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İnal N, Cavusoglu B, Ermiş Ç, Turan S, Gormez V, Karabay N. Reduced Cortical Thicknesses of Adolescents with Bipolar Disorder and Relationship with Brain-derived Neurotrophic Factor. Scand J Child Adolesc Psychiatr Psychol 2023; 11:78-86. [PMID: 37377456 PMCID: PMC10291755 DOI: 10.2478/sjcapp-2023-0008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/29/2023] Open
Abstract
Background Cortical thickness (CT) and brain-derived neurotrophic factor (BDNF) were widely investigated in bipolar disorder (BD). Previous studies focused on the association between the volume of subcortical regions and neurotrophic factor levels. Objective In this study, we aimed to evaluate the association of the CT in youth with early-onset BD with BDNF levels as a potential peripheral marker of neuronal integrity. Method Twenty-three euthymic patients having a clinical diagnosis of BD and 17 healthy subjects as an age-matched control group with neuroimaging and blood BDNF levels were found eligible for CT measurement. A structural magnetic resonance scan (MRI) and timely blood samples were drawn. Results Youth with BD exhibited lower cortical thickness in caudal part of left (L) middle frontal gyrus, right (R) paracentral gyrus, triangular part of R inferior frontal gyrus, R pericalcarine region, R precentral gyrus, L precentral gyrus, R superior frontal gyrus and L superior frontal gyrus when compared to healthy controls. The effect sizes of these differences were moderate to large (d=0.67-0.98) There was a significant correlation between BDNF levels with caudal part of the R anterior cingulate gyrus (CPRACG) in adolescents with BD (r=0.49, p=0.023). Conclusion As a special region for mood regulation, the CT of the caudal part of the R anterior cingulate gyrus had a positive correlation with BDNF. Regarding the key role of CPRACG for affective regulation skills, our results should be replicated in future follow-up studies, investigating a predictive neuroimaging biomarker for the early-onset BD.
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Affiliation(s)
- Neslihan İnal
- Department of Child and Adolescent Psychiatry, Dokuz Eylul University, Izmir, Turkey
| | | | - Çağatay Ermiş
- Department of Children and Adolescent Psyhciatry, Queen Silvia Children's Hospital, Gothenburg, Sweden
| | - Serkan Turan
- Department of Child and Adolescent Psychiatry, Uludag University, Bursa, Turkey
| | - Vahdet Gormez
- Department of Child and Adolescent Psychiatry, Medeniyet University Göztepe Training and Research Hospital, Istanbul, Turkey
| | - Nuri Karabay
- Department of Radiology, Dokuz Eylul University, Izmir, Turkey
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Topal Z, Demir N, Tufan E, Tuman TC, Semerci B. Emotional and cognitive conflict resolution and disruptive mood dysregulation disorder in adolescent offspring of parents diagnosed with major depressive disorder, bipolar disorder, and matched healthy controls. Nord J Psychiatry 2021; 75:427-436. [PMID: 33591219 DOI: 10.1080/08039488.2021.1880635] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
AIMS Children of parents with mood disorders have an elevated risk for various psychopathologies. In this study rate of psychopathologies among adolescent offspring of parents with major depressive (MDDoff) and bipolar disorder (BDoff), including disruptive mood dysregulation disorder (DMDD) along with the offspring ability to resolve cognitive and emotional conflicts were evaluated. METHOD 12-16 years old children of parents with MDD (n = 31, children= 36), BP (n = 20, children = 26) and controls (n = 25, children = 28) were enrolled. Children and parents were evaluated by using the Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS) and the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID); respectively. The parents completed the Child Behavior Checklist (CBCL)-dysregulation profile. The Stroop test-TBAG form and emotional Stroop test were given out to evaluate conflict resolution ability. RESULTS The most common diagnoses among the whole sample were attention deficit and hyperactivity, separation anxiety and oppositional defiant disorders. Five cases (5.5%) of lifetime DMDD were found (three from MDDoff, the rest from BDoff). Completion times for the Stroop test-TBAG form were ranked as: BDoff > MDDoff > Hoff. In the emotional Stroop test, the BDoff responded significantly later and had significantly reduced correct responses. CONCLUSION Rates of lifetime DMDD were similar in the MDDoff and BDoff groups. BDoff may experience greater difficulties in resolving cognitive and emotional conflicts.
