new free extensive online database of bipolar symptoms and DNA

August 8, 2007

Unfortunately, it’s not free to the public like the article implies; you have to be a “qualified investigator for research with legitimate scientific aims”.  (I think they just mean “not proprietary” by public.)

But still.  Huge online databases are some of the best new tools technology can give research.  I’m glad we’re seeing more and more.

And dammit, I want to poke around in the database.


back to circadian rhythms? treating bipolar depression with modafinil

August 7, 2007

Modafinil (more commonly known as Provigil), a drug approved for use in sleep apnea, narcolepsy, and shift work disorder, appears to be helpful with bipolar depression.

The article notes that the manufacturer supplied both the modafinil and the matching placebo.   I wonder how much placebo costs?  Are there places that manufacture brand-name placebo?  I mean, there must be, for researchers to run studies.

HealthCentral’s votes for best bipolar sites

August 5, 2007

Major health site HealthCentral has posted its list of picks for the highest-quality sites on bipolar disorder.  Via GJ of Living With A Purple Dog, who received one of the rewards.

bpII mixed states

August 4, 2007

 This article (abstract) compares “Mixed Depression” (major depression + some manic/hypomanic symptoms) with “Dysphoric/Mixed Hypomania” (major depression + full hypomania; as close as you can get to a DSM-defined mixed state (full mania + full depression) and still be bipolar-II.  They looked at a lot of bpII outpatients who presented for depression treatment, and also asked a separate bunch of bpII people who weren’t having symptoms at the time to remember what hypomania was like.  (Weird study design, but there’s probably a reason for it – maybe just that most people don’t come in complaining of regular hypomania.)

Seventeen percent of people had full-blown hypomania along with their depression, and 66% had mixed depression – that’s a *lot* of mixed states in people who are coming in for depression, not for mixed states.

More specifics at the link.  I’m at martial arts camp all this week, and am going to try very hard to keep up with regular content, but may have to just dump some links back in there.  After this week, I have no school or work for two weeks, and there will be extra-spiffy stuff then.

more crazy mice!

July 30, 2007

We had the manic mice; now, the schizophrenic mice!  Or, more accurately, the mouse model of mania and the mouse model of schizophrenia, since they’re unlikely to be exactly the same thing as what humans gets, just things that involve some of the same systems.  But even that will buy you a whole heck of a lot…

Coming soon: a mouse model of videogame addiction.  You give them a mini-Nintendo controller, and they punch the “A” key to get a pellet.  If you keep reinforcing them, they start punching it really fast.  (Maybe we should refer to the human model of mouse pellet addiction instead?)

sz mouse link via confused.

future potential bipolar treatment: dorky glasses?

July 28, 2007

Stabilizing circadian rhythms can be helpful with bipolar disorder, and there’s even one treatment called (straightforwardly) “dark therapy”, in which complete darkness is used to reset the circadian clock (there’s some limited data supporting this). Jim Phelps of bipolar site has written about circadian rhythms and dark therapy, and now has a paper out looking to get around the issue where nobody actually wants to be in total darkness for long periods of time except maybe when they’re sleeping.

The paper doesn’t have a controlled trial, just a series of case studies where people with bipolar disorder were able to fall asleep faster when they were undergoing treatment involving amber-tinted safety goggles, which block some wavelengths of light that knock melatonin levels down (e.g., the goggles keep melatonin at night-time levels).

So, don’t go out and buy dorky goggles just yet, and maybe not at all depending on how the evidence turns out, but if you’re interested in the circadian-rhythm angle this might be something to keep an eye on.

Bipolar I longitudinal assessment: good and bad findings

July 23, 2007

Often studies only give you snapshots of a population – what one set of people looks like at hospitalization. What a different set looks like five years after hospitalization at a different hospital and in a different region. What fifty-year-olds look like right now, and what twenty-five-year-olds look like right now.

We often infer information about the course of a disorder based on who we can pick up at different points in life. But there’s no guarantee that the people we catch when they’re fifty were, at twenty-five, like the twenty-five-year-olds we’re catching now. We might have used recruiting techniques that caught (say) twenty-five-year-olds who are heavy drinkers, and fifty-year-olds who are drinkers now but were teetotalers at that age. There are a lot of ways these problems can come up, and researchers work diligently to do what they can with what is actually feasible to do, and we do our best to check on that knowledge in a variety of ways.

But it’s always good to have extensive longitudinal research to address questions about course of illness. Here’s an article (cite at bottom of entry) reporting on a large longitudinal study of people with bipolar I. I wanted to get ahold of the article to go into more depth, but my university doesn’t have it and it appears to be in either Portuguese or Italian, and since the closest thing I have is some Spanish my translation would be highly questionable.

This is from a decade-long project, the McLean-Harvard First Episode Project & International Consortium for Bipolar Disorder Research which followed people with bipolar disorder and psychotic disorders from their first hospitalization. This abstract only looked at data for bipolar I.

There are several findings I would prefer not to be true, but if we don’t consider the possibility, we can’t plan for them. People usually do not recover fully from their first episode, and they are very likely to have more episodes in the first two years (and to switch from depression to mania or vice versa),

Some conditionally good or bad stuff: Most people have the most problems early on with depression/dysphoria, and they tend to have a worse course. Initial mania or psychosis shows a better prognosis (interestingly enough). Very high rates of suicidal behavior accidents occurred early but not as much later on (this finding is pretty extensively reported). Early substance-use and anxiety go together. Prodromal symptoms (stuff indicating you’re about to have an episode) predicts bipolar disorder better than non-affective psychotic disorders (good for bipolar, bad for others).

Some good stuff: Most people didn’t cycle more and more over time (but if I’m reading the abstract right, they didn’t stick to a single steady cycle length, either). Also, how long people waited and how many episodes they’d had was unrelated to their response to mood stabilizers.

Salvatore, P., et al. (2007). Longitudinal research on bipolar disorders. Epidemiologia e psichiatria sociale, 16(2), 109-17.