Bipolar Affektif Bozuklukta Remisyon Döneminde Rezidüel Belirtiler ve Klinik Sonuçları
Özet
Bipolar affektif bozukluk, manik, hipomanik ve depresif epizodlarla seyreden kronik ve yineleyici bir duygudurum bozukluğudur. Klinik remisyon sağlanmasına rağmen birçok hastada epizodlar arası dönemde rezidüel (kalıntı) belirtiler devam etmektedir. Bu belirtiler çoğunlukla subsendromal depresif ve manik semptomlar, bilişsel işlev bozuklukları ve uyku düzensizlikleri şeklinde ortaya çıkar. Rezidüel belirtiler, hastaların psikososyal işlevselliğini ve yaşam kalitesini olumsuz etkileyebildiği gibi hastalığın nüks riskini de artırmaktadır. Bu nedenle remisyon döneminde rezidüel belirtilerin sistematik biçimde değerlendirilmesi ve izlenmesi bipolar bozukluğun uzun dönem yönetiminde kritik öneme sahiptir. Bu bölümde bipolar affektif bozuklukta remisyon döneminde görülen rezidüel belirtilerin klinik özellikleri, işlevsellik ve hastalık gidişi üzerindeki etkileri ele alınmakta; değerlendirme araçları, olası nörobiyolojik mekanizmalar ve güncel tedavi yaklaşımları klinik perspektiften tartışılmaktadır.
Bipolar affective disorder is a chronic and recurrent mood disorder characterized by manic, hypomanic, and depressive episodes. Despite achieving clinical remission, many patients continue to experience residual symptoms during the inter-episode period. These symptoms often include subsyndromal depressive and manic features, cognitive dysfunction, and sleep disturbances. Residual symptoms can significantly impair psychosocial functioning and quality of life while also increasing the risk of relapse. Therefore, systematic assessment and monitoring of residual symptoms during remission are essential for the long-term management of bipolar disorder. This chapter discusses the clinical characteristics of residual symptoms during the remission phase of bipolar disorder and their impact on functioning and illness course. In addition, commonly used assessment tools, potential neurobiological mechanisms, and current pharmacological and psychosocial treatment approaches are reviewed from a clinical perspective.
Referanslar
Grasso V, Hernandorena C, Dines M, et al. Mixed features in depressive and bipolar disorders: An updated systematic review. Journal of Affective Disorders. 2026 Apr 1;398:120929. https://doi.org/10.1016/j.jad.2025.120929
Aguglia A, Giacomini G, Michiel CF De, et al. Characterization of Bipolar Disorder I and II: Clinical features, comorbidities, and pharmacological pattern. Alpha Psychiatry. 2024;25(4):472-479. doi: 10.5152/alphapsychiatry.2024.241474
Mardani P, Ramezani F, Cattarinussi G, et al. Task-based fMRI and neuropsychological insights into memory and attention in bipolar disorder: A systematic review. Journal of Affective Disorders. 2025 Dec 29;121066. https://doi.org/10.1016/j.jad.2025.121066
Zhao Y, Zhang Y, Zheng S, et al. Manic residual rymptoms also deserve attention: A symptom network analysis of residual symptoms in Bipolar Disorder. Neuropsychiatric Disease and Treament. 2024;20:1397-1408. doi: 10.2147/NDT.S466090
Dupouy M, Roux P, Munuera C, et al. K. The purpose of early maladaptive schemas (EMS) in the relationship dysfunction among people with bipolar disorder in the euthymic phase. Encephale. 2024 Jun 1;50(3):265–274. https://doi.org/10.1016/j.encep.2023.06.016
Bai C, Fan X, Lu W, et al. Meta-analysis of recurrence rate and influencing factors of bipolar disorder. Journal of Affective Disorders. 2026 Feb 1;394:120570. https://doi.org/10.1016/j.jad.2025.120570
Carta MG, Kurotschka PK, Machado S, et al. A Virtual reality cognitive stimulation program as an effective tool against residual/prodromal depressive symptoms in Bipolar Disorders. Journal of Clinical Medicine. 2024 Aug 1;13(16):4714. doi: 10.3390/jcm13164714
