In order to explore effective ways to reduce non-suicidal self-injury (NSSI) among female adolescents, a total of 45 female adolescent patients with NSSI in West China Hospital of Sichuan University and Guizhou Second Provincial People's Hospital from June 2021 to June 2024 were selected randomly that divided into groups A, B and C, with 15 cases in each group. Group A was treated with repeated transcranial magnetic stimulation (rTMS) and bipolar depression triple therapy, and group B was treated with bipolar depression triple therapy to compare the effectiveness and safety. Group C received bipolar depression triple therapy combined with sham stimulation which only produced stimulating sounds but no stimulating magnetic field as a control in the study. After treatment, the Hamilton Anxiety Score (HAMA), Hamilton Depression Score (HAMD) and Nurses' Global Assessment of Suicide Risk (NGASR) in group A were significantly lower than those in group B and C ( P < 0.01). rTMS combined with bipolar depression triple therapy has a definite effect on reducing NSSI in female adolescents, which can reduce the incidence rate of short-term NSSI behavior in patients.
Humans ; Female ; Adolescent ; Self-Injurious Behavior/prevention & control* ; Transcranial Magnetic Stimulation/methods* ; Bipolar Disorder/therapy* ; Combined Modality Therapy ; Treatment Outcome

OBJECTIVES: Whether vortioxetine has a utility as an adjuvant drug in the treatment of bipolar depression remains controversial. This study aimed to validate the efficacy and safety of vortioxetine in bipolar depression. METHODS: Patients with bipolar Ⅱ depression were enrolled in this prospective, two-center, randomized, 12-week pilot trial. The main indicator for assessing treatment effectiveness was a Montgomery-Asberg Depression Rating Scale (MADRS) of ≥50%. All eligible patients initially received four weeks of lurasidone monotherapy. Patients who responded well continued to receive this kind of monotherapy. However, no-response patients were randomly assigned to either valproate or vortioxetine treatment for eight weeks. By comprehensively comparing the results of MADRS over a period of 4‍‒‍12 weeks, a systematic analysis was conducted to determine whether vortioxetine could be used as an adjuvant drug for treating bipolar depression. RESULTS: Thirty-seven patients responded to lurasidone monotherapy, and 60 patients were randomly assigned to the valproate or vortioxetine group for eight weeks. After two weeks of combined valproate or vortioxetine treatment, the MADRS score in the vortioxetine group was significantly lower than that in the valproate group. There was no difference in the MADRS scores between the two groups at 8 and 12 weeks. The incidence of side effects did not significantly differ between the valproate and vortioxetine groups. Importantly, three patients in the vortioxetine group appeared to switch to mania or hypomania. CONCLUSIONS This study suggested that lurasidone combination with vortioxetine might have potential benefits to bipolar II depression in the early stage, while disease progression should be monitored closely for the risk of switching to mania.
Humans ; Bipolar Disorder/drug therapy* ; Vortioxetine/therapeutic use* ; Male ; Female ; Middle Aged ; Adult ; Valproic Acid/administration & dosage* ; Lurasidone Hydrochloride/administration & dosage* ; Prospective Studies ; Treatment Outcome ; Pilot Projects ; Drug Therapy, Combination ; Sulfides/therapeutic use* ; Antidepressive Agents/therapeutic use*

Humans ; Bipolar Disorder ; Schizophrenia ; Depression ; Electroencephalography

Bipolar disorder is a major mental illness that is difficult to treat and has a high degree of recurrence. This article reports general anesthesia for oral surgery in a patient with bipolar disorder complicated with hypothyroidism. It also discusses the rational application of antipsychotic drugs and anesthetics with reference to the literature to improve the understanding of the disease and help patients with mental disorders complete the surgical treatment quietly and smoothly.
Humans ; Bipolar Disorder/drug therapy* ; Antipsychotic Agents/therapeutic use* ; Hypothyroidism/drug therapy* ; Oral Surgical Procedures ; Anesthesia

