The World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for the Biological Treatment of Bipolar Disorders: Acute and long-term treatment of mixed states in bipolar disorder

Grunze, Heinz; Vieta, Eduard; Goodwin, Guy M.; Bowden, Charles L.; Licht, Rasmus W; Azorin, Jean‐Michel; Yatham, Lakshmi N.; Sn, Mosolov; Möller, Hans‐Jürgen; Kasper, Siegfried

doi:10.1080/15622975.2017.1384850

Cited by 147 publications

(128 citation statements)

References 319 publications

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“…Pharmacological treatment plays a crucial role in the continuous management of patients with bipolar disorder. According to several worldwide guidelines (12)(13)(14), pharmacology may be in the form of therapies for any mood episodes, including mania and depression, and as continued treatment for the prevention of any episodes in the maintenance phase. However, among girls, women of childbearing age, and pregnant women with bipolar disorder, continuous medication is often difficult to successfully administer; hence, the pharmacological strategy for these patients must be different from that for other patients due to the risks of congenital malformations.…”

Section: Introductionmentioning

confidence: 99%

Patterns in Psychiatrists’ Prescription of Valproate for Female Patients of Childbearing Age With Bipolar Disorder in Japan: A Questionnaire Survey

et al. 2020

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Section: Introductionmentioning

confidence: 99%

Patterns in Psychiatrists’ Prescription of Valproate for Female Patients of Childbearing Age With Bipolar Disorder in Japan: A Questionnaire Survey

et al. 2020

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“…1,9,10,41,42 Evidence concerning mood stabilisers as maintenance therapies for patients with mixed features is still virtually absent. 12 Lithium for the prevention of suicide and self-harm in patients with BD-II and mixed states It has been suggested that the risk of suicide in BD-II is higher than in BD-I. The reasons for this are not quite clear.…”

Section: Lithium As a Treatment For Bipolar Disorder With Mixed Featuresmentioning

confidence: 99%

Clinical course and need for hospital admission after lithium discontinuation in patients with bipolar disorder type I or II: mirror-image study based on the LiSIE retrospective cohort

Öhlund

Ott

Bergqvist³

et al. 2019

BJPsych open

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Background Currently, the evidence for lithium as a maintenance treatment for bipolar disorder type II (BD-II) remains limited. Guidelines commonly extrapolate recommendations for BD-II from available evidence for bipolar disorder type I (BD-I). Comparing the impact of lithium discontinuation is one way of assessing effectiveness in both groups. Aims To compare the impact of lithium discontinuation on hospital admissions and self-harm in patients with BD-I or schizoaffective disorder (SZD) and patients with BD-II or other bipolar disorder. Method Mirror-image study, examining hospital admissions within 2 years before and after lithium discontinuation in both patient groups. This study was part of a retrospective cohort study (LiSIE) into effects and side-effects of lithium for maintenance treatment of bipolar disorder as compared with other mood stabilisers. Results For the whole sample, the mean number of admissions/patient/review period doubled from 0.44 to 0.95 (P<0.001) after lithium discontinuation. The mean number of bed days/patient/review period doubled from 11 to 22 (P = 0.025). This increase in admissions and bed days was exclusively attributable to patients with BD-I/SZD. Not having consulted with a doctor prior to lithium discontinuation or no treatment with an alternative mood stabiliser at the time of lithium discontinuation led to more admissions. Conclusions The higher relapse risk in patients with BD-I/SZD suggests a higher threshold for discontinuing lithium than for patients with BD-II/other bipolar disorder. In patients with BD-II/other bipolar disorder, however, judged on the impact of discontinuation alone, lithium did not appear to prevent more severe depressive episodes requiring hospital admission.

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“…Moreover, DMX often requires prompt treatment including urgent admission and cautious medication different from those used for pure depression like vigorous antidepressant monotherapy [ 3 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

The 12-Item Self-Rating Questionnaire for Depressive Mixed State (DMX-12) for Screening of Mixed Depression and Mixed Features

2020

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For simultaneous screening of mixed features (MF) by DSM-5 and mixed depression (MD) by Benazzi, useful symptoms were extracted from our 12-item dimensional scale for depressive mixed state (DMX-12). Subjects were 190 consecutive cases with major depressive episode (MDE) who visited our clinic. Associations between symptomatological combinations of the DMX-12 and MF or MD were analyzed using receiver operating characteristic (ROC). The rate of MF was 4.2% while that of MD was 22.6%. Eight symptoms (overreactivity, inner tension, racing/crowded thought, impulsivity, irritability, aggression, risk-taking behavior, and dysphoria) with their AUC > 0.6 for ROC curves were specially focused on distinguishing patients with MF or MD from non-mixed patients. By using these 8 symptoms, 40.5% of the overall patients were screened as positive at the same cut-off value (≥13) for both MD and MF. The AUC of ROC curve and sensitivity/specificity were well balanced together with sufficient negative predictive values. The abovementioned 8 symptoms seem to be helpful for primary screening and negative check of DMX with considerable severity during MDE.

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The World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for the Biological Treatment of Bipolar Disorders: Acute and long-term treatment of mixed states in bipolar disorder

Abstract: Current treatment recommendations are still based on limited evidence, and there is a clear demand for confirmative studies adopting the DSM-5 specifier with mixed features concept.

Cited by 147 publications

References 319 publications

Patterns in Psychiatrists’ Prescription of Valproate for Female Patients of Childbearing Age With Bipolar Disorder in Japan: A Questionnaire Survey

Patterns in Psychiatrists’ Prescription of Valproate for Female Patients of Childbearing Age With Bipolar Disorder in Japan: A Questionnaire Survey

Clinical course and need for hospital admission after lithium discontinuation in patients with bipolar disorder type I or II: mirror-image study based on the LiSIE retrospective cohort

The 12-Item Self-Rating Questionnaire for Depressive Mixed State (DMX-12) for Screening of Mixed Depression and Mixed Features

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