Is unipolar mania a distinct entity: findings from the bipolar disorder course and outcome study from India (BiD-CoIN study)

Grover, Sandeep; Chakravarty, Rahul; Dan, Amitava; Chakraborty, Kaustav; Neogi, Rajarshi; Desouza, Avinash; Nayak, Omkar; Praharaj, Samir Kumar; Menon, Vikas; Pattanayak, Raman Deep; Bathla, Shalu; Subramanyam, Alka A; Nebhinani, Naresh; Ghosh, P.; Lakdawala, Bhavesh; Bhattacharya, Ranjan

doi:10.1080/08039488.2021.1914155

Cited by 8 publications

(7 citation statements)

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“…Twenty-one studies met the eligibility criteria and were included in the meta-analysis (Aghanwa, 2001 ; Akarsu et al, 2012 ; Amamou et al, 2018 ; Andrade-Nascimento, Miranda-Scippa, Nery-Fernandes, Kapczinski, & Quarantini, 2011 ; Angst, Gerber-Werder, Zuberbühler, & Gamma, 2004 ; Angst et al, 2019 ; Beesdo et al, 2009 ; Chang et al, 2022 ; Dakhlaoui, Essafi, & Haffani, 2008 ; Gorgulu, Uluturk, & Palabiyik, 2021 ; Grobler, Roos, & Bekker, 2014 ; Grover et al, 2021 ; Mittal, Mehta, Solanki, Swami, & Meena, 2013 ; Perugi et al, 2007 ; Rajkumar, 2016 ; Sangha et al, 2022 ; Sonkurt, Altınöz, Danışman Sonkurt, & Köşger, 2021 ; Stokes et al, 2020 ; Subramanian, Kattimani, Rajkumar, Bharadwaj, & Sarkar, 2016 ; Yazıcı & Çakır, 2012 ; Yazici et al, 2002 ). The flowchart with details on screening and study selection process is reported in Fig.…”

Section: Resultsmentioning

confidence: 99%

“…In terms of age comparability between UM and md-BD, 10 studies met the quality criterion (Akarsu et al, 2012 ; Beesdo et al, 2009 ; Chang et al, 2022 ; Gorgulu et al, 2021 ; Perugi et al, 2007 ; Rajkumar, 2016 ; Sangha et al, 2022 ; Sonkurt et al, 2021 ; Stokes et al, 2020 , UK cohort; Subramanian et al, 2016 ). On the contrary, illness duration comparability was warranted by the majority of studies, with just a few with unclear data (Grobler et al, 2014 ; Grover et al, 2021 ; Sangha et al, 2022 ; Yazıcı & Çakır, 2012 ) or a mean difference over 3 years between groups (Aghanwa, 2001 ; Andrade-Nascimento et al, 2011 ; Perugi et al, 2007 ; Sonkurt et al, 2021 ; Stokes et al, 2020 , France cohort). Most of the included studies were sufficiently representative, apart from one involving only subjects with disease onset during adolescence (Beesdo et al, 2009 ) and another which sampled also people with non-BD diagnoses (Grobler et al, 2014 ), respectively.…”

Section: Resultsmentioning

confidence: 99%

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Characterizing the clinical profile of mania without major depressive episodes: a systematic review and meta-analysis of factors associated with unipolar mania

et al. 2023

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Background The diagnostic concept of unipolar mania (UM), i.e. the lifetime occurrence of mania without major depressive episodes, remains a topic of debate despite the evidence accumulated in the last few years. We carried out a systematic review and meta-analysis of observational studies testing factors associated with UM as compared to bipolar disorder with a manic-depressive course (md-BD). Methods Studies indexed up to July 2022 in main electronic databases were searched. Random-effects meta-analyses of the association between UM and relevant correlates yielded odds ratio (OR) or standardized mean difference (SMD), with 95% confidence intervals (CIs). Results Based on data from 21 studies, factors positively or negatively associated with UM, as compared to md-BD, were: male gender (OR 1.47; 95% CI 1.11–1.94); age at onset (SMD −0.25; 95% CI −0.46 to −0.04); number of hospitalizations (SMD 0.53; 95% CI 0.21–0.84); family history of depression (OR 0.55; 95% CI 0.36–0.85); suicide attempts (OR 0.25; 95% CI 0.19–0.34); comorbid anxiety disorders (OR 0.35; 95% CI 0.26–0.49); psychotic features (OR 2.16; 95% CI 1.55–3.00); hyperthymic temperament (OR 1.99; 95% CI 1.17–3.40). The quality of evidence for the association with previous suicide attempts was high, moderate for anxiety disorders and psychotic features, and low or very low for other correlates. Conclusions Despite the heterogeneous quality of evidence, this work supports the hypothesis that UM might represent a distinctive diagnostic construct, with peculiar clinical correlates. Additional research is needed to better differentiate UM in the context of affective disorders, favouring personalized care approaches.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Characterizing the clinical profile of mania without major depressive episodes: a systematic review and meta-analysis of factors associated with unipolar mania

et al. 2023

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“…This study focused on understanding the course and outcome of BD in the form of the number of episodes, residual symptoms, disability, insight, and subjective cognitive dysfunction. [ 26 - 28 ] In this paper, we focus on cognitive dysfunction and its association with other variables.…”