Vidal N, Brunet-Gouet E, Frileux S, et al. Exploring the association between residual mood symptoms and self-reported side effects in the euthymic phase of Bipolar Disorders: A cross-sectional network analysis. Depression and Anxiety. 2024;2024(1):3375145. doi: 10.1155/2024/3375145
Grover S, Avasthi A, Chakravarty R, et al. Residual symptoms in bipolar disorders: Findings from the bipolar Disorder course and outcome study from India (BiD-CoIN study). Psychiatry Research. 2021 Aug 1;302:113995. https://doi.org/10.1016/j.psychres.2021.113995
Choi JW, Lee JH, MacDougall A, et al. Residual subjective depressive symptoms and resilience in patients with bipolar disorder. Journal of Affective Disorders. 2025 Jul 1;380:631–636. https://doi.org/10.1016/j.jad.2025.03.152
Yoldi-Negrete M, Palacios-Cruz L, Tirado-Durán E, et al. Looking for factors affecting functioning in euthymic patients with bipolar I disorder: the importance of cognitive complaints and BDNF‘s Val66Met polymorphism. Journal of Affective Disorders. 2022 Apr 1;302:131–138. https://doi.org/10.1016/j.jad.2022.01.006
Demir AM, Görgülü Y, Söğüt K, et al. Cognitive subgroups in bipolar disorder: associations with brain-derived neurotrophic factor and C-reactive protein. BJPsych Open. 2025 Jan 10;12(1):e9. doi: 10.1192/bjo.2025.10918
Li S, Ou Y, Liu H, et al. Differences in the Efficacy of Cognitive Function Treatment Related to Functional Patterns in the Frontal‐Limbic Network in Patients With Bipolar Disorder. CNS Neuroscience and Therapeutics. 2026 Jan 1;32(1):e70730. doi: 10.1002/cns.70730
Fujita A, Esaki Y, Obayashi K, et al. Comparison of objective and subjective sleep parameters in patients with bipolar disorder in both euthymic and residual symptomatic periods. Journal of Psychiatric Researches. 2022 Jan 1;145:190–196. https://doi.org/10.1016/j.jpsychires.2021.12.015
Takim U, Gokcay H, Sağlam T. Evaluation of sleep quality in patients diagnosed with bipolar disorder and major depression during remission period. World Journal of Psychiatry. 2025 Dec 19;15(12):112601. doi: 10.5498/wjp.v15.i12.112601
Hacimusalar Y, Karaaslan O, Misir E, et al. Sleep quality impairments in schizophrenia and bipolar affective disorder patients continue during periods of remission: a case-controlled study. Sleep Science. 2022;15(1):47-54. doi: 10.5935/1984-0063.20210036
Accardo V, Barlati S, Ceraso A, et al. Efficacy of Functional Remediation on Cognitive and Psychosocial Functioning in Patients with Bipolar Disorder: Study Protocol for a Randomized Controlled Study. Brain Sciences. 2023 May 1;13(5):708. doi: 10.3390/brainsci13050708
Chen M, Fitzgerald HM, Madera JJ, et al. Functional outcome assessment in bipolar disorder: A systematic literature review. Bipolar Disorders. 2019 May 1;21(3):194-214. doi: 10.1111/bdi.12775
Madera J, Such P, Zhang P, et al. Use of the Functioning Assessment Short Test (FAST) in defining functional recovery in bipolar I disorder. Post-hoc analyses of long-term studies of aripiprazole once monthly as maintenance treatment. Neuropsychiatric Disease and Treatment. 2019;15:2325-2338. doi: 10.2147/NDT.S209700
López-Villarreal A, Sánchez-Morla EM, Jiménez-López E, et al. Predictive factors of functional outcome in patients with bipolar I disorder: a five-year follow-up. Journal of Affective Disorders. 2020 Jul 1;272:249–258. https://doi.org/10.1016/j.jad.2020.03.140
Easwaran K, Palaniappan P. Social cue recognition and attributional bias in remitted bipolar disorder: Impact on social functioning. Psychiatry Researches. 2021 Dec 1;306:114300.
