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Bipolar Disorders

Noel Engels, Adriaan M van Alphen, Tessa M Bosch, Rocco Hoekstra
In 2010 a 69-year old patient with bipolar I disorder, type 2 diabetes and hypertension was referred to the Nephrology outpatient clinic of the Maasstad Hospital for progressive kidney disease. Her creatinine was 205 μmol/L (estimated Glomerular Filtration Rate (eGFR) 22 mL/min/1.73m2 ). Her diabetes was well controlled at a HbA1c of 6.6% with repaglindine 4mg once daily (QD). This article is protected by copyright. All rights reserved.
February 12, 2019: Bipolar Disorders
S Nassir Ghaemi, Sivan Mauer, Bennet I Omalu
Chronic traumatic encephalopathy (CTE) is a diagnosis recently discovered and described in the context of American football. It is a a neurodegenerative disease that is a consequence of repetitive brain injury such as concussion. Such injury most notably occurs in physically violent sports but can also occur in other settings, such as during military duty, where explosive blasts can cause subconcussive impacts to the head. The main clinical features of CTE involve three aspects: mood/impulsivity, suicide, and dementia...
February 12, 2019: Bipolar Disorders
Tammas Kelly
Lithium is the oldest and most-studied treatment for bipolar depression. Many treatment guidelines place Lithium as a top treatment recommendation for bipolar depression; yet some guidelines don't recommend lithium at all. These discrepancies were explored by examining the following errors: the Woozle effect (evidence by citation), reference inflation (overreporting the findings of cited studies) and belief perseverance (maintaining a belief despite new contradictory evidence) as possible causes for these discrepancies...
February 9, 2019: Bipolar Disorders
K W F Scheepstra, N Bayat, U Klumpers, R W Kupka
Lamotrigine plasma concentrations are potentially lowered up to 60% due to interaction with combined oral anticonceptives containing ethinyl estradiol. Our clinical experience is that this variability does not influence mood stability or side-effects. A pill-free week may be safe when treating stable bipolar disorder, but there is no evidence for this claim. A pill free week during dose escalation may hypothetically lead to a rapid increase of lamotrigine plasma concentration and thus the risk to induce rare but serious side effects...
February 7, 2019: Bipolar Disorders
Thomas T Kim, Steven Dufour, Colin Xu, Zachary D Cohen, Louisa Sylvia, Thilo Deckersbach, Robert J DeRubeis, Andrew A Nierenberg
OBJECTIVES: Lithium and quetiapine are known to be effective treatments for bipolar disorder. However, little information is available to inform prediction of response to these medications. Machine-learning methods can identify predictors of response by examining variables simultaneously. Further evaluation of models on a test sample can estimate how well these models would generalize to other samples. METHODS: Data (N=482) were drawn from a randomized clinical trial of outpatients with bipolar-I or II disorder who received adjunctive personalized treatment plus either lithium or quetiapine...
February 7, 2019: Bipolar Disorders
Siddharth Sarkar, Nishtha Chawla
Staging of psychiatric disorders can serve various purposes. Not only are they helpful for prognostication, they can also be linked to treatment approaches best suited to a particular phase of the disorder. Though there have been attempts at staging psychiatric disorders, there remains a void of universally accepted and implemented staging mechanisms and criteria for these illnesses. Researchers like Markt et al1 have attempted to address the gap by providing staging methods using patient data. Their findings generate interest and stimulates certain considerations for the future...
February 6, 2019: Bipolar Disorders
Francesco Bartoli, Cristina Crocamo, Giuseppe Carrà
Uric acid is the end-product of adenosine catabolism, influenced by the activity of the enzymes adenosine deaminase and xanthine oxidase. In recent years novel research has been conducted on the role of serum uric acid in both bipolar and major depressive disorders, possibly based on the imbalance of purinergic system metabolism. Despite some limitations, our previous meta-analysis preliminarily estimated increased levels of serum uric acid in subjects suffering from bipolar disorder as compared with both healthy controls and individuals with major depressive disorder...
