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Awareness weeks guide

World Bipolar Day

World Bipolar Day

30 March 2024

The vision of World Bipolar Day (WBD) is to bring world awareness to bipolar disorders and to eliminate social stigma.  Through international collaboration, the goal of World Bipolar Day is to bring the world population information about bipolar disorders that will educate and improve sensitivity towards the illness. World Bipolar Day

UpToDate

Adults

General

Geriatric

Paediatrics

Women

Cochrane Library

Articles

Diagnosis

Research

Treatment

Guidelines

Patient resources

Podcasts

Journals

E-books

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Articles

Diagnosis

Diagnosis and management of bipolar disorders
This review provides an overview of the clinical features, diagnostic subtypes, and major treatment modalities available to treat people with bipolar disorder, highlighting recent advances and ongoing therapeutic challenges. BMJ 12 April 2023

Diagnosis and treatment of Bipolar Disorder: A Review
Bipolar disorder affects approximately 8 million adults in the US. First-line therapy includes mood stabilizers, such as lithium, anticonvulsants, such as valproate and lamotrigine, and atypical antipsychotic drugs, such as quetiapine, aripiprazole, asenapine, lurasidone, and cariprazine. JAMA 10 October 2023

Differential diagnosis of unipolar versus bipolar depression by GSK3 levels in peripheral blood: a pilot experimental study
These results suggest that peripheral blood cells (PBMCs) Glycogen Synthase Kinase-3 (GSK3) could be a candidate biomarker for the differential diagnosis of bipolar disorder versus unipolar depression. This finding may help in implementing the still limited panel of peripheral biomarkers for differential diagnosis between unipolar and bipolar disorder in patients presenting with a depressive episode. International journal of bipolar disorders 8 October 2023

Differential characteristics of bipolar I and II disorders: a retrospective, cross-sectional evaluation of clinical features, illness course, and response to treatment
Differences between bipolar I and II disorders are not limited to the severity of (hypo)manic syndromes but include patterns of clinical course and family history. Caution in the use of potentially mood-destabilizing agents is warranted during the early course of bipolar II disorder. International journal of bipolar disorders 14 July 2023

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Research

High lithium concentration at delivery is a potential risk factor for adverse outcomes in breastfed infants: a retrospective cohort study
Neonatal symptoms are common after late intrauterine lithium exposure, however transient, treatable and mostly mild. In this study, a high lithium concentration at birth was a risk factor for an increased lithium level at follow-up. Polypharmacy may constitute an additional risk factor. This study suggests that the late intrauterine exposure to lithium might add to the adverse effects in lithium-exposed, breastfed infants. Consequently we recommend breastfed infants with therapeutic lithium concentrations at birth to be followed up promptly to avoid lithium toxicity. International journal of bipolar disorders 30 November 2023

Surgical outcomes for people with serious mental illness are poorer than for other patients: a systematic review and meta‐analysis
Having a serious mental illness is associated with higher rates of post‐operative complications and longer stays in hospital, but not with higher in‐hospital or 30‐day mortality. Targeted pre‐operative interventions may improve surgical outcomes for these vulnerable patients. MJA 19 April 2019

Risk of dementia in bipolar disorder and the interplay of lithium: a systematic review and meta-analyses
Individuals with bipolar disorder (BD) are at higher risk of dementia than both the general population or those with major depressive disorder (MDD). Lithium appears to reduce the risk of developing dementia in BD. Acta psychiatrica Scandinavica 18 January 2020

Bipolar Disorder
The diagnosis and treatment of bipolar disorder remain, to a large extent, subjective clinical exercises. Attention to the components of the disorder in an individual patient and to the response to each prescribed treatment is helpful in guiding therapy and providing a prognosis for the patient and family. Coexisting conditions, particularly medical disorders, are addressed as part of the overall treatment plan. Both pharmacologic and psychotherapeutic treatments have advantages and disadvantages and therefore require monitoring and skill in application. The development and validation of biomarkers for this disorder may allow earlier diagnosis and guide treatment selection, which are goals of precision psychiatry. NEJM 2 July 2020

