Eduard Vieta’s research while affiliated with Instituto de Salud Carlos III and other places

Introduction Impairment in both psychosocial functioning and neurocognition (NC) performance is present in bipolar disorder (BD) yet the role of sex differences in these deficits remains unclear. The present systematic review and meta-analysis examined whether males and females with BD demonstrate differences in psychosocial functioning and NC performance. Methods The Cochrane Library, EMBASE, PsycINFO, PubMed, Scopus, and Web of Science databases were systematically searched from inception until November 20, 2023. Results Twenty studies published between 2005 and 2023 with a total sample size of 2286 patients with BD were included. A random effects meta-analysis revealed a statistically significant result with a small effect (SMD = 0.313) for sex differences in verbal learning and memory as well as visual learning and memory (SMD = 0.263). Females outperformed males in both domains. No significant sex differences were observed for any other NC outcome or psychosocial functioning. High heterogeneity and differences in assessment scales used should be considered when interpreting these findings, given their potential impact on results. Conclusions Future research should adopt a more homogenous, standardized approach using longitudinal designs to gain a clearer insight into sex differences in this population. This approach so may increase the use of preventative therapeutic options to address the difficult clinical challenge of reaching cognitive and functional recovery.

Purpose of Review This paper explores Predominant Polarity (PP) in Bipolar Disorder (BD), defined as the predominance of either manic or depressive episodes over a patient’s course of illness. We examine its clinical relevance, neurobiological foundations, and potential for guiding personalized treatment strategies. The review seeks to determine whether PP is a reliable course specifier and how it can be utilized to improve clinical outcomes. Recent Findings PP has a significant impact on prognosis and treatment planning in BD. Manic and depressive PP are associated with distinct clinical and neurobiological profiles of BD, while individuals without a clear predominance of either episode type represent a more severe to-treat subgroup of patients. The development of the Polarity Index (PI) facilitates treatment decisions based on PP. Summary PP offers a valuable framework for refining BD treatment and understanding its complexity. Future research should focus on refining PP definitions, validating neurobiological markers, and integrating these insights into comprehensive treatment models to improve patient outcomes.

The current study assessed the psychometric properties of the long (24 items) and brief (12 items) versions of the Real Relationship Inventory–Client (RRI-C) in a United States sample. The RRI-C is the most used quantitative measure of the real relationship construct, yet its psychometric properties have not been explored outside its development studies. A sample of 700 adults in individual psychotherapy was recruited in the study and filled out a comprehensive battery of measures. Analytical techniques included confirmatory factor analysis (CFA), exploratory structural equation modeling (ESEM), multigroup CFA, multigroup factor analysis alignment, item response theory, internal reliability assessments, Bland-Altman regression analysis, and calculation of reliable change benchmark thresholds. Both RRI-C versions demonstrated a bifactor structure encompassing Genuineness and Realism dimensions. The bifactor ESEM model provided strong fit: χ²[210] = 482.464, CFI = 0.999, TLI = 0.998, RMSEA = 0.043, SRMR = 0.020 for the 24-item RRI-C; χ²[45] = 111.916, CFI = 0.999, TLI = 0.998, RMSEA = 0.046, SRMR = 0.028 for the 12-item RRI-C. McDonald’s omega total was 0.97 and 0.95 respectively. The correlation between the total scores of the two versions was r = 0.98; the average discrepancy was 1.85 points higher for the comprehensive version with a slope of -0.013 (p = 0.12). Both versions showed functionally identical reliability and factor structure when therapy is online vs. in-person. Significant correlations were found between the RRI-C and the Working Alliance Inventory (r = 0.68 and r = 0.67 for the 24-item and 12-item versions, respectively, both p < .001) and the Session Evaluation Scale (r = 0.62 and r = 0.58, respectively, both p < 0.001). This study substantiates the sound psychometric properties of the 24-item and 12-item RRI-C.

Background Individuals with bipolar disorder have been reported to have increased white matter hyperintensities (WMH) in fluid‐attenuated inversion recovery (FLAIR) magnetic resonance scans. However, it is unknown whether this WMH increase has any impact on white matter connectivity. The present study aimed to evaluate the effects of the bipolar disorder‐related WMH increase on white matter tracts and networks. Methods An expert neuroradiologist blindly assessed the type, size, and location of WMH from 128 FLAIR scans (bipolar disorder: n = 64, age = 38 ± 7 years; 53% females; matched healthy controls: n = 64, age = 36 ± 10 years, 58% females). Afterward, we conducted an atlas‐based analysis comparing the mean percentage parcel of damage in the white matter tracts of the Human Connectome Project tractography template and the networks of the 7‐Network Cortical Parcellation template. Results We did not detect WMH‐related effects on white matter connectivity when correcting for multiple comparisons. However, at the uncorrected level, we found a higher WMH‐related white matter disconnection in the right inferior fronto‐occipital fasciculus and the right middle longitudinal fasciculus. Conclusion This study evaluates, for the first time, the impact of WMH on bipolar brain structural connectivity. It finds an effect on two fasciculi, providing hints into one potential origin of the brain networks' alterations reported in the disorder. However, we only observed these results at the uncorrected statistical level, for which they are likely small and should be taken with caution until replicated.

Introduction Misdiagnosis of bipolar disorder (BD) can lead to ineffective treatment, increased risk of manic episodes, and increased severity. Objective diagnostic tests or precise tools to diagnose BD and distinguish it from major depressive disorder (MDD) in depressed patients are lacking. Aim To assess the external diagnostic validity of a blood-based test using an RNA epigenetic signature for the differential diagnosis of BD versus MDD in patients with depression. Methods and analysis Multicentre cross-sectional study including an adult sample of inpatients or outpatients diagnosed with BD or MDD, currently treated for a major depressive episode. A structured diagnostic interview based on validated scales will be conducted. Sociodemographic variables, clinical history, toxic consumption, current treatment and quality of life will be assessed. Blood samples will be obtained and stored at −80 °C until RNA sequencing analysis. The EDIT-B is a blood-based test that combines RNA editing biomarkers and individual data (e.g., age, sex, and tobacco consumption). The clinical validation performance of the EDIT-B will be evaluated using the area under the curve, sensitivity, specificity, positive and negative predictive values, and likelihood ratios. Ethics and dissemination The principles of the Declaration of Helsinki 2013, precision psychiatry research and good clinical practice will be followed. The Research Ethics Committees of the participating centres approved the study. Participants will receive an information sheet and must sign the informed consent before the interview. Participants’ data will be pseudonymized at the research sites. Any publication will use fully anonymized data. Publications with the final study results will be disseminated in international peer-reviewed journals and presented at international conferences. Study registration: This study has been registered on clinicaltrials.gov (NCT05603819). Registration date: 28-10-2022.