Bipolar Disorders最新文献

{"title":"Factors Predisposing to the Onset of Bipolar Disorder: A 30-Year Longitudinal Study.","authors":"Peter Tyrer, Min Yang, Helen Tyrer, Gin Malhi","doi":"10.1111/bdi.70026","DOIUrl":"https://doi.org/10.1111/bdi.70026","url":null,"abstract":"<p><strong>Objective: </strong>To examine the factors that predict the development of bipolar disorder in a population presenting with anxiety and depressive disorders.</p><p><strong>Method: </strong>In a 30-year study, the Nottingham Study of Neurotic Disorder, the personality status, life events, service data, and early course of patients recruited to a randomised controlled trial were compared in patients who developed bipolar pathology and those who had no bipolar symptoms.</p><p><strong>Results: </strong>Over 30 years, 5 (2.5%) of 200 patients assessed at baseline developed unequivocal bipolar disorder, one within the first 10 weeks of the study, and three (1.5%) had bipolar II pathology. Analysis of these data showed that those patients who had some degree of bipolarity had an increase in anxiety and depressive symptoms and general psychopathology, most pronounced in the second year of the study, that was not found with patients who had no bipolar pathology.</p><p><strong>Conclusions: </strong>Patients treated for anxiety and depressive disorders who remain unwell after initial treatment are more at risk of developing bipolar disorder than others.</p>","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143728352","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":"An Authentic Portrait of a Manic Episode From the Artistic Perspective of a Patient With Bipolar Disorder.","authors":"Onur Gökçen, Ceyhun Yilmaz","doi":"10.1111/bdi.70023","DOIUrl":"https://doi.org/10.1111/bdi.70023","url":null,"abstract":"","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662047","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":"Acute Upper Gastrointestinal Bleeding in a Patient With Bipolar II Disorder and Catatonia: A Case Report.","authors":"Ranxi Deng, Wanjing Yang, Jingyuan Zhou, Hongqi Xiao, Yingxu Duan, Lixin Shi, Changjian Qiu","doi":"10.1111/bdi.70024","DOIUrl":"https://doi.org/10.1111/bdi.70024","url":null,"abstract":"","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656010","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":"White Matter, Cognition, and Electrophysiological Variables in Bipolar Disorder: Using Multimodal Integration of Biomarker Variables Associated With Bipolar Disorder to Elucidate Deficits.","authors":"Audrey Berardi, Jennifer A Brown, Brooke S Jackson, Ling-Yu Huang, Rebekah L Trotti, David A Parker, Scot K Hill, Elena Ivleva, Godfrey D Pearlson, Carol A Tamminga, Matcheri S Keshavan, Sarah K Keedy, Elliot S Gershon, John A Sweeney, Brett A Clementz, Jennifer E McDowell","doi":"10.1111/bdi.70010","DOIUrl":"https://doi.org/10.1111/bdi.70010","url":null,"abstract":"<p><strong>Aim: </strong>This study aimed to evaluate associations in bipolar disorder (BD) across multimodal measures of white matter microstructure (using diffusion tensor imaging; DTI), cognitive, behavioral, and brain electrophysiological measures (using electroencephalography; EEG).</p><p><strong>Methods: </strong>Subjects were recruited through the Psychosis and Affective Research Domains and Intermediate Phenotypes Consortium (n = 45 bipolar with psychosis, n = 40 bipolar without psychosis, n = 66 healthy subjects). DTI data were used to quantify the white matter variables, fractional anisotropy (FA) and radial diffusivity (RD). The Brief Assessment of Cognition in Schizophrenia (BACS), Stop Signal Task (SST), pro- and anti-saccades, auditory event-related potentials (ERPs), and intrinsic brain activity were used as estimates of brain function.</p><p><strong>Results: </strong>The combined BD group differed from healthy controls, but no differences between BD with and without psychosis were observed. BD-related white matter abnormalities were seen across multiple tracts: right cingulum-cingulate gyrus, bilateral anterior thalamic radiation, bilateral superior longitudinal fasciculus, right inferior longitudinal fasciculus, and forceps major. Results also showed modestly compromised cognitive performance and elevated intrinsic EEG activity associated with BD.</p><p><strong>Conclusions: </strong>Further analysis indicated worse white matter integrity related to higher intrinsic EEG and modestly higher ERPs. These multimodal analyses are likely to aid in creating future informative diagnostic, etiological, and treatment targets for BD.