Disorders - Bipolar Disorders
Gruhn, M. A., West, A., Hamlat, E., Weinstein, S.
OBJECTIVE: Suicidal ideation (SI) is significantly higher for youth with pediatric bipolar
disorder (PBD), yet clinical correlates of suicidality remain poorly understood in this population. The current study investigates how change in risk
factors for SI relate to change in SI intensity over a 6-month period of treatment. METHOD(S): Children ages 9 to 13 (N=71; 41% female; 54%
Caucasian; Mean age=9.17) engaged in one of two psychotherapy treatment conditions and completed assessments of SI risk factors and psychopathology
symptoms at baseline (pre-treatment), 4 and 8weeks (during treatment), 12weeks (post-treatment), and 39weeks (follow-up assessment at 6months post-
treatment). Children also completed assessments of SI intensity at baseline, post-treatment (12weeks), and 6months post-treatment. RESULT(S): Mixed-
effects regression models indicate that increases in health-related quality of life in the family, mobilization of the family to acquire/accept help
for PBD, and child self-concept were associated with decreased SI intensity over time. CONCLUSION(S): Findings highlight the importance of family and
child level factors in influencing longitudinal change in SI intensity in youth with PBD. Clinical implications and future directions are
discussed.
Clinical
child psychology and psychiatry, : 1359104521996762
- Year: 2021
- Problem: Bipolar Disorders, Suicide or self-harm behaviours (excluding non-suicidal self-harm), Suicide or self-harm with comorbid mental disorder
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Family therapy
Gehue, L.
J., Crouse, J. J., Battisti, R. A., Yim, M., Carpenter, J. S., Scott, E. M., Hickie, I. B.
INTRODUCTION:
Young people with mental disorders present with diverse social, vocational, physical, and developmental needs. However, multifaceted interventions
are rare. We examine the effectiveness of a clinical trial targeting social participation and physical well-being in young people accessing clinical
services.\rMETHODS: The 'Youth Early-intervention Study' ('YES') was an unblinded, two-phase, pilot randomized controlled trial offered as an
adjunct to standard clinical care, consisting of group activities. Mixed effects models were used to examine functional outcomes over time measured
by the 'Social and Occupational Functioning Assessment Scale', 'Functioning Assessment Short Test', and 'Brief Disability Questionnaire' (items
7 and 8).\rRESULTS: 133 participants aged 14-25 were recruited. 87 participants completed both arms and 83 participants completed a 12-month post-
trial assessment. Functioning improved across all outcomes. While diagnoses differed in functioning at baseline (lower functioning in psychotic and
bipolar disorders compared to depression), they did not differ in the rate of improvement across any measure. Randomization groups did not differ in
baseline functioning or the rate of improvement, suggesting a non-specific impact of the intervention. Engagement with education increased from 11%
at baseline to 51% at 12-months post-trial and full-time employment increased from 8% at baseline to 20% at 12-months post-trial.\rLIMITATIONS: Small
sample, no control group, and unmeasured potential moderators (e.g. neurocognitive impairment).\rCONCLUSIONS: 'YES' was effective and preliminary
positive outcomes were observed across all functional outcomes. Future studies should compare the 'YES' intervention to a treatment-as-usual
control condition and conduct a multi-centre trial across early intervention service sites.
, 280(Pt A) : 180-188
- Year: 2021
- Problem: Bipolar Disorders
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder), At risk (indicated or selected prevention)
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Psychological Interventions
(any), Psychoeducation, Creative expression: music, dance, drama, art, Physical activity, exercise
Garrett, A. S., Chang, K. D., Singh, M. K., Armstrong, C. C., Walshaw, P. D., Miklowitz, D.
J.
