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Schizophrenia Research Jul 2017Historically, formal thought disorder has been considered as one of the distinctive symptoms of schizophrenia. However, research in last few decades suggested that there... (Meta-Analysis)
Meta-Analysis Review
Historically, formal thought disorder has been considered as one of the distinctive symptoms of schizophrenia. However, research in last few decades suggested that there is a considerable clinical and neurobiological overlap between schizophrenia and bipolar disorder (BP). We conducted a meta-analysis of studies comparing positive (PTD) and negative formal thought disorder (NTD) in schizophrenia and BP. We included 19 studies comparing 715 schizophrenia and 474 BP patients. In the acute inpatient samples, there was no significant difference in the severity of PTD (d=-0.07, CI=-0.22-0.09) between schizophrenia and BP. In stable patients, schizophrenia was associated with increased PTD compared to BP (d=1.02, CI=0.35-1.70). NTD was significantly more severe (d=0.80, CI=0.52-0.1.08) in schizophrenia compared to BP. Our findings suggest that PTD is a shared feature of both schizophrenia and BP but persistent PTD or NTD can distinguish subgroups of schizophrenia from BP and schizophrenia patients with better clinical outcomes.
Topics: Bipolar Disorder; Humans; Schizophrenia; Schizophrenic Psychology; Thinking
PubMed: 28017494
DOI: 10.1016/j.schres.2016.12.015 -
Scandinavian Journal of Pain Apr 2016Psychiatric disorders, e.g., depression, are often comorbid with, and can complicate the treatment of, patients with migraine headache. Although empirical work has... (Review)
Review
BACKGROUND AND AIMS
Psychiatric disorders, e.g., depression, are often comorbid with, and can complicate the treatment of, patients with migraine headache. Although empirical work has increasingly focused on the association between migraine and bipolar disorder, this topic has received little attention in the pain literature. Bipolar disorder is a chronic and recurrent mood disorder characterized by cyclic occurrence of elevated (i.e., manic or hypomanic) and depressed mood states. Bipolar I disorder is diagnosed when patients present with at least one abnormally and persistently elevated manic episode; bipolar II disorder is characterized by the presence of hypomanic episodes. Bipolar disorder warrants attention as depressive phases of the disorder can prevail and are often misconstrued by the unwary clinician as unipolar depression. However, treatment for bipolar disorder is distinct from that of unipolar depression and use of antidepressants, which are often invoked in migraine prophylaxis as well as the treatment of depression, may precipitate significant mood changes among bipolar disorder patients. A systematic review of the literature addressing the co-occurrence of bipolar disorder and migraine was conducted. The treatment of dually affected patients is also discussed.
METHODS
In order to review the literature to date on migraine and bipolar disorder co-occurrence, a comprehensive search of MEDLINE, EMBASE, PubMed, PsycINFO, Web of Science, and CINAHL for clinic-based and epidemiological studies was conducted using terms related to migraine and bipolar disorder. Studies were selected for review if they included subjects meeting validated diagnostic criteria for bipolar disorder as well as migraine headache and if a quantitative description of prevalence rates of comorbid bipolar disorder and migraine were reported. Weighted means of the prevalence rates were calculated to compare with general epidemiological prevalence trends for migraine and bipolar disorder, respectively.
RESULTS
Eleven studies met inclusion criteria. Although findings were constrained by methodological limitations and several low quality studies, clinic- and epidemiological cross-sectional investigations demonstrated a high rate of comorbidity between bipolar disorder and migraine. The weighted mean prevalence rate for migraine headache among bipolar disorder patients was 30.7%; for bipolar disorder among migraineurs, the weighted mean prevalence rates were 9% and 5.9% in clinic-based and epidemiological studies, respectively. The association between bipolar disorder and migraine was most notable among women and patients with the bipolar II disorder subtype.
CONCLUSIONS
High rates of comorbidity exist between migraine and bipolar disorder, exceeding estimated prevalence rates for those conditions in the general population. Comorbidity may portend a more serious clinical course for dually afflicted individuals.
IMPLICATIONS
Clinicians need to structure treatment approaches to address concurrent migraine and bipolar disorder in dually afflicted individuals. Although further evidence-based investigation is warranted to inform optimal treatment approaches for both conditions concurrently, anticonvulsants (e.g., valproate, lamotrigine and topiramate); atypical antipsychotics (e.g., olanzapine or quetiapine); and calcium channel blockers (e.g., verapamil) may be considered.