</p>","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143623375","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":"Multimodal Machine Learning Prediction of 12-Month Suicide Attempts in Bipolar Disorder.","authors":"Alessandro Pigoni, Isidora Tesic, Cecilia Pini, Paolo Enrico, Lorena Di Consoli, Francesca Siri, Guido Nosari, Adele Ferro, Letizia Squarcina, Giuseppe Delvecchio, Paolo Brambilla","doi":"10.1111/bdi.70011","DOIUrl":"https://doi.org/10.1111/bdi.70011","url":null,"abstract":"<p><strong>Introduction: </strong>Bipolar disorder (BD) patients present an increased risk of suicide attempts. Most current machine learning (ML) studies predicting suicide attempts are cross-sectional, do not employ time-dependent variables, and do not assess more than one modality. Therefore, we aimed to predict 12-month suicide attempts in a sample of BD patients, using clinical and brain imaging data.</p><p><strong>Methods: </strong>A sample of 163 BD patients were recruited and followed up for 12 months. Gray matter volumes and cortical thickness were extracted from the T1-weighted images. Based on previous literature, we extracted 56 clinical and demographic features from digital health records. Support Vector Machine was used to differentiate BD subjects who attempted suicide. First, we explored single modality prediction (clinical features, GM, and thickness). Second, we implemented a multimodal stacking-based data fusion framework.</p><p><strong>Results: </strong>During the 12 months, 6.13% of patients attempted suicide. The unimodal classifier based on clinical data reached an area under the curve (AUC) of 0.83 and balanced accuracy (BAC) of 72.7%. The model based on GM reached an AUC of 0.86 and BAC of 76.4%. The multimodal classifier (clinical + GM) reached an AUC of 0.88 and BAC of 83.4%, significantly increasing the sensitivity. The most important features were related to suicide attempts history, medications, comorbidities, and depressive polarity. In the GM model, the most relevant features mapped in the frontal, temporal, and cerebellar regions.</p><p><strong>Conclusions: </strong>By combining models, we increased the detection of suicide attempts, reaching a sensitivity of 80%. Combining more than one modality proved a valid method to overcome limitations from single-modality models and increasing overall accuracy.</p>","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143571594","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":"Treatment Patterns for Incident Bipolar Disorder Among Nonrefugee Immigrants, Refugees, Second-Generation Immigrants, and Host Population in Sweden.","authors":"Alexander Kautzky, Emma Pettersson, Ridwanul Amin, Aemal Akhtar, Antti Tanskanen, Heidi Taipale, Johannes Wancata, Katalin Gemes, Ellenor Mittendorfer-Rutz","doi":"10.1111/bdi.70007","DOIUrl":"https://doi.org/10.1111/bdi.70007","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Deviations in treatment practices toward immigrant groups compared to host populations are common in mental disorders but unknown in bipolar disorder (BD). We aim to close this research gap by analyzing age-stratified use patterns of antidepressants, mood stabilizers, and antipsychotics following an incident diagnosis of BD in Swedish-born, second- and first-generation nonrefugee immigrants, and refugees.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Individuals with incident BD between 2006 and 2018 were identified through Swedish national registers. Medication use was followed up until 5 years after diagnosis. Use rates adjusted for sociodemographic and disease-related covariates were computed with generalized estimation equations for each population group. Marginal means with 95% confidence intervals (CIs) and significance tests for main and interaction effects of population group and time points are presented. Furthermore, significant effects of population group, age group, time point, and their interaction were tested by Type III joint test yielding F and p values.