BACKGROUND Bipolar disorder(BD)is a severe mental illness characterized by significant mood swings.Effective drug treatment modalities are crucial for managing BD.AIM To analyze the current status and future trends of...BACKGROUND Bipolar disorder(BD)is a severe mental illness characterized by significant mood swings.Effective drug treatment modalities are crucial for managing BD.AIM To analyze the current status and future trends of global research on BD drug treatment over the last decade.METHODS The Web of Science Core Collection database spanning from 2015 to 2024 was utilized to retrieve literature related to BD drug treatment.A total of 2624 articles were extracted.Data visualization and analysis were conducted using CiteSpace,VOSviewer,Pajek,Scimago Graphica,and R-studio bibliometrix to identify RESULTS The United States,China,and the United Kingdom have made the most significant contributions to research on BD drug treatment and formed notable research collaboration networks.The University of Pittsburgh,Massachusetts General Hospital,and the University of Michigan have been identified as the major research institutions in this field.The Journal of Affective Disorders is the most influential journal.A keyword analysis revealed research hotspots related to clinical symptoms,drug efficacy,and genetic mechanisms.A citation analysis identified the management guidelines published by Yatham et al in 2018 as the most cited paper.CONCLUSION This study provides a detailed overview of the field of BD drug treatment,highlighting key contributors,research hotspots,and future directions.The study findings can be employed as a reference for future research and policymaking,which may enable further development and optimization of BD pharmacotherapy.展开更多
[Objectives]To investigate the potential causal relationship between psoriasis and common mental disorders,and to provide genetic epidemiological evidence for the early intervention of mental comorbidities.[Methods]Ba...[Objectives]To investigate the potential causal relationship between psoriasis and common mental disorders,and to provide genetic epidemiological evidence for the early intervention of mental comorbidities.[Methods]Based on publicly available large-scale GWAS data,a bidirectional Mendelian randomization(MR)approach was employed to assess the causal associations between psoriasis and major depressive disorder(MDD),bipolar disorder,schizophrenia,and anxiety disorders.The inverse variance weighted(IVW)method served as the primary analytical tool,supplemented by sensitivity analyses using MR-Egger and weighted median methods.Additionally,a subgroup analysis was conducted for psoriatic arthritis(PsA).[Results]Forward MR analysis revealed a significant positive causal association between the genetic predisposition to psoriasis and bipolar disorder as well as MDD,whereas no significant causal relationship was observed with schizophrenia or anxiety disorders.The reverse MR analysis found no causal effect of mental disorders on psoriasis.Subgroup analysis of PsA indicated that its genetic predisposition was significantly associated with the risk of bipolar disorder.The results of various sensitivity analyses and pleiotropy tests supported the robustness of the conclusions.[Conclusions]This study provides genetic evidence supporting a causal link between psoriasis and both MDD and bipolar disorder.In particular,patients with PsA are at a higher risk of developing bipolar disorder,highlighting the need to strengthen early screening and intervention for mental health in clinical management.展开更多
Clinically differentiating bipolarⅡdisorder(BD-Ⅱ)from major depressive disorder(MDD)remains a significant challenge in modern psychiatry.These two conditions share substantial clinical symptomatology,making accurate...Clinically differentiating bipolarⅡdisorder(BD-Ⅱ)from major depressive disorder(MDD)remains a significant challenge in modern psychiatry.These two conditions share substantial clinical symptomatology,making accurate diagnosis difficult in routine clinical practice.Misdiagnosis may lead to inappropriate treatment strategies,increased psychological and physical burdens,reduced quality of life,and impaired social functioning.Genetic overlap may partially explain the clinical similarities between MDD and BD-Ⅱ,and biomarkers along with neuroimaging techniques are receiving increasing attention as tools to aid in diagnosis.For example,electroencephalography has been shown to effectively distinguish between unipolar depression and bipolar depression;serum levels of glycogen synthase kinase-3 have also been investigated as a potential tool for differentiating between the two disorders.A comprehensive assessment integrating clinical characteristics,genetic basis research,and multimodal evaluations using neuroimaging and biomarkers through a multidisciplinary approach will help enhance clinicians'ability to distinguish between MDD and BD-Ⅱ.By improving diagnostic accuracy,more personalized and effective treatment strategies can be developed,ultimately improving patients'health outcomes and quality of life.展开更多
Bipolar disorder is a neurological disorder that consists of two main factors,i.e.mania and depression.There are two main drawbacks in clinical diagnosis of the bipolar disorder.First,bipolar disorder is mostly wrongl...Bipolar disorder is a neurological disorder that consists of two main factors,i.e.mania and depression.There are two main drawbacks in clinical diagnosis of the bipolar disorder.First,bipolar disorder is mostly wrongly diagnosed as unipolar depression in clinical diagnosis.This is,because in clinical diagnosis,the first factor is often neglected due to its approach toward positivity.Consequently,the element of bipolarity vanishes and the disease becomes worse.Second,the types of bipolhr disorder are mostly misdiagnosed due to similar symptoms.To overcome these problems,the bipolar fuzzy soft set(BFS-set)and bipolar fuzzy soft mappings(BFS-mappings)are useful to tackle bipolarity and to construct a strong mathematical modeling process to diagnose this disease correctly.This technique is extensive but simple as compared to existing medical diagnosis methods.A chart(relation between different types and symptoms of bipolar disorder)is provided which contains different ranges over the interval[-1,1].A process of BFS-mappings is also provided to obtain correct diagnosis and to suggest the best treatment.Lastly,a generalized BFS-mapping is introduced which is helpful to keep patient's improvement record.The case study indicates the reliability,efficiency and capability of the achieved theoretical results.Further,it reveals that the connection of soft set with bipolar fuzzy set is fruitful to construct a connection between symptoms which minimize the complexity of the case study.展开更多
Abnormal expression of microRNAs is connected to brain development and disease and could provide novel biomarkers for the diagnosis and prognosis of bipolar disorder. We performed a PubMed search for microRNA biomarke...Abnormal expression of microRNAs is connected to brain development and disease and could provide novel biomarkers for the diagnosis and prognosis of bipolar disorder. We performed a PubMed search for microRNA biomarkers in bipolar disorder and found 18 original research articles on studies performed with human patients and published from January 2011 to June 2023. These studies included microRNA profiling in bloodand brain-based materials. From the studies that had validated the preliminary findings,potential candidate biomarkers for bipolar disorder in adults could be miR-140-3p,-30d-5p,-330-5p,-378a-5p,-21-3p,-330-3p,-345-5p in whole blood, miR-19b-3p,-1180-3p,-125a-5p, let-7e-5p in blood plasma, and miR-7-5p,-23b-5p,-142-3p,-221-5p,-370-3p in the blood serum. Two of the studies had investigated the changes in microRNA expression of patients with bipolar disorder receiving treatment. One showed a significant increase in plasma miR-134 compared to baseline after 4 weeks of treatment which included typical antipsychotics, atypical antipsychotics, and benzodiazepines. The other study had assessed the effects of prescribed medications which included neurotransmitter receptorsite binders(drug class B) and sedatives, hypnotics, anticonvulsants, and analgesics(drug class C) on microRNA