Scotti-Muzzi E, Chile T, Moreno R, et al. ACC Glu/GABA ratio is decreased in euthymic bipolar disorder I patients: possible in vivo neurometabolite explanation for mood stabilization. European Archives of Psychiatry and Clinical Neuroscience 2020 271:3. 2020 Jan 28;271(3):537–547. https://doi.org/10.1007/s00406-020-01096-0
Gubert C, Jacintho Moritz CE, Vasconcelos-Moreno MP, et al. Peripheral adenosine levels in euthymic patients with bipolar disorder. Psychiatry Researches. 2016 Dec 30;246:421–426. https://doi.org/10.1016/j.psychres.2016.10.007
Fries GR, Vasconcelos-Moreno MP, Gubert C, et al. Hypothalamic-Pituitary-Adrenal Axis Dysfunction and Illness Progression in Bipolar Disorder. International Journal of Neuropsychopharmacology. 2014 Jan 1;18(1):pyu043. doi: 10.1093/ijnp/pyu043
van den Berg MT, Wester VL, Vreeker A, et al. Higher cortisol levels may proceed a manic episode and are related to disease severity in patients with bipolar disorder. Psychoneuroendocrinology. 2020 Sep 1;119:104658. https://doi.org/10.1016/j.psyneuen.2020.104658
Ozkaya AL, Gürbüzer N, Tozoğlu EÖ, et al. Serum Galectin-3 and IL-6 as Inflammatory Markers in Bipolar Disorder: Insights from Manic and Euthymic Episodes. Journal of Clinical Medicines. 2025 Feb 1;14(3): 803. doi: 10.3390/jcm14030803
Kulacaoglu F, Yıldırım YE, Aslan M, et al. Neutrophil to lymphocyte and monocyte to high-density lipoprotein ratios are promising inflammatory indicators of bipolar disorder. Nordic Journal of Psychiatryic. 2023;77(1):77–82. https://doi.org/10.1080/08039488.2022.2116106
Alkan S, Erensoy H, Berkol TD. Mindful Attention Awareness and Residual Mood and Anxiety Symptoms in Remitted Patients With Bipolar I Disorder. Alpha Psychiatry. 2025 Aug 25;26(4):46029. doi: 10.31083/AP46029
Nambiar S, Munivenkatappa M, Arumugham SS. Efficacy of brief cognitive behavior therapy in improving symptoms, functioning, and adherence to treatment in patients with bipolar disorder in remission: A randomized control study. Indian Journal of Psychiatry. 2024 Nov 1;66(11):1050-1058. doi: 10.4103/indianjpsychiatry.indianjpsychiatry_445_24
Chumakov E, Ashenbrenner Y, Gvozdetskii A, et al. Individual Burden of Illness Index in Bipolar Disorder Remission: A Cross-Sectional Study. Consortium Psychiatricum. 2024 Jul 6;5(2):17-30. doi: 10.17816/CP15471
Gutierrez G, Stephenson C, Eadie J, et al. Evaluating the Efficacy of Web-Based Cognitive Behavioral Therapy for the Treatment of Patients With Bipolar II Disorder and Residual Depressive Symptoms: Protocol for a Randomized Controlled Trial. JMIR Research Protocols. 2023;12:e46157. doi: 10.2196/46157
Saccaro LF, Gaviria J, Ville D Van De, et al. Dynamic functional hippocampal markers of residual depressive symptoms in euthymic bipolar disorder. Brain and Behavior. 2023 Jun 1;13(6):e3010. doi: 10.1002/brb3.3010
Carli M, Weiss F, Grenno G, et al. Pharmacological Strategies for Bipolar Disorders in Acute Phases and Chronic Management with a Special Focus on Lithium, Valproic Acid, and Atypical Antipsychotics. Current Neuropharmacology. 2023 Feb 24;21(4):935-950. doi: 10.2174/1570159X21666230224102318
Douglas KM, Inder ML, Crowe MT, et al. Randomised controlled trial of Interpersonal and Social Rhythm Therapy and group-based Cognitive Remediation versus Interpersonal and Social Rhythm Therapy alone for mood disorders: study protocol. BMC Psychiatry. 2022 Dec 1;22(1):115. doi: 10.1186/s12888-022-03747-z
Yatham LN, Kennedy SH, Parikh S V, et al. Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder. Bipolar Disorders. 2018 Mar 1;20(2):97-170. doi: 10.1111/bdi.12609
