Bipolar Disorders最新文献

{"title":"Behavioral skill practice as a predictor of mood and family functioning in adolescents with bipolar and depressive mood disorders: Results of a 6-month randomized trial of family-focused therapy","authors":"Marc J. Weintraub,&nbsp;John A. Merranko,&nbsp;Megan C. Ichinose,&nbsp;Danielle M. Denenny,&nbsp;Patricia D. Walshaw,&nbsp;Georga Morgan-Fleming,&nbsp;Robin D. Brown,&nbsp;Armen C. Arevian,&nbsp;David J. Miklowitz","doi":"10.1111/bdi.13466","DOIUrl":"10.1111/bdi.13466","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Behavioral interventions require considerable practice of treatment skills in between therapy sessions. The effects of these treatments may vary with the degree to which patients are able to implement these practices. In offspring of parents with bipolar and major depressive disorders, we examined whether youth who frequently practiced communication and problem-solving skills between family-focused therapy (FFT) sessions had less severe mood symptoms and better psychosocial functioning over 6 months than youth who practiced less frequently.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We randomly assigned offspring (ages 12–19) of parents with mood disorders to 12 sessions of FFT plus a mobile app that encouraged the practice of communication, problem-solving and mood management skills (FFT-MyCoachConnect [MCC] condition) or 12 sessions of FFT with an app that only allowed for tracking of symptoms and stress (FFT-Track condition). Independent evaluators assessed youths' mood and psychosocial functioning at 9-week intervals over 27 weeks. Clinicians rated participants' between-session skill practice at each FFT session.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>FFT-MCC was associated with more frequent skill practice than FFT-Track over 18 weeks of treatment. Skill practice was associated with reductions in youths' mood instability and perceptions of family conflict over 27 weeks in both app conditions. Skill practice mediated the effects of app condition on youths' mood instability and family functioning.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Mobile applications as adjuncts to family therapy for youth with mood disorders can help increase skill practice. These findings provide preliminary causal evidence for behavioral skill practice improving mood symptoms and family functioning among youth with mood disorders.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":"26 7","pages":"733-743"},"PeriodicalIF":5.0,"publicationDate":"2024-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141756979","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":"Who benefits from digital interventions for bipolar disorder? Stage of illness characteristics as predictors of changes in quality of life","authors":"Hailey Tremain,&nbsp;Kathryn Fletcher,&nbsp;Denny Meyer,&nbsp;Greg Murray","doi":"10.1111/bdi.13462","DOIUrl":"10.1111/bdi.13462","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study explored the potential role of stage-related variables in intervention outcomes in bipolar disorder (BD). Specifically, we aimed to identify which subgroups of individuals were most likely to experience improved quality of life following digitally delivered psychosocial interventions for BD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The study involved a secondary analysis of combined data from two randomised control trials (RCTs). Each trial assessed the effectiveness of digitally delivered interventions for improving quality of life, in late-stage (ORBIT RCT) or early-stage (BETTER RCT) BD. Three iterations of cluster analyses were performed, identifying subgroups of individuals based on (i) current phenomenology, (ii) course of illness and (iii) medication response. The resultant subgroups were compared with regard to changes in quality of life pre-post intervention, via repeated measures ANOVAs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In each cluster analysis, two clusters were found. The current phenomenology clusters reflected two impairment levels, ‘moderate impairment’ and ‘low impairment’. The course of illness clusters reflected ‘more chronicity’ and ‘less chronicity’ and the medication response clusters reflected ‘good medication response’ and ‘poor medication response’. Differences in changes in quality of life over time were observed between the two current phenomenology clusters and between the medication response clusters, while the course of illness subgroups did not respond differently.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>There are at least two distinct groups of treatment-seeking individuals with established BD, based on illness features with previously established links to different illness stages. Clusters within the current phenomenology and medication response domains demonstrated significantly different trajectories of QoL change over time in the context of our interventions, highlighting potential implications for treatment selection aligned with precision psychiatry.