Talk:Bipolar disorder

Edit Request for the Causes Section

There is a hypothesis already supported with scientific evidence that bipolar disorder might be caused by the dysfunction of mitochondria (or Mitochondrial disease) and it is hypothesized that mitochondrial modulators might be a new line of treatments that need more evidence and clinical trials to support their use and prescription. A few basic references including two reviews are below.

[1] Experimental and Molecular Pathology 83 (2007) 84–92 Mitochondrial dysfunction and molecular pathways of disease Steve R. Pieczenik, John Neustadt⁎ Received 30 August 2006 Available online 18 January 2007 Link to article

[2] Mitochondrial modulators for bipolar disorder: A pathophysiologically informed paradigm for new drug development Andrew A Nierenberg, Christine Kansky, Brian P Brennan, Richard C Shelton, Roy Perlis and Dan V Iosifescu Australian & New Zealand Journal of Psychiatry 47(1) 26–42 Link to article

[3] Neurosci Biobehav Rev. 2016 Sep;68:694-713. Epub 2016 Jul 1. Mitochondrial dysfunction in bipolar disorder: Evidence, pathophysiology and translational implications. Scaini G1, Rezin GT2, Carvalho AF3, Streck EL4, Berk M5, Quevedo J6. Link to article

[4] Bipolar Disorders 2000: 2: 180–190 Hypothesis Paper Mitochondrial dysfunction in bipolar disorder Tadafumi Kato and Nobumasa Kato Link to paper

[5] Molecular Psychiatry (2005) 10, 900–919. doi:10.1038/sj.mp.4001711; published online 12 July 2005 Mitochondrial dysfunction in bipolar disorder: evidence from magnetic resonance spectroscopy research C Stork1 and P F Renshaw1 Link to paper

[6] Neurochemical Research June 2009, 34:1021 Mitochondrial Dysfunction and Psychiatric Disorders Gislaine T. RezinGraziela Amboni Alexandra I. Zugno João Quevedo Emilio L. Streck Link to paper

[7] Experimental and Molecular Pathology 83 (2007) 84–92 Mitochondrial dysfunction and molecular pathways of disease Steve R. Pieczenik, John Neustadt Link to article in PubMed

Two blog posts on the same topics Mitocondrial Modulators and Mitocondrian dysfunction as a cause of disease — Preceding unsigned comment added by Alucarbon (talk • contribs) 09:08, 1 October 2017 (UTC)

These are all primary sources yet to be reviewed in secondary sources. Once there is some ongoing discussion in Review Articles we can think about including. Cas Liber (talk · contribs) 13:41, 1 October 2017 (UTC)

Re Cas Liber comment: Secondary sources already discuss this cause of BD. For example, The Bipolar Boook is a reference concerned with the neurobiology of BD and discusses mitochondrial dysfunction. A review by Nature Magazine published in 2005 and a second review by Nature Magazine published in 2001 (Nature Magazine is the highest ranked magazine in science!) provide evidence and discussion that supports this cause of BD. A few blog posts discuss mitochondrial dysfunction and they are a secondary source.

All other causes of BD are as well hypotheses and there might be even weaker evidence for them than the evidence for mitochondrial dysfunction. This topic would be a great addition to the causes section and there is enough scientific support and discussion for it to be included. Reference [6] above is a review and discusses even more broadly the implications of mitochondrial dysfunction for psychiatric disorders. Reference [7] above is a review article in the PubMed archives and it list bipolar disorder among several other diseases possibly caused by mitochondria disease. The search term "mitochondrial dysfunction bipolar disorder" has 26,000 results in Google Scholar and 89 articles in PubMed some of them reviews. — Preceding unsigned comment added by Alucarbon (talk • contribs) 16:26, 2 October 2017 (UTC)

Alright then, phrase in 1-2 sentences what you think should be added. I am mindful of the fact that even though this has been talked about for almost twenty years, it has yielded nothing effective clinically. At all. Cas Liber (talk · contribs) 20:31, 2 October 2017 (UTC)

Rfc Request for comment on bipolar disorder causes

The following discussion is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.

