International Journal of Bipolar Disorders最新文献

{"title":"SSRI versus SNRI initiation and incident bipolar disorder in tertiary psychiatric care: an active-comparator cohort study from the United Arab Emirates.","authors":"Syed Ali Bokhari, Abdulhameed Omer Elnour, Muhanad Elnoor","doi":"10.1186/s40345-026-00426-w","DOIUrl":"10.1186/s40345-026-00426-w","url":null,"abstract":"<p><p>BACKGROUND: Whether antidepressant class influences the risk of subsequent bipolar disorder diagnosis remains clinically relevant, though direct active-comparator studies are scarce. We compared incident bipolar disorder risk between selective serotonin reuptake inhibitor (SSRI) and serotonin-norepinephrine reuptake inhibitor (SNRI) initiators using tiered outcome definitions. METHODS: We conducted a retrospective cohort study from 2018 to 2025 using a 90-day landmark design at a tertiary psychiatric hospital in the United Arab Emirates. Adults aged 18–60 years initiating SSRIs or SNRIs for depressive disorders were followed for incident bipolar disorder. The primary outcome was anchored bipolar disorder, defined as two or more diagnoses at least 30 days apart plus new initiation of a mood stabiliser within 90 days of the first bipolar diagnosis. Secondary outcomes included confirmed bipolar disorder (two or more diagnoses) and any bipolar diagnosis. Cox proportional hazards models adjusted for age, sex, schizophrenia spectrum disorder, substance use disorder, and prior psychotropic use. Exploratory analyses examined individual antidepressants. RESULTS: Among 1,095 antidepressant initiators (818 SSRI; 277 SNRI), 72 (6.6%) developed anchored bipolar disorder over 1,610.6 person-years. SSRI versus SNRI initiation was not associated with differential risk of anchored bipolar disorder (adjusted hazard ratio [aHR] 1.07, 95% CI 0.63–1.84, p = 0.80). Findings were consistent across secondary outcomes (confirmed: aHR 1.24, 95% CI 0.96–1.60; any diagnosis: aHR 1.13, 95% CI 0.92–1.38) and drug-level comparisons, including venlafaxine versus pooled SSRIs (aHR 1.27, 95% CI 0.62–2.60). Event rates varied seven-fold by outcome stringency (6.6% to 46.3%). CONCLUSIONS: Antidepressant class was not associated with incident bipolar disorder using stringent outcome definitions. The marked variation in event rates across outcome tiers suggests that higher conversion rates reported using less specific outcome definitions may partly reflect diagnostic revision and outcome misclassification, in addition to any underlying pharmacological or clinical factors. </p>","PeriodicalId":13944,"journal":{"name":"International Journal of Bipolar Disorders","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13260464/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147770764","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":"Lithium effects on renal functioning: an expert opinion and management algorithm.","authors":"Charlotte Strandhave, Hans August Stengaard Hansen, Martin Alda, Michael Bauer, Michael Berk, Pichit Buspavanich, Lasse Brandt, Andre F Carvalho, Anne Duffy, Orestes Forlenza, Mathilde Frahm Laursen, Mark Frye, Michael Gitlin, Fabiano Alves Gomes, Ana Gonzalez-Pinto, Paul Grof, Tomas Hajek, Sanne V Hovgesen, Lars Vedel Kessing, Ralph Kupka, Ute Lewitzka, Rasmus W Licht, Rodrigo Machado-Vieira, Gin S Malhi, Mirko Manchia, Robert M Post, Andrea Murru, Andrew A Nierenberg, Eline Regeer, Eva Reininghaus, Phillip Ritter, Janusz Rybakowski, Balwinder Singh, Gabriele Sani, Christian Simhandl, Rebecca Strawbridge, Trisha Suppes, Mauricio Tohen, Leonardo Tondo, Eduard Vieta, Allan H Young, René Ernst Nielsen","doi":"10.1186/s40345-026-00423-z","DOIUrl":"10.1186/s40345-026-00423-z","url":null,"abstract":"<p><p>OBJECTIVE: This expert opinion paper addresses the critical balance between lithium’s therapeutic efficacy in recurrent mood disorders and its potential renal side effects. The objective is to provide evidence-based guidelines to enhance clinical decision-making, prevent emergence of, and mitigate risks associated with lithium-induced renal impairment. METHODS: An extensive review of epidemiological, observational, and experimental studies on lithium-induced renal impairment, focusing on its pathophysiology, clinical manifestations, and risk factors was conducted. Expert consensus and recent data were integrated to develop a management algorithm for renal monitoring and intervention. RESULTS: Lithium remains the gold standard for