Section: Methodsmentioning

confidence: 99%

Subjective cognitive deficits and its correlates among patients with bipolar disorder: Findings from the bipolar disorder course and outcome study from India (BiD-CoIN study)

Grover¹,

Chakravarty²,

Dan³

et al. 2023

Indian Journal of Psychiatry

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Aim: This study aimed to evaluate the prevalence of subjective cognitive complaints and their association with clinical variables, insight, and disability. Methodology: Seven hundred and seventy-three subjects with bipolar disorder (BD), recruited across 14 centers, currently in the euthymic phase were cross-sectionally evaluated on Cognitive Complaints in Bipolar Disorder Rating Assessment (COBRA). Results: The mean total COBRA score was 9.79 (SD: 6.99), and 322 (41.7%) of the participants were found to have subjective cognitive complaints when the cut-off of >10 was used. Compared to those without cognitive complaints, those with cognitive complaints more often had depression as the first episode in their lifetime, had a higher prevalence of alcohol dependence, a higher number of depressive episodes (first five years of illness, lifetime, and per year of illness), a higher number of manic episodes in the first five years of illness, more often had depressive or indeterminate predominant polarity, lower prevalence of at least one-lifetime episode with psychotic symptoms, higher severity of residual symptoms, spent more time in the episodes in the lifetime, had poorer insight and higher disability. Conclusion: The present study suggests subjective complaints complaints are associated with more severe illness, higher levels of residual symptoms, poor insight, and higher disability.

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“…For example, unipolar mania (defined as mania without history of depressive episodes) is a subtype described in both contemporary and classical writings on bipolar disorder 125 . It is estimated that approximately 5% of persons with bipolar I disorder experience this condition 125,126 .…”

Section: Clinical Subtypesmentioning

confidence: 99%

The clinical characterization of the adult patient with bipolar disorder aimed at personalization of management

et al. 2022

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Bipolar disorder is heterogeneous in phenomenology, illness trajectory, and response to treatment. Despite evidence for the efficacy of multimodal ity interventions, the majority of persons affected by this disorder do not achieve and sustain full syndromal recovery. It is eagerly anticipated that combining datasets across various information sources (e.g., hierarchical "multiomic" measures, electronic health records), analyzed using ad vanced computational methods (e.g., machine learning), will inform future diagnosis and treatment selection. In the interim, identifying clinically meaningful subgroups of persons with the disorder having differential response to specific treatments at pointofcare is an empirical priority. This paper endeavours to synthesize salient domains in the clinical characterization of the adult patient with bipolar disorder, with the overarching aim to improve health outcomes by informing patient management and treatment considerations. Extant data indicate that characterizing select domains in bipolar disorder provides actionable information and guides shared decision making. For example, it is robustly established that the presence of mixed features -especially during depressive episodes -and of physical and psychiatric comorbidities informs illness trajectory, response to treatment, and suicide risk. In addition, early environmental exposures (e.g., sexual and physical abuse, emotional neglect) are highly associated with more complicated illness presentations, inviting the need for developmentallyoriented and integrated treatment approaches. There have been significant advances in validating subtypes of bipolar disorder (e.g., bipolar I vs. II disorder), particularly in regard to pharmacological interventions. As with other severe mental disorders, social functioning, interpersonal/family relationships and internalized stigma are domains highly relevant to relapse risk, health outcomes, and quality of life. The elevated standardized mortality ratio for completed suicide and suicidal behaviour in bipolar disorder invites the need for characterization of this domain in all patients. The framework of this paper is to describe all the above salient domains, provid ing a synthesis of extant literature and recommendations for decision support tools and clinical metrics that can be implemented at pointofcare.

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Is unipolar mania a distinct entity: findings from the bipolar disorder course and outcome study from India (BiD-CoIN study)

Cited by 8 publications

References 20 publications

Characterizing the clinical profile of mania without major depressive episodes: a systematic review and meta-analysis of factors associated with unipolar mania

Characterizing the clinical profile of mania without major depressive episodes: a systematic review and meta-analysis of factors associated with unipolar mania

Subjective cognitive deficits and its correlates among patients with bipolar disorder: Findings from the bipolar disorder course and outcome study from India (BiD-CoIN study)

The clinical characterization of the adult patient with bipolar disorder aimed at personalization of management

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