion recognition deficit is related to impaired community functioning. Loneliness is also associated with impaired social performance. However, the way in which emotion recognition and loneliness may contribute to social functioning remains unclear in euthymic patients with bipolar disorder. We aimed to examine emotion recognition ability in Han Chinese euBD patients relative to healthy controls (HCs) and to investigate the associations between emotion recognition, loneliness, and social functioning. Thirty-nine HCs and 46 euthymic BD patients completed an emotion recognition task and nonsocial cognitive measures related to executive function and attention. The UCLA loneliness scale and Social Performance Scale were administered to evaluate psychological loneliness and social functioning, respectively. We observed lower emotion recognition accuracy, higher loneliness, and poorer social functioning in the BD patients after adjustment for demographic data. Loneliness was negatively associated with global social functioning in both the BD and HC groups. Higher loneliness and lower emotion recognition accuracy were associated with poorer social functioning in euthymic BD in different subdomains. Our study confirmed a subtle impairment of emotion recognition ability in euthymic BD. Loneliness impacts globally on social functioning, while emotion recognition ability may affect specific subdomains of social functioning in euthymic BD. Alleviation of loneliness and enhancement of social cognition might improve social functioning in BD patients.
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Affiliation(s)
- Chia Ning Lee
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yu-Lien Huang
- Department of Psychology, Fo Guang University, Yilan, Taiwan
| | - Hui Hua Chang
- Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,School of Pharmacy, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Department of Pharmacy, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Che Yu Kuo
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Tsung-Hua Lu
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yi-Ting Hsieh
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Wei Hung Chang
- Department of Psychiatry, National Cheng Kung University Hospital, Dou-Liou Branch, Yunlin, Taiwan
| | - Yen Kuang Yang
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Institute of Behavioral Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Department of Psychiatry, Tainan Hospital, Ministry of Health and Welfare, Tainan, Taiwan
| | - Po See Chen
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Institute of Behavioral Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Huai-Hsuan Tseng
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Institute of Behavioral Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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Yang H, Liu Y, Yang C, Lin X. The effect of systemic antidepressant treatments in early stage on neurocognitive function of euthymic bipolar patients initiated with a depressive onset: An observational, cross-sectional, single-blind study protocol. Brain Behav 2021; 11:e2360. [PMID: 34520638 PMCID: PMC8553326 DOI: 10.1002/brb3.2360] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 08/28/2021] [Accepted: 08/31/2021] [Indexed: 02/02/2023] Open
Abstract
OBJECTIVES Patients with bipolar disorder (BD) have a wide range of neurocognitive dysfunction even in euthymic state, leading to impaired psychosocial function and reduced quality of life. However, the understanding on risk factors related to neurocognitive impairment in such group of people is limited. In view of significantly delayed diagnosis of BD and common use of antidepressants prior to the BD diagnosis, the study aims to clarify whether systemic antidepressant use in early stage, defined as from the initial depressive episode to the diagnosis of BD, could impact neurocognitive function of euthymic bipolar patients. METHODS It is an observational, cross-sectional, single-blind trial, making a comparison in neurocognitive function between euthymic bipolar patients who had a depressive episode as initial onset and being with and without systemic antidepressant treatments in early stage (n = 62 and 62, respectively); secondary outcomes include the impact of systemic antidepressant use on global function, quality of life, sleep quality, positive and negative affect, and peripheral level of neuron-specific enolase. DISCUSSION The study will provide a comprehensive and in-depth understanding on the effect of systemic antidepressant treatments in early stage in such group of patients. It is expected to better guide the related prevention and treatment work of BD management. TRIAL REGISTRATION The study was registered on Clinicaltrials.gov with protocol ID (TJAH2020-18) and clinicaltrials.gov ID (NCT04564573).
