⭐今日精選 TOP Picks
Low-dose lithium vs valproate and incident dementia diagnoses in older adults: A propensity-matched cohort study using electronic health record data.
Psychiatry research · Low-dose lithium vs valproate and incident dementia diagnoses in older adults: A propensity-matched cohort study using electronic health record data.
在60歲以上無先前認知障礙的老年人中，低劑量鋰鹽顯著降低730天內痴呆發生率，風險降低62%，支持鋰鹽在OABD中的神經保護角色。
P60歲以上，無既往癡呆、輕度認知障礙、雙極症或帕金森病的成年人
I低劑量鋰鹽（血清鋰≤0.40 mmol/L）
C丙戊酸鈉
O730天內發生所有原因導致的癡呆
Comparative effectiveness of mood stabiliser monotherapy versus second-generation antipsychotic monotherapy versus combination therapy for continuation and maintenance treatment after a first episode of psychotic mania in North America, Chile, and Spain: a target trial emulation using data from the BD-CAUSAL Collaboration.
The lancet. Psychiatry · Comparative effectiveness of mood stabiliser monotherapy versus second-generation antipsychotic monotherapy versus combination therapy for continuation and maintenance treatment after a first episode of psychotic mania in North America, Chile, and Spain: a target trial emulation using data from the BD-CAUSAL Collaboration.
首次精神病性躁鬱發作後，穩定劑單療法在防止再住院方面優於第二代抗精神病藥物單獨使用或合併療法，支持早期優先選擇穩定劑。
P16歲以上，首次出現伴精神病特徵之躁鬱發作，且無過去3個月使用穩定劑或SGA的雙極I型患者
I穩定劑單療法
C第二代抗精神病藥物單療法 / 合併療法
O2年內因精神科原因導致的住院或急診
Association of lithium treatment with incident cardiovascular disease in patients with bipolar disorder: A claims-based longitudinal cohort study.
Journal of affective disorders · Association of lithium treatment with incident cardiovascular disease in patients with bipolar disorder: A claims-based longitudinal cohort study.
鋰鹽使用與雙極症患者整體心血管疾病風險降低62%相關，特別是缺血性心臟病風險降低80%，顯示其雙重精神與身體保護效益。
P新診斷雙極症患者（平均年齡44.5歲）
I鋰鹽使用
C非鋰鹽使用者
O發生心血管疾病（含缺血性心臟病與中風）
Neurofilament Light Chain as a Biomarker in Geriatric Psychiatry Practice: A Narrative Review.
The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry · Neurofilament Light Chain as a Biomarker in Geriatric Psychiatry Practice: A Narrative Review.
血縫神經鏈輕鏈（NFL）隨年齡增加而升高，在神退性疾病中顯著升高，但在主要精神疾病（含雙極症）中多與年齡預期範圍重疊，提示其在區分OABD併發神退性變化中的潛在用途。
P患有神退性疾病或主要精神疾病的老年成年人
I血漿或血清NfL濃度測量
C無（敘述性綜述）
ONfL水平與診斷群體、臨床脈絡及縱向變化的關聯
Structural brain alterations of the subcortical limbic system in schizophrenia and bipolar disorders.
Schizophrenia research · Structural brain alterations of the subcortical limbic system in schizophrenia and bipolar disorders.
雙極症患者右側紋叢與髮狀結構體積較健康對照組小，提示邊緣系統結構異常可能為OABD的神經生物學基礎之一。
P17-65歲，包含340名雙極症患者及802名健康對照
IT1加權MRI體積分析（使用ScLimbic工具）
C健康對照組
O邊緣系統副皮質結構（如紋叢、髮狀結構體）體積差異
📚其他值得關注的文獻
Life's essential 8 health profiles and risk of incident neuropsychiatric diseases: a nationwide prospective cohort study.
BMC psychiatry
健康生活方式（Life's Essential 8）中，較佳的健康檔案顯著降低焦慮與雙極症發生風險，雙極症風險降低最高達63%。
Internet-Delivered Cognitive Behavioral Therapy for Social Anxiety Disorder: Nationwide Retrospective Cohort Observational Study.
Journal of medical Internet research
網路認知行為療法對社交焦慮症具有大效應大小（Cohen d>1.0），顯示其在常規療效中的可行性，但未直接涉及雙極症。
Changes in Glutathione and Homocysteine Concentrations in Treatment-Resistant Depression After Electroconvulsive Therapy.
