Bipolar Disorders最新文献

{"title":"Hope as a Therapeutic Imperative for Treatment Resistant Depression","authors":"Qin Xiang Ng","doi":"10.1111/bdi.70174","DOIUrl":"10.1111/bdi.70174","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Treatment-resistant depression poses substantial clinical challenges, particularly following multiple unsuccessful pharmacologic treatments. This brief report considers the role of hope as a therapeutic imperative in the management of treatment-resistant depression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The case presented by Malhi and colleagues is considered in relation to established approaches to staging treatment resistance and the broader humanistic dimensions of caring for patients with chronic and refractory illness.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Existing staging systems can help characterize the extent of treatment resistance and support a systematic approach to management but do not fully capture these humanistic dimensions. Hope extends beyond simple optimism to encompass a realistic belief in the possibility of meaningful improvement despite previous treatment failures. Clinicians can foster hope by clarifying patients’ goals, identifying attainable improvements in quality of life and functioning, and reinforcing agency and purpose alongside continued multidisciplinary treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Treatment resistance should not be equated with irremediability; hope is an integral component of person-centred psychiatric care.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":"28 6","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148879023","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":"Welcome Letter","authors":"","doi":"10.1111/bdi.70158","DOIUrl":"https://doi.org/10.1111/bdi.70158","url":null,"abstract":"","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":"28 S1","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148872023","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":"2026 ISBD Posters","authors":"","doi":"10.1111/bdi.70163","DOIUrl":"https://doi.org/10.1111/bdi.70163","url":null,"abstract":"","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":"28 S1","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148872025","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":"Irritability in Bipolar Depression: Re-Examining a Neglected Dimension","authors":"Francesco Attanasio,&nbsp;Caterina Fumagalli,&nbsp;Rocco Miazzi,&nbsp;Valentina Fazio,&nbsp;Cristina Colombo","doi":"10.1111/bdi.70178","DOIUrl":"10.1111/bdi.70178","url":null,"abstract":"&lt;p&gt;“It feels like my nerves are constantly on edge”, “It's a continuous tension that makes me snap over nothing”, “Even the people I love irritate me, I can't control it.” These are common expressions voiced by patients with bipolar disorder (BD), reflecting a pervasive yet poorly understood experience: irritability.&lt;/p&gt;&lt;p&gt;Despite its prevalence, irritability lacks a clear and consistent definition and is often conflated with related constructs such as &lt;i&gt;anger&lt;/i&gt;, &lt;i&gt;aggression&lt;/i&gt;, or &lt;i&gt;frustration&lt;/i&gt; [&lt;span&gt;1, 2&lt;/span&gt;]. This conceptual ambiguity is also mirrored in diagnostic nosology. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision, refers to “&lt;i&gt;irritable mood&lt;/i&gt;” and “&lt;i&gt;irritable behavior&lt;/i&gt;” across several diagnostic categories but fails to provide a consistent or operational definition. Such inconsistency not only reflects broader theoretical uncertainty but also complicates how irritability is recognized and assessed in both clinical and research settings.&lt;/p&gt;&lt;p&gt;These challenges gain particular relevance in the context of BD. More than a century ago, Kraepelin (1921) described irritability as “a vulnerability to manic-depressive illness”, conceptualizing it as a form of inner tension bridging the manic and depressive poles. His early insight anticipated contemporary perspectives [&lt;span&gt;3, 4&lt;/span&gt;] that frame irritability as a transpolar symptom within the bipolar spectrum, one that cuts across affective phases and modulates clinical expression, thereby challenging the traditional view of depression and mania as strictly opposite poles.&lt;/p&gt;&lt;p&gt;Despite this long-standing recognition, research on irritability has remained unbalanced. Most studies have focused on its manifestation during manic and mixed episodes, where it is both part of the diagnostic criteria and a salient clinical feature [&lt;span&gt;3, 4&lt;/span&gt;]. By contrast, its manifestation in bipolar depression, which lacks explicit diagnostic recognition, has been comparatively neglected and remains systematically understudied, highlighting a significant gap in the literature. Nevertheless, existing empirical evidence indicates that the presence of irritability is associated with poorer quality of life, greater psychosocial dysfunction, higher levels of aggression and suicidality, and reduced treatment adherence [&lt;span&gt;4&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Irritability has also been proposed as a potential discriminant between unipolar and bipolar depression. Mesbah et al. [&lt;span&gt;5&lt;/span&gt;] reported that elevated irritability and anger may serve as early clinical indicators of BD. Conceptualizing irritability as a transpolar and transdiagnostic dimension could therefore improve early differential diagnosis between unipolar and bipolar depression, two conditions that require distinct management strategies and entail different clinical implications.