February 5, 2019: Bipolar Disorders
Katherine E Burdick, Caitlin E Millett, Caterina Del Mar Bonnín, Christopher Bowie, Andre F Carvalho, Lisa T Eyler, Peter Gallagher, Philip Harvey, Lars Vedel Kessing, Beny Lafer, Scott A Langenecker, Kathryn E Lewandowski, Carlos López-Jaramillo, David F Marshall, Anabel Martinez-Aran, Melvin McInnis, Roger McIntyre, Kamilla W Miskowiak, Richard J Porter, Scot Purdon, Kelly A Ryan, Tomiki Sumiyoshi, Ivan J Torres, Tamsyn E Van Rheenen, Eduard Vieta, Neil Woodward, Lakshmi N Yatham, Allan Young
Bipolar Disorder (BD) is the 4th leading cause of disability worldwide among young people ages 10-24 years. Although the diagnosis is largely defined by the mood episodes associated with the illness, cognitive deficits are among the most persistent and disabling symptoms of illness and have a profound impact on clinical course and functional outcome. Specifically, trait-like impairment is common in the domains of attention, verbal learning, and executive function; these deficits contribute to functional disability and are targets for emerging treatments and preventions...
February 5, 2019: Bipolar Disorders
Ana Flávia Barros da Silva Lima, Mirian Cohen, Sandro Miguel, Luciane Cruz
Economic evaluations in the field of psychiatry are still scarce. The article by Simon et al (2018) is unique as it proposes a comparative economic analysis of the association between lamotrigine and quetiapine (first-line treatment) in acute bipolar depression1 . Different economic analyses have already been performed with lamotrigine for disorders such as epilepsy, borderline personality disorder, and Lennox-Gastaut Syndrome. This article is protected by copyright. All rights reserved.
January 30, 2019: Bipolar Disorders
Lars Vedel Kessing
Clinical staging models have not been widely implemented in psychiatry and specifically not in bipolar disorder. Nevertheless, the clinical presentation, effect of treatment and underlying biology may change during the long-term course of bipolar disorder. Thus, it is imperative to describe and understand these changes during the longitudinal course of illness. The study by van der Markt et al is the first attempt to assess the clinical applicability of a staging model within bipolar disorder. This article is protected by copyright...
January 22, 2019: Bipolar Disorders
Awais Aftab, Martha Sajatovic
Older adults are a rapidly growing group world-wide. Among the elderly, anxiety disorders are among the most common psychiatric disorders, but are highly under-recognized and under-treated in clinical settings. Anxiety comorbidity is also very common in individuals with bipolar disorder, and in older adults with bipolar disorder (OABD), anxiety symptoms may emerge in the setting of increased medical burden, cognitive decline, and social isolation. Clinicians evaluating older people with BD need to assess for anxiety comorbidity, recognizing the potential for under-recognition and overlap with conditions that are relative to aging such as increased medical burden and cognitive impairment...
January 22, 2019: Bipolar Disorders
Andrea Amerio, Matteo Tonna, Massimo Prelati, Nassir S Ghaemi
No abstract text is available yet for this article.
January 21, 2019: Bipolar Disorders
Janusz K Rybakowski, Maj Vinberg, Lars V Kessing, Gin S Malhi, Marylou Selo, Rasmus W Licht
In November this year, we marked the 100th anniversary of the birthday of Mogens Schou, the great Danish clinical and basic scientist and a true giant of lithium research and treatment. Mogens Schou did more than anybody else in the world to establish lithium therapy, and without his assiduousness lithium may well have been forgotten. To commemorate his achievements a special symposium was organized in Copenhagen dedicated to lithium and the life time contributions of Mogens Schou. The celebration took place on November 23, 2018, the day before Mogens Schou's actual birthday...
December 14, 2018: Bipolar Disorders
Denise Razzouk
Simon et al.1 conducted a 52-week prospective cost-utility analysis (CUA) of 201 people with bipolar depression to assess the add-on lamotrigine effectiveness and efficacy (CEQUEL study2 ) in combination with quetiapine. To that end, they compared health gain using the EuroQol 5D- 3L (EQ-5D) between a quetiapine-only and quetiapine plus lamotrigine regimen in a multi-centre randomized control CEQUEL2 trial conducted in the United Kingdom and Austria with a health and social care perspective. In the CEQUEL trial, the efficacy of the add-on lamotrigine in decreasing depressive symptoms in Quick Inventory of Depressive Symptomatology (QIDS RS16) was not statistically significant between groups at 12 weeks, although clinical improvement was observed in both...
