To examine if the COVID-19 pandemic was associated with a differential effect longitudinally in relation to its psychological and functional impact on patients with bipolar disorder and Emotionally Unstable Personality Disorder (EUPD).

Semi-structured interviews were conducted with 29 individuals attending the Galway-Roscommon Mental Health Services with an ICD-10 diagnosis of either bipolar disorder (n = 18) or EUPD (n = 11). The impact of the COVID-19 pandemic was assessed in relation to anxiety and mood symptoms, social and occupational functioning, and quality of life utilising psychometric instruments and Likert scale data, with qualitative data assessing participants’ subjective experiences.

Individuals with EUPD exhibited significant anxiety and depressive symptoms and increased hopelessness compared to individuals with bipolar disorder. Repeated measures data demonstrated no significant change in symptomatology for either the EUPD or bipolar disorder group over time, but demonstrated an improvement in social (t = 4.40, p < 0.001) and occupational functioning (t = 3.65, p = 0.03), and in quality of life (t = 4.03, p < 0.001) for both participant groups. Themes attained from qualitative data included the positive impact of the discontinuation of COVID-19 mandated restrictions (n = 19), and difficulties experienced secondary to reductions in the provision of mental health services during the COVID-19 pandemic (n = 17).

Individuals with EUPD demonstrated increased symptomatology over a two-year period compared to those with bipolar disorder. The importance of face-to-face mental health supports for this cohort are indicated, particularly if future pandemics impact the delivery of mental health services.

Knowledge of the main markers of bipolarity, clinical features and the course of depression within BPAD in men and women will contribute to the correct diagnosis, prog- nostic assessment of the disease course and administration of an adequate therapy.

The aim of the investigation was to study the clinical features of depression in men and women with BPAD in order to identify markers of bipolarity, facilitate a diagnostic search and determine therapeutic tactics.

The study was conducted from 2018 to 2020 in outpatient and inpatient conditions of the S. S. Korsakov Psychiatric Clinic of Sechenov University. 100 patients (50 women and 50 men) with a diagnosis of F31.3-F31.5 according to ICD-10 were examined by the clinical method.

In the structure of the depressive phase in men, the following were more common: pronounced seasonality (with deterioration in autumn-winter) and daily fluctuations in the state (with improvement in the evening), anesthesia of the senses, depersonalization-derealization syndrome, decreased libido, difficulty falling asleep and increased appetite and / or body weight, comorbid depression, panic attacks and alcohol and surfactant abuse. Depression within the BPAD in women was characterized by a more frequent presence of apathy, tearfulness, self-harm, dysmorphophobic inclusions, decreased appetite.

The revealed features of psychopathological symptoms and correlations between some characteristics and factors, taking into account gender differences, can be used as markers of bipolarity, which will allow for an earlier and more accurate diagnosis of BPAD and adequate therapy.

No significant relationships.

Community Perinatal Mental Health Services (CPMHS) have been established in the UK, however, there is limited research around their real-world effectiveness. Post-Partum Psychosis (PPP), a severe episode of affective psychosis usually occurring soon after birth, has known risk factors. CPMHS offer assessment and interventions for women with risk factors for PPP, with a view to reducing the risk of its occurrence, as well as, where necessary, to proactively manage the illness to minimise the impact on the mother-infant dyad, as well as associated risks to self and/or others.

To review the rate of PPP in women with established risk factors, who were referred and managed by our CPMHS between September 2019-September 2021. This rate will be compared with the known rates of PPP reported in the literature. Rates of non-psychotic relapse, acute hospitalisation, children social care supervision and mother-infant separation as a result of postnatal relapse will be (amongst others) secondary outcomes. Perinatal interventions offered to reduce the risk of PPP and contingency planning will also be reviewed.

This will be a retrospective case review study involving women referred and cared for by our CPMHS from October 2019 to October 2021, with known risk factors for PPP. Women identified as high risk for PPP receive consultant led-care in our service, therefore cases will be identified via the individual caseloads. Subsequently, electronic case notes will be reviewed to determine the primary and secondary outcomes, as well as the perinatal interventions that were offered.

To be reported.

To be reported.

No significant relationships.