Micro non-coding RNA (microRNA, miRNA) is a small non-coding RNA involved in gene expression regulation that plays an important role in the onset and development of mental illness. Evidence suggests that several miRNAs are dysregulated in patients with mental illnesses. Because of its stability and quantitative detection in peripheral blood and cerebral fluid, miRNA is a particularly attractive biomarker. The objective of this research is to investigate the relationship between mental illness and miRNAs, as well as the potential processes through which miRNAs contribute to disease etiology. Schizophrenia, bipolar disorder, and depression are three major mental disorders with high disability and mortality. The study explored the particular dysregulated miRNAs for each condition as well as common dysregulated miRNAs across diseases. In this study, which analyzes the findings from relevant studies from 2016 to 2020, the authors discuss the functions of numerous severely dysfunctional miRNAs and their application potential in the field of psychiatry research.
Biomarkers ; Bipolar Disorder/genetics* ; Depression/genetics* ; Humans ; MicroRNAs ; Schizophrenia/genetics*

Early distinction of bipolar disorder (BD) from major depressive disorder (MDD) is difficult since no tools are available to estimate the risk of BD. In this study, we aimed to develop and validate a model of oxidative stress injury for predicting BD. Data were collected from 1252 BD and 1359 MDD patients, including 64 MDD patients identified as converting to BD from 2009 through 2018. 30 variables from a randomly-selected subsample of 1827 (70%) patients were used to develop the model, including age, sex, oxidative stress markers (uric acid, bilirubin, albumin, and prealbumin), sex hormones, cytokines, thyroid and liver function, and glycolipid metabolism. Univariate analyses and the Least Absolute Shrinkage and Selection Operator were applied for data dimension reduction and variable selection. Multivariable logistic regression was used to construct a model for predicting bipolar disorder by oxidative stress biomarkers (BIOS) on a nomogram. Internal validation was assessed in the remaining 784 patients (30%), and independent external validation was done with data from 3797 matched patients from five other hospitals in China. 10 predictors, mainly oxidative stress markers, were shown on the nomogram. The BIOS model showed good discrimination in the training sample, with an AUC of 75.1% (95% CI: 72.9%-77.3%), sensitivity of 0.66, and specificity of 0.73. The discrimination was good both in internal validation (AUC 72.1%, 68.6%-75.6%) and external validation (AUC 65.7%, 63.9%-67.5%). In this study, we developed a nomogram centered on oxidative stress injury, which could help in the individualized prediction of BD. For better real-world practice, a set of measurements, especially on oxidative stress markers, should be emphasized using big data in psychiatry.
Biomarkers/metabolism* ; Bipolar Disorder/metabolism* ; Depressive Disorder, Major/diagnosis* ; Early Diagnosis ; Humans ; Oxidative Stress

This is a case of a 22-year-old female who presented with labile mood, impulsivity and persistent suicidality. Despite numerous pharmacologic and psychotherapeutic regimens, she only had minimal improvement. Subsequently, she revealed traumatic events in younger years.She has been experiencing recurrent intrusive thoughts, low self-worth, guilt and avoidance behavior. Pharmacotherapeutic management was revised as well as her psychotherapy, which resulted in a positive outcome. However, recurrence occurred after she encountered negative life events. Electroconvulsive therapy and revision of pharmacologic treatment eventually led to significant improvement. This case highlights the importance of underlying psychological trauma that caused persistent symptoms. The intensity of impact and the chronic recurrent negative effect of the trauma on the patient influenced the treatment outcome. It is important to optimize therapeutic management with the use of pharmacologic agents, psychotherapy and somatic therapies.
Stress Disorders, Post-Traumatic ; Bipolar Disorder

