Lithium is a first-line treatment for bipolar disorder (BD), but weight gain is a common side effect, leading to physical comorbidities and reduced average life expectancy. Some individuals are predisposed to weight gain due to lithium therapy, indicating the need to explore metabolic differences to prevent health complications. This descriptive feasibility study aimed to explore metabolic parameters in lithium-naïve BD individuals who later gained weight during lithium therapy versus those who did not. Data from BD individuals (N = 10) were included, five of whom gained weight (≥ 5 kg) during lithium treatment and five who did not. Nuclear Magnetic Resonance spectroscopy was used to measure blood serum lipoprotein and inflammation parameters, as well as molecular metabolites before lithium treatment. Univariate t-tests and multivariate orthogonal partial least-squares discriminant analysis (oPLS-DA) were performed to observe metabolomic between-group differences. The multivariate oPLS-DA did not show significant differences between the groups, but data visualization suggested distinct metabolic profiles. Univariate analyses revealed significantly elevated lipoprotein parameters in the weight gain group, which did not remain significant after correction for multiple testing. Phenylalanine levels showed an observable but non-significant downward trend in the weight gain group (fold change = 0.40, p = .057). The findings suggest a link between weight gain during lithium therapy and altered lipoprotein metabolism, aligning with previous research. However, larger studies are needed to further explore the underlying mechanisms. These preliminary findings represent a stepping stone for personalized lithium treatment strategies, which could help mitigate adverse metabolic side effects and improve treatment adherence.

This scoping review synthesized evidence on vitamin D, parathyroid hormone (PTH), and serum calcium in bipolar disorder (BD) to evaluate their potential clinical utility. A systematic PubMed search identified original studies examining calcium metabolism biomarkers (vitamin D, PTH, serum calcium) exclusively in BD populations. Findings were synthesized narratively due to substantial methodological heterogeneity. Fourteen studies met inclusion criteria, with small sample sizes (median n = 55) and predominantly cross-sectional designs. Vitamin D comparisons between BD patients and controls yielded contradictory results: three studies reported significantly lower levels in BD patients, two found significantly higher levels, and three found no differences. Vitamin D deficiency definitions varied widely (< 25 to < 50 nmol/L), precluding meaningful comparisons. Four cognition studies showed inconsistent associations with vitamin D, with negative correlations, age-dependent effects, or no associations reported. Two small vitamin D supplementation studies in bipolar spectrum disorders yielded contradictory results in distinct populations, with one in youth and the other in adults. Data on PTH and calcium were sparse and inconsistent. Study limitations included a single database search, substantial study heterogeneity, and inadequate control for confounders, including seasonal variation. Evidence on calcium metabolism biomarkers in BD is contradictory and methodologically limited. Fundamental inconsistencies in vitamin D status between BD patients and controls, combined with conflicting supplementation data, preclude clinical recommendations. Routine vitamin D screening specifically for BD management cannot be supported. Large-scale, standardized studies are needed before clinical application.

INTRODUCTION:Global functioning is a common clinician-rated measure of treatment changes in inpatient psychiatric care, but its broad scope may limit its sensitivity to specific mental health changes. This study aimed to research interplay and improvements of global functioning and several mental health parameters. METHODS:At admission and discharge 561 inpatients at a psychiatric clinic received assessments for global functioning, depression severity (clinician- and self-rated), sleep quality, quality of life, life satisfaction, and mood level. ANCOVAs assessed mean changes, while multiple linear regressions explored predictors of global functioning at both time points and over time. RESULTS:Global functioning and most mental health parameters significantly improved (p < 0.001-0.019, partial η2 = 0.02-0.14), except for sleep quality. Clinician-rated depression severity was consistently the strongest predictor of global functioning at admission, discharge, and over time (β = -0.56 to -0.47, p < 0.001). At admission, life satisfaction predicted global functioning improvement (β = 0.27, p = 0.038), while lower sleep quality indicated higher global functioning (β = 0.16, p = 0.041). CONCLUSION:The strong association between clinician-rated measures suggests a halo effect. A diagnostic and visualized integration of clinician- and self-rated measures is proposed for more reliability.