Schizophrenia (SCH) and bipolar affective disorder (BP) are complex disorders that overlapping both in their clinical symptoms and certain familiar characteristics. They share some common characteristcs but there are also key differences. The frequency of overlapping symptoms between these diseases could give us more information about the current validity of the diagnosis based on existing diagnostic criteria. Similarities within and between these two disorders in the future, can possibly redefine greater reliability of diagnosis.

The aim of the study was to investigate the frequency of overlapping symptoms between BP and SCH.

The sample included 159 patients diagnosed with SCH and 61 with BP who were followed over a two year period. The research was conducted at the UCCS Psychiatric Clinic. Assessment of clinical symptoms and diagnosis were performed using a structured clinical interview (SCID I), a list of operationalized criteria (OPSCRIT), a scale for the assessment of positive and negative symptoms (PANSS), a scale for the assessment of manic symptoms (YMRS).

The overall PANSS score was significantly higher in patients with SCH compared to patients with BP, but on the general psychopatology there are no significant differences betwen SCH and BP. Symptoms of mania are significantly more pronounced in patients with BP compared to those with SCH.

Our results of overlapping of individual symptoms between SCH and BP can speak infavor of the theory of disease continuum. And can also help us in understanding symptoms and guide us to develop optimal treatment strategies.

No significant relationships.

To improve the effectiveness of treatment for atypical depression, it is necessary to revise the accumulated experience, taking into account new knowledge and drugs.

Comparative study of the efficacy and safety of therapy for atypical depression (AtD) in the structure of bipolar affective disorder (BAD), recurrent depressive disorder (RDR) and psychogenic depression (PD).

Clinical and clinical follow-up methods examined 77 patients with AtD, of which 35 - with bipolar disorder, 18 - with RDR and 24 - with PD. Patients in all three groups received monotherapy with an antidepressant or a mood stabilizer, or a combination of antidepressant and antipsychotic, antidepressant and mood stabilizer, mood stabilizer and antipsychotic, as well as a combination of antidepressant, antipsychotic and mood stabilizer.

Agomelatine was the most frequently used (27.3%) and effective in reducing MADRS in all groups both in monotherapy and in combination with other drugs. Also in the PD group, escitalopram and vortioxetine were highly effective. Of the antipsychotics, when combined with antidepressants, sulpiride was found to be the most effective. When comparing the tolerance of antidepressants in all groups showed the best results (by the CGI scale), agomelatine and venlafaxine, in the BAR group is also vortioxetine.

The best strategy for effective and safe treatment of atypical depression is the use of modern antidepressant, which does not increase the symptoms of the atypical spectrum and, if necessary, can be supplemented with some antipsychotics.

No significant relationships.

Sleep is paramount in bipolar affective disorder and sleep disturbance can be a trigger or initial manifestation of an episode of illness. Changes in the circadian rhythm in bipolar affective disorder have consistently been recognized and reported, however, this feature can be overlooked in daily clinical practice.

We aim to review and summarize the literature regarding changes in circadian rhythm in patients with bipolar affective disorder.

We performed an updated review in the PubMed database using the terms “circadian rhythm” and “bipolar affective disorder”.

Irregularity of the sleep–wake rhythm, eveningness chronotype, abnormality of melatonin secretion, vulnerability of clock genes, and the irregularity of social time cues are circadian rhythm markers disrupted in bipolar affective disorder. Circadian rhythm dysfunction might be a trait marker of this illness and can act as a predictor for the first onset of bipolar affective disorder and the relapse of mood episodes. Achieving normalization of circadian rhythm in combination with pharmacological, psychosocial and chronobiological treatments can be a tool for managing bipolar affective disorder.

Recognizing patterns of changes in circadian rhythms is important to detect and diagnose bipolar disorder in clinical practice, also affecting treatment. These alterations are often overlooked and can lead to inadequate treatment and management.

Attention deficit and hyperactivity disorder (ADHD) and bipolar disorder (BD) are two of the most prevalent psychiatric disorders presenting in children and adults, respectively. Reported co-occurrence of ADHD and BD in adulthood is higher than would be expected by chance, with great impact on prognosis and treatment. Since features of both entities can overlap, careful assessment of these patients is crucial.

To understand the relation between BD and ADHD, and how co-occurrence impacts clinical evaluation.

Bibliographic research was made through the PubMed/NCBI database. No time limit was specified on the search. Pertinent manuscripts were individually reviewed for additional relevant citations.

