Women with polycystic ovary syndrome (PCOS) have a high prevalence of psychiatric disorders, particularly mood disorders, research confirms.

Writing in the journal Comprehensive Psychiatry, Andre Barciela Veras and colleagues from the Federal University of Rio de Janeiro in Brazil explain that “endocrinopathies and psychiatric disorders, especially mood disorders, seem to be interconnected.”

They add: “It has been found that patients with bipolar mood disorder present an increase in the prevalence of menstrual abnormalities, and that among women with PCOS, the prevalence of depression can reach 50%.”

To investigate the prevalence of psychiatric disorders among women with PCOS in Brazil, the researchers studied 72 women, aged an average of 26 years, who were receiving treatment for the endocrine disorder.

All of the participants evaluated for DSM-IV Axis I psychiatric disorders using the Mini International Neuropsychiatric Interview (MINI) version 4.4. Data on sociodemographic characteristics and previous psychiatric treatments were also obtained from the participants’ medical records.

The researchers found that 56.9% of the women met criteria for at least one psychiatric disorder. Of these, 78% met criteria for a mood disorder.

The most common psychiatric disorder among the participants was major depression (26.4%), followed by bipolar disorder types I and II (11.1%), generalized anxiety disorder (9.7%), dysthymia (4.2%), and social phobia (4.2%).

“The results showed a high prevalence of psychiatric disorders among participants with PCOS. Mood disorders represented… 26.4% of the identified mental disorders in the whole sample,” Veras and team comment.

They add that the results also showed a greater prevalence than expected for bipolar disorder types I and II.

The findings “emphasize the importance of conducting research with the objective of elucidating the relationship between PCOS, peripheral resistance to insulin, and mood disorders,” they conclude.

MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2010

Free abstract

• Prepared Patient: Managing Mental And Medical Illness

Researchers have developed and validated a self-report measure for quantifying functional status across different clinical states in patients with bipolar disorder.

Bipolar disorder patients often show persistent impairments in psychosocial functioning and the researchers found that few instruments satisfactorily measure the psychometric characteristics experienced specifically by these patients.

Existing instruments tend to use adapted functional outcome measures originally developed for use in other conditions such as schizophrenia or major depression. In contrast, the new instrument ??” the Bipolar Functional Status Questionnaire (BFSQ) ??” was developed using domains identified a priori as fundamental to psychosocial adjustment in patients with bipolar disorder.

From a literature review, interviews with patients with bipolar disorder, and recommendations from a six-member academic advisory panel, eight constructs were identified as fundamental to functional status in bipolar disorder patients. These were cognitive function, sleep, role functioning, emotional functioning, energy/vitality, social functioning, personal management, and sexual functioning.

A 33-item questionnaire was developed based on these eight constructs and its effectiveness tested in 596 patients with bipolar disorder aged between 18 and 76 years. Initial testing resulted in the questionnaire being reduced to 24 items, based on exploratory factor analysis results, item-level statistics, and item content.

Further testing of this 24-item questionnaire showed high internal consistency (coefficient ?’s=0.93??”0.95) and high re-test reliability (intraclass correlation coefficient=0.86).

It also showed strong convergent validity with other functional disability measures and highly significant discriminant validity across illness phases, with large effect sizes.

Joseph Goldberg, from Mount Sinai School of Medicine in New York, USA, and colleagues report: “The discriminant validity of the 24-item BFSQ was strongly supported by statistically significant mean differences among the three clinical states (stable, hypomanic/manic, and depressed), with large effect size estimates, suggesting its potential utility to track changes in functional status across changing clinical states in treatment outcome studies of bipolar disorder.”

They add in the journal Bipolar Disorders that, as changes in functional status may precede clinical symptoms, further studies should examine the potential sensitivity of the BFSQ for identifying shifts in clinical status or prodromal signs of an impending affective episode.

“Because patients themselves appear able to detect prodromal signs of affective relapse only approximately half of the time, decremental changes in BFSQ scores over time may provide useful corroboration for detecting associated signs of relapse before fulminant episodes occur,” the team concludes.

MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2010

Free abstract

• Childhood ADHD impacts on clinical course of bipolar disorder
• For Bipolar Depression, Surveyed Experts Indicate That Current And Emerging Therapies Have No Advantage Over Seroquel In Decreasing The Syptoms

Postpartum bipolar II disorder may be mistakenly diagnosed as major depressive disorder, say Canadian and US scientists who make recommendations as to how patients should be treated.

Bipolar postpartum depression is commonly overlooked and mistaken for unipolar major depression. However, while bipolar I disorder is a reliable and relatively stable diagnosis, bipolar II disorder is less easily diagnosed and may be dismissed as a milder form of bipolar I disorder.

To examine the detection, diagnosis, and treatment of bipolar II postpartum depression Verinder Sharma, from the University of Western Ontario in London, Canada, and colleagues conducted a search of the PubMed database and reference lists for relevant articles published between 1998 and 2009.

