Genetic link to suicide risk

Researchers from Johns Hopkins University in Baltimore have identified a gene that could be linked to an increased risk of attempting suicide. The researchers studied 2,698 people with bipolar disorder, 1,201 of whom had a history of suicide attempts. Those with one copy of a genetic variation on chromosome 2 were 1.4x as likely to have attempted suicide while those with two variations were almost three times as likely. The gene involved - ACP1 - leads to increased levels of a protein called ACP1 in the brains of people who had committed suicide. The protein is thought to influence the same biological pathway - albeit in a different direction - as lithium, a drug known to reduce the rate of suicidal behaviour.

Premenstrual troubles and bipolar disorder

Researchers from Massachusetts General Hospital in Boston have been studying the interaction between premenstrual symptoms and bipolar disorder. They studied 293 women over a year and found that the women with premenstrual worsening of their bipolar disorder had more 'episodes' - mostly of depression - than the other women. They had more symptoms of depression and mania overall, relapsed more rapidly and had more severe symptoms.

Another gene linked to increased risk of mental illness

A team of researchers from Shanghai Jiao Tong University have been looking into the links between genetics and schizophrenia. They studied 12,229 people in Shanghai: 5,772 had no mental-health problems, 4,187 had schizophrenia, 1,135 had bipolar disorder and 1,135 had depression. The study found that variations in the BCL9 gene led to a greater risk of schizophrenia and were also associated with bipolar disorder and depression.

Li, Junyan ... [et al] - Common variants in the BCL9 gene conferring risk of schizophrenia Archives of General Psychiatry 2011; 68(3): 232-241

Lithium and bipolar brains

A team of researchers led by Brian Hallahan from the National University of Ireland in Galway have carried out a review of studies into brain volume, bipolar disorder and the effectiveness of lithium. They found that people with bipolar disorder had increased right lateral ventricular, left temporal lobe and right putamen volumes and decreased cerebral and hippocampal volumes. The longer people had been ill for the greater their cerebral volume reduction. However, people with bipolar disorder who took lithium had less reduction in these areas and showed increases in hippocampal and amygdala volume.

Bipolar disorder and recovery from depression

Some researchers think that people with depression who also show some of the symptoms of bipolar disorder are less likely to respond well to treatment. A team of researchers led by Roy H. Perlis from Harvard Medical School looked into this issue in a study of 4,041 people taking part in the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study. They found that irritability and symptoms of psychosis (delusions and hallucinations) at the start of the study were significantly associated with poorer treatment outcomes but other symptoms of bipolar disorder and a family history of the condition weren't.

Perlis, Roy H. ... [et al] - Association between bipolar spectrum features and treatment outcomes in outpatients with major depressive disorder Archives of General Psychiatry doi:10.1001/archgenpsychiatry.2010.179

Mental disorders and risk of suicide in veterans

Researchers from the Department of Veterans Affairs (VA) Healthcare System and the University of Michigan, Ann Arbor have been looking into the links between mental disorders and suicide in U.S. military veterans. They studied more than 3 million veterans who had received any type of care in a VA facility in 1999. They looked at their psychiatric diagnoses from their 1998 and 1999 treatment records and followed them over a seven-year period. By the end of the study 7,684 veterans had killed themselves. 46.8% of those who committed suicide had at least one psychiatric diagnosis and all of the diagnoses studied - depression, schizophrenia, bipolar disorder, drug abuse, post-traumatic stress disorder (PTSD) and anxiety - led to an increased risk of suicide. In men bipolar disorder was associated with the greatest risk of suicide while in the women drug abuse was - overall bipolar disorder led to the greatest increase in risk.

