Carter Sherman Annotated Bib. Bipolar Disorder

Carter Sherman
Dr. Zebrack
SW 686
12 April 2016
An Annotated Biblography to understand the Bio-Psycho-Social aspects of Bipolar Disorder for
the University of Michigan’s Heinz C. Prechter Bipolar Resarch Project

Sherman 1
Purpose: The purpose of this literature review is to analyze available research to better
understand how Bipolar Disorder (BD) affects people emotionally, socially, and physically, as
well as determine differences in BD in regards to gender, age, and race.
“The mission of the Heinz C. Prechter Bipolar Research Fund is to provide a repository of
longitudinal clinical, genetic, and biological data to investigators worldwide for collaborative
research on the causes, prevention, and treatment of bipolar disorder”
(www.prechterfund.org/about/mission/)
Emotional Findings: Aside from experiencing symptoms of BD, those with the disorder are also
at higher risk for other mental illness; this comorbidity appears to contribute to lower quality of
life among BD patients.
 BD is often associated with co-occurring mental illness
 Despite an increased risk of dual mental illness, some people with BD never seek
treatment
 Bipolar patients experience lower functioning and well-being even in the stable phase of
the disorder
o Lower quality of life
o Higher rates of suicide
Social Findings: Current and past behaviors and experiences of BD patients may provide insight
to patients who are at higher risk for suicide.
 Mortality rates among individuals with BD are elevated compared to the general
population
 Certain past events may identify those at high risk of suicide attempt in BD

Sherman 2
o Interpersonal problems with romantic partner
o Occupational problems
o Early age onset
 There is no evidence of nationality influencing the rates of BD
Physical Findings: BD patients may experience comorbid physical health problems which
includes problems with sleep.
 Severe Mental Illness leads to increased risk of chronic health problems
 Sleep disturbances can result from BD
Gender Findings: Men and women experience and present BD symptoms differently. It is
unclear if men or women with BD are at higher risk for substance abuse. It is also unclear if men
or women with BD are hospitalized more. Considering patients would enter the hospital in a
manic or depressed phase, it is possible that men are more likely to be hospitalized for mania
while women are more susceptible to hospitalization during depressiveness.
 Men and women with BD experience and present different internal and external
symptoms
o Men experience more manic symptoms
o Women experience more depressive symptoms
 The rates of BD are consistent among genders
 There is discrepancy in literature regarding gender differences in hospitalization rates due
to complications in determining hospitalization for manic or depressive symptoms
 Women with BD are at increased for substance abuse disorder compared to women
without BD

Sherman 3
 There is discrepancy in the literature around gender differences and the rates of substance
abuse
Race Findings: Considering BD patients of different race and ethnicity present symptoms
differently with less internalizing and externalizing factors, there is a history of misdiagnosis. As
understanding of BD increases, it is likely to see an increase in the rates of diagnosis in minority
groups.
 There is a history of misdiagnosis of schizophrenia among black and Hispanic groups
 African Americans and Hispanics experience and present BD differently than whites
o Less internalizing and externalizing disorders
 Depression, anxiety, substance abuse, impulse control disorder
Youth Findings: It is unclear as to whether or not youth of mothers with BD experience and
present symptoms of BD. It is determined that child abuse is a leading factor in early onset of
BD.
 There is a discrepancy in the literature regarding whether or not children of bipolar
women tend to show symptoms of BD in youth
 Child abuse influences early onset of BD
 Diagnoses of BD in youth has been rising in recent years

