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Bipolar Disorder: HELP
Articles from British Columbia
Based on 189 articles published since 2010
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These are the 189 published articles about Bipolar Disorder that originated from British Columbia during 2010-2020.
 
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4 · 5 · 6 · 7 · 8
1 Guideline Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder. 2018

Yatham, Lakshmi N / Kennedy, Sidney H / Parikh, Sagar V / Schaffer, Ayal / Bond, David J / Frey, Benicio N / Sharma, Verinder / Goldstein, Benjamin I / Rej, Soham / Beaulieu, Serge / Alda, Martin / MacQueen, Glenda / Milev, Roumen V / Ravindran, Arun / O'Donovan, Claire / McIntosh, Diane / Lam, Raymond W / Vazquez, Gustavo / Kapczinski, Flavio / McIntyre, Roger S / Kozicky, Jan / Kanba, Shigenobu / Lafer, Beny / Suppes, Trisha / Calabrese, Joseph R / Vieta, Eduard / Malhi, Gin / Post, Robert M / Berk, Michael. ·Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada. · Department of Psychiatry, University of Toronto, Toronto, ON, Canada. · Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA. · Department of Psychiatry, University of Minnesota, Minneapolis, MN, USA. · Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada. · Departments of Psychiatry and Obstetrics & Gynaecology, Western University, London, ON, Canada. · Department of Psychiatry, McGill University, Montreal, QC, Canada. · Department of Psychiatry, Dalhousie University, Halifax, NS, Canada. · Department of Psychiatry, University of Calgary, Calgary, AB, Canada. · Departments of Psychiatry and Psychology, Queen's University, Kingston, ON, Canada. · School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada. · Department of Neuropsychiatry, Kyushu University, Fukuoka, Japan. · Department of Psychiatry, University of Sao Paulo, Sao Paulo, Brazil. · Bipolar and Depression Research Program, VA Palo Alto, Department of Psychiatry & Behavioral Sciences Stanford University, Stanford, CA, USA. · Department of Psychiatry, University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, OH, USA. · Bipolar Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain. · Department of Psychiatry, University of Sydney, Sydney, NSW, Australia. · Department of Psychiatry, George Washington University, Washington, DC, USA. · Deakin Univeristy, IMPACT Strategic Research Centre, School of Medicine, Barwon Health, Geelong, Vic., Australia. ·Bipolar Disord · Pubmed #29536616.

ABSTRACT: The Canadian Network for Mood and Anxiety Treatments (CANMAT) previously published treatment guidelines for bipolar disorder in 2005, along with international commentaries and subsequent updates in 2007, 2009, and 2013. The last two updates were published in collaboration with the International Society for Bipolar Disorders (ISBD). These 2018 CANMAT and ISBD Bipolar Treatment Guidelines represent the significant advances in the field since the last full edition was published in 2005, including updates to diagnosis and management as well as new research into pharmacological and psychological treatments. These advances have been translated into clear and easy to use recommendations for first, second, and third- line treatments, with consideration given to levels of evidence for efficacy, clinical support based on experience, and consensus ratings of safety, tolerability, and treatment-emergent switch risk. New to these guidelines, hierarchical rankings were created for first and second- line treatments recommended for acute mania, acute depression, and maintenance treatment in bipolar I disorder. Created by considering the impact of each treatment across all phases of illness, this hierarchy will further assist clinicians in making evidence-based treatment decisions. Lithium, quetiapine, divalproex, asenapine, aripiprazole, paliperidone, risperidone, and cariprazine alone or in combination are recommended as first-line treatments for acute mania. First-line options for bipolar I depression include quetiapine, lurasidone plus lithium or divalproex, lithium, lamotrigine, lurasidone, or adjunctive lamotrigine. While medications that have been shown to be effective for the acute phase should generally be continued for the maintenance phase in bipolar I disorder, there are some exceptions (such as with antidepressants); and available data suggest that lithium, quetiapine, divalproex, lamotrigine, asenapine, and aripiprazole monotherapy or combination treatments should be considered first-line for those initiating or switching treatment during the maintenance phase. In addition to addressing issues in bipolar I disorder, these guidelines also provide an overview of, and recommendations for, clinical management of bipolar II disorder, as well as advice on specific populations, such as women at various stages of the reproductive cycle, children and adolescents, and older adults. There are also discussions on the impact of specific psychiatric and medical comorbidities such as substance use, anxiety, and metabolic disorders. Finally, an overview of issues related to safety and monitoring is provided. The CANMAT and ISBD groups hope that these guidelines become a valuable tool for practitioners across the globe.

2 Guideline Methodological recommendations for cognition trials in bipolar disorder by the International Society for Bipolar Disorders Targeting Cognition Task Force. 2017

Miskowiak, K W / Burdick, K E / Martinez-Aran, A / Bonnin, C M / Bowie, C R / Carvalho, A F / Gallagher, P / Lafer, B / López-Jaramillo, C / Sumiyoshi, T / McIntyre, R S / Schaffer, A / Porter, R J / Torres, I J / Yatham, L N / Young, A H / Kessing, L V / Vieta, E. ·Copenhagen Affective Disorder Research Centre, Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark. · Department of Psychology, University of Copenhagen, Copenhagen, Denmark. · Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. · Clinical Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain. · Department of Psychology, Queen's University, Kingston, Canada. · Department of Clinical Medicine, Federal University of Ceará, Fortaleza, Brazil. · Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK. · Bipolar Disorder Research Program, Institute of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil. · Research Group in Psychiatry, Department of Psychiatry, Universidad de Antioquia, Medellín, Colombia. · Department of Clinical Epidemiology, National Center of Neurology and Psychiatry, Tokyo, Japan. · Mood Disorders Psychopharmacology Unit, Brain and Cognition Discovery Foundation, University of Toronto, Toronto, Canada. · Department of Psychiatry, University of Toronto, Toronto, Canada. · Department of Psychological Medicine, University of Otago, Christchurch, New Zealand. · Department of Psychiatry, University of British Columbia, Vancouver, Canada. · Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK. ·Bipolar Disord · Pubmed #28895274.

ABSTRACT: OBJECTIVES: To aid the development of treatment for cognitive impairment in bipolar disorder, the International Society for Bipolar Disorders (ISBD) convened a task force to create a consensus-based guidance paper for the methodology and design of cognition trials in bipolar disorder. METHODS: The task force was launched in September 2016, consisting of 18 international experts from nine countries. A series of methodological issues were identified based on literature review and expert opinion. The issues were discussed and expanded upon in an initial face-to-face meeting, telephone conference call and email exchanges. Based upon these exchanges, recommendations were achieved. RESULTS: Key methodological challenges are: lack of consensus on how to screen for entry into cognitive treatment trials, define cognitive impairment, track efficacy, assess functional implications, and manage mood symptoms and concomitant medication. Task force recommendations are to: (i) enrich trials with objectively measured cognitively impaired patients; (ii) generally select a broad cognitive composite score as the primary outcome and a functional measure as a key secondary outcome; and (iii) include remitted or partly remitted patients. It is strongly encouraged that trials exclude patients with current substance or alcohol use disorders, neurological disease or unstable medical illness, and keep non-study medications stable. Additional methodological considerations include neuroimaging assessments, targeting of treatments to illness stage and using a multimodal approach. CONCLUSIONS: This ISBD task force guidance paper provides the first consensus-based recommendations for cognition trials in bipolar disorder. Adherence to these recommendations will likely improve the sensitivity in detecting treatment efficacy in future trials and increase comparability between studies.

3 Guideline The Canadian Network for Mood and Anxiety Treatments (CANMAT) task force recommendations for the management of patients with mood disorders and comorbid attention-deficit/hyperactivity disorder. 2012

Bond, David J / Hadjipavlou, George / Lam, Raymond W / McIntyre, Roger S / Beaulieu, Serge / Schaffer, Ayal / Weiss, Margaret / Anonymous2330717. ·Mood Disorders Centre, University of British Columbia, Vancouver, British Columbia, Canada. davidjbond@hotmail.com ·Ann Clin Psychiatry · Pubmed #22303520.

