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Luo Y, Bai Y, Wei K, Bi B. Toward a neurocircuit-based sequential transcranial magnetic stimulation treatment of pediatric bipolar II disorder. J Affect Disord 2024; 363:99-105. [PMID: 39009309 DOI: 10.1016/j.jad.2024.07.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 06/03/2024] [Accepted: 07/12/2024] [Indexed: 07/17/2024]
Abstract
BACKGROUND Abnormalities in large-scale neuronal networks-the frontoparietal central executive network (CEN)-are consistent findings in bipolar disorder and potential therapeutic targets for transcranial magnetic stimulation (TMS). OBJECTIVE The present study aimed to assess the effects of CEN neurocircuit-based sequential TMS on the clinical symptoms and cognitive functions of adolescents with bipolar II disorder. METHODS The study was a single-blinded, randomized, placebo-control trial. Participants with DSM-5-defined bipolar disorder II were recruited and randomized to receive either a sham treatment (n = 20) or an active TMS treatment (n = 22). The active group patients were taking medication, with intermittent theta burst stimulation (iTBS) treatment provided as adjunctive treatment targeting the left DLPFC, the left ITG, and the left PPC nodes consecutively. Patients completed the measurements of HAMD and the Das-Naglieri Cognition Assessment System at baseline and 3 weeks after the intervention. RESULTS A significant group-by-time interaction was observed in the HAMD, total cognition, and planning. Post-hoc analysis revealed that patients in the active group significantly improved HAMD scores following neurostimulation. Moreover, within-subject analysis indicated that the active group significantly improved in scores of total cognition and planning, while the sham group did not. No significant differences were seen in the other cognitive measures. CONCLUSION The neurocircuit-based sequential TMS protocol targeting three CEN nodes, in conjunction with medication, safely and effectively improved depressive symptoms and cognitive function in adolescents with bipolar II disorder.
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Affiliation(s)
- Yange Luo
- Department of Clinical Psychology, The Eighth Affiliated Hospital of Sun Yat-sen University, Shenzhen 518033, China
| | - Yuyin Bai
- Department of Clinical Psychology, The Eighth Affiliated Hospital of Sun Yat-sen University, Shenzhen 518033, China
| | - Kun Wei
- Department of Clinical Psychology, The Eighth Affiliated Hospital of Sun Yat-sen University, Shenzhen 518033, China
| | - Bo Bi
- Department of Clinical Psychology, The Eighth Affiliated Hospital of Sun Yat-sen University, Shenzhen 518033, China.
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2
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Gonzalez-Calvo I, Ronald A, Shakoor S, Taylor MJ, Eley TC, Hosang GM. Perinatal risk factors and subclinical hypomania: A prospective community study. J Affect Disord 2024; 362:885-892. [PMID: 39029678 DOI: 10.1016/j.jad.2024.07.118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Revised: 06/27/2024] [Accepted: 07/16/2024] [Indexed: 07/21/2024]
Abstract
BACKGROUND Perinatal risk factors are implicated in the development of psychopathology, but their role in bipolar disorder (BD) and hypomania is unclear. Using data from a prospective community cohort, this is the first study to investigate the association between a range of perinatal risk factors, hypomanic symptoms, and 'high-risk' for BD in the general population. METHODS Parent report of perinatal events were available for 26,040 eighteen-month-olds from the Twins Early Development Study. Subsequent self-report hypomania was measured at ages 16 (Hypomania Checklist-16; N = 2943) and 26 (Mood Disorders Questionnaire; N = 7748). Participants were categorised as 'high-risk' for BD using established classifications. Linear and logistic regressions were conducted within a generalised estimating equations framework to account for relatedness in the sample. RESULTS Prenatal alcohol exposure (β = 0.08, SE = 0.04, p = .0002) and number of alcohol units consumed (β = 0.09, SE = 0.02, p < .0001) were associated with hypomanic symptoms at age 16, and number of alcohol units (OR = 1.13, 95 % CI:1.06-1.21, p = .0003) and maternal stress (OR = 1.68, 95 % CI:1.21-2.34, p = .002) were associated with 'high-risk' for BD age 16. Prenatal tobacco exposure (β = 0.10, SE = 0.04, p < .0001) and number of cigarettes smoked (β = 0.10, SE = 0.01, p < .0001) were associated with hypomanic symptoms and 'high-risk' for BD at age 26, although these result were attenuated controlling for parental psychiatric history. LIMITATIONS Familial confounding could not be fully adjusted for. Rater reports include some biases. CONCLUSIONS These findings show perinatal risk factors to be associated with subclinical hypomania and 'high-risk' for BD. Future work should explore the mechanisms underlying these longitudinal associations, which could shed light on prevention and intervention efforts.
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Affiliation(s)
- Irene Gonzalez-Calvo
- Centre for Psychiatry and Mental Health, Wolfson Institute of Population Health, Faculty of Medicine & Dentistry, Queen Mary University of London, UK.
| | - Angelica Ronald
- Department of Psychology, Faculty of Health and Medical Sciences, University of Surrey, UK
| | - Sania Shakoor
- Centre for Psychiatry and Mental Health, Wolfson Institute of Population Health, Faculty of Medicine & Dentistry, Queen Mary University of London, UK
| | - Mark J Taylor
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Thalia C Eley
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, Denmark Hill, Camberwell, London, UK; UK National Institute for Health and Care Research (NIHR) Biomedical Research Centre, South London and Maudsley Hospital, London, UK
| | - Georgina M Hosang
- Centre for Psychiatry and Mental Health, Wolfson Institute of Population Health, Faculty of Medicine & Dentistry, Queen Mary University of London, UK
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Zhang Y, Wang SW, Ding J, Wen X, Li T, Yang L, Peng J, Dong Y, Mi W, Gao Y, Sun G. Causal role of immune cells in major depressive disorder and bipolar disorder: Mendelian randomization (MR) study. J Affect Disord 2024; 361:165-171. [PMID: 38838789 DOI: 10.1016/j.jad.2024.05.106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2024] [Revised: 05/19/2024] [Accepted: 05/21/2024] [Indexed: 06/07/2024]
Abstract
BACKGROUND Major depressive disorder (MDD) and bipolar disorder (BD) are prevalent psychiatric conditions linked to inflammatory processes. However, it is unclear whether associations of immune cells with these disorders are likely to be causal. METHODS We used two-sample Mendelian randomization (MR) approach to investigate the relationship between 731 immune cells and the risk of MDD and BD. Rigorous sensitivity analyses are conducted to assess the reliability, heterogeneity, and horizontal pleiotropy of the findings. RESULTS Genetically-predicted CD27 on IgD+ CD38- unswitched memory B cell (inverse variance weighting (IVW): odds ratio (OR) [95 %]: 1.017 [1.007 to 1.027], p = 0.001), CD27 on IgD+ CD24+ B cell (IVW: OR [95 %]: 1.021 [1.011 to 1.031], p = 4.821E-05) and other 12 immune cells were associated with increased risk of MDD in MR, while HLA DR++ monocyte %leukocyte (IVW: OR [95 %]: 0.973 [0.948 to 0.998], p = 0.038), CD4 on Central Memory CD4+ T cell (IVW: OR [95 %]: 0.979 [0.963 to 0.995], p = 0.011) and other 13 immune cells were associated with decreased risk of MDD in MR. Additionally, CD33+ HLA DR+ Absolute Count (IVW: OR [95 %]: 1.022[1.007 to 1.036], p = 0.007), CD28+ CD45RA- CD8+ T cell %T cell (IVW: OR [95 %]: 1.024 [1.008 to 1.041], p = 0.004) and other 18 immune cells were associated with increased risk of BD in MR, while CD62L on CD62L+ myeloid Dendritic Cell (IVW: OR [95 %]: 0.926 [0.871 to 0.985], p = 0.014), IgD- CD27- B cell %lymphocyte (IVW: OR [95 %]: 0.918 [0.880 to 0.956], p = 4.654E-05) and other 13 immune cells were associated with decreased risk of BD in MR. CONCLUSIONS This MR study provides robust evidence supporting a causal relationship between immune cells and the susceptibility to MDD and BD, offering valuable insights for future clinical investigations. Experimental studies are also required to further examine causality, mechanisms, and treatment potential for these immune cells for MDD and BD.
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Affiliation(s)
- Yi Zhang
- Department of Psychiatry, Binzhou Medical University Hospital, Binzhou, China; Department of Psychiatry, Wuhan Wuchang Hospital, Wuhan University of Science and Technology, Wuhan, 430063, China
| | - San-Wang Wang
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan 430060, China; Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing 100191, China; Peking-Tsinghua Center for Life Sciences and PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing 100871, China
| | - Jiahao Ding
- Shandong First Medical University (Shandong Academy Of Medical Sciences) No. 6699, Qingdao Road, Huaiyin District, Jinan City, Shandong Province, China
| | - Xin Wen
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing 100191, China; Peking-Tsinghua Center for Life Sciences and PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing 100871, China
| | - Tingting Li
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing 100191, China; Peking-Tsinghua Center for Life Sciences and PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing 100871, China
| | - Lu Yang
- Department of Psychiatry, Binzhou Medical University Hospital, Binzhou, China; Department of Psychiatry, Wuhan Wuchang Hospital, Wuhan University of Science and Technology, Wuhan, 430063, China
| | - Jintao Peng
- Department of Psychiatry, Binzhou Medical University Hospital, Binzhou, China; Department of Psychiatry, Wuhan Wuchang Hospital, Wuhan University of Science and Technology, Wuhan, 430063, China
| | - Yingying Dong
- Department of Psychiatry, Binzhou Medical University Hospital, Binzhou, China
| | - Weifeng Mi
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing 100191, China; Peking-Tsinghua Center for Life Sciences and PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing 100871, China.
| | - Yujun Gao
- Clinical and Translational Sciences (CaTS) Lab, The Douglas Research Centre, McGill University, Montréal, Québec, Canada; Binzhou Medical University, Binzhou, China.
| | - Guizhi Sun
- Department of Psychiatry, Binzhou Medical University Hospital, Binzhou, China.
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4
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Dev DA, Le GH, Kwan ATH, Wong S, Arulmozhi A, Ceban F, Teopiz KM, Meshkat S, Rosenblat JD, Guillen-Burgos HF, Rhee TG, Ho RC, Cao B, d'Andrea G, Sundberg I, McIntyre RS. Comparing suicide completion rates in bipolar I versus bipolar II disorder: A systematic review and meta-analysis. J Affect Disord 2024; 361:480-488. [PMID: 38901691 DOI: 10.1016/j.jad.2024.06.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Revised: 06/03/2024] [Accepted: 06/15/2024] [Indexed: 06/22/2024]
Abstract
BACKGROUND Bipolar disorder (BD) has a high disease burden and the highest mortality risk in BD comes from suicide. Bipolar disorder type II (BD-II) has been described as a milder form of bipolar disorder; however, extant literature is inconsistent with this description and instead describe illness burden and notably suicidality comparable to persons with bipolar I disorder (BD-I). Towards quantifying the hazard of BD-II, herein we aim via systematic review and meta-analysis to evaluate the rates of completed suicide in BD-I and BD-II. METHOD We conducted a literature search on PubMed, OVID (Embase, Medline) and PsychINFO databases from inception to June 30th, 2023, according to PRISMA guidelines. Articles were selected based on the predetermined eligibility criteria. A meta-analysis was performed, comparing the risk of completed suicide between individuals diagnosed with BD-I to BD-II. RESULTS Four out of eight studies reported higher suicide completion rates in persons living with BD-II when compared to persons living with BD-I; however, two of the studies reported non-significance. Two studies reported significantly higher suicide completion rates for BD-I than BD-II. The pooled odds ratio of BD-II suicide rates to BD-I was 1.00 [95 % CI = 0.75, 1.34]. LIMITATIONS The overarching limitation is the small number of studies and heterogeneity of studies that report on suicide completion in BD-I and BD-II. CONCLUSION Our study underscores the severity of BD-II, with a risk for suicide not dissimilar from BD-I. The greater propensity to depression, comorbidity and rapid-cycling course reported in BD-II are contributing factors to the significant mortality hazard in BD-II.
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Affiliation(s)
- Donovan A Dev
- Brain and Cognition Discovery Foundation, Toronto, ON, Canada; School of Medicine, University College Dublin, Dublin, Ireland; Department of Neuroscience Imaging and Clinical Sciences, University G d'Annunzio, Chieti, Italy.
| | - Gia Han Le
- Brain and Cognition Discovery Foundation, Toronto, ON, Canada; Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada; Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada.
| | - Angela T H Kwan
- Brain and Cognition Discovery Foundation, Toronto, ON, Canada; Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.
| | - Sabrina Wong
- Brain and Cognition Discovery Foundation, Toronto, ON, Canada; Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada; Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada.
| | - Akhilan Arulmozhi
- Brain and Cognition Discovery Foundation, Toronto, ON, Canada; Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
| | - Felicia Ceban
- Brain and Cognition Discovery Foundation, Toronto, ON, Canada; Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada; Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada.
| | - Kayla M Teopiz
- Brain and Cognition Discovery Foundation, Toronto, ON, Canada.
| | - Shakila Meshkat
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
| | - Joshua D Rosenblat
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada; Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada.
| | - Hernan F Guillen-Burgos
- Center for Clinical and Translational Research, Universidad Simón Bolívar, Barranquilla, Colombia; Center for Clinical and Translational Research, Faculty of Medicine, Universidad El Bosque, Bogotá D.C., Colombia; Department of Psychiatry and Mental Health, Pontificia Universidad Javeriana, Bogotá D.C., Colombia..
| | - Taeho Greg Rhee
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA; Department of Public Health Sciences, University of Connecticut School of Medicine, Farmington, CT, USA.
| | - Roger C Ho
- Institute for Health Innovation and Technology (iHealthtech), National University of Singapore, Singapore 117599, Singapore.; Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore.
| | - Bing Cao
- Key Laboratory of Cognition and Personality (SWU), Faculty of Psychology, Ministry of Education, Southwest University, Chongqing 400715, PR China.
| | - Giacomo d'Andrea
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Isak Sundberg
- Department of Neuroscience Psychiatry, Uppsala University Hospital, Uppsala, Sweden.
| | - Roger S McIntyre
- Brain and Cognition Discovery Foundation, Toronto, ON, Canada; Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada; School of Medicine, University College Dublin, Dublin, Ireland; Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
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5
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Stepan ME, Franzen PL, Teresi GI, Rode N, Goldstein TR. Sleep quality predicts future mood symptoms in adolescents with bipolar disorder. J Affect Disord 2024; 361:664-673. [PMID: 38917889 DOI: 10.1016/j.jad.2024.06.069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Revised: 06/17/2024] [Accepted: 06/19/2024] [Indexed: 06/27/2024]
Abstract
BACKGROUND Poor sleep is prevalent in adolescents with bipolar disorder, precedes illness onset, and is associated with worse mood symptoms. We examined interrelationships between sleep quality and mood symptoms in adolescents with bipolar disorder, particularly effects of sleep quality on emergent mood symptoms. METHODS Adolescents with bipolar disorder participated in a two-year longitudinal treatment study. Sleep quality (Pittsburgh Sleep Quality Index, PSQI) was assessed quarterly during treatment (baseline, 3-, 6-, 9-, 12-month visits) and twice during follow-up (18-, 24-month visits). Mood symptoms (ALIFE Psychiatric Status Ratings) were retrospectively rated weekly by an independent clinician. Lag models tested whether sleep quality predicted next month's mood symptoms and whether mood symptoms predicted future sleep quality. RESULTS Adolescents with bipolar disorder had poor sleep quality. Sleep quality initially improved but remained stable thereafter. Worse sleep quality at 6-months predicted worse depression, hypomania, and suicidal ideation the following month. Sleep quality was worse for adolescents who had a suicide attempt during the study compared to those who did not and was worse preceding months with a suicide attempt compared to months without attempts. Alternatively, worse depression predicted worse future sleep quality at baseline, 3-, and 18-months and worse suicidal ideation predicted worse future sleep quality at baseline, 12-, and 18-months. LIMITATIONS Mood symptoms were rated retrospectively and the PSQI may not capture all dimensions of sleep important for mood symptoms. CONCLUSIONS Targeted evidence-based sleep treatment in adolescents with bipolar disorder may alleviate sleep problems and have additional benefits on mood symptoms and suicidality risk.
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Affiliation(s)
- Michelle E Stepan
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, United States of America.
| | - Peter L Franzen
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, United States of America
| | - Giana I Teresi
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, United States of America
| | - Noelle Rode
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, United States of America
| | - Tina R Goldstein
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, United States of America
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6
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Camprodon-Boadas P, De Prisco M, Rabelo-da-Ponte FD, Sugranyes G, Clougher D, Baeza I, Torrent C, Castro-Fornieles J, Tosetti Y, Vieta E, de la Serna E, Amoretti S. Cognitive reserve and cognition in mood disorders: A systematic review and meta-analysis. Psychiatry Res 2024; 339:116083. [PMID: 39003801 DOI: 10.1016/j.psychres.2024.116083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 02/21/2024] [Accepted: 07/09/2024] [Indexed: 07/16/2024]
Abstract
Cognitive functioning heterogeneity is a well-recognized phenomenon in individuals diagnosed with mood disorders. Cognitive Reserve (CR) has been linked to multiple positive outcomes, including cognitive performance in these patients. This systematic review and meta-analysis aim to provide a comprehensive analysis of the relationship between CR and cognitive functioning in individuals with mood disorders, including bipolar disorder and depressive disorders. Following PRISMA guidelines, a systematic review and meta-analysis was conducted of original research exploring the relationship between CR and cognitive performance in adult individuals with mood disorders. The literature search was conducted on PubMed, Scopus, and Web of Science, from 2002 to September 2023, and the Newcastle-Ottawa Scale (NOS) was used to evaluate the quality of studies. Overall, 17 studies met the inclusion criteria for the systematic review and 11 for the meta-analysis. Both qualitative and quantitative findings suggested a positive relationship between CR measures and cognitive domains. CR emerges as a possible protective factor for cognitive functioning in adult individuals with mood disorders, potentially helping to mitigate the cognitive impairments associated with the disorder. These findings underscore the importance of the fact that promoting and enhancing CR could help in the cognitive prognosis of this population.
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Affiliation(s)
- Patricia Camprodon-Boadas
- Department of Child and Adolescent Psychiatry and Psychology, 2021SGR01319, Institute of Neuroscience, Hospital Clínic de Barcelona, Barcelona, Spain; Fundació de Recerca Clínic Barcelona-Institut d´Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM; Department of Medicine, Institute of Neuroscience, University of Barcelona, Spain.
| | - Michele De Prisco
- Fundació de Recerca Clínic Barcelona-Institut d´Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM; Bipolar and Depressive Disorders Unit, Hospital Clinic de Barcelona, Barcelona, Spain
| | - Francisco Diego Rabelo-da-Ponte
- Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, United Kingdom
| | - Gisela Sugranyes
- Department of Child and Adolescent Psychiatry and Psychology, 2021SGR01319, Institute of Neuroscience, Hospital Clínic de Barcelona, Barcelona, Spain; Fundació de Recerca Clínic Barcelona-Institut d´Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM
| | - Derek Clougher
- Fundació de Recerca Clínic Barcelona-Institut d´Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM; Bipolar and Depressive Disorders Unit, Hospital Clinic de Barcelona, Barcelona, Spain; BIOARABA, Department of Psychiatry. Hospital Universitario de Alava. University of the Basque Country, Vitoria, Spain
| | - Inmaculada Baeza
- Department of Child and Adolescent Psychiatry and Psychology, 2021SGR01319, Institute of Neuroscience, Hospital Clínic de Barcelona, Barcelona, Spain; Fundació de Recerca Clínic Barcelona-Institut d´Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM; Department of Medicine, Institute of Neuroscience, University of Barcelona, Spain
| | - Carla Torrent
- Fundació de Recerca Clínic Barcelona-Institut d´Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM; Bipolar and Depressive Disorders Unit, Hospital Clinic de Barcelona, Barcelona, Spain
| | - Josefina Castro-Fornieles
- Department of Child and Adolescent Psychiatry and Psychology, 2021SGR01319, Institute of Neuroscience, Hospital Clínic de Barcelona, Barcelona, Spain; Fundació de Recerca Clínic Barcelona-Institut d´Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM; Department of Medicine, Institute of Neuroscience, University of Barcelona, Spain
| | - Yamila Tosetti
- Department of Child and Adolescent Psychiatry and Psychology, 2021SGR01319, Institute of Neuroscience, Hospital Clínic de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM
| | - Eduard Vieta
- Fundació de Recerca Clínic Barcelona-Institut d´Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM; Bipolar and Depressive Disorders Unit, Hospital Clinic de Barcelona, Barcelona, Spain
| | - Elena de la Serna
- Department of Child and Adolescent Psychiatry and Psychology, 2021SGR01319, Institute of Neuroscience, Hospital Clínic de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM
| | - Silvia Amoretti
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM; Department of Psychiatry, Hospital Universitari Vall d'Hebron, Group of Psychiatry, Mental Health and Addictions, Psychiatric Genetics Unit, Vall d'Hebron Research Institute (VHIR), Barcelona, Spain
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7
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Kato T, Ogasawara K, Motomura K, Kato M, Tanaka T, Takaesu Y, Nio S, Kishi T, So M, Nemoto K, Suzuki E, Watanabe K, Matsuo K. Practice Guidelines for Bipolar Disorder by the JSMD (Japanese Society of Mood Disorders). Psychiatry Clin Neurosci 2024. [PMID: 39194164 DOI: 10.1111/pcn.13724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2024] [Revised: 07/15/2024] [Accepted: 07/23/2024] [Indexed: 08/29/2024]
Abstract
The Japanese Society of Mood Disorders (JSMD) published treatment guidelines of bipolar disorder in 2011. The present guidelines incorporating new findings were developed to comply to the guidelines of the National Academy of Medicine (NAM) by utilizing systematic reviews and meta-analysis and taking patient and family opinions as well as insights from multiple professional fields into account. They support combination therapy using mood stabilizers and second-generation antipsychotics in many aspects. They also have limitations, including the grouping of mood stabilizers and second-generation antipsychotics when meta-analysis was performed despite their distinct properties, due to the scarcity of drug-specific evidence. Despite the limitations, these guidelines provide clinical decision support for psychiatrists in Japan.
