Bipolar Disorders最新文献

{"title":"Risk Factors for Natural Cause Mortality in Bipolar Disorder","authors":"Faith Dickerson,&nbsp;Sabahat Khan,&nbsp;Andrea Origoni,&nbsp;Kelly Rowe,&nbsp;Emily Katsafanas,&nbsp;Fahad Mukhtar,&nbsp;Robert Yolken","doi":"10.1111/bdi.70092","DOIUrl":"10.1111/bdi.70092","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Bipolar disorder is associated with premature mortality, but risk factors for natural cause mortality in this population have not been identified.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This was a prospective, cohort study of persons with bipolar disorder enrolled June 1, 2001–December 31, 2022, at a psychiatric system in Maryland, USA. Participants were evaluated with an in-person assessment of their cognitive functioning, medical illnesses, and other clinical domains. Natural cause mortality through 2022 was determined with data from the National Death Index. Cox proportional hazards models were employed to determine factors contributing to natural cause mortality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The 553 persons in the study population had a mean age of 35.7 (SD13.0) years; 409 (74.0%) were White; 104 (18.8%) Black; 167 (30.2%) were male sex. The mean follow-up duration was 12.7 years (range 1.9–21.5). A total of 39 (7.1%) individuals died of natural causes such as cancer and cardiac disorders. The most significant predictor of natural cause mortality was a history of recent homelessness (HR 6.02, 95% CI 2.56, 14.19, <i>p</i> &lt; 0.001). Additional baseline factors independently associated with mortality included a diagnosis of type 2 diabetes (HR 3.67, 95% CI 1.67, 8.04, <i>p</i> = 0.001), tobacco smoking (HR 2.99, 95% CI 1.57, 6.52, <i>p</i> = 0.001), and lower cognitive functioning (HR 0.97, 95% CI 0.95, 0.99, <i>p</i> = 0.018).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In this prospective study of persons with bipolar disorder, a history of recent homelessness was a strong risk factor for natural cause mortality. Efforts should be directed at preventing homelessness, improving cognitive functioning, promoting smoking cessation, and managing diabetes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":"28 2","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146225262","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":"Cognitive Complaints in Bipolar Disorder: Relation to Estimated Illness-Related Objective Cognitive Decline, Functioning, and Quality of Life","authors":"Johanna Mariegaard Schandorff,&nbsp;Jeff Zarp,&nbsp;Anne Juul Bjertrup,&nbsp;Hanne Lie Kjærstad,&nbsp;Andreas Elleby Jespersen,&nbsp;Viktoria Damgaard,&nbsp;Maj Vinberg,&nbsp;Ulla Knorr,&nbsp;Lars Vedel Kessing,&nbsp;Kamilla Woznica Miskowiak","doi":"10.1111/bdi.70095","DOIUrl":"10.1111/bdi.70095","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Persons with bipolar disorder (BD) often present with cognitive complaints even in the absence of objective cognitive impairment as measured with neuropsychological tests. It remains unclear whether cognitive complaints reflect negative bias or illness-related decline from premorbid functioning, affecting functioning and quality of life (QoL).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data from <i>n</i> = 498 persons with BD and <i>n</i> = 320 healthy controls (HC) were included from a database based on seven studies. We calculated IQ-objective cognition discrepancy scores (−10 to +10; negative scores = lower cognitive performance than premorbid IQ, i.e., estimated ‘loss of function’) and subjective-objective cognitive discrepancy scores (−10 to +10; negative scores = less subjective than objective difficulties; positive scores = more subjective than objective impairments). We investigated associations between these variables and subjective cognitive complaints, functioning, and QoL with multiple regression models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Subjective cognitive complaints were associated with poorer global cognitive performance relative to premorbid IQ (i.e., estimated ‘loss of function’). More subjective than objective cognitive difficulties was associated with diminished functioning and QoL. A similar association was seen for objective cognitive performance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Subjective complaints may indicate a decline from premorbid cognitive function, even if objective cognitive performance is within the normal range after illness onset. More subjective than objective impairment correlates with poorer functioning and QoL. Hence, cognitive management initiatives should be centered around patients with cognitive complaints independent of objective cognitive status.