International Journal of Bipolar Disorders最新文献

{"title":"Psychotic features, particularly mood incongruence, as a hallmark of severity of bipolar I disorder.","authors":"Julien Elowe,&nbsp;Julie Vallat,&nbsp;Enrique Castelao,&nbsp;Marie-Pierre F Strippoli,&nbsp;Mehdi Gholam,&nbsp;Setareh Ranjbar,&nbsp;Jennifer Glaus,&nbsp;Kathleen Merikangas,&nbsp;Benjamin Lavigne,&nbsp;Pierre Marquet,&nbsp;Martin Preisig,&nbsp;Caroline L Vandeleur","doi":"10.1186/s40345-022-00280-6","DOIUrl":"https://doi.org/10.1186/s40345-022-00280-6","url":null,"abstract":"<p><strong>Background: </strong>The occurrence of psychotic features within mood episodes in patients with bipolar I disorder (BD I) has been associated in some studies with a more severe clinical and socio-professional profile. In contrast, other studies establishing the associations of psychotic features in BD I, and in particular of mood-congruent (MC) and mood-incongruent (MI) features, with clinical characteristics have yielded contradictory results. However, many pre-existing studies have been affected by serious methodological limitations. Using a sample of thoroughly assessed patients with BD I our aims were to: (1) establish the proportion of those with MI and MC features, and (2) compare BD I patients with and without psychotic features as well as those with MI to those with MC features on a wide array of socio-demographic and clinical characteristics including course, psychiatric comorbidity and treatment.</p><p><strong>Methods: </strong>A sample of 162 treated patients with BD I (60.5% female, mean age = 41.4 (s.d: 10.2) years) was recruited within a large family study of mood disorders. Clinical, course and treatment characteristics relied on information elicited through direct diagnostic interviews, family history reports and medical records.</p><p><strong>Results: </strong>(1) A total of 96 patients (59.3%) had experienced psychotic features over their lifetime. Among them, 44.8% revealed MI features at least once in their lives. (2) Patients with psychotic features were much less likely to be professionally active, revealed alcohol abuse more frequently and used health care, particularly inpatient treatment, more frequently than those without psychotic features. Within patients with psychotic symptoms, those with MI features showed more clinical severity in terms of a higher likelihood of reporting hallucinations, suicidal attempts and comorbid cannabis dependence.</p><p><strong>Conclusion: </strong>Our data provide additional support for both the distinction between BD-I with and without psychotic features as well as the distinction between MI and MC psychotic features. The more severe course of patients with psychotic features, and particularly those with MI psychotic features, highlights the need for thorough psychopathological evaluations to assess the presence of these symptoms to install appropriate treatment.</p>","PeriodicalId":13944,"journal":{"name":"International Journal of Bipolar Disorders","volume":null,"pages":null},"PeriodicalIF":4.0,"publicationDate":"2022-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9760584/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10391020","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 bipolar two-syndrome concept: questioning the shaping of a circular argument for subtyping a dimensional disorder.","authors":"Gin S Malhi,&nbsp;Erica Bell","doi":"10.1186/s40345-022-00278-0","DOIUrl":"https://doi.org/10.1186/s40345-022-00278-0","url":null,"abstract":"","PeriodicalId":13944,"journal":{"name":"International Journal of Bipolar Disorders","volume":null,"pages":null},"PeriodicalIF":4.0,"publicationDate":"2022-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9760581/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10391019","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 course of psychiatric symptoms in older age bipolar disorder during the COVID-19 pandemic.","authors":"Melis Orhan, Nicole Korten, Almar Kok, Dore Loef, Ralph Kupka, Sigfried Schouws, Patricia van Oppen, Annemiek Dols","doi":"10.1186/s40345-022-00274-4","DOIUrl":"10.1186/s40345-022-00274-4","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic gives us the unique opportunity to study the course of psychiatric symptoms and resilience in older adults with bipolar disorder (OABD) whilst experiencing a collective long lasting stressor. The aim of this study was to investigate the course of depressive, manic and anxiety symptoms in OABD during the first six months of COVID-19 and how loneliness and mastery are associated with this course. Mastery is defined as the control one experiences over one's life and environment. Resilience is defined as adaptation to challenging life conditions encompassing several aspects of personal resources.