Lithium Treatment in a Severely Depressed Child At Risk for Bipolar Disorder

2019 ◽  
Vol 21 (5) ◽  
Author(s):  
Gustavo Nogueira-Lima ◽  
Miguel Angelo Boarati ◽  
Lee Fu-I
Keyword(s):  
At Risk ◽  
Bipolar Disorder ◽  
Lithium Treatment ◽  
Depressed Child

Suicidal behaviour and bipolar disorder

2021 ◽  
pp. 293-300
Author(s):  
Maj Vinberg ◽  
Merete Nordentoft
Keyword(s):  
At Risk ◽  
Bipolar Disorder ◽  
Substance Abuse ◽  
Mental Illness ◽  
Substance Use ◽  
Risk Factor ◽  
Personality Disorder ◽  
Lithium Treatment ◽  
Major Risk Factor

Bipolar disorder is a severe mental illness characterized by mood swings with episodes of depression, hypomania, mania, and mixed episodes. Bipolar disorder, especially in depressed and mixed episodes, is a major risk factor for suicide. Further, untreated bipolar disorder, comorbid anxiety, substance abuse, personality disorder, and treatment-resistant course are all factors accentuating the overall risk for suicide among patients with bipolar disorder. Evidence of long-term effective treatment is scarce with one notable exception, long-term lithium treatment. Early treatment, addressing both bipolar disorder and it´s comorbidities, especially targeting identification of acute episodes and substance use is recommended to enhance the prevention of suicide in this inherited at-risk group of suicide patients. Future clinical research should target the efforts towards the development of pragmatic tools easy to translate and use in clinical everyday settings.

Prodromal and at-risk states for bipolar disorder: opportunities for prevention

2016 ◽  
Vol Ano 6 ◽  
pp. 32-37
Author(s):  
Mariane Nunes Noto ◽  
Adiel Rios ◽  
Mariana Pedrini
Keyword(s):  
At Risk ◽  
Bipolar Disorder

O transtorno bipolar (TB) é uma doença psiquiátrica crônica e potencialmente grave. Nos últimos anos, pesquisas que focaram nas fases prodrômicas e iniciais do TB demonstraram que estratégias de detecção e intervenção precoces têm o potencial de atrasar, diminuir a severidade ou prevenir episódios completos do TB. Dessa forma, um novo caminho se apresenta para a clínica dos transtornos do humor, que passa não só a preocupar-se com o tratamento dos episódios de mania e depressão, como a buscar a detecção e o diagnóstico precoce e, fundamentalmente, a prevenção. O objetivo deste artigo é discutir dados da literatura sobre as fases iniciais do TB, os desafios da detecção precoce e as implicações desse enfoque para intervenções e manejo clínico antes ou logo após o desenvolvimento do primeiro episódio de mania, que marca, oficialmente, o início da doença.

scholarly journals Deficits in explicit emotion regulation in bipolar disorder: a systematic review

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Marcel Kurtz ◽  
Pia Mohring ◽  
Katharina Förster ◽  
Michael Bauer ◽  
Philipp Kanske
Keyword(s):  
At Risk ◽  
Bipolar Disorder ◽  
Emotion Regulation ◽  
Mood State ◽  
Bipolar Disorders ◽  
Protective Measure ◽  
Behavioral Measures ◽  
Increased Risk ◽  
Regulation Strategies ◽  
Depressive Episodes

Abstract Background This study aimed to compile and synthesize studies investigating explicit emotion regulation in patients with bipolar disorder and individuals at risk of developing bipolar disorder. The importance of explicit emotion regulation arises from its potential role as a marker for bipolar disorders in individuals at risk and its potent role in therapy for bipolar disorder patients. Methods To obtain an exhaustive compilation of studies dealing specifically with explicit emotion regulation in bipolar disorder, we conducted a systematic literature search in four databases. In the 15 studies we included in our review, the emotion-regulation strategies maintenance, distraction, and reappraisal (self-focused and situation-focused) were investigated partly on a purely behavioral level and partly in conjunction with neural measures. The samples used in the identified studies included individuals at increased risk of bipolar disorder, patients with current affective episodes, and patients with euthymic mood state. Results In summary, the reviewed studies' results indicate impairments in explicit emotion regulation in individuals at risk for bipolar disorder, patients with manic and depressive episodes, and euthymic patients. These deficits manifest in subjective behavioral measures as well as in neural aberrations. Further, our review reveals a discrepancy between behavioral and neural findings regarding explicit emotion regulation in individuals at risk for bipolar disorders and euthymic patients. While these groups often do not differ significantly in behavioral measures from healthy and low-risk individuals, neural differences are mainly found in frontostriatal networks. Conclusion We conclude that these neural aberrations are a potentially sensitive measure of the probability of occurrence and recurrence of symptoms of bipolar disorders and that strengthening this frontostriatal route is a potentially protective measure for individuals at risk and patients who have bipolar disorders.

