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Lithium augmentation of topiramate for bipolar disorder with comorbid binge eating disorder and obesity.

OBJECTIVE: To evaluate the effectiveness of lithium augmentation of topiramate on mood symptoms, binge eating behavior, and body weight in obese bipolar patients with binge eating disorder (BED) seeking weight management. METHOD: We conducted a naturalistic study of 12 consecutive outpatients with bipolar disorders, BED, and obesity who received lithium augmentation for mood instability during the course of topiramate-based pharmacotherapy for obesity and BED. Lithium was added to topiramate (mean dose 514 mg i.d.) and titrated to a mean dose of 1009 mg i.d. (mean plasma concentration 0.7 mmo…

White matter microstructure in obesity and bipolar disorders: an ENIGMA bipolar disorder working group study in 2186 individuals.

Although specific risk factors for brain alterations in bipolar disorders (BD) are currently unknown, obesity impacts the brain and is highly prevalent in BD. Gray matter correlates of obesity in BD have been well documented, but we know much less about brain white matter abnormalities in people who have both obesity and BD. We obtained body mass index (BMI) and diffusion tensor imaging derived fractional anisotropy (FA) from 22 white matter tracts in 899 individuals with BD, and 1287 control individuals from 20 cohorts in the ENIGMA-BD working group. In a mega-analysis, we investigated the as…

Differences in clinical presentation between bipolar I and II disorders in the early stages of bipolar disorder: A naturalistic study.

AIM: In a naturalistic clinical study of patients in the early stages of bipolar disorders the aim was to assess differences between patients with bipolar I (BD I) and bipolar II (BD II) disorders on clinical characteristics including affective symptoms, subjective cognitive complaints, functional level, the presence of comorbid personality disorders and coping strategies. METHODS: Diagnoses were confirmed using the Structured Clinical Interview for DSM-IV Disorders. Clinical symptoms were rated with the Young Mania Rating Scale and the Hamilton Depression Rating Scale, and functional status …

The Bipolar Affective Disorder Dimension Scale (BADDS)--a dimensional scale for rating lifetime psychopathology in bipolar spectrum disorders.

BACKGROUND: Current operational diagnostic systems have substantial limitations for lifetime diagnostic classification of bipolar spectrum disorders. Issues include: (1) It is difficult to operationalize the integration of diverse episodes of psychopathology, (2) Hierarchies lead to loss of information, (3) Boundaries between diagnostic categories are often arbitrary, (4) Boundaries between categories usually require a major element of subjective interpretation, (5) Available diagnostic categories are relatively unhelpful in distinguishing severity, (6) "Not Otherwise Specified (NOS)" categori

Bipolar disorder and the mammalian rut: an evolutionary perspective.

We propose that bipolar disorder evolved from seasonal rhythms that guided the lives of early men and women. In the animal world seasonal cycles are marked by the alternation of torpor/quiescence and rut/activation and remain ubiquitous in larger mammals, including primates, living in both temperate and tropical zones. The heightened sexual drive and aggressiveness stoked by the rut provide the means for a species to pass along the best genes at the best time. The defining and ancillary characteristics of hypomania/mania and the rut are remarkably similar. They are described and compared. We t…

Harmful behaviours and suicide in later life bipolar disorder.

PURPOSE OF REVIEW: Harmful behaviours and suicidality are often linked to mental disorders, making it crucial to gain a deeper understanding of these issues. One significant area of focus is bipolar disorder in older adults, a condition that requires further exploration to better address its impact on this age group. RECENT FINDINGS: Longer hospital stays increased harmful behaviour among older adults with bipolar disorder. Older adults with bipolar disorder have lower suicide rates than younger individuals, possibly due to heightened risks shortly after diagnosis, so, it makes it important t…

Trajectories of Cognitive Functioning in Older Age Bipolar Disorder.

