Mania Research Papers - Academia.edu (original) (raw)

The spendthrift condition in the consumer society 1. APRESENTAÇÃO DO PROBLEMA Atividade realizada pelo homem diariamente, consumir é algo absolutamente normal, muito embora, hoje, no seio de uma sociedade cada dia mais aparadigmática,... more

The spendthrift condition in the consumer society 1. APRESENTAÇÃO DO PROBLEMA Atividade realizada pelo homem diariamente, consumir é algo absolutamente normal, muito embora, hoje, no seio de uma sociedade cada dia mais aparadigmática, discorrer sobre a normalidade seja tarefa inglória. Entretanto há que se destacar a noção, ainda vigente ao menos no campo da dogmática, segundo a qual gastar muito, desordenadamente, sem tempo nem finalidade, comprometendo o patrimônio talvez, gastar, em resumo, como um louco, deixa de ser normal. E quem assim procede é denominado pródigo. O Direito, então, em princípio, visando proteger aqueles que do pródigo dependiam e, depois, protegê-lo de si próprio, baixou sobre ele verdadeira capitis deminutio-isso mesmo sem nunca se ter chegado a uma conclusão definitiva sobre a prodigalidade, sua caracterização, sua natureza.

The diagnosis of mania largely depends on the quality of information the physician is provided with. Often, the patient cannot give an accurate account of the symptom development and thus information from relatives and friends is... more

The diagnosis of mania largely depends on the quality of information the physician is provided with. Often, the patient cannot give an accurate account of the symptom development and thus information from relatives and friends is required. No systematic rating instrument is available, however, to facilitate this.
In this study, the psychometric properties of the 49-item Observer-Rated Scale for Mania (ORSM) are reported.
The scale was used in 113 inpatients and the following psychometric aspects were assessed: reliability, test-retest reliability, construct validity (factor analysis, discriminant analysis, comparison of means), extreme-group validity, prognostic validity, sensitivity, specificity, positive and negative predictive values.
The ORSM proved highly valid and reliable. Factor analysis revealed three factors which were labelled euphoric mania, instable mania and psychotic mania.
The ORSM is a useful instrument to help non-professionals who are in regular contact with the patient diagnosed a manic/mixed episode. It thus complements existing rating scales for mania, which are either designed for professionals or are self-rating instruments.

In the present state of health and wellness, mental illness is always deemed less importance compared to other forms of physical illness. In reality, mental illness causes serious multi-dimensional adverse effect to the subject with... more

In the present state of health and wellness, mental illness is always deemed less importance compared to other forms of physical illness. In reality, mental illness causes serious multi-dimensional adverse effect to the subject with respect to personal life, social life, as well as financial stability. In the area of mental illness, bipolar disorder is one of the most prominent type which can be triggered by any external stimulation to the subject suffering from this illness. There diagnosis as well as treatment process of bipolar disorder is very much different from other form of illness where the first step of impediment is the correct diagnosis itself. According to the standard body, there are classification of discrete forms of bipolar disorder viz. type-I, type-II, and cyclothymic. Which is characterized by specific mood associated with depression and mania. However, there is no study associated with mixed-mood episode detection which is characterized by combination of various symptoms of bipolar disorder in random, unpredictable, and uncertain manner. Hence, the model contributes to obtain granular information with dynamics of mood transition. The simulated outcome of the proposed system in MATLAB shows that resulting model is capable enough for detection of mixed mood episode precisely.

With reference to the works of Charles Darwin, legal commentators and psychiatrists, this article explores the meaning of maternity in the Victorian and Edwardian periods with particular reference to puerperal mania, puerperal melancholia... more

With reference to the works of Charles Darwin, legal commentators and psychiatrists, this article explores the meaning of maternity in the Victorian and Edwardian periods with particular reference to puerperal mania, puerperal melancholia and infanticide (‘puerperal’ relating to childbirth or the period immediately following) . It illustrates how parturition was regarded as the fulcrum of women’s instability. ‘Puerperal insanity’ was a ‘catch-all’ phase used to describe a wide variety of reactions to pregnancy and childbirth. These ranged from the understandable despair of a young girl experiencing an illegitimate pregnancy, to the mother of ten infants who hallucinated because she breastfed whilst malnourished. The essay illustrates that some women clearly suffering from postpartum microbial infections were defined as having puerperal mania ; their feverish delirium was mistaken for maniacal insanity. The sanctions for maniacal behaviour, or understandable chagrin if vigorously expressed, were often very harsh and included institutionalisation, the use of restraints (chains or straitjackets) and seclusion. Puerperal melancholia was particularly associated with exhaustion, the mental cruelty of husbands and poverty. As Bucknill and Tuke’s remarks will make clear, parturition was a time when women were particularly at risk of being defined as insane.

