Abstract

SERAFINI, Gianluca et al. Clinical and functional outcome in a subject with bipolar disorder and severe white matter hyperintensities. Eur. J. Psychiat. [online]. 2011, vol.25, n.1, pp.41-45. ISSN 0213-6163.

Background and Objectives: Neuroimaging studies have found higher rates of white matter hyperintensities (WMHs) in patients with bipolar disorder (BD) of all ages, although whether BD is associated with increased rates of WMHs independently from age and cerebrovascular risk factors is still matter of debate. The outcome of BD associated with severe WMHs is generally poor, but several authors have suggested that some factors could have a protective role in BD. The aim of the present study was to report the two-year follow-up of a woman with BD type I and severe WMH/PWMH lesions who was taking high concentrations of vitamin-D in her nutrition, as well as taking lithium and haloperidol as treatment. Case presentation: A 76-year-old woman was hospitalized for a mixed state BD. She had severe WMHs. She took lithium and haloperidol during the hospitalization and was euthymic at discharge as well as after two-years of follow-up. Her nutrition had a high concentration of Vitamin-D. Unfortunately, it was not possible to give her a second MRI. Conclusions: Although there was probable persistence of WMHs, the patient improved in both mood and quality of life. The possible protective effect of lithium and Vitamin-D is discussed.

Keywords : White matter hyperintensities; Bipolar disorder; Lithium; Vitamin-D; Outcome.

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