mood stabilization in bipolar disorders, with robust evidence supporting its role in recurrence prevention and suicide risk reduction. While mild to moderate renal impairment is recognized as a risk factor, newer studies show a lower incidence of severe outcomes, such as end-stage kidney disease, necessitating dialysis treatment and renal transplantation, especially with appropriate monitoring, as compared to older studies. This paper addresses pathophysiological mechanisms, including arginine vasopressin resistance and chronic interstitial nephritis, alongside risk factors like rapid initial decline in glomerular filtration rate, early age at treatment initiation, cumulative dosage, mean serum levels of lithium and episodes of lithium intoxication. Effective management strategies, including judicious dosing, routine monitoring, and early nephrology referral, can significantly improve outcomes. CONCLUSIONS: Lithium remains an invaluable treatment for recurrent mood disorders, and its benefits often outweigh the risks when managed appropriately. This paper provides a practical framework for clinicians to address renal concerns, emphasizing the importance of systematic monitoring and individualized care. The paper underscores the need for continued research and education of clinicians and patients to optimize lithium use while safeguarding patient health. </p>","PeriodicalId":13944,"journal":{"name":"International Journal of Bipolar Disorders","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13253906/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147770803","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":"Baseline NMR lipoprotein profiles in lithium-naïve bipolar disorder patients who later showed weight gain during lithium therapy: a pilot study.","authors":"Elena Schönthaler, Frederike T Fellendorf, Tobias Madl, Hansjörg Habisch, Susanne Bengesser, Nina Dalkner, Eva Fleischmann, Johanna Georgi, Alfred Häussl, Dino Hasic, Julia Ilic, Amrei Lässer, Melanie Lenger, Alexander Maget, Claudia Mittmannsgruber, Darja Popkova, Robert Queissner, Anna Ramirez-Obermayer, Stefan Smolle, Tatjana Stross, Adelina Tmava-Berisha, Eva Z Reininghaus","doi":"10.1186/s40345-026-00425-x","DOIUrl":"10.1186/s40345-026-00425-x","url":null,"abstract":"<p><p>BACKGROUND: Lithium is a first-line treatment for bipolar disorder (BD), but weight gain is a common side effect, leading to physical comorbidities and reduced average life expectancy. Some individuals are predisposed to weight gain due to lithium therapy, indicating the need to explore metabolic differences to prevent health complications. This descriptive feasibility study aimed to explore metabolic parameters in lithium-naïve BD individuals who later gained weight during lithium therapy versus those who did not. METHODS: Data from BD individuals (N = 10) were included, five of whom gained weight (≥ 5 kg) during lithium treatment and five who did not. Nuclear Magnetic Resonance spectroscopy was used to measure blood serum lipoprotein and inflammation parameters, as well as molecular metabolites before lithium treatment. Univariate t-tests and multivariate orthogonal partial least-squares discriminant analysis (oPLS-DA) were performed to observe metabolomic between-group differences. RESULTS: The multivariate oPLS-DA did not show significant differences between the groups, but data visualization suggested distinct metabolic profiles. Univariate analyses revealed significantly elevated lipoprotein parameters in the weight gain group, which did not remain significant after correction for multiple testing. Phenylalanine levels showed an observable but non-significant downward trend in the weight gain group (fold change = 0.40, p = .057). CONCLUSIONS: The findings suggest a link between weight gain during lithium therapy and altered lipoprotein metabolism, aligning with previous research. However, larger studies are needed to further explore the underlying mechanisms. These preliminary findings represent a stepping stone for personalized lithium treatment strategies, which could help mitigate adverse metabolic side effects and improve treatment adherence. </p>","PeriodicalId":13944,"journal":{"name":"International Journal of Bipolar Disorders","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13253932/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147770801","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":"Examining the associations between