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Circadian Rhythms and Reward Neural Circuitry and the Relationship to Bipolar Disorder

Publish Date: October 25, 2011 Last Modified: December 21, 2017 Expires: December 26, 2013
This course has been expired.

Psychiatrist, Dr. Mary Phillips, looks at links between circadian function, brain imaging and bipolar disorder in the first of two presentations on circadian function and bipolar disorder from UPMC. Then UPMC expert in mood disorders and their treatment, Dr. Ellen Frank, explores circadian sleep alignment in the patient with bipolar disorder.

Educational Objectives:

Upon completion of this activity, participants should be able to:

  • Analyze models suggesting a relationship between rhythm disruption and mood in individuals with bipolar disorder
  • Recognize the concept of the phase angle difference (PAD) between dim-light melatonin onset (DLMO) and habitual mid-point of sleep as a marker of integrity of the circadian system
  • Evaluate data suggesting that both the PAD and sleep timing may be abnormal in at least a subset of individuals with bipolar disorder even in the euthymic state
  • Identify abnormalities in reward circuitry in bipolar disorder
  • Describe impact of sleep deprivation on reward circuitry

Reading References:

  • Social rhythm disruption and stressful life events in the onset of bipolar and unipolar episodes. Malkoff-Schwartz S, Frank E, Anderson BP, Hlastala SA, Luther JF, Sherrill JT, Houck PR, Kupfer DJ. Psychol Med. 2000 Sep;30(5):1005-16.
  • Where's the fun in that? Broadening the focus on reward function in depression. Forbes EE. Biol Psychiatry. 2009 Aug 1;66(3):199-200. No abstract available.
  • Sleep and circadian rhythm disturbances in bipolar disorder: an urgent need for objective assessment and systematic follow-up. Kapczinski F, Frey BN, Vieta E. J Clin Psychiatry. 2011 May;72(5):724. No abstract available.

Disclosures:

Dr. Phillips has no relevant relationships with any entities producing healthcare goods or services.
Dr. Frank is a consultant for Servier International and receives royalties from Guilford Press and the American Psychological Association.

Accreditation Statement:

The University of Pittsburgh School of Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The University of Pittsburgh School of Medicine designates this enduring material for a maximum of 1.0 AMA PRA Category 1 CreditsTM. Each physician should only claim credit commensurate with the extent of their participation in the activity. Other health care professionals are awarded (0.1) continuing education units (CEU) which are equivalent to 1.0 contact hours.

For your credit transcript, please access our website 4 weeks post-completion at http://ccehs.upmc.edu and follow the link to the Credit Transcript page. If you do not provide the last 5 digits of your SSN on the next page you will not be able to access a CME credit transcript. Providing your SSN is voluntary.

Release Date: 12/26/2012 | Last Modified On: 12/26/2012 | Expires: 12/26/2013

This course has been expired.

Presenters

  • Mary L Phillips MD
    Mary L. Phillips, MD
    Dr. Mary Phillips trained in Medicine at the University of Cambridge, UK and in Psychiatry at the Maudsley Hospital, London and Institute of Psychiatry, UK. She received a research training fellowship from the Medical Research Council (UK) to examine visual scan paths in schizophrenia. She subsequently developed a research interest in the application of functional neuroimaging techniques to the examination of the neural basis of emotion processing in healthy and psychiatric populations. She has, in particular, focused on the identification of neural correlates that underlie the symptoms of specific abnormalities in emotion processing in individuals with mood disorders. She became Professor of Neuroscience and Emotion and Head of Section of Neuroscience and Emotion within the Department of Psychiatry, Division of Psychological Medicine, Institute of Psychiatry, King?s College, London, UK in 2003. In October, 2004, she joined the Department of Psychiatry at the University of Pittsburgh as part-time Visiting Professor and Director of the Functional Neuroimaging Program, moving to become a Professor of Psychiatry in April, 2006. In 2005, Dr. Phillips became a member of The American College of Neuropsychopharmacology, and in 2006, was awarded the Nellie Blumenthal Investigator by the National Alliance for Research in Schizophrenia and Depression. Since 2006, Dr. Phillips has been Co-Director of the Brain Imaging Research Center within Carnegie Mellon University and the University of Pittsburgh. In January, 2008, Dr. Phillips moved her UK research base to Cardiff University, UK, to take up the position of Professor in Clinical Affective Neuroscience in the Department of Psychological Medicine part-time. Dr Phillips now heads teams of dedicated researchers in the US and UK at both institutions. Dr Phillips has received research funding awards from the Medical Research Council (UK) and the Wellcome Trust in the UK, and, more recently from NIMH in the US. Dr. Phillips is mentor to nearly 20 junior investigators in both institutions, and has authored or co-authored over 150 publications.
    full profile
  • Ellen Frank PhD
    Ellen Frank, PhD
    Dr. Ellen Frank is Distinguished Professor of Psychiatry and Professor of Psychology at the University of Pittsburgh School of Medicine and director of the Depression and Manic Depression Prevention program at Western Psychiatric Institute and Clinic. Dr. Frank and her colleagues developed a new psychotherapy?interpersonal and social rhythm therapy?for the treatment of manic depressive illness under a MERIT award from the National Institute of Mental Health (NIMH). She recently completed an NIMH-sponsored study of women with recurrent depression in which she examined how psychobiology, life stress, and different ?doses? of psychotherapy interact to increase or decrease vulnerability to new episodes of depression. In addition, Frank is completing a joint project with researchers at the University of Pisa, Italy, aimed at achieving a better understanding of the clinical importance of subsyndromal mood, anxiety and eating disorders?that is, when the symptoms are not severe enough for diagnosis as a clinically recognized syndrome. An expert in mood disorders and their treatment, Frank was Chair of the Food and Drug Administration Psychopharmacologic Drugs Advisory Panel. She also is a former member of the National Advisory Mental Health Council. She currently serves on the Mood Disorders Workgroup of the American Psychiatric Association Task Force on DSM-V. Frank is an honorary fellow of the American Psychiatric Association. In 1999 Dr. Frank was elected to the National Academy of Sciences Institute of Medicine. A graduate of Vassar College, Frank earned a master?s degree in English at Carnegie Mellon University and a doctorate in psychology at the University of Pittsburgh.
    full profile

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