Search for Articles:
Title / Keyword
Author / Affiliation / Email
Journal
Article Type
 
 
Advanced Search
 
Section
Special Issue
Volume
Issue
Number
Page
 
4.8
2.7
Journals
Brain Sciences
Special Issues
Personalized Approach to the Diagnosis and Treatment of Bipolar Disorder
share announcement

Personalized Approach to the Diagnosis and Treatment of Bipolar Disorder

A special issue of Brain Sciences (ISSN 2076-3425). This special issue belongs to the section "Neuropsychiatry".

Deadline for manuscript submissions: closed (20 December 2024) | Viewed by 7882

Special Issue Editors

Prof. Dr. Giulio Perugi

E-Mail Website
Guest Editor
2nd Psychiatric Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
Interests: neurodevelopment disorder; bipolar disorder and bipolar spectrum; anxiety disorder; panic anxiety
Dr. Margherita Barbuti

E-Mail Website
Guest Editor
Psychiatry 2 Unit, Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, 56126 Pisa, Italy
Interests: clinical psychiatry; psychopharmacology; psychopathology; bipolar disorder; depression

Special Issue Information

Dear Colleagues,

Bipolar disorders (BDs) are chronic and recurrent illnesses that affect >1% of the world’s population. The diagnostic category of BDs encompasses heterogeneous conditions that may include several biological entities with different etiopathogenesis, courses, and treatment managements.

Personalized medicine for mental disorders aims to develop diagnostic, prognostic, and therapeutic strategies tailored to each individual. In BD, clinical history, current symptomatology, longitudinal course, and physical and psychiatric comorbidity are still the most reliable markers for stratifying patients and guiding therapeutic management, although researchers are hard at work to develop new neuropsychological or biological markers that can reliably predict the effectiveness of individualized therapy.

This personalized approach could provide a new and rational way of developing treatments for targeted subgroups of BD patients. For example, this strategy could allow for the effective personalization of drug treatments in complex cases of comorbidities involving BD and neurodevelopmental disorders.

This Special Issue will highlight advances in personalized medicine for BD, with a focus on how psychopathology, disease course, and psychiatric comorbidities can influence treatment management and complement conventional treatment guidelines.

Prof. Dr. Giulio Perugi
Dr. Margherita Barbuti
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Brain Sciences is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2200 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • bipolar disorder
  • psychiatric comorbidity
  • neurodevelopmental disorders
  • neuro-progression
  • neurodegenerative bipo-larity, personalized medicine
  • mood-stabilizers
  • somatic treatments

Benefits of Publishing in a Special Issue

  • Ease of navigation: Grouping papers by topic helps scholars navigate broad scope journals more efficiently.
  • Greater discoverability: Special Issues support the reach and impact of scientific research. Articles in Special Issues are more discoverable and cited more frequently.
  • Expansion of research network: Special Issues facilitate connections among authors, fostering scientific collaborations.
  • External promotion: Articles in Special Issues are often promoted through the journal's social media, increasing their visibility.
  • e-Book format: Special Issues with more than 10 articles can be published as dedicated e-books, ensuring wide and rapid dissemination.

Further information on MDPI's Special Issue policies can be found here.

Published Papers (6 papers)

Download All Papers
Order results
Result details
Show export options expand_more Show export options expand_less
Select all
Export citation of selected articles as:

