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Management of Bipolar Disorder During the Perinatal Period. Nurs Womens Health 2023; 27:42-52. [PMID: 36528074 DOI: 10.1016/j.nwh.2022.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 07/13/2022] [Accepted: 11/05/2022] [Indexed: 12/15/2022]
Abstract
Bipolar disorder (BPD) is a lifelong mental health condition characterized by symptoms of mania, depression, and often anxiety. BPD can have detrimental consequences for individuals during pregnancy and the postpartum period, as well as for their offspring. This is often due to underdiagnosis and/or misdiagnosis as unipolar depression. There is a high incidence of first episodes of BPD in pregnant and postpartum persons. Perinatal care providers need to routinely screen for BPD and assess for relapse among those with a previous diagnosis during the pregnancy and postpartum periods. Medication management is complex and must be considered in the context of an individual's risk factors and perceptions about treatment as well as the limited evidence regarding fetal safety, using a shared decision-making model. Collaboration, consultation, and/or referral to mental health care providers are essential for managing acute and chronic BPD symptoms.
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Léger M, Wolff V, Kabuth B, Albuisson E, Ligier F. The mood disorder spectrum vs. schizophrenia decision tree: EDIPHAS research into the childhood and adolescence of 205 patients. BMC Psychiatry 2022; 22:194. [PMID: 35300648 PMCID: PMC8932125 DOI: 10.1186/s12888-022-03835-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 03/07/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The early detection of patients at risk of developing schizophrenia and bipolar disorder, and more broadly mood spectrum disorder, is a public health concern. The phenotypical overlap between the prodromes in these disorders calls for a simultaneous investigation into both illness trajectories. METHOD This is an epidemiological, retrospective, multicentre, descriptive study conducted in the Grand-Est region of France in order to describe and compare early symptoms in 205 patients: 123 of which were diagnosed with schizophrenia and 82 with bipolar disorder or mood spectrum disorder. Data corresponding to the pre-morbid and prodromal phases, including a timeline of their onset, were studied in child and adolescent psychiatric records via a data grid based on the literature review conducted from birth to 17 years of age. RESULTS Two distinct trajectories were highlighted. Patients with schizophrenia tended to present more difficulties at each developmental stage, with the emergence of negative and positive behavioural symptoms during adolescence. Patients with mood spectrum disorder, however, were more likely to exhibit anxiety and then mood-related symptoms. Overall, our results corroborate current literature findings and are consistent with the neurodevelopmental process. We succeeded in extracting a decision tree with good predictability based on variables relating to one diagnosis: 77.6% of patients received a well-indexed diagnosis. An atypical profile was observed in future mood spectrum disorder patients as some exhibited numerous positive symptoms alongside more conventional mood-related symptoms. CONCLUSION The combination of all these data could help promote the early identification of high-risk patients thereby facilitating early prevention and appropriate intervention in order to improve outcomes.
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Affiliation(s)
- Mathilde Léger
- Pôle Universitaire de Psychiatrie de l’Enfant et de l’Adolescent [University Department of Childhood and Adolescent Psychiatry], Centre Psychothérapique de Nancy [Nancy Psychotherapy Centre], F-54520 Laxou, France
| | - Vanessa Wolff
- Pôle Universitaire de Psychiatrie de l’Enfant et de l’Adolescent [University Department of Childhood and Adolescent Psychiatry], Centre Psychothérapique de Nancy [Nancy Psychotherapy Centre], F-54520 Laxou, France
| | - Bernard Kabuth
- Pôle Universitaire de Psychiatrie de l’Enfant et de l’Adolescent [University Department of Childhood and Adolescent Psychiatry], Centre Psychothérapique de Nancy [Nancy Psychotherapy Centre], F-54520 Laxou, France ,grid.29172.3f0000 0001 2194 6418EA 4432, PRISME, Université de Lorraine [Lorraine University], Laxou, France
| | - Eliane Albuisson
- grid.410527.50000 0004 1765 1301DRCI UMDS, Centre Hospitalier Universitaire de Nancy, Nancy University Hospital, Laxou, France
| | - Fabienne Ligier
- Pôle Universitaire de Psychiatrie de l'Enfant et de l'Adolescent [University Department of Childhood and Adolescent Psychiatry], Centre Psychothérapique de Nancy [Nancy Psychotherapy Centre], F-54520, Laxou, France. .,EA 4360 APEMAC, Université de Lorraine, Laxou, France.
