Psychotic and affective symptoms of early-onset bipolar disorder: an observational study of patients in first manic episode

Fu‐I, Lee; Gurgel, Wagner de Sousa; Caetano, Sheila C.; Machado‐Vieira, Rodrigo; Wang, Yuan‐Pang

doi:10.1590/1516-4446-2019-0455

Cited by 7 publications

(3 citation statements)

References 37 publications

(66 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We also found the rate of psychotic symptoms in the depression group was higher than the mania group, similar to a recent study ( 31 ). This study found many patients with bipolar disorder had prominent psychotic symptoms as a feature of a depressive episode.…”

Section: Discussionsupporting

confidence: 92%

Differences in Demographic and Clinical Characteristics of Patients With Depressive vs. Manic First Episode of Bipolar Disorder

Wang

Cao

Zhu³

et al. 2021

Front. Psychiatry

View full text Add to dashboard Cite

Background: Bipolar disorder is a serious mental disease marked by episodes of depression, mania, hypomania, or mixed states. Patients with bipolar disorder may present with different symptoms at first onset. The aim of this study is to compare demographic and clinical variables based on a patient's first episode of bipolar disorder, including risk of recurrence over a 2-year period.Methods: A large cohort (N = 742) of patients with bipolar disorder in China was analyzed. Patients were divided into two groups according to their first episode of bipolar disorder, either depression or mania. Patients in mixed state first episode were classified based on predominant symptoms. Three hundred eighteen patients of the cohort had a first episode of mania and 424 patients had initial symptoms of depression. Demographic and clinical data were collected. All patients were followed up for 24 months. Data on compliance with follow-up appointments and recurrence of symptoms after 6, 12, 18, and 24 months were collected. Clinical characteristics (course of disease, age of onset, psychiatric family history, etc.) were compared between the mania group and depression groups.Results: More patients with bipolar disorder had a first episode of depression than mania (57.14 vs. 42.86%). Compared with the depression group, the mania group had later age of diagnosis of bipolar disorder [(38.64 ± 13.50) vs. (36.34 ± 14.94), P = 0.028], lower education level [(9.37 ± 4.34) vs. (10.17 ± 4.81), P = 0.017] and longer latency between an initial episode of psychiatric symptoms and formal bipolar diagnosis [(10.80 ± 10.76) vs. (8.85 ± 9.90), P = 0.012]. More patients in the mania group were male and without psychotic symptoms (all P < 0.05). In comparison with the mania group, more patients in the depression group were female, with higher frequency of a reported precipitating event before first mood episode (all P < 0.05). Compared with the depression group, the mania group had more recurrences of illness at the end of 12 months (Z =-2.156, P = 0.031), 18 months (Z =-2.192, P = 0.028), and 24 months (Z = −2.364, P = 0.018).Conclusions: In our study, there are a number of differences in demographic and clinical characteristics of patients with different onset syndromes of bipolar disorder. These differences include gender, education level, diagnosis age, the rate of recurrences, and others. These data of a cohort of Chinese patients add to the growing international literature on the relationship between index episode of bipolar disorder and clinical variables and outcomes. These results and further study may allow clinicians to offer patients and families more reliable prognostic information at the onset of disease.

show abstract

Section: Discussionsupporting

confidence: 92%

Differences in Demographic and Clinical Characteristics of Patients With Depressive vs. Manic First Episode of Bipolar Disorder

Wang

Cao

Zhu³

et al. 2021

Front. Psychiatry

View full text Add to dashboard Cite

show abstract

“…Bipolar disorder (BD) is a pathological and complex genetic disorder that is usually accompanied by mood and behavioral dysfunctions ranging from extreme depression to mania or vice versa, in which delusions and hallucinations occur during affective periods. 1 BD typically includes remission between episodes, and modern operational diagnostic criteria indicate that it is equally common in men and women, with onset at a mean age of 21 years. Although genetic and family studies strongly suggest that neurobiological deterioration underlies the pathophysiology of BD, its etiology remains unclear.…”

Section: Introductionmentioning

confidence: 99%

Biomarker potential of hsa-miR-145-5p in peripheral whole blood of manic bipolar I patients

