Bipolar Disorders最新文献

{"title":"Comparison of Clinical Indicators for Differentiating Unipolar and Bipolar Depression","authors":"Fang Wu,&nbsp;Shuai Yu,&nbsp;Li-Fang Zhu,&nbsp;Yu-Yi Li,&nbsp;Peng-Jiao Xu,&nbsp;Xiao-Yang Zhang,&nbsp;Rong-Jie He,&nbsp;Ya-Nan Guo,&nbsp;Chuan-Sheng Wang,&nbsp;Ya-Hui Xu","doi":"10.1111/bdi.70190","DOIUrl":"10.1111/bdi.70190","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The global prevalence of major depressive disorder and bipolar depression (BD) has increased, with BD often underdiagnosed and mismanaged. This study aims to identify key biomarkers from demographic and laboratory indicators to differentiate unipolar depression (UD) from BD, aiding early diagnosis and personalized treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study was conducted at the Second Affiliated Hospital of Xinxiang Medical University between January 2022 and December 2024. A total of 174 inpatients were included, with 87 diagnosed with UD and 87 with BD. Demographic and laboratory data were collected. Univariate and multivariate logistic regression analyses were conducted to identify the risk factors. Receiver operating characteristic (ROC) curve analysis was used to evaluate discriminatory ability.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>BD exhibited a higher male proportion (<i>p</i> = 0.004) and significantly elevated total bilirubin (TBIL), creatinine, and creatine kinase (CK) levels, along with lower thyroxine (T4) levels, compared to UD (<i>p</i> &lt; 0.05). Multivariate analysis identified platelets, TBIL, T4, and CK as independent risk factors (<i>p</i> &lt; 0.05). ROC analysis revealed TBIL (Area Under the Curve [AUC] = 0.609) and CK (AUC = 0.621) as key discriminators, with a combined model achieving an AUC of 0.724, sensitivity of 75.9%, and specificity of 59.8%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Key metabolic and muscular biomarkers, including TBIL, CK, PLT, and T4, were identified as potential differentiators between UD and BD. These findings demonstrated diagnostic potential and underscored the need for further validation in larger studies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":"28 7","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149179352","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 Symptomatology as Predictors of Early Treatment Response in Adolescents and Young Adults With Major Depressive Episode","authors":"Lifei Wang,&nbsp;Rui Tang,&nbsp;Jie Liu,&nbsp;Jiayi Feng,&nbsp;Yuhong Lu,&nbsp;Siyu Gao,&nbsp;Rongxin Zhu,&nbsp;Jia Duan,&nbsp;Fei Wang","doi":"10.1111/bdi.70191","DOIUrl":"10.1111/bdi.70191","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>In clinics, major depressive episodes (MDE) in adolescents and early adults with mood disorders are a prevalent manifestation with limited treatment efficacy. Previous studies have suggested that early-stage treatment response is an important predictor of patients' final clinical outcome. Finding clinical features related to early-stage treatment response is crucial for optimizing interventions and understanding outcome determinants.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a study involving 218 inpatients aged 13–25 years with mood disorders currently in MDE. We evaluated patients' multi-dimensional clinical features both at baseline and after 2 weeks of treatment; the main outcome measure was the reduction rate of total the 17-item Hamilton Depression Rating Scale (HAMD-17) scores between baseline and 2 weeks of treatment. Logistic regression analysis was applied to identify baseline predictive clinical factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Baseline HAMD total score (OR = 1.10, 95% CI [1.00, 1.20], <i>p</i> = 0.045) and thought disorder factor scores of Brief Psychiatric Rating Scale (BPRS) (OR = 0.79, 95% CI [0.70, 0.91], <i>p</i> &lt; 0.001) were significantly associated with early-stage treatment response.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our study contributes to predicting early-stage treatment response in adolescents and young adults with MDE based on baseline clinical features. Baseline HAMD total score and thought disorder factor scores of BPRS are potential clinical predictors. Understanding such factors enhances treatment decision-making and efficacy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":"28 7","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149179407","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":"The Impact of Sexual Satisfaction on Marital Adjustment, Quality of Life, and Treatment Adherence in Patients Diagnosed With Bipolar Disorder and Their Spouses: A Cross-Sectional Study","authors":"Zerrin Demirel,&nbsp;Nurgül Ozdemir,&nbsp;Ayten Guner Atayoglu","doi":"10.1111/bdi.70189","DOIUrl":"10.1111/bdi.70189","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To examine the effects of sexual satisfaction on marital adjustment, quality of life, and treatment adherence in patients diagnosed with bipolar disorder (BD) and their spouses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This cross-sectional study included 124 euthymic patients with BD and their spouses (124 couples; <i>n</i> = 248 individuals), recruited from the psychiatry outpatient clinics of Gaziantep University Şahinbey Research and Practice Hospital, Türkiye. Data were collected using a Sociodemographic Form, the Young Mania Rating Scale (YMRS), the Beck Depression Inventory (BDI), the Golombok-Rust Inventory of Sexual Satisfaction (GRISS), the Dyadic Adjustment Scale (DAS), the Quality of Life in Bipolar Disorder Scale (QoL.BD), and the Morisky Medication Adherence Scale (MMAS).