Abstract:
BACKGROUND:Neurocognitive deficits are prevalent, persistent, and implicated as mediators of functional impairment in adults with bipolar disorder. Notwithstanding progress in the development of pharmacological treatments for various phases of bipolar disorder, no available treatment has been proven to be reliably efficacious in treating neurocognitive deficits. Emerging evidence indicates that insulin dysregulation may be pertinent to neurocognitive function. In keeping with this view, we tested the hypothesis that intranasal insulin administration would improve measures of neurocognitive performance in euthymic adults with bipolar disorder. METHODS:Sixty-two adults with bipolar I/II disorder (based on the Mini International Neuropsychiatric Interview 5.0) were randomized to adjunctive intranasal insulin 40 IU q.i.d. (n = 34) or placebo (n = 28) for eight weeks. All subjects were prospectively verified to be euthymic on the basis of a total score of ≤ 3 on the seven-item Hamilton Depression Rating Scale (HAMD-7) and ≤ 7 on the 11-item Young Mania Rating Scale (YMRS) for a minimum of 28 consecutive days. Neurocognitive function and outcome was assessed with a neurocognitive battery. RESULTS:There were no significant between-group differences in mean age of the subjects {i.e., mean age 40 [standard deviation (SD) = 10.15] years in the insulin and 39 [SD = 10.41] in the placebo groups, respectively}. In the insulin group, n = 27 (79.4%) had bipolar I disorder, while n = 7 (21.6%) had bipolar II disorder. In the placebo group, n = 25 (89.3%) had bipolar I disorder, while n = 3 (10.7%) had bipolar II disorder. All subjects received concomitant medications; medications remained stable during study enrollment. A significant improvement versus placebo was noted with intranasal insulin therapy on executive function (i.e., Trail Making Test-Part B). Time effects were significant for most California Verbal Learning Test indices and the Process Dissociation Task-Habit Estimate, suggesting an improved performance from baseline to endpoint with no between-group differences. Intranasal insulin was well tolerated; no subject exhibited hypoglycemia or other safety concerns. CONCLUSIONS:Adjunctive intranasal insulin administration significantly improved a single measure of executive function in bipolar disorder. We were unable to detect between-group differences on other neurocognitive measures, with improvement noted in both groups. Subject phenotyping on the basis of pre-existing neurocognitive deficits and/or genotype [e.g., apolipoprotein E (ApoE)] may possibly identify a more responsive subgroup.
journal_name
Bipolar Disordjournal_title
Bipolar disordersauthors
McIntyre RS,Soczynska JK,Woldeyohannes HO,Miranda A,Vaccarino A,Macqueen G,Lewis GF,Kennedy SHdoi
10.1111/bdi.12006subject
Has Abstractpub_date
2012-11-01 00:00:00pages
697-706issue
7eissn
1398-5647issn
1399-5618journal_volume
14pub_type
杂志文章,随机对照试验abstract:OBJECTIVE:Although second-generation antipsychotics (SGAs) are widely used in treating schizophrenia and bipolar disorder, their effects on dyslipidemia, glucose intolerance, metabolic syndrome (MetS), and coronary heart disease (CHD) risk are less well documented for bipolar disorder. We compared bipolar disorder and ...
journal_title:Bipolar disorders
pub_type: 杂志文章
doi:10.1111/j.1399-5618.2008.00625.x
更新日期:2008-11-01 00:00:00
abstract:BACKGROUND:Bipolar illness is frequently misdiagnosed. Several studies have focused on the underdiagnosis of this condition and the frequent long delay in its recognition. However, the illness is difficult to diagnose and many of its symptoms are shared by other conditions. In order to determine the accuracy of the dia...
journal_title:Bipolar disorders
pub_type: 杂志文章
doi:10.1111/j.1399-5618.2007.00465.x
更新日期:2007-09-01 00:00:00
abstract:OBJECTIVE:To examine gender differences in a large sample of patients with bipolar illness. METHODS:Exploratory analysis of baseline data from the first 500 patients in the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD), a multi-center NIMH project. Participants are allowed to have medical and...
journal_title:Bipolar disorders
pub_type: 杂志文章,多中心研究
doi:10.1111/j.1399-5618.2005.00237.x
更新日期:2005-10-01 00:00:00
abstract:OBJECTIVE:To determine the impact of acute depression on quality of life (QOL) in patients with bipolar I disorder and to compare these results with published data on QOL in patients with unipolar depression. METHODS:Quality of life was assessed using the SF-36 in bipolar patients (n = 958) who had recently experience...
journal_title:Bipolar disorders
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1111/j.1399-5618.2004.00134.x
更新日期:2004-10-01 00:00:00
abstract:OBJECTIVES:To examine the rates, types, and psychosocial correlates of legal charges in adolescents with newly diagnosed bipolar disorder (BD). METHODS:Adolescents (n = 80), between the ages of 12 and 21 years (mean = 15.6, standard deviation = 2.3), hospitalized for their initial manic or mixed episode of BD, were ev...