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Three months after diagnosis, estimated rates of lack of treatment differed significantly between population groups (p &lt; 0.0001) as Swedish-born (17.3%, CI: 16.8-17.7) lacked disease-specific treatment less often than second-generation immigrants (21.1%, 19.7-22.5), first-generation nonrefugee immigrants (23.1%, 21.3-25.0) and refugees (26.8%, 24.4-29.4). Antidepressant monotherapy was estimated in 17.7% (17.2-18.1) of Swedish-born, 16.8% (15.5-18.3) of second-generation immigrants, 17.7% (16.2-19.4) of first-generation nonrefugee immigrants, and was most prevalent in refugees (20.3%, 18.2-22.7; population group p = 0.0002). Mood stabilizers were most dispensed by Swedish-born (51.3%, 50.6-51.9), followed by second-generation (47.9%, 46.1-49.8) and first-generation nonrefugee immigrants (44.5%, 42.4-46.7) and refugees (35.4%, 32.8-38.2; population group p &lt; 0.0001). Use rates of antipsychotics were similar between population groups (p &gt; 0.05) and estimated at 14.1% (13.7-14.6) in Swedish-born, 14.0% (12.8-15.3) in second-generation, 13.0% in first-generation nonrefugee immigrants (12.0-14.6), and 12.9% (11.1-15.0) in refugees. Following up significant interactions of population and age group, lithium use was estimated to be lower in refugees aged 36-65 years (9.9%, 7.9-12.5; population group p = 0.0008) and olanzapine use to be higher in refugees aged 16-35 (9.2%, 7.1-11.9; population group p = 0.0002), respectively, compared to other population groups of the same age.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Immigrants, especially refugees, are at risk of not receiving adequate treatment following BD diagnosis, putatively owing to a lack of transcultural competence in healthcare, economic restraints, and community factors. Antidepressant monotherapy should be reduced, while recommended options such as mood stabilizers and specifically ","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143571668","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":"Hippocampal Volume Reductions in Key Regions and Their Role in Disease Progression in Adolescents at High Risk for Bipolar Disorder: Findings From the sBEAD Cohort.","authors":"Xiaofei Zhang, Tao Lin, Guanjie Zhang, Jianshan Chen, Xichao Wang, Wanheng Zhang, Xiaoqing Zhang, Jiaqi Sun, Weiming Li, Yutong Liu, Xuanlin Zeng, Lei Chen, Yimiao Mao, Biyu Ye, Yanling Zhou, Xuan Li, Chanjuan Yang, Liping Cao, Yuping Ning","doi":"10.1111/bdi.70014","DOIUrl":"https://doi.org/10.1111/bdi.70014","url":null,"abstract":"<p><strong>Background: </strong>Hippocampal subfield pathology is established in bipolar disorder (BD); yet no studies have investigated these alterations in adolescents at clinical high risk for BD (MDD-Sub), which is a critical gap given adolescence as a neurodevelopmental window for early intervention.</p><p><strong>Methods: </strong>We analyzed baseline 3D T1-weighted MRI data from 72 adolescents at Clinical High Risk for BD \"MDD-Sub\"MDD-Sub vs. MDD-nSub, 74 pure adolescents with MDD (MDD-nSub), and 72 healthy adolescents (HC) aged 12-18 years in the sBEAD cohort. Hippocampal subfields were segmented using FreeSurfer 7.3.1. All patients were followed up for at least 12 months to ensure that no participants progressed to schizophrenia or developed new manic symptoms in the MDD-nSub group.</p><p><strong>Results: </strong>MDD-Sub exhibited significant volume reductions in the left cornu ammonis (CA)1, CA3, CA4, molecular layer (ML) and dentate gyrus (DG) even after controlling for medication effects (d_{Hc Vs. Mdd-sub} = 0.70-0.78; d_{MDD-Sub vs. MDD-nSub} = 0.50-0.61). Strikingly, illness duration > 1 year predicted volumetric increases in bilateral CA1/ML/DG and left CA3/CA4 (R² = 0.13-0.21, p < 0.05), replicated in medication-naïve MDD-Sub (n = 32). MDD-nSub showed no subfield differences versus HC and MDD-Sub.</p><p><strong>Conclusions: </strong>This first hippocampal subfield study in BD high-risk adolescents suggests that prodromal-specific left CA1, CA3, CA4, ML, and DG atrophy may help differentiate BD risk from unipolar depression, while nonlinear volumetric trajectories, characterized by early reductions followed by compensatory increases with prolonged illness duration, provide new perspectives on classical neurodegeneration paradigms. These findings provide initial biological support for stage-specific interventions, enhancing neuroplasticity pre-conversion versus neuroprotection post-conversion.</p>","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143540052","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":"Impact of Activation Therapy for Inpatients With Major Depression: Primary and Secondary Outcomes From a Randomised Controlled Trial.","authors":"Katie M Douglas, Zoe A Odering, Jennifer Jordan, Marie T Crowe, Cameron J Lacey, Christopher M Frampton, Ian R E Averill, Cecilia Smith Hamel, Christopher R Bowie, Richard J Porter","doi":"10.1111/bdi.70021","DOIUrl":"https://doi.org/10.1111/bdi.70021","url":null,"abstract":"<p><strong>Introduction: </strong>Inpatient depression is associated with high morbidity and significant cognitive impairment. Inpatient treatment often focuses on short-term stabilization with medication. Readmission rates are high. We examined the impact of a novel psychological intervention, activation therapy (AT, Behavioural Activation combined with Cognitive Activation), versus treatment as usual (TAU) on readmission rates, and cognitive, functional, and depression outcomes, in inpatient depression.