Topics: Antidepressive Agents; Bipolar Disorder; Comorbidity; Cross-Sectional Studies; Female; Humans; Migraine Disorders
PubMed: 28850455
DOI: 10.1016/j.sjpain.2015.12.002 -
Brain and Behavior Oct 2022Bipolar (BP) disorder is a highly morbid disorder that is often misdiagnosed or undiagnosed and affects a large number of adults and children. Due to the coronavirus... (Review)
Review
OBJECTIVE
Bipolar (BP) disorder is a highly morbid disorder that is often misdiagnosed or undiagnosed and affects a large number of adults and children. Due to the coronavirus disease 2019 public health emergency stay at home orders, most outpatient mental health care was provided via telepsychiatry, and the many benefits of virtual care ensure that this will continue as an ongoing practice. The main aim of this review was to investigate what is currently known about the use of telepsychiatry services in the diagnosis and treatment of BP disorder across the lifespan.
METHOD
A systematic literature review assessing the use of telepsychiatry in BP disorder was conducted in PubMed, PsychINFO, and Medline.
RESULTS
Six articles were included in the final review. All included articles assessed populations aged 17 years or older. The literature indicates that BP disorder was addressed in telepsychiatry services at a similar rate as in-person services, reliable diagnoses can be made using remote interviews, satisfaction rates are comparable to in-person services, telepsychiatry services are able to reach and impact patients with BP disorder, are sustainable, and patient outcomes can improve using a telepsychiatry intervention.
CONCLUSIONS
Given the morbidity of BP disorder, the research addressing the telepsychiatry diagnosis and treatment of BP disorder is sparse, with only emerging evidence of its reliability, effectiveness, and acceptance. There is no research assessing the safety and efficacy of telepsychiatry in pediatric populations with BP disorder. Given the morbidity associated with BP disorder at any age, further research is needed to determine how to safely and effectively incorporate telepsychiatry into clinical care for BP adult and pediatric patients.
Topics: Adult; Bipolar Disorder; COVID-19; Child; Humans; Psychiatry; Reproducibility of Results; Telemedicine
PubMed: 36102239
DOI: 10.1002/brb3.2743 -
Psychological Medicine Dec 2023People with bipolar disorder (BD) often present emotion dysregulation (ED), a pattern of emotional expression interfering with goal-directed behavior. ED is a... (Meta-Analysis)
Meta-Analysis Review
People with bipolar disorder (BD) often present emotion dysregulation (ED), a pattern of emotional expression interfering with goal-directed behavior. ED is a transdiagnostic construct, and it is unclear whether it manifests itself similarly in other conditions, such as major depressive disorder (MDD) or borderline personality disorder (BPD), or has specific features in BD. The present systematic review and meta-analysis explored ED and adopted emotion regulation (ER) strategies in BD compared with other psychiatric conditions. PubMed/MEDLINE, EMBASE, Scopus, and PsycINFO databases were systematically searched from inception to April 28th, 2022. Studies implementing validated instruments assessing ED or ER strategies in BD and other psychiatric disorders were reviewed, and meta-analyses were conducted. Twenty-nine studies yielding multiple comparisons were included. BD was compared to MDD in 20 studies ( = 2451), to BPD in six studies ( = 1001), to attention deficit hyperactivity disorder in three studies ( = 232), to anxiety disorders in two studies ( = 320), to schizophrenia in one study ( = 223), and to post-traumatic stress disorder in one study ( = 31). BD patients did not differ from MDD patients in adopting most adaptive and maladaptive ER strategies. However, small-to-moderate differences in positive rumination and risk-taking behaviors were observed. In contrast, patients with BPD presented an overall higher degree of ED and more maladaptive ER strategies. There were insufficient data for a meta-analytic comparison with other psychiatric disorders. The present report further supports the idea that ED is a transdiagnostic construct spanning a continuum across different psychiatric disorders, outlining specific clinical features that could represent potential therapeutic targets.
Topics: Humans; Bipolar Disorder; Depressive Disorder, Major; Emotional Regulation; Attention Deficit Disorder with Hyperactivity; Borderline Personality Disorder; Emotions
PubMed: 37842774
DOI: 10.1017/S003329172300243X -
Acta Psychiatrica Scandinavica Aug 2023A growing body of evidence suggests that pediatric bipolar disorder (PBD) frequently co-occurs with comorbid psychiatric disorders that may impact functioning. (Review)
Review
BACKGROUND
A growing body of evidence suggests that pediatric bipolar disorder (PBD) frequently co-occurs with comorbid psychiatric disorders that may impact functioning.
OBJECTIVE
To review existing literature on the prevalence of psychiatric comorbidity and general functioning in patients with a primary diagnosis of PBD.
