Bipolar Disorder

Comorbid panic attacks and mania-associated symptoms are the most significant risk factors for manic switch during a depressive episode in bipolar patients, according to Dr. Tomihisa Niitsu and associates.

Risk factors for manic switch in any bipolar patient included younger age and recent histories of rapid cycling, severe manic symptoms, and certain pharmacological and psychotherapeutic treatments. Along with panic attacks and manic symptoms, any mood elevation during a depressive episode also indicated a risk for manic switch. During a depressive episode, the odds ratio of a switch if all three primary risk factors were present was 7.28 (95% confidence interval, 4.15-12.78; P < 0.001).

“These findings may represent useful clinical information for monitoring the risk of manic switch when treating depressive bipolar patients,” the investigators concluded.

Find the full study in the Journal of Psychiatric Research (doi: 10.1016/j.jpsychires.2015.04.014).

Comorbid panic attacks and mania-associated symptoms are the most significant risk factors for manic switch during a depressive episode in bipolar patients, according to Dr. Tomihisa Niitsu and associates.

Risk factors for manic switch in any bipolar patient included younger age and recent histories of rapid cycling, severe manic symptoms, and certain pharmacological and psychotherapeutic treatments. Along with panic attacks and manic symptoms, any mood elevation during a depressive episode also indicated a risk for manic switch. During a depressive episode, the odds ratio of a switch if all three primary risk factors were present was 7.28 (95% confidence interval, 4.15-12.78; P < 0.001).

“These findings may represent useful clinical information for monitoring the risk of manic switch when treating depressive bipolar patients,” the investigators concluded.

Find the full study in the Journal of Psychiatric Research (doi: 10.1016/j.jpsychires.2015.04.014).

Comorbid panic attacks and mania-associated symptoms are the most significant risk factors for manic switch during a depressive episode in bipolar patients, according to Dr. Tomihisa Niitsu and associates.

Risk factors for manic switch in any bipolar patient included younger age and recent histories of rapid cycling, severe manic symptoms, and certain pharmacological and psychotherapeutic treatments. Along with panic attacks and manic symptoms, any mood elevation during a depressive episode also indicated a risk for manic switch. During a depressive episode, the odds ratio of a switch if all three primary risk factors were present was 7.28 (95% confidence interval, 4.15-12.78; P < 0.001).

“These findings may represent useful clinical information for monitoring the risk of manic switch when treating depressive bipolar patients,” the investigators concluded.

Find the full study in the Journal of Psychiatric Research (doi: 10.1016/j.jpsychires.2015.04.014).

Rapid cycling bipolar disorder and migraines are independently associated with each other, a cross-sectional study shows.

“Our findings provide further evidence that comorbid migraine in [bipolar disorder] represents a more homogenous subgroup of [bipolar disorder] that may be associated with an unstable rapid cycling illness course,” wrote K. Gordon-Smith, Ph.D., and her colleagues.

The United Kingdom–based study included 1,488 individuals with lifetime clinical characteristics of bipolar disorder (BD). Of the study’s sample, 375 had comorbid migraines. Both patients with bipolar disorder I and bipolar disorder II participated in the self-report research project.

Among the study’s findings is that numerous clinical characteristics occurred significantly more often in the migraine group. Such characteristics included having a history of panic attacks, rapid cycling (defined as experiencing four or more episodes in a 12-month period), family history of affective disorders, and younger age at illness onset. The study also found that significantly more subjects in the migraine group had a lower history of psychiatric admission, and less impairment in functioning during their worst episode of (hypo)mania. The study confirmed the finding of previous research showing that bipolar patients with comorbid migraines are more likely to be female.

Further in-depth analyses of this patient population with more detailed information about the migraine phenotype is needed, the researchers said.

Read the full study in Journal of Affective Disorders (doi: 10.1016/j.jad.2015.01.024).

Rapid cycling bipolar disorder and migraines are independently associated with each other, a cross-sectional study shows.

