Materiały źródłowe

• #1 Predicting the course and outcome of bipolar disorder: A review | European Psychiatry | Cambridge Core

  https://www.cambridge.org/core/journals/european-psychiatry/article/predicting-the-course-and-outcome-of-bipolar-disorder-a-review/EE4167A482E67702DBEFDCBE6B3FF854

  Despite of advances in pharmacological and non-pharmacological treatments, bipolar disorder often entails multiple relapses and impaired psychological functioning. […] Prediction of the course and outcome of bipolar disorders continues to be challenging, despite the multiple research efforts worldwide. […] While considered to have more favorable prognosis than schizophrenia, it is not uncommon for bipolar disorder to include persisting alterations of psychosocial functioning. […] Although long-term symptomatic remission does not guarantee functional recovery, it may have a favorable impact on long-term overall prognosis. […] The high degree of treatment resistance in patients with bipolar disorder highlights the need to develop better identification of outcome predictors, prognosis and treatment intervention, designed to reverse or prevent this illness burden. […] This review summarizes the main factors involved in predicting the course and outcome of bipolar disorder.

• #1 Predicting the course and outcome of bipolar disorder: a review.

  https://vivo.health.unm.edu/display/n1926654462

  Despite of advances in pharmacological and non-pharmacological treatments, bipolar disorder often entails multiple relapses and impaired psychological functioning. […] Prediction of the course and outcome of bipolar disorders continues to be challenging, despite the multiple research efforts worldwide. […] While considered to have more favorable prognosis than schizophrenia, it is not uncommon for bipolar disorder to include persisting alterations of psychosocial functioning. […] Although long-term symptomatic remission does not guarantee functional recovery, it may have a favorable impact on long-term overall prognosis. […] The high degree of treatment resistance in patients with bipolar disorder highlights the need to develop better identification of outcome predictors, prognosis and treatment intervention, designed to reverse or prevent this illness burden.

• #2

  https://consensus.app/questions/prognosis-of-bipolar-disorder/

  Bipolar disorder is a complex mental health condition characterized by mood swings that include emotional highs (mania or hypomania) and lows (depression). Despite advances in treatment, predicting the course and outcome of bipolar disorder remains challenging due to its multifaceted nature and the lack of definitive diagnostic tests. This article synthesizes current research to highlight the key factors influencing the prognosis of bipolar disorder. […] The high degree of treatment resistance underscores the need for better identification of outcome predictors and tailored interventions to mitigate the illness burden. […] Early intervention is crucial in bipolar disorder management. Neuroimaging studies suggest that brain structure is relatively preserved at the first episode, with significant volume loss occurring only after multiple recurrences. Early pharmacotherapy and psychotherapy can be more effective, potentially altering the illness trajectory and providing neuroprotective benefits.

• #2 Predicting the course and outcome of bipolar disorder: A review | European Psychiatry | Cambridge Core

  https://www.cambridge.org/core/journals/european-psychiatry/article/predicting-the-course-and-outcome-of-bipolar-disorder-a-review/EE4167A482E67702DBEFDCBE6B3FF854

  Despite of advances in pharmacological and non-pharmacological treatments, bipolar disorder often entails multiple relapses and impaired psychological functioning. […] Prediction of the course and outcome of bipolar disorders continues to be challenging, despite the multiple research efforts worldwide. […] While considered to have more favorable prognosis than schizophrenia, it is not uncommon for bipolar disorder to include persisting alterations of psychosocial functioning. […] Although long-term symptomatic remission does not guarantee functional recovery, it may have a favorable impact on long-term overall prognosis. […] The high degree of treatment resistance in patients with bipolar disorder highlights the need to develop better identification of outcome predictors, prognosis and treatment intervention, designed to reverse or prevent this illness burden. […] This review summarizes the main factors involved in predicting the course and outcome of bipolar disorder.

