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[Status of thymoleptics in the treatment of bipolar disorders].

The widening of the concept of bipolar disorders to embrace the notion of a "spectrum" of disorders leads to the supposition that almost 5% of the general population may affected. Thymoleptics are the key treatment, but they should be prescribed over many years, and it is necessary to determine the threshold above which treatment should be considered. Lithium salts remain the reference thymoleptic treatment, but they are insufficiently effective in 30 to 60% of patients. They have a narrow therapeutic margin and are frequently accompanied by adverse effects. Numerous studies, mainly open, have…

Toward a re-definition of subthreshold bipolarity: epidemiology and proposed criteria for bipolar-II, minor bipolar disorders and hypomania.

BACKGROUND: The boundaries of bipolarity have been expanding over the past decade. Using a well characterized epidemiologic cohort, in this … nce rate of 10.9%, compared to 11.4% for broadly defined major depression. A special group of minor bipolar disorder (prevalence 9.4%) was identified, of whom 2.0% were cyclothymic; pure hypomania occurred in 3.3%. The total prevalence of the soft bipolar spectrum was 23.7%, comparable to that (24.6%) for the entire depressive spectrum (including dysthymia, minor …

Substance use disorders in outpatients with bipolar disorder and pain complaints.

INTRODUCTION: Pain and substance use disorders (SUDs) are common in bipolar disorder (BD), yet the associations between these comorbid conditions are poorly understood. Our hypotheses were: (1) the frequency of SUDs may vary according to pain intensity in individuals with BD, (2) individuals with BD, pain and SUDs may have specific characteristics, and (3) clinical variables could explain the associations between pain and SUDs. METHOD: We included outpatients from the FACE-BD cohort with a lifetime diagnosis of BD type I or II. Current pain was categorized using one item of the EQ-5D-5L scale…

Reconsideration of bipolar disorder as a developmental disorder: importance of the time of onset.

Bipolar disorder is a multifactorial psychiatric disorder with developmental and progressive neurophysiological alterations. This disorder is typically characterized by cyclical and recurrent episodes of mania and depression but is heterogeneous in its clinical presentation and outcome. Although the DSM-IV-TR criteria identify several features that are of phenomenological relevance, these are of less utility for defining homogeneous subgroups, for analyses of correlations with biomarkers or for directing focused medication strategies. We provide a comprehensive review of existing evidence rega…

Screening for bipolar disorder among outpatients with substance use disorders.

BACKGROUND: Comorbidity of bipolar disorder and alcohol or substance abuse/dependence is frequent and has marked negative consequences on the course of the illness and treatment compliance. The objective of this study was to compare the validity of two short instruments aimed at screening bipolar disorders among patients treated for substance use disorders. METHODS: The Mood Disorder Questionnaire (MDQ) and the Hypomania Checklist-32 (HCL-32) were tested with reference to the mood section of the Structured Clinical Interview for DSM-IV axis I disorders (SCID) in 152 patients, recruited in two…

Prevalence and correlates of eating disorders in 875 patients with bipolar disorder.

OBJECTIVE: Relatively little is known about the co-occurrence of bipolar and eating disorders. We therefore assessed the prevalence and clinical correlates of eating disorders in 875 patients with bipolar disorder. METHOD: 875 outpatients with DSM-IV bipolar I or II disorder were evaluated with structured diagnostic interviews and clinician- and self-administered questionnaires to determine bipolar and eating disorder diagnoses, other comorbid Axis I disorder diagnoses, and demographic and historical illness characteristics. RESULTS: 125 (14.3%) patients met DSM-IV criteria for at least one …

The effect of anxiety disorder comorbidity on treatment resistant bipolar disorders.

High rates of anxiety disorders have been reported in bipolar disorders. We undertook this study to determine the impact of anxiety disorders on bipolar disorders in our tertiary care referral center. We reviewed the literature on this topic and also reviewed records of 44 treatment resistant bipolar patients evaluated by DLD at the Center for Anxiety and Depression. Twenty-three patients had comorbid panic disorder, posttraumatic stress disorder, or obsessive-compulsive disorder. We compared bipolar patients with and without a history of comorbid anxiety disorders regarding several clinical f…

Substance use disorders among adolescents with bipolar spectrum disorders.