“Our findings provide further evidence that comorbid migraine in [bipolar disorder] represents a more homogenous subgroup of [bipolar disorder] that may be associated with an unstable rapid cycling illness course,” wrote K. Gordon-Smith, Ph.D., and her colleagues.

The United Kingdom–based study included 1,488 individuals with lifetime clinical characteristics of bipolar disorder (BD). Of the study’s sample, 375 had comorbid migraines. Both patients with bipolar disorder I and bipolar disorder II participated in the self-report research project.

Among the study’s findings is that numerous clinical characteristics occurred significantly more often in the migraine group. Such characteristics included having a history of panic attacks, rapid cycling (defined as experiencing four or more episodes in a 12-month period), family history of affective disorders, and younger age at illness onset. The study also found that significantly more subjects in the migraine group had a lower history of psychiatric admission, and less impairment in functioning during their worst episode of (hypo)mania. The study confirmed the finding of previous research showing that bipolar patients with comorbid migraines are more likely to be female.

Further in-depth analyses of this patient population with more detailed information about the migraine phenotype is needed, the researchers said.

Read the full study in Journal of Affective Disorders (doi: 10.1016/j.jad.2015.01.024).

Rapid cycling bipolar disorder and migraines are independently associated with each other, a cross-sectional study shows.

“Our findings provide further evidence that comorbid migraine in [bipolar disorder] represents a more homogenous subgroup of [bipolar disorder] that may be associated with an unstable rapid cycling illness course,” wrote K. Gordon-Smith, Ph.D., and her colleagues.

The United Kingdom–based study included 1,488 individuals with lifetime clinical characteristics of bipolar disorder (BD). Of the study’s sample, 375 had comorbid migraines. Both patients with bipolar disorder I and bipolar disorder II participated in the self-report research project.

Among the study’s findings is that numerous clinical characteristics occurred significantly more often in the migraine group. Such characteristics included having a history of panic attacks, rapid cycling (defined as experiencing four or more episodes in a 12-month period), family history of affective disorders, and younger age at illness onset. The study also found that significantly more subjects in the migraine group had a lower history of psychiatric admission, and less impairment in functioning during their worst episode of (hypo)mania. The study confirmed the finding of previous research showing that bipolar patients with comorbid migraines are more likely to be female.

Further in-depth analyses of this patient population with more detailed information about the migraine phenotype is needed, the researchers said.

Read the full study in Journal of Affective Disorders (doi: 10.1016/j.jad.2015.01.024).

Patients with bipolar disorder I have increased verbal learning impairment compared with those who have bipolar II, according to Corin Bourne, D.Phil., and associates.

The investigators looked at the performance of 183 bipolar I (BDI) patients with 96 bipolar II (BDII) outpatients on a modified version of the Rey Verbal Learning Task. They found that VLT scores were significantly lower in bipolar I patients, with effect sizes ranging from 0.13 to 0.17. Drug treatment and other illnesses were unrelated to the impairment, but age of onset affected outcomes in three of the five measured categories, and mood elevation incidence affected one measured category.

“Initially, both bipolar subtypes may have similar levels of verbal learning and memory performance” but BDI patients suffered steeper declines, noted Dr. Bourne of the department of psychiatry at the University of Oxford (England) and Warneford Hospital in Oxford.

Find the full study in the Journal of Affective Disorders (doi: 10.1016/j.jad.2015.04.021).

Patients with bipolar disorder I have increased verbal learning impairment compared with those who have bipolar II, according to Corin Bourne, D.Phil., and associates.

The investigators looked at the performance of 183 bipolar I (BDI) patients with 96 bipolar II (BDII) outpatients on a modified version of the Rey Verbal Learning Task. They found that VLT scores were significantly lower in bipolar I patients, with effect sizes ranging from 0.13 to 0.17. Drug treatment and other illnesses were unrelated to the impairment, but age of onset affected outcomes in three of the five measured categories, and mood elevation incidence affected one measured category.

“Initially, both bipolar subtypes may have similar levels of verbal learning and memory performance” but BDI patients suffered steeper declines, noted Dr. Bourne of the department of psychiatry at the University of Oxford (England) and Warneford Hospital in Oxford.

