Bipolar Disorders最新文献

英文中文

A Population-Based Cohort Study of Early Infant Feeding Initiation in Maternal Bipolar Disorder 母亲双相情感障碍早期婴儿喂养开始的人群队列研究。

IF 4.5 2区医学 Q1 CLINICAL NEUROLOGY

Bipolar Disorders

Pub Date : 2025-11-17 DOI: 10.1111/bdi.70070

Neda Askari, Shakked Lubotzky-Gete, Matthew Crocker, Lucy C. Barker, Hilary K. Brown, Anjie Huang, Clare Taylor, Crystal T. Clark, Cindy-Lee Dennis, Simone N. Vigod

Objective

In maternal bipolar disorder, decisions about early infant feeding are complex, and may depend on maternal mental health stability, sleep protection needs, and medication safety in lactation. We aimed to explore early infant feeding practices in this population.

Methods

This population-based cohort study in Ontario, Canada (2012–2018) compared mothers/birthing parents with bipolar disorder (n = 11,398), depressive and/or anxiety disorders (n = 209,929) and no mood or anxiety disorder (referent, n = 417,588) on exclusive feeding with breastmilk at hospital discharge (primary outcome), breastfeeding intention, early skin-to-skin contact and initiation of breastfeeding, and in-hospital breastfeeding support. Within mothers/birthing parents with bipolar disorder, we compared those prescribed each of antidepressant, antipsychotic, valproic acid, lithium, or other antiepileptic monotherapy and 2 or more of these medications (polypharmacy) to those not prescribed any of these medications. Modified Poisson regression generated relative risks (RR, 95% CI) adjusted for socio-demographics and clinical characteristics.

Results

Maternal bipolar disorder was associated with reduced exclusive feeding with breastmilk at discharge (57.4% vs. 62.3% in the referent, aRR 0.95, 95% CI 0.93–0.98), but maternal depression and/or anxiety disorder was not. Bipolar disorder was also associated with reduced intention to breastfeed (88.5% vs. 94.1%), early skin-to-skin contact (79.2% vs. 81.0%) and in-hospital breastfeeding support (88.9% vs. 94.4%) compared to those with no mood or anxiety disorder. Among those with maternal bipolar disorder, lithium and polypharmacy were each associated with reduced likelihood of the outcomes compared to those not prescribed any psychotropic medication; antidepressants, antipsychotics, and antiepileptics were not.

Conclusions

These data support the case for additional supports and services to support mothers with bipolar disorder in early infant feeding initiation, and for research into how to best utilize medications in lactation.

目的：在母亲双相情感障碍中，早期婴儿喂养的决定是复杂的，可能取决于母亲的心理健康稳定性、睡眠保护需求和哺乳期间的药物安全。我们的目的是探索这一人群的早期婴儿喂养实践。方法：这项基于人群的队列研究在加拿大安大略省（2012-2018）进行，比较了患有双相情感障碍（n = 11,398）、抑郁和/或焦虑障碍（n = 209,929）和无情绪或焦虑障碍（参考，n = 417,588）的母亲/分娩父母在出院时纯母乳喂养（主要结局）、母乳喂养意图、早期皮肤接触和开始母乳喂养以及院内母乳喂养支持。在患有双相情感障碍的母亲/分娩父母中，我们比较了服用抗抑郁药、抗精神病药、丙戊酸、锂或其他抗癫痫单药治疗和其中两种或两种以上药物（多种药物）的患者与未服用任何这些药物的患者。修正泊松回归产生经社会人口统计学和临床特征调整后的相对风险（RR, 95% CI）。结果：产妇双相情感障碍与出院时减少纯母乳喂养相关（57.4%对62.3%,aRR 0.95, 95% CI 0.93-0.98），但产妇抑郁和/或焦虑障碍与此无关。与没有情绪或焦虑障碍的患者相比，双相情感障碍还与母乳喂养意愿降低（88.5%对94.1%）、早期皮肤接触（79.2%对81.0%）和住院母乳喂养支持（88.9%对94.4%）相关。在母亲双相情感障碍患者中，与未服用任何精神药物的患者相比，锂离子和多种药物治疗均与结果的可能性降低有关；抗抑郁药、抗精神病药和抗癫痫药则没有。结论：这些数据支持额外的支持和服务，以支持双相情感障碍母亲在婴儿早期喂养开始，并研究如何在哺乳中最好地利用药物。