</p><p><strong>Methods: </strong>In April 2020 (n = 81), June 2020 (n = 66) and September 2020 (n = 51), participants were included from the Dutch Older Bipolars (DOBi) cohort study.</p><p><strong>Results: </strong>Depressive, manic and anxiety symptoms increased over all timepoints. Participants with a higher sense of mastery experienced a greater increase in depressive and anxiety symptoms. Loneliness did not interact with the course of these symptoms.</p><p><strong>Conclusions: </strong>OABD were resilient in the first months of COVID-19 outbreak, however depressive, manic and anxiety symptoms increased as the pandemic continued. Treatment strategies in coping with long lasting stressful events should include the focus on sense of mastery.</p>","PeriodicalId":13944,"journal":{"name":"International Journal of Bipolar Disorders","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2022-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9727013/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10369989","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":"Familial load of psychiatric disorders and overall functioning in patients newly diagnosed with bipolar disorder and their unaffected first-degree relatives.","authors":"Kimie Stefanie Ormstrup Sletved,&nbsp;Katrine Maiggaard,&nbsp;Anne Amalie Elgaard Thorup,&nbsp;Lars Vedel Kessing,&nbsp;Maj Vinberg","doi":"10.1186/s40345-022-00277-1","DOIUrl":"https://doi.org/10.1186/s40345-022-00277-1","url":null,"abstract":"<p><strong>Background: </strong>Overall functioning is already impaired in patients newly diagnosed with bipolar disorder (BD) and, to a lesser degree, also in their unaffected first-degree relatives (UR). Further, aggregation of psychiatric disorders among the patients' first-degree relatives seems to be associated with higher illness burden and poorer prognosis. However, whether this aggregation of psychiatric disorders among first-degree relatives, the familial load (FL), impacts overall functioning in patients newly diagnosed with BD and their UR remains unresolved.</p><p><strong>Methods: </strong>In total, 388 patients newly diagnosed with BD, 144 of their UR and 201 healthy control individuals were included. Overall functioning was assessed using three different assessment methods: The interviewer based \"Functioning Assessment Short Test\" (FAST), the questionnaire \"Work and Social Adjustment Scale\" (WSAS) and six outcome measures covering the participants' socio-economic status (SES); educational achievement, employment, work ability, relationship, cohabitation and marital status. Familial load of psychiatric disorder was assessed using the \"Family History Research Diagnostic Criteria\" interview. Associations between FL and overall functioning in patients and UR were investigated categorically using logistic and continuously in linear regression models.</p><p><strong>Results: </strong>Contrasting with the hypotheses, the FL of psychiatric disorders was not associated with impaired overall functioning, neither in patients newly diagnosed with BD nor in their UR.</p><p><strong>Conclusion: </strong>The findings indicate that impaired functioning in the early phase of BD is not associated with aggregation of psychiatric disorders among first-degree relatives. The observed functional impairment in patients newly diagnosed with BD seems driven by the personal impact of the disorder rather than the impact of having first-degree relatives with psychiatric disorders.</p>","PeriodicalId":13944,"journal":{"name":"International Journal of Bipolar Disorders","volume":null,"pages":null},"PeriodicalIF":4.0,"publicationDate":"2022-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9723061/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35209930","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: New vision on the mental problems of Vincent van Gogh; results from a bottom-up approach using (semi-)structured diagnostic interviews.","authors":"Willem A Nolen,&nbsp;Erwin van Meekeren,&nbsp;Piet Voskuil,&nbsp;Willem van Tilburg","doi":"10.1186/s40345-022-00273-5","DOIUrl":"https://doi.org/10.1186/s40345-022-00273-5","url":null,"abstract":"","PeriodicalId":13944,"journal":{"name":"International