&lt;/p&gt;&lt;p&gt;This clinical recognition remains constrained by how irritability is currently assessed. In adult mood disorder","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":"28 6","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13531018/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148863192","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":"Optimizing Ketamine Infusion Therapy for Treatment-Resistant Bipolar Depression: Commentary on Zhou et al. (2023)","authors":"Chih-Cheng Lin,&nbsp;Lien-Chung Wei","doi":"10.1111/bdi.70177","DOIUrl":"10.1111/bdi.70177","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To contextualize the real-world findings of repeated intravenous ketamine infusions for treatment-resistant bipolar depression (TRBPD) and identify priorities for safer, more durable clinical implementation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We provide a focused commentary on Zhou et al. (2023) and integrate selected evidence concerning inflammatory and metabolic correlates, neurocognitive outcomes, and continuation-phase ketamine treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Repeated subanesthetic ketamine infusions may rapidly improve depressive and anxiety symptoms with an acceptable short-term safety profile. However, the predictive value of C-reactive protein and body mass index varies across cohorts; available cognitive findings are reassuring but limited; and relapse after induction highlights the need for individualized maintenance planning.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Ketamine pathways for TRBPD should combine cautious patient stratification, repeatable cognitive monitoring, and explicit continuation or booster strategies. Prospective bipolar-specific studies are needed to clarify predictors, durability, and stopping rules.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":"28 6","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148863217","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":"State-Specific Segmental Abnormalities of White Matter Structure and Function in Pediatric Bipolar Disorders","authors":"Ziqi Chen,&nbsp;Weijia Gao,&nbsp;Ruhai Dou,&nbsp;Xin Zhang,&nbsp;Zhe Shen,&nbsp;Yongxin Guo,&nbsp;Dong Cui,&nbsp;Guanghui Yu,&nbsp;Weifang Cao,&nbsp;Qing Jiao,&nbsp;Guangming Lu","doi":"10.1111/bdi.70175","DOIUrl":"10.1111/bdi.70175","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>White matter (WM), as the critical infrastructure for neural communication, is implicated in pediatric bipolar disorder (PBD) pathophysiology. However, the state-specific abnormalities in the segmental structural and functional properties of adolescent fiber tracts remain unclear.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Processed fMRI and DTI data from 19 manic-phase PBD (MPBD), 20 euthymic-phase PBD (EPBD), and 17 matched healthy controls (HCs) were analyzed for structural and functional alterations across 100 segments of 8 WM tracts using Automated Fiber Quantification, with six machine learning classifiers subsequently employed for disease classification.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Tract-based analysis revealed predominant microstructural alterations in the left corticospinal tract (CST), characterized by concurrent increases in FA and CL alongside decreased RD, particularly in the posterior internal capsule and mid-portion of the tract. Functional ALFF abnormalities correlated with manic symptoms and episode frequency, suggesting affective dysregulation in emotion-regulation pathways (including anterior thalamic radiation and inferior fronto-occipital fasciculus). The random forest classifier, trained on a multimodal feature set combining DTI-derived tensor metrics, functional ALFF values, and clinical information, achieved 84% accuracy in distinguishing MPBD patients from HCs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This multimodal study reveals segmental abnormalities in the structure and function of WM tracts across different mood episodes in PBD, identifying a structure–function desynchronization pattern: motor pathway exhibits enhanced structural integrity with preserved function, whereas emotion-regulation pathways display functional hyperactivity without structural alterations. These alterations correlate with cognitive-executive impairment and enable clinical subtype differentiation, providing novel insights into PBD neuropathology and supporting neuroimaging-based diagnostic development.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":"28 6","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148825240","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 Shift in Trust: An Analysis of the Use of AI Chatbots Among People Living With Bipolar Disorder","authors":"Katherine Bassil,&nbsp;Dido Prins,&nbsp;Hine van Os,&nbsp;Georg Starke,&nbsp;Eline de Groot,&nbsp;Annemieke Dols,&nbsp;Edwin van Dellen","doi":"10.1111/bdi.70176","DOIUrl":"10.1111/bdi.70176","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To identify preliminary insights into the perceived utility and risks of commercially available AI chatbots such as ChatGPT used by individuals with severe mental illness (SMI), namely bipolar disorder, for self-reflection and mental health support.