ABSTRACT: BACKGROUND: Patients with bipolar disorder (BD) and major depressive disorder (MDD) experience adult attention-deficit/hyperactivity disorder (ADHD) at rates substantially greater than the general population. Nonetheless, ADHD frequently goes untreated in this population. METHODS: We reviewed the literature regarding the management of adult ADHD in patients with mood disorders. Because a limited number of studies have been conducted in adults, our treatment recommendations also are partly informed by research in children and adolescents with BD+ADHD or MDD+ADHD, adults with ADHD, and our clinical experience. RESULTS: In individuals with mood disorders, ADHD is best diagnosed when typical symptoms persist during periods of sustained euthymia. Individuals with BD+ADHD, particularly those with bipolar I disorder (BD I), are at risk for mood destabilization with many ADHD treatments, and should be prescribed mood-stabilizing medications before initiating ADHD therapies. Bupropion is a reasonable first-line treatment for BD+ADHD, while mixed amphetamine salts and methylphenidate also may be considered in patients determined to be at low risk for manic switch. Modafinil and cognitive-behavioral therapy (CBT) are second-line choices. In patients with MDD+ADHD and moderate to severe depression, MDD should be the treatment priority, whereas in mildly depressed or euthymic patients the order may be reversed. First-line treatments for MDD+ADHD include bupropion, an antidepressant plus a long-acting stimulant, or an antidepressant plus CBT. Desipramine, nortriptyline, and venlafaxine are second-line options. CONCLUSIONS: Clinicians should be vigilant in screening for comorbid ADHD in mood disorder patients. ADHD symptoms can respond to appropriately chosen treatments.

4 Editorial Editorial: Novel Approaches to the Neuropharmacology of Mood Disorders. 2019

Caruncho, Hector J / Kalynchuk, Lisa E / Loza, Maria I / Olivares, Jose M. ·Division of Medical Sciences, University of Victoria, Victoria, BC, Canada. · Department of Pharmacology, University of Santiago de Compostela, Santiago de Compostela, Spain. · Department of Psychiatry, Alvaro Cunqueiro Hospital, Vigo, Spain. ·Front Pharmacol · Pubmed #31156442.

ABSTRACT: -- No abstract --

5 Review Efficacy and safety of cariprazine in the treatment of bipolar disorder. 2019

Saraf, Gayatri / Pinto, Jairo Vinícius / Yatham, Lakshmi N. ·Department of Psychiatry, University of British Columbia, Vancouver, Canada. · Department of Psychiatry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil. ·Expert Opin Pharmacother · Pubmed #31644326.

ABSTRACT:

6 Review The chronotherapeutic treatment of bipolar disorders: A systematic review and practice recommendations from the ISBD task force on chronotherapy and chronobiology. 2019

Gottlieb, John F / Benedetti, Francesco / Geoffroy, Pierre A / Henriksen, Tone E G / Lam, Raymond W / Murray, Greg / Phelps, James / Sit, Dorothy / Swartz, Holly A / Crowe, Marie / Etain, Bruno / Frank, Ellen / Goel, Namni / Haarman, Bartholomeus C M / Inder, Maree / Kallestad, Håvard / Jae Kim, Seong / Martiny, Klaus / Meesters, Ybe / Porter, Richard / Riemersma-van der Lek, Rixt F / Ritter, Philipp S / Schulte, Peter F J / Scott, Jan / Wu, Joseph C / Yu, Xin / Chen, Shenghao. ·Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA. · Chicago Psychiatry Associates, Chicago, IL, USA. · Division of Neuroscience, Scientific Institute San Raffaele, Milano, Italy. · Department of Psychiatry and Addictive Medicine, University Hospital Bichat-Claude Bernard, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France. · Paris Diderot University - Paris VII, Paris, France. · Faculty of Medicine, Section for Psychiatry, Department of Clinical Medicine, University of Bergen, Bergen, Norway. · Faculty of Psychology, Bergen Stress and Sleep Group, University of Bergen, Bergen, Norway. · Valen Hospital, Fonna Health Authority, Division of Mental Health Care, Valen, Norway. · Department of Psychiatry, The University of British Columbia, Vancouver, BC, Canada. · Swinburne University of Technology, Hawthorn, VIC, Australia. · Samaritan Mental Health, Corvallis, OR, USA. · Asher Center for the Study and Treatment of Depressive Disorders, Northwestern University Feinberg School of Medicine, Chicago, IL, USA. · Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA. · Department of Psychological Medicine, University of Otago Christchurch, Christchurch, New Zealand. · Department of Psychological Medicine, Universite Paris Diderot UFR de Medecine, Paris, France. · Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA. · Department of Psychiatry Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA. · Department of Psychiatry Groningen, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands. · Faculty of Medicine and Health Sciences, Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway. · Division of Psychiatry, Department of Research and Development, St. Olavs University Hospital, Trondheim, Norway. · Department of Psychiatry, Doeun Hospital, Jincheon, Korea. · Department of Clinical Medicine, University of Copenhagen, Kobenhavns, Denmark. · Canterbury District Health Board, Christchurch, New Zealand. · Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universitatsklinikum Carl Gustav Carus, Dresden, Germany. · Mental Health Services Noord-Holland-Noord, Alkmaar, Netherlands. · Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK. · Department of Psychiatry & Human Behavior, University of California Irvine School of Medicine, Irvine, CA, USA. · Department of Public Mental Health, Peking University Institute of Mental Health, Beijing, China. ·Bipolar Disord · Pubmed #31609530.

ABSTRACT: AIMS: To systematically review the literature on the efficacy and tolerability of the major chronotherapeutic treatments of bipolar disorders (BD)-bright light therapy (LT), dark therapy (DT), treatments utilizing sleep deprivation (SD), melatonergic agonists (MA), interpersonal social rhythm therapy (IPSRT), and cognitive behavioral therapy adapted for BD (CBTI-BP)-and propose treatment recommendations based on a synthesis of the evidence. METHODS: PRISMA-based systematic review of the literature. RESULTS: The acute antidepressant (AD) efficacy of LT was supported by several open-label studies, three randomized controlled trials (RCTs), and one pseudorandomized controlled trial. SD showed rapid, acute AD response rates of 43.9%, 59.3%, and 59.4% in eight case series, 11 uncontrolled, studies, and one RCT, respectively. Adjunctive DT obtained significant, rapid anti-manic results in one RCT and one controlled study. The seven studies on MA yielded very limited data on acute antidepressant activity, conflicting evidence of both antimanic and maintenance efficacy, and support from two case series of improved sleep in both acute and euthymic states. IPSRT monotherapy for bipolar II depression had acute response rates of 41%, 67%, and 67.4% in two open studies and one RCT, respectively; as adjunctive therapy for bipolar depression in one RCT, and efficacy in reducing relapse in two RCTs. Among euthymic BD subjects with insomnia, a single RCT found CBTI-BP effective in delaying manic relapse and improving sleep. Chronotherapies were generally safe and well-tolerated. CONCLUSIONS: The outcome literature on the adjunctive use of chronotherapeutic treatments for BP is variable, with evidence bases that differ in size, study quality, level of evidence, and non-standardized treatment protocols. Evidence-informed practice recommendations are offered.

