Bipolar Affective Disorder Research Articles

Mapping review of register-based cohort studies of bipolar disorder.

Register-based cohorts allow us to better understand bipolar disorder over a life course. They are inclusive and their long-term data collection provides a longer scope than most clinical trials. This mapping review provides an overview of register-based cohort studies of bipolar disorder to inform researchers of the strengths and limitations to this body of research and identify gaps for future research. A systematic search was performed of Medline, EMBASE, and PsycINFO databases. Cohort studies were included if they focused on bipolar disorder and had a minimum of 1 year of longitudinal data. Studies needed to be from databases that monitor the whole state or national population. A descriptive analysis of the studies' populations and methodology provides an overview of this field of study and identifies evidence gaps. A hundred and forty-six studies were included. The majority were from databases in Taiwan (n = 63), Denmark (n = 38), Sweden (n = 23), and Finland (n = 11). Forty-eight studies focused on aetiological questions. Sixty prognostic studies identified cohorts with bipolar disorder and described the impact of the illness by considering comorbidity, prescribing patterns, social functioning, and mortality. Thirty-six treatment studies focused on the efficacy and adverse effects of pharmaceuticals and ECT. No studies focused on psychological treatments. Bipolar disorder research should include register-based cohorts with greater geopolitical and cultural diversity. Custodians of health registers should consider how non-pharmaceutical interventions such as psychotherapy are captured. Register-based cohorts investigating treatments of bipolar disorder should consider long-term social outcomes alongside the usual clinical outcomes.

Etiopathogenesis in Neuropsychological Aspects of Mood Disorders and Self-Harming Behavior in Adolescents: A Review

The average prevalence of self-harm in school-age adolescents in the world is 17.20% with bipolar spectrum disorders (37%) apparently higher than among adolescents with depressive disorders (13%). Based on etiopathogenesis, neuropsychological factors are associated with the emergence of mood disorders and self-harm behavior. The method used is the preparation of this article review was carried out through the process of searching, collecting data, and analyzing several articles from Science Direct, Proquest, Pubmed, and Google Scholar. The extracted data were analyzed to summarize the findings related to the etiopathogenesis of mood disorders and self-harm behavior in adolescents reviewed from a neurophysiological aspect. Discussion: Based on the results of the analysis of several articles, the etiopathogenesis of mood disorders and self-harm behavior in adolescents reviewed from a neurophysiological aspect is related to the influence of neurotransmitters and changes in the functional structure of the brain. The related neurotransmitters are serotonin, dopamine, GABA, glutamate, norepinephrine, and histamine. In adolescents who are not accompanied by psychological maturity, it can cause conflicts that result in emotional stress and distress as well as the emergence of negative emotions related to changes in brain function and structure related to brain neuroplasticity and disruption of the reward and punishment system in the limbic system.

Oral health knowledge, attitudes, and practices of people living with mental illness: a mixed-methods systematic review

People living with mental illness experience poorer oral health outcomes compared to the general population, yet little is known about their oral health knowledge, attitudes, and practices. The aim of this mixed-methods systematic review was to synthesise evidence regarding oral health knowledge, attitudes, and practices of people living with mental illness to inform preventative strategies and interventions. Database searches were conducted in PubMed, MEDLINE, PsycINFO, CINAHL, ProQuest, and Scopus with no limitations placed on the year of study. All studies available in the English language, that explored the oral health knowledge, attitudes, and/or practices of people with a mental illness were included. Articles were excluded if they primarily pertained to intellectual disability, behavioural and psychological symptoms of dementia, drug and alcohol or substance use, or eating disorders. A thematic synthesis was undertaken of 36 studies (26 high-moderate quality), resulting in 3 themes and 9 sub-themes. Study participants ranged from n = 7 to n = 1095 and aged between 15–83 years with most having a diagnosis of schizophrenia, schizoaffective, or bipolar affective disorder. People diagnosed with a mental illness were found to have limited oral health knowledge, particularly regarding the effects of psychotropic medication. Various barriers to oral health care were identified, including high dental costs, the negative impact of mental illness, dental fears, lack of priority, and poor communication with dental and health care providers. Study participants often displayed a reduced frequency of tooth brushing and dental visits. The findings highlight the potential for mental health care providers, oral health and dental professionals, mental health consumers, and carers to work together more closely to improve oral health outcomes for people with mental illness. The systematic review protocol is registered with the International Prospective Register of Systematic Reviews (PROSPERO), (registration ID CRD42022352122).