OBJECTIVES: The prevalence of cognitive impairment is high in older age bipolar disorder (OABD). It remains unclear whether the course of cognitive functioning in these individuals follows a course of cognitive decline, whether this is different among subgroups, and if so, which factors are associated with cognitive decline. METHODS: Our clinical sample included 206 patients aged over 50 years from the Dutch Older Bipolar (DOBi) cohort with a total range of included measures of 306 months (1997-2022). Growth Mixture Modeling (GMM) was used to find homogeneous subgroups based on their longitud…

Cognitive correlates of Antisaccade Task performance in bipolar disorder.

BACKGROUND: The Antisaccade Task is often used to measure inhibitory control. While pooled effects in meta-analyses demonstrate antisaccade impairments in bipolar disorder (BD), individual studies show considerable variability in effect sizes and case-control significance, particularly in euthymic samples. This variability may reflect cognitive heterogeneity across BD samples. In this exploratory study we investigated whether antisaccade performance correlated with other cognitive domains in BD, and whether impairments were confined to specific cognitive subgroups. METHOD: 152 individuals (44…

Cognitive impairment in bipolar disorder: How close to dementia?

Bipolar disorder (BD) is a severe mental illness associated with cognitive and functional impairment. This cross-sectional study evaluated the heterogeneity of cognitive and psychosocial functioning in BD, compared cognitive performance between BD and dementia groups, and identified factors associated with cognitive dysfunction. The study included 108 individuals with BD, of whom 32 were euthymic, while the remainder were symptomatic and 39 with major neurocognitive disorder. Sociodemographic data and mood symptoms were collected through structured interviews. Cognitive and functional status w…

Mood switching in 1629 antidepressant-treated bipolar disorder patients.

Mood-switching from depression into [hypo]mania is prevalent in bipolar disorder (BD) patients, particularly during treatment with an antidepressant, but many characteristics associated with such responses require clarification. Using standard bivariate and multivariate measures we compared characteristics of 1629 prospectively evaluated BD patients who did or did not become [hypo]manic during antidepressant treatment. Mood-switching occurred in 27.6% of BD patients (type II [BD2]: 31.4%; type I [BD1]: 24.5%) observed prospectively for 4.98 years, most often (65.5%) with new hypomania. Factors…

Long-Acting Injectable Antipsychotics in Adolescents with Bipolar Disorder.

Background: Bipolar disorder often begins in adolescence or early adulthood, characterized by recurrent manic episodes that can lead to neurodegenerative brain changes and functional decline. While several oral second-generation antipsychotics are Food and Drug Administration (FDA)-approved for mania, adherence to maintenance treatment is frequently poor due to factors such as anosognosia, cognitive dysfunction, impulsivity, side effects aversion, and substance use. Long-acting injectable (LAI) antipsychotics, approved for adults with bipolar mania or schizoaffective disorder (bipolar type), o…

Ferroptosis as a potential molecular mechanism of bipolar disorder.

The unclear pathogenesis of bipolar disorder (BD) poses a challenge, especially with the striking rates of comorbid medical and psychiatric disorders, treatment resistance, and premature mortality in the absence of a specific diagnostic marker. We put forward the hypothesis of ferroptosis, a recently identified iron-dependent cell death, as a potential underlying mechanism of BD. We aimed to portray the possibility of ferroptosis involvement in BD pathogenesis as a doorway to encourage both animal and clinical studies on the topic. Ferroptosis is associated with multiple psychiatric disorders,…

Genomics yields biological and phenotypic insights into bipolar disorder.

Bipolar disorder is a leading contributor to the global burden of disease1. Despite high heritability (60-80%), the majority of the underlying genetic determinants remain unknown2. We analysed data from participants of European, East Asian, African American and Latino ancestries (n = 158,036 cases with bipolar disorder, 2.8 million controls), combining clinical, community and self-reported samples. We identified 298 genome-wide significant loci in the multi-ancestry meta-analysis, a fourfold increase over previous findings3, and identified an ancestry-specific association in the East Asian coh…

Fine-mapping genomic loci refines bipolar disorder risk genes.

