Bipolar Disorders最新文献

{"title":"Longitudinal Trajectory of Cognition, Brain Morphometry, and Brain Predicted Age in Unaffected First-Degree Relatives of Patients With Bipolar Disorder","authors":"Hanne Lie Kjærstad,&nbsp;Julian Macoveanu,&nbsp;Alexander Tobias Ysbæk-Nielsen,&nbsp;Viktoria Damgaard,&nbsp;Sophia Frangou,&nbsp;Gitte M. Knudsen,&nbsp;Klara Coello,&nbsp;Sharleny Stanislaus,&nbsp;Maria Faurholt-Jepsen,&nbsp;Maj Vinberg,&nbsp;Lars Vedel Kessing,&nbsp;Kamilla Woznica Miskowiak","doi":"10.1111/bdi.70050","DOIUrl":"10.1111/bdi.70050","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Prior research suggests structural brain abnormalities and cognitive difficulties in patients with bipolar disorder. Although there is some evidence that similar structural and cognitive changes may also be present in unaffected relatives (UR) of patients with bipolar disorder, it is not known whether they remain static or aggravate over time. In this study, we investigate the longitudinal trajectories of cognition and brain structure in UR.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Longitudinal neurocognitive and MRI data were acquired at baseline from UR (<i>n</i> = 72) and healthy controls (HC; <i>n</i> = 65) and at 15 (±4) months follow-up (UR <i>n</i> = 32; HC <i>n</i> = 38). The differential trajectories between UR and HC in neurocognitive performance, white matter volume, regional cortical gray matter (GM) volume and thickness, hippocampal and amygdala volumes, and the difference between biological age and age estimated from brain MRI (brainPAD) were investigated using linear mixed models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>UR showed subtle impairments in processing speed, which normalized at follow-up to levels comparable to HC. At both time points, UR showed stable enlargement of amygdalae compared to HC. There was a significant group-by-time interaction effect for the GM volume in the left superior temporal gyrus, driven by UR at baseline displaying larger GM volume compared to HC, which normalized over time. There was no significant difference between UR and HC in brainPAD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Bilaterally enlarged amygdala and larger temporal GM volume in UR compared to HC may reflect a vulnerability factor for bipolar disorder. Longer follow-up times are needed to elucidate structural predictors of risk of subsequent illness onset.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":"27 6","pages":"424-434"},"PeriodicalIF":4.5,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bdi.70050","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144844307","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":"Defining Treatment-Resistant Bipolar Depression: Recommendations From the ISBD Task Force","authors":"Eduard Vieta,&nbsp;Roger S. McIntyre,&nbsp;Trisha Suppes,&nbsp;Tamsyn E. Van Rheenen,&nbsp;Balwinder Singh,&nbsp;Kamilla Woznica Miskowiak,&nbsp;Allan H. Young,&nbsp;Lakshmi N. Yatham,&nbsp;Kyooseob Ha,&nbsp;Michael Berk,&nbsp;Holly A. Swartz,&nbsp;Chantal Henry,&nbsp;Maja Pantovic Stefanovic,&nbsp;Gerard Anmella Diaz,&nbsp;Aysegul Ozerdem,&nbsp;Wiesław J. Cubała,&nbsp;Diego Hidalgo-Mazzei,&nbsp;Mauricio Tohen,&nbsp;Isabella Pacchiarotti,&nbsp;Paula Villela Nunes,&nbsp;Carlos Lopez-Jaramillo,&nbsp;Ana Gonzalez-Pinto,&nbsp;Paolo Brambilla,&nbsp;Robert Post,&nbsp;Jair C. Soares,&nbsp;Michael Bauer,&nbsp;Ana C. Andreazza,&nbsp;Xavier Justes Fradera,&nbsp;Montserrat Cosials-Lopez,&nbsp;Giovanna Fico","doi":"10.1111/bdi.70048","DOIUrl":"10.1111/bdi.70048","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Despite the availability of approved treatments, a substantial proportion of patients with bipolar disorder experience treatment-resistant bipolar depression (TRBD), characterized by persistent depressive symptoms unresponsive to standard therapies. However, a universally accepted definition of TRBD is lacking. This consensus document, developed by the International Society for Bipolar Disorders (ISBD) Task Force on TRBD, aims to provide a standardized definition of TRBD to facilitate clinical trials, research, and treatment strategies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The Task Force employed a literature review, clinical trials analysis, and expert consensus meetings to define TRBD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>TRBD was defined as the failure to achieve a significant and sustained clinical response after at least two approved and adequately dosed pharmacological treatments, administered for a sufficient duration with treatment adherence. For bipolar I (BD-I) depression, approved treatments included quetiapine (300–600 mg/day for ≥ 8 weeks), lurasidone (20–120 mg/day for ≥ 6 weeks), the combination of olanzapine (6–12 mg/day) and fluoxetine (25–75 mg/day for ≥ 8 weeks), cariprazine (1.5–3 mg/day for ≥ 6 weeks), and lumateperone (42 mg/day for ≥ 6 weeks). For bipolar II (BD-II) depression, approved treatments included quetiapine (300–600 mg/day for ≥ 8 weeks) and lumateperone (42 mg/day for ≥ 6 weeks).