Predictors of COVID-19 vaccine uptake among youth with bipolar disorder spectrum disorders and their caregivers

BackgroundLittle is known about rates of COVID-19 vaccine uptake among youth with bipolar spectrum disorders (BSD). As such, the aim of this study is to assess rates and predictors of COVID-19 vaccine uptake among youth with BSD and their caregivers in the United States. MethodsYouth and their main caregiver were recruited from a large pragmatic study cohort. Youth who were aged 8–22 at the time of this data collection, had a bipolar-spectrum disorder diagnosis, had overweight or obesity, and were treated with a second-generation antipsychotic were invited to participate in an online survey and interview assessing the impact of the COVID-19 pandemic. ResultsA total of 453 surveys and 341 interviews were completed 07/2021–05/2022 by youth and their caregivers. Sixty-seven percent of caregivers and 63 % of youth reported receiving the COVID-19 vaccine. Vaccine uptake rates among youth and caregivers were highly correlated. Predictors of vaccine uptake among youth were older age and living in the Northeast Region of the United States. Predictors of caregiver vaccine uptake were male sex, higher annual household income and not having to quarantine due to COVID-19. LimitationsThe sample was small and not a full representation of a population with bipolar-spectrum disorders therefore, the results may not be generalizable. The study design and statistical method do not allow for causal inferences to be made. ConclusionsThese findings may aid in targeting interventions to maximize COVID-19 and other vaccine uptake in youth with bipolar disorders and their families.

The role of quantitative electroencephalography in diagnostic workup of mental disorders.

Electroencephalography (EEG) is a non-invasive diagnostic tool, enabling us to assess the electrical activity of the brain and its disturbance in a great number of psychiatric conditions. This paper provides a narrative overview of the most recent advantages of EEG use in various psychiatric disorders that are associated. This article analyses selected psychiatric disorders. We discussed anxiety disorders characterized by chronic fear, dementia leading to cognitive decline, schizophrenia disrupting logical thinking, bipolar affective disorder with alternating episodes of mania and depression, and depression manifested by gradual loss of vital energy. We have shown that EEG testing, by monitoring the electrical activity of the brain, is a helpful tool in identifying specific brain wave patterns associated with these disorders. In the study of mental illness the EEG variant called quantitative EEG (QEEG) is of particular avail as to the spatial discrimination. QEEG is based on digital coding and transformation according to Fourier algorithm. Recently, even more complex methods of EEG data analysis have been implemented, including artificial intelligence (AI), deep learning (DL) and its branch: machine learning (ML). The use of sophisticated EEG postprocessing adds important information about the pathophysiology of mental disorders. More so, EEG/QEEG recording (in particular spectral analysis), if repeated over time may help to follow up the treatment results and to establish a prognosis as to the course of the given condition. Reliability, safety and availability of EEG makes it to be an indispensable tool in modern psychiatry. Use of EEG, QEEG may lead to faster and more precise differential diagnostic workup. Use of EEG/QEEG changes as an objective outcome measure in clinical trials may support the development of personalized pharmacotherapy or psychotherapy.

Nonsyndromic craniosynostosis associated with bipolar affective disorder and mild cognitive disorder.

Nonsyndromic craniosynostosis associated with bipolar affective disorder and mild cognitive disorder.