Malhi GS, Bell E, Bassett D, et al. The 2020 Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for mood disorders. Australian& New Zealand Journal of Psychiatry. 2021 Jan 1;55(1):7–117. doi: 10.1177/0004867420979353
Geddes JR, Miklowitz DJ. Treatment of bipolar disorder. Lancet. 2013;381(9878):10.1016/S0140-6736(13)60857-0. doi: 10.1016/S0140-6736(13)60857-0
McElroy SL, Weisler RH, Chang W, et al. A double-blind, placebo-controlled study of quetiapine and paroxetine as monotherapy in adults with bipolar depression (EMBOLDEN II). Journal of Clinical Psychiatry. 2010 Feb;71(2):163–174. doi: 10.4088/JCP.08m04942gre
Yatham LN, Mackala S, Basivireddy J, et al. Lurasidone versus treatment as usual for cognitive impairment in euthymic patients with bipolar I disorder: a randomised, open-label, pilot study. Lancet Psychiatry. 2017 Mar 1;4(3):208–217. doi: 10.1016/S2215-0366(17)30046-9
Nguyen TD, Hieronymus F, Lorentzen R, et al. The efficacy of repetitive transcranial magnetic stimulation (rTMS) for bipolar depression: A systematic review and meta-analysis. Journal of Affective Disorders. 2021 Jan 15;279:250–255. doi: 10.1016/j.jad.2020.10.013
Bahji A, Zarate CA, Vazquez GH. Ketamine for Bipolar Depression: A Systematic Review. Internatıonal Journal of Neuropsychopharmacology. 2021 Jul 1;24(7):535–541. doi: 10.1093/ijnp/pyab023
Torous J, Staples P, Onnela JP. Realizing the potential of mobile mental health: new methods for new data in psychiatry. Current Psychiatry Reports. 2015 Aug 18;17(8): 602. doi: 10.1007/s11920-015-0602-0
Faurholt-Jepsen M, Munkholm K, Frost M, et al. Electronic self-monitoring of mood using IT platforms in adult patients with bipolar disorder: A systematic review of the validity and evidence. BMC Psychiatry. 2016 Jan 15;16(1). doi: 10.1186/s12888-016-0713-0
Crowe M, Beaglehole B, Inder M. Social rhythm interventions for bipolar disorder: a systematic review and rationale for practice. Journal of Psychiatriary Mental Health Nurse. 2016 Feb 1;23(1):3–11. doi: 10.1111/jpm.12271
Grover S, Chakrabarti S, Sahoo S. Prevalence and clinical correlates of residual symptoms in remitted patients with bipolar disorder: An exploratory study. Indian Journal of Psychiatry. 2020 May 1;62(3):295-305. doi: 10.4103/psychiatry.IndianJPsychiatry_760_19
Léda-Rêgo G, Miranda-Scippa Â. The frontier between residual and subsyndromal symptoms in bipolar disorder: revisiting concepts and discussing clinical relevance. Brazilian Journal of Psychiatry. 2020;43(3):235-236. doi: 10.1590/1516-4446-2020-0929
Belete H, Ali T, Legas G, et al. Relapse and Clinical Characteristics of Patients with Bipolar Disorders in Central Ethiopia: A Cross-Sectional Study. Psychiatry Journal. 2020 Sep 28;2020:8986014. doi: 10.1155/2020/8986014
Ehrminger M, Brunet-Gouet E, Cannavo AS, et al. Longitudinal relationships between cognition and functioning over 2 years in euthymic patients with bipolar disorder: a cross-lagged panel model approach with the FACE-BD cohort. The British Journal of Psychiatry. 2021 Feb 1;218(2):80–87. DOI: https://doi.org/10.1192/bjp.2019.180
Bo Q, Tian L, Li F, et al. Quality of life in euthymic patients with unipolar major depressive disorder and bipolar disorder. Neuropsychiatry Disease and Treatment. 2019;15:1649-1657. doi: 10.2147/NDT.S201567
Valls È, Bonnín CM, Torres I, et al. Efficacy of an integrative approach for bipolar disorder: preliminary results from a randomized controlled trial. Psychological Medicine. 2021 Dec 16;52(16):4094-4105. doi: 10.1017/S0033291721001057
Zhang X, Cheng X, Chen J, et al. Association of subthreshold manic symptoms and cognitive impairments in euthymic patients with bipolar disorder I. Psychiatry Research. 2019 Aug 1;278:303–308. DOI: 10.1016/j.psychres.2019.06.032