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Affiliation(s)
- Zehra Topal
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Gaziantep University, Osmangazi, Turkey
| | - Nuran Demir
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Yıldırım Bayezit University, Ankara, Turkey
| | - Evren Tufan
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Abant Izzet Baysal University, Bolu, Turkey
| | - Taha Can Tuman
- Department of Psychiatry, Health Practice and Researching Center, Istanbul Medipol University, İstanbul, Turkey
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Baykara B, Koc D, Resmi H, Akan P, Tunca Z, Ozerdem A, Ceylan D, Yalcın NG, Binici NC, Guney SA, Mesman E, Hillegers MHJ, Emiroglu NI. Brain-derived neurotrophic factor in bipolar disorder: Associations with age at onset and illness duration. Prog Neuropsychopharmacol Biol Psychiatry 2021; 108:110075. [PMID: 32798619 DOI: 10.1016/j.pnpbp.2020.110075] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 07/21/2020] [Accepted: 08/11/2020] [Indexed: 01/09/2023]
Abstract
Bipolar disorder (BD) is a heterogeneous disorder that contains neurodevelopmental differences. Defining homogeneous subgroups of BD patients by using age at onset (AAO) as a specifier may promote the classification of biomarkers. This study compares peripheral BDNF levels between pediatric and adult BD patients to investigate the associations between BDNF levels, AAO, and illness duration. We enrolled two groups of euthymic patients, those with pediatric BD (n = 39) and those with adult BD (n = 31), as well as a group of healthy controls (HCs) (n = 90). Participants were assessed using clinical measures and BDNF serum levels were obtained using ELISA. We observed that BDNF levels were comparable between adult BD and HCs, but were clearly lower in pediatric BD than in HCs. In adult BD with AAO ≥30 years, BDNF levels were significantly higher than in adult BD with AAO <30 years. In pediatric BD, patients with prepubertal-onset had higher BDNF levels than those with pubertal-onset. BDNF levels demonstrated the accuracy of being able to distinguish pediatric BD from healthy controls in a receiver operating characteristic (ROC) curve analysis (area under the curve [AUC] = 0.792). In adult BD, higher BDNF levels were associated with later disease onset, but this was not the case in pediatric BD. Finally, reduced BDNF levels were associated with illness duration in adult BD. The findings indicate that BDNF levels in BD patients are associated with AAO. BDNF may, therefore, potentially serve as a developmental marker in BD, when AAO is taken into account.
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Affiliation(s)
- Burak Baykara
- Department of Child and Adolescent Psychiatry, Dokuz Eylul University, Izmir, Turkey
| | - Dogukan Koc
- Department of Child and Adolescent Psychiatry, Dokuz Eylul University, Izmir, Turkey.
