A multidimensional approach for differentiating the clinical needs of young people presenting for primary mental health care

Objectives There is an ongoing necessity to match clinical interventions with the multidimensional needs of young people. A key step toward better service planning and the design of optimal models of care is to use multidimensional assessment to understand the clinical needs of those presenting to primary mental health care. Methods 1284 people aged 12–25 years presenting to […]

Suicidal behavior in mood disorders: Response to pharmacological treatment

Suicidal behavior is strongly associated with depression, especially if accompanied by behavioral activation, dysphoria, or agitation. It may respond to some treatments, but the design of scientifically sound, ethical trials to test for therapeutic effects on suicidal behavior is highly challenging. In bipolar disorder, and possibly also unipolar major depression, an underprescribed medical intervention with […]

Cause-specific excess mortality after first diagnosis of bipolar disorder: Population-based cohort study

Background: Bipolar disorder (BD) is associated with increased mortality, but evidence on cause-specific mortality is limited. Objective: To investigate cause-specific premature excess mortality in BD. Methods: Finnish nationwide cohort study of individuals with and without a diagnosis of BD who were aged 15-64 years during 2004-2018. Standardised mortality ratios (SMRs) with 95% CIs were calculated for BD using […]

Effects of BPD tendencies and subjective well-being on NSSI in adolescents with PTSD

Background: Severe posttraumatic stress disorder (PTSD) may lead to non-suicidal self-injury (NSSI), and borderline personality disorder (BPD) tendencies may play a role in this process. Secondary vocational students experience more social, familial and other pressures and are more vulnerable to psychological problems. Thus, we explored the effect of BPD tendencies and subjective well-being (SWB) on […]

Clinical characteristics and prescriptions associated with a 2-year course of rapid cycling and euthymia in bipolar disorder: A multicenter treatment survey for bipolar disorder in psychiatric clinics

Objective: In patients with bipolar disorder (BD), rapid cycling (RC) presents a risk for a more severe illness, while euthymia (EUT) has a better prognosis. This study focused on the progression of RC and EUT, which are contrasting phenomenology, and aimed to clarify the influence of patient backgrounds and prescription patterns on these different progressions, using […]

Towards suicide prevention from bipolar disorder with temporal symptom-aware multitask learning

Bipolar disorder (BD) is closely associated with an increased risk of suicide. However, while the prior work has revealed valuable insight into understanding the behavior of BD patients on social media, little attention has been paid to developing a model that can predict the future suicidality of a BD patient. Therefore, this study proposes a […]

Association of bipolar disorder diagnosis with suicide mortality rates in adolescents in Sweden

Importance The association of early diagnosis and management of bipolar disorder with adolescent suicide mortality (ASM) is unknown. Objective To assess regional associations between ASM and bipolar disorder diagnosis frequencies. Design, Setting, and Participants This cross-sectional study investigated the association between annual regional ASM and bipolar disorder diagnosis rates in Swedish adolescents aged 15 to […]

Influence of childhood maltreatment on prevalence, onset, and persistence of psychiatric comorbidities and suicide attempts in bipolar disorders

Background: Psychiatric comorbidities and suicide attempts are highly prevalent in Bipolar Disorders (BD). We examined the associations between childhood maltreatment, psychiatric comorbidities, and suicide attempts, in terms of lifetime prevalence, sequence of onset, and current symptoms. Methods: We assessed 3,047 individuals with BD for suicide attempts, anxiety disorders, substance use disorders, and eating disorders. Participants […]

The mediating role of time perspective in the relationship between chronotype and suicide in bipolar disorder

(1) Background: Suicide in patients with bipolar disorder (BD) is related to the chronotype of the person from a biological perspective. However, it is not known whether there is a relationship between suicide and psychological time in BD. The aim of our study was to evaluate the relationship between time perspective (TP) and suicide and […]

The effect of emotional dysregulation and impulsivity on suicidality in patients with bipolar disorder

Background: We aimed to evaluate the effect of emotional dysregulation and impulsivity on suicidality in patients with bipolar disorder by comparing patients with bipolar disorder with healthy individuals. Subjects and methods: The study included 85 patients (59 women, 26 men) with bipolar disorder and education and age matched 65 (44 women, 21 men) healthy volunteers. […]

Raising capacity to address mental health concerns in Costa Rica

Background A family medicine team based out of Mayo Clinic, Rochester assembled in 2019 to provide home visits and direct care to underserved populations of patients in La Cruz, Costa Rica. In addition to the provision of direct patient care, our team was interested in conducting a community needs-based assessment to identify an area for provider […]

Mood stabilizers and risk of all-cause, natural, and suicide mortality in bipolar disorder: A nationwide cohort study

Objectives People with bipolar disorder have an elevated risk of mortality. This study evaluated associations between the use of mood stabilizers and the risks of all-cause mortality, suicide, and natural mortality in a national cohort of people with bipolar disorder. Methods In this nationwide cohort study, we used data from January 1, 2000, to December […]