7 Review Affective cognition in bipolar disorder: A systematic review by the ISBD targeting cognition task force. 2019

Miskowiak, Kamilla W / Seeberg, Ida / Kjaerstad, Hanne L / Burdick, Katherine E / Martinez-Aran, Anabel / Del Mar Bonnin, Caterina / Bowie, Christopher R / Carvalho, Andre F / Gallagher, Peter / Hasler, Gregor / Lafer, Beny / López-Jaramillo, Carlos / Sumiyoshi, Tomiki / McIntyre, Roger S / Schaffer, Ayal / Porter, Richard J / Purdon, Scot / Torres, Ivan J / Yatham, Lakshmi N / Young, Allan H / Kessing, Lars V / Van Rheenen, Tamsyn E / Vieta, Eduard. ·Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark. · Department of Psychology, University of Copenhagen, Copenhagen, Denmark. · Department of Psychiatry, Brigham and Women's Hospital, Boston, MA, USA. · Department of Psychiatry, Harvard Medical School, Boston, MA, USA. · Clinical Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain. · Department of Psychology, Queen's University, Kingston, Canada. · Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada. · Department of Psychiatry, University of Toronto, Toronto, Canada. · Institute of Neuroscience, Newcastle University, Newcastle-upon-Tyne, UK. · Psychiatry Research Unit, University of Fribourg, Fribourg, Switzerland. · Bipolar Disorder Research Program, Departamento de Psiquiatria, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil. · Research Group in Psychiatry, Department of Psychiatry, Universidad de Antioquia, Medellín, Colombia. · Department of Clinical Epidemiology, Translational Medical Center, National Center of Neurology and Psychiatry, Tokyo, Japan. · Mood Disorders Psychopharmacology Unit Brain and Cognition Discovery Foundation, University of Toronto, Toronto, Canada. · Department of Psychological Medicine, University of Otago, Christchurch, New Zealand. · Department of Psychiatry, University of Alberta, Edmonton, Canada. · Department of Psychiatry, University of British Columbia, Vancouver, Canada. · Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK. · Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne, Carlton, Australia. · Centre for Mental Health, Faculty of Health, Arts and Design, Swinburne University, Australia. ·Bipolar Disord · Pubmed #31491048.

ABSTRACT: BACKGROUND: Impairments in affective cognition are part of the neurocognitive profile and possible treatment targets in bipolar disorder (BD), but the findings are heterogeneous. The International Society of Bipolar Disorder (ISBD) Targeting Cognition Task Force conducted a systematic review to (i) identify the most consistent findings in affective cognition in BD, and (ii) provide suggestions for affective cognitive domains for future study and meta-analyses. METHODS: The review included original studies reporting behavioral measures of affective cognition in BD patients vs controls following the procedures of the Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) statement. Searches were conducted on PubMed/MEDLINE, EMBASE, and PsychInfo from inception until November 2018. RESULTS: A total of 106 articles were included (of which nine included data for several affective domains); 41 studies assessed emotional face processing; 23 studies investigated reactivity to emotional words and images; 3 investigated explicit emotion regulation; 17 assessed implicit emotion regulation; 31 assessed reward processing and affective decision making. In general, findings were inconsistent. The most consistent findings were trait-related difficulties in facial emotion recognition and implicit emotion regulation, and impairments in reward processing and affective decision making during mood episodes. Studies using eye-tracking and facial emotion analysis revealed subtle trait-related abnormalities in emotional reactivity. CONCLUSION: The ISBD Task Force recommends facial expression recognition, implicit emotion regulation, and reward processing as domains for future research and meta-analyses. An important step to aid comparability between studies in the field would be to reach consensus on an affective cognition test battery for BD.

8 Review An International Society of Bipolar Disorders task force report: Precursors and prodromes of bipolar disorder. 2019

Faedda, Gianni L / Baldessarini, Ross J / Marangoni, Ciro / Bechdolf, Andreas / Berk, Michael / Birmaher, Boris / Conus, Philippe / DelBello, Melissa P / Duffy, Anne C / Hillegers, Manon H J / Pfennig, Andrea / Post, Robert M / Preisig, Martin / Ratheesh, Aswin / Salvatore, Paola / Tohen, Mauricio / Vázquez, Gustavo H / Vieta, Eduard / Yatham, Lakshmi N / Youngstrom, Eric A / Van Meter, Anna / Correll, Christoph U. ·Mood Disorders Center, New York, NY, USA. · International Consortium for Mood and Psychotic Disorders Research, McLean Hospital, Belmont, MA, USA. · Department of Psychiatry, Harvard Medical School, Mailman Research Center, McLean Hospital, Boston, MA, USA. · Department of Psychiatry-District 3, ULSS 9 Scaligera, Verona, Italy. · Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany. · Department of Psychiatry, Psychotherapy and Psychosomatics, Vivantes Hospital am Urban and Vivantes Hospital im Friedrichschain, Charite Universitätsmedizin, Berlin, Germany. · IMPACT Strategic Research Centre, University Hospital Geelong, Barwon Health, Deakin University, Geelong, VIC, Australia. · Orygen, The National Center of Excellence in Youth Mental Health, Parkville, VIC, Australia. · The Florey Institute for Neuroscience and Mental Health and the Department of Psychiatry, University of Melbourne, Melbourne, VIC, Australia. · Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA. · Treatment and Early Intervention in Psychosis Program (TIPP), Département de Psychiatrie CHUV, Université de Lausanne, Lausanne, Switzerland. · Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH, USA. · Department of Psychiatry, Student Wellness Services, Queen's University, Kingston, ON, Canada. · Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands. · Department of Child and Adolescent Psychiatry, Erasmus medical Center Rotterdam, Rotterdam, The Netherlands. · Department of Psychiatry and Psychotherapy, Carl Gustav Carus University Hospital, Technische Universität Dresden, Dresden, Germany. · Bipolar Collaborative Network, Bethesda, MD, USA. · Department of Psychiatry, George Washington University School of Medicine, Washington, DC, USA. · Department of Psychiatry, University Hospital of Lausanne, Lausanne, Switzerland. · Psychiatry Section, Department of Neuroscience, School of Medicine, University of Parma, Parma, Italy. · Department of Psychiatry & Behavioral Sciences, University of New Mexico Health Sciences Center, Albuquerque, NM, USA. · Psychiatry, Queen's University, Kingston, ON, Canada. · Bipolar Disorder Unit, Institute of Neuroscience, Hospital Clinic, IDIBAPS, CIBERSAM, University of Barcelona, Barcelona, Spain. · Department of Psychiatry, Mood Disorders Centre, University of British Columbia, Vancouver, BD, Canada. · Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. · Department of Psychiatry and Molecular Medicine, Hofstra Northwell School of Medicine, Hempstead, NY, USA. · The Zucker Hillside Hospital, Psychiatry Research, Northwell Health, Glen Oaks, NY, USA. · The Feinstein Institute for Medical Research, Center for Psychiatric Neuroscience, Manhasset, NY, USA. · Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany. ·Bipolar Disord · Pubmed #31479581.

ABSTRACT: OBJECTIVES: To clarify the clinical features preceding the onset of bipolar disorder (BD) has become a public health priority for the prevention of high morbidity and mortality. BD remains frequently under- or misdiagnosed, and under- or mistreated, often for years. METHODS: We assessed the predictive value of precursors and prodromes of BD. We assessed precursors of first-lifetime manic or hypomanic episodes with/without mixed features in retrospective and prospective studies. The task force evaluated and summarized separately assessments of familial risk, premorbid personality traits, retrospective, and prospective studies. RESULTS: Cyclothymic features, a family history of BD, retrospectively reported attenuated manic symptoms, prospectively identified subthreshold symptoms of hypomania, recurrence of depression, panic anxiety and psychotic features, have been identified as clinical precursors of BD. The prodromal symptoms like [hypo]mania often appears to be long enough to encourage early identification and timely intervention. CONCLUSIONS: The predictive value of any risk factor identified remains largely unknown. Prospective controlled studies are urgently needed for prevention and effective treatment.