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引用次数: 0

Association Between Adherence Barriers, Self-Reported Adherence, and Psychiatric Symptoms Among Adults With Bipolar Disorder 成人双相情感障碍患者依从性障碍、自我报告依从性与精神症状之间的关系

IF 4.5 2区医学 Q1 CLINICAL NEUROLOGY

Bipolar Disorders

Pub Date : 2025-11-11 DOI: 10.1111/bdi.70067

Martha Sajatovic, Jennifer B. Levin, Clara Adeniyi, Jessica Black, Celeste Weise, Nicole Fiorelli, Erika Kelley, Doug Einstadter, Mark Bauer, Farren B. S. Briggs

<div> <section> <h3> Aims</h3> <p>While suboptimal medication adherence is a widely recognized problem for people with bipolar disorder (BD), it is less clear how individual characteristics are associated with varying levels of adherence and how specific adherence barriers impact behaviors. This interim analysis from an ongoing randomized controlled trial (RCT) examined associations between patient-reported adherence, adherence barriers, and mood symptoms among poorly adherent individuals with BD.</p> </section> <section> <h3> Methods</h3> <p>RCT participants were adults age ≥ 18 years old with BD Type 1 or 2, difficulties with medication adherence, and actively symptomatic as measured by Brief Psychiatric Rating Scale (BPRS) score ≥ 36, Young Mania Rating Scale (YMRS) > 8, or Montgomery Asberg Depression Rating Scale (MADRS) > 8. Adherence was assessed using the self-reported Tablets Routine Questionnaire (TRQ) and grouped into 3 clinically relevant groups: those with TRQs < 20% (good adherence), ≥ 20% and < 50% (fair adherence), and ≥ 50% (poor adherence). Adherence barriers were assessed with the Oxford Bipolar Knowledge Questionnaire (OBQ), Self-Report Habit Index (SRHI), Communication Styles Scale (CSS), and Stages of Change Readiness and Treatment Eagerness Scale (SOCRATES 8A).</p> </section> <section> <h3> Results</h3> <p>Analysis was derived from screening and baseline data on the first 129 randomized participants. Mean age was 42.18 (SD = 13.04) years, with 76.74% (<i>n</i> = 99) female and 41.09% (<i>n</i> = 53) non-White. The mean past 7-day percentage of days with missed BD medications using TRQ was 34.34% (SD = 30.32) at screening and 24.82% (SD = 27.70) at baseline. The average time between screening visit and baseline was 18.90 (SD = 12.46) days. Comparing adherence groups, MADRS and BPRS were significantly higher in those with worse adherence both at screening and baseline (<i>p</i> < 0.05 for all). With respect to BD adherence barriers, only SRHI was significantly inversely correlated with TRQ at screening (<i>p</i> < 0.001) and both SRHI and SOCRATES 8A (Taking steps sub-scale) were significantly inversely correlated with TRQ at baseline (<i>p</i> = 0.001 and <i>p</i> = 0.022, respectively).</p> </section> <section> <h3> Conclusions</h3> <p>Poorly adherent individuals with BD have significantly more severe global psychopathology and worse depressive severity. Significant adherence barriers include lifestyle routines that do not promote regular medication-taking and engagement in reducing the use of substances. Gi

