Bipolar Disorders最新文献

{"title":"A 6-month, prospective, randomized controlled trial of customized adherence enhancement versus a bipolar-specific educational control in poorly adherent adolescents and young adults living with bipolar disorder","authors":"Jennifer B. Levin,&nbsp;Melissa DelBello,&nbsp;Avani C. Modi,&nbsp;Farren Briggs,&nbsp;Larry F. Forthun,&nbsp;Molly McVoy,&nbsp;Joy Yala,&nbsp;Raechel Cooley,&nbsp;Jessica Black,&nbsp;Carla Conroy,&nbsp;Martha Sajatovic","doi":"10.1111/bdi.13489","DOIUrl":"10.1111/bdi.13489","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Few studies have addressed medication adherence in adolescents and young adults (AYAs) with bipolar disorder (BD). This 6-month prospective randomized-controlled trial (RCT) tested customized adherence enhancement for adolescents and young adults (CAE-AYA), a behavioral intervention for AYAs versus enhanced treatment as usual (ETAU).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Inclusion criteria were AYAs age 13–21 with BD type I or II with suboptimal adherence defined as missing ≥20% of medications. Assessments were conducted at Screening, Baseline, and weeks 8, 12 and 24. Primary outcome was past 7 day self-reported Tablets Routine Questionnaire (TRQ) validated by electronic pillbox monitoring (SimpleMed). Symptom measures included the Hamilton Depression Rating Scale (HAM-D) and Young Mania Rating Scale (YMRS).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The mean sample age (<i>N</i> = 36) was 19.1 years (SD = 2.0); 66.7% (<i>N</i> = 24) female, BD Type I (81%). The mean missed medication on TRQ for the total sample was 35.4% (SD = 28.8) at screening and 30.4% (SD = 30.5) at baseline. Both CAE-AYA and ETAU improved on TRQ from screening to baseline. Baseline mean missed medication using SimpleMed was 51.6% (SD = 38.5). Baseline HAM-D and YMRS means were 7.1 (SD = 4.7) and 6.0 (SD = 7.3), respectively. Attrition rate at week 24 was 36%. Baseline to 24-week change on TRQ, adjusting for age, gender, educational level, living situation, family history, race, and ethnicity, showed improvement favoring CAE-AYA versus ETAU of 15%. SimpleMed interpretation was limited due to substantial missing data. There was a significant reduction in depression favoring CAE-AYA.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>CAE-AYA may improve adherence in AYAs with BD, although conclusions need to be made cautiously given study limitations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Clinical Trials Registration</h3>\u0000 \u0000 <p>ClinicalTrials.gov identifier: NCT04348604.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":"26 7","pages":"696-707"},"PeriodicalIF":5.0,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11560489/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142131752","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":"Case report: Manic-like symptoms mimicking early-onset bipolar disorder in a case of neuropsychiatric lupus","authors":"Ming Chen,&nbsp;Yi Tang,&nbsp;Gang Li,&nbsp;Ming-Zhi Xu,&nbsp;Cai-Lan Hou","doi":"10.1111/bdi.13495","DOIUrl":"10.1111/bdi.13495","url":null,"abstract":"","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":"26 8","pages":"835-838"},"PeriodicalIF":5.0,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142118923","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 case of delirious mania in the context of concurrent cardiac comorbidities and autonomic instability","authors":"Cathy Daichang,&nbsp;Eric Rutkowski,&nbsp;Zeshawn Ali","doi":"10.1111/bdi.13502","DOIUrl":"10.1111/bdi.13502","url":null,"abstract":"<p>The authors declare that they have no conflict of interest.</p><p>Written informed consent was obtained from the patient to write about and publish his clinical case.</p>","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":"27 1","pages":"77-80"},"PeriodicalIF":5.0,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bdi.13502","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142118922","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":"Postpartum rage attacks in a female with bipolar II disorder and obsessive-compulsive disorder: Diagnostic and treatment challenges","authors":"Verinder Sharma","doi":"10.1111/bdi.13499","DOIUrl":"10.1111/bdi.13499","url":null,"abstract":"&lt;p&gt;A 26-year-old first-time mother was referred for assessment and management of postpartum depression. A few weeks before her first visit to the clinic, she was prescribed sertraline which she had previously taken with for treatment of non-puerperal episodes of depression. Within 2 weeks of the retrial of sertraline 75 mg daily, there was a marked improvement in symptoms