• #3

  https://consensus.app/questions/prognosis-of-bipolar-disorder/

  Bipolar disorder is a complex mental health condition characterized by mood swings that include emotional highs (mania or hypomania) and lows (depression). Despite advances in treatment, predicting the course and outcome of bipolar disorder remains challenging due to its multifaceted nature and the lack of definitive diagnostic tests. This article synthesizes current research to highlight the key factors influencing the prognosis of bipolar disorder. […] The high degree of treatment resistance underscores the need for better identification of outcome predictors and tailored interventions to mitigate the illness burden. […] Early intervention is crucial in bipolar disorder management. Neuroimaging studies suggest that brain structure is relatively preserved at the first episode, with significant volume loss occurring only after multiple recurrences. Early pharmacotherapy and psychotherapy can be more effective, potentially altering the illness trajectory and providing neuroprotective benefits.

• #4

  https://consensus.app/questions/prognosis-of-bipolar-disorder/

  Switching polarity within episodes is a strong prognostic indicator for long-term prognosis in bipolar I disorder, with no evidence of shortening cycle lengths over time. […] Early intervention in bipolar disorder treatment is more effective and may alter the illness trajectory, highlighting the need for early identification and tailored treatments. […] Combining drug and cognitive-behavioral treatment, fewer prior hospitalizations, and higher self-esteem are key factors in a favorable prognosis for patients with refractory bipolar disorder. […] Poor optimal functioning in the 5 years before baseline and persistent depressive symptoms in the first 2 years are associated with a poor long-term prognosis in bipolar affective disorder. […] Bipolar disorder often has a chronic course and multisystem involvement, with affective instability, circadian rhythm dysregulation, and cognitive impairments as potential predictors of long-term prognosis.

• #5 Journal of Medical Internet Research – Privacy-Preserving Federated Model Predicting Bipolar Transition in Patients With Depression: Prediction Model Development Study

  https://www.jmir.org/2023/1/e46165/

  Mood disorder has emerged as a serious concern for public health; in particular, bipolar disorder has a less favorable prognosis than depression. […] Prompt recognition of depression conversion to BD may help prevent the negative consequences of BD because BD is initially confused with depression. […] However, early BD recognition or prediction among people with depression is challenging due to delayed diagnostic differentiation. […] The federated models average performance on all test data sets had an AUC of 0.726, which is higher than the 0.642-0.707 of other local models. […] The FL model performed better than any other model in external validation. […] Additionally, the FL model was well calibrated compared to any other model in internal and external test data. […] The model performance degradation in such a nonidentical, independent data set is one of the well-known challenges of FL.

• #6

  https://consensus.app/questions/prognosis-of-bipolar-disorder/

  Accurate and early diagnosis of bipolar disorder, particularly type II, is essential for improving prognosis. Misdiagnosis can lead to inappropriate treatments and prolonged suffering. […] The prognosis of bipolar disorder is influenced by a multitude of factors, including the nature of mood episodes, early intervention, comorbidities, and treatment strategies. Advances in neurobiological research and machine learning offer promising avenues for improving prognosis prediction and personalized treatment. Early and accurate diagnosis, combined with tailored therapeutic approaches, can significantly enhance long-term outcomes for individuals with bipolar disorder. […] Bipolar disorder has a more favorable prognosis than schizophrenia, but long-term symptomatic remission may improve long-term prognosis.

• #7 Socio-demographic and clinical predictors of outcome to long-term treatment with lithium in bipolar disorders: a systematic review of the contemporary literature and recommendations from the ISBD/IGSLI Task Force on treatment with lithium | International

  https://journalbipolardisorders.springeropen.com/articles/10.1186/s40345-020-00203-3

  To identify possible socio-demographic and clinical factors associated with Good Outcome (GO) as compared with Poor Outcome (PO) in adult patients diagnosed with Bipolar Disorder (BD) who received long-term treatment with lithium. […] Forty-three potential predictors of outcome to lithium were identified. Four factors were associated with PO to lithium: alcohol use disorder; personality disorders; higher lifetime number of hospital admissions and rapid cycling pattern. Two factors were associated with GO in patients treated with lithium: good social support and episodic evolution of BD. […] Despite decades of research on lithium and its clinical use, besides lifetime number of hospital admissions, no factor being consistently associated with GO or PO to lithium was identified. Hence, there remains a substantial gap in our understanding of predictors of outcome of lithium treatment indicating there is a need of high quality research on large representative samples.