METHODS
We performed a systematic literature search on the PubMed, Embase and PsycInfo databases on November 16th, 2022. We included original papers on patients ≤18 years with primary PBD and any comorbid psychiatric disorder, diagnosed according to a validated diagnostic tool. Risk of bias of the individual studies was assessed using the STROBE checklist. We calculated weighted means to assess the comorbidity prevalence. The review complied with PRISMA statement guidelines.
RESULTS
Twenty studies with a total study population of 2722 patients with PBD were included (mean age = 12.2 years). We found an overall high prevalence of comorbidity in patients with PBD. The most common comorbidities were attention-deficit-hyperactivity disorder (ADHD) (60%) and oppositional defiant disorder (ODD) (47%). Anxiety disorders, obsessive-compulsive disorder, conduct disorder, tic disorders and substance-related disorders affected between 13.2% and 29% of patients, while one in 10 had comorbid mental retardation or autism spectrum disorder (ASD). The prevalence of comorbid disorders was lower in studies that assessed the current prevalence in patients in full or partial remission. General functioning was overall not specifically decreased in patients with comorbidity.
CONCLUSIONS
Comorbidity across a broad range of disorders was high in children diagnosed with PBD, especially regarding ADHD, ASD, behavioral and anxiety disorders including OCD. Future original studies should assess current prevalence of comorbidities in patients with PBD who are in remission to obtain more reliable estimates of psychiatric comorbidity in this patient group. The review highlights the clinical and scientific importance of comorbidity in PBD.
Topics: Humans; Child; Bipolar Disorder; Autism Spectrum Disorder; Attention Deficit Disorder with Hyperactivity; Obsessive-Compulsive Disorder; Comorbidity
PubMed: 36941106
DOI: 10.1111/acps.13548 -
Psychiatric Rehabilitation Journal Sep 2017Internet (eHealth) and smartphone-based (mHealth) approaches to self-management for bipolar disorder are increasingly common. Evidence-based self-management strategies... (Review)
Review
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
Topics: Bipolar Disorder; Humans; Internet; Medical Informatics Applications; Mobile Applications; Self-Management; Telemedicine
PubMed: 28594196
DOI: 10.1037/prj0000270 -
Journal of Affective Disorders Oct 2023To examine gender differences in suicidal ideation, suicide attempts, and suicide deaths in patients with bipolar disorder. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
To examine gender differences in suicidal ideation, suicide attempts, and suicide deaths in patients with bipolar disorder.
METHODS
PubMed, Web of Science, and Embase were systematic searched from inception to March 7, 2023. Two reviewers extract data independently. Demographic data, the number of males and females with bipolar disorder, and the number of individuals with suicidal ideation, suicide attempts, and suicide deaths among participants were extracted.
RESULTS
The pooled prevalence of suicidal ideation in males and females was 48.0 % and 44.0 %, respectively, and the overall male-to-female ratios present a statistically insignificant result (OR = 0.95, 95%CI = 0.75-1.21) among patients with bipolar disorder. The pooled prevalence of suicide attempts in males and females was 6.7 % and 9.3 %, respectively, and there was a statistically significant lower prevalence among male patients with bipolar disorder (OR = 0.71, 95%CI = 0.67-0.75). However, the pooled prevalence of suicide deaths in males and females was 0.7 % and 0.3 % respectively, and there was a statistically significant higher prevalence among male patients with bipolar disorder (OR = 1.86, 95%CI = 1.63-2.13).
LIMITATIONS
The included studies were from mainly middle- and high-income countries and used inconsistent measurement tools. Thus, there is a potential for bias in our results.
CONCLUSIONS
Among patients with bipolar disorder, females were found to have a higher prevalence of suicide attempts, while males have a higher prevalence of suicide deaths. However, there is no significant gender difference in suicidal ideation. Efforts to optimize recognition, treatment, and administration in males and females may reduce gender differences.
Topics: Humans; Male; Female; Bipolar Disorder; Sex Factors; Suicide, Attempted; Suicidal Ideation; Prevalence
PubMed: 37467799
DOI: 10.1016/j.jad.2023.07.060 -
Journal of Affective Disorders Oct 2014Bipolar disorder (BD) is a severe mental disorder affecting 1-4% of the population worldwide. It is characterized by periods of (hypo)manic and depressive episodes.... (Review)
Review
INTRODUCTION
Bipolar disorder (BD) is a severe mental disorder affecting 1-4% of the population worldwide. It is characterized by periods of (hypo)manic and depressive episodes. Seasonal patterns (SP) may be observed in admission rates, mood relapses and symptom fluctuations.
METHODS
We conducted a systematic review of seasonality in BD, classifying studies based on seasonal admission rates to seasonality of symptoms assessments.
