Long-Term implications of early onset in bipolar disorder: data from the first 1000 participants in the systematic treatment enhancement program for bipolar disorder (STEP-BD)

Aim: Early onset of psychopathology is often an index of a more severe clinical course and worse prognosis. This review examined the course of bipolar disorder (BD) with onset in childhood and adolescence, with a focus on persistence of symptoms, severity of illness, comorbidity, and functional impairment. Methods: The databases of PubMed, Embase, and PsycInfo were systematically searched for publications since 1990 reporting on long-term (12 months or longer) assessments of patients with early onset BD. Results: Forty-two relevant publications were identified, which reported on data derived from 15 different patient cohorts, including 7 prospective research psychopathology studies, 4 medical record reviews, 2 follow-ups of clinical trial samples, 1 managed care database, and 1 nationwide registry, for a total of 10,187 patients. The length of follow-ups ranged from 1.0 to 15 years. Diagnostic stability of BD ranged from 73% to 100% over ten years. Recovery rate from an index episode was 81.5–100% and recurrence rate was 35–67%. Suicide attempt cumulative prevalence in five years was 18–20%. Earlier age at the first episode predicted a more severe clinical course. Conclusions: Early onset BD persists over time through adolescence, with homotypic diagnostic continuity over the years, but heterogeneity in the severity of the clinical course. Whether early identification and treatment improves distal prognosis remains to be further investigated.

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What is the optimal serum lithium level in the long-term treatment of bipolar disorder? A review

Pharmacopsychiatry ◽

10.1055/s-2007-1002803 ◽

2007 ◽

Vol 40 (06) ◽

Cited By ~ 1

Author(s):

E Severus ◽

N Kleindienst ◽

F Seemüller ◽

S Frangou ◽

HJ Möller ◽

...

Keyword(s):

Bipolar Disorder ◽

Term Treatment ◽

Lithium Level ◽

Serum Lithium Level ◽

Long Term Treatment

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Long-term lithium treatment of bipolar disorder influences very small embryonic-like stem cells and mRNA expression of pluripotency and glial markers

10.26226/morressier.5971be83d462b80290b52f69 ◽

2017 ◽

Author(s):

Ewa Ferensztajn

Keyword(s):

Stem Cells ◽

Bipolar Disorder ◽

Mrna Expression ◽

Lithium Treatment

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Considering a Potential Role of Linalool as a Mood Stabilizer for Bipolar Disorder

Current Pharmaceutical Design ◽

10.2174/1381612826666200724160742 ◽

2020 ◽

Vol 26 (40) ◽

pp. 5128-5133

Author(s):

Kate Levenberg ◽

Wade Edris ◽

Martha Levine ◽

Daniel R. George

Keyword(s):

Bipolar Disorder ◽

Treatment Options ◽

Mood Stabilizer ◽

Well Being ◽

Epidemiologic Studies ◽

Treatment Regimens ◽

Bipolar Spectrum Disorders ◽

Short And Long Term

Epidemiologic studies suggest that the lifetime prevalence of bipolar spectrum disorders ranges from 2.8 to 6.5 percent of the population. To decrease morbidity and mortality associated with disease progression, pharmacologic intervention is indicated for the majority of these patients. While a number of effective treatment regimens exist, many conventional medications have significant side effect profiles that adversely impact patients’ short and long-term well-being. It is thus important to continue advancing and improving therapeutic options available to patients. This paper reviews the limitations of current treatments and examines the chemical compound Linalool, an alcohol found in many plant species, that may serve as an effective mood stabilizer. While relatively little is known about Linalool and bipolar disorder, the compound has been shown to have antiepileptic, anti-inflammatory, anxiolytic, anti-depressive, and neurotrophic effects, with mechanisms that are comparable to current bipolar disorder treatment options.

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Affective Temperaments and Illness Severity in Patients with Bipolar Disorder

Medicina ◽

10.3390/medicina57010054 ◽

2021 ◽

Vol 57 (1) ◽

pp. 54

Author(s):

Mario Luciano ◽

Luca Steardo ◽

Gaia Sampogna ◽

Vito Caivano ◽

Carmen Ciampi ◽

...

Keyword(s):

Quality Of Life ◽

Bipolar Disorder ◽

Protective Factor ◽

Psychiatric Symptoms ◽

Control Group ◽

Term Outcome ◽

Long Term Outcome ◽

Affective Temperaments

Background and objectives: Bipolar disorder (BD) is one of the most burdensome psychiatric illnesses, being associated with a negative long-term outcome and the highest suicide rate. Although affective temperaments can impact on BD long-term outcome, their role remains poorly investigated. The aims of the present study are to describe the clinical characteristics of patients with BD more frequently associated with the different affective temperaments and to assess the relation between affective temperaments and severity of clinical picture in a sample of patients with BD. Materials and Methods: A total of 199 patients have been recruited in the outpatients units of two university sites. Patients’ psychiatric symptoms, affective temperaments, and quality of life were investigated through validated assessment instruments. Results: Predominant cyclothymic and irritable temperaments are associated to higher number of relapses, poorer quality of life, higher rates of aggressive behaviors, and suicide attempts. Conversely, the predominant hyperthymic disposition was a protective factor for several outcome measures, including relapse rate, severity of anxiety, depressive and manic symptoms, suicidality, and earlier age at onset. One limitationo of the present study is that the recruitment took place in two university sites; therefore, our findings cannot be fully generalized to the whole community of BD patients. Other limitations are the lack of a control group and the cross-sectional design of the study. Conclusions: The early identification of affective temperaments can help clinicians to identify those BD patients who are more likely to show a poor long-term outcome. An early screening of affective temperaments can be useful to develop targeted integrated pharmacological and psychosocial interventions.

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