Bipolar at-risk criteria and risk of Bipolar Disorder over 10 or more years
In this cohort study of participants seeking care for mental health difficulties, patients meeting the bipolar at-risk (BAR) criteria were significantly more likely to transition to bipolar disorder (BD) over a decade after ascertainment compared with patients not meeting the BAR criteria. The findings suggest that those meeting BAR criteria may benefit from longer-term monitoring and support. Evaluation of predictive properties in longer-term studies using a risk measure will help with implementation of BAR criteria in clinical settings. JAMA 15 September 2023

Prevention of suicidal behavior with lithium treatment in patients with recurrent mood disorders
The authors review and update selected research literature on effects of lithium treatment in reducing suicidal behavior and consider proposals that higher levels of lithium in drinking water may be associated with lower suicide rates. International journal of bipolar disorders 9 March 2024

Why is lithium [not] the drug of choice for bipolar disorder? a controversy between science and clinical practice
Decades of scientific investigations and education and teaching of clinicians and the public has not increased the use of lithium on a population-based large scale. It is argued that lithium should be the drug of choice for maintenance therapy as the single first-line treatment and that organizational changes are needed with specialised care for bipolar disorder to systematically and long-term change the use of lithium on a large-scale population-level. International journal of bipolar disorders 16 January 2024

Perceived loneliness and social support in bipolar disorder: relation to suicidal ideation and attempts
Findings expand the evidence base supporting a relationship between perceived social connectedness and suicidal thoughts and behaviors (STBs) in bipolar disorder (BD). They suggest that this modifiable variable could be a fruitful treatment target for preventing STBs in BD. International journal of bipolar disorders 20 March 2024

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Treatment

Monitoring drug interventions in people with bipolar disorder

What you need to know

  • At each consultation, assess patients with bipolar disorder for potential adverse effects of medication, and consider how they may be monitored going forward.
  • In patients taking lithium, discuss and look out for signs of toxicity, especially if renal function is deteriorating
  • In patients taking antipsychotics, assess for extrapyramidal side effects and signs of metabolic syndrome
  • In those taking anticonvulsants, look for agranulocytosis with carbamazepine, pancreatitis with valproate, and Stevens-Johnson syndrome with lamotrigine
  • Ensure women and girls of childbearing age with bipolar disorder are offered pre-conception counselling by a specialist to discuss risk and benefits of ongoing use of medication. For those taking valproate, ensure that they are enrolled in a pregnancy prevention programme

BMJ 7 February 2023

Gabapentin and pregabalin in bipolar disorder, anxiety states, and insomnia: Systematic review, meta-analysis, and rationale
The authors conducted a systematic review and conclude that there is moderate evidence of the efficacy of gabapentinoids in anxiety states, but minimal evidence in bipolar disorder and insomnia and they should be used for these disorders only with strong justification. Molecular psychiatry 24 November 2021

Dialectical Behavior Therapy for adolescents with Bipolar Disorder: A randomized clinical trial
In this randomized clinical trial, dialectical behavior therapy (DBT) demonstrated efficacy in decreasing suicide attempts among the high-risk population of adolescents with bipolar spectrum disorder. JAMA 13 September 2023

Cognitive behavioural therapy for social anxiety disorder in people with bipolar disorder: a case series
This case series provides preliminary evidence that CBT is acceptable, safe, and effective for treating social anxiety disorder in people with bipolar disorder during euthymia. A randomized controlled trial is needed to confirm these findings, and to establish whether treatment for social anxiety disorder improves the course of bipolar disorder. International journal of bipolar disorders 5 January 2024

Effectiveness of ultra-long-term lithium treatment: relevant factors and case series
The authors of the paper reckon that in the case of good response, lithium can be given indefinitely. Given the appropriate candidates for such therapy and successful management of the adverse effects, ultra-long term lithium therapy is possible and beneficial for such patients. International journal of bipolar disorders 15 March 2024

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Journals

This is just a sample of the journals the library subscribes to – you will need your library login

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E-books

This is just a sample of the e-books the library subscribes to – you will need your library login

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