bipolar disorder

#Functional MRI distinguishes #bipolar disorder from #depression

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  •  Noticias Médicas Univadis

Amygdala activation and connectivity during facial emotion processing can distinguish bipolar disorder (BP) from major depressive disorder (MDD), even among patients in remission, according to new research.

Although emotion-elicited amygdala reactivity has been found to distinguish BP from MDD in depressed states, this study examined the distinction is patients in remission.

Supra- and sub-liminal processing of threat, sad, happy and neutral faces during functional magnetic resonance imaging (fMRI) was completed for 23 BP patient and 25 MDD patients matched for age-gender, the number of depressive episodes and severity, along with 25 age-gender matched healthy controls.

The BP and MDD groups were distinct from controls across several measures for amygdala activation and connectivity.

Compared with the MDD group, BP patients showed lower left amygdala activation during supraliminal and subliminal threat, sad and neutral processing and for subliminal happy processing. BP was associated with lower connectivity to the insula and hippocampus for threat, and to the medial orbito-frontal cortex for supraliminal and subliminal happy processing. BP participants had greater amygdala-insula connectivity for supraliminal and subliminal sad face processing.

The authors say the findings “provide evidence that this neural substrate could be a potential trait-marker to differentiate these two disorders, largely independent of illness state”.

#ECG distinguishes #depression from #bipolar disorder

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A groundbreaking study suggests that a simple 15-minute electrocardiogram (ECG) could help to determine whether a patient has major depression or bipolar disorder. The research found that heart rate variability measured by electrocardiogram distinguished between the two conditions.

The findings of the study, presented in the World Journal of Biological Psychiatry, suggest ECG could limit the risk of misdiagnosis of bipolar disorder as major depression, and avoid inadvertently triggering a manic episode by prescribing an antidepressant without a safeguard mood stabilising drug.

A total of 64 adults with major depression and 37 adults with bipolar disorder were enrolled in the study. Subjects with major depression were found to have significantly higher respiratory sinus arrhythmia than those with bipolar disorder. In a secondary finding, patients with bipolar disorder demonstrated higher blood levels of inflammation biomarkers than patients with major depression.

Commenting on the results, senior study author, Angelos Halaris said: “Having a noninvasive, easy-to-use and affordable test to differentiate between major depression and bipolar disorder would be a major breakthrough in both psychiatric and primary care practices.” However, he added that further research is needed to confirm the study’s findings and determine their clinical significance.

Hage B, Britton B, Daniels D, Heilman K, PorgesSW, Halaris A. Low cardiac vagal tone index by heart rate variability differentiates bipolar from major depression. World J Biol Psychiatry. 2017 Oct 5:1-9. doi: 10.1080/15622975.2017.1376113. PMID: 28895492. [Epub ahead of print]

Marijuana shows benefit as an ‘exit drug’ for people with more harmful addictions

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A review of the evidence suggests cannabis may also help with symptoms of depression, PTSD, and social anxiety, but not bipolar disorder or psychosis.

Marijuana is regularly referred to as a ‘gateway’ drug, but a new review of available evidence suggests it may also have a role as an ‘exit drug’ for people who are addicted to more harmful substances.

“Research suggests that people may be using cannabis as an exit drug to reduce the use of substances that are potentially more harmful, such as opioid pain medication,” says the study’s lead investigator Zach Walsh, an associate professor of psychology at University of British Columbia, Canada.

The review also found some evidence that cannabis may help with symptoms of depression, post-traumatic stress disorder, and social anxiety. However, cannabis use may not be recommended for conditions such as bipolar disorder and psychosis.

“In reviewing the limited evidence on medical cannabis, it appears that patients and others who have advocated for cannabis as a tool for harm reduction and mental health have some valid points,” says Walsh.

According to the latest figures from the European Monitoring Centre for Drugs and Drug Addiction, one in four Europeans will use cannabis in their lifetime. France, Spain, Italy, the Netherlands, Denmark, Czech Republic, Estonia and Finland had the highest prevalence of use in young adults in 2015.