RESULTS
Fifty-one papers were identified of which 32 addressed hospitalization rates by season, 6 addressed categorical diagnoses, and 13 explored symptom dimensions. Seasonal peaks for different BD mood episodes are observed worldwide and widely replicated. Manic episodes peak during spring/summer and, to a lesser extent, in autumn, depressive episodes peak in early winter and, to a lesser extent, summer, and mixed episodes peak in early spring or mid/late summer. There was a high frequency of SP for manic episodes (15%) and depressive episodes (25%), the latter being associated with a more complex clinical profile (BD II subtype, comorbid eating disorders, more relapses and rapid cycling). Finally, there was evidence for greater seasonal fluctuations in mood and behavior in individuals with BD than in those with unipolar depression or 'healthy' controls.
LIMITATIONS
Sample size, gender distribution, methodological quality and sophistication of the analytical approaches employed varied considerably.
CONCLUSIONS
There is evidence of seasonality in BD, with emerging evidence that climatic conditions may trigger BD symptoms or episodes. A better understanding of the underlying mechanisms would facilitate the development of personalized chronobiological therapeutic and preventive strategies.
Topics: Affect; Bipolar Disorder; Depressive Disorder, Major; Female; Hospitalization; Humans; Patient Admission; Recurrence; Seasons
PubMed: 25063960
DOI: 10.1016/j.jad.2014.07.002 -
Trends in Psychiatry and Psychotherapy Dec 2022Based on studies of the biographies of artists and on research in which modern diagnostic criteria were applied, it has been suggested that there is a relationship...
INTRODUCTION
Based on studies of the biographies of artists and on research in which modern diagnostic criteria were applied, it has been suggested that there is a relationship between bipolar disorder (BD) and creativity. Objective: To investigate the relationship between BD and creativity and whether creative capacity varies depending on mood state.
METHOD
We conducted a systematic search of the scientific literature indexed on the PubMed, ISI Web of Science, PsycINFO, and SciELO databases using the terms "bipolar" OR "bipolar disorder" OR "mania" OR "manic" AND "creativ*". Original studies were selected that investigated samples of at least ten patients with BD using at least one psychometric instrument to assess creativity.
RESULTS
Twelve articles met the selection criteria. The results of comparisons of BD patients with control groups without BD were heterogeneous. BD was not associated with higher levels of creativity than other mental disorders. When comparing BD phases, depression was associated with worse performance on creativity tests and patients in mania (or hypomania) were not distinguished from euthymia patients.
CONCLUSION
It was not possible to corroborate the hypothesis that individuals with BD are more creative than individuals without psychiatric diagnoses or than patients suffering from other mental disorders, which may be related to the cross-sectional rather than longitudinal designs of virtually all of the clinical studies.
Topics: Humans; Cross-Sectional Studies; Creativity; Bipolar Disorder
PubMed: 34374271
DOI: 10.47626/2237-6089-2021-0196 -
Journal of Affective Disorders Dec 2015Fibromyalgia (FM) is a chronic disorder with high morbidity and significant health service utilization costs. Few studies have reported on the phenotypic overlap of FM... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Fibromyalgia (FM) is a chronic disorder with high morbidity and significant health service utilization costs. Few studies have reported on the phenotypic overlap of FM and bipolar disorder (BD). The aim of this review is to qualitatively and quantitatively summarize the results and clinical implications of the extant literature on the co-occurrence of FM and BD.
METHODS
A systematic search of PubMed/Medline, Cochrane, PsycINFO, CINAHL and Embase was conducted to search for relevant articles. Articles were included if incidence and/or prevalence of BD was determined in the FM sample. Results of prevalence were pooled from all studies. Pooled odds ratio (OR) was calculated based on case-control studies using standard meta-analytic methods.
RESULTS
A total of nine studies were included. The pooled rate of BD comorbidity in samples of FM patients was 21% (n=678); however, results varied greatly as a function of study methodology. Case-controlled studies revealed a pooled OR of 7.55 of BD co-morbidity in samples of FM patients [95% Confidence Interval (CI)=3.9-14.62, FM n=268, controls n=413] with low heterogeneity (I(2)=0%).
LIMITATIONS
The current study was limited by the low number of available studies and heterogeneity of study methods and results.
CONCLUSIONS
These data strongly suggest an association between BD and FM. Future studies employing a validated diagnostic screen are needed in order to more accurately determine the prevalence of BD in FM. An adequate psychiatric assessment is recommended in FM patients with suspected symptoms consistent with BD prior to administration of antidepressants in the treatment of FM.
Topics: Antidepressive Agents; Bipolar Disorder; Comorbidity; Depression; Female; Fibromyalgia; Humans; Mental Health; Middle Aged; Prevalence
PubMed: 26363263
DOI: 10.1016/j.jad.2015.08.030