Journal of Bipolar Disorders","volume":null,"pages":null},"PeriodicalIF":4.0,"publicationDate":"2022-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9663767/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40474962","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 physically active lifestyle is associated with lower long-term incidence of bipolar disorder in a population-based, large-scale study.","authors":"Martina Svensson,&nbsp;Sophie Erhardt,&nbsp;Ulf Hållmarker,&nbsp;Stefan James,&nbsp;Tomas Deierborg","doi":"10.1186/s40345-022-00272-6","DOIUrl":"https://doi.org/10.1186/s40345-022-00272-6","url":null,"abstract":"<p><strong>Background: </strong>Physical activity has been proposed to be beneficial for the symptomatic control of bipolar disorder, but the duration of the effects, sex-specific mechanisms, and impact of exercise intensity are not known.</p><p><strong>Method: </strong>With an observational study design, we followed skiers and age and sex-matched non-skiers from the general population to investigate if participation in a long-distance cross-country ski race (Vasaloppet) was associated with a lower risk of getting diagnosed with bipolar disorder. Using the Swedish population and patient registries, skiers in Vasaloppet and age and sex-matched non-skiers from the general population were analyzed for any diagnosis of bipolar disorder after participation in the race. Additionally, we used finishing time of the ski race as a proxy for intensity levels to investigate if exercise intensity impacts the risk of bipolar disorder among the physically active skiers.</p><p><strong>Results: </strong>Previous participation in a long distance ski race (n = 197,685, median age 36 years, 38% women) was associated with a lower incidence of newly diagnosed bipolar compared to an age and sex-matched general population (n = 197,684) during the up to 21 years follow-up (adjusted hazard ratio, HR = 0.48). The finishing time of the race did not significantly impact the risk of bipolar disorder in men. Among women, high performance (measured as the finishing time to complete the race, a proxy for higher exercise dose) was associated with an increased risk of bipolar disorder compared to slower skiing women (HR = 2.07).</p><p><strong>Conclusions: </strong>Our results confirm that a physically active lifestyle is associated with a lower risk of developing bipolar disorder. Yet, to elucidate the direction of causality in this relationship requires complementary study designs. And the influence of physical performance level on the risk of bipolar disorder warrants further examinations among women.</p>","PeriodicalId":13944,"journal":{"name":"International Journal of Bipolar Disorders","volume":null,"pages":null},"PeriodicalIF":4.0,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9622955/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40446843","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 interplay of daily affect and impulsivity measured by mobile surveys in bipolar disorder.","authors":"Madison K Titone,&nbsp;Colin Depp,&nbsp;Federica Klaus,&nbsp;Jessica Carrasco,&nbsp;Jared W Young,&nbsp;Lisa T Eyler","doi":"10.1186/s40345-022-00270-8","DOIUrl":"https://doi.org/10.1186/s40345-022-00270-8","url":null,"abstract":"<p><strong>Background: </strong>Impulsivity is a prominent feature of bipolar disorder associated with various negative sequelae; moreover, it may be a precursor to shifts in affect or mood, but little is known about its association with affect on a day-to-day timescale. Ecological momentary assessments (a method that captures moment-to-moment ratings of psychological states by repeatedly sampling the same individual) of impulsivity and affect using mobile surveys allow for more nuanced examination of mechanisms of mood and behavior dysregulation. However, few existing studies have validated an ecological momentary assessment of impulsivity in bipolar disorder and examined its time-lagged associations with positive and negative affect. 70 participants with bipolar disorder and 102 healthy comparisons participated in an intensive longitudinal study: they underwent 14 days of ecological momentary assessment data collection annually for 1-4 years. Multiple measures of impulsivity and affect were collected using self-report, behavioral, and ecological momentary assessment modalities; these measures were compared, and levels of impulsivity were compared between bipolar disorder and healthy comparison groups. Time-lagged analyses using daily means explored the next-day predictive relationship of impulsivity on positive/negative affect, and vice versa.