manic symptoms and cognitive performance in bipolar disorders: evidence from a cross-sectional replication study in the FACE-BD cohort.","authors":"Nathan Vidal, Eric Brunet-Gouet, Solène Frileux, Raoul Belzeaux, Philippe Courtet, Thierry D'Amato, Caroline Dubertret, Bruno Etain, Emmanuel Haffen, Dominique Januel, Marion Leboyer, Antoine Lefrere, Pierre-Michel Llorca, Emeline Marlinge, Paula Martinez, Katia M'Bailara, Emilie Olié, Mircea Polosan, Raymund Schwan, Michel Walter, Christine Passerieux, Paul Roux","doi":"10.1186/s40345-026-00420-2","DOIUrl":"10.1186/s40345-026-00420-2","url":null,"abstract":"<p><p>Studies examining the effect of mania on cognition in Bipolar Disorders (BD) have yielded contradictory results. Koenders and collaborators showed in 2014 that, among 189 adults with BD, adults with subclinical manic symptoms perform a task measuring divided attention significantly better than adults with less or more severe manic symptoms. We aimed to replicate this finding in a larger sample. We included adults from the FACE-BD cohort with a BD diagnosis based on the DSM-IV-R criteria. We excluded adults with a current characterized depressive or manic episode or with other possible sources of cognitive impairment. We assessed the associations between the YMRS score and cognitive functions involved in divided attention using linear regression models, adjusting for the same covariates as the original study. We found no significant linear or quadratic associations between the YMRS total score and attention, working memory, and executive performance in the bivariable models nor after adjusting for covariates in 2,739 adults with BD. We were unable to replicate the findings reported by Koenders and collaborators. The low variance and mean severity of manic symptoms in our sample may partly explain the absence of significant associations. Our results suggest that subclinical hypomanic symptoms neither enhance nor impair cognitive performance in adults with BD, calling into question the benefit of residual hypomanic symptoms on patients' cognitive functioning.</p>","PeriodicalId":13944,"journal":{"name":"International Journal of Bipolar Disorders","volume":"14 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13083468/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147689944","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 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/s40345-026-00419-9","DOIUrl":"10.1186/s40345-026-00419-9","url":null,"abstract":"<p><p>BACKGROUND: Bipolar disorder (BD) is a heterogeneous psychiatric disorder that is increasingly recognized as having immune-inflammatory pathogenesis. Previous studies have shown thyroid autoimmunity, in particular, thyroid peroxidase antibody (TPO-Ab), is associated with rapid cycling and antidepressant-induced mania in BD. We examined the relationship between TPO-Ab seropositivity and BD clinical sub-phenotypes and lithium response. METHODS: In this cross-sectional study, adult patients with BD enrolled in the Mayo Clinic BD Biobank were stratified into TPO-Ab positive versus negative groups using all available information (research data and electronic health records). Multivariable logistic regression analyses were conducted to assess associations between TPO-Ab status and clinical sub-phenotypes, including early age at onset, history of psychosis, rapid cycling, suicide attempt, and antidepressant-induced mania. Linear regression was used to examine associations with lithium treatment response (Alda A score). All models were adjusted for age, sex, BMI, and laboratory data source for TPO-Ab values. RESULTS: Among 339 individuals (mean age = 43.8 ± 15.2 years, 61.1% female), 23.9% were TPO-Ab positive. In adjusted models, TPO-Ab positivity was associated with reduced odds of history of psychosis (OR = 0.49, 95% CI 0.27–0.87, p = 0.017) and poorer treatment response to lithium (β = -0.92, 95% CI -1.74 – -0.11, p = 0.026). In exploratory analyses, no significant interactions of TPO-Ab status with age and sex were observed across different sub-phenotypes. CONCLUSIONS: Our findings suggest that thyroid autoimmunity is associated with a distinct BD phenotype characterized by less psychosis and a poor response to lithium treatment. Future prospective longitudinal studies should validate these findings in larger cohorts and investigate underlying biological mechanisms by incorporating thyroid function status, thyroid antibody