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":"28 2","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146225288","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":"Consensus on Subdomains and Measures of Relevance to Affective and Social Cognition Research on Bipolar Disorder (CAS-BD); Outcomes and Recommendations From an International Society for Bipolar Disorders Targeting Cognition Taskforce Study","authors":"T. E. Van Rheenen,&nbsp;K. E. Lewandowski,&nbsp;A. Pinkham,&nbsp;C. Varo,&nbsp;G. Caruana,&nbsp;J. Gruber,&nbsp;J. Zarp,&nbsp;A. H. Young,&nbsp;L. N. Yatham,&nbsp;E. Vieta,&nbsp;I. J. Torres,&nbsp;D. Tsapekos,&nbsp;T. Sumiyoshi,&nbsp;P. R. A. Stokes,&nbsp;A. Schaffer,&nbsp;S. Purdon,&nbsp;R. J. Porter,&nbsp;R. S. McIntyre,&nbsp;A. Martinez-Aran,&nbsp;C. López-Jaramillo,&nbsp;B. Lafer,&nbsp;L. V. Kessing,&nbsp;H. L. Kjærstad,&nbsp;G. Hasler,&nbsp;P. Gallagher,&nbsp;K. Douglas,&nbsp;A. Dols,&nbsp;A. F. Carvalho,&nbsp;K. E. Burdick,&nbsp;C. R. Bowie,&nbsp;C. M. Bonnin,&nbsp;V. Balanzá-Martínez,&nbsp;K. W. Miskowiak","doi":"10.1111/bdi.70083","DOIUrl":"10.1111/bdi.70083","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The Consensus on subdomains and measures of Affective and Social cognition for research on Bipolar Disorder (CAS-BD) project aimed to formulate preliminary consensus-based recommendations for assessing affective and social cognition in BD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Three sequential surveys administered to experts on affective and social cognition in BD were conducted using the Delphi process. Experts responded to questions regarding affective and social cognition subdomains and rated their importance to research on BD. Experts also nominated measures, rated them for suitability, and ranked them by preference for use. Consensus was defined as ≥ 80% agreement.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>31 experts completed the initial survey, with 20–23 completing subsequent surveys. Consensus was obtained for the subdomain structure of both <i>affective cognition</i> and <i>social cognition</i>, and the definition of each subdomain within. Explicit emotion regulation was ranked as being of highest priority for further research on affective cognition, and theory of mind as highest priority for further research on social cognition. The top-preferenced measures of all affective cognition subdomains were considered by consensus to be suitable for use in BD research. Agreement that the top-preferenced measures of social cognition were suitable ranged from 71.5% to 95.3%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Expert consensus on subdomains and measures of affective and social cognition for research on BD was obtained via a staged approach. Prior familiarity may have influenced some experts' rankings, but generally there was a notable lack of consistency in the use of available measures by BD experts. This reaffirms the need for more specific guidance and validated batteries of social and affective cognition to direct the field and allow for more consistency and replication of research in the future.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":"28 2","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12914090/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146211943","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 Significant Decline of Glomerular Filtration Rate in the Majority of Long-Term Lithium Users: Results of a Dutch Prospective 10-Year Cohort Study","authors":"M. J. van der Aa,&nbsp;D. Zittema,&nbsp;J. Doornebal,&nbsp;E. G. T. M. Hartong,&nbsp;E. M. Bisseling,&nbsp;J. Dammers,&nbsp;U. M. H. Klumpers,&nbsp;A. P. M. Kerckhoffs,&nbsp;R. W. Kupka,&nbsp;T. Nijenhuis","doi":"10.1111/bdi.70082","DOIUrl":"10.1111/bdi.70082","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>It remains unclear to what extent long-term lithium use leads to significant eGFR decline. This study examines the course of eGFR in a 10-year prospective cohort of lithium users and the association with duration of lithium use, lithium serum concentration, and comedication.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Material and Methods</h3>\u0000 \u0000 <p>This 10-year prospective cohort study included patients using lithium at inclusion. Medical records were reviewed for lithium concentration, eGFR, discontinuation of lithium, and other medication use. Primary outcome was a description of eGFR decline, quantified as delta eGFR per year of follow-up.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In total 196 patients were analyzed (42% male, mean age 51.1 ± 12.2, median follow-up time 8.8 years [IQR 1.3]). Median yearly decline was 0.79 mL/min/1.73 m². Of the participants, 48% had a yearly decline between 0.5 and 2.5 mL/min/1.73 m², while 11% showed a decline &gt; 2.5 mL/min/1.73 m². Duration of lithium use was associated with eGFR decline. A positive association between lithium serum concentration and kidney function decline was shown, when corrected for age, sex and duration of lithium use. Comedication was not associated with eGFR decline. In the participants who discontinued lithium (20%) during follow up, there was no significant difference in eGFR before and after cessation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study provides further evidence that eGFR decline occurs in most long-term lithium users. Of this cohort, 59% of the participants had faster eGFR decline than the mean decline in the general population. Lithium exposure, quantified as mean serum lithium concentration, could be a contributing factor in this decline. eGFR trajectory was not altered by ceasing lithium.