目的：虽然次优药物依从性是双相情感障碍（BD）患者普遍存在的问题，但个体特征如何与不同程度的依从性相关联以及特定的依从性障碍如何影响行为尚不清楚。这项中期分析来自一项正在进行的随机对照试验（RCT），研究了依从性差的bd患者中患者报告的依从性、依从性障碍和情绪症状之间的关系。RCT参与者为年龄≥18岁的双相障碍1型或2型患者，有药物依从性困难，症状明显（以简短精神病学评定量表（BPRS）评分≥36分、青年躁狂症评定量表（YMRS） bbbb8分或蒙哥马利阿斯伯格抑郁评定量表（MADRS） bbbb8分衡量）。使用自我报告的片剂常规问卷（TRQ）评估依从性，并将其分为3个临床相关组：TRQ组。结果：分析来自前129名随机受试者的筛查和基线数据。平均年龄42.18 （SD = 13.04）岁，女性占76.74% (n = 99)，非白人占41.09% （n = 53）。在筛查时，使用TRQ错过BD药物治疗的平均7天百分比为34.34% (SD = 30.32)，基线时为24.82% （SD = 27.70）。从筛查访问到基线的平均时间为18.90 （SD = 12.46）天。与依从性组相比，在筛查和基线时，依从性较差的双相障碍患者的MADRS和BPRS均显著较高(p)。结论：依从性较差的双相障碍患者总体精神病理和抑郁严重程度明显更严重。严重的依从性障碍包括不能促进定期服药和参与减少物质使用的生活习惯。鉴于BD患者依从性差的广泛负担，依从性促进工作应针对具体和可操作的障碍。试验注册：ClinicalTrials.gov标识符：NCT04622150。

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引用次数: 0

Featured Cover 了封面

IF 4.5 2区医学 Q1 CLINICAL NEUROLOGY

Bipolar Disorders

Pub Date : 2025-09-30 DOI: 10.1111/bdi.70068

Shiyun Wu, Zhongwan Liu, Robin Shao, Wenjin Zou, Xiaoyue Li, Weicong Lu, Jinyong Chen, Suk-Yu Yau, Kangguang Lin

The cover image is based on the article The Role of the Complement C3-Hippocampus Pathway in Relation With Mood Symptoms in Offspring of Parents With Bipolar Disorder by Robin Shao et al., https://doi.org/10.1111/bdi.70056.

封面图片基于Robin Shao等人的文章The补体c3 -海马通路在双相情感障碍父母后代情绪症状中的作用https://doi.org/10.1111/bdi.70056。

引用次数: 0

Neurostructural Correlates of Polygenic Risk for Coronary Artery Disease in Relation to Youth Bipolar Disorder 与青少年双相情感障碍相关的冠状动脉疾病多基因风险的神经结构相关性

IF 4.5 2区医学 Q1 CLINICAL NEUROLOGY

Bipolar Disorders

Pub Date : 2025-09-24 DOI: 10.1111/bdi.70065

Nidhi P. Kulkarni, Clement C. Zai, Kody G. Kennedy, Megan Mio, L. Trevor Young, Bradley J. MacIntosh, Benjamin I. Goldstein

Introduction

Bipolar disorder (BD), characterized by anomalous neurostructural phenotypes, is also strongly associated with cardiovascular disease. Here we examined polygenic risk for coronary artery disease (CAD) in relation to gray matter structure in youth BD.

Methods

Youth participants (mean age 17.1 years; n = 66 BD, n = 45 healthy controls [HC]) underwent T1-weighted magnetic resonance imaging. CAD polygenic risk scores (CAD-PRS) were calculated using independent, adult genome-wide summary statistics. Covariate-adjusted vertex-wise analyses examined the association of CAD-PRS with cortical volume, thickness, and surface area (SA) in the overall sample, and within BD and HC groups. Additional region-of-interest (ROI) analyses were conducted to examine the anterior cingulate cortex (ACC), amygdala, and hippocampus. Exploratory sex-stratified analyses were also undertaken.

Results

In the overall sample, higher CAD-PRS was associated with lower right inferior temporal gyrus volume (β = −0.32, p = 0.03). There were also negative associations between CAD-PRS and brain structure within BD (5 cortical thickness clusters) and HC (1 SA cluster). Within the BD group, sex-stratified analyses revealed significant findings for females, but not for males. ROI analyses revealed a nominal association of higher CAD-PRS with lower ACC thickness in the BD group (β = −0.31, p_uncorrected = 0.05, p_corrected = 0.20).