Brain scans shed new light on childhood problems

The symptoms which can lead to children being diagnosed with bipolar disorder or attention deficit hyperactivity disorder (ADHD) can be quite similar but new research, from a team led by Alessandra M. Passarotti from the University of Chicago at Illinois, suggests that what goes on inside their brains might be completely different. The study involved children between the ages of 10 and 18, some diagnosed with bipolar disorder, some diagnosed with ADHD and others with no mental health problems. The children were wired up to an MRI scanner while they did a memory task involving faces with angry, happy or neutral expressions. Both groups showed dysfunction in the prefrontal cortex which controls executive function, working memory, attention, language and impulsivity. However, the ADHD group showed more severe dysfunction in the areas relating to working memory while the bipolar group showed more dysfunction in areas involved with processing and regulating emotions.

Bipolar disorder and violence

Previous research into bipolar disorder and violent crime has found that those with the condition are more likely to engage in acts of violence. However, it is unclear whether the disorder itself, or some of the problems that go with it are behind the link. Researchers from the Karolinska Institutet in Sweden and Oxford University carried out research in Sweden where the state keeps a huge amount of information about people. They compared 3,700 patients with bipolar disorder, cared for in Swedish hospitals between 1973 and 2004, with 37,000 unaffected people from the general public. They found that the number of people committing violent crime was about the same in people with bipolar disorder and no substance-abuse problem and unaffected people (5% vs 3%). However, people with bipolar disorder and a substance-abuse problem were much more likely (21%) to commit violent crimes. The findings mirror similar research into schizophrenia which also found that it was schizophrenic's drug problems not their condition in itself that lead to an increased risk of violence.

You can find out more about this research by clicking on the title of this post.

Drug company pays out in diabetes cases

Anglo-Swedish drug company AstraZeneca is to pay out £125m to people who developed diabetes after taking its schizophrenia and bipolar drug Seroquel. Seroquel had worldwide sales of $4.9bn last year, representing 15% of AstraZeneca's total revenue. The payment settles 17,500 claims against the company.

You can find out more about this story by clicking on the link in the title of this post.

Could 'Special K' be a solution for bipolar depression?

Ketamine could help people with bipolar disorder shake off depression. Ketamine was first introduced in 1962 and is legally used as a human, and animal, anaesthetic. It is also used as a 'party' drug when it is known, among other things, as 'Special K'. Researchers from the National Institutes of Health in Bethesda, Maryland used much smaller doses of the drug than are used recreationally on 18 patients with severe bipolar depression. The patients had tried an average of seven different drugs to treat their illness and 55% had had electroconvulsive therapy (ECT). However, 40 minutes after receiving a ketamine injection the patients depressive symptoms had improved - an effect that lasted for at least three days. Side effects included anxiety, feeling woozy, headaches and a temporary sense of disconnection from reality although there were no 'serious adverse effects.'

You can find out more about this research by clicking on the title of this post.

Bipolar and high blood pressure

There is already an established link between bipolar disorder and heart disease and diabetes and now there is evidence that the condition could also be linked to high blood pressure. Researchers from Michigan State University studied 99 people who had been hospitalized for bipolar disorder. Nearly half of them had high blood pressure and the younger someone was when they were first diagnosed as bipolar the more likely they were to develop high blood pressure. The patients who had high blood pressure also had higher levels of mania.

You can find out more about this research at

http://www.sciencedaily.com/releases/2010/06/100610171716.htm?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+sciencedaily+%28ScienceDaily%3A+Latest+Science+News%29&utm_content=Google+Reader

Early intervention for bipolar disorder - reviewing the evidence

Treating people early, as soon as they start to show signs of distress, is now seen as the best way of dealing with mental-health problems. A team of researchers, led by Michael Berk from the University of Melbourne in Australia, has been reviewing the evidence supporting such early intervention for treatment with bipolar disorder. They found that in the early stages of bipolar disorder there are few changes to people's brain structure and that it is only with repeated incidences that there is a loss of brain volume. The review found that both drug and talking therapies were more effective when given earlier in the course of the condition and that the longer people are ill the less well they respond to treatment. Overall the review backed early intervention for bipolar disorder and suggested that it is particularly important to start treatment before people's brains suffer irreparable changes.