results. The combined effects of the two drug classes increased the significance of the results for miR-219 and-29c with miR-30e-3p and-526b* acquiring significance. MicroRNAs were tested to see if they could serve as biomarkers of bipolar disorder at different clinical states of mania, depression, and euthymia. One study showed that upregulation in whole blood of miR-9-5p,-29a-3p,-106a-5p,-106b-5p,-107,-125a-3p,-125b-5p and of miR-107,-125a-3p occurred in manic and euthymic patients compared to controls, respectively, and that upregulation of miR-106a-5p,-107 was found for manic compared to euthymic patients. In two other studies using blood plasma,downregulation of miR-134 was observed in manic patients compared to controls, and dysregulation of miR-134,-152,-607,-633,-652,-155 occurred in euthymic patients compared to controls. Finally, microRNAs such as miR-34a,-34b,-34c,-137, and-140-3p,-21-3p,-30d-5p,-330-5p,-378a-5p,-134,-19b-3p were shown to have diagnostic potential in distinguishing bipolar disorder patients from schizophrenia or major depressive disorder patients, respectively. Further studies are warranted with adolescents and young adults having bipolar disorder and consideration should be given to using animal models of the disorder to investigate the effects of suppressing or overexpressing specific microRNAs.展开更多
Recent literature based on peripheral immunity findings speculated that neuroinflammation,with its connection to microglial activation,is linked to bipolar disorder.The endorsement of the neuroinflammatory hypotheses ...Recent literature based on peripheral immunity findings speculated that neuroinflammation,with its connection to microglial activation,is linked to bipolar disorder.The endorsement of the neuroinflammatory hypotheses of bipolar disorder requires the demonstration of causality,which requires longitudinal studies.We aimed to review the evidence for neuroinflammation as a pathogenic mechanism of the bipolar disorder.We carried out a hyper inclusive PubMed search using all appropriate neuroinflammation-related terms and crossed them with bipolar disorder-related terms.The search produced 310 articles and the number rose to 350 after adding articles from other search engines and reference lists.Twenty papers were included that appropriately tackled the issue of the presence(but not of its pathophysiological role)of neuroinflammation in bipolar disorder.Of these,15 were postmortem and 5 were carried out in living humans.Most articles were consistent with the presence of neuroinflammation in bipolar disorder,but factors such as treatment may mask it.All studies were cross-sectional,preventing causality to be inferred.Thus,no inference can be currently made about the role of neuroinflammation in bipolar disorder,but a link is likely.The issue remains little investigated,despite an excess of reviews on this topic.展开更多
BACKGROUND Phelan-McDermid syndrome(PMS)is a rare genetic disorder characterized by intellectual disability,delayed language development,autism spectrum disorders,motor tone abnormalities,and a high risk of psychiatri...BACKGROUND Phelan-McDermid syndrome(PMS)is a rare genetic disorder characterized by intellectual disability,delayed language development,autism spectrum disorders,motor tone abnormalities,and a high risk of psychiatric symptoms,including bipolar disorder.CASE SUMMARY This report presented an 18-year clinical history of a 36-year-old woman with PMS,marked by intellectual disabilities,social withdrawal,and stereotyped behaviors.Diagnosed with bipolar disorder at the age of 18 years old,she encountered significant treatment challenges,including severe adverse reactions to antipsychotic medications in 2022,which led to speech and functional regression.Through rehabilitation and comprehensive therapy,her condition gradually improved.In 2024,after further treatment,her symptoms stabilized,highlighting the complexities and successes of long-term management.CONCLUSION Effective management of PMS requires a thorough clinical history,genetic testing,and long-term supportive care.展开更多
Sleep is a critical yet often underestimated physiological parameter in psychiatric disorders.In their article,Gokcay et al examined sleep quality in bipolar disorder patients treated with lithium or valproic acid,sho...Sleep is a critical yet often underestimated physiological parameter in psychiatric disorders.In their article,Gokcay et al examined sleep quality in bipolar disorder patients treated with lithium or valproic acid,showing lithium’s advantage in habitual sleep efficiency and reduced disturbances.While this study provides valuable data in a chronic and clinically challenging cohort,reliance solely on self-reported sleep measures remains a limitation.Polysomnography,although the gold standard,is not always practical;therefore,actigraphy and wearable technologies represent feasible alternatives to capture objective sleep patterns.This letter emphasizes the importance of integrating objective,scalable technologies and pharmacological monitoring into longitudinal designs to clarify whether improvements in sleep translate into better clinical outcomes and reduced relapse risk in bipolar disorder.展开更多
BACKGROUND Sleep disturbances and residual functional impairment are increasingly recognized as important determinants of outcome in mood disorders,even during remission.Persistent disruptions in sleep may reflect und...BACKGROUND Sleep disturbances and residual functional impairment are increasingly recognized as important determinants of outcome in mood disorders,even during remission.Persistent disruptions in sleep may reflect underlying pathophysiological mechanisms and contribute to impaired psychosocial recovery.By comparing remitted bipolar disorder(BD)and major depressive disorder(MDD)patients with healthy controls,the present study sought to clarify the extent of these disturbances and their correlates.AIM To evaluate differences in sleep quality,psychosocial functioning,and insomnia severity among remitted patients with BD and MDD,in comparison with healthy controls.A secondary aim was to examine the clinical and psychosocial factors influencing sleep quality within these groups.METHODS The study included 135 participants:45 remitted BD patients,45 remitted MDD patients,and 45 healthy controls.Sleep quality was assessed with the Pittsburgh Sleep Quality Index,psychosocial functioning with the global assessment of functioning,and insomnia severity with the Insomnia Severity Index.Sociodemographic and clinical characteristics were also recorded.Comparative analyses were conducted to evaluate differences between groups,and regression models were used to identify predictors of sleep quality.RESULTS Both BD and MDD groups demonstrated significantly poorer sleep quality and higher insomnia severity compared with healthy controls.Poor sleep quality was observed in 75.6%of BD patients and 57.8%of MDD patients.Group differences were most pronounced in Pittsburgh Sleep Quality Index subdomains including sleep latency,sleep duration,and habitual sleep efficiency.Regression analysis identified insomnia severity(β=0.510)and functional capacity(β=-0.043)as significant correlates of sleep quality,indicating that greater insomnia severity and lower functioning were independently associated with poorer sleep.CONCLUSION The findings underscore that even during remission,BD and MDD are accompanied by substantial impairments in sleep quality and psychosocial functioning.These results highlight the importance of addressing residual symptoms,particularly insomnia and functional difficulties,in long-term management strategies.Interventions aimed at improving sleep and enhancing daily functioning should be considered essential components of treatment to promote recovery and quality of life in remitted patients.展开更多