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":"26 7","pages":"684-695"},"PeriodicalIF":5.0,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bdi.13462","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141750999","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":"Need for further exploring at the intersection of ADHD medications and bipolar disorder","authors":"U. Volpe","doi":"10.1111/bdi.13467","DOIUrl":"10.1111/bdi.13467","url":null,"abstract":"&lt;p&gt;Bipolar disorder (BD) and attention-deficit hyperactivity disorder (ADHD) may copresent and manifest as complex clinical presentations, often accompanied by further comorbidities such as anxiety and substance use disorders. ADHD/BD comorbidity not only relies on a widely reported symptomatological and neurobiological overlap, but it also creates an intricate interplay between ADHD, affective and other psychiatric conditions, requiring a more nuanced understanding of their comorbid nature. Moreover, clinical and nosological perspectives on the nature of the ADHD/BD comorbidity may significantly vary across developmental stages, ranging from an overestimated comorbidity (possibly due to the confound role of greater symptoms' overlap in childhood, adolescence and youth cases) to a prodromal developmental pattern (i.e., from ADHD to BD) or a separate nosological entity (“ADHD-BD”).&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; In younger patients, in particular, recent literature also suggests a possible specific role of emotional dysregulation, a common key feature of ADHD and bipolar spectrum disorders, acting as a confound variable that may enhance the misconception of ADHD/BD comorbidity and favor the misdiagnosis of ADHD as a BD spectrum disorder.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; Clearly, the emphasis on the need to disentangle the complex relationship between juvenile ADHD and BD highlights the challenges in delineating these disorders for better diagnostic characterization and therapeutic indications.&lt;/p&gt;&lt;p&gt;The systematic review by Miskowiak et al.&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; addresses a highly relevant clinical topic, reporting on the available evidence on the efficacy and safety of ADHD pharmacotherapies to treat cognitive impairment and ADHD symptoms in juvenile and adult BD. Shared neurobiological dysregulations, particularly involving dopamine and norepinephrine signalling pathways, may significantly contribute to the symptomatic overlap between BD and ADHD. However, pharmacological interventions targeting dopamine and noradrenaline pathways (such as stimulants and alpha-2-adrenergic agonists) long held promise to ameliorate cognitive deficits and ADHD symptoms in individuals with BD. Indeed, the evidence relative to dysfunctions of the dopamine transporter (DAT) gene and catechol-O-methyltransferase (COMT) gene variants underscores the intricate interplay between these disorders and prompts for therapeutic implications.&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt; Miskowiak et al.&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; also report preliminary favorable evidence of efficacy of ADHD drugs in treating ADHD symptoms in BD, with a current lack of evidence for psychostimulants to trigger or exacerbate mania and insufficient evidence to conclude on their role in improving cognitive symptoms in BD.&lt;/p&gt;&lt;p&gt;Also in our previous work,&lt;span&gt;&lt;sup&gt;5&lt;/sup&gt;&lt;/span&gt; we underscored the potential benefits of adjunctive therapy in alleviating ADHD symptoms in BD patients. Indeed, while mood stabilization should remain th","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":"26 6","pages":"622-623"},"PeriodicalIF":5.0,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bdi.13467","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141750998","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":"How to study psychological mechanisms of mania? A systematic review on the methodology of experimental studies on manic mood dysregulation of leading theories on bipolar disorder","authors":"V. F. J. Glas,&nbsp;M. A. Koenders,&nbsp;R. W. Kupka,&nbsp;E. J. Regeer","doi":"10.1111/bdi.13463","DOIUrl":"10.1111/bdi.13463","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Although there are several psychological theories on bipolar disorders (BD), the empirical evidence on these theories through experimental studies is still limited. The current study systematically reviews experimental methods used in studies on the main theories of BD: Reward Hypersensitivity Theory (RST) or Behavioral Activation System (BAS), Integrative Cognitive Model (ICM), Positive Emotion Persistence (PEP), Manic Defense theory (MD), and Mental Imagery (MI). The primary aim is to provide an overview of the used methods and to identify limitations and suggest areas of improvement.