No description available.

I syfte att undersöka psykometriska egenskaper hos Affektiv självskattningsskala (AS-18) fyllde 88 patienter med diagnos bipolär typ I (N=46) eller typ II (N=42) i självskattningsskalorna AS-18 och MADRS-S vid två tillfällen med en dags mellanrum. Principalkomponentsanalys för AS-18 genomfördes med extrahering av två komponenter. Items laddade i de delskalor de tillhörde. Intern konsistens mättes med Cronbachs alfa och överensstämmelse med Cohens kappa. Test-retest-reliabiliteten beräknades. Grupperna bipolär typ I och typ II skiljde sig inte åt, vid rutinuppföljningsbesök, vad gäller skattning av mani eller depression. Studien gällande AS-18 visade att faktorstrukturen från tidigare studier kunde bekräftas, att test-retest-reliabiliteten var hög och att AS-18 är användbar även för patienter med bipolär typ II-diagnos. Skalan hade sammanfattningsvis goda psykometriska egenskaper. / <p>Psykoterapeutexamensarbete (PTU)</p>

Submitted by Geandra Rodrigues (geandrar@gmail.com) on 2018-04-19T13:29:11Z No. of bitstreams: 1 andreluciopintocoelhostroppa.pdf: 19317921 bytes, checksum: f8efcd9a0d197ed526f74c9541ac1634 (MD5) / Approved for entry into archive by Adriana Oliveira (adriana.oliveira@ufjf.edu.br) on 2018-04-19T13:55:45Z (GMT) No. of bitstreams: 1 andreluciopintocoelhostroppa.pdf: 19317921 bytes, checksum: f8efcd9a0d197ed526f74c9541ac1634 (MD5) / Made available in DSpace on 2018-04-19T13:55:45Z (GMT). No. of bitstreams: 1 andreluciopintocoelhostroppa.pdf: 19317921 bytes, checksum: f8efcd9a0d197ed526f74c9541ac1634 (MD5) Previous issue date: 2018-02-08 / Contexto: Apesar do grande número de estudos encontrados na literatura sobre as relações entre religiosidade/espiritualidade e depressão, outros transtornos mentais e doenças físicas, há uma carência de pesquisas acerca do impacto da religiosidade/espiritualidade em pacientes bipolares, notadamente de estudos longitudinais. Objetivos: Investigar as possíveis relações entre diversas dimensões de religiosidade/espiritualidade sobre sintomas de depressão, mania e qualidade de vida em um estudo longitudinal de 24 meses. Métodos: Estudo observacional longitudinal de dois anos acrescido de aspectos qualitativos, com 168 pacientes bipolares ambulatoriais, avaliando dados sócio demográficos, sintomas de mania (Young Mania Rating Scale), depressão (Montgomery–Asberg Depression Rating Scale), religiosidade (Duke Religious Index), coping religioso (Brief RCOPE) e qualidade de vida (World Health Organization Quality of Life–Brief Version). Análises de regressão linear da associação entre indicadores religiosos e variáveis clínicas foram controladas por variáveis sociodemográficas. Resultados: Entre os 158 pacientes reavaliados após dois anos, Coping Religioso Positivo em T1 predisse melhor qualidade de vida em todos os seus quatro domínios: físico (β 10,2; 95%CI; 4,2–16,1), mental (β 13,4; 95%CI; 7,1–19,7), social (β 10,5; 95%CI, 3,6–17,33) e ambiental (β 11,1; 95%CI; 6,2–16,1) em T2, dois anos depois. Coping Religioso Negativo em T1 predisse pior saúde mental (β -28,1; 95%CI; -52,06– -4,2) e ambiental (β -20,4; 95%CI; -39,3– -1,6) em qualidade de vida. Religiosidade Intrínseca em T1 predisse melhor qualidade de vida ambiental (β 9,56; 95%CI; 2,76–16,36) em T2. Coping Religioso Negativo em T1 predisse sintomas maníacos (β 4.1) em T2. Na investigação qualitativa, 88,2% dos sujeitos relataram que sua fé ajudou a lidar com sua doença e o apoio de sua comunidade religiosa em relação ao tratamento foi apontado por 35,3%. Não houve relato de oposição de líderes religiosos ao tratamento. Limitações: Este é um estudo observacional, inferências causais devem ser feitas com cautela. Conclusão: religiosidade/espiritualidade pode influenciar a qualidade de vida de pacientes com transtorno bipolar, mesmo quando em eutimia. Usar religiosidade/espiritualidade (especialmente coping religioso positivo e negativo) em intervenções psicossociais podem contribuir para melhorar a qualidade de vida de pacientes com transtorno bipolar. / Background: Although several studies have examined the relationship between religiosity/spirituality and depression, there is little research examining the effect of religious involvement on the course of bipolar disorder. This study investigated the effects of religious activity and coping behaviors on the course of depression, mania and quality of life in patients with bipolar disorder. Methods: Two-year longitudinal study of 168 outpatients with bipolar disorder. Linear regression was used to examine associations between religious predictors and outcome variables (manic symptoms, depression, and quality of life), controlling for sociodemographic variables. Results: Among the 158 patients reassessed after two years, positive religious coping at T1 (baseline) predicted better quality of life across all four domains: physical (β 10.2, 95%CI, 4.2 - 16.1), mental (β 13.4; 95%CI; 7.1–19.7), social (β 10.5; 95%CI; 3.6–17.33) and environmental (β 11.1; 95%CI; 6.2–16.1) at T2 (2-years later). Negative religious coping at T1 predicted worse mental (β -28.1; 95%CI; -52.06– -4.2) and environmental (β -20.4; 95%CI; -39.3– -1.6) quality of life. Intrinsic religiosity at T1 predicted better environmental quality of life (β 9.56; 95%CI; 2.76–16.36) at T2. Negative religious coping at T1 predicted manic symptoms (β 4.1) at T2. In the qualitative research, 88.2% of the subjects reported that their faith helped to cope with their illness and the support of their religious community regarding the treatment was pointed out by 35.3%, there was no report of opposition of religious leaders to the treatment. Limitations: This is an observational study, causal inferences must be made cautiously. Conclusions: religiosity/spirituality may influence the quality of life of patients with bipolar disorder over time, even among euthymic patients. Targeting religiosity/spirituality (especially positive and negative religious coping) in psychosocial interventions may enhance the quality of recovery in patients with bipolar disorder.