Sherman 4
Key Findings Evidence Sources
Bio-Psycho-Social Aspects of Bipolar Disorder
Emotional Findings
Bipolar Disorder
(BD) is often
associated with co-
occurring mental
illness
“82.8% [of people with bipolar disorder] had
experienced an additional mental disorder in their
lifetime.”
Have, M., Vollebergh, W., Bijl, R., &
Nolen, W. (2002). Bipolar disorder in
the general population in The
Netherlands (prevalence, consequences
and care utilisation): ResultsfromThe
Netherlands Mental Health Survey and
Incidence Study (NEMESIS). Journal
of Affective Disorders, 68(2), 203-213.
doi:10.1016/S0165-0327(00)00310-4
Despite an
increased risk of
dual mental illness,
some people with
BD never seek
treatment
“25.5% had never sought help for their emotional
problems, not even primary, informal or alternative
care.”
doi:10.1016/S0165-0327(00)00310-4
Bipolar patients
experience lower
functioning and
well-being even in
the stable phase of
the disorder
“The group of [euthymic] bipolar patients obtained
statistically significantlylower scores on all the [Quality
of Life] subscales when compared with the control
population.”
Sierra, P., Livianos, L., & Rojo, L.
(2005). Quality of life for patientswith
bipolar disorder: Relationship with
clinical and demographic variables.
Bipolar Disorders, 7(2), 159-165.
doi:10.1111/j.1399-5618.2005.00186.x
“Compared to other mental disorders, people with
bipolar disorder were more often incapacitated and were
more likely to have attempted suicide and reported a
poorer quality of life”
doi:10.1016/S0165-0327(00)00310-4
Social Findings
Mortality rates
among individuals
with BD are
elevated compared
to the general
population
“Life-expectancy was 13.6 years shorter for bipolar men
compared to men in the general population.
Corresponding numbers for bipolar women was
12.1 years.”
Laursen, T. (2011). Life expectancy
among persons with schizophrenia or
bipolar affective disorder.
Schizophrenia Research, 131(1), 101-
104. doi:10.1016/j.schres.2011.06.008
Certain past events
may identify those
at high risk of
suicide attempt in
BD
“Multiple logistic regression showed that [bipolar]
subjects with a history of suicide attempts were more
likely to have interpersonal problems with spouse or
romantic partner, occupational problems mainly
maladjustment and frequently changing job, and an
earlier age (≤22 years) of onset”
Tsai, S., Lee, J., & Chen, C. (1999).
Characteristics and psychosocial
problems of patientswith bipolar
disorder at high risk for suicide
attempt. Journal of Affective
Disorders, 52(1-3),145-152.
doi:10.1016/s0165-0327(98)00066-4
There is no
evidence of
“The lifetime rates of bipolar disorder are consistent
across countries: United States, Canada, Puerto Rico,
Weissman, M., Bland, R., Canino, G.,
Faravelli, C., Greenwald, S., Hwu, H., .

Sherman 5
nationality
influencing the rates
of BD
France, West Germany, Italy, Lebanon, Taiwan, Korea,
and New Zealand.”
. . Yeh, E. (1996). Cross-National
Epidemiology of Major Depression
and Bipolar Disorder. The Journal of
the American Medical Association,
276(4), 293.
doi:10.1001/jama.1996.0354004003703
0
Physical Findings
Severe Mental
Illness leads to
increased risk of
chronic health
problems
“Of persons with serious mental illness enrolled in
Medicaid… 74 percent of the study sample (N=109) had
been given a diagnosis of at least one chronic health
problem, and 50 percent (N=73) had been given a
diagnosis of two or more chronic health problems.”
Jones, D., Macias, C., Barreira, P.,
Fisher, W., Hargreaves, W., & Harding,
C. (2004). Prevalence, Severity,and
Co-occurrence of Chronic Physical
Health Problems of Persons With
Serious Mental Illness. Psychiatric
Services, 55(11), 1250-1257.
doi:10.1176/appi.ps.55.11.1250
“Mortality from cardiovascular causesand pulmonary
embolism, and morbidity from obesity and type 2
diabetes mellitus may be increased in BD compared to
the general population. Reduced exercise and poor diet,
frequent depressive episodes, comorbidity with
substance misuse and poor quality general medical care
contribute to the additional risk of these medical
problems in people with BD.”
Morriss, R. (2005). Metabolism,
lifestyle and bipolar affective disorder.
Journal of Psychopharmacology, 19(6),
94-101.
doi:10.1177/0269881105058678
Sleep disturbances
can result from BD
“Seventy percent of the euthymic patients with bipolar
disorder exhibited a clinically significant sleep
disturbance. Compared with the other groups, the
bipolar disorder group exhibited impaired sleep
efficiency, higher levels of anxiety and fear about poor
sleep, lower daytime activity levels, and a tendency to
misperceive sleep. The bipolar disorder group held a
level of dysfunctional beliefs about sleep that was
comparable to that in the insomnia group and
significantly higher than that in the good sleeper group.”
Harvey, A., Schmidt, D., Scarna, A.,
Semler, C., & Goodwin, G. (2005).
Sleep-Related Functioningin Euthymic
PatientsWith Bipolar Disorder,
PatientsWith Insomnia, and Subjects
Without Sleep Problems. The
American Journal of Psychiatry, 162(1),
50-57. Retrieved from
http://ajp.psychiatryonline.org/doi/pd
f/10.1176/appi.ajp.162.1.50
Gender Findings
Men and women
with BD experience
and present
different internal
and external
symptoms
“More men than women reported mania at the onset of
bipolar I disorder. Men also had higher rates of
comorbid alcohol abuse/dependence, cannabis
abuse/dependence, pathological gambling and conduct
disorder. Men were more likely to report ‘behavioral
problems’ and ‘being unable to hold a conversation’
during mania.”
Kawa, I., Carter, J., Joyce, P., Doughty,
C., Frampton, C., Wells, J., . . . Olds, R.
(2005). Gender differences in bipolar
disorder: Age of onset, course,
comorbidity, and symptom
presentation. Bipolar Disorders, 7(2),
119-125. doi:10.1111/j.1399-
5618.2004.00180.x
“Women reported higher rates of comorbid eating
disorders, and weight change, appetite change and
middle insomnia during depression.”