Referanslar
Grasso V, Hernandorena C, Dines M, et al. Mixed features in depressive and bipolar disorders: An updated systematic review. Journal of Affective Disorders. 2026 Apr 1;398:120929. https://doi.org/10.1016/j.jad.2025.120929
Aguglia A, Giacomini G, Michiel CF De, et al. Characterization of Bipolar Disorder I and II: Clinical features, comorbidities, and pharmacological pattern. Alpha Psychiatry. 2024;25(4):472-479. doi: 10.5152/alphapsychiatry.2024.241474
Mardani P, Ramezani F, Cattarinussi G, et al. Task-based fMRI and neuropsychological insights into memory and attention in bipolar disorder: A systematic review. Journal of Affective Disorders. 2025 Dec 29;121066. https://doi.org/10.1016/j.jad.2025.121066
Zhao Y, Zhang Y, Zheng S, et al. Manic residual rymptoms also deserve attention: A symptom network analysis of residual symptoms in Bipolar Disorder. Neuropsychiatric Disease and Treament. 2024;20:1397-1408. doi: 10.2147/NDT.S466090
Dupouy M, Roux P, Munuera C, et al. K. The purpose of early maladaptive schemas (EMS) in the relationship dysfunction among people with bipolar disorder in the euthymic phase. Encephale. 2024 Jun 1;50(3):265–274. https://doi.org/10.1016/j.encep.2023.06.016
Bai C, Fan X, Lu W, et al. Meta-analysis of recurrence rate and influencing factors of bipolar disorder. Journal of Affective Disorders. 2026 Feb 1;394:120570. https://doi.org/10.1016/j.jad.2025.120570
Carta MG, Kurotschka PK, Machado S, et al. A Virtual reality cognitive stimulation program as an effective tool against residual/prodromal depressive symptoms in Bipolar Disorders. Journal of Clinical Medicine. 2024 Aug 1;13(16):4714. doi: 10.3390/jcm13164714
Vidal N, Brunet-Gouet E, Frileux S, et al. Exploring the association between residual mood symptoms and self-reported side effects in the euthymic phase of Bipolar Disorders: A cross-sectional network analysis. Depression and Anxiety. 2024;2024(1):3375145. doi: 10.1155/2024/3375145
Grover S, Avasthi A, Chakravarty R, et al. Residual symptoms in bipolar disorders: Findings from the bipolar Disorder course and outcome study from India (BiD-CoIN study). Psychiatry Research. 2021 Aug 1;302:113995. https://doi.org/10.1016/j.psychres.2021.113995
Choi JW, Lee JH, MacDougall A, et al. Residual subjective depressive symptoms and resilience in patients with bipolar disorder. Journal of Affective Disorders. 2025 Jul 1;380:631–636. https://doi.org/10.1016/j.jad.2025.03.152
Yoldi-Negrete M, Palacios-Cruz L, Tirado-Durán E, et al. Looking for factors affecting functioning in euthymic patients with bipolar I disorder: the importance of cognitive complaints and BDNF‘s Val66Met polymorphism. Journal of Affective Disorders. 2022 Apr 1;302:131–138. https://doi.org/10.1016/j.jad.2022.01.006
Demir AM, Görgülü Y, Söğüt K, et al. Cognitive subgroups in bipolar disorder: associations with brain-derived neurotrophic factor and C-reactive protein. BJPsych Open. 2025 Jan 10;12(1):e9. doi: 10.1192/bjo.2025.10918
Li S, Ou Y, Liu H, et al. Differences in the Efficacy of Cognitive Function Treatment Related to Functional Patterns in the Frontal‐Limbic Network in Patients With Bipolar Disorder. CNS Neuroscience and Therapeutics. 2026 Jan 1;32(1):e70730. doi: 10.1002/cns.70730
Fujita A, Esaki Y, Obayashi K, et al. Comparison of objective and subjective sleep parameters in patients with bipolar disorder in both euthymic and residual symptomatic periods. Journal of Psychiatric Researches. 2022 Jan 1;145:190–196. https://doi.org/10.1016/j.jpsychires.2021.12.015
