Tailored treatments a priority for people with bipolar II
June 15, 2021, MELBOURNE, Australia—A preliminary inquiry into how adults with bipolar II disorder manage their condition indicates they are hungry for tailored psychological treatments delivered by clinicians knowledgeable about this form of bipolar.
Utilizing an online questionnaire with individuals having a confirmed bipolar II diagnosis, Australian researchers looked at types of therapeutic interventions and self-help coping strategies employed, as well as views on helping tools offered through digital platforms.
Participants favored seeking treatment when dealing with depressive symptoms. Accessibility, cost, and finding a practitioner attuned to the nuances of bipolar II were named as barriers to treatment. Self-care strategies were prioritized for hypomanic symptoms.
Despite generally positive attitudes toward digital interventions, use was limited. The authors said more attention should be paid to “the potential role of digital mental health interventions for this underserved group.”
The study, which appeared in the Journal of Affective Disorders, was entitled “Towards tailored psychosocial intervention for BD-II: Lived experience perspectives on current and future management options.”
Specific cognitive rehab may help adherence in bipolar I
July 1, 2021, CAIRO, Egypt—A new study suggests that rehabilitation of specific cognitive skills may increase the likelihood that people will continue taking medication as prescribed for treatment of bipolar I disorder.
Egyptian researchers, noting non-adherence to prescribed medication is common in people with bipolar I, assessed more than 100 inpatients with the disorder when they were admitted to the hospital and again six months after discharge. At follow-up, close to 60 percent of people were not taking their medications as prescribed.
The study found that younger age and having episodic memory deficits were the strongest predictors of non-adherence to medication. Younger males with fewer years of education and lower scores on cognitive measures such as visual memory and learning domains had the highest rates of non-adherence.
“These results suggest that rehabilitation of specific cognitive skills may improve adherence,” the authors said.
Lithium may offer small protective effect against cancer
July 1, 2021, BARCELONA, Spain—Lithium, a first-line mood stabilizer for treating bipolar disorder, may have protective properties against cancer, a new study suggests.
An international network of researchers analyzed numerous studies involving millions of people and found people with bipolar were at higher risk of any type of cancer, particularly breast cancer in women. But they also found there was no elevated risk of cancer among people with bipolar using lithium. The data also suggested lithium may offer a small protective effect for cancer overall, particularly urinary cancer.
The authors concluded that active screening for cancer should be integrated into the clinical management of bipolar.
The study, which appeared in the journal Neuroscience and Biobehavioral Reviews, was entitled “Risk of cancer in bipolar disorder and the potential role of lithium: International collaborative systematic review and meta-analyses.”
Internet-based tool helpful for monitoring cognition
June 15, 2021, COPENHAGEN, Denmark—An internet-based tool appears to be effective for assessing the cognitive function of people with bipolar disorder, a new study suggests.
Danish researchers noted that an international task force on cognition and bipolar disorder recommends that more use be made of the Screen for Cognition Impairment in Psychiatry test among individuals with bipolar. The test must be administered by a health care professional, however, which creates obstacles related to people’s time and resources.
Therefore, the researchers developed and tested a web-based, self-administered test called the Internet-Based Cognitive Assessment Tool (ICAT). They found the test to be valid, sensitive, and effective for large-scale testing—meaning it could be useful for ongoing monitoring of cognitive function in the clinical management of bipolar disorder.
The study, which appeared in the Journal of Affective Disorders, was entitled “Internet-based cognitive assessment tool: Sensitivity and validity of a new online cognition screening tool for patients with bipolar disorder.”
Differences seen in protein levels based on age of onset of bipolar
June 8, 2021, IZMIR, Turkey—Levels of a protein called brain derived neurotrophic factor (BDNF) may be a viable marker for bipolar disorder in adolescents, a new study suggests.
Turkish and Dutch researchers examined levels of the protein, which plays a role in the growth, maturation, and maintenance of neurons, among youth and adults with bipolar. They found that while BDNF levels were comparable among adults with and without bipolar, they were clearly lower in youth with bipolar as compared to their peers without a diagnosis.
