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Handbook of Clinical Neurology 2012Bipolar disorder is a serious disorder of mood that is associated with considerable psychosocial and economic morbidity. Even though it is more common than previously... (Review)
Review
Bipolar disorder is a serious disorder of mood that is associated with considerable psychosocial and economic morbidity. Even though it is more common than previously thought, it has until relatively recently been somewhat neglected in terms of research when compared to disorders such as schizophrenia and major depression. Recent advances in the fields of nosology, epidemiology, and molecular genetics in particular have begun to unravel some of the complexity of this disorder and the next few years are likely to witness substantial changes to the ways in which the broad spectrum of bipolar disorders is diagnosed and managed.
Topics: Animals; Bipolar Disorder; Disease Models, Animal; Gene-Environment Interaction; Humans; Personality
PubMed: 22608626
DOI: 10.1016/B978-0-444-52002-9.00015-2 -
Current Neuropharmacology Apr 2017Episode duration, recurrence rates, and time spent in manic and depressive phases of bipolar disorder (BD) is not well defined for subtypes of the disorder. (Review)
Review
BACKGROUND
Episode duration, recurrence rates, and time spent in manic and depressive phases of bipolar disorder (BD) is not well defined for subtypes of the disorder.
METHODS
We reviewed the course, timing, and duration of episodes of mania and depression among 1130 clinically treated DSM-IV-TR BD patients of various types, and compared duration and rates as well as total proportion of time in depressive versus manic episodes during 16.7 average years at risk.
RESULTS
As expected, episodes of depressions were much longer than manias, but episode-duration did not differ among BD diagnostic types: I, II, with mainly mixed-episodes (BD-Mx), or with psychotic features (BD-P). Recurrence rates (episodes/year) and proportion of time in depression and their ratios to mania were highest in BD-II and BD-Mx subjects, with more manias/year in psychotic and BD-I subjects. In most BD-subtypes, except with psychotic features, there was more time in depressive than manic morbidity, owing mainly to longer depressive than manic episodes. The proportion of time in depression was highest among those who followed a predominant DMI course, whereas total time in mania was greatest in BD with psychotic features and BD-I. and with an MDI course.
CONCLUSIONS
Subtypes of BD patients differed little in episode-duration, which was consistently much longer for depression. The findings underscore the limited control of bipolar depression with available treatments.
Topics: Bipolar Disorder; Depression; History, 18th Century; History, 19th Century; History, 20th Century; Humans
PubMed: 28503106
DOI: 10.2174/1570159X14666160606210811 -
The International Journal of... Aug 2017Over the last decade, there has been a growing appreciation of the importance of identifying and treating cognitive impairment associated with bipolar disorder, since it... (Review)
Review
Over the last decade, there has been a growing appreciation of the importance of identifying and treating cognitive impairment associated with bipolar disorder, since it persists in remission periods. Evidence indicates that neurocognitive dysfunction may significantly influence patients' psychosocial outcomes. An ever-increasing body of research seeks to achieve a better understanding of potential moderators contributing to cognitive impairment in bipolar disorder in order to develop prevention strategies and effective treatments. This review provides an overview of the available data from studies examining treatments for cognitive dysfunction in bipolar disorder as well as potential novel treatments, from both pharmacological and psychological perspectives. All these data encourage the development of further studies to find effective strategies to prevent and treat cognitive impairment associated with bipolar disorder. These efforts may ultimately lead to an improvement of psychosocial functioning in these patients.
