Focus on Bipolar Disorder: 6 New Studies

"One of things so bad about depression and bipolar disorder is that if you don't have prior awareness, you don't have any idea what hit you.” -Kay Redfield Jamison, MA, PhD, Clinical psychologist and writer

The 1-year adjusted cumulative incidence of treatment failure in patients with bipolar disorder in a recent study was 75.7% in those who used mood stabilizers without second-generation antipsychotics (SGAPs), 75.3% in those who used SGAPs only, and 60.5% in those who used both. The adjusted difference in incidence for SGAPs compared with mood stabilizers was −0.40% in the whole population, −2.2% in patients younger than 65 years, and +6.7% in patients 65 years and older. No overall difference in treatment failure was observed among strategies, but the incidence was high.

Nerve growth factor (NGF) may be a useful biomarker for early detection of conversion from major depressive disorder (MDD) to bipolar disorder in women. NGF serum levels were increased in patients who converted to bipolar disorder compared with remitted MDD and current MDD groups. Significant differences were revealed for higher NGF levels in patients who converted to bipolar disorder compared with patients with current MDD. Interleukin‐6, tumor necrosis factor‐α, and other serum levels did not differ among the groups.

New findings suggest a relationship between mood and how persons with bipolar disorder understand and experience creativity. Patients who reported clinically significant depressive symptoms had significantly lower creativity scores than those who reported clinically significant hypomania or no current symptoms. Creativity scores were not significantly different in the hypomania and no current symptom groups but were significantly higher than in patients who reported symptoms of both hypomania and depression in the past week.

Tobacco smoking was independently associated with recurrent suicide attempts in patients with bipolar disorder, both alone and comorbid with other substance use disorders (SUDs). At least 1 suicide attempt was reported by 37% of patients with bipolar disorder, and about half of them (51%) reported recurrence. Tobacco smoking only accounted for 43% of SUD comorbidity, and tobacco smoking with at least another SUD for 20%. Also independently associated with recurrent suicide attempts were depressive polarity of bipolar disorder onset and female sex.

Mindfulness‐Based Cognitive Therapy for Children (MBCT‐C) may be effective for improving overall clinical severity in youth with anxiety disorders who are at risk for bipolar disorder. Children and adolescents who have at least 1 parent with bipolar disorder showed significantly greater improvements in overall clinical severity in an MBCT‐C period than a subset who participated in a prior psychoeducation waitlist control period. Significantly greater improvements were not seen in clinician‐ and child‐rated anxiety, emotion regulation, or mindfulness.

In the first study to systematically seek service user perspectives on a major classification and diagnostic guideline, researchers used focus groups to collect feedback from persons who have bipolar type 1 disorder, depressive episode, generalized anxiety disorder, schizophrenia, or personality disorder on how their disorder will be described in the 11th revision of the International Classification of Diseases and Related Health Problems (ICD-11). They suggested that accessible lay language in the ICD-11 could benefit both patients and clinicians.