Background: Patients with mood disorders may benefit from psychosocial interventions through changes
in brain networks underlying emotion processing. In this study, we used functional magnetic resonance imaging (fMRI) to investigate treatment-related
changes in emotion processing networks in youth at familial high risk for bipolar disorder (BD). Method(s): Youth, ages 9-17, were randomly assigned
to family-focused therapy for high-risk youth (FFT-HR) or an active comparison treatment, Enhanced Care (EC). Before and after these 4-month
treatments, participants underwent fMRI while viewing happy, fearful, and calm facial expressions. Twenty youth in FFT-HR and 20 in EC were included
in analyses of pre- to post-treatment changes in activation across the whole brain. Significant clusters were assessed for correlation with mood
symptom improvement. Result(s): In the dorsolateral prefrontal cortex (DLPFC), activation increased from pre- to post-treatment in the FFT-HR group
and decreased in the EC group. Insula activation decreased in the FFT-HR group and did not change in the EC group. Across both treatments, decreasing
activation in the hippocampus and amygdala was correlated with pre- to post-treatment improvement in hypomania, while increasing activation in the
DLPFC was correlated with pre- to post-treatment improvement in depression. Discussion(s): Psychosocial treatment addresses abnormalities in emotion
regulation networks in youth at high risk for BD. Increased prefrontal cortex activation suggests enhanced emotion regulation from pre- to post-
treatment with FFT-HR. Improvements in family interactions may facilitate the development of prefrontal resources that provide protection against
future mood episodes. Copyright © 2021 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd
Bipolar
Disorders., :
- Year: 2021
- Problem: Bipolar Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Family therapy, Psychoeducation
Fristad, M. A., Roley-Roberts, M.
E., Black, S. R., Arnold, L. E.
BACKGROUND: This
naturalistic follow-up study examines outcomes for youth with depression (n = 25) or subsyndromal bipolar disorder (n = 13) 2-5 years after
participation in randomized clinical trials (RCTs) of omega-3 fatty acids (OMEGA3), individual family psychoeducational psychotherapy (IF-PEP), and
their combination METHODS: Forty percent (38/95) of RCT families completed a follow-up assessment RESULTS: Relapse rates and conversion to bipolar
disorder were consistent with published literature. Original treatment assignment did not impact current functioning. Overall, participants' mood
severity, executive functioning, and global functioning continued to be better than at RCT baseline. Depressive symptoms increased significantly from
end of RCT. Manic symptom severity, executive functioning, and global functioning remained comparable to end of RCT. The majority of parents and
youth reported improved youth emotion regulation skills and family communication. They considered study participation beneficial, with increased
understanding of mood disorders being the top reason. Half of youth commenced or continued OMEGA3 and 58% commenced or continued psychotherapy post-
RCT, suggesting some degree of consumer satisfaction; these youth had lower depression severity than other participants.\rLIMITATIONS: Only 40%
returned to this naturalistic follow-up; they were less likely to have an African-American parent, were of higher income, and youth were more
symptomatic at end of RCT than those who did not return CONCLUSIONS: Improvement from RCT baseline continued although depressive symptom severity
increased from end of RCT to follow-up. Meaningful improvements in youth and family functioning persisted 2-5 years later. Interventions that prevent
relapse or conversion to BPSD are still needed for these vulnerable populations.
, 281 : 24-32
- Year: 2021
- Problem: Bipolar Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention), Disorder established (diagnosed disorder)
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Psychological Interventions
(any), Family therapy, Psychoeducation, Fish oil (Omega-3 fatty acids), Omega 3 fatty
acids (e.g. fish oil, flax oil)
Del-Favero, E., Montemagni, C., Bozzatello, P., Brasso, C., Riccardi, C., Rocca, P.
The onset of prodromal symptoms in subjects who are at familial or
clinical risk for bipolar disorder could be considered as an important alarm bell for the development of the disease and should be carefully
detected. The management of prodromes in bipolar high-risk patients appears to be an important means of prevention; nevertheless, at the moment,
there aren't clear and widely shared treatment indications. The aim of this review is to summarize the available treatment options (pharmacological,
psychosocial and nutraceutical) for the management of prodromal symptoms in subjects who are at familial or clinical risk for bipolar disorder.
Medicina, 57(6) : 28
- Year: 2021
- Problem: Bipolar Disorders
- Type: Systematic reviews
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Biological Interventions
(any), Complementary & Alternative
Interventions (CAM), Psychological Interventions
(any)
Correll, C. U., Cortese, S., Croatto, G., Monaco, F., Krinitski, D., Arrondo, G., Ostinelli, E., Zangani, C., Fornaro, M., Estrade, A., Fusar-Poli, P., Carvalho, A. F., Solmi, M.