OBJECTIVE: We set out to examine the prevalence and correlates of substance use disorders (SUD) in a large sample of adolescents with bipolar disorder (BP). METHODS: Subjects were 249 adolescents ages 12 to 17 years old who fulfilled DSM-IV criteria for bipolar I disorder [(BPI), n = 154], or bipolar II disorder [(BPII), n = 25], or operationalized criteria for BP not otherwise specified [(BP NOS), n = 70], via the Schedule for Affective Disorders and Schizophrenia for School-Aged Children (K-SADS). As part of the multi-site Course and Outcome of Bipolar Youth study, demographic, clinical, an…

Comorbid disorders in patients with bipolar disorder and concomitant substance dependence.

OBJECTIVE: Substance dependence is common in bipolar disorder and is associated with an increase in Axis I and II comorbidity. Little research has compared the relative rates of comorbidity among bipolar patients with dependence on different substances. METHODS: The Mini International Neuropsychiatric Interview (MINI) was used to assess 166 outpatients involved in one of three clinical trials of medications for bipolar disorder and substance dependence. Patients had concurrent alcohol dependence, cocaine dependence, or both conditions. RESULTS: Generalized anxiety disorder and current depres…

Anxiety disorders in children and adolescents with bipolar disorder: a neglected comorbidity.

OBJECTIVE: We describe a consecutive clinical sample of children and adolescents with bipolar disorder to define the pattern of comorbid anxiety and externalizing disorders (attention-deficit hyperactivity disorder [ADHD] and conduct disorder [CD]) and to explore the possible influence of such a comorbidity on their cross-sectional and longitudinal clinical characteristics. METHODS: The sample comprised 43 outpatients, 26 boys and 17 girls, (mean age 14.9 years, SD 3.1; range 7 to 18), with bipolar disorder type I or II, according to DSM-IV diagnostic criteria. All patients were screened for …

MCMI-II personality disorders in recent-onset bipolar disorders.

This study investigated the personality disorders of 21 recent-onset Bipolar Disorder patients using the revised Million Clinical Multiaxial Inventory (MCMI-II; Millon, 1987). Personality disorder assessments, conducted after patients' clinical symptoms had settled, indicated that 17 patients received at least one MCMI-II personality disorder diagnosis with a trend toward multiple diagnoses. Narcissistic, Antisocial, and Histrionic personality disorders were diagnosed most frequently and were the scales most elevated. Schizoid and Compulsive personality disorders were the scales least elevated…

Machine learning approaches to distinguish bipolar disorder from borderline personality disorder: a scoping review.

BACKGROUND: Borderline personality disorder (BPD) and bipolar disorder (BD) are debilitating psychiatric illnesses with significant rates of misdiagnosis. This scoping review explores the potential of machine learning (ML) approaches in distinguishing individuals diagnosed with BD from those with BPD, reporting the performance metrics of various predictive models. METHODS: We searched Ovid MEDLINE, PubMed, Scopus, and Web of Science from inception to March 2025 for studies involving the terms "bipolar disorder," "borderline personality disorder," "machine learning", and "artificial intelligen…

Bipolar disorder and borderline personality disorder comorbidity: an 8-year population-based retrospective study.

BACKGROUND: Comorbidity between bipolar disorder (BD) and borderline personality disorder (BPD) is associated with greater clinical severity, yet its impact in inpatient settings remains insufficiently characterized. This study aimed to evaluate the association between comorbid BPD, clinical characteristics and inpatient outcomes among BD hospitalizations. METHODS: A population-based retrospective study was conducted using a nationwide administrative database of public general and psychiatric hospital admissions in mainland Portugal over an 8-year period. Hospitalizations involving adults wit…

Парафилия и гиперсексуальность в биполярном расстройстве I и расстройстве личности историй: доклад по делу.