Background: Cognitive impairments and inaccurate metacognitive self-evaluation of performance (introspective accuracy; IA), reflected as over- or underestimation (introspective bias; IB), are common in psychiatric disorders. While prior work suggests links between mood and IA/IB, the underlying mechanisms remain unclear. This study examined how emotional valence and intensity shape cognitive performance, IB, and IA in affective disorders. Methods: A total of 185 participants (77 with affective disorders, 108 healthy controls) completed a neuropsychological battery (Trail Making Test A/B (TMT-A/B), Digit Symbol Substitution Test, Letter-Number Sequencing Test, Animal Naming Test, Hopkins Verbal Learning Test). After each task, participants rated their perceived performance, emotional valence, and emotion intensity. Robust regression models examined the effects of emotion on cognition, IB, and IA. Results: After adjusting for confounders (age, education, depression severity), groups did not differ in most cognitive, IB, or IA measures. Emotional valence affected cognitive performance, IB, and IA in task- and group-specific manners. Positive emotional valence was associated with better performance on some tasks but greater overestimation (higher IB) on others, while negative emotional valence and higher emotional intensity were linked to poorer accuracy (higher IA). Participants with affective disorders showed increased overestimation on the TMT-A and TMT-B with higher positive valence and intensity, respectively. Conclusion: Emotional valence and intensity affect cognitive performance, IA, and IB in a task-specific manner, underscoring their clinical relevance for understanding metacognitive functions, self-evaluation, and treatment planning in affective disorders. Our findings highlight the importance of considering emotional states when interpreting cognitive test results and clinical insight.

Valproic acid (VPA), a widely prescribed mood stabilizer and antiepileptic drug, is frequently associated with metabolic side effects, particularly weight gain. Despite its clinical relevance, the range and diversity of mechanisms underlying VPA-associated weight gain remain incompletely mapped. To map the breadth of evidence on mechanisms of VPA-associated weight gain, characterize the types of studies and populations investigated, and identify knowledge gaps to inform future research. This PRISMA-ScR-guided scoping review searched PubMed, Cochrane Library, Scopus, and Google Scholar for studies on VPA-weight gain mechanisms in adults. One reviewer charted data using a piloted form; two independently assessed quality (Newcastle-Ottawa Scale). Sources were grouped by mechanistic pathway with descriptive summaries and vote-counting. Fifteen studies (n = 1,339 participants) were included, representing diverse designs: cross-sectional (n = 4), prospective observational (n = 3), genetic association (n = 2), and others. Evidence mapped to three primary mechanistic domains: hormonal dysregulation (like elevated insulin, leptin, insulin resistance, and other findings); genetic predispositions, including CYP2C19 polymorphisms, CRTC1 methylation, and other genetic variants; and lipid metabolism alterations (increased TC, LDL-C, TG, FFAs; decreased Apo A1; mixed HDL-C findings). Hormonal and lipid pathways are well-documented, while genetic mechanisms require validation in larger, standardized cohorts. This scoping review identifies a heterogeneous evidence base with well-established hormonal and lipid mechanisms and emerging genetic pathways. Key gaps include underrepresentation of bipolar disorder populations, limited longitudinal genetic studies, and lack of integrated frameworks combining hormonal, genetic, and metabolic data. Findings inform future research priorities and highlight the need for personalized monitoring strategies.

Background:Psoriasis and mental health are closely intertwined; however, certain aspects remain underexplored. Thus, continued research on this topic is important to deepen our understanding. Objectives:To explore the mental health of individuals with psoriasis - specifically depressive symptoms, mental functioning, stress symptoms and coping strategies - and to find associations with physical manifestations of psoriasis. Methods:A cross-sectional sample of 214 individuals with psoriasis (107 with illness duration >16 years and 107 with illness duration ≤16 years; cut-off: median) completed the Beck Depression Inventory-II, the SF-12 measuring mental and physical functioning, and the Stress and Coping Inventory. Additionally, the Psoriasis Area and Severity Index (PASI) was assessed. The study was conducted during the COVID-19 pandemic. Results:Individuals with psoriasis reported worse mental and physical health than the general population (norm sample of SF-12) but did not differ significantly from each other. While individuals with illness duration >16 years had lower psoriasis severity than those with illness duration ≤16 years, mean PASI scores indicated low illness severity overall. PASI scores did not show significant correlations with mental health inventories in either group. Conclusions:Individuals with psoriasis reported lower mental health during the COVID-19 pandemic than a healthy, prepandemic norm sample, independent of psoriasis severity. Age and illness duration seem to facilitate coping with the disease. Nevertheless, individuals with psoriasis are in need of continued mental health support, regardless of illness duration.