Top-tier evidence on the safety/tolerability
of 80 medications in children/adolescents with mental disorders has recently been reviewed in this jour-nal. To guide clinical practice, such data
must be combined with evidence on efficacy and acceptability. Besides medications, psychosocial inter-ventions and brain stimulation techniques are
treatment options for children/adolescents with mental disorders. For this umbrella review, we systematically searched network meta-analyses (NMAs)
and meta-analyses (MAs) of randomized controlled trials (RCTs) evaluating 48 medications, 20 psychosocial interventions, and four brain stimulation
techniques in children/adolescents with 52 different mental disorders or groups of mental disorders, reporting on 20 different efficacy/acceptability
outcomes. Co-primary outcomes were disease-specific symptom reduction and all-cause discontinuation (\"acceptability\"). We included 14 NMAs and 90
MAs, reporting on 15 mental disorders or groups of mental disorders. Overall, 21 medications outperformed placebo regarding the co-primary outcomes,
and three psychosocial interventions did so (while seven outperformed waiting list/no treatment). Based on the meta-analytic evidence, the most
convincing efficacy profile emerged for amphetamines, methylphenidate and, to a smaller extent, behavioral therapy in attention-deficit/hyperactivity
disorder; aripiprazole, risperidone and several psychosocial interventions in autism; risperidone and behavioral interventions in disruptive behavior
disorders; several antipsychotics in schizophrenia spectrum disorders; fluoxetine, the combination of fluoxetine and cognitive behavioral therapy
(CBT), and interpersonal therapy in depression; aripiprazole in mania; fluoxetine and group CBT in anxiety disorders; fluoxetine/selective serotonin
reuptake inhibitors, CBT, and behavioral therapy with exposure and response prevention in obsessive-compulsive disorder; CBT in post-traumatic stress
disorder; imipramine and alarm behavioral intervention in enuresis; behavioral therapy in encopresis; and family therapy in anorexia nervosa. Results
from this umbrella review of interventions for mental disorders in children/adolescents provide evidence-based information for clinical decision
making.Copyright © 2021 World Psychiatric Association
World Psychiatry, 20(2) : 244-
275
- Year: 2021
- Problem: Anxiety Disorders (any), Obsessive Compulsive Disorder, Bipolar Disorders, Depressive Disorders, Anorexia Nervosa, Psychosis Disorders, Suicide or self-harm behaviours (excluding non-suicidal self-harm)
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any), Psychological Interventions
(any)
Towbin, K.
Objectives: Despite the clinical importance of chronic and severe irritability, there is a paucity of controlled trials for its
pharmacological treatment. Here, we examine the effects of adding citalopram (CTP) to methylphenidate (MPH) in the treatment of chronic severe
irritability in youth using a double-blind randomized placebo-controlled design. Method(s): After a lead-in phase of open treatment with stimulant,
53 youth meeting criteria for severe mood dysregulation (SMD) were randomly assigned to receive CTP or placebo (PBO) for 8 weeks. A total of 49
participants, 48 of them (98%) meeting disruptive mood dysregulation disorder (DMDD) criteria, were included in the intent-to-treat analysis. The
primary outcome measure was the proportion of response based on improvements of irritability at the week 8 of the trial. Result(s): At the end of the
trial, a significantly higher proportion of response was seen in those participants randomly assigned to CTP+MPH compared to PBO+MPH (35% CTP+MPH vs
6% PBO+MPH; OR = 11.70, 95% CI = 2.00-68.16, p = 0.006). However, there were no differences in functional impairment between groups at the end of the
trial. No differences were found in any adverse effect between treatment groups, and no trial participant exhibited hypomanic or manic symptoms.
Conclusion(s): Adjunctive CTP might be efficacious in the treatment of chronic severe irritability in youth resistant to stimulant treatment alone.
IMD, PPC, ADP Copyright © 2020
Journal of the American Academy of Child and Adolescent Psychiatry, 59 (10
Supplement) : S120
- Year: 2020
- Problem: Bipolar Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Biological Interventions
(any), Selective serotonin reuptake inhibitors (SSRIs), Antidepressants
(any), Other biological interventions
Ciray, R. O., Hancer, P., Tuncturk, M., Emiroglu, N. I.
