International Journal of Bipolar Disorders最新文献

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Toxoplasma gondii IgG serointensity and cognitive function in bipolar disorder. 弓形虫 IgG 血清密度与双相情感障碍的认知功能。
IF 2.8 2区 医学
International Journal of Bipolar Disorders Pub Date : 2024-08-23 DOI: 10.1186/s40345-024-00353-8
Paul Rensch, Teodor T Postolache, Nina Dalkner, Tatjana Stross, Niel Constantine, Aline Dagdag, Abhishek Wadhawan, Farooq Mohyuddin, Christopher A Lowry, Joshua Joseph, Armin Birner, Frederike T Fellendorf, Alexander Finner, Melanie Lenger, Alexander Maget, Annamaria Painold, Robert Queissner, Franziska Schmiedhofer, Stefan Smolle, Adelina Tmava-Berisha, Eva Z Reininghaus
{"title":"Toxoplasma gondii IgG serointensity and cognitive function in bipolar disorder.","authors":"Paul Rensch, Teodor T Postolache, Nina Dalkner, Tatjana Stross, Niel Constantine, Aline Dagdag, Abhishek Wadhawan, Farooq Mohyuddin, Christopher A Lowry, Joshua Joseph, Armin Birner, Frederike T Fellendorf, Alexander Finner, Melanie Lenger, Alexander Maget, Annamaria Painold, Robert Queissner, Franziska Schmiedhofer, Stefan Smolle, Adelina Tmava-Berisha, Eva Z Reininghaus","doi":"10.1186/s40345-024-00353-8","DOIUrl":"10.1186/s40345-024-00353-8","url":null,"abstract":"<p><strong>Background: </strong>Alongside affective episodes, cognitive dysfunction is a core symptom of bipolar disorder. The intracellular parasite T. gondii has been positively associated with both, the diagnosis of bipolar disorder and poorer cognitive performance, across diagnostic boundaries. This study aims to investigate the association between T. gondii seropositivity, serointensity, and cognitive function in an euthymic sample of bipolar disorder.</p><p><strong>Methods: </strong>A total of 76 participants with bipolar disorder in remission were tested for T. gondii-specific IgG and IgM antibodies and for cognitive performance using neuropsychological test battery. Cognitive parameters were categorized into three cognitive domains (attention and processing speed, verbal memory, and executive function). Statistical analysis of associations between continuous indicators of cognitive function as dependent variables in relationship to T. gondii, included multivariate analyses of co-variance for seropositivity, and partial correlations with IgG serointensity in IgG seropositives. All analyses were controlled for age and premorbid IQ.</p><p><strong>Results: </strong>In seropositives (n = 27), verbal memory showed significant inverse partial correlations with IgG antibody levels (short delay free recall (r=-0.539, p = 0.005), long delay free recall (r=-0.423, p = 0.035), and immediate recall sum trial 1-5 (r=-0.399, p = 0.048)). Cognitive function did not differ between IgG seropositive and seronegative individuals in any of the cognitive domains (F (3,70) = 0.327, p = 0.806, n = 76). IgM positives (n = 7) were too few to be analyzed.</p><p><strong>Conclusions: </strong>This investigation is the first to show an association between T. gondii IgG serointensity and memory function in a well-diagnosed bipolar disorder sample. It adds to the existing literature on associations between latent T. gondii infection and cognition in bipolar disorder, while further research is needed to confirm and expand our findings, eliminate potential sources of bias, and establish cause-effect relationships.</p>","PeriodicalId":13944,"journal":{"name":"International Journal of Bipolar Disorders","volume":"12 1","pages":"31"},"PeriodicalIF":2.8,"publicationDate":"2024-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11343948/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142046636","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}
引用次数: 0
Home-based transcranial direct current stimulation in bipolar depression: an open-label treatment study of clinical outcomes, acceptability and adverse events. 基于家庭的经颅直流电刺激治疗双相抑郁症:一项关于临床结果、可接受性和不良反应的开放标签治疗研究。
IF 2.8 2区 医学
International Journal of Bipolar Disorders Pub Date : 2024-08-20 DOI: 10.1186/s40345-024-00352-9
Ali-Reza Ghazi-Noori, Rachel D Woodham, Hakimeh Rezaei, Mhd Saeed Sharif, Elvira Bramon, Philipp Ritter, Michael Bauer, Allan H Young, Cynthia H Y Fu
