Bipolar Disorders最新文献

{"title":"Managing Bipolar Disorder During Apheresis: A Case Based Observation.","authors":"Dilara Üzüm, Merve Rana Altunel Ülkü, Nazife Gamze Usta Sağlam, Şenol Turan","doi":"10.1111/bdi.70150","DOIUrl":"10.1111/bdi.70150","url":null,"abstract":"","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":"28 5","pages":"e70150"},"PeriodicalIF":3.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13373743/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148454418","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":"Sedentary Behavior and Physical Activity in Individuals With Bipolar Disorder: An Evidence Synthesis and Position Statement From the ISBD Nutrition and Exercise Task Force (NExT).","authors":"Beny Lafer, Lucas M Neves, Davy Vancampfort, Brendon Stubbs, Ana Gonzalez-Pinto, Andrew Nierenberg, Andrew T Olagunju, Benjamin I Goldstein, Eduard Vieta, Elena Koning, Fabiano A Gomes, Gayatri Saraf, Jess G Fiedorowicz, Lakshmi N Yatham, Louisa Sylvia, Maj Vinberg, Manuel Gardea-Resendez, Marco Solmi, Mark A Frye, Michael Berk, Mohammad Alsuwaidan, Rodrigo B Mansur, Roumen Milev, Simon Rosenbaum, Tamsyn Van Rheenen, Vicent Balanzá-Martínez, Wolfgang Marx, Felipe Schuch, Elisa Brietzke","doi":"10.1111/bdi.70164","DOIUrl":"10.1111/bdi.70164","url":null,"abstract":"<p><strong>Background: </strong>Higher time in sedentary behavior and insufficient physical activity are very common in bipolar disorder (BD). Whereas physical activity and exercise offer significant benefits across mental health, brain health, and heart health in BD. The International Society for Bipolar Disorders Nutrition and Exercise Task Force (NExT) synthesized evidence to evaluate the impacts of sedentary behavior, physical activity, and exercise on illness course, physical health, and treatment outcomes.</p><p><strong>Methods: </strong>A best-evidence synthesis was conducted using a question-and-answer format. We searched PsycINFO, SPORTDiscus, Embase, PubMed, and Web of Science from inception to March 1st, 2026, supplemented by reference lists and existing guidelines. Search terms included combinations of physical activity, exercise, sedentary behavior, and bipolar disorder-related terms.</p><p><strong>Results: </strong>Observational studies show that individuals with BD exhibit significantly higher sedentary behavior and lower physical activity compared to the general population, with notable discrepancies between self-reported and objective measurements. Evidence on physical activity's protective role against BD onset is mixed, with some prospective and Mendelian randomization studies suggesting reduced risk, while others report bidirectional or null associations. Preliminary findings from clinical trials indicate that exercise improves overall functioning, reduces mood episode frequency and hospitalizations, and alleviates depressive symptoms, with one pilot study showing an 82% antidepressant response rate. Exercise also shows potential to reduce anxiety and improve sleep, though robust data are limited.</p><p><strong>Conclusions: </strong>Despite limited high-quality evidence, physical activity and exercise demonstrate promising physical and mental health benefits for individuals with BD. Future research should prioritize multicenter randomized controlled trials, enhanced assessment tools, and accessible, tailored programs to integrate physical activity into routine BD management.</p>","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":"28 5","pages":"e70164"},"PeriodicalIF":3.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13431146/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148663061","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":"Establishing a Specialty Bipolar Clinic: The National Network of Depression Centers Consensus Recommendations.","authors":"Christopher D Schneck, Jorge R C Almeida, David J Bond, Katherine E Burdick, Mark A Frye, Fernando S Goes, Rebekah S Huber, Rodrigo Machado-Vieira, Pamela Mahon, Melvin G McInnis, John Nurnberger, Dost Ongur, Michael J Ostacher, Sagar V Parikh, Kristin S Raj, Matteo Respino, Barbara W Schweizer, Jair C Soares, Sarah H Sperry, Aimee E Sullivan, Trisha Suppes, Marin Veldic, Peter P Zandi, J Raymond DePaulo","doi":"10.1111/bdi.70154","DOIUrl":"10.1111/bdi.70154","url":null,"abstract":"<p><strong>Objective: </strong>To provide expert recommendations for the development of a specialty bipolar clinic that promotes best clinical practices for the delivery of safe and effective care.