Tekin¹,

Asoğlu²,

Ay³

et al. 2022

Brazilian Journal of Psychiatry

View full text Add to dashboard Cite

Objective: Bipolar I disorder (BD-I) is a type of bipolar spectrum disorder characterized by manic or mixed episodes. Detecting microRNA regulations as epigenetic actors in BD-I is important to elucidate the pathogenesis of the disease and reveal the potential of microRNAs (miRNAs) as biomarkers. Methods: We evaluated the expression profile of six candidate miRNAs ( hsa-miR-145-5p , hsa-miR-376a-3p , hsa-miR-3680-5p , hsa-miR-4253-5p , hsa-miR-4482-3p , and hsa-miR-4725 ) in patients with BD-I and in healthy controls (aged 11-50 years). We also determined the potential target genes of these miRNAs through in silico analysis. The diagnostic values of the miRNAs were calculated through receiver operating characteristic curve analysis. Results: Four miRNAs were upregulated ( hsa-miR-376a-3p , hsa-miR-3680-5p , hsa-miR-4253-5p , hsa-miR-4482-3p ) and hsa-miR-145-5p was downregulated in patients (p < 0.001). The target gene analyses showed that hsa-miR-145-5p specifically targets the dopamine decarboxylase ( DDC ) gene. The area under the curve of hsa-miR-145-5p was 0.987. Conclusion: Differential expression of five miRNAs in peripheral blood may be associated with the pathogenesis of BD-I, and hsa-miR-145-5p has potential as a BD-I biomarker. This miRNA can be used in dopamine-serotonin regulation and dose adjustment in drug therapy via the DDC gene.

show abstract

“…The clinical management of PMA and irritability is no easy task during manic episodes. While several studies focused on PMA and irritability in adolescents with BD (Fu et al, 2020; Salazar de Pablo et al, 2020; Weintraub et al, 2020), the co-occurrence of both condition remained an unresolved research entity. A recent study showed that the risk of suicide increased during manic episode when anxiety, irritability and PMA co-occurred (Eberhard & Weiller, 2016).…”

Section: Introductionmentioning

confidence: 99%

Psychomotor agitation and irritability in adolescents with manic episode: Clinical data from three inpatient units

Turan

Ermiş

Eray

et al. 2022

Clin Child Psychol Psychiatry

View full text Add to dashboard Cite

Objectives We aimed to investigate the characteristics of adolescents with Bipolar disorder-I with irritability and agitation (Mania+IA) compared to those without irritability and agitation (Mania-IA) in a multi-center representative sample. Methods Data of 145 patients from three tertiary-care inpatient units between 2016 and 2021 were obtained. Psychomotor agitation was defined as a score of ≥3 on the YMRS “Increased Motor Activity––Energy” item, irritability as a score of ≥4 on the YMRS ‘irritability’ item, and severity anchors of speech and thought disturbance on the YMRS ‘6 and 7’ items. Results Previous manic episodes ( p = 0.013), involuntary hospitalization ( p = 0.006), psychotic features ( p = 0.001), formal thought disorder ( p = 0.010) and aggressive/disruptive behavior ( p = 0.021) were more frequent in the Mania+IA group. Conversely, depressive episodes ( p = 0.006) and family history of depression ( p = 0.024) were more frequent in the Mania-IA group. The Mania+IA had poorer functioning at the time of discharge. Conclusions Irritability and agitation were closely related to complications, psychotic symptoms and thought disorder. Assessment and monitoring of psychomotor agitation and irritability may help child and adolescent psychiatrists to predict clinical difficulties and appropriate interventions.

show abstract

Psychotic and affective symptoms of early-onset bipolar disorder: an observational study of patients in first manic episode

Cited by 7 publications

References 37 publications

Differences in Demographic and Clinical Characteristics of Patients With Depressive vs. Manic First Episode of Bipolar Disorder

Differences in Demographic and Clinical Characteristics of Patients With Depressive vs. Manic First Episode of Bipolar Disorder

Biomarker potential of hsa-miR-145-5p in peripheral whole blood of manic bipolar I patients

Psychomotor agitation and irritability in adolescents with manic episode: Clinical data from three inpatient units

Contact Info

Product

Resources

About