Psychiatry Outpatients' Willingness to Share Social Media Posts and Smartphone Data for Research and Clinical Purposes: Survey Study.

Background: Psychiatry research has begun to leverage data collected from patients' social media and smartphone use. However, information regarding the feasibility of utilizing such data in an outpatient setting and the acceptability of such data in research and practice is limited.

Objective: This study aimed at understanding the outpatients' willingness to have information from their social media posts and their smartphones used for clinical or research purposes.

Divergent relationship of depression severity to social reward responses among patients with bipolar versus unipolar depression.

Neuroimaging studies of mood disorders demonstrate abnormalities in brain regions implicated in reward processing. However, there is a paucity of research investigating how social rewards affect reward circuit activity in these disorders. Here, we evaluated the relationship of both diagnostic category and dimensional depression severity to reward system function in bipolar and unipolar depression.

Antidepressants in Type II Versus Type I Bipolar Depression: A Randomized Discontinuation Trial.

Background: We sought to test the hypothesis that antidepressants (ADs) may show preferential efficacy and safety among patients with type II bipolar disorder (BD, BD-II) more than patients with type I BD (BD-I).

Methods: Patients with Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, BD-I (n = 21) and BD-II (n = 49) in acute major depressive episodes were treated with ADs plus mood stabilizers to euthymia sustained for 2 months and then randomized openly to continue or discontinue ADs for up to 3 years. Outcomes were episode recurrences and changes in standardized symptom ratings.

Antidepressants worsen rapid-cycling course in bipolar depression: A STEP-BD randomized clinical trial.

Background: The use of antidepressants in rapid-cycling bipolar disorder has been controversial. We report the first randomized clinical trial with modern antidepressants on this topic.

Methods: As part of the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD) study, we analyzed, as an a priori secondary outcome, rapid cycling as a predictor of response in 68 patients randomized to continue vs.

Common and Dissociable Dysfunction of the Reward System in Bipolar and Unipolar Depression.

Unipolar and bipolar depressive episodes have a similar clinical presentation that suggests common dysfunction of the brain's reward system. Here, we evaluated the relationship of both dimensional depression severity and diagnostic category to reward system function in both bipolar and unipolar depression. In total, 89 adults were included, including 27 with bipolar depression, 25 with unipolar depression, and 37 healthy comparison subjects.

Bipolar depression: an evidence-based approach.

Bipolar disorder is a complex, multidimensional illness that is often difficult to treat. Unfortunately, bipolar patients are much more likely to experience depression, which is all too often severe and a potentially lethal phase of the illness. In addition, pharmacotherapies with strong evidence for bipolar depression are limited.

Antidepressant discontinuation in bipolar depression: a Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD) randomized clinical trial of long-term effectiveness and safety.

Objective: To assess long-term effectiveness and safety of randomized antidepressant discontinuation after acute recovery from bipolar depression.

Method: In the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD) study, conducted between 2000 and 2007, 70 patients with DSM-IV-diagnosed bipolar disorder (72.5% non-rapid cycling, 70% type I) with acute major depression, initially responding to treatment with antidepressants plus mood stabilizers, and euthymic for 2 months, were openly randomly assigned to antidepressant continuation versus discontinuation for 1-3 years.

Correlates of functioning in bipolar disorder.

Objectives: Our primary aim was to describe unique correlates of functioning in bipolar disorder (BD).

Experimental Design: The study included the first 500 patients enrolled in the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD). Patients were 41.

Self-reported history of manic/hypomanic switch associated with antidepressant use: data from the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD).

Objective: Antidepressant safety and efficacy remain controversial for the treatment of bipolar depression. The present study utilized data from the National Institute of Mental Health Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD) to examine the prevalence and clinical correlates of self-reported switch into mania/hypomania during antidepressant treatment.

Method: Antidepressant treatment histories were examined from intake assessments for the first 500 subjects enrolled into the STEP-BD between November 1999 and November 2000.

An open prospective study of zonisamide in acute bipolar depression.

Objective: To examine the effectiveness and safety of zonisamide in the treatment of acute bipolar depression.

Methods: An open-label, prospective, nonrandomized, 8-week study conducted in bipolar outpatients (type I, type II, or not otherwise specified) with depressive symptoms. No patient was manic or mixed at study entry.

Menstrual dysfunction prior to onset of psychiatric illness is reported more commonly by women with bipolar disorder than by women with unipolar depression and healthy controls.

Background: Preliminary reports suggest that menstrual cycle irregularities occur more commonly in women with bipolar disorder and unipolar depression than in the general population. However, it is not always clear whether such abnormalities, reflecting disruption of the hypothalamic-pituitary-gonadal (HPG) axis, are caused by psychotropic treatments or associated with the disorder per se.

Method: The prevalence of early-onset (within the first 5 postmenarchal years) menstrual cycle dysfunction (menstrual cycle length unpredictable within 10 days or menstrual cycle length<25 days or >35 days) occurring before onset of psychiatric illness was compared between subjects with DSM-IV bipolar disorder participating in the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD) and subjects with DSM-IV unipolar depression or no psychiatric illness participating in the Harvard Study of Moods and Cycles.