| | - Halil Resmi
- Department of Biochemistry, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey
| | - Pınar Akan
- Department of Biochemistry, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey
| | - Zeliha Tunca
- Department of Psychiatry, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey
| | - Aysegul Ozerdem
- Department of Psychiatry, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey; Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA; Department of Neurosciences, Dokuz Eylul University, Health Sciences Institute, Izmir, Turkey
| | - Deniz Ceylan
- Department of Psychiatry, Izmir University of Economics, Faculty of Medicine, Izmir, Turkey
| | - Neslihan Gurz Yalcın
- Department of Psychiatry, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey
| | - Nagihan Cevher Binici
- Department of Child and Adolescent Psychiatry, University of Health Sciences Dr. Behcet Uz Child Disease and Pediatric Surgery Training and Research Hospital, Izmir, Turkey
| | - Sevay Alsen Guney
- Department of Child and Adolescent Psychiatry, Dokuz Eylul University, Izmir, Turkey
| | - Esther Mesman
- Department of Child and Adolescent Psychiatry and Psychology, Erasmus University Medical Center-Sophia Children's Hospital, Rotterdam, the Netherlands
| | - Manon H J Hillegers
- Department of Child and Adolescent Psychiatry and Psychology, Erasmus University Medical Center-Sophia Children's Hospital, Rotterdam, the Netherlands
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Cevher Binici N, Alşen Güney S, İnal Emiroğlu FN. Neutrophil-lymphocyte and platelet-lymphocyte ratios among adolescents with bipolar disorder: A preliminary study. Psychiatry Res 2018; 269:178-182. [PMID: 30149275 DOI: 10.1016/j.psychres.2018.08.065] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2018] [Revised: 08/02/2018] [Accepted: 08/16/2018] [Indexed: 12/21/2022]
Abstract
We aimed to evaluate the neutrophil lymphocyte and platelet lymphocyte ratios among euthymic adolescents with bipolar disorder (BD) type I. Thirty-six adolescents with BD and 30 healthy controls were included in the study. The diagnosis was made by experienced physicians using the Kiddie and Young Adult Schedule for Affective Disorders and Schizophrenia Present and Lifetime Version and the affective module of Washington University in St. Louis Kiddie and Young Adult Schedule for Affective Disorders and Schizophrenia-Present State and Lifetime. Blood samples were taken during euthymia, which was defined as Young Mania Rating Scale and Hamilton Depression Rating Scale scores below 7. There was no significant difference in neutrophil lymphocyte ratio and platelet lymphocyte ratio between the patient and control group. Considering the literature, we may speculate that in the early stages, euthymia is associated with a lower inflammatory response, and prolongation of BD causes increased inflammatory processes predominant even in euthymia. In pediatric BD, further studies that assess neutrophil lymphocyte ratio and platelet lymphocyte ratio during different mood episodes and that identify neutrophil lymphocyte ratio and platelet lymphocyte ratio changes during the course of the disease will clarify the role of inflammation in the etiology of pediatric BD.
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Affiliation(s)
- Nagihan Cevher Binici
- Department of Child and Adolescent Psychiatry, University of Health Sciences Dr. Behçet Uz Child Disease and Pediatric Surgery Training and Research Hospital, İzmir, Turkey.
| | - Sevay Alşen Güney
- Department of Child and Adolescent Psychiatry, University of Health Sciences Dr. Behçet Uz Child Disease and Pediatric Surgery Training and Research Hospital, İzmir, Turkey
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Papachristou E, Oldehinkel AJ, Ormel J, Raven D, Hartman CA, Frangou S, Reichenberg A. The predictive value of childhood subthreshold manic symptoms for adolescent and adult psychiatric outcomes. J Affect Disord 2017; 212:86-92. [PMID: 28157551 DOI: 10.1016/j.jad.2017.01.038] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Accepted: 01/23/2017] [Indexed: 10/20/2022]
Abstract
BACKGROUND Childhood subthreshold manic symptoms may represent a state of developmental vulnerability to Bipolar Disorder (BD) and may also be associated with other adverse psychiatric outcomes. To test this hypothesis we examined the structure and predictive value of childhood subthreshold manic symptoms for common psychiatric disorders presenting by early adulthood. METHODS Subthreshold manic symptoms at age 11 years and lifetime clinical outcomes by age 19 years were ascertained in the TRacking Adolescents' Individual Lives Survey (TRAILS), a prospective Dutch community cohort. We used latent class analysis to identify subthreshold manic symptom profiles at baseline. The association between class membership and subsequent clinical diagnoses of BD (comprising BD-I, BD-II, mania and hypomania), depressive, anxiety and substance abuse disorders was determined using Cox proportional-hazard ratio (HR) models. RESULTS At age 11 years, we identified a normative (n=916; 47%), a mildly symptomatic (n=843; 43%) and a highly symptomatic class (n=198; 10%). Referenced to the normative class, the sex- and age-adjusted risk of new-onset BD by the age of 19 years was significantly increased in the mildly (HR=2.01, 95%CI 1.13-3.59) and highly symptomatic classes (HR=5.02, 95%CI 2.48-10.16). These estimates remained significant after further adjustments for cognitive and family function, parental socioeconomic status, parental psychiatric morbidity, and comorbid disorders at baseline (p-value for linear trend across classes<0.01). Class membership did not show significant associations with incident depressive, anxiety and substance abuse disorders in the fully adjusted regression models. LIMITATIONS The period of risk for adult-onset BD extends beyond the observational period of the study. CONCLUSIONS Elevated childhood subthreshold manic symptoms are associated with increased risk of BD by early adulthood and are therefore a potentially useful phenotype for the early identification of at-risk individuals.