dynamics, and broader autoantibody proteome. </p>","PeriodicalId":13944,"journal":{"name":"International Journal of Bipolar Disorders","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13172239/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147608741","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":"Sleep fluctuations precede self-reported mood changes in bipolar disorder: results from the BipoSense study.","authors":"Andrea Ulrichsen, Esther Mühlbauer, Vera Miriam Ludwig, Emanuel Severus, Anthony Cleare, Sameer Jauhar, Michael Bauer, Ulrich W Ebner-Priemer","doi":"10.1186/s40345-026-00416-y","DOIUrl":"10.1186/s40345-026-00416-y","url":null,"abstract":"<p><p>BACKGROUND: The temporal relationship between sleep and mood changes in bipolar disorder (BD) has been investigated before, and this paper aims to replicate results from previous analyses while adding new details to the understanding of the relationship between fluctuations of sleep and mood. Furthermore, we comment on the use of sleep changes as a prodrome to mood changes in BD, which could improve clinical outcomes. METHODS: BD outpatients in remission (N = 29) recorded daily their sleep of the past 24 h and rated their mood on a visual analogue scale for 1 year (total of 9,433 days). Cross-correlation functioning was employed to identify potential relationships between self-reported sleep values and mood scores, for both the days before and after a change in mood. RESULTS: 41% of participants reported a negative relationship between changes in total time spent in bed and mood the following day, e.g. spending more time in bed before a shift towards depressive symptoms. Additionally, 21%-28% of all participants experienced an increase (or decrease) in their 7-day sleep average (sleep duration and awake in bed duration) in the week before a change in mood towards a lower (or higher) score. Only a few participants showed any relationship between changes in the 7-day variability of sleep and mood change. CONCLUSION: Our findings align with and support those of earlier studies with similar designs. The duration of sleep and time in bed may serve as early indicators of mood changes in BD for about two-fifths of patients, and integrating these symptoms into clinical practice may help anticipate critical clinical shifts. </p>","PeriodicalId":13944,"journal":{"name":"International Journal of Bipolar Disorders","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13066072/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147520651","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":"Vitamin D and calcium metabolism in bipolar disorder: a scoping review of contradictory evidence.","authors":"Amirzhan Kulmagambetov, Adelina Tmava-Berisha, Frederike T Fellendorf, Melanie Lenger, Tatjana Stross, Marko Stijic, Eva Fleischmann, Julia Ilić, Alexander Finner, Anna Ramirez-Obermayer, Johanna Georgi, Alexander Maget, Amrei Lässer, Claudia Mittmannsgruber, Stefan Smolle, Alfred Häussl, Jonas Schuller, Dino Hasic, Susanne Bengesser, Robert Queissner, Nina Dalkner, Eva Z Reininghaus","doi":"10.1186/s40345-026-00422-0","DOIUrl":"10.1186/s40345-026-00422-0","url":null,"abstract":"<p><strong>Background: </strong>This scoping review synthesized evidence on vitamin D, parathyroid hormone (PTH), and serum calcium in bipolar disorder (BD) to evaluate their potential clinical utility.</p><p><strong>Methods: </strong>A systematic PubMed search identified original studies examining calcium metabolism biomarkers (vitamin D, PTH, serum calcium) exclusively in BD populations. Findings were synthesized narratively due to substantial methodological heterogeneity.</p><p><strong>Results: </strong>Fourteen studies met inclusion criteria, with small sample sizes (median n = 55) and predominantly cross-sectional designs. Vitamin D comparisons between BD patients and controls yielded contradictory results: three studies reported significantly lower levels in BD patients, two found significantly higher levels, and three found no differences. Vitamin D deficiency definitions varied widely (< 25 to < 50 nmol/L), precluding meaningful comparisons. Four cognition studies showed inconsistent associations with vitamin D, with negative correlations, age-dependent effects, or no associations reported. Two small vitamin D supplementation studies in bipolar spectrum disorders yielded contradictory results in distinct populations, with one in youth and the other in adults. Data on PTH and calcium were sparse and inconsistent.