Fast Five Quiz: Are You Familiar With These Conditions Associated With Depression?

Stephen Soreff, MD

Disclosures

December 16, 2019

Reports such as a study by Tighe and colleagues noted that hyperintensities in white matter of the temporal lobes of patients with bipolar disorder on MRI are more common than in healthy patients. White matter hyperintensity is the result of demyelination of the neurons. The myelin sheath plays a key role in the ability of the neurons to transmit signals.

The total value of performing MRI in a patient with bipolar disorder, or manic-depressive illness, remains unclear; however, a couple of reasons for performing an imaging study are recognized. Because bipolar disorder is a lifelong disease, a strong battery of studies rules out any other medical etiology and establishes a baseline. Furthermore, there is a strong genetic link to bipolar disorder. MRI testing may have a public health and familial education aspect to it.

Although not a routine screening test in bipolar disorder and unnecessary in patients with normal liver function test results, urine copper level testing may be performed to rule out Wilson disease, a rare condition that produces mental changes.

Thyroid function tests are performed to rule out symptoms of mania from hyperthyroidism and symptoms of depression from hypothyroidism.

In addition, treatment with lithium for bipolar disorder can cause hypothyroidism, resulting in rapid cycling of mood, especially in women.

In general, routine electroencephalography is unnecessary in the evaluation of bipolar disorder.

For more on the workup of bipolar disorder, read here.

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