Mitochondrial dysfunction in the pathophysiology of bipolar disorder: effects of pharmacotherapy

Bipolar disorder is a common, chronic, and complex mental illness. Bipolar disorder is frequently comorbid with primary mitochondrial and metabolic disorders, and studies have implicated mitochondrial dysfunction in its pathophysiology. In the brains of people with bipolar disorder, high-energy phosphates are decreased, lactate is elevated and pH decreased, which together suggest a shift toward glycolysis for energy production. Furthermore, oxidative stress is increased, and calcium signalling dysregulated. Additionally there is downregulation of the expression of mitochondrial complexes, especially complex I. The therapeutic effects of some bipolar disorder drugs have recently been shown to be related to these mechanisms. In this review we will evaluate current research on the interactions between mitochondrial dysfunction and bipolar disorder pathology. We will then appraise the current literature describing the effects of bipolar disorder drugs on mitochondrial function, and discuss ramifications for future research

Crisis and triage clinicians\u27 attitudes toward working with people with personality disorder

PURPOSE. This study aimed to investigate the attitudes of Australian psychiatric triage and crisis clinicians toward those with a diagnosis of personality disorder.DESIGN AND METHODS. The design of the study was exploratory descriptive research. The study employed a survey method using Bowers and Allan\u27s (2006) Attitude to Personality Disorder Questionnaire, which was designed to identify global attitudes toward those with a diagnosis of personality disorder.FINDINGS. The findings of this study indicate that psychiatric crisis and triage clinicians hold negative attitudes toward those with a diagnosis of personality disorder.PRACTICE IMPLICATIONS. Education and clinical supervision is required to address negative clinician attitudes.<br /