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Affiliation(s)
- Huizeng Yang
- Tianjin Mental Health Center, Tianjin Anding Hospital, Tianjin, China
| | - Yuanyuan Liu
- Tianjin Mental Health Center, Tianjin Anding Hospital, Tianjin, China
| | - Chenghao Yang
- Tianjin Mental Health Center, Tianjin Anding Hospital, Tianjin, China
| | - Xiaoling Lin
- School of Nursing, Sun Yat-sen University, Guangzhou, China
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Masuda Y, Okada G, Takamura M, Shibasaki C, Yoshino A, Yokoyama S, Ichikawa N, Okuhata S, Kobayashi T, Yamawaki S, Okamoto Y. White matter abnormalities and cognitive function in euthymic patients with bipolar disorder and major depressive disorder. Brain Behav 2020; 10:e01868. [PMID: 33009714 PMCID: PMC7749556 DOI: 10.1002/brb3.1868] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 08/12/2020] [Accepted: 09/14/2020] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVES In recent years, a growing number of diffusion tensor imaging (DTI) studies have compared white matter integrity between patients with major depressive disorder (MDD) and bipolar disorder (BD). However, few studies have examined the pathophysiological significance of different degrees of white matter abnormalities between the two disorders. The present study comprehensively assessed white matter integrity among healthy controls (HC) and euthymic patients with MDD and BD using whole-brain tractography and examined associations between white matter integrity and cognitive functioning. METHODS We performed neurocognitive examinations and DTI with 30 HCs, 30 patients with MDD, and 30 patients with BD. We statistically evaluated white matter integrity and cognitive function differences across the three groups, assessing associations between white matter integrities and cognitive function. RESULTS The BD group showed lower fractional anisotropy (FA) for the corpus callosum body, as well as lower, sustained attention and set-shifting scores compared to the other groups. FA for the left body of the corpus callosum was correlated with sustained attention in patients with BD. CONCLUSIONS The significant reduction of white matter integrity in the corpus callosum in BD, compared to MDD, was associated with an impairment of sustained attention. This result promotes the understanding of the significance of white matter integrity in mood disorders.
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Affiliation(s)
- Yoshikazu Masuda
- Department of Psychiatry and Neuroscience, Hiroshima University, Hiroshima, Japan
| | - Go Okada
- Department of Psychiatry and Neuroscience, Hiroshima University, Hiroshima, Japan
| | - Masahiro Takamura
- Department of Psychiatry and Neuroscience, Hiroshima University, Hiroshima, Japan
| | - Chiyo Shibasaki
- Department of Psychiatry and Neuroscience, Hiroshima University, Hiroshima, Japan
| | - Atsuo Yoshino
- Department of Psychiatry and Neuroscience, Hiroshima University, Hiroshima, Japan
| | - Satoshi Yokoyama
- Department of Psychiatry and Neuroscience, Hiroshima University, Hiroshima, Japan
| | - Naho Ichikawa
- Department of Psychiatry and Neuroscience, Hiroshima University, Hiroshima, Japan
| | - Shiho Okuhata
- Graduate School of Engineering, Kyoto University, Kyoto, Japan
| | | | - Shigeto Yamawaki
- Department of Psychiatry and Neuroscience, Hiroshima University, Hiroshima, Japan
| | - Yasumasa Okamoto
- Department of Psychiatry and Neuroscience, Hiroshima University, Hiroshima, Japan
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Smirnova D, Cumming P, Sloeva E, Kuvshinova N, Romanov D, Nosachev G. Language Patterns Discriminate Mild Depression From Normal Sadness and Euthymic State. Front Psychiatry 2018; 9:105. [PMID: 29692740 PMCID: PMC5902561 DOI: 10.3389/fpsyt.2018.00105] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Accepted: 03/15/2018] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES Deviations from typical word use have been previously reported in clinical depression, but language patterns of mild depression (MD), as distinct from normal sadness (NS) and euthymic state, are unknown. In this study, we aimed to apply the linguistic approach as an additional diagnostic key for understanding clinical variability along the continuum of affective states. METHODS We studied 402 written reports from 124 Russian-speaking patients and 77 healthy controls (HC), including 35 cases of NS, using hand-coding procedures. The focus of our psycholinguistic methods was on lexico-semantic [e.g., rhetorical figures (metaphors, similes)], syntactic [e.g., predominant sentence type (single-clause and multi-clause)], and lexico-grammatical [e.g., pronouns (indefinite, personal)] variables. Statistical