Bipolar Disorder & Schizophrenia
Articles
The Bipolar Child by Demitri and Janice Papolos (book review)
A new diagnostic category is emerging: Childhood bipolar disorder. It was traditionally thought that as few as one in 200 cases of bipolar disorder had an onset which could be traced to childhood. Biederman's recent research shows that perhaps on the other of 20% of children identified as ADHD could be on the way to developing full-blown bipolar disorder. To make this identification, however, the markers of childhood bipolar disorder are destructive rage and irritation rather than the euphoria and elation that characterizes the adult form. The proof that the childhood form of the disorder metamorphoses into the adult form eventually must still be outstanding. The model is still too new.
Bipolar Disorder - Childhood Onset
A 12-year-old boy with signs of Bipolar Disorder has been on Concerta, Risperdal, and Zoloft for the last three years. He has trichotillomania (involuntary hair-pulling) since beginning the Concerta. He is very anxious. He is verbally inappropriate with peers. He exhibits manic sleep behavior, in that he sleeps very few hours.
On the construct of "The Bipolar Child," proposed by Demitri and Janice Papolos
Over the years we have talked about our own son Brian in terms of his temporal lobe epilepsy, and we generalized from there to severe behavioral disorders. That always had limited appeal as a model for both practitioners attending our classes and for parents of difficult children. Most professionals don't relate readily to "subclinical seizure phenomena," nor are parents thrilled to see the term seizure disorder used in connection with their children unless the diagnosis is obligatory. Talking about seizure disorder in larger terms was a non-starter.
Research Papers
Neurofeedback for the Bipolar Child (abs.)
Bipolar Disorder used to be a rare diagnosis in childhood. Recent research has elevated the importance of Bipolar Disorder as an issue in perhaps 20% of children formally diagnosed as ADHD. The medical management of these children is problematic, tending to involve anti-convulsants and neuroleptics rather than stimulants and anti-depressants.
Self-Regulation of Electrocortical Activity in Schizophrenia and Schizotypy: A Review (abs.)
Contrary to the belief that schizophrenic patients will be unable to learn self control of electrocortical activity due to attentional and motivational deficits, the two studies which have investigated this, both involving operant conditioning of slow cortical potentials, have demonstrated that self regulation can take place.
Learned Control of Slow Potential Interhemispheric Asymmetry in Schizophrenia (abs.)
We report on the feasibility of teaching 16 (DSM-IV) schizophrenic patients, subdivided by syndrome, self-regulation of interhemispheric asymmetry having demonstrated efficient learning of interhemispheric control in normal subjects. Reversal of asymmetry may be important to treatment and recovery in schizophrenia for following improvement on neuroleptic drugs functional hemispheric asymmetries have reversed, with directions of reversal and pre-existing asymmetry dependent on syndrome.
Self-Regulation of Slow Cortical Potentials in Psychiatric Patients: Schizophrenia (abs.)
Slow cortical potentials (SCPs) are considered to reflect the regulation of attention resources and cortical excitability in cortical neuronal networks. Impaired attentional functioning, as found in patients with schizophrenic disorders, may covary with impaired SCP regulation. This hypothesis was tested using a self-regulation paradigm. Twelve medicated male schizophrenic inpatients and 12 healthy male controls received continuous feedback of their SCPs, during intervals of 8 s each, by means of a visual stimulus (a stylized rocket) moving horizontally across a TV screen.