{"title":"Home-based transcranial direct current stimulation in bipolar depression: an open-label treatment study of clinical outcomes, acceptability and adverse events.","authors":"Ali-Reza Ghazi-Noori, Rachel D Woodham, Hakimeh Rezaei, Mhd Saeed Sharif, Elvira Bramon, Philipp Ritter, Michael Bauer, Allan H Young, Cynthia H Y Fu","doi":"10.1186/s40345-024-00352-9","DOIUrl":"10.1186/s40345-024-00352-9","url":null,"abstract":"<p><strong>Background: </strong>Current treatments for bipolar depression have limited effectiveness, tolerability and acceptability. Transcranial direct current stimulation (tDCS) is a novel non-invasive brain stimulation method that has demonstrated treatment efficacy for major depressive episodes. tDCS is portable, safe, and individuals like having sessions at home. We developed a home-based protocol with real-time remote supervision. In the present study, we have examined the clinical outcomes, acceptability and feasibility of home-based tDCS treatment in bipolar depression.</p><p><strong>Results: </strong>Participants were 44 individuals with bipolar disorder (31 women), mean age 47.27 ± 12.89 years, in current depressive episode of at least moderate severity (mean Montgomery Asberg Depression Rating Scale (MADRS) score 24.59 ± 2.64). tDCS was provided in bilateral frontal montage, F3 anode, F4 cathode, 2 mA, for 30 min, in a 6-week trial, for total 21 sessions, a follow up visit was conducted 5 months from baseline. Participants maintained their current treatment (psychotherapy, antidepressant or mood stabilising medication) or maintained being medication-free. A research team member was present by video conference at each session. 93.2% participants (n = 41) completed the 6-week treatment and 72.7% of participants (n = 32) completed the 5 month follow up. There was a significant improvement in depressive symptoms following treatment (mean MADRS 8.77 ± 5.37) which was maintained at the 5 month follow up (mean MADRS 10.86 ± 6.90), rate of clinical response was 77.3% (MADRS improvement of 50% or greater from baseline), and rate of clinical remission was 47.7% (MADRS rating of 9 or less). Acceptability was endorsed as \"very acceptable\" or \"quite acceptable\" by all participants. No participants developed mania or hypomania.</p><p><strong>Conclusions: </strong>In summary, home-based tDCS with real-time supervision was associated with significant clinical improvements and high acceptability in bipolar depression. Due to the open-label design, efficacy findings are preliminary.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov number NCT05436613 registered on 23 June 2022 https//www.</p><p><strong>Clinicaltrials: </strong>gov/study/NCT05436613.</p>","PeriodicalId":13944,"journal":{"name":"International Journal of Bipolar Disorders","volume":"12 1","pages":"30"},"PeriodicalIF":2.8,"publicationDate":"2024-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11336151/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142004131","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}
引用次数: 0
Lithium in the time of COVID: forever vigilant. COVID 时代的锂:永远保持警惕。
IF 2.8 2区 医学
International Journal of Bipolar Disorders Pub Date : 2024-08-07 DOI: 10.1186/s40345-024-00351-w
Frances N Adiukwu, Anastasia K Yocum, Brittany M Wright, Ian Gesler, Melvin G McInnis
{"title":"Lithium in the time of COVID: forever vigilant.","authors":"Frances N Adiukwu, Anastasia K Yocum, Brittany M Wright, Ian Gesler, Melvin G McInnis","doi":"10.1186/s40345-024-00351-w","DOIUrl":"10.1186/s40345-024-00351-w","url":null,"abstract":"<p><strong>Background: </strong>There have been case reports of renal dysfunction with lithium toxicity among severely ill COVID-19 patients. Lithium levels may be affected by comorbid conditions and the presence of infective disease states like the SARS-CoV-2 which clearly adds systemic health burden. This study aimed to review the effect SARS-CoV-2 has on serum Li levels and the possible mechanism underlying it.