International Journal of Bipolar Disorders最新文献

{"title":"Exploring the temporal relationship between mood, alcohol- and nicotine use in bipolar disorder using time-series analyses.","authors":"Stine Holmstul Glastad, Ole Klungsøyr, Sofie Ragnhild Aminoff, Roger Hagen, Thomas Bjella, Magnus Johan Engen, Siv Hege Lyngstad, Cecilie Busch, Romain Icick, Bruno Etain, Ingrid Melle, Ole A Andreassen, Margrethe Collier Høegh, Trine Vik Lagerberg","doi":"10.1186/s40345-025-00388-5","DOIUrl":"10.1186/s40345-025-00388-5","url":null,"abstract":"<p><strong>Background: </strong>The prevalence of substance use disorders in bipolar disorder (BD) is high. Exploring potential interactions between mood and the use of common substances such as alcohol and nicotine may contribute to a better understanding of the mechanisms underlying such comorbidities. Digital tools now allow for continuous monitoring and data collection of both symptoms and behavior. This enables time-series analyses to explore such associations with greater precision.</p><p><strong>Methods: </strong>Thirty-two individuals in the early phases of BD registered their mood daily and their use of substances weekly in the MinDag (MyDay) app for up to 6 months. We explored temporal relationships between the use of alcohol and nicotine and the levels of depressed, elevated, irritable, and anxious mood using Vector Autoregressive Models and Granger causality tests.</p><p><strong>Results: </strong>We found indications that mood influenced alcohol- and nicotine use, and vice versa. Significant temporal relationships (Granger causality) were found in 55% (11 out of 20) of the participants for alcohol and 70% (7 out of 10) for nicotine use, and with high proportions of the variance explained by the one time-series on the other. The associations were consistent with causal effects in one or both directions, but with no adjustment for confounding.</p><p><strong>Conclusion: </strong>Our findings indicate that mood influences alcohol- and nicotine use and vice versa in individuals with BD, although caution should be taken due to the exploratory approach. Larger samples are needed to further disentangle these relationships to provide insight for better prevention and treatment of BD and comorbid substance use disorders.</p>","PeriodicalId":13944,"journal":{"name":"International Journal of Bipolar Disorders","volume":"13 1","pages":"18"},"PeriodicalIF":2.8,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12102454/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127323","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":"Short-term and long-term effects of Muslim fasting on lithium pharmacokinetics and renal function in bipolar disorder: a prospective observational study.","authors":"Mohamed Abouzed, Abdullah Saleh Altuhayni, Salwa Rashed Alshammari, Mohamed Saad Almuqahhwi, Mohamed Elgernas, Abdulkarim Almazyadi, Abdullah Abdulaziz Alghuraymil, Yousef Ibrahim, Awwad Alenezy","doi":"10.1186/s40345-025-00378-7","DOIUrl":"10.1186/s40345-025-00378-7","url":null,"abstract":"<p><p>This prospective observational study aimed to investigate the effects of Ramadan fasting on serum lithium levels, renal function, and electrolyte balance in patients with bipolar disorder undergoing lithium maintenance therapy. Conducted in Saudi Arabia, a region characterized by hot and arid climates (30-36 °C, 25% humidity during Ramadan 2024), the study included 250 participants divided into fasting (n = 131) and non-fasting (n = 119) groups. Serum lithium levels, renal function parameters (serum creatinine and estimated glomerular filtration rate), and electrolyte levels (sodium and potassium) were assessed at baseline, mid-Ramadan, one month post-Ramadan, and three months post-Ramadan. Statistical analyses included mixed-effects models, linear regression, and Wilcoxon rank-sum tests. The results indicate that Ramadan fasting did not significantly alter serum lithium levels, renal function, or electrolyte balance across all time points. These findings suggest that fasting during Ramadan can be safely practiced by patients with bipolar disorder receiving lithium therapy, provided they maintain adequate hydration and adhere to their prescribed medication regimen.</p>","PeriodicalId":13944,"journal":{"name":"International Journal of Bipolar Disorders","volume":"13 1","pages":"17"},"PeriodicalIF":2.8,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12078900/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144006697","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 and neuroprotection: a review of molecular targets and biological effects at subtherapeutic concentrations in preclinical models of Alzheimer's disease.","authors":"Vanessa de Jesus R De-Paula, Marcia Radanovic, Orestes Vicente Forlenza","doi":"10.1186/s40345-025-00386-7","DOIUrl":"https://doi.org/10.1186/s40345-025-00386-7","url":null,"abstract":"<p><strong>Background: </strong>Experimental studies consistently demonstrate that lithium modulates multiple intracellular signaling pathways involved in crucial neurobiological responses, highlighting its therapeutic potential in degenerative diseases. Lithium has demonstrated significant neuroprotective potential in preclinical models of Alzheimer's disease (AD) and other neurodegenerative disorders.