Cerebrovascular Disease and Bipolar Disorder

Joanne A Byars; Jess G Fiedorowicz

doi:10.1007/978-1-4471-2428-3_14

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Book chapter

Cerebrovascular Disease and Bipolar Disorder

Joanne A Byars and Jess G Fiedorowicz

Neuropsychiatric Symptoms of Cerebrovascular Diseases, pp.307-330

Neuropsychiatric Symptoms of Neurological Disease, Springer London

06/12/2013

DOI: 10.1007/978-1-4471-2428-3_14

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Abstract

Bipolar disorder has been strongly associated with cardiovascular disease although the relationship between the two conditions is complex with regard to directionality and mechanisms. The defining syndromes of bipolar disorder, mania and hypomania, can occur following stroke, including in individuals who are seemingly otherwise not at risk based on age, family history, and past psychiatric history. This has led many experts to conclude that bipolar disorder may occur secondary to stroke. Individuals with idiopathic forms of bipolar disorder further face a considerably increased risk for cerebrovascular mortality and stroke. This elevation in risk is large and estimated to be approximately twice that expected from general population estimates for both cerebrovascular mortality and events. There exist a variety of mechanisms that may link bipolar disorder with cerebrovascular disease, and some risk factors may predispose vulnerable individuals to both conditions. These mechanisms include–though are not limited to–inflammation, oxidative stress/mitochondrial dysfunction, abnormalities in the hypothalamic-pituitary-adrenal axis, and sleep disorders. Clinicians should be mindful of the potential for stroke to induce mania and recognize that individuals with bipolar disorder are at special risk for vascular disease, a risk that early and assertive clinical intervention may potentially mitigate.

Obesity

Oxidative stress

Cerebrovascular disorders

Stroke

White matter hyperintensities

Vascular diseases

Major depression

Bipolar disorder

Inflammation

Pituitary-adrenal function tests

Details

Title: Subtitle: Cerebrovascular Disease and Bipolar Disorder
Creators: Joanne A Byars - Department of Neurology, University of Florida College of Medicine, Gainesville, USA
Jess G Fiedorowicz - Department of Epidemiology, College of Public Health, The University of Iowa, Iowa City, USA
Resource Type: Book chapter
Publication Details: Neuropsychiatric Symptoms of Cerebrovascular Diseases, pp.307-330
Publisher: Springer London; London
Series: Neuropsychiatric Symptoms of Neurological Disease
DOI: 10.1007/978-1-4471-2428-3_14
eISSN: 2196-2901
ISSN: 2196-2898
Language: English
Date published: 06/12/2013
Academic Unit: Epidemiology; Iowa Neuroscience Institute; Psychiatry
Record Identifier: 9984070413702771

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