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This consensus definition aims to provide clarity for clinical trials, improve consistency in research, and guide treatment approaches and inform regulatory pathways. It represents a foundational step in addressing the unmet needs in TRBD and promoting the development of innovative therapeutic strategies. Future efforts will focus on adapting the definition to better align with real-world clinical challenges and optimize patient care.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":"27 6","pages":"411-423"},"PeriodicalIF":4.5,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12393891/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144844331","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":"Pursuing, Protecting and Publishing the Truth: The Three Benjamins","authors":"Gin S. Malhi,&nbsp;Kinga Szymaniak,&nbsp;Erica Bell,&nbsp;Gurubhaskar Shivakumar,&nbsp;Amber Hamilton,&nbsp;Grace Morris,&nbsp;Ralph Kupka,&nbsp;Erin E. Michalak,&nbsp;Ayal Schaffer,&nbsp;Holly A. Swartz","doi":"10.1111/bdi.70039","DOIUrl":"10.1111/bdi.70039","url":null,"abstract":"","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":"27 4","pages":"261-267"},"PeriodicalIF":5.0,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144567033","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":"Developing a Decision Support Tool to Guide Shared Decision-Making in Bipolar Depression Treatment: Results From a Collaboration Between Clinicians and People With Lived Experience","authors":"Manuel Fuentes-Salgado,&nbsp;Manuel Gardea-Resendez,&nbsp;Andrew Smith,&nbsp;Angie Lam,&nbsp;Kimberly Allen,&nbsp;Mete Ercis,&nbsp;Ashley Kremin,&nbsp;Jeremiah B. Joyce,&nbsp;Jin Hong Park,&nbsp;Nicola Keeth,&nbsp;Katherine Moore,&nbsp;Hannah Betcher,&nbsp;Padao Yang,&nbsp;Jonathan G. Leung,&nbsp;Aysegul Ozerdem,&nbsp;Samuel T. Savitz,&nbsp;Mark D. Williams,&nbsp;Victor M. Montori,&nbsp;Pollock Michael,&nbsp;Mark A. Frye","doi":"10.1111/bdi.70037","DOIUrl":"10.1111/bdi.70037","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To build consensus from different stakeholders on the content and digital interactivity of a shared decision making (SDM) tool to guide patient-clinician collaborative conversations about treatment for bipolar depression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and Methods</h3>\u0000 \u0000 <p>This study was conducted between September 2022 and September 2023. In the first phase, we conducted a narrative review on pharmacological, neuromodulatory, and psychotherapeutic treatments available for bipolar depression. For each option, we assessed treatment effectiveness, side effects, need for clinical monitoring, clinical considerations, and cost. In the second phase, committees comprised of mental health clinicians and people with lived experience with bipolar disorder from a national mood disorders advocacy group identified key features and content to be included in the SDM tool. A thematic analysis of these data then contributed to populate the SDM tool.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty-one evidence-based treatment options identified from the narrative review were presented to the four convened committees (clinical, lived experience, peer council, and integrated steering committees) in five meetings. After discussions and thematic analysis, 12 outcomes of interest for each of the therapeutic interventions were delineated for inclusion in a web-based SDM tool. A detailed description of the development process and SDM tool is provided.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This is the first partnership between clinicians and persons with bipolar disorder lived experience charged with the development of a patient-centered SDM tool to integrate clinical evidence with real-world clinical practice and patient preferences for use during clinical encounters. Human-centered design and testing in real clinical encounters will now contribute to refining the instrument and readying it for rigorous evaluation and implementation in practice.