Bipolar Disorder in a Patient with VACTERL Syndrome: A Case Report
Bibliographic record
Abstract
VACTERL association is a non-random constellation of congenital anomalies, typically involving at least three of the following systems: vertebral defects, anal atresia, cardiac malformations, tracheoesophageal fistula, renal anomalies, and limb abnormalities. While defined by structural defects, emerging evidence suggests increased rates of correlations with neurodevelopmental and psychiatric conditions. Bipolar disorder is a chronic mood disorder marked by recurrent episodes of mania or hypomania and depression, with pathophysiology involving fronto-limbic dysregulation, neurotransmitter imbalance, neuroinflammation, mitochondrial dysfunction, and impaired neuroplasticity. We report a case of Bipolar I Disorder in a 21-year-old man with VACTERL association (vertebral anomalies, anal atresia, cardiac defects, tracheoesophageal fistula) and normal cognitive development. He presented with a two-week manic episode with psychotic features and responded well to lithium and olanzapine. To our knowledge, this is the first case reported a potential link between VACTERL association and a bipolar disorder. This case highlights the need for increased awareness of possible psychiatric comorbidities in patients with complex congenital anomalities and underscores the importance of incorporating neuropsychiatric screening into VACTERL patient care.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.003 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".