</p><p><strong>Contents: </strong>This review examines the molecular mechanisms and biological effects of lithium at subtherapeutic concentrations, focusing on its ability to modulate key intracellular pathways, such as the inhibition of glycogen synthase kinase-3 beta (GSK-3β), reduction of Tau hyperphosphorylation, and enhancement of neurotrophic and anti-inflammatory responses. Evidence from animal and cellular studies underscores lithium's ability to reduce amyloid plaques, maintain neuronal integrity, improve memory, and decrease neuroinflammation, even at doses much lower than those used clinically for mood stabilization.</p><p><strong>Conclusion: </strong>Evidence from animal and cellular models indicates that subtherapeutic lithium doses may provide a safer and more practical approach to neuroprotection, particularly in AD. However, further research is necessary to optimize dosing strategies, assess long-term safety, and translate these findings into clinical applications.</p>","PeriodicalId":13944,"journal":{"name":"International Journal of Bipolar Disorders","volume":"13 1","pages":"16"},"PeriodicalIF":2.8,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12065699/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143985512","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 interrelationship of depression, stigma, and suicide risk among patients with bipolar disorder and their caregivers: a six-month follow-up study.","authors":"Chia-Chi Lin, Yu Lee, Nien-Mu Chiu, Pao-Yen Lin, Yu-Chi Huang, Chi-Fa Hung, Liang-Jen Wang","doi":"10.1186/s40345-025-00383-w","DOIUrl":"https://doi.org/10.1186/s40345-025-00383-w","url":null,"abstract":"<p><strong>Background: </strong>Despite significant research on bipolar disorder, the interplay between depression, suicide risk, and stigma in patients with bipolar disorder and their caregivers remains underexplored. This study aimed to examine how stigma and suicide risk affect the severity of depression in both patients with bipolar disorder and their caregivers.</p><p><strong>Methods: </strong>We recruited 76 patients with bipolar disorder and their 76 caregivers from a general hospital between August 2023 and July 2024. Assessments included a psychiatric diagnostic interview using the Mini-International Neuropsychiatric Interview, the Hospital Anxiety and Depression Scale, the Family APGAR Index, the Stigma Subscale of the Explanatory Model Interview Catalogue, and the Suicide Assessment Scale. Structural equation modeling (SEM) was employed to explore the mechanisms underlying depression in caregivers. Additionally, a stepwise forward logistic regression model identified key factors associated with depressive disorders in caregivers.</p><p><strong>Results: </strong>Among caregivers, depressive disorders were the most common psychiatric diagnosis (27.6%), followed by anxiety disorders (17.1%) and insomnia disorders (11.8%). SEM analysis revealed that suicidal ideation in patients (β = 0.72, p < 0.001) was significantly associated with depression severity in patients with bipolar disorder. Caregivers' stigma (β = 0.41, p < 0.001) and suicide risk (β = 0.39, p < 0.001) were positively associated with their own depression severity. Interestingly, caregivers' suicide risk (β = -0.20, p < 0.01) was inversely related to patients' depression severity. Unemployment, anxiety severity, suicide risk, and family support were also significant predictors of depression in caregivers.</p><p><strong>Conclusions: </strong>Suicidal ideation in patients with bipolar disorder is strongly linked to the severity of their depressive symptoms. Among caregivers, higher levels of stigma and suicide risk are associated with greater depressive symptom severity, while caregivers' suicide risk appears to have a protective effect on patients' depression severity. Early identification and targeted interventions for individuals at high risk of suicide and stigma may help alleviate depression in both patients and their caregivers.</p>","PeriodicalId":13944,"journal":{"name":"International Journal of Bipolar Disorders","volume":"13 1","pages":"15"},"PeriodicalIF":2.8,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11992270/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143964127","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 MinDag app for symptom monitoring and feedback to patients and clinicians during the initial treatment of bipolar disorder - a feasibility study.","authors":"Margrethe Collier Høegh, Stine Holmstul Glastad, Siv Hege Lyngstad, Magnus Johan Engen, Sofie Ragnhild Aminoff, Ingrid Melle, Thomas Bjella, Trine Vik Lagerberg","doi":"10.1186/s40345-025-00382-x","DOIUrl":"10.1186/s40345-025-00382-x","url":null,"abstract":"<p><strong>Background: </strong>The app \"MinDag\" (MyDay) was developed as a tool for monitoring mood, symptoms and illness-relevant behaviour in the initial treatment of bipolar disorder. Digital self-monitoring may provide patients and clinicians with valuable data for tailoring treatment interventions. This study aims to evaluate the practical use and clinical implications of integrating MinDag in the early treatment of bipolar disorder from the perspectives of both patients and clinicians.