Парафилии редки и часто упускают из виду психические заболевания, характеризующиеся интенсивными, атипичными и повторяющимися сексуальными желаниями или поведением. В этом деле описана 33-летняя женщина с коморбидным биполярным расстройством I и истерическим расстройством личности, характеризующимся гиперсексуализмом и рискованной сексуальной практикой, что указывает на количественную парафилию. Поведение пациента включало групповые сексуальные контакты, незащищенный половой акт и импульсивное распространение эксплицитных изображений через социальные сети, что привело к инфекции влагалища Трих

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… Hypersexuality, a common feature in manic episodes of bipolar disorder (BD), may be exacerbated by the presence of personality disorders, such as histrionic personality disorder (HPD) [ 5 - 7 ]. …

Temperament, but not childhood trauma, distinguishes borderline personality disorder from bipolar disorder and ADHD.

BACKGROUND: The aim of this study was to investigate if temperament and experience of childhood trauma differed between young psychiatric patients with borderline personality disorder (BPD), bipolar disorder (BD) and attention-deficit/hyperactivity disorder (ADHD). METHODS: Diagnoses were based on the Structured Clinical Interview for DSM Axis I and Axis II. Temperament was assessed by the Temperament and Character Inventory (TCI) and childhood trauma by the Early Trauma Inventory-Self Report-Short Form (ETI-SR-SF). Temperament and childhood trauma were compared between the BPD group (n = 19)…

Obsessive-Compulsive Disorder as an Epiphenomenon of Comorbid Bipolar Disorder? An Updated Systematic Review.

BACKGROUND: Bipolar disorder (BD) and obsessive-compulsive disorder (OCD) comorbidity is an emerging condition in psychiatry, with relevant nosological, clinical, and therapeutic implications. METHODS: We updated our previous systematic review on epidemiology and standard diagnostic validators (including phenomenology, course of illness, heredity, biological markers, and treatment response) of BD-OCD. Relevant papers published until (and including) 15 October 2023 were identified by searching the electronic databases MEDLINE, Embase, PsychINFO, and Cochrane Library, according to the PRISMA st…

Rates of Major Depressive Disorder and Bipolar Disorder in Black and White Postpartum Women.

Importance: Little is known about differences between Black and White women with respect to the prevalence of postpartum mood disorders or s … ve and accepted a psychiatric diagnostic interview, 163 and 85 Black women had major depressive and bipolar disorders, respectively, and 508 and 177 White women had major depressive and bipolar disorders, respectively. Those with an EPDS score greater than or equal to 10 were offered a psychiatric assessment (in-person at home or by telephone) with the Structured …

Identifying plasma metabolic characteristics of major depressive disorder, bipolar disorder, and schizophrenia in adolescents.

Major depressive disorder (MDD), bipolar disorder (BD), and schizophrenia (SCZ) are classified as major mental disorders and together account for the second-highest global disease burden, and half of these patients experience symptom onset in adolescence. Several studies have reported both similar and unique features regarding the risk factors and clinical symptoms of these three disorders. However, it is still unclear whether these disorders have similar or unique metabolic characteristics in adolescents. We conducted a metabolomics analysis of plasma samples from adolescent healthy controls …

Dialectical Behavior and Social Rhythm Therapy for Comorbid Bipolar Disorder and Borderline Personality Disorder.

Bipolar disorder and borderline personality disorder commonly co-occur. Each disorder is associated with substantial morbidity and mortality, which are worsened by co-occurrence of the disorders. Emotional dysregulation, suicidality, and disrupted circadian rhythm are key aspects of psychopathology associated with both conditions. A novel psychotherapy combining elements of two evidence-based treatments (i.e., dialectical behavior therapy [DBT] for borderline personality disorder and social rhythm therapy [SRT] for bipolar disorder) is described. Unlike either treatment alone, the new therapy,…

Management of Concurrent Bipolar I Disorder and Compulsive Sexual Behavior Disorder: A Case Report.

Pornography addiction is not currently recognized in the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-V), but it can be broadly classified under compulsive sexual behavior disorder (CSBD) in the International Classification for Diseases (ICD). An increased incidence of CSBD has been reported in patients with bipolar I disorder (BPI) as an independent compulsion, not secondary to mania. Due to the ambiguity of identifying pornography addiction in the DSM-V, approved treatment for patients with a concurrent diagnosis of CSBD in the context of BPI is limited. We report