ABSTRACT
OBJECTIVE: In bipolar disorder, serum brain-derived neurotrophic factor (BDNF) level decreases leading to dysfunctions of critical neurotrophic, cellular plasticity and neuroprotective processes. The present study was conducted to evaluate the change in serum BDNF level with oxcarbazepine monotherapy in bipolar mania. METHODS: The present study is a prospective, interventional, open label clinical study conducted on 25 patients of bipolar mania and 25 healthy controls. Detailed history, clinical evaluation including Young Mania Rating Scale (YMRS) scoring and serum BDNF were assessed at baseline for all 50 subjects. The bipolar patients were prescribed tablet oxcarbazepine and followed up after 4 weeks for clinical evaluation and re-estimation of serum BDNF and YMRS scoring. RESULTS: The serum BDNF level in bipolar manic patients were compared with healthy controls at baseline and results revealed that there is a significant reduction (p=0.002) in serum BDNF level in bipolar patients. At follow-up after 4 weeks, the mean change in serum BDNF in bipolar group who were on oxcarbazepine monotherapy was found statistically significant (p=0.02) in comparison to healthy controls. In bipolar group, the YMRS score and serum BDNF at baseline have an inverse relation(r=−0.59) whereas change of the YMRS score had a positive correlation (r=0.67) with the change of serum BDNF over 4 weeks. CONCLUSION: In bipolar mania serum BDNF level is low and it is found to be increased with short term monotherapy with oxcarbazepine.
Subject(s)
Humans , Bipolar Disorder , Brain , Brain-Derived Neurotrophic Factor , Cell Plasticity , Clinical Study , Follow-Up Studies , Prospective StudiesABSTRACT
Topiramate (TPM) shows idiosyncratic adverse reaction of peripheral ciliochoroidal effusion leading to acute angle closure glaucoma (AACG), which should be diagnosed and managed at the earliest to prevent irreversible visual loss. We report, a case of TPM-induced bilateral AACG and myopic shift, which was reversed by omitting TPM and administering antiglaucoma medications.
ABSTRACT
Topiramate (TPM) is a new potent antiepileptic drug (AED) used as add-on therapy for generalized and partial seizures that are resistant to the other AEDs; or as a mood stabilizer, and for reducing weight gain associated with olanzapine and clozapine in patients with bipolar disorder or schizophrenia. However, there is a higher risk of psychosis with TPM in patients with a past history of psychiatric disorder. This case report highlights emergence of psychosis that was related to TPM which resolved on discontinuation.
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ObjectiveTo discuss the mental state and its influencing factors of perioperative patients with mania.Methods 40 perioperative mania patients were investigated with Bech-Rafaelsdn Mania Rating Scale (BRMS) and Life Event Scale(LES) ,assisted with self-designed influential factors to survey the correlation factors.ResultsThe perioperative patients were interestd in therapeutic correlation question preoperative and worry about their recovery after operation.The worry showed that operations was mental work load and psycho-burden to the patients.Perioperative patients' mental activities were main of perceptual insecurity.The psycho-feature must influence the compliance of mania patients' therapy and nursing.What follows next is the quality of therapy and nursing.ConclusionThe main problem to be solved is intervention the tension, anxiety, scare psychology of the patients in perioperative.At the same time it must be strengthened to talk to the family member of the patients knowledge about the disease and its recovery.
ABSTRACT
OBJECTIVES: The reliability and validity of the Korean version of Young Mania Rating Scale (K-YMRS) were examined in the Korean patients with major psychosis. METHODS: One hundred and twenty inpatients diagnosed as major psychosis by DSM-IV criteria were assessed with both K-YMRS and expanded Brief Psychiatric Rating Scale (BPRS-E) during the first 3 days in hospital and after 4-week treatment. RESULTS: The Cronbach's alpha coefficient of K-YMRS was 0.73. The inter-rater reliabilities of total score (r=0.93, p=0.000) and individual item scores were high (r=0.65-0.96, p=0.000). The correlations of each items of K-YMRS with total score were statistically significant (r=0.35-0.78, p=0.000) except for the "insight" item. The principal component analysis for K-YMRS produced three factors;a) mood and vegetative symptoms, b) behavioral symptoms, and c) thought content and insight. The total scores of K-YMRS showed a significant correlation with the manic-excitement factor scores of BPRS-E at baseline and after 4-week treatment (r=0.82, r=0.72, respectively, p=0.000). The discriminant function analysis showed that manic (n=43) and non-manic patients (n=73) were discriminated 73.7% correctly by K-YMRS total score (p=0.01). The change of the total score of K-YMRS after 4-week treatment in manic patients was significantly greater than that in non-manic patients (p=0.000). CONCLUSIONS: K-YMRS was demonstrated to have good reliability and validity for measuring the severity of manic symptoms. It is expected that K-YMRS will be a useful tool for assessing mania symptoms in Korea.