</p><p><strong>Methods: </strong>Retrospective data from all clinical service encounters within the University of Michigan health system between September 2019 and September 2023 were reviewed. The study cohort included 98 patients with an average age of 45 years (62% female) who were diagnosed with any subtype of bipolar disorder, actively taking Li, and infected with SARS-CoV-2 during the study timeframe.</p><p><strong>Results: </strong>There was no overarching effect of a SARS-CoV-2 infection on Li chemistry in the overall sample. Higher serum Li levels were not significantly associated with SARS-CoV-2 infection nor total comorbidity index. However, higher Li levels were observed in males while infected with SARS-CoV-2 when compared with no infection. eGFR remained unassociated with serum Li level. Receiving COVID vaccination was associated with lower serum Li levels (Coeff. = - 0.88, p = 0.048).</p><p><strong>Conclusions: </strong>Patients with a diagnosis of BD, treated with Li, and infected with SARS-CoV-2 were not likely to present with elevated Li levels unless they are male or unvaccinated. Elevated serum Li level was not associated with significant renal dysfunction in this cohort. The case reports of severe renal complications and Li toxicity may be among cases of greater overall clinical severity of COVID-19. These findings are reassuring that Li may be used in the context of a COVID-19 illness but emphasize the ongoing need for clinical vigilance.</p>","PeriodicalId":13944,"journal":{"name":"International Journal of Bipolar Disorders","volume":"12 1","pages":"29"},"PeriodicalIF":2.8,"publicationDate":"2024-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11306459/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141901702","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}
引用次数: 0
Hypomania-Checklist-33: risk stratification and factor structure in a mixed psychiatric adolescent sample. 躁狂症检查表-33:青少年精神病混合样本的风险分层和因子结构。
IF 2.8 2区 医学
International Journal of Bipolar Disorders Pub Date : 2024-08-07 DOI: 10.1186/s40345-024-00350-x
Miriam Gerstenberg, Lukasz Smigielski, Anna M Werling, Maria E Dimitriades, Christoph U Correll, Susanne Walitza, Jules Angst
{"title":"Hypomania-Checklist-33: risk stratification and factor structure in a mixed psychiatric adolescent sample.","authors":"Miriam Gerstenberg, Lukasz Smigielski, Anna M Werling, Maria E Dimitriades, Christoph U Correll, Susanne Walitza, Jules Angst","doi":"10.1186/s40345-024-00350-x","DOIUrl":"10.1186/s40345-024-00350-x","url":null,"abstract":"<p><strong>Background: </strong>The 33-item Hypomania Checklist (HCL-33) has been shown to distinguish between adolescent bipolar disorder (BD) and unipolar depression. To investigate the utility of the HCL-33 as a screening tool in routine diagnostics, the frequency and psychopathological characteristics of detected individuals in a mixed psychiatric sample necessitate more examination.</p><p><strong>Methods: </strong>The HCL-33, Children's Depression Inventory, Beck's Anxiety Inventory, and Strengths and Difficulties Questionnaire were completed by 285 children and adolescents (12-18 years) in a mixed psychiatric sample. Applying the proposed HCL-33 cut-off score of ≥ 18, individuals with depressive symptoms were divided into at-risk or not at-risk for BD groups. The factorial structure, sum and factor score correlations with psychopathology, and impact on daily functioning were assessed.</p><p><strong>Results: </strong>20.6% of the sample met at-risk criteria for BD. These individuals (n = 55) were older, more anxious, and showed more conduct problems vs the not at-risk group (n = 107). A two- and a three-factor model were pursued with the same Factor 1 (\"active-elated\"). Factor 2 (\"risk-taking/irritable\") was separated into 2a (\"irritable-erratic\") and 2b (\"outgoing-disinhibited\") in the three-factor model. Whereas higher Factor 2 and 2a scores correlated with a broad range of more severe symptomatology (i.e., depression, anxiety, hyperactivity), higher Factor 1 and 2b scores correlated with more emotional and conduct problems, respectively. 51.7% of the sample reported a negative impact from hypomanic symptoms on daily functioning.</p><p><strong>Limitations: </strong>Cross-sectional design and data collection in a single mental health service.</p><p><strong>Conclusions: </strong>The HCL-33 may be a useful tool to improve diagnostics, especially in adolescents with depressive symptoms additionally presenting with anxious symptoms and conduct problems.</p>","PeriodicalId":13944,"journal":{"name":"International Journal of Bipolar Disorders","volume":"12 1","pages":"28"},"PeriodicalIF":2.8,"publicationDate":"2024-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11306698/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141901701","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}
