Bipolar disorder

Humboldt-Universität zu Berlin, Berlín, Berlin, Germany
The Lancet (Impact Factor: 45.22). 02/2002; 359(9302):241-7. DOI: 10.1016/S0140-6736(02)07450-0
Source: PubMed


Bipolar, or manic-depressive, disorder is a frequent, severe, mostly recurrent mood disorder associated with great morbidity. The lifetime prevalence of bipolar disorder is 1.3 to 1.6%. The mortality rate of the disease is two to three times higher than that of the general population. About 10-20% of individuals with bipolar disorder take their own life, and nearly one third of patients admit to at least one suicide attempt. The clinical manifestations of the disease are exceptionally diverse. They range from mild hypomania or mild depression to severe forms of mania or depression accompanied by profound psychosis. Bipolar disorder is equally prevalent across sexes, with the exception of rapid cycling, a severe and difficult to treat variant of the disorder, which arises mostly in women. Because of the high risk of recurrence and suicide, long-term prophylactic pharmacological treatment is indicated. Lithium salts are the first choice long-term preventive treatment for bipolar disorder. They also possess well documented antisuicidal effects. Second choice prophylactic treatments are carbamazepine and valproate, although evidence of their effectiveness is weaker.

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    • "It is believed that BD is a complex genetic disease that is caused by various interactions between the environment and by multiple genes [1]. Although a high degree of heritability is known for BD, the mode of inheritance for this disorder appears complex, indicating that it is non-Mendelian in nature and involves genes that have yet to be identified [2]. One of the suggestions for why BD has not been clarified as a single genetic disease is heterogeneity. "
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    ABSTRACT: Background Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is an inherited cerebrovascular disease, clinically characterized by variable manifestations of migraine, recurrent transient ischemic attack or lacunar strokes, cognitive decline, and mood disturbances. However, manic episodes have rarely been documented as an initial symptom of CADASIL and bipolar disorder presenting as the first manifestation in CADASIL has not been reported previously from evaluations by psychiatrists or psychological testing by psychologists. Case presentation A 53 year old woman developed symptoms of mania in her 50s leading to a personality change involving a continuously labile mood and irritability over a number of years. Neuropsychological testing revealed an intact memory, but impairment in attention and executive function. In the Rorschach test, she showed a high level of cognitive rigidity. Magnetic resonance imaging findings were very consistent with a diagnosis of CADASIL, which was confirmed by genetic testing for NOTCH3 mutations. Atypical antipsychotics proved to be helpful in treating her manic symptoms and for behavior control. Conclusion We present a novel case of CADASIL that first presented as bipolar disorder. We contend that when patients show a late onset personality change or chronically irritable mood that deteriorates over many years, an organic cause such as CADASIL must be considered. Further studies are needed to better understand the exact impacts of cerebral tissue lesions and psychiatric symptoms in CADASIL patients.
    Full-text · Article · Jun 2014 · BMC Psychiatry
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    • "Lithium is a cation that is present in an insignificant concentration (b 0.2 mEq/L) in body fluids [6]. Lithium is the drug of choice for bipolar disorder and it is widely prescribed in psychiatric practices [7]. It has a narrow therapeutic index; target therapeutic plasma concentrations range from 0.6 to 1.0 mEq/L. "
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    ABSTRACT: Patients receiving preoperative lithium therapy for bipolar disorder may present unique challenges in the perioperative period and during critical illness. Two cases of critically ill patients who developed lithium-induced adverse reactions in the perioperative period due to the low therapeutic index are reported.
    Full-text · Article · May 2014 · Journal of clinical anesthesia
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    • "Mood disorders are among the most common psychiatric disorders, exhibiting a depressed mood in periods of depression and an elevated mood during mania periods (8). Although bipolar mood disorder (BMD) is traditionally considered to be a disease with desirable results in the long-term, a large percentage of bipolar mood patients in recent studies have reported severe periods of the condition, along with a high recurrence of residual symptoms of cognitive and functional disorders, as well as chronic psychosocial disabilities (9). Mortality rates in people with bipolar mood disorder are two to three times higher than in the general population. "
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    ABSTRACT: Background:Behavioral addictions (BAs) can be understood as disorders characterized by repetitive occurrence of reactivity and uncontrolled behaviors. Very few studies have investigated their association with bipolar mood disorders.Objectives:The present study aimed to determine the role of behavioral addictions in predicting interpersonal behavioral addictions in bipolar mood disorder patients.Materials and Methods:This study had a cross-sectional correlation design. The statistical population was composed of all outpatients with bipolar mood disorders referring to clinical centers in Ardabil. The sample included 60 bipolar mood patients selected from patients referring to clinical centers using the available sampling method. A researcher-made behavioral addiction checklist, Interpersonal Behavioral Addictions Index, and exercise, sexual, and work addiction questionnaires, were used for data collection. The data were analyzed with a Pearson’s correlation coefficient and multivariate regression analysis.Results:The results showed a significant negative relationship between behavioral addictions and interpersonal behavioral addictions (P ≥ 0.01). Multivariate regression analysis results also showed that behavioral addictions are significant and can explain 61% of the variance of interpersonal behavioral addictions in bipolar mood patients.Conclusions:These results suggest that addictive behaviors can affect behavioral addictions in bipolar mood patients. Behavioral addictions lead to negative emotional regulation strategies and result in increased behavioral addictions in these patients. People with high levels of arousal or those who cannot control their behavioral addictions are probably more prone to addictive behaviors.
    Full-text · Article · Mar 2014
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