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IL-1α, IL-1β and IL-1RN haplotypes are associated with bipolar I disorder and its characteristics: A pilot case-control study. Meta Gene 2021. [DOI: 10.1016/j.mgene.2021.100977] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Amini A, Aghabozorg Afjeh SS, Boshehri B, Hamednia S, Mashayekhi P, Omrani MD. The Relationship between rs534654 Polymorphism in TMEM165 Gene and Increased Risk of Bipolar Disorder Type 1. INTERNATIONAL JOURNAL OF MOLECULAR AND CELLULAR MEDICINE 2021; 10:162-165. [PMID: 34703799 PMCID: PMC8496248 DOI: 10.22088/ijmcm.bums.10.2.155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 06/16/2021] [Indexed: 11/04/2022]
Abstract
Bipolar disorder (BD) is a major health care concern worldwide. There are some reports showing an association between genes and their variants involved in circadian rhythm; clock and clock related genes function and development of BD in patients. Therefore, the aim of this study was to investigate the possible association of rs534654 variant on TMEM165 (transmembrane protein 165) gene with the risk of BD. Genotyping of the rs534654 was carried out using the tetra primers- amplification refractory mutation system-PCR (4P-ARMS-PCR) method in 203 patients with BD type 1 and their healthy and normal counterpart. The frequency of the G and A alleles of rs534654 polymorphism was 53% and 47%, respectively in patients. Genotype frequency in patients in comparison with control subjects was 5.4% vs 2.5% for the AA homozygous; 11.3% vs 80.8% for the GG homozygous; and 83.3% vs 16.7% for the heterozygous AG. Statistical analysis showed a significant difference in frequencies between the control and patient groups (P = 0.001). Based on this finding, it is possible to conclude that the impairment in the rs534654 single nucleotide polymorphism in TMEM165 gene is associated with the risk of BD development.
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Affiliation(s)
| | | | - Behzad Boshehri
- Department of Forensic Medicine and Toxicology, Urmia University of Medical Sciences, Urmia, Iran
| | - Safar Hamednia
- Department of Psychiatry, Urmia University of Medical Sciences, Urmia, Iran
| | | | - Mir Davood Omrani
- Department of Medical Genetics, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Urogenital Stem Cell Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Paul MS, Bhattacharjee D, Khanande RV, Nizamie SH. Early-onset bipolar disorder, stress, and coping responses of mothers: A comparative study. Indian J Psychiatry 2021; 63:152-161. [PMID: 34194059 PMCID: PMC8214135 DOI: 10.4103/psychiatry.indianjpsychiatry_865_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 08/30/2020] [Accepted: 10/23/2020] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Providing care and nurturance to a child with bipolar disorder (BPAD) is a challenging task for parents, especially mothers. In Indian contexts, mothers are the primary caregivers of ailing children and they have to keep intrafamily situation stable, which makes their role more stressful. OBJECTIVES The objective of the study was to assess maternal stress and coping in mothers of adolescents with BPAD. MATERIALS AND METHODS This study was a comparative one and carried out on sixty mothers of adolescents; of which thirty were adolescents with BPAD, and the remaining thirty were the mothers of normal adolescents. The participants were selected purposively as per the mothers' age and education level, and the socioeconomic status of the families they belong to. Sociodemographic and clinical data sheet, Parenting Stress Index/Short Form (PSI/SF), and Brief COPE were applied on the mothers for data collection. RESULTS Mothers' of the BPAD adolescents reported higher scores in the both PSI/SF and Brief COPE. CONCLUSION Mothers of the adolescents with BPAD tend to perceive high level of stress and they also use maladaptive coping more in dealing with stressful situations.
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Affiliation(s)
- M Sam Paul
- Department of Psychiatry, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Dipanjan Bhattacharjee
- Department of Psychiatric Social Work, Central Institute of Psychiatry, Ranchi, Jharkhand, India.,Department of Psychiatry, Central Institute of Psychiatry, Ranchi, Jharkhand, India
| | - Roshan Vitthalrao Khanande
- Department of Psychiatric Social Work, Central Institute of Psychiatry, Ranchi, Jharkhand, India.,Department of Psychiatry, Central Institute of Psychiatry, Ranchi, Jharkhand, India
| | - Shamsul Haque Nizamie
- Department of Psychiatric Social Work, Central Institute of Psychiatry, Ranchi, Jharkhand, India.,Department of Psychiatry, Central Institute of Psychiatry, Ranchi, Jharkhand, India
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Garobbio S, Roinishvili M, Favrod O, da Cruz JR, Chkonia E, Brand A, Herzog MH. Electrophysiological correlates of visual backward masking in patients with bipolar disorder. Psychiatry Res Neuroimaging 2021; 307:111206. [PMID: 33092939 DOI: 10.1016/j.pscychresns.2020.111206] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 09/25/2020] [Accepted: 10/02/2020] [Indexed: 11/28/2022]
Abstract
In visual backward masking (VBM), a target is followed by a mask that decreases target discriminability. Schizophrenia patients (SZ) show strong and reproducible masking impairments, which are associated with reduced EEG amplitudes. Patients with bipolar disorder (BP) show masking deficits, too. Here, we investigated the neural EEG correlates of VBM in BP. 122 SZ, 94 unaffected controls, and 38 BP joined a standard VBM experiment. 123 SZ, 94 unaffected controls and 16 BP joined a corresponding EEG experiment, analyzed in terms of global field power. As in previous studies, SZ and BP show strong masking deficits. Importantly and similarly to SZ, BP show decreased global field power amplitudes at approximately 200 ms after the target onset, compared to controls. These results suggest that VBM deficits are not specific for schizophrenia but for a broader range of functional psychoses. Potentially, both SZ and BP show deficient target enhancement.