Medical science monitor : international medical journal of experimental and clinical research
電痙攣療法顯著改善治療抵抗性憂鬱症狀，但未改變谷胱甘肽或同半胱氨酸濃度；雙極症患者基礎谷胱甘肽較高，提示潛在生物亞型差異。
SGLT2 inhibitors versus GLP-1 receptor agonists and risk of kidney replacement therapy and healthcare utilization in bipolar disorder with chronic kidney disease: An active-comparator, new-user cohort study.
Journal of affective disorders
在雙極症合併慢性腎病患者中，SGLT2i與GLP-1 RA在腎替代療法風險上無顯著差異，但SGLT2i組醫療利用率5年無事件生存率略優。
Demographic moderators of the relationship between psychiatric diagnosis and functional capacity in people with serious mental illness.
Psychiatry research
在嚴重精神疾病者中，年齡與性別顯著調節診斷與功能容量的關係，男性與老年功能表現較差，提示OABD需關注性別與年齡差異。
Somatostatin expression is associated with mitochondrial-related gene expression in a brain region-specific manner: Evidence from human transcriptomic analysis.
Behavioural brain research
腦內腦內啡素表達與線粒體相關基因（如BCL2、MFN2、SOD2）在特定區域呈正相關，提示其在情緒障礙神經機制中的潛在角色。
Higher blood pressure is associated with lower cerebral blood flow in youth with bipolar disorder.
Journal of affective disorders
青少年雙極症患者收縮與舒張血壓升高與額葉及皮質下區域腦血流減少相關，提示高血壓可能促進神血管功能障礙。
Association Between Lithium Use and Suicide-Related Behaviors in Bipolar Disorder: A Multicenter Study.
Bipolar disorders
過去一年內使用鋰鹽與雙極症患者自殺相關行為風險降低47%相關，部分經由降低攻擊行為介導。
Association of betel quid chewing with specific major psychiatric disorders in Taiwan Biobank-NHIRD linked data.
Epidemiology and psychiatric sciences
在台灣男性中，檳榔嚼食經調整後僅與憂鬱症相關（OR 1.19），與雙極症等其他精神疾病顯著關係在調整混雜因素後消失。
Differences in associations between long-acting injectable and oral antipsychotic prescribing and healthcare utilisation in people with intellectual disability: a self-controlled case series (LOID study).
BMJ mental health
在智能障礙者中，長效注射抗精神病藥物相較於口服藥物降低急診與住院風險，特別是對精神疾病相關住院及錐體外症狀保護作用明顯。
Prevalence of metabolic syndrome among people with psychiatric disorders in Japan: A cross-sectional study using nationwide health insurance claims and health check-up data.
Psychiatry research
精神疾病者代謝綜合症罹患率顯著高於一般人群，特別是雙極症、精神分裂症及憂鬱症患者，提醒需關注身心併發症。
Variables associated with self- and proxy-perceived difficulties in independent living for patients with bipolar disorder and comorbid dementia.
European archives of psychiatry and clinical neuroscience
在雙極症併癡呆患者中，自覺與代理人報告的獨立生活困難因子不一致，說明需雙向評估以進行適當介入規劃。
Gastrointestinal Diagnoses and Symptoms in Medicare Patients With Neuropsychiatric Diseases.
Journal of clinical gastroenterology
雙極症患者腸易激綜合症與消化不良風險顯著升高，提醒臨床需關注躁鬱症患者的胃腸共病。
Comparative risk of early-onset dementia with lithium versus valproate in bipolar disorder: A real-world cohort study.
Journal of affective disorders
在18-60歲雙極症新診斷患者中，鋰鹽起始者5年內早發性癡呆風險低於丙戊酸鈉（HR 0.815），支持其神經保護優勢。
Demographic moderators of the relationship between psychiatric diagnosis and functional capacity in people with serious mental illness.
Psychiatry research
年齡與性別顯著調節嚴重精神疾病患者的診斷與功能表現關係，提示老年雙極症需考慮性別與歲數對功能的影響。
The dynamic influence of exercise on emotional state among people with a history of mood disorder.
Psychiatry research
在有情緒障礙病史者中，運動顯著降低後續焦慮感，但對悲傷、激躁或精力感無影響，顯示其對焦慮的特異性調節作用。
Structural brain alterations of the subcortical limbic system in schizophrenia and bipolar disorders.
Schizophrenia research
雙極症患者右側紋叢與髮狀結構體積較健康對照組小，提示邊緣系統結構異常可能為OABD的神經生物學基礎之一。
The impact of affective symptoms and mood instability on sexual desire and sexual distress in newly diagnosed bipolar disorder: a longitudinal study.