• #8

  https://consensus.app/questions/prognosis-of-bipolar-disorder/

  Patients with polyphasic episodes tend to have a poorer prognosis compared to those with monophasic episodes. […] The presence of psychiatric comorbidities and medical burdens, such as disturbances in circadian rhythms and cognitive impairments, are common in bipolar disorder and can negatively affect long-term outcomes. Persistent depressive symptoms, particularly in the early years of the disorder, are strong predictors of poor long-term prognosis. […] Recent research has focused on identifying neurobiological markers to predict treatment response and functional changes in bipolar disorder. […] Machine learning algorithms are emerging as valuable tools for improving diagnosis and prognosis in bipolar disorder. […] Studies indicate that combined drug and cognitive-behavioral therapy (CBT) is more effective than drug treatment alone in improving prognosis for patients with refractory bipolar disorder.

• #9

  https://consensus.app/questions/prognosis-of-bipolar-disorder/

  Switching polarity within episodes is a strong prognostic indicator for long-term prognosis in bipolar I disorder, with no evidence of shortening cycle lengths over time. […] Early intervention in bipolar disorder treatment is more effective and may alter the illness trajectory, highlighting the need for early identification and tailored treatments. […] Combining drug and cognitive-behavioral treatment, fewer prior hospitalizations, and higher self-esteem are key factors in a favorable prognosis for patients with refractory bipolar disorder. […] Poor optimal functioning in the 5 years before baseline and persistent depressive symptoms in the first 2 years are associated with a poor long-term prognosis in bipolar affective disorder. […] Bipolar disorder often has a chronic course and multisystem involvement, with affective instability, circadian rhythm dysregulation, and cognitive impairments as potential predictors of long-term prognosis.

• #10

  https://consensus.app/questions/prognosis-of-bipolar-disorder/

  Switching polarity within episodes is a strong prognostic indicator for long-term prognosis in bipolar I disorder, with no evidence of shortening cycle lengths over time. […] Early intervention in bipolar disorder treatment is more effective and may alter the illness trajectory, highlighting the need for early identification and tailored treatments. […] Combining drug and cognitive-behavioral treatment, fewer prior hospitalizations, and higher self-esteem are key factors in a favorable prognosis for patients with refractory bipolar disorder. […] Poor optimal functioning in the 5 years before baseline and persistent depressive symptoms in the first 2 years are associated with a poor long-term prognosis in bipolar affective disorder. […] Bipolar disorder often has a chronic course and multisystem involvement, with affective instability, circadian rhythm dysregulation, and cognitive impairments as potential predictors of long-term prognosis.

• #11 Lack of Insight in Bipolar Disorder: The Impact on Treatment Adherence, Adverse Clinical Outcomes and Quality of Life | IntechOpen

  https://www.intechopen.com/chapters/60685

  Insight is a multidimensional construct, defined as the awareness of having a mental disorder, of specific symptoms and their attribution to the disorder, the awareness of social consequences, and of need for treatment. […] In bipolar disorder (BD), clinical insight varies substantially over time. […] Lack of insight is a consistent factor of non-adherence to medication in bipolar patients, along with severity of BD, side effects of medication, effectiveness, and patient-related factors. […] Also, impaired insight into treatment and a great number of previous hospitalizations are associated with poorer clinical outcomes (psychiatric hospitalization, emergency room visits, violent or suicidal behavior) among the patients with bipolar I disorder. […] In the management of bipolar disorder, improving quality of life (QoL) and outcome should be one the most important goals.

• #12 Lack of Insight in Bipolar Disorder: The Impact on Treatment Adherence, Adverse Clinical Outcomes and Quality of Life | IntechOpen

  https://www.intechopen.com/chapters/60685

  Billod also observed that insight is a good prognostic factor of the evolution of the disease and for illness recurrence. […] Most studies about insight were conducted with patients suffering from schizophrenia and other psychotic disorders, neglecting patients with mood disorders. However, in the last few years, there has been an increase in interest about insight in patients with bipolar disorder. […] Given the importance of insight to diagnosis, treatment adherence, and psychosocial outcome, we considered that it is appropriate to pay attention to this phenomenon. […] The awareness of illness can be quite impaired in mania, second only to schizophrenia, even in the absence of psychosis. […] This chapter presents few remarks about the history of the concept, different models of insight, the most important psychometric tools in assessing insight and clinical implications of poor insight in patients diagnosed with bipolar disorder.

