Guy M Goodwin

..Our data also suggests that some of the positive biases in emotional processing produced by SSRI treatment might be detectable at the beginning of treatment...

..Adopting these innovations could contribute towards lower failure rates for future placebo-controlled clinical trials in the field...

..Aripiprazole is an atypical antipsychotic with a pharmacological and clinical profile distinct from other atypical antipsychotics...

..The efficacy of agomelatine in major depression has thus been demonstrated at doses of 25-50 mg against the full range of symptoms that make up the depressive syndrome in patients with moderate to severe major depression...

..This study evaluates the efficacy of agomelatine, the first antidepressant that is an agonist at MT(1)/MT(2) receptors and an antagonist at 5-HT(2C) receptor, in the prevention of relapse of depression following successful response...

....

..Two clinical trials, prospectively designed for combined analysis, compared placebo, lithium, and lamotrigine for treatment of bipolar I disorder in recently depressed or manic patients...

..Agomelatine is well tolerated in other respects; only occasional dizziness emerges at significant rates higher than with placebo in the controlled data...

..Assay sensitivity and patient acceptability are enhanced if the outcome in long-term studies is 'time to intervention for a new episode' for discontinuation designs...

..To report a case in which the aromatase inhibitor letrozole produced irritable mood elevation followed by depression in a woman with a history of postpartum depression...

..A new collaborative approach based on simple clinical trials is required to change current medical practice...

....

..These can only develop out of genuine clinician and patient uncertainty and the creation of a trial culture in everyday practice...

..The present study supports the notion that Epo may have clinical applications in the treatment of psychiatric disorder characterized by cognitive dysfunction...

..The authors investigated whether this effect is apparent in depressed patients early in treatment, prior to changes in mood and symptoms...

..Although negatively biased cognitions are well documented in depressed patients and to some extent in recovered patients, it remains unclear whether these abnormalities are present before the first depressive episode...

..They also suggest a mechanism of action potentially compatible with cognitive theories of anxiety and depression...

....

..We hypothesized that dysregulation of the neural circuitry underlying emotion regulation is the mechanism whereby pain processing is affected during depressed mood...

..These results highlight a role of the fronto-parietal circuitry in emotional processing and further suggest that negative biases in these neural processes may be involved in risk for depression...

..The study highlights the potential value of volunteer models in drug development for screening and profiling of novel antidepressants...

..Thus, motivations constitute important mechanisms linking mood fluctuations and gambling. However, little is known about how different kinds of affective disturbance, such as mood elevation and dysphoria, motivate gambling behavior...

....

..Therefore the authors investigated and compared imagery and verbal thoughts related to past suicidality in individuals with bipolar disorder (n = 20) and unipolar depression (n = 20)...

..The findings were consistent with predictions. Further investigation of imagery in bipolar disorder appears warranted as it may highlight processes that contribute to mood instability with relevance for cognitive behaviour therapy...

..The serotonergic system has been implicated in emotional processing in animals and humans. Although the contribution of different receptor subtypes has been hypothesised, there have been few direct tests of this in human subjects...

..These results support the hypothesis that antidepressants have early effects on the neural processing of emotional material which may be important in their therapeutic actions...

..Consistent with our previous finding, Epo improved self-reported mood for all 3 days post-administration. Together, these results suggest that characterization of the effects of Epo in a clinically depressed group is warranted...

..This study reviewed the evidence from randomized, controlled trials on the efficacy and safety of antidepressants in the short-term treatment of bipolar depression...

..The neuropharmacological actions of antidepressants are well characterised but our understanding of how these changes translate into improved mood are still emerging...

..More generally, the findings suggest that pinpointing the cognitive actions of treatments may inform future development of combination strategies in mental health...

..CONCLUSIONS: These results suggest that increased recognition of fear is a trait vulnerability marker for depression and that this is normalized following a single dose of citalopram...

..It is currently unclear if this is the case both for people with normal folate levels, and for those with folate deficiency...

..This study aimed to replicate a deficit in sustained attention in euthymic bipolar patients and investigate sustained attention in first-degree relatives of bipolar probands and in remitted patients with major depressive disorder...

..Depression is associated with neural abnormalities in emotional processing...