</p><p><strong>Results: </strong>The ecological momentary measure of impulsivity was moderately correlated with the self-report but not behavioral impulsivity measure. Bipolar disorder participants evinced higher self-report, behavioral, and daily impulsivity than healthy comparison participants. Time-lagged analyses revealed a bi-directional association between high impulsivity and high next-day negative (but not positive) affect. Post hoc analyses showed that impulsivity specifically predicted next-day anger and anxiety.</p><p><strong>Conclusions: </strong>Our multimodal assessment of impulsivity allowed for an examination of the day-to-day course of impulsivity and affect, crucial steps toward understanding the mechanisms of mood symptom and episode onset in bipolar disorder.</p>","PeriodicalId":13944,"journal":{"name":"International Journal of Bipolar Disorders","volume":null,"pages":null},"PeriodicalIF":4.0,"publicationDate":"2022-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9618470/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40655307","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 adjunctive therapy to lamotrigine, lithium, or valproate monotherapy in bipolar depression: a systematic review and meta-analysis of randomized controlled trials.","authors":"Taku Maruki,&nbsp;Tomohiro Utsumi,&nbsp;Masahiro Takeshima,&nbsp;Yu Fujiwara,&nbsp;Marie Matsui,&nbsp;Yumi Aoki,&nbsp;Hiroyuki Toda,&nbsp;Norio Watanabe,&nbsp;Koichiro Watanabe,&nbsp;Yoshikazu Takaesu","doi":"10.1186/s40345-022-00271-7","DOIUrl":"https://doi.org/10.1186/s40345-022-00271-7","url":null,"abstract":"<p><strong>Background: </strong>The efficacy and safety of adjunctive therapy are unclear in bipolar depression. In this systematic review and meta-analysis, we aimed to evaluate the efficacy and safety of second-generation antipsychotic, lamotrigine, lithium, or valproate therapy used in adjunction with lamotrigine, lithium, or valproate monotherapy in bipolar depression. A literature search of major electronic databases was conducted in February 2021, and all articles published until then were eligible. Two researchers independently screened relevant publications, extracted data, and evaluated methodological quality according to the Cochrane criteria.</p><p><strong>Results: </strong>Five studies met the inclusion criteria. The meta-analysis revealed significant differences in the following outcomes: (i) remission rates from depressive episodes (risk ratio [RR]: 1.23, 95% confidence interval [CI] 1.01-1.50, p = 0.04), (ii) improvement in depressive symptoms (standardized mean difference [SMD]: 0.21, 95% CI 0.09-0.34, p = 0.001), (iii) improvement in quality of life (SMD: 0.22, 95% CI 0.06-0.37, p = 0.005), and (iv) rate of adverse events during the study period (RR: 1.12, 95% CI 1.03-1.22, p = 0.008). There was no significant difference between adjunctive therapy and monotherapy in the emergence of suicide-related behaviors, dropout rate during the study period, or rate of manic switching.</p><p><strong>Conclusions: </strong>Our results suggest that adjunctive second-generation antipsychotics, lamotrigine, lithium, or valproate increase both the benefits and risks in patients with bipolar depression, although there is no significant difference in severe adverse events. Adjunctive therapy should be provided through shared decision-making while considering the patients' condition in clinical settings.</p>","PeriodicalId":13944,"journal":{"name":"International Journal of Bipolar Disorders","volume":null,"pages":null},"PeriodicalIF":4.0,"publicationDate":"2022-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9587199/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40564331","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":"Clinical research diagnostic criteria for bipolar illness (CRDC-BP): rationale and validity.","authors":"S Nassir Ghaemi,&nbsp;Jules Angst,&nbsp;Paul A Vohringer,&nbsp;Eric A Youngstrom,&nbsp;James Phelps,&nbsp;Philip B Mitchell,&nbsp;Roger S McIntyre,&nbsp;Michael Bauer,&nbsp;Eduard Vieta,&nbsp;Samuel Gershon","doi":"10.1186/s40345-022-00267-3","DOIUrl":"https://doi.org/10.1186/s40345-022-00267-3","url":null,"abstract":"<p><strong>Background: </strong>In the 1970 s, scientific research on psychiatric nosology was summarized in Research Diagnostic Criteria (RDC), based solely on