of depression and anxiety. She also had obsessions and compulsions, but these were not severe enough to reach the diagnostic criteria of obsessive-compulsive disorder (OCD). The diagnosis of major depressive disorder was confirmed due to the history of at least 10 episodes over as many years (see Figure 1). She had made two suicide attempts including a drug overdose following which she was hospitalized. She denied hypo/manic symptoms; however, she reported a history of bipolar I disorder in a sibling. Due to the history of sustained response to sertraline, we recommended continuation of the current dose (75 mg daily). She took it for several months before discontinuing it during her subsequent pregnancy. She remained well after stopping it but had a recurrence of depression immediately following her delivery. She was prescribed sertraline by her family physician, and after a few weeks, quetiapine 25 mg was added. She was also taking lorazepam 0.5 mg/daily, as needed.&lt;/p&gt;&lt;p&gt;She was referred to our clinic again 8 months after giving birth to her second child for evaluation of intrusive thoughts of harm coming to her children. She had become increasingly worried about their safety since the abrupt cessation of breastfeeding 4 months earlier. In particular, she was afraid of them dying in a motor vehicle accident, or a fire at home. She had spent thousands of dollars on car seats, strollers, mattresses, baby monitors, car window breakers, and fire alarms to safeguard her children. She also reported a history of compulsive skin-picking and hair-pulling. She had become overly sensitive to noises in the house, such as the dishwasher, breathing sounds, and chewing. On the Mood Disorder Questionnaire, she endorsed all items with co-occurrence and moderate functional impairment. She reported having had brief hypomanic and mixed episodes lasting up to a week since her last delivery. She did not have psychotic features and denied abusing alcohol or using illicit drugs.&lt;/p&gt;&lt;p&gt;Of her extant symptoms, she was particularly concerned about the daily occurrences of episodes of intense anger toward her husband and children. These episodes lasted 45–60 min and were accompanied by yelling, and destruction of property. There were no acts of violence, but she was afraid that she might harm others. She experienced anger attacks after her first delivery, but these were less intense, and less frequent than her rage attacks over the last few months. Her diagnosis was revised to bipolar II disorder and OCD. The sertraline dose was tapered off over 2 weeks due to lack of effectiveness and concerns about ind","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":"27 1","pages":"84-86"},"PeriodicalIF":5.0,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bdi.13499","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142118924","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":"Concept article: Antidepressant-induced destabilization in bipolar illness mediated by serotonin 3 receptor (5HT3)","authors":"Irem Hacisalihoglu Aydin,&nbsp;Rif S. El-Mallakh","doi":"10.1111/bdi.13494","DOIUrl":"10.1111/bdi.13494","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Antidepressants used by patients with bipolar disorder have been associated with destabilization with an increase in mania, depression, and cycling. The most commonly proposed mechanism, that antidepressants ‘overshoot’ their antidepressant effect to create a manic or mixed state, is unlikely since antidepressants have actually been found to be ineffective in treating bipolar depression. Beginning with known bipolar-specific pathophysiologic abnormalities provides the greatest likelihood of insight.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>PubMed was queried with ‘bipolar’, ‘sodium’, ‘intracellular sodium’, ‘serotonin 3’, ‘5HT₃’, ‘5-hydroxytryptamine type 3 receptors’, and ‘antidepressant’ either individually or in combination.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Pathologic mood states (both mania and depression) are associated with increased intracellular sodium (Na) concentrations that depolarize the resting membrane potential to increase cellular excitability (mania) or cause depolarization block (depression). Stimulation of the serotonin (5HT) receptors depolarizes the post-synaptic neuron. Stimulation of 5HT₃ may be of particular importance since it is coupled to a cation channel that directly depolarizes the membrane. These effects <i>directly</i> impact the physiology of patients with bipolar disorder to alter neuronal excitability in a fashion that worsens both mania and depression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Proposed Concept</h3>\u0000 \u0000 <p>The most consistently observed biological abnormality in individuals going through mania or bipolar depression involves a decline in Na pump activity, with consequent elevation of intracellular Na levels. Antidepressant treatment potentiates this, particularly by activation of 5HT₃. This hypothesis can be tested by coadministering a 5HT₃ antagonist (e.g., vortioxetine or ondansetron) to achieve blockade of that receptor while treating bipolar depression with a serotoninergic antidepressant.