Bipolar Disorders最新文献

{"title":"The Character of Depression","authors":"Gin S. Malhi, Erica Bell, Gracie Meng-Cin Tsai, Ching-Wen Hung, Mei-tzu Tsai, Chia-Yi Wu","doi":"10.1111/bdi.13514","DOIUrl":"10.1111/bdi.13514","url":null,"abstract":"","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":"27 1","pages":"72-73"},"PeriodicalIF":5.0,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142862960","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":"Chronic Serotonin Syndrome Masquerading as Anxiety and Agitation in a Patient With Mood Disorder: A Clinical Dilemma!","authors":"Nicola Keeth, Jonathan G Leung, Balwinder Singh","doi":"10.1111/bdi.13513","DOIUrl":"https://doi.org/10.1111/bdi.13513","url":null,"abstract":"","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142823824","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 Diagnostic Conversion From Major Depressive Disorder to Bipolar Disorder: An EHR Based Study From Colombia","authors":"Susan K. Service,&nbsp;Juan F. De La Hoz,&nbsp;Ana M. Diaz-Zuluaga,&nbsp;Alejandro Arias,&nbsp;Aditya Pimplaskar,&nbsp;Chuc Luu,&nbsp;Laura Mena,&nbsp;Johanna Valencia-Echeverry,&nbsp;Mauricio Castaño Ramírez,&nbsp;Carrie E. Bearden,&nbsp;Chiara Sabatti,&nbsp;Victor I. Reus,&nbsp;Carlos López-Jaramillo,&nbsp;Nelson B. Freimer,&nbsp;Loes M. Olde Loohuis","doi":"10.1111/bdi.13512","DOIUrl":"10.1111/bdi.13512","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Most bipolar disorder (BD) patients initially present with depressive symptoms, resulting in a delayed diagnosis of BD and poor clinical outcomes. This study aims to identify features predictive of the conversion from Major Depressive Disorder (MDD) to BD by leveraging electronic health record (EHR) data from the Clínica San Juan de Dios Manizales in Colombia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We employed a multivariable Cox regression model to identify important predictors of conversion from MDD to BD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Analyzing 15 years of EHR data from 13,607 patients diagnosed with MDD, a total of 1610 (11.8%) transitioned to BD. Predictive features of the conversion to BD included severity of the initial MDD episode, presence of psychosis and hospitalization at first episode, family history of BD, and female gender. Additionally, we observed associations with medication classes (positive associations with prescriptions of mood stabilizers, antipsychotics, and negative associations with antidepressants) and a positive association with suicidality, a feature derived from natural language processing (NLP) of clinical notes. Together, these risk factors predicted BD conversion within 5 years of the initial MDD diagnosis, with a recall of 72% and a precision of 38%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our study confirms previously identified risk factors identified through registry-based studies (female gender and psychotic depression at the index MDD episode) and identifies novel ones (suicidality extracted from clinical notes). These results simultaneously demonstrate the validity of using EHR data for predicting BD conversion and underscore its potential for the identification of novel risk factors, thereby improving early diagnosis.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":"27 1","pages":"47-56"},"PeriodicalIF":5.0,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bdi.13512","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142817060","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":"Patients' Perspectives on the Consequences of Eliminating Prepubertal-Pediatric Bipolar Disorder as a Valid Diagnosis","authors":"Katrin I. Kutlucinar,&nbsp;Kathryn Burrows","doi":"10.1111/bdi.13510","DOIUrl":"10.1111/bdi.13510","url":null,"abstract":"","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":"27 1","pages":"67-68"},"PeriodicalIF":5.0,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142806056","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,&nbsp;Mauricio Tohen,&nbsp;Diane McIntosh,&nbsp;Lars Vedel Kessing,&nbsp;Martha Sajatovic,&nbsp;Roger S. McIntyre","doi":"10.1111/bdi.13498","DOIUrl":"10.1111/bdi.13498","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>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>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>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>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>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>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>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>\u0000 </section>\u0000 </div>","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":"27 1","pages":"7-16"},"PeriodicalIF":5.0,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bdi.13498","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychotherapy online: Bridging the gap between recommendations and reality","authors":"Ralph Kupka,&nbsp;Manja Koenders,&nbsp;Susan Zyto","doi":"10.1111/bdi.13509","DOIUrl":"10.1111/bdi.13509","url":null,"abstract":"&lt;p&gt;There is a simple, layman's version of bipolar disorder: an episodic mental illness with seriously disturbing manic and depressive episodes, and after recovery long periods of euthymia in which all is well again. Medication is effective in the acute symptomatic treatment, and maintenance pharmacotherapy prevents future episodes, if prescribed and taken indefinitely. Psychoeducation will increase insight and awareness of the characteristics of the illness, and thereby facilitate acceptance, self-management, and treatment compliance.