Bipolar Disorders最新文献

{"title":"White Matter Changes During Manic and Depressive Episodes and Phase Switching in Bipolar Disorder: A Tractography Study","authors":"Giuseppe Delvecchio,&nbsp;Giovanni Videtta,&nbsp;Letizia Squarcina,&nbsp;Lorena Di Consoli,&nbsp;Francesca Siri,&nbsp;Adele Ferro,&nbsp;Giandomenico Schiena,&nbsp;Ylenia Barone,&nbsp;Antonio Callari,&nbsp;Guido Nosari,&nbsp;Fabio Maria Triulzi,&nbsp;Giorgio Conte,&nbsp;Judith R. Homberg,&nbsp;Paolo Brambilla","doi":"10.1111/bdi.70131","DOIUrl":"10.1111/bdi.70131","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Bipolar disorder (BD) is a severe psychiatric condition characterized by recurrent episodes of mania and depression. A critical aspect of BD is phase switching, the rapid transition between affective states, which remains poorly understood at the neurobiological level. Recent neuroimaging advancements, particularly in diffusion tensor imaging (DTI) and tractography, have provided insights into the structural white matter (WM) alterations associated with mood transitions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted an integrated diffusion neuroimaging study to investigate WM modifications in BD patients experiencing manic and depressive phases, as well as those undergoing phase switching. Thirty-two BD type I patients (14 manic, 18 depressive) and 20 healthy controls underwent Magnetic Resonance Imaging scanning, including DTI-based analyses. WM integrity was assessed using Tract-Based Spatial Statistics (TBSS) and tractography to explore fractional anisotropy (FA) differences.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Compared to healthy controls and depressive BD patients, manic BD patients exhibited significant FA reductions in the corpus callosum, anterior limb of the internal capsule, and thalamic projections. Tractography revealed local FA alterations in fronto-limbic and occipito-parietal pathways, suggesting disrupted structural connectivity. Phase switching was associated with reduced FA in the right superior longitudinal fasciculus III, indicating its potential role as a neurobiomarker of mood instability.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our findings highlight widespread WM abnormalities in BD, particularly in manic phases, and suggest a neurobiological signature for phase switching. Understanding these alterations can improve early detection, targeted interventions, and personalized treatment approaches for BD.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":"28 5","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148262960","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":"Clinical Phenomenology of Bipolar Disorder With Substance Use Disorders: A Systematic Review","authors":"Shivahn Garvie,&nbsp;Maryam Sorkhou,&nbsp;Tony P. George","doi":"10.1111/bdi.70132","DOIUrl":"https://doi.org/10.1111/bdi.70132","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Bipolar disorder (BD) frequently co-occurs with substance use disorders (SUDs), including alcohol, cannabis, tobacco, stimulants, and opioids. Comorbid SUDs can worsen the clinical presentation of BD, contributing to more severe mood episodes, rapid cycling, and poorer recovery outcomes. However, the unique impacts of different SUDs on the BD clinical profile are less studied, potentially obscuring substance-specific effects on the course of illness and prognosis in BD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a systematic review of the literature (PubMed, PsycINFO) and identified <i>N</i> = 48 clinical studies exploring the clinical effects of specific SUDs on BD symptomatology, course of illness, and treatment outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Our findings revealed that cannabis use disorder (CUD) and alcohol use disorder (AUD) are the most studied SUDs in BD. Concurrent CUD is frequently associated with increased manic episodes, rapid cycling, psychosis, and earlier BD onset, with mixed findings for depressive episodes, suicidality, and treatment outcomes. AUD is frequently linked with worse depression outcomes and increased suicidality, with mixed findings for manic symptoms, rapid cycling, age of onset, psychosis, and treatment outcomes. Other SUDs, including cocaine, tobacco, opioids, and methamphetamine, were underexplored but were linked to increased suicidality, hospitalizations, and medication nonadherence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Specific clinical profiles were associated