Allostatic load in bipolar disorder: Implications for pathophysiology and treatment

Kapczinski, Flávio; Vieta, Eduard; Andreazza, Ana Cristina; Frey, Benício N.; Gomes, Fabiano A.; Tramontina, Juliana; Kauer-Sant’Anna, Márcia; Grassi‐Oliveira, Rodrigo; Post, Robert M.

doi:10.1016/j.neubiorev.2007.10.005

Cited by 414 publications

(308 citation statements)

References 199 publications

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“…It has been hypothesized that BD and metabolic syndrome share a set of common risk factors and overlapping pathophysiology 782, 783, 784. While medications used to treat BD, particularly atypical antipsychotics, can also lead to metabolic dysfunction and weight problems (Section 8), insufficient access to primary and preventative health care, low socioeconomic status, habitual inactivity, insulin dysfunction, peripheral inflammation and neuroinflammation, oxidative stress, and childhood adversity are also important contributors 785…”

Section: Specific Populationsmentioning

confidence: 99%

Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder

et al. 2018

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The Canadian Network for Mood and Anxiety Treatments (CANMAT) previously published treatment guidelines for bipolar disorder in 2005, along with international commentaries and subsequent updates in 2007, 2009, and 2013. The last two updates were published in collaboration with the International Society for Bipolar Disorders (ISBD). These 2018 CANMAT and ISBD Bipolar Treatment Guidelines represent the significant advances in the field since the last full edition was published in 2005, including updates to diagnosis and management as well as new research into pharmacological and psychological treatments. These advances have been translated into clear and easy to use recommendations for first, second, and third‐ line treatments, with consideration given to levels of evidence for efficacy, clinical support based on experience, and consensus ratings of safety, tolerability, and treatment‐emergent switch risk. New to these guidelines, hierarchical rankings were created for first and second‐ line treatments recommended for acute mania, acute depression, and maintenance treatment in bipolar I disorder. Created by considering the impact of each treatment across all phases of illness, this hierarchy will further assist clinicians in making evidence‐based treatment decisions. Lithium, quetiapine, divalproex, asenapine, aripiprazole, paliperidone, risperidone, and cariprazine alone or in combination are recommended as first‐line treatments for acute mania. First‐line options for bipolar I depression include quetiapine, lurasidone plus lithium or divalproex, lithium, lamotrigine, lurasidone, or adjunctive lamotrigine. While medications that have been shown to be effective for the acute phase should generally be continued for the maintenance phase in bipolar I disorder, there are some exceptions (such as with antidepressants); and available data suggest that lithium, quetiapine, divalproex, lamotrigine, asenapine, and aripiprazole monotherapy or combination treatments should be considered first‐line for those initiating or switching treatment during the maintenance phase. In addition to addressing issues in bipolar I disorder, these guidelines also provide an overview of, and recommendations for, clinical management of bipolar II disorder, as well as advice on specific populations, such as women at various stages of the reproductive cycle, children and adolescents, and older adults. There are also discussions on the impact of specific psychiatric and medical comorbidities such as substance use, anxiety, and metabolic disorders. Finally, an overview of issues related to safety and monitoring is provided. The CANMAT and ISBD groups hope that these guidelines become a valuable tool for practitioners across the globe.

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Section: Specific Populationsmentioning

confidence: 99%

Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder

et al. 2018

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“…1 In a large subgroup of patients, BD follows a progressive course, which can lead to structural brain damage and functional impairment. 2 In recent years, staging models for BD have been proposed. 3,4 (A detailed review is available elsewhere.…”

Section: Introductionmentioning

confidence: 99%

Clinical characteristics and influence of childhood trauma on the prodrome of bipolar disorder

Noto

Caribé

et al. 2015

Rev. Bras. Psiquiatr.

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Objectives: To describe the onset pattern, frequency, and severity of the signs and symptoms of the prodrome of the first hypomanic/manic episode and first depressive episode of bipolar disorder (BD) and to investigate the influence of a history of childhood maltreatment on the expression of prodromal symptoms. Methods: Using a semi-structured interview, the Bipolar Prodrome Symptom Scale-Retrospective (BPSS-R), information regarding prodromal symptoms was assessed from patients with a DSM-IV diagnosis of BD. History of childhood maltreatment was evaluated using the Childhood Trauma Questionnaire (CTQ). Results: Forty-three individuals with stable BD were included. On average, the prodrome of mania lasted 35.8668.7 months and was predominantly subacute or insidious, with rare acute presentations. The prodrome of depression lasted 16.6623.3 months and was also predominantly subacute or insidious, with few acute presentations. The prodromal symptoms most frequently reported prior to the first hypomanic or manic episode were mood lability, depressive mood, and impatience. A history of childhood abuse and neglect was reported by 81.4% of participants. Presence of childhood maltreatment was positively associated with prodromal symptoms, including social withdrawal, decreased functioning, and anhedonia. Conclusions: This study provides evidence of a long-lasting, symptomatic prodrome prior to first hypomanic/manic and depressive episode in BD and suggests that a history of childhood maltreatment influences the manifestations of this prodrome.

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“…6 These methods were originally designed to help patients with neurological conditions, but their applications were later extended to include treatment of psychiatric disorders. 6,7 Therefore, given that individual and social impairments during the course of BD are usually related to persistent and progressive cognitive impairment, [8][9][10][11] CR programs have emerged as a potential adjunctive treatment for BD. The primary focus of CR programs is on cognitive enhancement and daily life functioning and is not restricted to psychoeducation and coping strategies, unlike traditional psychosocial treatments.…”

Section: Introductionmentioning

confidence: 99%

A systematic review of cognitive rehabilitation for bipolar disorder

Kluwe-Schiavon

Viola

Levandowski

et al. 2015

Trends Psychiatry Psychother.

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Introduction: It has been shown that bipolar disorder (BD) has a direct impact on neurocognitive functioning and behavior. This finding has prompted studies to investigate cognitive enhancement programs as potential treatments for BD, primarily focusing on cognitive reinforcement and daily functioning and not restricted to psychoeducation and coping strategies, unlike traditional psychosocial treatments. Objective: This study presents a systematic review of controlled trials of cognitive rehabilitation (CR) for BD. Our main objective is to describe the results of studies of rehabilitation programs for BD and related methodological issues. Method: Electronic database searches (MEDLINE, Web of Science, and Embase) were conducted to identify articles using terms related to BD and CR. The methodological quality of each article was measured using the 5-item Jadad scale. Results: A total of 239 articles were initially identified, but after application of exclusion criteria, only four were retained for this review. An average of 17 hours of intervention sessions were conducted, distributed as 0.95 hours per week and three of the four studies reported better executive function performance after CR interventions. Conclusions: We did not find robust evidence to support cognitive rehabilitation as an effective treatment for BD, because of: 1) the variety of intervention designs; 2) the methodological limitations of the studies; and 3) the lack of studies in the field.

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Allostatic load in bipolar disorder: Implications for pathophysiology and treatment

Cited by 414 publications

References 199 publications

Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder

Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder

Clinical characteristics and influence of childhood trauma on the prodrome of bipolar disorder

A systematic review of cognitive rehabilitation for bipolar disorder

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