International Journal of Bipolar Disorders最新文献

{"title":"In memoriam Jules Angst, MD.","authors":"René Ernst Nielsen, Michael Bauer, Paul Grof, Lars Vedel Kessing, Rasmus W Licht, Bruno Müller-Oerlinghausen, Janusz Rybakowski, Marylou Selo, Leonardo Tondo, Allan Young","doi":"10.1186/s40345-026-00433-x","DOIUrl":"10.1186/s40345-026-00433-x","url":null,"abstract":"<p><p>This in memoriam honours Professor Jules Angst, MD, and reflects on his major contributions to mood disorder research, psychiatric classification, longitudinal clinical studies, and lithium prophylaxis. It also commemorates his enduring influence on IGSLi, clinical psychiatry, and generations of researchers and clinicians.</p>","PeriodicalId":13944,"journal":{"name":"International Journal of Bipolar Disorders","volume":"14 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13433660/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148663959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trajectories of psychotropic drug use patterns in psychiatric inpatients with acute depressive episodes of bipolar disorder: results from a pharmacovigilance program in German-speaking countries from 2007 to 2024.","authors":"Johanna Seifert, Susanne Stübner, Dominik Dabbert, Waldemar Greil, Hannah B Maier, Renate Grohmann, Sermin Toto","doi":"10.1186/s40345-026-00435-9","DOIUrl":"10.1186/s40345-026-00435-9","url":null,"abstract":"<p><strong>Background: </strong>With limited evidence-based options, treatment of depressive episodes in bipolar disorder (BD-DE) remains challenging. This study examines the trajectories of psychotropic drug use and polypsychopharmacy in psychiatric inpatients with acute BD-DE.</p><p><strong>Methods: </strong>Using data from the German pharmacovigilance program \"Arzneimittelsicherheit in der Psychiatrie\" (AMSP), the pharmacological treatment of 1,902 psychiatric inpatients with BD-DE between 2007-2024 was analyzed. Temporal changes in drug use between early (T1: 2007-2010) and late (T2: 2021-2024) periods were calculated using prevalence ratios (PR) with 95% confidence intervals (CI) and Welch's t-test.</p><p><strong>Results: </strong>Overall, 98.5% of inpatients with acute BD-DE were treated with psychotropic drugs. Antipsychotic drugs (APD) were the most used psychotropic drug group (76.2%), followed by antidepressant (ADD; 70.3%) and antiepileptic drugs (AED; 44.3%) during the entire study period. Over time, APD use increased from 70.1% in T1 to 80.7% in T2 (PR 1.15, CI 1.06-1.25), attributable to the increased use of second-generation APD (PR 1.19, CI 1.07-1.32), especially quetiapine and aripiprazole. ADD (T1: 78.1% vs T2: 67.6%; PR 0.87, CI 0.79-0.95) and AED (T1: 56.7% vs T2: 34.6%; PR 0.61, CI 0.51-0.73) use significantly declined, while lithium use remained stable (31.7% from 2007-2024). Although the mean number of psychotropic drugs per patient decreased (T1: 3.85 vs T2: 3.34, p < 0.001, d=-0.30), complex polypsychopharmacy consisting of ≥3 psychotropic drugs remained prevalent (66.1% of patients during the entire study period). Combination strategies involving APD, especially use of two APD, significantly increased (T1: 15.6% vs T2: 31.5%; PR 2.01, CI 1.51-2.69).</p><p><strong>Conclusion: </strong>Pharmacological treatment of BD-DE has shifted towards an increased use of second-generation APD while AED are less utilized. ADD use and complex polypsychopharmacy continue to be prevalent, indicating a persistent gap between guideline recommendations and real-world practice.</p>","PeriodicalId":13944,"journal":{"name":"International Journal of Bipolar Disorders","volume":"14 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13428732/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148653679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Somatic morbidity in bipolar disorders.","authors":"Christine Takami, Suvi Savinen, Arvid Sjölander, Zheng Chang, Isabell Brikell, Ralf Kuja-Halkola, Brian M D'Onofrio, Soffia Gudbjornsdottir, Miguel Garcia-Argibay, Henrik Larsson, Erik Pettersson, Paul Lichtenstein, Mikael Landén","doi":"10.1186/s40345-026-00432-y","DOIUrl":"10.1186/s40345-026-00432-y","url":null,"abstract":"","PeriodicalId":13944,"journal":{"name":"International Journal of Bipolar Disorders","volume":"14 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13319857/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148351860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Objective sleep parameters and cognitive performance in euthymic bipolar disorder: a cross-sectional 21-day actigraphy study.","authors":"Candice Libourel, Mathilde Charron, Victoire Martinot, Mathilde Carminati, Bruno Etain, Vincent Hennion","doi":"10.1186/s40345-026-00431-z","DOIUrl":"10.1186/s40345-026-00431-z","url":null,"abstract":"<p><strong>Background: </strong>Sleep disturbances persist during euthymia in bipolar disorder (BD) and may contribute to cognitive impairment. While subjective sleep complaints have been linked to cognition, associations between objective sleep parameters and objective cognitive performance are under-explored.