Bipolar Disorders最新文献

{"title":"A 6-month, prospective, randomized controlled trial of customized adherence enhancement versus a bipolar-specific educational control in poorly adherent adolescents and young adults living with bipolar disorder.","authors":"Jennifer B Levin, Melissa DelBello, Avani C Modi, Farren Briggs, Larry F Forthun, Molly McVoy, Joy Yala, Raechel Cooley, Jessica Black, Carla Conroy, Martha Sajatovic","doi":"10.1111/bdi.13489","DOIUrl":"10.1111/bdi.13489","url":null,"abstract":"<p><strong>Objective: </strong>Few studies have addressed medication adherence in adolescents and young adults (AYAs) with bipolar disorder (BD). This 6-month prospective randomized-controlled trial (RCT) tested customized adherence enhancement for adolescents and young adults (CAE-AYA), a behavioral intervention for AYAs versus enhanced treatment as usual (ETAU).</p><p><strong>Methods: </strong>Inclusion criteria were AYAs age 13-21 with BD type I or II with suboptimal adherence defined as missing ≥20% of medications. Assessments were conducted at Screening, Baseline, and weeks 8, 12 and 24. Primary outcome was past 7 day self-reported Tablets Routine Questionnaire (TRQ) validated by electronic pillbox monitoring (SimpleMed). Symptom measures included the Hamilton Depression Rating Scale (HAM-D) and Young Mania Rating Scale (YMRS).</p><p><strong>Results: </strong>The mean sample age (N = 36) was 19.1 years (SD = 2.0); 66.7% (N = 24) female, BD Type I (81%). The mean missed medication on TRQ for the total sample was 35.4% (SD = 28.8) at screening and 30.4% (SD = 30.5) at baseline. Both CAE-AYA and ETAU improved on TRQ from screening to baseline. Baseline mean missed medication using SimpleMed was 51.6% (SD = 38.5). Baseline HAM-D and YMRS means were 7.1 (SD = 4.7) and 6.0 (SD = 7.3), respectively. Attrition rate at week 24 was 36%. Baseline to 24-week change on TRQ, adjusting for age, gender, educational level, living situation, family history, race, and ethnicity, showed improvement favoring CAE-AYA versus ETAU of 15%. SimpleMed interpretation was limited due to substantial missing data. There was a significant reduction in depression favoring CAE-AYA.</p><p><strong>Conclusions: </strong>CAE-AYA may improve adherence in AYAs with BD, although conclusions need to be made cautiously given study limitations.</p><p><strong>Clinical trials registration: </strong>ClinicalTrials.gov identifier: NCT04348604.</p>","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":" ","pages":"696-707"},"PeriodicalIF":8.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11560489/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142131752","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":"Commentary on 'Comorbidity of bipolar disorder and borderline personality disorder: Phenomenology, course and treatment considerations' by Temes et al.","authors":"Roger T Mulder","doi":"10.1111/bdi.13508","DOIUrl":"10.1111/bdi.13508","url":null,"abstract":"","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":" ","pages":"748-749"},"PeriodicalIF":5.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142457216","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":"Early use of long-acting injectable antipsychotics in bipolar disorder type I: An expert consensus.","authors":"Eduard Vieta, Mauricio Tohen, Diane McIntosh, Lars Vedel Kessing, Martha Sajatovic, Roger S McIntyre","doi":"10.1111/bdi.13498","DOIUrl":"https://doi.org/10.1111/bdi.13498","url":null,"abstract":"<p><strong>Introduction: </strong>Long-acting injectable antipsychotics (LAIs) are not routinely offered to patients living with bipolar disorder type I (BP-I), despite widespread evidence that supports their benefits over oral antipsychotics, particularly in early disease.</p><p><strong>Methods: </strong>A round-table meeting of psychiatrists convened to discuss barriers and opportunities and provide consensus recommendations around the early use of LAIs for BP-I.</p><p><strong>Results: </strong>LAIs are rarely prescribed to treat BP-I unless a patient has severe symptoms, sub-optimal adherence to oral antipsychotics, or has experienced multiple relapses. Beyond country-specific accessibility issues (e.g., healthcare infrastructure and availability/approval status), primary barriers to the effective use of LAIs were identified as attitudinal and knowledge/experience-based. Direct discussions between healthcare providers and patients about treatment preferences may not occur due to a preconceived notion that patients prefer oral antipsychotics. Moreover, as LAIs have historically been limited to the treatment of schizophrenia and the most severe cases of BP-I, healthcare providers might be unaware of the benefits LAIs provide in the overall management of BP-I. Improved treatment adherence associated with LAIs compared to oral antipsychotics may support improved outcomes for patients (e.g., reduced relapse and hospitalization). Involvement of all stakeholders (healthcare providers, patients, and their supporters) participating in the patient journey is critical in early and shared decision-making processes. Clinical and database studies could potentially bridge knowledge gaps to facilitate acceptance of LAIs.