Systematic Review and Network Meta-Analysis: Efficacy and Safety of Antipsychotics vs Antiepileptics or Lithium for Acute Mania in Children and Adolescents

To compare second-generation antipsychotics (SGAs) and mood stabilizers (MSs) in youth with a bipolar disorder type I (BD-I) manic/mixed episode. A systematic PubMed/Embase/PsycInfo literature search until December 31, 2023, for randomized trials of SGAs or MSs in patients≤18 years of age with BD-I manic/mixed episode was conducted. The study included a network meta-analysis comparing treatments regarding mania symptoms and mania response (co-primary outcomes), and secondary efficacy and tolerability outcomes. Eighteen studies (n= 2844, mean age= 11.74, female participants= 48.0%, mean study duration= 5.4 weeks) comparing 6 SGAs (aripiprazole, asenapine, olanzapine, quetiapine, risperidone, and ziprasidone) and 4 MSs (lithium, oxcarbazepine, topiramate, and valproate) were meta-analyzed. All 6 SGAs outperformed placebo in reducing manic symptomatology, including risperidone (standardized mean difference [SMD]=-1.18, 95% CI=-0.92,-1.45, Confidence in Network Meta-Analysis [CINeMA]= moderate confidence), olanzapine (SMD=-0.77, 95% CI=-0.36,-1.18, low confidence), aripiprazole (SMD=-0.67, 95% CI=-0.33,-1.01, moderate confidence), quetiapine (SMD=-0.60, 95% CI=-0.32,-0.87, high confidence), asenapine (SMD=-0.54, 95% CI=-0.19,-0.89, moderate confidence), and ziprasidone (SMD=-0.43, 95% CI=-0.17, 0.70, low confidence), whereas no mood stabilizer outperformed placebo. Concerning mania response, risperidone (RR= 2.58, 95% CI= 1.88, 3.54, low confidence), olanzapine (RR= 2.42, 95% CI= 1.33, 3.54, very low confidence), aripiprazole (RR= 2.05, 95% CI= 1.44, 2.92, low confidence), quetiapine (RR= 1.89, 95% CI= 1.45n 2.47, moderate confidence), asenapine (RR= 1.81, 95% CI= 1.28, 2.55, very low confidence) and lithium (RR= 1.35, 95% CI= 1.00, 1.83, p= .049, very low confidence) outperformed placebo, without superiority of other MSs vs placebo. Individually, risperidone was more efficacious in reducing manic symptomatology than all other comparators, except olanzapine and topiramate, yet with low/very low confidence, and was associated with increased prolactin and glucose. Pooled together, SGAs outperformed both placebo and MSs for mania symptom reduction (SMD=-0.68, 95% CI=-0.86,-0.51 and SMD=-0.61, 95% CI=-0.82,-0.40, moderate confidence), and mania response (RR= 1.85, 95% CI= 1.53, 2.24 and RR= 1.65, 95% CI= 1.33, 2.04, moderate confidence) without differences between MSs and placebo. There were no significant treatment-placebo differences for all-cause discontinuation, whereas lithium, ziprasidone, and oxcarbazepine were associated with more adverse event-related drop-outs than placebo. Most SGAs were associated with more sedation, weight gain, and metabolic issues vs placebo and MSs. SGAs were more efficacious than placebo and MSs in treating acute mania symptoms, however, their use must be carefully weighed against important side effects.

Uric Acid as a Biomarker for Mood Disorders: A Comparative Study of Blood Uric Acid Levels Correlating With the Symptom Severity and Treatment Response.