journal_title:Bipolar disorders
pub_type: 杂志文章
doi:10.1111/j.1399-5618.2007.00423.x
更新日期:2007-06-01 00:00:00
abstract::Lithium, the major drug used to treat manic depressive illness, robustly protects cultured rat brain neurons from glutamate excitotoxicity mediated by N-methyl-D-aspartate (NMDA) receptors. The lithium neuroprotection against glutamate excitotoxiciy is long-lasting, requires long-term pretreatment and occurs at therap...
journal_title:Bipolar disorders
pub_type: 杂志文章,评审
doi:10.1034/j.1399-5618.2002.01179.x
更新日期:2002-04-01 00:00:00
abstract:OBJECTIVE:Although bipolar disorder has high heritability, the onset occurs during several decades of life, suggesting that social and environmental factors may have considerable influence on disease onset. This study examined the association between the age of onset and sunlight at the location of onset. METHOD:Data ...
journal_title:Bipolar disorders
pub_type: 杂志文章
doi:10.1111/j.1399-5618.2012.01025.x
更新日期:2012-09-01 00:00:00
abstract:OBJECTIVE:To investigate the diagnostic profile of women referred for postpartum depression. METHODS:Fifty-six women seen consecutively with the referral diagnosis of postpartum depression were administered structured instruments to gather information about their DSM-IV Axis I diagnoses. RESULTS:In terms of frequency...
journal_title:Bipolar disorders
pub_type: 杂志文章
doi:10.1111/j.1399-5618.2008.00606.x
更新日期:2008-09-01 00:00:00
abstract:OBJECTIVES:Patients experiencing an acute mood episode of bipolar disorder are impaired on cognitive tests of executive functioning when compared with healthy subjects. However, it is unclear to what extent executive dysfunction exists (i) during syndromal remission, when mood symptoms are attenuated, and (ii) during t...
journal_title:Bipolar disorders
pub_type: 杂志文章
doi:10.1111/j.1399-5618.2008.00582.x
更新日期:2008-06-01 00:00:00
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journal_title:Bipolar disorders
pub_type: 杂志文章
doi:10.1111/j.1399-5618.2009.00701.x
更新日期:2009-06-01 00:00:00
abstract:OBJECTIVES:Caregivers of people with bipolar disorder often have depression and health problems. This study aimed to evaluate the sustained effects of a 12-15 week psychoeducational intervention on the health and mental health of caregivers of persons with bipolar disorder. We also evaluated the effects of the interven...
journal_title:Bipolar disorders
pub_type: 杂志文章,随机对照试验
doi:10.1111/bdi.12621
更新日期:2018-11-01 00:00:00
abstract:OBJECTIVES:While the pathophysiology of bipolar disorder (BD) remains to be elucidated, postmortem and neuroimaging studies have suggested that abnormalities in the dorsolateral prefrontal cortex (DLPFC) are implicated. We compared the levels of specific brain chemicals of interest measured with proton magnetic resonan...
journal_title:Bipolar disorders
pub_type: 杂志文章
doi:10.1111/j.1399-5618.2007.00454.x
更新日期:2007-06-01 00:00:00
abstract:OBJECTIVES:Mismatch negativity (MMN) and its magnetic counterpart (MMNm) are thought to reflect an automatic process that detects a difference between an incoming stimulus and the sensory memory trace of preceding stimuli. In patients with schizophrenia, an attenuation of the MMN/MMNm amplitude has been repeatedly repo...
journal_title:Bipolar disorders
pub_type: 杂志文章
doi:10.1111/bdi.12208
更新日期:2014-09-01 00:00:00
abstract:OBJECTIVES:Bipolar disorder (BD) is a psychiatric disorder with high morbidity and mortality that cannot be distinguished from major depressive disorder (MDD) until the first manic episode. A biomarker able to differentiate BD and MDD could help clinicians avoid risks of treating BD with antidepressants without mood st...
journal_title:Bipolar disorders
pub_type: 杂志文章
doi:10.1111/bdi.12175
更新日期:2014-06-01 00:00:00
abstract:OBJECTIVE:Bipolar major depression differs considerably from unipolar major depression with regard to the efficacy of treatment with antidepressants. In bipolar depression, response to treatment with antidepressants is disappointing. Whether response to electroconvulsive therapy (ECT) differs between bipolar and unipol...
journal_title:Bipolar disorders
pub_type: 杂志文章,meta分析,评审
doi:10.1111/j.1399-5618.2012.00997.x
更新日期:2012-03-01 00:00:00
abstract:OBJECTIVE:To review research findings on clinical effects of discontinuing lithium maintenance treatment. METHODS:Data from studies reported since 1970 plus our recent findings were updated. RESULTS:Discontinuing lithium maintenance treatment led to marked increases of early affective morbidity and suicidal risk. Gra...
journal_title:Bipolar disorders
pub_type: 杂志文章
doi:10.1034/j.1399-5618.1999.10106.x
更新日期:1999-09-01 00:00:00
abstract:OBJECTIVES:Bipolar disorders are associated with high rates of suicide attempts (SAs) and completions. Several factors have been reported to be associated with suicide in persons with bipolar disorder, but most studies to date have been retrospective and have not utilized multivariate statistics to account for the redu...