</p><p><strong>Limitations: </strong>Study limitations included a single database search, substantial study heterogeneity, and inadequate control for confounders, including seasonal variation.</p><p><strong>Conclusions: </strong>Evidence on calcium metabolism biomarkers in BD is contradictory and methodologically limited. Fundamental inconsistencies in vitamin D status between BD patients and controls, combined with conflicting supplementation data, preclude clinical recommendations. Routine vitamin D screening specifically for BD management cannot be supported. Large-scale, standardized studies are needed before clinical application.</p>","PeriodicalId":13944,"journal":{"name":"International Journal of Bipolar Disorders","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13136459/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147511865","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":"The effect of smartphone-based monitoring and treatment including clinical feedback in progressed bipolar disorder: the SmartBipolar trial randomised controlled parallel-group trial.","authors":"Maria Faurholt-Jepsen, Asbjørn Risom, Malene Schwarz Dyreholt, Natacha Blauenfeldt Kyster, Ellen Margrethe Christensen, Birte Smidt, Ulla Knorr, Kim Brøndmark, Anja Mathiesen, Denis Cululejevic, Rene Sjaelland, Henrik Nørbak-Emig, Lotte Linnemann Sponsor, Darius Mardosas, Jens Drachmann Bukh, Trine Vøgg Heller, Nanna Iversen, Maj Vinberg, Esben Budtz-Jørgensen, Lars Vedel Kessing","doi":"10.1186/s40345-026-00418-w","DOIUrl":"10.1186/s40345-026-00418-w","url":null,"abstract":"<p><p>INTRODUCTION: A substantial proportion of patients with bipolar disorder experience daily variability in mood that seems associated with poor prognostic factors, including impaired functioning, and increased risk of hospitalisation and relapse. The present SmartBipolar randomised controlled trial (RCT) investigated whether group (1) daily smartphone-based outpatient monitoring and treatment including CBT elements with clinical feedback (intervention group) versus group (2) daily smartphone-based monitoring and treatment with CBT elements without clinical feedback (content was the same as intervention group but without clinical feedback) (control group) or group (3) daily smartphone-based mood monitoring only without CBT elements or other smartphone content (control group), improved mood instability and other clinically relevant patient-related outcomes in patients who have had a bipolar disorder for more than two years, and typically many years. METHODS: This study was a pragmatic, randomised controlled trial with a follow-up period of 6 months. The outcomes were (1) mood instability (primary), (2) questionnaire-based evaluations of quality of life, depressive symptoms, manic symptoms, perceived stress, as well as smartphone-based measures of mood, activity, stress, anxiety, irritability, and sleep. Group differences were quantified using linear mixed models. RESULTS: A total of 201 patients with progressed bipolar disorder were included as part of their specialised outpatient treatment in the Mental Health Services in the Capital Region of Denmark. The trial began in March 2021 with last patient follow-up in July 2025. Intention-to-treat analyses showed no differences in the primary outcome mood instability (difference: 0, 95%CI: -0.16; 0.16, p = 0.98). In addition, there were no differences in other patient-reported outcome measures. LIMITATIONS: This was an unblinded trial. CONCLUSION: There was no positive or negative effects of smartphone-based monitoring and treatment on primary or secondary outcomes in the present trial. CLINICAL TRIALS REGISTRATION: NCT04230421. Registered January, 2020. </p>","PeriodicalId":13944,"journal":{"name":"International Journal of Bipolar Disorders","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13129000/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147498748","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":"Characterizing high cognitive performance in persons with mood disorders and their unaffected relatives: associations with emotional cognition, functioning, and clinical outcomes.","authors":"Hanne Lie Kjaerstad, Bjørn Ole Barkholt Nordseth, Maj Vinberg, Lars Vedel Kessing, Kamilla Woznica Miskowiak","doi":"10.1186/s40345-026-00417-x","DOIUrl":"10.1186/s40345-026-00417-x","url":null,"abstract":"<p><p>BACKGROUND: Mood