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":"26 8","pages":"772-778"},"PeriodicalIF":5.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142103932","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":"NMDA antagonists use in bipolar depression: A case report","authors":"Kirolos Ibrahim,&nbsp;Sara Abell,&nbsp;Rif El-Mallakh","doi":"10.1111/bdi.13496","DOIUrl":"10.1111/bdi.13496","url":null,"abstract":"","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":"27 1","pages":"81-83"},"PeriodicalIF":5.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142103935","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":"Conceptualizing the relationship between synthetic cannabinoid use and neuroleptic malignant syndrome","authors":"Vincent Zhang,&nbsp;Alexis June Wirtz,&nbsp;Anmol Dhingra,&nbsp;Ashar Zahid,&nbsp;Najeeb Hussain","doi":"10.1111/bdi.13503","DOIUrl":"10.1111/bdi.13503","url":null,"abstract":"&lt;p&gt;The patient is a 29-year-old female with history of bipolar disorder (multiple past psychiatric admissions) and cannabis/synthetic cannabinoid (SC) use disorder who was recently admitted to an inpatient psychiatric facility for disorganization and agitation. Following this hospitalization, she was discharged on aripiprazole 20 mg daily and lithium 300 mg twice daily. Four days later, she presented to the emergency room following multiple seizure-like episodes and aggressive behavior. Due to ongoing agitation with violence, patient required multiple doses of droperidol, midazolam, hydroxyzine, and was status post administration of soft restraints. The patient's mother described and recorded three episodes of diffuse jerking that lasted 5 min each, with urinary incontinence and oral frothing. Each episode self-resolved, and the patient was conversant throughout episodes with no post-ictal state nor tongue-biting. Neurology was consulted and concluded that her presentation was not consistent with seizures. The patient subsequently was found to have bradykinesia, rigidity, and a rapid increase in creatine kinase from 310 on arrival to a level of 2428 during evaluation- mild neuroleptic malignant syndrome (NMS) was suspected. Her symptoms were thought to be due to use of aripiprazole and droperidol, leading to NMS; however, toxicity from SC's could not be ruled out. Indeed, this was actually suspected, given that the patient had previously been admitted multiple times with similar medication regimens (with higher doses of antipsychotics) without developing NMS. Antipsychotics were discontinued, restraints were avoided as much as possible, and benzodiazepines were instead started for agitation. This resulted in eventual resolution of both her psychiatric and physical symptoms following a short stay in the inpatient unit.&lt;/p&gt;&lt;p&gt;Neuroleptic Malignant Syndrome (NMS) is a well-known side effect of potentially all antipsychotics, as antagonism of dopamine receptors lead to drops in neurotransmitter activity within dopaminergic pathways.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; It has a textbook triad of fever, muscle rigidity, and altered mental status (AMS), but in clinical practice, the majority of cases actually present heterogeneously.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; Similarly, synthetic cannabinoids (SC) possess a widely varying drug profile, due to the vast number of derivatives sold. In recent years, SC have become increasingly popular due to their lower cost, easy obtainability and non-detectability on traditional drug screens.&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; This is of increasing concern, due to their vastly more unpredictable, severe side-effects compared to cannabis- zero fatalities have been seen with cannabis toxicity, while many have been reported due to SC. Psychiatrically, SC has been show to drastically exacerbate certain conditions including schizophrenia, anxiety, and bipolar disorder. For psychosis in particular, it has been shown that SC use serves as an agonist ","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":"27 2","pages":"161-162"},"PeriodicalIF":5.