evaluations included Cohen's kappa for inter-rater reliability measures, a non-parametric approach (Mann-Whitney U-test and Pearson chi-square test), one-way ANOVA for between-group differences, Spearman's and point-biserial correlations to analyze relationships between linguistic and gender variables, discriminant analysis (Wilks' λ) of linguistic variables in relation to the affective diagnostic types, all using SPSS-22 (significant, p < 0.05). RESULTS In MD, as compared with healthy individuals, written responses were longer, demonstrated descriptive rather than analytic style, showed signs of spoken and figurative language, single-clause sentences domination over multi-clause, atypical word order, increased use of personal and indefinite pronouns, and verb use in continuous/imperfective and past tenses. In NS, as compared with HC, we found greater use of lexical repetitions, omission of words, and verbs in continuous and present tenses. MD was significantly differentiated from NS and euthymic state by linguistic variables [98.6%; Wilks' λ(40) = 0.009; p < 0.001; r = 0.992]. The highest predictors in discrimination between MD, NS, and euthymic state groups were the variables of word order (typical/atypical) (r = -0.405), ellipses (omission of words) (r = 0.583), colloquialisms (informal words/phrases) (r = 0.534), verb tense (past/present/future) (r = -0.460), verbs form (continuous/perfect) (r = 0.345), amount of reflexive (e.g., myself)/personal (r = 0.344), and negative (e.g., nobody)/indefinite (r = 0.451) pronouns. The most significant between-group differences were observed in MD as compared with both NS and euthymic state. CONCLUSION MD is characterized by patterns of atypical language use distinguishing depression from NS and euthymic state, which points to a potential role of linguistic indicators in diagnosing affective states.
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Affiliation(s)
- Daria Smirnova
- Department of Psychiatry, Addictology, Psychotherapy and Clinical Psychology, Samara State Medical University, Samara, Russia.,Centre for Clinical Research in Neuropsychiatry, University of Western Australia, Perth, WA, Australia
| | - Paul Cumming
- School of Psychology and Counselling, Queensland University of Technology, QIMR Berghofer Institute, Brisbane, QLD, Australia
| | - Elena Sloeva
- Department of Pedagogy, Psychology and Psycholinguistics, Samara State Medical University, Samara, Russia
| | - Natalia Kuvshinova
- Department of Pedagogy, Psychology and Psycholinguistics, Samara State Medical University, Samara, Russia
| | - Dmitry Romanov
- Department of Psychiatry, Addictology, Psychotherapy and Clinical Psychology, Samara State Medical University, Samara, Russia
| | - Gennadii Nosachev
- Department of Psychiatry, Addictology, Psychotherapy and Clinical Psychology, Samara State Medical University, Samara, Russia
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Abstract
Bipolar patients often experience subjective symptoms even if they do not have active psychotic symptoms in their euthymic state. Most studies about subjective symptoms are conducted in schizophrenia, and there are few studies involving bipolar patients. We examined the nature of the subjective symptoms of bipolar patients in their euthymic state, and we also compared it to that of schizophrenia and normal control. Thirty bipolar patients, 25 patients with schizophrenia, and 21 normal control subjects were included. Subjective symptoms were assessed using the Korean version of the Frankfurter Beschwerde Fragebogen (K-FBF) and the Symptom Check List 90-R (SCL90-R). Euthymic state was confirmed by assessing objective psychopathology with the Positive and Negative Syndrome scale of Schizophrenia (PANSS), the Young Mania Rating Scale (YMRS), and the Montgomery Asberg Depression Rating Scale (MADRS). K-FBF score was significantly higher in bipolar patients than in normal controls, but similar to that in schizophrenia patients (F=5.86, p=0.004, R2=2033.6). In contrast, SCL90-R scores did not differ significantly among the three groups. Euthymic bipolar patients experience subjective symptoms that are more confined to cognitive domain. This finding supports the hypothesis that subtle cognitive impairments persists in euthymic bipolar patients.
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Affiliation(s)
- Soohyun Joe
- Department of Psychiatry, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Yeonho Joo
- Department of Psychiatry, Asan Medical Center, University of Ulsan, Medical College, Seoul, Korea
| | - Seongyoon Kim
- Department of Psychiatry, Asan Medical Center, University of Ulsan, Medical College, Seoul, Korea
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