PURPOSE OF REVIEW:This review summarizes current research on resilience in individuals with borderline personality disorder (BPD), its role in the development of BPD, and its impact on symptoms and recovery. Low resilience is considered a key factor contributing to emotional dysregulation and difficulty coping with adversity in BPD. RECENT FINDINGS:A scoping literature search identified 177 records, of which 12 studies met the inclusion criteria. Patients with BPD consistently exhibit lower resilience scores compared to mentally healthy control groups, with higher BPD features linked to reduced resilience. When compared to other mental disorders, such as major depressive disorder, persistent depressive disorder, and posttraumatic stress disorder, individuals with BPD tend to show the lowest resilience levels. Additionally, resilience has been identified as a mediator between childhood maltreatment and BPD features. Treatment interventions like dialectical behavior therapy have been found to significantly improve resilience in patients with BPD. SUMMARY:The findings underline the importance of resilience regarding the development, symptoms, and treatment of BPD, with lower resilience linked to higher BPD features and a history of childhood adversity. Results also suggest that enhancing resilience, particularly through interventions such as dialectical behavior therapy, could be a valuable therapeutic target.

BackgroundBipolar disorder is associated with impairments in cognition and psychosocial functioning. Although these impairments occur frequently, often persist during euthymic times, and worsen quality of life, the impact of cognitive abilities on functioning has not yet been fully elucidated.MethodsThe current study investigated the effects of cognitive domains (attention/psychomotor speed, verbal learning/memory, executive function) on psychosocial functioning cross-sectionally. Data from 210 euthymic individuals with bipolar disorder [101 female, 109 male; M(age) = 44.47; SD(age) = 14.25] were included into the analysis. A neurocognitive test battery was administered and the Global Assessment of Functioning was used to depict psychosocial functioning. Correlation analyses were conducted to observe the associations between functioning and the cognitive domains. Moreover, three hierarchical regression analyses were applied to predict functioning by each of the cognitive domains, while considering age, sex, and education as control variables.ResultsCorrelation analyses revealed that functioning was positively associated with attention/psychomotor speed and verbal learning/memory. However, the consecutive hierarchical regression analyses found that none of the cognitive domains were able predict functioning beyond the control variables age, sex, and education.ConclusionOur findings indicate that greater abilities in the domains of attention/psychomotor speed and verbal learning/memory are associated with better functioning. However, this association can be explained by other relevant variables such as age or education, indicating that cognitive abilities are not the sole contributor of psychosocial functioning. Investigating other measurements of functioning or cognitive abilities could lead to different results. Nevertheless, promoting cognitive abilities and autonomy in daily life remains an important aspect of therapy in bipolar disorder.

Current literature reveals no increased risk for adverse non-hereditary health outcomes in the offspring of childhood cancer survivors (CCS), yet survivors reported concerns regarding their offspring’s health. To investigate how the fear of cancer development in offspring influences parental behavior related to health and prevention, survey reports from 256 European adult CCS and 256 age- and sex-matched siblings who participated in a multicenter study on offspring health were analyzed in the present study. Analyses of covariance and chi-square tests were conducted to test for differences between CCS and siblings in outcome variables (all related to healthy parenting behavior). CCS reported higher fear levels (p = 0.044, Partial η2 = 0.01) and less alcohol consumption (p = 0.011, Phi = 0.12) and smoking (p = 0.022, Phi = 0.11) during pregnancy than siblings. In survivor families, children were breastfed less often (p < 0.001, Phi = 0.18). Partial correlation analyses showed that CCS’ fear levels decreased with increasing age (r = −0.16, p = 0.014), time since oncological therapy (r = −0.19, p = 0.003), and number of children (r = −0.21, p = 0.001). Overall, due to their own experiences with cancer, many CCS harbor misperceptions regarding the health outcomes of their offspring. Although the fear decreases with increasing distance from the active disease, any fear should be taken seriously, even if unfounded, and combated through targeted educational measures.

