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Treatment of Bipolar Depression

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Mental Health".

Deadline for manuscript submissions: closed (31 May 2019) | Viewed by 29453

Special Issue Editors


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Guest Editor
1. Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital “Maria SS dello Splendore”, ASL 4 Teramo, Italy
2. Department of Neuroscience, Reproductive Science and Odontostomatology, School of Medicine 'Federico II' Naples, 80138 Naples, Italy
Interests: schizophrenia; bipolar disorder; neuropsychopharmacology; neuropsychobiology; clinical pharmacology; neuroscience; translational pchiatry
Special Issues, Collections and Topics in MDPI journals

E-Mail Website
Guest Editor
1. National Health Service, Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital “G. Mazzini”, ASL 4 Teramo, Italy
2. Department of Neuroscience, Imaging and Clinical Science, Chair of Psychiatry, University “G. D’Annunzio”, Chieti, Italy
Interests: bipolar disorder; alexithymia; psychosis; mood disorders; clinical pharmacology
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

On behalf of the Journal of Clinical Medicine (JCM) editorial team, we are delighted to present a new Special Issue on the topic of “Treatment of Bipolar Depression”, guest edited by Dr. Carmine Tomasetti and Dr. Domenico De Berardis.

In terms of neuropsychiatric diseases, Bipolar Disorder (BD) is one of the main contributors to chronic disability throughout the world. The World Health Organization established that BD represents the 17th biggest cause of years lived with disability (YLD) in Europe with 1.6% of the total population affected (source: Global Health Estimates 2014 Summary Tables. YLD by cause, age and sex, by WHO Region, 2000–2012). Intrinsically, BD is characterized by highly unstable mood and recurring episodes, which are poorly responsive to current available treatment strategies. Indeed, although monotherapy is suggested, the use of several, often unapproved, therapeutic combinations seems the rule. Bipolar depression is particularly unresponsive to treatments. In fact, if globally bipolar patients remain ill in 50% of follow-ups after onset, then 75% of those unresponsive patients are depressed. Hence, many cases, above all amongst bipolar depressive patients, may be considered “treatment resistant”. To date, scientific evidence points out some encouraging strategies based on pharmacotherapeutic add-ons or experimental treatments. However, more and more precise and systematic studies are needed in order to shed light on this intricate argument.

The present Special Issue aims at deepening the present knowledge on clinical treatment approaches to Bipolar Depression, based on the ultimate neurobiological physiopathogenetic scientific evidence. This issue will cover the most recent advances in Bipolar Depression treatment strategies, in order to provide a useful tool to address the most fitting therapies for these complex cases in everyday clinical practice.

Dr. Carmine Tomasetti
Dr. Domenico De Berardis
Guest Editors

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Keywords

  • Bipolar Disorder
  • Antipsychotics
  • Mood stabilizers
  • Antidepressants
  • Neurobiology
  • New experimental treatments
  • Phases of Bipolar Disorder
  • Maintenance strategies

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Published Papers (4 papers)

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Research

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11 pages, 497 KiB  
Article
Effects of Inflammation and Depression on Telomere Length in Young Adults in the United States
by Dayeon Shin, Jungwoon Shin and Kyung Won Lee
J. Clin. Med. 2019, 8(5), 711; https://doi.org/10.3390/jcm8050711 - 19 May 2019
Cited by 26 | Viewed by 4172
Abstract
Little is known about the associations of inflammation and depression with telomere length. Using data from the National Health and Nutrition Examination Survey (NHANES) 1999–2002, the current study assessed the effects of inflammation and depression on telomere length in 1141 young adults in [...] Read more.
Little is known about the associations of inflammation and depression with telomere length. Using data from the National Health and Nutrition Examination Survey (NHANES) 1999–2002, the current study assessed the effects of inflammation and depression on telomere length in 1141 young adults in the USA. Depression status was assessed from the World Health Organization Composite International Diagnostic Interview and inflammation status was measured based on C-reactive protein (CRP) concentrations. Information on telomere length was obtained using the quantitative polymerase chain reaction method to measure telomere length relative to standard reference DNA (T/S ratio). Unadjusted and adjusted linear and logistic regression models were used to assess the relationship between the tertiles of CRP concentration and the telomere length stratified by the status of depression such as major depression or depressed affect vs. no depression. The adjusted models were controlled for age, family poverty income ratio, race/ethnicity, marital status, physical activity, body mass index, and alcohol drinking status. A significant and decreasing linear trend in telomere length was found as CRP levels increased in men, regardless of the depression status, and women with major depression or depressed affect (p values < 0.05). Among men without depression, those with an elevated CRP level had increased odds of having a shortened telomere length compared to men with low CRP levels after controlling for covariates (adjusted odds ratio 1.77, 95% confidence interval (CI) 1.09–2.90). In women, there was no association between CRP and telomere length, regardless of the depression status. In conclusion, there was a significant and inverse association between inflammation and telomere length according to the depression status in men but not in women. The present findings may be of clinical significance for the monitoring of inflammation levels and depression status as determinants of telomere length. Full article
(This article belongs to the Special Issue Treatment of Bipolar Depression)
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11 pages, 1481 KiB  
Article
Abnormal Brain-Derived Neurotrophic Factor Exon IX Promoter Methylation, Protein, and mRNA Levels in Patients with Major Depressive Disorder
by Men-Ting Hsieh, Chin-Chuen Lin, Chien-Te Lee and Tiao-Lai Huang
J. Clin. Med. 2019, 8(5), 568; https://doi.org/10.3390/jcm8050568 - 26 Apr 2019
Cited by 34 | Viewed by 3185
Abstract
Brain-derived neurotrophic factor (BDNF) exon IX promoter methylation levels, serum BDNF protein levels, and serum mRNA levels were investigated in patients with major depressive disorder (MDD) and healthy controls. Over two years, 51 patients with MDD and 62 healthy controls were recruited. Peripheral [...] Read more.
Brain-derived neurotrophic factor (BDNF) exon IX promoter methylation levels, serum BDNF protein levels, and serum mRNA levels were investigated in patients with major depressive disorder (MDD) and healthy controls. Over two years, 51 patients with MDD and 62 healthy controls were recruited. Peripheral blood was drawn from all participants to analyze the BDNF exon IX promoter methylation levels as well as serum BDNF protein and mRNA levels, at baseline and after four weeks of antidepressant treatment. Methylation sequential analysis showed that patients with MDD (n = 39) had a higher methylation level at CpG site 217 and lower methylation levels at CpG site 327 and CpG site 362. Drug responders (n = 25) had a higher methylation level at CpG site 24 and CpG site 324 than the non-responders (n = 11). Patients with MDD had a lower serum BDNF protein and mRNA levels than the healthy controls. In conclusion, these results showed that BDNF exon IX promoter methylation levels, serum BDNF protein level, and serum BDNF mRNA level could contribute to the pathophysiology of a major depressive disorder. Full article
(This article belongs to the Special Issue Treatment of Bipolar Depression)
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Review

