Circadian activity rhythm abnormalities in ill and recovered bipolar I disorder patients

OBJECTIVES

Most physiological indicators of bipolar disorder (BPD) reflect current acute illness, and rarely have proved to be state-independent. Activity rhythms are highly abnormal in acute phases of BPD; we compared circadian activity rhythms in BPD I patients during ill and recovered states to those of normal controls to test the hypothesis that some abnormalities may persist.

METHODS

We compared 36 adult DSM-IV BPD I patients during acute mania or mixed states, and during full and sustained clinical recovery, to 32 healthy controls of similar age and sex distribution, using wrist-worn, piezoelectric actigraphic monitoring for 72 h and computed cosinor analysis of circadian activity rhythms.

RESULTS

We verified expected major differences between manic or mixed-state BPD I patients and matched normal controls, including phase advances averaging 2.1 h in ill BPD I patients and 1.8 h in recovered patients. Moreover, recovered BPD patients differed highly significantly from controls in several measures, including acrophase advance, higher percentage of nocturnal sleep, and lower average daily activity (mesor). Actigraphic measures among recovered BPD patients were independent of ratings of mania (on the Young Mania Rating Scale), depression (on the Hamilton Depression Rating Scale), or rating-scale scored subjective distress, as well as the type and dose of concurrent psychotropic medication.

CONCLUSIONS

These findings suggest that abnormal activity rhythms, including sustained phase advances, may represent enduring (trait) characteristics of BPD patients even during clinical recovery. If verified, such indices may be useful in supporting diagnoses and as an objective phenotype for genetic or other biological studies.

Body image disturbance, parental bonding and alexithymia in patients with eating disorders

BACKGROUND

To evaluate if body image disturbance and alexithymia, two major clinical features of eating disorders (ED), are predicted by an altered parental bonding.

SAMPLING AND METHODS

64 female ED outpatients and 68 female healthy controls were assessed by means of the Parental Bonding Instrument (PBI), the Body Uneasiness Test (BUT), and the Toronto Alexithymia Scale (TAS-20). Pearson's correlations and multiple stepwise regression analysis were applied to explore the contribution of PBI factors on BUT and TAS scores.

RESULTS

BUT weight phobia, body image concerns, avoidance, depersonalization, Global Severity Index and positive symptom total were predicted by low parental care, while compulsive self-monitoring was predicted by parental overprotection. TAS total score and difficulty in describing feelings were predicted by low maternal care.

CONCLUSIONS

Body image disturbance in ED may be conceptualized as a deficit in self-development, resulting from failures in parent-child interactions which impaired the ability to distinguish bodily needs from emotional experiences.

Anhedonic-like behavior and BDNF dysregulation following a single injection of cocaine during adolescence

We have previously demonstrated that a single exposure to cocaine during adolescence causes several behavioural and neurobiological changes, highlighting the unique vulnerability of this period of life. The purpose of our work was to investigate whether a single exposure to cocaine during brain development is sufficient to shape a negative emotional state in adolescent rats. A single injection of cocaine during adolescence followed by measurement of sucrose consumption, a measure of anhedonia, identifies two separate groups of rats, i.e. anhedonic (AN) and non anhedonic (NON-AN) rats. AN rats show reduced ability to synthesize, traffic and translate the neurotrophin BDNF at synaptic level, reduced activation of hippocampal BDNF signaling, reduced BDNF plasma levels and a steep rise of corticosterone secretion. Conversely, NON-AN rats exhibit reduced trafficking of BDNF while up-regulating hippocampal BDNF synthesis and stabilizing its downstream signaling with no changes of BDNF and corticosterone plasma levels. Adult rats exposed to cocaine showed no signs of anhedonia, an increase of BDNF both in hippocampus and plasma and decreased levels of corticosterone. In conclusion, our findings reveal a complex central and peripheral dysregulation of BDNF-related mechanisms that instead are preserved in NON-AN rats, suggesting that BDNF modulation dictates behavioural vulnerability vs. resiliency to cocaine-induced anhedonia, a profile uniquely restricted to adolescent rats.

The effects of cocaine exposure in adolescence: Behavioural effects and neuroplastic mechanisms in experimental models

Drug addiction is a devastating disorder with a huge economic and social burden for modern society. Although an individual may slip into drug abuse throughout his/her life, adolescents are at higher risk, but, so far, only a few studies have attempted to elucidate the underlying cellular and molecular bases of such vulnerability. Indeed, preclinical evidence indicates that psychostimulants and adolescence interact and contribute to promoting a dysfunctional brain. In this review, we have focused our attention primarily on changes in neuroplasticity brought about by cocaine, taking into account that there is much less evidence from exposure to cocaine in adolescence, compared with that from adults. This review clearly shows that exposure to cocaine during adolescence, acute or chronic, as well as contingent or non‐contingent, confers a vulnerable endophenotype, primarily, by causing changes in neuroplasticity. Given the close relationship between drug abuse and psychiatric disorders, we also discuss the translational implications providing an interpretative framework for clinical studies involving addictive as well as affective or psychotic behaviours.

Eating Attitudes Test and culture: a study in northern and southern Italy

The EAT (Eating Attitudes Test) has been widely used to compare eating morbidity in cultural groups and variations in it have been taken as indicative of cultural differences. This study assumed the existence of cultural differences between the north and the south of Italy. The EAT scores of female students from a northern and a southern Italian high school were compared. They were both higher than in other European studies, though there were no significant differences between the two groups. The result could be due to sampling limitations, but could also indicate that the EAT is not a reliable yardstick of cultural differences.

[Bone scintigraphy in osteodystrophia deformans (Paget's disease)]

The value of combined investigations using both scintiscanning and radiological procedures has been proved for the disease's extension and activity in 28 patients suffering from osteodystrophia deformans (Pagets disease). It was seen that such a method leads to more precise results concerning the patient's condition. Special therapy indications were set up, based on these summarized findings. A further advantage of bones scanning alone is the lower radiation dose, which is mainly indicated for control tests in Paget's course. At present, we have no experience of malignant forms of this disease among our group of patients.

Clearancebestimmung im Rahmen der nuklearmedizinischen Nierendiagnostik

In einer Gegenüberstellung von Resultaten der glomerulären Filtrationsrate (GFR), des effektiven Nierenplasmastroms (RPF), der seitengetrennten Clearance und der Filtrationsfraktion bei verschiedenen Krankheitsgruppen wird ihre weitgehende Korrelation mit den bisherigen Angaben der laborchemischen Ergebnisse und dem vorhandenen klinischen Gesamtbefund aufgezeigt. Darüber hinaus konnte eine rationelle Bestimmungsmethode im Rahmen einer Multifunktionsanalyse an der Gammacamera vorgestellt werden. Daraus ergab sich ein verkürzter Diagnosegang, dessen Einsatz im klinischen Routinebetrieb gerechtfertigt erscheint.