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Background: Early intervention for people diagnosed with bipolar disorder has been identified as a priority, but little is known about how existing early intervention services are experienced by this group or could be tailored to their needs. Aims: This study examined the experience of early intervention in psychosis (EIP) services for people diagnosed with bipolar disorder, following first episode psychotic mania. Method: Semi-structured interviews were conducted with 11 adults in EIP services and analysed using Interpretative Phenomenological Analysis. Results: One superordinate theme was formed, Rebuilding within EIP service, consisting of five subthemes: (i) Piecing together episode through talking to staff; (ii) Exploring other perspectives during CBT; (iii) Empowered through shared decision-making; (iv) Reconsidering future and purpose; (v) Service as safety-net. EIP provision was pivotal in helping participants understand their episode, adjust their perspective, build confidence and progress. Conclusions: Aspects of the service that were valued, including person-centred relationships with staff, shared decision-making and the development of motivation and opportunities, reflect key principles of mental health care for young people following first episode psychosis. Furthermore, findings point to elements that may be particularly relevant to early intervention following first episode psychotic mania including managing mood escalation and individualised approaches to goals. [ABSTRACT FROM AUTHOR]

Optimal intervention for people diagnosed with bipolar disorder (BD) is seen as a priority within early intervention psychosis services. This is the first study to explore the experience of first-episode psychotic mania and its aftermath for people diagnosed with BD, and the potential implications for treatment. Semi-structured interviews were conducted with 11 young adults following first-episode psychotic mania and analysed using Interpretative Phenomenological Analysis (IPA). Two overarching themes were identified: (i) "Changing states of self during first episode"; (ii) "Struggling with loss of self during episode aftermath". Participants experienced exceptional, persecutory and angry states during psychotic mania, leading to identity disruption and low feelings or depression post-episode. Some mourned the loss of their exceptional manic self, and attempted to relapse into mania, while others struggled with the loss of who they had been prior to their episode. Results emphasise the importance of understanding identity change during first-episode psychotic mania and how that might be used to address identity disruption and low feelings during recovery. This process is likely to be pertinent to early intervention and prevention of manic relapse following first-episode BD. [ABSTRACT FROM AUTHOR]

Living with episodes of mania and depression is recognised to instil profound instability in people diagnosed with bipolar disorder, but little is known about how these mood changes arise through a person’s trajectory over time. This longitudinal study aimed to investigate the experience of mood change within and between bipolar disorder episodes. Semi-structured interviews were conducted with three women at two time points and were analysed using longitudinal interpretative phenomenological analysis to form idiographic trajectories. Three longitudinal themes illustrated the changing experiences of participants during periods of depression, euthymia (stability) and mania: (i) Extreme changes in activity and agency, (ii) Changes in feelings and connectivity, (iii) Shifting sense of the future disrupts momentum. The findings highlighted trajectories of change in key areas of the participants’ lives including activity levels, routine and agency, intensity of feelings and connectivity, and their sense of the future and progression. Changes experienced during episodes were cumulative, impacting participants’ ability to reconnect, take control and move forward during euthymia. The clinical value of mapping a client’s sense of change across BD phases is indicated, along with the need to build agency, progression and connectivity during euthymic periods. Suggestions for research and practice are discussed. [ABSTRACT FROM AUTHOR]

When hybridization or other forms of lateral gene transfer have occurred, evolutionary relationships of species are better represented by phylogenetic networks than by trees. While inference of such networks remains challenging, several recently proposed methods are based on quartet concordance factors-the probabilities that a tree relating a gene sampled from the species displays the possible 4-taxon relationships. Building on earlier results, we investigate what level-1 network features are identifiable from concordance factors under the network multispecies coalescent model. We obtain results on both topological features of the network, and numerical parameters, uncovering a number of failures of identifiability related to 3-cycles in the network. Addressing these identifiability issues is essential for designing statistically consistent inference methods., (© 2024. The Author(s).)