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22 pages, 1549 KiB  
Review
Risk of Depression and Suicidality among Diabetic Patients: A Systematic Review and Meta-Analysis
by Rasha Elamoshy, Yelena Bird, Lilian Thorpe and John Moraros
J. Clin. Med. 2018, 7(11), 445; https://doi.org/10.3390/jcm7110445 - 16 Nov 2018
Cited by 30 | Viewed by 6392
Abstract
The purpose of this study is to conduct a systematic review and meta-analysis to evaluate the risk of depression and suicidality among diabetic patients. Methods: Medline, PubMed, EMBASE, Cochrane library, and Psych INFO were searched for studies published from 2008 onwards. Meta-analysis was [...] Read more.
The purpose of this study is to conduct a systematic review and meta-analysis to evaluate the risk of depression and suicidality among diabetic patients. Methods: Medline, PubMed, EMBASE, Cochrane library, and Psych INFO were searched for studies published from 2008 onwards. Meta-analysis was conducted to estimate the pooled effect size. Sources of heterogeneity were investigated by subgroup analysis and meta-regression. Results: In total, 5750 articles were identified and of those, 17 studies on suicidality and 36 on depression were included in this study. Our analysis suggests a positive relationship between diabetes and depression (cohort studies odds ratio (OR) 1.49, 95% confidence interval (CI): 1.36–1.64 and cross-sectional studies OR 2.04, 95% CI, 1.73–2.42). Pooled OR values for suicidal ideation, attempted suicide, and completed suicide were 1.89 (95% CI: 1.36–2.63), 1.45 (95% CI: 1.07–1.96), and 1.85 (95% CI: 0.97–3.52), respectively. All findings were statistically significant except for completed suicide. Conclusions: The increased risk of depression and suicidality in diabetic patients highlights the importance of integrating the evaluation and treatment of depression with diabetes management in primary healthcare settings. Further research in this area is needed. Full article
(This article belongs to the Special Issue Treatment of Bipolar Depression)
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16 pages, 3092 KiB  
Review
Effects of Meditative Movements on Major Depressive Disorder: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
by Liye Zou, Albert Yeung, Chunxiao Li, Gao-Xia Wei, Kevin W. Chen, Patricia Anne Kinser, Jessie S. M. Chan and Zhanbing Ren
J. Clin. Med. 2018, 7(8), 195; https://doi.org/10.3390/jcm7080195 - 1 Aug 2018
Cited by 102 | Viewed by 14694
Abstract
Background: Tai Chi, Qigong, and Yoga are recognized as the most popular complementary approaches for alleviating musculoskeletal pain, improving sleep quality, and reducing blood pressure. The therapeutic effects of these meditative movements for treating major depressive disorder (MDD) is yet to be determined. [...] Read more.
Background: Tai Chi, Qigong, and Yoga are recognized as the most popular complementary approaches for alleviating musculoskeletal pain, improving sleep quality, and reducing blood pressure. The therapeutic effects of these meditative movements for treating major depressive disorder (MDD) is yet to be determined. Therefore, we examined whether meditative movements (Tai Chi, Qigong, and Yoga) are effective for treating MDD. Seven electronic databases (SPORTDiscus, PubMed, PsycINFO, Cochrane Library, Web of Science, CNKI, and Wanfang) were used to search relevant articles. Randomized controlled trials (RCT) using Tai Chi, Qigong or Yoga as intervention for MDD were considered for the meta-analysis (standardized mean difference: SMD). Results: Meta-analysis on 15 fair-to-high quality RCTs showed a significant benefit in favor of meditative movement on depression severity (SMD = −0.56, 95% CI −0.76 to −0.37, p < 0.001, I2 = 35.76%) and on anxiety severity (SMD = −0.46, 95% CI −0.71 to −0.21, p < 0.001, I2 = 1.17%). Meditative movement interventions showed significantly improved treatment remission rate (OR = 6.7, 95% CI 2.38 to 18.86, p < 0.001) and response rate (OR = 5.2, 95% CI 1.73 to 15.59, p < 0.001) over passive controls. Conclusions: Emphasizing the therapeutic effects of meditative movements for treating MDD is critical because it may provide a useful alternative to existing mainstream treatments (drug therapy and psychotherapy) for MDD. Given the fact that meditative movements are safe and easily accessible, clinicians may consider recommending meditative movements for symptomatic management in this population. Full article
(This article belongs to the Special Issue Treatment of Bipolar Depression)
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