</p><p><strong>Conclusion: </strong>This review discusses the benefits of LAIs in the management of BP-I and identifies barriers to use, while providing expert consensus recommendations for potential solutions to support informed treatment decision-making.</p>","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142494582","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":"Predicting remission after acute phase pharmacotherapy in patients with bipolar I depression: A machine learning approach with cross-trial and cross-drug replication.","authors":"Jean Marrero-Polanco, Jeremiah B Joyce, Caroline W Grant, Paul E Croarkin, Arjun P Athreya, William V Bobo","doi":"10.1111/bdi.13506","DOIUrl":"https://doi.org/10.1111/bdi.13506","url":null,"abstract":"<p><strong>Objectives: </strong>Interpatient variability in bipolar I depression (BP-D) symptoms challenges the ability to predict pharmacotherapeutic outcomes. A machine learning workflow was developed to predict remission after 8 weeks of pharmacotherapy (total score of ≤8 on the Montgomery Åsberg Depression Rating Scale [MADRS]).</p><p><strong>Methods: </strong>Supervised machine learning models were trained on data from BP-D patients treated with olanzapine (N = 168) and were externally validated on patients treated with olanzapine/fluoxetine combination (OFC; N = 131) and lamotrigine (LTG; N = 126). Top predictors were used to develop a prognosis rule informing how many symptoms should change and by how much within 4 weeks to increase the odds of achieving remission.</p><p><strong>Results: </strong>An AUC of 0.76 (NIR:0.59; p = 0.17) was established to predict remission in olanzapine-treated subjects. These trained models achieved AUCs of 0.70 with OFC (NIR:0.52; p < 0.03) and 0.73 with LTG (NIR:0.52; p < 0.003), demonstrating external replication of prediction performance. Week-4 changes in four MADRS symptoms (reported sadness, reduced sleep, reduced appetite, and concentration difficulties) were top predictors of remission. Across all pharmacotherapies, three or more of these symptoms needed to improve by ≥2 points at Week-4 to have a 65% chance of achieving remission at 8 weeks (OR: 3.74, 95% CI: 2.45-5.76; p < 9.3E-11).</p><p><strong>Conclusion: </strong>Machine learning strategies achieved cross-trial and cross-drug replication in predicting remission after 8 weeks of pharmacotherapy for BP-D. Interpretable prognoses rules required only a limited number of depressive symptoms, providing a promising foundation for developing simple quantitative decision aids that may, in the future, serve as companions to clinical judgment at the point of care.</p>","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142370912","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":"Mood regulation in euthymic patients with a history of antidepressant-induced mania.","authors":"Ramzi Halabi, Khairatun Yusuff, Clara Park, Alexandra DeShaw, Christina Gonzalez-Torres, Muhammad I Husain, Claire O'Donovan, Martin Alda, Benoit H Mulsant, Abigail Ortiz","doi":"10.1111/bdi.13504","DOIUrl":"https://doi.org/10.1111/bdi.13504","url":null,"abstract":"<p><strong>Introduction: </strong>The use of antidepressants in bipolar disorder (BD) remains contentious, in part due to the risk of antidepressant-induced mania (AIM). However, there is no information on the architecture of mood regulation in patients who have experienced AIM. We compared the architecture of mood regulation in euthymic patients with and without a history of AIM.</p><p><strong>Methods: </strong>Eighty-four euthymic participants were included. Participants rated their mood, anxiety and energy levels daily using an electronic (e-) visual analog scale, for a mean (SD) of 280.8(151.4) days. We analyzed their multivariate time series by computing each variable's auto-correlation, inter-variable cross-correlation, and composite multiscale entropy of mood, anxiety, and energy. Then, we compared the data features of participants with a history of AIM and those without AIM, using analysis of covariance, controlling for age, sex, and current treatment.</p><p><strong>Results: </strong>Based on 18,103 daily observations, participants with AIM showed significantly stronger day-to-day auto-correlation and cross-correlation for mood, anxiety, and energy than those without AIM. The highest cross-correlation in participants with AIM was between mood and energy within the same day (median (IQR), 0.58 (0.27)). The strongest negative cross-correlation in participants with AIM was between mood and anxiety series within the same day (median (IQR), -0.52 (0.34)).</p><p><strong>Conclusion: </strong>Patients with a history of AIM have a different underlying mood architecture compared to those without AIM. Their mood, anxiety and energy stay the same from day-to-day; and their anxiety is negatively correlated with their mood.