Die Störungen der Zeiterfahrung in Depression und Manie gehen über das Erleben von Verlangsamung und Beschleunigung des Zeitverlaufs hinaus. Die Erfahrungsberichte von Betroffenen zeugen von einer ganzen Reihe von vielschichtigen und... more

Die Störungen der Zeiterfahrung in Depression und Manie gehen über das Erleben von Verlangsamung und Beschleunigung des Zeitverlaufs hinaus. Die Erfahrungsberichte von Betroffenen zeugen von einer ganzen Reihe von vielschichtigen und komplexen Veränderungen der Zeitlichkeit: Bipolare Störungen können die Erfahrung von Vergangenheit, Gegenwart und Zukunft transformieren, sie können eine Desynchronisierung von Eigen- und Weltzeit bedeuten, die Bedeutung von Zeit radikal verändern und schließlich eine Diskontinuität von Selbst- und Lebensentwürfen bewirken. Dieser Aufsatz stellt anhand klassischer und zeitgenössischer phänomenologischer Psychopathologie die etablierten Theorien über die Zeitlichkeit in Depression und Manie dar, um dann Erweiterungen und offene Forschungsfragen aufzuzeigen.

The faculty of memory, comprising memorization and remembrance, is often viewed as entirely rational. This paper focuses on three phenomena, poetry, mystery initiations, and Plato’s philosophy, in order to demonstrate that in some... more

The faculty of memory, comprising memorization and remembrance, is often viewed as entirely rational. This paper focuses on three phenomena, poetry, mystery initiations, and Plato’s philosophy, in order to demonstrate that in some spheres, mania and mnêmê intertwined. The poet’s memory is only partially his own: he recalls and commemorates in the grip of divine inspiration, when he is out of his mind. Creation of the eternal memory of the life-changing ecstatic experience was the aim of mystery rites, whereas the mnêmê of the ceremony was enhanced by means of mania. Finally, in Plato, the philosopher’s recollection of his soul’s true knowledge is pictured as a seizure of mania. Magic memory and inspired knowledge are present in all these phenomena. The ancient mingling of thinking, alteration of consciousness and remembering, expressed by means of the words deriving from the Indo-European root men-, denoting ‘active mental force,’ did not disappear in Greece.

Every disorder is embedded within multiple sociocultural aspects, and in mental disorders these aspects acquire paramount significance. Nonetheless and despite the cultural diversity of ancient and modern societies, the consistency of... more

Every disorder is embedded within multiple sociocultural aspects, and in mental disorders these aspects acquire paramount significance. Nonetheless and despite the cultural diversity of ancient and modern societies, the consistency of psychiatric reactions to combat stress throughout history is remarkable. The situation in ancient Greece was quite different from the contemporary one. Hippocratic physicians turned a blind eye to a series of worrying conditions they could neither explicate nor treat, but enlightened laypeople noticed mental disorders disregarded by physicians and even looked for ways to assuage them. In ancient Greece, fear, panic, and ensuing short-term psychological consequences were well-known to military men who tried to prevent them by methods that are considered to be efficient even today. Nonetheless, long-term mental disorders following exposure to battle were almost entirely ignored. The 5th century BC sophist Gorgias seems to be the only author who discussed their nature. Combat-related mental disorders existed two thousand and several hundred years ago, as they do today, and the idea that they could be prevented by means of social conditioning proved to be false. The fact that some modern therapeutic approaches appear to have been used in Greece is reassuring: it suggests that modern Western attitudes to psychological treatment of trauma are not entirely culturally-dependent, but rather make use of some universal human traits, and may therefore be applied to the treatment of trauma with patients from different cultural traditions. Awareness of the persistence of combat psychological trauma in history may provide insights to different professionals: historians may identify and comprehend allusions to combat trauma in their sources, while mental health professionals may use ancient history to broaden their understanding of the effects of trauma

- ‘Our greatest blessings come to us by way of mania, provided it is given us by divine gift,’ – says Socrates in Plato’s Phaedrus. Certain forms of alteration of consciousness, considered to be inspired by supernatural forces, were... more

- ‘Our greatest blessings come to us by way of mania, provided it is given us by divine gift,’ – says Socrates in Plato’s Phaedrus. Certain forms of alteration of consciousness, considered to be inspired by supernatural forces, were actively sought in ancient Greece. Divine mania comprises a fascinating array of diverse experiences: numerous initiates underwent some kind of alteration of consciousness during mystery rites; sacred officials and inquirers attained revelations in major oracular centres; possession states were actively sought; finally, some thinkers, such as Pythagoras and Socrates, probably practiced manipulation of consciousness. These experiences, which could be voluntary or involuntary, intense or mild, were interpreted as an invasive divine power within one’s mind, or illumination granted by a superhuman being. In ancient Greece, these mental states were treated with cautious respect, and in contrast to the majority of complex societies, ancient and modern, were never suppressed or pushed to the cultural and social periphery.