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Affiliation(s)
| | - Albertine J Oldehinkel
- Interdisciplinary Center Psychopathology and Emotion Regulation, University Medical Center Groningen, University of Groningen, The Netherlands
| | - Johan Ormel
- Interdisciplinary Center Psychopathology and Emotion Regulation, University Medical Center Groningen, University of Groningen, The Netherlands
| | - Dennis Raven
- Interdisciplinary Center Psychopathology and Emotion Regulation, University Medical Center Groningen, University of Groningen, The Netherlands
| | - Catharina A Hartman
- Interdisciplinary Center Psychopathology and Emotion Regulation, University Medical Center Groningen, University of Groningen, The Netherlands
| | - Sophia Frangou
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, USA.
| | - Abraham Reichenberg
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, USA; Department of Preventive Medicine, Icahn School of Medicine at Mount Sinai, New York, USA
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Palacio-Ortíz JD, Uribe-Villa E, Duque-Ríos P, Gutiérrez-Briceño P, Zapata-Henao V, Peña-Quintero CE, López-Jaramillo C. Descripción de perfiles psicopatológicos y neurocognitivos de hijos de pacientes con trastorno bipolar tipo I dentro un programa de intervencion multimodal: PRISMA. ACTA ACUST UNITED AC 2015; 44:150-8. [DOI: 10.1016/j.rcp.2015.03.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2014] [Revised: 01/26/2015] [Accepted: 03/21/2015] [Indexed: 11/30/2022]
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Sucksdorff D, Chudal R, Suominen A, Jokiranta E, Brown AS, Sourander A. Bipolar disorder and parental psychopathology. Soc Psychiatry Psychiatr Epidemiol 2014; 49:1973-84. [PMID: 24791657 DOI: 10.1007/s00127-014-0885-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2013] [Accepted: 04/14/2014] [Indexed: 11/27/2022]
Abstract
PURPOSE Few population-based studies have examined the association between parental psychopathology and bipolar disorder (BPD) in offspring. One limitation is lack of control for potential confounding by indicators of parental socio-economic status or maternal smoking during pregnancy. Furthermore, none of them included analyses restricted to parental diagnoses received prior to the birth of the offspring. Associations could not be affected by child-related factors affecting the parent in such analyses. This study explores associations between those parental psychiatric disorders diagnosed at any point of time as well as those diagnosed before offspring birth, and BPD in offspring. METHODS In this nested case-control study, we identified 1,861 cases, age up to 25 years, 3,643 matched controls, and their parents from Finnish national registers. The associations were examined using conditional logistic regression, calculating odds ratios (OR) and adjusting for region of birth, parental age and education and mother's smoking during pregnancy. RESULTS Anytime diagnosed parental disorders associating with BPD in offspring (95% confidence interval) were BPD [OR (maternal) 5.2 (2.52-10.62); OR (paternal) 8.1 (3.77-17.26)], schizophrenia and related psychoses [OR (maternal) 3.1 (1.69-5.84); OR (paternal) 4.5 (1.97-10.27)], other affective disorders [OR (maternal) 3.0 (2.08-4.21); OR (paternal) 3.0 (1.97-4.47)] and maternal anxiety disorders OR 2.6 (1.08-6.42). Statistically significant associations were also found for parental schizophrenia and related psychoses, and other affective disorders, diagnosed before offspring birth. CONCLUSIONS BPD is associated with many parental psychiatric disorders, particularly BPD and schizophrenia and related psychoses. The associations must be partially due to child-independent factors. Covariate adjustments had only a minor impact on the associations.