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Affiliation(s)
- Tadafumi Kato
- Department of Psychiatry & Behavioral Science, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Kazuyoshi Ogasawara
- Center for Postgraduate Clinical Training and Career Development, Nagoya University Hospital, Nagoya, Japan
| | - Keisuke Motomura
- Clinical Research Division, NHO Hizen Psychiatric Medical Center, Yoshinogari, Japan
| | - Masaki Kato
- Department of Neuropsychiatry, Kansai Medical University, Hirakata, Japan
| | - Teruaki Tanaka
- Deparment of Psychiatry, KKR Sapporo Medical Center, Sapporo, Japan
| | - Yoshikazu Takaesu
- Department of Neuropsychiatry, Graduate school of Medicine, University of the Ryukyus, Nishihara, Japan
| | - Shintaro Nio
- Department of Psychiatry, Saiseikai Central Hospital, Tokyo, Japan
| | - Taro Kishi
- Department of Psychiatry, Fujita Health University School of Medicine, Toyoake, Japan
| | - Mirai So
- Department of Psychiatry, Tokyo Dental College, Tokyo, Japan
| | - Kiyotaka Nemoto
- Department of Psychiatry, Institute of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Eiji Suzuki
- Division of Psychiatry, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - Koichiro Watanabe
- Department of Neuropsychiatry, Kyorin University Faculty of Medicine, Mitaka, Japan
| | - Koji Matsuo
- Department of Psychiatry, Faculty of Medicine, Saitama Medical University, Moroyama, Japan
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8
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Xiao Z, Zheng N, Chen H, Yang Z, Wang R, Liang Z. Identifying novel proteins underlying bipolar disorder via integrating pQTLs of the plasma, CSF, and brain with GWAS summary data. Transl Psychiatry 2024; 14:344. [PMID: 39191728 DOI: 10.1038/s41398-024-03056-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2024] [Revised: 08/19/2024] [Accepted: 08/21/2024] [Indexed: 08/29/2024] Open
Abstract
Bipolar disorder (BD) presents a significant challenge due to its chronic and relapsing nature, with its underlying pathogenesis remaining elusive. This study employs Mendelian randomization (MR), a widely recognized genetic approach, to unveil intricate causal associations between proteins and BD, leveraging protein quantitative trait loci (pQTL) as key exposures. We integrate pQTL data from brain, cerebrospinal fluid (CSF), and plasma with genome-wide association study (GWAS) findings of BD within a comprehensive systems analysis framework. Our analyses, including two-sample MR, Steiger filtering, and Bayesian colocalization, reveal noteworthy associations. Elevated levels of AGRP, FRZB, and IL36A in CSF exhibit significant associations with increased BD_ALL risk, while heightened levels of CTSF and LRP8 in CSF, and FLRT3 in plasma, correlate with decreased BD_ALL risk. Specifically for Bipolar I disorder (BD_I), increased CSF AGRP levels are significantly linked to heightened BD_I risk, whereas elevated CSF levels of CTSF and LRP8, and plasma FLRT3, are associated with reduced BD_I risk. Notably, genes linked to BD-related proteins demonstrate substantial enrichment in functional pathways such as "antigen processing and presentation," "metabolic regulation," and "regulation of myeloid cell differentiation." In conclusion, our findings provide beneficial evidence to support the potential causal relationship between IL36A, AGRP, FRZB, LRP8 in cerebrospinal fluid, and FLRT3 in plasma, and BD and BD_I, providing insights for future mechanistic studies and therapeutic development.
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Affiliation(s)
- Zhehao Xiao
- Fujian Medical University Union Hospital, Fuzhou, China
- Department of Neurosurgery, Fujian Medical University Union Hospital, Fuzhou, China
| | - Nan Zheng
- Fujian Medical University Union Hospital, Fuzhou, China
- Department of Anesthesiology, Fujian Medical University Union Hospital, Fuzhou, China
| | - Haodong Chen
- Fujian Medical University Union Hospital, Fuzhou, China
- Department of Neurosurgery, Fujian Medical University Union Hospital, Fuzhou, China
| | - Zhelun Yang
- Fujian Medical University Union Hospital, Fuzhou, China
- Department of Neurosurgery, Fujian Medical University Union Hospital, Fuzhou, China
| | - Rui Wang
- Fujian Medical University Union Hospital, Fuzhou, China.
- Department of Neurosurgery, Fujian Medical University Union Hospital, Fuzhou, China.
| | - Zeyan Liang
- Fujian Medical University Union Hospital, Fuzhou, China.
- Department of Neurosurgery, Fujian Medical University Union Hospital, Fuzhou, China.
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Bareis N, Olfson M, Dixon LB, Chwastiak L, Monroe-Devita M, Kessler RC, Gibbons RD, Edlund M, Guyer H, Kreski NT, Graupensperger S, Winans KT, Stroup TS. Clinical characteristics and functioning of adults with bipolar I disorder: Evidence from the mental and substance use disorders prevalence study. J Affect Disord 2024:S0165-0327(24)01365-X. [PMID: 39191309 DOI: 10.1016/j.jad.2024.08.133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2024] [Revised: 07/26/2024] [Accepted: 08/23/2024] [Indexed: 08/29/2024]
Abstract
BACKGROUND Knowledge of clinical, treatment and life circumstances of individuals with bipolar I disorder (BP-I) in US households is informed by decades old epidemiological surveys. METHODS The Mental and Substance Use Disorders Prevalence Study was conducted October 2020-October 2022. Clinicians administered the Structured Clinical Interview for the DSM-5 diagnosing 12-month prevalence of BP-I and other mental health disorders (MHD) among 4764 adults aged 18-65 years and collected sociodemographic information. We examined clinical characteristics, differences by sex and age among adults with BP-I, and compared adults with BP-I versus no MHD regarding sociodemographic characteristics, functioning, and substance use disorders (SUDs). RESULTS Prevalence of BP-I in the MDPS was 1.5 %. Among those with BP-I, 73.4 % had comorbid psychiatric disorders, and 43.4 % had comorbid SUDs. Alcohol use disorder was higher in those with BP-I versus no MHD (33.0 % vs. 6.3 %). Mean Global Assessment of Functioning scores were lower among those with BP-I versus no MHD (53.2 vs. 77.0). Of individuals with BP-I, 64.9 % had past-year outpatient, 5.4 % inpatient, and 18.7 % minimally adequate treatment (≥1 antimanic agent and ≥ 4 outpatient visits). Individuals with BP-I were less likely to be employed (37.3 % vs. 63.0 %) and have a family income ≥$20,000 (48.2 % vs. 81.9 %) versus no MDPS MHD. LIMITATIONS The survey response rate was low. CONCLUSIONS In this sample, many individuals with BP-I had psychiatric and SUD comorbidities, lived in poverty and had functional impairment. Few received adequate treatment; women and younger individuals were particularly disadvantaged. Early detection and treatment represent substantial opportunities to improve outcomes.
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Affiliation(s)
- Natalie Bareis
- Department of Psychiatry, Columbia University Irving Medical Center, New York State Psychiatric Institute, New York, NY, United States of America.
| | - Mark Olfson
- Department of Psychiatry, Columbia University Irving Medical Center, New York State Psychiatric Institute, New York, NY, United States of America; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States of America
| | - Lisa B Dixon
- Department of Psychiatry, Columbia University Irving Medical Center, New York State Psychiatric Institute, New York, NY, United States of America
| | - Lydia Chwastiak
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, United States of America
| | - Maria Monroe-Devita
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, United States of America
| | - Ronald C Kessler
- Department of Health Care Policy, Harvard Medical School, Harvard University, Boston, MA, United States of America
| | - Robert D Gibbons
- Department of Public Health Sciences, The University of Chicago, Chicago, IL, United States of America
| | - Mark Edlund
- RTI International, Research Triangle Park, NC, United States of America
| | - Heidi Guyer
- RTI International, Research Triangle Park, NC, United States of America
| | - Noah T Kreski
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States of America
| | - Scott Graupensperger
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, United States of America
| | - Katherine T Winans
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, United States of America
| | - T Scott Stroup
- Department of Psychiatry, Columbia University Irving Medical Center, New York State Psychiatric Institute, New York, NY, United States of America
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10
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Yang R, Wang R, Zhao D, Lian K, Shang B, Dong L, Yang X, Dang X, Sun D, Cheng Y. Integrative analysis of transcriptome-wide association study and mRNA expression profile identified risk genes for bipolar disorder. Neurosci Lett 2024; 839:137935. [PMID: 39151574 DOI: 10.1016/j.neulet.2024.137935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Revised: 08/05/2024] [Accepted: 08/09/2024] [Indexed: 08/19/2024]
Abstract
OBJECTIVE Bipolar disorder (BD) is a debilitating neuropsychiatric disorder, which is associated with genetic variation through "vast but mixed" Genome-Wide Association Studies (GWAS). Transcriptome-Wide Association Study (TWAS) is more effective in explaining genetic factors that influence complex diseases and can help identifying risk genes more reliably. So, this study aims to identify potential BD risk genes in pedigrees with TWAS. METHODS We conducted a TWAS analysis with expression quantitative trait loci (eQTL) analysis on extended BD pedigrees, and the BD genome-wide association study (GWAS) summary data acquired from the Psychiatric Genomics Consortium (PGC). Furthermore, the BD-associated genes identified by TWAS were validated by mRNA expression profiles from the Gene Expression Omnibus (GEO) Datasets (GSE23848 and GSE46416). Functional enrichment and annotation analysis were implemented by RStudio (version 4.2.0). RESULTS TWAS identified 362 genes with P value < 0.05, and 18 genes remain significant after Bonferroni correction, such as SEMA3G (PTWAS=1.07 × 10-11), ALOX5AP (PTWAS=3.12 × 10-8), and PLEC (PTWAS=1.27 × 10-7). Further 6 overlapped genes were detected in integrative analysis, such as UQCRB (PTWAS=0.0020, PmRNA=0.0000), TMPRSS9 (PTWAS=0.0405, PmRNA=0.0032), and SNX10 (PTWAS=0.0104, PmRNA=0.0015). Using genes identified by TWAS, Gene Ontology (GO) enrichment analysis identified 40 significant GO terms, such as mitochondrial ATP synthesis coupled electron transport, mitochondrial respiratory, aerobic electron transport chain, oxidative phosphorylation, mitochondrial membrane proteins, and ubiquinone activity. The Kyoto Encyclopedia of Genes and Genomes (KEGG) Pathway enrichment analysis identified significant 15 pathways for BD, such as Oxidative phosphorylation, endocannabinoids signaling, neurodegeneration, and reactive oxide species. CONCLUSIONS We found a set of BD-associated genes and pathways, validating the important role of neurodevelopmental abnormalities, inflammatory responses, and mitochondrial dysfunction in the pathology of BD, offering novel information for comprehending the genetic basis of BD.
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Affiliation(s)
- Runxu Yang
- Psychiatry Department, First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Rui Wang
- Department of Prevention and Health Care, First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Dongyan Zhao
- First Affiliated Hospital of Dali University, Dali, Yunnan, China
| | - Kun Lian
- Psychiatry Department, First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Binli Shang
- Psychiatry Department, First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Lei Dong
- Psychiatry Department, First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Xuejuan Yang
- Lincang Psychiatric Hospital, Lincang, Yunnan, China
| | - Xinglun Dang
- Key Laboratory of Animal Models and Human Disease Mechanisms of the Chinese Academy of Sciences and Yunnan Province, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming, Yunnan, China
| | - Duo Sun
- Psychiatry Department, First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Yuqi Cheng
- Psychiatry Department, First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China.
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11
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Kaçar A, Karakuş OB, Aydın ZE, Adak İ. Effectiveness of Agomelatine in Generalized Anxiety Disorder Comorbid to Bipolar 1 Disorder in a Male Adolescent Patient. Clin Neuropharmacol 2024:00002826-990000000-00091. [PMID: 39140640 DOI: 10.1097/wnf.0000000000000604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/15/2024]
Abstract
ABSTRACT Anxiety comorbidity in bipolar disorder (BD) is important and thus significantly affects the course of BD and its outcomes. The treatment of generalized anxiety disorder comorbid with BD involves certain challenges, as antidepressant medications, which are standard in the treatment of anxiety disorder, have the risk of shifting to manic episodes and rapid cycling. In this case report, the response to agomelatine treatment in generalized anxiety disorder comorbid with bipolar 1 disorder was evaluated.
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Affiliation(s)
- Aysu Kaçar
- Department of Child and Adolescent Psychiatry, Istanbul Erenköy Mental Health and Neurological Diseases Training and Research Hospital, Istanbul
| | - Oğuz Bilal Karakuş
- Department of Child and Adolescent Psychiatry, Trabzon Kanuni Training and Research Hospital, Trabzon, Turkey
| | - Zeynep Ece Aydın
- Department of Child and Adolescent Psychiatry, Istanbul Erenköy Mental Health and Neurological Diseases Training and Research Hospital, Istanbul
| | - İbrahim Adak
- Department of Child and Adolescent Psychiatry, Istanbul Erenköy Mental Health and Neurological Diseases Training and Research Hospital, Istanbul
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12
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Nan X, Li W, Wang L. Functional magnetic resonance imaging studies in bipolar disorder in resting state: A coordinates-based meta-analysis. Psychiatry Res Neuroimaging 2024; 344:111869. [PMID: 39146823 DOI: 10.1016/j.pscychresns.2024.111869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 07/20/2024] [Accepted: 08/06/2024] [Indexed: 08/17/2024]
Abstract
Exploring changes in the intrinsic activity of the brain in people with bipolar disorder (BD) is necessary. However, the findings have not yet led to consistent conclusions. In this regard, this paper aims to extract more obvious differential brain areas and neuroimaging markers, for the purpose of providing assistance for early clinical diagnosis and subsequent treatment. We conducted a meta-analysis of whole-brain resting-state functional magnetic resonance imaging (rs-fMRI) studies using seed-based d-mapping software that examined differences in amplitude of low-frequency fluctuations (ALFF), fractional amplitude of low-frequency fluctuations (fALFF), and regional homogeneity (ReHo) between patients with BD and healthy controls (HCs). Seed-based d-Mapping (formerly Signed Differential Mapping) with Permutation of Subject Images, or SDM-PSI, is a statistical technique for meta-analyzing studies of differences in brain activity or structure. A total of 16 articles involving 1112 individuals were included in this study for meta-analysis. This paper confidently analyzes the correlation between the clinical scales HAMD, HAMA, and YMRS, and the area of difference. We found significant changes that increased activation in the anterior connective and left lens nucleus, the nucleus of the shell, and BA 48 in BD patients compared with HC (P < 0.05, uncorrected), as well as a significant correlation between HAMD and the left superior frontal gyrus (after FWE correction P < 0.05). Therefore, basal ganglia and frontal cortex may have important significance in the pathogenesis and pathological basis of BD, making it an important issue to be attached importance to.
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Affiliation(s)
- Xia Nan
- Baiyin City Central Hospital, Baiyin, China
| | - Wenling Li
- The NO.2 People's Hospital of Lanzhou, Lanzhou, China
| | - Lin Wang
- Department of Radiology, Affiliated Hospital of Gansu University of Chinese Medicine, Lanzhou, China; Cancer Clinical Medical Research Center, Gansu combination of traditional Chinese and Western medicine, Lanzhou, China.
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13
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Vita G, Nöhles VB, Ostuzzi G, Barbui C, Tedeschi F, Heuer FH, Keller A, DelBello MP, Welge JA, Blom TJ, Kowatch RA, Correll CU. Systematic Review and Network Meta-Analysis: Efficacy and Safety of Antipsychotics vs Antiepileptics or Lithium for Acute Mania in Children and Adolescents. J Am Acad Child Adolesc Psychiatry 2024:S0890-8567(24)01316-9. [PMID: 39128561 DOI: 10.1016/j.jaac.2024.07.920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 07/02/2024] [Accepted: 08/02/2024] [Indexed: 08/13/2024]
Abstract
OBJECTIVE To compare second-generation antipsychotics (SGAs) and mood stabilizers (MSs) in youth with a bipolar disorder type I (BD-I) manic/mixed episode. METHOD A systematic PubMed/Embase/PsycInfo literature search until December 31, 2023, for randomized trials of SGAs or MSs in patients ≤18 years of age with BD-I manic/mixed episode was conducted. The study included a network meta-analysis comparing treatments regarding mania symptoms and mania response (co-primary outcomes), and secondary efficacy and tolerability outcomes. RESULTS Eighteen studies (n = 2844, mean age = 11.74, female participants = 48.0%, mean study duration = 5.4 weeks) comparing 6 SGAs (aripiprazole, asenapine, olanzapine, quetiapine, risperidone, and ziprasidone) and 4 MSs (lithium, oxcarbazepine, topiramate, and valproate) were meta-analyzed. All 6 SGAs outperformed placebo in reducing manic symptomatology, including risperidone (standardized mean difference [SMD] = -1.18, 95% CI = -0.92, -1.45, Confidence in Network Meta-Analysis [CINeMA] = moderate confidence), olanzapine (SMD = -0.77, 95% CI = -0.36, -1.18, low confidence), aripiprazole (SMD = -0.67, 95% CI = -0.33, -1.01, moderate confidence), quetiapine (SMD = -0.60, 95% CI = -0.32, -0.87, high confidence), asenapine (SMD = -0.54, 95% CI = -0.19, -0.89, moderate confidence), and ziprasidone (SMD = -0.43, 95% CI = -0.17, 0.70, low confidence), whereas no mood stabilizer outperformed placebo. Concerning mania response, risperidone (RR = 2.58, 95% CI = 1.88, 3.54, low confidence), olanzapine (RR = 2.42, 95% CI = 1.33, 3.54, very low confidence), aripiprazole (RR = 2.05, 95% CI = 1.44, 2.92, low confidence), quetiapine (RR = 1.89, 95% CI = 1.45n 2.47, moderate confidence), asenapine (RR = 1.81, 95% CI = 1.28, 2.55, very low confidence) and lithium (RR = 1.35, 95% CI = 1.00, 1.83, p = .049, very low confidence) outperformed placebo, without superiority of other MSs vs placebo. Individually, risperidone was more efficacious in reducing manic symptomatology than all other comparators, except olanzapine and topiramate, yet with low/very low confidence, and was associated with increased prolactin and glucose. Pooled together, SGAs outperformed both placebo and MSs for mania symptom reduction (SMD = -0.68, 95% CI = -0.86, -0.51 and SMD = -0.61, 95% CI = -0.82, -0.40, moderate confidence), and mania response (RR = 1.85, 95% CI = 1.53, 2.24 and RR = 1.65, 95% CI = 1.33, 2.04, moderate confidence) without differences between MSs and placebo. There were no significant treatment-placebo differences for all-cause discontinuation, whereas lithium, ziprasidone, and oxcarbazepine were associated with more adverse event-related drop-outs than placebo. Most SGAs were associated with more sedation, weight gain, and metabolic issues vs placebo and MSs. CONCLUSION SGAs were more efficacious than placebo and MSs in treating acute mania symptoms, however, their use must be carefully weighed against important side effects.
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Affiliation(s)
| | | | - Giovanni Ostuzzi
- WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, University of Verona, Verona, Italy
| | - Corrado Barbui
- WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, University of Verona, Verona, Italy
| | - Federico Tedeschi
- WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, University of Verona, Verona, Italy
| | | | | | | | - Jeffrey A Welge
- University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Thomas J Blom
- University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Robert A Kowatch
- Ohio State University Wexner Medical Center / Nationwide Children's Hospital, Columbus, Ohio
| | - Christoph U Correll
- Zucker Hillside Hospital, Psychiatry Research, Northwell Health, Glen Oaks, New York; Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York; German Center for Mental Health (DZPG), partner site Berlin, Germany.
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14
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Kong L, Chen Y, Shen Y, Zhang D, Wei C, Lai J, Hu S. Progress and Implications from Genetic Studies of Bipolar Disorder. Neurosci Bull 2024; 40:1160-1172. [PMID: 38206551 PMCID: PMC11306703 DOI: 10.1007/s12264-023-01169-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Accepted: 10/05/2023] [Indexed: 01/12/2024] Open
Abstract
With the advancements in gene sequencing technologies, including genome-wide association studies, polygenetic risk scores, and high-throughput sequencing, there has been a tremendous advantage in mapping a detailed blueprint for the genetic model of bipolar disorder (BD). To date, intriguing genetic clues have been identified to explain the development of BD, as well as the genetic association that might be applied for the development of susceptibility prediction and pharmacogenetic intervention. Risk genes of BD, such as CACNA1C, ANK3, TRANK1, and CLOCK, have been found to be involved in various pathophysiological processes correlated with BD. Although the specific roles of these genes have yet to be determined, genetic research on BD will help improve the prevention, therapeutics, and prognosis in clinical practice. The latest preclinical and clinical studies, and reviews of the genetics of BD, are analyzed in this review, aiming to summarize the progress in this intriguing field and to provide perspectives for individualized, precise, and effective clinical practice.
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Affiliation(s)
- Lingzhuo Kong
- Department of Psychiatry, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, China
| | - Yiqing Chen
- Department of Psychiatry, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, China
| | - Yuting Shen
- Department of Psychiatry, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, China
| | - Danhua Zhang
- Department of Psychiatry, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, China
| | - Chen Wei
- Department of Psychiatry, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, China
| | - Jianbo Lai
- Department of Psychiatry, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, China.
- The Key Laboratory of Mental Disorder Management in Zhejiang Province, Hangzhou, 310003, China.
- Brain Research Institute of Zhejiang University, Hangzhou, 310003, China.
- Zhejiang Engineering Center for Mathematical Mental Health, Hangzhou, 310003, China.
- Department of Neurobiology, NHC and CAMS Key Laboratory of Medical Neurobiology, School of Brain Science and Brian Medicine, and MOE Frontier Science Center for Brain Science and Brain-machine Integration, Zhejiang University School of Medicine, Hangzhou, 310003, China.
| | - Shaohua Hu
- Department of Psychiatry, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, China.
- The Key Laboratory of Mental Disorder Management in Zhejiang Province, Hangzhou, 310003, China.
- Brain Research Institute of Zhejiang University, Hangzhou, 310003, China.
- Zhejiang Engineering Center for Mathematical Mental Health, Hangzhou, 310003, China.
- Department of Neurobiology, NHC and CAMS Key Laboratory of Medical Neurobiology, School of Brain Science and Brian Medicine, and MOE Frontier Science Center for Brain Science and Brain-machine Integration, Zhejiang University School of Medicine, Hangzhou, 310003, China.
