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Trajectories of Cognitive Functioning in Older Age Bipolar Disorder.
Bipolar disorders · Trajectories of Cognitive Functioning in Older Age Bipolar Disorder.
透過Growth Mixture Modeling識別出老年雙極症患者認知功能的三種異質軌跡,顯示進階年齡與早起病為認知衰退的重要預測因子,支持MMSE作為廣泛篩查工具之臨床實用性。
P年齡超過50歲的雙極症患者(n=206),來自荷蘭DOBi隊列
I無(觀察性研究)
C無(觀察性研究)
O透過MMSE及九項認知測量評估之長期認知功能軌跡
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.
老年雙極症患者在8年追蹤中顯著較對照組早逝(HR=1.72),平均存活時間短3.5個月,證實過度死亡風險延伸至晚年,非僅為幸存者效應。
P年齡≥50歲之雙極症患者(n=227,DOBi隊列)與年齡性別匹配之一般人群對照組(n=681,LASA隊列)
I無(觀察性研究)
C年齡性別匹配之一般人群
O8年全因死亡率、限制平均存活時間及風險比
Association between lithium treatment and vascular calcification in bipolar disorder: A retrospective cohort study.
Journal of affective disorders · Association between lithium treatment and vascular calcification in bipolar disorder: A retrospective cohort study.
鋰鹽治療顯著降低主動脈及冠狀動脈鈣化風險(AC OR=0.11, CAC OR=0.19),支持其具有血管保護作用,而非僅具精神療效。
P具有可用基線與約10年隨訪胸部X光之雙極症患者(n=177)
I鋰鹽治療
C未使用鋰鹽
O主動脈鈣化(AC)及冠狀動脈鈣化(CAC)
Effects of Lithium Treatment on Renal Function in Bipolar Disorder: A Retrospective Cohort Study.
Psychiatry research · Effects of Lithium Treatment on Renal Function in Bipolar Disorder: A Retrospective Cohort Study.
長期鋰鹽使用導致eGFR下降≥25%之風險與進階年齡及高鋰鹽血濃度相關,但與治療期間無關,提醒需定期監測並避免超療劑量。
P接受至少一年鋰鹽治療之雙極症患者(n=636,單一精神科診所,2010-2022)
I長期鋰鹽治療
C無(觀察性研究)
OeGFR下降≥25%之發生率及其預測因子
Diagnostic concordance in consultation-liaison psychiatry: A retrospective analysis of 4,556 referrals in a tertiary hospital.
Psychiatry research · Diagnostic concordance in consultation-liaison psychiatry: A retrospective analysis of 4,556 referrals in a tertiary hospital.
諮詢聯絡精神科之診斷一致性極低(kappa=0.228),尤其對躁症篇雙極症僅2.4%一致,顯示非精神科醫師對老年躁鬱症之識別嚴重不足。
P成人精神科諮詢(n=4556次,3070位患者),2018-2022於三級醫院
I無(觀察性研究)
C諮詢醫師初步診斷 vs. 聯絡精神科最終診斷
O診斷一致性(Cohen's kappa)及影響因素
📚其他值得關注的文獻
Accelerated brain aging as a transdiagnostic biomarker: A lifespan MRI brain age study across seven disorders.
Psychological medicine
雙極症患者腦-PAD顯著升高約2.08年,支持其具有加速腦老化之生物標記特徵,雖非特異性。
Cognitive performance and self-reported physical exercise in bipolar disorder: A cross-sectional analysis of pre-randomization screening data from an ongoing randomized controlled trial.
Journal of affective disorders
規律身體運動與更好認知表現相關(d=0.95),特別是言語學習與工作記憶,支持運動為非藥物介入之潛在益處。
Exposure to residential greenness and subsequent risk of common mental disorders among individuals with COVID-19 in South Korea: A nationwide cohort study.