Bipolar disorder(BD)affects 1%of the global population.BD is a group of chronic psychiatric disorders characterized by recurrent manic or hypomanic episodes that may alternate with depressive episodes.Given the curren...Bipolar disorder(BD)affects 1%of the global population.BD is a group of chronic psychiatric disorders characterized by recurrent manic or hypomanic episodes that may alternate with depressive episodes.Given the current diagnostic modalities,accurately diagnosing BD,particularly distinguishing it from unipolar depression(UD),is challenging.Biomarkers have emerged as potent instruments for estab-lishing objective diagnostic criteria for BD,and their identification,which reflects the pathophysiological processes of BD,can facilitate the precise diagnosis of the disorder.In this review,the search terms"BD"and"diagnosis"or"biomarker"were used as the key search syntax.In total,110 studies were included.This review systematically examines the research in the field and summarizes current studies on bio-markers of BD in omics and neuroimaging.We hope that this review will benefit research aimed at establishing objective diagnostic criteria for BD and developing novel therapeutic interventions.展开更多
To the editor:A wide range of affective disorders affects people of all ages globally and contributes significantly to the global disease burden.1 In China,a nationwide survey found a 3.21% prevalence of affective dis...To the editor:A wide range of affective disorders affects people of all ages globally and contributes significantly to the global disease burden.1 In China,a nationwide survey found a 3.21% prevalence of affective disorders in children and adolescents,with major depressive disorder(MDD)at 2.00%and bipolar disorder at 0.86%.展开更多
BACKGROUND Bipolar disorder(BD),marked by recurring manic and depressive episodes,often coexists with anxiety disorder(AD),which increases treatment complexity and morbidity.Although quetiapine,an atypical antipsychot...BACKGROUND Bipolar disorder(BD),marked by recurring manic and depressive episodes,often coexists with anxiety disorder(AD),which increases treatment complexity and morbidity.Although quetiapine,an atypical antipsychotic,has demonstrated efficacy in treating BD and AD,further investigation is needed regarding its effectiveness and safety in patients with AD at high-risk factors for BD.AIM To explore the application and efficacy of quetiapine in combination therapy for patients with AD at high-risk factors for BD.METHODS This study included 67 patients,with two excluded,leaving 65 divided into Group A(sertraline treatment)and Group B(combination treatment).All patients received sertraline,with Group B additionally receiving quetiapine.Efficacy was assessed using the Hamilton anxiety scale(HAMA),Hamilton depression scale(HAMD),and Bech-Rafaelsen Mania sale(BRMS)throughout the treatment period.Side effects and physiological indicators were also monitored.RESULTS No significant baseline differences existed between the two groups at treatment onset.Over the treatment course,Group B exhibited significantly lower HAMA scores than Group A at the end of weeks 1 and 24.HAMD scores gradually decreased over time,with Group B consistently showing lower scores than Group A.BRMS scores decreased significantly from baseline by week 8.In Group A,27.27%of patients received zolpidem treatment compared to 10.53%in Group B,which was a significant difference.Incidence of adverse reactions did not differ significantly between groups at treatment onset,but most patients experienced relief from adverse reactions within 4 weeks.CONCLUSION Combination of quetiapine and sertraline can more rapidly alleviate anxiety and depressive symptoms in patients with AD at high-risk factors for BD,improving treatment outcomes.展开更多
BACKGROUND Sleep disturbances are a prominent feature of bipolar disorder(BD)and often persist even in remission,thereby contributing to poor clinical outcomes.Despite the widespread use of lithium and valproic acid a...BACKGROUND Sleep disturbances are a prominent feature of bipolar disorder(BD)and often persist even in remission,thereby contributing to poor clinical outcomes.Despite the widespread use of lithium and valproic acid as mood stabilizers,their effects on sleep quality have not been examined in adequate detail.AIM To evaluate and compare the effects of lithium and valproic acid on sleep quality in BD patients under remission.METHODS A total of 130 patients meeting the Diagnostic and Statistical Manual of Mental Disorders,Fifth Edition criteria for BD in remission were included in this crosssectional study.The participants were receiving either lithium(n=78),or valproic acid(n=52),for a minimum of six months either alone or in combination with antipsychotics.Sleep quality was measured using the Pittsburgh Sleep Quality Index(PSQI).Comparative analyses between the lithium and valproic acid groups were conducted using independent t-tests,χ^(2)tests,and ANCOVA,adjusting for key variables such as age,sex,and body mass index.RESULTS Both groups demonstrated poor sleep quality,with the mean PSQI scores above the clinical threshold of 5.Patients in the lithium group exhibited significantly better habitual sleep efficiency(lithium:0.47±0.65,valproic acid:0.78±0.87,P=0.009)and fewer sleep disturbances(lithium:1.26±0.57,valproic acid:1.61±0.84,P=0.005).Other sleep parameters,including total sleep duration(P=0.082)and sleep latency(P=0.625),did not differ significantly.CONCLUSION Patients in the lithium group showed significantly better habitual sleep efficiency and fewer sleep disturbances compared to those receiving valproic acid,although other sleep parameters did not differ.These findings suggest a potential advantage of lithium in certain aspects of sleep quality in BD patients under remission.Future studies using objective sleep measures and longitudinal designs are warranted to confirm these findings.展开更多
Bipolar disorder(BD)is a severe mood disorder characterized by recurrent episodes of mania and depression,and it is prone to delayed diagnosis,which can lead to worsened outcomes,including more frequent mood episodes,...Bipolar disorder(BD)is a severe mood disorder characterized by recurrent episodes of mania and depression,and it is prone to delayed diagnosis,which can lead to worsened outcomes,including more frequent mood episodes,greater functional impairment,and comorbidities.Early diagnosis of BD remains a significant challenge,although recent advances offer promising insights,such as research in molecular biomarkers,neuroimaging,exosomes,genetics,and epigenetics.This mini-review highlights their potential for providing earlier,more accurate identification of BD and discusses the underlying reasons why current research has not yet succeeded.For instance,the high heterogeneity of symptomatic presentations leads to low consistency in study participants;delayed BD diagnosis results in the inclusion of potential BD patients in the depression group;low specificity of biomarkers stems from limited understanding of BD pathophysiology;and there is a possibility that BD is not innate but develops over the course of the disease.Deepening our understanding of BD pathology,identifying more specific biomarkers,and integrating multiomics approaches for validation studies in well-defined homogeneous cohorts hold promise for significant breakthroughs.展开更多
This study reviewed the clinical characteristics of adolescent bipolar disorder,the shortcomings of traditional treatment models in a systematical manner,analyzed the application status of virtual reality(VR)technolog...This study reviewed the clinical characteristics of adolescent bipolar disorder,the shortcomings of traditional treatment models in a systematical manner,analyzed the application status of virtual reality(VR)technology in mental and psychological diseases,and explored the potential mechanism of VR intervention for adolescent bipolar disorder patients,especially the value of PET/CT in the evaluation of brain energy metabolism.Studies have shown that VR treatment may optimize the neurological function of patients with bipolar disorder by enhancing the prefrontal-limbic system network,regulating the reward circuit and improving the executive function,and show positive changes in the metabolism of key brain areas at the PET/CT imaging level.展开更多