Randomized placebo controlled trials (RCT) are very important for testing efficacy and safety of a
medical treatment. There is no too much RCT's in childhood bipolar disorder manic episode. In these trials, high placebo response poses a problem
for the definition of real drug responses in practice. Therefore, analysis of predictors of drug and placebo response are important for conducting
more reliable RCT's in the future. Comprehensive search conducted in PubMed, ClinicalTrials.gov, Cochrane Central Register of Controlled Trials
(CENTRAL) and some other electronic databases. Studies including participants with Bipolar Disorder manic episode and associated symptoms (e.g ADHD,
irritability) included. There was no restriction in terms of sex, ethnicity or initial severity. Participants over age 18 were excluded. Random
effect size model was used for calculate effect sizes for placebo and drugs. A total of 1974 participants and 11 studies were included in the meta-
analysis. Risperidone was highest effect size among drug arms. Number of the sites and number of the participants were associated with higher placebo
response in meta-regression. We did not find any variable had an impact on drug response. There was no any publication bias in this meta-analysis. We
found similar results as adult studies. Modifying number of the sites or ramdomized sample size may limit placebo response and could improve the
efficacy of RCT's and enhance drug-placebo contrasts. (PsycInfo Database Record (c) 2021 APA, all rights reserved) Abstract (Turkish) Randomize
plasebo kontrollu calismalar (RKC) tibbi tedavilerin etkinligini ve guvenligini test etmekte cok onemlidir. Cocukluk cagi bipolar bozuklugun manik
epi-zodunda yapilmis cok fazla RKC bulunmamaktadir. Bu calismalardaki yuksek plasebo yaniti pratikte gercek ilac yanitlarinin tespitinde sorunlara
neden olmaktadir. Bu nedenle ilac ve plasebo yanitinin belirleyicilerini analiz etmek ileride daha guvenilir RKC'ler yurutebilmek icin onemli
olmaktadir. PubMed, ClinicalTrials.gov, Cochrane Central Register of Controlled Trials ve bazi diger arama motorlarinda genis bir tarama yapildi.
Bipolar bozukluk manik epizod ve eslik eden semptomlar (DEHB, irritabilite vb.) calismaya dahil edildi. Cinsiyet, etnisite ya da baslangic siddeti
ile ilgili bir sinirlama getirilmedi. 18 yasin uzerinde katilimci olan calismalar dislandi. Plasebo ve ilac etki buyukluklerini hesaplamak icin
random etki buyuklugu modeli kullanildi. Toplamda 1974 katilimci ve 11 calisma meta-analize dahil edildi. Risperidon ilac kolunda en yuksek etki
buyuklugune sahipti. Meta-regresyonda merkezlerin sayisi ve katilimcilarin sayisi yuksek plasebo yanitiyla iliskili bulundu. Ilac yaniti etkileyen
herhangi bir degisken bulunmadi. Meta-analizde herhangi bir yayin yanligi tespit edilmedi. Calismada eriskin calismalari ile benzer sonuclar bulundu.
Randomize edilen katilimci sayisini ve katilan merkez sayisini modifye etmek plasebo yanitini sinirlayabilir ve RKC'lerin etkinligini gelistirebilir
ve ilac-plasebo farkliliklarini arttirabilir. (PsycInfo Database Record (c) 2021 APA, all rights reserved)
Klinik Psikiyatri Dergisi: The Journal of Clinical
Psychiatry, 23(3) : 375-385
- Year: 2020
- Problem: Bipolar Disorders
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any)
Cho, C. H., Lee, T., Lee, J. B., Seo, J. Y., Jee, H. J., Son, S., An, H., Kim, L., Lee, H.
J.
Background: Smartphones and wearable devices can be used to
obtain diverse daily log data related to circadian rhythms. For patients with mood disorders, giving feedback via a smartphone app with appropriate
behavioral correction guides could play an important therapeutic role in the real world. Objective(s): We aimed to evaluate the effectiveness of a
smartphone app named Circadian Rhythm for Mood (CRM), which was developed to prevent mood episodes based on a machine learning algorithm that uses
passive digital phenotype data of circadian rhythm behaviors obtained with a wearable activity tracker. The feedback intervention for the CRM app
consisted of a trend report of mood prediction, H-score feedback with behavioral guidance, and an alert system triggered when trending toward a
high-risk state. Method(s): In total, 73 patients with a major mood disorder were recruited and allocated in a nonrandomized fashion into 2 groups:
the CRM group (14 patients) and the non-CRM group (59 patients). After the data qualification process, 10 subjects in the CRM group and 33 subjects
in the non-CRM group were evaluated over 12 months. Both groups were treated in a similar manner. Patients took their usual medications, wore a
wrist-worn activity tracker, and checked their eMoodChart daily. Patients in the CRM group were provided with daily feedback on their mood prediction
and health scores based on the algorithm. For the CRM group, warning alerts were given when irregular life patterns were observed. However, these
alerts were not given to patients in the non-CRM group. Every 3 months, mood episodes that had occurred in the previous 3 months were assessed based
on the completed daily eMoodChart for both groups. The clinical course and prognosis, including mood episodes, were evaluated via face-to-face