9 Review Machine learning and big data analytics in bipolar disorder: A position paper from the International Society for Bipolar Disorders Big Data Task Force. 2019

Passos, Ives C / Ballester, Pedro L / Barros, Rodrigo C / Librenza-Garcia, Diego / Mwangi, Benson / Birmaher, Boris / Brietzke, Elisa / Hajek, Tomas / Lopez Jaramillo, Carlos / Mansur, Rodrigo B / Alda, Martin / Haarman, Bartholomeus C M / Isometsa, Erkki / Lam, Raymond W / McIntyre, Roger S / Minuzzi, Luciano / Kessing, Lars V / Yatham, Lakshmi N / Duffy, Anne / Kapczinski, Flavio. ·Laboratory of Molecular Psychiatry and Bipolar Disorder Program, Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil. · School of Technology, Pontifícia Universidade Católica do Rio Grande do Sul, Rio Grande do Sul, Brazil. · Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada. · Department of Psychiatry and Behavioral Sciences, UT Center of Excellence on Mood Disorders, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA. · Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA. · Department of Psychiatry, Queen's University School of Medicine, Kingston, ON, Canada. · Department of Psychiatry, Dalhousie University, Halifax, NS, Canada. · National Institute of Mental Health, Klecany, Czech Republic. · Research Group in Psychiatry, Department of Psychiatry, Faculty of Medicine, University of Antioquia, Medellín, Colombia. · Mood Disorders Program, Hospital Universitario San Vicente Fundación, Medellín, Colombia. · Mood Disorders Psychopharmacology Unit (MDPU), University Health Network, University of Toronto, Toronto, ON, Canada. · Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. · Department of Psychiatry, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland. · Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada. · Department of Psychiatry, University of Toronto, Toronto, ON, Canada. · Copenhagen Affective Disorder Research Center (CADIC), Psychiatric Center Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark. ·Bipolar Disord · Pubmed #31465619.

ABSTRACT: OBJECTIVES: The International Society for Bipolar Disorders Big Data Task Force assembled leading researchers in the field of bipolar disorder (BD), machine learning, and big data with extensive experience to evaluate the rationale of machine learning and big data analytics strategies for BD. METHOD: A task force was convened to examine and integrate findings from the scientific literature related to machine learning and big data based studies to clarify terminology and to describe challenges and potential applications in the field of BD. We also systematically searched PubMed, Embase, and Web of Science for articles published up to January 2019 that used machine learning in BD. RESULTS: The results suggested that big data analytics has the potential to provide risk calculators to aid in treatment decisions and predict clinical prognosis, including suicidality, for individual patients. This approach can advance diagnosis by enabling discovery of more relevant data-driven phenotypes, as well as by predicting transition to the disorder in high-risk unaffected subjects. We also discuss the most frequent challenges that big data analytics applications can face, such as heterogeneity, lack of external validation and replication of some studies, cost and non-stationary distribution of the data, and lack of appropriate funding. CONCLUSION: Machine learning-based studies, including atheoretical data-driven big data approaches, provide an opportunity to more accurately detect those who are at risk, parse-relevant phenotypes as well as inform treatment selection and prognosis. However, several methodological challenges need to be addressed in order to translate research findings to clinical settings.

10 Review The case for improved care and provision of treatment for people with first-episode mania. 2019

Jauhar, Sameer / Ratheesh, Aswin / Davey, Christopher / Yatham, Lakshmi N / McGorry, Patrick D / McGuire, Phillip / Berk, Michael / Young, Allan H. ·Department of Psychological Medicine, Psychology and Neuroscience, King's College London, London; Early intervention Pathway, Psychosis Clinical Academic Group, South London and Maudsley National Health Service Foundation Trust, London. Electronic address: sameer.jauhar@kcl.ac.uk. · Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia; Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, Australia. · Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia. · Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada. · Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London; Early intervention Pathway, Psychosis Clinical Academic Group, South London and Maudsley National Health Service Foundation Trust, London. · The Florey Institute for Neuroscience and Mental Health and the Department of Psychiatry, University of Melbourne, Parkville, VIC, Australia; IMPACT Strategic Research Centre, School of Medicine and Barwon Health, Deakin University, Geelong, VIC, Australia. · Department of Psychological Medicine, Psychology and Neuroscience, King's College London, London. ·Lancet Psychiatry · Pubmed #31248840.

ABSTRACT: The care of people with first-episode mania has been overlooked in comparison with the care of patients with other non-affective psychoses, despite evidence suggesting targeted treatments might be of benefit for this patient group. In this Personal View, we outline the general epidemiology of first-episode mania in the context of bipolar disorder, the natural history of mania (with an emphasis on its recurrent nature), current evidence for pharmacological, psychological, and service-level interventions, current guidelines for the treatment of first-episode mania, and provide a patient's point of view of the care pathway (appendix). We note the paucity of high-quality evidence for interventions in first-episode mania and the lack of agreement among treatment guidelines in relation to treatment, especially maintenance treatment. We suggest that, based on high morbidity and clinical need, research evidence to inform guideline development is necessary, and in the interim, clearer guidance on treatment and diagnosis should be given; specifically, we have suggested that patients should be cared for within a first-episode psychosis service, when such a service exists.

11 Review Childbirth and prevention of bipolar disorder: an opportunity for change. 2019

Sharma, Verinder / Bergink, Veerle / Berk, Michael / Chandra, Prabha S / Munk-Olsen, Trine / Viguera, Adele C / Yatham, Lakshmi N. ·Department of Psychiatry and Department of Obstetrics and Gynecology, Western University, London, ON, Canada; Parkwood Institute, London, ON, Canada. Electronic address: vsharma@uwo.ca. · Department of Psychiatry and Department of Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Psychiatry, Erasmus Medical Center, Rotterdam, Netherlands. · Innovation in Mental and Physical Health and Clinical Treatment Strategic Research Centre, School of Medicine, Deakin University, Geelong, VIC, Australia; Orygen, the National Centre of Excellence in Youth Mental Health, Florey Institute for Neuroscience and Mental Health, and the Department of Psychiatry, University of Melbourne, Parkville, VIC, Australia. · Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India. · National Centre for Register-based Research, Aarhus University, Aarhus, Denmark; Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark. · Cleveland Clinic, Cleveland, OH, USA; Massachusetts General Hospital, Boston, MA, USA. · Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada. ·Lancet Psychiatry · Pubmed #30981755.

ABSTRACT: The recent conceptualisation of bipolar disorder as a neuroprogressive illness has highlighted the potential importance of prevention and early intervention in high-risk populations. Undiagnosed bipolar disorder early in the disease course is associated with adverse clinical outcomes and impaired functioning for patients, which in turn has economic consequences. Despite the mounting evidence that childbirth is one of the most potent and specific triggers of manic symptoms, studies are not available on the effectiveness of targeted interventions in the prevention of bipolar disorder in women who have recently given birth. In this Personal View, we describe the clinical characteristics of women at risk of developing bipolar disorder after childbirth, before discussing opportunities for prevention and early intervention and outlining challenges in the assessment and management of women at risk of transitioning to bipolar disorder after childbirth. Existing evidence, although scarce, supports a clinical staging model by which at-risk women are managed with a variety of behavioural and pharmacological interventions aimed at preventing bipolar disorder. Close monitoring and early intervention might reduce the risk of hypomanic or manic symptoms in women at risk of developing bipolar disorder after childbirth; however, the potential benefits of early identification and intervention need to be carefully balanced against the additional risks for affected women.

12 Review ECT beyond unipolar major depression: systematic review and meta-analysis of electroconvulsive therapy in bipolar depression. 2019

Bahji, A / Hawken, E R / Sepehry, A A / Cabrera, C A / Vazquez, G. ·Department of Psychiatry, Providence Care Hospital, Queen's University, Kingston, ON, Canada. · Division of Neurology, University of British Columbia, Vancouver, BC, Canada. ·Acta Psychiatr Scand · Pubmed #30506992.