引用次数: 0
The perceived social support of parents having bipolar disorder impacts their children’s mental health: a 10-year longitudinal study 双相情感障碍父母的社会支持感知对子女心理健康的影响:一项为期 10 年的纵向研究
IF 4 2区 医学
International Journal of Bipolar Disorders Pub Date : 2024-07-27 DOI: 10.1186/s40345-024-00349-4
Florencia Trespalacios, Ariel Boyle, Lisa Serravalle, Sheilagh Hodgins, Mark A. Ellenbogen
{"title":"The perceived social support of parents having bipolar disorder impacts their children’s mental health: a 10-year longitudinal study","authors":"Florencia Trespalacios, Ariel Boyle, Lisa Serravalle, Sheilagh Hodgins, Mark A. Ellenbogen","doi":"10.1186/s40345-024-00349-4","DOIUrl":"https://doi.org/10.1186/s40345-024-00349-4","url":null,"abstract":"The offspring of parents with bipolar disorder (OBD) are at higher risk of developing psychopathology than the offspring of parents with no affective disorder (control). In addition to genetic predisposition, childhood adversity and a stressful family environment are important risk factors for the OBD. Protective factors in parents, such as social support and coping strategies, may buffer the effects of stress on at-risk children. This study tested whether parents’ social support and coping style attenuated the link between risk status (OBD vs. control) and psychopathology in offspring. During offspring’s middle childhood, parents underwent a diagnostic interview and completed social support and coping style questionnaires. Sixty-nine OBD (39 female) and 69 control (29 female) offspring between ages 13 and 29 completed a diagnostic interview approximately 10 years later. Parents’ social support satisfaction moderated the link between offspring risk status and their development of substance use disorder (SUD) symptoms (F(1,131) = 5.90, p = .017). Parents’ social network size moderated the link between offspring risk status and their development of anxiety and depression symptoms in an unexpected direction (F(1,131) = 5.07, p = .026). No effects of parents’ coping style were found. Among the OBD, having parents with greater social support satisfaction and, unexpectedly, a smaller social network buffered their development of SUD and depression and anxiety symptoms by early adulthood. Parents’ social support may thus have a protective function for children in these high-risk families.","PeriodicalId":13944,"journal":{"name":"International Journal of Bipolar Disorders","volume":"1 1","pages":""},"PeriodicalIF":4.0,"publicationDate":"2024-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141783545","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}
引用次数: 0
Correction: Overview of lithium's use: a nationwide survey. 更正:锂的使用概况:一项全国性调查。
IF 2.8 2区 医学
International Journal of Bipolar Disorders Pub Date : 2024-07-25 DOI: 10.1186/s40345-024-00343-w
Xabier Pérez de Mendiola, Diego Hidalgo-Mazzei, Eduard Vieta, Ana González-Pinto
{"title":"Correction: Overview of lithium's use: a nationwide survey.","authors":"Xabier Pérez de Mendiola, Diego Hidalgo-Mazzei, Eduard Vieta, Ana González-Pinto","doi":"10.1186/s40345-024-00343-w","DOIUrl":"10.1186/s40345-024-00343-w","url":null,"abstract":"","PeriodicalId":13944,"journal":{"name":"International Journal of Bipolar Disorders","volume":"12 1","pages":"26"},"PeriodicalIF":2.8,"publicationDate":"2024-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11269530/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141758506","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}
引用次数: 0
Correction: Type of cycle, temperament and childhood trauma are associated with lithium response in patients with bipolar disorders. 更正:躁郁症患者的周期类型、气质和童年创伤与锂反应有关。
IF 2.8 2区 医学