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15
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Chiorean A, Jones BDM, Murong M, Gonzalez-Torres C, Kloiber S, Ortiz A, Rosenblat JD, Mulsant BH, Husain MI. Prescribed psychostimulants and other pro-cognitive medications in bipolar disorder: A systematic review and meta-analysis of recurrence of manic symptoms. Bipolar Disord 2024; 26:418-430. [PMID: 38670627 DOI: 10.1111/bdi.13440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/28/2024]
Abstract
OBJECTIVES Clinicians are often hesitant to prescribe psychostimulants in bipolar disorder (BD) due to concerns of inducing (hypo)mania, despite limited published evidence on associations between prescribed psychostimulant use and recurrence of mood episodes in BD. The current systematic review and meta-analysis evaluated the emergence of (hypo)manic symptoms in patients with BD receiving prescribed psychostimulants or other pro-cognitive medications in euthymic or depressive states. METHODS A systematic search was performed of MEDLINE, Embase, and PsychINFO from inception to April 5, 2023 and search of Clinicaltrials.gov and Clinicaltrialsregister.eu for unpublished data. References of included studies were hand-searched. Randomized trials and prospective longitudinal studies that evaluated psychostimulants and non-stimulant medications recommended for the treatment of ADHD by the Canadian ADHD practice guidelines were included. The review was reported in line with PRISMA guidelines and was preregistered on PROSPERO (CRD42022358588). RESULTS After screening 414 unique records, we included 27 studies, of which five reported data that was quantitatively synthesized (n = 1653). The use of psychostimulants in BD was not associated with increased scores on the Young Mania Rating Scale in patients who were in a euthymic or depressed state (SMD IV -0.17; 95% CI, -0.40 to 0.06) compared to placebo. There was a high degree of study-level heterogeneity (I2 = 80%). A qualitative synthesis of studies revealed a limited risk of medication-induced manic symptoms. CONCLUSIONS Our review provides preliminary evidence to suggest psychostimulants and non-stimulant ADHD medications have a limited risk of precipitating (hypo)mania symptoms. More extensive studies evaluating the safety and efficacy of these medications are warranted.
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Affiliation(s)
- Andreea Chiorean
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Centre for Addiction & Mental Health (CAMH), Toronto, Ontario, Canada
| | - Brett D M Jones
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Centre for Addiction & Mental Health (CAMH), Toronto, Ontario, Canada
| | - Mijia Murong
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Centre for Addiction & Mental Health (CAMH), Toronto, Ontario, Canada
| | - Christina Gonzalez-Torres
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Centre for Addiction & Mental Health (CAMH), Toronto, Ontario, Canada
| | - Stefan Kloiber
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Centre for Addiction & Mental Health (CAMH), Toronto, Ontario, Canada
| | - Abigail Ortiz
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Centre for Addiction & Mental Health (CAMH), Toronto, Ontario, Canada
| | - Joshua D Rosenblat
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Toronto Western Hospital, Toronto, Ontario, Canada
| | - Benoit H Mulsant
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Centre for Addiction & Mental Health (CAMH), Toronto, Ontario, Canada
| | - M Ishrat Husain
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Centre for Addiction & Mental Health (CAMH), Toronto, Ontario, Canada
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16
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Scott K, O'Donovan C, Brancati GE, Cervantes P, Ardau R, Manchia M, Severino G, Rybakowski J, Tondo L, Grof P, Alda M, Nunes A. Phenotypic clustering of bipolar disorder supports stratification by lithium responsiveness over diagnostic subtypes. Acta Psychiatr Scand 2024; 150:91-104. [PMID: 38643982 DOI: 10.1111/acps.13692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Revised: 03/08/2024] [Accepted: 04/10/2024] [Indexed: 04/23/2024]
Abstract
INTRODUCTION The aim of this study was to determine whether the clinical profiles of bipolar disorder (BD) patients could be differentiated more clearly using the existing classification by diagnostic subtype or by lithium treatment responsiveness. METHODS We included adult patients with BD-I or II (N = 477 across four sites) who were treated with lithium as their principal mood stabilizer for at least 1 year. Treatment responsiveness was defined using the dichotomized Alda score. We performed hierarchical clustering on phenotypes defined by 40 features, covering demographics, clinical course, family history, suicide behaviour, and comorbid conditions. We then measured the amount of information that inferred clusters carried about (A) BD subtype and (B) lithium responsiveness using adjusted mutual information (AMI) scores. Detailed phenotypic profiles across clusters were then evaluated with univariate comparisons. RESULTS Two clusters were identified (n = 56 and n = 421), which captured significantly more information about lithium responsiveness (AMI range: 0.033 to 0.133) than BD subtype (AMI: 0.004 to 0.011). The smaller cluster had disproportionately more lithium responders (n = 47 [83.8%]) when compared to the larger cluster (103 [24.4%]; p = 0.006). CONCLUSIONS Phenotypes derived from detailed clinical data may carry more information about lithium responsiveness than the current classification of diagnostic subtype. These findings support lithium responsiveness as a valid approach to stratification in clinical samples.
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Affiliation(s)
- Katie Scott
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Claire O'Donovan
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Giulio Emilio Brancati
- Department of Clinical and Experimental Medicine, University Hospital of Pisa, Pisa, Italy
| | - Pablo Cervantes
- Department of Psychiatry, McGill University Health Centre, Montreal, Quebec, Canada
| | - Rafaella Ardau
- Unit of Clinical Pharmacology, University Hospital of Cagliari, Cagliari, Italy
| | - Mirko Manchia
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
- Department of Pharmacology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Giovanni Severino
- Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Janusz Rybakowski
- Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland
| | - Leonardo Tondo
- Department of Psychiatry, Harvard Medical School, Boston, Nova Scotia, USA
- Lucio Bini Mood Disorder Center, Cagliari, Italy
| | - Paul Grof
- Mood Disorders Center of Ottawa, Ottawa, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Martin Alda
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Abraham Nunes
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
- Faculty of Computer Science, Dalhousie University, Halifax, Nova Scotia, Canada
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Haenen N, Kamperman AM, Prodan A, Nolen WA, Boks MP, Wesseloo R. The efficacy of lamotrigine in bipolar disorder: A systematic review and meta-analysis. Bipolar Disord 2024; 26:431-441. [PMID: 38750644 DOI: 10.1111/bdi.13452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/27/2024]
Abstract
OBJECTIVE To provide up-to-date clinical guidance on the efficacy of lamotrigine in bipolar disorder (BD). METHODS Eligible studies were identified during a systematic literature search according to PRISMA-guidelines. We included randomized controlled trials (RCTs) and cohort studies that quantitatively assessed lamotrigine's efficacy in BD. We divided the included studies into three groups: 1. acute treatment of depression, 2. acute treatment of mania and hypomania, and 3. maintenance treatment. Analyses were stratified by control group (placebo vs active comparator) and treatment strategy (monotherapy vs add-on treatment). RESULTS We included 20 RCTs (n = 1166 lamotrigine users) and 20 cohort studies (n = 11,141 lamotrigine users). Twenty-four of these studies were included in meta-analyses. During depressive episodes, greater decreases in depressive symptomatology were associated with initiation of lamotrigine as add-on treatment than with placebo (SMD -0.30 [95% CI = -0.51, -0.10], df = 3, p = 0.004). Decreases in depressive symptomatology did not differ significantly between lamotrigine and the active comparator (SMD -0.28 [95% CI = -1.06, 0.50], df = 3, p = 0.488). As a maintenance treatment, lamotrigine was associated with a significantly lower relapse/recurrence rate than placebo (risk ratio (RR) 0.84 [95% CI = 0.71, 0.99], df = 2, p = 0.037). Relapse/recurrence rates did not differ significantly between lamotrigine and lithium (RR 1.06 [95% CI = 0.89, 1.25], df = 2, p = 0.513). A qualitative assessment of high-quality register-based studies found that lamotrigine was associated with lower hospital admission rates than other commonly used treatment regimes. CONCLUSIONS There is substantial evidence for the efficacy of lamotrigine in BD, specifically as add-on treatment during acute depressive episodes and as maintenance treatment for preventing relapse and recurrence.
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Affiliation(s)
- N Haenen
- Department of Psychiatry, Erasmus University Medical Center, Rotterdam, the Netherlands
- The Netherlands Institute for Forensic Psychiatry and Psychology (NIFP), Penitentiary Psychiatric Centre (PPC), Vught, the Netherlands
| | - A M Kamperman
- Department of Psychiatry, Erasmus University Medical Center, Rotterdam, the Netherlands
- Department of Psychiatry, Epidemiological and Social Psychiatric Research Institute (ESPRi), Erasmus University Medical Center, Rotterdam, the Netherlands
| | - A Prodan
- Department of Psychiatry, UMC Utrecht Brain Center, University Medical Center, Utrecht, the Netherlands
| | - W A Nolen
- Department of Psychiatry, University Medical Center Groningen, Groningen, the Netherlands
| | - M P Boks
- Department of Psychiatry, UMC Utrecht Brain Center, University Medical Center, Utrecht, the Netherlands
| | - R Wesseloo
- Department of Psychiatry, Erasmus University Medical Center, Rotterdam, the Netherlands
- Bipolar Disorder Expert Team, GGZ Delfland, Delft, the Netherlands
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Freyberg Z, Andreazza AC, McClung CA, Phillips ML. Linking mitochondrial dysfunction, neurotransmitter, neural network abnormalities and mania: Elucidating neurobiological mechanisms of the therapeutic effect of the ketogenic diet in Bipolar Disorder. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2024:S2451-9022(24)00199-X. [PMID: 39053576 DOI: 10.1016/j.bpsc.2024.07.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2024] [Revised: 06/25/2024] [Accepted: 07/15/2024] [Indexed: 07/27/2024]
Abstract
There is growing interest in the ketogenic diet as a treatment for Bipolar Disorder (BD), with promising anecdotal and small case study reports of efficacy. Yet, the neurobiological mechanisms by which diet-induced ketosis might ameliorate BD symptoms remain to be determined, particularly in manic and hypomanic states - defining features of BD. Identifying these mechanisms will therefore provide new markers to guide personalized interventions and provide targets for novel treatment developments for individuals with BD. In this critical review, we describe recent findings highlighting two types of neurobiological abnormalities in BD: 1) mitochondrial dysfunction; and 2) neurotransmitter and neural network functional abnormalities. We will consequently link these abnormalities lead to mania/hypomania and depression in BD and then describe the biological underpinnings by which the ketogenic diet might have a beneficial effect in individuals with BD. We end the review by describing future approaches that can be employed to elucidate the neurobiology underlying the therapeutic effect of the ketogenic diet in BD. In so doing, this may provide marker predictors to identify individuals who will respond well to the ketogenic diet, as well as offer neural targets for novel treatment developments for BD.
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Affiliation(s)
- Zachary Freyberg
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA 15213, USA; Department of Cell Biology, University of Pittsburgh, Pittsburgh, PA 15213, USA.
| | - Ana C Andreazza
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON M5S 1A8, Canada; Department of Psychiatry, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Colleen A McClung
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Mary L Phillips
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA 15213, USA.
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Ioannou M, Borkent J, Andreu-Sánchez S, Wu J, Fu J, Sommer IEC, Haarman BCM. Reproducible gut microbial signatures in bipolar and schizophrenia spectrum disorders: A metagenome-wide study. Brain Behav Immun 2024; 121:165-175. [PMID: 39032544 DOI: 10.1016/j.bbi.2024.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Revised: 05/30/2024] [Accepted: 07/15/2024] [Indexed: 07/23/2024] Open
Abstract
BACKGROUND Numerous studies report gut microbiome variations in bipolar disorder (BD) and schizophrenia spectrum disorders (SSD) compared to healthy individuals, though, there is limited consensus on which specific bacteria are associated with these disorders. METHODS In this study, we performed a comprehensive metagenomic shotgun sequencing analysis in 103 Dutch patients with BD/SSD and 128 healthy controls matched for age, sex, body mass index and income, while accounting for diet quality, transit time and technical confounders. To assess the replicability of the findings, we used two validation cohorts (total n = 203), including participants from a distinct population with a different metagenomic isolation protocol. RESULTS The gut microbiome of the patients had a significantly different β-diversity, but not α-diversity nor neuroactive potential compared to healthy controls. Initially, twenty-six bacterial taxa were identified as differentially abundant in patients. Among these, the previously reported genera Lachnoclostridium and Eggerthella were replicated in the validation cohorts. Employing the CoDaCoRe learning algorithm, we identified two bacterial balances specific to BD/SSD, which demonstrated an area under the receiver operating characteristic curve (AUC) of 0.77 in the test dataset. These balances were replicated in the validation cohorts and showed a positive association with the severity of psychiatric symptoms and antipsychotic use. Last, we showed a positive association between the relative abundance of Klebsiella and Klebsiella pneumoniae with antipsychotic use and between the Anaeromassilibacillus and lithium use. CONCLUSIONS Our findings suggest that microbial balances could be a reproducible method for identifying BD/SSD-specific microbial signatures, with potential diagnostic and prognostic applications. Notably, Lachnoclostridium and Eggerthella emerge as frequently occurring bacteria in BD/SSD. Last, our study reaffirms the previously established link between Klebsiella and antipsychotic medication use and identifies a novel association between Anaeromassilibacillus and lithium use.
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Affiliation(s)
- Magdalini Ioannou
- University of Groningen and University Medical Center Groningen, Department of Psychiatry, Groningen, the Netherlands; University of Groningen and University Medical Center Groningen, Department of Biomedical Sciences, Groningen, the Netherlands.
| | - Jenny Borkent
- University of Groningen and University Medical Center Groningen, Department of Biomedical Sciences, Groningen, the Netherlands
| | - Sergio Andreu-Sánchez
- University of Groningen and University Medical Center Groningen, Department of Genetics, Groningen, the Netherlands; University of Groningen and University Medical Center Groningen, Department of Pediatrics, Groningen, the Netherlands
| | - Jiafei Wu
- University of Groningen and University Medical Center Groningen, Department of Genetics, Groningen, the Netherlands
| | - Jingyuan Fu
- University of Groningen and University Medical Center Groningen, Department of Genetics, Groningen, the Netherlands; University of Groningen and University Medical Center Groningen, Department of Pediatrics, Groningen, the Netherlands
| | - Iris E C Sommer
- University of Groningen and University Medical Center Groningen, Department of Biomedical Sciences, Groningen, the Netherlands
| | - Bartholomeus C M Haarman
- University of Groningen and University Medical Center Groningen, Department of Psychiatry, Groningen, the Netherlands
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Primavera D, Urban A, Cantone E, Nonnis M, Aviles Gonzalez CI, Perra A, Tusconi M, Sancassiani F. The Impact on Anxiety Symptoms of an Immersive Virtual Reality Remediation Program in Bipolar Disorders: A Randomized Clinical Trial. J Clin Med 2024; 13:4203. [PMID: 39064243 PMCID: PMC11277986 DOI: 10.3390/jcm13144203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2024] [Revised: 07/03/2024] [Accepted: 07/13/2024] [Indexed: 07/28/2024] Open
Abstract
Background: The objective of this work is to investigate the effectiveness of a cognitive remediation intervention on anxiety symptoms in people with bipolar disorder and the therapeutic effect on people whose anxiety symptoms were above the threshold for a screener and whose comorbidity could be identified as an anxiety disorder. Methods: The experimental intervention included 24 sessions (around 45 min each), two for each week over three months. The entire program was inspired by user-centered rehabilitation principles in a recovery-oriented perspective and an approach to bipolar disorder in an evolutionary and non-discriminating vision. The primary outcomes measure the score of the Zung Self-Rating Anxiety Scale (SAS), hypothesizing a higher decrease in the experimental group than in the control group. The survey has been conducted per the CONSORT guidelines for feasibility studies. Results: We evaluate a decrease in the overall SAS score from T0 to T1 to be higher in the experimental group compared to the control group, indicating an improvement in anxiety symptoms (p < 0.0001). Conclusions: The study suggests that virtual reality could have a role in treating anxiety symptoms and disorders in young adults with bipolar disorders or anxiety symptoms in people with hyperactivity and novelty-seeking behaviorsunder stress and high risk for bipolar disorder.
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Affiliation(s)
- Diego Primavera
- Department of Medical Sciences and Public Health, University of Cagliari, Monserrato Blocco I (CA), 09042 Cagliari, Italy (A.P.)
| | - Antonio Urban
- Department of Medical Sciences and Public Health, University of Cagliari, Monserrato Blocco I (CA), 09042 Cagliari, Italy (A.P.)
- University Hospital of Cagliari, 09042 Cagliari, Italy
| | - Elisa Cantone
- Department of Medical Sciences and Public Health, University of Cagliari, Monserrato Blocco I (CA), 09042 Cagliari, Italy (A.P.)
| | - Marcello Nonnis
- Department of Pedagogy, Psychology, Philosophy, University of Cagliari, 09123 Cagliari, Italy;
| | - Cesar Ivan Aviles Gonzalez
- Department of Medical Sciences and Public Health, University of Cagliari, Monserrato Blocco I (CA), 09042 Cagliari, Italy (A.P.)
- Department of Nursing, Universidad Popular del Cesar, Valledupar 200001, Colombia
| | - Alessandra Perra
- Department of Medical Sciences and Public Health, University of Cagliari, Monserrato Blocco I (CA), 09042 Cagliari, Italy (A.P.)
| | | | - Federica Sancassiani
- Department of Medical Sciences and Public Health, University of Cagliari, Monserrato Blocco I (CA), 09042 Cagliari, Italy (A.P.)
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Denomme N, Hernandez CC, Bock HA, Ohana RF, Bakshi S, Sherwood AM, McCorvy JD, Daley PF, Callaway WB, Hull JM, Alt A, Isom LL, Cozzi NV. N-(4-Bromo-2,5-Dimethoxyphenethyl)-6-(4-Phenylbutoxy)Hexan-1-Amine (XOB): A Novel Phenylalkylamine Antagonist of Serotonin 2A Receptors and Voltage-Gated Sodium Channels. Mol Pharmacol 2024; 106:92-106. [PMID: 38821630 PMCID: PMC11254453 DOI: 10.1124/molpharm.123.000837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 05/17/2024] [Accepted: 05/23/2024] [Indexed: 06/02/2024] Open
Abstract
Bipolar disorder impacts millions of patients in the United States but the mechanistic understanding of its pathophysiology and therapeutics is incomplete. Atypical antipsychotic serotonin2A (5-HT2A) receptor antagonists, such as quetiapine and olanzapine, and mood-stabilizing voltage-gated sodium channel (VGSC) blockers, such as lamotrigine, carbamazepine, and valproate, show therapeutic synergy and are often prescribed in combination for the treatment of bipolar disorder. Combination therapy is a complex task for clinicians and patients, often resulting in unexpected difficulties with dosing, drug tolerances, and decreased patient compliance. Thus, an unmet need for bipolar disorder treatment is to develop a therapeutic agent that targets both 5-HT2A receptors and VGSCs. Toward this goal, we developed a novel small molecule that simultaneously antagonizes 5-HT2A receptors and blocks sodium current. The new compound, N-(4-bromo-2,5-dimethoxyphenethyl)-6-(4-phenylbutoxy)hexan-1-amine (XOB) antagonizes 5-HT-stimulated, Gq-mediated, calcium flux at 5-HT2A receptors at low micromolar concentrations while displaying negligible affinity and activity at 5-HT1A, 5-HT2B, and 5-HT2C receptors. At similar concentrations, XOB administration inhibits sodium current in heterologous cells and results in reduced action potential (AP) firing and VGSC-related AP properties in mouse prefrontal cortex layer V pyramidal neurons. Thus, XOB represents a new, proof-of-principle tool that can be used for future preclinical investigations and therapeutic development. This polypharmacology approach of developing a single molecule to act upon two targets, which are currently independently targeted by combination therapies, may lead to safer alternatives for the treatment of psychiatric disorders that are increasingly being found to benefit from the simultaneous targeting of multiple receptors. SIGNIFICANCE STATEMENT: The authors synthesized a novel small molecule (XOB) that simultaneously antagonizes two key therapeutic targets of bipolar disorder, 5-HT2A receptors and voltage-gated sodium channels, in heterologous cells, and inhibits the intrinsic excitability of mouse prefrontal cortex layer V pyramidal neurons in brain slices. XOB represents a valuable new proof-of-principle tool for future preclinical investigations and provides a novel molecular approach to the pharmacological treatment of complex neuropsychiatric disease, which often requires a combination of therapeutics for sufficient patient benefit.