Bipolar disorder is a heritable mental illness with complex etiology. While the largest published genome-wide association study identified 64 bipolar disorder risk loci, the causal SNPs and genes within these loci remain unknown. We applied a suite of statistical and functional fine-mapping methods to these loci and prioritized 17 likely causal SNPs for bipolar disorder. We mapped these SNPs to genes and investigated their likely functional consequences by integrating variant annotations, brain cell-type epigenomic annotations, brain quantitative trait loci and results from rare variant exome …

Pain in women with and without bipolar spectrum disorder.

INTRODUCTION: Bipolar disorder is associated with several physical conditions and possibly increased pain, although research outside hospital settings is limited. We compared perceived pain among population-based women with and without bipolar disorder. METHOD: This study examined 113 women with bipolar disorder (59 euthymic, 54 symptomatic in past month) and 316 age-matched women without bipolar disorder drawn from studies located in the same region of south-eastern Australia. Mental disorders were confirmed by clinical interview (SCID-I/NP). Pain during the past week was determined by numer…

Genomic relationship between polycystic ovary syndrome and bipolar disorder.

Women with bipolar disorder (BIP) have a higher risk of developing polycystic ovary syndrome (PCOS). Shared genetic architecture may underlie this comorbidity. Valproate, a mood-stabilizer commonly used to treat BIP, increases the risk of PCOS. Still, the mechanism underlying PCOS in BIP remains unknown. Here, we aimed to identify genetic variants shared between BIP and PCOS, as well as their interaction with valproate. We used the results of large-scale genome-wide association studies of BIP (41,510 cases and 354,340 controls), and PCOS (3,609 cases and 229,788 controls). Using conditional fa…

Expressed Emotions in Families of Patients With Bipolar Disorder.

Introduction Bipolar affective disorder (BPAD) is a chronic psychiatric illness characterized by recurrent episodes of mania, hypomania, and … within families may contribute to improved illness course and reduced relapse risk in patients with bipolar disorder. Future research should explore culturally appropriate strategies to manage EE and strengthen supportive family environments.

Bipolar II disorder: a state-of-the-art review.

Bipolar II disorder (BD-II) is currently identified by both the DSM-5 and ICD-11 as a distinct subtype of bipolar disorder, defined by at least one depressive episode and at least one hypomanic episode, with no history of mania. Despite its prevalence and impact, the literature on BD-II remains relatively sparse. This paper provides a comprehensive overview of the available research and current debate on the disorder, including its diagnostic criteria, clinical presentations, comorbidities, epidemiology, risk factors, and treatment strategies. Patients with BD-II often present with recurrent d…

Литиум как лекарство от биполярного расстройства.

Литий — это классическое, первичное лечение биполярного расстройства, которое, как ни парадоксально, с течением времени использовалось реже, особенно в Северной Америке, что противоречит накопившимся доказательствам его эффективности. Биполярное расстройство все чаще воспринимается как хроническое, потенциально прогрессивное состояние, ухудшающееся и ускоряющееся каждым эпизодом настроения, которое может быть похоже на множественный склероз или ревматоидный артрит как состояние, требующее коррекции заболеваний для изменения траектории болезни. В этом личном взгляде мы утверждаем, что литий дей

Совпадение в аннотации оригинала
Lithium is a classic, primary treatment for bipolar disorder that has paradoxically been used less over time, especially in North America, which goes against the accumulating evidence for its efficacy. Bipolar disorder is increasingly conceptualised as a chronic, potentially progressive condition worsened and accelerated by each mood episode, which might res…

Impaired facial emotion recognition in individuals with bipolar disorder.

BACKGROUND: Individuals with bipolar disorder (BD) often struggle with emotional regulation and social interactions, partly due to difficulties in accurately recognizing facial emotions. METHODS: From September 2021 to February 2023, 69 BD individuals-comprising 23 with bipolar manic/hypomanic episode (BME), 23 with bipolar depressive episode (BDE), 23 with bipolar euthymic (EUT)-and 23 healthy controls (HCs) were enrolled. Diagnosis adhered to DSM-IV criteria using M.I.N.I 5.0, alongside assessments via Hamilton Depression Scale 17 and Young Manic Rating Scale. Recognition tasks involving 84…