ABSTRACT: OBJECTIVE: In this systematic review and meta-analysis, the response, remission, and speed of response in adults with major depressive disorder (MDD) and bipolar disorder in depressive episode (BDD) receiving an acute course of electroconvulsive therapy (ECT) were quantitatively analyzed. METHODS: Using the Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines, 1660 citations were identified through five electronic databases. Nineteen articles met final inclusion criteria for meta-analysis. RESULTS: The pooled response and remission rates with ECT in MDD were 74.2% (n = 1246/1680) and 52.3% (n = 850/1626), respectively. In BDD, they were 77.1% (n = 437/567) and 52.3% (n = 275/377), respectively. Although response rates to ECT were statistically higher in BDD (OR = 0.73, 95% CI: 0.56-0.95, P = 0.02), remission rates were similar (OR = 0.91, 95% CI: 0.65-1.26, P = 0.56). Individuals with BDD vs. MDD required fewer number of ECT sessions to achieve response (SMD = -0.23, 95% CI: -0.44 to -0.023, P = 0.03). There were no significant moderator effects identified. CONCLUSION: Response rates and speed of response are higher in individuals with BDD; however, remission rates are equivalent. These findings support increased utilization of ECT in individuals with treatment-refractory BDD.

13 Review Assessing and addressing cognitive impairment in bipolar disorder: the International Society for Bipolar Disorders Targeting Cognition Task Force recommendations for clinicians. 2018

Miskowiak, K W / Burdick, K E / Martinez-Aran, A / Bonnin, C M / Bowie, C R / Carvalho, A F / Gallagher, P / Lafer, B / López-Jaramillo, C / Sumiyoshi, T / McIntyre, R S / Schaffer, A / Porter, R J / Purdon, S / Torres, I J / Yatham, L N / Young, A H / Kessing, L V / Vieta, E. ·Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark. · Deparment of Psychology, University of Copenhagen, Copenhagen, Denmark. · Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. · Clinical Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain. · Department of Psychology, Queen's University, Kingston, Canada. · Department of Clinical Medicine and Translational Psychiatry Research Group, Faculty of Medicine, Federal University of Ceará, Fortaleza, Brazil. · Institute of Neuroscience, Newcastle University, Newcastle-upon-Tyne, UK. · Bipolar Disorder Research Program, Departamento de Psiquiatria, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil. · Research Group in Psychiatry, Department of Psychiatry, Universidad de Antioquia, Medellín, Colombia. · Department of Clinical Epidemiology, Translational Medical Center, National Center of Neurology and Psychiatry, Tokyo, Japan. · Mood Disorders Psychopharmacology Unit Brain and Cognition Discovery Foundation, University of Toronto, Toronto, Canada. · Department of Psychiatry, University of Toronto, Toronto, Canada. · Department of Psychological Medicine, University of Otago, Christchurch, New Zealand. · Department of Psychiatry, University of Alberta, Edmonton, Canada. · Department of Psychiatry, University of British Columbia, Vancouver, Canada. · Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK. ·Bipolar Disord · Pubmed #29345040.

ABSTRACT: OBJECTIVES: Cognition is a new treatment target to aid functional recovery and enhance quality of life for patients with bipolar disorder. The International Society for Bipolar Disorders (ISBD) Targeting Cognition Task Force aimed to develop consensus-based clinical recommendations on whether, when and how to assess and address cognitive impairment. METHODS: The task force, consisting of 19 international experts from nine countries, discussed the challenges and recommendations in a face-to-face meeting, telephone conference call and email exchanges. Consensus-based recommendations were achieved through these exchanges with no need for formal consensus methods. RESULTS: The identified questions were: (I) Should cognitive screening assessments be routinely conducted in clinical settings? (II) What are the most feasible screening tools? (III) What are the implications if cognitive impairment is detected? (IV) What are the treatment perspectives? Key recommendations are that clinicians: (I) formally screen cognition in partially or fully remitted patients whenever possible, (II) use brief, easy-to-administer tools such as the Screen for Cognitive Impairment in Psychiatry and Cognitive Complaints in Bipolar Disorder Rating Assessment, and (III) evaluate the impact of medication and comorbidity, refer patients for comprehensive neuropsychological evaluation when clinically indicated, and encourage patients to build cognitive reserve. Regarding question (IV), there is limited evidence for current evidence-based treatments but intense research efforts are underway to identify new pharmacological and/or psychological cognition treatments. CONCLUSIONS: This task force paper provides the first consensus-based recommendations for clinicians on whether, when, and how to assess and address cognition, which may aid patients' functional recovery and improve their quality of life.

14 Review Allostatic load but not medical burden predicts memory performance in late-life bipolar disorder. 2018

Vaccarino, Sophie R / Rajji, Tarek K / Gildengers, Ariel G / Waters, Sarah E S / Butters, Meryl A / Menon, Mahesh / Blumberger, Daniel M / Voineskos, Aristotle N / Miranda, Dielle / Mulsant, Benoit H. ·Geriatric Psychiatry Division, Centre for Addiction and Mental Health, Toronto, Canada. · Department of Psychiatry, University of Toronto, Centre for Addiction and Mental Health, Toronto, Canada. · Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA. · Department of Psychiatry, University of British Columbia, Vancouver, Canada. · Centre for Addiction and Mental Health, Toronto, Canada. ·Int J Geriatr Psychiatry · Pubmed #29235143.

ABSTRACT: OBJECTIVE: Older patients with bipolar disorder (BD) present with variable degrees of cognitive impairment. Over time, stress, mood episodes, and comorbidities increase the body's allostatic load. We assessed the extent to which allostatic load vs more traditional measures of medical burden account for the heterogeneity in cognition in this population. METHODS: Thirty-five older euthymic patients with BD and 30 age-equated, gender-equated, and education-equated comparison participants were administered a comprehensive assessment including a neuropsychological battery, and 9 physiological measures to determine allostatic load. The relationship among allostatic load, medical burden, and cognition was assessed. RESULTS: Compared with the mentally healthy comparators, patients were impaired globally, and in 4 cognitive domains-information-processing speed / executive functioning, delayed memory, language, and visuomotor ability, and presented with greater medical burden but not a different allostatic load. Allostatic load, but not medical burden, was associated with delayed memory performance both in a correlational analysis and in a multivariate regression analysis. CONCLUSION: Euthymic older patients with BD are impaired on several cognitive domains and have high medical burden. Their memory performance is more strongly associated with allostatic load than with traditional measures of medical burden. These findings need to be replicated and extended longitudinally.

15 Review The World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for the Biological Treatment of Bipolar Disorders: Acute and long-term treatment of mixed states in bipolar disorder. 2018

Grunze, Heinz / Vieta, Eduard / Goodwin, Guy M / Bowden, Charles / Licht, Rasmus W / Azorin, Jean-Michel / Yatham, Lakshmi / Mosolov, Sergey / Möller, Hans-Jürgen / Kasper, Siegfried / Anonymous5450925. ·a Institute of Neuroscience , Newcastle University , Newcastle upon Tyne , UK. · b Paracelsus Medical University , Nuremberg , Germany. · c Zentrum für Psychiatrie Weinsberg , Klinikum am Weissenhof , Weinsberg , Germany. · d Bipolar Disorders Programme, Institute of Neuroscience , Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM , Barcelona , Catalonia , Spain. · e Department of Psychiatry , University of Oxford, Warneford Hospital , Oxford , UK. · f Dept. of Psychiatry , University of Texas Health Science Center , San Antonio , TX , USA. · g Psychiatric Research Unit, Psychiatry , Aalborg University Hospital , Aalborg , Denmark. · h Clinical Department of Medicine , Aalborg University , Aalborg , Denmark. · i Department of Psychiatry , Hospital Ste. Marguerite , Marseille , France. · j Department of Psychiatry , University of British Columbia , Vancouver , BC , Canada. · k Department for Therapy of Mental Disorders , Moscow Research Institute of Psychiatry , Moscow , Russia. · l Department of Psychiatry and Psychotherapy , Ludwigs-Maximilian University , Munich , Germany. · m Department of Psychiatry and Psychotherapy , Medical University of Vienna , Vienna , Austria. ·World J Biol Psychiatry · Pubmed #29098925.