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Affiliation(s)
- Nicholas Denomme
- Department of Pharmacology (N.D., S.B., A.A., L.L.I.), Michigan Psychedelic Center (M-PsyC) (N.D., L.L.I.), Life Sciences Institute (C.C.H., A.A.), University of Michigan, Ann Arbor, Michigan; Promega Corporation, Fitchburg, Wisconsin (R.F.O.); Usona Institute, Fitchburg, Wisconsin (A.M.S.); Department of Cell Biology, Neurobiology, and Anatomy. Medical College of Wisconsin, Milwaukee, Wisconsin (H.A.B., J.D.M.); Department of Neurology and Neurologic Sciences, Stanford University, Stanford, California (J.M.H.); and Alexander Shulgin Research Institute, Lafayette, California (P.F.D., W.B.C., N.V.C.)
| | - Ciria C Hernandez
- Department of Pharmacology (N.D., S.B., A.A., L.L.I.), Michigan Psychedelic Center (M-PsyC) (N.D., L.L.I.), Life Sciences Institute (C.C.H., A.A.), University of Michigan, Ann Arbor, Michigan; Promega Corporation, Fitchburg, Wisconsin (R.F.O.); Usona Institute, Fitchburg, Wisconsin (A.M.S.); Department of Cell Biology, Neurobiology, and Anatomy. Medical College of Wisconsin, Milwaukee, Wisconsin (H.A.B., J.D.M.); Department of Neurology and Neurologic Sciences, Stanford University, Stanford, California (J.M.H.); and Alexander Shulgin Research Institute, Lafayette, California (P.F.D., W.B.C., N.V.C.)
| | - Hailey A Bock
- Department of Pharmacology (N.D., S.B., A.A., L.L.I.), Michigan Psychedelic Center (M-PsyC) (N.D., L.L.I.), Life Sciences Institute (C.C.H., A.A.), University of Michigan, Ann Arbor, Michigan; Promega Corporation, Fitchburg, Wisconsin (R.F.O.); Usona Institute, Fitchburg, Wisconsin (A.M.S.); Department of Cell Biology, Neurobiology, and Anatomy. Medical College of Wisconsin, Milwaukee, Wisconsin (H.A.B., J.D.M.); Department of Neurology and Neurologic Sciences, Stanford University, Stanford, California (J.M.H.); and Alexander Shulgin Research Institute, Lafayette, California (P.F.D., W.B.C., N.V.C.)
| | - Rachel F Ohana
- Department of Pharmacology (N.D., S.B., A.A., L.L.I.), Michigan Psychedelic Center (M-PsyC) (N.D., L.L.I.), Life Sciences Institute (C.C.H., A.A.), University of Michigan, Ann Arbor, Michigan; Promega Corporation, Fitchburg, Wisconsin (R.F.O.); Usona Institute, Fitchburg, Wisconsin (A.M.S.); Department of Cell Biology, Neurobiology, and Anatomy. Medical College of Wisconsin, Milwaukee, Wisconsin (H.A.B., J.D.M.); Department of Neurology and Neurologic Sciences, Stanford University, Stanford, California (J.M.H.); and Alexander Shulgin Research Institute, Lafayette, California (P.F.D., W.B.C., N.V.C.)
| | - Shreeya Bakshi
- Department of Pharmacology (N.D., S.B., A.A., L.L.I.), Michigan Psychedelic Center (M-PsyC) (N.D., L.L.I.), Life Sciences Institute (C.C.H., A.A.), University of Michigan, Ann Arbor, Michigan; Promega Corporation, Fitchburg, Wisconsin (R.F.O.); Usona Institute, Fitchburg, Wisconsin (A.M.S.); Department of Cell Biology, Neurobiology, and Anatomy. Medical College of Wisconsin, Milwaukee, Wisconsin (H.A.B., J.D.M.); Department of Neurology and Neurologic Sciences, Stanford University, Stanford, California (J.M.H.); and Alexander Shulgin Research Institute, Lafayette, California (P.F.D., W.B.C., N.V.C.)
| | - Alexander M Sherwood
- Department of Pharmacology (N.D., S.B., A.A., L.L.I.), Michigan Psychedelic Center (M-PsyC) (N.D., L.L.I.), Life Sciences Institute (C.C.H., A.A.), University of Michigan, Ann Arbor, Michigan; Promega Corporation, Fitchburg, Wisconsin (R.F.O.); Usona Institute, Fitchburg, Wisconsin (A.M.S.); Department of Cell Biology, Neurobiology, and Anatomy. Medical College of Wisconsin, Milwaukee, Wisconsin (H.A.B., J.D.M.); Department of Neurology and Neurologic Sciences, Stanford University, Stanford, California (J.M.H.); and Alexander Shulgin Research Institute, Lafayette, California (P.F.D., W.B.C., N.V.C.)
| | - John D McCorvy
- Department of Pharmacology (N.D., S.B., A.A., L.L.I.), Michigan Psychedelic Center (M-PsyC) (N.D., L.L.I.), Life Sciences Institute (C.C.H., A.A.), University of Michigan, Ann Arbor, Michigan; Promega Corporation, Fitchburg, Wisconsin (R.F.O.); Usona Institute, Fitchburg, Wisconsin (A.M.S.); Department of Cell Biology, Neurobiology, and Anatomy. Medical College of Wisconsin, Milwaukee, Wisconsin (H.A.B., J.D.M.); Department of Neurology and Neurologic Sciences, Stanford University, Stanford, California (J.M.H.); and Alexander Shulgin Research Institute, Lafayette, California (P.F.D., W.B.C., N.V.C.)
| | - Paul F Daley
- Department of Pharmacology (N.D., S.B., A.A., L.L.I.), Michigan Psychedelic Center (M-PsyC) (N.D., L.L.I.), Life Sciences Institute (C.C.H., A.A.), University of Michigan, Ann Arbor, Michigan; Promega Corporation, Fitchburg, Wisconsin (R.F.O.); Usona Institute, Fitchburg, Wisconsin (A.M.S.); Department of Cell Biology, Neurobiology, and Anatomy. Medical College of Wisconsin, Milwaukee, Wisconsin (H.A.B., J.D.M.); Department of Neurology and Neurologic Sciences, Stanford University, Stanford, California (J.M.H.); and Alexander Shulgin Research Institute, Lafayette, California (P.F.D., W.B.C., N.V.C.)
| | - Wyeth B Callaway
- Department of Pharmacology (N.D., S.B., A.A., L.L.I.), Michigan Psychedelic Center (M-PsyC) (N.D., L.L.I.), Life Sciences Institute (C.C.H., A.A.), University of Michigan, Ann Arbor, Michigan; Promega Corporation, Fitchburg, Wisconsin (R.F.O.); Usona Institute, Fitchburg, Wisconsin (A.M.S.); Department of Cell Biology, Neurobiology, and Anatomy. Medical College of Wisconsin, Milwaukee, Wisconsin (H.A.B., J.D.M.); Department of Neurology and Neurologic Sciences, Stanford University, Stanford, California (J.M.H.); and Alexander Shulgin Research Institute, Lafayette, California (P.F.D., W.B.C., N.V.C.)
| | - Jacob M Hull
- Department of Pharmacology (N.D., S.B., A.A., L.L.I.), Michigan Psychedelic Center (M-PsyC) (N.D., L.L.I.), Life Sciences Institute (C.C.H., A.A.), University of Michigan, Ann Arbor, Michigan; Promega Corporation, Fitchburg, Wisconsin (R.F.O.); Usona Institute, Fitchburg, Wisconsin (A.M.S.); Department of Cell Biology, Neurobiology, and Anatomy. Medical College of Wisconsin, Milwaukee, Wisconsin (H.A.B., J.D.M.); Department of Neurology and Neurologic Sciences, Stanford University, Stanford, California (J.M.H.); and Alexander Shulgin Research Institute, Lafayette, California (P.F.D., W.B.C., N.V.C.)
| | - Andrew Alt
- Department of Pharmacology (N.D., S.B., A.A., L.L.I.), Michigan Psychedelic Center (M-PsyC) (N.D., L.L.I.), Life Sciences Institute (C.C.H., A.A.), University of Michigan, Ann Arbor, Michigan; Promega Corporation, Fitchburg, Wisconsin (R.F.O.); Usona Institute, Fitchburg, Wisconsin (A.M.S.); Department of Cell Biology, Neurobiology, and Anatomy. Medical College of Wisconsin, Milwaukee, Wisconsin (H.A.B., J.D.M.); Department of Neurology and Neurologic Sciences, Stanford University, Stanford, California (J.M.H.); and Alexander Shulgin Research Institute, Lafayette, California (P.F.D., W.B.C., N.V.C.)
| | - Lori L Isom
- Department of Pharmacology (N.D., S.B., A.A., L.L.I.), Michigan Psychedelic Center (M-PsyC) (N.D., L.L.I.), Life Sciences Institute (C.C.H., A.A.), University of Michigan, Ann Arbor, Michigan; Promega Corporation, Fitchburg, Wisconsin (R.F.O.); Usona Institute, Fitchburg, Wisconsin (A.M.S.); Department of Cell Biology, Neurobiology, and Anatomy. Medical College of Wisconsin, Milwaukee, Wisconsin (H.A.B., J.D.M.); Department of Neurology and Neurologic Sciences, Stanford University, Stanford, California (J.M.H.); and Alexander Shulgin Research Institute, Lafayette, California (P.F.D., W.B.C., N.V.C.)
| | - Nicholas V Cozzi
- Department of Pharmacology (N.D., S.B., A.A., L.L.I.), Michigan Psychedelic Center (M-PsyC) (N.D., L.L.I.), Life Sciences Institute (C.C.H., A.A.), University of Michigan, Ann Arbor, Michigan; Promega Corporation, Fitchburg, Wisconsin (R.F.O.); Usona Institute, Fitchburg, Wisconsin (A.M.S.); Department of Cell Biology, Neurobiology, and Anatomy. Medical College of Wisconsin, Milwaukee, Wisconsin (H.A.B., J.D.M.); Department of Neurology and Neurologic Sciences, Stanford University, Stanford, California (J.M.H.); and Alexander Shulgin Research Institute, Lafayette, California (P.F.D., W.B.C., N.V.C.)
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D'Amico A, Sung H, Arbona-Lampaya A, Freifeld A, Hosey K, Garcia J, Lacbawan L, Besançon E, Kassem L, Akula N, Knowles EEM, Dickinson D, McMahon FJ. Independent inheritance of cognition and bipolar disorder in a family sample. Am J Med Genet B Neuropsychiatr Genet 2024:e33001. [PMID: 39011872 DOI: 10.1002/ajmg.b.33001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 05/28/2024] [Accepted: 06/17/2024] [Indexed: 07/17/2024]
Abstract
Cognitive deficits in people with bipolar disorder (BD) may be the result of the illness or its treatment, but they could also reflect genetic risk factors shared between BD and cognition. We investigated this question using empirical genetic relationships within a sample of patients with BD and their unaffected relatives. Participants with bipolar I, II, or schizoaffective disorder ("narrow" BD, n = 69), related mood disorders ("broad" BD, n = 135), and their clinically unaffected relatives (n = 227) completed five cognitive tests. General cognitive function (g) was quantified via principal components analysis (PCA). Heritability and genetic correlations were estimated with SOLAR-Eclipse. Participants with "narrow" or "broad" diagnoses showed deficits in g, although affect recognition was unimpaired. Cognitive performance was significantly heritable (h2 = 0.322 for g, p < 0.005). Coheritability between psychopathology and g was small (0.0184 for narrow and 0.0327 for broad) and healthy relatives of those with BD were cognitively unimpaired. In this family sample, cognitive deficits were present in participants with BD but were not explained by substantial overlaps in genetic determinants of mood and cognition. These findings support the view that cognitive deficits in BD are largely the result of the illness or its treatment.
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Affiliation(s)
- Alexander D'Amico
- Intramural Research Program, National Institute of Mental Health, NIH, DHHS, Bethesda, Maryland, USA
| | - Heejong Sung
- Intramural Research Program, National Institute of Mental Health, NIH, DHHS, Bethesda, Maryland, USA
| | - Alejandro Arbona-Lampaya
- Intramural Research Program, National Institute of Mental Health, NIH, DHHS, Bethesda, Maryland, USA
| | - Ally Freifeld
- Intramural Research Program, National Institute of Mental Health, NIH, DHHS, Bethesda, Maryland, USA
| | - Katie Hosey
- Intramural Research Program, National Institute of Mental Health, NIH, DHHS, Bethesda, Maryland, USA
| | - Joshua Garcia
- Intramural Research Program, National Institute of Mental Health, NIH, DHHS, Bethesda, Maryland, USA
| | - Ley Lacbawan
- Intramural Research Program, National Institute of Mental Health, NIH, DHHS, Bethesda, Maryland, USA
| | - Emily Besançon
- Intramural Research Program, National Institute of Mental Health, NIH, DHHS, Bethesda, Maryland, USA
| | - Layla Kassem
- Intramural Research Program, National Institute of Mental Health, NIH, DHHS, Bethesda, Maryland, USA
| | - Nirmala Akula
- Intramural Research Program, National Institute of Mental Health, NIH, DHHS, Bethesda, Maryland, USA
| | | | - Dwight Dickinson
- Intramural Research Program, National Institute of Mental Health, NIH, DHHS, Bethesda, Maryland, USA
| | - Francis J McMahon
- Intramural Research Program, National Institute of Mental Health, NIH, DHHS, Bethesda, Maryland, USA
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Sajatovic M, Briggs F, Adeniyi C, Koopman J, Black J, Weise C, Fiorelli N, Yala J, Lesanpezeshki M, Einstadter D, Levin JB. Association Between Symptom Severity and Medication Adherence in Adults with Bipolar Disorder Reporting Adherence Challenges. PSYCHOPHARMACOLOGY BULLETIN 2024; 54:60-72. [PMID: 38993661 PMCID: PMC11235580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 07/13/2024]
Abstract
Background Given the importance of medication adherence among individuals with bipolar disorder (BD), this analysis from an ongoing randomized controlled trial (RCT) examined the relationship between BD symptoms, functioning and adherence in 69 poorly adherent adults with BD. Method Study inclusion criteria included being ≥ 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 measured in 2 ways: 1) the self-reported Tablets Routine Questionnaire (TRQ) and 2) electronic pill container monitoring (eCap pillbox). BD symptoms and functioning were measured with the MADRS, YMRS, Clinical Global Impressions Scale (CGI), and Global Assessment of Functioning (GAF). Only screening and baseline data were examined. Results Mean age was 42.32 (SD = 12.99) years, with 72.46% (n = 50) female and 43.48% (n = 30) non-white. Mean past 7-day percentage of days with missed BD medications using TRQ was 40.63% (SD = 32.61) and 30.30% (SD = 30.41) at screening and baseline, respectively. Baseline adherence using eCap was 42.16% (SD = 35.85) in those with available eCap data (n = 41). Worse adherence based on TRQ was significantly associated with higher MADRS (p = 0.04) and CGI (p = .03) but lower GAF (p = 0.02). eCAP measured adherence was not significantly associated with clinical variables. Conclusion While depression and functioning were approximate markers of adherence, reliance on patient self-report or BD symptom presentation may give an incomplete picture of medication-taking behaviors.
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Affiliation(s)
- Martha Sajatovic
- Sajatovic, MD, Department of Psychiatry, Case Western Reserve University School of Medicine, Cleveland, OH, USA; Neurological and Behavioral Outcomes Center, University Hospitals Cleveland Medical Center, Cleveland, OH, USA; Department of Psychiatry, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Farren Briggs
- Briggs, PhD, Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Clara Adeniyi
- Adeniyi, Department of Psychiatry, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Jacob Koopman
- Koopman, Department of Psychiatry, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Jessica Black
- Black, Department of Psychiatry, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Celeste Weise
- Weise, Department of Psychiatry, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Nicole Fiorelli
- Fiorelli, Department of Psychiatry, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Joy Yala
- Yala, Department of Psychiatry, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | | | - Douglas Einstadter
- Einstadter, Center for Health Care Research and Policy, MetroHealth System, Cleveland, OH, USA; Departments of Medicine and Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Jennifer B Levin
- Levin, PhD, Department of Psychiatry, Case Western Reserve University School of Medicine, Cleveland, OH, USA; Neurological and Behavioral Outcomes Center, University Hospitals Cleveland Medical Center, Cleveland, OH, USA; Department of Psychiatry, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
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24
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Joseph JT, Vishwanath R, Praharaj SK. Efficacy and safety of endoxifen in bipolar disorder: A systematic review. Hum Psychopharmacol 2024; 39:e2899. [PMID: 38683854 DOI: 10.1002/hup.2899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Revised: 04/10/2024] [Accepted: 04/17/2024] [Indexed: 05/02/2024]
Abstract
BACKGROUND Endoxifen, a protein kinase C inhibitor and selective estrogen receptor modulator, primarily used in breast cancer treatment, has recently emerged as a potential therapeutic option for managing manic episodes associated with bipolar disorder (BD). This review aims to assess the existing evidence base for endoxifen in BD treatment and evaluate the strengths and limitations of current research findings. METHODS A systematic search was conducted on Medline, Embase, and Web of Science databases. We included studies published in English that used endoxifen in BD, alongside any relevant studies identified through manual searching and conference papers with full-text availability. Information pertaining to dose, duration, clinical effects, and safety profiles was extracted from the included studies. The Cochrane Risk of Bias 2 tool was used to assess the risk of bias in clinical trials. RESULTS The final review included seven case reports (including two conference presentations), two clinical trials, and one prospective study. Most studies administered endoxifen 8 mg and reported an improvement in manic symptoms. Several case reports included patients with comorbid substance use, and most patients received mood stabilizers concurrently. Few reports lacked any structured outcome measures. The clinical trials used divalproex 1000 mg as an active comparator, which was deemed sub-therapeutic. Despite being multicentric, the first trial lacked data on center-wise recruitment, and certain methodological concerns were observed across the included trials. There were no serious adverse effects noted, except for a significant elevation in lipid profile within a 3-week period. Limited data were available regarding endoxifen efficacy and safety in mixed episodes, depressive episodes, and maintenance treatment. CONCLUSION There is a paucity of research on the efficacy and safety of endoxifen in BD. While existing evidence suggests short-term efficacy in manic episodes, significant limitations were identified in most of the included studies. Further research is imperative to establish the efficacy and safety of endoxifen in BD before considering its recommendation as a viable treatment option.
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Affiliation(s)
- Jithin Thekkelkuthiyathottil Joseph
- Clinical Research Centre for Neuromodulation in Psychiatry, Department of Psychiatry, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Rashmi Vishwanath
- Department of Psychiatry, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Samir Kumar Praharaj
- Clinical Research Centre for Neuromodulation in Psychiatry, Department of Psychiatry, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
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Léda-Rêgo G, Studart-Bottó P, Abbade P, Rabelo-Da-Ponte FD, Casqueiro JS, Sarmento S, Dallalana C, Troesch M, Prates S, Miranda-Scippa Â. Lifetime prevalence of psychiatric comorbidities in patients with bipolar disorder: A systematic review and meta-analysis. Psychiatry Res 2024; 337:115953. [PMID: 38763079 DOI: 10.1016/j.psychres.2024.115953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 04/26/2024] [Accepted: 05/07/2024] [Indexed: 05/21/2024]
Abstract
BACKGROUND Bipolar disorder (BD) is a severe psychiatric disease and part of its burden is related to the high rates of lifetime psychiatric comorbidity (PC), with diagnostic, therapeutic, and prognostic implications. METHODS Registered in PROSPERO (CRD42021282356). Meta-analyses were performed, searching for relevant papers published from 1993 to 2022 in Medline/PubMed (including E-Pub Ahead of Print), Embase, Cochrane Library (Central), PsycINFO, Scopus, Web of Science and via hand-searching, without language restrictions. 12.698 studies were initially identified, 114 of which were ultimately chosen based on the eligibility criteria. We performed two meta-analyses (prevalence and risk ratio) of mental health conditions among subjects with BD and then conducted a comprehensive examination of moderator effects using multivariable meta-regression models for moderators identified as significant in the univariable analysis. FINDINGS Overall PC prevalence of at least one disorder was 38.91 % (95 % CI 35.24-42.70) and the most frequent disorders were: anxiety (40.4 % [34.97-46.06]), SUD (30.7 % [23.73-38.73]), ADHD (18.6 % [10.66-30.33]) and Disruptive, impulse-control and conduct disorder (15 % [6.21-31.84). The moderators with higher association with individual prevalences were UN's Human Development Index (HDI), female gender, age, suicide attempt, and age at onset (AAO). INTERPRETATION It becomes evident that the prevalence of PC among individuals with BD is notably high, surpassing rates observed in the general population. This heightened prevalence persists despite significant heterogeneity across studies. Consequently, it is imperative to redirect clinical focus towards comprehensive mental health assessments, emphasizing personalized and routine screening. Additionally, there is a pressing need for the enhancement of public policies to create a supportive environment for individuals with BD, ensuring better therapeutic conditions and sustained assistance. By addressing these aspects, we can collectively strive towards fostering improved mental health outcomes for individuals with BD.
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Affiliation(s)
- Gabriela Léda-Rêgo
- Centro de Estudos dos Transtornos de Humor e de Ansiedade (CETHA), Universidade Federal da Bahia (UFBA), Salvador, BA, Brasil; Programa de Pós-Graduação em Medicina e Saúde, UFBA, Salvador, BA, Brasil; Faculdade de Medicina da Bahia, UFBA, Salvador, BA, Brasil.
| | - Paula Studart-Bottó
- Centro de Estudos dos Transtornos de Humor e de Ansiedade (CETHA), Universidade Federal da Bahia (UFBA), Salvador, BA, Brasil; Programa de Pós-Graduação em Medicina e Saúde, UFBA, Salvador, BA, Brasil; Faculdade de Medicina da Bahia, UFBA, Salvador, BA, Brasil
| | - Pedro Abbade
- Centro de Estudos dos Transtornos de Humor e de Ansiedade (CETHA), Universidade Federal da Bahia (UFBA), Salvador, BA, Brasil
| | - F Diego Rabelo-Da-Ponte
- Institute of Psychiatry, Psychology, and Neurosciences, King's College London, United Kingdom
| | - Juliana Socorro Casqueiro
- Centro de Estudos dos Transtornos de Humor e de Ansiedade (CETHA), Universidade Federal da Bahia (UFBA), Salvador, BA, Brasil; Programa de Pós-Graduação em Medicina e Saúde, UFBA, Salvador, BA, Brasil; Faculdade de Medicina da Bahia, UFBA, Salvador, BA, Brasil; Departamento de Neurociências e Saúde Mental, Faculdade de Medicina, UFBA, Salvador, BA, Brasil
| | - Stella Sarmento
- Centro de Estudos dos Transtornos de Humor e de Ansiedade (CETHA), Universidade Federal da Bahia (UFBA), Salvador, BA, Brasil; Programa de Pós-Graduação em Medicina e Saúde, UFBA, Salvador, BA, Brasil; Faculdade de Medicina da Bahia, UFBA, Salvador, BA, Brasil
| | - Caroline Dallalana
- Centro de Estudos dos Transtornos de Humor e de Ansiedade (CETHA), Universidade Federal da Bahia (UFBA), Salvador, BA, Brasil; Programa de Pós-Graduação em Medicina e Saúde, UFBA, Salvador, BA, Brasil; Faculdade de Medicina da Bahia, UFBA, Salvador, BA, Brasil
| | - Mariana Troesch
- Centro de Estudos dos Transtornos de Humor e de Ansiedade (CETHA), Universidade Federal da Bahia (UFBA), Salvador, BA, Brasil; Programa de Pós-Graduação em Medicina e Saúde, UFBA, Salvador, BA, Brasil; Faculdade de Medicina da Bahia, UFBA, Salvador, BA, Brasil
| | - Sarah Prates
- Centro de Estudos dos Transtornos de Humor e de Ansiedade (CETHA), Universidade Federal da Bahia (UFBA), Salvador, BA, Brasil; Programa de Pós-Graduação em Medicina e Saúde, UFBA, Salvador, BA, Brasil; Faculdade de Medicina da Bahia, UFBA, Salvador, BA, Brasil
| | - Ângela Miranda-Scippa
- Centro de Estudos dos Transtornos de Humor e de Ansiedade (CETHA), Universidade Federal da Bahia (UFBA), Salvador, BA, Brasil; Programa de Pós-Graduação em Medicina e Saúde, UFBA, Salvador, BA, Brasil; Faculdade de Medicina da Bahia, UFBA, Salvador, BA, Brasil; Departamento de Neurociências e Saúde Mental, Faculdade de Medicina, UFBA, Salvador, BA, Brasil
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Grigoroiu-Serbanescu M, van der Veen T, Bigdeli T, Herms S, Diaconu CC, Neagu AI, Bass N, Thygesen J, Forstner AJ, Nöthen MM, McQuillin A. Schizophrenia polygenic risk scores, clinical variables and genetic pathways as predictors of phenotypic traits of bipolar I disorder. J Affect Disord 2024; 356:507-518. [PMID: 38640977 DOI: 10.1016/j.jad.2024.04.066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Revised: 04/05/2024] [Accepted: 04/16/2024] [Indexed: 04/21/2024]
Abstract
AIM We investigated the predictive value of polygenic risk scores (PRS) derived from the schizophrenia GWAS (Trubetskoy et al., 2022) (SCZ3) for phenotypic traits of bipolar disorder type-I (BP-I) in 1878 BP-I cases and 2751 controls from Romania and UK. METHODS We used PRSice-v2.3.3 and PRS-CS for computing SCZ3-PRS for testing the predictive power of SCZ3-PRS alone and in combination with clinical variables for several BP-I subphenotypes and for pathway analysis. Non-linear predictive models were also used. RESULTS SCZ3-PRS significantly predicted psychosis, incongruent and congruent psychosis, general age-of-onset (AO) of BP-I, AO-depression, AO-Mania, rapid cycling in univariate regressions. A negative correlation between the number of depressive episodes and psychosis, mainly incongruent and an inverse relationship between increased SCZ3-SNP loading and BP-I-rapid cycling were observed. In random forest models comparing the predictive power of SCZ3-PRS alone and in combination with nine clinical variables, the best predictions were provided by combinations of SCZ3-PRS-CS and clinical variables closely followed by models containing only clinical variables. SCZ3-PRS performed worst. Twenty-two significant pathways underlying psychosis were identified. LIMITATIONS The combined RO-UK sample had a certain degree of heterogeneity of the BP-I severity: only the RO sample and partially the UK sample included hospitalized BP-I cases. The hospitalization is an indicator of illness severity. Not all UK subjects had complete subphenotype information. CONCLUSION Our study shows that the SCZ3-PRS have a modest clinical value for predicting phenotypic traits of BP-I. For clinical use their best performance is in combination with clinical variables.
