Editorial: A Meta-Analysis of the Treatment of Acute Mania in Youth: Why Do Atypical Antipsychotics Work Better Than Mood Stabilizers?

Randomized controlled trials (RCTs) of youth with mania are very challenging to conduct, given the low base rate of bipolar disorder (BD) and the relative rarity of mania (vs bipolar depression, which tends to be much more common). Thus, many of the RCTs are relatively small, and it may be difficult to clinically interpret results. At the same time, findings about which anti-manic medications are most effective in youth are of critical importance, both because (1) poorly treated mania can lead to substantial negative psychosocial consequences, and (2) these medications can have significant adverse effects.

Person-level contributions of bipolar polygenic risk score to the prediction of new-onset bipolar disorder in at-risk offspring.

Background: Previous work indicates that polygenic risk scores (PRS) for bipolar disorder (BD) are elevated in adults and youth with BD, but whether BD-PRS can inform person-level diagnostic prediction is unknown. Here, we test whether BD-PRS improves performance of a previously published risk calculator (RC) for BD.

Methods: 156 parents with BD-I/II and their offspring ages 6-18 were recruited and evaluated with standardized diagnostic assessments every two years for >12 years.

Editorial: Following Offspring of Parents With Bipolar Disorder Into Middle Adulthood: Risk Windows Relevant to Child Psychiatrists.

The most important predictor of bipolar disorder (BD) onset is a family history. Based on this premise, several offspring studies have recruited and followed offspring of parents with BD into early adulthood, including the Pittsburgh Bipolar Offspring Study, the Canadian Flourish Cohort, and the Dutch Bipolar Offspring Study (DBOS). These studies have shed important light on the incidence and prevalence of BD and other psychopathology in these offspring (11%-13% for BD-I/II), as well as the most important symptom-level and diagnostic predictors of BD in these youth.

Mindfulness-based intervention to decrease mood lability in at-risk youth: Preliminary evidence for changes in resting state functional connectivity.

Background: In youth at familial risk for bipolar disorder (BD), mood lability is an important precursor to BD onset. Previous work in adults indicates that mindfulness-based interventions (MBI) may improve emotion regulation, in part by increasing resting-state functional connectivity (rsFC) between posterior cingulate cortex (PCC) and executive control network (ECN). In this pilot study, we assessed effects of an MBI on PCC-ECN rsFC and mood lability in at-risk youth.

Abnormal deactivation of the inferior frontal gyrus during implicit emotion processing in youth with bipolar disorder: attenuated by medication.

Previous neuroimaging studies of youth with bipolar disorder (BD) have identified abnormalities in emotion regulation circuitry. Using data from the Longitudinal Assessment of Manic Symptoms Cohort (a clinical sample recruited for behavioral and emotional dysregulation), we examined the impact of BD and medication on activation in these regions. Functional neuroimaging data were obtained from 15 youth with BD who currently were unmedicated with a mood stabilizer or antipsychotic (U-BD), 19 youth with medicated BD (M-BD), a non-bipolar clinical sample with high rates of disruptive behavioral disorders (non-BD, n = 59), and 29 healthy controls (HC) while they were shown task-irrelevant morphing emotional faces and shapes.