Bipolar disorder - analysis of the impact of selected factors on treatment and course - review
DOI:
https://doi.org/10.12775/QS.2024.28.56835Keywords
bipolar disorder, physical activity, inflammation, microbiota, psychotherapy, sleep regulation, sleepAbstract
Introduction: Bipolar Disorder (BD) affects millions worldwide, impacting emotional, social, and cognitive functioning. This disorder, characterized by alternating episodes of mania and depression, carries high risks including suicide. Pharmacological treatment is the cornerstone of management, but its effectiveness can be limited, prompting the exploration of adjunctive treatment methods. This paper discusses the potential of interventions such as physical activity, sleep regulation, psychotherapy, and research on inflammation and gut microbiota as supplementary elements to standard BD treatment.
Objective: This review aims to evaluate the role of adjunctive therapies, including physical activity, sleep regulation, inflammation, gut microbiota interventions, and psychotherapy, in improving outcomes for patients with BD.
Materials and Methods: A literature review covering research on various forms of treatment for bipolar disorder, the impact of physical activity, inflammation, microbiota, sleep and psychotherapy in the treatment of this disease, published on the PubMed and Google Scholar platforms.
Conclusions: Emerging evidence suggests that non-pharmacological interventions can complement standard treatments for BD. Physical activity helps alleviate depressive symptoms and improve psychosocial functioning, while regulating sleep patterns can reduce mood disturbances and suicidality. Managing systemic inflammation and optimizing gut microbiota may address neuropsychiatric symptoms and enhance cognitive performance. Psychotherapeutic approaches like CBT and MBCT lower relapse rates and improve quality of life. Integrating these strategies into routine care could enhance long-term management of BD.
References
“Bipolar disorder.” Accessed: Dec. 03, 2024. [Online]. Available: https://www.who.int/news-room/fact-sheets/detail/bipolar-disorder
I. Arnold, J. Dehning, A. Grunze, and A. Hausmann, “Old Age Bipolar Disorder—Epidemiology, Aetiology and Treatment,” Medicina (B Aires), vol. 57, no. 6, p. 587, Jun. 2021, doi: 10.3390/MEDICINA57060587.
K. R. Merikangas et al., “Prevalence and Correlates of Bipolar Spectrum Disorder in the World Mental Health Survey Initiative,” Arch Gen Psychiatry, vol. 68, no. 3, p. 241, Mar. 2011, doi: 10.1001/ARCHGENPSYCHIATRY.2011.12.
M. Ekman, O. Granström, S. Omérov, J. Jacob, and M. Landén, “The societal cost of bipolar disorder in Sweden,” Soc Psychiatry Psychiatr Epidemiol, vol. 48, no. 10, pp. 1601–1610, Oct. 2013, doi: 10.1007/S00127-013-0724-9.
E. Pålsson et al., “Neurocognitive function in bipolar disorder: a comparison between bipolar I and II disorder and matched controls,” BMC Psychiatry, vol. 13, p. 165, Jun. 2013, doi: 10.1186/1471-244X-13-165.
P. J. Harrison, J. R. Geddes, and E. M. Tunbridge, “The Emerging Neurobiology of Bipolar Disorder,” Trends Neurosci, vol. 41, no. 1, pp. 18–30, Jan. 2018, doi: 10.1016/J.TINS.2017.10.006.
G. H. Jones, C. M. Vecera, O. F. Pinjari, and R. Machado-Vieira, “Inflammatory signaling mechanisms in bipolar disorder,” J Biomed Sci, vol. 28, no. 1, Dec. 2021, doi: 10.1186/S12929-021-00742-6.
S. J. Haggarty, R. Karmacharya, and R. H. Perlis, “Advances toward precision medicine for bipolar disorder: mechanisms & molecules,” Mol Psychiatry, vol. 26, no. 1, p. 168, Jan. 2020, doi: 10.1038/S41380-020-0831-4.
B. Lafer et al., “Structured physical exercise for bipolar depression: an open-label, proof-of concept study,” Int J Bipolar Disord, vol. 11, no. 1, Dec. 2023, doi: 10.1186/S40345-023-00294-8.
G. A. Tew et al., “Physical Activity in Adults with Schizophrenia and Bipolar Disorder: A Large Cross-Sectional Survey Exploring Patterns, Preferences, Barriers, and Motivating Factors,” Int J Environ Res Public Health, vol. 20, no. 3, p. 2548, Feb. 2023, doi: 10.3390/IJERPH20032548/S1.
B. Stubbs et al., “EPA guidance on physical activity as a treatment for severe mental illness: a meta-review of the evidence and Position Statement from the European Psychiatric Association (EPA), supported by the International Organization of Physical Therapists in Mental Health (IOPTMH),” European Psychiatry, vol. 54, pp. 124–144, Oct. 2018, doi: 10.1016/j.eurpsy.2018.07.004.
A. Arslan, O. Aydin, and F. P. Çökmüş, “Editorial: The inflammation markers in schizophrenia and bipolar disorder: Do we have promising results?,” Front Psychiatry, vol. 13, p. 1128355, Jan. 2023, doi: 10.3389/FPSYT.2022.1128355.
A. Cuomo et al., “Biomarkers, Inflammation, and Bipolar Disorder: Association Between the Improvement of Bipolar Disorder Severity and the Improvement in C-Reactive Protein Levels After 7 Days of Inpatient Treatment,” Front Psychiatry, vol. 12, Dec. 2021, doi: 10.3389/FPSYT.2021.803034.