BACKGROUND Intimate partner violence(IPV)is a major public health concern linked to psychiatric and physical morbidity.However,evidence from East Asia,particularly from registry-based and sex-inclusive analyses,remain...BACKGROUND Intimate partner violence(IPV)is a major public health concern linked to psychiatric and physical morbidity.However,evidence from East Asia,particularly from registry-based and sex-inclusive analyses,remains limited.We hypothesized that IPV survivors would have elevated risks of psychiatric disorders and stressrelated physical conditions.AIM To assess psychiatric and physical health risks following IPV exposure in Taiwan region of China.METHODS We conducted a nationwide,registry-based case control study using data from Taiwan’s Health and Welfare Data Science Center.Adults aged 18-64 years with a first IPV report in 2019(n=43393)were matched 1:1 by sex and age to controls.Incident diagnoses within 1 year were identified from claims data.Conditional logistic regression was used to estimate adjusted odds ratios(AORs).RESULTS Compared to controls,IPV survivors had higher risks of depressive disorders[AOR=4.18,95%confidence interval(CI):3.78-4.60,P<0.001],bipolar disorder(AOR=4.81,95%CI:3.83-6.10,P<0.001),schizophrenia(AOR=1.75,95%CI:1.46-2.10,P<0.001),and alcohol/substance use disorders(AOR=5.98,95%CI:2.21-8.50,P<0.001).The risk of asthma was modestly elevated(AOR=1.31,95%CI:1.08-1.60,P=0.006).No significant association was observed for irritable bowel syndrome(P=0.94).CONCLUSION IPV survivors in Taiwan face substantially increased psychiatric risk and a modestly elevated risk of asthma,warranting early screening and integrated mental and physical health care.展开更多
Early distinction of bipolar disorder(BD)from major depressive disorder(MDD)is difficult since no tools are available to estimate the risk of BD.In this study,we aimed to develop and validate a model of oxidative stre...Early distinction of bipolar disorder(BD)from major depressive disorder(MDD)is difficult since no tools are available to estimate the risk of BD.In this study,we aimed to develop and validate a model of oxidative stress injury for predicting BD.Data were collected from 1252 BD and 1359 MDD patients,including 64 MDD patients identified as converting to BD from 2009 through 2018.30 variables from a randomly-selected subsample of 1827(70%)patients were used to develop the model,including age,sex,oxidative stress markers(uric acid,bilirubin,albumin,and prealbumin),sex hormones,cytokines,thyroid and liver function,and glycolipid metabolism.Univariate analyses and the Least Absolute Shrinkage and Selection Operator were applied for data dimension reduction and variable selection.Multivariable logistic regression was used to construct a model for predicting bipolar disorder by oxidative stress biomarkers(BIOS)on a nomogram.Internal validation was assessed in the remaining 784 patients(30%),and independent external validation was done with data from 3797 matched patients from five other hospitals in China.10 predictors,mainly oxidative stress markers,were shown on the nomogram.The BIOS model showed good discrimination in the training sample,with an AUC of 75.1%(95%CI:72.9%–77.3%),sensitivity of 0.66,and specificity of 0.73.The discrimination was good both in internal validation(AUC 72.1%,68.6%–75.6%)and external validation(AUC 65.7%,63.9%–67.5%).In this study,we developed a nomogram centered on oxidative stress injury,which could help in the individualized prediction of BD.For better real-world practice,a set of measurements,especially on oxidative stress markers,should be emphasized using big data in psychiatry.展开更多
OBJECTIVE： To examine the efficacy and safety of short-term and long-term use of antidepres- sants in the treatment of bipolar disorder. DATA SOURCES： A literature search of randomized, double-blind, controlled tria...OBJECTIVE： To examine the efficacy and safety of short-term and long-term use of antidepres- sants in the treatment of bipolar disorder. DATA SOURCES： A literature search of randomized, double-blind, controlled trials published until December 2012 was performed using the PubMed, ISI Web of Science, Medline and Cochrane Central Register of Controlled Trials databases. The keywords ＂bipolar disorder, bipolar I disorder, bipolar II disorder, bipolar mania, bipolar depression, cyclothymia, mixed mania and depression, rapid cycling and bipolar disorder＂, AND ＂antidepressant agent, antidepressive agents second- generation, antidepressive agents tricyclic, monoamine oxidase inhibitor, noradrenaline uptake in- hibitor, serotonin uptake inhibitor, and tricyclic antidepressant agent＂ were used. The studies that were listed in the reference list of the published papers but were not retrieved in the above-mentioned databases were supplemented. STUDY SELECTION： Studies selected were double-blind randomized controlled trials assessing the efficacy and safety of antidepressants in patients with bipolar disorder. All participants were aged 18 years or older, and were diagnosed as having primary bipolar disorder. Antidepressants or antidepressants combined with mood stabilizers were used in experimental interventions. Placebos, mood stabilizers, antipsychotics and other antide pressants were used in the control interventions. Studies that were quasi-randomized studies, or used antidepressants in combination with antipsy- chotics in the experimental group were excluded. All analyses were conducted using Review Man- ager 5.1 provided by the Cochrane Collaboration.展开更多
The aim of this study was to investigate proton magnetic resonance spectroscopy metabolite values in the medial prefrontal cortex of individuals with euthymic bipolar disorder. The subjects consisted of 15 patients wi...The aim of this study was to investigate proton magnetic resonance spectroscopy metabolite values in the medial prefrontal cortex of individuals with euthymic bipolar disorder. The subjects consisted of 15 patients with euthymic bipolar disorder type I and 15 healthy controls. We performed proton magnetic resonance spectroscopy of the bilateral medial prefrontal cortex and measured levels of N-acetyl aspartate, choline and creatine. Levels of these three metabolites in the medial prefrontal cortex were found to be lower in patients with bipolar disorder compared with healthy controls. A positive correlation was found between illness duration and choline levels in the right medial prefrontal cortex. Our study suggests that during the euthymic period, there are abnormalities in cellular energy and membrane phospholipid metabolism in the medial prefrontal cortex, and that this may impair neuronal activity and integrity.展开更多
AIM To study if anxiety, depression and experience of stress are associated with gastrointestinal(GI) symptoms in patients with bipolar disorder.METHODS A total of 136 patients with bipolar disorder(mean age 49.9 year...AIM To study if anxiety, depression and experience of stress are associated with gastrointestinal(GI) symptoms in patients with bipolar disorder.METHODS A total of 136 patients with bipolar disorder(mean age 49.9 years; 61% women) and 136 controls from the general population(mean age 51.0 years; 60% women) were included in the study. GI symptoms were assessed with The Gastrointestinal Symptom Rating Scale-irritable bowel syndrome(GSRS-IBS), level of anxiety and depression with The Hospital Anxiety and Depression Scale(HADS) and stress-proneness with Perceived Stress Questionnaire. Over a ten year period, all visits in primary care were retrospectively recorded in order to identify functional GI disorders.RESULTS In subjects with low total HADS-score, there were no significant differences in GI-symptoms between patients and controls(GSRS-IBS 7.0 vs 6.5, P = 0.513). In the patients with bipolar disorder there were significant correlations between all GSRS and HADS subscores for all symptom clusters except for "constipation" and "reflux". Factors associated to GI symptoms in the patient group were female sex(adjusted OR = 2.37, 95%CI: 1.07-5.24) and high HADS-Depression score(adjusted OR = 3.64, 95%CI: 1.07-12.4). These patients had also significantly more visits for IBS than patients with low HADS-Depression scores(29% vs 8%, P = 0.008). However, there was no significant differences in consulting behaviour for functional GI disorders between patients and controls(25% vs 17%, P = 0.108).CONCLUSION Female patients and patients with high HADS depression score reported significantly more GI symptoms, whereas patients with low HADS scores did not differ from control subjects.展开更多
基金Supported by the National College Students’Innovative Entrepreneurial Training Plan Program,No.202410403067the Innovation and Entrepreneurship Training Program for College Students in Jiangxi Province,No.S202410403035.