&lt;/p&gt;&lt;p&gt;Anyone who has to deal with bipolar illness, either as a patient, a family member, a caregiver, or a professional, knows that the reality is far more complex. If this is true for the acute management and pharmacotherapy, it is even more for the time after the storm has calmed down. Subsyndromal residual symptoms and mood instability, subtle but annoying cognitive impairments, occupational and interpersonal problems as a result of past manic behavior, an injured self-image, and doubts about what to expect in the future, may all have a negative impact on psychosocial functioning and emotional wellbeing. Highly prevalent comorbid psychiatric conditions like anxiety disorders, personality disorders, and substance abuse further complicate this situation.&lt;/p&gt;&lt;p&gt;Of the psychological approaches, psychoeducation is now a well-established intervention which is part of standard treatment. In addition, family-focused therapy (FFT), cognitive behavioral therapy (CBT), and interpersonal and social rhythm therapy (IPSRT) are also recommended in most clinical guidelines, in combination with pharmacotherapy. A major concern is: while most treated patients with bipolar disorder will receive pharmacotherapy, and many will have had some form of psychoeducation, how many do get one of these recommended psychotherapies? How many psychologists and psychotherapist have an interest in bipolar disorder, let alone will be trained in these specific interventions? Bipolar disorder has long been viewed as a highly biologically rooted psychiatric illness, where pharmacotherapy is the cornerstone of acute curative and long-term preventive treatment. Moreover, dare psychotherapists treat a person with an anxiety or personality disorder, when she/he also suffers from bipolar disorder? The recently established ISBD Psychological Interventions Taskforce&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; is a welcome initiative to improve this situation, as is this special issue of Bipolar Disorders Journal.&lt;/p&gt;&lt;p&gt;Tremain et al.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; address several important issues that underscore the potential for psychological treatment in addition to pharmacotherapy and clinical management of mood episodes.&lt;/p&gt;&lt;p&gt;First, we have to extend treatment of bipolar disorder beyond symptomatic recovery. Van der Voort et al.&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; showed that functional recovery in recurrent depressive and bipolar disorder seriously lags behind recovery of a depressive ep","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":"26 7","pages":"746-747"},"PeriodicalIF":5.0,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bdi.13509","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142457217","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":"26 7","pages":"748-749"},"PeriodicalIF":5.0,"publicationDate":"2024-10-17","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":"The Holy Grail revisited: What works for whom?","authors":"Holly A. Swartz","doi":"10.1111/bdi.13507","DOIUrl":"10.1111/bdi.13507","url":null,"abstract":"","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":"26 7","pages":"744-745"},"PeriodicalIF":5.0,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142387653","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,&nbsp;Jeremiah B. Joyce,&nbsp;Caroline W. Grant,&nbsp;Paul E. Croarkin,&nbsp;Arjun P. Athreya,&nbsp;William V. Bobo","doi":"10.1111/bdi.13506","DOIUrl":"10.1111/bdi.13506","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>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>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Supervised machine learning models were trained on data from BP-D patients treated with olanzapine (<i>N</i> = 168) and were externally validated on patients treated with olanzapine/fluoxetine combination (OFC; <i>N</i> = 131) and lamotrigine (LTG; <i>N</i> = 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>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>An AUC of 0.76 (NIR:0.59; <i>p</i> = 0.17) was established to predict remission in olanzapine-treated subjects. These trained models achieved AUCs of 0.70 with OFC (NIR:0.52; <i>p</i> &lt; 0.03) and 0.73 with LTG (NIR:0.52; <i>p</i> &lt; 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; <i>p</i> &lt; 9.3E-11).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>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>\u0000 </section>\u0000 </div>","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":"27 1","pages":"36-46"},"PeriodicalIF":5.0,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bdi.13506","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":"OA","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,&nbsp;Khairatun Yusuff,&nbsp;Clara Park,&nbsp;Alexandra DeShaw,&nbsp;Christina Gonzalez-Torres,&nbsp;Muhammad I. Husain,&nbsp;Claire O'Donovan,&nbsp;Martin Alda,&nbsp;Benoit H. Mulsant,&nbsp;Abigail Ortiz","doi":"10.1111/bdi.13504","DOIUrl":"10.1111/bdi.13504","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>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>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>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>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>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>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>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>\u0000 </section>\u0000 </div>","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":"26 8","pages":"810-819"},"PeriodicalIF":5.0,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11627008/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}