Takim U, Gokcay H, Sağlam T. Evaluation of sleep quality in patients diagnosed with bipolar disorder and major depression during remission period. World Journal of Psychiatry. 2025 Dec 19;15(12):112601. doi: 10.5498/wjp.v15.i12.112601
Hacimusalar Y, Karaaslan O, Misir E, et al. Sleep quality impairments in schizophrenia and bipolar affective disorder patients continue during periods of remission: a case-controlled study. Sleep Science. 2022;15(1):47-54. doi: 10.5935/1984-0063.20210036
Accardo V, Barlati S, Ceraso A, et al. Efficacy of Functional Remediation on Cognitive and Psychosocial Functioning in Patients with Bipolar Disorder: Study Protocol for a Randomized Controlled Study. Brain Sciences. 2023 May 1;13(5):708. doi: 10.3390/brainsci13050708
Chen M, Fitzgerald HM, Madera JJ, et al. Functional outcome assessment in bipolar disorder: A systematic literature review. Bipolar Disorders. 2019 May 1;21(3):194-214. doi: 10.1111/bdi.12775
Madera J, Such P, Zhang P, et al. Use of the Functioning Assessment Short Test (FAST) in defining functional recovery in bipolar I disorder. Post-hoc analyses of long-term studies of aripiprazole once monthly as maintenance treatment. Neuropsychiatric Disease and Treatment. 2019;15:2325-2338. doi: 10.2147/NDT.S209700
López-Villarreal A, Sánchez-Morla EM, Jiménez-López E, et al. Predictive factors of functional outcome in patients with bipolar I disorder: a five-year follow-up. Journal of Affective Disorders. 2020 Jul 1;272:249–258. https://doi.org/10.1016/j.jad.2020.03.140
Easwaran K, Palaniappan P. Social cue recognition and attributional bias in remitted bipolar disorder: Impact on social functioning. Psychiatry Researches. 2021 Dec 1;306:114300.
Scotti-Muzzi E, Chile T, Moreno R, et al. ACC Glu/GABA ratio is decreased in euthymic bipolar disorder I patients: possible in vivo neurometabolite explanation for mood stabilization. European Archives of Psychiatry and Clinical Neuroscience 2020 271:3. 2020 Jan 28;271(3):537–547. https://doi.org/10.1007/s00406-020-01096-0
Gubert C, Jacintho Moritz CE, Vasconcelos-Moreno MP, et al. Peripheral adenosine levels in euthymic patients with bipolar disorder. Psychiatry Researches. 2016 Dec 30;246:421–426. https://doi.org/10.1016/j.psychres.2016.10.007
Fries GR, Vasconcelos-Moreno MP, Gubert C, et al. Hypothalamic-Pituitary-Adrenal Axis Dysfunction and Illness Progression in Bipolar Disorder. International Journal of Neuropsychopharmacology. 2014 Jan 1;18(1):pyu043. doi: 10.1093/ijnp/pyu043
van den Berg MT, Wester VL, Vreeker A, et al. Higher cortisol levels may proceed a manic episode and are related to disease severity in patients with bipolar disorder. Psychoneuroendocrinology. 2020 Sep 1;119:104658. https://doi.org/10.1016/j.psyneuen.2020.104658
Ozkaya AL, Gürbüzer N, Tozoğlu EÖ, et al. Serum Galectin-3 and IL-6 as Inflammatory Markers in Bipolar Disorder: Insights from Manic and Euthymic Episodes. Journal of Clinical Medicines. 2025 Feb 1;14(3): 803. doi: 10.3390/jcm14030803
Kulacaoglu F, Yıldırım YE, Aslan M, et al. Neutrophil to lymphocyte and monocyte to high-density lipoprotein ratios are promising inflammatory indicators of bipolar disorder. Nordic Journal of Psychiatryic. 2023;77(1):77–82. https://doi.org/10.1080/08039488.2022.2116106
Alkan S, Erensoy H, Berkol TD. Mindful Attention Awareness and Residual Mood and Anxiety Symptoms in Remitted Patients With Bipolar I Disorder. Alpha Psychiatry. 2025 Aug 25;26(4):46029. doi: 10.31083/AP46029
Nambiar S, Munivenkatappa M, Arumugham SS. Efficacy of brief cognitive behavior therapy in improving symptoms, functioning, and adherence to treatment in patients with bipolar disorder in remission: A randomized control study. Indian Journal of Psychiatry. 2024 Nov 1;66(11):1050-1058. doi: 10.4103/indianjpsychiatry.indianjpsychiatry_445_24