The global spread of the coronavirus disease (COVID-19) has created new challenges for the entire healthcare system, and those who work directly with the patients or even on the front lines with COVID-19 patients have been particularly stressed. Only a few studies are currently available investigating psychosomatic symptoms among healthcare workers, particularly frontline workers, over the entire pandemic period (2020–2022). There is also a lack of knowledge about strategies to prevent stress during and after a health crisis. Methods: An online survey was conducted at three times (April 2020, winter 2020/2021, and winter 2021/2022) during the COVID-19 pandemic in Austria. The sample included 160 healthcare workers at screening time 1, 1.361 healthcare workers at screening time 2, and 1.134 healthcare workers at screening time 3. The survey included COVID-19 work-related fears, satisfaction with the frontline work, and standardized inventories to assess psychosomatic symptoms, such as the Patient Health Questionnaire (PHQ-D). Results: Psychosomatic symptoms were more common among women compared to men, and among frontline workers compared to non-frontline workers, especially during the course of the pandemic at t2 and t3. Self-reported scores of COVID-19 work-related fears were significantly associated with psychosomatic symptoms. Furthermore, in frontline workers, there was a significant association between the feeling of being safe and well-informed and psychosomatic symptoms. Conclusion: COVID-19 work-related fears and psychosomatic symptoms have been prevalent among healthcare workers throughout the pandemic. Feeling safe and informed appears to be essential to prevent psychosomatic symptoms, leading to a recommendation for employers in the healthcare sector to focus on communication and information. As frontline workers are especially prone to psychosomatic symptoms, more stress prevention programs for them will be essential to maintain productivity and reduce sick days and fluctuations in the healthcare system.

The connection between cognitive function and the "Big Five" personality traits (openness, conscientiousness, extraversion, agreeableness, and neuroticism) in the general population is well known; however, studies researching bipolar disorder (BD) are scarce. Therefore, this study aimed to investigate the Big Five as predictors of executive function, verbal memory, attention, and processing speed in euthymic individuals with BD (cross-sectional: n = 129, including time point t1; longitudinal: n = 35, including t1 and t2). Participants completed the NEO Five-Factor Inventory, the Color and Word Interference Test, the Trail Making Test, the d2 Test of Attention Revised, and the California Verbal Learning Test. The results showed a significant negative correlation between executive function and neuroticism at t1. Changes in cognitive function between t1 and t2 did not correlate with and could not be predicted by the Big Five at t1. Additionally, worse executive function at t2 was predicted by higher neuroticism and lower conscientiousness at t1, and high neuroticism was a predictor of worse verbal memory at t2. The Big Five might not strongly impact cognitive function over short periods; however, they are significant predictors of cognitive function. Future studies should include a higher number of participants and more time in between points of measurement.

Introduction The COVID-19 pandemic with its protective measures (e. g. lockdown) had far-reaching effects on everyone's well-being. The aim of this study was to examine lifestyle variables during the first Austrian lockdown in patients with bipolar disorder in comparison to a healthy control group and to assess subjective changes caused by the pandemic. Method At the beginning of April 2020, an online survey of n=75 participants (35 people with bipolar disorder and 40 healthy controls) with standardized questionnaires (Beck Depression Inventory-2, Food Craving Inventory, Altman Self Rating Mania Scale) as well as non-standardized COVID-19-specific questions on the subject of "Psychological stress and effects of the COVID-19 pandemic in bipolar disorder" was created and distributed via LimeSurvey. Results Both groups reported a negative impact on their mental health. The participants with bipolar disorder showed significantly higher values in the Beck Depression Inventory-2 score (p<0,001), in emotional distress due to social distancing (p=0,003) and significantly lower values in muscle-strengthening exercise (p=0,039) and in sport units (p=0,003) compared to the control group. In addition, patients with bipolar disorder smoked more often than individuals of the control group. People with bipolar disorder were 42,9% more likely to report they were less efficient during the pandemic, and 22,9% experienced weight gain compared to before the pandemic. The control group, on the other hand, was less efficient at 17,5% and 5,0% reported weight gain. However, a comparison with pre-pandemic data showed a decrease in food craving in both groups. Conclusion This study provided first evidence of self-reported adverse effects on mental stress and lifestyle in people with bipolar disorder at the beginning of the COVID-19 pandemic. Psychiatric care and early interventions for patients with bipolar disorder would be particularly important in times of crisis in order to help maintain a healthy lifestyle and thus counteract unfavourable developments.