Here we consider interpersonal experience in schizophrenia, melancholia, and mania. Our goal is to improve understanding of similarities and differences in how other people can be experienced in these disorders, through a review of... more

Here we consider interpersonal experience in schizophrenia, melancholia, and mania. Our goal is to improve understanding of similarities and differences in how other people can be experienced in these disorders, through a review of first-person accounts and case examples and of contemporary and classic literature on the phenomenology of these disorders. We adopt a tripartite/dialectical structure: first we explore main differences as traditionally described; next we consider how the disorders may resemble each other; finally we discuss more subtle but perhaps foundational ways in which the phe-nomenology of these disorders may nonetheless be differentiated. These involve disruptions of common sense and conventionality, abnormalities of empathy, distinct forms of paranoia and the sense of personal centrality, and altered perceptions of inten-tionality, deadness, and artificiality. We end by considering some neurocognitive research relevant to these abnormal forms of subjectivity, including work on theory of mind, experience of human movement, and perception of faces. Keywords schizophrenia – mood disorder – mania – melancholia – depression – interpersonal phenomenology – phenomenological psychopathology

Turkish version of the Cognition Checklist Mania Revised (CCL-M-R)

Background: Whilst cannabis use appears to be a causal risk factor for the development of schizophrenia-related psychosis, associations with mania remain relatively unknown. This review aimed to examine the impact of cannabis use on the... more

Some famous Greek philosophers, traditional sages and prophetic priests, used similar methods of attaining the state of inspiration. The paper describes ancient practices, underscores the interaction between this cross-cultural proclivity... more

Some famous Greek philosophers, traditional sages and prophetic priests, used similar methods of attaining the state of inspiration. The paper describes ancient practices, underscores the interaction between this cross-cultural proclivity and the historically conditioned environment of a particular culture, and uses Greece as an example illustrating the antiquity of the aspiration for mind enhancement.

In the history of psychiatry in Spain, the first half of the nineteenth century has been considered a period of uncritical reception of the theories of Philippe Pinel and Jean Étienne Esquirol. In this article I strive to problematise the... more

In the history of psychiatry in Spain, the first half of the nineteenth century has been considered
a period of uncritical reception of the theories of Philippe Pinel and Jean Étienne Esquirol. In this article
I strive to problematise the diffusionist assumptions of this thesis, studying the participation of local agents
in the circulation and reception of medical knowledge. Through a comparative analysis of the paratexts and
the modifications made to the translations of the works of these authors, I intend to expose how the theories
of Pinel and Esquirol were unified in the Spanish case. Through a concrete analysis of the modification
of the diagnoses of melancholy, hypochondria, mania and hysteria, I intend to expose the variations that
were applied to medical knowledge in its reception in Spain in order to adapt it to the frameworks of local
medicine. Lastly, I intend to expose the methodological advantages offered by conceiving the translations of
works and books as cultural products whose meaning is constructed in its place of reception, and not in the
place of original publication

This book examines the nature and significance of religious enthusiasm in early Enlightenment England. In the early modern period, the term ‘enthusiasm’ was a smear word used to discredit the dissenters of the radical Reformation as... more

This book examines the nature and significance of religious enthusiasm in early Enlightenment England. In the early modern period, the term ‘enthusiasm’ was a smear word used to discredit the dissenters of the radical Reformation as dangerous religious fanatics. In England, the term gained prominence from the Civil War period and throughout the eighteenth century. Anglican ministers and the proponents of the Enlightenment used it more widely against Paracelsian chemists, experimental philosophers, religious dissenters and divines, astrologers or anyone claiming superior knowledge. As a result, our understanding of enthusiasm is largely influenced by the hostile discourse of Augustan moralist and early Enlighteners. But who exactly were these enthusiasts? What did they believe in, how did they operate as a community and what impact did they have on their contemporaries? This book aims to answer these questions by concentrating on the notorious case of the French Prophets. It demonstrates how the understanding of enthusiasm evolved around 1700, designating anything from a religious fanaticism to a social epidemic and even a bodily disease. It offers the first comprehensive approach to enthusiasm, looking at this multifarious issue from a successively social, religious, cultural, political and medical perspective. Based on extensive archival research, it sheds new light on the reality of enthusiasm away from the hostility of Enlightenment discourse.

