Spotlight on Bipolar disorder

Bipolar disorder, or manic depression, is a serious mental illness that may drastically affect an individual’s ability to function because of mood instability. Given the unpredictability of severe high (mania) and severe low (depression) mood states, people with bipolar disorder may struggle with social and workplace settings. Bipolar disorder affects mood, sleep, concentration, and reasoning. Some individuals may experience psychosis or may struggle with suicidal thoughts. Although the underlying cause of bipolar disorder is not clear, research in neurobiology and genetics provides some insight into this complex illness. Treatment of the disorder is primarily with mood stabilizers but often requires additional adjunctive medications. Additionally, psychosocial support and therapy are essential for maintaining stability.

In this article, Dr. John Hammond and Dr. David Geldmacher of the University of Alabama at Birmingham aim to provide distinction between bipolar disorder subtypes and includes updates on the current research regarding the underlying pathology as well as guidance on the pharmacologic treatment of the illness.

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Spotlight on Sleep and depression

Sleep disturbances are common in psychiatric disorders. The relationship between poor sleep and depression is well established. Epidemiologic data suggest that people with psychiatric disorders account for 30% to 40% of those in a community reporting symptoms of insomnia and that depression is the most common psychiatric cause of insomnia. Depression is associated with longer sleep latency, frequent and long awakenings, and early morning awakening associated with poor sleep satisfaction. Sleep disturbance associated with depression sometimes responds to treatment of the underlying depression. Some antidepressants, such as mirtazapine, directly improve sleep quality. Unfortunately, most antidepressants, including the selective serotonin reuptake inhibitors and duloxetine, have the side effect of insomnia. Adjunctive medication is often necessary to treat depression- or antidepressant-associated insomnia.

In this article, Dr. Federica Provini of the University of Bologna and IRCCS Institute of Neurological Sciences of Bologna discusses the evaluation and treatment of sleep disorders associated with depression.

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Spotlight on Sleep and depression

Sleep disturbances are common in psychiatric disorders. The relationship between poor sleep and depression is well established. Epidemiologic data suggest that people with psychiatric disorders account for 30% to 40% of those in a community reporting symptoms of insomnia and that depression is the most common psychiatric cause of insomnia. Depression is associated with longer sleep latency, frequent and long awakenings, and/or early morning awakening associated with poor sleep satisfaction. Sleep disturbance associated with depression sometimes responds to treatment of the underlying depression. Some antidepressants, such as mirtazapine, directly improve sleep quality. Unfortunately most antidepressants, including the selective serotonin reuptake inhibitors and duloxetine, have the side effect of insomnia. Adjunctive medication is often necessary to treat depression- or antidepressant-associated insomnia.

In this article, Dr. Federica Provini of the University of Bologna and IRCCS Institute of Neurological Sciences of Bologna discusses the evaluation and treatment of sleep disorders associated with depression.

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Spotlight on Affective disorders in neurologic disease

In this article, Dr. Sergio Starkstein of the University of Western Australia and Dr. Jaime Pahissa of the Instituto Universitario CEMIC review the frequency, diagnostic strategies, clinical correlates, mechanism, differential diagnoses, and management of affective disorders in frequent acute and chronic neurologic disorders, such as stroke, traumatic brain injury, dementia, Parkinson disease, Huntington disease, multiple sclerosis, and epilepsy. Studies using sophisticated neuroimaging techniques have provided important clues regarding the mechanism of depression and disinhibition in neurologic conditions. Randomized clinical trials have been reported for depression in stroke, Parkinson disease, and Alzheimer disease as well as for the prevention of depression after stroke.

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