Bipolar Disorders最新文献

{"title":"Developing a Decision Support Tool to Guide Shared Decision-Making in Bipolar Depression Treatment: Results From a Collaboration Between Clinicians and People With Lived Experience.","authors":"Manuel Fuentes-Salgado, Manuel Gardea-Resendez, Andrew Smith, Angie Lam, Kimberly Allen, Mete Ercis, Ashley Kremin, Jeremiah B Joyce, Jin Hong Park, Nicola Keeth, Katherine Moore, Hannah Betcher, Padao Yang, Jonathan G Leung, Aysegul Ozerdem, Samuel T Savitz, Mark D Williams, Victor M Montori, Pollock Michael, Mark A Frye","doi":"10.1111/bdi.70037","DOIUrl":"https://doi.org/10.1111/bdi.70037","url":null,"abstract":"<p><strong>Objective: </strong>To build consensus from different stakeholders on the content and digital interactivity of a shared decision making (SDM) tool to guide patient-clinician collaborative conversations about treatment for bipolar depression.</p><p><strong>Patients and methods: </strong>This study was conducted between September 2022 and September 2023. In the first phase, we conducted a narrative review on pharmacological, neuromodulatory, and psychotherapeutic treatments available for bipolar depression. For each option, we assessed treatment effectiveness, side effects, need for clinical monitoring, clinical considerations, and cost. In the second phase, committees comprised of mental health clinicians and people with lived experience with bipolar disorder from a national mood disorders advocacy group identified key features and content to be included in the SDM tool. A thematic analysis of these data then contributed to populate the SDM tool.</p><p><strong>Results: </strong>Twenty-one evidence-based treatment options identified from the narrative review were presented to the four convened committees (clinical, lived experience, peer council, and integrated steering committees) in five meetings. After discussions and thematic analysis, 12 outcomes of interest for each of the therapeutic interventions were delineated for inclusion in a web-based SDM tool. A detailed description of the development process and SDM tool is provided.</p><p><strong>Conclusion: </strong>This is the first partnership between clinicians and persons with bipolar disorder lived experience charged with the development of a patient-centered SDM tool to integrate clinical evidence with real-world clinical practice and patient preferences for use during clinical encounters. Human-centered design and testing in real clinical encounters will now contribute to refining the instrument and readying it for rigorous evaluation and implementation in practice.</p>","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144257285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Popularity Is Not Consensus.","authors":"Sergio Strejilevich, Cecilia Samamé, Danilo Quiroz","doi":"10.1111/bdi.70036","DOIUrl":"https://doi.org/10.1111/bdi.70036","url":null,"abstract":"","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144126574","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assisted Dying in the Context of Depression: A Consequential Matter Warranting Systematic Research?","authors":"Gin S Malhi","doi":"10.1111/bdi.70035","DOIUrl":"https://doi.org/10.1111/bdi.70035","url":null,"abstract":"","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144109637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of Refractory Catatonia Associated With OCD Exacerbation in a Patient With Bipolar I Disorder: A Case Report.","authors":"Jiyun Lee, Rahat Hossain, Nikola Grujich, Ayal Schaffer","doi":"10.1111/bdi.70034","DOIUrl":"https://doi.org/10.1111/bdi.70034","url":null,"abstract":"","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143972611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Towards a Better Understanding of the Lived Experience of Carers of People With Bipolar Disorder: A Mixed-Methods Study.","authors":"Juliet Robinson, Bronte Speirs, Frances Kay-Lambkin, Tanya Hanstock","doi":"10.1111/bdi.70033","DOIUrl":"https://doi.org/10.1111/bdi.70033","url":null,"abstract":"<p><strong>Background: </strong>Caring for someone with Bipolar disorder (BD) is unique, and the severity and complexity of symptoms can overwhelm informal carers such as family, friends, and partners.</p><p><strong>Aim: </strong>This study employed a concurrent mixed-methods model to investigate the lived experience of informal carers caring for those with BD in Australia.