The study also found differences in BDNF levels depending on age of onset. BDNF levels were significantly higher in adults whose bipolar emerged at or after the age of 30. In pediatric bipolar, BDNF levels were higher among those who symptoms started before puberty compared to those whose symptoms developed during puberty.
June 1, 2021, NEW YORK, NY—A small pilot study suggests an intervention developed for older adults with co-existing, chronic pain and mental health conditions may reduce their reliance on opioid pain relievers.
A small group of people ages 55 to 62 participated in the Behavioral Activation for Pain Rehabilitation therapy, which is co-facilitated by the clinician and participant. The study found a significant link to reduced opioid prescription painkiller misuse.
Other reported results included reductions in pain intensity and depression severity and improvements in active and passive pain coping strategies, although the effect was not statistically significant.
The authors said that while the results are promising, more study is needed before rigorous effectiveness testing.
The study, which appeared in the journal The Psychiatric Quarterly, was entitled “Preliminary outcomes of an older peer and clinician co-facilitated pain rehabilitation intervention among adults aged 50 years and older with comorbid chronic pain and mental health conditions.”
Men, women with bipolar display different characteristics
June 1, 2021, UDUPI, India—Men and women in India who have bipolar disorder experience the condition differently, a new study has found.
Indian researchers noted that the course and clinical features of bipolar have been shown to differ according to sex in studies outside of India, but there was little evidence regarding their nation’s population.
They found that while the total number of mood episodes was similar in both sexes, the number of manic episodes was significantly higher in males while the number of depressive episodes and episodes with mixed features was significantly higher in women.
In addition, men were far more likely to experience mania as their first mood episode, while for women the first episode was typically depressive.
Co-existing physical disorders were seen in 61 per cent of females and 40 per cent of males. Co-existing hypothyroidism, migraines, and obesity were seen more often in women, and co-existing substance use was higher in men.
The study, which appeared in the journal The Psychiatric Quarterly, was entitled “Gender differences in clinical characteristics and comorbidities in bipolar disorder: A study from south India.”
Symptoms appear improved during pandemic
June 1, 2021, AMSTERDAM, The Netherlands—According to a new study, some older adults with bipolar disorder experienced fewer psychiatric symptoms during the pandemic as compared to a pre-pandemic baseline measurement.
Dutch researchers looked at people over age 50 with bipolar who had participated in mood assessments during 2017 and 2018. During that period, around 41 percent were euthymic, meaning they were not experiencing significant mood symptoms. When the group was assessed during lockdown measures, that figure rose to nearly 70 percent.
In addition, reported rates of loneliness did not differ between the pandemic and the comparison period.
Factors associated with more psychiatric symptoms during the pandemic included having no children, lower mastery of managing the disorder, a passive coping style, and neuroticism.
Elevated lipids linked with smaller brain volume in youth
June 1, 2021, TORONTO, ON—Higher levels of fats in the bloodstream have been associated with reduced brain volume in younger people with bipolar disorder in a new study.
Canadian researchers looked at regions of the brain, cholesterol levels, and levels of triglycerides to compare youth ages 13 to 20 with and without a bipolar diagnosis. They found a link between elevated lipids (the medical name for a group of fatty acids) and smaller size of two structures in the brain in youth with bipolar as compared to the control group.
Higher levels of triglycerides were linked to smaller volume and area of the anterior cingulate cortex, which helps govern attention allocation, reward anticipation, decision-making, and impulse control. Smaller volume in the hippocampus, which plays a role in memory, was associated with elevated “bad” (LDL) cholesterol and reduced “good” (HDL) cholesterol.
The authors said research is needed to see if optimizing fat levels in the bloodstream has a beneficial effect on brain structure.
The study, which appeared in the journal Acta Psychiatrica Scandinavica, was entitled “Elevated lipids are associated with reduced regional brain structure in youth with bipolar disorder.”
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