International Journal of Bipolar Disorders Pub Date : 2024-07-11 DOI: 10.1186/s40345-024-00347-6
Delfina Janiri, Alessio Simonetti, Mario Luciano, Silvia Montanari, Evelina Bernardi, Giuseppe Carrà, Andrea Fiorillo, Gabriele Sani
{"title":"Correction: Type of cycle, temperament and childhood trauma are associated with lithium response in patients with bipolar disorders.","authors":"Delfina Janiri, Alessio Simonetti, Mario Luciano, Silvia Montanari, Evelina Bernardi, Giuseppe Carrà, Andrea Fiorillo, Gabriele Sani","doi":"10.1186/s40345-024-00347-6","DOIUrl":"10.1186/s40345-024-00347-6","url":null,"abstract":"","PeriodicalId":13944,"journal":{"name":"International Journal of Bipolar Disorders","volume":"12 1","pages":"24"},"PeriodicalIF":2.8,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11239618/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141590263","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}
引用次数: 0
The influence of PER3 VNTR genotypes on the age of onset in a group of bipolar I disorder patients: an exploratory study. PER3 VNTR基因型对一组双相情感障碍 I 患者发病年龄的影响:一项探索性研究。
IF 2.8 2区 医学
International Journal of Bipolar Disorders Pub Date : 2024-07-11 DOI: 10.1186/s40345-024-00346-7
Tommaso Barlattani, Bettina Soltmann, Chiara D'Amelio, Valentina Socci, Francesca Pacitti, Maurizio Pompili, Philipp Ritter
{"title":"The influence of PER3 VNTR genotypes on the age of onset in a group of bipolar I disorder patients: an exploratory study.","authors":"Tommaso Barlattani, Bettina Soltmann, Chiara D'Amelio, Valentina Socci, Francesca Pacitti, Maurizio Pompili, Philipp Ritter","doi":"10.1186/s40345-024-00346-7","DOIUrl":"10.1186/s40345-024-00346-7","url":null,"abstract":"<p><strong>Background: </strong>PER3 is a circadian gene that contains a variable number of tandem repeats (VNTR) which codifies for three genotypes: 4/4; 4/5; and 5/5 and is involved in non-visual response to light, a critical process associated with bipolar disorder onset. Benedetti et al. (Neurosci Lett 445(2):184-7) related this VNTR with bipolar disorder age of onset and linked genotype 5/5 with an earlier onset. In this study, we aimed to investigate these associations of PER3 VNTR genotypes with age of onset in a homogenous sample of German patients with bipolar I disorder through Kaplan-Meier curves.</p><p><strong>Methods: </strong>45 patients were enrolled and divided into three groups according to PER3 VNTR genotypes. Recognizing common biological features, we built a combined group of -5 allele carriers (4/5 + 5/5). As a primary outcome, Kaplan-Meier analysis was conducted to delineate the three genotypes' influence on age of onset. The secondary Kaplan-Meier analysis aimed to evaluate the relation between the 4/4 homozygotes group and the combined group (4/5 + 5/5) with age of onset. Finally, we proceeded to compare groups through a Log Rank Test and performed an analysis of covariance (ANCOVA).</p><p><strong>Results: </strong>The Kaplan-Meier analysis with three separate genotypes didn't replicate the findings of Benedetti's study. The analysis comparing genotype 4/4 with the combined group showed the influence of PER3 VNTR variants on the age of onset and relates genotype 4/4 to an earlier onset. ANCOVA between the combined and the 4/4 genotype groups, correlated genotype 4/4 with an increased number of depressive episodes.</p><p><strong>Conclusion: </strong>This study showed no significant effect of PER3 VNTR genotypes on the age of onset and in linking genotype 5/5 with an earlier onset age. Contrasting results may arise from intrinsic differences between the two studies but also shed light on hypothetically different levels of functioning of PER3 VNTR genotypes in the context of bipolar pathology. Further studies will require bigger and more homogeneous clinical samples.</p>","PeriodicalId":13944,"journal":{"name":"International Journal of Bipolar Disorders","volume":"12 1","pages":"25"},"PeriodicalIF":2.8,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11239620/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141590293","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}
引用次数: 0
Lithium and its effects: does dose matter? 锂及其影响:剂量重要吗?