Background Bipolar affective disorder (BPAD) and major depressive disorder (MDD) are two mood disorders whose pathophysiology may involve the purinergic system. Elevated uric acid levels, associated with this system, can impact various behaviors in individuals affected by these conditions. In addition to genetic predisposition, blood uric acid levels can be impacted by various factors, including metabolic syndrome, the consumption of psychoactive medications, and other underlying kidney conditions such as gout. Objective The study aims to investigate the relationship between blood uric acid levels and mental health conditions, specifically BPAD subtypes (manic and depressive) and MDD. The study also examines changes in blood uric acid levels following treatment and evaluates the effectiveness of different treatment approaches in reducing uric acid levels. Methodology To be eligible to participate, individuals must have a confirmed diagnosis of BPAD (manic or depressive type) or MDD, according to the International Classification of Diseases (ICD-10). Blood uric acid levels were measured at both baseline and follow-up assessments. Symptoms were assessed weekly using standardized rating scales (Young Mania Rating Scale (YMRS) and Hamilton Rating Scale for Depression (HAM-D)) until treatment response was achieved, which was defined as a 50% reduction in initial scores on both scales. We used ANOVA to examine the differences among the three patient groups and paired sample t-tests to examine the changes in means before and after treatment conditions. Results A significant positive correlation was found between the severity of illness and serum uric acid levels across all three patient groups: those with BPAD-mania, BPAD-depression, and MDD. Notably, patients with BPAD-mania patients had significantly higher serum uric acid levels (5.2±0.9 mg/dL) compared to those with BPAD-depression (4.8±1.0 mg/dL) and MDD (4.0±1.1 mg/dL). After treatment, all patient groups exhibited a decrease in serum uric acid levels. The reduction in serum uric acid levels was pronounced in all patient groups, with decreases of 3.1±0.8 mg/dL in patients with BPAD-mania, 3.1±0.9 mg/dL in those with BPAD-depression, and 3.5±1.1 mg/dL in those with MDD. The study showed that the reduction in serum uric acid levels was significantly correlated with the severity of illness in patients with BPAD-mania, but not in those with BPAD-depression or MDD. Furthermore, the study found that treatment with lithium carbonate, sodium valproate, or carbamazepine was equally effective in reducing serum uric acid levels, regardless of the mood stabilizer used. Conclusion The study supports that dysfunction in the purine system might play a significant role in the development and progression of BPAD, suggesting that this phenomenon is not solely due to chronicity or medication exposure. This study also introduces a fresh perspective on the underlying biological processes that contribute to the development of BPAD and also sheds light on new treatment regimens targeting uric acid reduction in treating patients with bipolar disorder.

Simultaneous Utilization of Mood Disorder Questionnaire and Bipolar Spectrum Diagnostic Scale for Machine Learning-Based Classification of Patients With Bipolar Disorders and Depressive Disorders.

Bipolar and depressive disorders are distinct disorders with clearly different clinical courses, however, distinguishing between them often presents clinical challenges. This study investigates the utility of self-report questionnaires, the Mood Disorder Questionnaire (MDQ) and Bipolar Spectrum Diagnostic Scale (BSDS), with machine learning-based multivariate analysis, to classify patients with bipolar and depressive disorders. A total of 189 patients with bipolar disorders and depressive disorders were included in the study, and all participants completed both the MDQ and BSDS questionnaires. Machine-learning classifiers, including support vector machine (SVM) and linear discriminant analysis (LDA), were exploited for multivariate analysis. Classification performance was assessed through cross-validation. Both MDQ and BSDS demonstrated significant differences in each item and total scores between the two groups. Machine learning-based multivariate analysis, including SVM, achieved excellent discrimination levels with area under the ROC curve (AUC) values exceeding 0.8 for each questionnaire individually. In particular, the combination of MDQ and BSDS further improved classification performance, yielding an AUC of 0.8762. This study suggests the application of machine learning to MDQ and BSDS can assist in distinguishing between bipolar and depressive disorders. The potential of combining high-dimensional psychiatric data with machine learning-based multivariate analysis as an effective approach to psychiatric disorders.

Epidemiological study on seroprevalence of syphilis in patients with mental diseases.

The objective of this study was to investigate the seroprevalence of syphilis and its possible influencing factors in patients with mental illness. A total of 24,414 patients with mental illness from 2019 to 2021 were included. Serum syphilis antibody test results and available demographic data were collected. Chi-square test and regression analysis were used to analyze the data. The seroprevalence of syphilis was 0.59% (95% CI 0.49-0.69%) in patients with mental illness in the study area. There were significant differences in the seroprevalence of syphilis in age, marital status, occupation, urban region, and mental disease classification. The seroprevalence of syphilis increased with age (p < 0.01). The seroprevalence of syphilis was higher in patients with "Nonorganic sleep disorders" and "Reaction to severe stress, and adjustment disorders". Adjusted logistic regression analysis showed that the seroprevalence of syphilis in patients with mental illness was associated with age, region, and psychiatric classification. Older age group was a risk factor for syphilis seropositivity. Compared with schizophrenia, "bipolar affective disorder" (OR = 1.707, 95% CI: 1.017-2.864, p = 0.043) and "severe stress response and adjustment disorders"(R = 4.912, 95% CI: 1.138-21.204, p = 0.033) were risk factors for syphilis antibody positivity. The patients with "nonorganic sleep disorders" and "reaction to severe stress, and adjustment disorders" had a high seroprevalence of syphilis. Age and psychosis types became the influencing factors of the positive rate of serum syphilis antibody in patients with mental illness.