OBJECTIVE: To study the changes in metabolic markers and clinical outcome after treatment with different drug regimens in children with bipolar affective disorder. METHODS: A retrospective analysis was performed on the medical data of 220 children with bipolar affective disorder who attended the hospital from January 2017 to January 2020. According to the treatment method, 112 children treated with atypical antipsychotic drugs alone were enrolled as the control group, and 108 children treated with atypical antipsychotic drugs combined with mood stabilizer were enrolled as the study group. The two groups were compared in terms of baseline data, changes in related metabolic markers[fasting insulin (FIN), glycosylated hemoglobin (HbAlc), total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C)] after treatment, incidence rate of metabolic syndrome, and clinical outcome. RESULTS: There were no significant differences in the baseline data including age, sex, and course of disease between the two groups ( CONCLUSIONS Atypical antipsychotic drugs combined with mood stabilizer in the treatment of bipolar disorder in children have little effect on the level of metabolic markers, and the curative effect is significant.
Antipsychotic Agents/therapeutic use* ; Biomarkers/blood* ; Bipolar Disorder/drug therapy* ; Child ; Cholesterol, HDL ; Humans ; Mood Disorders ; Retrospective Studies ; Triglycerides

This research aimed to describe the demographic and clinical presentation over the course of hospital stay of all patients who underwent at least 6 sessions of electroconvulsive therapy (ECT) from September 1, 2015 to August 31, 2016. METHODOLOGY: This was a retrospective case series. After extensive inclusion and exclusion criteria were employed, seven out of the 13 patients given ECT that year were included for this study (n=7). This was comprised of: three (n=3) with MDD, two (n=2) with Bipolar Disorder Most Recent Episode (MRE) Depressed, two (n=2) with schizophrenia spectrum disorders. For these cases, they were all initially recommended to undergo 6 ECT sessions. All underwent the same anesthetic technique, performed by the same anesthesiologist. Comparison of their course during treatment was obtained through chart review and through recorded DSM-5 symptom checker accomplished on their admission, after 4th ECT session, after the last ECT session and 24 hours before discharge. RESULTS: Only cases with MDD were in their early adulthood (n=2) showed reduction of symptoms 24 hours after the 4th ECT session and did not require further sessions or any changes in the placement of the ECT leads. In contrast, two (n=2) of the cases who were women in their late adulthood required a shift from an initial unilateral ECT to bilateral ECT after no improvement was noted in their 4th session, thereby requiring more sessions than planned. Cases with other diagnoses (n=4) also required more sessions than initially planned and did not show improvement in their symptom checkers 24 hours after the 4th ECT session. Findings and how each case compared with current literature on the understanding of ECT and factors such as age, gender, diagnosis, history of psychopathology, lead placement, were further explored in the discussion. CONCLUSION: The study shows that there was significant reduction in symptoms during the course of admission among patients receiving ECT at the tertiary institution of study; however, the course of symptom reduction varied based on several factors. Factors discussed in this study were age, biological sex, history of psychopathology, diagnosis and ECT lead placement. Due to the limited number of cases,, it is recommended for future researchers to compare symptomatology of patients and their clinical course during the duration of ECT treatment for a longer period of time and with a larger sample size in order to arrive at a more generalizable protocol.
Humans ; Bipolar Disorder ;

OBJECTIVE: To investigate the changes of functional connectivity (FC) in the suprachiasmatic nucleus (SCN) of patients with bipolar disorder and perform a cluster analysis of patients with bipolar disorder based on FC. METHODS: The study recruited 138 patients with bipolar disorder (BD) diagnosed according to the 4th edition of Diagnostic and Statistical Manual of Mental Disorders IV (DSM-IV) and 150 healthy control subjects. All the participants underwent resting-state functional magnetic resonance brain scans. DPARSF software was used to generate the FC diagram of the SCN. Based on the FC data, principal components analysis (PCA) and k-means in scikit-learn 0.20.1 were used for cluster analysis of the patients with bipolar disorder. RESULTS: Compared with the healthy controls, the patients showed enhanced functional connections between the SCN and the paraventricular nucleus and between the SCN and the dorsomedial hypothalamus nucleus. Based on these FC values, the optimal cluster of unsupervised k-means machine learning for bipolar disorder was 2, and the Silhouette coefficient was 0.49. CONCLUSIONS Patients with bipolar disorder have changes in the FC of the SCN, and the FC of the rhythm pathway can divide bipolar disorder into two subtypes, suggesting that biological rhythm is one of the potential biomarkers of bipolar disorder.
Bipolar Disorder ; Brain ; Circadian Rhythm ; Humans ; Magnetic Resonance Imaging ; Neuroimaging