with different SUDs, which underscores the need for more research to improve our understanding and treatment of comorbid BD-SUDs. Further research exploring non-alcohol and non-cannabis SUDs and utilizing more rigorous methodological designs is needed to clearly elucidate these associations and advance substance-specific interventions in BD patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":"28 5","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148238217","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":"Clinical and Sociodemographic Correlates of Poor Medication Adherence in People With Bipolar Disorder: A Systematic Review and Meta-Analysis","authors":"Francesco Bartoli,&nbsp;Daniele Cavaleri,&nbsp;Ilaria Riboldi,&nbsp;Chiara Alessandra Capogrosso,&nbsp;Carlo Bassetti,&nbsp;Marco Broccia,&nbsp;Giorgio Cucchi,&nbsp;Cristina Crocamo,&nbsp;Martha Sajatovic,&nbsp;Giuseppe Carrà","doi":"10.1111/bdi.70127","DOIUrl":"10.1111/bdi.70127","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Poor adherence to psychopharmacological treatment may contribute to relapses in bipolar disorder (BD). We performed a systematic review and meta-analysis to identify factors associated with poor adherence in BD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The protocol was registered in Open Science Framework Registries (https://doi.org/10.17605/OSF.IO/2KZFJ). We searched main electronic databases through March 2025. Random-effects meta-analyses were performed to obtain pooled odds ratios (ORs) and standardized mean differences (SMDs) for relevant correlates.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We included 19 studies. Subjects with poor adherence were more likely to be younger (SMD = <b>−</b>0.22, 95% CI: <b>−</b>0.42–<b>−</b>0.02) and to have lower education (SMD = <b>−</b>0.34, 95% CI: <b>−</b>0.55–<b>−</b>0.12), and less likely to be in a relationship (OR = 0.54, 95% CI: 0.34–0.86). Moreover, earlier age at onset (SMD = <b>−</b>0.29, 95% CI: <b>−</b>0.53–<b>−</b>0.04), psychotic features (OR = 1.58, 95% CI: 1.30–1.92), a history of suicide attempts (OR = 1.36, 95% CI: 1.03–1.78), a higher number of manic (SMD = 0.34, 95% CI: 0.08–0.61) and mixed (SMD = 0.16, 95% CI: 0.03–0.28) episodes, and more hospitalizations (SMD = 0.53, 95% CI: 0.32–0.73) all emerged as correlates of poor adherence. Also, cannabis (OR = 2.34, 95% CI: 1.79–3.07) and alcohol use disorders (OR = 1.71, 95% CI: 1.39–2.12), comorbid generalized anxiety disorder (OR = 3.70, 95% CI: 1.90–7.22), and comorbid personality disorders (OR = 5.54, 95% CI: 1.32–23.15) were associated with poor adherence. Finally, poorly adherent individuals had higher global severity (SMD = 0.21, 95% CI: 0.01–0.41), lower insight (SMD = <b>−</b>0.74, 95% CI: <b>−</b>1.08–<b>−</b>0.41), and lower global functioning (SMD = <b>−</b>0.60, 95% CI: <b>−</b>0.87–<b>−</b>0.34). No differences were estimated for other variables.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This meta-analysis showed that poor adherence in people with BD is associated with specific correlates. Although evidence was generally weak due to small effect sizes, imprecision, inconsistency, and potential publication bias, our findings highlight the importance of strategies to improve adherence.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":"28 5","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bdi.70127","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148209749","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":"Determinants of Digital Health Resource Utilization Among Individuals With Self-Reported Bipolar Disorder in Germany—A Cross-Sectional Study Based on the Andersen Model","authors":"Linda Kokwaro,&nbsp;Helena Krüger,&nbsp;Dennis Stratmann,&nbsp;Daniel Schulze,&nbsp;Daniel Fürstenau,&nbsp;Eva Friedel,&nbsp;Esther Quinlivan,&nbsp;Surjo R. Soekadar,&nbsp;Sonia Lech,&nbsp;Stefanie Schreiter","doi":"10.1111/bdi.70128","DOIUrl":"10.1111/bdi.70128","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>This study examines the utilization of digital health resources among individuals with bipolar disorder (BD) in Germany, applying the Andersen Healthcare Utilization Model (AHUA) to this context for the first time. While resources such as health-related websites, social media and online forums, smartphone apps, digital devices such as wearables, and online interaction with health care professionals offer new opportunities for self-management, less is known about which factors systematically influence their use among individuals with BD. To address this gap, the AHUA, which classifies healthcare utilization through predisposing, enabling, and need factors, was adapted to investigate digital health resource utilization.