The great recession, neurotic personality, and subjective sleep quality among patients with mood disorders

Previous studies exploring the effects of the business cycle on sleep have mostly focused on the general population, and their results have been inconclusive. This study aimed to explore the effects of the 2008 economic crisis and personality traits on the subjective sleep quality of outpatients with mood disorders. In this cross-sectional study, patients with mood disorders were recruited from two medical centers and a psychiatric hospital. Socio-demographics, the Eysenck Personality Questionnaire-Revised, and the Pittsburgh Sleep Quality Index (PSQI) were collected through in-person interviews. Candidate predictors significantly associated with PSQI scores in univariate analysis were included in a multiple linear regression model. There were 334 participants; 29% had unipolar depression, and 71% had bipolar affective disorder. The average PSQI score was 11.0 (±4.0). A higher degree of neuroticism [β(se) = 0.49 (0.07), p < 0.001] and recession period (vs. recovery period) [β(se) = 1.72 (0.47), p < 0.001] were associated with a higher PSQI score after adjusting for education, occupational class, and diagnosis. In conclusion, neuroticism and macroeconomy were independent predictors of subjective sleep quality in patients with mood disorders. This study suggests that large-scale economic crises have negative impacts on the sleep health of high-risk clinical populations.

Behavioral skill practice as a predictor of mood and family functioning in adolescents with bipolar and depressive mood disorders: Results of a 6-month randomized trial of family-focused therapy.

Behavioral interventions require considerable practice of treatment skills in between therapy sessions. The effects of these treatments may vary with the degree to which patients are able to implement these practices. In offspring of parents with bipolar and major depressive disorders, we examined whether youth who frequently practiced communication and problem-solving skills between family-focused therapy (FFT) sessions had less severe mood symptoms and better psychosocial functioning over 6 months than youth who practiced less frequently. We randomly assigned offspring (ages 12-19) of parents with mood disorders to 12 sessions of FFT plus a mobile app that encouraged the practice of communication, problem-solving and mood management skills (FFT-MyCoachConnect [MCC] condition) or 12 sessions of FFT with an app that only allowed for tracking of symptoms and stress (FFT-Track condition). Independent evaluators assessed youths' mood and psychosocial functioning at 9-week intervals over 27 weeks. Clinicians rated participants' between-session skill practice at each FFT session. FFT-MCC was associated with more frequent skill practice than FFT-Track over 18 weeks of treatment. Skill practice was associated with reductions in youths' mood instability and perceptions of family conflict over 27 weeks in both app conditions. Skill practice mediated the effects of app condition on youths' mood instability and family functioning. Mobile applications as adjuncts to family therapy for youth with mood disorders can help increase skill practice. These findings provide preliminary causal evidence for behavioral skill practice improving mood symptoms and family functioning among youth with mood disorders.

Levels of expressed emotions and life satisfaction in patients with bipolar affective disorder

Levels of expressed emotions and life satisfaction in patients with bipolar affective disorder

Seasonality and sun exposure in incidence of major depression, bipolar disorder, and first-time use of antidepressant medication

Introduction Seasonality in depressive and bipolar disorders, are recognized in the ICD-10/11 and DSM-5 diagnostic systems. The existence of a seasonal pattern of hospital diagnosis of major depression, bipolar disorder and prescription of antidepressant medications has not been evaluated in the Danish population. Methods We retrieved date and year for all first-time hospital contacts with depression or bipolar disorder between 1999 and 2019, registered in the Danish National Patient Registry. Depression was defined using the ICD-10 F32-F33 codes, and for bipolar disorder the F30 or F31 codes. Date and year of all first-time purchases of antidepressant medications with ATC codes (N06A) between 1999 and 2021 were retrieved from the Danish National Prescription Registry, containing information on all prescribed drugs dispensed at pharmacies since 1995. Data on sunlight hours from 2012 to 2021 were retrieved from the Danish Metrological Institute. Results Incidences of hospital diagnoses as well as purchases of medication varied with month and season. The monthly variations were larger for antidepressant medication and smallest for bipolar disorder. The multiple linear regression analysis showed that number of first-time diagnoses of depression or bipolar disorder did not correlate with season. For antidepressant medication the number of first-time prescriptions was significantly lower in summer compared to the winter season. Conclusion This study found a seasonal variation of first-time prescriptions of antidepressant medication. We did not find a seasonal variation in first-time hospital diagnoses. Further research looking into depression severity, polarity of bipolar illness episodes, lag-time for sunlight exposure, and specific parts of the yearly photoperiods should be conducted.