PloS one
中等程度住宅綠化與較低精神疾病風險相關,尤其是雙極症(aHR=0.84),但高綠化反而可能增加焦慮風險。
Anterior Cruciate Ligament Reconstruction and Mental Health: A Bidirectional Relationship.
Sports health
既有精神疾病(含雙極症)患者在ACL重建術後初期功能較差,但差異僅在2週後消失;新發精神疾病率低。
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
雙極症合併慢性失眠與皮質醇下降、TNF-α上升及與端粒縮短相關之TERT基因型同合併,提示其可能參與加速老化生物路徑。
Longer Sleep Duration Predicts Progression to Bipolar or Psychotic Disorders in Youth Accessing Early Intervention Mental Health Services.
Bipolar disorders
青少年較長睡眠期間預測未來發展為躁鬱或精神病症之風險增加(OR=2.23),支持睡眠異常為早期生物標記。
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
雙極症與較低心房顫動(OR=0.848)及急性冠狀綜合症(OR=0.504)風險相關,提示其可能具複雜心血管影響。
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相關行為風險顯著相關(OR=0.55),部份經由降低攻擊性行為中介,支持其防護作用。
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
雙極症與重度憂鬱症在抑鬱及部分緩解階段具有可辨識之腦功能模式,但在完全緩解階段無法區分,挑診斷穩定性之利用。
Gaze fixation stability is a transdiagnostic marker of major psychiatric disorders: A high-density family-based study.
Psychiatry research
注視穩定性在精神分裂症與雙極症中受損,但未見於一級親屬或健康對照組,提示其為疾病狀態標誌而非內表型。
Therapeutic strategies after discontinuation of valproate in females of child-bearing potential with bipolar disorder: an insurance claims database study in France and the United Kingdom.
Psychiatry research
孕婦潛能女性停止丙戊酸後,約半數能維持不重新使用,尤其年輕且病情穩定者較成功,提示替代方案之可行性。
Association of lithium treatment with incident cardiovascular disease in patients with bipolar disorder: A claims-based longitudinal cohort study.
Journal of affective disorders
鋰鹽使用顯著降低整體心血管疾病(HR=0.38)及缺血性心臟病(HR=0.20)風險,尤其在老年男性及具危險因子者中較明顯。
Cognitive impairment in bipolar disorder: How close to dementia?
Journal of affective disorders
雙極症患者可依認知功能分為三組:痴呆樣、輕度及保存組,前組認知表現顯著劣化,接近痴呆程度,提醒臨床辨識之必要。
Comparative risk of early-onset dementia with lithium versus valproate in bipolar disorder: A real-world cohort study.
Journal of affective disorders
鋰鹽起始相較於丙戊酸起始與較低早-onset痴呆風險相關(HR=0.815),支持其可能具神經保護作用。
Cardiometabolic Treatment Gap in Routine Psychiatric Care: A Cross-Sectional Study of 1553 Patients.
Acta psychiatrica Scandinavica
重度精神疾病患者中高血壓、高膽固醇等代謝異常極常見,但藥物治療率極低(如高血壓僅5.7%報告使用抗高血壓藥),顯示顯著治療落差。
Association between lithium and arterial atherosclerosis in physically healthy bipolar disorder.
Journal of affective disorders
在身體健康之雙極症患者中,較低鋰鹽血濃度與較高頸動脈內中厚相關,但BMI為目前使用者中唯一獨立相關因子,提示體重管理之重要性。
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
父母而非子女之情緒波動報告可預測高基因風險青少年未來發展為雙極症,主要經由易怒與焦慮/憂鬱因子。
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數據無法區分雙極症I型與II型,但個人化模型(含主動自報)具較佳辨識力,支持個體層級之數位表型應用。
Incidence and predictors of new persistent benzodiazepine and Z-drug use after critical illness: a nationwide cohort study.
European journal of anaesthesiology
既有精神疾病(包括雙極症,OR=1.27)是重症後持續使用苯二氮䓬類藥物之強烈預測因子,提示需監控此群之藥物使用風險。