Research

Jump to: Review

14 pages, 278 KiB  
Article
Emotional Eating, Impulsivity, and Affective Temperaments in a Sample of Obese Candidates for Bariatric Surgery: Which Linkage?
by Davide Gravina, Miriam Violi, Andrea Bordacchini, Elisa Diadema, Sara Fantasia, Marly Simoncini and Claudia Carmassi
Brain Sci. 2025, 15(4), 372; https://doi.org/10.3390/brainsci15040372 - 3 Apr 2025
Viewed by 422
Abstract
Background/Objectives: Obesity is a major public health challenge of the 21st century, with prevalence rates steadily rising globally. Disordered eating behaviors, particularly emotional eating (EE), complicate the clinical management of obesity and hinder long-term outcomes, such as maintaining weight loss after bariatric [...] Read more.
Background/Objectives: Obesity is a major public health challenge of the 21st century, with prevalence rates steadily rising globally. Disordered eating behaviors, particularly emotional eating (EE), complicate the clinical management of obesity and hinder long-term outcomes, such as maintaining weight loss after bariatric surgery. Studies reveal that EE affects 65–75% of overweight or obese adults, and such behavior may stem from a disrupted brain reward system linked to emotional dysregulation and impulsivity. Impulsivity in obesity involves deficient cognitive inhibitory control, creating an imbalance between impulsive and reflective systems. While problematic eating behaviors and obesity are well studied, the role of affective temperaments—innate traits influencing mood, energy, and responses to stimuli—remains underexplored. This study aims to examine the interplay between emotional eating, impulsivity, and affective temperaments in obese patients preparing for bariatric surgery. Methods: A total sample of 304 obese outpatients was consecutively enrolled at the Psychiatry Clinic of the Department of Clinical and Experimental Medicine of the University of Pisa during the presurgical mental health evaluation routinely performed before the bariatric intervention. Sociodemographic and clinical data were collected by psychiatrists during a single consultation. Assessments also included the following psychometric tests: the Structured Clinical Interview (SCID-5), the Emotional Eating Scale (EES), the Barratt Impulsivity Scale-Version 11 (BIS-11), and the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego-Auto-questionnaire (TEMPS-A). Results: A significant correlation was observed between the EES total score and the BIS total score (p = 0.003), as well as with the sub-dimensions of attentional impulsivity (p < 0.001) and motor impulsivity (p = 0.024). In addition, a significant correlation has been found between the total score of EES and the cyclothymic (p < 0.001), depressive (p < 0.001), irritable (p = 0.013), and anxious (0.020) temperaments. When comparing obese patients with EE and without EE (No-EE), higher rates of both current (p = 0.007) and lifetime (p = 0.024) psychiatric comorbidities were observed in the EE group, namely for anxiety disorders (p = 0.008) and eating disorders (p = 0.014). Conclusions: Our study highlights a significant association between EE in obese patients with the cyclothymic, irritable, anxious, and depressive temperaments, and impulsivity dimension. Thus, problematic eating behaviors and temperamental traits may have a bidirectional psychopathological influence in obese patients and need to be carefully evaluated in subjects seeking bariatric surgery. Full article
(This article belongs to the Special Issue Personalized Approach to the Diagnosis and Treatment of Bipolar Disorder)
15 pages, 242 KiB  
Article
Clinical Predictors of Cognitive Impairment in a Cohort of Patients with Older Age Bipolar Disorder
by Camilla Elefante, Giulio Emilio Brancati, Maria Francesca Beatino, Benedetta Francesca Nerli, Giulia D’Alessandro, Chiara Fustini, Daniela Marro, Gabriele Pistolesi, Filippo Baldacci, Roberto Ceravolo and Lorenzo Lattanzi
Brain Sci. 2025, 15(4), 349; https://doi.org/10.3390/brainsci15040349 - 27 Mar 2025
Viewed by 373
Abstract
Background: An increased risk of cognitive decline has been reported in patients with older age bipolar disorder (OABD); however, the underlying factors contributing to this association remain unclear. This cross-sectional study aims to identify the clinical features associated with cognitive impairment in [...] Read more.
Background: An increased risk of cognitive decline has been reported in patients with older age bipolar disorder (OABD); however, the underlying factors contributing to this association remain unclear. This cross-sectional study aims to identify the clinical features associated with cognitive impairment in OABD. Methods: A total of 152 participants, aged at least 50 years and diagnosed with bipolar disorder (BD) and related disorders in agreement with the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision criteria, were included in the study and divided into two subgroups based on the presence/absence of cognitive impairment, defined as a diagnosis of Mild Neurocognitive Disorder or Major Neurocognitive Disorder. Univariate comparisons and multivariate logistic regression models were performed to investigate the associations between clinical variables and cognitive impairment. Results: Cognitively impaired patients had a higher prevalence of otherwise specified BD/cyclothymic disorder, while BD type 2 was more common in the cognitively unimpaired group. Additionally, the cognitively impaired group had a later onset of major mood episodes (p < 0.05), fewer lifetime depressive episodes (p = 0.006), a higher prevalence of vascular leukoencephalopathy (p = 0.022) and dyslipidemia (p = 0.043), a lower prevalence of agoraphobia (p = 0.040), worse global functioning (p < 0.001), and higher psychopathology severity (p < 0.001). Late onset, vascular leukoencephalopathy, and dyslipidemia were all independently associated with cognitive impairment. Conclusions: Atypical BD, late onset of mood episodes, and somatic comorbidities like vascular leukoencephalopathy and dyslipidemia are associated with a higher risk of developing cognitive impairment and neurodegenerative disorders in OABD patients. Full article
(This article belongs to the Special Issue Personalized Approach to the Diagnosis and Treatment of Bipolar Disorder)
14 pages, 252 KiB  
Article
Mood Stabilizers for Treating Emotional Dysregulation in Adults with Attention-Deficit/Hyperactivity Disorder (ADHD) with or Without Comorbid Bipolar Spectrum Disorders
by Giulio Emilio Brancati, Ugo De Rosa, Anna Magnesa, Francesco De Dominicis, Alessandra Petrucci, Elisa Schiavi, Pierpaolo Medda, Margherita Barbuti and Giulio Perugi
Brain Sci. 2025, 15(2), 182; https://doi.org/10.3390/brainsci15020182 - 12 Feb 2025
Viewed by 1892
Abstract
Objectives: The treatment of emotional dysregulation (ED) poses a major challenge for clinicians managing adult attention-deficit/hyperactivity disorder (ADHD). This naturalistic longitudinal study aimed to evaluate the effects of combining mood stabilizers (MS) with standard pharmacotherapy in this population. Methods: Fifty-six adult [...] Read more.
Objectives: The treatment of emotional dysregulation (ED) poses a major challenge for clinicians managing adult attention-deficit/hyperactivity disorder (ADHD). This naturalistic longitudinal study aimed to evaluate the effects of combining mood stabilizers (MS) with standard pharmacotherapy in this population. Methods: Fifty-six adult patients with ADHD, with or without bipolar spectrum disorders, who were followed-up for at least 4 months at Pisa University Hospital were included and grouped based on the prescription of ADHD treatment with prior MS, with conomitant MS and without MS. Changes in self-reported ED, self-reported and informant-reported ADHD severity were assessed using RIPoSt-40, ASRS-v1.1, and CAARS-O:SV. Longitudinal analyses were conducted separately for each group using a pairwise one-sample paired Student’s t-test. Results: A significant reduction in ED severity was observed in those treated with methylphenidate (MPH) and concomitant MS and in those with atomoxetine (ATX) without MS. Negative emotionality and emotional impulsivity significantly decreased in both these groups, while affective instability only improved in those with MPH and concomitant MS. Self-reported ADHD improvements were significant in all groups receiving MPH, whether with concomitant, prior, or without MS. Significant changes in informant-reported ADHD severity were found in those receiving MPH with concomitant or prior MS. Conclusions: The findings highlight the benefits of concomitant MS and MPH treatment on ED, suggest a preferential effect of ATX on negative emotionality, and confirm the effectiveness of MPH for adult ADHD symptoms, regardless of additional treatment with MS. Further studies are needed to explore whether and how MS and MPH may complement each other in reducing ED. Full article
(This article belongs to the Special Issue Personalized Approach to the Diagnosis and Treatment of Bipolar Disorder)