..Emotional disorders such as depression and anxiety have been associated with hyperactivity of the amygdala, but it is unknown whether antidepressant treatment directly affects amygdala responses to emotionally significant information...

..Although bipolar disorder is associated with various adverse health outcomes, the relationship with violent crime is uncertain...

..Human models of emotional processing may provide a useful means of assessing the likely therapeutic potential of new treatments for depression...

..Cognitive theories suggest that biases in information processing lead depressed patients to make unrealistically negative judgments about themselves and the world...

..It has been hypothesized, but not proved, that psychological interventions may alter the function of prefrontal regions supervising the allocation of attentional resources...

..This study was undertaken to examine whether brain 5-HT(1A) receptor binding is reduced in euthymic bipolar patients...

..However, studies of euthymic bipolar disorder patients may be confounded by the experience of mood episodes and medication. We therefore assessed an adolescent group for vulnerability markers associated with the bipolar phenotype...

..To ascertain whether a small sample of patients with chronic pelvic pain experienced any pain-related cognitions in the form of mental images...

..We aimed to establish whether lithium plus valproate was better than monotherapy with either drug alone for relapse prevention in bipolar I disorder...

..Internet gamblers appear to be heterogeneous but composed of several subgroups, differing markedly on both demographic and clinical characteristics...

..The Stroop interference effect was abolished by TMS over both anterior cingulate sites. These findings support functional neuroimaging research which suggests that cingulate cortex is central to the processes underlying the Stroop task...

..BALANCE is now actively recruiting in the UK and USA...

..Our results show that reboxetine modulates the neural substrates of emotional processing, highlighting a mechanism by which drug treatment could normalise negative bias in depression and anxiety...

..Introducing imagery has novel implications for bipolar treatment innovation--an area where CBT improvements are much-needed...

..CONCLUSIONS: Abnormalities in waking cortisol are associated with neuroticism in a way similar to those seen in major depression. Elevated waking cortisol may represent a vulnerability marker for mood disorder...

..The authors sought to determine the efficacy and acceptability of lithium for relapse prevention in bipolar disorder...

..CONCLUSIONS: Sustained attention deficit may represent a neuropsychological vulnerability marker for bipolar disorder, providing a focus for further understanding of the phenotype and analysis of the neuronal networks involved...

..In rats, amino acid mixtures lacking tyrosine and its precursor phenylalanine decrease the release of dopamine produced by the psychostimulant drug amphetamine. Amphetamine has been proposed as a model for clinical mania...

..These observations suggest that the dampened intoxication may contribute to the increased rates of alcohol misuse in young people at-risk for BD, and suggest possible shared etiological factors in the development of AUDs and BD...

..Deficits in sustaining attention may help explain the difficulties in psychological and occupational functioning in bipolar disorder patients during remission...

..Greater validation is required to assess whether these effects are an obligatory component of effective treatment of depression and whether use of these models can improve the accuracy of go/no-go decisions in drug development...

..Some people who take selective serotonin reuptake inhibitor (SSRI) antidepressants report that their experience of emotions is 'blunted'. This phenomenon is poorly understood...

..Most importantly, however, it is a term that is innately appealing because of what it promises: for this reason alone it should encompass only those agents that can deliver...

....

..There is uncertainty about the efficacy of lamotrigine in bipolar depressive episodes...

....

..Where available, a range of specific psychological interventions can be effective as an adjunct to medication.When discontinuation of prophylaxis is necessary, gradual tapering of dose over weeks or months is recommended...

..Antidepressant drugs can promote remission from acute depressive episodes. Our aim was to establish how long such treatments should be continued to prevent relapse...

..There has been concern about its safety but no adequate synthesis of the evidence for adverse effects. We aimed to undertake a clinically informative, systematic toxicity profile of lithium...

..However, a number of more distal cortical areas were also affected in these experiments. These additional changes may reflect either 'downstream' effects of altered cingulate cortex activity or direct effects of the coil...

..Correspondence between preoperative and higher resolution ex vivo DT supports the validity of DT as a presurgical planning tool for DBS...

..72; 95% CI 0.49, 1.07). Factors such as disease subtype, likelihood of adherence to treatment regimen, tolerability, and dose uncertainty should be considered in the selection of lithium maintenance therapy...

..We conclude that there is no evidence from this study of an increase in suicide rates following the introduction of SSRIs in the general population or in a high-risk inpatient sample...