Chumakov E, Ashenbrenner Y, Gvozdetskii A, et al. Individual Burden of Illness Index in Bipolar Disorder Remission: A Cross-Sectional Study. Consortium Psychiatricum. 2024 Jul 6;5(2):17-30. doi: 10.17816/CP15471
Gutierrez G, Stephenson C, Eadie J, et al. Evaluating the Efficacy of Web-Based Cognitive Behavioral Therapy for the Treatment of Patients With Bipolar II Disorder and Residual Depressive Symptoms: Protocol for a Randomized Controlled Trial. JMIR Research Protocols. 2023;12:e46157. doi: 10.2196/46157
Saccaro LF, Gaviria J, Ville D Van De, et al. Dynamic functional hippocampal markers of residual depressive symptoms in euthymic bipolar disorder. Brain and Behavior. 2023 Jun 1;13(6):e3010. doi: 10.1002/brb3.3010
Carli M, Weiss F, Grenno G, et al. Pharmacological Strategies for Bipolar Disorders in Acute Phases and Chronic Management with a Special Focus on Lithium, Valproic Acid, and Atypical Antipsychotics. Current Neuropharmacology. 2023 Feb 24;21(4):935-950. doi: 10.2174/1570159X21666230224102318
Douglas KM, Inder ML, Crowe MT, et al. Randomised controlled trial of Interpersonal and Social Rhythm Therapy and group-based Cognitive Remediation versus Interpersonal and Social Rhythm Therapy alone for mood disorders: study protocol. BMC Psychiatry. 2022 Dec 1;22(1):115. doi: 10.1186/s12888-022-03747-z
Yatham LN, Kennedy SH, Parikh S V, et al. Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder. Bipolar Disorders. 2018 Mar 1;20(2):97-170. doi: 10.1111/bdi.12609
Malhi GS, Bell E, Bassett D, et al. The 2020 Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for mood disorders. Australian& New Zealand Journal of Psychiatry. 2021 Jan 1;55(1):7–117. doi: 10.1177/0004867420979353
Geddes JR, Miklowitz DJ. Treatment of bipolar disorder. Lancet. 2013;381(9878):10.1016/S0140-6736(13)60857-0. doi: 10.1016/S0140-6736(13)60857-0
McElroy SL, Weisler RH, Chang W, et al. A double-blind, placebo-controlled study of quetiapine and paroxetine as monotherapy in adults with bipolar depression (EMBOLDEN II). Journal of Clinical Psychiatry. 2010 Feb;71(2):163–174. doi: 10.4088/JCP.08m04942gre
Yatham LN, Mackala S, Basivireddy J, et al. Lurasidone versus treatment as usual for cognitive impairment in euthymic patients with bipolar I disorder: a randomised, open-label, pilot study. Lancet Psychiatry. 2017 Mar 1;4(3):208–217. doi: 10.1016/S2215-0366(17)30046-9
Nguyen TD, Hieronymus F, Lorentzen R, et al. The efficacy of repetitive transcranial magnetic stimulation (rTMS) for bipolar depression: A systematic review and meta-analysis. Journal of Affective Disorders. 2021 Jan 15;279:250–255. doi: 10.1016/j.jad.2020.10.013
Bahji A, Zarate CA, Vazquez GH. Ketamine for Bipolar Depression: A Systematic Review. Internatıonal Journal of Neuropsychopharmacology. 2021 Jul 1;24(7):535–541. doi: 10.1093/ijnp/pyab023
Torous J, Staples P, Onnela JP. Realizing the potential of mobile mental health: new methods for new data in psychiatry. Current Psychiatry Reports. 2015 Aug 18;17(8): 602. doi: 10.1007/s11920-015-0602-0
Faurholt-Jepsen M, Munkholm K, Frost M, et al. Electronic self-monitoring of mood using IT platforms in adult patients with bipolar disorder: A systematic review of the validity and evidence. BMC Psychiatry. 2016 Jan 15;16(1). doi: 10.1186/s12888-016-0713-0
Crowe M, Beaglehole B, Inder M. Social rhythm interventions for bipolar disorder: a systematic review and rationale for practice. Journal of Psychiatriary Mental Health Nurse. 2016 Feb 1;23(1):3–11. doi: 10.1111/jpm.12271
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