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":"27 5","pages":"358-364"},"PeriodicalIF":4.5,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144257285","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":"Popularity Is Not Consensus","authors":"Sergio Strejilevich,&nbsp;Cecilia Samamé,&nbsp;Danilo Quiroz","doi":"10.1111/bdi.70036","DOIUrl":"10.1111/bdi.70036","url":null,"abstract":"","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":"27 4","pages":"323-324"},"PeriodicalIF":5.0,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144126574","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":"Assisted Dying in the Context of Depression: A Consequential Matter Warranting Systematic Research?","authors":"Gin S. Malhi","doi":"10.1111/bdi.70035","DOIUrl":"10.1111/bdi.70035","url":null,"abstract":"","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":"27 3","pages":"173-175"},"PeriodicalIF":5.0,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144109637","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":"Management of Refractory Catatonia Associated With OCD Exacerbation in a Patient With Bipolar I Disorder: A Case Report","authors":"Jiyun Lee,&nbsp;Rahat Hossain,&nbsp;Nikola Grujich,&nbsp;Ayal Schaffer","doi":"10.1111/bdi.70034","DOIUrl":"10.1111/bdi.70034","url":null,"abstract":"&lt;p&gt;A 31-year-old with Bipolar I Disorder (BD-I) and longstanding comorbid obsessive-compulsive disorder (OCD) was re-hospitalized for severe exacerbation of OCD symptoms associated with intolerable distress and inability to cope at home. This occurred one week after discharge for a recent manic episode with mixed and catatonic features. The recent hospitalization involved six sessions of bilateral electroconvulsive therapy (ECT) and a switch from olanzapine to loxapine as part of his triple anti-manic therapy with ongoing lithium and valproate.&lt;/p&gt;&lt;p&gt;Since his mania onset in his early twenties, the course of illness was characterized by four manias, two depressions, and one mixed state with unspecified polarity. One of his four manic episodes was medication-induced, following the use of an antidepressant for depressive symptoms. There were eight psychiatric admissions and three episodes of catatonia associated with depression or mania. One of these involved developing bilateral pulmonary emboli as a complication of his catatonia.&lt;/p&gt;&lt;p&gt;At the time of admission, he did not initially present with any depressive, (hypo)manic or catatonic symptoms, and his lithium and valproic acid levels were within therapeutic ranges. Within week one in the hospital, emerging signs of catatonia and/or “obsessive slowness” appeared, including marked psychomotor retardation, speech abnormalities ranging from mutism to one-word responses or halting speech, ambitendency, and intermittent thought blocking, with a frequently fluctuating pattern. Intense preoccupation with his predominantly mental rituals and obsessions resulted in difficulty with self-initiating behavioral responses. By week three, he developed acute stuporous catatonia, which included immobility, mutism, catalepsy, waxy flexibility, grimacing, and negativism. An intramuscular lorazepam challenge elicited a partial response within 30 min of administration, so oral lorazepam 2 mg three times daily was initiated. Medical work-up was non-contributory.&lt;/p&gt;&lt;p&gt;Due to prior ECT response and residual catatonic symptoms despite high-dose benzodiazepines, five sessions of bilateral ECT were administered and tolerated well, but only to partial effect (Bush-Francis Catatonia Rating scale score = 12/69). As such, clomipramine was introduced along with ongoing ECT despite concerns about manic induction (especially given the recent manic episode) and gradually uptitrated to 50 mg daily. After notable and sustained improvement in his OCD and catatonia, ECT was stopped after 11 sessions. The patient remained stable and was discharged home.&lt;/p&gt;&lt;p&gt;Two days following discharge, the patient was readmitted to hospital with acute re-worsening of OCD and manic symptoms. He had missed one dose of loxapine due to a prescription error. The manic symptoms rapidly resolved upon readmission; however, he again presented with intermittent catatonia that resolved with oral lorazepam. Clomipramine was increased to 75 mg daily for a 3-day","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":"27 5","pages":"393-395"},"PeriodicalIF":4.5,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bdi.70034","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143972611","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":"Towards a Better Understanding of the Lived Experience of Carers of People With Bipolar Disorder: A Mixed-Methods Study","authors":"Juliet Robinson,&nbsp;Bronte Speirs,&nbsp;Frances Kay-Lambkin,&nbsp;Tanya Hanstock","doi":"10.1111/bdi.70033","DOIUrl":"10.1111/bdi.70033","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Caring for someone with Bipolar disorder (BD) is unique, and the severity and complexity of symptoms can overwhelm informal carers such as family, friends, and partners.