..This difference in perception may be relevant to the decreased self-esteem and social functioning that have been associated with the euthymic phase of this disorder...

..However, the improvement in cognitive function often found following successful pharmacological treatment in depression may be confounded by symptom improvement...

..The processing of other fear-relevant cues, such as facial expressions, has also been associated with amygdala function, but an effect of serotonin depletion on these processes has not been assessed...

..Administration of a complex tyrosine-free amino acid drink acutely decreases manic symptoms. Although a nutrient-based approach to illness management is attractive, complex amino acid drinks are too unpalatable for repeated administration...

..The current study examines whether Mansell's hypomania-related dysfunctional belief scale specifically identifies bipolar disorder patients...

..The more prominent impairments of memory are likely to be associated with the finding of impaired temporal function or with a more diffuse failure of neuromodulation...

..This effect may represent an early acute effect of SSRIs on social and emotional processing that is relevant to their therapeutic actions...

..Such information could establish tyrosine depletion as an effective probe of dopamine function in healthy volunteers and would also have relevance for future therapeutic applications of this manipulation...

..We found that TMS over the medial-frontal cortex impairs the processing of angry, but not happy, facial expressions of emotion...

..This study aimed to explore the feasibility and potential benefits of a new psychological treatment (Mindfulness-based Cognitive Therapy: MBCT) for people with bipolar disorder focusing on between-episode anxiety and depressive symptoms...

..However, the BCAA mixture also lowers the ratio of tryptophan (TRP) to BCAA which could impair brain serotonin function...

..Such adaptations in the neural processing of emotional information support the hypothesis that antidepressants have early effects on emotional processing in a manner which would be expected to reverse negative biases in depression...

..The amygdala has also been associated with the processing of facial expressions of emotion, particularly those of fear and sadness. However, the role of noradrenaline in the latter process is unknown...

..FIMM incorporated a novel mood monitoring program based on mobile phone technology...

..Despite frequent use, little is known about the metabolic and endocrine side-effects of antipsychotics in individuals with intellectual disability...

..We suggest that there is no single brain location responsible for perceptual switching in all different ambiguous figures and that perceptual switching is generated by the actions of local cortical circuitry...

..Although usually well tolerated, headache, insomnia and drowsiness are probably the most common side effects...

..The data do not implicate ventral prefrontal cortex disruption as a locus of pathology in acute mania. Verbal memory and sustained attention deficits may relate differentially to the state and trait characteristics of bipolar disorder...

..The strength of supporting evidence was rated. The guidelines cover the diagnosis of bipolar disorder, clinical management, and strategies for the use of medicines in treatment of episodes, relapse prevention and stopping treatment...

..The authors investigated sleep-related functioning in euthymic patients with bipolar disorder...

..The APOE epsilon4 allele modulates brain function decades before any clinical or neurophysiological expression of neurodegenerative processes...

..In this study, we investigated the effects of highlighting rewards versus highlighting punishments in the risky decision-making of euthymic individuals with bipolar disorder...

..Performance on frontal lobe tests appears to be insensitive to normal mood fluctuations, which supports the argument that the deficits in mood disorder patient groups may instead reflect core disturbances of neurobiological processes...

..CONCLUSIONS: This is the first study to demonstrate fronto-striatal atrophy in patients with depression with poor outcome; the atrophy is more marked in those with more severe illness...

..The guidelines cover the diagnosis of bipolar disorder, clinical management and strategies for the use of medicines in short-term treatment of episodes, relapse prevention and stopping treatment...

..CONCLUSIONS: Our data suggest that abnormal cerebellar function could be a marker of vulnerability to recurrent depression. This could provide a new target for therapeutic interventions...

..However, services cannot be enhanced on a rational basis without an improved understanding and capacity to measure and target caregiver burden the impact of any change in services be evaluated...

..CONCLUSIONS: A drink containing branch chain amino acids is well tolerated in healthy volunteers and produces effects consistent with lowered dopamine function...

....

..This is the first demonstration of a difference in hypothalamic--pituitary--adrenal axis regulation associated with neuroticism...

..It is timely since awareness of the specific needs of bipolar patients is growing and there is an increased choice of effective treatments for all phases of the illness...