</p><p><strong>Methods: </strong>Members of the National Network of Depression Centers (NNDC) Bipolar Clinics Work Group met in a series of 1-h monthly video calls over 18 months to discuss all aspects of their respective institution's bipolar clinics, including services provided, administrative processes, staffing models, characteristics of patients treated, patient volumes, finances, and research. The group also invited psychiatrists from outside of the NNDC who ran large bipolar clinics to contribute their thoughts and experiences on the subject. In addition, the NNDC sent a 20-question survey to all 27 sites asking clinic directors specific questions about their bipolar clinics, if applicable. Further meetings and discussions incorporating results from the survey took place to produce a comprehensive set of recommendations.</p><p><strong>Results: </strong>Twenty-one of 27 NNDC sites (81%) responded to the survey. Twelve of 21 (57%) sites had a specific bipolar clinic, and another 4 (19%) were looking to start one. Clinics were based in university settings. The meetings, clinic survey, and discussions resulted in 10 recommendations describing services and operations for bipolar specialty clinics.</p><p><strong>Conclusions: </strong>Given the complexity of bipolar disorder, specialty clinics are important to enhance care. Clinics with a wide array of services that include consultation, medication management, bipolar-specific psychotherapies, and patient/family psychoeducation provide the most comprehensive care. Challenges to these clinics include maintaining ongoing patient access as well as ensuring long-term financial stability.</p>","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":"28 5","pages":"e70154"},"PeriodicalIF":3.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13353258/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148418346","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":"Identifying Mood Instability and Circadian Rest-Activity Patterns Using Digital Remote Monitoring and Actigraphy in Participants at Risk for Bipolar Disorder.","authors":"Priyanka Panchal, Natalie Nelissen, Niall M McGowan, Lauren Z Atkinson, Kate E A Saunders, Paul J Harrison, Matthew Rushworth, Dejan Draschkow, John Geddes, Anna C Nobre, Catherine J Harmer","doi":"10.1111/bdi.70156","DOIUrl":"10.1111/bdi.70156","url":null,"abstract":"<p><strong>Introduction: </strong>Mood and/or affective instability and circadian rhythm disruptions are increasingly recognised in psychiatric disorders, notably bipolar disorder (BD), but their interrelationship remains unclear. By definition, both have an integral temporal component and, as such, measuring them longitudinally and remotely is desirable.</p><p><strong>Methods: </strong>We assessed the feasibility and value of digital devices to capture mood and subjective state (affect) instability and daily rest-activity patterns over a 10-week period in two groups of participants. The first group (n = 37) scored > 7 on the Mood Disorder Questionnaire (MDQ) ('high MDQ'), indicating a history of mood elevation and increased risk for BD. They were compared with a group (n = 37) scoring < 5 on the MDQ ('low MDQ'). Over the 10-week period, mood was rated daily, clinical ratings of depression, mania and anxiety were captured weekly, and a GENEActiv actigraph was worn to collect rest-activity pattern data.</p><p><strong>Results: </strong>The main findings were that (1) MDQ score predicted instability in mood and subjective state; (2) high MDQ score was associated with greater negative affect, mood symptoms and altered circadian activity profiles compared with low MDQ; and (3) mood and subjective state instability appeared unrelated to circadian indices.</p><p><strong>Conclusion: </strong>These findings suggest that (1) remote monitoring of these domains is feasible and valuable; (2) selection of participants based on MDQ score is useful for studying mood and affective instability; and (3) this approach has potential utility for clinical and experimental medicine studies assessing interventions targeting mood dysregulation and affective instability.</p>","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":"28 5","pages":"e70156"},"PeriodicalIF":3.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13377006/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148468592","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":"Time Trends in Excess Mortality Among Individuals With Bipolar Disorder in Finland, 2000–2023: A Nationwide Register Study","authors":"Julia Rimmington,&nbsp;Sonja Lumme,&nbsp;Kimmo Suokas,&nbsp;Mai Gutvilig,&nbsp;Marko Elovainio,&nbsp;Christian Hakulinen","doi":"10.1111/bdi.70147","DOIUrl":"10.1111/bdi.70147","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To investigate excess all-cause mortality among individuals with bipolar disorder in Finland and examine time trends in the mortality gap between individuals with bipolar disorder and the general population during 2000–2023.