Sherman 6
119-125. doi:10.1111/j.1399-
5618.2004.00180.x
“Compared to men with bipolar disorder, women have
more pervasive depressive symptoms and experience
more major depressive episodes. They are also at higher
risk for obesity and certain other medical and psychiatric
comorbidities. Mood changes across the menstrual cycle
are common, although the severity, timing, and type of
changes are variable. Bipolar disorder is frequently
associated with menstrual abnormalities and ovarian
dysfunction, including polycystic ovarian syndrome.
Although some cases of menstrual disturbance precede
the treatment of bipolar disorder, it is possible that
valproate and/or antipsychotic treatment may play a
contributory role in young women.”
Suppes, T. (2006). Gender Differences
in Bipolar Disorder. CNS Spectrums,
11(5), 2-4.
doi:10.1017/S1092852900025670
The rates of BD are
consistent among
genders
“Most gender comparisons showed no evidence of
differences.”
119-125. doi:10.1111/j.1399-
5618.2004.00180.x
“No significant gender differences were found in the rate
of bipolar I or bipolar II diagnoses. Also, no significant
gender differences emerged in age at onset or number of
depressive or manic episodes”
Hendrick, V., Altshuler, L., Gitlin, M.,
Delrahim, S., & Hammen, C. (2000).
Gender and Bipolar Illness. The
Journal of Clinical Psychiatry, 61(5),
393-396. doi:10.4088/jcp.v61n0514
There is
discrepancy in
literature regarding
gender differences
in hospitalization
rates due to
complications in
determining
hospitalization for
manic or depressive
symptoms
“No significant gender differences were found in…
number of hospitalizations for depression”
393-396. doi:10.4088/jcp.v61n0514
“Women had been hospitalized significantly more often
than men for mania.”
393-396. doi:10.4088/jcp.v61n0514
“Bipolar disorder related hospitalization was more
prevalent among female adolescents and adults”
Blader, J., & Carlson, G. (2007).
Increased Ratesof Bipolar Disorder
Diagnoses Among U.S. Child,
Adolescent, and Adult Inpatients,
1996–2004. Biological Psychiatry,