Topics: Bipolar Disorder; Cognitive Dysfunction; Humans
PubMed: 28498954
DOI: 10.1093/ijnp/pyx032 -
Trends in Neurosciences Jan 2018Bipolar disorder (BD) is a leading cause of global disability. Its biological basis is unknown, and its treatment unsatisfactory. Here, we review two recent areas of... (Review)
Review
Bipolar disorder (BD) is a leading cause of global disability. Its biological basis is unknown, and its treatment unsatisfactory. Here, we review two recent areas of progress. First, the discovery of risk genes and their implications, with a focus on voltage-gated calcium channels as part of the disease process and as a drug target. Second, facilitated by new technologies, it is increasingly apparent that the bipolar phenotype is more complex and nuanced than simply one of recurring manic and depressive episodes. One such feature is persistent mood instability, and efforts are underway to understand its mechanisms and its therapeutic potential. BD illustrates how psychiatry is being transformed by contemporary neuroscience, genomics, and digital approaches.
Topics: Animals; Bipolar Disorder; Humans
PubMed: 29169634
DOI: 10.1016/j.tins.2017.10.006 -
Journal of the American Association of... Sep 2015This review article provides an overview of the frequency, burden of illness, diagnosis, and treatment of bipolar disorder (BD) from the perspective of the advanced... (Review)
Review
PURPOSE
This review article provides an overview of the frequency, burden of illness, diagnosis, and treatment of bipolar disorder (BD) from the perspective of the advanced practice nurses (APNs).
DATA SOURCES
PubMed searches were conducted using the following keywords: "bipolar disorder and primary care," restricted to dates 2000 to present; "bipolar disorder and nurse practitioner"; and "bipolar disorder and clinical nurse specialist." Selected articles were relevant to adult outpatient care in the United States, with a prioritization of articles written by APNs or published in nursing journals.
CONCLUSIONS
BD has a substantial lifetime prevalence in the population at 4%. Because the manic or depressive symptoms of BD tend to be severe and recurrent over a patient's lifetime, the condition is associated with significant burden to the individual, caregivers, and society. Clinician awareness that BD may be present increases the likelihood of successful recognition and appropriate treatment. A number of pharmacological and nonpharmacological treatments are available for acute and maintenance treatments, with the prospect of achieving reduced symptom burden and increased functioning for many patients.
IMPLICATIONS FOR PRACTICE
Awareness of the disease burden, diagnostic issues, and management choices in BD has the potential to enhance outcome in substantial proportions of patients.
Topics: Bipolar Disorder; Humans; Nurse Practitioners; Practice Patterns, Nurses'; Psychiatric Nursing
PubMed: 26172568
DOI: 10.1002/2327-6924.12275 -
Methods in Molecular Biology (Clifton,... 2019Characterized by the switch of manic and depressive phases, bipolar disorder was described as early as the fifth century BC. Nevertheless up to date, the underlying... (Review)
Review
Characterized by the switch of manic and depressive phases, bipolar disorder was described as early as the fifth century BC. Nevertheless up to date, the underlying neurobiology is still largely unclear, assuming a multifactor genesis with both biological-genetic and psychosocial factors. Significant process has been achieved in recent years in researching the causes of bipolar disorder with modern molecular biological (e.g., genetic and epigenetic studies) and imaging techniques (e.g., positron emission tomography (PET) and functional magnetic resonance imaging (fMRI)). In this chapter we will first summarize our recent knowledge on the etiology of bipolar disorder. We then discuss how several factors observed to contribute to bipolar disorder in human patients can be manipulated to generate rodent models for bipolar disorder. Finally, we will give an overview on behavioral test that can be used to assess bipolar-disorder-like behavior in rodents.
Topics: Animals; Behavior Rating Scale; Bipolar Disorder; Disease Management; Disease Models, Animal; Disease Susceptibility; Environment; Genetic Predisposition to Disease; Humans; Rodentia
PubMed: 31273693
DOI: 10.1007/978-1-4939-9554-7_4 -
BMJ (Clinical Research Ed.) Dec 2012
Review
Topics: Bipolar Disorder; Diagnosis, Differential; Female; Humans; Medical History Taking; Preconception Care; Prognosis; Psychotherapy; Referral and Consultation; Surveys and Questionnaires
PubMed: 23271744
DOI: 10.1136/bmj.e8508 -
The International Journal of... Aug 2019People with bipolar disorder frequently experience persistent residual symptoms, problems in psychosocial functioning, cognitive impairment, and poor quality of life. In...