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>This study employed a concurrent mixed-methods model to investigate the lived experience of informal carers caring for those with BD in Australia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Participants (<i>n</i> = 46) answered an online survey containing standardised measures of quality of life and coping mechanisms as well as open-ended questions about their caring role challenges and support.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Carers reported mental health problems as the highest care-related burden and reported low perceived social support. However, a one-way MANOVA indicated no difference in these dimensions between carers of people with BD I and II. Reflexive thematic analysis revealed five superordinate themes relating to informal caregivers' challenges, coping strategies, and the support they need. The themes were<i>: like a roller-coaster</i>; <i>carer mental health</i>; <i>complexities of the carer role and diagnosis</i>; <i>how to cope</i>; <i>and multifaceted support</i>. The oscillation of symptoms and complexities of the caring role increased the burden on carers and created mental health challenges, requiring carers to use various coping strategies. Findings highlight the need for individualised, multimodal support for carers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Carers need adequate and accessible support through strong partnerships with healthcare providers to improve their own quality of life and mental health and, in turn, those in their care.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":"27 4","pages":"270-279"},"PeriodicalIF":5.0,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bdi.70033","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143976601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Conundrum: SSRI Emergent Hypomania, a Turn in the Road to Bipolarity?","authors":"Matthew Cohen,&nbsp;Prateek Varshney,&nbsp;Jasmine Ronsisvalle,&nbsp;Violeta Perez-Rodriguez","doi":"10.1111/bdi.70031","DOIUrl":"10.1111/bdi.70031","url":null,"abstract":"&lt;p&gt;(All identifiable patient information has been anonymised to maintain confidentiality).&lt;/p&gt;&lt;p&gt;Jane is a 16-year-old female who presented to child and adolescent mental health services (CAMHS) in June 2023 following 9 months of insidious onset, progressively deteriorating mood and social anxiety. Her symptoms had recently worsened with passive suicidal ideations and increased aggression, in the context of familial disputes and rising academic pressures. Jane had a history of domestic abuse in her early years leading to parental separation. Jane had been previously known to CAMHS and received family therapy at the age of 10 for low mood in the context of bullying. Jane's parent and younger sibling had DiGeorge syndrome. Jane was awaiting genetic testing for the same. A family history of autism spectrum disorder (ASD), attention deficit hyperactivity disorder (ADHD) and epilepsy were also noted in Jane's sibling. Jane's maternal grandmother had a history of severe mental illness of unknown diagnosis. Jane had a history of migraines but no other medical history or known neurodevelopmental conditions. Jane was referred for an autism assessment due to social communication difficulties and sensory sensitivities. A diagnosis of ASD was subsequently made. The multi-disciplinary team agreed on an initial working diagnosis of moderate depression and recommended for Jane to receive individual cognitive behavioural therapy (CBT) and group dialectical behaviour therapy (DBT).&lt;/p&gt;&lt;p&gt;Jane's symptoms worsened in October 2023 following starting a new school, a significant change. She experienced increased anxiety, worsening mood with agitation, and escalating suicidal ideation. In November 2023, at her psychiatric review, Jane expressed a desire to trial an anti-depressant. A plan was made for a slow titration of sertraline and to discuss with neurology if a recent prescription of sumatriptan could be switched to another anti-migraine medication, given the risk of serotonin syndrome when co-prescribed. Jane discontinued sumatriptan due to nausea and began sertraline 3 days later, initially at 25 mg once a morning for 1 week, increasing to 50 mg thereafter.