Find the full study in the Journal of Affective Disorders (doi: 10.1016/j.jad.2015.04.021).

Patients with bipolar disorder I have increased verbal learning impairment compared with those who have bipolar II, according to Corin Bourne, D.Phil., and associates.

The investigators looked at the performance of 183 bipolar I (BDI) patients with 96 bipolar II (BDII) outpatients on a modified version of the Rey Verbal Learning Task. They found that VLT scores were significantly lower in bipolar I patients, with effect sizes ranging from 0.13 to 0.17. Drug treatment and other illnesses were unrelated to the impairment, but age of onset affected outcomes in three of the five measured categories, and mood elevation incidence affected one measured category.

“Initially, both bipolar subtypes may have similar levels of verbal learning and memory performance” but BDI patients suffered steeper declines, noted Dr. Bourne of the department of psychiatry at the University of Oxford (England) and Warneford Hospital in Oxford.

Find the full study in the Journal of Affective Disorders (doi: 10.1016/j.jad.2015.04.021).

The Workplace Bipolar Inventory, a 39-item questionnaire used to screen for bipolar disorder in the workplace, showed promise in a small study, according to Kotaro Imamura, Ph.D., and his associates.

The investigator asked workers who were on sick leave because of mental health problems to complete the Workplace Bipolar Inventory (WBI), the Mood Disorder Questionnaire, and the Bipolar Spectrum Diagnostic Scale. A subscale of the WBI called the WBI-AB4 proved to have the screening performance that was most informative.

“According to the optimal cut-off point, WBI-AB4 would be useful for occupational mental health staffs to screen out bipolarity among workers who have depressive symptoms at the workplace; however, more information of the suspected subjects about the manic/hypomanic episode from their supervisor, colleagues, or family was needed,” reported Dr. Imamura of the department of mental health at the University of Tokyo, and his associates.

Find the full study in the Journal of Affective Disorders (doi:10.1016/j.jad.2015.02.034).

The Workplace Bipolar Inventory, a 39-item questionnaire used to screen for bipolar disorder in the workplace, showed promise in a small study, according to Kotaro Imamura, Ph.D., and his associates.

The investigator asked workers who were on sick leave because of mental health problems to complete the Workplace Bipolar Inventory (WBI), the Mood Disorder Questionnaire, and the Bipolar Spectrum Diagnostic Scale. A subscale of the WBI called the WBI-AB4 proved to have the screening performance that was most informative.

“According to the optimal cut-off point, WBI-AB4 would be useful for occupational mental health staffs to screen out bipolarity among workers who have depressive symptoms at the workplace; however, more information of the suspected subjects about the manic/hypomanic episode from their supervisor, colleagues, or family was needed,” reported Dr. Imamura of the department of mental health at the University of Tokyo, and his associates.

Find the full study in the Journal of Affective Disorders (doi:10.1016/j.jad.2015.02.034).

The Workplace Bipolar Inventory, a 39-item questionnaire used to screen for bipolar disorder in the workplace, showed promise in a small study, according to Kotaro Imamura, Ph.D., and his associates.

The investigator asked workers who were on sick leave because of mental health problems to complete the Workplace Bipolar Inventory (WBI), the Mood Disorder Questionnaire, and the Bipolar Spectrum Diagnostic Scale. A subscale of the WBI called the WBI-AB4 proved to have the screening performance that was most informative.

“According to the optimal cut-off point, WBI-AB4 would be useful for occupational mental health staffs to screen out bipolarity among workers who have depressive symptoms at the workplace; however, more information of the suspected subjects about the manic/hypomanic episode from their supervisor, colleagues, or family was needed,” reported Dr. Imamura of the department of mental health at the University of Tokyo, and his associates.

Find the full study in the Journal of Affective Disorders (doi:10.1016/j.jad.2015.02.034).

The Food and Drug Administration has approved several generic formulations of the atypical antipsychotic aripiprazole, the agency announced April 28.