</p><p><strong>Methods: </strong>The MinDag app includes six content modules covering mood, sleep, functioning/activities, substance use, emotional reactivity, and psychotic symptoms. Patients were asked to use the app for six months, and automated feedback based on the app registrations was delivered to the patients' clinicians biweekly. The study involved quantitative evaluations completed by patients (n = 20), as well as interviews with patients (n = 7) and clinicians (n = 2).</p><p><strong>Results: </strong>Overall, the patients reported that they felt that MinDag was safe, relevant and easy to use, although technical difficulties such as too many automated reminders and need for reinstallations were reported. The patients appreciated the potential for increased awareness of their mental health, but expressed a desire for direct access to their data. Clinicians found the visual reports and feedback useful for tailoring treatment, even though the alert system for high-risk variables needed refinement. The quantitative evaluations indicated a positive general reception, with suggestions for improvement in usability and accessibility.</p><p><strong>Conclusion: </strong>The MinDag app shows promise as a tool for enhancing the treatment of bipolar disorder by facilitating self-monitoring and providing actionable data to clinicians. However, technical issues and the need for direct patient access to data must be addressed. Development of digital tools to support the treatment of bipolar disorder and other mental health conditions is resource demanding, and there is a need to clarify criteria to establish proof of concept to guide the selection of tools for upscaling and implementation.</p>","PeriodicalId":13944,"journal":{"name":"International Journal of Bipolar Disorders","volume":"13 1","pages":"14"},"PeriodicalIF":2.8,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11968593/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772184","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":"Day-to-day variability in activity levels detects transitions to depressive symptoms in bipolar disorder earlier than changes in sleep and mood.","authors":"Abigail Ortiz, Ramzi Halabi, Martin Alda, Alexandra DeShaw, Muhammad I Husain, Abraham Nunes, Claire O'Donovan, Rachel Patterson, Benoit H Mulsant, Arend Hintze","doi":"10.1186/s40345-025-00379-6","DOIUrl":"10.1186/s40345-025-00379-6","url":null,"abstract":"<p><p>Anticipating clinical transitions in bipolar disorder (BD) is essential for the development of clinically actionable predictions. Our aim was to determine what is the earliest indicator of the onset of depressive symptoms in BD. We hypothesized that changes in activity would be the earliest indicator of future depressive symptoms. The study was a prospective, observational, contactless study. Participants were 127 outpatients with a primary diagnosis of BD, followed up for 12.6 (5.7) [(mean (SD)] months. They wore a smart ring continuously, which monitored their daily activity and sleep parameters. Participants were also asked to complete weekly self-ratings using the Patient Health Questionnaire (PHQ-9) and Altman Self-Rating Mania Scale (ASRS) scales. Primary outcome measures were depressive symptom onset detection metrics (i.e., accuracy, sensitivity, and specificity); and detection delay (in days), compared between self-rating scales and wearable data. Depressive symptoms were labeled as two or more consecutive weeks of total PHQ-9 > 10, and data-driven symptom onsets were detected using time-frequency spectral derivative spike detection (TF-SD²). Our results showed that day-to-day variability in the number of steps anticipated the onset of depressive symptoms 7.0 (9.0) (median (IQR)) days before they occurred, significantly earlier than the early prediction window provided by deep sleep duration (median (IQR), 4.0 (5.0) days; p <.05). Taken together, our results demonstrate that changes in activity were the earliest indicator of depressive symptoms in participants with BD. Transition to dynamic representations of behavioral phenomena in psychiatry may facilitate episode forecasting and individualized preventive interventions.