</p><p><strong>Methods: </strong>Participants (n = 46) answered an online survey containing standardised measures of quality of life and coping mechanisms as well as open-ended questions about their caring role challenges and support.</p><p><strong>Results: </strong>Carers reported mental health problems as the highest care-related burden and reported low perceived social support. However, a one-way MANOVA indicated no difference in these dimensions between carers of people with BD I and II. Reflexive thematic analysis revealed five superordinate themes relating to informal caregivers' challenges, coping strategies, and the support they need. The themes were: like a roller-coaster; carer mental health; complexities of the carer role and diagnosis; how to cope; and multifaceted support. The oscillation of symptoms and complexities of the caring role increased the burden on carers and created mental health challenges, requiring carers to use various coping strategies. Findings highlight the need for individualised, multimodal support for carers.</p><p><strong>Conclusion: </strong>Carers need adequate and accessible support through strong partnerships with healthcare providers to improve their own quality of life and mental health and, in turn, those in their care.</p>","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143976601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Conundrum: SSRI Emergent Hypomania, a Turn in the Road to Bipolarity?","authors":"Matthew Cohen, Prateek Varshney, Jasmine Ronsisvalle, Violeta Perez-Rodriguez","doi":"10.1111/bdi.70031","DOIUrl":"https://doi.org/10.1111/bdi.70031","url":null,"abstract":"","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143977476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is Postpartum Bipolar Disorder a Distinct Diagnostic Entity?","authors":"Verinder Sharma, Katelyn N Wood, Boseok Cha, Dwight Mazmanian","doi":"10.1111/bdi.70032","DOIUrl":"https://doi.org/10.1111/bdi.70032","url":null,"abstract":"","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143958285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Plasma Glial Fibrillary Acidic Protein and Neurofilament Light Are Elevated in Bipolar Depression: Evidence for Neuroprogression and Astrogliosis.","authors":"Matthew J Y Kang, Dhamidhu Eratne, Olivia Dean, Michael Berk, Adam J Walker, Cassandra Wannan, Charles B Malpas, Claudia Cicognola, Shorena Janelidze, Oskar Hansson, Jasleen Grewal, Philip B Mitchell, Malcolm Hopwood, Christos Pantelis, Alexander F Santillo, Dennis Velakoulis","doi":"10.1111/bdi.70029","DOIUrl":"https://doi.org/10.1111/bdi.70029","url":null,"abstract":"<p><strong>Background: </strong>Recent advances now allow detection of brain-specific proteins in blood, including neurofilament light chain (NfL), a marker of axonal pathology, and glial fibrillary acidic protein (GFAP), indicative of astrocytic activation. Given the evidence of astroglial pathology and neuronal dysfunction in bipolar disorder, and ongoing debates on neuroprogression, we investigated plasma NfL and GFAP levels in affected individuals.</p><p><strong>Methods: </strong>This study analysed plasma NfL and GFAP measured in 216 individuals using Simoa. We used bootstrapped general linear models (GLM) to compare plasma NfL and GFAP levels between people with bipolar depression (n = 120) and healthy controls (n = 96), adjusting for age, sex, and weight. We examined associations between these biomarkers and clinical variables while adjusting for multiple comparisons. For sensitivity analyses, predictors were evaluated using Bayesian model averaging (BMA).</p><p><strong>Results: </strong>Plasma GFAP (β = 0.21 [0.07, 0.35], p = 0.006) and NfL (β = 0.06 [0.01, 0.10], p = 0.028) were elevated in people with bipolar depression. Illness duration was positively associated with NfL (r = 2.97, p = 0.002), and further supported by BMA analysis (posterior inclusion probability, PIP = 0.85). Age of onset was positively associated with GFAP (r = 0.246 p = 0.041), which was also supported by BMA analysis (PIP = 0.67).</p><p><strong>Conclusions: </strong>These findings indicate increased plasma NfL and GFAP levels in bipolar disorder. Our findings support the neuroprogression hypothesis, where prolonged illness duration contributes to neuroaxonal damage. Elevated GFAP in those with later onset suggests a role for neuroinflammation, potentially linked to increased cardiovascular and metabolic comorbidities.