Aripiprazole was approved in 2002 for the treatment of schizophrenia and is marketed as Abilify by the Otsuka Pharmaceutical. It is now also approved for indications that include bipolar disorder. Multiple dosage forms and strengths of generic aripiprazole have been approved, according to the FDA statement.

The generic manufacturers are Alembic Pharmaceuticals, Hetero Drugs, Teva Pharmaceuticals, and Torrent Pharmaceuticals.

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The Food and Drug Administration has approved several generic formulations of the atypical antipsychotic aripiprazole, the agency announced April 28.

Aripiprazole was approved in 2002 for the treatment of schizophrenia and is marketed as Abilify by the Otsuka Pharmaceutical. It is now also approved for indications that include bipolar disorder. Multiple dosage forms and strengths of generic aripiprazole have been approved, according to the FDA statement.

The generic manufacturers are Alembic Pharmaceuticals, Hetero Drugs, Teva Pharmaceuticals, and Torrent Pharmaceuticals.

[email protected]

The Food and Drug Administration has approved several generic formulations of the atypical antipsychotic aripiprazole, the agency announced April 28.

Aripiprazole was approved in 2002 for the treatment of schizophrenia and is marketed as Abilify by the Otsuka Pharmaceutical. It is now also approved for indications that include bipolar disorder. Multiple dosage forms and strengths of generic aripiprazole have been approved, according to the FDA statement.

The generic manufacturers are Alembic Pharmaceuticals, Hetero Drugs, Teva Pharmaceuticals, and Torrent Pharmaceuticals.

[email protected]

WASHINGTON – Only 20% of women of childbearing age taking antiepileptic drugs also received a folate prescription, a small study revealed – but a brief intervention helped boost the rate above 60%.

Folic acid supplementation is de rigueur for women of childbearing age – and especially important in very early pregnancy. The need appears even greater in women who take antiepileptic drugs, many of which increase the risk of birth defects.

Despite current recommendations for folic acid supplementation in all women, prescription by neurologists seems low, according to Dr. Brian D. Moseley of the University of Cincinnati.

“We wanted to look at the rates of the prescription of folic acid to women on antiepileptic drugs who were seen in our general neurology clinic,” Dr. Moseley explained.

In an interview at the annual meeting of the American Academy of Neurology, Dr. Moseley discussed the study’s findings, how a brief intervention with the clinic’s physicians increased folic acid prescription rates, and which folic acid dosages may be optimal.

[email protected]

WASHINGTON – Only 20% of women of childbearing age taking antiepileptic drugs also received a folate prescription, a small study revealed – but a brief intervention helped boost the rate above 60%.

Folic acid supplementation is de rigueur for women of childbearing age – and especially important in very early pregnancy. The need appears even greater in women who take antiepileptic drugs, many of which increase the risk of birth defects.

Despite current recommendations for folic acid supplementation in all women, prescription by neurologists seems low, according to Dr. Brian D. Moseley of the University of Cincinnati.

“We wanted to look at the rates of the prescription of folic acid to women on antiepileptic drugs who were seen in our general neurology clinic,” Dr. Moseley explained.

In an interview at the annual meeting of the American Academy of Neurology, Dr. Moseley discussed the study’s findings, how a brief intervention with the clinic’s physicians increased folic acid prescription rates, and which folic acid dosages may be optimal.

[email protected]

WASHINGTON – Only 20% of women of childbearing age taking antiepileptic drugs also received a folate prescription, a small study revealed – but a brief intervention helped boost the rate above 60%.

Folic acid supplementation is de rigueur for women of childbearing age – and especially important in very early pregnancy. The need appears even greater in women who take antiepileptic drugs, many of which increase the risk of birth defects.

Despite current recommendations for folic acid supplementation in all women, prescription by neurologists seems low, according to Dr. Brian D. Moseley of the University of Cincinnati.

“We wanted to look at the rates of the prescription of folic acid to women on antiepileptic drugs who were seen in our general neurology clinic,” Dr. Moseley explained.