</p><p><strong>Method: </strong>A randomised controlled trial in adults hospitalised with a major depressive episode. Inpatients were randomised to AT (8 individual sessions over 2 weeks) or not (TAU). Key time points were baseline (on admission) and 14 weeks after baseline. The primary outcome was psychiatric hospital readmission rates within 12 weeks of discharge. Secondary outcomes were cognition, general functioning, depression, and 'deactivation' symptoms (change from baseline to 14 weeks).</p><p><strong>Results: </strong>Ninety-seven individuals were randomised to AT (n = 47) or TAU (n = 50). Readmission rates did not differ between treatment arms (34% vs. 40%; OR = 0.76, CI = 0.30-1.90). Significant improvements for verbal learning and memory (d = 0.42) and general functioning (d = 0.58) were in favour of the AT versus TAU arms. Per protocol analysis showed additional significant effects of AT on psychomotor speed (d = 0.64) and clinician-rated depression symptoms (d = 0.56). No significant effects were observed for other secondary outcomes (subjective cognition, self-reported depression symptoms, and deactivation symptoms).</p><p><strong>Conclusions: </strong>The AT intervention showed durable, pro-cognitive effects. Further adaptations of AT, such as the addition of maintenance sessions as patients transition to community-based care, need exploring.</p>","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143536377","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":"Embracing Uncertainty in Bipolar Disorder Treatment: The Balancing Act in Post-Mania Adjunctive Antipsychotic Therapy.","authors":"Alexis Carnduff, Katherine Snyder","doi":"10.1111/bdi.70017","DOIUrl":"https://doi.org/10.1111/bdi.70017","url":null,"abstract":"","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143514602","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":"Exploration of Genetic Liability to Insomnia and Substance Use Disorders in Patients With Bipolar Disorder.","authors":"Lindsay M Melhuish Beaupre, Brandon J Coombes, Anthony Batzler, Jorge A Sanchez-Ruiz, Bhanu Prakash Kolla, Francisco Romo-Nava, Vanessa Pazdernik, Gregory Jenkins, T Cameron Waller, Michelle Skime, Susan L McElroy, Mark A Frye, Joanna M Biernacka","doi":"10.1111/bdi.70018","DOIUrl":"https://doi.org/10.1111/bdi.70018","url":null,"abstract":"<p><strong>Background: </strong>Insomnia and substance use disorders (SUD) are common comorbidities of bipolar disorder (BD). Genome-wide association studies (GWAS) have uncovered shared genetic contributions to insomnia and BD as well as SUDs and BD. Electronic health record (EHR) derived phenotypes (phecodes) and questionnaire data were used to examine the relationship between insomnia genetic liability and SUDs in BD.</p><p><strong>Methods: </strong>40,839 participants from the Mayo Clinic Bipolar Disorder Biobank (BD Biobank; n = 774) and Mayo Clinic Biobank (n = 485 BD cases, n = 39,580 controls) were included in the analyses of diagnosis (phecode) outcomes (insomnia, SUD, alcohol use disorder [AUD] and tobacco use disorder [TUD]). Analyses of specific SUD outcomes obtained through the BD Biobank questionnaire included 1789 cases and considered BD subtype. Logistic regression was used to test for associations between insomnia polygenic risk scores (PRS) and insomnia and SUD outcomes in BD cases and controls.</p><p><strong>Results: </strong>Insomnia PRS was associated with having an insomnia diagnosis (phecode) in the EHR in controls (OR = 1.19, p = 9.64e-33) but not in BD cases (OR = 1, p = 0.95). Associations between insomnia PRS and SUD diagnoses were significant in BD cases and controls, with the association being stronger in BD cases (interaction p = 0.024). In the BD Biobank data, the insomnia PRS was associated with increased odds of AUD (OR = 1.19, p = 4.26e-04), TUD (OR = 1.21, p = 1.25e-05) and cannabis use disorder (OR = 1.16, p = 4.19e-03).</p><p><strong>Conclusion: </strong>The effect of genetic predisposition to insomnia on SUD risk may be stronger in BD cases than in controls, which could have clinical care implications for individuals with BD and comorbid SUD.</p>","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143498823","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}