• #13 Lack of Insight in Bipolar Disorder: The Impact on Treatment Adherence, Adverse Clinical Outcomes and Quality of Life | IntechOpen

  https://www.intechopen.com/chapters/60685

  Patients insight into treatment is a significant predictor of adverse clinical outcomes. […] Research has revealed that a lack of insight is associated with poorer clinical outcomes in both schizophrenia and bipolar disorder. […] Poor insight is associated with non-adherence. […] The impact of insight on quality of life may be subtle during remission and may be more substantially affected in full-blown manic symptoms. […] Impaired insight into treatment and a greater number of previous admissions significantly increased the risk of adverse clinical outcomes with bipolar disorder.

• #14 Prediction of Treatment Outcome in Bipolar Disorder: When Can We Expect Clinical Relevance? – PubMed

  https://pubmed.ncbi.nlm.nih.gov/39954922/

  Long-term pharmacological treatment is the cornerstone of the management of bipolar disorder (BD). […] This process could be optimized by using robust predictors of treatment response. […] We review clinical features and biological markers studied in relation to outcome of long-term treatment of BD. […] The most promising results show association of lithium response with certain clinical features (episodic clinical course and absence of rapid cycling, low rates of comorbid conditions, family history of BD and lithium response) as well as low polygenic risk for schizophrenia and major depression. […] The clinical application of these findings remains limited, however, due to heterogeneity of the illness as well as unanswered questions about specificity of the effects of different medications.

• #15 Neurobiological Markers for Predicting Treatment Response in Patients with Bipolar Disorder

  https://www.mdpi.com/2227-9059/10/12/3047

  Predictive neurobiological markers for prognosis are essential but underemphasized for patients with bipolar disorder (BD), a neuroprogressive disorder. Hence, we developed models for predicting symptom and functioning changes. […] The prediction of treatment responses as early as possible is essential for making optimal treatment decisions to protect against continuously remaining diminished clinical performance. […] The neurobiological markers for predicting treatment-response symptoms and functioning changes were consistent with the neuropathology of BD and with the differences found between treatment responders and nonresponders. […] The present study aimed to use potential predictors from structural or functional neuroimaging and inflammatory biomarkers for predicting the change in symptom and functioning scores during one year.

• #16

  https://consensus.app/questions/prognosis-of-bipolar-disorder/

  Neurobiological markers can predict treatment response in bipolar disorder patients, with consistent neuropathology and differences between treatment responders and nonresponders. […] Machine learning techniques may improve diagnosis, personalized treatment, and prognosis orientation for patients with bipolar disorder. […] Early diagnosis of bipolar disorder type II is crucial for improving patient outcomes and recognizing premorbid symptoms, especially in those resistant to antidepressant treatment. […] Biomarkers that differentiate bipolar disorder from unipolar depression could improve diagnosis and provide targets for developing new personalised treatments for all affective disorders.

• #17 Neurobiological Markers for Predicting Treatment Response in Patients with Bipolar Disorder

  https://www.mdpi.com/2227-9059/10/12/3047

  The predicted changes in the YMRS, MADRS, PANSS, and UKU scores were highly correlated with the actual changes and explained more than 75% of the variance in response. […] The results of the present study suggest that changes in the YMRS, MADRS, and UKU scores are mainly predicted by the SC. Changes in the YMRS and MADRS scores are also predicted by the MON. […] The functional connectivity related to the neuropathology of BD is essential in predicting treatment-response symptom and functioning changes. […] The present study demonstrated that changes in the symptom and functioning scores of patients with BD can be predicted using multiple large-scale networks.