Background: Due to the COVID-19 pandemic, workplaces in the medical field experienced changes. Non-frontline workers in the health sector (WHS) were in many cases allowed to work from home (WFH). Changes in work locations have affected the perception of productivity during the COVID-19 pandemic compared to the pre-pandemic perception. Studies regarding this research field are rare for WHS. The aim of the present study was to investigate the perception of productivity and its impact on symptoms of depression during the COVID-19 pandemic. The second objective was to assess the implications for post-pandemic work settings such as WFH or work scenarios in hospitals during pandemics. Methods: At three points in time during the COVID-19 pandemic (t1; n = 161: April 2020, t2; n = 1598 winter 2020/2021, t3; n = 1879 winter 2021/2022), an online survey of WHS (e.g., medical doctors, nurses, scientific staff) in Austria concerning their productivity in their current workplace (pre- and post-pandemic) was conducted. The online survey included questions about the perceptions of productivity changes (i.e., perceptions of lower, equal, and higher productivity, before and during the COVID-19 pandemic) in different work settings (e.g., working in a hospital or working from home), as well as standardized questionnaires like the Patient Health Questionnaire (PHQ-9), assessing symptoms of depression in WHS. Results: χ2 tests showed that WHS working in hospitals experienced significantly fewer fluctuations in their perceptions of productivity than WHS working from home. An analysis of variance (ANOVA) indicated that WHS with a lower perception of productivity tended to have higher self-assessed depressive symptoms. Conclusion: The possibility of remaining working in the hospital in stressful scenarios like the COVID-19 pandemic might stabilize the feeling of productivity. Moreover, productivity is associated with self-assessed depressive symptoms. Hence, looking into the reasons behind this discrepancy between WHS in hospitals and those working from home might help to improve the home office modality and to create better structures, which are related to symptoms of depression.

Background The processes underlying believing have been labeled “creditions”, which are important brain functions between emotion and cognition. Creditions are influenced by both internal and external factors, one of which is the coronavirus disease 2019 (COVID-19) pandemic and the vaccination against the disease. Methods To investigate believing processes shortly before the implementation of a mandatory vaccination in Austria, both vaccinated and unvaccinated workers in the health sector (WHS) were surveyed in December 2021/January 2022. In total, 1,062 vaccinated and 97 unvaccinated WHS (920 females) completed the online survey. Beliefs were assessed using the parameters of the credition model (narrative, certainty, emotion, and mightiness) with regard to ( 1 ) the COVID-19 pandemic in general, and ( 2 ) the vaccination. Type of emotion and narrative were divided into positive, negative, and indifferent. Moreover, the congruence between emotion and narrative was calculated. Results The vaccination rate of the sample was 91.6%, with a significantly higher percentage of men being in the group of vaccinated (21.1%) as compared to unvaccinated individuals (12.4%). Pertaining beliefs about the COVID-19 vaccination, unvaccinated WHS reported more negative and less positive emotions as well as content of narrative than vaccinated WHS. In addition, they showed higher levels of certainty as well as mightiness while believing and felt less sufficiently informed about governmental and workplace-related COVID-19 measures. The groups did not differ in the type of emotion or content of narrative in their beliefs about the pandemic in general. Conclusion In conclusion, unvaccinated WHS had more negative and less positive emotions and thoughts than vaccinated WHS in their beliefs about the COVID-19 vaccination and their motivations for not having received it. They were more certain about their beliefs and felt stronger negative emotions in their beliefs compared to vaccinated individuals. Providing unvaccinated WHS with adequate information might be helpful in reducing their mental burden.