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>An anonymous online cross-sectional survey of 213 individuals with a self-reported diagnosis of bipolar disorder collected data on demographics, illness history, digital literacy, and digital health resource utilization. Hierarchical multiple linear regression analysis was conducted to examine associations between predisposing, enabling, and need-related factors with digital health resources.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The final model explained 30.6% of the variance in digital health resource utilization. Among predisposing factors, female gender was associated with higher utilization. Among enabling factors, wearable ownership was the strongest and most significant factor associated with higher utilization. Among need factors, earlier age of diagnosis and lower health-related quality of life were significantly associated with greater utilization. In contrast, smartphone ownership, digital health literacy, subjective health status, concentration difficulties, and the interaction between cognition and wearable ownership were not significantly associated with utilization.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>These findings highlight that digital health resource utilization in individuals with BD is primarily driven by enabling factors and objective health-related need rather than subjective health perceptions or cognitive functioning. The results underscore the importance of device access and clinical characteristics in influencing engagement with digital health tools. Targeting wearable-based interventions and tailoring digital health solutions to individuals with greater clinical need may enhance adoption and improve self-management in BD.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":"28 4","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bdi.70128","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148203863","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":"Trends in the Use of Atypical Antipsychotics Among Children and Adolescents With Bipolar Spectrum Disorders in Korea","authors":"Kee Jeong Park,&nbsp;Ye-Jee Kim,&nbsp;Eunji Jung,&nbsp;Ju Yeon Kim,&nbsp;Hyo-Won Kim","doi":"10.1111/bdi.70125","DOIUrl":"10.1111/bdi.70125","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Atypical antipsychotics (AAPs) are increasingly prescribed for bipolar spectrum disorders in children and adolescents. This study aimed to investigate the prevalence and trends of AAP prescriptions among Korean children and adolescents with bipolar spectrum disorders.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We analyzed data from the Korean National Health Insurance Review and Assessment Service to assess AAP use among Koreans aged 0–18 years with bipolar spectrum disorders between 2010 and 2022. This population-based study used an annual cross-sectional assessment to evaluate trends in AAP prescription.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The prevalence of AAP prescriptions for children and adolescents with bipolar spectrum disorders increased over the 13-year study period, rising from 0.14 in 2010 up to 1.23 per 1000 persons in 2022. During this time, the dominant AAP shifted from risperidone to aripiprazole. Data from 2022 revealed that the most prescribed AAP for children was aripiprazole, followed by risperidone, quetiapine, and olanzapine. Children and adolescents with bipolar spectrum disorders and psychiatric comorbidities, particularly ADHD, were prescribed AAPs more frequently (<i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The prescription of AAPs in Korean children and adolescents with bipolar spectrum disorders has increased over the last decade. This trend was particularly pronounced among individuals with psychiatric comorbidities, especially ADHD. Future research is needed to develop more evidence-based AAP treatments for bipolar spectrum disorders in this population.