&lt;/p&gt;&lt;p&gt;2 weeks later Jane was followed up (on sertraline 50 mg) and reported no improvement in her low mood. Jane, however, reported worsening sleep, heightened anxiety, derealisation, and vague experiences of hearing her name called in her room (without psychotic conviction). No changes to her medication were made. 3 days later, a change in Jane's presentation was noted. She had absconded from school, reporting new grandiose plans and was later found by the police at a bridge. At her psychiatric review, Jane reported having increased energy, feeling ‘high’ in mood, and shared her grandiose plans. She presented as distractible and, although there was ongoing sleep disturbance, Jane was not tired. Her Young Mania Score rated 13. Due to concerns of emerging hypomanic symptoms, sertraline was discontinued and Jan","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":"27 5","pages":"399-401"},"PeriodicalIF":4.5,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bdi.70031","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143977476","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":"Is Postpartum Bipolar Disorder a Distinct Diagnostic Entity?","authors":"Verinder Sharma,&nbsp;Katelyn N. Wood,&nbsp;Boseok Cha,&nbsp;Dwight Mazmanian","doi":"10.1111/bdi.70032","DOIUrl":"10.1111/bdi.70032","url":null,"abstract":"&lt;p&gt;Since the mid-19th century when Louis-Victor Marcé's monograph describing the effect of pregnancy, postpartum, and lactation on mental illness was published, the question of whether serious mental illness in the postpartum period is a distinct diagnostic entity has been intensely debated. Marcé noted that each symptom of postpartum mental illness could be found in non-postpartum cases; however, the syndromes of postpartum illnesses were different from those of nonpuerperal mental illnesses. While DSM does not consider postpartum illnesses as separate entities, the unofficial yet popular classification promulgates the use of terms such as postpartum depression and postpartum psychosis. Until recently, the discussion about the diagnosis of postpartum disorders focused mainly on the distinctiveness of postpartum depression. Evidence for postpartum depression being a separate entity is mixed and depends largely on the definition of the postpartum period. Depression occurring later in the postpartum period appears to be more like depression occurring outside the postpartum period. However, depression in the early postpartum period (usually the first few weeks after delivery) may be a distinct entity, likely due to its later association with bipolar disorder—that is, the subsequent emergence of bipolar symptoms. While childbirth is a well-known trigger of bipolar disorder in females, there is a lack of information about how it affects the symptom profile, course, and treatment response. Revisiting the debate about whether bipolar disorder in the postpartum period is different from its non-postpartum counterpart is crucially important to improve the detection, diagnosis, and treatment of postpartum bipolar disorder. Due to the common practice of diagnosing patients with mood episodes and psychotic features as postpartum psychosis, it is unclear how commonly bipolar disorder begins with a manic or mixed episode in the postpartum period. Psychiatric disorders occurring immediately after delivery can be harbingers of bipolar disorder in some cases. Psychiatric disorders that morph into or are followed by bipolar disorder are more likely to have a first onset postpartum or an onset immediately after delivery than disorders occurring later in the postpartum period [&lt;span&gt;1&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Studies on the phenomenology of postpartum manic episodes have provided mixed results. Compared with their non-postpartum counterparts, postpartum manic episodes are more likely to be characterized by depression, anxiety, perplexity, mood lability, lassitude, and disorientation [&lt;span&gt;2&lt;/span&gt;]. A within-subject study retrospectively compared symptom profiles of postpartum and non-postpartum manic episodes [&lt;span&gt;3&lt;/span&gt;]. Manic episodes in the postpartum period had significantly fewer manic symptoms but more depressive symptoms. The duration of hospitalizations and short-term outcomes were similar. Psychotic symptoms are common in females with postpartum manic, mixed, o","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":"27 4","pages":"268-269"},"PeriodicalIF":5.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bdi.70032","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143958285","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}