IF 2.8 2区 医学
International Journal of Bipolar Disorders Pub Date : 2024-06-24 DOI: 10.1186/s40345-024-00345-8
Mirko Manchia, Pasquale Paribello, Martina Pinna, Luca Steardo, Bernardo Carpiniello, Federica Pinna, Claudia Pisanu, Alessio Squassina, Tomas Hajek
{"title":"Lithium and its effects: does dose matter?","authors":"Mirko Manchia, Pasquale Paribello, Martina Pinna, Luca Steardo, Bernardo Carpiniello, Federica Pinna, Claudia Pisanu, Alessio Squassina, Tomas Hajek","doi":"10.1186/s40345-024-00345-8","DOIUrl":"10.1186/s40345-024-00345-8","url":null,"abstract":"<p><strong>Background: </strong>Decades of clinical research have demonstrated the efficacy of lithium in treating acute episodes (both manic and depressive), as well as in preventing recurrences of bipolar disorder (BD). Specific to lithium is its antisuicidal effect, which appears to extend beyond its mood-stabilizing properties. Lithium's clinical effectiveness is, to some extent, counterbalanced by its safety and tolerability profile. Indeed, monitoring of lithium levels is required by its narrow therapeutic index. There is consensus that adequate serum levels should be above 0.6 mEq/L to achieve clinical effectiveness. However, few data support the choice of this threshold, and increasing evidence suggests that lithium might have clinical and molecular effects at much lower concentrations.</p><p><strong>Content: </strong>This narrative review is aimed at: (1) reviewing and critically interpreting the clinical evidence supporting the use of the 0.6 mEq/L threshold, (2) reporting a narrative synthesis of the evidence supporting the notion that lithium might be effective in much lower doses. Among these are epidemiological studies of lithium in water, evidence on the antisuicidal, anti-aggressive, and neuroprotective effects, including efficacy in preventing cognitive impairment progression, Alzheimer's disease (AD), and amyotrophic lateral sclerosis (ALS), of lithium; and (3) revieweing biological data supporting clinically viable uses of lithium at low levels with the delineation of a mechanistic hypothesis surrounding its purported mechanism of action. The study selection was based on the authors' preference, reflecting the varied and extensive expertise on the review subject, further enriched with an extensive pearl-growing strategy for relevant reviews and book sections.</p><p><strong>Conclusions: </strong>Clinical and molecular effects of lithium are numerous, and its effects also appear to have a certain degree of specificity related to the dose administered. In sum, the clinical effects of lithium are maximal for mood stabilisation at concentrations higher than 0.6 mEq/l. However, lower levels may be sufficient for preventing depressive recurrences in older populations of patients, and microdoses could be effective in decreasing suicide risk, especially in patients with BD. Conversely, lithium's ability to counteract cognitive decline appears to be exerted at subtherapeutic doses, possibly corresponding to its molecular neuroprotective effects. Indeed, lithium may reduce inflammation and induce neuroprotection even at doses several folds lower than those commonly used in clinical settings. Nevertheless, findings surrounding its purported mechanism of action are missing, and more research is needed to investigate the molecular targets of low-dose lithium adequately.</p>","PeriodicalId":13944,"journal":{"name":"International Journal of Bipolar Disorders","volume":"12 1","pages":"23"},"PeriodicalIF":2.8,"publicationDate":"2024-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11196441/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141446112","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}
引用次数: 0
The research landscape of bipolar disorder in Germany: productive, but underfunded. 德国双相情感障碍的研究现状:成果丰硕,但资金不足。
IF 4 2区 医学
International Journal of Bipolar Disorders Pub Date : 2024-06-15 DOI: 10.1186/s40345-024-00344-9
Cindy Eckart, Andreas Reif
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