ADHD influences the course and manifestations of BD, regardless of its presence later in adulthood. There is a 3-fold increase of ADHD co-occurrence in individuals with BD when compared to normal population, and ADHD seems to co-occur in about 20% of BD patients (even after correction for overlapping symptoms). Features which may suggest simultaneous diagnosis are: earlier occurrence of BD-related symptoms (especially manic or hypomanic states), more severe course of the mood disorder, less adherence to treatment and higher functioning impact. This makes for a worse prognosis, with increased suicidal risk in these patients.

The co-occurrence of BD and ADHD may represent a distinct clinical phenotype, with recent findings highlighting the presence of common neurobiological mechanisms. Accordingly, patients with BD should be screened for ADHD and viceversa. There is no consensus for treatment of ADHD-BD patients, with further studies being necessary to better define and define possible therapeutic approaches.

Lithium has been one of the oldest substances used in psychiatric treatments and remains the first-line treatment for prevention of manic and depressive episodes of bipolar disorder (BD), but it has also a wide spectrum of side-effects.

The goal is to review efficacy, and clinical use of lithium, such as its side effects, and its benefit-to-risk ratio.

Non-systematic literature review based on scientific databases such as PubMed.

The first modern use of lithium was for the treatment of mania. Lithium has also proven useful in major depression, particularly for augmentation of antidepressants, for aggressive behavior and it has a specific antisuicide effect. Lithium’s prophylactic and antisuicidal effects are most unique. However, the use of lithium became problematic due to the serious toxicity since lithium also a narrow therapeutic index, with therapeutic levels between 0.6 and 1.5 mEq/L.

Awareness of the benefits and risks of lithium is essential for the use of this lifesaving agent. Lithium levels must be carefully monitored and lithium dosage adjusted as necessary.

No significant relationships.

Neurobiological research frequently implicates inflammatory and neurogenic components with core aspects of bipolar disorder. Even in periods of symptom remission (euthymia), individuals with bipolar disorder experience cognitive impairments, which are increasingly being proposed as an outcome for interventions; identifying biomarkers associated with cognitive impairment in people with bipolar disorder could advance progress in this therapeutic field through identifying biological treatment targets.

We aimed to identify proteomic biomarker correlates of cognitive impairment in individuals with euthymic bipolar disorder.

Forty-four adults with a bipolar disorder diagnosis in euthymia underwent a battery of cognitive assessments and provided blood for biomarkers. We examined a comprehensive panel of inflammatory and trophic proteins as putative cross-sectional predictors of cognition, conceptualised according to recommended definitions of clinically significant cognitive impairment (binary construct) and global cognitive performance (continuous measure).

A total of 48% of the sample met the criteria for cognitive impairment. Adjusting for potentially important covariates, regression analyses identified lower levels of three proteins as significantly and independently associated with cognitive deficits, according to both binary and continuous definitions (interleukin-7, vascular endothelial growth factor C and placental growth factor), and one positively correlated with (continuous) global cognitive performance (basic fibroblast growth factor).

This study identifies four candidate markers of cognitive impairment in bipolar disorder, none of which have been previously compared with cognitive function in participants with bipolar disorder. Pending replication in larger samples and support from longitudinal studies, these markers could have implications for treating cognitive dysfunction in this patient population.

To examine the psychological and social impact of the COVID-19 pandemic on patients with established mood disorders during a period of stringent mandated social restrictions.

Semi-structured interviews were conducted with 36 individuals attending the Galway–Roscommon Mental Health Services with an International Statistical Classification of Diseases and Related Health Problems, tenth revision (ICD-10) diagnosis of either Bipolar Affective Disorder (BPAD) (n = 20) or Emotionally Unstable Personality Disorder (EUPD) (n = 16) in this cross-sectional study. We determined the impact of the COVID-19 restrictions on anxiety and depressive symptoms, impulsivity, thoughts of self-harm, social and occupational functioning and quality of life.

The COVID-19 pandemic deleteriously impacted mental health (56.3% v. 15.0%, χ2 = 7.42, p = 0.02), and mood (75.0% v. 20.0%, χ2 = 11.17, p = 0.002) to a greater extent in the EUPD compared to the bipolar disorder cohort, with 43.8% of individuals with EUPD reporting an increase in suicidal ideation. Psychometric rating scales [Beck Anxiety Inventory (BAI), Beck Depression Scale (BDS), Beck Hopelessness Scale (BHS), Barratt Impulsivity Scale (BIS)] and Likert scales for anxiety, mood and quality of life noted significantly higher levels of psychopathology in the EUPD cohort (p < 0.01). Qualitative analysis reflected quantitative data with themes of the employment of maladaptive coping mechanisms and reduced mental health supports notable.