The degree to which insanity or mental infirmity can be instrumentalized in legal debate is shaped by understandings of what insanity is, the currency of a specific diagnosis, as well as official and unofficial symptomatologies, all of... more

The degree to which insanity or mental infirmity can be instrumentalized in legal debate is shaped by understandings of what insanity is, the currency of a specific diagnosis, as well as official and unofficial symptomatologies, all of which render the law, as a system of knowledge and social practices, porous and permeable in regards to what might be abstractly called »the human mind and heart«. This article explores the changing role of emotions in explaining, demonstrating, and adjudicating insanity during the nineteenth and early
twentieth centuries. Over the course of the nineteenth century, the insanity plea became a matter of heated debate in relation to specific trials of capital offenses, which not only brought crime but also the subject of criminal insanity into the public eye. At the same time, the rise of expert scientific testimony and the modern medical sciences – specifically medical psychology and the advent of psychiatry – created different definitions and understandings of mental illness that challenged legal definitions of insanity. This led to interdisciplinary discussion and debate, as physicians sought to provide a serviceable system to the lawyers, and lawyers sought new ways to discover and prove cases. The medicalization and pathologization of emotions not only led to the introduction and interpretation of new kinds of emotional evidence in the courtroom, it also gave emotions a range of different potential meanings, challenging the psychological premises and assumptions of the law as well as the principles and purposes of criminal justice.

In this paper I examine the ways in which our language and terminology predetermine how we approach, investigate and conceptualise mental illness. I address this issue from the standpoint of hermeneutic phenomenology, and my primary... more

In this paper I examine the ways in which our language and terminology predetermine how we approach, investigate and conceptualise mental illness. I address this issue from the standpoint of hermeneutic phenomenology, and my primary object of investigation is the phenomenon referred to as “mania”. Drawing on resources from classical phenomenology, I show how phenomenologists attempt to overcome their latent presuppositions and prejudices in order to approach “the matters themselves”. In other words, phenomenologists are committed to the idea that in our everyday, natural attitude, we take for granted a number of prejudices and presuppositions that predetermine how we conceive of and understand what we experience. In order to properly approach the phenomena themselves, we need to find ways of neutralising our presuppositions and prejudices in order to develop new (and hopefully more accurate) accounts of the phenomena under investigation. One of the most popular examples of such an attempt at neutralisation is what Edmund Husserl calls the epoché, which is the practice of bracketing out or suspending presuppositions. However, later phenomenologists developed alternative approaches. Martin Heidegger, for instance, engaged in etymological analyses to discover latent meanings in our language and terminology. Hans-Georg Gadamer also engaged in historical analyses of how our traditions sediment into latent prejudices. After discussing the various ways in which phenomenologists have attempted to neutralise presuppositions and prejudices prior to engaging in their investigations, I apply some of these principles and methods to the domain of psychopathology, and discuss some of the prejudices inherent in contemporary discussions of the phenomenon of mania. I examine recent attempts to link the phenomenon that we today refer to as “mania” with the ancient Greek concept of “μανία” (mania), and argue that the practice of linking contemporary and historical concepts can be detrimental to attempts at reclassifying disorders. In addition, I consider the implications of the shift in terminology from “manic depressive illness” to “bipolar disorder” – especially how conceiving of mania as one of two “poles” predetermines its description by both clinicians and patients. Finally, I address the implications of the headings under which mania and bipolar disorder are discussed within diagnostic manuals. For example, I discuss the removal of the headings of affective and mood disorders in the DSM-5, and the explicit decision by the authors to place bipolar disorder between depressive disorders and schizophrenia. What I aim to accomplish in this paper is not so much a phenomenological investigation of mania as it is a pre-phenomenological investigation. In other words, I offer a preparatory investigation of the phenomenon (or phenomena) referred to as “mania” in contemporary discourse, with the intention of laying the groundwork for further phenomenological and psychological research.

We measured plasma free HVA and MHPG in 39 cases of psychosis or mania judged to be caused by antidepressant exacerbation of symptoms. A total of 24 of patients had been receiving selective serotonin reuptake inhibitors (SSRI’s). The SSRI... more

We measured plasma free HVA and MHPG in 39 cases of psychosis or mania judged to be caused by antidepressant exacerbation of symptoms. A total of 24 of patients had been receiving selective serotonin reuptake inhibitors (SSRI’s). The SSRI group showed a pattern of increased plasma HVA similar to a comparison group of patients with a psychotic/manic relapse secondary to medication non-compliance.