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data were collected via semi-structured interviews from two individuals diagnosed with bipolar disorder who independently used ChatGPT for self-reflection and to explore diagnosis, symptom management, and treatment. Both individuals presented to psychiatric services for clinical reasons unrelated to chatbot use. The interviews were audio-recorded, transcribed verbatim, and thematically analyzed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We identified a few key themes in the data. First, both participants perceived ChatGPT as a versatile tool, providing educational, emotional, and social support, with use evolving from information seeking to more personal and relational functions. Second, distinct attachment patterns reflected their clinical and psychological profiles: one engaged in reflective, intellectualized conversations, whereas the other developed emotionally intimate interactions. Third, both described therapeutic benefits, including nonjudgmental support and reassurance, sometimes perceived as more accessible or understanding than professional care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>These cases suggest that ChatGPT can shift trust from mental health professionals to AI, fulfilling multiple roles resulting in role blurring and fluid boundaries. Engagement patterns varied with clinical stability, highlighting greater reliance and less distancing in more vulnerable individuals. Although perceived benefits were reported, risks include overreliance, diminished trust in clinicians, and limited awareness of AI limitations, underscoring ethical and clinical considerations for integrating AI in psychiatric care. These cases highlight persistent challenges in psychiatric care that AI alone cannot address.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":"28 6","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bdi.70176","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148825203","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":"Prescription Trends for Bipolar Disorder With and Without Comorbid Substance Use and Anxiety Disorders: A Global Bipolar Cohort Collaborative Study","authors":"Anastasia K. Yocum,&nbsp;Martin Alda,&nbsp;Bruno Aouizerate,&nbsp;Valerie Aubin,&nbsp;Frank Bellivier,&nbsp;Raoul Belzeaux,&nbsp;Michael Berk,&nbsp;Joanna M. Biernacka,&nbsp;Monika Budde,&nbsp;Katherine E. Burdick,&nbsp;Yun-Hsuan Chang,&nbsp;Brandon J. Coombes,&nbsp;Philippe Courtet,&nbsp;Nina Dalkner,&nbsp;Claudia Diaz-Byrd,&nbsp;Caroline Dubertret,&nbsp;Bruno Etain,&nbsp;Giovanna Fico,&nbsp;Janice M. Fullerton,&nbsp;Ophelia Godin,&nbsp;Katherine Gordon-Smith,&nbsp;Emmanuel Haffen,&nbsp;Dominique Januel,&nbsp;Kamyar Keramatian,&nbsp;Marion Leboyer,&nbsp;Antoine Lefrere,&nbsp;Pierre-Michel Llorca,&nbsp;Marzieh Majd,&nbsp;Philip B. Mitchell,&nbsp;Benson Mwangi,&nbsp;Emilie Olie,&nbsp;Bronwyn J. Overs,&nbsp;Joanne Petite,&nbsp;Mircea Polosan,&nbsp;Romain Rey,&nbsp;Gloria Roberts,&nbsp;Paul Roux,&nbsp;Ludovic Samalin,&nbsp;Raymund Schwan,&nbsp;Alessandro Serretti,&nbsp;Jair C. Soares,&nbsp;Sarah H. Sperry,&nbsp;Rebecca Strawbridge,&nbsp;Tatjana Stross,&nbsp;Eduard Vieta,&nbsp;Michel Walter,&nbsp;Lana J. Williams,&nbsp;Mon-Ju Wu,&nbsp;Lakshmi N. Yatham,&nbsp;Allan H. Young,&nbsp;Antoine Yrondi,&nbsp;Giovana B. Zunta-Soares,&nbsp;Mark A. Frye,&nbsp;Melvin G. McInnis,&nbsp;Balwinder Singh","doi":"10.1111/bdi.70167","DOIUrl":"10.1111/bdi.70167","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To investigate pharmacological treatment patterns in individuals with bipolar disorder (BD) with and without comorbid substance use disorder (SUD) and anxiety disorder (AX), we leveraged the Global Bipolar Cohort to analyze cross-regional practices across North America, Europe, and the Pacific.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Fourteen cohorts contributed aggregate data on pharmacotherapy, demographics, diagnostic subtypes, and comorbidities. Proportional meta-analyses using generalized linear mixed models were conducted to examine prescription trends and identify clinical differences.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The sample (<i>N</i> = 11,521) was 60% female and 84% Caucasian. Participants were categorized into four mutually exclusive groups based on comorbidity status: those with comorbid AX only, comorbid SUD only, both AX and SUD, or neither. The AX+SUD subgroup showed higher rates of attention-deficit/hyperactivity disorder (ADHD), post-traumatic stress disorder (PTSD), rapid cycling, obesity, and unemployment, reflecting a more severe clinical profile. Regional variations were notable: North American cohorts reported higher prevalence of AX and SUD than European and Pacific cohorts. Antidepressants use for AX were more common in Europe and the Pacific, while North American prescribing patterns were more variable. Benzodiazepine use was high among individuals with SUD across all regions. Lithium and first-generation antipsychotic prescriptions varied, with higher rates observed in Europe.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Findings underscore the heterogeneity of BD and the influence of comorbid AX and SUD on illness burden and treatment. Regional prescribing variations underscore the need for context-specific guidelines. Gaps in data on medication-assisted treatment for SUD point to areas for future research. These insights can support more individualized and effective care for complex BD presentations.