5 recent studies in bipolar disorder

Bipolar disorder, also known as manic depression, is a mental disorder that brings low and high moods and changes in energy, sleep, behavior, and thinking. Recent studies in bipolar disorder across the world have assisted mental health professionals in better understanding the disorder. Some studies are as follows:

1) Lithium response in bipolar disorder correlates with improved cell viability of patient-derived cell lines

Lithium is a well-established, effective treatment for bipolar disorder. However, the reasons for variations in its clinical response and the mechanisms of its actions were unclear. Researchers used lymphoblastoid cell lines (LCLs) and neural precursor cells (NPCs) from bipolar disorder patients. They were characterized for clinical response to lithium to interrogate cellular phenotypes related to both clinical and disease lithium response. NPCs of two biologically-related bipolar disorder patients who showed varying clinical responses to lithium were compared under healthy controls. RNA-sequences, cell proliferation parameters, cell viability, mitochondrial membrane potential (MMP) were assessed without and within vitro lithium. Research findings indicated that cellular phenotypes related to the disease (cell proliferation, MMP) in LCLs and NPCs and those related to clinical lithium response (BCL2/GSK3B expression, cell viability) in LCLs.


2) Decelerated epigenetic aging associated with mood stabilizers in the blood of patients with bipolar disorder

According to studies, patients with bipolar disorder have accelerated biological aging, and there is a high mortality rate among patients with bipolar disorder. DNA methylation (DNAm) profiles as “epigenetic clocks” were recently developed by Horvath and Hannum et al. independently, which are the most accurate biological age estimates. Two accomplished measures of epigenetic age acceleration (EAA) using blood samples were developed, namely, extrinsic and intrinsic EAA. IEAA indicates cell-intrinsic aging and is independent of blood cell counts. A DNAm dataset was used from whole blood samples obtained from 30 healthy controls and 30 patients with bipolar disorder. There was a decrease in Horvath EAA and IEAA in people with bipolar disorder compared to healthy controls. There was a further significant decrease in Horvath IEAA and EAA in patients with BD taking medication combinations of mood stabilizers compared to those with no medication or monotherapy and thus providing novel evidence that suggests that epigenetic aging associated with mood stabilizers is decelerated in patients with bipolar disorder.


3) While anticipating a working-memory task, brain activity could help distinguish depression in bipolar disorder from major depression

Working memory is a procedure that the human brain uses to manipulate, maintain, and update information about tasks that are immediately at hand. Damage to neural networks engaged during working memory results in impairments in reasoning, decision-making, and learning, which are observed in people with mood disorders, like depression. Researchers recruited 23 healthy controls, 18 people in the depressive phase of bipolar disorder, and 23 people with major depressive disorder who were also depressed. Under conditions in which each participant was exposed to a range of emotional stimuli from negative to neutral to positive, each participant was scanned for both difficult and easy working memory tasks. The analysis of the resultant brain scans of all participants confirmed the hypothetical assumption that brain activity patterns during anticipation of a working-memory task vary according to whether the task is difficult or easy, thus making it easy to distinguish depressed individuals with bipolar disorder from those with major depressive disorder.


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4) Severe psychiatric history in the family affects the treatment of bipolar disorder patients.

Bipolar disorder patients who have family members with severe mental disorders (associated with sociodemographic measures and disease severity)require more medicine and are more difficult to treat. Researchers also found that the higher number of family members with severe mental disorders was linked to lower-income, lower levels of education, and the earlier debut. Among the most frequent disorders were alcoholism, depression, and bipolar disorder. These results were based on two large randomized American control trials comprising 757 participants and were conducted in 11 hospitals in the United States. The research indicates that a family history of psychiatric disorders places a greater burden on patients already suffering from bipolar disorder.

5) Prevalence and predictors of bipolar disorders in patients with major depressive episodes

Early diagnosis of bipolar disorder and subsequent appropriate treatment is critical for patients with a major depressive episode. This study examined patients with a major depressive episode, conducted in clinical settings in Japan, and investigated the prevalence and predictors of bipolar disorder. To determine the presence of psychiatric comorbidities and mood episodes, a total of 448 patients were interviewed using the Mini-International Neuropsychiatric Interview. 25.4% of the total patients were diagnosed with bipolar disorder. Five predictors that are significantly correlated with bipolar disorder, as identified by multivariate logistic regression, were mixed depression, related antidepressant switch to hypomania or mania, at least two previous mood episodes within the last year, a history of suicide attempts and an early onset of a major depressive episode.

The differential diagnosis of major depressive disorder and bipolar disorder (wherein both exhibit similar depressive symptoms) is essential for patients with a major depressive episode. Predictors identified in this study could come of help in distinguishing and supporting a different diagnosis of these disorders in routine clinical practice.


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