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Individuals diagnosed with bipolar disorder during 1975–2023 in Finland were identified using the Care Register for Health Care and linked to population register data on mortality and demographics. Mortality was examined using age-standardized rates per 100,000 person-years. Relative excess mortality was estimated using mortality rate ratios (RRs) comparing individuals with bipolar disorder with the general population, stratified by sex and age group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>During 2000–2023, individuals with bipolar disorder had substantially higher all-cause mortality than the general population. The age-standardized mortality rate ratios were 2.85 (95% CI 2.77–2.92) for men and 3.25 (95% CI 3.14–3.36) for women. Mortality declined over time in both groups, and relative excess mortality decreased, although improvements were not uniform across age and sex groups. Relative excess mortality was particularly elevated among younger individuals and was more pronounced in women than in men.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Individuals with bipolar disorder in Finland experience substantial excess all-cause mortality compared with the general population. Although relative excess mortality declined during 2000–2023, it remains considerable. Because causes of death were not examined, these all-cause estimates do not identify specific drivers of excess mortality, especially in younger age groups where relative excess mortality is highest.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":"28 5","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bdi.70147","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148390035","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":"Turning Phenomenology Into Dual-Diagnosis Care for Bipolar Disorder","authors":"Jen-Chin Lee,&nbsp;Lien-Chung Wei","doi":"10.1111/bdi.70145","DOIUrl":"10.1111/bdi.70145","url":null,"abstract":"","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":"28 5","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148390116","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":"Epigenetic Age Accelerations and the Clinical Presentation of Bipolar Disorders: A Latent Profile Analysis in the FACE-BD Sample","authors":"Luana Spano,&nbsp;Céline Bourdon,&nbsp;Mohamed Lajnef,&nbsp;Ophélia Godin,&nbsp;Marion Leboyer,&nbsp;Katia M'Bailara,&nbsp;Antoine Lefrere,&nbsp;Raoul Belzeaux,&nbsp;Philippe Courtet,&nbsp;Emilie Olie,&nbsp;Caroline Dubertret,&nbsp;Raymund Schwan,&nbsp;Paul Roux,&nbsp;Mircea Polosan,&nbsp;Ludovic Samalin,&nbsp;FondaMental Advanced Centers of Expertise in Bipolar Disorders (FACE-BD) Collaborators,&nbsp;Frank Bellivier,&nbsp;Cynthia Marie-Claire,&nbsp;Bruno Etain","doi":"10.1111/bdi.70143","DOIUrl":"10.1111/bdi.70143","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Epigenetic age accelerations have been associated with the clinical expression of BD; however, with few available studies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>We calculated Horvath, Hannum, EN, GrimAge, and PhenoAge epigenetic ages in a sample of 139 individuals with BD. We used a latent profile analysis to identify subgroups of individuals based on their profile of epigenetic age accelerations. We compared these profiles for socio-demographic characteristics, course of BD, associated psychiatric conditions, current medication use, telomere length, mitochondrial DNA copy number (mtDNAcn), markers of metabolic syndrome, and of systemic inflammation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The latent profile analysis identified two subgroups, one with accelerated and one with decelerated epigenetic aging (respectively 58% and 42%). Subgroups did not differ for socio-demographic characteristics, course of BD, associated psychiatric conditions, nor current medication use. The accelerated aging subgroup was characterized by higher depressive symptoms (<i>p</i> &lt; 0.001), lower mtDNAcn (<i>p</i> &lt; 0.001), higher levels of systemic inflammation (platelet/neutrophil ratio, neutrophil/lymphocyte ratio, systemic inflammation index, <i>p</i> &lt; 0.001) that remained significant after correction for multiple testing. Some associations with anxiety symptoms, social functioning, blood pressure, and waist circumference did not remain significant after correction for multiple testing.