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic search of six databases until October 2023 was conducted. Study selection involved two independent reviewers extracting data on experimental study design and methodology.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 84 experimental studies were reviewed. BAS and RST were the most frequently studied theories. The majority of these experimental studies focus on mechanisms of reward sensitivity. Other important elements of the reviewed theories, such as goal setting and—attainment, situation selection (avoidance or approach), activation, affective/emotional reactivity, and regulatory strategies, are understudied. Self-report and neuropsychological tasks are most often used, while mood induction and physiological measures are rarely used.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>There is a need for more consensus on the operationalization of psychological theories of mania. Standardization of test batteries could improve comparability among studies and foster a more systematic approach to experimental research. Research on affective (activated) states is still underrepresented in comparison with studies on trait vulnerabilities.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":"26 7","pages":"646-660"},"PeriodicalIF":5.0,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bdi.13463","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141750997","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":"Comorbidity of bipolar disorder and borderline personality disorder: Phenomenology, course, and treatment considerations","authors":"Christina M. Temes,&nbsp;Chelsea Boccagno,&nbsp;Alexandra K. Gold,&nbsp;Hadi Kobaissi,&nbsp;Ingrid Hsu,&nbsp;Sofia Montinola,&nbsp;Louisa G. Sylvia","doi":"10.1111/bdi.13465","DOIUrl":"10.1111/bdi.13465","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Bipolar disorder (BD) and borderline personality disorder (BPD) are both serious psychiatric conditions that elevate the risk for harmful outcomes. Although these conditions represent distinct diagnostic entities, existing research suggests that approximately 20% of individuals with BD meet the criteria for comorbid BPD. Individuals with comorbid BD/BPD appear to have a markedly more severe and phenomenologically distinct clinical course when compared with those with BD alone. However, treatments have generally not been tested in this specific population, and currently, no formal treatment guidelines exist for this subgroup of patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>In the current paper, we review the epidemiological and descriptive research characterizing those with comorbid BD/BPD and discuss the impact of this comorbidity on psychosocial treatment. We also review current findings on evidence-based treatments for BD and BPD that show promise in treating those with comorbid BD/BPD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In our review of the literature, we highlight the importance of recognizing this comorbidity and discuss avenues for developing and integrating evidence-based treatment approaches for this understudied clinical population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Although formal trials of interventions targeted to comorbid BD/BPD are limited, there is promising evidence regarding the possibility of using or integrating existing evidence-based approaches for this population. There are also several areas of clinical practice improvement and future research directions that stem from this literature.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":"26 6","pages":"548-555"},"PeriodicalIF":5.0,"publicationDate":"2024-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141733503","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":"How far have we advanced in early intervention for bipolar disorder?","authors":"Raphael Cerqueira,&nbsp;Juliana Surjan,&nbsp;Acioly L. T. Lacerda,&nbsp;Cristiano Noto","doi":"10.1111/bdi.13461","DOIUrl":"10.1111/bdi.13461","url":null,"abstract":"","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":"26 5","pages":"493-494"},"PeriodicalIF":5.0,"publicationDate":"2024-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141199283","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":"Decoding the enigma: Valproate encephalopathy in a bipolar affective disorder without hyperammonemia","authors":"Bárbara Sofia Gonçalves Castro Sousa,&nbsp;Zoé Correia de Sá,&nbsp;Joana