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Psychiatria Danubina 2020The comorbidity of bipolar disorder (BD) and obsessive-compulsive disorder (OCD) is widely known. The overall rate of association between BD and OCD is very high and... (Review)
Review
The comorbidity of bipolar disorder (BD) and obsessive-compulsive disorder (OCD) is widely known. The overall rate of association between BD and OCD is very high and varies, depending on the authors, from 11% to 18%, with peaks of 21% in primarily bipolar patients. Vice versa, about 60% of patients with OCD have a second psychiatric diagnosis, which in 23% of cases turns out to be BD. The differences between the BD patients with and without OCD were so numerous and important (e.g., different onset of mood episodes, history of suicide attempts, seasonality, rapid cycling and impulsivity) that the comorbidity between BD and OCD may represent a distinct form of BD, similar to cyclothymic BD for psychopathological features. However, the comorbidity does not seem to have any impact on cognitive performance, such as there is no specific difference between patients who first develop BD and then OCD or vice versa. Anyway, the detection of the neurocognitive profile of these patients at the time of the first clinical evaluation could have clinical implications also in the therapeutic and rehabilitative management of this type of patient. Indeed, it would be desirable to develop a new model of rehabilitation that is less differentiated for both BD and OCD or for their comorbidity, also to make cognitive rehabilitation faster and less expensive. The purpose of this mini-review is to update the knowledge currently available on the impact of BD and OCD comorbidity on neurocognitive profile.
Topics: Bipolar Disorder; Comorbidity; Humans; Impulsive Behavior; Mental Status and Dementia Tests; Obsessive-Compulsive Disorder; Suicide, Attempted
PubMed: 33370731
DOI: 10.24869/psyd.2020.346 -
The Journal of Clinical Psychiatry Jul 2022To estimate overall prevalence of bipolar disorder (BD) and the prevalence and timing of bipolar-spectrum mood episodes in perinatal women. Databases (PubMed, Scopus,... (Meta-Analysis)
Meta-Analysis
To estimate overall prevalence of bipolar disorder (BD) and the prevalence and timing of bipolar-spectrum mood episodes in perinatal women. Databases (PubMed, Scopus, PsycINFO, CINAHL, Cochrane, ClincalTrials.gov) were searched from inception to March 2020. Included studies were original research in English that had (1) populations of perinatal participants (pregnant or within 12 months postpartum), aged ≥ 18 years, and (2) a screening/diagnostic tool for BD. Search terms described the population (eg, ), illness (eg, ), and detection (eg, , ). Study design data, rates, and timing of positive screens/diagnoses and mood episodes were extracted by 3 independent reviewers. Pooled prevalences were estimated using random-effects meta-analyses. Twenty-two articles were included in qualitative review and 12 in the meta-analysis. In women with no known psychiatric illness preceding the perinatal period, pooled prevalence of BD was 2.6% (95% CI, 1.2%-4.5%) and prevalence of bipolar-spectrum mood episodes (including depressed, hypomanic/manic, mixed) during pregnancy and the postpartum period was 20.1% (95% CI, 16.0%-24.5%). In women with a prior BD diagnosis, 54.9% (95% CI, 39.2%-70.2%) were found to have at least one bipolar-spectrum mood episode occurrence in the perinatal period. Our review suggests that the perinatal period is associated with high rates of bipolar-spectrum mood episodes and that pregnant and postpartum women represent a special risk population. This review may help to inform clinical care recommendations, thus helping to identify those who may have.
Topics: Affect; Bipolar Disorder; Female; Humans; Postpartum Period; Pregnancy; Prevalence; Risk Factors
PubMed: 35830616
DOI: 10.4088/JCP.21r14045 -
Canadian Journal of Psychiatry. Revue... Feb 2017The purpose of this study is to address the question of whether a universal staging model of severe psychiatric disorders is a viable direction for future research by... (Review)
Review
OBJECTIVE
The purpose of this study is to address the question of whether a universal staging model of severe psychiatric disorders is a viable direction for future research by examining the extant literature.
METHOD
A narrative review was conducted of the relevant historical, conceptual, and empirical literature pertaining to the clinical trajectory of bipolar disorder and schizophrenia and issues relevant to staging.