December 11, 2018: Bipolar Disorders
Hai-Yin Jiang, Lian-Lian Xu, Xue Zhang, Zhe Zhang, Bing Ruan
No abstract text is available yet for this article.
December 9, 2018: Bipolar Disorders
Yonglin Gao, Kavita Lohano, Nicholas A Delamere, Zhenmin Lei, Rif S El-Mallakh
Alcohol use disorders are quite common in bipolar patients with a prevalence of comorbidity that exceeds all other primary psychiatric diagnoses other than other substance use disorders; over 60% of people with BD I have comorbid alcohol dependence at some point in their lives. This intimate relationship has served as the basis of the proposed idea of 'self-medication.' However, biological confirmation of 'self-medication,' specifically, the correction of an abnormal biologic marker with alcohol, has never been demonstrated...
December 9, 2018: Bipolar Disorders
Giorgio Marotta, Giuseppe Delvecchio, Alessandro Pigoni, Gianmario Mandolini, Valentina Ciappolino, Lucio Oldani, Domenico Madonna, Marika Grottaroli, Alfredo Carlo Altamura, Paolo Brambilla
OBJECTIVES: Psychotic symptoms are a common feature in bipolar disorder (BD), especially during manic phases, and are associated with a more severe course of illness. However, not all bipolar subjects experience psychosis during the course of their illness, and this difference often guides assessment and pharmacological treatment. The aim of the present study is to elucidate, for the first time, the FDG uptake dysfunctions associated with psychosis in BD patients with and without a history of past psychotic symptoms, through a positron emission tomography (PET) approach...
December 1, 2018: Bipolar Disorders
E Garcia-Rill, S D'Onofrio, S Mahaffey, V Bisagno, F J Urbano
OBJECTIVES: This limited review examines the role of the reticular activating system (RAS), especially the pedunculopontine nucleus (PPN), one site of origin of bottom-up gamma, in the symptoms of bipolar disorder (BD). METHODS: The expression of neuronal calcium sensor protein 1 (NCS-1) in the brains of BD patients is increased. It has recently been found that all PPN neurons manifest intrinsic membrane beta/gamma frequency oscillations mediated by high threshold calcium channels, suggesting that it is one source of bottom-up gamma...
December 1, 2018: Bipolar Disorders
Carrie A H Vaudreuil, Stephen V Faraone, Maura Di Salvo, Janet R Wozniak, Rebecca A Wolenski, Nicholas W Carrellas, Joseph Biederman
OBJECTIVE: The objective of this study was to evaluate the morbidity of subthreshold pediatric bipolar (BP) disorder. METHODS: We performed a systematic literature search in November 2017 and included studies examining the morbidity of pediatric subthreshold BP. Extracted outcomes included functional impairment, severity of mood symptoms, psychiatric comorbidities, suicidal ideation and behaviors, and mental health treatment. We used meta-analysis to compute the pooled standardized mean difference (SMD) for continuous measures and the pooled risk ratio (RR) for binary measures between two paired groups: subthreshold pediatric BP vs controls and subthreshold pediatric BP vs pediatric BP-I...
November 27, 2018: Bipolar Disorders
J Angst, W Rössler, V Ajdacic-Gross, F Angst, H-U Wittchen, R Lieb, K Beesdo-Baum, E Asselmann, K R Merikangas, L Cui, L H Andrade, M C Viana, F Lamers, B W J H Penninx, T de Azevedo Cardoso, K Jansen, L Dias de Mattos Souza, R Azevedo da Silva, F Kapczinski, C Grobler, M Gholam-Rezaee, M Preisig, C L Vandeleur
OBJECTIVES: Although clinical evidence suggests important differences between unipolar mania and bipolar-I disorder (BP-I), epidemiological data are limited. Combining data from 9 population-based studies, we compared subjects with mania (M) or mania with mild depression (Md) to those with BP-I with both manic and depressive episodes with respect to demographic and clinical characteristics in order to highlight differences. METHODS: Participants were compared for gender, age, age at onset of mania, psychiatric comorbidity, temperament and family history of mental disorders...
November 26, 2018: Bipolar Disorders
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