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":"28 4","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bdi.70125","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148203898","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 Distinct Role of Family History and Polygenic Risk Scores of Psychiatric Disorders on Lithium Response in Bipolar Disorder","authors":"Mete Ercis,&nbsp;Brandon J. Coombes,&nbsp;Lindsay M. Melhuish Beaupre,&nbsp;Melissa Solares-Bravo,&nbsp;Marin Veldic,&nbsp;Katherine M. Moore,&nbsp;Hannah K. Betcher,&nbsp;Francisco Romo-Nava,&nbsp;Aysegul Ozerdem,&nbsp;David J. Bond,&nbsp;Alfredo B. Cuellar-Barboza,&nbsp;Miguel L. Prieto,&nbsp;Susan L. McElroy,&nbsp;Mark A. Frye,&nbsp;Joanna M. Biernacka,&nbsp;Balwinder Singh","doi":"10.1111/bdi.70126","DOIUrl":"10.1111/bdi.70126","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>This study aimed to explore the effect of family history (FH) and polygenic risk scores (PRS) for multiple psychiatric disorders on lithium response in bipolar disorder (BD).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>The sample included patients from the Mayo Clinic BD Biobank. FH in first-degree relatives was obtained via the patient questionnaire. Linear regression models tested the association of FH and PRS for BD, major depressive disorder (MDD), schizophrenia (SCZ), alcohol use disorder (AUD), anxiety disorder (ANX), and attention-deficit/hyperactivity disorder (ADHD) with lithium response measured by the Alda A score adjusted for the Alda B sum score. Post hoc models additionally adjusted for clinical covariates (age at onset, rapid cycling, and BD subtype).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>716 patients had Alda scores for lithium response (61.9% females, mean age = 43.4 years). FH-BD (<i>β</i> = −0.57, <i>p</i> = 0.015), AUD (<i>β</i> = −0.44, <i>p</i> = 0.045), and ANX (<i>β</i> = −0.61, <i>p</i> = 0.050) were associated with worse lithium response. After adjusting for clinical covariates, associations for FH-BD and FH-ANX were no longer significant. PRS-BD was associated with better response (<i>β</i> = 0.22, <i>p</i> = 0.041), while PRS-MDD (<i>β</i> = −0.28, <i>p</i> = 0.01) and PRS-ADHD (<i>β</i> = −0.24, <i>p</i> = 0.028) were associated with worse response, with effects largely unchanged after adjusting for clinical covariates. In the combined model considering all FHs simultaneously, only FH-BD remained significantly associated with worse lithium response (<i>β</i> = −0.71, <i>p</i> = 0.039). In the combined model for PRS, only PRS-BD (<i>β</i> = 0.31, <i>p</i> = 0.008; better response) and PRS-MDD (<i>β</i> = −0.29, <i>p</i> = 0.020; worse response) showed significant associations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In this exploratory study, FH-BD, AUD, and ANX were associated with poor response, though only FH-AUD remained significant after adjusting for clinical factors. PRS-BD predicted better response, while PRS-MDD was associated with worse response. These findings suggest independent and potentially complementary roles of FH and PRS. Integrating both familial and genetic risk measures may improve personalized treatment strategies and outcomes for BD patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":"28 4","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148209691","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":"Bipolar Disorder Psychosis Risk Predicts Cue Discrimination on the AX-Continuous Performance Task Paradigm","authors":"Meghan Fiske,&nbsp;Dominique L. DiDomenico,&nbsp;Henry W. Chase,&nbsp;Yvette Afriyie-Agyemang,&nbsp;Genna Bebko,&nbsp;Haris A. Aslam,&nbsp;Simona Graur,&nbsp;Osasumwen Benjamin,&nbsp;Yiming Wang,&nbsp;Richelle Stiffler,&nbsp;Michele Bertocci,&nbsp;Brian A. Coffman,&nbsp;Deepak K. Sarpal,&nbsp;Cameron S. Carter,&nbsp;Mary L. Phillips","doi":"10.1111/bdi.70129","DOIUrl":"10.1111/bdi.70129","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Bipolar Disorder (BD)—characterized by mania, affective lability, and elevated psychosis risk—is associated with sustained attention deficits. However, evidence regarding performance on the AX-Continuous Performance test task (AX-CPT), a task reliably impaired in schizophrenia-spectrum psychosis, is mixed. This study examined whether individual differences in mania/affective lability risk and psychosis risk, across cohorts of BD and BD-at-risk individuals, were associated with altered AX-CPT performance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The standard measures d'context and A-cue bias quantified AX-CPT performance. Factors from the Mood Spectrum Self Report (MOODS-SR-L) indexed lifetime mania/affective lability risk (psychomotor activation, suicidality, and mixed instability) and lifetime psychosis risk. Linear regressions were performed for dimensional continuous aims (Aims 1–2) for both d'context and A-cue bias. Tests between BD with low and high-risk groups (Aims 3–4) were completed with ANCOVAs for both AX-CPT output measures.