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Affiliation(s)
- Simona Garobbio
- Laboratory of Psychophysics, Brain Mind Institute, École Polytechnique Fédérale de Lausanne (EPFL), Switzerland.
| | - Maya Roinishvili
- Laboratory of Vision Physiology, Beritashvili Centre of Experimental Biomedicine, Tbilisi, Georgia; Institute of Cognitive Neurosciences, Free University of Tbilisi, Tbilisi, Georgia
| | - Ophélie Favrod
- Laboratory of Psychophysics, Brain Mind Institute, École Polytechnique Fédérale de Lausanne (EPFL), Switzerland
| | - Janir Ramos da Cruz
- Laboratory of Psychophysics, Brain Mind Institute, École Polytechnique Fédérale de Lausanne (EPFL), Switzerland
| | - Eka Chkonia
- Institute of Cognitive Neurosciences, Free University of Tbilisi, Tbilisi, Georgia; Department of Psychiatry, Tbilisi State Medical University, Tbilisi, Georgia
| | - Andreas Brand
- Laboratory of Psychophysics, Brain Mind Institute, École Polytechnique Fédérale de Lausanne (EPFL), Switzerland
| | - Michael H Herzog
- Laboratory of Psychophysics, Brain Mind Institute, École Polytechnique Fédérale de Lausanne (EPFL), Switzerland
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Zhang YS, Rao WW, Zeng LN, Lok GKI, Cui LJ, Li JF, Li L, Ungvari GS, Hall BJ, Li KQ, Xiang YT. Prevalence and correlates of bipolar disorder in the adult population of Hebei province, China. J Affect Disord 2020; 263:129-133. [PMID: 31818768 DOI: 10.1016/j.jad.2019.11.104] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 10/04/2019] [Accepted: 11/21/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND Few studies have estimated the prevalence and correlates of bipolar disorder (BP) in agricultural areas of China. This study examined the one-month and lifetime prevalence of BP, its subtypes and socio-demographic factors in the adult population of Hebei province, a predominantly agricultural area of China. METHODS A multistage, stratified, cluster random sampling method was used to estimate the prevalence and correlates of BP in adults in Hebei province, China. The expanded version of the 12-item General Health Questionnaire (GHQ-12) and the Structured Clinical Interview for DSM-IV Axis I Disorders-Patient Edition (SCID-I/P/C) were administered to establish the diagnosis of BP. RESULTS A total of 20,884 participants were screened. The weighted lifetime prevalence of BP, BP type I (BP-I), type II (BP-II), and BP not otherwise specified (BP-NOS) were 0.20% (95% CI: 0.14-0.26%), 0.13% (95% CI: 0.08-0.18%), 0.03% (95% CI: 0.009-0.06%) and 0.03% (95% CI: 0.009-0.06%), respectively. The weighted one-month prevalence estimates were 0.12% (95% CI: 0.08-0.17%) for BP, 0.07% (95% CI: 0.04-0.11%) for BP-I, 0.03% (95% CI: 0.006-0.05%) for BP-II, and 0.02% (95% CI: 0.003-0.04%) for BP-NOS. Multiple Poisson regression analysis revealed that positive family history of any psychiatric disorder (P<0.001, OR=6.48, 95% CI: 2.53-16.56) was significantly associated with greater risk of BP. CONCLUSION The prevalence of BP in Hebei province appears lower than in most areas of China and other countries. Continued surveillance of BP in China along with the development of primary and tertiary preventative interventions for psychiatric disorders is indicated.