Berk, Michael ... [et al] - Evidence and implications for early intervention in bipolar disorder Journal of Mental Health April 2010, 19(2), 113-126

Drugs and bipolar disorder

People with bipolar disorder are more likely to use drugs than people with any other mental illness yet the effects of drugs on bipolar disorder are not clearly understood. A team of researchers led by Michael J. Ostacher from Massachusetts General Hospital studied 3,750 people with bipolar disorder over two years. Contrary to the researchers' expectations the people who used drugs were no slower to recover from the depressive phase of the illness than those who didn't. However, the people who used drugs were more likely to switch straight from a depressed to a manic state with no period of 'normality' in between.

Ostacher, Michael J. ... [et al] - Impact of substance use disorders on recovery from episodes of depression in bipolar disorder patients: prospective data from the systematic treatment enhancement program for bipolar disorder (STEP-BD) American Journal of Psychiatry March 2010, 167(3), 289-297

Alcohol and bipolar disorder

Researchers from the University Medical Centre in Amsterdam have been looking into the effects of alcohol consumption on people with bipolar disorder. They studied 137 people with bipolar disorder. 44 drank very little or nothing at all, 49 were moderate drinkers who drank less than the Government's recommended amount and 44 were heavy drinkers who drank more than this. The participants kept diaries of their moods for at least two months. Contrary to expectations the group of heavy drinkers did not have a greater number of depressed days, mood swings or other symptoms than the occasional or moderate drinkers. 90% of the sample took their medication regularly and none of them had any other health problems so these factors may have lessened the impact of the alcohol. The study was a small-scale one and it is not a good idea to drink more than the recommended limits of alcohol - even if there is no impact on bipolar disorder!

You can find out more about this research at

http://uk.reuters.com/article/idUKTRE61H4R020100218?feedType=RSS&feedName=healthNews&sp=true

Brighter children at higher bipolar risk

Children who do better at school are more likely to develop bipolar disorder later in life. Researchers from King's College London and the Karolinska Institute in Gothenburg looked at the exam results of more than 700,000 Swedish teenagers and compared them to their later medical history. They found that those children with the highest performance were nearly four times as likely to develop bipolar disorder as those with average grades. Children with the poorest grades were twice as likely to develop bipolar disorder in adulthood as those with average grades. The link between high grades and bipolar disorder was particularly strong for creative subjects such as Swedish or music. People who suffer from bipolar disorder often experience extra energy, creativity and ability to connect ideas during the manic phase of their illness although mania can lead to inappropriate, dangerous or excessive behaviour. It is also worth remembering that on the whole people who do well at school tend to have better mental health than other people.

You can find out more about this research at

http://www.telegraph.co.uk/health/healthnews/7137591/Straight-A-schoolchildren-at-higher-risk-of-bipolar-disorder-research-claims.html

Mini people with mini bipolar disorder?

Bipolar disorder in children is a controversial topic. It has traditionally been thought to be very rare but the rate of diagnosis has increased dramatically over the last decade. There is a lot of heated debate as to whether this increase reflects past under-diagnosis or present over-diagnosis. The last large-scale study found a rate of 0.1% of mood disturbances in children under 13 but an official diagnosis requires lengthy periods of disturbance. If shorter periods of altered mood are included then the number of children affected by the condition could be much higher. One study found that 25% of children who had the shorter period of mood disturbance went on to develop bipolar disorder within the next two years. Researchers led by Argyris Stringaris from the Institute of Psychiatry, King's College London studied 5,326 8-19 year-olds from the general population. They found that while only 0.1% of the sample met the criteria for bipolar disorder, 1.1%-1.5% (depending on whether the parents or children respectively were asked about symptoms) had shorter episodes of mood disturbance. These mood disturbances were associated with social impairments over and above those caused by other mental-health problems but the researchers questioned whether, although they were superficially similar to bipolar disorder, they were actually part of the same condition with the same origin and potential treatments.