• #18

  https://consensus.app/questions/prognosis-of-bipolar-disorder/

  Switching polarity within episodes is a strong prognostic indicator for long-term prognosis in bipolar I disorder, with no evidence of shortening cycle lengths over time. […] Early intervention in bipolar disorder treatment is more effective and may alter the illness trajectory, highlighting the need for early identification and tailored treatments. […] Combining drug and cognitive-behavioral treatment, fewer prior hospitalizations, and higher self-esteem are key factors in a favorable prognosis for patients with refractory bipolar disorder. […] Poor optimal functioning in the 5 years before baseline and persistent depressive symptoms in the first 2 years are associated with a poor long-term prognosis in bipolar affective disorder. […] Bipolar disorder often has a chronic course and multisystem involvement, with affective instability, circadian rhythm dysregulation, and cognitive impairments as potential predictors of long-term prognosis.

• #19

  https://consensus.app/questions/prognosis-of-bipolar-disorder/

  Neurobiological markers can predict treatment response in bipolar disorder patients, with consistent neuropathology and differences between treatment responders and nonresponders. […] Machine learning techniques may improve diagnosis, personalized treatment, and prognosis orientation for patients with bipolar disorder. […] Early diagnosis of bipolar disorder type II is crucial for improving patient outcomes and recognizing premorbid symptoms, especially in those resistant to antidepressant treatment. […] Biomarkers that differentiate bipolar disorder from unipolar depression could improve diagnosis and provide targets for developing new personalised treatments for all affective disorders.

• #20 Predicting diagnostic progression to schizophrenia or bipolar disorder via machine learning applied to electronic health record data | medRxiv

  https://www.medrxiv.org/content/10.1101/2024.07.02.24309828v1.full-text

  Model performance was mainly driven by the inclusion of text-based predictors extracted from clinical notes. Indeed, models trained with both structured and text-based predictors performed practically equivalently to models trained with only text-based features. […] The present study developed and validated models for predicting progression to schizophrenia or bipolar disorder using electronic health record data. The model predicting schizophrenia performed substantially better than the model predicting bipolar disorder, likely due to heterogenic clinical manifestations of the latter. Lastly, text-based features from clinical notes show great promise for improving the prediction of psychiatric outcomes and should be explored further.

• #21 Predicting diagnostic progression to schizophrenia or bipolar disorder via machine learning applied to electronic health record data | medRxiv

  https://www.medrxiv.org/content/10.1101/2024.07.02.24309828v1.full-text

  The diagnosis of schizophrenia and bipolar disorder is often delayed several years despite illness typically emerging in late adolescence or early adulthood, which impedes initiation of targeted treatment. […] It is possible to predict diagnostic transition to schizophrenia and bipolar disorder from routine clinical data extracted from EHRs, with schizophrenia being notably easier to predict than bipolar disorder. […] In this study, which included all patients aged between 15 and 60 years with contacts to the psychiatric services of the Central Denmark Region between 2011 and 2021, progression to schizophrenia was predicted with high accuracy, with bipolar disorder proving a more difficult target. […] A model predicting the progression to either of the two disorders achieved an AUROC of 0.64 on the test set, with a notable disparity in predictive performance between the two disorders. While the best model for predicting progression to schizophrenia achieved an AUROC of 0.80 on the test set, predicting bipolar disorder proved more challenging with the best model achieving an AUROC of 0.62.

• #22 Predicting the risk and timing of major mood disorder in offspring of bipolar parents: exploring the utility of a neural network approach

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8245610/

  This evaluation of PLANN is a useful step in the investigation of using neural networks as tools in the prediction of diagnosis of mood disorders for at-risk individuals and demonstrated the potential that neural networks have in this field. […] PLANN performed better than the traditional discrete time survival model in predicting the development of major mood disorders in high-risk individuals.

• #23 Predicting the risk and timing of major mood disorder in offspring of bipolar parents: exploring the utility of a neural network approach | International Journal of Bipolar Disorders | Full Text

  https://journalbipolardisorders.springeropen.com/articles/10.1186/s40345-021-00228-2

  Future research is needed to replicate these findings in a separate high-risk offspring sample. […] PLANN outperformed the discrete survival model on the Brier score which measures the difference between observed and predicted values. […] PLANN outperformed the discrete survival model at all three interval lengths. […] For five-year predictions, the average AUC from PLANN was 0.74, which indicates that the model shows good discrimination between high and low risk individuals. […] Individualized risk prediction has important implications for research and clinical practice. […] Our risk prediction approach of using PLANN to predict onset of bipolar-related major mood disorder differs from other published risk calculators. […] This evaluation of PLANN is a useful step in the investigation of using neural networks as tools in the prediction of diagnosis of mood disorders for at-risk individuals and demonstrated the potential that neural networks have in this field. […] PLANN performed better than the traditional discrete time survival model in predicting the development of major mood disorders in high-risk individuals.