RESULTS
There is substantive evidence that classic recurrent bipolar disorder is separable from schizophrenia on the basis of family history, developmental and clinical course, treatment response, and neurobiological findings. However, because of the intrinsic heterogeneity of diagnostic categories that has been amplified by recent changes in psychiatric taxonomy, key distinctions between the groups have become obfuscated. While mapping risk and illness markers to emerging psychopathology is a logical approach and may be of value for some psychiatric disorders and/or their clinical subtypes, robust evidence supporting identifiable stages per se is still lacking. Presently, even rudimentary stages such as prodromes cannot be meaningfully applied across different disorders and no commonalities can be found for the basis of universal staging.
CONCLUSIONS
Advances in the prediction of risk, accurate early illness detection, and tailored intervention will require mapping biomarkers and other risk indicators to reliable clinical phases of illness progression. Given the capricious nature of mood and psychotic disorders, this task is likely to yield success only if conducted in narrowly defined subgroups of individuals at high risk for specific illnesses. This approach is diametrically opposite to that being promulgated by proponents of a universal staging model.
Topics: Bipolar Disorder; Disease Progression; Humans; Prodromal Symptoms; Schizophrenia
PubMed: 27310243
DOI: 10.1177/0706743716649189 -
Translational Psychiatry Apr 2020Psychiatry is constructed around a taxonomy of several hundred diagnoses differentiated by nuances in the timing, co-occurrence, and severity of symptoms. Bipolar... (Review)
Review
Psychiatry is constructed around a taxonomy of several hundred diagnoses differentiated by nuances in the timing, co-occurrence, and severity of symptoms. Bipolar disorder (BD) is notable among these diagnoses for manic, depressive, and psychotic symptoms all being core features. Here, we trace current understanding of the neurobiological origins of BD and related diagnoses. To provide context, we begin by exploring the historical origins of psychiatric taxonomy. We then illustrate how key discoveries in pharmacology and neuroscience gave rise to a generation of neurobiological hypotheses about the origins of these disorders that facilitated therapeutic innovation but failed to explain disease pathogenesis. Lastly, we examine the extent to which genetics has succeeded in filling this void and contributing to the construction of an objective classification of psychiatric disturbance.
Topics: Bipolar Disorder; Humans; Neurobiology; Psychotic Disorders
PubMed: 32327632
DOI: 10.1038/s41398-020-0796-8 -
Journal of the American Academy of... Dec 2011
Topics: Adolescent; Bipolar Disorder; Child; Cross-Sectional Studies; Diagnosis, Differential; Follow-Up Studies; Humans; Incidence
PubMed: 22115139
DOI: 10.1016/j.jaac.2010.07.008 -
Trends in Psychiatry and Psychotherapy 2015A growing body of evidence suggests that bipolar disorder (BD) is a progressive disease according to clinical, biochemical and neuroimaging findings. This study reviewed... (Review)
Review
INTRODUCTION
A growing body of evidence suggests that bipolar disorder (BD) is a progressive disease according to clinical, biochemical and neuroimaging findings. This study reviewed the literature on the relationship between specific biomarkers and BD stages.
METHODS
A comprehensive literature search of MEDLINE and PubMed was conducted to identify studies in English and Portuguese using the keywords biomarker, neurotrophic factors, inflammation, oxidative stress, neuroprogression and staging models cross-referenced with bipolar disorder.
RESULTS
Morphometric studies of patients with BD found neuroanatomic abnormalities, such as ventricular enlargement, grey matter loss in the hippocampus and cerebellum, volume decreases in the prefrontal cortex and variations in the size of the amygdala. Other studies demonstrated that serum concentrations of neurotrophic factors, inflammatory mediators and oxidative stress may be used as BD biomarkers.
CONCLUSIONS
The analysis of neurobiological changes associated with BD progression and activity may confirm the existence of BD biomarkers, which may be then included in staging models that will lead to improvements in treatment algorithms and more effective, individually tailored treatment regimens. Biomarkers may also be used to define early interventions to control disease progression.