In an interview at the annual meeting of the American Academy of Neurology, Dr. Moseley discussed the study’s findings, how a brief intervention with the clinic’s physicians increased folic acid prescription rates, and which folic acid dosages may be optimal.

[email protected]

Metabolic syndrome was significantly more prevalent in patients with bipolar disorder than in those with major depressive disorder or in controls, Barbora Silarova, Ph.D., and her coauthors reported.

In a study of 2,431 patients the investigators found that those with bipolar disorder had a significantly higher prevalence of metabolic syndrome, compared with patients with major depressive disorder and nonpsychiatric controls (28.4% vs. 20.2% and 16.5%, respectively; P < .001). This difference was consistent when adjusted for sociodemographic and lifestyle factors, Dr. Silarova and her colleagues said in the paper.

“Clinically, it might be relevant to apply individualized treatment for [bipolar disorder] patients that also includes assessment of metabolic risk factors, psychoeducation, weight loss intervention, and improvement of health-related behaviors,” the authors said.

Read the full article in the Journal of Psychosomatic Research here.

Metabolic syndrome was significantly more prevalent in patients with bipolar disorder than in those with major depressive disorder or in controls, Barbora Silarova, Ph.D., and her coauthors reported.

In a study of 2,431 patients the investigators found that those with bipolar disorder had a significantly higher prevalence of metabolic syndrome, compared with patients with major depressive disorder and nonpsychiatric controls (28.4% vs. 20.2% and 16.5%, respectively; P < .001). This difference was consistent when adjusted for sociodemographic and lifestyle factors, Dr. Silarova and her colleagues said in the paper.

“Clinically, it might be relevant to apply individualized treatment for [bipolar disorder] patients that also includes assessment of metabolic risk factors, psychoeducation, weight loss intervention, and improvement of health-related behaviors,” the authors said.

Read the full article in the Journal of Psychosomatic Research here.

Metabolic syndrome was significantly more prevalent in patients with bipolar disorder than in those with major depressive disorder or in controls, Barbora Silarova, Ph.D., and her coauthors reported.

In a study of 2,431 patients the investigators found that those with bipolar disorder had a significantly higher prevalence of metabolic syndrome, compared with patients with major depressive disorder and nonpsychiatric controls (28.4% vs. 20.2% and 16.5%, respectively; P < .001). This difference was consistent when adjusted for sociodemographic and lifestyle factors, Dr. Silarova and her colleagues said in the paper.

“Clinically, it might be relevant to apply individualized treatment for [bipolar disorder] patients that also includes assessment of metabolic risk factors, psychoeducation, weight loss intervention, and improvement of health-related behaviors,” the authors said.

Read the full article in the Journal of Psychosomatic Research here.

Women with bipolar disorder exhibit a higher lifetime prevalence of unplanned pregnancies when compared to healthy women, according to a study in the Journal of Affective Disorders.

A team of researchers led by Dr. Eliana Marengo of Favaloro University in Buenos Aires compared 63 women with type I, II, or non-specified bipolar disorder between the ages of 18-55 to 63 healthy controls. “In our sample, near 80% of pregnancies were planned among healthy control women but 33% were intended in the [bipolar] group. Conversely, one third of pregnancies were unplanned among [bipolar women] while just 7% occurred within control women group,” Dr. Marengo and her associates wrote.

In addition, women with bipolar disorder were more likely to report elective interruption of pregnancies than the general study population, with 42.4% of subjects reported having voluntarily terminated a pregnancy, compared with 13.5% of healthy controls of similar socioeconomic status.

“Clinicians must be aware of the reproductive health and take measures to improve better family planning access when treating” young women with biipolar disorder, the researchers wrote.

Read the entire article here: Journal of Affective Disorders 178 (2015) 201–205 (http://dx.doi.org/10.1016/j.jad.2015.02.033)

Women with bipolar disorder exhibit a higher lifetime prevalence of unplanned pregnancies when compared to healthy women, according to a study in the Journal of Affective Disorders.