文摘BACKGROUND Bipolar disorder(BD)is a severe mental illness characterized by significant mood swings.Effective drug treatment modalities are crucial for managing BD.AIM To analyze the current status and future trends of global research on BD drug treatment over the last decade.METHODS The Web of Science Core Collection database spanning from 2015 to 2024 was utilized to retrieve literature related to BD drug treatment.A total of 2624 articles were extracted.Data visualization and analysis were conducted using CiteSpace,VOSviewer,Pajek,Scimago Graphica,and R-studio bibliometrix to identify RESULTS The United States,China,and the United Kingdom have made the most significant contributions to research on BD drug treatment and formed notable research collaboration networks.The University of Pittsburgh,Massachusetts General Hospital,and the University of Michigan have been identified as the major research institutions in this field.The Journal of Affective Disorders is the most influential journal.A keyword analysis revealed research hotspots related to clinical symptoms,drug efficacy,and genetic mechanisms.A citation analysis identified the management guidelines published by Yatham et al in 2018 as the most cited paper.CONCLUSION This study provides a detailed overview of the field of BD drug treatment,highlighting key contributors,research hotspots,and future directions.The study findings can be employed as a reference for future research and policymaking,which may enable further development and optimization of BD pharmacotherapy.
文摘[Objectives]To investigate the potential causal relationship between psoriasis and common mental disorders,and to provide genetic epidemiological evidence for the early intervention of mental comorbidities.[Methods]Based on publicly available large-scale GWAS data,a bidirectional Mendelian randomization(MR)approach was employed to assess the causal associations between psoriasis and major depressive disorder(MDD),bipolar disorder,schizophrenia,and anxiety disorders.The inverse variance weighted(IVW)method served as the primary analytical tool,supplemented by sensitivity analyses using MR-Egger and weighted median methods.Additionally,a subgroup analysis was conducted for psoriatic arthritis(PsA).[Results]Forward MR analysis revealed a significant positive causal association between the genetic predisposition to psoriasis and bipolar disorder as well as MDD,whereas no significant causal relationship was observed with schizophrenia or anxiety disorders.The reverse MR analysis found no causal effect of mental disorders on psoriasis.Subgroup analysis of PsA indicated that its genetic predisposition was significantly associated with the risk of bipolar disorder.The results of various sensitivity analyses and pleiotropy tests supported the robustness of the conclusions.[Conclusions]This study provides genetic evidence supporting a causal link between psoriasis and both MDD and bipolar disorder.In particular,patients with PsA are at a higher risk of developing bipolar disorder,highlighting the need to strengthen early screening and intervention for mental health in clinical management.
文摘Clinically differentiating bipolarⅡdisorder(BD-Ⅱ)from major depressive disorder(MDD)remains a significant challenge in modern psychiatry.These two conditions share substantial clinical symptomatology,making accurate diagnosis difficult in routine clinical practice.Misdiagnosis may lead to inappropriate treatment strategies,increased psychological and physical burdens,reduced quality of life,and impaired social functioning.Genetic overlap may partially explain the clinical similarities between MDD and BD-Ⅱ,and biomarkers along with neuroimaging techniques are receiving increasing attention as tools to aid in diagnosis.For example,electroencephalography has been shown to effectively distinguish between unipolar depression and bipolar depression;serum levels of glycogen synthase kinase-3 have also been investigated as a potential tool for differentiating between the two disorders.A comprehensive assessment integrating clinical characteristics,genetic basis research,and multimodal evaluations using neuroimaging and biomarkers through a multidisciplinary approach will help enhance clinicians'ability to distinguish between MDD and BD-Ⅱ.By improving diagnostic accuracy,more personalized and effective treatment strategies can be developed,ultimately improving patients'health outcomes and quality of life.
文摘Bipolar disorder is a neurological disorder that consists of two main factors,i.e.mania and depression.There are two main drawbacks in clinical diagnosis of the bipolar disorder.First,bipolar disorder is mostly wrongly diagnosed as unipolar depression in clinical diagnosis.This is,because in clinical diagnosis,the first factor is often neglected due to its approach toward positivity.Consequently,the element of bipolarity vanishes and the disease becomes worse.Second,the types of bipolhr disorder are mostly misdiagnosed due to similar symptoms.To overcome these problems,the bipolar fuzzy soft set(BFS-set)and bipolar fuzzy soft mappings(BFS-mappings)are useful to tackle bipolarity and to construct a strong mathematical modeling process to diagnose this disease correctly.This technique is extensive but simple as compared to existing medical diagnosis methods.A chart(relation between different types and symptoms of bipolar disorder)is provided which contains different ranges over the interval[-1,1].A process of BFS-mappings is also provided to obtain correct diagnosis and to suggest the best treatment.Lastly,a generalized BFS-mapping is introduced which is helpful to keep patient's improvement record.The case study indicates the reliability,efficiency and capability of the achieved theoretical results.Further,it reveals that the connection of soft set with bipolar fuzzy set is fruitful to construct a connection between symptoms which minimize the complexity of the case study.