Mental health care use and quality among Medicaid adults with serious mental illness receiving care at Federally Qualified Health Centers vs. other settings

BackgroundFederally Qualified Health Centers (FQHCs) are a critical source of care for medically underserved populations and often serve as medical homes for individuals with serious mental illness (SMI). Many FQHCs provide mental health services and could facilitate access to mental health treatment within and outside of FQHCs. This study compared mental health care utilization and acute care events for adult Medicaid enrollees with SMI who receive care at Federally Qualified Health Centers (FQHCs) vs. other settings.MethodsThis study used the 2015–2016 Massachusetts All-Payer Claims Database to examine outpatient mental health care and acute care events for 32,330 Medicaid adults, ages 18–64 and with major depressive, bipolar, or schizophrenia spectrum disorders (SSD), who resided in FQHC service areas and received care from FQHCs vs. other settings in 2015. Multivariable linear regressions assessed associations between receiving care at FQHCs and outpatient mental health visits, psychotropic medication fills, and acute care events in 2016.ResultsThere were 8,887 (27.5%) adults in the study population (N = 32,330) who had at least one FQHC visit in 2015. Those who received care at FQHCs were more likely to have outpatient mental health visits (73.3% vs. 71.2%) and psychotropic medication fills (73.2% vs. 69.0%, both p < .05), including antidepressants among those with depressive disorders and antipsychotics among those with SSD. They were more likely to have ED visits (74.0% vs. 68.7%), but less likely to be hospitalized (27.8% vs. 31.9%, both p < .05). However, there was no significant difference in the likelihood of having an acute psychiatric hospitalization (9.5% vs. 9.8%, p = .35).ConclusionsAmong Medicaid enrollees with SMIs who had access to care at FQHCs, those receiving care at FQHCs were more likely to have outpatient mental health visits and psychotropic medication fills, with lower rates of hospitalization, suggesting potentially improved quality of outpatient care. Higher ED visit rates among those receiving care at FQHCs warrant additional investigation.

The weight of weights: Causal impact of overweight on major depressive disorder and its disparate association with suicide attempts in over 450,000 individuals of European ancestry (AM-SRNMA 003)

AimSome studies and societal discussions have suggested a potential link between overweight and a higher risk of mental disorders and suicidal ideation. However, the causal relationships between these factors remain unclear. This study aims to assess the bidirectional causal associations between overweight and mental disorders, including suicidal attempts. MethodWe conducted a Two-Sample Mendelian Randomization study utilizing data from over 450,000 individuals of European ancestry sourced from a comprehensive Genome-Wide Association Study database. We chose single-nucleotide polymorphisms as instrumental variables. ResultsOur analyses consistently supported a unidirectional causal association of overweight with the increased risk of major depressive disorder (MDD, β = 0.152, se = 0.069, P = 0.027), bipolar affective disorders (BD, β = 0.197, se = 0.092, P = 0.033), and attention-deficit / hyperactivity disorder (ADHD, β = 0.308, se = 0.080, P = 1.366 × 10−4). We observed no significant causal relationships for the exposure of overweight to anxiety disorder (AD), manic episode (MA), panic disorder (PD), schizophrenia (SZ), substance use disorder (SUD), autism spectrum disorder (ASD), ever attempted suicide, recent thoughts of suicide or self-harm, and suicide or other intentional self-harm events. ConclusionThis study has provided evidence for the causal relationship between overweight and MDD, BD, ADHD, with no observed relationship between overweight and AD, MA, PD, SZ, SUD, ASD, ever attempted suicide, recent thoughts of suicide or self-harm, and suicide or other intentional self-harm events.