Conclusion

Higher CAD-PRS was associated with lower regional gray matter structure in youth, in regions implicated in BD. Findings were more pronounced in the BD group, particularly among females, and related to cortical thickness specifically. Future longitudinal studies are needed to examine the association of CAD-PRS with neurodevelopmental changes over time and to discern mechanisms underlying the observed findings.

导读：双相情感障碍（BD）以异常的神经结构表型为特征，也与心血管疾病密切相关。在这里，我们研究了与青年BD灰质结构相关的冠状动脉疾病（CAD）的多基因风险。方法：青年参与者（平均年龄17.1岁；n = 66 BD, n = 45健康对照[HC]）进行了t1加权磁共振成像。CAD多基因风险评分（CAD- prs）采用独立的成人全基因组汇总统计计算。协变量调整的顶点分析检验了CAD-PRS与整个样本以及BD组和HC组中皮质体积、厚度和表面积（SA）的关系。额外的兴趣区（ROI）分析被用于检查前扣带皮层（ACC）、杏仁核和海马。还进行了探索性的性别分层分析。结果：在整个样本中，较高的CAD-PRS与右下颞回体积相关（β = -0.32, p = 0.03）。CAD-PRS与BD（5个皮质厚度簇）和HC（1个SA簇）的脑结构也呈负相关。在双相障碍组中，性别分层分析显示女性有显著的发现，但男性没有。ROI分析显示，BD组较高的CAD-PRS与较低的ACC厚度存在名义关联（β = -0.31, puncorrected = 0.05, pcorrected = 0.20）。结论：较高的CAD-PRS与青年中与双相障碍相关的区域灰质结构降低有关。这一发现在双相障碍组中更为明显，尤其是在女性中，并且与皮层厚度有关。未来的纵向研究需要检查CAD-PRS与神经发育变化的关系，并辨别观察到的发现背后的机制。

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引用次数: 0

Mood Stabilizers (Lamotrigine, Lithium, and Valproic Acid) Decrease Bipolar Disease Model (Ouabain)-Induced Oxidative Stress and Apoptosis Through the Inhibition of the TRPM2 Channel in Neuronal Cells 情绪稳定剂（拉莫三嗪、锂和丙戊酸）通过抑制神经元细胞中的TRPM2通道减少双相情感障碍模型（瓦巴因）诱导的氧化应激和细胞凋亡。

IF 4.5 2区医学 Q1 CLINICAL NEUROLOGY

Bipolar Disorders

Pub Date : 2025-09-18 DOI: 10.1111/bdi.70053

Esra Nur Kaplan, İbrahim Eren, Mustafa Nazıroğlu

Background

Bipolar disease (BD) has been strongly associated with the etiologies of mitochondrial reactive oxygen species (mROS), apoptosis, and Ca²⁺ influx. With the exception of BD, a number of neurological disorders have been linked to apoptosis and neuronal death mediated by mROS-dependent activated TRPM2 channel stimulation. Lamotrigine (LMT), lithium (Li), and valproic acid (VPA) are mood stabilizers in BD, and they have strong antioxidant roles. However, the molecular mechanisms underlying LMT, Li, and VPA neuroprotection through TRPM2 channel inhibiton remain elusive in BD.

Aim

We evaluated the protective actions of LMT, Li, and VPA on BD (ouabain, OUA)-induced oxidative neurotoxicity in SH-SY5Y neuronal cells by modulating TRPM2.

Methods

The SH-SY5Y cells were divided into nine groups as follows: control, Li, VPA, LMT, OUA, OUA + Li, OUA + VPA, LMT + VPA, and OUA + TRPM2 antagonists (N-(p-amylcinnamoyl)anthranilic acid or carvacrol).

Results

OUA exposure and TRPM2 agonist (H₂O₂ and ADP-ribose)-induced TRPM2 stimulation and TRPM2 current densities were downregulated by the treatments of TRPM2 antagonist, Li, VPA, and LMT. The OUA-induced upregulations of mROS, cytosolic ROS, lipid peroxidation, mitochondrial membrane dysfunction, apoptosis, Zn²⁺, cell death, and caspase-3, -8, and -9 values were also downregulated through the increases of cell viability, glutathione, and glutathione peroxidase by the treatments.

