Conference paper

BIPOLAR DISORDER – FROM ENDOPHENOTYPES TO TREATMENT

Luchezar G. Hranov ; Second Psychiatric Clinic of the University Hospital for Active Treatment in Neurology and Psychiatry “Sveti Naum”, Sofia, Bulgaria
Petra Marinova ; Second Psychiatric Clinic of the University Hospital for Active Treatment in Neurology and Psychiatry “Sveti Naum”, Sofia, Bulgaria
Maria Stoyanova ; Second Psychiatric Clinic of the University Hospital for Active Treatment in Neurology and Psychiatry “Sveti Naum”, Sofia, Bulgaria
Milena Pandova ; Second Psychiatric Clinic of the University Hospital for Active Treatment in Neurology and Psychiatry “Sveti Naum”, Sofia, Bulgaria
Georgi Hranov ; Second Psychiatric Clinic of the University Hospital for Active Treatment in Neurology and Psychiatry “Sveti Naum”, Sofia, Bulgaria

Abstract

Introduction: There are a lot of unresolved issues associated with the classification, diagnosis, clinical management and
understanding of the underlying pathogenic mechanisms of bipolar affective disorder.
Aim: To search for discrete endophenotypes in BAD.
Subjects and methods: We studied various bipolar I and II and recurrent depression patient samples and healthy controls using
descriptive data, self and clinician-rated scales for neurological and psychopathological symptoms, neurocognitive instruments, and
inventories for temperamental and characterological features. We also looked into the efficacy, tolerability and cost/benefit ratio of
sodium valproate in the treatment of acute mania.
Results: BAD patients display deficits in the domains of memory, selective attention, working memory and psychomotor speed.
Sensory, motor and complex neurological soft signs can be considered part and parcel of the symptomatology of BAD. The evidence
linking hyperthymic temperament to the bipolar spectrum is not supported, while cyclothymia seems to be a marker of vulnerability
to affective psychopathology. In contrast to others, we found significantly lower self-transcendence in BAD patients compared to
controls. Early age of onset, abrupt onset, lability of mood and energy with late-day brightening and activation, discriminate bipolar
from unipolar depression. Sodium valproate (especially if started intravenously) is a highly efficacious, cost-effective treatment
approach for acute mania.
Conclusion: The discovery of BAD endophenotypes can enhance early diagnosis, prevent errors in treatment and help elucidate
the genetic vulnerability for this grave disease.

Keywords

bipolar disorder – endophenotypes – cognition - neurologic soft signs – temperament - bipolar depression - sodium valproate

Hrčak ID:

161208

URI

https://hrcak.srce.hr/161208

Publication date:

17.9.2013.

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