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The article discusses the importance of psychological interventions in treating bipolar disorder (BD) alongside medication. It highlights various evidence-based psychological interventions such as psychoeducation, cognitive behavioral therapy (CBT), and family-focused therapy (FFT) that have shown positive outcomes in managing BD. The paper emphasizes the need for personalized treatment plans based on individual needs and stages of the disorder, as well as the challenges of accessing evidence-based psychological interventions globally due to factors like awareness, availability, and affordability. The authors recommend large-scale efforts to develop and implement psychological interventions for BD, optimize treatments based on treatment moderators, and work towards equitable access to these interventions worldwide. [Extracted from the article]

Objectives: To understand treatment practices for bipolar disorders (BD), this study leveraged the Global Bipolar Cohort collaborative network to investigate pharmacotherapeutic treatment patterns in multiple cohorts of well‐characterized individuals with BD in North America, Europe, and Australia. Methods: Data on pharmacotherapy, demographics, diagnostic subtypes, and comorbidities were provided from each participating cohort. Individual site and regional pooled proportional meta‐analyses with generalized linear mixed methods were conducted to identify prescription patterns. Results: This study included 10,351 individuals from North America (n = 3985), Europe (n = 3822), and Australia (n = 2544). Overall, participants were predominantly female (60%) with BD‐I (60%; vs. BD‐II = 33%). Cross‐sectionally, mood‐stabilizing anticonvulsants (44%), second‐generation antipsychotics (42%), and antidepressants (38%) were the most prescribed medications. Lithium was prescribed in 29% of patients, primarily in the Australian (31%) and European (36%) cohorts. First‐generation antipsychotics were prescribed in 24% of the European versus 1% in the North American cohort. Antidepressant prescription rates were higher in BD‐II (47%) compared to BD‐I (35%). Major limitations were significant differences among cohorts based on inclusion/exclusion criteria, data source, and time/year of enrollment into cohort. Conclusions: Mood‐stabilizing anticonvulsants, second‐generation antipsychotics, and antidepressants were the most prescribed medications suggesting prescription patterns that are not necessarily guideline concordant. Significant differences exist in the prescription practices across different geographic regions, especially the underutilization of lithium in the North American cohorts and the higher utilization of first‐generation antipsychotics in the European cohorts. There is a need to conduct future longitudinal studies to further explore these differences and their impact on outcomes, and to inform and implement evidence‐based guidelines to help improve treatment practices in BD. [ABSTRACT FROM AUTHOR]

The present paper highlights how alcohol use disorder (AUD) conceptualizations and resulting diagnostic criteria have evolved over time in correspondence with interconnected sociopolitical influences in the United States. We highlight four illustrative examples of how DSM-defined alcoholism, abuse/dependence, and AUD have been influenced by sociopolitical factors. In doing so, we emphasize the importance of recognizing and understanding such sociopolitical factors in the application of AUD diagnoses. Last, we offer a roadmap to direct the process of future efforts toward the improved diagnosis of AUD, with an emphasis on pursuing falsifiability, acknowledging researchers' assumptions about human behavior, and collaborating across subfields. Such efforts that center the numerous mechanisms and functions of behavior, rather than signs or symptoms, have the potential to minimize sociopolitical influences in the development of diagnostic criteria and maximize the treatment utility of diagnoses. [ABSTRACT FROM AUTHOR]

Although sleep disturbances are well documented in bipolar spectrum disorders (BSDs), significantly less research has examined whether these disturbances are present in those at risk for developing BSDs or with subsyndromal symptoms. The present study examined associations between risk for BSDs, as measured by the Hypomanic Personality Scale (HPS), and sleep assessed using experience sampling. We assessed whether intraindividual variability in sleep was associated with affect, cognition, and behavior in daily life and potential directionality of these relationships. 233 young adults oversampled for high scores on the HPS completed 14 days of experience sampling assessing total sleep time (TST), bed/rise time, sleep quality, affect (negative and positive affect), cognition (difficulty concentrating, racing thoughts), and behavior (impulsivity) in daily life. We used Dynamic Structural Equation Modeling (DSEM) to assess within-person links between sleep and bipolar spectrum psychopathology. HPS scores were associated with less TST, later bedtime, and more variable TST and bedtime. Variability in TST was associated with negative affect, difficulty concentrating/racing thoughts, and impulsivity. Within-person decreases in sleep were associated with next day increases in negative affect, stress, difficulty concentrating, and racing thoughts. Measurement of sleep was limited. Future studies should examine both objective measures of sleep (e.g., actigraphy) and fragmentation in sleep. Risk for BSD was associated with similar patterns of sleep disruptions as seen in BSDs. Important dynamic links between sleep and bipolar spectrum psychopathology emerged indicating that sleep is an important target for improving symptoms of BSDs in daily life. [ABSTRACT FROM AUTHOR]

Objective: Impulsivity appears to be best conceptualized as a multidimensional construct. For example, the UPPS-P model posits that there are five underlying facets of impulsivity. The present study examined the expression of the UPPS-P facets in daily life using experience sampling methodology. A specific goal of the study was to examine positive urgency, a facet added to the original UPPS model, and its convergence and divergence from the negative urgency facet.Method: A large nonclinical sample of young adults (n = 294) completed the UPPS-P scale and was signaled to complete questionnaires assessing daily affect, cognitions, sense of self, and impulsive behaviors eight times a day for 7 days.Results: Results indicated that the UPPS-P facets are associated with disruptions in affect, cognitions, and behavior in daily life. Furthermore, all of the UPPS-P facets were associated with impulsivity in daily life. Contrary to expectation, positive urgency was associated with negative affect rather than positive affect and had a profile indistinguishable from negative urgency.Conclusions: These results generally support a four-factor model of multidimensional impulsivity with a general overall urgency factor instead of separate positive and negative urgency facets. [ABSTRACT FROM AUTHOR]

Affective temperaments are trait-like expressions of affect that underlie mood psychopathology. Numerous studies have examined affective temperaments in laboratory-based studies; however, few have examined the expression of these temperaments in daily life. The present study examined affective temperaments and their associations with the expression of bipolar spectrum characteristics in daily life using experience sampling methodology. Young adults ( n = 290) completed the TEMPS-A and were signaled eight times daily for 1 week to complete smartphone surveys assessing affect, cognition, and behavior. Hyperthymic temperament was associated with positive affect, sense of self, and success. In contrast, cyclothymic/irritable temperament was associated with negative affect, impulsivity, negative sense of self, and difficulty concentrating. Those high in cyclothymic/irritable temperament were especially reactive to the experience of stress. Affective temperaments were differentially associated with the expression of bipolar spectrum psychopathology in daily life. The findings offer validation of the TEMPS-A, as well as the adaptive and maladaptive characteristics of hyperthymic and cyclothymic/irritable temperaments. [ABSTRACT FROM AUTHOR]