Bipolar disorder is characterized by episodes of mania and depression and serious suicidal risks. Recent studies reported high mental imagery susceptibility (general use of imagery in daily life and emotional impact of prospective imagery) in euthymic bipolar patients. This thesis aims to: a) replicate these findings in patients at different phases of bipolar disorder and with varying degrees of bipolarity, and b) explore how mental imagery susceptibility, ruminative processing, and behavioural approach system (BAS) sensitivity interact to amplify mood symptoms. Chapter 1 provides an overview of current theories of mood amplification and recurrence in bipolar disorders. Chapter 2 details the local validation of scales used in the thesis. Chapter 3 (Study 1) investigated whether mental imagery susceptibility, positive rumination and BAS sensitivity were elevated in remitted bipolar I disorder compared with major depressive disorder and non-psychiatric controls. Results suggested that these cognitive variables were elevated in remitted bipolar I disorder. Positive rumination also interacted with positive prospective images to predict bipolarity. Chapter 4 (Study 2) found that these cognitive variables were elevated in bipolar I disorder during manic and euthymic phases, compared to major depression. Further, the number of positive prospective images predicted recovery status and manic symptom severity. Chapters 5, 6 and 7 report that, compared with people without bipolar spectrum conditions, these cognitive characteristics were elevated in sub-threshold bipolar disorder (Study 3), individuals with high bipolar risks based on a behavioural paradigm (Study 4), and individuals with high familial risk (Study 5). Studies 3-5 confirmed that positive and negative prospective images interacted with rumination to amplify hypomanic and depressive symptoms respectively. Chapter 8 (Study 6) showed that suicidal flash-forwards function as a psychological escape from perceived entrapment and defeat in suicidality. Based on these findings, Chapter 9 proposes novel imagery-based techniques for targeting problematic imagery in bipolar disorders.

Systematic review Background: Bipolar disorder is associated with a higher rate of physical health problems and lower levels of physical activity than other clinical and general populations. Despite the potential benefits of physical activity to people with bipolar disorder, little research has been published around this and no recent review of this topic is available. Due to the clinical utility of summarising the available research evidence on this topic, this review aimed to answer the question “Is physical activity associated with manic and depressive symptoms in people with bipolar disorder?”. Methods: Seven electronic databases were searched using a range of search terms to reflect physical activity and bipolar disorder variables. Results: Ten studies were identified that reported associations between physical activity and mood symptoms of bipolar disorder. There were inconsistent findings on the relationship between physical activity and mood, in particular with relation to manic symptoms, with reports of physical activity being both helpful and harmful to manic symptoms. Findings were more consistent with regards to the association between physical activity and depressive symptoms, with most showing that higher levels of physical activity are associated with lower depressive symptoms. Limitations: Many studies had small sample sizes and very few manipulated physical activity and included a control group. Measures and diagnosis method were heterogeneous. Four studies lacked a direct measure of manic symptoms. Conclusions: Results showed inconsistent findings with regards to the relationship between physical activity and mood symptoms and further research is needed to inform any guidelines developed for this client group. Empirical paper: Background: Despite the published evidence for the benefits of physical activity on mood in the general population and in people with mental illness, there is a lack of research into the associations between physical activity and mood in people with bipolar disorder. The current study therefore aimed to investigate the relationship between symptoms of mania and depression and different intensities, regularity, and total duration of physical activity per day and across the week. Methods: People with a diagnosis of bipolar disorder (N = 29) completed daily diaries on physical activity and manic and depressive symptoms over 14 days. Analysis included multilevel modelling, t-tests and correlation analysis. Results: No association was found between manic symptoms and physical activity, either at the within- or the between-person level. An association was found at the within-person level between higher duration of physical activity and lower depression symptoms, however no association was found at the between-person level. Limitations: The small sample size was adequate only to detect large-sized effects for between-person hypotheses. Participants were highly active and may not be representative of the wider BD population. Physical activity levels were assessed via self-report. Conclusions: The relationship between physical activity and manic symptoms in BD remains inconclusive, but a significant within-person association indicates that physical activity may reduce depressive symptoms in the short term. Given previous research on physical activity and manic symptoms, people with BD and professionals working with them may need to remain cautious, modifying any PA engagement depending on mood state.

Doctorat en sciences médicales / info:eu-repo/semantics/nonPublished

TOPIC. Advances in the psychopharmacologic treatment of bipolar affective disorders (BPAD). PURPOSE. To increase advanced practice nurses' ability to match prescribing practices with known etiological factors and the neurobiology of this complex set of disorders. SOURCES. Published literature. CONCLUSIONS. A wide array of pharmacological agents exist that can be useful to manage BPAD symptoms. APRNs play a critical role in helping patients and their families to use these drugs effectively.

Films of three depress ed persons, one manic, and one normal individual were analyzed frame-by-frame to determine body activity rates. Speech rates were also determined. It was found that the manic had the highest activity rate, followed by the normal comparison, and with the depressed patients having the lowest activity rates. The depressed subjects also had lower speech rates than did the normal or the manic subjects. The term 'psychomotor retardation 1 is called into question, as the frequency distributions of movement durations were similar for all subjects. Implications for treatment and for development are also discussed.

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No description available.