Estimates of the prevalence of hypomania in non-clinical populations ranged from 9.6% to 20.4% on day 3 postpartum, at an average of approximately 15.0%. Furthermore, almost 20% of patients with hypomanic symptoms at day 3 postpartum developed postpartum depression in one study, with a significant proportion diagnosed with bipolar II disorder or bipolar disorder not otherwise specified (NOS).

Crucially, the team says in the Journal of Affective Disorders that, although there are formal rating scales for assessing bipolar spectrum disorder and unipolar postpartum depression, there are no validated instruments for screening, diagnosing, or monitoring bipolar disorder during pregnancy or postpartum, with even the Highs scale not validated as a diagnostic instrument.

There have only been three randomized controlled trials and six open-label studies of the pharmacologic treatment of postpartum depression, and three studies of the treatment of bipolar disorder during postpartum depression.

While the evidence suggests that postpartum bipolar depression should follow the same guidelines as for non-puerperal bipolar depression, the team says there is a lack of evidence-based treatment options. Women should be monitored closely, they argue, and prophylactic treatment may be considered.

The researchers conclude: “The lack of data on postpartum bipolar II and bipolar disorder NOS is surprising given the high prevalence of hypomanic symptoms immediately after delivery, the unique pharmacologic challenges posed by bipolar depression, and the heightened risk for suicide associated with bipolar spectrum disorder. and illness course that are commonly used to establish the bipolar diathesis of a clinical condition.”

MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2009

Free abstract

• Eighth International Conference On Bipolar Disorder To Be Held In Pittsburgh, June 25 To 27
• Brain activity determines risk or resilience in bipolar disorder

At the edu/stanley/8thbipconf/” target=”_blank” rel=”nofollow”>8th International Conference on Bipolar Disorder this week in Pittsburgh, four distinguished individuals will be honored for their contributions to bipolar disorder research, education and service. The conference is the only venue in the world devoted exclusively to highlighting new research into bipolar disorder

Joyce and Dusty Sang will receive the Mogens Schou Award for Public Service for founding The Ryan Licht Sang Bipolar Foundation, in memory of their only son, Ryan, who had early-onset bipolar disorder and died at the age of 24 in 2004. The foundation’s mission is to foster awareness, understanding and research for child and adolescent bipolar disorder. One of its major initiatives is a “Quest For The Test™” to find an empirical test for bipolar disorder so that early detection and intervention become a reality.

Lakshmi N. Yatham, M.B.B.S., F.R.C.P.C., M.R.C.Psych. (U.K.), will receive the Mogens Schou Award for Education and Advocacy. Dr. Yatham is a professor of psychiatry and associate head for research and international affairs in the Department of Psychiatry, University of British Columbia, Vancouver, where his research focuses on neurobiology and treatment of bipolar disorder and major depression. Dr. Yatham leads a Canadian consortium on bipolar disorder, which is pursuing testing of new treatments for bipolar disorder. He also is chair of the bipolar group of the Canadian Network for Mood and Anxiety Treatments and is actively involved at a national and international level in continuing medical and public education on diagnosis and treatment of bipolar disorder.

Guy Goodwin, D.Phil., F.Med.Sci., will receive the Mogens Schou Award for Research. Dr. Goodwin is the head of the Department of Psychiatry, Oxford University, where his research focuses on the treatment of severe psychiatric illness and the application of neuroscience in understanding the neurobiology of mood disorders. Dr. Goodwin is researching the neurobiology of vulnerability to mood disorders and the psychopharmacology of emotional processing. He also has helped develop the basis for larger-scale clinical trials in bipolar affective disorder (BALANCE and CEQUEL).

“This year’s Mogens Schou Awards continue the strong tradition of honoring those heroes who are making major advances that bring hope to those suffering from bipolar disorder,” said David J. Kupfer, M.D., the Thomas P. Detre Professor and chairman, Department of Psychiatry, University of Pittsburgh School of Medicine.

The Mogens Schou Awards were named in recognition and appreciation of Mogens Schou, M.D., Dr. Med. Sci., honorary president, International Society of Bipolar Disorders, and emeritus professor, The Psychiatric Hospital, Risskov, Denmark. His groundbreaking research over 50 years ago proved lithium’s significant mood stabilizing effects for the treatment of bipolar disorders. The awards ceremony takes place at 8:30 p.m., Friday, June 26, at The Carnegie Museums of Pittsburgh in Oakland.

The Eighth International Conference on Bipolar Disorder, which is being sponsored by the University of Pittsburgh School of Medicine and Western Psychiatric Institute and Clinic of UPMC, is the only venue in the world devoted exclusively to highlighting new research into bipolar disorder. The disease affects both adults and children, devastates families and work relationships, accounts for nearly half of all suicides in the United States, and costs billions in medical bills, missed work and lower productivity.

For more information on the meeting, visit http://www.8thbipolar.org.

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8th International Conference on Bipolar Disorder

• Combined Lithium Plus Valproate Or Lithium Monotherapy Better At Preventing Relapse In Bipolar Patients Than Valproate Monotherapy (Balance Study)