⭐今日精選 TOP Picks
Comparing 8-Year Survival Rates in Older-Age Bipolar Disorder (OABD) and Its Clinical Predictors to the General Population
The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry · Comparing 8-Year Survival Rates in Older-Age Bipolar Disorder (OABD) and Its Clinical Predictors to the General Population
OABD 群組在8年追蹤中顯著高於一般人口的全因死亡率，提醒�床師需積極干預身體健康風險以降低過早死亡。
P227位年齡≥50歲、雙極症患者（DOBi隊列）與681位年齡性別匹配的一般人口對照組
I無（觀察隊列）
C年齡與性別匹配的一般人口對照組
O8年內全因死亡率、限制生存時間及死亡風險比
Trajectories of Cognitive Functioning in Older Age Bipolar Disorder
Bipolar disorders · Trajectories of Cognitive Functioning in Older Age Bipolar Disorder
透過GROWTH MIXTURE MODELLING識別出OABD中三種認知軌跡類別，基線年齡與早起病為認知惡化的預測因子，支持MMSE作為篩檢工具。
P206位年齡>50歲的雙極症患者（DOBi隊列）
I無（觀察性縱向研究）
C無（內部軌跡分群）
OMMSE縱向軌跡及九項補充認知測試表現
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
鋰鹽使用顯著降低雙極症患者整體心血管疾病與缺血性心臟病風險，尤其在老年男性及具心血管危險因子者中效果較佳。
P2945位新診斷雙極症患者（平均年齡44.5歲）
I鋰鹽使用 vs. 非鋰鹽使用
C非鋰鹽使用組
O缺血性心臟病、中風及整體心血管疾病發生率
The recognition, diagnosis, and management of late-onset bipolar disorder
Expert review of neurotherapeutics · The recognition, diagnosis, and management of late-onset bipolar disorder
晚發型雙極症（LOBD）為異質性疾病，可能與血管負荷、神經退化及年齡相關生物脆弱性有關，需綜合身心評估，鋰鹽可能為首選藥物。
P晚發型雙極症患者（文獻綜述）
I綜合評估與個別化治療
C傳統雙極症管理
O診斷準確度、治療反應與長期預後
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
低劑量鋰鹽（血清≤0.40 mmol/L）顯著降低≥60歲老年人痴呆發生率，相較於丙戊酸，提醒醫師在老年雙極症優先考慮鋰鹽以防認知衰退。
P≥60歲、無既往痴呆或輕度認知障礙者，接受低劑量鋰鹽或丙戊酸治療
I低劑量鋰鹽 vs. 丙戊酸
C丙戊酸組
O730天內全因痴呆發生率
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
血神經纖維輕鏈（NFL）隨年齡增加且受腎功能影響，在老年精神疾病中可協助辨識神經退化風險，但主要精神疾病多與年齡調整後正常範圍重疊。
P老年患者（神經退化或主要精神疾病）
I血NFL測量
C無（敘述性文獻回顧）
ONFL水準與診斷群體、併存症及縱向變化的關聯
Association between lithium and arterial atherosclerosis in physically healthy bipolar disorder
Journal of affective disorders · Association between lithium and arterial atherosclerosis in physically healthy bipolar disorder
在身體健康的雙極症患者中，較低血清鋰鹽水準與較高頸動脈內中厚度相關，提示鋰鹽可能經由改善脂質代謝與體重管理發揮抗動脈硬化作用。
P110名身體健康的雙極I型患者（20-60歲）與107名健康對照組
I血清鋰鹽水準分層
C健康對照組
O頸動脈內中厚度（CIMT）
Impact of Cannabis Use on Time to Psychiatric Rehospitalization in Young Adults With Bipolar and Psychotic Disorders: A Survival Analysis
The Journal of clinical psychiatry · Impact of Cannabis Use on Time to Psychiatric Rehospitalization in Young Adults With Bipolar and Psychotic Disorders: A Survival Analysis
在18-29歲雙極或精神病患者中，住院時大麻使用可預測早期再住院（首月HR=2.8），提示出院後首3個月為乾預防再住院的關鍵窗口。
P200名18-29歲、因精神病或雙極症住院者
I住院時大麻使用 vs. 未使用
C未使用大麻組
O出院後1年內精神科再住院風險
📚其他值得關注的文獻
Loneliness as a risk factor for bipolar disorder and its related brain structure alterations.
Psychological medicine
孤獨感顯著增加雙極症發病風險（HR=2.83），並與廣泛腦灰質體積減少相關，尤其在高遺傳風險者中更明顯。
Clinical and Biological Characterization of Bipolar Disorder Patients With Chronic Insomnia Reveals Cortisol Reductions, Elevated TNF-α, and Increased Genetic Risk for Accelerated Aging.
Bipolar disorders
雙極症伴慢性失眠者長期顯示醒來時皮質醇降低、TNF-α上升，且更易具備與端粒短縮相關的TERT基因變異。
Longer Sleep Duration Predicts Progression to Bipolar or Psychotic Disorders in Youth Accessing Early Intervention Mental Health Services.
Bipolar disorders
青少年基線較長睡眠 duration 預測較早發展為全陣列雙極或精神病，提醒過度睡眠可能為早期脆弱性標誌。
Medicine Use Preceding Fatal Poisonings Among Individuals With Bipolar Disorder.
Basic & clinical pharmacology & toxicology
三環抗憂鬱藥、加巴朋類、阿片類等藥物與雙極症患者致命中毒顯著相關，提醒醫師在高風險患者處方時需謹慎。
Independent associations of psychiatric disorders with atrial fibrillation and acute coronary syndrome: An analysis of the National Inpatient Sample.