Individuals with EUPD are experiencing significant mental health difficulties related to the COVID-19 pandemic. The provision and recommencement of therapeutic interventions to this cohort, in particular, are warranted given the significant distress and symptoms being experienced.

The CACNA1C rs1006737 risk A allele has been associated with affective psychoses and functional studies indicate that it is associated with increased hippocampal/amygdala activity during emotional face-processing. Here we studied the impact of the risk A allele on affective startle modulation.

Hundred and ninety-four healthy males stratified for their CACNA1C rs1006737 genotype (GG:111, GA:67, AA:16) were presented with 18 pleasant, 18 unpleasant and 18 neutral pictures with acoustic probes (104 dB) occurring during 12 pictures in each affective category. Baseline startle was assessed during blank screens. State mood was self-rated on arrival, pre- and post-test and the emotional valence and arousal of affective pictures at post-test.

Relative to the other genotypes, risk A allele homozygotes presented with higher anxiety/negative affect at pre-test, reduced and exaggerated physiological responses to the pleasant and negative pictures respectively, negative affect with reduced arousal at post-test and rated the affective pictures as less arousing and inconsistently to their physiological responses (all P < 0.05). Sustained contextual negative mood predicted reduced baseline and affective startle reactivity in the AA group.

Healthy homozygous males for the risk A allele appear to have marked contextual sensitivity, affective reactivity akin to anxiety and depression and inefficient emotional appraisal. Our findings provide phenotypic detail of the CACNA1C AA genotype in non-symptomatic individuals, which suggest primary effects in emotional circuitry, consistent with previously documented alterations in hippocampal/amygdala processing.

With the shift from deinstitutionalization to community care in mental health services, relatives of persons with severe and enduring mental illnesses have had to take over the role as primary caregivers. Disturbed family dynamics have been observed within families with an ‘ill’ member. Although schizophrenia and related mental illnesses are biologically based disorders, environmental stress (including stress within family relationships) plays a major role in the onset and maintenance of symptoms. With this study, we assume that family dynamics play a central role in the course of severe psychiatric illness and hypothesized that dysfunction within family systems is a prognostic indicator of hospitalization in the course of schizophrenia/bipolar and schizoaffective disorders.

Prospective, observational cohort study evaluating family functioning of 121 patients (schizophrenia/bipolar and schizoaffective disorder) from community at baseline and followed-up over 12-month period after recruitment. Measurements included demographics, diagnosis, Family Assessment Device – General Functioning, Perceived Criticism Scale, Brief Psychiatric Rating Scale, Global Assessment of Functioning and Social Support Questionnaire-6.

Significant differences found between patients admitted and not admitted during the 12-month time period for age (p = 0.003), Brief Psychiatric Rating Scale (BPRS; p = 0.026), Family Assessment Device – General Functioning (FAD-GF; p = 0.007) and Social Support Questionnaire total satisfaction level (p = 0.042) at baseline. Bivariate analysis showed that those admitted into hospital were younger with a higher BPRS score, less social satisfaction and disturbed family dynamics. FAD-GF (p = 0.006) and age (p = 0.022) were significant independent predictors for admission.

This provides further evidence supporting importance of promoting better family functioning through modified family dynamics, integrating and involving family into the care of such patients.

The OPTIMA mood disorders service is a newly established specialist programme for people with bipolar disorder requiring frequent admissions. This audit compared data on hospital admissions and home treatment team (HTT) spells in patients before entry to and after discharge from the core programme. We included patients admitted between April 2015 and March 2017 who were subsequently discharged. Basic demographic data and numbers of admissions and HTT spells three years before and after discharge were collected and analysed.

Thirty patients who completed the programme were included in the analyses. The median monthly rate of hospital admissions after OPTIMA was significantly reduced compared with the rate prior to the programme. HTT utilisation was numerically reduced, but this difference was not statistically significant.

These results highlight the effectiveness and importance of individually tailored, specialist care for patients with bipolar disorder following discharge from hospital.

None.