</p>","PeriodicalId":13944,"journal":{"name":"International Journal of Bipolar Disorders","volume":"13 1","pages":"13"},"PeriodicalIF":2.8,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11965041/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772183","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":"Strategies for occupational recovery processes in individuals with bipolar disorder type I: a qualitative study.","authors":"J Koene, E Maassen, N van Lang, J van der Stel, R Kupka, J van Weeghel, H Kroon","doi":"10.1186/s40345-025-00380-z","DOIUrl":"10.1186/s40345-025-00380-z","url":null,"abstract":"<p><strong>Background: </strong>Employment is a challenging life domain for individuals with bipolar disorder (BD), illustrated by high unemployment numbers and various experienced problems within the workplace. While regaining a satisfactory level of occupational functioning is an important aspect of recovery, there is little qualitative research exploring occupational recovery in individuals with BD. The aim of this qualitative study was first to gain insight into the (self-regulation) strategies used by patients and peer support workers with BD type I (BD-I) regarding their occupational functioning. Our second aim was to construct a conceptual model based on these strategies used to better understand how individuals with BD-I might recover during their occupational functioning. In our study, inspired by Glaser and Strauss' constructivist Grounded Theory, we interviewed 21 patients and 15 peer support workers with BD-I about their experiences in occupational functioning and about the strategies they use for dealing with difficulties, as well as their occupational recovery processes. We analysed the data through open, axial, and selective coding.</p><p><strong>Results: </strong>The results showed one overarching theme and three subthemes of strategies used by individuals with BD-I: (1) organizing work, (2) self-regulatory actions in relation to employment, and (3) getting support. Based on the narratives of the participants, a conceptual model was found in which differing strategies are used based on the recovery process: acute mood episode or longer lasting recovery process.</p><p><strong>Conclusion: </strong>The narratives of individuals with BD-I show that two types of recovery can be experienced in relation to work: recovery after an acute mood episode and a longer lasting recovery process that is intertwined with several aspects of daily working life. We identified three different types of strategies that participants with BD-I implement to create a fitting employment situation and that it might depend on the type of recovery process which strategies are most helpful.</p>","PeriodicalId":13944,"journal":{"name":"International Journal of Bipolar Disorders","volume":"13 1","pages":"12"},"PeriodicalIF":2.8,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11926288/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669753","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":"Effect of home-based transcranial direct current stimulation (tDCS) on cognitive functioning in bipolar depression: an open-label, single-arm acceptability and feasibility study.","authors":"Hakimeh Rezaei, Rachel D Woodham, Ali-Reza Ghazi-Noori, Philipp Ritter, Elvira Bramon, Michael Bauer, Allan H Young, Cynthia H Y Fu","doi":"10.1186/s40345-025-00376-9","DOIUrl":"10.1186/s40345-025-00376-9","url":null,"abstract":"<p><p>Bipolar depression is commonly accompanied by cognitive impairments. Transcranial direct current stimulation (tDCS) is emerging as a novel non-invasive treatment for bipolar depression. Given the portability and safety of tDCS, we developed a home-based protocol with real-time supervision. Our aim was to assess the cognitive effects of a course of tDCS treatment in bipolar depression. 44 participants (31 women, mean age 47.27 years, SD 12.89) with bipolar depression of at least a moderate severity received 21 sessions of home-based tDCS over 6 weeks in an open-label design. The stimulation protocol involved 2 mA in a bilateral frontal montage (F3 anode, F4 cathode) for 30 min per session. Cognitive assessments were conducted at baseline and after the course of treatment: Rey Auditory Verbal Learning Test (RAVLT) to assess verbal learning and memory and Symbol Digit Modalities Test (SDMT) to assess psychomotor processing speed and visuospatial attention. 93.18% (n = 41) completed RAVLT and 59.09% of participants (n = 26) completed SDMT. A significant improvement was observed in RAVLT verbal learning score post-treatment (p = 0.002), which was not maintained following adjustment for improvement in depressive symptoms. In summary, a course of home-based tDCS in bipolar depression was associated with an improvement in verbal learning, which appeared to be related to improvement in depressive symptoms. These findings suggest potential benefits of tDCS for addressing cognitive impairments in bipolar depression, which can be investigated further in a sham-controlled design.</p>","PeriodicalId":13944,"journal":{"name":"International Journal of Bipolar Disorders","volume":"13 1","pages":"11"},"PeriodicalIF":2.8,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11914700/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143648205","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":"Lipid oxidation in young patients with newly diagnosed bipolar disorder and their relatives.","authors":"Sharleny Stanislaus, Klara Coello, Hanne Lie Kjaerstad, Kimie Stefanie Ormstrup Sletved, Kamilla Woznica Miskowiak, Maria Faurholt-Jepsen, Klaus Munkholm, Henrik Enghusen Poulsen, Maj Vinberg, Jens Lykkesfeldt, Lars V Kessing","doi":"10.1186/s40345-025-00377-8","DOIUrl":"10.1186/s40345-025-00377-8","url":null,"abstract":"<p><strong>Background: </strong>Oxidative stress may be involved in the pathophysiology of bipolar disorder (BD). Malondialdehyde (MDA), a product of fatty acid peroxidation has been proposed as a trait marker of BD associated with familial risk. However, little is known about MDA levels in young patients newly diagnosed with BD and their unaffected first-degree relatives (UR).