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Affiliation(s)
- Yun-Shu Zhang
- Department of Sleep Medicine, Hebei Mental Health Centre, Hebei province, China
| | - Wen-Wang Rao
- Unit of Psychiatry, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China; Center for Cognition and Brain Sciences, University of Macau, Macao SAR, China
| | - Liang-Nan Zeng
- Unit of Psychiatry, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China; Center for Cognition and Brain Sciences, University of Macau, Macao SAR, China; Department of Neurosurgery, Affiliated Hospital of Southwest Medical University, Sichuan, China
| | - Grace K I Lok
- Unit of Psychiatry, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China; Center for Cognition and Brain Sciences, University of Macau, Macao SAR, China; Kiang Wu Nursing College of Macau, Macau SAR, China
| | - Li-Jun Cui
- Department of Sleep Medicine, Hebei Mental Health Centre, Hebei province, China
| | - Jian-Feng Li
- Department of Sleep Medicine, Hebei Mental Health Centre, Hebei province, China
| | - Lin Li
- Department of Sleep Medicine, Hebei Mental Health Centre, Hebei province, China
| | - Gabor S Ungvari
- Division of Psychiatry, School of Medicine, University of Western Australia, Perth, Australia; University of Notre Dame Australia, Fremantle, Australia
| | - Brian J Hall
- Department of Psychology, University of Macau SAR, China
| | - Ke-Qing Li
- Department of Sleep Medicine, Hebei Mental Health Centre, Hebei province, China.
| | - Yu-Tao Xiang
- Unit of Psychiatry, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China; Center for Cognition and Brain Sciences, University of Macau, Macao SAR, China.
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Sharma V, Bergink V, Berk M, Chandra PS, Munk-Olsen T, Viguera AC, Yatham LN. Childbirth and prevention of bipolar disorder: an opportunity for change. Lancet Psychiatry 2019; 6:786-792. [PMID: 30981755 DOI: 10.1016/s2215-0366(19)30092-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 02/05/2019] [Accepted: 02/06/2019] [Indexed: 12/25/2022]
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.
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Affiliation(s)
- Verinder Sharma
- Department of Psychiatry and Department of Obstetrics and Gynecology, Western University, London, ON, Canada; Parkwood Institute, London, ON, Canada.
| | - Veerle Bergink
- 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
| | - Michael Berk
- 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
| | - Prabha S Chandra
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Trine Munk-Olsen
- National Centre for Register-based Research, Aarhus University, Aarhus, Denmark; Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
| | - Adele C Viguera
- Cleveland Clinic, Cleveland, OH, USA; Massachusetts General Hospital, Boston, MA, USA
| | - Lakshmi N Yatham
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
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Abstract
BACKGROUND Bipolar Disorder (BD), along with depression and schizophrenia, is one of the most serious mental illnesses, and one of the top 20 causes of severe impairment in everyday life. Recent molecular studies, using both traditional approaches and new procedures such as Whole-Genome Sequencing (WGS), have suggested that genetic factors could significantly contribute to the development of BD, with heritability estimates of up to 85%. However, it is assumed that BD is a multigenic and multifactorial illness with environmental factors that strongly contribute to disease development/progression, which means that progress in genetic knowledge of BD might be difficult to interpret in clinical practice. OBJECTIVE The aim of this study is to provide a synthetic description of the main SNPs variants identified/confirmed by recent extensive WGS analysis as well as by reconstruction in an in vitro mechanism or by amygdala activation protocol in vivo. METHOD Bibliographic data, genomic and protein Data Banks were consulted so as to carry out a cross genomic study for mutations, SNPs and chromosomal alterations described in these studies in BD patients. RESULTS Fifty-five different mutations have been described in 30 research papers by different genetic analyses including recent WGS analysis. Many of these studies have led to the discovery of the most probable susceptibility genes for BD, including ANK3, CACNA1C, NCAN, ODZ4, SYNE1, and TRANK1. Exploration has started the role of several of these mutations in BD pathophysiology using in vitro and animal models. CONCLUSION Although new genomic research technology in BD opens up new possibilities, the current results for common variants are still controversial because of four broad conditions: analytical validity, clinical validity, clinical utility and a reasonable cost for genetic analysis are not yet accessible.
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Affiliation(s)
- Germano Orrù
- Department of Surgical Sciences, Molecular Biology Service (MBS), University of Cagliari, Cagliari, Italy
- National Research Council of Italy, ISPA, Sassari, Italy
- Address correspondence to this author at the Department of Surgical Sciences, University of Cagliari, Germano Orrù Ph.D, via Ospedale 54, 09124 Cagliari, Italy; Tel: +39 070 609-2568; E-mail:
| | - Mauro Giovanni Carta
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
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