ABSTRACT
Background: Dissociative symptoms are under recognized and scarcely studied by clinicians and researchers in patients with bipolar disorder (BD). We examined the relationship between dissociative symptoms and the psychotic features in patients with BD and assessed clinical and socio-demographic characteristics more frequently associated with dissociative symptoms and treatment response. Methods: Participants were 100 adult outpatients with BD. They were screened with semi-structured interview to collect socio-demographic and clinical characteristics; the Dissociative Experiences Scale-II (DES-II) and the ALDA scale were used to assess dissociative psychopathologies and response to treatment with mood stabilizers, respectively. Results: DES score (mean 31.7 ± 21.7) correlated with clinical variables, BD features, and course of illness. Psychotic symptoms, mixed features, and previous suicide attempts significantly predicted DES score [F (3, 47) = 39.880, p < 0.001, R 2 corrected = 0.713]. Dissociative symptoms were inversely correlated with poor response to treatment (r = -0.593; p < 0.001). Limitations: Cross-sectional design with a small sample and backward clinical assessment of psychotic symptoms. Conclusions: Dissociative phenomena are closely related to the presence of psychotic symptoms, mixed features, and previous suicide attempts in BD, especially in BD-I. Given the close association between dissociative and psychotic symptoms, this association could represent a diagnostic indicator of BD-I that may guide the clinician to plan the most appropriate treatment.
ABSTRACT
The pharmacological approach to eating disorders (ED) is effective in a few conditions, and to date, no treatment has shown certain efficacy in treating patients with this disorder. Furthermore, attempts to regulate hunger and satiety through modulation pharmacological effects of neurotransmitters and neuropeptides have shown only short-term benefit. However, in light of the serious impact of DCA on patients and the scarcity of non-pharmacological therapeutic approaches, research in this area should not be abandoned, also because new generation "molecules" become increasingly available. Many studies looked at efficacy of antipsychotics, Tryciclics, SSRI, mood stabilizers in the treatment of ED. Gabaergic circuit, the opioid one are extremely involved in the neurohormonal mechanisms of regulation of dietary behaviors and that molecules that influence these circuits could be used in the pharmacological treatment of ED as already happens in the case of Naltrexone, gabapentine or gabaergic drugs.
