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Bipolar disorder

Daniel O Scharfstein, Aidan McDermott
Randomized trials with patient-reported outcomes are commonly plagued by missing data. The analysis of such trials relies on untestable assumptions about the missing data mechanism. To address this issue, it has been recommended that the sensitivity of the trial results to assumptions should be a mandatory reporting requirement. In this paper, we discuss a recently developed methodology (Scharfstein et al., Biometrics, 2018) for conducting sensitivity analysis of randomized trials in which outcomes are scheduled to be measured at fixed points in time after randomization and some subjects prematurely withdraw from study participation...
January 1, 2018: Statistical Methods in Medical Research
Miguel A Marín Gabriel, Ana M Malalana Martínez, Ibone Olza Fernández
Lithium therapy is currently a cornerstone of treatment for mothers who suffer bipolar disorders. Those who wish to breastfeed their children are often told they have to decide whether modifying the treatment for their disorder or even avoiding lactation. Lithium administration during breastfeeding has been described to produce certain side effects such as thyroid disorders, hypothermia and hypotonia. To our knowledge, there are few publications where infants have no laboratory abnormalities. Here we present the case of an infant without renal or thyroid alteration while he was breastfed...
April 1, 2018: Archivos Argentinos de Pediatría
David Edberg, Debra Hoppensteadt, Amanda Walborn, Jawed Fareed, James Sinacore, Angelos Halaris
Immune system activation and neuroinflammation appear to play a key role in the pathophysiology and treatment of bipolar depression (BDD). This study is the first to analyze blood levels of the pro-inflammatory biomarker C-reactive protein (CRP) in bipolar disorder patients treated with the cyclooxygenase-2 inhibitor, celecoxib (CBX). In this double-blind study, 47 consenting patients with BDD were randomized to receive either escitalopram (10 mg twice/day) + CBX (200 mg twice/day), or escitalopram (10 mg twice/day) + placebo (twice/day)...
February 13, 2018: Journal of Psychiatric Research
Yi-Feng Carol Lan, Diane C Zelman, Wen-Tao Chao
Bipolar disorder (BD) affects a significant proportion of Taiwanese individuals (Weissman et al., 1996; Yang, Yeh, & Hwu, 2012). Psychotropic medications are typically the mainstay of treatment for BD, and there is an abundance of international research on biological etiology and medication options. However, there is comparatively little research on psychosocial aspects of BD, including how it is understood and managed within families. As culture provides the context in which psychiatric disease is managed, there is a need to identify distinct Chinese psychosocial perspectives that might shed light on intervention options...
January 1, 2018: Transcultural Psychiatry
Bart N Ford, Robert H Yolken, Faith B Dickerson, T Kent Teague, Michael R Irwin, Martin P Paulus, Jonathan Savitz
BACKGROUND: Depression can impair the immunogenicity of vaccine administration in adults. Whereas many vaccinations are administered in childhood, it is not known whether adolescent or adult onset depression is associated with impairments in the maintenance of protection of childhood vaccines. This study tested the hypothesis that individuals with adolescent or adult onset mood disorders would display compromised immunity to measles, a target of childhood vaccination. METHODS: IgG antibodies to measles were quantified using a solid phase immunoassay in volunteers with bipolar disorder (BD, n = 64, mean age of onset = 16...
March 19, 2018: Psychological Medicine
Viktoriya L Nikolova, Keerati Pattanaseri, Diego Hidalgo-Mazzei, David Taylor, Allan H Young
BACKGROUND: Lithium is widely used for the treatment of bipolar disorder. Owing to its narrow therapeutic index and side-effect profile, regular monitoring of serum levels, renal and thyroid function has been recommended by all major guidelines on lithium use. OBJECTIVES: We investigated whether lithium monitoring during maintenance phase treatment in clinical practice meets the latest recommendation by the National Institute for Health and Clinical excellence (i...
March 1, 2018: Journal of Psychopharmacology
Morgwn Paris, Yatin Mahajan, Jeesun Kim, Tanya Meade
BACKGROUND: Deficits in emotional prosody processing have been observed in bipolar disorder (BD). While recent neural studies have explored impaired processing of facial expressions, little is known about deficits in emotional speech processing, or the specific stages of processing at which they occur. This study examined if pre-attentive detection and attention to emotional speech is impaired in BD, relative to healthy individuals. METHODS: The EEG data was collected from 14 individuals with BD and 14 healthy control (HC) participants while the auditory stimuli was presented via a passive three-stimulus oddball sequence which included emotionally (neutral, happy, sad) spoken syllables and acoustically matched nonvocal tones...
