October 1, 2020, CHAPEL HILL, NC—Integrating primary care services and behavioral health services appears to reduce emergency room visits among people with severe psychiatric conditions such as bipolar disorder, a new study suggests.
American researchers, using the customary term “serious mental illness,” noted that individuals with such conditions have high rates of emergency department visits and high premature mortality rates. They analyzed results from a model of treatment known as enhanced primary care to determine its effect on emergency room visits for physical health complaints.
They found that after people with serious mental illness had been enrolled in the program for three to four years, the average number of annual visits fell from 3.23 visits per person to 1.83 visits. For people with multiple co-existing physical health conditions, the average number of visits per year dropped from 4.04 to 2.48.
The study, which appeared in the Community Mental Health Journal, was entitled “The effects of an enhanced primary care model for patients with serious mental illness on emergency department utilization.”
October 1, 2020, LOS ANGELES, CA—Family-focused therapy appears to reduce suicidal thinking among youth who are considered at risk for bipolar disorder, a new study suggests.
American researchers followed at-risk youth who took part in either 12 sessions of family-focused therapy over four months or six sessions of psychoeducation over four months. Of those who had high levels of suicidal thinking at the start of the study, the youth who took part in family-focused therapy had lower levels of—and fewer weeks of—suicidal thinking than the youth who received psychoeducation.
Higher levels of parent/offspring conflict moderated the therapeutic benefits, indicating that reducing family conflict should be a central objective of psychosocial interventions for this group, the authors said.
The study, which appeared in the Journal of Affective Disorders, was entitled “Effects of family-focused therapy on suicidal ideation and behavior in youth at high risk for bipolar disorder.”
Higher cortisol levels may warn of manic episode in bipolar I
September 1, 2020, ROTTERDAM, The Netherlands—Levels of the stress hormone cortisol appear to spike prior to a manic episode in people with bipolar I disorder, a new study has found.
In a small pilot study, Dutch researchers explored the relationship between the central stress response system (the hypothalamic-pituitary-adrenal axis) and manic episodes by measuring levels of the stress hormone cortisol deposited in hair over a number of months.
By studying hair samples from people with bipolar I in manic states, people with bipolar I in remission, and people without bipolar, the authors found a significant peak in hair cortisol before a manic relapse.
The authors also found higher concentrations of hair cortisol concentrations were associated with a greater number of mood episodes in the course of bipolar I.
The study, which appeared in the journal Psychoneuroendocrinology, was entitled “Higher cortisol levels may proceed a manic episode and are related to disease severity in patients with bipolar disorder.”
September 1, 2020, PITTSBURGH, PA—Experiencing trauma, especially violence or abuse, worsens the course of bipolar disorder in young people, a new study suggests.
American researchers said exposure to severe traumatic events has been associated with worse course of illness and poorer outcomes in adults with bipolar, but less is known about how trauma affects youth with bipolar.
The researchers followed 375 children, teens and young adults for nearly nine years, assessing them roughly every seven months. Having one or more lifetime traumatic events was associated with earlier onset of bipolar, more severe mood symptoms, more suicidal thinking, increased risk of relapse, poorer psychosocial functioning, and more co-existing conditions.
The authors said their findings suggest the need for prompt screening for trauma and early intervention to minimize the impact of traumatic events.
The study, which appeared in the Journal of Affective Disorders, was entitled “The effect of traumatic events on the longitudinal course and outcomes of youth with bipolar disorder.”
Group cognitive behavioral therapy may be beneficial
September 1, 2020, VELDHOVEN, The Netherlands—Receiving cognitive behavioral therapy in a group setting has lasting benefits for people with bipolar I or II, according to Dutch researchers.
Looking at a small cohort of people with bipolar I or bipolar II who participated in group cognitive behavioral therapy in addition to treatment as usual, the researchers analyzed daily mood monitoring during the active portion of the study and assessments at two months and a year post-therapy.
They found that over the course of the intervention and afterward, participants tended to have fewer mood variations, less time spent in depressive episodes, improved psychosocial functioning, and better self-reported psychological health. The results were moderated by higher reported lifetime depressive episodes.
The study, which appeared in the journal Behavioural and Cognitive Psychotherapy, was entitled “A cognitive behavioural group therapy for bipolar disorder using daily mood monitoring.”
Family history of depression predicts re-hospitalization
September 1, 2020, SEOUL, South Korea—A family history of depression appears influential in predicting which individuals with bipolar I disorder will return to the hospital in the year following a psychiatric hospitalization, a new study suggests.
South Korean researchers, noting that medication is fundamental to treating bipolar disorder, tracked 138 individuals with bipolar I who were receiving one of three atypical antipsychotic medications as part of their pharmacotherapy. About 18 percent had a subsequent hospitalization, and time to relapse did not differ among the three treatment groups.
In addition to family history of depression, number of previous hospital admissions was a strong predictor of relapse.
The study, which appeared in the journal International Clinical Psychopharmacology, was entitled “Predictors of 1-year rehospitalization in patients with bipolar I disorder treated with atypical antipsychotics.”
September 1, 2020, PARIS, France— French researchers using magnetic resonance imaging (MRI) found high concentrations of lithium in the left hippocampus of the brain in people with bipolar disorder who have been treated with the mood stabilizer for at least two years.
