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The Differential Diagnosis of Pseudobulbar Affect (PBA): Distinguishing PBA Among Disorders of Mood and Affect

Published online by Cambridge University Press:  07 November 2014

David B. Arciniegas*
Affiliation:
Dr. Arciniegas is director of the neuropsychiatry service and assistant professor in the Departments of Psychiatry and Neurology at, the University of Colorado School of Medicine in Denver, Colorado. He is a consultant to Avanir and Novartis, and has received grant/research support from Eisai, Forest, and Novartis.
Edward C. Lauterbach
Affiliation:
Dr. Lauterbach is professor in the Departments of Psychiatry, Radiology, and Neurology at, the Mercer University School of Medicine in Macon, Georgia. He is a speaker for Forest, and receives grant/research support from Bristol-Myers Squibb.
Karen E. Anderson
Affiliation:
Dr. Anderson is assistant professor in the Departments of Psychiatry and Neurology at, the University of Maryland School of Medicine in Baltimore, Maryland. She reports no affiliation with or financial interest in any organization that may pose a conflict of interest.
Tiffany W. Chow
Affiliation:
Dr. Chow is assistant professor in the Department of Medicine, Division of Neurology at, the University of Toronto in Ontario, Canada. She reports no affiliation with or financial interest in any organization that may pose a conflict of interest.
Laura A. Flashman
Affiliation:
Dr. Flashman is associate professor in the Department of Psychiatry at, Dartmouth Medical School in Lebanon, New Hampshire. She reports no affiliation with or financial interest in any organization that may pose a conflict of interest.
Robin A. Hurley
Affiliation:
Dr. Hurley is a neuropsychiatrist for the Mental Health Service Line at the W.G. “Bill” Hefner Veterans Affairs Medical Center (Salisbury VAMC) in Salisbury, North Carolina. She reports no affiliation with or financial interest in any organization that may pose a conflict of interest.
Daniel I. Kaufer
Affiliation:
Dr. Kaufer is associate professor in the Department of Neurology at, the University of North Carolina School of Medicine in Chapel Hill, North Carolina. He is a consultant to Bayer and Tap Holdings; is on the speaker's bureaus of Bayer, Eisai, and Pfizer; and receives grant/research support from Eisai and Pfizer.
Thomas W. McAllister
Affiliation:
Dr. McAllister is professor and director of neuropsychiatry in the Department of Psychiatry at, Dartmouth Medical School in Lebanon, New Hampshire. He has received grant/research support from Novartis.
Alison Reeve
Affiliation:
Dr. Reeve is associate professor in the Department of Psychiatry at, the University of New Mexico School of Medicine in Albuquerque, New Mexico. She is a consultant to Abbott.
Randolph B. Schiffer
Affiliation:
Dr. Schiffer is professor and chairman of the Department of Neuropsychiatry and Behavioral Sciences at, the Texas Tech University Health Sciences Center in Lubbock, Texas. He is a consultant to, on the speaker's bureau of, and has received grant/research support from Avanir.
Jonathan M. Silver
Affiliation:
Dr. Silver is clinical professor in the Department of Psychiatry at, the New York University School of Medicine in New York City. He is a consultant to Avanir and Novartis, and has received grant/research support from Novartis.
*
David B. Arciniegas, MD, Neuropsychiatry Service, University of Colorado School of Medicine, Campus Box C268-25, 4200 East Ninth Ave, Denver, CO 80211; Tel: 303-315-5365; Fax:, 303-315-5641; E-mail:, David.Arciniegas@UCHSC.edu

Abstract

This monograph summarizes the proceedings of a roundtable meeting convened to discuss pseudobulbar affect (PBA). Two didactic lectures were presented, followed by a moderated discussion among 11 participants. Post-meeting manuscript development synthesized didactic- and discussion-based content and incorporated additional material from the neuroscience literature. A conceptual framework with which to distinguish between disorders of mood and affect is presented first, and disorders of affect regulation are then reviewed briefly. A detailed description of the most common of these disorders, PBA, is the focus of the remainder of the monograph. The prevalence, putative neuranatomic and neurochemical bases of PBA are reviewed, and current and emerging methods of evaluation and treatment of persons with PBA are discussed. The material presented in this monograph will help clinicians better recognize, diagnose, and treat PBA, and will form a foundation for understanding and interpreting future studies of this condition.

Type
Research Article
Copyright
Copyright © Cambridge University Press 2005

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