Ramos","doi":"10.1111/bdi.13460","DOIUrl":"10.1111/bdi.13460","url":null,"abstract":"","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":"26 5","pages":"507-509"},"PeriodicalIF":5.0,"publicationDate":"2024-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141199282","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":"Cultural narratives and modern psychiatry: Bridging perspectives on bipolar disorder's impact on sexual and familial dynamics","authors":"Lien-Chung Wei,&nbsp;Wei-Ching Huang","doi":"10.1111/bdi.13445","DOIUrl":"10.1111/bdi.13445","url":null,"abstract":"","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":"26 6","pages":"624-625"},"PeriodicalIF":5.0,"publicationDate":"2024-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141155129","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":"Adding esketamine to lamotrigine to treat major depression: Combinatorial synergism, augmentation, or neither?","authors":"Gin S. Malhi,&nbsp;Uyen Le,&nbsp;Cornelia Kaufmann,&nbsp;Erica Bell","doi":"10.1111/bdi.13448","DOIUrl":"10.1111/bdi.13448","url":null,"abstract":"&lt;p&gt;In an investigator-initiated study&lt;sup&gt;1&lt;/sup&gt; designed to determine the positioning of esketamine in the treatment (PoET) of depression, we have treated patients with severe depression. As it is a naturalistic study, we have no stipulations as to the antidepressant treatment the person is taking when commencing add-on esketamine therapy, which is administered via bi-weekly insufflation under medical supervision. Most patients that are referred are taking SSRIs, SNRIs or TCAs, and occasionally are taking MAOIs or novel agents such as vortioxetine. However, in one patient who had trialled most treatments, the physician had resorted to trialling lamotrigine even though the patient had no history of bipolar disorder, possibly because of the complexity of the illness (number of comorbidities) and lack of response.&lt;/p&gt;&lt;p&gt;It is this case, of a 44-year-old Caucasian female (LE) with a current psychiatric history of treatment resistant depression (TRD), along with generalized anxiety disorder (GAD), obsessive-compulsive disorder (OCD) and iatrogenic benzodiazepine dependence that we present here. Previous diagnoses also included orthorexia in recovery and substance misuse in young adulthood. Her medical history includes osteoporosis and ulcerative colitis, but she has been off steroids since 2015, and does not smoke, consume alcohol or use substances.&lt;/p&gt;&lt;p&gt;In late 2018, LE, then 40 years old, was diagnosed with major depressive disorder with anxiety. There was no significant precipitant for her depressive episodes and because of her illness, she stopped working in 2019. Her depressive symptoms included sadness, numbness, anhedonia, low self-worth, feelings of helplessness and hopelessness, loss of appetite, detachment and passive suicidal ideation. She described her depression as “&lt;i&gt;depression with unbearable pain&lt;/i&gt;”, and she was “&lt;i&gt;unable to see the future&lt;/i&gt;”. In addition to receiving psychological and dietetic treatments weekly, she also trialled multiple pharmacological treatments including SSRIs, SNRIs, TCAs, MAOIs, atypical antipsychotics and lithium augmentation (see Figure 1). She experienced a partial response with some medications but also had severe side effects. She also underwent a course of rTMS, which she reported “&lt;i&gt;did nothing for me, I felt like it did less than an SSRI&lt;/i&gt;”.&lt;/p&gt;&lt;p&gt;In January 2024, the patient was referred to the CADE clinic&lt;sup&gt;2&lt;/sup&gt; and screened for PoET. After an extensive assessment process, we deemed the patient suitable for enrolment. She consented and commenced the study in January 2024. As per our protocol, she received esketamine treatments twice weekly for 4 weeks. At the time of enrolment, LE was taking lamotrigine 200 mg daily, diazepam 4.5 mg daily (slowly weaning off, but kept at a stable dose for the duration of the trial) and suvorexant for sleep. She completed a baseline questionnaire and received her first esketamine treatment in January 2024. She completed the course by mid-February having","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":"26 5","pages":"500-504"},"PeriodicalIF":5.0,"publicationDate":"2024-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bdi.13448","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141086822","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":"ChatGPT in academic psychiatry","authors":"Hinpetch Daungsupawong,&nbsp;Viroj Wiwanitkit","doi":"10.1111/bdi.13451","DOIUrl":"10.1111/bdi.13451","url":null,"abstract":"","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":"26 5","pages":"495"},"PeriodicalIF":5.0,"publicationDate":"2024-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141070308","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}