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Patients' mean age was 43.62 ± 9.68 years; 51.61% had been married for ≥ 21 years. Mean scores: BDI 6.6 ± 7.51, QoL.BD 43.93 ± 12.08, DAS 17.16 ± 6.36, GRISS 39.63 ± 23.72, MMAS 1.31 ± 1.35. Greater sexual dissatisfaction was associated with poorer marital adjustment (<i>r</i> = 0.325, <i>p</i> &lt; 0.001). No significant direct association was found between sexual satisfaction and adherence. Higher quality of life was associated with lower depression, better marital adjustment, and greater sexual satisfaction.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Sexual satisfaction is closely linked to marital adjustment and quality of life in BD, with a less direct relationship to treatment adherence. Couple-based psychoeducation addressing sexual health may support marital and quality-of-life outcomes in this population.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":"28 7","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103755","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":"Emotional Responses (Intensity/Valence) Fulfill RDoC Criteria but Remain Excluded From Diagnostic Classifications of Mood Disorders","authors":"Chantal Henry,&nbsp;Chlöé Müh,&nbsp;Claire-Hélène de Badts,&nbsp;Mariana Alonso,&nbsp;Lucie Berkovitch","doi":"10.1111/bdi.70182","DOIUrl":"10.1111/bdi.70182","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Categorical classifications of depression, such as DSM-5 and ICD, are limited by high clinical heterogeneity, arbitrary diagnostic thresholds, and weak links to underlying pathophysiology. In line with the Research Domain Criteria (RDoC) framework, this article proposes a dimensional and mechanistic approach centered on emotional responses as core transdiagnostic features of mood disorders. Emotional responses are conceptualized along two fundamental dimensions: intensity (arousal) and hedonic valence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This perspective integrates evidence from clinical, psychophysiological, neuroimaging, and preclinical studies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Depressive episodes may be characterized by either emotional hyporeactivity (emotional blunting and reduced responsiveness) or emotional hyperreactivity (heightened distress, anxiety, irritability, and emotional lability), the latter being closely associated with mixed features, particularly in bipolar depression. In parallel, depression is marked by maladaptive valence attribution, encompassing anhedonia related to reward-system dysfunction and a pervasive negativity bias. Preclinical findings implicate dysregulated basolateral amygdala circuits in valence attribution and demonstrate the reversibility of negativity bias with antidepressant interventions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Integrating emotional intensity and valence within an RDoC-informed framework provides a biologically grounded account of depressive heterogeneity, refines the characterization of mixed states, and offers clinically relevant guidance for treatment selection. This perspective supports the development of personalized therapeutic strategies and the systematic inclusion of emotional dimensions in clinical research.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":"28 7","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13628418/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103783","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":"Irritability in the Mix: An Exploratory Study of the Role of Irritability in Characterising Mood Disorders","authors":"Erica Bell,&nbsp;Maree Inder,&nbsp;Gin S. Malhi,&nbsp;Richard Bryant,&nbsp;Philip Boyce,&nbsp;Richard J. Porter","doi":"10.1111/bdi.70185","DOIUrl":"10.1111/bdi.70185","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To examine the relationship between irritability and mixed states in bipolar disorder to determine how subjective irritability and mixed symptoms of mania and depression manifest in patients with bipolar disorder over a period of 18 months.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This exploratory analysis examined longitudinal data from a randomised controlled trial of a psychological intervention for patients with bipolar disorder. Scores of subjective irritability and mood morbidity were analysed from data sampled over ten timepoints over the trial from 82 patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Significant associations were found between the presence of irritability and mixed symptoms (<i>F</i>(1, 684) = 20.468, <i>p</i> &lt; 0.001). This relationship remained significant throughout the duration of the study and the administration of a psychological treatment which reduced both ratings of mood and irritability. Notably, when mixed symptoms are absent, irritability nevertheless remained for nearly half the time.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Irritability and mixed symptoms are phenomenologically linked. The persistence of this link, regardless of the existence of mixed symptoms, suggests that irritability permeates bipolar disorder and is core to its phenomenology. Future studies should interrogate the tethering of mixed symptoms and irritability in the context of bipolar disorder as this may lead to a deeper understanding of the core characteristics of the illness—both clinically and in terms of its neurobiology.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":"28 7","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13625195/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149079535","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":"‘It's a Balancing Act’: A Qualitative Analysis of the Experiences of Caffeine Use in Individuals With Bipolar Disorder","authors":"Sammy Eden,&nbsp;Michaela Sibsey,&nbsp;Sarah Dean,&nbsp;Javier T. Gonzalez,&nbsp;Kim Wright","doi":"10.1111/bdi.70171","DOIUrl":"10.1111/bdi.70171","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Bipolar Disorder (BD) is a complex and often chronic mood disorder that can cause significant distress and disruption to everyday life. The condition often requires lifelong treatment and self-management. Caffeine is a lifestyle behaviour that could be useful in self-management alongside traditional treatments, but further research is needed to explore the relationship between this lifestyle behaviour and its potential significance on affective state.