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Objective: To verify the prevalence and clinical impact of excessive daytime sleepiness (EDS) in outpatients with bipolar disorder. Methods: Eighty‐one outpatients with bipolar disorder and 79 healthy control subjects were recruited. Patients were required not to be acutely manic or depressed. We used the Epworth Sleepiness Scale, the Pittsburgh Sleep Quality Index and the Functioning Assessment Short Test to assess sleepiness, sleep problems and functioning, respectively. Results: Patients had a higher prevalence of sleepiness (40%) than the control group (18%). Sleepiness and sleep disturbance had independent impacts on disability in the multivariable model. Conclusions: This study suggests that EDS is a relevant clinical dimension in patients with bipolar disorder. It is a frequent symptom that often overlaps with other sleep disturbances. This study also reveals that once present it has the potential to increase functional impairment. [ABSTRACT FROM AUTHOR]

The article discusses the moderating effects of diagnosis and gender on the influence of age on the outcome of electroconvulsive therapy (ECT). The study included adult inpatients who underwent ECT for acute mental illness and analyzed the relationship between age, diagnosis, gender, and remission. The results showed that age alone was not a significant predictor of remission, but when diagnosis and gender were taken into account, older age predicted a higher likelihood of nonremission. The study suggests that diagnosis and gender may be important factors to consider when examining the relationship between age and ECT outcomes. [Extracted from the article]

The article presents a study on the effectiveness of N-acetyl cysteine (NAC) for the treatment of bipolar disorder. A total of 74 patients participated in a placebo-controlled trial and received NAC twice daily for 24 weeks to assess the relationship between functioning, quality of life, and bipolar disorder. The trial revealed that a considerable part of the impact of NAC on functioning has no relation with the change in depression.

The authors explore the reliability of the Portuguese version of the Bipolar Depression Rating Scale (BDRS) that has been developed to identify typical and atypical depressive symptoms as well as depressive mixed states. They note that BDRS was translated into Portuguese by two independent translators. Its structure has been evaluated using cluster analysis which involves sorting variables according to similarity on one or more dimensions. They believe that the reliability and the two-cluster solution demonstrates the validity of the scale.

Gomes FA, Kauer-Sant’Anna M, Magalhães PV, Jacka FN, Dodd S, Gama CS, Cunha Â, Berk M, Kapczinski F. Obesity is associated with previous suicide attempts in bipolar disorder. Objective: There is a paucity of data about risk factors for suicide attempts in bipolar disorder. The aim of this study is to examine the association between suicide attempts and obesity in people with bipolar disorder. Methods: Two hundred fifty-five DSM-IV out-patients with bipolar disorder were consecutively recruited from the Bipolar Disorder Program at Hospital das Clínicas de Porto Alegre and the University Hospital at the Universidade Federal de Santa Maria, Brazil. Diagnosis and clinical variables were assessed with Structured Clinical Interview for DSM-IV-axis I (SCID I) and Program structured protocol. History of suicide attempts was obtained from multiple information sources including patients, relatives and review of medical records. Patients with body mass index (BMI) ≥ 30 were classified as obese. Results: Over 30% of the sample was obese and over 50% had a history of suicide attempt. In the multivariate model, obese patients were nearly twice (OR = 1.97, 95% CI: 1.06–3.69, p = 0.03) as likely to have a history of suicide attempt(s). Conclusion: Our results emphasise the relevance of obesity as an associated factor of suicide attempts in bipolar disorder. Obesity may be seen as correlate of severity and as such, must be considered in the comprehensive management of bipolar patients. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to explore effects of adjunctive treatment with N -acetyl cysteine (NAC) on markers of inflammation and neurogenesis in bipolar depression. Methods: This is a secondary analysis of a placebo-controlled randomised trial. Serum samples were collected at baseline, week 8, and week 32 of the open-label and maintenance phases of the clinical trial to determine changes in interleukin (IL)-6, IL-8, IL-10, tumour necrosis factor-α (TNF-α), C-reactive protein (CRP) and brain-derived neurotrophic factor (BDNF) following adjunctive NAC treatment, and to explore mediation and moderator effects of the listed markers. Results: Levels of brain-derived neurotrophic factor (BDNF), tumour necrosis factor-α (TNF-α), C-reactive protein (CRP), interleukins (IL) -6, 8, or 10 were not significantly changed during the course of the trial or specifically in the open-label and maintenance phases. There were no mediation or moderation effects of the biological factors on the clinical parameters. Conclusion: The results suggest that these particular biological parameters may not be directly involved in the therapeutic mechanism of action of adjunctive NAC in bipolar depression. [ABSTRACT FROM AUTHOR]