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":"28 2","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12910323/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146206403","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":"Antidepressant-Associated Risk of Manic and Mixed Episode Hospitalization in Bipolar I Disorder: A 10-Year Population-Based Cohort Study","authors":"Diego Hidalgo-Mazzei,&nbsp;Gerard Anmella,&nbsp;Michele De Prisco,&nbsp;Vincenzo Oliva,&nbsp;Giovanna Fico,&nbsp;Clàudia Valenzuela-Pascual,&nbsp;Ariadna Mas,&nbsp;Marta Korniyenko,&nbsp;Marc Valentí,&nbsp;Jordi Blanch,&nbsp;Allan H. Young,&nbsp;Eduard Vieta","doi":"10.1111/bdi.70088","DOIUrl":"10.1111/bdi.70088","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Antidepressant (AD) use in bipolar I disorder (BD-I) remains controversial due to concerns about inducing manic/mixed episodes. We examined hospitalization risk following AD initiation in BD-I patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Using electronic health records from Catalonia (2010–2019), we conducted a retrospective cohort study of 7946 BD-I patients. We performed 1:1 propensity score matching based on age, sex, comorbidity count, and baseline mood stabilizer and antipsychotic use, yielding 3973 AD users matched to 3973 controls (mean age 50.9 years, 47.3% female) with 12-month follow-up. AD users were categorized by treatment strategy: AD monotherapy, AD plus antipsychotic (AD + AP), AD plus mood stabilizer (AD + MS), and AD plus both (AD + MS + AP). We estimated hospitalization risk using Cox proportional hazards models adjusted for clinical and demographic factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>During follow-up, 6.3% of patients experienced manic/mixed episode hospitalization. Overall, AD use was associated with increased risk (HR = 1.27, <i>p</i> = 0.008), with AD monotherapy showing highest risk (HR = 1.51, <i>p</i> &lt; 0.001). Notably, AD + MS combinations showed no significant risk increase. All AD strategies were associated with substantially higher risk for mixed episodes compared to pure mania. Age significantly modified risk, with patients 18–35 years showing greatest vulnerability to AD monotherapy (HR = 2.36, <i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In BD-I, AD use increases manic/mixed episode hospitalization risk by approximately 30%, with differential effects across treatment strategies and patient subgroups. Combining ADs with mood stabilizers appears to mitigate this risk, while mixed episodes and younger age represent particularly high-risk scenarios. These findings support guideline recommendations against AD monotherapy while suggesting opportunities for personalized treatment approaches in BD-I.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":"28 2","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146206440","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":"A High-Accuracy and Easy-Use Differential Diagnosis Method of Bipolar Disorder Depressive Phase and Major Depressive Disorder Using a Wearable Near-Infrared Spectroscopy","authors":"Yuji Sasaki,&nbsp;Koichi Ishizu,&nbsp;Akitoshi Seiyama,&nbsp;Naozo Sugimoto","doi":"10.1111/bdi.70089","DOIUrl":"10.1111/bdi.70089","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Although conventional multichannel near-infrared spectroscopy (cNIRS) has been reported to be useful in differentiating bipolar disorder depressive phase (BDD) from major depressive disorder (MDD), its utilization in real clinical practice remains limited. The objective of this study was to evaluate the performance of wearable NIRS (wNIRS), which is cheaper to install and easier to use than cNIRS, in differentiating between BDD and MDD, and to propose an optimal index for wNIRS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The subjects were 16 BDD patients, 16 MDD patients, and 16 healthy controls. Changes in the total hemoglobin signal (Δ[total-Hb]) in the bilateral frontal cortex during a 60 s verbal fluency task (VFT) were measured using the HOT-2000, a wNIRS capable of reducing noise from skin blood flow. In addition to evaluating the discriminative performance of the integral and centroid values proposed in previous studies, the ratio of the mean values of the Δ[total-Hb] during the first 20 s and subsequent 40 s (20–40 ratio) during the VFT was also employed and assessed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Only the 20–40 ratio showed significant differences between BDD and MDD, whereas the integral and centroid values did not. Using a cut-off value of 2.00 for the 20–40 ratio, the sensitivity and specificity of the BDD diagnosis were 100% and 93.4%, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The wNIRS measurements and the 20–40 ratio of the Δ[total-Hb] in the forehead area enabled more accurate differentiation between MDD and BDD than the conventional analysis.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":"28 2","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12908433/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146200062","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":"Understanding the Current State of Play of Early Intervention for Bipolar Disorder: Qualitative Analysis of Consultations With International Stakeholders","authors":"Sue M. Cotton,&nbsp;Vani Jain,&nbsp;Aswin Ratheesh,&nbsp;Clare Shelton,&nbsp;Craig Macneil,&nbsp;Kate M. Filia,&nbsp;Jacob Crouse,&nbsp;Annabel Burnside,&nbsp;Emily Clarke,&nbsp;Alesha Prasad,&nbsp;Rosie Arnold,&nbsp;Paul Badcock,&nbsp;Melissa Hasty","doi":"10.1111/bdi.70091","DOIUrl":"10.1111/bdi.70091","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Despite the burden associated with bipolar disorder (BD), research into early diagnosis and treatment of BD lags approximately 20 years behind the field of early intervention for psychosis. This study evolved through a partnership between Orygen (Melbourne, Australia) and the Daymark Foundation (Toronto, Canada). The primary focus was to answer the question: “How might we advance an early intervention approach for people at-risk of or with BD?”