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Affiliation(s)
- Maria Grigoroiu-Serbanescu
- Psychiatric Genetics Research Unit, Alexandru Obregia Clinical Psychiatric Hospital, Bucharest, Romania.
| | - Tracey van der Veen
- Molecular Psychiatry Laboratory, Division of Psychiatry, University College London, London, UK
| | - Tim Bigdeli
- SUNY Downstate Medical Center, Brooklyn, NY, USA
| | - Stefan Herms
- Department of Biomedicine, University of Basel, Basel, Switzerland; Institute of Human Genetics, University of Bonn, School of Medicine, University Hospital Bonn, Germany
| | | | | | - Nicholas Bass
- Molecular Psychiatry Laboratory, Division of Psychiatry, University College London, London, UK
| | - Johan Thygesen
- Molecular Psychiatry Laboratory, Division of Psychiatry, University College London, London, UK; Institute of Health Informatics, University College London, London, UK
| | - Andreas J Forstner
- Institute of Human Genetics, University of Bonn, School of Medicine, University Hospital Bonn, Germany
| | - Markus M Nöthen
- Institute of Human Genetics, University of Bonn, School of Medicine, University Hospital Bonn, Germany
| | - Andrew McQuillin
- Molecular Psychiatry Laboratory, Division of Psychiatry, University College London, London, UK
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27
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Salvetat N, Checa-Robles FJ, Delacrétaz A, Cayzac C, Dubuc B, Vetter D, Dainat J, Lang JP, Gamma F, Weissmann D. AI algorithm combined with RNA editing-based blood biomarkers to discriminate bipolar from major depressive disorders in an external validation multicentric cohort. J Affect Disord 2024; 356:385-393. [PMID: 38615844 DOI: 10.1016/j.jad.2024.04.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 04/02/2024] [Accepted: 04/05/2024] [Indexed: 04/16/2024]
Abstract
Bipolar disorder (BD) is a leading cause of disability worldwide, as it can lead to cognitive and functional impairment and premature mortality. The first episode of BD is usually a depressive episode and is often misdiagnosed as major depressive disorder (MDD). Growing evidence indicates that peripheral immune activation and inflammation are involved in the pathophysiology of BD and MDD. Recently, by developing a panel of RNA editing-based blood biomarkers able to discriminate MDD from depressive BD, we have provided clinicians a new tool to reduce the misdiagnosis delay observed in patients suffering from BD. The present study aimed at validating the diagnostic value of this panel in an external independent multicentric Switzerland-based cohort of 143 patients suffering from moderate to major depression. The RNA-editing based blood biomarker (BMK) algorithm developped allowed to accurately discriminate MDD from depressive BD in an external cohort, with high accuracy, sensitivity and specificity values (82.5 %, 86.4 % and 80.8 %, respectively). These findings further confirm the important role of RNA editing in the physiopathology of mental disorders and emphasize the possible clinical usefulness of the biomarker panel for optimization treatment delay in patients suffering from BD.
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Affiliation(s)
- Nicolas Salvetat
- ALCEDIAG/Sys2Diag, CNRS UMR 9005, Parc Euromédecine, Montpellier, France
| | | | - Aurélie Delacrétaz
- Les Toises. Center for psychiatry and psychotherapy, Lausanne, Switzerland
| | - Christopher Cayzac
- ALCEDIAG/Sys2Diag, CNRS UMR 9005, Parc Euromédecine, Montpellier, France
| | - Benjamin Dubuc
- ALCEDIAG/Sys2Diag, CNRS UMR 9005, Parc Euromédecine, Montpellier, France
| | - Diana Vetter
- ALCEDIAG/Sys2Diag, CNRS UMR 9005, Parc Euromédecine, Montpellier, France
| | - Jacques Dainat
- ALCEDIAG/Sys2Diag, CNRS UMR 9005, Parc Euromédecine, Montpellier, France
| | - Jean-Philippe Lang
- ALCEDIAG/Sys2Diag, CNRS UMR 9005, Parc Euromédecine, Montpellier, France; Les Toises. Center for psychiatry and psychotherapy, Lausanne, Switzerland
| | - Franziska Gamma
- Les Toises. Center for psychiatry and psychotherapy, Lausanne, Switzerland
| | - Dinah Weissmann
- ALCEDIAG/Sys2Diag, CNRS UMR 9005, Parc Euromédecine, Montpellier, France.
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28
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Eckart C, Reif A. The research landscape of bipolar disorder in Germany: productive, but underfunded. Int J Bipolar Disord 2024; 12:22. [PMID: 38878206 PMCID: PMC11180073 DOI: 10.1186/s40345-024-00344-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2024] [Accepted: 06/06/2024] [Indexed: 06/19/2024] Open
Abstract
BACKGROUND The recurrent mental illness bipolar disorder is a major burden on the healthcare system, which underlines the importance of research into this disease. Germany is one of the most productive countries in this research activity. This bibliometric analysis aims to outline the social and conceptual structure of the German research landscape on bipolar disorder over the last decade. Furthermore, we provide a short overview over current public funding. RESULTS Concerning the social structure, most of the German publications were collaboration projects, both with a national but also international orientation, in the latter case predominantly with countries of the global North. Analysis of the conceptual structure of German research activity identified psychiatric genetics, early recognition of bipolar disorder, neuroimaging, and pharmacological interventions as important topics within the field. In the context of a survey, only few publicly funded research projects were reported, many of which did not exclusively investigate bipolar disorder but followed a transdiagnostic approach. CONCLUSIONS Our bibliometric analysis revealed internationally well-networked German research activities on bipolar disorder. In stark contrast to its high prevalence and correspondingly high financial burden to the healthcare system, current grant support for research on this illness is strikingly low, particularly concerning the development of novel treatments.
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Affiliation(s)
- Cindy Eckart
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe University Frankfurt, University Hospital, Heinrich-Hoffmann-Str. 10, 60528, Frankfurt, Germany
- German Society for Bipolar Disorders (DGBS e.V.), Heinrich-Hoffmann-Str. 10, 60528, Frankfurt, Germany
| | - Andreas Reif
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe University Frankfurt, University Hospital, Heinrich-Hoffmann-Str. 10, 60528, Frankfurt, Germany.
- German Society for Bipolar Disorders (DGBS e.V.), Heinrich-Hoffmann-Str. 10, 60528, Frankfurt, Germany.
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Theodor-Stern-Kai 7, 60596, Frankfurt am Main, Germany.
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29
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Li C, Tian H, Li R, Jia F, Wang L, Ma X, Yang L, Zhang Q, Zhang Y, Yao K, Zhuo C. Molecular mechanisms of quetiapine bidirectional regulation of bipolar depression and mania based on network pharmacology and molecular docking: Evidence from computational biology. J Affect Disord 2024; 355:528-539. [PMID: 38518857 DOI: 10.1016/j.jad.2024.03.096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 03/15/2024] [Accepted: 03/18/2024] [Indexed: 03/24/2024]
Abstract
BACKGROUND Quetiapine monotherapy is recommended as the first-line option for acute mania and acute bipolar depression. However, the mechanism of action of quetiapine is unclear. Network pharmacology and molecular docking were employed to determine the molecular mechanisms of quetiapine bidirectional regulation of bipolar depression and mania. METHODS Putative target genes for quetiapine were collected from the GeneCard, SwissTargetPrediction, and DrugBank databases. Targets for bipolar depression and bipolar mania were identified from the DisGeNET and GeneCards databases. A protein-protein interaction (PPI) network was generated using the String database and imported into Cytoscape. DAVID and the Bioinformatics platform were employed to perform the Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses of the top 15 core targets. The drug-pathway-target-disease network was constructed using Cytoscape. Finally, molecular docking was performed to evaluate the interactions between quetiapine and potential targets. RESULTS Targets for quetiapine actions against bipolar depression (126 targets) and bipolar mania (81 targets) were identified. Based on PPI and KEGG pathway analyses, quetiapine may affect bipolar depression by targeting the MAPK and PI3K/AKT insulin signaling pathways via BDNF, INS, EGFR, IGF1, and NGF, and it may affect bipolar mania by targeting the neuroactive ligand-receptor interaction signaling pathway via HTR1A, HTR1B, HTR2A, DRD2, and GRIN2B. Molecular docking revealed good binding affinity between quetiapine and potential targets. LIMITATIONS Pharmacological experiments should be conducted to verify and further explore these results. CONCLUSIONS Our findings suggest that quetiapine affects bipolar depression and bipolar mania through distinct biological core targets, and thus through different mechanisms. Furthermore, our results provide a theoretical basis for the clinical use of quetiapine and possible directions for new drug development.
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Affiliation(s)
- Chao Li
- Computational Biology Centre (CBC), Tianjin Anding Hospital, Nankai University Affiliated Tianjin Anding Hospital, Tianjin Medical University Affiliated Tianjin Anding Hospital, Tianjin 300222, China; Laboratory of Psychiatric-Neuroimaging-Genetic and Co-morbidity (PGNP_Lab), Tianjin Anding Hospital, Tianjin Mental Health Center of Tianjin Medical University, Tianjin 300222, China
| | - Hongjun Tian
- Animal Imaging Center (AIC) of Tianjin Fourth Center Hospital, Nankai University Affiliated Tianjin Fourth Center Hospital, Tianjin 300140, China
| | - Ranli Li
- Computational Biology Centre (CBC), Tianjin Anding Hospital, Nankai University Affiliated Tianjin Anding Hospital, Tianjin Medical University Affiliated Tianjin Anding Hospital, Tianjin 300222, China
| | - Feng Jia
- Computational Biology Centre (CBC), Tianjin Anding Hospital, Nankai University Affiliated Tianjin Anding Hospital, Tianjin Medical University Affiliated Tianjin Anding Hospital, Tianjin 300222, China
| | - Lina Wang
- Laboratory of Psychiatric-Neuroimaging-Genetic and Co-morbidity (PGNP_Lab), Tianjin Anding Hospital, Tianjin Mental Health Center of Tianjin Medical University, Tianjin 300222, China
| | - Xiaoyan Ma
- Laboratory of Psychiatric-Neuroimaging-Genetic and Co-morbidity (PGNP_Lab), Tianjin Anding Hospital, Tianjin Mental Health Center of Tianjin Medical University, Tianjin 300222, China
| | - Lei Yang
- Laboratory of Psychiatric-Neuroimaging-Genetic and Co-morbidity (PGNP_Lab), Tianjin Anding Hospital, Tianjin Mental Health Center of Tianjin Medical University, Tianjin 300222, China
| | - Qiuyu Zhang
- Laboratory of Psychiatric-Neuroimaging-Genetic and Co-morbidity (PGNP_Lab), Tianjin Anding Hospital, Tianjin Mental Health Center of Tianjin Medical University, Tianjin 300222, China
| | - Ying Zhang
- Laboratory of Psychiatric-Neuroimaging-Genetic and Co-morbidity (PGNP_Lab), Tianjin Anding Hospital, Tianjin Mental Health Center of Tianjin Medical University, Tianjin 300222, China
| | - Kaifang Yao
- Laboratory of Psychiatric-Neuroimaging-Genetic and Co-morbidity (PGNP_Lab), Tianjin Anding Hospital, Tianjin Mental Health Center of Tianjin Medical University, Tianjin 300222, China
| | - Chuanjun Zhuo
- Computational Biology Centre (CBC), Tianjin Anding Hospital, Nankai University Affiliated Tianjin Anding Hospital, Tianjin Medical University Affiliated Tianjin Anding Hospital, Tianjin 300222, China; Laboratory of Psychiatric-Neuroimaging-Genetic and Co-morbidity (PGNP_Lab), Tianjin Anding Hospital, Tianjin Mental Health Center of Tianjin Medical University, Tianjin 300222, China.
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30
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Klaus F, Ng HX, Barbosa IG, Beunders A, Briggs F, Burdick KE, Dols A, Forlenza O, Gildengers A, Millett C, Mulsant BH, Orhan M, Rajji TK, Rej S, Sajatovic M, Sarna K, Schouws S, Sutherland A, Teixeira AL, Yala JA, Eyler LT. Cognition in older age bipolar disorder: An analysis of archival data across the globe. J Affect Disord 2024; 355:231-238. [PMID: 38548199 DOI: 10.1016/j.jad.2024.03.126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 02/27/2024] [Accepted: 03/23/2024] [Indexed: 04/04/2024]
Abstract
BACKGROUND Cognitive deficits in bipolar disorder (BD) impact functioning and are main contributors to disability in older age BD (OABD). We investigated the difference between OABD and age-comparable healthy comparison (HC) participants and, among those with BD, the associations between age, global cognitive performance, symptom severity and functioning using a large, cross-sectional, archival dataset harmonized from 7 international OABD studies. METHODS Data from the Global Aging and Geriatric Experiments in Bipolar Disorder (GAGE-BD) database, spanning various standardized measures of cognition, functioning and clinical characteristics, were analyzed. The sample included 662 euthymic to mildly symptomatic participants aged minimum 50years (509 BD, 153 HC), able to undergo extensive cognitive testing. Linear mixed models estimated associations between diagnosis and global cognitive performance (g-score, harmonized across studies), and within OABD between g-score and severity of mania and depressive symptoms, duration of illness and lithium use and of global functioning. RESULTS After adjustment for study cohort, age, gender and employment status, there was no significant difference in g-score between OABD and HC, while a significant interaction emerged between employment status and diagnostic group (better global cognition associated with working) in BD. Within OABD, better g-scores were associated with fewer manic symptoms, higher education and better functioning. LIMITATIONS Cross-sectional design and loss of granularity due to harmonization. CONCLUSION More research is needed to understand heterogenous longitudinal patterns of cognitive change in BD and understand whether particular cognitive domains might be affected in OABD in order to develop new therapeutic efforts for cognitive dysfunction OABD.
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Affiliation(s)
- Federica Klaus
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA; Desert-Pacific Mental Illness Research Education and Clinical Center, VA San Diego Healthcare System, San Diego, CA, USA.
| | - Hui Xin Ng
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA
| | - Izabela G Barbosa
- Departamento de Psiquiatria, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Alexandra Beunders
- GGZ inGeest Specialized Mental Health Care, Department of Old Age Psychiatry, Amsterdam, the Netherlands; Amsterdam UMC, Amsterdam Public Health research institute, Amsterdam, the Netherlands
| | - Farren Briggs
- Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Katherine E Burdick
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Annemieke Dols
- Amsterdam UMC, Amsterdam Neuroscience, Mood, Anxiety, Psychosis, Sleep & Stress Program, Amsterdam, the Netherlands; Department of Psychiatry, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Orestes Forlenza
- Laboratory of Neuroscience (LIM-27), Department and Institute of Psychiatry, HCFMUSP, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
| | - Ariel Gildengers
- Department of Psychiatry, University of Pittsburgh School of Medicine, Western Psychiatric Hospital, USA
| | - Caitlin Millett
- Institute of Behavioral Science, The Feinstein Institutes of Medical Research, New York, USA
| | - Benoit H Mulsant
- Department of Psychiatry, Center for Addiction & Mental Health, University of Toronto, Toronto, Canada
| | - Melis Orhan
- Institute of Clinical Psychology, Leiden University, Leiden, the Netherlands
| | - Tarek K Rajji
- Department of Psychiatry, Center for Addiction & Mental Health, University of Toronto, Toronto, Canada
| | - Soham Rej
- Department of Psychiatry, Jewish General Hospital/Lady Davis Institute, McGill University, Montreal, Canada
| | - Martha Sajatovic
- Case Western Reserve University School of Medicine (MS), University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Kaylee Sarna
- Case Western Reserve University School of Medicine (MS), University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Sigfried Schouws
- GZZ inGeest Specialized Mental Health Care, Department of Old Age Psychiatry, Amsterdam, the Netherlands
| | - Ashley Sutherland
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA; Desert-Pacific Mental Illness Research Education and Clinical Center, VA San Diego Healthcare System, San Diego, CA, USA
| | - Antonio L Teixeira
- Department of Psychiatry and Behavioral Sciences, University of Texas/McGovern Medical School, Houston, TX, USA; Faculdade Santa Casa BH, Belo Horizonte, Minas Gerais, Brazil
| | - Joy A Yala
- Case Western Reserve University School of Medicine (MS), University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Lisa T Eyler
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA; Desert-Pacific Mental Illness Research Education and Clinical Center, VA San Diego Healthcare System, San Diego, CA, USA
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Helmink FGL, Mesman E, Hillegers MHJ. Beyond the Window of Risk? The Dutch Bipolar Offspring Study: 22-Year Follow-up. J Am Acad Child Adolesc Psychiatry 2024:S0890-8567(24)00308-3. [PMID: 38851383 DOI: 10.1016/j.jaac.2024.05.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 04/03/2024] [Accepted: 05/30/2024] [Indexed: 06/10/2024]
Abstract
OBJECTIVE Adolescent offspring of parents with bipolar disorder (BD) are at high risk to develop BD and other psychopathology, yet how this risk continues into middle adulthood remains unknown. This study aimed to determine the window of risk for BD and other psychopathology in offspring of parents with BD followed from adolescence into adulthood. METHOD This study reported on the 22-year follow-up assessment of the Dutch Bipolar Offspring Study, a fixed cohort study of 140 participants established in 1997. Offspring (n = 100; mean [SD] age = 38.28 [2.74] years) of parents with bipolar I disorder or bipolar II disorder were assessed at baseline and 1-, 5-, 12-, and 22-year follow-up. RESULTS No new BD onsets occurred since the 12-year follow-up (lifetime prevalence = 11%-13%; bipolar I disorder = 4%; bipolar II disorder = 7%). Lifetime prevalence of any mood disorder was 65%; for major depressive disorder, prevalence was 36%; and for recurrent mood episodes, prevalence was 37%. Prevalence of major depressive disorder more than doubled in the past decade. Point prevalence of any psychopathology peaked between 20 and 25 years (38%-46%), subsiding to 29% to 35% per year after age 30. Overall, 71% of offspring contacted mental health services since the last assessment. CONCLUSION The risk for homotypic transmission of BD in offspring of parents with BD is highest during adolescence. The heterotypic risk for mood disorder onset and recurrences continues over the life course. Severe mood disorders are often preceded by milder psychopathology, emphasizing the need for early identification and interventions. This study allows for better understanding of the onset and course of mood disorders and specific windows of risk in a familial high-risk population.
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Affiliation(s)
| | - Esther Mesman
- Erasmus MC Sophia Children's Hospital, Rotterdam, the Netherlands
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McCartan CJ, Yap J, Best P, Breedvelt J, Breslin G, Firth J, Tully MA, Webb P, White C, Gilbody S, Churchill R, Davidson G. Factors that influence participation in physical activity for people with bipolar disorder: a synthesis of qualitative evidence. Cochrane Database Syst Rev 2024; 6:CD013557. [PMID: 38837220 PMCID: PMC11152184 DOI: 10.1002/14651858.cd013557.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/07/2024]
Abstract
BACKGROUND Mental health problems contribute significantly to the overall disease burden worldwide and are major causes of disability, suicide, and ischaemic heart disease. People with bipolar disorder report lower levels of physical activity than the general population, and are at greater risk of chronic health conditions including cardiovascular disease and obesity. These contribute to poor health outcomes. Physical activity has the potential to improve quality of life and physical and mental well-being. OBJECTIVES To identify the factors that influence participation in physical activity for people diagnosed with bipolar disorder from the perspectives of service users, carers, service providers, and practitioners to help inform the design and implementation of interventions that promote physical activity. SEARCH METHODS We searched MEDLINE, PsycINFO, and eight other databases to March 2021. We also contacted experts in the field, searched the grey literature, and carried out reference checking and citation searching to identify additional studies. There were no language restrictions. SELECTION CRITERIA We included qualitative studies and mixed-methods studies with an identifiable qualitative component. We included studies that focused on the experiences and attitudes of service users, carers, service providers, and healthcare professionals towards physical activity for bipolar disorder. DATA COLLECTION AND ANALYSIS We extracted data using a data extraction form designed for this review. We assessed methodological limitations using a list of predefined questions. We used the "best fit" framework synthesis based on a revised version of the Health Belief Model to analyse and present the evidence. We assessed methodological limitations using the CASP Qualitative Checklist. We used the GRADE-CERQual (Confidence in the Evidence from Reviews of Qualitative research) guidance to assess our confidence in each finding. We examined each finding to identify factors to inform the practice of health and care professionals and the design and development of physical activity interventions for people with bipolar disorder. MAIN RESULTS We included 12 studies involving a total of 592 participants (422 participants who contributed qualitative data to an online survey, 170 participants in qualitative research studies). Most studies explored the views and experiences of physical activity of people with experience of bipolar disorder. A number of studies also reported on personal experiences of physical activity components of lifestyle interventions. One study included views from family carers and clinicians. The majority of studies were from high-income countries, with only one study conducted in a middle-income country. Most participants were described as stable and had been living with a diagnosis of bipolar disorder for a number of years. We downgraded our confidence in several of the findings from high confidence to moderate or low confidence, as some findings were based on only small amounts of data, and the findings were based on studies from only a few countries, questioning the relevance of these findings to other settings. We also had very few perspectives of family members, other carers, or health professionals supporting people with bipolar disorder. The studies did not include any findings from service providers about their perspectives on supporting this aspect of care. There were a number of factors that limited people's ability to undertake physical activity. Shame and stigma about one's physical appearance and mental health diagnosis were discussed. Some people felt their sporting skills/competencies had been lost when they left school. Those who had been able to maintain exercise through the transition into adulthood appeared to be more likely to include physical activity in their regular routine. Physical health limits and comorbid health conditions limited activity. This included bipolar medication, being overweight, smoking, alcohol use, poor diet and sleep, and these barriers were linked to negative coping skills. Practical problems included affordability, accessibility, transport links, and the weather. Workplace or health schemes that offered discounts were viewed positively. The lack of opportunity for exercise within inpatient mental health settings was a problem. Facilitating factors included being psychologically stable and ready to adopt new lifestyle behaviours. There were positive benefits of being active outdoors and connecting with nature. Achieving balance, rhythm, and routine helped to support mood management. Fitting physical activity into a regular routine despite fluctuating mood or motivation appeared to be beneficial if practised at the right intensity and pace. Over- or under-exercising could be counterproductive and accelerate depressive or manic moods. Physical activity also helped to provide a structure to people's daily routines and could lead to other positive lifestyle benefits. Monitoring physical or other activities could be an effective way to identify potential triggers or early warning signs. Technology was helpful for some. People who had researched bipolar disorder and had developed a better understanding of the condition showed greater confidence in managing their care or providing care to others. Social support from friends/family or health professionals was an enabling factor, as was finding the right type of exercise, which for many people was walking. Other benefits included making social connections, weight loss, improved quality of life, and better mood regulation. Few people had been told of the benefits of physical activity. Better education and training of health professionals could support a more holistic approach to physical and mental well-being. Involving mental health professionals in the multidisciplinary delivery of physical activity interventions could be beneficial and improve care. Clear guidelines could help people to initiate and incorporate lifestyle changes. AUTHORS' CONCLUSIONS There is very little research focusing on factors that influence participation in physical activity in bipolar disorder. The studies we identified suggest that men and women with bipolar disorder face a range of obstacles and challenges to being active. The evidence also suggests that there are effective ways to promote managed physical activity. The research highlighted the important role that health and care settings, and professionals, can play in assessing individuals' physical health needs and how healthy lifestyles may be promoted. Based on these findings, we have provided a summary of key elements to consider for developing physical activity interventions for bipolar disorder.
