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Activation Levels, Cardiovascular Risk, and Functional Impairment in Remitted Bipolar Patients: Clinical Relevance of a Dimensional Approach

Activation Levels, Cardiovascular Risk, and Functional Impairment in Remitted Bipolar Patients:... Bipolar disorder (BD) patients frequently present chronic mood instability likely associated with functioning impairment and suicidal behavior [1]. However, the current classification systems assign primacy to mood and use symptom-based categorical approaches, which, as a result, often lack sensitivity to detect subtle behavioral changes in BD patients, particularly during the remission phase [2]. Assessing BD patients using a dimensional approach (MAThyS), which is able to uncouple the assessment of activation levels from mood, we have demonstrated 2 subforms of BD depression, i.e., one characterized by behavioral inhibition/emotional hyporeactivity and another defined by behavioral hyperactivation/emotional hyperreactivity [3], and that emotional reactivity is a relevant dimension for identification of BD patients at an increased risk for cardiometabolic dysfunction and suicide [4].While some studies have identified changes in energy/motor activity in BD patients using single symptoms [5], the use of activation levels to distinguish clinical phenotypes among remitted BD patients has not yet been explored. Levels of activation are mediated by a set of interacting brain structures that process and respond to emotional/perceptual stimuli associated with motivation/reward. We aimed to characterize remitted BD patients based on levels of activation through 5 dimensions of behavior, i.e., emotional reactivity, sensory perception, psychomotor activity, motivation, http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Psychotherapy and Psychosomatics Karger

Activation Levels, Cardiovascular Risk, and Functional Impairment in Remitted Bipolar Patients: Clinical Relevance of a Dimensional Approach

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References (12)

Publisher
Karger
Copyright
© 2018 S. Karger AG, Basel
ISSN
0033-3190
eISSN
1423-0348
DOI
10.1159/000493690
Publisher site
See Article on Publisher Site

Abstract

Bipolar disorder (BD) patients frequently present chronic mood instability likely associated with functioning impairment and suicidal behavior [1]. However, the current classification systems assign primacy to mood and use symptom-based categorical approaches, which, as a result, often lack sensitivity to detect subtle behavioral changes in BD patients, particularly during the remission phase [2]. Assessing BD patients using a dimensional approach (MAThyS), which is able to uncouple the assessment of activation levels from mood, we have demonstrated 2 subforms of BD depression, i.e., one characterized by behavioral inhibition/emotional hyporeactivity and another defined by behavioral hyperactivation/emotional hyperreactivity [3], and that emotional reactivity is a relevant dimension for identification of BD patients at an increased risk for cardiometabolic dysfunction and suicide [4].While some studies have identified changes in energy/motor activity in BD patients using single symptoms [5], the use of activation levels to distinguish clinical phenotypes among remitted BD patients has not yet been explored. Levels of activation are mediated by a set of interacting brain structures that process and respond to emotional/perceptual stimuli associated with motivation/reward. We aimed to characterize remitted BD patients based on levels of activation through 5 dimensions of behavior, i.e., emotional reactivity, sensory perception, psychomotor activity, motivation,

Journal

Psychotherapy and PsychosomaticsKarger

Published: Mar 1, 2019

Keywords: Activation level; Cardiovascular risk; Functional impairment

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