interviews based on the completed daily eMoodChart. For a 1-year prospective period, the number and duration of mood episodes were compared between
the CRM and non-CRM groups using a generalized linear model. Result(s): The CRM group had 96.7% fewer total depressive episodes (n/year; exp
beta=0.033, P=.03), 99.5% shorter depressive episodes (total; exp beta=0.005, P<.001), 96.1% shorter manic or hypomanic episodes (exp beta=0.039,
P<.001), 97.4% fewer total mood episodes (exp beta=0.026, P=.008), and 98.9% shorter mood episodes (total; exp beta=0.011, P<.001) than the non-CRM
group. Positive changes in health behaviors due to the alerts and in wearable device adherence rates were observed in the CRM group. Conclusion(s):
The CRM app with a wearable activity tracker was found to be effective in preventing and reducing the recurrence of mood disorders, improving
prognosis, and promoting better health behaviors. Patients appeared to develop a regular habit of using the CRM app. Copyright © Chul-Hyun Cho, Taek
Lee, Jung-Been Lee, Ju Yeon Seo, Hee-Jung Jee, Serhim Son, Hyonggin An, Leen Kim, Heon-Jeong Lee. Originally published in JMIR Mental Health
(http://mental.jmir.org), 05.08.2020. This is an open-access article distributed under the terms of the Creative Commons Attribution License
(https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original
work, first published in JMIR Mental Health, is properly cited. The complete bibliographic information, a link to the original publication on
http://mental.jmir.org/, as well as this copyright and license information must be included.
JMIR Mental
Health, 7(8) :
- Year: 2020
- Problem: Bipolar Disorders
- Type: Controlled clinical trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Biofeedback, neurofeedback, audio/video feedback, Technology, interventions delivered using technology (e.g. online, SMS)
Besenek, M.
Background: Given the high hereditary rates for bipolar disorder (BD), offspring of BD patients (high-risk [HR]
group) are perfect candidates for research on early detection and prevention strategies. Psychoeducation is a structured and systematic intervention,
in which the knowledge of the illness and its treatment is transferred to the patient and/or family in a didactic approach and it is a core component
of psychotherapeutical interventions. Several studies which explored the effectiveness of these interventions in HR youth reported positive out-
comes; but these were mainly focused on symptomatic HR and none of them were done among asymptomatic HR. Therefore with this study, we aimed to
evaluate the effect of psychoeducational intervention on asymptomatic HR youth. Method(s): In this prospective randomized controlled study, total of
60 cases (aged between 11 - 18 years) were enrolled and randomized into two group as cases who received psychoeducational intervention (PE+) (n=30)
and who did not receive psychoeducational intervention (PE-) (n=30) on the first visit (T0). Groups were evaluated regarding their psychiatric
symptomatology and quality of life (QoL) using DSM-5 Level 1 Cross-cutting Symptom Scale Child Form (CCSS-5) and Pediatric Quality of Life
Questionnaire throughout four interviews with 3-month intervals (T0 - T3). Total of 14 cases in PE+ and 10 cases in PE - group were diagnosed with at
least one psychiatric disorder in the duration of the study and one case in PE+ dropped-out from the study without further notice; so total of 15
children in PE+ and 20 children in PE - group completed all of the interviews. Result(s): Ages of PE+ group ranged between 10.58 and 17.58 years
(mean[+/-SD]=14.80[+/-2.56]) and PE - group ranged between 10.83 and 17.25 years (mean[+/-SD]=13.83[+/-2.33]). Male participants comprised 66.67% of
PE+ group and 56.67% of PE - group. There was no statistically significant difference between groups regarding age (p=0.096) and gender (p=0.426).
Even though psychoeducation did not have effect on QoL of the high-risk population; overall reduction in somatic (p<0.001) and manic (p=0.026)
symptom severity in CCSS-5 was more distinct for PE+ group compared to PE - group. There were no significant effects of psychoeducation on the other
subscales of CCSS-5. Conclusion(s): Improvement in affective symptomatology with CBT and longer remission periods with FFT can be explored in the
same scope with the overall reduction in manic symptom severity we showed in PE+ group. Overall reduction in somatic symptom severity of PE+ group
might be due to the positive effect of psychoeducation on family communication and problem-solving skill. However, there is no previous research
indicating the presence of somatic symptoms/somatization disorders among HR youth; so whether somatic symptoms are the consequences of family
conflict or a core component of prodromal phase of BD is still unclear. Studies state that psychological interventions are most effective if they are
performed in the early stages of BD; therefore asymptomatic HR youth are critical for prevention strategies and more studies are needed in this
population.Copyright © 2020, AVES. All rights reserved.