disorders are characterized by considerable cognitive heterogeneity. However, little is known about high cognitive performance and its associations with relevant clinical outcomes. High cognitive performance in persons with mood disorders and high-risk unaffected relatives (UR) may be an expression of resilience to illness-related neuropathology. METHODS: Cross-sectional data from persons with mood disorders (n = 212), unaffected relatives (UR) (n = 96), and healthy controls (HC) (n = 152) were pooled from two cohort studies, during which participants completed neuropsychological test batteries comprising both non-emotional and emotional cognition. Participants were grouped into ‘high’ or ‘normal cognitive performance’ subgroups based on their global cognitive performance. Groups were compared to investigate high-performing persons with mood disorders and relatives, respectively, in demographic and clinical variables and emotional cognition. RESULTS: Resulting subgroups were persons with mood disorders with high (P-HP = 67) and normal cognitive performance (P-NP = 135), UR with high (UR-HP = 41) and normal cognitive performance (UR-NP = 52) and HC with high (HC-HP = 86) and normal cognitive performance (HC-NP = 66). P-HP were characterized by fewer experiences of physical abuse, fewer mood episodes and improved functioning compared to P-NP. Both P-HP and UR-HP experienced more overall childhood trauma, compared to HC-HP. All cognitively high-performing subgroups exhibited faster recognition of emotional faces compared to their corresponding normally performing group. CONCLUSION: High cognitive performance was associated with favorable clinical outcomes and improved functioning in persons with mood disorders and high-risk UR. Given this association, above-average enhancement of cognition beyond normalization may aid functional recovery. </p>","PeriodicalId":13944,"journal":{"name":"International Journal of Bipolar Disorders","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13086977/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147432519","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":"The association between psychotropic medications and cognitive functioning in bipolar disorder.","authors":"Faith Dickerson, Andrea Origoni, Emily Katsafanas, Kelly Rowe, Sabahat Khan, Allana Therese Calahatian, Fahad Mukhtar, Robert Yolken","doi":"10.1186/s40345-026-00413-1","DOIUrl":"10.1186/s40345-026-00413-1","url":null,"abstract":"<p><strong>Background: </strong>Many individuals with bipolar disorder have decreased levels of cognitive functioning even when in a euthymic mood state. Persons with bipolar disorder are usually treated with psychotropic agents, but the effects of these medications on their cognitive functioning have not been extensively studied.</p><p><strong>Methods: </strong>A total of 567 people with bipolar disorder were assessed on a cognitive battery, the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), and Trail Making Test, part A (Trails A) and Letter-Number Sequencing. The machine-learning tool of cross-fit partialing-out least absolute shrinkage and selection operator (LASSO) regression was used to examine the independent association between the cognitive test scores and receipt of individual psychotropic medications considering relevant demographic and clinical covariates. Ordered logistic regression models were employed to examine the effects of medication dosage on the cognitive scores.</p><p><strong>Results: </strong>We found that 3 medications, ziprasidone, benztropine, and clonazepam, were independently associated with significantly reduced cognitive scores compared with individuals not receiving these medications. Benztropine showed a significant dose-related relationship with all of the cognitive measures. Reduced memory and psychomotor speed were the domains most associated with receipt of these medications.</p><p><strong>Conclusions: </strong>Prescribers may consider limiting the administration of the medications which can affect cognitive functioning. Interventions should be further developed for people with bipolar disorder to improve their cognitive functioning and quality of life.</p>","PeriodicalId":13944,"journal":{"name":"International Journal of Bipolar Disorders","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13111742/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147365096","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}