Bipolar Disorders最新文献

{"title":"Mood stabilizers for treatment of bipolar disorder in pregnancy and impact on neonatal outcomes.","authors":"Nalinoë Kernizan, Alicia Forinash, Abigail Yancey, Samuel Kruger, Niraj R Chavan, Katherine Mathews","doi":"10.1111/bdi.13481","DOIUrl":"10.1111/bdi.13481","url":null,"abstract":"<p><strong>Introduction: </strong>Untreated bipolar disorder in pregnancy is associated with adverse maternal and neonatal outcomes. Despite advances in clinical management, there is concern among obstetric providers and patients about the safety of pharmacological agents for the treatment of bipolar disorder in pregnancy. Recent studies have shown atypical antipsychotics and lamotrigine to have a favorable safety profile; however, little information is published on lurasidone.</p><p><strong>Objectives: </strong>The objective of this retrospective chart review was to evaluate pregnancy and neonatal outcomes in obstetric patients with bipolar disorder who are untreated, compared to those treated with lurasidone, other atypical antipsychotics, and lamotrigine at a tertiary teaching institution.</p><p><strong>Methods: </strong>This retrospective cohort study included neonates whose mothers had a diagnosis of bipolar disorder and were referred to the Maternal & Fetal Care Clinic with two documented visits after January 1, 2014, with delivery by October 31, 2017, within an SSM health-system hospital.</p><p><strong>Results: </strong>In this study, women with untreated bipolar disorder (not on any mood stabilizer) in pregnancy had significantly higher rates of premature delivery and low birth weight compared to women on mood stabilizers of lamotrigine, lurasidone, and other atypical antipsychotics. No difference was observed for pregnancy or neonatal outcomes between patients taking any of the mood stabilizers.</p><p><strong>Conclusions: </strong>This study suggests that the use of lurasidone, other atypical antipsychotics, and lamotrigine have better neonatal outcomes than untreated bipolar disorder in pregnancy.</p>","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":" ","pages":"779-784"},"PeriodicalIF":5.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142035128","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":"Utilizing long-acting injectables to address noncompliance among adolescents diagnosed with bipolar disorder.","authors":"Kanuja Sood, Mahiya Buddhavarapu, Lajpat Rai Bansal, Daniel Schaefer, Parinda Parikh","doi":"10.1111/bdi.13493","DOIUrl":"10.1111/bdi.13493","url":null,"abstract":"","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":" ","pages":"831-834"},"PeriodicalIF":5.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142103938","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":"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, 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":"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}