.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Semi-structured interviews were conducted with international experts and other stakeholders in early intervention and BD to identify challenges and barriers in early intervention approaches to BD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty-eight experts participated. Nine themes emerged as challenges: (i) limited recognition and understanding of BD across stakeholders; (ii) lack of definitions; (iii) poor resourcing and lack of prioritisation in funding models; (iv) absence of validated tools for diagnosis, monitoring treatment response and/or disorder progression; (v) absence of “big data”; (vi) scarcity of evidence-based treatments and clinical guidelines for the early stages of the disorder; (vii) obscurity around optimal service models; (viii) the need for better support and involvement of families and significant others; and (ix) the need for collaboration (across disciplines, stakeholders, and settings) to progress the field.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Limitations</h3>\u0000 \u0000 <p>Of those approached, 54.9% participated in the study. Given the qualitative nature of the study, recruiting more experts to the study would not necessarily change the outcomes as data saturation was achieved.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This work lays the foundations for developing a collaborative research framework to progress early intervention for young people with BD.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":"28 2","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12910188/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146206400","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":"Potential Impact of Childhood Abuse on Quality of Life During Mood-Stabilising Treatment in Individuals Living With Bipolar Disorder","authors":"Anna L. Wrobel,&nbsp;Olivia M. Dean,&nbsp;Mojtaba Lotfaliany,&nbsp;Michael Berk,&nbsp;Louisa G. Sylvia,&nbsp;Michael E. Thase,&nbsp;Thilo Deckersbach,&nbsp;Mauricio Tohen,&nbsp;Melvin G. McInnis,&nbsp;James H. Kocsis,&nbsp;Richard C. Shelton,&nbsp;Susan L. McElroy,&nbsp;Alyna Turner,&nbsp;Andrew A. Nierenberg","doi":"10.1111/bdi.70079","DOIUrl":"10.1111/bdi.70079","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>There is a lack of research examining whether childhood abuse affects the quality of life (QoL) of individuals living with bipolar disorder and its improvement over the course of treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data from the Clinical Health Outcomes Initiative in Comparative Effectiveness for Bipolar Disorder were used to explore the associations between childhood abuse and multiple domains of QoL among 476 outpatients with bipolar disorder. Rates of change in QoL throughout treatment were explored with a series of Generalised Estimation Equations for repeated measures.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>At baseline, childhood abuse was related to poorer QoL in the domains of subjective feelings of wellbeing, social relationships and general activities—but not in physical health or leisure activities. Throughout treatment, participants with a history of childhood abuse reported significantly worse QoL in the same domains, than participants with no history of childhood abuse. Interestingly, exploratory analyses showed that participants with a history of childhood abuse <i>and</i> a current diagnosis of post-traumatic stress disorder (PTSD) had significantly worse QoL in all domains, than participants with no history of childhood abuse <i>or</i> diagnosis of PTSD. There were no significant differences between groups in change in QoL in any of the domains.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study comprehensively investigated the relationships between a history of childhood abuse and QoL among people with bipolar disorder who were receiving pharmacotherapy. Although the present findings need to be replicated, they suggest significant impairment in several domains of QoL associated with childhood abuse, which has service and treatment implications for trauma-informed care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>ClinicalTrials.gov identifier: NCT01331304</p>\u0000 </section>\u0000 </div>","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":"28 2","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12896086/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146163657","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":"Collaborative Chronic Care Models for Bipolar Disorder: A Meta-Analysis","authors":"Mark S. Bauer,&nbsp;Christopher J. Miller","doi":"10.1111/bdi.70085","DOIUrl":"10.1111/bdi.70085","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Bipolar disorder is a chronic, complex mental health condition. Chronic Care Models were developed to treat chronic medical conditions in primary care. Several clinical trials have assessed their effects in treating individuals with bipolar disorder.