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The causes section of the bipolar disorder makes very brief mention of mitochondria but not mitochondrial dysfunction or mitochondrial disease as a possible cause. Would it be good to add more on mitochondrial dysfunction to the causes section on the topic? This addition would make Neurobiology role as a cause more prominent on the article. Alucarbon (talk) 20:17, 2 October 2017 (UTC)

In current treatment and management of bipolar, none of this comes up at all - it is all still in research and theory stage. Hence I feel it does not warrant more than a couple of sentences. Still, why not discuss what you think should be added here? Cas Liber (talk · contribs) 10:15, 3 October 2017 (UTC)

Thanks! I would add something like: Neurobiology might play a role in the development of bipolar disorder and its treatment and there is evidence that mitochondrial disease or mitochondrial dysfunction might be a cause of bipolar disorder. Mitochondria function is essential for the energy production of the cells, called ATP, and for regulating cellular metabolism. --Alucarbon (talk) 18:20, 3 October 2017 (UTC)

I'd leave out the last sentence with the explanation of what mitochondria do. A link suffices. Other than that, do we have consensus now? PizzaMan ♨♨♨ 20:44, 6 October 2017 (UTC)

• This ref says "implicate mitochondrial dysfunction as an important component of the pathophysiology" So belongs in the pathophysiology section not the cause section. Doc James (talk · contribs · email) 22:44, 6 October 2017 (UTC)

Doc James makes an important point - agree with pathophysiology and not causes as a destination for this extra material Cas Liber (talk · contribs) 23:20, 6 October 2017 (UTC)

The cause is mithocondrial dysfunction and the pathophysiology would tells us how precisely the mythochondria malfunctions. I would add a couple of sentences on this to both sections. --Alucarbon (talk) 19:53, 20 October 2017 (UTC)

"MtDNA/nDNA mutational damage, failure of endogenous antioxidant defenses, hormonal mal-function, altered membrane permeability, metabolic dysregulation, disruption of calcium buffering capacity and ageing have been found to be the root causes of mitochondrial dys- function in psychatric and neurodegenerative diseases." Please see this reference and review article because it explains the ways mithocondria mal-functions and thus can enrich the pathophysiology section as well. --Alucarbon (talk) 23:34, 23 October 2017 (UTC)

• Too many "might" and "possible" phrases to list as cause. Bipolar is poorly understood to begin with, we need better research before we have better sources, certainly before making a claim as to cause. Dennis Brown - 2¢ 10:42, 7 October 2017 (UTC)
• Comment Agree with PizzaMan and Doc James. I propose a slight adjustment of wording, something like:
  Evidence suggests that neurobiology is relevant both to the development of bipolar disorder and to its treatment. There also is reason to believe that mitochondrial disease or mitochondrial dysfunction can be important in the development of bipolar disorder. JonRichfield (talk) 06:45, 9 October 2017 (UTC)

Yes, JonRichfield wording is better! --Alucarbon (talk) 19:53, 20 October 2017 (UTC)

• Comment The phrase "mitochondrial disease as a possible cause" is confusing. It sounds as if mitochondrial disease means "a disease of the mitochodria". It doesn't mean that. It means a disease caused by defective mitochdria. Bipolar disorder is (maybe) a mitochondrial disease. Maproom (talk) 16:28, 12 October 2017 (UTC)
• Comment Many genes have been claimed to play a role in bipolar disorder. Most are chromosomal, at least one is mitochondrial. Do we have any reason to single out mitochondrial genes for special mention? Maproom (talk) 16:28, 12 October 2017 (UTC)

References

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The discussion above is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.