</p><p><strong>Methods: </strong>In this exploratory cross-sectional study, 40 euthymic individuals with BD underwent 21 days of actigraphy to assess objective sleep parameters, including sleep duration, sleep onset latency, sleep efficiency, wake time after sleep onset (WASO), and fragmentation index. Cognitive performance was assessed using the Screen for Cognitive Impairment in Psychiatry (SCIP). Associations between sleep parameters and cognitive outcomes were examined using Spearman correlations, then using multivariable linear regression models, including a stepwise selection of potential confounding factors and a false discovery rate correction for multiple testing.</p><p><strong>Results: </strong>Assumed sleep duration was negatively associated with the SCIP total score (β = -0.38, p = 0.011), with age retained as a covariate (p = 0.011). Total sleep time was negatively associated with delayed verbal learning (β = -0.48, p = 0.003), with no covariate retained. Sleep onset latency was negatively associated with working memory (β = -0.41, p = 0.014), with no covariate retained. Sleep onset latency was negatively associated with processing speed (β = -0.38, p = 0.002), with age (p < 0.001) and sex (p = 0.022) retained as covariates. WASO was negatively associated with verbal fluency (β = -0.39, p = 0.016), with no covariate retained.</p><p><strong>Conclusions: </strong>In euthymic individuals with BD, objective measures of sleep duration, sleep initiation, and sleep continuity were associated with distinct cognitive domains. These findings highlight the relevance of sleep continuity and sleep initiation, beyond sleep duration alone, as correlates of cognitive functioning in BD. Due to methodological limitations, these results should be considered hypothesis-generating and require replication in larger, longitudinal cohorts.</p><p><strong>Clinical trial registration: </strong>This study was conducted as part of a larger research protocol entitled GAN (Genetics, Actimetry, and Neuropsychology in Bipolar Disorders). The protocol has been registered on ClinicalTrials.gov on November 13, 2015 (NCT02627404).</p>","PeriodicalId":13944,"journal":{"name":"International Journal of Bipolar Disorders","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148345253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Thyroid peroxidase antibodies in bipolar disorder: implications for clinical sub-phenotypes and lithium response.","authors":"Bishnu D Pathak, Mete Ercis, Melissa Solares-Bravo, Nik Ghafouri, Balwinder Singh, Aysegul Ozerdem, Jin Hong Park, Deniz Ceylan, Brandon J Coombes, Francisco Romo-Nava, Marin Veldic, Alfredo Cuellar-Barboza, Manuel Gardea-Resendez, Matthew L Baum, Katherine E Burdick, Marius N Stan, Susan L McElroy, Joanna M Biernacka, Mark A Frye","doi":"10.1186/s40345-026-00430-0","DOIUrl":"10.1186/s40345-026-00430-0","url":null,"abstract":"","PeriodicalId":13944,"journal":{"name":"International Journal of Bipolar Disorders","volume":"14 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13263360/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148224835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A preliminary cross-sectional study of bipolarity and primary pharmacotherapy in long-term stable patients with major depressive disorder.","authors":"Taku Maruki, Takashi Tsuboi, Hitoshi Maeshima, Yasuyuki Matsumoto, Teruo Tada, Koichiro Watanabe","doi":"10.1186/s40345-026-00428-8","DOIUrl":"10.1186/s40345-026-00428-8","url":null,"abstract":"<p><strong>Background: </strong>Patients with major depressive disorder (MDD) who exhibit high bipolarity are at increased risk of future diagnostic conversion to bipolar disorder. However, treatment recommendations for MDD with bipolarity are constrained by limited direct evidence. We examined the association between bipolarity and primary pharmacotherapy in long-term stable outpatients with MDD and explored a clinically useful Bipolarity Index (BI) threshold.</p><p><strong>Methods: </strong>In this two-center cross-sectional study, participants were classified into an antidepressant (AD) group or a mood stabilizer/second-generation antipsychotic (MS/SGA) group. Bipolarity was assessed with the BI. Receiver operating characteristic (ROC) analysis was used to identify a BI cutoff discriminating MS/SGA from AD.</p><p><strong>Results: </strong>Of 103 participants, 54 were assigned to the AD group and 49 to the MS/SGA group. The BI score was significantly higher in the MS/SGA group than in the AD group (24.1 ± 12.9 vs 13.3± 7.0; p < 0.001). ROC analysis indicated a BI cutoff of 16 (Area Under the Curve = 0.765), yielding 69.4% sensitivity and 77.8% specificity for identifying the MS/SGA group.