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In the final sample of euthymic BD (<i>n</i> = 27) and at-risk individuals (<i>n</i> = 121), higher levels of psychosis and mania/affective lability risk were associated with reduced target discrimination (d'context; absolute <i>t</i>'s &gt; 2.015, <i>p</i>'s &lt; 0.047), but not with altered A-cue bias. Group comparisons showed no significant differences for either AX-CPT measure. Associations with d'context from Aims 1–2 remained after covarying for current depressive symptoms but were removed when covarying for current mania severity (absolute <i>t</i>'s &lt; 1.26, all <i>p</i>'s &gt; 0.203).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Target discrimination deficits were associated dimensionally with psychosis and mania/affective lability risk but not categorically with BD diagnosis. This suggests scope for dimensional risk models for understanding sustained attention deficits in BD and at-risk individuals and highlights contributions of mania/affective lability and psychosis risk.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":"28 4","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bdi.70129","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148203936","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":"Advancing Brain and Body Vascular Imaging in Bipolar Disorder: A Report From the International Society for Bipolar Disorders Vascular Task Force","authors":"Megan Mio,&nbsp;Pao-Huan Chen,&nbsp;Kody G. Kennedy,&nbsp;Hilary P. Blumberg,&nbsp;David J. Bond,&nbsp;Eric L. Goldwaser,&nbsp;Fabiano A. Gomes,&nbsp;Jody L. Greaney,&nbsp;Tomas Hajek,&nbsp;Susan L. McElroy,&nbsp;Roger S. McIntyre,&nbsp;Abigail Ortiz,&nbsp;Miguel L. Prieto,&nbsp;Elysha Ringin,&nbsp;Louisa G. Sylvia,&nbsp;Shang-Ying Tsai,&nbsp;Jess G. Fiedorowicz,&nbsp;Benjamin I. Goldstein","doi":"10.1111/bdi.70120","DOIUrl":"https://doi.org/10.1111/bdi.70120","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The heart–brain nexus is increasingly recognized as important for human health. Nonetheless, integration of this perspective in research and treatment remains limited in psychiatry, particularly in bipolar disorder (BD). Multisystem vascular imaging may help elucidate mechanisms linking heart and brain health in BD. The ultimate purpose of this review is to inspire and guide integration of vascular imaging more broadly in BD research.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>An international group of experts reviewed the vascular imaging literature in BD, synthesizing key studies, limitations, and future directions. Findings were organized by organ system (brain, eye, heart, body), including novel methods reported in other psychiatric or neurological disorders that are understudied in BD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Structural and functional vascular differences, reflecting macro- and microvascular health, are reported across the lifespan in BD. State effects are more apparent for functional than structural metrics. BD-related differences in vascular metrics were independent of traditional vascular risk factors in some but not all studies. Accessibility ranged from widespread (e.g., tonometry, retinal imaging) to specialized (e.g., cardiac magnetic resonance imaging [MRI], arterial-spin labeling MRI). Although small BD samples were common, general population cohorts demonstrate feasibility for broader use.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>BD-related differences in vascular imaging metrics are evident within and beyond the brain. Continued progress is warranted to realize potential implications for brain, heart, and mental health. Larger studies, powered for subgroup analyses and robust covariate modeling, are warranted. Future studies including prospective designs, fluid biomarkers, and lived-experience perspectives would further enhance the relevance of vascular imaging for those with BD.