ABSTRACT: OBJECTIVES: Although clinically highly relevant, the recognition and treatment of bipolar mixed states has played only an underpart in recent guidelines. This WFSBP guideline has been developed to supply a systematic overview of all scientific evidence pertaining to the acute and long-term treatment of bipolar mixed states in adults. METHODS: Material used for these guidelines is based on a systematic literature search using various data bases. Their scientific rigour was categorised into six levels of evidence (A-F), and different grades of recommendation to ensure practicability were assigned. We examined data pertaining to the acute treatment of manic and depressive symptoms in bipolar mixed patients, as well as data pertaining to the prevention of mixed recurrences after an index episode of any type, or recurrence of any type after a mixed index episode. RESULTS: Manic symptoms in bipolar mixed states appeared responsive to treatment with several atypical antipsychotics, the best evidence resting with olanzapine. For depressive symptoms, addition of ziprasidone to treatment as usual may be beneficial; however, the evidence base is much more limited than for the treatment of manic symptoms. Besides olanzapine and quetiapine, valproate and lithium should also be considered for recurrence prevention. LIMITATIONS: The concept of mixed states changed over time, and recently became much more comprehensive with the release of DSM-5. As a consequence, studies in bipolar mixed patients targeted slightly different bipolar subpopulations. In addition, trial designs in acute and maintenance treatment also advanced in recent years in response to regulatory demands. CONCLUSIONS: Current treatment recommendations are still based on limited evidence, and there is a clear demand for confirmative studies adopting the DSM-5 specifier with mixed features concept.

16 Review Revisiting the wandering womb: Oxytocin in endometriosis and bipolar disorder. 2017

Dinsdale, Natalie L / Crespi, Bernard J. ·Department of Biological Sciences, Simon Fraser University, 8888 University Drive, Burnaby V5A 1S6, BC, Canada; Department of Psychology, 9 Campus Drive, 154 Arts, University of Saskatchewan, Saskatoon S7N 5A5, SK, Canada. Electronic address: natalie_dinsdale@sfu.ca. · Department of Biological Sciences, Simon Fraser University, 8888 University Drive, Burnaby V5A 1S6, BC, Canada. Electronic address: crespi@sfu.ca. ·Horm Behav · Pubmed #28919554.

ABSTRACT: Hippocrates attributed women's high emotionality - hysteria - to a 'wandering womb'. Although hysteria diagnoses were abandoned along with the notion that displaced wombs cause emotional disturbance, recent research suggests that elevated levels of oxytocin occur in both bipolar disorder and endometriosis, a gynecological condition involving migration of endometrial tissue beyond the uterus. We propose and evaluate the hypothesis that elevated oxytocinergic system activity jointly contributes to bipolar disorder and endometriosis. First, we provide relevant background on endometriosis and bipolar disorder, and then we examine evidence for comorbidity between these conditions. We next: (1) review oxytocin's associations with personality traits, especially extraversion and openness, and how they overlap with bipolar spectrum traits; (2) describe evidence for higher oxytocinergic activity in both endometriosis and bipolar disorder; (3) examine altered hypothalamic-pituitary-gonadal axis functioning in both conditions; (4) describe data showing that medications that treat one condition can improve symptoms of the other; (5) discuss fitness-related impacts of endometriosis and bipolar disorder; and (6) review a pair of conditions, polycystic ovary syndrome and autism, that show evidence of involving reduced oxytocinergic activity, in direct contrast to endometriosis and bipolar disorder. Considered together, the bipolar spectrum and endometriosis appear to involve dysregulated high extremes of normally adaptive pleiotropy in the female oxytocin system, whereby elevated levels of oxytocinergic activity coordinate outgoing sociality with heightened fertility, apparently characterizing, overall, a faster life history. These findings should prompt a re-examination of how mind-body interactions, and the pleiotropic endocrine systems that underlie them, contribute to health and disease.

17 Review Online and mobile technologies for self-management in bipolar disorder: A systematic review. 2017

Gliddon, Emma / Barnes, Steven J / Murray, Greg / Michalak, Erin E. ·IMPACT Strategic Research Centre, Deakin University. · Department of Psychology, University of British Columbia. · Faculty of Health, Arts and Design, Swinburne University. · Department of Psychiatry, University of British Columbia. ·Psychiatr Rehabil J · Pubmed #28594196.

ABSTRACT: OBJECTIVE: Internet (eHealth) and smartphone-based (mHealth) approaches to self-management for bipolar disorder are increasingly common. Evidence-based self-management strategies are available for bipolar disorder and provide a useful framework for reviewing existing eHealth/mHealth programs to determine whether these strategies are supported by current technologies. This review assesses which self-management strategies are most supported by technology. METHOD: Based on 3 previous studies, 7 categories of self-management strategies related to bipolar disorder were identified, followed by a systematic literature review to identify existing eHealth and mHealth programs for this disorder. Searches were conducted by using PubMed, CINAHL, PsycINFO, EMBASE, and the Cochrane Database of Systematic Reviews for relevant peer-reviewed articles published January 2005 to May 2015. eHealth and mHealth programs were summarized and reviewed to identify which of the 7 self-management strategy categories were supported by eHealth or mHealth programs. RESULTS: From 1,654 publications, 15 papers were identified for inclusion. From these, 9 eHealth programs and 2 mHealth programs were identified. The most commonly supported self-management strategy categories were "ongoing monitoring," "maintaining hope," "education," and "planning for and taking action"; the least commonly supported categories were "relaxation" and "maintaining a healthy lifestyle." eHealth programs appear to provide more comprehensive coverage of self-management strategies compared with mHealth programs. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: Both eHealth and mHealth programs present a wide range of self-management strategies for bipolar disorder, although individuals seeking comprehensive interventions might be best served by eHealth programs, while those seeking more condensed and direct interventions might prefer mHealth programs. (PsycINFO Database Record

18 Review Dopaminergic agents in the treatment of bipolar depression: a systematic review and meta-analysis. 2017

Szmulewicz, A G / Angriman, F / Samamé, C / Ferraris, A / Vigo, D / Strejilevich, S A. ·Hospital de Emergencias Psiquiátricas Torcuato de Alvear, Buenos Aires, Argentina. · Bipolar Disorder Program, Neuroscience Institute, Favaloro University, Buenos Aires, Argentina. · Pharmacology Department, University of Buenos Aires School of Medicine, Buenos Aires, Argentina. · Internal Medicine Department, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina. · National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina. · Global Health Systems Cluster, Harvard TH Chan School of Public Health, Boston, MA, USA. · International Consortium for Bipolar Disorder Research, Mc Lean Hospital, Belmont, MA, USA. · Center for Applied Research in Mental Health and Addictions, Simon Fraser University, Vancouver, Canada. · Institute of Cognitive Neurology (INECO), Buenos Aires, Argentina. ·Acta Psychiatr Scand · Pubmed #28256707.

ABSTRACT: OBJECTIVE: To systematically examine the effects of dopaminergic agents (modafinil, armodafinil, pramipexole, methylphenidate, and amphetamines) on bipolar depression outcomes. METHODS: Meta-analysis of randomized controlled trials was performed to assess the efficacy and safety of treatment with dopaminergic agents in bipolar depression. In a secondary analysis, findings from both randomized controlled trials and high-quality observational studies were pooled by means of meta-analytic procedures to explore dopaminergic treatment-related new mania. RESULTS: Nine studies (1716 patients) were included in our meta-analysis of randomized controlled trials. Treatment with dopaminergic agents for bipolar depression was associated with an increase in both response (1671 individuals, RR 1.25, 95% CI 1.05 to 1.50) and remission rates (1671 individuals, RR 1.40, 95% CI 1.14, 1.71). There was no evidence of an increased risk of mood switch associated with this treatment (1646 individuals, RR 0.96, 95% CI 0.49, 1.89). Our secondary analysis (1231 individuals) yielded a cumulative incidence of mood switch of 3% (95% CI 1.0, 5.0) during a mean follow-up period of 7.5 months. CONCLUSIONS: Preliminary findings suggest that dopaminergic agents may represent a useful alternative for the treatment of bipolar depression, with no evidence for a related increase in the risk of mood destabilization during short-term follow-up.