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Affiliation(s)
- Claire J McCartan
- IMPACT Research Centre, Northern Health & Social Care Trust, Antrim, UK
| | - Jade Yap
- Mental Health Foundation, London, UK
| | - Paul Best
- School of Social Sciences, Education & Social Work, Queen's University Belfast, Belfast, UK
| | - Josefien Breedvelt
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Gavin Breslin
- School of Psychology, Queen's University Belfast, Belfast, UK
| | - Joseph Firth
- Division of Psychology & Mental Health, University of Manchester, Manchester, UK
| | - Mark A Tully
- Institute of Mental Health Sciences, School of Health Sciences, Ulster University, Newtownabbey, UK
| | | | | | - Simon Gilbody
- Mental Health and Addiction Research Group, Department of Health Sciences, University of York, York, UK
| | - Rachel Churchill
- Centre for Reviews and Dissemination, University of York, York, UK
- Cochrane Common Mental Disorders, University of York, York, UK
| | - Gavin Davidson
- School of Social Sciences, Education & Social Work, Queen's University Belfast, Belfast, UK
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Queissner R, Fellendorf FT, Dalkner N, Bengesser SA, Maget A, Birner A, Platzer M, Reininghaus B, Häussl A, Schönthaler E, Tmava-Berisha A, Lenger M, Reininghaus EZ. The influence of chronic inflammation on the illnesscourse of bipolar disorder: A longitudinal study. J Psychiatr Res 2024; 174:258-262. [PMID: 38670061 DOI: 10.1016/j.jpsychires.2024.04.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 04/02/2024] [Accepted: 04/09/2024] [Indexed: 04/28/2024]
Abstract
INTRODUCTION C-reactive protein (CRP) is a systemic inflammatory marker, which indicates systemic inflammatory processes It is involved in different inflammatory processes of the body and is a reliable marker for the general inflammatory state of the body. High sensitive CRP seems to play a key role as a state and trait marker of bipolar disorder (BD). In the current study, we tried to determine the long-term effect of CRP levels on clinical symptoms and illness course of bipolar disorder. METHODS For the current study, we examined 106 patients with BD for a period of four years. Participants underwent a clinical screening for depressive and manic episodes with the Hamilton Depression Scale (HAMD) and the Young Mania Rating Score (YMRS) and a serological diagnostic for inflammatory parameters every six months, thus leading to 8 measurement times in total. Patients with the presence of severe medical or neurological comorbidities such as active cancer, chronic obstructive lung disease, rheumatoid arthritis, systemic lupus erythematosus, Alzheimer's disease, Parkinson's disease, Huntington's disease or multiple sclerosis and acute infections were not included in the study. RESULTS In our sample, 26% showed a mean hsCRP above 5 mg/dl. Those patients showed a significantly higher mean YMRS score than those with a mean hsCRP under 5 mg/dl during our observation period. Regarding HAMD there was no significant difference in hsCRP values. The existence of lithium treatment showed no significant influence on mean hsCRP levels between the start and endpoint. CONCLUSION Individuals who were exposed to a higher level of inflammation over time suffered from more manic symptoms in this period. These findings underline the hypothesis that inflammatory processes have an accumulative influence on the illness course of BD, especially concerning manic symptoms and episodes.
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Affiliation(s)
- Robert Queissner
- Medical University Graz, Department for Psychiatry and Psychotherapeutic Medicine, Auenbruggerplatz 31, 8036, Graz, Austria
| | - Frederike T Fellendorf
- Medical University Graz, Department for Psychiatry and Psychotherapeutic Medicine, Auenbruggerplatz 31, 8036, Graz, Austria.
| | - Nina Dalkner
- Medical University Graz, Department for Psychiatry and Psychotherapeutic Medicine, Auenbruggerplatz 31, 8036, Graz, Austria
| | - Susanne A Bengesser
- Medical University Graz, Department for Psychiatry and Psychotherapeutic Medicine, Auenbruggerplatz 31, 8036, Graz, Austria
| | - Alexander Maget
- Medical University Graz, Department for Psychiatry and Psychotherapeutic Medicine, Auenbruggerplatz 31, 8036, Graz, Austria
| | - Armin Birner
- Medical University Graz, Department for Psychiatry and Psychotherapeutic Medicine, Auenbruggerplatz 31, 8036, Graz, Austria
| | - Martina Platzer
- Medical University Graz, Department for Psychiatry and Psychotherapeutic Medicine, Auenbruggerplatz 31, 8036, Graz, Austria
| | - Bernd Reininghaus
- Medical University Graz, Department for Psychiatry and Psychotherapeutic Medicine, Auenbruggerplatz 31, 8036, Graz, Austria
| | - Alfred Häussl
- Medical University Graz, Department for Psychiatry and Psychotherapeutic Medicine, Auenbruggerplatz 31, 8036, Graz, Austria
| | - Elena Schönthaler
- Medical University Graz, Department for Psychiatry and Psychotherapeutic Medicine, Auenbruggerplatz 31, 8036, Graz, Austria
| | - Adelina Tmava-Berisha
- Medical University Graz, Department for Psychiatry and Psychotherapeutic Medicine, Auenbruggerplatz 31, 8036, Graz, Austria
| | - Melanie Lenger
- Medical University Graz, Department for Psychiatry and Psychotherapeutic Medicine, Auenbruggerplatz 31, 8036, Graz, Austria
| | - Eva Z Reininghaus
- Medical University Graz, Department for Psychiatry and Psychotherapeutic Medicine, Auenbruggerplatz 31, 8036, Graz, Austria
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Dell'Osso B, Cremaschi L, Macellaro M, Cafaro R, Girone N. Bipolar disorder staging and the impact it has on its management: an update. Expert Rev Neurother 2024; 24:565-574. [PMID: 38753491 DOI: 10.1080/14737175.2024.2355264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Accepted: 05/10/2024] [Indexed: 05/18/2024]
Abstract
INTRODUCTION The longitudinal course of bipolar disorder (BD) is associated with an active process of neuroprogression, characterized by structural brain alterations and progressive functional impairment. In the last decades, a growing need of a standardized staging model for BD arose, with the aim of a more appropriate definition of stage-specific clinical manifestations and the identification of more customized therapeutic tools. AREAS COVERED The authors review the literature on clinical aspects, neurobiological correlates and treatment issues related to BD progression. Thereafter, they address the definition, constructs, and evolution of the staging concept, focusing on the clinical applications of BD staging models available in literature. EXPERT OPINION Although several staging models for BD have been proposed to date, their application in clinical practice is still relatively scant. This may have a detrimental impact on the clinical and therapeutic management of BD, in terms of early and proper diagnosis as well as tailored treatment interventions according to the different stages of illness. Future research efforts should tend to the integration of recent insights on neuroimaging and epigenetic markers, toward a standardized and multidimensional staging model.
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Affiliation(s)
- Bernardo Dell'Osso
- Department of Biomedical and Clinical Sciences "Luigi Sacco", University of Milan, Milan, Italy
- CRC "Aldo Ravelli" for Neurotechnology and Experimental Brain Therapeutics, University of Milan, Milan, Italy
- Department of Psychiatry and Behavioural Sciences, Stanford University, Stanford, CA, USA
| | - Laura Cremaschi
- Department of Biomedical and Clinical Sciences "Luigi Sacco", University of Milan, Milan, Italy
| | - Monica Macellaro
- Department of Biomedical and Clinical Sciences "Luigi Sacco", University of Milan, Milan, Italy
- CRC "Aldo Ravelli" for Neurotechnology and Experimental Brain Therapeutics, University of Milan, Milan, Italy
| | - Rita Cafaro
- Department of Biomedical and Clinical Sciences "Luigi Sacco", University of Milan, Milan, Italy
| | - Nicolaja Girone
- Department of Biomedical and Clinical Sciences "Luigi Sacco", University of Milan, Milan, Italy
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Dolman C, Howard L, Goodwin GM, Young A, Jones IR, Bergink V, Richardson T, Di Florio A. Hypersexuality in bipolar disorder: an overlooked symptom. Lancet Psychiatry 2024; 11:405-406. [PMID: 38760105 DOI: 10.1016/s2215-0366(24)00093-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Accepted: 03/08/2024] [Indexed: 05/19/2024]
Affiliation(s)
- Clare Dolman
- Department of Health Service and Population Research, Institude of Psychiatry, Pschology and Neuroscience, King's College London, London, UK.
| | - Louise Howard
- Department of Health Service and Population Research, Institude of Psychiatry, Pschology and Neuroscience, King's College London, London, UK
| | - Guy M Goodwin
- Department of Psychiatry, Oxford University, Oxford, UK
| | - Allan Young
- Centre for Affective Disorders, Institude of Psychiatry, Pschology and Neuroscience, King's College London, London, UK
| | - Ian R Jones
- National Centre for Mental Health, Cardiff University, Cardiff, UK
| | - Veerle Bergink
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | - Arianna Di Florio
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
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Varela RB, Boschen SL, Yates N, Houghton T, Blaha CD, Lee KH, Bennet KE, Kouzani AZ, Berk M, Quevedo J, Valvassori SS, Tye SJ. Anti-manic effect of deep brain stimulation of the ventral tegmental area in an animal model of mania induced by methamphetamine. Bipolar Disord 2024; 26:376-387. [PMID: 38558302 DOI: 10.1111/bdi.13423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
BACKGROUND Treatment of refractory bipolar disorder (BD) is extremely challenging. Deep brain stimulation (DBS) holds promise as an effective treatment intervention. However, we still understand very little about the mechanisms of DBS and its application on BD. AIM The present study aimed to investigate the behavioural and neurochemical effects of ventral tegmental area (VTA) DBS in an animal model of mania induced by methamphetamine (m-amph). METHODS Wistar rats were given 14 days of m-amph injections, and on the last day, animals were submitted to 20 min of VTA DBS in two different patterns: intermittent low-frequency stimulation (LFS) or continuous high-frequency stimulation (HFS). Immediately after DBS, manic-like behaviour and nucleus accumbens (NAc) phasic dopamine (DA) release were evaluated in different groups of animals through open-field tests and fast-scan cyclic voltammetry. Levels of NAc dopaminergic markers were evaluated by immunohistochemistry. RESULTS M-amph induced hyperlocomotion in the animals and both DBS parameters reversed this alteration. M-amph increased DA reuptake time post-sham compared to baseline levels, and both LFS and HFS were able to block this alteration. LFS was also able to reduce phasic DA release when compared to baseline. LFS was able to increase dopamine transporter (DAT) expression in the NAc. CONCLUSION These results demonstrate that both VTA LFS and HFS DBS exert anti-manic effects and modulation of DA dynamics in the NAc. More specifically the increase in DA reuptake driven by increased DAT expression may serve as a potential mechanism by which VTA DBS exerts its anti-manic effects.
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Affiliation(s)
- Roger B Varela
- Functional Neuromodulation and Novel Therapeutics Laboratory, Asia Pacific Centre for Neuromodulation, Queensland Brain Institute, The University of Queensland, Brisbane, Queensland, Australia
| | - Suelen L Boschen
- Department of Neurologic Surgery, Neural Engineering Laboratories, Mayo Clinic, Rochester, Minnesota, USA
- Department of Neurologic Surgery, Applied Computational Neurophysiology and Neuromodulation Laboratory, Mayo Clinic, Rochester, Minnesota, USA
| | - Nathanael Yates
- Functional Neuromodulation and Novel Therapeutics Laboratory, Asia Pacific Centre for Neuromodulation, Queensland Brain Institute, The University of Queensland, Brisbane, Queensland, Australia
| | - Tristan Houghton
- Functional Neuromodulation and Novel Therapeutics Laboratory, Asia Pacific Centre for Neuromodulation, Queensland Brain Institute, The University of Queensland, Brisbane, Queensland, Australia
| | - Charles D Blaha
- Department of Neurologic Surgery, Neural Engineering Laboratories, Mayo Clinic, Rochester, Minnesota, USA
| | - Kendall H Lee
- Department of Neurologic Surgery, Neural Engineering Laboratories, Mayo Clinic, Rochester, Minnesota, USA
| | - Kevin E Bennet
- Department of Neurologic Surgery, Neural Engineering Laboratories, Mayo Clinic, Rochester, Minnesota, USA
- Division of Engineering, Mayo Clinic, Rochester, Minnesota, USA
| | - Abbas Z Kouzani
- School of Engineering, Deakin University, Geelong, Victoria, Australia
| | - Michael Berk
- School of Medicine, IMPACT-The Institute for Mental and Physical Health and Clinical Translation, Barwon Health, Deakin University, Geelong, Victoria, Australia
| | - João Quevedo
- Faillace Department of Psychiatry and Behavioral Sciences, Center for Interventional Psychiatry, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth Houston), Houston, Texas, USA
- Faillace Department of Psychiatry and Behavioral Sciences, Center of Excellence on Mood Disorders, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, Texas, USA
- Faillace Department of Psychiatry and Behavioral Sciences, Translational Psychiatry Program, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, Texas, USA
- Translational Psychiatry Laboratory, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Criciúma, Santa Catarina, Brazil
| | - Samira S Valvassori
- Translational Psychiatry Laboratory, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Criciúma, Santa Catarina, Brazil
| | - Susannah J Tye
- Functional Neuromodulation and Novel Therapeutics Laboratory, Asia Pacific Centre for Neuromodulation, Queensland Brain Institute, The University of Queensland, Brisbane, Queensland, Australia
- Department of Psychiatry and Psychology, Translational Neuroscience Laboratory, Mayo Clinic, Rochester, Minnesota, USA
- Department of Psychiatry, University of Minnesota, Minneapolis, Minnesota, USA
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, Georgia, USA
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Thela L, Paruk S, Bhengu B, Chiliza B. Psychiatric emergencies during pregnancy and puerperium in low - And middle-income countries. Best Pract Res Clin Obstet Gynaecol 2024; 94:102478. [PMID: 38401484 DOI: 10.1016/j.bpobgyn.2024.102478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Revised: 01/29/2024] [Accepted: 02/05/2024] [Indexed: 02/26/2024]
Abstract
Pregnancy and puerperium are critical points in women's health, and various psychiatric emergencies may worsen or manifest (for the first time) during this period. In the presence of a psychiatric emergency, the pregnancy and puerperium outcomes may be compromised. In addition to the mother being at risk, the health of the fetus and the newborn may also be compromised if the psychiatric emergency is not managed appropriately. Early detection and collaborative approaches between mental health practitioners and obstetricians are of utmost importance in women who are at risk and those living with psychiatric illnesses during pregnancy and puerperium. Practitioners should also ensure that women with impaired capacity due to psychiatric disease are treated in a non-judgmental and respectful manner, even if their autonomies have been overridden.
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Affiliation(s)
- Lindokuhle Thela
- University of KwaZulu Natal, School of Clinical Medicine, Discipline of Psychiatry, South Africa.
| | - Saeeda Paruk
- University of KwaZulu Natal, School of Clinical Medicine, Discipline of Psychiatry, South Africa
| | - Busisiwe Bhengu
- University of KwaZulu Natal, School of Clinical Medicine, Discipline of Psychiatry, South Africa
| | - Bonginkosi Chiliza
- University of KwaZulu Natal, School of Clinical Medicine, Discipline of Psychiatry, South Africa
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Xiao Q, Zhang G, Zhong Y. Abnormal functional connectivity of the intrinsic networks in adolescent bipolar I versus bipolar II disorder. Psychiatry Res Neuroimaging 2024; 340:111802. [PMID: 38428239 DOI: 10.1016/j.pscychresns.2024.111802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 01/07/2024] [Accepted: 02/19/2024] [Indexed: 03/03/2024]
Abstract
BACKGROUND The symptoms of pediatric bipolar disorder (PBD)-I and PBD-II differ, but accurate identification at an early stage is difficult and may prevent effective treatment of this disorder. Therefore, it is urgent to elucidate a biological marker based on objective imaging indicators to help distinguish the two. Therefore, this research aims to compare the functional connectivity between PBD-I patient and PBD-II patient in different brain networks. METHODS Our study enrolled 31 PBD-I and 23 PBD-II patients from 12 to 17 years of age. They were analyzed by resting state-functional connectivity through Independent component analysis (ICA). RESULTS We found differences between PBD-I and PBD-II in functional connectivity of the default network, frontoparietal network, salience network and limbic system. In addition, the clinical features, cognitive functions are associated with the functional connectivity of the intrinsic networks in PBD-I and PBD-II separately. CONCLUSION This research is the first to find differences in functional connectivity between PBD-I and PBD-II, suggesting that abnormality of the functional connectivity within large networks may be biomarkers that help differentiate PBD-I from PBD-II in the future.
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Affiliation(s)
- Qian Xiao
- Mental Health Centre of Xiangya Hospital, Central South University, Changsha 410008, Hunan, China
| | - Gui Zhang
- School of Psychology, Nanjing Normal University, Nanjing 210097, China
| | - Yuan Zhong
- School of Psychology, Nanjing Normal University, Nanjing 210097, China.
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Mihoub O, Chaaben AB, Boukouaci W, Lajnef M, Wu CL, Bouassida J, Saitoh K, Sugunasabesan S, Naamoune S, Richard JR, El Kefi H, Ben Ammar H, El Hechmi Z, Guemira F, Kharrat M, Leboyer M, Tamouza R. A replication study of sHLA-E influence on schizophrenia and bipolar disorder. L'ENCEPHALE 2024:S0013-7006(24)00113-1. [PMID: 38824045 DOI: 10.1016/j.encep.2024.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 03/18/2024] [Accepted: 04/05/2024] [Indexed: 06/03/2024]
Abstract
OBJECTIVES Schizophrenia (SZ) and bipolar disorders (BP) are chronic and severe neuropsychiatric diseases. These disorders are tightly related to immune deregulations. In the current study, we intended to replicate the previously reported involvement of the soluble HLA-E isoforms (sHLA-E) in the risk of developing the two conditions along with disease severity in a Tunisian population group. PATIENTS AND METHODS One hundred and twenty-four patients with schizophrenia and 121 with bipolar disorder meeting the DSM-IV criteria along 111 healthy controls were included in this present case-control study. The soluble HLA-E isoforms circulating levels were measured using the ELISA method. The statistical analyses were performed using Kruskal-Wallis and Wilcoxon rank sum tests by R software and GraphPad prism 9. RESULTS We found that the sHLA-E circulating levels were significantly higher in BP patients as compared to healthy controls (P<0.0001) and that such increases were mainly observed in patients during an acute phase of their disease (P<0.0001). In SZ patients, while we failed to observe an association with the levels of sHLA-E in the entire SZ sample, we found that high sHLA-E levels characterized stabilized patients in comparison with those during an acute episode (P=0.022). Finally, we did not observe any association between sHLA-E circulating levels and symptoms assessed by the classical clinical scales either in BP or SZ patients. CONCLUSION Overall, the present findings replicate in a Tunisian population group the previously demonstrated implication of sHLA-E circulating levels in the risk of developing BP or SZ in a French patient cohort. Such replication allows to consider HLA-E as a potent and true inflammatory marker in the context of the two disorders.
