Overview
Bipolar disorder (BD) is a mood disorder characterized by significant mood fluctuations, including manic, hypomanic, depressive, and mixed episodes 456. Aberrant neurophysiological responses, such as reduced 40-Hz auditory steady-state responses (ASSR), are observed in patients with BD 2.Diagnosis
Diagnosis is based on clinical presentation and established criteria 46.
Reduced 40-Hz ASSR, measured by electroencephalography (EEG) or magnetoencephalography (MEG), is a potential biomarker of neuronal circuit dysfunction in BD 2.Management
Psychotherapy, including cognitive behavioral therapy (CBT), family therapy, interpersonal therapy, and psychoeducational therapy, is recommended as an adjunct to pharmacotherapy to reduce recurrences and stabilize symptoms 3.
Lifestyle interventions targeting diet, physical activity, substance use, sleep, stress management, and social relationships may improve depressive symptoms and functioning 1.
Combined diet and physical activity interventions have shown significant improvements in depressive symptoms and functioning 1.
Sleep interventions have demonstrated significant improvements in depressive symptoms 1.
Clinical practice guidelines provide evidence-based recommendations for the management of bipolar disorder across different phases of illness 456.Key Recommendations
Adjunctive manualized psychotherapies (e.g., CBT, family therapy, interpersonal therapy, psychoeducational therapy) are associated with reduced recurrences and symptom stabilization in bipolar disorder 3. (Evidence: Moderate)
Lifestyle interventions, particularly combined diet and physical activity, and sleep interventions, can lead to significant improvements in depressive symptoms and functioning 1. (Evidence: Moderate)
40-Hz ASSRs are reduced in patients with bipolar disorder compared to healthy controls, suggesting a potential neurophysiological marker 2. (Evidence: Moderate)References
1 Simjanoski M, Patel S, Boni R, Balanzá-Martínez V, Frey BN, Minuzzi L et al.. Lifestyle interventions for bipolar disorders: A systematic review and meta-analysis. Neuroscience and biobehavioral reviews 2023. link
2 Jefsen OH, Shtyrov Y, Larsen KM, Dietz MJ. The 40-Hz auditory steady-state response in bipolar disorder: A meta-analysis. Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology 2022. link
3 Miklowitz DJ, Efthimiou O, Furukawa TA, Scott J, McLaren R, Geddes JR et al.. Adjunctive Psychotherapy for Bipolar Disorder: A Systematic Review and Component Network Meta-analysis. JAMA psychiatry 2021. link
4 Mok YM, Chan HN, Chee KS, Chua TE, Lim BL, Marziyana AR et al.. Ministry of Health clinical practice guidelines: bipolar disorder. Singapore medical journal 2011. link
5 Malhi GS, Adams D, Lampe L, Paton M, O'Connor N, Newton LA et al.. Clinical practice recommendations for bipolar disorder. Acta psychiatrica Scandinavica. Supplementum 2009. link
6 Bauer MS, Callahan AM, Jampala C, Petty F, Sajatovic M, Schaefer V et al.. Clinical practice guidelines for bipolar disorder from the Department of Veterans Affairs. The Journal of clinical psychiatry 1999. link