文摘Abnormal expression of microRNAs is connected to brain development and disease and could provide novel biomarkers for the diagnosis and prognosis of bipolar disorder. We performed a PubMed search for microRNA biomarkers in bipolar disorder and found 18 original research articles on studies performed with human patients and published from January 2011 to June 2023. These studies included microRNA profiling in bloodand brain-based materials. From the studies that had validated the preliminary findings,potential candidate biomarkers for bipolar disorder in adults could be miR-140-3p,-30d-5p,-330-5p,-378a-5p,-21-3p,-330-3p,-345-5p in whole blood, miR-19b-3p,-1180-3p,-125a-5p, let-7e-5p in blood plasma, and miR-7-5p,-23b-5p,-142-3p,-221-5p,-370-3p in the blood serum. Two of the studies had investigated the changes in microRNA expression of patients with bipolar disorder receiving treatment. One showed a significant increase in plasma miR-134 compared to baseline after 4 weeks of treatment which included typical antipsychotics, atypical antipsychotics, and benzodiazepines. The other study had assessed the effects of prescribed medications which included neurotransmitter receptorsite binders(drug class B) and sedatives, hypnotics, anticonvulsants, and analgesics(drug class C) on microRNA results. The combined effects of the two drug classes increased the significance of the results for miR-219 and-29c with miR-30e-3p and-526b* acquiring significance. MicroRNAs were tested to see if they could serve as biomarkers of bipolar disorder at different clinical states of mania, depression, and euthymia. One study showed that upregulation in whole blood of miR-9-5p,-29a-3p,-106a-5p,-106b-5p,-107,-125a-3p,-125b-5p and of miR-107,-125a-3p occurred in manic and euthymic patients compared to controls, respectively, and that upregulation of miR-106a-5p,-107 was found for manic compared to euthymic patients. In two other studies using blood plasma,downregulation of miR-134 was observed in manic patients compared to controls, and dysregulation of miR-134,-152,-607,-633,-652,-155 occurred in euthymic patients compared to controls. Finally, microRNAs such as miR-34a,-34b,-34c,-137, and-140-3p,-21-3p,-30d-5p,-330-5p,-378a-5p,-134,-19b-3p were shown to have diagnostic potential in distinguishing bipolar disorder patients from schizophrenia or major depressive disorder patients, respectively. Further studies are warranted with adolescents and young adults having bipolar disorder and consideration should be given to using animal models of the disorder to investigate the effects of suppressing or overexpressing specific microRNAs.
文摘Recent literature based on peripheral immunity findings speculated that neuroinflammation,with its connection to microglial activation,is linked to bipolar disorder.The endorsement of the neuroinflammatory hypotheses of bipolar disorder requires the demonstration of causality,which requires longitudinal studies.We aimed to review the evidence for neuroinflammation as a pathogenic mechanism of the bipolar disorder.We carried out a hyper inclusive PubMed search using all appropriate neuroinflammation-related terms and crossed them with bipolar disorder-related terms.The search produced 310 articles and the number rose to 350 after adding articles from other search engines and reference lists.Twenty papers were included that appropriately tackled the issue of the presence(but not of its pathophysiological role)of neuroinflammation in bipolar disorder.Of these,15 were postmortem and 5 were carried out in living humans.Most articles were consistent with the presence of neuroinflammation in bipolar disorder,but factors such as treatment may mask it.All studies were cross-sectional,preventing causality to be inferred.Thus,no inference can be currently made about the role of neuroinflammation in bipolar disorder,but a link is likely.The issue remains little investigated,despite an excess of reviews on this topic.
基金Supported by the Zhejiang Province Medicine and Health Science and Technology Program,No.2023KY980Hangzhou Municipal Health and Family Planning Commission,No.A20220133.
文摘BACKGROUND Phelan-McDermid syndrome(PMS)is a rare genetic disorder characterized by intellectual disability,delayed language development,autism spectrum disorders,motor tone abnormalities,and a high risk of psychiatric symptoms,including bipolar disorder.CASE SUMMARY This report presented an 18-year clinical history of a 36-year-old woman with PMS,marked by intellectual disabilities,social withdrawal,and stereotyped behaviors.Diagnosed with bipolar disorder at the age of 18 years old,she encountered significant treatment challenges,including severe adverse reactions to antipsychotic medications in 2022,which led to speech and functional regression.Through rehabilitation and comprehensive therapy,her condition gradually improved.In 2024,after further treatment,her symptoms stabilized,highlighting the complexities and successes of long-term management.CONCLUSION Effective management of PMS requires a thorough clinical history,genetic testing,and long-term supportive care.
文摘Sleep is a critical yet often underestimated physiological parameter in psychiatric disorders.In their article,Gokcay et al examined sleep quality in bipolar disorder patients treated with lithium or valproic acid,showing lithium’s advantage in habitual sleep efficiency and reduced disturbances.While this study provides valuable data in a chronic and clinically challenging cohort,reliance solely on self-reported sleep measures remains a limitation.Polysomnography,although the gold standard,is not always practical;therefore,actigraphy and wearable technologies represent feasible alternatives to capture objective sleep patterns.This letter emphasizes the importance of integrating objective,scalable technologies and pharmacological monitoring into longitudinal designs to clarify whether improvements in sleep translate into better clinical outcomes and reduced relapse risk in bipolar disorder.
文摘BACKGROUND Sleep disturbances and residual functional impairment are increasingly recognized as important determinants of outcome in mood disorders,even during remission.Persistent disruptions in sleep may reflect underlying pathophysiological mechanisms and contribute to impaired psychosocial recovery.By comparing remitted bipolar disorder(BD)and major depressive disorder(MDD)patients with healthy controls,the present study sought to clarify the extent of these disturbances and their correlates.AIM To evaluate differences in sleep quality,psychosocial functioning,and insomnia severity among remitted patients with BD and MDD,in comparison with healthy controls.A secondary aim was to examine the clinical and psychosocial factors influencing sleep quality within these groups.METHODS The study included 135 participants:45 remitted BD patients,45 remitted MDD patients,and 45 healthy controls.Sleep quality was assessed with the Pittsburgh Sleep Quality Index,psychosocial functioning with the global assessment of functioning,and insomnia severity with the Insomnia Severity Index.Sociodemographic and clinical characteristics were also recorded.Comparative analyses were conducted to evaluate differences between groups,and regression models were used to identify predictors of sleep quality.RESULTS Both BD and MDD groups demonstrated significantly poorer sleep quality and higher insomnia severity compared with healthy controls.Poor sleep quality was observed in 75.6%of BD patients and 57.8%of MDD patients.Group differences were most pronounced in Pittsburgh Sleep Quality Index subdomains including sleep latency,sleep duration,and habitual sleep efficiency.Regression analysis identified insomnia severity(β=0.510)and functional capacity(β=-0.043)as significant correlates of sleep quality,indicating that greater insomnia severity and lower functioning were independently associated with poorer sleep.CONCLUSION The findings underscore that even during remission,BD and MDD are accompanied by substantial impairments in sleep quality and psychosocial functioning.These results highlight the importance of addressing residual symptoms,particularly insomnia and functional difficulties,in long-term management strategies.Interventions aimed at improving sleep and enhancing daily functioning should be considered essential components of treatment to promote recovery and quality of life in remitted patients.
基金the Health System Key Discipline of Shanghai(Program No.:2024zDxK0013).