The purpose of the current investigation was to examine the personality predictors of bipolar disorder symptoms, conceptualized as one-dimensional (bipolarity) or two-dimensional (mania and depression). A psychiatric sample (N = 370; 45%... more

The purpose of the current investigation was to examine the personality predictors of bipolar disorder symptoms, conceptualized as one-dimensional (bipolarity) or two-dimensional (mania and depression). A psychiatric sample (N = 370; 45% women; mean age 39.50 years) completed the Revised NEO Personality Inventory and the Minnesota Multiphasic Personality Inventory —2. A model in which bipolar symptoms were represented as a single dimension provided a good fit to the data. This dimension was predicted by Neuroticism and (negative) Agreeableness. A model in which bipolar symptoms were represented as two separate dimensions of mania and depression also provided a good fit to the data. Depression was associated with Neuroticism and (negative) Extraversion, whereas mania was associated with Neuroticism, Extraversion and (negative) Agreeableness. Symptoms of bipolar disorder can be usefully understood in terms of two dimensions of mania and depression, which have distinct personality correlates.

Melampus is a seer-healer of Greek myth attributed with having healed the young princesses of Argos of madness. Analysis of this legend and its sources sheds light on the early stages of the “medicalizing” shift in the history of ancient... more

Melampus is a seer-healer of Greek myth attributed with having healed the young princesses of Argos of madness. Analysis of this legend and its sources sheds light on the early stages of the “medicalizing” shift in the history of ancient Greek medicine. Retrospective psychological diagnosis suggests that the descriptions of the youths’ madness rose from actual observation of behavioral and mental disorders. Melampus is credited with having healed them by administering hellebore. Pharmacological analysis of botanical specimens proves that Helleborus niger features actual neurological properties effective in the treatment of mental disorders. The discussion aims at examining the rational aspects of the treatment of mental conditions in Greco-Roman antiquity.

Analysis of various sources from Late Antiquity to the early Middle Ages, with a focus on texts by Church Fathers and conciliar norms intended to regulate the dancing practices, enables examination of the formation of Christian prejudice... more

Analysis of various sources from Late Antiquity to the early Middle Ages, with a focus on texts by Church Fathers and conciliar norms intended to regulate the dancing practices, enables examination of the formation of Christian prejudice against dancing. A connection can be established between the choreia (choral dance) of the Ideal City described by Plato and the ideal of harmony that the early medieval Church attempted to impose as a form of social control. Such reflections, on dancing as well as on harmony – or the lack thereof – thus facilitate an in-depth reflection on the choreutic aspects of demonic possession.

Humans have the ability to mentally time travel through past, present, and future. But can a disruption in emotion characteristic of emotional disorders cause this ability to unwind, leaving people ‘stuck’ in the present emotional moment?... more

Humans have the ability to mentally time travel through past, present, and future. But can a disruption in emotion characteristic of emotional disorders cause this ability to unwind, leaving people ‘stuck’ in the present emotional moment? Two studies are presented that examine emotional time perspective in a disorder (mania) characterized by present-oriented tendencies, including impulsivity and emotion dysregulation. In Study 1, associations were reported between mania proneness and emotion time-perspective (n = 509) and Study 2 compared emotion time-perspective between individuals with a clinical history of mania (n = 32), and controls (n = 30). We show that mania is associated with increased present and decreased future focus. These findings suggest that emotional disorders can be understood, at least in part, by examining how people understand and use time to guide their behavior and feelings.

Background: Although quality of life (QoL) is receiving increasing attention in bipolar disorder (BD) research and practice, little is known about its naturalistic trajectory. The dual aims of this study were to prospectively investigate:... more

Background: Although quality of life (QoL) is receiving increasing attention in bipolar disorder (BD) research and practice, little is known about its naturalistic trajectory. The dual aims of this study were to prospectively investigate: (a) the trajectory of QoL under guideline-driven treatment and (b) the dynamic relationship between mood symptoms and QoL.
Methods: In total, 362 patients with BD receiving guideline-driven treatment were prospectively followed at 3-month intervals for up to 5 years. Mental (Mental Component Score - MCS) and physical (Physical Component Score - PCS) QoL were measured using the self-report SF-36. Clinician-rated symptom data were recorded for mania and depression. Multilevel modelling was used to analyse MCS and PCS over time, QoL trajectories predicted by time-lagged symptoms, and symptom trajectories predicted by time-lagged QoL.
Results: MCS exhibited a positive trajectory, while PCS worsened over time. Investigation of temporal relationships between QoL and symptoms suggested bidirectional effects: earlier depressive symptoms were negatively associated with mental QoL, and earlier manic symptoms were negatively associated with physical QoL. Importantly, earlier MCS and PCS were both negatively associated with downstream symptoms of mania and depression.
Conclusions: The present investigation illustrates real-world outcomes for QoL under guideline-driven BD treatment: improvements in mental QoL and decrements in physical QoL were observed. The data permitted investigation of dynamic interactions between QoL and symptoms, generating novel evidence for bidirectional effects and encouraging further research into this important interplay. Investigation of relevant time-varying covariates (e.g. medications) was beyond scope. Future research should investigate possible determinants of QoL and the interplay between symptoms and wellbeing/satisfaction-centric measures of QoL.