Text in Afrikaans / Binne die tradisionele christelike westerse samelewing waarin ons leef is daar diskoerse en meta-narratiewe wat dikteer wat van ons as huweliksmaats verwag word. Ons is dikwels onbewus van hoe hierdie verwagtinge, rolle en eise wat aan ons gestel word, deur verskillende diskoerse en stories tot stand gekom het. Die spesifieke lewenstorie en omstandlghede van die indiwidu(e) word meestal in die proses geignoreer, byvoorbeeld die saamleef met 'n huweliksmaat wat "gediagnoseer" is as iemand met 'n "bipolêre gemoedsversteuring", bring noodwendig omstandighede mee wat vir die meeste mense onuithoudbaar mag wees. Hierdie studie vertel die storie van 'n persoon wie daarin kon slaag om ten spyte van hierdie "omstandighede", sy storie so te kon herskryf dat hy steeds met hierdie persoon suksesvol binne die huwelik kan saamleef. Die studie fokus op 'n persoon, wie se lewe op grond van die christelike narratief leef, se belewing van die saamleef met 'n persoon met 'n "bipolere gemoedsversteuring". Die algemene doel van die studie was om aan die deelnemer 'n geleentheid te skep om sy belewinge in die saamleef van 'n persoon met 'n "bipolêre gemoedsversteuring" te kon deel. 'n Spesifieke fokus is geplaas om die rol wat christelike spiritualiteit speel in die verwerking en hantering daarvan, te beskryf. Daar is ook aan die persoon geleentheid gegee om op grond van sy belewlnge en verstaan van christenskap, aanbevelings te maak aan die professlone!e gemeenskap, die geloofsgemeenskap en aan huweliksmaats wat met soortgelyke omstandighede meet saamleef. Die navorslng is vanuit 'n postmoderne diskoers-oogpunt aangepak en op 'n kwalitatiewe wyse uitgevoer by wyse van 'n gevallestudle. Die deelnemer se storie is deur middel van sosiale konstruksieteorie en 'n narratiewe terapeutiese benadering, gedekonstrueer. Dit was duidelik vanuit die studie dat die funksie wat mense se spirituele oortuiginge en hul belewing daarvan in hul lewens verrig, in berekening gebring moet word in die terapeutiese proses. Wanneer kliënte belangrike besluite moet neem, moet die invloed van geloofsoortuiginge in die besluitnemingsproses in berekening gebring word. / Practical Theology / M. Th. - (Pastoral Theology)

Text in Afrikaans / Binne die tradisionele christelike westerse samelewing waarin ons leef is daar diskoerse en meta-narratiewe wat dikteer wat van ons as huweliksmaats verwag word. Ons is dikwels onbewus van hoe hierdie verwagtinge, rolle en eise wat aan ons gestel word, deur verskillende diskoerse en stories tot stand gekom het. Die spesifieke lewenstorie en omstandlghede van die indiwidu(e) word meestal in die proses geignoreer, byvoorbeeld die saamleef met 'n huweliksmaat wat "gediagnoseer" is as iemand met 'n "bipolêre gemoedsversteuring", bring noodwendig omstandighede mee wat vir die meeste mense onuithoudbaar mag wees. Hierdie studie vertel die storie van 'n persoon wie daarin kon slaag om ten spyte van hierdie "omstandighede", sy storie so te kon herskryf dat hy steeds met hierdie persoon suksesvol binne die huwelik kan saamleef. Die studie fokus op 'n persoon, wie se lewe op grond van die christelike narratief leef, se belewing van die saamleef met 'n persoon met 'n "bipolere gemoedsversteuring". Die algemene doel van die studie was om aan die deelnemer 'n geleentheid te skep om sy belewinge in die saamleef van 'n persoon met 'n "bipolêre gemoedsversteuring" te kon deel. 'n Spesifieke fokus is geplaas om die rol wat christelike spiritualiteit speel in die verwerking en hantering daarvan, te beskryf. Daar is ook aan die persoon geleentheid gegee om op grond van sy belewlnge en verstaan van christenskap, aanbevelings te maak aan die professlone!e gemeenskap, die geloofsgemeenskap en aan huweliksmaats wat met soortgelyke omstandighede meet saamleef. Die navorslng is vanuit 'n postmoderne diskoers-oogpunt aangepak en op 'n kwalitatiewe wyse uitgevoer by wyse van 'n gevallestudle. Die deelnemer se storie is deur middel van sosiale konstruksieteorie en 'n narratiewe terapeutiese benadering, gedekonstrueer. Dit was duidelik vanuit die studie dat die funksie wat mense se spirituele oortuiginge en hul belewing daarvan in hul lewens verrig, in berekening gebring moet word in die terapeutiese proses. Wanneer kliënte belangrike besluite moet neem, moet die invloed van geloofsoortuiginge in die besluitnemingsproses in berekening gebring word. / Philosophy, Practical and Systematic Theology / M. Th. - (Pastoral Theology)

Bipolar disorder is a serious illness affecting approximately 2-4% of the population and is one of the world’s leading causes of disability. In individuals with bipolar disorder, medical comorbidity associated with cardiovascular, respiratory and endocrine disorders is related to increased rates of mortality. Recent updates to multi-system inflammatory related conceptualizations of bipolar disorder focus on the unique power that medical illness and biological processes may play as factors associated with course and outcome in bipolar disorder. The current study examined medical comorbidity and its associations with various demographic and psychological variables in individuals with bipolar disorder, schizophrenia, and major depressive disorder with psychotic features followed for 10 years from their first hospital admission. When compared to an age, gender and race-matched control sample from the population, those with bipolar disorder had significantly higher medical comorbidity across a range of medical diagnoses both at 6 months and 10 years after first hospital admission. Ten years following initial hospitalization, individuals in all three diagnostic groups reported increased rates of diabetes (OR: 2.0 – 3.7), stroke (OR: 4.6 – 7.0) and asthma (OR: 1.9 - 3.1), and individuals with bipolar disorder reported increased rates of cancer (OR = 2.1). A number of psychological and demographic symptoms were examined for their ability to predict the development of medical illness across the assessment interval. Overall rates of medical illness were elevated both early in illness course and 10 years after diagnosis, suggesting that broad sequelae of multi-system inflammation are present early and progress over time.