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Affiliation(s)
- Dan Sucksdorff
- Department of Child Psychiatry, Faculty of Medicine, Research Centre for Child Psychiatry, Institute of Clinical Medicine, University of Turku, Lemminkäisenkatu 3/Teutori (3rd floor), 20014, Turku, Finland,
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Papachristou E, Ormel J, Oldehinkel AJ, Kyriakopoulos M, Reinares M, Reichenberg A, Frangou S. Child Behavior Checklist-Mania Scale (CBCL-MS): development and evaluation of a population-based screening scale for bipolar disorder. PLoS One 2013; 8:e69459. [PMID: 23967059 PMCID: PMC3743889 DOI: 10.1371/journal.pone.0069459] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2012] [Accepted: 06/10/2013] [Indexed: 11/18/2022] Open
Abstract
CONTEXT Early identification of Bipolar Disorder (BD) remains poor despite the high levels of disability associated with the disorder. OBJECTIVE We developed and evaluated a new DSM orientated scale for the identification of young people at risk for BD based on the Child Behavior Checklist (CBCL) and compared its performance against the CBCL-Pediatric Bipolar Disorder (CBCL-PBD) and the CBCL-Externalizing Scale, the two most widely used scales. METHODS The new scale, CBCL-Mania Scale (CBCL-MS), comprises 19 CBCL items that directly correspond to operational criteria for mania. We tested the reliability, longitudinal stability and diagnostic accuracy of the CBCL-MS on data from the TRacking Adolescents' Individual Lives Survey (TRAILS), a prospective epidemiological cohort study of 2230 Dutch youths assessed with the CBCL at ages 11, 13 and 16. At age 19 lifetime psychiatric diagnoses were ascertained with the Composite International Diagnostic Interview. We compared the predictive ability of the CBCL-MS against the CBCL-Externalising Scale and the CBCL-PBD in the TRAILS sample. RESULTS The CBCL-MS had high internal consistency and satisfactory accuracy (area under the curve = 0.64) in this general population sample. Principal Component Analyses, followed by parallel analyses and confirmatory factor analyses, identified four factors corresponding to distractibility/disinhibition, psychosis, increased libido and disrupted sleep. This factor structure remained stable across all assessment ages. Logistic regression analyses showed that the CBCL-MS had significantly higher predictive ability than both the other scales. CONCLUSIONS Our data demonstrate that the CBCL-MS is a promising screening instrument for BD. The factor structure of the CBCL-MS showed remarkable temporal stability between late childhood and early adulthood suggesting that it maps on to meaningful developmental dimensions of liability to BD.
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Affiliation(s)
- Efstathios Papachristou
- Child Psychiatry Department, Institute of Psychiatry, King's College London, London, United Kingdom
| | - Johan Ormel
- Interdisciplinary Center of Psychpathology and Emotion Regulation, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Albertine J. Oldehinkel
- Interdisciplinary Center of Psychpathology and Emotion Regulation, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Marinos Kyriakopoulos
- Child Psychiatry Department, Institute of Psychiatry, King's College London, London, United Kingdom
- Child and Adolescent Mental Health Services, Maudsley Hospital, London, United Kingdom
| | - María Reinares
- Child Psychiatry Department, Institute of Psychiatry, King's College London, London, United Kingdom
| | - Abraham Reichenberg
- Ichan School of Medicine at Mount Sinai, New York City, New York, United States of America
| | - Sophia Frangou
- Ichan School of Medicine at Mount Sinai, New York City, New York, United States of America
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Skirrow C, Hosang GM, Farmer AE, Asherson P. An update on the debated association between ADHD and bipolar disorder across the lifespan. J Affect Disord 2012; 141:143-59. [PMID: 22633181 DOI: 10.1016/j.jad.2012.04.003] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2011] [Revised: 04/05/2012] [Accepted: 04/05/2012] [Indexed: 12/12/2022]