Sherman 7
62(2), 107-114.
doi:10.1016/j.biopsych.2006.11.006
Women with BD
are at increased for
substance abuse
disorder compared
to women without
BD
“Women with bipolar disorder had 4 times the rate of
alcohol use disorders and 7 times the rate of other
substance use disorders than reported in women from
community-derived samples.”
393-396. doi:10.4088/jcp.v61n0514
There is
discrepancy in the
literature around
gender differences
and the rates of
substance abuse
“The risk of having alcoholism was greater for women
with bipolar disorder than for men with bipolar
disorder”
Frye, M., Altshuler, L., Mcelroy, S.,
Suppes, T., Keck, P., Denicoff, K., . . .
Post, R. (2003). Gender Differencesin
Prevalence, Risk, and Clinical
Correlates of Alcoholism Comorbidity
in Bipolar Disorder. American Journal
of Psychiatry, 160(5), 883-889.
doi:10.1176/appi.ajp.160.5.883
“Bipolar men were significantly more likely than bipolar
women to have a comorbid substance use disorder”
393-396. doi:10.4088/jcp.v61n0514
Race Findings
There is a history of
misdiagnosis of
schizophrenia
among African
American and
Hispanic groups
“Ethnicity remained significantly associated with
misdiagnosis of bipolar patients as schizophrenic even
after all other significant variables were partialled out of
the equation. It appears from these data that black and
Hispanic bipolar patients may be at a higher risk than
whites for misdiagnosis as schizophrenic”
Misdiagnosis of schizophrenia in
bipolar patients: A multiethnic
comparison. (1983). American Journal
of Psychiatry, 140(12), 1571-1574.
doi:10.1176/ajp.140.12.1571
“Black individuals, especially men, had lower rates of BD
diagnoses in early survey years, but more recently their
rate of BD related hospitalizations has exceeded other
NHDS race groups.”
62(2), 107-114.
doi:10.1016/j.biopsych.2006.11.006
African Americans
and Hispanics
experience and
present BD
differently than
whites: less
internalizing and
externalizing
disorders
“[Non-Hispanic Black and Hispanic] groups had lower
risk for common internalizing disorders: depression,
generalized anxiety disorder, and social phobia. In
addition, Hispanics had lower risk for dysthymia,
oppositional-defiant disorder and attention deficit
hyperactivity disorder; non-Hispanic Blacks had lower
risk for panic disorder, substance use disorders and early-
onset impulse control disorders.”
Breslau, J., Aguilar-Gaxiola, S.,
Kendler, K., Su, M., Williams, D., &
Kessler, R. (2006). Specifyingrace-
ethnic differences in risk for psychiatric
disorder in a USA national sample.
Psychological Medicine, 36(01), 57-68.
doi:10.1017/s0033291705006161