</p><p><strong>Methods: </strong>In this substudy of the ongoing longitudinal \"Bipolar Illness Onset study\", we included baseline data and first, we compared fasting blood MDA levels in 130 young patients aged 15-25 years newly diagnosed with BD, 57 UR, and 88 healthy control individuals (HC). Second, we investigated associations between levels of MDA and illness variables in patients with BD. Third, we investigated associations between MDA levels and nucleoside damage by oxidation measured in urine. Fasting MDA levels from blood samples were measured using high-performance liquid chromatography (HPLC).</p><p><strong>Results: </strong>In linear mixed effect models, adjusted for age and sex, MDA levels did not differ between patients with BD, UR, and HC, respectively. In patients with BD, we found no associations between levels of MDA and duration of illness, number of affective phases, illness onset or oxidatively damaged RNA and DNA.</p><p><strong>Conclusion: </strong>Against expectations, MDA levels did not differ between young patients with BD, UR, and HC, thus, our findings did not support MDA being a state or a trait marker of BD associated with familial risk.</p>","PeriodicalId":13944,"journal":{"name":"International Journal of Bipolar Disorders","volume":"13 1","pages":"10"},"PeriodicalIF":2.8,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11906955/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624541","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":"\"Bad timing for illness relapse!\" Mood symptoms, challenges and strategies for wellbeing in the first year postpartum among infant mothers with bipolar disorder: a mixed-methods study.","authors":"Teija Ms Anke, Dag Vegard Skjelstad","doi":"10.1186/s40345-025-00374-x","DOIUrl":"10.1186/s40345-025-00374-x","url":null,"abstract":"<p><strong>Background: </strong>The postpartum period is associated with a high risk of illness episodes in women with bipolar disorder (BD) and is a critical developmental phase for both a new mother and her infant. This mixed-methods study aimed to investigate the occurrence of mood symptoms among infant mothers with BD in the first year postpartum, as well as their perceptions of the first year, their challenges and their strategies for wellbeing.</p><p><strong>Methods: </strong>Twenty-six women with BD participated. Mood symptoms were assessed at 3 and 12 months postpartum with the Inventory of Depressive Symptomatology and Young Mania Rating Scale. Occurrences of additional postpartum mood deviations were investigated through an interview at 12 months, which also covered the women's postpartum experiences. Thematic analysis was applied to the qualitative dataset (interviews and field notes).</p><p><strong>Results: </strong>42% of the women were euthymic or had only mild mood symptoms at 3 and 12 months. 58% had moderate to severe symptoms at either or both time points. A positive (38%) vs. mixed (62%) perception of the first year was strongly associated with euthymia-mild vs. moderate-severe mood deviations, as was the experience of maternal developmental achievement vs. struggles. The women experienced postpartum mood deviations and illness episodes as being particularly poorly timed. Further challenges included balancing self-care and infant mothering, familial relations, and negative experiences with the health and care systems. Illness acceptance with mindfulness of one's own and the infant's needs was a primary strategy for wellbeing, which was complemented by the support of one's partner and family and postpartum treatment.</p><p><strong>Conclusions: </strong>Our findings propose that without impeding mood deviations and concomitant challenges, infant mothers with BD can enjoy their new motherhood and experience phase-specific growth equally to healthy mothers. On the other hand, moderate to severe mood deviations can adversely impact the experience of the postpartum year and one's own sense of mothering. Efforts to prevent postpartum mood deviations need to be complemented with interventions that target phase-specific BD challenges and support wellbeing strategies for both the mother and her infant. In summary, women's needs to function as infant mothers must be considered in the postpartum treatment of BD.</p>","PeriodicalId":13944,"journal":{"name":"International Journal of Bipolar Disorders","volume":"13 1","pages":"9"},"PeriodicalIF":2.8,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11850689/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143482910","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}