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Most individuals with BD were characterized by an accelerated epigenetic age profile. This study suggests a link between epigenetic age acceleration, systemic inflammation, and mtDNAcn. This subgroup might represent a target for personalized prevention and treatment.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":"28 5","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bdi.70143","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148381470","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":"Risk of Major Malformations Following First-Trimester Exposure to Cariprazine: Preliminary Data From the MGH National Pregnancy Registry for Psychiatric Medications","authors":"Adele C. Viguera,&nbsp;Marlene P. Freeman,&nbsp;Ella K. Slaby,&nbsp;Ana M. Manuelian,&nbsp;Peter Gaccione,&nbsp;David Chitayat,&nbsp;Sonia Hernández-Díaz,&nbsp;Lee S. Cohen","doi":"10.1111/bdi.70138","DOIUrl":"10.1111/bdi.70138","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Systematically collected pregnancy safety data for cariprazine have been lacking, despite growing use of this medication across psychiatric indications. The goal of this analysis was to determine the risk of major malformations among infants of mothers with psychiatric illness who used cariprazine during the first trimester of pregnancy compared to unexposed controls.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The National Pregnancy Registry for Psychiatric Medications (NPRPM) is a prospective pharmacovigilance program in which pregnant women with psychiatric diagnoses are enrolled during pregnancy and followed through the postpartum period. Labor and delivery and pediatric medical records are reviewed for evidence of major malformations followed by final adjudication by a dysmorphologist blinded to medication exposure. Infants with first-trimester exposure to cariprazine were compared to controls not exposed to second-generation antipsychotic medications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>As of September 9, 2025, <i>N</i> = 4,125 have enrolled in the study. Of those enrolled, 58 cariprazine-exposed infants and 2,098 infants in the comparison group were eligible for inclusion in this analysis. There were no major malformations in the cariprazine-exposed group (absolute risk 0.00%; 95% confidence interval, 0.00%–6.16%) compared to 32 infants with major malformations in the control group (1.53%; 1.05%–2.15%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In this prospective cohort, 0 of 58 infants exposed to cariprazine during the first trimester had major malformations, compared with 32 of 2,098 (1.53%) unexposed infants. Although these data are preliminary and cannot rule out modest teratogenic effects, they are nonetheless important to provide to health care providers and the public, as cariprazine use has been rising among women of reproductive age.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":"28 5","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148374394","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 3-Month Follow-Up Pilot Study on Accelerated Intermittent Theta Burst Stimulation for Bipolar Depression","authors":"Daan Neuteboom,&nbsp;Urmi Pahladsingh,&nbsp;Martijn C. Steinbach,&nbsp;Marjan C. Ploegaert,&nbsp;Jasper B. Zantvoord,&nbsp;Anja Lok,&nbsp;Lieuwe de Haan,&nbsp;Karel W. F. Scheepstra","doi":"10.1111/bdi.70148","DOIUrl":"10.1111/bdi.70148","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Approximately 25% of patients with bipolar disorder are reported to have treatment-resistant bipolar depression (TRBD). Accelerated intermittent Theta Burst Stimulation (aiTBS) is an innovative form of repetitive transcranial magnetic stimulation (rTMS), delivering bursts of stimulation at theta wave frequencies, which are believed to enhance synaptic plasticity. This pilot study aimed to explore the safety, tolerability, and preliminary efficacy of aiTBS in individuals with treatment-resistant bipolar depression (TRBD).