Zusammenfassung Hintergrund Die COVID-19-Pandemie mit ihren Schutzmaßnahmen (z. B. Lockdown) hat einen weitreichenden Einfluss auf die Befindlichkeit aller Menschen. Das Ziel dieser Studie war es, Lebensstilvariablen während des ersten österreichischen Lockdowns bei Patient*innen mit bipolarer Erkrankung im Vergleich zu einer gesunden Kontrollgruppe zu untersuchen und subjektive Veränderungen durch die Pandemie zu erheben. Methode Anfang April 2020 wurde eine Online-Befragung mit 75 Teilnehmer*innen (35 Patient*innen und 40 Kontrollpersonen) mit standardisierten Fragebögen (Beck Depression Inventory-2, Food Craving Inventory, Altman Self Rating Mania Scale) sowie nicht-standardisierten COVID-19-spezifischen Fragen zum Thema „Psychische Belastung und Auswirkungen der COVID-19-Pandemie bei bipolarer Störung“ per LimeSurvey durchgeführt. Ergebnisse Beide Gruppen gaben an, dass sich die Pandemie negativ auf ihre psychische Gesundheit ausgewirkt habe. Die Studienteilnehmer*innen mit bipolarer Störung zeigten signifikant höhere Werte im Beck Depression Inventory-2 (p<0,001), in der emotionalen Belastung durch die räumliche Distanzierung (p=0,003) und signifikant niedrigere Werte im Kraftsport (p=0,039) sowie im Sport generell (p=0,003) im Vergleich zur Kontrollgruppe. Außerdem rauchten Patient*innen mit bipolarer Erkrankung während dieser Zeit kompensatorisch mehr als Personen der Kontrollgruppe. Personen mit bipolarer Störung gaben mit 42,9% häufiger an, während der Pandemie weniger leistungsfähig zu sein, und 22,9% verzeichneten eine Gewichtszunahme im Vergleich zu vor der Pandemie. Die Kontrollgruppe war hingegen mit 17,5% weniger leistungsfähig und 5,0% berichteten über eine Gewichtszunahme. Ein Vergleich mit Prä-Pandemie-Daten zeigte jedoch eine Abnahme im Food Craving in beiden Gruppen. Konklusion Diese Studie lieferte erste Hinweise auf die psychische Belastung und auf die ungünstigen Auswirkungen auf den Lebensstil von Menschen mit einer bipolaren Störung zu Beginn der COVID-19-Pandemie. Eine psychiatrische Betreuung und Erste-Hilfe-Maßnahmen für Patient*innen mit psychischer Störung wären gerade in Krisenzeiten wichtig, um einen gesunden Lebensstil zu pflegen und so ungünstigen Entwicklungen gegenzusteuern.

Cognition, emotion, emotional regulation, and believing play a special role in psychosocial functioning, especially in times of crisis. So far, little is known about the process of believing during the COVID-19 pandemic. The aim of this study was to examine the process of believing (using the Model of Credition) and the associated psychosocial strain/stress during the first lockdown in the COVID-19 pandemic. An online survey via LimeSurvey was conducted using the Brief Symptom Inventory-18 (BSI-18), the Pittsburgh Sleep Quality Index (PSQI), and a dedicated Believing Questionnaire, which assesses four parameters of credition (propositions, certainty, emotion, mightiness) between April and June, 2020, in Austria. In total, n = 156 mentally healthy participants completed all questionnaires. Negative credition parameters were associated with higher global symptom load (from BSI-18): narratives: r = 0.29, p < 0.001; emotions r = 0.39, p < 0.001. These findings underline the importance of credition as a link between cognition and emotion and their impact on psychosocial functioning and stress regulation in implementing novel strategies to promote mental health.

BACKGROUND:The prevalence of metabolic syndrome and overweight/obesity is increased in bipolar disorder (BD) compared to the general population and is related to suicidality. The aim of this study was to examine the association between both the rate of suicidal ideation and suicide attempts and metabolic variables in individuals with BD.METHODS:Anthropometric measures, socio-demographic data, suicide history and serum lipid levels were measured in 215 individuals with BD. Individuals were divided into normal weight, overweight and obese according to their body mass index (BMI), and metabolic syndrome was assessed using "The International Diabetes Federation"-criteria.RESULTS:Of the 215 individuals studied, 80.9% reported suicidal ideation, 35.3% reported at least one suicide attempt and 30.7% were diagnosed with metabolic syndrome. Both metabolic syndrome and BMI were not related to suicide attempts. However, individuals with normal weight had more suicidal ideation than overweight individuals, while obese individuals did not differ from either group. Furthermore, there was no association between suicide attempts or suicidal ideation and serum lipid levels.LIMITATIONS:The cross-sectional design of the study, a non-standardized questionnaire for suicidality, and not controlling the medication intake are limiting factors.CONCLUSION:Contrary to expectations, a difference was found in the BMI categories and suicidal ideation, but not suicide attempts. Serum lipid levels were found to be unsuitable as possible biomarkers for suicidality in individuals with BD. Special attention should be paid to suicidal ideation and BMI rather than metabolic syndrome or lipid values when treating suicidal individuals with BD.