19 Review What does quality of life refer to in bipolar disorders research? A systematic review of the construct's definition, usage and measurement. 2017

Morton, Emma / Michalak, Erin E / Murray, Greg. ·Swinburne University of Technology, Psychological Sciences and Statistics, Australia. · University of British Columbia, Department of Psychiatry, Canada. · Swinburne University of Technology, Psychological Sciences and Statistics, Australia. Electronic address: gwmurray@swin.edu.au. ·J Affect Disord · Pubmed #28160685.

ABSTRACT: BACKGROUND: Quality of life (QoL) is increasingly investigated in bipolar disorders (BD) research, yet little attention has been paid to its optimal definition and measurement. This is a significant limitation, as the broader QoL literature recognises a number of divergent meanings and measurement tensions. The aim here was to advance understanding of QoL in BD by clarifying use of the construct in the existing literature and considering measurement implications. METHODS: Thematic analysis techniques were used to interrogate articles identified via systematic search for (a) explicit discussion of QoL definitional/measurement issues, and (b) usage of the term QoL. RESULTS: A total of 275 articles were included in the analysis. A range of definitional and methodological issues confounding the study of QoL in BD were identified. While explicit definition of QoL proved rare, thematic analysis of usage of the construct revealed the concepts of functioning, health, subjective experience and wellbeing were thought to be relevant to QoL in BD. LIMITATIONS: The review does not engage in top-down theory development. Our analysis was grounded in the empirical literature to support future theoretical work relevant to existing usage of QoL in BD. CONCLUSIONS: There was no evidence of a consensus definition of QoL in BD. A plurality of QoL definitions is not necessarily a flaw in the literature, but points to empirical and conceptual issues demanding attention. Awareness of the diversity of constructs associated with QoL will enable clinicians to better select treatments on the basis of specific QoL outcomes. A research agenda and provisional considerations for empirical research are outlined based on the present analyses.

20 Review Towards recovery-oriented psychosocial interventions for bipolar disorder: Quality of life outcomes, stage-sensitive treatments, and mindfulness mechanisms. 2017

Murray, Greg / Leitan, Nuwan D / Thomas, Neil / Michalak, Erin E / Johnson, Sheri L / Jones, Steven / Perich, Tania / Berk, Lesley / Berk, Michael. ·Psychological Science, Swinburne University of Technology, Australia. Electronic address: gwm@swin.edu.au. · Psychological Science, Swinburne University of Technology, Australia. · Department of Psychiatry, University of British Columbia, Canada. · Department of Psychology, University of California, Berkeley, United States. · Spectrum Centre, Lancaster University, United Kingdom. · Psychology, University of Western Sydney, Australia. · School of Medicine, Deakin University, Australia. ·Clin Psychol Rev · Pubmed #28129636.

ABSTRACT: Current adjunctive psychosocial interventions for bipolar disorder (BD) aim to impact illness course via information sharing/skill development. This focus on clinical outcomes contrasts with the emergent recovery paradigm, which prioritises adaptation to serious mental illness and movement towards personally meaningful goals. The aim of this review is to encourage innovation in the psychological management of BD by considering three recovery-oriented trends in the literature. First, the importance of quality of life as a target of recovery-oriented clinical work is considered. Second, the recent staging approach to BD is described, and we outline implications for psychosocial interventions tailored to stage. Finally, we review evidence suggesting that mindfulness-based psychosocial interventions have potential across early, middle and late stages of BD. It is concluded that the humanistic emphasis of the recovery paradigm provides a timely stimulus for development of a next generation of psychosocial treatments for people with BD.

21 Review The International College of Neuro-Psychopharmacology (CINP) Treatment Guidelines for Bipolar Disorder in Adults (CINP-BD-2017), Part 3: The Clinical Guidelines. 2017

Fountoulakis, Konstantinos N / Grunze, Heinz / Vieta, Eduard / Young, Allan / Yatham, Lakshmi / Blier, Pierre / Kasper, Siegfried / Moeller, Hans Jurgen. ·3rd Department of Psychiatry, School of Medicine, Aristotle University, Thessaloniki, Greece; Paracelsus Medical University, Salzburg, Austria; Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain; Centre for Affective Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; Department of Psychiatry, University of British Columbia, Mood Disorders Centre of Excellence, Djavad Mowafaghian Centre for Brain Health, Vancouver, Canada; The Royal Institute of Mental Health Research, Department of Psychiatry, University of Ottawa, Ottawa, Canada; Department of Psychiatry and Psychotherapy, Medical University Vienna, MUV, AKH, Vienna, Austria; Psychiatric Department, Ludwig Maximilians University, Munich, Germany. ·Int J Neuropsychopharmacol · Pubmed #27941079.

ABSTRACT: Background: The current paper introduces the actual International College of Neuro-Psychopharmacology clinical guidelines for the treatment of bipolar disorder. Concept and structure of the guidelines: The current clinical guidelines are based on evidence-based data, but they also intend to be clinically useful, while a rigid algorithm was developed on the basis of firm evidence alone. Monotherapy was prioritized over combination therapy. There are separate recommendations for each of the major phases of bipolar disorder expressed as a 5-step algorithm. Discussion: The current International College of Neuro-Psychopharmacology clinical guidelines for the treatment of bipolar disorder are the most up-to-date guidance and are as evidence based as possible. They also include recommendations concerning the use of psychotherapeutic interventions, again on the basis of available evidence. This adherence of the workgroup to the evidence in a clinically oriented way helped to clarify the role of specific antidepressants and traditional agents like lithium, valproate, or carbamazepine. The additional focus on specific clinical characteristics, including predominant polarity, mixed features, and rapid cycling, is also a novel approach. Many issues need further studies, data are sparse and insufficient, and many questions remain unanswered. The most important and still unmet need is to merge all the guidelines that concern different phases of the illness into a single one and in this way consider BD as a single unified disorder, which is the real world fact. However, to date the research data do not permit such a unified approach.

22 Review Research Domain Criteria versus DSM V: How does this debate affect attempts to model corticostriatal dysfunction in animals? 2017

Young, Jared W / Winstanley, Catharine A / Brady, Anne Marie / Hall, Frank Scott. ·Department of Psychiatry, University of California San Diego, 9500 Gilman Dr., MC 0804, La Jolla, CA 92093, USA; Research Service, VA San Diego Healthcare System, San Diego, CA, USA. Electronic address: jaredyoung@ucsd.edu. · Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2215 Wesbrook Mall, Vancouver, British Columbia V6T 1Z3, Canada. · Department of Psychology and Neuroscience Program, St. Mary's College of Maryland, 18952 E. Fisher Rd., St. Mary's City, MD 20686, USA. · Department of Pharmacology and Experimental Therapeutics, University of Toledo College of Pharmacy and Pharmaceutical Sciences, 300 Arlington Ave., MS 1015, University of Toledo, Toledo, OH 43614, USA. ·Neurosci Biobehav Rev · Pubmed #27826070.

ABSTRACT: For decades, the nosology of mental illness has been based largely upon the descriptions in the Diagnostic and Statistical Manual of the American Psychiatric Association (DSM). A recent challenge to the DSM approach to psychiatric nosology from the National Institute on Mental Health (USA) defines Research Domain Criteria (RDoC) as an alternative. For RDoC, psychiatric illnesses are not defined as discrete categories, but instead as specific behavioral dysfunctions irrespective of DSM diagnostic categories. This approach was driven by two primary weaknesses noted in the DSM: (1) the same symptoms occur in very different disease states; and (2) DSM criteria lack grounding in the underlying biological causes of mental illness. RDoC intends to ground psychiatric nosology in those underlying mechanisms. This review addresses the suitability of RDoC vs. DSM from the view of modeling mental illness in animals. A consideration of all types of psychiatric dysfunction is beyond the scope of this review, which will focus on models of conditions associated with frontostriatal dysfunction.