International journal of cardiology. Cardiovascular risk and prevention
雙極症與心房顫動及急性冠狀綜合症呈負相關，但此關聯在年輕族群中不顯著，提醒需區分年齡效應。
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
首次 psychotic mania 後，穩定劑單一療法在預防再住院方面可能優於第二代抗精神病藥物單獨或併用療法，但研究尚未完成。
Association Between Lithium Use and Suicide-Related Behaviors in Bipolar Disorder: A Multicenter Study.
Bipolar disorders
鋰鹽使用與較低自殺行為風險相關（OR=0.55），此保護效應約20.9%經由降低攻擊性行為中介。
Distinct brain functional patterns across the entire disease course between bipolar disorder and major depressive disorder: A Gaussian mixture model analysis.
Journal of affective disorders
雙極症與重度抑鬱症在抑鬱階段及部分緩解期的腦功能模式可區分，但完全緩解後無法透過靜息態fMRI有效鑑別。
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，尤其男性患者達24.8%，提醒需常規篩查代謝異常。
Demographic moderators of the relationship between psychiatric diagnosis and functional capacity in people with serious mental illness.
Psychiatry research
在嚴重精神疾病中，年齡與性別顯著調節診斷與功能能力的關聯，男性與老年人表現較差，提示需針對性介入。
Somatostatin expression is associated with mitochondrial-related gene expression in a brain region-specific manner: Evidence from human transcriptomic analysis.
Behavioural brain research
生長抑素表達與特定線粒體相關基因（如BCL2、MFN2、SOD2）在腦區特定方式呈正相關，提示其在神經保護中的潛在角色。
Higher blood pressure is associated with lower cerebral blood flow in youth with bipolar disorder.
Journal of affective disorders
雙極症青少年收縮與舒張壓升高與皮質血流減少相關，此關聯在健康對照組中不存在，提示早期血管功能障礙可能影響認知與情緒。
Mental illness among persons with and without dementia in continuing care: A multi-jurisdictional, repeated cross-sectional study.
Journal of Alzheimer's disease : JAD
在長期照護設施中，伴有癡呆的照護接受者有高達70-80%併發任何精神疾病，其中4%為雙極症，凸�整合照護的必要性。
Individualized Connectivity-Guided Versus Conventional Targeting of Accelerated Theta-Burst Stimulation in Depression: A Randomized, Double-Blind, Parallel-Design Trial.
The American journal of psychiatry
以結構連接引導的間歇性θ爆發刺激（SC-guided iTBS）在緩解抑鬱症狀方面優於常規5cm定位，效應在週6仍顯著。
Symptom Burden and Quality of Life in Patients With Severe Mental Disorders Initiating Cancer Treatment.
Clinical oncology (Royal College of Radiologists (Great Britain))
伴有嚴重精神疾病的癌症患者在開始治療前生活品質顯著較低（56.7 vs 69.0），精神症狀負擔較高，提示需早期介入心理支持。
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
雙極症伴失智患者自評與代理人評的獨立生活困難因子顯著不同，提醒臨床師需同時考慮患者與照護者視角進行干預規劃。
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顯著相關，提醒醫師在處理 neuropsychiatric 病人時需留意併發胃腸症狀。
Comparative risk of early-onset dementia with lithium versus valproate in bipolar disorder: A real-world cohort study.
Journal of affective disorders
起始使用鋰鹽相較於丙戊酸與較低5年內早發性癡呆風險相關（HR=0.815），支持鋰鹽具神經保護潛力。
The dynamic influence of exercise on emotional state among people with a history of mood disorder.
Psychiatry research
在有情緒疾病史者中，運動顯著降低後續焦慮感，但對悲傷、激活或精力感無影響，效應在BD與MDD間無顯著差異。
Structural brain alterations of the subcortical limbic system in schizophrenia and bipolar disorders.
Schizophrenia research
雙極症患者右側纖維體與基底前脈容積較健康對照組小，提示邊緣系統結構異常可能參與其發病機制。
Cardiometabolic Treatment Gap in Routine Psychiatric Care: A Cross-Sectional Study of 1553 Patients.
Acta psychiatrica Scandinavica
精神科門診中，只有極少數具客觀心血管代謝異常的患者接受對應藥物治療（如高血壓僅5.7%使用降壓藥），顯示顯著治療落差。
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
新診斷雙極症中，抑鬱症狀降低性慾並增加性困擾，躁狂症狀增加性慾，情緒不穩增加性困擾，提醒需關注性功能作為復原部分。
Differential burden of five major mental disorders in the United States across the COVID-19 pandemic.
European archives of psychiatry and clinical neuroscience
COVID-19大流行期間，焦慮與抑鬱症負擔顯著上升，而雙極症輕微下降，提示疫情對不同精神疾病衝擊具選擇性。
Electroconvulsive therapy in Germany: a nationwide multilevel analysis of determinants, regional patterns, and institutional variation.
European archives of psychiatry and clinical neuroscience
德國電痙攣治療使用率與區域診斷負荷關聯弱，主要受機構規模與結構因素影響，提示存在區域與提供者間的公平性問題。
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
鋰鹽使用相較於丙戊酸與較低癡呆、未明確性癡呆及自殺企圖風險相關，但無顯著影響血透依賴症或死亡率。
Resting magnetoencephalography alterations in severe mental illnesses: A systematic review.
Neuroscience and biobehavioral reviews
β波功率可能為嚴重精神疾病跨診斷生物標記，但直接跨疾病比較研究稀少，慢波活動在精神分裂症增加而在情緒障礙中減少。
Cognitive impairment in bipolar disorder: How close to dementia?
Journal of affective disorders
雙極症患者可依據認知功能分為痴呆樣、輕度及保存型三組，認知功能受損程度在痴呆樣組可近似癡呆患者。