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":"28 4","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bdi.70120","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148174274","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":"Uncovering Shared and Distinct Brain Connectome Dynamics in Working Memory Tasks Between Bipolar and Unipolar Depression","authors":"Fuping Sun,&nbsp;Feiwen Wang,&nbsp;Zhening Liu,&nbsp;Maoxing Zhong,&nbsp;Jun Yang,&nbsp;Jie Yang","doi":"10.1111/bdi.70124","DOIUrl":"10.1111/bdi.70124","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Differences in working memory (WM) may serve to distinguish bipolar disorder depression (BDD) from major depressive disorder (MDD). This work aims to utilize degree centrality (DC), a metric of graph theory, to explore whole-brain dynamic functional connectivity alterations related to WM in the two disorders.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We calculated the coefficient variation of dynamic DC (CVDC) and utilized clustering analysis to identify persistent meta-stable states of DC configuration in BDD, MDD, and healthy controls (HC) during n-back tasks. We further tested associations of the altered DC and clinical symptoms. Meanwhile, imaging transcriptomic analysis was used to explore the genetic mechanisms underlying the differences in DC between BDD and MDD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>No significant difference was observed in CVDC among the three groups. In the meta-stable state 1 under the ‘2-back vs. 0-back’ contrast, there showed a ladder-like pattern across BDD, MDD, and HC in bilateral parahippocampal gyri, left anterior cingulate cortex, left Heschl gyrus, right precentral gyrus, right precuneus, bilateral middle temporal gyrius, right inferior frontal gyrus, and right superior frontal gyrus. Significant DC differences between BDD and MDD in the right superior frontal gyrus and right middle temporal gyrus were primarily associated with gene enrichment in the chemical synaptic transmission, glutamatergic synapse, calcium ion binding, and pathways of neurodegeneration—multiple diseases pathway.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>BDD and MDD showed highly similar aberrant dynamic characteristics of brain functional connectivity when facing increased cognitive demands, but BDD showed a relatively greater magnitude than MDD.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":"28 4","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148155264","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":"Bipolar Disorder Incidence During Pregnancy and in the Postpartum Period: A Population-Based Study","authors":"Veerle Bergink,&nbsp;Merete Lund Mægbæk,&nbsp;Emely Ek Blæhr,&nbsp;Xiaoqin Liu,&nbsp;Trine Munk-Olsen","doi":"10.1111/bdi.70122","DOIUrl":"10.1111/bdi.70122","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The postpartum period is a well-described high-risk time for bipolar episodes, but the risks during pregnancy remain debated. This study examined the incidence of bipolar disorder before, during, and after pregnancy, compared to an age-matched female population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>In this population-based study we investigated first bipolar episodes in 1,217,354 childbirths in Denmark between 2002 and 2021 (ICD-10 codes: F30–F31). We calculated the monthly incidence proportion of both inpatient and outpatient visits for bipolar disorder in mothers from 1 year before pregnancy to 1 year after delivery (perinatal period), as well as in a 1:5 matched background female cohort during the same time frame.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The incidence of bipolar diagnosis in the perinatal period was lower among mothers (0.39 per 1000 childbirths) compared to the background female population (0.82 per 1000 women), with an incidence proportion ratio of 0.47. Hospital admissions for bipolar disorder were rare during pregnancy but increased sharply postpartum, peaking in the first month. The incidence of outpatient treatment decreased in late pregnancy but rose postpartum.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Pregnancy appears to be a low-risk period for bipolar disorders, but we confirmed a well-described peak in severe episodes postpartum. Across the entire perinatal period we, however, found an overall lower incidence of bipolar diagnosis compared to the background female population. Earlier studies have described a significant bipolar diagnostic delay after psychiatric episodes in the postpartum, and we encourage increased focus on timely diagnosis.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":"28 4","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148142608","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}