Throughout the COVID-19 pandemic, mental health of individuals with bipolar disorders (BD) is potentially more vulnerable, especially regarding COVID-19-related regulations and associated symptomatic changes. A multicentric online study was conducted in Austria, Germany, and Denmark during the COVID-19 pandemic. Overall, data from 494 participants were collected (203 individuals with BD, 291 healthy controls (HC)). Participants filled out questionnaires surveying emotional distress due to social distancing, fear of COVID-19, and the Brief Symptom Inventory-18 to assess symptom severity at four points of measurement between 2020 and 2021. General linear mixed models were calculated to determine the difference between the groups in these pandemic specific factors. Individuals with BD reported higher distress due to social distancing than HC, independently of measurement times. Fear of COVID-19 did not differ between groups; however, it was elevated in times of higher infection and mortality due to COVID-19. Individuals with BD reported higher psychiatric symptom severity than HC; however, symptom severity decreased throughout the measured time in the pandemic. Overall, individuals with BD experienced more distress due to the COVID-19 situation than HC. A supportive mental health system is thus recommended to ensure enhanced care, especially in times of strict COVID-19-related regulations.

The coronavirus disease (COVID-19) pandemic and the social distancing resulting thereof are having a great impact on psychological well-being. Studies investigating resilience found that it impacts mental health during crises. This study aimed to evaluate the influence of pre-crisis temperament on resilience in individuals with bipolar disorder during the COVID-19 pandemic. An online survey was conducted in Austria between April and June 2020, including 36 individuals with bipolar disorder and 39 healthy controls. Resilience was assessed with the 13-item resilience scale, and temperament was measured with the Temperament Evaluation of Memphis, Pisa, Paris and San Diego-autoquestionnaire (TEMPS-A). The bipolar disorder group showed lower resilience than the control group, and scored higher on the TEMPS-A for depressive, cyclothymic, and anxious temperaments. Resilience could be predicted by anxious temperament in individuals with bipolar disorder, and correlated negatively with depressive symptoms in both groups. The results suggest that anxious temperament influences the resilience of individuals with bipolar disorder, likely more than temporary hardships, such as the first months of the COVID-19 crisis. It is therefore important to improve the resilience of individuals with bipolar disorder not only by short-term interventions, but by strengthening resilience and reducing anxious temperament in the long term.

BackgroundBelieving processes represent fundamental brain functions between cognition and emotion. Shortly before the introduction of a compulsory vaccination against COVID-19 in Austria, motives and underlying believing processes regarding the vaccination were collected in individuals with affective disorder (AD) and healthy controls (HC).Methods79 individuals with AD and 173 HC were surveyed online to assess believing processes with the parameters of the credition model (narratives, certainty, emotion, mightiness) about (1) the coronavirus itself and (2) why someone is vaccinated or not. In addition, we calculated congruence scores between content of narrative and type of emotion and divided the narrative content into positive, negative, and indifferent.ResultsThere were no differences in vaccination status between AD and HC. Higher levels of certainty were observed in HC compared to AD in both vaccinated and unvaccinated individuals. The effects were higher when asked about the motivation to vaccinate or not than about the coronavirus itself. In HC, more positive emotions and more congruence between emotions and narratives were reported during believing in their vaccination motives. No group differences were found in mightiness for both items. Independently from diagnosis, unvaccinated people had high levels of certainty and more negative emotions and narratives while believing in their motives for not getting vaccinated.ConclusionWhen believing about the COVID-19 vaccination, individuals with AD were more uncertain and experienced fewer positive emotions than HC, although both groups did not differ in vaccination status. These effects were not that strong when believing about the coronavirus in general.