Semi-protected edit request on 9 May 2018

Please change

"Bipolar disorder is the sixth leading cause of disability worldwide and has a lifetime prevalence of about 3 percent in the general population.[5][137] However, a reanalysis of data from the National Epidemiological Catchment Area survey in the United States suggested that 0.8 percent of the population experience a manic episode at least once (the diagnostic threshold for bipolar I) and a further 0.5 percent have a hypomanic episode (the diagnostic threshold for bipolar II or cyclothymia). Including sub-threshold diagnostic criteria, such as one or two symptoms over a short time-period, an additional 5.1 percent of the population, adding up to a total of 6.4 percent, were classified as having a bipolar spectrum disorder.[138] A more recent analysis of data from a second US National Comorbidity Survey found that 1 percent met lifetime prevalence criteria for bipolar I, 1.1 percent for bipolar II, and 2.4 percent for subthreshold symptoms.[139]"

to

"Bipolar disorder is the sixth leading cause of disability worldwide [137] and has a lifetime prevalence of 1.02%. There are several different types of bipolar disorder with type I [link to https://en.wikipedia.org/wiki/Bipolar_I_disorder] accounting for 0.62%, type II [link to https://en.wikipedia.org/wiki/Bipolar_II_disorder] for 0.36%, and “Not Otherwise Specified (NOS) [link to https://en.wikipedia.org/wiki/Bipolar_disorder_not_otherwise_specified]” for 0.96%. () Other studies have suggested a lifetime prevalence of about 3 percent in the general population (). Including sub-threshold diagnostic criteria, such as one or two symptoms over a short time-period, an additional 5.1 percent of the population, adding up to a total of 6.4 percent, were classified as having a bipolar spectrum disorder.[138]" A1moreira (talk) 12:03, 9 May 2018 (UTC)

Bipolar I disorder is already linked higher up in the article. So no need to link again.

Which ref supports "has a lifetime prevalence of 1.02%" Doc James (talk · contribs · email) 13:42, 9 May 2018 (UTC)

These results are from a recent meta-analysis ref Moreira ALR, Van Meter A, Genzlinger J, et al. Review and meta-analysis of epidemiologic studies of adult bipolar disorder. J Clin Psychiatry. 2017;78(9):e1259–e1269. Changes to the text with the inclusion of prevalence rates for bipolar type I, II, and NOS from this recent meta-analysis add to completion and updating of the text. That ref concludes prevalence rates are not increasing over time and vary by geographic region, further research could help unpack specific risk factors at play. — Preceding unsigned comment added by A1moreira (talk • contribs) 15:47, 14 May 2018 (UTC)

 Not done for now: I am very hesitant to add any study proposed by its primary author, particularly a new study by a new editor which proposes substantial re-analysis. If other studies present similar findings, then we can add it at that time. Eggishorn (talk) (contrib) 04:18, 21 May 2018 (UTC)

It is a decent ref. Have adjusted to "Bipolar disorder is the sixth leading cause of disability worldwide and has a lifetime prevalence of about 1 to 3 percent in the general population." User:A1moreira your thoughts? Doc James (talk · contribs · email) 05:14, 21 May 2018 (UTC)

References

Semi-protected edit request on 20 July 2018

please, in history section, of the origin of melenchoni, it is around the word milan not melas of greek word. i think milan can be found in ancient greek otherwise it is latin(i consider latin language & sanskrit same). milan means socialising or matching. 117.197.16.161 (talk) 18:41, 20 July 2018 (UTC)

 Not done: please provide reliable sources that support the change you want to be made. I see that Melancholia and wikt:Melancholia agree with this article on the word origin. ‑‑ElHef (Meep?) 18:52, 20 July 2018 (UTC)

Semi-protected edit request on 21 July 2018

Remove dramatic mask symbols as representation of a disease. It's offensive. 78.147.181.186 (talk) 13:07, 21 July 2018 (UTC)

 Not done for now: This image has been a point of contention in this article for many years. I see discussions about the infobox image going back to at least 2012, and I haven't looked that hard. As such, this can't be considered an uncontroversial improvement per WP:EDITREQ#General considerations and would need consensus before being changed. It may be worth holding another RFC at this point - the last RFC in 2016 doesn't look like it was open for very long, and I don't see it being closed at all. ‑‑ElHef (Meep?) 14:35, 21 July 2018 (UTC)

See Talk:Bipolar_disorder/Archive_7#RfC: Is the happy/sad mask in the infobox section appropriate? Looie496 (talk) 16:23, 21 July 2018 (UTC)