Journal of psychiatric research
新診斷雙極症患者中，抑鬱症狀降低性慾並增加性痛苦，躁狂症狀增加性慾，情緒不穩增加性痛苦，提示需在治療中關注性功能。
Differential burden of five major mental disorders in the United States across the COVID-19 pandemic.
European archives of psychiatry and clinical neuroscience
在疫情期間，焦慮與憂鬱症負擔顯著增加，而雙極症與精神分裂症負擔略降，提示疫情對不同精神疾病的衝擊具有選擇性。
Low-dose lithium vs valproate and incident dementia diagnoses in older adults: A propensity-matched cohort study using electronic health record data.
Psychiatry research
在60歲以上無先前認知障礙的老年人中，低劑量鋰鹽顯著降低730天內痴呆發生率，風險降低62%，支持鋰鹽在OABD中的神經保護角色。
Electroconvulsive therapy in Germany: a nationwide multilevel analysis of determinants, regional patterns, and institutional variation.
European archives of psychiatry and clinical neuroscience
德國電痙攣療法使用率與區域臨床需求關聯弱，而受制度與機構因素強烈影響，提示存在區域與提供者間的使用不公平。
Lithium versus valproate in bipolar disorder: Associations with dementia, mortality, suicide attempt, and end-stage renal disease in adults aged 45 years and older - a propensity score-matched retrospective cohort study.
Psychiatry research
45歲以上雙極症患者中，鋰鹽相較於丙戊酸鈉降低癡呆（HR 0.689）、未明示癡呆（HR 0.677）及自殺企圖（HR 0.594）風險，但對血管性癡呆、死亡或腎末期疾病無顯著影響。
Association between lithium and arterial atherosclerosis in physically healthy bipolar disorder.
Journal of affective disorders
在身體健康的雙極症患者中，較低血清鋰與較高頸動脈內中厚度相關，但較高鋰水平與較低動脈粥樣硬化風險相關，提示鋰鹽可能具抗動脈粥樣硬化作用。
Parental but not child reports of affective lability in offspring predict conversion to bipolar disorder in youth at increased genetic risk.
Journal of affective disorders
在高遺傳風險青少年中，父母報告的情緒不穩（特別是易怒與焦慮/憂鬱因子）可預測其後雙極症發病，但兒童自報無此預測力。
Multimodal digital phenotyping of bipolar disorder subtypes: Differences between bipolar disorder I and II based on passive and active behavioral features from smartphones.
Journal of affective disorders
被動智慧型手機感測資料單獨無法區分雙極I型與II型，但個人化模型結合主動自報可達較佳區分力（AUC 0.87），顯示數位表型在個人層級的潛力。
Accelerated biological aging in bipolar disorder as determined by artificial intelligence-based electrocardiographic assessment.
Journal of affective disorders
雙極症患者經AI-ECG評估的生理年齡顯著高於實際年齡（平均2.5歲），提示其存在加速生物老化現象，與心血管風險因素獨立。
Risk of self-harm in first-diagnosed mental disorders: A 16-year territory-wide health-record database study in Hong Kong.
European neuropsychopharmacology : the journal of the European College of Neuropsychopharmacology
首次診斷精神疾病者自傷風險顯著升高（HR 10.59），其中雙極症患者風險為一般人的6.43倍，青年以及女性風險最高。
Antidepressant use and risk of bipolar disorder in children, adolescents and young adults with unipolar depression: a target trial emulation study.
European neuropsychopharmacology : the journal of the European College of Neuropsychopharmacology
在兒童與青少年單極憂鬱中，抗憂鬱藥物使用在52週內輕微增加雙極症轉換風險（HR 2.14），但此關聯可能由混雜因素解釋而非因果。
Evening chronotype is associated with affective temperaments, emotional dysregulation, and bipolar-spectrum features: An observational study in 1997 adults from a large community sample.
Journal of affective disorders
晚型昇夜節律與較高憂鬱、焦慮、易怒、循環質氣質及情緒調節困難顯著相關，並與較高雙極譜系分數相關，支持其作為躁鬱譜系特徵的潛在標誌。
Mental Health Conditions and Incident Cancer: A Prospective Cohort Study of 402,255 UK Biobank Participants.
International journal of cancer
雙極症診斷與整體癌症風險增加29%相關（HR 1.29），尤其在男性中更顯著（HR 1.54），提示需將精神健康納入癌症風險分層考量。