February 23, 2018: Journal of Affective Disorders
Jonika Tannous, Henrique Amaral-Silva, Bo Cao, Mon-Ju Wu, Giovana B Zunta-Soares, Iram Kazimi, Cristian Zeni, Benson Mwangi, Jair C Soares
The hippocampus has been implicated in various mood disorders, with global volume deficits consistently found in patient populations. The hippocampus, however, consists of anatomically distinct subfields, and examination of specific subfield differences may elucidate the possible molecular mechanisms behind psychiatric pathologies. Indeed, adult studies have reported smaller hippocampal subfield volumes in regions within the cornu ammonis (CA1 and CA4), dentate gyrus (DG), and hippocampal tails in both patients with Major Depressive Disorder (MDD) and Bipolar Disorder (BD) compared to healthy controls...
March 12, 2018: Journal of Psychiatric Research
Michael Thomson, Verinder Sharma
PURPOSE OF REVIEW: The management of bipolar disorder during pregnancy requires difficult treatment decisions be made by both women and their clinicians. There is little consensus on management despite the high prevalence of bipolar disorder in reproductive-aged women. In this review, we have summarized the available literature and discuss the balancing of risks associated with treatment decisions. RECENT FINDINGS: Cohort studies have shown a high relapse rate in women with bipolar disorder who discontinue mood-stabilizing medications...
March 17, 2018: Current Psychiatry Reports
Misbah Salim, Verinder Sharma, Kelly K Anderson
We conducted a systematic review of the literature to determine the prevalence of mood episode recurrences during pregnancy among women with bipolar disorder. Included studies (n = 11) had wide variation in the reported proportions of pregnant women with bipolar disorder who experienced a recurrence (median = 24%, range = 4-73%). There is some evidence that pregnant women are more likely to have a depressive or mixed episode, rather than hypomanic or manic. The extant literature cannot answer the question of how pregnancy affects the course of bipolar disorder; it merely informs us of the effect of medication discontinuation during pregnancy...
March 17, 2018: Archives of Women's Mental Health
Noa Tsujii, Wakako Mikawa, Toru Adachi, Tomoyuki Hirose, Osamu Shirakawa
Schizophrenia (SZ) and bipolar I disorder (BD-I) share genetic risk factors and cognitive impairments, but these conditions may exhibit differences in cortical functioning associated with inhibitory control. We measured hemodynamic responses during a stop-signal task using near-infrared spectroscopy (NIRS) in 20 patients with SZ, 21 patients with BD-I and 18 healthy controls (HCs). We used stop-signal reaction time (SSRT) to estimate behavioural inhibition. Compared with HCs, patients with either SZ or BD-I exhibited significantly reduced activation in the bilateral inferior, middle and superior frontal gyri...
March 16, 2018: Scientific Reports
Nicolas A Nuñez, Stefano Comai, Eduard Dumitrescu, Maykel F Ghabrash, John Tabaka, Marie Saint-Laurent, Stephen Vida, Theodore Kolivakis, Allan Fielding, Nancy Low, Pablo Cervantes, Linda Booij, Gabriella Gobbi
BACKGROUND: Some authors have hypothesized that Treatment-Resistant Unipolar Depression (TRD-UP) should be considered within the bipolar spectrum disorders and that hidden bipolarity may be a risk factor for TRD-UP. However, there are neither studies comparing clinical and sociodemographic data of patients with TRD-UP versus Bipolar (BP) disorders nor are there any examining differences versus Bipolar type I (BP-I) and Bipolar type II (BP-II). METHODS: Charts analysis was conducted on 194 patients followed at the Mood Disorders Clinic of the McGill University Health Center...
March 16, 2018: BMC Psychiatry
Antonella Sferra, Fabiana Fattori, Teresa Rizza, Elsabetta Flex, Emanuele Bellacchio, Alessandro Bruselles, Stefania Petrini, Serena Cecchetti, Massimo Teson, Fabrizia Restaldi, Andrea Ciolfi, Filippo M Santorelli, Ginevra Zanni, Sabina Barresi, Claudia Castiglioni, Marco Tartaglia, Enrico Bertini
Microtubules participate in fundamental cellular processes, including chromosomal segregation and cell division, migration, and intracellular trafficking. Their proper function is required for correct central nervous system development and operative preservation, and mutations in genes coding tubulins, the constituting units of microtubules, underlie a family of neurodevelopmental and neurodegenerative diseases, collectively known as "tubulinopathies", characterized by a wide range of neuronal defects resulting from defective proliferation, migration, and function...
March 14, 2018: Human Molecular Genetics
Kai G Kahl, Michael Deuschle, Brendon Stubbs, Ulrich Schweiger
Background Severe mental illnesses (SMIs), i.e. major depression, schizophrenia and bipolar disorder, are associated with an elevated risk for the development of type-2 diabetes mellitus and cardiovascular disorders. Several factors have been associated with increased cardiometabolic morbidity and mortality in SMI, including lifestyle factors (smoking, inactivity, unhealthy diet), endocrine and immunologic alterations; however, the underlying mechanisms remain to be fully uncovered. It is now well accepted that visceral adipose tissue (VAT) promotes the development of cardiometabolic disorders, at least in part by inflammatory and metabolic functions...