A literature search, supplemented by an expert survey and selected reanalyses of existing data from epidemiological studies was performed to determine the prevalence and associated burden of bipolar I and II disorder in EU countries. Only studies using established diagnostic instruments based on DSM-III-R or DSM-IV, or ICD-10 criteria were considered. Fourteen studies from a total of 10 countries were identified. The majority of studies reported 12-month estimates of approximately 1% (range 0.5–1.1%), with little evidence of a gender difference. The cumulative lifetime incidence (two prospective-longitudinal studies) is slightly higher (1.5–2%); and when the wider range of bipolar spectrum disorders is considered estimates increased to approximately 6%. Few studies have reported separate estimates for bipolar I and II disorders. Age of first onset of bipolar disorder is most frequently reported in late adolescence and early adulthood. A high degree of concurrent and sequential comorbidity with other mental disorders and physical illnesses is common. Most studies suggest equally high or even higher levels of impairments and disabilities of bipolar disorders as compared to major depression and schizophrenia. Few data are available on treatment and health care utilization.

We examined prospectively whether mania and hypomania are associated with an elevated risk for suicidality in a community sample of adolescents and young adults. Baseline and four-year follow-up data were used from the Early-Developmental- Stages-of-Psychopathology (EDSP) Study, a prospective longitudinal study of adolescents and young adults in Munich. Suicidal tendencies (ideation/attempts), mania, and hypomania were assessed using the standardized Munich-Composite-International- Diagnostic-Interview. At baseline, mania/hypomania was associated to a different degree with suicidality (Odds ratios [OR] range from 1.9 to 13.7). In the prospective analyses, the risk for subsequent incident suicidal ideation was increased in the presence of prior mania (38.0% vs. 14.1%; OR = 4:4; 95% CI = 1.4–13.5). No associations could be found between prior mania/hypo-mania and incident suicide attempts. The prospective analyses revealed a remarkable relationship between preexisting mania and increased risk for subsequent suicidal ideation.

No description available.