This paper utilizes a number of different works by Freud in order to understanding the psychic forces of melancholia and mania that were prevalent in Trump and his supporters during his presidential campaign of 2015- 2016. The paper does... more

This paper utilizes a number of different works by Freud in order to understanding the psychic forces of melancholia and mania that were prevalent in Trump and his supporters during his presidential campaign of 2015- 2016. The paper does so by revisiting an early treatment of melancholia in American politics published by Mary Caputo in Theory and Event in 2000.

In this paper, I will explain “Environmental Melancholia” and “Collective Social Mania,” and describe how they are connected in a hedonic loop of capitalism and buyer’s remorse. I will explain the role of symbolism and symbolic acts in... more

In this paper, I will explain “Environmental Melancholia” and “Collective Social Mania,” and describe how they are connected in a hedonic loop of capitalism and buyer’s remorse. I will explain the role of symbolism and symbolic acts in healing one’s grief, and the connection it has to art. I will briefly trace how I moved into a layered visual language that synthesizes all of these ideas in one formally and conceptually balanced thesis, entitled Relentless Memorial.
The materials used in Relentless Memorial reference the unyielding pollution and mass production of goods created by the petroleum industry, as well as creating a dichotomy between a clean, white, virgin plastic to an ever-increasingly polluted, contaminated world. The formal presentation of Relentless Memorial as an installation is intended to provide a place of contemplation and mourning. Furthermore, the presentation of the installation as a panorama is related to the phenomenon of panoramas of the nineteenth century. This directly references the onset of environmental pollution during the French and English industrial revolution of that time, inviting a layered investigation into the implications of how that industry has influenced the environmental melancholia felt by society today.

Purpose This case-control study assessed the prevalence of psychiatric disorders in Arab (Saudi) patients with narcolepsy using a structured clinical interview. Methods The study included 74 adult patients with narcolepsy and 265 controls... more

Purpose This case-control study assessed the prevalence of psychiatric disorders in Arab (Saudi) patients with narcolepsy using a structured clinical interview. Methods The study included 74 adult patients with narcolepsy and 265 controls matched for age and sex. Narcolepsy diagnosis was made according to the International Classification of Sleep Disorders-Third Edition. Psychiatric disorders were diagnosed via using a validated Arabic version of the Mini International Neuropsychiatric Interview DSM-IV (MINI version 6). A multivariate logistic regression model was used to assess the potential influence of narcolepsy on the comorbidity of psychiatric disorders. Results The mean age of the patients was 29.4 ± 10.2 years, and males accounted for 81% of the study sample. Forty-four patients (60%) were diagnosed with narcolepsy type-1 (NT1) and 30 (40%) with narcolepsy type-2 (NT2). Psychiatric disorders were diagnosed in 45% of patients with narcolepsy compared with 15% of the controls (p < 0.001). The multivariate logistic regression models demonstrated that compared with the controls, patients with narcolepsy were more likely to have major depressive disorders (OR, 4.3 [CI, 2.2-8.2]), and generalized anxiety disorders (OR, 9.5 [CI, 1.8-50.2]). No difference was detected between the prevalence of various psychiatric disorders in patients with NT1 and NT2. Conclusion Comorbid psychiatric disorders are common among Arab (Saudi) patients with narcolepsy compared with the general population. Therefore, clinicians should be aware of the comorbidity of narcolepsy and psychiatric disorders, particularly depression.

The aim of this study was to delineate the associations between the tryptophan catabolite (TRYCAT) pathway and affective symptoms in schizophrenia. Towards this end we measured immunoglobulin (Ig)A and IgM responses to relatively noxious... more