</p>","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142341015","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":"Oral Abstracts","authors":"","doi":"10.1111/bdi.13475","DOIUrl":"https://doi.org/10.1111/bdi.13475","url":null,"abstract":"","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":"26 S1","pages":"45-71"},"PeriodicalIF":5.0,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bdi.13475","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142244560","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":"ISBD Keynote Abstracts","authors":"","doi":"10.1111/bdi.13473","DOIUrl":"https://doi.org/10.1111/bdi.13473","url":null,"abstract":"","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":"26 S1","pages":"8-9"},"PeriodicalIF":5.0,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bdi.13473","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142244558","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":"Concurrent State of the Art Abstracts","authors":"","doi":"10.1111/bdi.13474","DOIUrl":"https://doi.org/10.1111/bdi.13474","url":null,"abstract":"","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":"26 S1","pages":"10-44"},"PeriodicalIF":5.0,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bdi.13474","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142244559","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":"Poster Abstracts","authors":"","doi":"10.1111/bdi.13476","DOIUrl":"https://doi.org/10.1111/bdi.13476","url":null,"abstract":"","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":"26 S1","pages":"72-150"},"PeriodicalIF":5.0,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bdi.13476","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142244554","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":"Welcome Letter","authors":"","doi":"10.1111/bdi.13471","DOIUrl":"https://doi.org/10.1111/bdi.13471","url":null,"abstract":"&lt;p&gt;Welcome to the 26th Annual Conference of the International Society for Bipolar Disorders! The annual meeting brings together experts in bipolar disorders including researchers, educators, clinicians, and experts by experience. We are a global organization with representation from over 20 countries. Over three jam-packed days in Reykjavik, a first-time location for ISBD, we will share knowledge and wisdom about mood disorders. Through improved understanding of the causes and treatments for these conditions, we will be better prepared to support those we serve.&lt;/p&gt;&lt;p&gt;Meaningfully, 2024 marks the 30th anniversary of ISBD's inception. In 1994, Drs. David Kupfer and Ellen Frank hosted the first International Conference on Bipolar Disorders (ICBD), the precursor to ISBD, in Pittsburgh, Pennsylvania. An eager group of researchers and clinicians gathered on the University of Pittsburgh campus from June 23–24, 1994, for the latest updates on bipolar disorder. On June 17, 1999, ISBD was officially launched in Pittsburgh during the 3rd biennial ICBD meeting. Guided by Dr. Kupfer's vision for an international community of experts who gather regularly to share scientific advances and engage in advocacy for equitable research funding for bipolar disorders, ISBD was born. Thirty years later, ISBD is alive and well.&lt;/p&gt;&lt;p&gt;Selected from an outstanding pool of submissions, this year's program comprises 30 symposia, six workshops, 66 oral reports, and two poster sessions. We will also host the Women's Initiative to support gender diversity in our Society and an Early-Mid Career Committee networking session to advance the up-and-coming leaders in our field.&lt;/p&gt;&lt;p&gt;Among our truly exceptional line-up of presentations, I would like to highlight six invited plenary talks: &lt;i&gt;My Bipolar Journey&lt;/i&gt; (Leah Charles-King), &lt;i&gt;Debate on Antidepressant Medication for Bipolar Disorder&lt;/i&gt; (Ralph Kupka, Eduard Vieta, Lakshmi Yatham), &lt;i&gt;Genetic Architecture of Bipolar Disorder: Knowns and Unknowns&lt;/i&gt; (Ole A. Andreassen), &lt;i&gt;From Speech to Emotion to Mood: Mental Health Modeling in Natural Environments&lt;/i&gt; (Emily Mower Provost), &lt;i&gt;Older Age Bipolar Disorder: Cognitive and Somatic Comorbidities (&lt;/i&gt;Annemiek Dols&lt;i&gt;), and Ongoing Bipolar Mood Instability: What Can, or Could, Psychological Interventions Offer?&lt;/i&gt; (Kim Wright). Don't miss any of them!&lt;/p&gt;&lt;p&gt;Because of the large number of outstanding submissions this year, we expanded our oral report offerings. With 66 presentations, it is impossible to highlight all of them, but I wanted to call your attention to just a few offerings to give you a taste of the feast awaiting us: &lt;i&gt;Polygenic Scores and Mood Disorder Risk in Context of Family History and Developmental Psychopathology&lt;/i&gt; (Rudolf Uher), &lt;i&gt;Elucidating Neurovascular Dynamics in Bipolar Disorder with Patient-Derived Vascularized Cerebral Organoids&lt;/i&gt; (Annie Kathuria), &lt;i&gt;Fostering Network Opportunities and Creating a Community of Early and Mid-Career Members of t","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":"26 S1","pages":"6"},"PeriodicalIF":5.0,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bdi.13471","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142244556","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}