Bipolar

2022 - 6 - 16

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Image courtesy of "Hindustan Times"

In two minds: Aparna Piramal Raje talks about living with bipolar ... (Hindustan Times)

Her new memoir, Chemical Khichdi, offers candid and intimate insight. 'I realised that living differently and healing differently would be key,' Raje says.

So the first part is a willingness to accommodate someone who has a mental health condition. The workplace itself is a very stressful place. It takes a long time to recover [from an episode]. There is this virtuous cycle that I know I have to achieve, which means doing things in a more regulated way — not taking on so many projects, slowing down — rather than going down the vicious cycle of bipolarity [which is fuelled by either mania or depression]. So, the question I posed to myself was how do I get there? The path was therapy, the right lifestyle, understanding your triggers and how to manage them, getting perspective on why you do the things you do, playing opposite-handed because your natural hand is flawed. Raje’s book is different in that it is a combination of personal experience and scientific discourse — she quotes extensively from the Diagnostic and Statistical Manual of Mental Disorders, the American handbook for psychiatrists, as well as from scientific journals and peer-reviewed data. Early on in her memoir on living with bipolar disorder, Aparna Piramal Raje writes about the realisation that recovery is as much part of her condition as depression and mania.

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Image courtesy of "Psychiatric Times"

Thyroid Function in Drug-Naïve Bipolar Disorder (Psychiatric Times)

Do your patients have abnormal thyroid indices? Researchers performed a comparison of thyroid function based on mood state in drug-naïve patients with ...

Thyroid hormone levels may contribute to mood changes in bipolar disorder, which should be assessed in prospective studies. There is evidence for more severe thyroid axis dysfunction in patients with bipolar mania versus depression. The authors included 291 patients (136 with mania, 128 with depression, and 27 with mixed). The mean participant age was 27 years, the mean illness duration was 6.7 years, and 48% were male. Zhao and colleagues5 investigated thyroid function in drug-naïve patients with bipolar disorder, considering effects of current mood state. The small number of subjects in the bipolar mixed subgroup also limited statistical power for between-group comparisons. FT3 levels were significantly positively correlated with the severity of mania. Inclusion criteria were that participants must be aged 18 to 65 years and drug-naïve before hospitalization, with a discharge diagnosis of ICD-10 bipolar disorder. The authors also did not screen for thyroid autoantibodies. Fluctuations in mood state in bipolar disorder may be spontaneous or associated with psychological and/or pharmacologic factors. The primary study strength was that subjects were drug-naïve, which means findings are independent of the effects of psychotropic medications. Indices of thyroid function included TSH, free and total T3 and T4 (FT3, TT3, FT4, and TT4), as well as the rate of thyroid hormone secretion. She took lithium briefly in the past, but her current psychotropic medications include risperidone and oxcarbazepine.

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Image courtesy of "Psychiatry Advisor"

Findings of Bipolar Disorder Studies in Low/Lower-Middle Income ... (Psychiatry Advisor)

The studies investigated 4 types of interventions: pharmacotherapy, psychosocial, electroconvulsive therapy, and traditional medicine. Despite the fact that ...

Overall, the studies supported the use of quetiapine, risperidone, and risperidone combined with valproate for the management of BD mania. The studies were conducted in Pakistan, India, China, Egypt, Iran, and South Africa. Investigators from Aarhus University in Denmark and the College of Medicine and Health Sciences University of Rwanda searched publication databases through November 2021 for studies of BD conducted in low- and lower middle-income countries. A total of 2 trials were of nonrandomized designs and the remaining 19 were randomized clinical trials. The outcomes of interest were symptom severity, relapse, recovery, medical adherence, quality of life, psychosocial functioning, and level of stigma. One study found that including a family component to psychoeducation enhanced clinical outcomes.

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