A team of researchers led by Dr. Eliana Marengo of Favaloro University in Buenos Aires compared 63 women with type I, II, or non-specified bipolar disorder between the ages of 18-55 to 63 healthy controls. “In our sample, near 80% of pregnancies were planned among healthy control women but 33% were intended in the [bipolar] group. Conversely, one third of pregnancies were unplanned among [bipolar women] while just 7% occurred within control women group,” Dr. Marengo and her associates wrote.

In addition, women with bipolar disorder were more likely to report elective interruption of pregnancies than the general study population, with 42.4% of subjects reported having voluntarily terminated a pregnancy, compared with 13.5% of healthy controls of similar socioeconomic status.

“Clinicians must be aware of the reproductive health and take measures to improve better family planning access when treating” young women with biipolar disorder, the researchers wrote.

Read the entire article here: Journal of Affective Disorders 178 (2015) 201–205 (http://dx.doi.org/10.1016/j.jad.2015.02.033)

Women with bipolar disorder exhibit a higher lifetime prevalence of unplanned pregnancies when compared to healthy women, according to a study in the Journal of Affective Disorders.

A team of researchers led by Dr. Eliana Marengo of Favaloro University in Buenos Aires compared 63 women with type I, II, or non-specified bipolar disorder between the ages of 18-55 to 63 healthy controls. “In our sample, near 80% of pregnancies were planned among healthy control women but 33% were intended in the [bipolar] group. Conversely, one third of pregnancies were unplanned among [bipolar women] while just 7% occurred within control women group,” Dr. Marengo and her associates wrote.

In addition, women with bipolar disorder were more likely to report elective interruption of pregnancies than the general study population, with 42.4% of subjects reported having voluntarily terminated a pregnancy, compared with 13.5% of healthy controls of similar socioeconomic status.

“Clinicians must be aware of the reproductive health and take measures to improve better family planning access when treating” young women with biipolar disorder, the researchers wrote.

Read the entire article here: Journal of Affective Disorders 178 (2015) 201–205 (http://dx.doi.org/10.1016/j.jad.2015.02.033)

Increased impulsive behavior is a risk factor for bipolar disorder, according to Dr. Michèle Wessa and her associates.

Both high-risk groups studied -- relatives of bipolar disorder patients and study participants with high Hypomanic Personality Scale scores -- demonstrated heightened impulsivity and impulsive decision making, compared with the low-risk control groups. No signficant difference in response inhibition was seen between any of the study groups.

“The knowledge derived from this and other studies helps in the assessment of early inventions in participants at risk, who develop the disorder by. . .training them to make less impulsive decisions, which might prevent them from a progression on the bipolar spectrum,” the investigators concluded.

Find the full study in the Journal of Affective Disorders (doi: 10.1016/j.jad.2015.02.018).

Increased impulsive behavior is a risk factor for bipolar disorder, according to Dr. Michèle Wessa and her associates.

Both high-risk groups studied -- relatives of bipolar disorder patients and study participants with high Hypomanic Personality Scale scores -- demonstrated heightened impulsivity and impulsive decision making, compared with the low-risk control groups. No signficant difference in response inhibition was seen between any of the study groups.

“The knowledge derived from this and other studies helps in the assessment of early inventions in participants at risk, who develop the disorder by. . .training them to make less impulsive decisions, which might prevent them from a progression on the bipolar spectrum,” the investigators concluded.

Find the full study in the Journal of Affective Disorders (doi: 10.1016/j.jad.2015.02.018).

Increased impulsive behavior is a risk factor for bipolar disorder, according to Dr. Michèle Wessa and her associates.

Both high-risk groups studied -- relatives of bipolar disorder patients and study participants with high Hypomanic Personality Scale scores -- demonstrated heightened impulsivity and impulsive decision making, compared with the low-risk control groups. No signficant difference in response inhibition was seen between any of the study groups.

“The knowledge derived from this and other studies helps in the assessment of early inventions in participants at risk, who develop the disorder by. . .training them to make less impulsive decisions, which might prevent them from a progression on the bipolar spectrum,” the investigators concluded.

Find the full study in the Journal of Affective Disorders (doi: 10.1016/j.jad.2015.02.018).