</p>","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143971834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is Theta Burst Stimulation Ready as a Clinical Treatment for Bipolar Disorder?","authors":"Yufei Wu, Danni Yan, Jianli Yang","doi":"10.1111/bdi.70025","DOIUrl":"https://doi.org/10.1111/bdi.70025","url":null,"abstract":"<p><strong>Background: </strong>To date, no studies have investigated the efficacy of theta burst stimulation (TBS) in the treatment of bipolar disorder (BD), and the results are inconclusive.</p><p><strong>Objective: </strong>We aim to systematically review the existing literature related to the efficacy of TBS in BD and synthesize the results through meta-analysis.</p><p><strong>Methods: </strong>We searched for PubMed, Embase, Cochrane Central Register of Controlled Trials, Web of science, PsycINFO, CNKI, and Wan fang databases without language restriction through July 30, 2023, and included randomized-controlled trials that assessed the treatment effect of TBS in patients with BD. We used a random-effects model to pool effect sizes, which were expressed as Cohen's d (or Odds ratio) and 95% confidence intervals (CIs). The outcome measures include changes in Montgomery-Asberg Depression Rating Scale (MADRS) scores, response and remission rates of depression, and dropout rates.</p><p><strong>Result: </strong>Eight randomized sham-controlled trials were included in the meta-analysis. The overall effect size of the outcome measures, including changes in MARDS scale scores, response rate, and remission rates, were -0.81 (95% confidence interval [CI]: 4.07 to 2.44), 1.07 (95% CI: 0.47 to 2.44) and 0.74 (95% CI: 0.38 to 1.45), respectively. Notably, the TBS group showed favorable efficacy without major adverse events.</p><p><strong>Conclusion: </strong>Current studies indicate that TBS does not show significant antidepressant efficacy in patients with BD, although it is very well tolerated.</p>","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143963410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ketamine's Influence on Magnetoencephalography Patterns During a Working Memory Task in Treatment-Resistant Depression: An Exploratory Study.","authors":"Adam Fijtman, Mani Yavi, Abigail Vogeley, Dede Greenstein, Jessica R Gilbert, Carlos A Zarate","doi":"10.1111/bdi.70027","DOIUrl":"https://doi.org/10.1111/bdi.70027","url":null,"abstract":"<p><strong>Introduction: </strong>Treatment-resistant depression (TRD) remains a challenge, necessitating novel interventions that address associated cognitive deficits. The glutamatergic modulator ketamine exerts rapid antidepressant effects, prompting investigators to assess its impact on cognitive function, specifically working memory. This study explored ketamine's influence on working memory and magnetoencephalography (MEG) patterns during a working memory task in individuals with TRD.</p><p><strong>Objectives: </strong>To examine the effects of ketamine on working memory, attention, and concentration, and to study MEG patterns during a working memory task in individuals with TRD.</p><p><strong>Methods: </strong>Twenty-one individuals with TRD (14 with bipolar disorder, 7 with major depressive disorder) received ketamine and placebo infusions in a crossover trial. Behavioral and MEG data were collected at baseline and 6 to 9 h after ketamine and placebo (normal saline) infusion. Working memory, attention, and concentration were assessed with the N-back task.</p><p><strong>Results: </strong>Ketamine significantly improved depressive symptoms but had no effect on cognitive performance. MEG revealed increased gamma power in the parieto-occipital junction coupled with decreased gamma power in the posterior superior temporal sulcus and inferior frontal gyrus after ketamine administration compared to placebo.</p><p><strong>Conclusions: </strong>Despite robust antidepressant effects, ketamine did not affect working memory, attention, or concentration. However, distinct gamma power changes in brain regions linked to attention and working memory highlight the need to further explore the neurobiological mechanisms underlying ketamine's cognitive effects in TRD. Future research with larger samples, broader cognitive batteries, and repeated ketamine infusions are needed to fully elucidate ketamine's cognitive effects in individuals with TRD.</p>","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771317","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}