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Individuals with BD (<i>N</i> = 20) took part in qualitative semi-structured interviews, engaging in discussion about their personal experiences of caffeine consumption in relation to BD mood symptoms. Interviews were analysed using Interpretative Phenomenological Analysis (IPA).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Analysis revealed the superordinate theme ‘it's a balancing act’ was present in the majority of the transcripts, describing the caffeine-bipolar relationship. This superordinate theme comprised themes specifically linked to lower mood states, ‘little helper’ and ‘nothing works’ and others linked to higher mood states ‘increased manic-ness’ and ‘can't recall/concentrate’, in addition to themes around habitual caffeine consumption ‘habit/routine’ and planned use of caffeine ‘strategic routine’.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The complexities of the caffeine-bipolar relationship are highlighted. Participants indicated that caffeine requires a very delicate balancing act, having the potential to be both helpful and harmful. Findings emphasise the importance of increasing knowledge surrounding caffeine use for both patients with BD and clinical professionals.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":"28 7","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13627961/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103785","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":"Trajectories of Cognitive Functioning in Older Age Bipolar Disorder","authors":"Melis Orhan,&nbsp;Erik J. Giltay,&nbsp;Azita Ghasemi,&nbsp;Alexandra Beunders,&nbsp;Nicole Korten,&nbsp;Manja Koenders,&nbsp;Sigfried Schouws,&nbsp;Annemiek Dols","doi":"10.1111/bdi.70188","DOIUrl":"10.1111/bdi.70188","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The prevalence of cognitive impairment is high in older age bipolar disorder (OABD). It remains unclear whether the course of cognitive functioning in these individuals follows a course of cognitive decline, whether this is different among subgroups, and if so, which factors are associated with cognitive decline.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Our clinical sample included 206 patients aged over 50 years from the Dutch Older Bipolar (DOBi) cohort with a total range of included measures of 306 months (1997–2022). Growth Mixture Modeling (GMM) was used to find homogeneous subgroups based on their longitudinal trajectories of the Mini-Mental State Examination (MMSE) scores. Patients were categorized in classes based on similar trajectories, and these classes were compared based on their performance on nine cognitive tests using mixed models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Three classes could be identified through GMM, each demonstrating a modest, parallel decline in MMSE scores: one class showed consistently high cognitive performance; another with moderate cognitive functioning; and a third group with significant cognitive impairment. Multivariate analyses showed that an advanced age at baseline and an earlier onset of the disorder were predictive of a more impaired cognitive trajectory. Furthermore, nine supplementary cognitive assessments demonstrated pronounced disparities across these three groups, with the most substantial cognitive deficits in individuals with the most unfavorable MMSE trajectories.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Our findings underscore the heterogeneous nature of cognitive aging in OABD, revealing a spectrum of cognitive longitudinal trajectories. Findings indicate that the MMSE is a valid screener in order to broadly predict cognitive functioning and its course in OABD. Identifying individuals who are particularly susceptible to cognitive decline is crucial for initiating tailored rehabilitation strategies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":"28 7","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149079493","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":"Bipolar Disorder and Perimenopause: An Update","authors":"Jana Radosavljevic,&nbsp;Deniz Bengi,&nbsp;Benicio N. Frey","doi":"10.1111/bdi.70186","DOIUrl":"10.1111/bdi.70186","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Perimenopause has been associated with mood worsening in some individuals, including increased depressive symptoms. Yet, the link between bipolar disorder (BD) and perimenopause remains understudied. This review aimed to provide an update on recent original studies and contextualize findings within the broader literature to guide future research and clinical practice.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic search was conducted on Embase (January 1, 2018 to August 5, 2026) to identify studies on BD (I, II, or NOS/BD spectrum) that directly or indirectly examined perimenopause and BD. Pooled samples were included if they reported separate BD results. Results were narratively synthesized.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Fourteen studies were identified from Australia (<i>n</i> = 4), Italy (<i>n</i> = 3), UK (<i>n</i> = 2), Taiwan (<i>n</i> = 1), South Korea (<i>n</i> = 1), Sweden (<i>n</i> = 1), USA (<i>n</i> = 1), and one study of international trials. There is converging evidence showing that perimenopause is a period of higher risk of first onset BD. Among individuals with existing BD, increased depression and heightened anxiety during perimenopause were the most consistent illness-course findings, whereas findings for hypo/mania were mixed. Evidence concerning psychotherapy or pharmacological treatment, including hormone replacement therapy, was limited or absent.