</p><p><strong>Conclusion: </strong>Among long-term stable outpatients with MDD, higher BI scores were associated with the use of MS and/or SGA rather than antidepressant monotherapy as primary pharmacotherapy. In this Japanese stable outpatient sample, a BI score of 16 or above identified patients who were more likely to be receiving MS and/or SGA. These findings reflect prescription patterns observed in this cross-sectional sample and should not be interpreted as evidence that MS and/or SGA are preferable treatments for patients with greater bipolarity. Further prospective studies are needed to clarify the clinical significance of BI-defined bipolarity and its relationship to treatment outcomes in patients with MDD.</p>","PeriodicalId":13944,"journal":{"name":"International Journal of Bipolar Disorders","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13462023/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148175832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thyroid hormone augmentation for bipolar disorder: a neurobiological and clinical narrative review.","authors":"Muhammad Ibrahim, Umair F Bhutto, Ramy Yassa, Rif S El-Mallakh","doi":"10.1186/s40345-026-00429-7","DOIUrl":"10.1186/s40345-026-00429-7","url":null,"abstract":"<p><strong>Background: </strong>Bipolar disorder (BD) is a severe, chronic psychiatric illness defined by profound and recurrent fluctuations in mood, energy, and function. Treatment is generally limited by both the efficacy and safety of available agents. Thyroid augmentation has been found to be useful to treat depression and rapid cycling in BD. Herein, we provide a narrative review of adjunctive use of thyroid hormone in BD with a specific focus on its potential mechanism of action.</p><p><strong>Discussion: </strong>Ion dysregulation with mood-state-related reduced sodium pump activity and increased intracellular sodium and calcium are among the most reproduced biologic findings in manic and depressed bipolar patients. Thyroid hormone directly increases sodium pump expression and activity, and indirectly improves energy utilization in bipolar patients. Across the reviewed literature, approximately 300-350 patients received supraphysiologic doses of thyroid hormone (T3 or T4), with the majority comprising individuals with BD and yielding generally very positive outcomes and minimal harm. Thyroid hormone augmentation can improve depression and reduce rapid cycling, and while never studied to treat mania, it does not increase the risk of manic episodes in all of the studies. Inconsistencies in data are related to different dosing regimens in different studies.</p><p><strong>Conclusion: </strong>Thyroid hormone appears to directly correct known pathophysiologic abnormalities in patients with bipolar disorder. While additional studies are needed to confirm these findings, sufficient data are available to warrant the use of supertherapeutic thyroid hormone augmentation in selected patients.</p>","PeriodicalId":13944,"journal":{"name":"International Journal of Bipolar Disorders","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13461996/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148175817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and safety of pharmacological and non-invasive brain stimulation for adolescent bipolar depression: a systematic review and network meta-analysis.","authors":"Lifei Wang, Hui Xue, Tianyou Fu, Xiaohong Gong, Rongxin Zhu, Jia Duan, Chunyu Pan, Jingshuai Zhou, Zexin Lin, Wei Du, Fei Wang","doi":"10.1186/s40345-026-00421-1","DOIUrl":"10.1186/s40345-026-00421-1","url":null,"abstract":"<p><p>This network meta-analysis evaluates the efficacy and safety of pharmacological and physical treatments for depressive episodes in adolescents with bipolar disorder (BD), incorporating evidence from six randomized controlled trials (RCTs), total N = 879. Due to the absence of shared comparators, pharmacological treatments and non-invasive brain stimulation (NIBS) were analyzed in separate evidence networks rather than being directly compared.Pharmacological treatments included lurasidone, olanzapine-fluoxetine combination (OFC), and quetiapine, while NIBS consisted of transcranial direct current stimulation (tDCS) and intermittent theta-burst stimulation (iTBS). P-scores probabilities showed lurasidone as the most effective for reducing depressive symptoms (CDRS-R SMD: -0.41, 95% CI: -0.62 to -0.19) and improving response rates (RR: 1.64, 95% CI: 1.30-2.04). OFC had the highest remission rates (RR: 1.39, 95% CI: 1.03-1.89). Quetiapine demonstrated limited antidepressant efficacy (CDRS-R SMD: -0.12, 95% CI: -0.38-0.15) but significantly reduced treatment-emergent mania risk (RR: 0.22, 95% CI: 0.05-0.97). In NIBS, tDCS outperformed both iTBS and placebo for reducing depressive (HAMD SMD: -2.56, 95% CI: -3.40 to -1.73) and anxiety symptoms (HAMA SMD: -3.21, 95% CI: -4.15 to -2.28). These results suggest that lurasidone and tDCS may be promising options for symptom management in adolescents with BD, while quetiapine may be considered for preventing manic switching. Further studies, including head-to-head trials, are needed to better understand the long-term effects and address gaps in suicide risk management and multimodal treatment strategies.