Course and outcome of bipolar I disorder among Indian patients: A retrospective life‑chart study

Background: Indian studies on the course and outcome of bipolar disorder (BD) are scarce and their methodologies vary. Nevertheless, differences from Western ones have been noted. Methods: A systematic random sample of 200 patients with BD attending a general hospital psychiatric unit was chosen. They were assessed using the clinician and self-rated versions of the National Institute […]

Maladaptive personality traits and the course of suicidal ideation in young adults with bipolar disorder: Cross-sectional and prospective approaches

Background Childhood-onset bipolar disorder (BD) has considerable morbidity and mortality, including suicide. Many risk factors have been identified for suicidality, but the potential role of personality traits as assessed by a computer-assisted self-report measure remains unclear. Aims To address this gap in knowledge, we tested relations between pathological-range personality traits and suicidal ideation among young […]

Psychotic symptoms in bipolar disorder and their impact on the illness: A systematic review

BACKGROUND Lifetime psychotic symptoms are present in over half of the patients with bipolar disorder (BD) and can have an adverse effect on its course, outcome, and treatment. However, despite a considerable amount of research, the impact of psychotic symptoms on BD remains unclear, and there are very few systematic reviews on the subject. AIM […]

Understanding the development of bipolar disorder and borderline personality disorder in young people: A meta-review of systematic reviews

Background: There is ongoing debate on the nosological position of bipolar disorder (BD) and borderline personality disorder (BPD). Identifying the unique and shared risks, developmental pathways, and symptoms in emerging BD and BPD could help the field refine aetiological hypotheses and improve the prediction of the onset of these disorders. This study aimed to: (a) systematically […]

The association between variability, intensity, and persistence of suicidal ideation and prospective suicidal behavior in the systematic treatment enhancement program for bipolar disorder (STEP‑BD) study

Background This study sought to examine the association between prospective suicidal behavior and variability, intensity, and persistence of suicidal ideation (SI) in bipolar disorder (BD). Methods Data were drawn from the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD), a naturalistic study of 4360 outpatients 15 years or older with BD. In separate models, logistic regressions […]

COVID‑19 lockdown – who cares? The first lockdown from the perspective of relatives of people with severe mental illness

Background Informal care is vital to many people with severe mental illness under normal circumstances. Little is known about how extraordinary circumstances affect relatives with a family member with mental illness. This study investigated the consequences of the first COVID-19 lockdown in Norway from the perspective of relatives of persons with psychotic- and/or bipolar disorders: […]

Exploration of mood spectrum symptoms during a major depressive episode: The impact of contrapolarity—Results from a transdiagnostic cluster analysis on an Italian sample of unipolar and bipolar patients

Background: Subthreshold hypomania during a major depressive episode challenges the bipolar-unipolar dichotomy. In our study we employed a cross-diagnostic cluster analysis – to identify distinct subgroups within a cohort of depressed patients. Methods: A k-means cluster analysis- based on the domain scores of the Mood Spectrum Self-Report (MOODS-SR) questionnaire-was performed on a data set of 300 adults […]

Association among early life stress, mood features, hopelessness and suicidal risk in bipolar disorder: The potential contribution of insomnia symptoms

Aim The study aimed to investigate the potential pathways mediating early exposure to stressful events and the clinical manifestations of bipolar disorder (BD), such as severity of mood symptoms, hopelessness and suicidal ideation, focusing on the potential role of insomnia symptoms. Method A sample of 162 adult participants with BD I or II were assessed during depressed phase […]

Lithium treatment of bipolar disorder in adults: A systematic review of randomized trials and meta-analyses

The aim of the study was to systematically review the hard evidence alone, concerning lithium efficacy separately for the phases and clinical facets of Bipolar disorder (BD). The PRISMA method was followed to search the MEDLINE for Randomized Controlled trials, Post-hoc analyses and Meta-analyses and review papers up to August 1st 2020, with the combination […]

Pharmacological and somatic treatment effects on suicide in adults: A systematic review and meta-analysis

Background: Suicide is a public health crisis. We conducted a systematic review and meta-analysis of the effects of psychopharmacologic and somatic therapies on suicide risk. Methods: A systematic search of MEDLINE for studies evaluating the effects of pharmacologic (excluding antidepressants) or somatic interventions on suicide risk was conducted. Studies were included if they used a comparison group, […]

Lithium treatment in the prevention of repeat suicide-related outcomes in veterans with major depression or bipolar disorder: A randomized clinical trial

Objective: To assess whether lithium augmentation of usual care reduces the rate of repeated episodes of suicide-related events (repeated suicide attempts, interrupted attempts, hospitalizations to prevent suicide, and deaths from suicide) in participants with bipolar disorder or depression who have survived a recent event. Design, setting, and participants: This double-blind, placebo-controlled randomized clinical trial assessed lithium vs […]