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This review provides an updated perspective on BD and perimenopause, extending existing knowledge beyond mood symptoms and identifying several clinical and research gaps. Clinicians should consider the potential impact of perimenopause in BD management. Research using standardized menopause staging criteria (e.g., STRAW+10) is encouraged to inform mechanisms, illness trajectories, treatments, and to better support individuals with BD through perimenopause.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":"28 7","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13624690/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149079592","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 and Biological Characterization of Bipolar Disorder Patients With Chronic Insomnia Reveals Cortisol Reductions, Elevated TNF-α, and Increased Genetic Risk for Accelerated Aging","authors":"Kayla E. Rohr,&nbsp;Charles B. Schaffer,&nbsp;Linda C. Schaffer,&nbsp;Thomas E. Nordahl,&nbsp;Pei-An Shih,&nbsp;John R. Kelsoe,&nbsp;Michael J. McCarthy","doi":"10.1111/bdi.70187","DOIUrl":"10.1111/bdi.70187","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Among patients with bipolar disorder, chronic insomnia is a common comorbidity that adversely affects mood instability, quality of life, disability, accelerated aging, and increased suicide risk.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This matched case–control study characterized the clinical features of insomnia in a bipolar disorder clinic population and identified biological and genetic correlates affecting diurnal patterns of cortisol, inflammation, and aging. Cross-sectional data were collected from 22 patients with bipolar disorder and chronic insomnia (BD + INS), and 22 age- and sex-matched bipolar disorder patients without insomnia (BD-INS).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>BD + INS patients reported sleep problems independent of current mood state with a mean insomnia duration of 22.5 years. Compared to BD-INS participants, BD + INS patients reported more disturbed sleep, more use of daytime anxiolytics, and reduced use of antidepressants, but reported no differences in overall functioning, quality of life, or severity of mood episodes. Compared to matched participants, BD + INS patients also had reduced waking cortisol, increased levels of the inflammatory cytokine tumor necrosis factor α (TNF-α), and were more likely to be homozygous for a genetic variant in <i>TERT</i> previously linked with short telomere length and premature aging.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>These findings suggest that chronic insomnia in BD can persistently alter sleep independent of mood symptoms and may be associated with distinct biological features, including cortisol and inflammatory systems.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":"28 7","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149011787","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":"Comparative Effectiveness of Lithium- Vs. Valproate-Based Combinations With Atypical Antipsychotics in Preventing Rehospitalization After a First Manic Episode of Bipolar I Disorder","authors":"Pei-Ying Li,&nbsp;Meng-Ting Wang,&nbsp;Jia-Shyun Jeng,&nbsp;Tzu-Chieh Lin,&nbsp;Tung-Ying Hung,&nbsp;Yi-Hsuan Chen,&nbsp;Ying-Jay Liou","doi":"10.1111/bdi.70184","DOIUrl":"10.1111/bdi.70184","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Relapse after a first manic episode is common in bipolar I disorder and frequently leads to rehospitalization. Lithium and valproate, often prescribed with atypical antipsychotics, remain central to maintenance therapy; however, no randomized trials have directly compared these regimens in early-course illness. This study compared lithium plus atypical antipsychotics (Li + AAPs) versus valproate plus atypical antipsychotics (Val + AAPs) for preventing bipolar-related rehospitalizations after the first hospitalization for mania.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This was a new-user, propensity score–matched cohort study of patients discharged after their first hospitalization for acute mania, using Taiwan's National Health Insurance claims data (2011–2022). Patients initiating Li + AAPs or Val + AAPs within 30 days of discharge were followed for rehospitalization for any mood episode (manic, depressive, or mixed). Secondary outcomes included episode-specific rehospitalization and annualized hospitalization rates.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 3,909 matched patients (1397 Li + AAP and 2,512 Val + AAP; mean [SD] age, 42.4 [14.2] years; 42.9% male), Li + AAPs were associated with a higher risk of rehospitalization for any mood episode compared to Val + AAPs (hazard ratio [HR], 1.18; 95% CI, 1.03–1.35), primarily driven by manic relapse (HR, 1.16; 95% CI, 1.01–1.35). No significant differences were observed for depressive or mixed episodes. The annual rehospitalization rate for any mood episodes was also higher with Li + AAPs (incidence rate ratio, 1.34; 95% CI, 1.17–1.54).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In this nationwide cohort of patients with first-episode mania, Val + AAPs were associated with a lower risk of bipolar rehospitalization compared to Li + AAPs, suggesting potential early-phase maintenance advantages of valproate combinations over lithium combinations following first mania discharge.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":"28 7","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149011826","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}