Le trouble bipolaire est une maladie invalidante caractérisée par une alternance d’épisodes maniaques et dépressifs. Malgré des efforts de recherche notables, la physiopathologie et les mécanismes d’action des traitements du trouble bipolaire demeurent peu connus. La protéine kinase C (PKC) est récemment apparue comme une cible moléculaire potentielle pour le traitement du trouble bipolaire. Dans ce travail de thèse, nous avons cherché à étudier le rôle de la PKC dans les phases maniaque et dépressive du trouble bipolaire. Nous avons montré que l’inhibition de la PKC a un effet antimaniaque non seulement chez le rat naïf, mais aussi dans un modèle de manie basé sur une privation de sommeil, que nous avons validé au cours de notre étude. De plus, les inhibiteurs de la PKC sont capables de rétablir les déficits de prolifération cellulaire hippocampique que présentent les rats privés de sommeil. Ces effets prolifératifs et antimaniaques seraient indépendants, puisque le blocage de la prolifération cellulaire n’abolit pas l’efficacité antimaniaque des inhibiteurs de la PKC dans le modèle de privation de sommeil. En parallèle, nous avons montré que l’activation de la PKC a un effet antidépresseur chez le rat naïf, alors que son inhibition provoque un phénotype pseudodépressif qui s’accompagne d’une diminution de la prolifération cellulaire hippocampique. L’ensemble de ces données révèle une implication de la PKC dans les deux phases du trouble bipolaire, et soutient l’hypothèse qu’une suractivation du système PKC serait à l’origine des perturbations de neuroplasticité associées à la manie. / Bipolar disorder is a devastating long-term disease characterized by alternate episodes of mania and depression. Despite extensive research, the molecular and cellular underpinnings of bipolar disorder remain to be fully elucidated. Protein kinase C (PKC) has emerged as a potential molecular target for the treatment of bipolar disorder. The present study investigated the role of PKC in manic- and depressive-like behaviors. Our results showed that PKC inhibition produced an antimanic-like effect not only in naive rats, but also in an animal model of mania based on sleep deprivation, that we have validated in our study. Interestingly, PKC inhibitors rescued the hippocampal cell proliferation deficits displayed by sleep-deprived animals. These proliferative and antimanic effects were independent, since blockade of cell proliferation did not abolish the antimanic efficacy of PKC inhibitors in the sleep deprivation model. At the same time, we showed that PKC activation had an antidepressant-like effect in naive rats, whereas its inhibition caused a depressive-like phenotype accompanied by a decrease in hippocampal cell proliferation. Taken together, our results demonstrate the involvement of the PKC system in regulating opposite facets of bipolar disorder, and support the hypothesis that an overactivation of the PKC signaling system may be crucial for the deficits of neuroplasticity associated with mania.

This study investigates the connection between different pathophysiological processes in mitochondria and psychopathological symptoms in patients with bipolar disorder. Changes in activity of selected components of the respiratory chain and overall respiratory rate of mitochondria were analyzed in patients with bipolar disorder when compared to healthy controls. Diagnostic scales and questionnaires, high-resolution respirometry, radiochemical and spectroscopic methods were used. 37 patients with a diagnosis of bipolar disorder (F31) and 21 healthy volunteers were involved in the study. Statistical analysis included the methods of parametric and nonparametric analysis, factor analysis, one-way analysis of variance and linear regression analysis. Obtained results revealed that cellular energetics plays a great role in the pathophysiology of bipolar disorder. There was a mild difference between different mitochondrial enzymes activity in patients within manic phases and depressive phases of the disease. Changes in mitochondrial respiration in patients with BD as compared to healthy controls were also shown. Mitochondrial respiration indexes for patients with BD in remission as compared to healthy controls were altered in accordance with the previous phase of the disease. Association between the...