empirical data, an important source for the third revision of the official nomenclature of the American Psychiatric Association in 1980, the Diagnostic and Statistical Manual, Third Edition (DSM-III). The intervening years, especially with the fourth edition in 1994, saw a shift to a more overtly \"pragmatic\" approach to diagnostic definitions, which were constructed for many purposes, with research evidence being only one consideration. The latest editions have been criticized as failing to be useful for research. Biological and clinical research rests on the validity of diagnostic definitions that are supported by firm empirical foundations, but critics note that DSM criteria have failed to prioritize research data in favor of \"pragmatic\" considerations.</p><p><strong>Results: </strong>Based on prior work of the International Society for Bipolar Diagnostic Guidelines Task Force, we propose here Clinical Research Diagnostic Criteria for Bipolar Illness (CRDC-BP) for use in research studies, with the hope that these criteria may lead to further refinement of diagnostic definitions for other major mental illnesses in the future. New proposals are provided for mixed states, mood temperaments, and duration of episodes.</p><p><strong>Conclusions: </strong>A new CRDC could provide guidance toward an empirically-based, scientific psychiatric nosology, and provide an alternative clinical diagnostic approach to the DSM system.</p>","PeriodicalId":13944,"journal":{"name":"International Journal of Bipolar Disorders","volume":null,"pages":null},"PeriodicalIF":4.0,"publicationDate":"2022-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9561456/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33504833","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 mindfulness-based cognitive therapy on rumination and a task-based measure of intrusive thoughts in patients with bipolar disorder.","authors":"Jelle Lubbers,&nbsp;Dirk Geurts,&nbsp;Imke Hanssen,&nbsp;Marloes Huijbers,&nbsp;Jan Spijker,&nbsp;Anne Speckens,&nbsp;Mira Cladder-Micus","doi":"10.1186/s40345-022-00269-1","DOIUrl":"https://doi.org/10.1186/s40345-022-00269-1","url":null,"abstract":"<p><strong>Background: </strong>Preliminary evidence suggests that Mindfulness-Based Cognitive Therapy (MBCT) is a promising treatment for bipolar disorder (BD). A proposed working mechanism of MBCT in attenuating depressive symptoms is reducing depressive rumination. The primary aim of this study was to investigate the effect of MBCT on self-reported trait depressive rumination and an experimental state measure of negative intrusive thoughts in BD patients. Exploratively, we investigated the effect of MBCT on positive rumination and positive intrusive thoughts.</p><p><strong>Methods: </strong>The study population consisted of a subsample of bipolar type I or II patients participating in a multicenter randomized controlled trial comparing MBCT + treatment as usual (TAU) (N = 25) to TAU alone (N = 24). Trait depressive rumination (RRS brooding subscale) and intrusive thoughts (breathing focus task (BFT)) were assessed at baseline (full subsample) and post-treatment (MBCT + TAU; n = 15, TAU; n = 15). During the BFT, participants were asked to report negative, positive and neutral intrusive thoughts while focusing on their breathing.</p><p><strong>Results: </strong>Compared to TAU alone, MBCT + TAU resulted in a significant pre- to post-treatment reduction of trait depressive rumination (R² = .16, F(1, 27) = 5.15, p = 0.031; medium effect size (f² = 0.19)) and negative intrusive thoughts on the BFT (R² = .15, F(1, 28) = 4.88, p = 0.036; medium effect size (f² = 0.17)). MBCT did not significantly change positive rumination or positive intrusive thoughts.</p><p><strong>Conclusions: </strong>MBCT might be a helpful additional intervention to reduce depressive rumination in BD which might reduce risk of depressive relapse or recurrence. Considering the preliminary nature of our findings, future research should replicate our findings and explore whether this reduction in rumination following MBCT indeed mediates a reduction in depressive symptoms and relapse or recurrence in BD.</p>","PeriodicalId":13944,"journal":{"name":"International Journal of Bipolar Disorders","volume":null,"pages":null},"PeriodicalIF":4.0,"publicationDate":"2022-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9374865/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40624158","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}