文摘Bipolar disorder(BD)affects 1%of the global population.BD is a group of chronic psychiatric disorders characterized by recurrent manic or hypomanic episodes that may alternate with depressive episodes.Given the current diagnostic modalities,accurately diagnosing BD,particularly distinguishing it from unipolar depression(UD),is challenging.Biomarkers have emerged as potent instruments for estab-lishing objective diagnostic criteria for BD,and their identification,which reflects the pathophysiological processes of BD,can facilitate the precise diagnosis of the disorder.In this review,the search terms"BD"and"diagnosis"or"biomarker"were used as the key search syntax.In total,110 studies were included.This review systematically examines the research in the field and summarizes current studies on bio-markers of BD in omics and neuroimaging.We hope that this review will benefit research aimed at establishing objective diagnostic criteria for BD and developing novel therapeutic interventions.
基金the Tianjin Health Research Project(Grant No.TJWJ2023MS038)Tianjin Education Commission Research Project(Grant No.2023KJ044)S&T Program of Hebei(SG2021189)。
文摘To the editor:A wide range of affective disorders affects people of all ages globally and contributes significantly to the global disease burden.1 In China,a nationwide survey found a 3.21% prevalence of affective disorders in children and adolescents,with major depressive disorder(MDD)at 2.00%and bipolar disorder at 0.86%.
基金Supported by Huzhou City Science and Technology Plan Public Welfare Technology Application Research Project[Key Project],No.2020GZ42.
文摘BACKGROUND Bipolar disorder(BD),marked by recurring manic and depressive episodes,often coexists with anxiety disorder(AD),which increases treatment complexity and morbidity.Although quetiapine,an atypical antipsychotic,has demonstrated efficacy in treating BD and AD,further investigation is needed regarding its effectiveness and safety in patients with AD at high-risk factors for BD.AIM To explore the application and efficacy of quetiapine in combination therapy for patients with AD at high-risk factors for BD.METHODS This study included 67 patients,with two excluded,leaving 65 divided into Group A(sertraline treatment)and Group B(combination treatment).All patients received sertraline,with Group B additionally receiving quetiapine.Efficacy was assessed using the Hamilton anxiety scale(HAMA),Hamilton depression scale(HAMD),and Bech-Rafaelsen Mania sale(BRMS)throughout the treatment period.Side effects and physiological indicators were also monitored.RESULTS No significant baseline differences existed between the two groups at treatment onset.Over the treatment course,Group B exhibited significantly lower HAMA scores than Group A at the end of weeks 1 and 24.HAMD scores gradually decreased over time,with Group B consistently showing lower scores than Group A.BRMS scores decreased significantly from baseline by week 8.In Group A,27.27%of patients received zolpidem treatment compared to 10.53%in Group B,which was a significant difference.Incidence of adverse reactions did not differ significantly between groups at treatment onset,but most patients experienced relief from adverse reactions within 4 weeks.CONCLUSION Combination of quetiapine and sertraline can more rapidly alleviate anxiety and depressive symptoms in patients with AD at high-risk factors for BD,improving treatment outcomes.
文摘BACKGROUND Sleep disturbances are a prominent feature of bipolar disorder(BD)and often persist even in remission,thereby contributing to poor clinical outcomes.Despite the widespread use of lithium and valproic acid as mood stabilizers,their effects on sleep quality have not been examined in adequate detail.AIM To evaluate and compare the effects of lithium and valproic acid on sleep quality in BD patients under remission.METHODS A total of 130 patients meeting the Diagnostic and Statistical Manual of Mental Disorders,Fifth Edition criteria for BD in remission were included in this crosssectional study.The participants were receiving either lithium(n=78),or valproic acid(n=52),for a minimum of six months either alone or in combination with antipsychotics.Sleep quality was measured using the Pittsburgh Sleep Quality Index(PSQI).Comparative analyses between the lithium and valproic acid groups were conducted using independent t-tests,χ^(2)tests,and ANCOVA,adjusting for key variables such as age,sex,and body mass index.RESULTS Both groups demonstrated poor sleep quality,with the mean PSQI scores above the clinical threshold of 5.Patients in the lithium group exhibited significantly better habitual sleep efficiency(lithium:0.47±0.65,valproic acid:0.78±0.87,P=0.009)and fewer sleep disturbances(lithium:1.26±0.57,valproic acid:1.61±0.84,P=0.005).Other sleep parameters,including total sleep duration(P=0.082)and sleep latency(P=0.625),did not differ significantly.CONCLUSION Patients in the lithium group showed significantly better habitual sleep efficiency and fewer sleep disturbances compared to those receiving valproic acid,although other sleep parameters did not differ.These findings suggest a potential advantage of lithium in certain aspects of sleep quality in BD patients under remission.Future studies using objective sleep measures and longitudinal designs are warranted to confirm these findings.
基金Supported by Research Plan Project of Tianjin Municipal Education Commission,No.2022KJ264.
文摘Bipolar disorder(BD)is a severe mood disorder characterized by recurrent episodes of mania and depression,and it is prone to delayed diagnosis,which can lead to worsened outcomes,including more frequent mood episodes,greater functional impairment,and comorbidities.Early diagnosis of BD remains a significant challenge,although recent advances offer promising insights,such as research in molecular biomarkers,neuroimaging,exosomes,genetics,and epigenetics.This mini-review highlights their potential for providing earlier,more accurate identification of BD and discusses the underlying reasons why current research has not yet succeeded.For instance,the high heterogeneity of symptomatic presentations leads to low consistency in study participants;delayed BD diagnosis results in the inclusion of potential BD patients in the depression group;low specificity of biomarkers stems from limited understanding of BD pathophysiology;and there is a possibility that BD is not innate but develops over the course of the disease.Deepening our understanding of BD pathology,identifying more specific biomarkers,and integrating multiomics approaches for validation studies in well-defined homogeneous cohorts hold promise for significant breakthroughs.
文摘This study reviewed the clinical characteristics of adolescent bipolar disorder,the shortcomings of traditional treatment models in a systematical manner,analyzed the application status of virtual reality(VR)technology in mental and psychological diseases,and explored the potential mechanism of VR intervention for adolescent bipolar disorder patients,especially the value of PET/CT in the evaluation of brain energy metabolism.Studies have shown that VR treatment may optimize the neurological function of patients with bipolar disorder by enhancing the prefrontal-limbic system network,regulating the reward circuit and improving the executive function,and show positive changes in the metabolism of key brain areas at the PET/CT imaging level.
基金Supported by National Science and Technology Council,Taiwan,No.MOST 111-2629-H-227-001-MY2.