Examination of Cases Who Admitted to the Emergency Department of a Mental Health Hospital in 2020

Objective: This study aimed to retrospectively examine the sociodemographic and clinical characteristics of cases who admitted to the emergency department of a mental health hospital in 2020. Material and Methods: Cases who admitted to the emergency department of XXX Mental Health and Diseases Hospital between 01.01.2020 and 31.12.2020 were included. Sociodemographic and clinical data of the cases were accessed through the patient record system. Results: The total number of applications to the XXX MHDH emergency department between the specified dates was 7071 [5262 (74.4%) male and 1809 (25.6%) female].Sixty-four percent of the cases admitted through the Social Security Institution and 28% through the Ministry of Justice. Seven thousand fifty-five cases (99.7%) were the Republic of Turkey citizens. Three thousand two hundred fifty-four (46.0%) of the cases were evaluated within the scope of medical examination, 1599 (22.6%) were injection, 156 (2.2%) were involuntary hospitalization, and 1887 (26.7%) were judicial illegal substance screening. While 5877 (83.1%) of the cases left the emergency department after examination, 1194 (16.9%) were hospitalized at XXX MHDH. Two thousand one hundred forty-six (30.3%) of the cases were diagnosed with general psychiatric examination, 866 (12.2%) were anxiety spectrum disorders, 1464 (20.7%) were schizophrenia spectrum disorders, and 1658 (23.4%) were bipolar spectrum disorders. A statistically significant difference was found between male and female cases in terms of health insurance (p

Successful Electroconvulsive Therapy in a Patient With Catatonia and Maternal Duplication 15q11-13 Syndrome.

The 15q11-q13 chromosomal region contains genes encoding for GABA-A receptor subunits and is a known region of epigenetic modification associated with the development of neurodevelopmental disorders. The presence of at least one additional copy of the maternal 15q11-q13 results in a syndrome (maternal dup15q) characterized by intellectual disability, autism spectrum disorder, mood disorders, and epilepsy. Catatonia is a serious syndrome of behavioral and motor dysfunction, which occurs across a variety of psychiatric, neurologic, and general medical conditions, which has successfully been treated with benzodiazepines and electroconvulsive therapy. In this case report, we describe the treatment course of a patient with established maternal dup 15q with comorbid intellectual disability, autism spectrum disorder, bipolar mood disorder, and juvenile epilepsy who developed hypokinetic catatonia refractory to high-dose benzodiazepine therapy. In contrast with benzodiazepine treatment, electroconvulsive therapy resulted in rapid improvement in catatonic symptoms and return to premorbid baseline. This case suggests that electroconvulsive therapy can be safely delivered for some patients with maternal dup 15q and may be rapidly effective when benzodiazepine treatment results in inadequate symptom improvement.

Plasma neurofilament light protein is differentially associated with age in individuals with treatment-resistant schizophrenia and bipolar affective disorder compared to controls

Accelerated brain ageing has been observed in multiple psychiatric disorders. This study examined whether relationships between age and plasma neurofilament light (NfL) protein differed in individuals with psychiatric disorders (major depressive disorder (n = 42), bipolar affective disorder (n = 121), treatment-resistant schizophrenia (TRS, n = 82)) compared to two healthy control (HC) groups (n = 1,926 and n = 59). Compared to two independent HC samples, individuals with TRS demonstrated a stronger positive relationship between age and NfL levels. Individuals with BPAD had a stronger negative relationship between age and NfL levels compared to the large normative HC cohort, but not locally-acquired HCs. These findings show that plasma NfL levels are differentially associated with age in individuals with TRS and BPAD compared to healthy individuals.

Lithium-induced Thyroiditis in a Patient with Bipolar Affective Disorder: A Rare Presentation

Lithium is used in the treatment of bipolar disorder to manage and stabilize mood, proving effective in addressing both manic and depressive phases. In these patients, the use of lithium is associated with various thyroid disorders, such as goiter and hypothyroidism; thyrotoxicosis is a rare presentation. In this case report, we demonstrated lithium-induced thyroiditis on thyroid scintigraphy.