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Affiliation(s)
- Ons Mihoub
- Laboratory of Human Genetics (LR99ES10), Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia.
| | - Arij Ben Chaaben
- Laboratory of Human Genetics (LR99ES10), Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Wahid Boukouaci
- Translational Neuropsychiatry Laboratory and Paris Est Créteil University, Inserm U955 IMRB, 94010 Créteil, France
| | - Mohamed Lajnef
- Translational Neuropsychiatry Laboratory and Paris Est Créteil University, Inserm U955 IMRB, 94010 Créteil, France
| | - Ching-Lien Wu
- Translational Neuropsychiatry Laboratory and Paris Est Créteil University, Inserm U955 IMRB, 94010 Créteil, France
| | - Jihène Bouassida
- Translational Neuropsychiatry Laboratory and Paris Est Créteil University, Inserm U955 IMRB, 94010 Créteil, France
| | - Kaori Saitoh
- Translational Neuropsychiatry Laboratory and Paris Est Créteil University, Inserm U955 IMRB, 94010 Créteil, France
| | - Sobika Sugunasabesan
- Translational Neuropsychiatry Laboratory and Paris Est Créteil University, Inserm U955 IMRB, 94010 Créteil, France
| | - Soumia Naamoune
- Translational Neuropsychiatry Laboratory and Paris Est Créteil University, Inserm U955 IMRB, 94010 Créteil, France
| | - Jean-Romain Richard
- Translational Neuropsychiatry Laboratory and Paris Est Créteil University, Inserm U955 IMRB, 94010 Créteil, France
| | - Hamdi El Kefi
- Department of Psychiatry, Military Hospital of Tunis, Tunis, Tunisia
| | - Hanen Ben Ammar
- Department of Psychiatry F, Razi Hospital, Mannouba, Tunisia
| | | | - Fathi Guemira
- Clinical Biology, Salah Azaiz Institute, Tunis, Tunisia
| | - Maher Kharrat
- Laboratory of Human Genetics (LR99ES10), Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Marion Leboyer
- Translational Neuropsychiatry Laboratory, fédération hospitalo-universitaire de médecine de précision en psychiatrie (FHU ADAPT), DMU IMPACT, AP-HP, Paris Est Créteil University and Fondation FondaMental, Inserm U955 IMRB, 94010 Créteil, France
| | - Ryad Tamouza
- Translational Neuropsychiatry Laboratory, fédération hospitalo-universitaire de médecine de précision en psychiatrie (FHU ADAPT), DMU IMPACT, AP-HP, Paris Est Créteil University and Fondation FondaMental, Inserm U955 IMRB, 94010 Créteil, France
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Desai Boström AE, Cars T, Hellner C, Lundberg J. Adolescent and Adult Transitions From Major Depressive Disorder to Bipolar Disorder. JAMA Psychiatry 2024:2818944. [PMID: 38809562 PMCID: PMC11137653 DOI: 10.1001/jamapsychiatry.2024.1133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Accepted: 03/17/2024] [Indexed: 05/30/2024]
Abstract
Importance Bipolar disorder (BD) often first appears in adolescence after onset of major depressive disorder (MDD), but diagnosis and treatment are commonly delayed. This delay is a concern because untreated BD is associated with adverse long-term outcomes, a more recurrent disease course and difficult-to-treat illness, and suicide attempts and deaths. Objective To examine the association of age at MDD onset with early transition to BD and the subsequent use of psychiatric inpatient services as a severity indicator. Design, Setting, and Participants This retrospective cohort study analyzed comprehensive data sourced from the Stockholm MDD Cohort data from 1997 to 2018, which encompass both outpatient and inpatient care. Individuals with an initial MDD episode from January 1, 2010, to December 31, 2013, who transitioned to BD by December 31, 2018, were identified. Data were analyzed between September 5 and December 28, 2023. Exposures Post MDD assessments included a depression severity index, comorbidities, psychotherapy, psychotropic drugs, and electroconvulsive therapy. Main Outcomes and Measures The main outcome was the transition from MDD to BD, dichotomized as occurring early (within 3 years of MDD onset) or late (3 years after MDD onset). Secondary outcomes encompassed the use of psychiatric inpatient services post transition and patterns of medication usage. A robust propensity score matching framework was used to estimate outcomes. Results The final balanced cohort included 228 individuals, with an equal distribution between adults (n = 114; mean [SD] age, 24.5 [6.3] years; 96 female [84.2%]; 20 experiencing an early transition to BD [17.5%]) and youths (n = 114; mean [SD] age, 15.3 [1.6] years; 93 female [81.6%]; 8 experiencing an early transition to BD [7.0%]). Youths were substantially less likely to transition early (odds ratio, 0.42; 95% CI, 0.20-0.88; P = .02), despite having more outpatient visits (mean [SD] visits per month, 1.21 [1.07] vs 0.97 [0.98] for adults; P = .01). Both groups experienced substantially reduced inpatient care following a BD diagnosis, concurring with a marked decline in antidepressant use without increased lithium use. Conclusions and Relevance These findings suggest that adolescents may experience delayed BD progression and that diagnosis substantially reduced inpatient care in all age groups, which coincided with a reduction in the use of antidepressants. These findings may inform pharmacologic strategies in patients with first-episode MDD at risk for BD.
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Affiliation(s)
- Adrian E Desai Boström
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, and Stockholm Health Care Services, Region Stockholm, Karolinska University Hospital, Stockholm, Sweden
- Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
- Department of Clinical Sciences/Psychiatry, Umeå University, Umeå, Sweden
| | | | - Clara Hellner
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, and Stockholm Health Care Services, Region Stockholm, Karolinska University Hospital, Stockholm, Sweden
- Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Johan Lundberg
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, and Stockholm Health Care Services, Region Stockholm, Karolinska University Hospital, Stockholm, Sweden
- Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
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Lei B, Feng H, Yang L, Wang J, Chen J, Song W, Jiang C, Zhang K, Wang Q, Tsang JCC, Chan NY, Liu Y, Chan JW, Pan J, Zhang B, Li T, Merikangas KR, Zhang J, Wing YK. Circadian rhythm dysfunction and psychopathology in the offspring of parents with bipolar disorder: a high-risk study in the Chinese population. Gen Psychiatr 2024; 37:e101239. [PMID: 38800632 PMCID: PMC11116863 DOI: 10.1136/gpsych-2023-101239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Accepted: 04/11/2024] [Indexed: 05/29/2024] Open
Abstract
Background Understanding the evolution of circadian rhythm dysfunction and psychopathology in the high-risk population has important implications for the prevention of bipolar disorder. Nevertheless, some of the previous studies on the emergence of psychopathologies and circadian dysfunction among high-risk populations were inconsistent and limited. Aims To examine the prevalence rates of sleep and circadian dysfunctions, mental disorders and their symptoms in the offspring of parents with (O-BD) and without bipolar disorder (O-control). Methods The study included 191 O-BD and 202 O-control subjects aged 6-21 years from the Greater Bay Area, China. The diagnoses and symptoms of sleep/circadian rhythm and mental disorders were assessed by the Diagnostic Interview for Sleep Patterns and Disorders, and the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version, respectively. Generalised estimating equations and shared frailty proportional hazards models of survival analysis were applied to compare the outcomes in the offspring. Results Adjusting for age, sex and region of recruitment, there was a significantly higher risk of delayed sleep phase symptoms (9.55% vs 2.58%, adjusted OR: 4.04) in O-BD than in O-control. O-BD had a nearly fivefold higher risk of mood disorders (11.70% vs 3.47%, adjusted OR: 4.68) and social anxiety (6.28% vs 1.49%, adjusted OR: 4.70), a fourfold higher risk of depressive disorders (11.17% vs 3.47%, adjusted OR: 3.99) and a threefold higher risk of mood symptoms (20.74% vs 10.40%, adjusted OR: 2.59) than O-control. Subgroup analysis revealed that O-BD children (aged under 12 years) had a nearly 2-fold higher risk of any mental and behavioural symptoms than O-control, while there was a nearly 4-fold higher risk of delayed sleep phase symptoms, a 7.5-fold higher risk of social anxiety and a 3-fold higher risk of mood symptoms in O-BD adolescents (aged 12 years and over). Conclusions There was an increase in delayed sleep phase symptoms in O-BD adolescents compared with their control counterparts, confirming the central role of circadian rhythm dysfunction in bipolar disorder. The findings of the specific age-related and stage-related developmental patterns of psychopathologies and circadian dysfunction in children and adolescent offspring of parents with bipolar disorder paved the way to develop specific and early clinical intervention and prevention strategies. Trial registration number NCT03656302.
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Affiliation(s)
- Binbin Lei
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong, China
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Hongliang Feng
- Center for Sleep and Circadian Medicine, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Hong Kong, China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Lulu Yang
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong, China
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Jing Wang
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
- Center for Sleep and Circadian Medicine, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Jie Chen
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Weidong Song
- Shenzhen Nanshan Center for Chronic Diseases Control (Shenzhen Nanshan Mental Health Center), Shenzhen, China
| | - Chao Jiang
- Department of Clinical Psychology, Shenzhen Fuyong People's Hospital, Shenzhen, China
| | - Kun Zhang
- Department of Mental Illness Prevention and Treatment, Shenzhen Longgang Center for Chronic Diseases Control, Shenzhen, China
| | - Qunfeng Wang
- Department of Neurology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China
| | - Jessie Chi Ching Tsang
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Hong Kong, China
| | - Ngan Yin Chan
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Hong Kong, China
| | - Yaping Liu
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
- Center for Sleep and Circadian Medicine, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Hong Kong, China
| | - Joey W.Y. Chan
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Hong Kong, China
| | - Jiyang Pan
- Sleep Medical Center, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, China
| | - Bin Zhang
- Department of Psychiatry, Nanfang Hospital, Southern Medical University; Guangdong-Hong Kong-Macao Greater Bay Area Center for Brain Science and Brain-Inspired Intelligence, Guangzhou, Guangdong, China
| | - Tao Li
- Department of Neurobiology, Affiliated Mental Health Center & Hangzhou Seventh People's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Kathleen Ries Merikangas
- Genetic Epidemiology Research Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, Maryland, USA
| | - Jihui Zhang
- Center for Sleep and Circadian Medicine, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Hong Kong, China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Yun Kwok Wing
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Hong Kong, China
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Zou T, Yang M, Chen Z, Xie H, Huang J, Qin Y, Liu F, Chen H, Xu X, Chen J, Tang H, Xiang H, Wu H, Liu M, Luo W, Liu J, Teng Z. Association among abnormal glycolipids, reproductive hormones, and cognitive dysfunction in female patients with bipolar disorder. BMC Psychiatry 2024; 24:385. [PMID: 38773397 PMCID: PMC11110249 DOI: 10.1186/s12888-024-05831-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 05/09/2024] [Indexed: 05/23/2024] Open
Abstract
BACKGROUND Patients with bipolar disorder (BD) show abnormalities in glucolipid metabolism and reproductive hormone levels, which are of concern in women with BD. This study was dedicated to investigating the glucolipid and reproductive hormone levels of female patients, and to preliminarily investigating their relationships with cognition. METHODS A total of 58 unmedicated female BD patients, 61 stable-medicated female BD patients, and 63 healthy controls (HC) were recruited in this study. Serum glycolipid indexes and reproductive hormones were measured. Cognitive function was assessed using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) and the Stroop Color-Word Test (Stroop test). RESULTS Patients with BD showed significant cognitive impairment (p < 0.05), which was not affected by medication. Triglycerides (TG), luteinizing hormone (LH), and high-density lipoprotein cholesterol (HDL-c) were altered in stable-medicated BD patients. In addition, regression analysis showed that progesterone (PRGE) and prolactin (PRL) were negatively associated with cognitive performance in stable-medicated BD patients. CONCLUSIONS Female BD patients may have cognitive deficits and abnormal levels of glycolipids and reproductive hormones. And abnormal levels of glycolipids and reproductive hormones may be associated with cognitive dysfunction in female BD patients.
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Affiliation(s)
- Tianxiang Zou
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - Min Yang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - Zhuohui Chen
- Department of Neurosurgery, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, China
| | - Haiqing Xie
- Department of Ultrasound Diagnosis, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - Jing Huang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - Yue Qin
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - Furu Liu
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - Haiyu Chen
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - Xuelei Xu
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - Jindong Chen
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - Hui Tang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - Hui Xiang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - Haishan Wu
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - MingHui Liu
- Department of Ultrasound Diagnosis, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - Wenbo Luo
- Department of Ultrasound Diagnosis, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - Jieyu Liu
- Department of Ultrasound Diagnosis, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China.
| | - Ziwei Teng
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China.
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Lee H, Han D, Hong KS, Ha K, Kim H, Cho EY, Myung W, Rhee SJ, Kim J, Ha TH, Lee KE, Jung HW, Lee Y, Lee D, Yu H, Lee D, Park YS, Ahn YM, Baek JH, Kim SH. Integrated proteomic and genomic analysis to identify predictive biomarkers for valproate response in bipolar disorder: a 6-month follow-up study. Int J Bipolar Disord 2024; 12:19. [PMID: 38758284 PMCID: PMC11101393 DOI: 10.1186/s40345-024-00342-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Accepted: 05/03/2024] [Indexed: 05/18/2024] Open
Abstract
BACKGROUND Several genetic studies have been undertaken to elucidate the intricate interplay between genetics and drug responses in bipolar disorder (BD). However, there has been notably limited research on biomarkers specifically linked to valproate, with only a few studies investigating integrated proteomic and genomic factors in response to valproate treatment. Therefore, this study aimed to identify biological markers for the therapeutic response to valproate treatment in BD. Patients with BD in remission were assessed only at baseline, whereas those experiencing acute mood episodes were evaluated at three points (baseline, 8 ± 2 weeks, and 6 ± 1 months). The response to valproate treatment was measured using the Alda scale, with individuals scoring an Alda A score ≥ 5 categorized into the acute-valproate responder (acute-VPAR) group. We analyzed 158 peptides (92 proteins) from peripheral blood samples using multiple reaction monitoring mass spectrometry, and proteomic result-guided candidate gene association analyses, with 1,627 single nucleotide variants (SNVs), were performed using the Korean chip. RESULTS The markers of 37 peptides (27 protein) showed temporal upregulation, indicating possible association with response to valproate treatment. A total of 58 SNVs in 22 genes and 37 SNVs in 16 genes showed nominally significant associations with the Alda A continuous score and the acute-VPAR group, respectively. No SNVs reached the genome-wide significance threshold; however, three SNVs (rs115788299, rs11563197, and rs117669164) in the secreted phosphoprotein 2 gene reached a gene-based false discovery rate-corrected significance threshold with response to valproate treatment. Significant markers were associated with the pathophysiological processes of bipolar disorders, including the immune response, acute phase reaction, and coagulation cascade. These results suggest that valproate effectively suppresses mechanisms associated with disease progression. CONCLUSIONS The markers identified in this study could be valuable indicators of the underlying mechanisms associated with response to valproate treatment.
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Affiliation(s)
- Hyunju Lee
- Department of Neuropsychiatry, Seoul National University Hospital, 101, Daehak-Ro, Jongno-Gu, Seoul, 03080, Republic of Korea
| | - Dohyun Han
- Proteomics Core Facility, Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea
- Transdisciplinary Department of Medicine & Advanced Technology, Seoul National University Hospital, Seoul, Republic of Korea
| | - Kyung Sue Hong
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
- Department of Psychiatry, Lions Gate Hospital - Vancouver Coastal Health, British Columbia, Canada
| | - Kyooseob Ha
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
- Department of Psychiatry, Lions Gate Hospital - Vancouver Coastal Health, British Columbia, Canada
| | - Hyeyoon Kim
- Proteomics Core Facility, Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea
| | - Eun Young Cho
- Samsung Institute of Future Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Woojae Myung
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Sang Jin Rhee
- Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea
| | - Jayoun Kim
- Medical Research Collaborating Center, Seoul National University Hospital, Seoul, Republic of Korea
| | - Tae Hyon Ha
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Kang Eun Lee
- Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea
| | - Hye Won Jung
- Samsung Institute of Future Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Yejin Lee
- Samsung Institute of Future Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Dongbin Lee
- Department of Psychiatry, Samsung Medical Center, Sunkyunkwan University School of Medicine, 115 Irwon-Ro, Gangnam-Gu, Seoul, 03080, Republic of Korea
| | - Hyeona Yu
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Daseul Lee
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Yun Seong Park
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Yong Min Ahn
- Department of Neuropsychiatry, Seoul National University Hospital, 101, Daehak-Ro, Jongno-Gu, Seoul, 03080, Republic of Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
- Institute of Human Behavioral Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea
| | - Ji Hyun Baek
- Department of Psychiatry, Samsung Medical Center, Sunkyunkwan University School of Medicine, 115 Irwon-Ro, Gangnam-Gu, Seoul, 03080, Republic of Korea.
| | - Se Hyun Kim
- Department of Neuropsychiatry, Seoul National University Hospital, 101, Daehak-Ro, Jongno-Gu, Seoul, 03080, Republic of Korea.
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Reilly S, Hobson-Merrett C, Gibbons B, Jones B, Richards D, Plappert H, Gibson J, Green M, Gask L, Huxley PJ, Druss BG, Planner CL. Collaborative care approaches for people with severe mental illness. Cochrane Database Syst Rev 2024; 5:CD009531. [PMID: 38712709 PMCID: PMC11075124 DOI: 10.1002/14651858.cd009531.pub3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/08/2024]
Abstract
BACKGROUND Collaborative care for severe mental illness (SMI) is a community-based intervention that promotes interdisciplinary working across primary and secondary care. Collaborative care interventions aim to improve the physical and/or mental health care of individuals with SMI. This is an update of a 2013 Cochrane review, based on new searches of the literature, which includes an additional seven studies. OBJECTIVES To assess the effectiveness of collaborative care approaches in comparison with standard care (or other non-collaborative care interventions) for people with diagnoses of SMI who are living in the community. SEARCH METHODS We searched the Cochrane Schizophrenia Study-Based Register of Trials (10 February 2021). We searched the Cochrane Common Mental Disorders (CCMD) controlled trials register (all available years to 6 June 2016). Subsequent searches on Ovid MEDLINE, Embase and PsycINFO together with the Cochrane Central Register of Controlled Trials (with an overlap) were run on 17 December 2021. SELECTION CRITERIA Randomised controlled trials (RCTs) where interventions described as 'collaborative care' were compared with 'standard care' for adults (18+ years) living in the community with a diagnosis of SMI. SMI was defined as schizophrenia, other types of schizophrenia-like psychosis or bipolar affective disorder. The primary outcomes of interest were: quality of life, mental state and psychiatric admissions at 12 months follow-up. DATA COLLECTION AND ANALYSIS Pairs of authors independently extracted data. We assessed the quality and certainty of the evidence using RoB 2 (for the primary outcomes) and GRADE. We compared treatment effects between collaborative care and standard care. We divided outcomes into short-term (up to six months), medium-term (seven to 12 months) and long-term (over 12 months). For dichotomous data we calculated the risk ratio (RR) and for continuous data we calculated the standardised mean difference (SMD), with 95% confidence intervals (CIs). We used random-effects meta-analyses due to substantial levels of heterogeneity across trials. We created a summary of findings table using GRADEpro. MAIN RESULTS Eight RCTs (1165 participants) are included in this review. Two met the criteria for type A collaborative care (intervention comprised of the four core components). The remaining six met the criteria for type B (described as collaborative care by the trialists, but not comprised of the four core components). The composition and purpose of the interventions varied across studies. For most outcomes there was low- or very low-certainty evidence. We found three studies that assessed the quality of life of participants at 12 months. Quality of life was measured using the SF-12 and the WHOQOL-BREF and the mean endpoint mental health component scores were reported at 12 months. Very low-certainty evidence did not show a difference in quality of life (mental health domain) between collaborative care and standard care in the medium term (at 12 months) (SMD 0.03, 95% CI -0.26 to 0.32; 3 RCTs, 227 participants). Very low-certainty evidence did not show a difference in quality of life (physical health domain) between collaborative care and standard care in the medium term (at 12 months) (SMD 0.08, 95% CI -0.18 to 0.33; 3 RCTs, 237 participants). Furthermore, in the medium term (at 12 months) low-certainty evidence did not show a difference between collaborative care and standard care in mental state (binary) (RR 0.99, 95% CI 0.77 to 1.28; 1 RCT, 253 participants) or in the risk of being admitted to a psychiatric hospital at 12 months (RR 5.15, 95% CI 0.67 to 39.57; 1 RCT, 253 participants). One study indicated an improvement in disability (proxy for social functioning) at 12 months in the collaborative care arm compared to usual care (RR 1.38, 95% CI 0.97 to 1.95; 1 RCT, 253 participants); we deemed this low-certainty evidence. Personal recovery and satisfaction/experience of care outcomes were not reported in any of the included studies. The data from one study indicated that the collaborative care treatment was more expensive than standard care (mean difference (MD) international dollars (Int$) 493.00, 95% CI 345.41 to 640.59) in the short term. Another study found the collaborative care intervention to be slightly less expensive at three years. AUTHORS' CONCLUSIONS This review does not provide evidence to indicate that collaborative care is more effective than standard care in the medium term (at 12 months) in relation to our primary outcomes (quality of life, mental state and psychiatric admissions). The evidence would be improved by better reporting, higher-quality RCTs and the assessment of underlying mechanisms of collaborative care. We advise caution in utilising the information in this review to assess the effectiveness of collaborative care.
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Affiliation(s)
- Siobhan Reilly
- Centre for Applied Dementia Studies, Faculty of Health Studies, University of Bradford, Bradford, UK
- Wolfson Centre for Applied Health Research, Bradford, UK
- Division of Health Research, Lancaster University, Lancaster, UK
| | - Charley Hobson-Merrett
- Primary Care Plymouth, University of Plymouth, Plymouth, UK
- National Institute for Health Research Applied Research Collaboration South West Peninsula, Plymouth, UK
| | | | - Ben Jones
- College of Medicine and Health, University of Exeter, Exeter, UK
| | - Debra Richards
- Primary Care Plymouth, University of Plymouth, Plymouth, UK
| | - Humera Plappert
- Primary Care Clinical Sciences, University of Birmingham, Birmingham, UK
| | | | - Maria Green
- Pennine Health Care NHS Foundation Trust, Bury, UK
| | - Linda Gask
- Health Sciences Research Group, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK
| | - Peter J Huxley
- Centre for Mental Health and Society, School of Health Sciences, Bangor University, Bangor, UK
| | - Benjamin G Druss
- Department of Health Policy and Management, Emory University, Atlanta, USA
| | - Claire L Planner
- Centre for Primary Care and Health Services Research, University of Manchester, Manchester, UK
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Bartoli F, Bassetti C, Gazzola M, Gianfelice L, Cavaleri D, Crocamo C, Carrà G. Prevalence and correlates of manic/hypomanic and depressive predominant polarity in bipolar disorder: systematic review and meta-analysis. BJPsych Open 2024; 10:e100. [PMID: 38708573 PMCID: PMC11094450 DOI: 10.1192/bjo.2024.51] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 02/23/2024] [Accepted: 03/10/2024] [Indexed: 05/07/2024] Open
Abstract
BACKGROUND Identification of the predominant polarity, i.e. hypomanic/manic (mPP) or depressive predominant polarity (dPP), might help clinicians to improve personalised management of bipolar disorder. AIMS We performed a systematic review and meta-analysis to estimate prevalence and correlates of mPP and dPP in bipolar disorder. METHOD The protocol was registered in the Open Science Framework Registries (https://doi.org/10.17605/OSF.IO/8S2HU). We searched main electronic databases up to December 2023 and performed random-effects meta-analyses of weighted prevalence of mPP and dPP. Odds ratios and weighted mean differences (WMDs) were used for relevant correlates. RESULTS We included 28 studies, providing information on rates and/or correlates of mPP and dPP. We estimated similar rates of mPP (weighted prevalence = 30.0%, 95% CI: 23.1 to 37.4%) and dPP (weighted prevalence = 28.5%, 95% CI: 23.7 to 33.7%) in bipolar disorder. Younger age (WMD = -3.19, 95% CI: -5.30 to -1.08 years), male gender (odds ratio = 1.39, 95% CI: 1.10 to 1.76), bipolar-I disorder (odds ratio = 4.82, 95% CI: 2.27 to 10.24), psychotic features (odds ratio = 1.56, 95% CI: 1.01 to 2.41), earlier onset (WMD = -1.57, 95% CI: -2.88 to -0.26 years) and manic onset (odds ratio = 13.54, 95% CI: 5.83 to 31.46) were associated with mPP (P < 0.05). Depressive onset (odds ratio = 12.09, 95% CI: 6.38 to 22.90), number of mood episodes (WMD = 0.99, 95% CI: 0.28 to 1.70 episodes), history of suicide attempts (odds ratio = 2.09, 95% CI: 1.49 to 2.93) and being in a relationship (odds ratio = 1.98, 95% CI: 1.22 to 3.22) were associated with dPP (P < 0.05). No differences were estimated for other variables. CONCLUSIONS Despite some limitations, our findings support the hypothesis that predominant polarity might be a useful specifier of bipolar disorder. Evidence quality was mixed, considering effects magnitude, consistency, precision and publication bias. Different predominant polarities may identify subgroups of patients with specific clinical characteristics.