March 16, 2018: Hormone Molecular Biology and Clinical Investigation
Yijun Pan, Jennifer L Short, Stephanie A Newman, Kwok H C Choy, Durgesh Tiwari, Christopher Yap, Danielle Senyschyn, William A Banks, Joseph A Nicolazzo
Epidemiological evidence suggests that people with bipolar disorder prescribed lithium exhibit a lower risk of Alzheimer's disease (AD) relative to those prescribed other mood-stabilizing medicines. Lithium chloride (LiCl) reduces brain β-amyloid (Aβ) levels, and the brain clearance of Aβ is reduced in AD. Therefore, the purpose of this study was to assess whether the cognitive benefits of LiCl are associated with enhanced brain clearance of exogenously-administered Aβ. The brain clearance of intracerebroventricularly (icv) administered125 I-Aβ42 was assessed in male Swiss outbred mice administered daily oral NaCl or LiCl (300 mg/kg for 21 days)...
March 12, 2018: Brain, Behavior, and Immunity
Ying Han, Zhenyu Lu, Zhenguang Du, Qi Luo, Sheng Chen
BACKGROUND AND OBJECTIVE: Bipolar disorder is often mis-diagnosed as unipolar depression in the clinical diagnosis. The main reason is that, different from other diseases, bipolarity is the norm rather than exception in bipolar disorder diagnosis. YinYang bipolar fuzzy set captures bipolarity and has been successfully used to construct a unified inference mathematical modeling method to bipolar disorder clinical diagnosis. Nevertheless, symptoms and their interrelationships are not considered in the existing method, circumventing its ability to describe complexity of bipolar disorder...
May 2018: Computer Methods and Programs in Biomedicine
Ali Sahraian, Zahra Ehsaei, Arash Mowla
BACKGROUND AND OBJECTIVE: Our Objective is to study the effects of aripiprazole as an adjuvant treatment for obsessive and compulsive (OC) symptoms in patients with bipolar disorder (BD) type I, manic phase. PATIENTS AND METHODS: In this 8-week, double-blind, placebo-controlled randomized clinical trial, 56 patients with BD who had OC symptoms were randomly allocated to receive aripiprazole or placebo plus their routine medication regimen (lithium + clonazepam)...
March 12, 2018: Progress in Neuro-psychopharmacology & Biological Psychiatry
Emanuele F Osimo, Rudolf N Cardinal, Peter B Jones, Golam M Khandaker
Low-grade inflammation is a risk factor for depression, psychosis and other major psychiatric disorders. It is associated with poor response to antidepressant and antipsychotics, and could potentially be a treatment target. However, there is limited data on the prevalence of low-grade inflammation in major psychiatric disorders, and on the characteristics of patients who show evidence of inflammation. We examined the prevalence of low-grade inflammation and associated socio-demographic and clinical factors in acute psychiatric inpatients...
March 1, 2018: Psychoneuroendocrinology
Toby Wise, Matthew J Taylor, Andres Herane-Vives, Antonella Marino Gammazza, Francesco Cappello, David J Lythgoe, Steve Cr Williams, Allan H Young, Anthony J Cleare, Danilo Arnone
BACKGROUND: There is uncertainty as to whether alterations in glutamatergic function in affective disorders differ between unipolar and bipolar disorders and between depressive and euthymic states. Additionally, there are currently no available blood-based markers of central glutamatergic function to support clinical diagnosis and aid brain based investigations. METHODS: In this study, we measured levels of glutamate in the dorsal anterior cingulate cortex in-vivo using 1H-Magnetic Resonance Spectroscopy in medication free unipolar and bipolar patients (n = 29, 20 unipolar and 9 bipolar) experiencing a major depressive episode, in comparison with a group of matched healthy controls (n = 20)...
February 27, 2018: Journal of Affective Disorders
Bruno Romeo, Lisa Blecha, Katia Locatelli, Amine Benyamina, Catherine Martelli
The objective of this meta-analysis is to assess the efficacy and safety of partial and complete dopamine agonists in the treatment of acute mood disorder episodes. Randomized, double-blind and placebo-controlled trials of dopamine agonists in the treatment of acute mood disorder episodes were identified in the MEDLINE and PsycINFO databases and included in the meta-analysis. In monotherapy of mania, improved remission rates were found for cariprazine (odds ratio (OR): 2.08, P < 0.01) and for high-dose aripiprazole (OR: 3...
March 1, 2018: Journal of Psychopharmacology
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