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The basis of this study is an association between the deregulation of HPA axis and BD diagnosis, present in all clinical cases of BD.
A dysfunction of the HPA axis may be caused by an alteration the rate limiting step of cortisol metabolism. A mitochondrial membrane translocator protein (TSPO) is a key regulator in this pathway as it limits the translocation of cholesterol into the power house (Colasanti, Owen, & Grozeva, et al., 2013). An amino acid substitution polymorphism (rs 6971) in the gene encoding for this transporter protein greatly affects the affinity of TSPO to cholesterol. This altered affinity in the defective protein in turn impairs the metabolism of steroids including those of HPA axis. This study provides evidence of association between a single nucleotide polymorphism in the TSPO gene and the diagnosis of bipolar disorder in a large scale case control study (Colasanti, Owen, & Grozeva, et al., 2013). However, the results of this study are suggestive as the findings did not reach genome wise significance; though they were reproducible. This nominal association suggests the possible existence of other confounding factors in the etiopathogenesis of bipolar disorder. A limitation of this study is in the use of imputation in the analysis for the rs6971 SNP in the TSPO gene.
In conclusion, a bipolar disorder is a mental illness characterized by mood swings. There are several environmental and genetic etiologies to this condition, which can progress to severe forms such as psychosis. A study by Colasanti, Owen, and Grozeva, et al., suggests a possible genetically altered HPA axis function as a causative factor in BD. The genetic mutation in the mitochondrial translocator protein (TSPO) impairs the metabolism of neurosteroids, which in turn alters the HPA axis function (Colasanti, Owen, & Grozeva, et al., 2013). The deregulation in HPA axis has been reported in all BD cases suggesting a
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Where genetic determinants have not been conclusively identified, psychological stress factors as determinants of bipolar disorder have been inferred to be a rich research vein, in light of findings that implicate such stress factors to the disorder's onset and recurrence.
It deals with the case of bipolar disorder which is a mental illness disorder. Bipolar disorder, also referred to as manic depression (Lyness, 2011), is a mental disorder that leads to changes in a person’s moods, ability to work or undertake numerous activities as well as shifts in energy (Goodwin & Sachs, 2010).
A person with the disorder experiences bouts of mood elevation (mania and/or hypomania) and major depressive episodes. Sometimes these episodes are mixed in that the symptoms of both mania and depression are experienced in the same episode. Patients may also have psychotic symptoms while being manic or depressed.
Other common symptoms are irritability, mood swings, anger, suicidal thoughts and a sense of hopelessness (National Institute of Mental Health, 2012). Therefore, this discourse aims at discussing in length about the current mental health among the Americans, bipolar disorder, signs and symptoms, diagnosis, mitigation strategies and treatment.
According to research, one of the basic pointers of bipolar disorder is as a genetic condition, where the patient almost always has a history of bipolar in the family. For example, according to Chung (2007), the case study presented involved a history of manic depression in the family.
These swings from high state to low state and back can be very extreme. Bipolar disorder is usually diagnosed in late adolescence or adulthood. Children may also have the disorder but the symptoms are difficult to distinguish from other childhood behavioural disorders.
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