• #24 Predicting the risk and timing of major mood disorder in offspring of bipolar parents: exploring the utility of a neural network approach | International Journal of Bipolar Disorders | Full Text

  https://journalbipolardisorders.springeropen.com/articles/10.1186/s40345-021-00228-2

  Bipolar disorder onset peaks over early adulthood and confirmed family history is a robust risk factor. […] Individualized risk prediction would be helpful for identifying those young people most at risk and to inform targeted intervention. […] Overall, for predictive performance, PLANN outperformed the more traditional discrete survival model for 3-year and 5-year predictions. […] PLANN was better able to discriminate or rank individuals based on their risk of developing a major mood disorder, better able to predict the probability of developing a major mood disorder and better able to identify individuals who would be diagnosed in future time intervals. […] The average AUC achieved by PLANN for 5-year prediction was 0.74, which indicates good discrimination. […] This evaluation of PLANN is a useful step in the investigation of using neural networks as tools in the prediction of mood disorders in at-risk individuals and the potential that neural networks have in this field.

• #25 Journal of Medical Internet Research – Privacy-Preserving Federated Model Predicting Bipolar Transition in Patients With Depression: Prediction Model Development Study

  https://www.jmir.org/2023/1/e46165/

  However, our model performed better in KDH than any local models developed outside of KDH, suggesting the KDH data with these different distributions contributed sufficiently to the models training. […] Bipolar transition could be more effectively predicted using the federated model than a model based only on local data. […] In clinical situations where data are distributed, our findings suggest that FL would be more useful to develop the prediction model.

• #26 Outcome Prediction for Patients with Bipolar Disorder Using Prodromal and Onset Data

  https://www.mdpi.com/2076-3417/13/3/1552

  Outcome prediction can facilitate physician and patient decision making as well as disease management. In the management of serious mental illnesses, the accurate and early identification of patients at high risk of mortality and other adverse event will enable a targeted monitoring and interventions to improve prognosis. […] The key research question in this study was how well (in terms of AUC and accuracy) the adverse outcome (all-cause mortality and number of all-cause hospitalizations) of bipolar disorder (BD) can be predicted after the initial diagnosis. […] The ability to predict a patient outcome at the time of the initial BD diagnosis has several implications. Patients who are predicted to have poor outcomes can be closely monitored and considered for additional interventions by clinicians.

• #27 Lack of Insight in Bipolar Disorder: The Impact on Treatment Adherence, Adverse Clinical Outcomes and Quality of Life | IntechOpen

  https://www.intechopen.com/chapters/60685

  The relationship of insight to episode subtypes and symptom dimensions is analyzed in detail. […] Than other important themes are addressed: the impact of unawareness of illness on non-adherence to medication, on outcome, and quality of life (QoL). […] Insight appears to improve markedly upon acute recovery from psychotic depression. […] The relationship between insight and suicidality is complex. […] An altered self-esteem insight was associated not only with suicidal ideation or suicide attempt but also with activity reduction and psychomotor retardation. […] It was shown that, in order to target a better patient outcome, treatment-related insight should be improved. […] Insight, therapeutic alliance with the treating psychiatrist, and medication adherence are highly correlated in bipolar patients as in patients diagnosed with schizophrenia.

• #28 Outcome Prediction for Patients with Bipolar Disorder Using Prodromal and Onset Data

  https://www.mdpi.com/2076-3417/13/3/1552

  Applying deep learning and temporal graphics is a promising approach to predicting adverse health outcomes of BD patients. Depending on the number and type of hospitalization as outcomes, the best accuracies and AUCs reached over 90%. However, single hospitalizations in a year and hospitalizations due to other nonorganic psychoses and anxiety dissociative and somatoform disorders were harder to predict.

Zobacz więcej