Conclusions

The treatments of Li, VPA, and LMT modulate OUA-mediated mROS, apoptosis, Zn²⁺, glutathione, and TRPM2-mediated excess Ca²⁺ influx. This could potentially offer protection against BD linked to elevated levels of mROS, Ca²⁺, and Zn²⁺.

背景：双相情感障碍（BD）与线粒体活性氧（mROS）、细胞凋亡和Ca2+内流的病因密切相关。除BD外，许多神经系统疾病都与mros依赖性激活TRPM2通道刺激介导的细胞凋亡和神经元死亡有关。拉莫三嗪（LMT）、锂（Li）和丙戊酸（VPA）是BD患者的情绪稳定剂，具有较强的抗氧化作用。然而，LMT、Li和VPA通过抑制TRPM2通道保护BD神经的分子机制尚不清楚。目的：研究LMT、Li和VPA通过调节TRPM2对BD（瓦阿因、OUA）诱导的SH-SY5Y神经元细胞氧化神经毒性的保护作用。方法：将SH-SY5Y细胞分为对照组、Li组、VPA组、LMT组、OUA组、OUA + Li组、OUA + VPA组、LMT + VPA组、OUA + TRPM2拮抗剂（N-（对戊肉桂基）邻氨基苯甲酸或香芹酚）组。结果：OUA暴露和TRPM2激动剂（H2O2和adp核糖）诱导的TRPM2刺激和TRPM2电流密度被TRPM2拮抗剂、Li、VPA和LMT处理下调。oua诱导的mROS、胞质ROS、脂质过氧化、线粒体膜功能障碍、凋亡、Zn2+、细胞死亡和caspase-3、-8和-9值的上调也通过处理增加细胞活力、谷胱甘肽和谷胱甘肽过氧化物酶而下调。结论：Li、VPA和LMT可调节oua介导的mrs、凋亡、Zn2+、谷胱甘肽和trpm2介导的过量Ca2+内流。这可能潜在地提供与升高的mROS、Ca2+和Zn2+水平相关的BD保护。

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引用次数: 0

Changes in the Blood Transcriptome Highlights Disturbed Peripheral Biochemical Homeostasis in Bipolar Disorder 双相情感障碍患者外周血生化稳态紊乱的血液转录组变化

IF 4.5 2区医学 Q1 CLINICAL NEUROLOGY

Bipolar Disorders

Pub Date : 2025-09-15 DOI: 10.1111/bdi.70058

Brian Dean, Elizabeth Scarr, Susan L. Rossell, Tamsyn E. Van Rheenen

Objectives

Studies have reported changes in the transcriptome in the brain and blood from people with bipolar disorders (BD). We completed this study to test the hypothesis that there would be changes in the blood transcriptome that would mirror cortical changes in RNA levels in BD.

Methods

Levels of RNA were measured in blood from 19 people with BD and 19 controls using Affymetrix Human Exon 1.0 ST Arrays. Significant differences in levels of RNA with diagnosis were identified using JMP Genomics 9.0, and the potential biological impact of changes in RNA was investigated using the Panther Classification System.

Results

Levels of RNA for 19,473 coding and non-coding RNAs were detected. Compared to controls, there were changes in levels of 98 (65 with higher levels than controls) coding and non-coding RNAs at the criteria of fold ≥ ±20% and p < 0.05 in BD. The changes in levels of RNA were predicted to impact toll-like receptor function and Wnt signalling, response to virus, cell–cell signalling, and protein metabolic processing as well as post-synaptic organisation, dendritic spine morphogenesis, and pattern recognition receptor signalling pathways. Four of the RNAs found to be altered in blood in this study were also found to be altered in our previous study of the cortical transcriptome using tissue of people with BD.