The aim of this study was to delineate the associations between the tryptophan catabolite (TRYCAT) pathway and affective symptoms in schizophrenia. Towards this end we measured immunoglobulin (Ig)A and IgM responses to relatively noxious TRYCATs, namely quinolinic (QA), xanthurenic (XA), picolinic (PA) acid and 3-OH-kynurenine (3HK), and generally protective TRYCATs, namely anthranilic (AA) and kynurenic (KA) acid in 80 patients with schizophrenia and 40 healthy controls. The Hamilton Rating Scale for Depression (HDRS) and anxiety (HAMA), Young Mania Rating Scale (YMRS) as well as the Positive and Negative Symptoms Scale of Schizophrenia (PANSS) were measured. Depression, anxiety and hypomanic as well as negative and positive symptoms were associated with increased IgA responses to PA. Increased IgA responses to XA were associated with anxiety, hypomanic and negative symptoms. Moreover, depressive, anxiety, hypomanic and negative symptoms were characterized by increased IgA responses to the noxious (XA+3HK+QA+PA)/protective (AA+KA) TRYCAT ratio. All symptom dimensions were associated with increased IgM responses to QA, while depressive, anxiety, positive and negative symptoms were accompanied by lowered IgM responses to 3HK. Hypomanic symptoms were additionally accompanied by lowered IgM responses to AA, and negative symptoms by increased IgM responses to KA. In conclusion, both shared and distinct alterations in the activity of the TRYCAT pathway, as well as its regulatory factors and consequences, may underpin affective and classical psychotic symptoms of schizophrenia. Increased mucosa-generated production of noxious TRYCATs, especially PA, and specific changes in IgM-mediated regulatory activities may be associated with the different symptom dimensions of schizophrenia.

The capacity for the imaginative reception of feeling states, through symbolisation and dream thoughts, and for their transformation into a creative and alive responsiveness, was named "alpha function" or "alpha process" or “narrative... more

The capacity for the imaginative reception of feeling states, through symbolisation and dream thoughts, and for their transformation into a creative and alive responsiveness, was named "alpha function" or "alpha process" or “narrative alpha” by Bion.
From some clinical dream material and a short story by Sylvia Plath, entitled The Wishing Box, this paper outlines an unconscious process that may attack and "devour" the perception of emotional meaning. This has a drastic, but disguised effect on creativity and the capacity for love - replacing meaningful symbols with a flashy, but precocious, contrived and emotionally-sterile sheen of anti-symbols - a kind of mental cancer.
Both patient and therapist may become fascinated, or stupefied, by this 'impressive' imitation of genuine alpha process, unless the therapist recovers a thirst for sincere emotional contact and nourishment. Then, the difference can be conveyed, with words that feel alive and hand-made to revive that thirst in the patient.

Characteristic disturbances of temporality in mania, readily apparent in the disorder, are nonetheless underemphasized in present-day accounts. For example, disturbances of temporality are not included among the criteria for a manic... more

Characteristic disturbances of temporality in mania, readily apparent in the disorder, are nonetheless underemphasized in present-day accounts. For example, disturbances of temporality are not included among the criteria for a manic episode in DSM-IV, DSM-5, ICD-10 or the Beta Version of ICD-11.
Nonetheless, it can be claimed, as already expressed by Binswanger in 1964, that aberrant temporality is core to the disorder. Persons with mania live almost exclusively in the present and hardly at all into the future. Especially in the larger scheme of things, their future is already here. There is no “advancing, developing or maturing,” Anticipations have already been achieved, all that I strive for is basically present and readily at hand - if you will just get out of my way and be helpful and not an obstacle. A half century ago, Binswanger spelled out this temporal foundation for mania and summed up its consequence. The manic self, not living into the future, “is not, to borrow a word, an existential self.”
In this presentation, the author will further describe phenomenological characteristics of such a self in mania as well as in its attenuated form, hypomania. Subsequently, he will outline findings from contemporary neuroscience that correlate with the above phenomenology. Importantly, these findings complement and clarify rational present and future therapeutic interventions. The ever advancing science of chronobiology can increasingly characterize human biological clocks anatomically, physiologically and functionally. Of critical importance in mania, clocks in our brains afford receptor sites for the lithium ion. Furthermore, It is now well established that lithium is a potent inhibitor of the circadian rhythm regulator glycogen synthase kinase 3 (GSK3). In consequence, lithium will impinge upon and alter the biological cascade that follows. By taking a close look, step by step, we can begin to comprehend implications for mania as well as for its treatment with lithium. We can begin to see how lithium disrupts mania rhythm dysregulation and can restoring a more “normalized” temporality. The consequence is no less than the return of the existential self. We will also briefly glance, in this presentation, at the window that the comprehension of lithium cellular efficacy offers for future developments of more specific and safer treatment options “after lithium.”
In conclusion, this presentation aims to clarify: 1) Core phenomenological temporal experiences in mania. 2) Correlations between the manic experience and neurobiology. 3) Consequences for current and potential interventions at personal, therapeutic, social and biological (including pharmacological) levels.