Abstract
Diagnostic formulations for attention deficit hyperactivity disorder (ADHD) and bipolar disorder (BD) both include symptoms of distractibility, psychomotor agitation and talkativeness, alongside associated emotional features (irritability and emotional lability). Treatment studies suggest the importance of accurate delineation of ADHD and BD. However, boundaries between the two disorders are blurred by the introduction of broader conceptualisations of BD. This review attempts to elucidate whether associations between ADHD and BD are likely to be driven by superficial symptomatological similarities or by a more meaningful etiological relationship between the disorders. This is achieved by outlining findings on comorbidity, temporal progression of the disorders, familial co-variation, and neurobiology in ADHD and BD across the lifespan. Longitudinal studies fail to consistently show developmental trajectories between ADHD and BD. Comparative research investigating neurobiology is in its infancy, and although some similarities are seen between ADHD and BD, studies also emphasise differences between the two disorders. However, comorbidity and family studies appear to show that the two disorders occur together and aggregate in families at higher than expected rates. Furthermore close inspection of results from population studies reveals heightened co-occurrence of ADHD and BD even in the context of high comorbidity commonly noted in psychopathology. These results point towards a meaningful association between ADHD and BD, going beyond symptomatic similarities. However, future research needs to account for heterogeneity of BD, making clear distinctions between classical episodic forms of BD, and broader conceptualisations of the disorder characterised by irritability and emotional lability, when evaluating the relationship with ADHD.
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Affiliation(s)
- Caroline Skirrow
- MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, United Kingdom.
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Baykara B, Inal-Emiroglu N, Karabay N, Çakmakçı H, Cevher N, Şentürk Pilan B, Alşen S. Increased hippocampal volumes in lithium treated adolescents with bipolar disorders: a structural MRI study. J Affect Disord 2012; 138:433-9. [PMID: 22325693 DOI: 10.1016/j.jad.2011.12.047] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2011] [Revised: 12/08/2011] [Accepted: 12/29/2011] [Indexed: 12/13/2022]
Abstract
BACKGROUND Structural neuroimaging studies in bipolar disorder (BD) have consistently identified several anatomical abnormalities in many brain areas related to mood regulation. Hippocampus is one of the key components of emotional regulatory networks in the brain. Evidence about hippocampal changes in BD is quite limited and inconsistent particularly for adolescent onset BD. It is aimed to compare hippocampus volumes of euthymic BD-I adolescents with healthy controls using structural MRI. METHODS Hippocampal volumes of seventeen youths between 13 and 19 age period with DSM-IV BD (seven boys) and twelve healthy comparison subjects (five boys) were compared using structural MRI. Differences in hippocampal volumes between groups were tested. RESULTS There was no significant difference between the right and left hippocampus volumes of patients with BD and the control group. However boys tended to have significantly larger right hippocampal volumes than girls both in BD and control group. Right hippocampal volumes were enlarged in lithium treated bipolar patients. This enlargement is not related to sex. LIMITATIONS Future, longitudinal follow-up studies need large enough sample sizes of both sexes and a sex-matched healthy comparison group to sort out developmental, gender and medication influences on brain structures over time in BD. CONCLUSIONS Lithium treatment in adolescent-onset BD has a significant effect on hippocampus volumes.
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Affiliation(s)
- Burak Baykara
- Dokuz Eylul University, School of Medicine, Department of Child Psychiatry, Izmir, Turkey.