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":"28 6","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148705246","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 Relation Between Perceived Social Support, Treatment Adherence and Recovery Among Individuals Diagnosed With Bipolar Disorder","authors":"Cemile Hürrem Ayhan,&nbsp;Mehmet Cihad Aktaş,&nbsp;Ramazan Aydar,&nbsp;Sakine Aktaş,&nbsp;Seda Karakaya Cataldas","doi":"10.1111/bdi.70170","DOIUrl":"10.1111/bdi.70170","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>This cross-sectional descriptive study aims to examine the relationship between perceived social support, treatment adherence and recovery in individuals diagnosed with bipolar disorder. The impact of social support elements, especially family, friend and special person support, on the treatment adherence and recovery are evaluated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>105 individuals diagnosed with bipolar disorder participated in the study. Data were collected using the Multidimensional Perceived Social Support Scale (MSPSS), Morisky Medication Adherence Scale (MMAS) and Recovery Assessment Scale (RAS). The obtained data were evaluated using the SPSS program.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Analysis showed a significant and positive relationship between perceived social support and recovery levels (<i>p</i> &lt; 0.05). It was determined that family support, in particular, significantly increases treatment adherence and contributes positively to the recovery process. It was also determined that the RAS sub-dimensions of hope, help, success, trust and coping levels were in a strong relationship with social support. Moreover, perceived social support has consistently been identified as a significant predictor of recovery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Study findings reveal that social support is of critical importance in the treatment of bipolar disorder. In particular, strengthening family support can positively affect treatment adherence and the recovery process. These results emphasize that the effective use of social support systems should be considered a key element in treatment planning. By demonstrating this relationship, the study provides a valuable basis for future investigations that may further clarify how social support can be systematically leveraged to improve treatment effectiveness.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":"28 6","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148705230","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":"Cortical Thickness in Middle and Older Aged Adults With Bipolar Disorder Across Six International Sites","authors":"Rebecca Marks,&nbsp;Anjali Sankar,&nbsp;Lejla Colic,&nbsp;Jair Soares,&nbsp;Joaquim Radua,&nbsp;Eduard Vieta,&nbsp;Benson Mwangi,&nbsp;Mon-Ju Wu,&nbsp;Enric Vilajosana,&nbsp;Edith Pomarol-Clotet,&nbsp;Erick Canales-Rodríguez,&nbsp;Raymond Salvador,&nbsp;Brian Pittman,&nbsp;Annemieke Dols,&nbsp;Martha Sajatovic,&nbsp;Lisa T. Eyler,&nbsp;Hilary P. Blumberg","doi":"10.1111/bdi.70166","DOIUrl":"10.1111/bdi.70166","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Older adults with bipolar disorder (BD) are at high risk for severe mood symptoms, cognitive difficulties, and early mortality; however, underlying brain alterations have received little study. Gray matter decreases in ventral prefrontal cortex (VPFC) seen in younger persons with BD, and additionally in dorsal PFC (DPFC), are implicated. Here, cortical thickness was examined in an international sample.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Cortical thickness in 34 regions was measured from structural magnetic resonance imaging data using enhancing neuroImaging genetics through meta-analysis pipelines for individuals with BD (<i>n</i> = 308) and non-psychiatric comparison participants (<i>n</i> = 287), ages 40–70y, from six Global Aging and Geriatric Experiments in BD (GAGE-BD) consortium sites. Group differences were assessed for VPFC, DPFC and remaining cortical regions, covarying for scanner, age and sex. Results were considered significant corrected for false discovery fate (FDR) at p_FDR &lt; 0.05. Relationships with demographic and clinical factors were explored.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Cortical thickness was significantly lower among BD in VPFC and DPFC, and additional distributed regions (p_FDR &lt; 0.05) and negatively associated with age (<i>p</i> &lt; 0.05); group and age did not interact significantly. Relationships with BD subtype and medications were observed; lithium was associated with higher frontal pole and anterior cingulate thickness (p_FDR &lt; 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In this international middle and older aged adult BD sample, lower VPFC cortical thickness was observed, suggesting these deficits persist from younger age. DPFC and additional regions of reduced cortical thickness could contribute to the older adult BD phenotype. Cortical thinning was more pronounced among older individuals regardless of diagnosis. Lithium may lessen cortical thinning.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":"28 6","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148688562","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}