journal_title:Bipolar disorders
pub_type: 杂志文章
doi:10.1111/j.1399-5618.2006.00369.x
更新日期:2006-10-01 00:00:00
abstract::Bipolar disorder is a complex condition that includes symptoms of mania, depression, and often anxiety. Diagnosing and treating bipolar depression is challenging, with the disorder often being diagnosed as unipolar depression. In addition, comorbid anxiety can be a significant detractor to successful outcomes, increas...
journal_title:Bipolar disorders
pub_type: 杂志文章,评审
doi:10.1111/j.1399-2406.2003.00061.x
更新日期:2003-01-01 00:00:00
abstract::The Diagnostic Guidelines Task Force of the International Society for Bipolar Disorders (ISBD) presents in this document and this special issue a summary of the current nosological status of bipolar illness, a discussion of possible revisions to current DSM-IV and ICD-10 definitions, an examination of the relevant lit...
journal_title:Bipolar disorders
pub_type: 杂志文章,实务指引
doi:10.1111/j.1399-5618.2007.00556.x
更新日期:2008-02-01 00:00:00
abstract:OBJECTIVES:Neuropsychological studies in subjects with bipolar disorder (BD) have reported deficits on a variety of cognitive measures. However, because the majority of subjects were medicated at the time of testing in previous studies, it is currently unclear whether the pattern of deficits reported is related to BD i...
journal_title:Bipolar disorders
pub_type: 杂志文章
doi:10.1111/j.1399-5618.2009.00669.x
更新日期:2009-03-01 00:00:00
abstract:OBJECTIVE:Diffusion-weighted magnetic resonance imaging (MRI) has shown increased sensitivity in detecting brain white matter disease compared to traditional T2-weighted MRI. Diffusion-weighted imaging (DWI) can quantitatively assess the microstructural integrity of white matter using the average apparent diffusion coe...
journal_title:Bipolar disorders
pub_type: 杂志文章
doi:10.1111/j.1399-5618.2006.00281.x
更新日期:2006-04-01 00:00:00
abstract:OBJECTIVES:Electroconvulsive therapy is an effective treatment for bipolar depression, but there are concerns about whether it causes long-term neurocognitive impairment. METHODS:In this multicenter randomized controlled trial, in-patients with treatment-resistant bipolar depression were randomized to either algorithm...
journal_title:Bipolar disorders
pub_type: 杂志文章,随机对照试验
doi:10.1111/bdi.12594
更新日期:2018-09-01 00:00:00
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journal_title:Bipolar disorders
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1111/j.1399-5618.2007.00343.x
更新日期:2007-02-01 00:00:00
abstract:OBJECTIVES:A high prevalence rate of bipolar disorder (BP) comorbid with alcohol dependence (AD) (BP+AD) in Western patients with BP has been reported, but whether this is true for Han Chinese with BP is uncertain. We explored the prevalence of BP+AD in a Han Chinese population with BP, and investigated the effect of a...
journal_title:Bipolar disorders
pub_type: 杂志文章
doi:10.1111/bdi.12313
更新日期:2015-08-01 00:00:00
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journal_title:Bipolar disorders
pub_type: 杂志文章,meta分析
doi:10.1111/bdi.12859
更新日期:2020-03-01 00:00:00
abstract:OBJECTIVES:Lithium overdose may result in encephalopathy and electroencephalographic abnormalities. Three poisoning patterns have been identified based on the ingested dose, previous treatment duration and renal function. Whether the severity of lithium-induced encephalopathy depends on the poisoning pattern has not be...
journal_title:Bipolar disorders
pub_type: 杂志文章
doi:10.1111/bdi.12482
更新日期:2017-03-01 00:00:00
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journal_title:Bipolar disorders
pub_type: 杂志文章
doi:10.1111/j.1399-5618.2009.00744.x
更新日期:2009-11-01 00:00:00
abstract:OBJECTIVES:Significant debate exists on whether early onset bipolar disorder is mistakenly attributed to attention deficit hyperactivity disorder (ADHD) or conduct disorder (CD), or whether ADHD and CD are frequently misdiagnosed as mania. We review the literature on the extent to which these disorders can be reliably ...
journal_title:Bipolar disorders
pub_type: 杂志文章,评审
doi:10.1034/j.1399-5618.2002.01191.x
更新日期:2002-08-01 00:00:00
abstract:OBJECTIVES:Although olfactory abnormalities are well established in schizophrenia, considerably less work has examined olfactory performance in other neuropsychiatric conditions. In the current study, we examined odor identification, odor discrimination, detection threshold, and odor hedonic processing performance in i...
journal_title:Bipolar disorders
pub_type: 杂志文章
doi:10.1111/bdi.12625
更新日期:2018-09-01 00:00:00
abstract:OBJECTIVES:Manic patients exhibit impaired verbal learning and memory, particularly following longstanding illness. However, it is unclear whether recognition and recall performance are differentially influenced by a manic mood state. METHODS:To examine this issue, we administered the California Verbal Learning Test a...
journal_title:Bipolar disorders
pub_type: 杂志文章
doi:10.1034/j.1399-5618.2003.00055.x
更新日期:2003-10-01 00:00:00