Gender differences in bipolar disorder: retrospective data from the first 500 STEP-BD participants.

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 psychiatric comorbidities, and to enter in any mood state, thus making the population more generalizable than many research cohorts.

Ziprasidone: a novel psychotropic with unique properties.

Ziprasidone (Geodon) is a relatively new atypical antipsychotic medication with a unique pharmacological profile. It is indicated for the treatment of schizophrenia, but has also often been used off-label for other uses. This review summarizes its important properties, specifically the pharmacodynamic parameters, receptor-binding profile and relevance to clinical outcomes, side effects, and potential for drug-drug interactions and established clinical indications.

Assessment tools for screening and monitoring bipolar disorder.

Objective: To review the availability and suitability of tools for screening, diagnosing, and monitoring people with bipolar disorder in both psychiatric and general practice.

Methods: Currently available assessment tools suitable for use with patients with bipolar disorder were identified through a MEDLINE search using the following key terms: bipolar, screening, diagnosis, monitoring. Only peer-reviewed papers published in English were considered for further review.

Omega-3 fatty acids decreased irritability of patients with bipolar disorder in an add-on, open label study.

This is a report on a 37-patient continuation study of the open ended, Omega-3 Fatty Acid (O-3FA) add-on study. Subjects consisted of the original 19 patients, along with 18 new patients recruited and followed in the same fashion as the first nineteen. Subjects carried a DSM-IV-TR diagnosis of Bipolar Disorder and were visiting a Mood Disorder Clinic regularly through the length of the study.

Acute treatment of bipolar depression with adjunctive zonisamide: a retrospective chart review.

Background: This retrospective chart review evaluated the use of zonisamide as adjunctive treatment in patients with bipolar depression.

Method: The charts of outpatients with bipolar I or II disorder treated with adjunctive zonisamide were reviewed. The efficacy of zonisamide was assessed via comparison of physician-rated Global Assessment of Functioning (GAF) and Clinical Global Impression of Severity (CGI-S) Scale scores at baseline and after 6 weeks of therapy using paired t-tests.

Rethinking the treatment paradigm for bipolar depression: the importance of long-term management.

The need for long-term management of bipolar disorder is evident. Bipolar patients spend more time depressed than manic; however, few agents used for maintenance therapy of bipolar disorder have demonstrated good efficacy in delaying relapse into depression. This article provides a comprehensive review of open-label and randomized, controlled studies examining prophylactic efficacy in bipolar disorder, especially bipolar depression.

Bipolar spectrum disorder: a pilot study.

Objective: To assess depressive features of a proposed definition of bipolar spectrum disorder (BSD).

Methods: Thirty-six patients with bipolar disorder type I or II were compared to 37 patients with unipolar major depressive disorder through patient interview and chart review.

Results: Univariate analysis suggests that 7 of 12 (recurrent major depressive episodes, brief major depressive episodes, atypical depressive symptoms, early age of onset, family history of bipolar disorder, antidepressant tolerance, and antidepressant-induced mania) features of major depressive episodes were more likely to occur in bipolar versus unipolar patients.

The current understanding of lamotrigine as a mood stabilizer.

Objective: To examine whether lamotrigine has a unique role in the treatment of bipolar disorder, we evaluated the results of recent clinical trials and molecular and cell biological studies on lamotrigine.

Data Sources: Using keywords such as bipolar disorder, lamotrigine, clinical trial, outcomes studies, and mechanisms, we conducted a search for English-language articles on MEDLINE and Index Medicus and also on abstracts presented in recent research conferences.

Data Synthesis: Several studies have strongly suggested that lamotrigine is effective for the acute treatment of bipolar depression as well as for long-term maintenance treatment of bipolar disorder.

What drugs are best for bipolar depression?

Bipolar depression is a severe, potentially lethal disorder for which there are no specific, FDA-indicated pharmacotherapies. Research in this area has been limited, and most treatments are based on unsupported extrapolation from the treatment of unipolar depression, or follow guidelines derived largely from the clinical practice experience of experts in this field. There is clearly a medical need for new and more effective treatments for bipolar depression.

Antidepressant treatment in bipolar versus unipolar depression.

Objective: Antidepressant responses were compared in DSM-IV bipolar and unipolar depression.

Method: The authors analyzed clinical records for outcomes of antidepressant trials for 41 patients with bipolar depression and 37 with unipolar depression, similar in age and sex distribution.

Results: Short-term nonresponse was more frequent in bipolar (51.

Modafinil: past, present and future.

Modafinil is a novel wake-promoting agent approved for the treatment of excessive sleepiness associated with narcolepsy that holds significant promise as an alternative treatment to traditional psychostimulants for excessive fatigue associated with medical and psychiatric disorders and as augmentation medication for treatment-resistant depression.