23 Review The International College of Neuro-Psychopharmacology (CINP) Treatment Guidelines for Bipolar Disorder in Adults (CINP-BD-2017), Part 2: Review, Grading of the Evidence, and a Precise Algorithm. 2017

Fountoulakis, Konstantinos N / Yatham, Lakshmi / Grunze, Heinz / Vieta, Eduard / Young, Allan / Blier, Pierre / Kasper, Siegfried / Moeller, Hans Jurgen. ·3rd Department of Psychiatry, School of Medicine, Aristotle University, Thessaloniki, Greece; Department of Psychiatry, University of British Columbia, Mood Disorders Centre of Excellence, Djavad Mowafaghian Centre for Brain Health, Canada; Paracelsus Medical University, Salzburg, Austria; Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain; Centre for Affective Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, United Kingdom; The Royal Institute of Mental Health Research, Department of Psychiatry, University of Ottawa, Ottawa, Canada; Department of Psychiatry and Psychotherapy, Medical University Vienna, MUV, AKH, Vienna, Austria; Psychiatric Department Ludwig Maximilians University, Munich, Germany. ·Int J Neuropsychopharmacol · Pubmed #27816941.

ABSTRACT: Background: The current paper includes a systematic search of the literature, a detailed presentation of the results, and a grading of treatment options in terms of efficacy and tolerability/safety. Material and Methods: The PRISMA method was used in the literature search with the combination of the words 'bipolar,' 'manic,' 'mania,' 'manic depression,' and 'manic depressive' with 'randomized,' and 'algorithms' with 'mania,' 'manic,' 'bipolar,' 'manic-depressive,' or 'manic depression.' Relevant web pages and review articles were also reviewed. Results: The current report is based on the analysis of 57 guideline papers and 531 published papers related to RCTs, reviews, posthoc, or meta-analysis papers to March 25, 2016. The specific treatment options for acute mania, mixed episodes, acute bipolar depression, maintenance phase, psychotic and mixed features, anxiety, and rapid cycling were evaluated with regards to efficacy. Existing treatment guidelines were also reviewed. Finally, Tables reflecting efficacy and recommendation levels were created that led to the development of a precise algorithm that still has to prove its feasibility in everyday clinical practice. Conclusions: A systematic literature search was conducted on the pharmacological treatment of bipolar disorder to identify all relevant random controlled trials pertaining to all aspects of bipolar disorder and graded the data according to a predetermined method to develop a precise treatment algorithm for management of various phases of bipolar disorder. It is important to note that the some of the recommendations in the treatment algorithm were based on the secondary outcome data from posthoc analyses.

24 Review The International College of Neuropsychopharmacology (CINP) Treatment Guidelines for Bipolar Disorder in Adults (CINP-BD-2017), Part 1: Background and Methods of the Development of Guidelines. 2017

Fountoulakis, Konstantinos N / Young, Allan / Yatham, Lakshmi / Grunze, Heinz / Vieta, Eduard / Blier, Pierre / Moeller, Hans Jurgen / Kasper, Siegfried. ·3rd Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece; Centre for Affective Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, UK; Department of Psychiatry, University of British Columbia, Mood Disorders Centre of Excellence, Djavad Mowafaghian Centre for Brain Health, Vancouver, Canada; Paracelsus Medical University, Salzburg, Austria; Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain; The Royal Institute of Mental Health Research, Department of Psychiatry, University of Ottawa, Ottawa, Canada; Psychiatric Department, Ludwig Maximilians University, Munich, Germany; Department of Psychiatry and Psychotherapy, Medical University Vienna, MUV, AKH, Vienna, Austria. ·Int J Neuropsychopharmacol · Pubmed #27815414.

ABSTRACT: Background: This paper includes a short description of the important clinical aspects of Bipolar Disorder with emphasis on issues that are important for the therapeutic considerations, including mixed and psychotic features, predominant polarity, and rapid cycling as well as comorbidity. Methods: The workgroup performed a review and critical analysis of the literature concerning grading methods and methods for the development of guidelines. Results: The workgroup arrived at a consensus to base the development of the guideline on randomized controlled trials and related meta-analyses alone in order to follow a strict evidence-based approach. A critical analysis of the existing methods for the grading of treatment options was followed by the development of a new grading method to arrive at efficacy and recommendation levels after the analysis of 32 distinct scenarios of available data for a given treatment option. Conclusion: The current paper reports details on the design, method, and process for the development of CINP guidelines for the treatment of Bipolar Disorder. The rationale and the method with which all data and opinions are combined in order to produce an evidence-based operationalized but also user-friendly guideline and a specific algorithm are described in detail in this paper.

25 Review The International College of Neuropsychopharmacology (CINP) Treatment Guidelines for Bipolar Disorder in Adults (CINP-BD-2017), Part 4: Unmet Needs in the Treatment of Bipolar Disorder and Recommendations for Future Research. 2017

Fountoulakis, Konstantinos N / Vieta, Eduard / Young, Allan / Yatham, Lakshmi / Grunze, Heinz / Blier, Pierre / Moeller, Hans Jurgen / Kasper, Siegfried. ·3rd Department of Psychiatry, School of Medicine Aristotle University of Thessaloniki Greece; Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain; Centre for Affective Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, United Kingdom; Department of Psychiatry, University of British Columbia, Mood Disorders Centre of Excellence, Djavad Mowafaghian Centre for Brain Health, Vancouver, Canada; Paracelsus Medical University, Salzburg, Austria; The Royal Institute of Mental Health Research, Department of Psychiatry, University of Ottawa, Ottawa, Canada; Psychiatric Department Ludwig Maximilians University, Munich, Germany; Department of Psychiatry and Psychotherapy, Medical University Vienna, Vienna, Austria. ·Int J Neuropsychopharmacol · Pubmed #27677983.

ABSTRACT: Background: The current fourth paper on the International College of Neuropsychopharmacology guidelines for the treatment of bipolar disorder reports on the unmet needs that became apparent after an extensive review of the literature and also serves as a conclusion to the project of the International College of Neuropsychopharmacology workgroup. Materials and Methods: The systematic review of the literature that was performed to develop the International College of Neuropsychopharmacology guidelines for bipolar disorder identified and classified a number of potential shortcomings. Results: Problems identified concerned the reliability and validity of the diagnosis of bipolar disorder and especially of bipolar depression. This, in turn, has profound consequences for early detection and correct treatment of the disorder. Another area that needs improvement is the unsatisfactory efficacy and effectiveness of therapeutic options, especially in special populations such as those with mixed features and rapid cycling course. Gender issues and adherence problems constitute an additional challenge. The literature suggests that while treatment providers are concerned more with treatment-related issues, patients and their caregivers worry more about issues pertaining to the availability of services and care, quality of life, and various types of burden. The workgroup identified additional unmet needs related to the current standard of research in bipolar disorder. These include the fragmentation of bipolar disorder into phases that are handled as being almost absolutely independent from each other, and thus the development of an overall therapeutic strategy on the basis of the existing evidence is very difficult. Trials are not always designed in a way that outcomes cover the most important aspects of bipolar disorder, and often the reporting of the results is biased and unsatisfactory. The data on combination treatments and high dosages are sparse, whereas they are common in real world practice. Conclusions: The workgroup endorses the full release of raw study data to the scientific community, and the development of uniform clinical trial standards (also including more realistic outcomes) and the reporting of results. The 2 large appendices summarize the results of this systematic review with regard to the areas of lack of knowledge where further focused research is necessary.

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