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Affiliation(s)
- Francesco Bartoli
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Carlo Bassetti
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Marco Gazzola
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Letizia Gianfelice
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Daniele Cavaleri
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Cristina Crocamo
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Giuseppe Carrà
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy; and Division of Psychiatry, University College London, UK
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Sleurs D, Speranza M, Etain B, Aouizerate B, Aubin V, Bellivier F, Belzeaux R, Carminati M, Courtet P, Dubertret C, Fredembach B, Haffen E, Groppi F, Laurent P, Leboyer M, Llorca PM, Olié E, Polosan M, Schwan R, Weill D, Passerieux C, Roux P. Functioning and neurocognition in very early and early-life onset bipolar disorders: the moderating role of bipolar disorder type. Eur Child Adolesc Psychiatry 2024:10.1007/s00787-024-02372-3. [PMID: 38702455 DOI: 10.1007/s00787-024-02372-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 01/08/2024] [Indexed: 05/06/2024]
Abstract
Defining homogeneous subgroups of bipolar disorder (BD) is a major goal in personalized psychiatry and research. According to the neurodevelopmental theory, age at onset may be a key variable. As potential trait markers of neurodevelopment, cognitive and functional impairment should be greater in the early form of the disease, particularly type 1 BD (BD I). The age at onset was assessed in a multicenter, observational sample of 4190 outpatients with BD. We used a battery of neuropsychological tests to assess six domains of cognition. Functioning was measured using the Functioning Assessment Short Test (FAST). We studied the potential moderation of the type of BD on the associations between the age at onset and cognitive and functioning in a subsample of 2072 euthymic participants, controlling for potential clinical and socio-demographic covariates. Multivariable analyses showed cognition to not be impaired in individuals with early (21-30 years) and very early-life (before 14 years) onset of BD. Functioning was equivalent between individuals with early and midlife-onset of BD II and NOS but better for individuals with early onset of BD I. In contrast, functioning was not worse in individuals with very early-onset BD I but worse in those with very early-onset BD II and NOS. Early-life onset BDs were not characterized by poorer cognition and functioning. Our results do not support the neurodevelopmental view that a worse cognitive prognosis characterizes early-life onset BD. This study suggests that functional remediation may be prioritized for individuals with midlife-onset BD I and very early life onset BD 2 and NOS.
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Affiliation(s)
- D Sleurs
- Fondation FondaMental, Créteil, France.
- AP-HP, Groupe Hospitalo-Universitaire AP-HP Nord, DMU ESPRIT, Service de Psychiatrie Et Addictologie, Hopital Louis Mourier, 178 Rue Des Renouillers, 92700, Colombes, France.
- Inserm U1266, Faculté de Médecine, Université Paris Cité, Paris, France.
| | - M Speranza
- Fondation FondaMental, Créteil, France
- Centre Hospitalier de Versailles, Service Universitaire de Psychiatrie de L'Enfant Et de L'Adolescent, Le Chesnay, France
- Université Paris-Saclay, Paris, France
- Université de Versailles Saint-Quentin-En-Yvelines, Versailles, France
- DisAP-DevPsy-CESP, INSERM UMR1018, Villejuif, France
| | - B Etain
- Fondation FondaMental, Créteil, France
- AP-HP, Groupe Hospitalo-Universitaire AP-HP Nord, DMU Neurosciences, Département de Psychiatrie Et de Médecine Addictologique, Hôpital Fernand Widal, Paris, France
- INSERM UMR-S 1144, Optimisation Thérapeutique en Neuropsychopharmacologie OTeN, Université Paris Cité, Paris, France
| | - B Aouizerate
- Fondation FondaMental, Créteil, France
- Laboratoire NutriNeuro (UMR INRA 1286), Centre Hospitalier Charles Perrens, Université de Bordeaux, Bordeaux, France
| | - V Aubin
- Fondation FondaMental, Créteil, France
- Pôle de Psychiatrie, Centre Hospitalier Princesse Grace, Monaco, France
| | - F Bellivier
- Fondation FondaMental, Créteil, France
- AP-HP, Groupe Hospitalo-Universitaire AP-HP Nord, DMU Neurosciences, Département de Psychiatrie Et de Médecine Addictologique, Hôpital Fernand Widal, Paris, France
- INSERM UMR-S 1144, Optimisation Thérapeutique en Neuropsychopharmacologie OTeN, Université Paris Cité, Paris, France
| | - R Belzeaux
- Fondation FondaMental, Créteil, France
- Pôle de Psychiatrie, Assistance Publique Hôpitaux de Marseille, Marseille, France
- INT-UMR7289, CNRS Aix-Marseille Université, Marseille, France
| | - M Carminati
- Fondation FondaMental, Créteil, France
- AP-HP, Groupe Hospitalo-Universitaire AP-HP Nord, DMU Neurosciences, Département de Psychiatrie Et de Médecine Addictologique, Hôpital Fernand Widal, Paris, France
- INSERM UMR-S 1144, Optimisation Thérapeutique en Neuropsychopharmacologie OTeN, Université Paris Cité, Paris, France
| | - P Courtet
- Fondation FondaMental, Créteil, France
- Department of Emergency Psychiatry and Acute Care, CHU Montpellier, Montpellier, France
- IGF, Université de Montpellier, CNRS, INSERM, Montpellier, France
| | - C Dubertret
- Fondation FondaMental, Créteil, France
- AP-HP, Groupe Hospitalo-Universitaire AP-HP Nord, DMU ESPRIT, Service de Psychiatrie Et Addictologie, Hopital Louis Mourier, 178 Rue Des Renouillers, 92700, Colombes, France
- Inserm U1266, Faculté de Médecine, Université Paris Cité, Paris, France
| | - B Fredembach
- Fondation FondaMental, Créteil, France
- Grenoble Institut Des Neurosciences (GIN), Université Grenoble Alpes, CHU de Grenoble Et Des Alpes, Inserm U 1216, Grenoble, France
| | - E Haffen
- Fondation FondaMental, Créteil, France
- Département de Psychiatrie Clinique, CIC-1431 INSERM, CHU de Besançon, Besançon, France
- EA481 Neurosciences, Université Bourgogne Franche-Comté, Besançon, France
| | - F Groppi
- Fondation FondaMental, Créteil, France
- Pôle de Psychiatrie, Assistance Publique Hôpitaux de Marseille, Marseille, France
- INT-UMR7289, CNRS Aix-Marseille Université, Marseille, France
| | - P Laurent
- Fondation FondaMental, Créteil, France
- AP-HP, Groupe Hospitalo-Universitaire AP-HP Nord, DMU ESPRIT, Service de Psychiatrie Et Addictologie, Hopital Louis Mourier, 178 Rue Des Renouillers, 92700, Colombes, France
- Inserm U1266, Faculté de Médecine, Université Paris Cité, Paris, France
| | - M Leboyer
- Fondation FondaMental, Créteil, France
- Translational NeuroPsychiatry Laboratory, Univ Paris Est Créteil, INSERM U955, IMRB, Créteil, France
- AP-HP, Hôpitaux Universitaires Henri Mondor, Département Médico-Universitaire de Psychiatrie Et d'Addictologie (DMU IMPACT), Fédération Hospitalo-Universitaire de Médecine de Précision en Psychiatrie (FHU ADAPT), Créteil, France
| | - P M Llorca
- Fondation FondaMental, Créteil, France
- Département de Psychiatrie, Centre Hospitalier Et Universitaire, Clermont-Ferrand, France
- Université d'Auvergne, EA 7280, 63000, Clermont-Ferrand, France
| | - E Olié
- Fondation FondaMental, Créteil, France
- Grenoble Institut Des Neurosciences (GIN), Université Grenoble Alpes, CHU de Grenoble Et Des Alpes, Inserm U 1216, Grenoble, France
| | - M Polosan
- Fondation FondaMental, Créteil, France
- Centre Psychothérapique de Nancy, Université de Lorraine , Inserm U1254, Nancy, France
| | - R Schwan
- Fondation FondaMental, Créteil, France
- Centre Psychothérapique de Nancy, Université de Lorraine , Inserm U1254, Nancy, France
| | - D Weill
- Fondation FondaMental, Créteil, France
- Translational NeuroPsychiatry Laboratory, Univ Paris Est Créteil, INSERM U955, IMRB, Créteil, France
- AP-HP, Hôpitaux Universitaires Henri Mondor, Département Médico-Universitaire de Psychiatrie Et d'Addictologie (DMU IMPACT), Fédération Hospitalo-Universitaire de Médecine de Précision en Psychiatrie (FHU ADAPT), Créteil, France
| | - C Passerieux
- Fondation FondaMental, Créteil, France
- Université Paris-Saclay, Paris, France
- Université de Versailles Saint-Quentin-En-Yvelines, Versailles, France
- DisAP-DevPsy-CESP, INSERM UMR1018, Villejuif, France
- Centre Hospitalier de Versailles, Service Universitaire de Psychiatrie d'Adultes Et d'Addictologie, Le Chesnay, France
| | - P Roux
- Fondation FondaMental, Créteil, France
- Université Paris-Saclay, Paris, France
- Université de Versailles Saint-Quentin-En-Yvelines, Versailles, France
- DisAP-DevPsy-CESP, INSERM UMR1018, Villejuif, France
- Centre Hospitalier de Versailles, Service Universitaire de Psychiatrie d'Adultes Et d'Addictologie, Le Chesnay, France
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Azevedo J, Carreiras D, Guiomar R, Martins MJ, Macedo A, Castilho P. Validation of the Bipolar Recovery Questionnaire for the Portuguese Population: Recovery and Predictors in People with Bipolar Disorder. ACTA MEDICA PORT 2024; 37:368-378. [PMID: 38621253 DOI: 10.20344/amp.20790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 03/11/2024] [Indexed: 04/17/2024]
Abstract
INTRODUCTION The paradigm in mental health care is progressively moving towards a recovery-focused perspective. Thus, there is a need for validated instruments to measure recovery in bipolar disorder (BD). The Bipolar Recovery Questionnaire (BRQ) is the most used instrument to assess it. The aim of this study was to translate and perform a cross-cultural adaptation of the BRQ to European Portuguese (PT-PT) and to explore further associations of recovery with sociodemographic and emotional regulation, as well as recovery predictors to inform future research and clinical practice. METHODS The BRQ was forward-translated and back-translated until a consensus version was found, and a test-retest design was used to assess temporal stability. Participants were recruited in public hospitals and organizations supporting people with BD, either referred by their psychiatrists or psychologists or through self-referral. Eighty-eight individuals diagnosed with BD were recruited to complete a battery of Portuguese-validated self-report questionnaires to assess recovery (BRQ), clinical mood symptoms (Hospital Anxiety and Depression Scale), affect (Positive and Negative Affect Scale), well-being (brief Quality of Life for Bipolar Disorder; Satisfaction with Life Scale) and emotion regulation (Difficulties in Emotion Regulation Scale). RESULTS The BRQ showed excellent internal consistency with a Cronbach alpha of 0.92, and test-retest exhibited good reliability (r = 0.88). Construct validity was confirmed through/by positive and moderate correlations with quality of life (QoL; r = 0.58) and positive affect (r = 0.52), and negative moderate correlations with depression (r = -0.64), and negative affect (r = -0.55). Both satisfaction with life (β = 0.38, p = 0.010) and recovery (β = 0.34, p = 0.022) impacted quality of life, supporting the BRQ's incremental validity. Depressive symptoms and emotion dysregulation accounted for 51% of its variance. CONCLUSION The BRQ is a valid and reliable instrument to measure recovery in people with BD in the Portuguese population and is suitable for both clinical and research contexts.
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Affiliation(s)
- Julieta Azevedo
- Center for Research in Neuropsychology and Cognitive and Behavioral Intervention (CINEICC). Faculdade de Psicologia e de Ciências da Educação. Universidade de Coimbra. Coimbra; Institute of Psychological Medicine (IPM). Faculdade de Medicina. Universidade de Coimbra. Coimbra; School of Psychology and Sport Science. Bangor University. Bangor. United Kingdom
| | - Diogo Carreiras
- Center for Research in Neuropsychology and Cognitive and Behavioral Intervention (CINEICC). Faculdade de Psicologia e de Ciências da Educação. Universidade de Coimbra. Coimbra; Instituto Superior Miguel Torga. Coimbra. Portugal
| | - Raquel Guiomar
- Center for Research in Neuropsychology and Cognitive and Behavioral Intervention (CINEICC). Faculdade de Psicologia e de Ciências da Educação. Universidade de Coimbra. Coimbra. Portugal
| | - Maria João Martins
- Center for Research in Neuropsychology and Cognitive and Behavioral Intervention (CINEICC). Faculdade de Psicologia e de Ciências da Educação. Universidade de Coimbra. Coimbra; Institute of Psychological Medicine (IPM). Faculdade de Medicina. Universidade de Coimbra. Coimbra; Serviços Médicos Universitários. Universidade de Coimbra. Coimbra. Portugal
| | - António Macedo
- Institute of Psychological Medicine (IPM). Faculdade de Medicina. Universidade de Coimbra. Coimbra; Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT). Coimbra; Centro Hospitalar e Universitário de Coimbra (CHUC). Coimbra. Portugal
| | - Paula Castilho
- Center for Research in Neuropsychology and Cognitive and Behavioral Intervention (CINEICC). Faculdade de Psicologia e de Ciências da Educação. Universidade de Coimbra. Coimbra. Portugal
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Kazemi Naeini M, Akbarzadeh M, Kazemi I, Speed D, Hosseini SM. Using the Bayesian variational spike and slab model in a genome-wide association study for finding associated loci with bipolar disorder. Ann Hum Genet 2024; 88:212-246. [PMID: 38161273 DOI: 10.1111/ahg.12538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 10/17/2023] [Accepted: 10/23/2023] [Indexed: 01/03/2024]
Abstract
OBJECTIVE The genome-wide association studies (GWAS) analysis, the most successful technique for discovering disease-related genetic variation, has some statistical concerns, including multiple testing, the correlation among variants (single-nucleotide polymorphisms) based on linkage disequilibrium and omitting the important variants when fitting the model with just one variant. To eliminate these problems in a small sample-size study, we used a sparse Bayesian learning model for finding bipolar disorder (BD) genetic variants. METHODS This study used the Wellcome Trust Case Control Consortium data set, including 1998 BD cases and 1500 control samples, and after quality control, 380,628 variants were analysed. In this GWAS, a Bayesian logistic model with hierarchical shrinkage spike and slab priors was used, with all variants considered simultaneously in one model. In order to decrease the computational burden, an alternative inferential method, Bayesian variational inference, has been used. RESULTS Thirteen variants were selected as associated with BD. The three of them (rs7572953, rs1378850 and rs4148944) were reported in previous GWAS. Eight of which were related to hemogram parameters, such as lymphocyte percentage, plateletcrit and haemoglobin concentration. Among selected related genes, GABPA, ELF3 and JAM2 were enriched in the platelet-derived growth factor pathway. These three genes, along with APP, ARL8A, CDH23 and GPR37L1, could be differential diagnostic variants for BD. CONCLUSIONS By reducing the statistical restrictions of GWAS analysis, the application of the Bayesian variational spike and slab models can offer insight into the genetic link with BD even with a small sample size. To uncover related variations with other traits, this model needs to be further examined.
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Affiliation(s)
- Maryam Kazemi Naeini
- Department of Biostatistics and Epidemiology, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mahdi Akbarzadeh
- Cellular and Molecular Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Iraj Kazemi
- Department of Statistics, Faculty of Mathematics & Statistics, University of Isfahan, Isfahan, Iran
| | - Doug Speed
- Bioinformatics Research Centre, Institute of Advanced Studies, Quantitative Genetics and Genomics, Aarhus University, Aarhus, Denmark
| | - Sayed Mohsen Hosseini
- Department of Biostatistics and Epidemiology, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
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Zhang L, Ding Y, Li T, Li H, Liu F, Li P, Zhao J, Lv D, Lang B, Guo W. Similar imaging changes and their relations to genetic profiles in bipolar disorder across different clinical stages. Psychiatry Res 2024; 335:115868. [PMID: 38554494 DOI: 10.1016/j.psychres.2024.115868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 03/12/2024] [Accepted: 03/20/2024] [Indexed: 04/01/2024]
Abstract
Bipolar disorder (BD) across different clinical stages may present shared and distinct changes in brain activity. We aimed to reveal the neuroimaging homogeneity and heterogeneity of BD and its relationship with clinical variables and genetic variations. In present study, we conducted fractional amplitude of low-frequency fluctuations (fALFF), functional connectivity (FC) and genetic neuroimaging association analyses with 32 depressed, 26 manic, 35 euthymic BD patients and 87 healthy controls (HCs). Significant differences were found in the bilateral pre/subgenual anterior cingulate cortex (ACC) across the four groups, and all bipolar patients exhibited decreased fALFF values in the ACC when compared to HCs. Furthermore, positive associations were significantly observed between fALFF values in the pre/subgenual ACC and participants' cognitive functioning. No significant changes were found in ACC-based FC. We identified fALFF-alteration-related genes in BD, with enrichment in biological progress including synaptic and ion transmission. Taken together, abnormal activity in ACC is a characteristic change associated with BD, regardless of specific mood stages, serving as a potential neuroimaging feature in BD patients. Our genetic neuroimaging association analysis highlights possible heterogeneity in biological processes that could be responsible for different clinical stages in BD.
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Affiliation(s)
- Leyi Zhang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Yudan Ding
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Tingting Li
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Huabing Li
- Department of Radiology, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, China
| | - Feng Liu
- Department of Radiology, Tianjin Medical University General Hospital, Tianjin, China
| | - Ping Li
- Department of Psychiatry, Qiqihar Medical University, Qiqihar, Heilongjiang 161006, China
| | - Jingping Zhao
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Dongsheng Lv
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China; Center of Mental Health, Inner Mongolia Autonomous Region, Hohhot 010010, China.
| | - Bing Lang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Wenbin Guo
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China.
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Kong L, Wang H, Yan N, Xu C, Chen Y, Zeng Y, Guo X, Lu J, Hu S. Effect of antipsychotics and mood stabilisers on metabolism in bipolar disorder: a network meta-analysis of randomised-controlled trials. EClinicalMedicine 2024; 71:102581. [PMID: 38618207 PMCID: PMC11015341 DOI: 10.1016/j.eclinm.2024.102581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 03/17/2024] [Accepted: 03/19/2024] [Indexed: 04/16/2024] Open
Abstract
Background Antipsychotics and mood stabilisers are gathering attention for the disturbance of metabolism. This network meta-analysis aims to evaluate and rank the metabolic effects of the commonly used antipsychotics and mood stabilisers in treating bipolar disorder (BD). Methods Registries including PubMed, Embase, Cochrane Library, Web of Science, Ovid, and Google Scholar were searched before February 15th, 2024, for randomised controlled trials (RCTs) applying antipsychotics or mood stabilisers for BD treatment. The observed outcomes were twelve metabolic indicators. The data were extracted by two reviewers independently, and confirmed by another four reviewers and a corresponding author. The above six reviewers all participated in data analyses. Data extraction was based on PRISMA guidelines, and quality assessment was conducted according to the Cochrane Handbook. Use a random effects model for data pooling. The PROSPERO registration number is CRD42023466669. Findings Together, 5421 records were identified, and 41 publications with 11,678 complete-trial participants were confirmed eligible. After eliminating possible sensitivity, risperidone ranked 1st in elevating fasting serum glucose (SUCRA = 90.7%) and serum insulin (SUCRA = 96.6%). Lurasidone was most likely to elevate HbA1c (SUCRA = 82.1%). Olanzapine ranked 1st in elevating serum TC (SUCRA = 93.3%), TG (SUCRA = 89.6%), and LDL (SUCRA = 94.7%). Lamotrigine ranked 1st in reducing HDL (SUCRA = 82.6%). Amisulpride ranked 1st in elevating body weight (SUCRA = 100.0%). For subgroup analyses, quetiapine is more likely to affect indicators of glucose metabolism among male adult patients with bipolar mania, while long-term lurasidone tended to affect glucose metabolism among female patients with bipolar depression. Among patients under 18, divalproex tended to affect glucose metabolism, with lithium affecting lipid metabolism. In addition, most observed antipsychotics performed higher response and remission rates than placebo, and displayed a similar dropout rate with placebo, while no between-group significance of rate was observed among mood stabilisers. Interpretation Our findings suggest that overall, antipsychotics are effective in treating BD, while they are also more likely to disturb metabolism than mood stabilisers. Attention should be paid to individual applicability in clinical practice. The results put forward evidence-based information and clinical inspiration for drug compatibility and further research of the BD mechanism. Funding The National Key Research and Development Program of China (2023YFC2506200), and the Research Project of Jinan Microecological Biomedicine Shandong Laboratory (No. JNL-2023001B).
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Affiliation(s)
- Lingzhuo Kong
- Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, China
| | - Huaizhi Wang
- School of Psychiatry, Wenzhou Medical University, Wenzhou, 325000, China
| | - Ning Yan
- Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, China
- Shanghai Jing ‘an District Mental Health Centre, Shanghai, 200040, China
| | - Chenyue Xu
- Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, China
| | - Yiqing Chen
- Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, China
| | - Yuanyuan Zeng
- Hangzhou Medical College, School of Clinical Medicine, Hangzhou, 310003, China
| | - Xiaonan Guo
- Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, China
| | - Jing Lu
- Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, China
- Zhejiang Key Laboratory of Precision Psychiatry, Hangzhou, 310003, China
- Brain Research Institute of Zhejiang University, Hangzhou, 310003, China
- Zhejiang Engineering Centre for Mathematical Mental Health, Hangzhou, 310003, China
- MOE Frontier Science Centre for Brain Science & Brain-Machine Integration, Zhejiang University, Hangzhou, 310003, China
| | - Shaohua Hu
- Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, China
- School of Psychiatry, Wenzhou Medical University, Wenzhou, 325000, China
- Zhejiang Key Laboratory of Precision Psychiatry, Hangzhou, 310003, China
- Brain Research Institute of Zhejiang University, Hangzhou, 310003, China
- Zhejiang Engineering Centre for Mathematical Mental Health, Hangzhou, 310003, China
- MOE Frontier Science Centre for Brain Science & Brain-Machine Integration, Zhejiang University, Hangzhou, 310003, China
- Department of Psychology and Behavioral Sciences, Zhejiang University, Hangzhou, 310003, China
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