The researchers said the results were interesting given the major role of the hippocampus in emotion processing and regulation, the consistent atrophy of the hippocampus in people with untreated bipolar, and the “normalization effect” of lithium.
They said more study is needed to understand the relationship between lithium distribution in the brain and its therapeutic response, notably in people newly diagnosed with bipolar.
The study, which appeared in the journal Biological Psychiatry, was entitled “Accumulation of lithium in the hippocampus of patients with bipolar disorder: A lithium-7 magnetic resonance imaging study at 7 tesla.”
August 30, 2020, AURANGABAD, India—Structural differences in the brain associated with bipolar I disorder appear to worsen as the illness progresses, a small study suggests.
Indian researchers, noting that bipolar disorder is associated with lower volume and surface area in the cerebral cortex, said it has been unclear whether the deviations are static or change over the course of illness. They used magnetic resonance imaging (MRI) to compare the cortical region in people with bipolar I who had experienced a single manic episode, people with bipolar I who had experienced multiple manic episodes, and people without bipolar.
Cortical thickness was similar across the three groups, but cortical surface area was notably lower in individuals with multi-episode bipolar. The authors said their findings underscore the importance of early diagnosis and intervention in preventing further brain changes and improving functional recovery.
The study, which appeared in the journal Psychiatry Research: Neuroimaging, was entitled “Comparison of first-episode and multiple-episode bipolar disorder: A surface-based morphometry study.”
August 10, 2020, EDMONTON, AB—A new study suggests that focusing on the health of people’s gut microbiome could play an important role in dealing with bipolar disorder and other mental health conditions.
“Microbiome” refers to a community of bacteria and other microorganisms. The human intestine contains roughly 100 trillion bacteria cells, predominated by 30 to 40 species. Imbalances in the normal distribution and interaction of the microbial community is referred to dysbiosis.
Canadian researchers reviewed existing literature on the relationships between the gut microbiome and mental health conditions, including bipolar, and found that dysbiosis is seen in connection with various diagnoses.
Noting that some psychotropic medications have an antimicrobial effect, the authors said better understanding of the relationship between dysbiosis and psychiatric symptoms may open the door to “gut-related microbiota management” as part of mental health treatment.
The new study, which appeared in the journal Annals of Medicine online ahead of print, was entitled
“Gut microbes in neurocognitive and mental health disorders.”
Cognitive impairments appear to predict mania in the long-term
August 8, 2020, BUENOS AIRES, Argentina—Identifying cognitive deficits in individuals with bipolar I disorder may flag who is at higher risk for future manic episodes, a new study suggests.
Argentinian researchers followed a cohort of people with bipolar for at least four years, looking at number of mood episodes and time spent ill. At the outset, the individuals underwent neurocognitive assessments to measure cognitive domains such as verbal memory and executive function, which relates to the ability to plan and organize.
Impairments in two or more domains was an independent predictor of both mania and hypomania. No relationship was seen between the neurocognitive measurements and depressive symptoms during follow-up.
The study, which appeared in the Australian and New Zealand Journal of Psychiatry online ahead of print, was entitled “Neurocognitive predictors of long-term clinical course in bipolar disorder.”
Sub-threshold symptoms causes impairment in stabilized teens
August 1, 2020, BARCELONA, Spain—Teens with bipolar disorder who have been stabilized after a mood episode may need additional intervention to return to pre-episode levels of functioning, a new study suggests.
Spanish researchers compared young people ages 12 to 19 with bipolar to peers without the disorder. Even with psychiatric treatment to control symptoms, the youth with bipolar had lower levels of academical and cognitive performance and rated worse on social and emotional well-being
The authors said that in addition to early detection of and intervention for mood symptoms, it’s important to address sub-threshold symptoms—that is, symptoms that are present but fall below the full criteria for a mood episode—and to emphasize the social and rehabilitative components of treatment.
The study, which appeared in the Journal of the Canadian Academy of Child and Adolescent Psychiatry, was entitled “Functional impairment and clinical correlates in adolescents with bipolar disorder compared to healthy controls: A case-control study.”
Lower socioeconomic status puts teens at risk of problems
August 1, 2020, TORONTO, ON—Lower socioeconomic status puts young people at greater risk of developing bipolar disorder at an earlier age, a new study suggests.
Canadian researchers noted that lower socioeconomic status is associated with greater symptom severity, functional impairment, and co-existing conditions in adults with bipolar disorder. The researchers looked at young people ages 13 to 20 with bipolar I, bipolar II, or bipolar not otherwise specified to see how they were affected.
The study found that lower socioeconomic status in youth was associated with bipolar symptoms occurring at a younger age and higher risk of legal problems and post-traumatic stress disorder. In addition, these youth were less likely to be white and living with natural parents, and more likely to be undertreated for attention-deficit/hyperactivity disorder (ADHD).
The study, which appeared in the journal Comprehensive Psychiatry, was entitled “Clinical correlates of socioeconomic status in adolescent bipolar disorder.”
At-risk kids may have dysregulated coping mechanisms December 1, 2020, RIZE, Turkey—A new study has found distinct psychological features among children at high risk for bipolar disorder due to observable symptoms or family history. The Turkish study compared high-risk kids to children without risk factors. They found the high-risk kids were less likely to suppress...
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