Conclusions

This, and other studies, suggest changes in the blood transcriptome are affecting peripheral biochemical homeostasis in BD and some of the changes are present in the cortex of those with the disorder. Therefore, it could be possible that changes in the blood transcriptome in people with BD could contain diagnostic or theranostic markers for the disorder.

研究报告了双相情感障碍（BD）患者大脑和血液中转录组的变化。我们完成了这项研究，以验证血液转录组的变化可以反映BD患者皮质RNA水平变化的假设。方法：使用Affymetrix Human Exon 1.0 ST阵列测量了19名BD患者和19名对照者血液中的RNA水平。使用JMP Genomics 9.0识别诊断中RNA水平的显著差异，并使用Panther分类系统研究RNA变化的潜在生物学影响。结果：检测到19473种编码和非编码RNA的RNA水平。与对照组相比，在fold≥±20%和p的标准下，有98种编码和非编码rna的水平发生了变化（65种编码和非编码rna的水平高于对照组）。结论：这一研究和其他研究表明，血液转录组的变化影响了BD患者的外周生化稳态，其中一些变化存在于患者的皮层。因此，双相障碍患者血液转录组的变化可能包含该疾病的诊断或治疗标记物。

{"title":"Changes in the Blood Transcriptome Highlights Disturbed Peripheral Biochemical Homeostasis in Bipolar Disorder","authors":"Brian Dean, Elizabeth Scarr, Susan L. Rossell, Tamsyn E. Van Rheenen","doi":"10.1111/bdi.70058","DOIUrl":"10.1111/bdi.70058","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Studies have reported changes in the transcriptome in the brain and blood from people with bipolar disorders (BD). We completed this study to test the hypothesis that there would be changes in the blood transcriptome that would mirror cortical changes in RNA levels in BD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Levels of RNA were measured in blood from 19 people with BD and 19 controls using Affymetrix Human Exon 1.0 ST Arrays. Significant differences in levels of RNA with diagnosis were identified using JMP Genomics 9.0, and the potential biological impact of changes in RNA was investigated using the Panther Classification System.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Levels of RNA for 19,473 coding and non-coding RNAs were detected. Compared to controls, there were changes in levels of 98 (65 with higher levels than controls) coding and non-coding RNAs at the criteria of fold ≥ ±20% and <i>p</i> < 0.05 in BD. The changes in levels of RNA were predicted to impact toll-like receptor function and Wnt signalling, response to virus, cell–cell signalling, and protein metabolic processing as well as post-synaptic organisation, dendritic spine morphogenesis, and pattern recognition receptor signalling pathways. Four of the RNAs found to be altered in blood in this study were also found to be altered in our previous study of the cortical transcriptome using tissue of people with BD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This, and other studies, suggest changes in the blood transcriptome are affecting peripheral biochemical homeostasis in BD and some of the changes are present in the cortex of those with the disorder. Therefore, it could be possible that changes in the blood transcriptome in people with BD could contain diagnostic or theranostic markers for the disorder.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":"27 7","pages":"501-510"},"PeriodicalIF":4.5,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145063498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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2025 ISBD Symposia Abstracts 2025 ISBD专题讨论会摘要

IF 4.5 2区医学 Q1 CLINICAL NEUROLOGY

Bipolar Disorders

Pub Date : 2025-09-12 DOI: 10.1111/bdi.70042

引用次数: 0

2025 ISBD Oral Abstracts 2025 ISBD口头摘要

IF 4.5 2区医学 Q1 CLINICAL NEUROLOGY

Bipolar Disorders

Pub Date : 2025-09-12 DOI: 10.1111/bdi.70044

引用次数: 0

2025 ISBD Keynote Abstracts 2025 ISBD主题演讲摘要

IF 4.5 2区医学 Q1 CLINICAL NEUROLOGY

Bipolar Disorders

Pub Date : 2025-09-12 DOI: 10.1111/bdi.70043

引用次数: 0

ISBD 2025 Welcome Letter ISBD 2025欢迎信

IF 4.5 2区医学 Q1 CLINICAL NEUROLOGY

Bipolar Disorders

Pub Date : 2025-09-12 DOI: 10.1111/bdi.70041

引用次数: 0

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