Topics: Biomarkers; Bipolar Disorder; Disease Progression; Humans
PubMed: 25860561
DOI: 10.1590/2237-6089-2014-0002 -
Frontiers in Bioscience (Scholar... Jan 2022Recent studies provide evidence that similar to early-stage Parkinson's disease, depression is a neurodegenerative disease characterized by the degeneration of monoamine... (Review)
Review
Recent studies provide evidence that similar to early-stage Parkinson's disease, depression is a neurodegenerative disease characterized by the degeneration of monoamine axons. The major difference between the two disorders is that the symptoms of depression become evident without loss of monoamine neurons, while the motor symptoms of Parkinson's disease appear after loss of the cell body. Given that the axonal degeneration of monoamine neurons underlies the pathophysiology of neurological (Parkinson's disease) and neuropsychiatric (depression) diseases, axonal impairment of monoamine neurons is thought to also occur in schizophrenia and bipolar disorder and play a significant role in the pathophysiology of these mental illnesses. The positive symptoms of schizophrenia and manic symptoms of bipolar disorder are known to occur in hyper-monoaminergic states, opposite to depressive symptoms, negative/cognitive symptoms of schizophrenia, and motor disorders of Parkinson's disease, all occurring in hypo-monoaminergic states. Since monoamine axons have the capacity to spontaneously regenerate or sprout in response to damage in the adult brain and sometimes show hyperinnervation due to excessive regeneration/sprouting beyond normal levels, it is possible that schizophrenia and bipolar disorder are disorders that include excessive regeneration/sprouting of monoamine axons leading to hyper-monoaminergic states. Together, based on accumulating data from animal and human studies, the pathophysiology of schizophrenia, major depression, and bipolar disorder is summarized as follows: The degeneration of monoamine axons is associated with the negative and cognitive symptoms of schizophrenia, major and bipolar depression, while hyper-regeneration/sprouting of monoamine axons underlies the positive symptoms of schizophrenia and bipolar mania. The integrated understanding of schizophrenia, major depression, and bipolar disorder as monoamine axon disorder will open the door to the development of new diagnosis and treatment methods for major mental illnesses as well as early-stage Parkinson's disease.
Topics: Axons; Bipolar Disorder; Depression; Depressive Disorder, Major; Humans; Neurodegenerative Diseases; Parkinson Disease; Schizophrenia
PubMed: 35320915
DOI: 10.31083/j.fbs1401004 -
International Journal of Molecular... Apr 2021The gut microbiota is the set of microorganisms that colonize the gastrointestinal tract of living creatures, establishing a bidirectional symbiotic relationship that is... (Review)
Review
The gut microbiota is the set of microorganisms that colonize the gastrointestinal tract of living creatures, establishing a bidirectional symbiotic relationship that is essential for maintaining homeostasis, for their growth and digestive processes. Growing evidence supports its involvement in the intercommunication system between the gut and the brain, so that it is called the gut-brain-microbiota axis. It is involved in the regulation of the functions of the Central Nervous System (CNS), behavior, mood and anxiety and, therefore, its implication in the pathogenesis of neuropsychiatric disorders. In this paper, we focused on the possible correlations between the gut microbiota and Bipolar Disorder (BD), in order to determine its role in the pathogenesis and in the clinical management of BD. Current literature supports a possible relationship between the compositional alterations of the intestinal microbiota and BD. Moreover, due to its impact on psychopharmacological treatment absorption, by acting on the composition of the microbiota beneficial effects can be obtained on BD symptoms. Finally, we discussed the potential of correcting gut microbiota alteration as a novel augmentation strategy in BD. Future studies are necessary to better clarify the relevance of gut microbiota alterations as state and disease biomarkers of BD.
Topics: Biomarkers; Bipolar Disorder; Gastrointestinal Microbiome; Humans
PubMed: 33918462
DOI: 10.3390/ijms22073723 -
European Neuropsychopharmacology : the... Jun 2017The hopes for readily implementable precision medicine are high. For many complex disorders, such as bipolar disorder, these hopes critically hinge on tangible successes... (Review)
Review
The hopes for readily implementable precision medicine are high. For many complex disorders, such as bipolar disorder, these hopes critically hinge on tangible successes in pharmacogenetics of treatment response or susceptibility to adverse events. In this article, we review the current state of pharmacogenomics of bipolar disorder including latest results from candidate genes and genome-wide association studies. The majority of studies focus on response to lithium treatment. Although a host of genes has been studied, hardly any replicated findings have emerged so far. Very small samples sizes and heterogeneous phenotype definition may be considered the major impediments to success in this field. Drawing from current experiences and successes in studies on diagnostic psychiatric phenotypes, we suggest several approaches for our way forward.
Topics: Antipsychotic Agents; Bipolar Disorder; Case-Control Studies; Humans; Lithium; Pharmacogenetics
PubMed: 28342679
DOI: 10.1016/j.euroneuro.2017.02.001 -
Trends in Psychiatry and Psychotherapy 2019
Topics: Aging, Premature; Bipolar Disorder; Disease Progression; Humans
PubMed: 31967192
DOI: 10.1590/2237-6089-2019-0038