Bipolar Disorder (BD) optimal care involves pharmacotherapy in conjunction with psychosocial interventions. Both treatment modalities require the establishment of a therapeutic alliance (TA), a cornerstone necessary for the successful treatment of any chronic illness regardless of the psychotherapeutic model1 . In mental disorders, TA has been considered a mediator of adherence and treatment success in a number of conditions, including but not being restricted to schizophrenia spectrum disorders...
Last. Beny Lafer(USP: University of São Paulo)H-Index: 45
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We read the recent Clinical Conundrum article by Khosravi1 with great interest. It makes an important contribution as it describes a typical case of bipolar disorder (BD): onset in early adulthood with one manic episode and significant stabilization reached through lithium treatment for many years. However, changes in the clinical picture at the age of 60 raised important concerns regarding co-occurring disorders, especially neurodegenerative conditions. The presence of cognitive fluctuations, p...
#1Robert K. McNamara(University of Cincinnati Academic Health Center)H-Index: 58
#2Wenbin Li(University of Cincinnati Academic Health Center)
Last. Melissa P. DelBello(University of Cincinnati Academic Health Center)H-Index: 23
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OBJECTIVE To evaluate the effects of fish oil (FO), a source of the omega-3 polyunsaturated fatty acids (n-3 PUFA) eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), on emotion-generated corticolimbic functional connectivity in depressed youth at high risk for developing bipolar I disorder. METHODS Thirty-nine antidepressant-free youth with a current depressive disorder diagnosis and a biological parent with bipolar I disorder were randomized to 12-week double-blind treatment with FO or...
#1Abhishek Ghosh(PGIMER: Post Graduate Institute of Medical Education and Research)H-Index: 10
#2Seema Rani(PGIMER: Post Graduate Institute of Medical Education and Research)H-Index: 3
Last. Sandeep Grover(PGIMER: Post Graduate Institute of Medical Education and Research)H-Index: 58
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We read the article by Ahmad et al1 with great interest. The study concluded that endoxifen is efficacious and safe in patients with acute manic episodes with/without mixed features. However, we are worried about internal and external validity of study results. We have reservations about the sample size estimation, statistical analysis, and missing data handling. Sample size, in a randomized clinical trial depends on the study hypothesis, i.e., superiority, non-inferiority or equivalence of two ...
A 63-year-old woman, followed at our psychiatric outpatient clinic for Bipolar Disorder type I and intellectual disability (DSM-5), was admitted to our inpatient unit due to a three-day episode of psychomotor agitation, elevated mood, decreased need for sleep, accelerated speech, and persecutory delusions. She was not compliant with her psychiatric medication. There were no relevant laboratory findings, and the urine toxicology was negative.
Last. Benicio N. Frey(St. Joseph's Healthcare Hamilton)H-Index: 53
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Objectives null Clinical staging is widely used in medicine to map disease progression, inform prognosis and guide treatment decisions; in psychiatry, however, staging remains a hypothetical construct. To facilitate future research in bipolar disorders (BD), a well-defined nomenclature is needed, especially since diagnosis is often imprecise with blurred boundaries, and a full understanding of pathophysiology is lacking. null Methods null Under the auspices of the International Society of Bipola...
#1Gin S Malhi(RNSH: Royal North Shore Hospital)H-Index: 91
#2Erica Bell(RNSH: Royal North Shore Hospital)H-Index: 7
The prospect of staging psychiatric disorders has been a source of ongoing controversy since the idea was first proposed in the early 1990s, based on the staging models used for cancer. More recently, several staging models have been proposed for bipolar disorder, however as yet there is no consensus as to which model (or composite) is best, and there is no substantive evidence in support of any of the models. The fundamental problem is that, unlike cancer, the pathophysiology of psychiatric dis...
The bipolar disorder and major depression summaries of the 2020 Royal Australian and New Zealand College of Psychiatrists (RANZCP) clinical practice guidelines for mood disorders, published in the December 2020 issue of Bipolar Disorders, provide accessible and condensed overviews of current recommendations for diagnosis and management1,2 . The 2020 guidelines3 replace the 2015 versions, and include some notable differences, most obviously in the language used to characterise approaches to treat...
OBJECTIVES Cognitive impairment occurs in approximately 50% of remitted patients with bipolar disorder (BD). However, there exists no treatment with replicated and robust efficacy on cognition in BD. This is partially due to limited insight into the neuronal underpinnings of cognitive impairment in these patients. This is the first study to investigate neuronal underpinnings of cognitive impairment in a large functional magnetic resonance imaging (fMRI) dataset comparing neural activity patterns...
OBJECTIVES Repetitive transcranial magnetic stimulation (rTMS) is commonly used in unipolar depression; yet there its evidence in bipolar disorder (BD) is limited. We sought to review the evidence on the use of rTMS across the different stages of BD. METHODS MEDLINE database was systematically searched using the PubMed interface following the PRISMA guidelines. Inclusion criteria were: (i) randomized clinical trials (RCTs), open-label studies, and case series (ii) specific evaluation of the trea...