Review

Jump to: Research

11 pages, 242 KiB  
Review
Perspectives on Precision Psychiatry Using Antipsychotics in the Management of Bipolar Disorder
by Michele Fornaro, Alessandro Miola, Domenico De Berardis, Alessio Squassina, Mirko Manchia and Marco Solmi
Brain Sci. 2025, 15(5), 430; https://doi.org/10.3390/brainsci15050430 - 23 Apr 2025
Viewed by 239
Abstract
Background/Objectives: Precision medicine is not just hype. Instead, it represents a high bar for developing more effective, safer, and better-tolerated therapies in medicine, without exception in psychiatry, including bipolar disorder (BD). A burgeoning body of narrative reviews and perspective papers has already appraised [...] Read more.
Background/Objectives: Precision medicine is not just hype. Instead, it represents a high bar for developing more effective, safer, and better-tolerated therapies in medicine, without exception in psychiatry, including bipolar disorder (BD). A burgeoning body of narrative reviews and perspective papers has already appraised the boundaries of precision medicine in BD. Methods: This brief perspective follows a narrative, critical approach focusing explicitly on the antipsychotic management of BD using precision approaches. Results: While most controversies align with those previously appraised in BD’s overall precision medicine approach, specific insights are provided herein. Conclusions: Beyond other implications and the strengthened call for valid diagnostic coding systems, the implementation of shared decision-making tools and pharmacogenomics studies focusing on persons with BD are particularly warranted. Full article
(This article belongs to the Special Issue Personalized Approach to the Diagnosis and Treatment of Bipolar Disorder)
19 pages, 811 KiB  
Review
Mitochondrial Dysfunction as a Biomarker of Illness State in Bipolar Disorder: A Critical Review
by Anna Giménez-Palomo, Helena Andreu, Oscar de Juan, Luis Olivier, Iñaki Ochandiano, Lidia Ilzarbe, Marc Valentí, Aldo Stoppa, Cristian-Daniel Llach, Giulio Pacenza, Ana Cristina Andreazza, Michael Berk, Eduard Vieta and Isabella Pacchiarotti
Brain Sci. 2024, 14(12), 1199; https://doi.org/10.3390/brainsci14121199 - 28 Nov 2024
Cited by 2 | Viewed by 2311
Abstract
Mitochondria are organelles involved in different cellular functions, especially energy production. A relationship between mitochondrial dysfunction and mood disorders, especially bipolar disorder (BD), has been reported in the scientific literature, which suggests altered energy production and higher levels of oxidative stress compared to [...] Read more.
Mitochondria are organelles involved in different cellular functions, especially energy production. A relationship between mitochondrial dysfunction and mood disorders, especially bipolar disorder (BD), has been reported in the scientific literature, which suggests altered energy production and higher levels of oxidative stress compared to healthy controls. Specifically, in BD, the hypothesis of a biphasic pattern of energy availability has been postulated according to mood states. Current evidence highlights the presence of mitochondrial dysfunction in BD and variations between the manic, depressive, and euthymic phases. These findings need to be confirmed in future studies to identify biomarkers that may lead to individualized management of patients with BD and also to identify profiles with a higher risk of presenting an unfavorable course of illness, which would enable the design of preventive and therapeutic strategies in determined subpopulations of patients with BD. The limitations of this review include the non-systematic methodology, variety of mitochondrial-related functions associated with BD, heterogeneous study designs, preliminary evidence for specific findings, and limited recommendations regarding the use of mitochondrial modulators in BD. Full article
(This article belongs to the Special Issue Personalized Approach to the Diagnosis and Treatment of Bipolar Disorder)
►▼ Show Figures

