ABSTRACT
BACKGROUND: The modern practice of using artificial light to extend waking activities into the nighttime hours might be expected to precipitate or exacerbate bipolar illness, because it has been shown that modifying the timing and duration of sleep can induce mania in susceptible individuals. With this possibility in mind, we treated a patient with rapidly cycling bipolar illness by creating an environment that was likely to increase and to stabilize the number of hours that he slept each night. METHODS: We asked the patient to remain at bed rest in the dark for 14 hours each night (later this was gradually reduced to 10 hours). Over a period of several years, his clinical state was assessed with twice-daily self-ratings, once-weekly observer ratings, and continuous wrist motor activity recordings. Times of sleeping and waking were recorded with sleep logs, polygraphic recordings, and computer-based event recordings. RESULTS: The patient cycled rapidly between depression and mania and experienced marked fluctuations in the timing and duration of sleep when he slept according to his usual routine, but his sleep and mood stabilized when he adhered to a regimen of long nightly periods of enforced bed rest in the dark. CONCLUSIONS: Fostering sleep and stabilizing its timing by scheduling regular nightly periods of enforced bed rest in the dark may help to prevent mania and rapid cycling in bipolar patients.
Subject(s)
Bed Rest , Bipolar Disorder/therapy , Circadian Rhythm , Darkness , Sleep Initiation and Maintenance Disorders/therapy , Bipolar Disorder/diagnosis , Bipolar Disorder/psychology , Follow-Up Studies , Humans , Male , Middle Aged , Polysomnography , Signal Processing, Computer-Assisted , Sleep Initiation and Maintenance Disorders/diagnosis , Sleep Initiation and Maintenance Disorders/psychologyABSTRACT
Six subjects who as children had received a diagnosis of seasonal affective disorder consented to participate in a 7-year follow-up study. Structured and semistructured interviews were conducted to assess the course of illness, response to treatment, and current clinical state. Seasonal patterns of symptoms and response to light therapy remained relatively stable over a 7-year period. Two subjects were using adjunctive fluoxetine. Seasonal affective disorder can occur in children and adolescents, responds to light therapy, and should be considered in the differential diagnosis of pediatric affective symptoms or cyclic school performance.
Subject(s)
Seasonal Affective Disorder , Adolescent , Child , Comorbidity , Disease Progression , Female , Follow-Up Studies , Humans , Male , Phototherapy , Seasonal Affective Disorder/physiopathology , Seasonal Affective Disorder/therapyABSTRACT
We validated the Hypomania Interview Guide-Seasonal Affective Disorder version (HIGH-SAD) in patients with rapid cycling bipolar disorder (RCBD). Fourteen outpatients were rated on six separate occasions (total = 84 visits). On each visit the patients were rated with the HIGH-SAD and the Young Mania Rating Scale (YMRS) in a counterbalanced order. Clinical assessment was completed at the end of the visit by the treating psychiatrist. Patients were assessed as hypomanic/manic on 22 of the visits. Pearson correlation coefficient between the YMRS total scores and the HIGH-SAD total scores for those 22 visits in which patients were hypomanic/manic was r = 0.629 (P < 0.05) and for all visits was r = 0.769 (P < 0.0001). Analysis with only one rating per patient yielded a Pearson correlation coefficient of r = 0.792 (P < 0.0004). We found that the HIGH-SAD was a valid scale for the measurement of hypomania in patients with RCBD. However, the scale does not differentiate hypomania from mania in this group of patients.
Subject(s)
Bipolar Disorder/diagnosis , Psychiatric Status Rating Scales , Seasonal Affective Disorder/diagnosis , Adult , Bipolar Disorder/psychology , Female , Humans , Male , Reproducibility of Results , Seasonal Affective Disorder/psychology , Severity of Illness IndexSubject(s)
Acclimatization , Body Temperature , Reptiles/physiology , Animals , Anura , Blood , Body Temperature Regulation , Bufo marinus , Bufonidae , Chemical Phenomena , Chemistry, Physical , Chickens , Cold Temperature , Fishes , Freezing , Humans , Lizards , Rana catesbeiana , Rana pipiens , Rats , Seawater , Snakes , Species Specificity , Turtles , WaterSubject(s)
Biological Evolution , Cytogenetics , Lizards , Animals , Arizona , Karyotyping , Mexico , New Mexico , UtahABSTRACT
Regression analysis (analysis of covariance) is contrasted with the conventional "mean period length" for estimating the length of period of the spontaneous activity frequency (free-running period) in population samples of Gila monsters (Heloderma suspectum) and kangaroo rats (Dipodomys merriami) in the Sonoran Desert. The mean period length in each population does not differ significantly from 24:00 hours (P > .05) and it does not differ significantly (P > .05) between the species studied; the probability that the free-running period a(in constant dark) in natural populations of Gila monsters and kangaroo rats is different from 24:00.0 is less than 1 in 1000 (P < .001). The so-called "mean period length" is of little or no use for precise determination of the period and phase relationships in circadian rhythms; moreover, it is entirely without value for statistical testing of differences either within or between populations.
Subject(s)
Behavior, Animal , Circadian Rhythm , Reptiles/physiology , Rodentia/physiology , AnimalsABSTRACT
Karyotypes of many species of the genus Sceloporus support the generalization that there are no morphologically recognizable sex chromosomes in lizards; however, there is a marked sexual dimorphism in the karyotypes of Sceloporus jarrovi and Sceloporus poinsetti. During meiosis in males, whose diploid number of chromosomes is 31, preferential segregation of chromosomes from a trivalent results in heterogamety.