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Zappitelli MC, Bordin IA, Hatch JP, Caetano SC, Zunta-Soares G, Olvera RL, Soares JC. Lifetime psychopathology among the offspring of Bipolar I parents. Clinics (Sao Paulo) 2011; 66:725-30. [PMID: 21789371 PMCID: PMC3109366 DOI: 10.1590/s1807-59322011000500003] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2011] [Accepted: 01/20/2011] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Recent studies have demonstrated high rates of psychopathology in the offspring of parents with bipolar disorder. The aim of this study was to identify psychiatric diagnoses in a sample of children of bipolar parents. METHOD This case series comprised 35 children and adolescents aged 6 to 17 years, with a mean age of 12.5 ± 2.9 years (20 males and 15 females), who had at least one parent with bipolar disorder type I. The subjects were assessed using the Schedule for Affective Disorders and Schizophrenia for School-Age Children - Present and Lifetime version (K-SADS-PL). Family psychiatric history and demographics were also evaluated. RESULTS Of the offspring studied, 71.4% had a lifetime diagnosis of at least one psychiatric disorder (28.6% with a mood disorder, 40% with a disruptive behavior disorder and 20% with an anxiety disorder). Pure mood disorders (11.4%) occurred less frequently than mood disorders comorbid with attention deficit hyperactivity disorder (17.1%). Psychopathology was commonly reported in second-degree relatives of the offspring of parents with bipolar disorder (71.4%). CONCLUSIONS Our results support previous findings of an increased risk for developing psychopathology, predominantly mood and disruptive disorders, in the offspring of bipolar individuals. Prospective studies with larger samples are needed to confirm and expand these results.
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Emiroglu FNI, Diler RS. Pediatric bipolar disorders: from the perspective of Turkey. JOURNAL OF THE CANADIAN ACADEMY OF CHILD AND ADOLESCENT PSYCHIATRY = JOURNAL DE L'ACADEMIE CANADIENNE DE PSYCHIATRIE DE L'ENFANT ET DE L'ADOLESCENT 2009; 18:206-14. [PMID: 19718421 PMCID: PMC2732726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 03/10/2009] [Accepted: 07/06/2009] [Indexed: 05/28/2023]
Abstract
INTRODUCTION In Turkey, there is much controversy and skepticism about the existence of mania in children and adolescents, and a paucity of rigorous data. Despite ongoing controversy, the view that pediatric Bipolar Disorder(BD) is rare or non-existent has been increasingly challenged not only by case reports but also by systematic research. METHODS Diagnostic and Statistical Manual for Mental Disorders (DSM) criteria are usually employed in these research studies and case reports and it was strongly suggested that pediatric BD may not be rare but that it may be difficult to diagnose. RESULTS In concordance with the current literature, euphoric mood and episodic course is rare in Turkish children and adolescents and the affective phenomenology is often mixed and dysphoric, with affective storms and temper outbursts. Comorbidity (especially with ADHD) is a big issue in accurate diagnosis and treatment. CONCLUSION There are promising treatment studies, but we need more studies in both prepubertal children and adolescents about phenomenology, etiology, and treatment of this important condition.
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Affiliation(s)
| | - Rasim Somer Diler
- Western Psychiatric Institute and Clinic, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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Miklowitz DJ, Chang KD. Prevention of bipolar disorder in at-risk children: theoretical assumptions and empirical foundations. Dev Psychopathol 2008; 20:881-97. [PMID: 18606036 PMCID: PMC2504732 DOI: 10.1017/s0954579408000424] [Citation(s) in RCA: 61] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
This article examines how bipolar symptoms emerge during development, and the potential role of psychosocial and pharmacological interventions in the prevention of the onset of the disorder. Early signs of bipolarity can be observed among children of bipolar parents and often take the form of subsyndromal presentations (e.g., mood lability, episodic elation or irritability, depression, inattention, and psychosocial impairment). However, many of these early presentations are diagnostically nonspecific. The few studies that have followed at-risk youth into adulthood find developmental discontinuities from childhood to adulthood. Biological markers (e.g., amygdalar volume) may ultimately increase our accuracy in identifying children who later develop bipolar I disorder, but few such markers have been identified. Stress, in the form of childhood adversity or highly conflictual families, is not a diagnostically specific causal agent but does place genetically and biologically vulnerable individuals at risk for a more pernicious course of illness. A preventative family-focused treatment for children with (a) at least one first-degree relative with bipolar disorder and (b) subsyndromal signs of bipolar disorder is described. This model attempts to address the multiple interactions of psychosocial and biological risk factors in the onset and course of bipolar disorder.
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Affiliation(s)
- David J Miklowitz
- Department of Psychology, University of Colorado at Boulder, Boulder, CO 80309, USA.
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