Figure 1

18 pages, 467 KiB  
Review
Efficacy and Safety of Lithium for Suicide and Suicide-Related Behaviors in Youth: A Review of the Literature
by Gianluca Sesso, Francesca Bargnesi, Francesca Olzi, Giulia Mutti, Stefano Berloffa, Valentina Viglione, Pamela Fantozzi, Greta Tolomei, Fulvio Guccione, Annarita Milone and Gabriele Masi
Brain Sci. 2024, 14(11), 1139; https://doi.org/10.3390/brainsci14111139 - 13 Nov 2024
Viewed by 1964
Abstract
Objectives: This systematic review evaluates the anti-suicidal properties of Lithium in children and adolescents with Bipolar Disorder (BD), addressing gaps in evidence regarding its efficacy and safety in reducing suicidality and self-harming behaviors. Methods: A comprehensive literature search was conducted across PubMed, Web [...] Read more.
Objectives: This systematic review evaluates the anti-suicidal properties of Lithium in children and adolescents with Bipolar Disorder (BD), addressing gaps in evidence regarding its efficacy and safety in reducing suicidality and self-harming behaviors. Methods: A comprehensive literature search was conducted across PubMed, Web of Science, and Scopus up to February 2024. Eligible studies were those focusing on patients aged 25 years or younger, examining Lithium therapy and its impact on suicidal ideation and behaviors. The review included randomized controlled trials, longitudinal prospective and retrospective studies, and cross-sectional studies, while excluding expert opinions and case reports. Results: Evidence generally supports the efficacy of Lithium in reducing suicidal ideation and self-harming behaviors in youth with BD, though results are mixed. Randomized controlled trials demonstrated its effectiveness in mitigating suicidal thoughts during acute manic episodes, with effects persisting post-treatment. Longitudinal studies suggested that Lithium might offer superior outcomes compared to other mood stabilizers, although its specific impact on suicidality remains inconclusive. Cross-sectional studies and retrospective analyses reveal associations between Lithium use and reduced self-harming behaviors, but causality remains uncertain. While mood-stabilizing effects of Lithium offer potential benefits for reducing suicidality in youth, evidence on its direct impact on emotional dysregulation (ED) and long-term efficacy is limited. Variability in individual responses and adherence issues underscore the need for further research. Future studies should include larger, diverse samples, focus on ED symptoms, and explore Lithium mechanisms in suicidality prevention. Conclusions: Lithium remains a promising treatment for mood stabilization and reduction in suicidality in youth with BD. Full article
(This article belongs to the Special Issue Personalized Approach to the Diagnosis and Treatment of Bipolar Disorder)
►▼ Show Figures

Figure 1

Show export options expand_more Show export options expand_less
Select all
Export citation of selected articles as:
 
Displaying articles 1-6
Back to TopTop