Cette thèse propose d’observer les ambiances sonores (i.e. sons, cris, paroles, bruits, moments de silence, etc.) et les musiques qui interviennent dans les cultes de la Mère des dieux, de Dionysos et de Déméter dans l’Athènes archaïque et classique, et d’en cerner les fonctions et significations. La composante sonore des cultes grecs, peu prise en considération dans les reconstructions historiques de la religion grecque ancienne, du moins jusqu’à récemment, joue un rôle pourtant fondamental tant dans la pratique rituelle que dans le récit. Ces deux formes d’expression de la religion – pratique rituelle et récit – sont d’ailleurs indissociables dans les témoignages anciens, de la même façon que les éléments imaginaires truffent les représentations inspirées de l’expérience rituelle. En examinant différents types de sources, parmi lesquelles les œuvres littéraires et les images sur vase demeurent les plus nombreuses et les plus instructives, et en abordant les différents aspects cultuels (pratique et récit / éléments imaginaires et réels) comme un ensemble cohérent, la phonosphère propre à chaque divinité se révèle de façon parfois frappante. Une telle démarche globalisante permet de mieux saisir l’expérience religieuse des Grecs, tout en favorisant une meilleure appréhension de certains phénomènes encore aujourd’hui sujets à controverses, par exemple le « ménadisme » et l’extatisme rituel. Car il ressort des témoignages que la musique, les sons et le silence, par leur pouvoir de communication notamment, remplissent des fonctions précises dans la pratique et le récit. Alors que certains sons et musiques visent à plaire à la divinité et, ainsi, à gagner sa faveur, par exemple, d’autres, investis de l’empreinte sonore de la divinité, exercent une emprise sur les mortels, emprise expérimentée dans le cadre de la pratique rituelle comme un moment de contact avec le divin. De cette emprise exercée par le moyen de la musique et des sons, peut résulter, dans certains cas, une guérison, une régulation des instabilités internes. Par ailleurs, la terminologie sonore dans la littérature se montre pratiquement toujours porteuse de sens, et permet de reconnaître l’univers évoqué et la ou les figure(s) divine(s) concernée(s). Répertorier les termes sonores propres à l’un ou l’autre culte facilite le repérage des associations établies entre certaines divinités, permettant ainsi des interprétations plus justes de certains passages de la littérature. D’un autre côté, la recherche sur les instruments de musique révèle des goûts et des tendances, possiblement attribuables dans certains cas à des changements significatifs survenus dans la sphère religieuse et politique de l’Athènes de la fin du Ve siècle. Par exemple, l’introduction progressive du tympanon dans l’univers dionysiaque à partir de la deuxième moitié du Ve siècle suggère une appropriation du culte de la Mère de dieux et de son instrument de prédilection par le peuple athénien. Cette observation, basée sur des témoignages de l’époque, contribue à illustrer la distinction que faisaient les Athéniens entre une religion considérée comme ancestrale, et une autre aux multiples formes et pour ainsi dire « additionnelle ». À cet égard, observer les éléments sonores dans les cultes mène non seulement à une meilleure connaissance desdits cultes, mais également à une meilleure compréhension de la société athénienne et des événements importants qui l’ont marquée. L’étude des sons, de leur place et de leurs fonctions dans la pratique et les récits contribue à l’approfondissement des connaissances concernant la religion grecque et les procédés de communication qu’elle met en place entre la sphère des mortels et celle des dieux, tout en favorisant une meilleure définition du milieu social et culturel dans lequel elle a évolué. / This thesis will consider the sound atmosphere (including cries, speech, noises and moments of silence) and music in the cults of the Great Mother, Dionysus and Demeter in Archaic and Classical Greece and their roles and meanings. Until recently, the audible component of Greek cults has rarely been considered by historical reconstructions. However, it played a fundamental role both in ritual practice and tales. These two expressions of religion – ritual practice and tales – are inextricably linked in ancient storytelling, just as representations inspired by the rituals are rife with imaginary elements. Examining different types of sources – of which the literary works and painted vases are the most numerous and enlightening – and considering the various cultural ingredients (tales and ritual practice, the imaginary and the real) as a coherent whole can provide insight into the phonosphere unique to each god in striking ways. This comprehensive approach leads to a better understanding of the religious experience of the Greeks, including certain phenomena that remain controversial today, such as maenadism and ecstatic ritual. The sources reveal that through their communicative power, music, sounds and silence filled specific functions in the ritual practices and tales. While some sounds and music were intended to please the god and hence gain favour, others bearing the god’s sonic signature held sway over mortals during rituals as a moment of personal contact with the divine. In certain cases, this aural sway could bring healing and a balancing of internal instability. Moreover, the sound vocabulary found in the literature almost invariably carries meaning that makes it possible to recognize the world and divine figures it describes. Cataloguing the sound vocabularies of individual cults/deities helps identify the relationships between certain gods. This in turn can clarify interpretations of certain passages in the literature. Similarly, research on musical instruments reveals tastes and trends, which could be attributed to the significant 5 changes in the religious and political spheres of Athens in the late 5th century BC. For example, the progressive introduction of the tympanum to the Dionysian world starting in the first half of the 5th century BC suggests that Athenians appropriated the cult of the Great Mother and the instrument most commonly associated with it. This observation, based on contemporary accounts, corroborates the distinction Athenians made between an ancestral religion and an “additional” multifaceted one. In that respect, investigating the sound atmosphere in these cults improves our understanding of not only the cults themselves, but also Athenian society as a whole and the milestone events that shaped it. Studying the sounds and their place and function in ritual practice and tales deepens our knowledge of Greek religion and the methods of communication it established between the realms of mortals and the gods. It also allows us to better characterize the social and cultural environments in which it developed