Sherman 8
“African–Caribbean and African groups were
significantly less likely to have experienced a depressive
episode before onset of first mania, at 13.5% and 6.1%,
respectively, compared with 28.1% in the white
European group. African–Caribbean and African groups
also experienced more severe psychotic symptoms at
first mania, but there were no differences in mood
incongruent or first rank symptoms between ethnic
groups.”
Kennedy, N., Boydell, J., Os, J., &
Murray, R. (2004). Ethnic differences
in first clinical presentation of bipolar
disorder: Resultsfrom an
epidemiological study. Journal of
Affective Disorders, 83(2-3), 161-168.
doi:10.1016/j.jad.2004.06.006
Youth Findings
There is a
discrepancy in the
literature regarding
whether or not
children of bipolar
women tend to
show symptoms of
BD in youth
“[Relating to] behavior problems, social competence,
internalizing and externalizing behaviors, academic
performance, and school behavior… children of bipolar
women did not differ from children of psychiatrically
normal women.”
Anderson, C., & Hammen, C. (1993).
Psychosocial outcomes of children of
unipolar depressed, bipolar, medically
ill, and normal women: A longitudinal
study. Journal of Consulting and
Clinical Psychology, 61(3), 448-454.
doi:10.1037/0022-006X.61.3.448
“Children of bipolar mothers experienced significant
rates of disorder… it appeared that most children who
had diagnoses had onsets in preadolescence and
continued a chronic or intermittent course of disorder.
Thus, risk to offspring of ill mothers is not transitory and
indicates a pernicious course that commonly includes
affective disorders alone or in combination with
behavior and anxiety disorders.”
Hammen, C., Burge, D., Burney, E., &
Adrian, C. (1990). Longitudinal Study
of Diagnoses in Children of Women
With Unipolar and Bipolar Affective
Disorder. Arch Gen Psychiatry
Archives of General Psychiatry, 47(12),
1112-1117.
doi:10.1001/archpsyc.1990.018102400
32006
Child abuse
influences early
onset of BD
“Those who endorsed a history of child or adolescent
physical or sexual abuse… had a history of an earlier
onset of bipolar illness, an increased number of Axis I,
II, and III comorbid disorders, including drug and
alcohol abuse, faster cycling frequencies, a higher rate of
suicide attempts, and more psychosocial stressors
occurring before the first and most recent affective
episode.”
Leverich, G., Mcelroy, S., Suppes, T.,
Keck, P., Denicoff, K., Nolen, W., . . .
Post, R. (2002). Early physical and
sexual abuse associated with an adverse
course of bipolar illness. Biological
Psychiatry, 51(4), 288-297.
doi:10.1016/S0006-3223(01)01239-2
“Histories of severe childhood abuse were identified in
about half of the [bipolar] sample and were associated
with early age at illness onset”
Garno, J., Goldberg, J., Ramirez, P., &
Ritzler, B. (2005). Impact of childhood
abuse on the clinical course of bipolar
disorder. The British Journal of
Psychiatry, 186(2), 121-125.
doi:10.1192/bjp.186.2.121
Diagnoses of BD in
youth has been
rising in recent
years
“Population-adjusted rates of hospital discharges of
children with a primary diagnosis of BD increased
linearly over survey years. The rate in 1996 was 1.3 per
10,000 U.S. children and climbed to 7.3 per 10,000 U.S.
children in 2004. Bipolar disorder related discharges also
increased fourfold among adolescents.”
62(2), 107-114.
doi:10.1016/j.biopsych.2006.11.006

Sherman 9
Works Cited
Anderson,C.,&Hammen,C. (1993). Psychosocial outcomesof childrenof unipolardepressed,bipolar,
medicallyill,andnormal women:A longitudinal study.Journal of ConsultingandClinical
Psychology,61(3),448-454. doi:10.1037/0022-006X.61.3.448
Blader,J.,& Carlson,G. (2007). IncreasedRatesof BipolarDisorderDiagnosesAmongU.S.Child,
Adolescent,andAdultInpatients,1996–2004. Biological Psychiatry,62(2),107-114.
doi:10.1016/j.biopsych.2006.11.006
Breslau,J.,Aguilar-Gaxiola,S.,Kendler,K.,Su,M.,Williams,D.,&Kessler,R.(2006). Specifyingrace-
ethnicdifferencesinriskforpsychiatricdisorderinaUSA national sample.Psychological
Medicine,36(01),57-68. doi:10.1017/s0033291705006161
Frye,M., Altshuler,L.,Mcelroy,S.,Suppes,T.,Keck,P.,Denicoff,K.,... Post,R. (2003). Gender
DifferencesinPrevalence,Risk,andClinical Correlatesof AlcoholismComorbidityinBipolar
Disorder.AmericanJournal of Psychiatry,160(5),883-889. doi:10.1176/appi.ajp.160.5.883
Garno, J.,Goldberg,J.,Ramirez,P.,& Ritzler,B.(2005). Impact of childhoodabuse onthe clinical course
of bipolardisorder.The BritishJournalof Psychiatry,186(2),121-125. doi:10.1192/bjp.186.2.121
Hammen,C.,Burge,D., Burney,E.,& Adrian,C. (1990). Longitudinal Studyof DiagnosesinChildrenof
WomenWithUnipolarand BipolarAffective Disorder.ArchGenPsychiatryArchivesof General
Psychiatry,47(12), 1112-1117. doi:10.1001/archpsyc.1990.01810240032006
Harvey,A.,Schmidt,D.,Scarna, A.,Semler,C.,&Goodwin,G. (2005). Sleep-RelatedFunctioningin
EuthymicPatientsWithBipolarDisorder,PatientsWithInsomnia,andSubjectsWithoutSleep
Problems.The AmericanJournal of Psychiatry,162(1),50-57. Retrievedfrom
http://ajp.psychiatryonline.org/doi/pdf/10.1176/appi.ajp.162.1.50
Have,M., Vollebergh,W.,Bijl,R.,&Nolen,W.(2002). Bipolardisorderinthe general populationinThe
Netherlands(prevalence,consequencesandcare utilisation):ResultsfromThe Netherlands
Mental HealthSurveyandIncidence Study(NEMESIS).Journal of Affective Disorders,68(2),203-
213. doi:10.1016/S0165-0327(00)00310-4
Hendrick,V.,Altshuler,L.,Gitlin,M.,Delrahim, S.,&Hammen,C.(2000). Genderand BipolarIllness.The
Journal of Clinical Psychiatry,61(5),393-396. doi:10.4088/jcp.v61n0514
Jones,D.,Macias, C.,Barreira,P., Fisher,W.,Hargreaves,W.,& Harding,C.(2004). Prevalence,Severity,
and Co-occurrence of ChronicPhysical HealthProblemsof Persons WithSeriousMental Illness.
PsychiatricServices,55(11),1250-1257. doi:10.1176/appi.ps.55.11.1250
Kawa,I., Carter,J.,Joyce,P.,Doughty,C.,Frampton,C.,Wells,J.,.. . Olds,R.(2005). Genderdifferences
inbipolardisorder:Age of onset,course,comorbidity,andsymptompresentation.Bipolar
Disorders,7(2),119-125. doi:10.1111/j.1399-5618.2004.00180.x