Insulin resistance (IR) is a key factor in diabetes mellitus, metabolic syndrome (MetS) and obesity and may occur in mood disorders and tobacco use disorder (TUD), where disturbances of immune-inflammatory, oxidative and nitrosative... more

Insulin resistance (IR) is a key factor in diabetes mellitus, metabolic syndrome (MetS) and obesity and may occur in mood disorders and tobacco use disorder (TUD), where disturbances of immune-inflammatory, oxidative and nitrosative stress (IO&NS) pathways are important shared pathophysiological pathways. This study aimed to a) examine IR and β-cell function as measured by the homeostasis model assessment of insulin resistance (HOMA-IR) and insulin sensitivity and β cell function (HOMA-B) and glucotoxicity (conceptualized as increased glucose levels versus lowered HOMA-B values) in 74 participants with major depressive disorder (MDD) and bipolar disorder, with and or without MetS and TUD, versus 46 healthy controls, and b) whether IR is associated with IO&NS biomarkers, including nitric oxide metabolites (NOx), lipid hydroperoxides (LOOH), plasma advanced oxidation protein products (AOPP), C-reactive protein (CRP), haptoglobin (Hp) and uric acid. Mood disorders are not associated wi...

This study was performed to evaluate the optimal doses and clinical efficacy of clonazepam as a first-line drug in acute mania, as well as to determine its effective plasma concentrations. Clonazepam was administered orally to 11 newly... more

This study was performed to evaluate the optimal doses and clinical efficacy of clonazepam as a first-line drug in acute mania, as well as to determine its effective plasma concentrations. Clonazepam was administered orally to 11 newly admitted inpatients. On day 0, the loading dose was ...

In this paper, I develop the ideas posed in Filtration Failure: On Selection for Societal Sanity. I consider the defaults of attention in paying attention by following the emotions of interest and love. Interest is explored via... more

In this paper, I develop the ideas posed in Filtration Failure: On Selection for Societal Sanity. I consider the defaults of attention in paying attention by following the emotions of interest and love. Interest is explored via algorithmic governmentability, while love is interpreted through aesthetic experimentation by the avant-garde and amateurs. As distinguished from a lack of information, the question of information overload, or Annie Le Brun’s reality overload, is problematized in terms of filtration failure. Filtration failure and hyperindustrialization produce deindividuation, i.e., attentional and symbolic privation. At variance with censorship, attention behaviors are affected by calculated contexts, optimization algorithms judging excessive attention space based on past choices. Such privations mentioned above disrupt care and allow for probabilistic, prefabricated, default attention behavior. I consider Bernard Stiegler’s concept of default through Augustine of Hippo’s interpretation of Evil [Malus] as the diminution of Being. I transcribe Evil from his theodicy to Stiegler’s notions of mal-être and malaise (ill-being), which are questions of symbolic misery in attention’s aesthetic conditioning. The symbolic defaults as the diabolic, mandating pharmacological care.

Background: Hyperthymic Temperament (HYT) and a closely related trait, Hypomanic Personality (HYP), have both been related to bipolar affective disorder (BAD). Intensity dependence of auditory evoked potentials (IAEP) is a suggested... more

Background: Hyperthymic Temperament (HYT) and a closely related trait, Hypomanic Personality (HYP), have both been related to bipolar affective disorder (BAD). Intensity dependence of auditory evoked potentials (IAEP) is a suggested inverse indicator of serotonergic neurotransmission and has been found to be elevated in BAD. Therefore the present study explored for the first time whether subclinical variance of HYT/HYP is also associated with IAEP in a healthy sample. As several traits from biological personality research are correlated with HYT/HYP and also with BAD, the specificity of results against these traits was further analyzed by calculating multiple regression analyses. Methods: Evoked potentials were recorded from a sample (N = 87) homogenous for confounding variables influencing IAEP. For this reason, only 19 to 27-year-old non-smoker psychiatrically healthy male students were included. Results: Significant correlations were found between IAEP and both HYP and HYT. Including Sensation or Novelty Seeking and Extraversion in Regression Analyses did not weaken the associations of HYP with IAEP much, but did affect those of HYT. However, these competing biological personality traits were hardly able to predict IAEP themselves. Impulsivity, though, was able to reduce the predictive power of HYP and HYT and to explain unique IAEP-variance. This was even more the case for Behavioral-Activation-System-Sensitivity (BAS) subscale Fun Seeking clearly dominating all regression analyses. Limitations: Homogeneity of sample. Conclusions: The impact of BAS is in agreement with the assumption that heightened BAS-sensitivity is an underlying biological cause for HYP/HYT and for BAD. Future studies on BAD should include BAS and Impulsivity besides HYP/HYT to further explore uniqueness of the latter and to develop questionnaires based on those items of a hyperthymic–hypomanic–impulsive– funseeking item pool, which possess the most external validity.