People with bipolar disorder frequently experience persistent residual symptoms, problems in psychosocial functioning, cognitive impairment, and poor quality of life. In the last decade, the treatment target in clinical and research settings has focused not only on clinical remission, but also on functional recovery and, more lately, in personal recovery, taking into account patients' well-being and quality of life. Hence, the trend in psychiatry and psychology is to treat bipolar disorder in an integrative and holistic manner. This literature review offers an overview regarding psychosocial functioning in bipolar disorder. First, a brief summary is provided regarding the definition of psychosocial functioning and the tools to measure it. Then, the most reported variables influencing the functional outcome in patients with bipolar disorder are listed. Thereafter, we include a section discussing therapies with proven efficacy at enhancing functional outcomes. Other possible therapies that could be useful to prevent functional decline and improve functioning are presented in another section. Finally, in the last part of this review, different interventions directed to improve patients' well-being, quality of life, and personal recovery are briefly described.
Topics: Bipolar Disorder; Combined Modality Therapy; Health Status; Humans; Mental Health; Quality of Life; Treatment Outcome
PubMed: 31093646
DOI: 10.1093/ijnp/pyz018 -
Acta Neuropsychiatrica Apr 2023Paediatric bipolar disorder - bipolar disorder occurring in prepubertal children - is a diagnosis subject to considerable controversy. Whilst historically considered to... (Review)
Review
OBJECTIVES
Paediatric bipolar disorder - bipolar disorder occurring in prepubertal children - is a diagnosis subject to considerable controversy. Whilst historically considered to be very rare, proponents since the 1990s have argued that mania can present differently in children and, as such, is much more common than previously thought. Such proposals raise questions about the validity of proposed phenotypes and potential risks of iatrogenic harm.
METHODS
I critically examine the construct of paediatric bipolar disorder using Robins and Guze's (1970, , 983-987) influential criteria for the validity of a psychiatric diagnosis. I review, in turn, evidence relating to its clinical description, delimitation from other conditions, follow-up studies, family studies, laboratory studies, and treatment response.
RESULTS
Across domains, existing research highlights significant challenges establishing the diagnosis. This includes significant heterogeneity in operationalising criteria for children; variable or poor inter-rater reliability; difficulty distinguishing paediatric bipolar disorder from other conditions; large differences in rates of diagnosis between the United States of America and other countries; limited evidence of continuity with adult forms; and a lack of evidence for proposed paediatric phenotypes in children at genetic high-risk of the condition. Laboratory and treatment studies are limited, but also do not provide support for the construct.
CONCLUSIONS
Evidence for the more widespread existence of paediatric bipolar disorder and its various proposed phenotypes remains weak. The ongoing popularity of the diagnosis, most evident in America, may reflect social pressures and broader limitations in psychiatric nosology. The uncertainty around the diagnosis highlights the need for careful longitudinal assessment of children potentially affected.
Topics: Humans; Bipolar Disorder; Reproducibility of Results; Diagnosis, Differential; Phenotype; Follow-Up Studies
PubMed: 36373500
DOI: 10.1017/neu.2022.28 -
American Family Physician Sep 1989Bipolar illness is a serious heritable mood disorder characterized by recurrent episodes of depression and mania. The mean age of onset is under 25 years of age, but the... (Review)
Review
Bipolar illness is a serious heritable mood disorder characterized by recurrent episodes of depression and mania. The mean age of onset is under 25 years of age, but the period of risk extends from prepuberty to senescence. Fifteen percent of persons with the disorder commit suicide. Bipolar disorder carries an increased risk of cardiovascular disease.
Topics: Bipolar Disorder; Humans; Lithium
PubMed: 2672748
DOI: No ID Found