Delayed diagnosis of bipolar disorder (BD) is common. However, diagnostic validity may be enhanced using reliable neurobiological markers for BD. Degree centrality (DC) is one such potential marker that enables researchers to visualize neuronal network abnormalities in the early stages of some neuropsychiatric disorders. In the present study, we measured resting-state DC abnormalities and cognitive deficits in order to identify early neurobiological markers for BD. We recruited 23 patients with BD who had recently experienced manic episodes (duration of illness <2 years) and 46 matched healthy controls. Our findings indicated that patients with BD exhibited DC abnormalities in frontal areas, temporal areas, the right postcentral gyrus, and the posterior lobe of the cerebellum. Moreover, correlation analysis revealed that psychomotor speed indicators were associated with DC in the superior temporal and inferior temporal gyri, while attention indicators were associated with DC in the inferior temporal gyrus, in patients with early BD. Our findings suggest that DC abnormalities in neural emotion regulation circuits are present in patients with early BD, and that correlations between attention/psychomotor speed deficits and temporal DC abnormalities may represent early markers of BD.

Background Bipolar I disorder (BD‐I) is associated with a high risk of suicide attempt; however, the neural circuit dysfunction that confers suicidal vulnerability in individuals with this disorder remains largely unknown. Resting‐state functional magnetic resonance imaging (rs‐fMRI) allows non‐invasive mapping of brain functional connectivity. The current study used an unbiased voxel‐based graph theory analysis of rs‐fMRI to investigate the intrinsic brain networks of BD‐I patients with and without suicide attempt. Methods A total of 30 BD‐I patients with suicide attempt (attempter group), 82 patients without suicide attempt (non‐attempter group), and 67 healthy controls underwent rs‐fMRI scan, and then global brain connectivity (GBC) was computed as the sum of connections of each voxel with all other gray matter voxels in the brain. Results Compared with the non‐attempter group, we found regional differences in GBC values in emotion‐encoding circuits, including the left superior temporal gyrus, bilateral insula/rolandic operculum, and right precuneus (PCu)/cuneus in the bipolar disorder (BD) attempter group, and these disrupted hub‐like regions displayed fair to good power in distinguishing attempters from non‐attempters among BD‐I patients. GBC values of the right PCu/cuneus were positively correlated with illness duration and education in the attempter group. Conclusions Our results indicate that abnormal connectivity patterns in emotion‐encoding circuits are associated with the increasing risk of vulnerability to suicide attempt in BD patients, and global dysconnectivity across these emotion‐encoding circuits might serve as potential biomarkers for classification of suicide attempt in BD patients.

Background Depression research historically uses both self‐ and clinician ratings of symptoms with significant and substantial correlations. It is often assumed that manic patients lack insight and cannot accurately report their symptoms. This delayed the development of self‐rating scales for mania, but several scales now exist and are used in research. Our objective is to systematically review the literature to identify existing self‐ratings of symptoms of (hypo)mania and to evaluate their psychometric properties. Methods PubMed, Web of Knowledge, and Ovid were searched up until June 2018 using the keywords: “(hypo)mania,” “self‐report,” and “mood disorder” to identify papers which included data on the validity and reliability of self‐rating scales for (hypo)mania in samples including patients with bipolar disorder. Results We identified 55 papers reporting on 16 different self‐rating scales claiming to assess (hypo)manic symptoms or states. This included single item scales, but also some with over 40 items. Three of the scales, the Internal State Scale (ISS), Altman Self‐Rating Mania Scale (ASRM), and Self‐Report Manic Inventory (SRMI), provided data about reliability and/or validity in more than three independent studies. Validity was mostly assessed by comparing group means from individuals in different mood states and sometimes by correlation to clinician ratings of mania. Conclusions ASRM, ISS, and SRMI are promising self‐rating tools for (hypo)mania to be used in clinical contexts. Future studies are, however, needed to further validate these measures; for example, their associations between each other and sensitivity to change, especially if they are meant to be outcome measures in studies.

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