Beneficial effect of lithium in female patient with bipolar affective illness and psoriasis

2021 ◽  
Vol 37 (2) ◽  
Author(s):  
Przemysław Filipiak ◽  
Anna Jaskóła ◽  
Karolina Gattner
Keyword(s):  
Bipolar Disorder ◽  
Case Report ◽  
Beneficial Effect ◽  
Female Patient ◽  
Lithium Treatment ◽  
The Other ◽  
Patient Needs ◽  
Affective Illness ◽  
First Time

Objectives. Psoriasis makes a relative contraindication for lithium treatment which can exacerbate its symptoms or induce it itself. On the other hand, lithium exerts immuno-modulatory activity. Case study. In this paper, a case of a female patient is presented. The patient has been treated since 2012 for bipolar affective illness (bipolar disorder – BD) and psori­asis, which occurred for the first time during a depress­ive episode. Despite intensive pharmacological treatment, both as inpatient and outpatient, a satisfactory improvement of affective illness has not been obtained. After the introduction of lithium, a remission of BD was achieved as well as a reduction of psoriatic changes, which have been maintained until now (2021). Conclusion. The remission of Bipolar Disorder (BD) on lithium can suggest that the patient belongs to the group of the so-called excellent lithium responders. In the presen­ted case remission of psoriasis was observed during lithium treatment. This case report must be treated with caution because remission could be spontaneous and the patient needs further observation.

scholarly journals Delphi survey of maintenance lithium treatment in older adults with bipolar disorder: An ISBD task force report

2018 ◽  
Vol 21 (2) ◽  
pp. 117-123 ◽  
Author(s):  
Kenneth I. Shulman ◽  
Osvaldo P. Almeida ◽  
Nathan Herrmann ◽  
Ayal Schaffer ◽  
Sergio A. Strejilevich ◽  
...  
Keyword(s):  
Older Adults ◽  
Bipolar Disorder ◽  
Task Force ◽  
Lithium Treatment ◽  
Delphi Survey ◽  
Task Force Report

scholarly journals Polygenic scores for major depressive disorder and depressive symptoms predict response to lithium in patients with bipolar disorder

2018 ◽  
Author(s):  
Azmeraw T. Amare ◽  
Klaus Oliver Schubert ◽  
Liping Hou ◽  
Scott R. Clark ◽  
Sergi Papiol ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Major Depressive Disorder ◽  
Depressive Symptoms ◽  
Depressive Disorder ◽  
Treatment Response ◽  
Lithium Treatment ◽  
Mapk Signaling ◽  
Genome Wide Association Studies ◽  
Major Depressive ◽  
Polygenic Scores

AbstractBackgroundLithium is a first-line medication for bipolar disorder (BD), but only ~30% of patients respond optimally to the drug. Since genetic factors are known to mediate lithium treatment response, we hypothesized whether polygenic susceptibility to the spectrum of depression traits is associated with treatment outcomes in patients with BD. In addition, we explored the potential molecular underpinnings of this relationship.MethodsWeighted polygenic scores (PGSs) were computed for major depressive disorder (MDD) and depressive symptoms (DS) in BD patients from the Consortium on Lithium Genetics (ConLi+Gen; n=2,586) who received lithium treatment. Lithium treatment outcome was assessed using the ALDA scale. Summary statistics from genome-wide association studies (GWAS) in MDD (130,664 cases and 330,470 controls) and DS (n=161,460) were used for PGS weighting. Associations between PGSs of depression traits and lithium treatment response were assessed by binary logistic regression. We also performed a cross-trait meta-GWAS, followed by Ingenuity® Pathway Analysis.OutcomesBD patients with a low polygenic load for depressive traits were more likely to respond well to lithium, compared to patients with high polygenic load (MDD: OR =1.64 [95%CI: 1.26-2.15], lowest vs highest PGS quartiles; DS: OR=1.53 [95%CI: 1.18-2.00]). Associations were significant for type 1, but not type 2 BD. Cross-trait GWAS and functional characterization implicated voltage-gated potassium channels, insulin-related pathways, mitogen-activated protein-kinase (MAPK) signaling, and miRNA expression.InterpretationGenetic loading to depression traits in BD patients lower their odds of responding optimally to lithium. Our findings support the emerging concept of a lithium-responsive biotype in BD.FundingSee attached details

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