Can we prevent the neuroinflammation and neuroprogression produced by oxidative stress in euthymic bipolar patients, using mood stabilizers?

Bipolar Disorder (BD) is associated with systemic toxicity, represented by changes in the biomarkers, associated with mood episodes, leading to neurological damage, which may reflect on cognitive functions and functionality, and the progression of the disease. We aimed to analyze the effect of four biomarkers superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GSH-Px) enzymes, and thiobarbituric acid reactive substances (TBA-RS) related to oxidative stress in BD and to correlate them with cognitive functions and functionality. We studied 50 bipolar patients type I/II, in the euthymic phase, which was divided into two subgroups with 25 patients, (≤3 years and ≥10 years of diagnosis, from the first episode of mania), and 25 control patients. To analyze frontal cognitive functions and functionality, we used the tests: Frontal Assessment Battery (FAB) and Functioning Assessment Short Test (FAST), respectively. The FAST test scores results were ≤3 years (20.63±8.21), ≥10 years (27.80±12.50), and control group (9.80±5.94), p<0.001. Changes occurred in all domains. The FAB test scores were ≤3 years (14.64±2.48), ≥10 years (12.44±2.78), and control group (15.84±1.55), p<0.001, and showed lower scores in four domains. The oxidative stress showed an increase in TBA-RS levels: ≤3 years (3.18±1.17), ≥10 years (3.01±1.03) compared to the control group (1.62±0.28), p<0.0001; and in the CAT enzyme activity we found, ≤3 years (8.10±4.18), ≥10 years (9.41±4.95), compared to the control group (3.47±0.77), p<0.0001. Even during the euthymic phase, bipolar patients showed and maintained an increase in CAT activity and lipid peroxidation with significant changes in the FAB and FAST tests in different groups of patients, demonstrating impairment in cognitive functions and functionality since disease onset.

Oxidative Stress and Bipolar Mood Disorder: An Important Yet Ambiguous Relationship

Bipolar disorder is a chronic psychological condition that disturbs many patients' lives around the world. The exact pathophysiology of bipolar disorder is yet unknown, but there are several hypotheses to explain this condition. One of the most challenging theories is the role of oxidative stress in the progression of bipolar disorder. Here, we conducted a narrative review to gather the studies that investigated the relationship between bipolar disorder and oxidative stress. We searched PubMed, Scopus, Web of science, and google scholar databases using the following keywords: “bipolar disorder,” “oxidative stress,” “oxidative markers,” and “bipolar patients.” A majority of studies showed that oxidative markers such as Thiobarbituric acid reactive substances are significantly higher in bipolar patients compared to healthy subjects. Based on the included articles, bipolar disorder is associated with oxidative stress. Nevertheless, further well-established Cohorts are required to support these results.

Pareidolia in Schizophrenia and Bipolar Disorder

While there are many studies on pareidolia in healthy individuals and patients with schizophrenia, to our knowledge, there are no prior studies on pareidolia in patients with bipolar disorder. Accordingly, in this study, we, for the first time, measured pareidolia in patients with bipolar disorder (N = 50), and compared that to patients with schizophrenia (N = 50) and healthy controls (N = 50). We have used (a) the scene test, which consists of 10 blurred images of natural scenes that was previously found to produce illusory face responses and (b) the noise test which had 32 black and white images consisting of visual noise and 8 images depicting human faces; participants indicated whether a face was present on these images and to point to the location where they saw the face. Illusory responses were defined as answers when observers falsely identified objects that were not on the images in the scene task (maximum illusory score: 10), and the number of noise images in which they reported the presence of a face (maximum illusory score: 32). Further, we also calculated the total pareidolia score for each task (the sum number of images with illusory responses in the scene and noise tests). The responses were scored by two independent raters with an excellent congruence (kappa &gt; 0.9). Our results show that schizophrenia patients scored higher on pareidolia measures than both healthy controls and patients with bipolar disorder. Our findings are agreement with prior findings on more impaired cognitive processes in schizophrenia than in bipolar patients.

How to make online mood-monitoring in bipolar patients a success? A qualitative exploration of requirements

Background The Life-Chart Method (LCM) is an effective self-management treatment option in bipolar disorder (BD). There is insufficient knowledge about the consumers’ needs and desires for an e-monitoring solution. The first step towards a new mood monitoring application is an extended inventory among consumers and professionals. Methods The aim of the current study was: to identify opinions about online mood monitoring of patients with BD and professionals and to identify preferences on design, technical features and options facilitating optimal use and implementation of online mood monitoring. This study used a qualitative design with focus-groups. Participants were recruited among patients and care providers. Three focus-groups were held with eight consumers and five professionals. Results The focus-group meetings reveal a shared consciousness of the importance of using the Life-Chart Method for online mood monitoring. There is a need for personalization, adjustability, a strict privacy concept, an adjustable graphic report, and a link to early intervention strategies in the design. Due to the fact that this is a qualitative study with a relative small number of participants, so it remains unclear whether the results are fully generalizable. We can’t rule out a selection bias. Conclusions This study demonstrates the importance of involving stakeholders in identifying a smartphone-based mood charting applications’ requirements. Personalization, adjustability, privacy, an adjustable graphic report, and a direct link to early intervention strategies are necessary requirements for a successful design. The results of this value specification are included in the follow-up of this project.