文摘BACKGROUND Intimate partner violence(IPV)is a major public health concern linked to psychiatric and physical morbidity.However,evidence from East Asia,particularly from registry-based and sex-inclusive analyses,remains limited.We hypothesized that IPV survivors would have elevated risks of psychiatric disorders and stressrelated physical conditions.AIM To assess psychiatric and physical health risks following IPV exposure in Taiwan region of China.METHODS We conducted a nationwide,registry-based case control study using data from Taiwan’s Health and Welfare Data Science Center.Adults aged 18-64 years with a first IPV report in 2019(n=43393)were matched 1:1 by sex and age to controls.Incident diagnoses within 1 year were identified from claims data.Conditional logistic regression was used to estimate adjusted odds ratios(AORs).RESULTS Compared to controls,IPV survivors had higher risks of depressive disorders[AOR=4.18,95%confidence interval(CI):3.78-4.60,P<0.001],bipolar disorder(AOR=4.81,95%CI:3.83-6.10,P<0.001),schizophrenia(AOR=1.75,95%CI:1.46-2.10,P<0.001),and alcohol/substance use disorders(AOR=5.98,95%CI:2.21-8.50,P<0.001).The risk of asthma was modestly elevated(AOR=1.31,95%CI:1.08-1.60,P=0.006).No significant association was observed for irritable bowel syndrome(P=0.94).CONCLUSION IPV survivors in Taiwan face substantially increased psychiatric risk and a modestly elevated risk of asthma,warranting early screening and integrated mental and physical health care.
基金supported by the National Key Research and Development Program of China(2016YFC1307100)the National Natural Science Foundation of China(81930033,81771465,and 91232719)+3 种基金the Shanghai Mental Health Centre Clinical Research Center Special Project for Big Data Analysis(CRC2018DSJ01-1)Shanghai Municipal Science and Technology Major Project(2018SHZDZX05)Scientific Research Project of Hongkou District Health Commission(2101-03)Shanghai Clinical Research Center for Mental Health(SCRC-MH and 19MC1911100)。
文摘Early distinction of bipolar disorder(BD)from major depressive disorder(MDD)is difficult since no tools are available to estimate the risk of BD.In this study,we aimed to develop and validate a model of oxidative stress injury for predicting BD.Data were collected from 1252 BD and 1359 MDD patients,including 64 MDD patients identified as converting to BD from 2009 through 2018.30 variables from a randomly-selected subsample of 1827(70%)patients were used to develop the model,including age,sex,oxidative stress markers(uric acid,bilirubin,albumin,and prealbumin),sex hormones,cytokines,thyroid and liver function,and glycolipid metabolism.Univariate analyses and the Least Absolute Shrinkage and Selection Operator were applied for data dimension reduction and variable selection.Multivariable logistic regression was used to construct a model for predicting bipolar disorder by oxidative stress biomarkers(BIOS)on a nomogram.Internal validation was assessed in the remaining 784 patients(30%),and independent external validation was done with data from 3797 matched patients from five other hospitals in China.10 predictors,mainly oxidative stress markers,were shown on the nomogram.The BIOS model showed good discrimination in the training sample,with an AUC of 75.1%(95%CI:72.9%–77.3%),sensitivity of 0.66,and specificity of 0.73.The discrimination was good both in internal validation(AUC 72.1%,68.6%–75.6%)and external validation(AUC 65.7%,63.9%–67.5%).In this study,we developed a nomogram centered on oxidative stress injury,which could help in the individualized prediction of BD.For better real-world practice,a set of measurements,especially on oxidative stress markers,should be emphasized using big data in psychiatry.
基金supported in part by the Key Projects of Science and Technology Research of the Department of Education in Henan Province,China,No.13A320869a special fund from Henan Health Science and Technology Innovation Talent Project,No.4173(2010-2015)
文摘OBJECTIVE： To examine the efficacy and safety of short-term and long-term use of antidepres- sants in the treatment of bipolar disorder. DATA SOURCES： A literature search of randomized, double-blind, controlled trials published until December 2012 was performed using the PubMed, ISI Web of Science, Medline and Cochrane Central Register of Controlled Trials databases. The keywords ＂bipolar disorder, bipolar I disorder, bipolar II disorder, bipolar mania, bipolar depression, cyclothymia, mixed mania and depression, rapid cycling and bipolar disorder＂, AND ＂antidepressant agent, antidepressive agents second- generation, antidepressive agents tricyclic, monoamine oxidase inhibitor, noradrenaline uptake in- hibitor, serotonin uptake inhibitor, and tricyclic antidepressant agent＂ were used. The studies that were listed in the reference list of the published papers but were not retrieved in the above-mentioned databases were supplemented. STUDY SELECTION： Studies selected were double-blind randomized controlled trials assessing the efficacy and safety of antidepressants in patients with bipolar disorder. All participants were aged 18 years or older, and were diagnosed as having primary bipolar disorder. Antidepressants or antidepressants combined with mood stabilizers were used in experimental interventions. Placebos, mood stabilizers, antipsychotics and other antide pressants were used in the control interventions. Studies that were quasi-randomized studies, or used antidepressants in combination with antipsy- chotics in the experimental group were excluded. All analyses were conducted using Review Man- ager 5.1 provided by the Cochrane Collaboration.
基金supported by Pamukkale University(Scientific Research Projects Coordination Unit)
文摘The aim of this study was to investigate proton magnetic resonance spectroscopy metabolite values in the medial prefrontal cortex of individuals with euthymic bipolar disorder. The subjects consisted of 15 patients with euthymic bipolar disorder type I and 15 healthy controls. We performed proton magnetic resonance spectroscopy of the bilateral medial prefrontal cortex and measured levels of N-acetyl aspartate, choline and creatine. Levels of these three metabolites in the medial prefrontal cortex were found to be lower in patients with bipolar disorder compared with healthy controls. A positive correlation was found between illness duration and choline levels in the right medial prefrontal cortex. Our study suggests that during the euthymic period, there are abnormalities in cellular energy and membrane phospholipid metabolism in the medial prefrontal cortex, and that this may impair neuronal activity and integrity.
文摘AIM To study if anxiety, depression and experience of stress are associated with gastrointestinal(GI) symptoms in patients with bipolar disorder.METHODS A total of 136 patients with bipolar disorder(mean age 49.9 years; 61% women) and 136 controls from the general population(mean age 51.0 years; 60% women) were included in the study. GI symptoms were assessed with The Gastrointestinal Symptom Rating Scale-irritable bowel syndrome(GSRS-IBS), level of anxiety and depression with The Hospital Anxiety and Depression Scale(HADS) and stress-proneness with Perceived Stress Questionnaire. Over a ten year period, all visits in primary care were retrospectively recorded in order to identify functional GI disorders.RESULTS In subjects with low total HADS-score, there were no significant differences in GI-symptoms between patients and controls(GSRS-IBS 7.0 vs 6.5, P = 0.513). In the patients with bipolar disorder there were significant correlations between all GSRS and HADS subscores for all symptom clusters except for "constipation" and "reflux". Factors associated to GI symptoms in the patient group were female sex(adjusted OR = 2.37, 95%CI: 1.07-5.24) and high HADS-Depression score(adjusted OR = 3.64, 95%CI: 1.07-12.4). These patients had also significantly more visits for IBS than patients with low HADS-Depression scores(29% vs 8%, P = 0.008). However, there was no significant differences in consulting behaviour for functional GI disorders between patients and controls(25% vs 17%, P = 0.108).CONCLUSION Female patients and patients with high HADS depression score reported significantly more GI symptoms, whereas patients with low HADS scores did not differ from control subjects.