R. Queissner et al., “The influence of chronic inflammation on the illnesscourse of bipolar disorder: A longitudinal study,” J Psychiatr Res, vol. 174, pp. 258–262, Jun. 2024, doi: 10.1016/J.JPSYCHIRES.2024.04.024.
A. T. Peters et al., “C-reactive protein and affective inhibition in bipolar disorder,” J Affect Disord, vol. 306, pp. 39–46, Jun. 2022, doi: 10.1016/J.JAD.2022.02.073.
R. Machado-Vieira, A. C. Courtes, C. A. Zarate, I. D. Henter, and H. K. Manji, “Non-canonical pathways in the pathophysiology and therapeutics of bipolar disorder,” Front Neurosci, vol. 17, p. 1228455, 2023, doi: 10.3389/FNINS.2023.1228455.
G. Clarke, R. M. Stilling, P. J. Kennedy, C. Stanton, J. F. Cryan, and T. G. Dinan, “Minireview: Gut microbiota: the neglected endocrine organ,” Mol Endocrinol, vol. 28, no. 8, pp. 1221–1238, 2014, doi: 10.1210/ME.2014-1108.
S. A. Flowers, K. M. Ward, and C. T. Clark, “The Gut Microbiome in Bipolar Disorder and Pharmacotherapy Management,” Neuropsychobiology, vol. 79, no. 1, pp. 43–49, Jan. 2020, doi: 10.1159/000504496.
S. J. Evans et al., “The gut microbiome composition associates with bipolar disorder and illness severity,” J Psychiatr Res, vol. 87, pp. 23–29, Apr. 2017, doi: 10.1016/J.JPSYCHIRES.2016.12.007.
F. Dickerson et al., “Adjunctive probiotic microorganisms to prevent rehospitalization in patients with acute mania: A randomized controlled trial,” Bipolar Disord, vol. 20, no. 7, pp. 614–621, Nov. 2018, doi: 10.1111/BDI.12652.
E. Z. Reininghaus et al., “Probiotic Treatment in Individuals with Euthymic Bipolar Disorder: A Pilot-Study on Clinical Changes and Compliance,” Neuropsychobiology, vol. 79, no. 1, pp. 71–79, Jan. 2020, doi: 10.1159/000493867.
W. Dai et al., “Gut Microbial Dysbiosis and Cognitive Impairment in Bipolar Disorder: Current Evidence,” Front Pharmacol, vol. 13, p. 893567, May 2022, doi: 10.3389/FPHAR.2022.893567.
A. Hombali et al., “Prevalence and correlates of sleep disorder symptoms in psychiatric disorders,” Psychiatry Res, vol. 279, pp. 116–122, Sep. 2019, doi: 10.1016/J.PSYCHRES.2018.07.009.
T. Roloff, I. Haussleiter, K. Meister, and G. Juckel, “Sleep disturbances in the context of neurohormonal dysregulation in patients with bipolar disorder,” Int J Bipolar Disord, vol. 10, no. 1, Dec. 2022, doi: 10.1186/S40345-022-00254-8.
Y. Hacimusalar, O. Karaaslan, E. Misir, O. C. Amuk, and G. Hacimusalar, “Sleep quality impairments in schizophrenia and bipolar affective disorder patients continue during periods of remission: a case-controlled study,” Sleep Sci, vol. 15, no. 1, pp. 47–54, 2022, doi: 10.5935/1984-0063.20210036.
M. E. Stepan, P. L. Franzen, G. I. Teresi, N. Rode, and T. R. Goldstein, “Sleep quality predicts future mood symptoms in adolescents with bipolar disorder,” J Affect Disord, vol. 361, pp. 664–673, Sep. 2024, doi: 10.1016/J.JAD.2024.06.069.
G. M. Goodwin et al., “Evidence-based guidelines for treating bipolar disorder: revised third edition Recommendations from the British Association for Psychopharmacology,” J Psychopharmacol, vol. 30, no. 6, p. 495, Jun. 2016, doi: 10.1177/0269881116636545.
J. R. Geddes and D. J. Miklowitz, “Treatment of bipolar disorder,” Lancet, vol. 381, no. 9878, pp. 1672–1682, 2013, doi: 10.1016/S0140-6736(13)60857-0.
D. J. Miklowitz et al., “Adjunctive Psychotherapy for Bipolar Disorder: A Systematic Review and Component Network Meta-analysis,” JAMA Psychiatry, vol. 78, no. 2, pp. 141–150, Feb. 2021, doi: 10.1001/JAMAPSYCHIATRY.2020.2993.
S. Salcedo et al., “Empirically supported psychosocial interventions for bipolar disorder: Current state of the research,” J Affect Disord, vol. 201, pp. 203–214, Sep. 2016, doi: 10.1016/J.JAD.2016.05.018.
P. Haffner et al., “Improving functional outcome in bipolar disorder: A pilot study on metacognitive training,” Clin Psychol Psychother, vol. 25, no. 1, pp. 50–58, Jan. 2018, doi: 10.1002/CPP.2124.
M. Lou Chatterton, E. Stockings, M. Berk, J. J. Barendregt, R. Carter, and C. Mihalopoulos, “Psychosocial therapies for the adjunctive treatment of bipolar disorder in adults: network meta-analysis,” Br J Psychiatry, vol. 210, no. 5, pp. 333–341, May 2017, doi: 10.1192/BJP.BP.116.195321.
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