</p>","PeriodicalId":13944,"journal":{"name":"International Journal of Bipolar Disorders","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13337984/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148042196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"On Churchill's black dog, Barzun's bicycle, and cartoon bears: living within the bipolar temperament.","authors":"Douglas V D' Agati, Donald C D' Agati","doi":"10.1186/s40345-026-00424-y","DOIUrl":"10.1186/s40345-026-00424-y","url":null,"abstract":"<p><p>Life lessons from a civilization’s most consequential individuals are hard to come by and, certainly, rarely find their way into a medical journal. However, such investigations can repay study—as Plutarch’s continued popularity demonstrates. Our subjects lived before the era of medications and might today be diagnosed, not coincidentally, as having bipolar temperaments, and possibly bipolar disorder as well, and suffered severe depressions. We consider Robert Burton, Samuel Johnson, Meriwether Lewis, Winston Churchill, William Osler, and Jacques Barzun with an eye toward understanding how they were able to get the best from themselves and stimulate the most intense expression of their remarkable gifts—all the while escaping crippling depressions to which they were prone. Their insights were forged in the harsh crucible of life experience. Five of them (there appears no record of how Lewis understood his temperament) sought to pass on what they had learned, even writing about their discovered truths in similar fashion. Each found salvation in total commitment to a creative and spiritually satisfying challenge of an all-encompassing sort. Such a technique proved to be both palliative and prophylactic for reasons that, scientifically, are unclear. Some of the questions that their distinguished lives suggest are discussed.</p>","PeriodicalId":13944,"journal":{"name":"International Journal of Bipolar Disorders","volume":"14 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13212876/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148029941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Somatic morbidity in bipolar disorders.","authors":"Christine Takami, Suvi Savinen, Arvid Sjölander, Zheng Chang, Isabell Brikell, Ralf Kuja-Halkola, Brian M D'Onofrio, Soffia Gudbjornsdottir, Miguel Garcia-Argibay, Henrik Larsson, Erik Pettersson, Paul Lichtenstein, Mikael Landén","doi":"10.1186/s40345-026-00427-9","DOIUrl":"10.1186/s40345-026-00427-9","url":null,"abstract":"<p><strong>Objective: </strong>This Swedish nationwide cohort study used large-scale data to investigate the associations between bipolar disorder and somatic disorders and whether these risks differ by subtype, sex, or exposure to compulsory care.</p><p><strong>Methods: </strong>61,071 individuals diagnosed with bipolar disorder in inpatient (from 1973) or outpatient care (from 2001) care were compared with the general population without bipolar disorder. The cohort included individuals born in 1932 or later, with follow-up from 1973 to 2020. Cox regression models estimated associations with a range of somatic conditions, including cardiovascular, endocrine, neurological, and infectious diseases. Subtype-specific analyses were conducted in individuals with type 1 (n = 8,352) or type 2 (n = 9,674), and in those with a history of compulsory care (n = 6,748).</p><p><strong>Results: </strong>Bipolar disorder was associated with significantly increased risks for most examined somatic conditions. The highest hazard ratios (HRs) were observed for sleep disorders (HR 3.79; 95% CI, 3.71-3.87) and dementias (HR 4.32; 95% CI, 3.82-4.79). Type 2 diabetes risk was elevated, while no association was found for type 1 diabetes. Most risks were comparable across bipolar subtypes, though certain conditions-such as migraine and fibromyalgia-were more strongly associated with type 2. Individuals with a history of compulsory psychiatric care showed elevated risks for several conditions.</p><p><strong>Conclusions: </strong>Regardless of sex or subtype, bipolar disorder is associated with substantially higher lifetime risks of a broad range of somatic conditions. Integrated psychiatric and somatic health care may help reduce morbidity and improve outcomes.</p>","PeriodicalId":13944,"journal":{"name":"International Journal of Bipolar Disorders","volume":"14 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13156340/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}