Psychiatry and Clinical Psychopharmacology, 30(4) : 388-395
- Year: 2020
- Problem: Bipolar Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Psychoeducation
Miklowitz, D. J., Schneck, C. D., Walshaw, P. D., Garrett, A. S., Singh, M. K., Sugar, C. A., Chang, K. D.
Aims: Despite
the considerable public health impact of bipolar disorder (BD), no psychosocial interventions have been systematically evaluated in its early
prodromal stages. We describe the rationale, design and analytic methods for a 3-site randomized trial of family-focused treatment for youth at high
risk (FFT-HR) for BD. Method(s): Participants (ages 9-17 years) have a diagnosis of unspecified BD or major depressive disorder, current mood
symptoms and at least one first- or second-degree relative with a lifetime history of BD I or II. Participants are randomly assigned to FFT-HR (12
sessions in 4 months of family psychoeducation and skills training) or enhanced care (EC; 6 individual and family sessions over 4 months), with
pharmacotherapy provided as needed. A subset of participants undergo pre- and post-treatment functional MRI (fMRI) scans while performing face-rating
and family problem-solving tasks designed to activate corticolimbic circuitry. Independent evaluators assess participants' status every 4 to 6
months for up to 4 years. Result(s): We hypothesize that FFT-HR will be more effective than EC in reducing the severity of mood symptoms (primary
outcome) and the hazard of a first manic episode (secondary) over 4 years. Secondarily, we will explore whether FFT-HR is associated with greater
decreases in amygdala activation and increases in dorsolateral, ventrolateral or anterior medial prefrontal cortex activation from pre- to post-
treatment. Clinical characteristics of 133 subjects enrolled at baseline are described. Conclusion(s): This study will test a novel intervention to
reduce the early symptoms of BD, and identify neural and behavioural mechanisms that may help refine future treatments. Copyright © 2017 John Wiley &
Sons Australia, Ltd
Early Intervention in Psychiatry, 13(2) : 208-
216
- Year: 2019
- Problem: Bipolar Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Family therapy, Psychoeducation, Skills training
Hamer,
J. A., McIntyre, R. S., Subramaniapillai, M., Lee, Y., Brietzke, E., Mansur, R. B., Lu, W., Chen, K., Gao, Y., Xu, G., So, K. F., Lin, K.
Introduction: Identifying pre-emptive and preventative strategies for mood
disorders are a priority research vista. Convergent evidence broadly suggests that aerobic exercise exerts therapeutic and preventative effects for
brain-based disorders1,2. Herein, we sought to determine whether aerobic exercise reduces affective symptom burden amongst adolescents at risk for
mood disorders. Method(s): 55 adolescents with sub-clinical bipolar disorder (BD) (with 2 or more DSM-4-defined symptoms of depression but not
meeting criteria for diagnosis of major depressive disorder, or with 2 or more DSM-4-defined symptoms of mania but not meeting criteria for diagnosis
of hypomania) and 166 healthy controls, ages 12-14, were randomized into a 12-week aerobic exercise intervention or placebo psychoeducation.
Participants completed the MATRICS Consensus Cognitive Battery (MCCB), Hypomania Checklist 15 (HCL-15), and Personal Health Questionnaire 9 (PHQ-9)
both pre and post. Participants were recruited from a middle school in Guangzhou, China. Result(s): There were no significant differences in baseline
neurocognitive measures (P > 0.005). Both at-risk and control groups in the exercise arm improved in sustained attention and vigilance (P < 0.05).
Both at-risk and control groups in the placebo arm improved in spatial spanning, executive functioning, working memory, reasoning and problem solving
and overall neurocognition (P < 0.0005). All groups presented a decrease in HCL-15 (P < 0.0001), and an increase in PHQ-9 (P < 0.0001). There were no
interaction effects between intervention type and risk for BP for all measures of neurocognition overtime. Conclusion(s): We conclude that a moderate
aerobic exercise intervention program does not differ from psychoeducation in improving cognition or affective symptom burden for youth at-risk for
mood disorders.
Bipolar Disorders, 21 (Supplement
1) : 136-137
- Year: 2019
- Problem: Bipolar Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Physical activity, exercise