Stringaris, Argyris ... [et al] - Youth meeting symptom and impairment criteria for mania-like episodes lasting less than four days: an epidemiological enquiry Journal of Child Psychology and Psychiatry January 2010, 51(1), 31-38

CBT may not be a miracle cure for major mental illness

Cognitive behavioural therapy (CBT) is now the dominant form of psychotherapy and is being used in severe mental illnesses such as schizophrenia, major depression and bipolar disorder that have traditionally been treated primarily with drugs. A team of researchers from the U.K. and Spain - none of whom declared any connections to the drug industry - reviewed a number of studies into the effectiveness of using CBT to treat schizophrenia, major depression and bipolar disorder. They found that CBT was not effective in reducing symptoms in schizophrenia or preventing relapse. It had a small effect in treating major depression but was not effective at preventing relapse in bipolar disorder.

Lynch, D., Laws, K.R. and McKenna, P.J. - Cognitive behavioural therapy for major psychiatric disorder: does it really work? A meta-analytical review of well-controlled trials Psychological Medicine January 2010, 40(1), 9-24

Bipolar disorder, antiepileptics and suicide risk

People with bipolar disorder are sometimes treated with antiepileptic drugs but there have been worries that these can increase people's suicide risk. Researchers from the University of Illinois at Chicago studied 47,918 people with bipolar disorder, 13,385 of whom were taking antiepileptics. They found that those taking the antiepileptic drugs had similar rates of suicide attempts as those taking lithium or those people who were taking no medication at all. In fact after people started taking the antiepileptic drugs they had a significantly lower rate of suicide attempts than before they had started taking them. Relative to taking no medication at all taking antiepileptic medication led to a fivefold decrease in risk.

You can find out more about this research at

http://psychcentral.com/news/2009/12/08/antiepileptics-not-linked-to-bipolar-suicide-attempts/10051.html

10 Common myths about bipolar disorder

Adrienne Carlson has compiled a list of 10 common myths about bipolar disorder with lots of useful information aimed at combating some of the stigma around the condition. The myths are:

1. Bipolar disorder is merely mood swings
2. Manic episodes are characterized by extreme happiness
3. Bipolar shifts happen very quickly
4. It is OK to quit taking medication during manic episodes
5. Bipolar disorder is very rare
6. Bipolar disorder is not an illness
7. People with bipolar disorder are inherently unstable or violent
8. Most people with bipolar disorder are women
9. Prolonged drug abuse can eventually lead to bipolar disorder
10. People with bipolar disorder cannot hold down jobs

You can find out more about these issues on Adrienne's blog at

http://www.x-raytechschools.org/10-common-myths-about-bipolar-disorder/

Attachment style and bipolar disorder

Attachment style can be defined as the way in which we carry our relationship with our closest childhood caregiver (usually our mother) into our own adult relationships. Attachment style can be described as secure - characterised by comfort with intimacy and autonomy and with a positive model of oneself and the other in a relationship - or insecure. Insecure attachment can be further divided into three types: anxious in which people are fearful on intimacy and socially avoidant, preoccupied with relationships in which people have a negative model of the self and a postiive model of the other, and dismissing in which the subject has a positive model of the self but is dismissive of the value of intimacy. Researchers from the universities of Nottingham, Liverpool, Lancaster and Bangor looked into attachment style in people with bipolar disorder. They studied 148 people, 107 of whom had the condition. They found that 78% of the bipolar patients had an insecure attachment style compared to only 32% of those unaffected. Healthy people had higher secure attachment, lower anxious attachment and lower preoccupied attachment. Mania was associated with higher secure and preoccupied attachment styles and depression was associated with higher preoccupied and lower dismissing attachment style scores.

Morriss, Richard K. ... [et al] - Adult attachment in bipolar 1 disorder Psychology and Psychotherapy: theory, research and practice September 2009, 82(3), 267-277