&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This open-label pilot study (registered at Overview of Medical Research in the Netherlands (OMON), NL-OMON53634), conducted between July 2023 and September 2024, included patients aged 43–64 years who were diagnosed with bipolar I or II and were experiencing a current moderate-to-severe depressive episode. Patients were required to have treatment-refractory symptoms according to the Hidalgo-Mazzei criteria. All patients were receiving antidepressant medication. Patients received eight daily sessions of intermittent Theta Burst Stimulation (iTBS) over five consecutive days, with 50-min intervals between sessions. Stimulation targeted the left dorsolateral prefrontal cortex (DLPFC) using the BeamF3 targeting method. Outcomes included safety, tolerability, and efficacy and were assessed at day 3, day 5, week 2, week 4 and week 12 post-treatment. Safety was assessed by documentation of serious adverse events (SAEs) and adverse events (AEs); tolerability was evaluated based on reported side effects. Efficacy was measured by the mean reduction in depression symptoms using the 17-item Hamilton Depression Rating Scale (HDRS-17).&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Eight patients were recruited, all of whom completed the treatment course. aiTBS was well tolerated and no SAEs occurred during the treatment week or during follow-up. The most frequently reported AEs were discomfort at the stimulation site and fatigue (87.5%). Although one patient experienced hypomanic symptoms (YMRS = 13) at the 3-month follow-up visit, this was considered unrelated to the study treatment due to the timing of onset, and because several significant psychosocial stressors were identified in the patient's life during that period. Mean HDRS scores decreased from 22.9 (SD = 4.4) at baseline to 16.6 (SD = 4.2) on day 3 of treatment (difference = 6.3 (95% CI, 1.6–10.9); 27.3% improvement, &lt;i&gt;p&lt;/i&gt; = 0.01), 12.8 (SD = 4.1) on day 5 (difference = 10.1 (95% CI, 2.2–18.1); 44.3%, &lt;i&gt;p&lt;/i&gt; = 0.02), 11.1 (SD = 3.8) at week 2 (difference = 11.8 (95% CI, 4.5–19.0); 51.4%, &lt;i&gt;p&lt;/i&gt; ","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":"28 5","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bdi.70148","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148374416","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":"The Theory of Metabolic Jet Lag in Bipolar Disorder: A Pilot Feasibility Study Exploring the Association Between Eating Rhythm Disruption and Illness Burden Parameters","authors":"Elena Koning,&nbsp;Vitor Breda,&nbsp;Sareh Panjeh,&nbsp;Elisa Brietzke","doi":"10.1111/bdi.70146","DOIUrl":"10.1111/bdi.70146","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Changes in energy metabolism are commonly observed in bipolar disorder (BD) and have been linked to a more severe clinical course. ‘Metabolic jet lag’ (MJL) is a state of shift in circadian patterns of energy homeostasis, expressed through behavioral changes such as irregular meal timing. However, the relationship between MJL and the pathophysiology of BD remains unknown. The objective of this study is to determine the feasibility of an investigation assessing the association between MJL, evaluated through eating rhythm disruption, and markers of illness burden in ten individuals with DSM-5-defined BD type 1.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and Methods</h3>\u0000 \u0000 <p>This is a 14-day longitudinal, naturalistic study that used the smartphone application ‘RxFood’ to elaborate a personalized, time-stamped “feedogram” for each participant. Illness burden and severity parameters were collected at baseline, and the Acceptability E-Scale was administered at the endpoint. Eating rhythm disruption scores were calculated based on a novel analytical approach applied to the “feedogram” data.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The use of ‘RxFood’ demonstrated excellent feasibility and acceptability (94%) in individuals with BD and captured 628 eating occasions over the study period. Eating rhythm disruption scores varied between participants and correlated with the number of manic episodes (<i>r</i> = 0.718, <i>p</i> = 0.019), although the association was not significant after correcting for multiple comparisons.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Ecological momentary assessment of eating rhythms is feasible in individuals with BD. Larger investigations evaluating the association between eating rhythm disruption and clinical illness trajectories are needed to delineate the role of MJL in the pathophysiology of BD.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":"28 5","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bdi.70146","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148374367","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}