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bdi.13503","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142103933","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":"Utilizing long-acting injectables to address noncompliance among adolescents diagnosed with bipolar disorder","authors":"Kanuja Sood,&nbsp;Mahiya Buddhavarapu,&nbsp;Lajpat Rai Bansal,&nbsp;Daniel Schaefer,&nbsp;Parinda Parikh","doi":"10.1111/bdi.13493","DOIUrl":"10.1111/bdi.13493","url":null,"abstract":"","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":"26 8","pages":"831-834"},"PeriodicalIF":5.0,"publicationDate":"2024-09-01","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":"Treatment resistant but not irremediable","authors":"Gin S. Malhi,&nbsp;Erica Bell,&nbsp;Uyen Le,&nbsp;Philip Boyce,&nbsp;Michael Berk","doi":"10.1111/bdi.13490","DOIUrl":"10.1111/bdi.13490","url":null,"abstract":"&lt;p&gt;In decades gone by, of the many pharmacotherapeutic strategies that have been trialled to overcome non-response when managing depression, three have stood the test of time. The first, is to optimise the prescribed antidepressant by increasing its dose while maintaining tolerability, the second is to switch to a different class of antidepressant, and the third is to augment antidepressant action by adding an agent that enhances its effect. In some cases, the augmenting agent may exert a synergistic, and independent antidepressant effect. Medications that enhance noradrenergic and dopamine neurotransmission, in addition to enhancing serotonergic activity, such as high-dose venlafaxine and tricyclic antidepressants have long been known to be effective in overcoming non-response.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; However, this strategy is not always effective and in such instances, the management paradigm then changes to third-line agents like monoamine oxidase inhibitors or, to physical treatments such as electroconvulsive therapy (ECT). In most cases, the MiDAS paradigm, (which denotes Medication, Increase in Dose, Augmentation, and Switch) is effective,&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; however, occasionally nothing seems to work, or if it does its effect does not last. It is this instance of seemingly irremediable depression where multiple treatments have been trialled that is the focus of this case. With increasing chronicity and repeated treatment failures, there is a risk of growing loss of hope, instilling a sense of futility that is difficult to reverse. And yet, as we shall show, even when all avenues have been trialled, improvement is possible—suggesting that genuine treatment resistance that is complete and immutable is extremely rare.&lt;/p&gt;&lt;p&gt;A severely depressed white male (ET) just embarking on his seventh decade of life with a long-standing history of treatment non-response—designated early in the course of his illness as having treatment resistant depression (TRD), presented with anxiety that he had self-managed over the years mostly with alcohol. At its nadir, his depression manifests with melancholic features, precipitated by flashbacks of work-related trauma, as a consequence of which he also acquired a diagnosis of post-traumatic stress disorder (PTSD). In addition to his psychiatric conditions, he had developed benign prostatic hyperplasia (BPH) and idiopathic hypertension and, over the years, had undergone several surgical operations including bilateral hip replacement and carpal tunnel release. On top of this, in 2018 (5 years prior to his current presentation), he became briefly addicted to OxyContin following an injury but managed to wean himself off within a matter of months. Since then, he has had no further illicit substance misuse but does smoke tobacco several times a day and drinks excessively—often up to 7 units of alcohol on most days. In this regard, it is important to note that there is a family history of alcohol use disorder but ","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":"27 2","pages":"157-160"},"PeriodicalIF":5.0,"publicationDate":"2024-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bdi.13490","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142103937","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 development of reliable criteria for at-risk states for bipolar disorders","authors":"Michael Berk,&nbsp;Aswin Ratheesh,&nbsp;Jan Scott","doi":"10.1111/bdi.13497","DOIUrl":"10.1111/bdi.13497","url":null,"abstract":"","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":"26 8","pages":"759-760"},"PeriodicalIF":5.0,"publicationDate":"2024-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142103936","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}