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic literature review identified randomized controlled trials that tested interventions utilizing at least three of the five Chronic Care Model clinical elements. Random effects meta-analysis assessed impact on six outcome domains: overall mental health, mania, depression, mental health-related quality of life, physical health-related quality of life, and treatment costs. Risk of bias for individual trials and confidence in the point estimate for outcome domains were determined following the Cochrane methodology.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Eight randomized controlled trials were identified, resulting in six meta-analyses of two to eight trials each. The single-blind methodology resulted in a high overall risk of bias for each trial. Statistically significant benefit was seen for overall mental health (standardized mean difference (SMD) = 0.28, 95% CI = 0.13–0.43, <i>p</i> &lt; 0.01), mania (SMD = 0.16, 95% CI = 0.01–0.30, <i>p</i> = 0.03), and mental health-related quality of life (SMD = 0.24, 95% CI = 0.08–0.41, <i>p</i> &lt; 0.01). No evidence of an effect was seen for depression, physical health-related quality of life, or costs. Confidence was moderate for overall mental health outcome, mania, depression, and mental health-related quality of life; low for physical health-related quality of life; and very low for costs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Trials in diverse health care systems indicate that Chronic Care Model elements may improve mental health outcomes for bipolar disorder. This meta-analysis highlights the need for research to further explore the effectiveness and implementation of these models of care.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":"28 2","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146148860","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":"Perioperative Management of Lithium Therapy: Considerations and Recommendations","authors":"L. S. Dominicus,&nbsp;F. van Houwelingen,&nbsp;M. Marsman,&nbsp;G. Lefeber,&nbsp;I. Wilting,&nbsp;A. Dols","doi":"10.1111/bdi.70087","DOIUrl":"10.1111/bdi.70087","url":null,"abstract":"&lt;p&gt;Lithium is a widely used mood stabilizer, primarily prescribed for patients with bipolar disorder (BD). It is also used as an adjunct therapy next to antidepressants in treatment-resistant unipolar depressive disorder and, off-label, as a prophylactic treatment for cluster headaches. Lithium has a narrow therapeutic index and its pharmacokinetics shows high inter- and intraindividual variation meaning that relatively small changes in serum level of lithium pose a significant risk of toxic or subtherapeutic serum levels, necessitating careful therapeutic drug monitoring. Lithium toxicity carries both acute and chronic health risks. In the short term, patients may experience neurotoxicity, which can manifest as confusion, cognitive impairment, and neuromuscular disturbances, alongside gastrointestinal symptoms and cardiovascular complications, and the rare but well-described pulmonary manifestations of acute non-cardiogenic pulmonary edema and acute respiratory distress syndrome (ARDS). Long-term exposure to toxic lithium levels is linked to the development of progressive chronic kidney disease and cerebellar toxicity (ataxia and cognitive impairment), also known as syndrome of irreversible lithium effectuated neurotoxicity (SILENT). In recent years, lithium-related renal decline has been linked to sustained supratherapeutic levels; this represents one of the risk factors for episodes of acute intoxication [&lt;span&gt;1&lt;/span&gt;], urging clinicians to monitor levels carefully.&lt;/p&gt;&lt;p&gt;Monitoring lithium serum trough levels during the perioperative and postoperative periods is essential due to the risk of toxicity, which can result from fluctuations in lithium clearance due to changes in fluid/salt intake, hemodynamic changes caused by blood loss and/or fluid shifts, and the use of concomitant medications such as diuretics and NSAIDs. Cautious dosing is therefore recommended during these periods, with a preference for lower doses rather than higher ones. In clinical practice, the risk of manic or psychotic decompensation from subtherapeutic lithium levels for a few days is generally lower than the risk of acute lithium toxicity. Furthermore, acute psychiatric symptoms can be treated with rapid acting agents such as benzodiazepines and antipsychotics, whereas lithium toxicity may cause permanent renal and neurotoxic damage.&lt;/p&gt;&lt;p&gt;Clinical guidelines on perioperative management of lithium usually advise to discontinue lithium 24–72 h before major surgery [&lt;span&gt;2-4&lt;/span&gt;], but lack specifying measures based on a low, intermediate, or high risk for intoxication.&lt;/p&gt;&lt;p&gt;Inadequate monitoring of lithium in the perioperative period poses significant risks, particularly when hemodynamic instability or impaired renal function affects sodium and potassium balance. Toxicity may develop rapidly, especially in patients with nephrogenic diabetes insipidus (NDI), a condition associated with large fluid loss which requires large fluid intake, affecting 20%–40% of long-t","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":"28 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12875007/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146123521","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}