Sherman 10
Kennedy,N.,Boydell,J.,Os,J.,& Murray, R. (2004). Ethnic differencesinfirstclinical presentationof
bipolardisorder:Resultsfroman epidemiological study.Journal of Affective Disorders,83(2-3),
161-168. doi:10.1016/j.jad.2004.06.006
Laursen,T. (2011). Life expectancyamongpersonswithschizophreniaorbipolaraffective disorder.
SchizophreniaResearch,131(1),101-104. doi:10.1016/j.schres.2011.06.008
Leverich,G.,Mcelroy,S.,Suppes,T.,Keck,P.,Denicoff,K.,Nolen,W.,.. . Post,R. (2002). Early physical
and sexual abuse associatedwithanadverse course of bipolarillness.BiologicalPsychiatry,
51(4), 288-297. doi:10.1016/S0006-3223(01)01239-2
Misdiagnosisof schizophreniainbipolarpatients:A multiethniccomparison.(1983).AmericanJournal of
Psychiatry,140(12), 1571-1574. doi:10.1176/ajp.140.12.1571
Morriss,R. (2005). Metabolism,lifestyleandbipolaraffectivedisorder.Journal of Psychopharmacology,
19(6), 94-101. doi:10.1177/0269881105058678
Sierra,P.,Livianos,L.,& Rojo,L. (2005). Qualityof life forpatientswithbipolardisorder:Relationship
withclinical anddemographicvariables.BipolarDisorders,7(2),159-165. doi:10.1111/j.1399-
5618.2005.00186.x
Suppes,T.(2006). GenderDifferencesinBipolarDisorder.CNSSpectrums,11(5),2-4.
doi:10.1017/S1092852900025670
Tsai,S., Lee,J.,& Chen,C.(1999). Characteristicsandpsychosocial problemsof patientswithbipolar
disorderathighrisk forsuicide attempt.Journal of AffectiveDisorders,52(1-3),145-152.
doi:10.1016/s0165-0327(98)00066-4
Weissman,M.,Bland,R.,Canino,G., Faravelli,C.,Greenwald,S.,Hwu,H.,. . . Yeh,E. (1996). Cross-
National Epidemiologyof MajorDepressionandBipolarDisorder.The Journal of the American
Medical Association,276(4),293. doi:10.1001/jama.1996.03540040037030

Carter Sherman Annotated Bib. Bipolar Disorder

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