1
|
Primavera D, Aviles Gonzalez C, Perra A, Kalcev G, Cantone E, Cossu G, Holzinger A, Carta MG, Sancassiani F. Virtual Reality Cognitive Remediation in Older Adults with Bipolar Disorder: The Effects on Cognitive Performance and Depression in a Feasibility Randomized Controlled Trial. Healthcare (Basel) 2024; 12:1753. [PMID: 39273777 PMCID: PMC11394966 DOI: 10.3390/healthcare12171753] [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: 08/12/2024] [Revised: 08/27/2024] [Accepted: 08/29/2024] [Indexed: 09/15/2024] Open
Abstract
INTRODUCTION Dementia, depression, and cardiovascular disease are major public health concerns for older adults, requiring early intervention. This study investigates whether a virtual reality cognitive remediation program (VR-CR) can improve cognitive function and depressive symptoms in older adults, and determines the necessary sample size for future studies. Integrated VR and CR interventions have shown promising outcomes in older adults with neurodegenerative and mental health disorders. METHODS This secondary analysis of a randomized controlled trial involves adults aged 58-75 years with bipolar disorder, excluding those with acute episodes, epilepsy, or severe eye diseases. The experimental group received standard treatment plus VR-CR, while the control group received only standard treatment. RESULTS No baseline differences were found between the experimental and control groups. No significant improvement was observed in the overall cognitive function test (p = 0.897) or in depressive symptoms (p = 0.322). A phase III efficacy study requires a sample size of 28 participants (alpha = 0.05, beta = 0.20). CONCLUSIONS VR-CR can potentially treat depressive symptoms in adults and older adults, but the results support conducting phase III studies to further investigate these outcomes. However, the improvement in cognitive performance in the elderly is less pronounced than in younger individuals.
Collapse
Affiliation(s)
- Diego Primavera
- Department of Medical Sciences and Public Health, University of Cagliari, 09042 Cagliari, Italy
| | - Cesar Aviles Gonzalez
- Department of Medical Sciences and Public Health, University of Cagliari, 09042 Cagliari, Italy
- Department of Nursing, Universidad Popular del Cesar, Valledupar 200001, Colombia
| | - Alessandra Perra
- Department of Medical Sciences and Public Health, University of Cagliari, 09042 Cagliari, Italy
| | - Goce Kalcev
- The National Alliance for Neuromuscular Diseases and Neuroscience GANGLION Skopje, 1000 Skopje, North Macedonia
| | - Elisa Cantone
- Department of Medical Sciences and Public Health, University of Cagliari, 09042 Cagliari, Italy
| | - Giulia Cossu
- Department of Medical Sciences and Public Health, University of Cagliari, 09042 Cagliari, Italy
| | - Anita Holzinger
- Department at Medical, University of Wien, Spitalgasse 23, 1090 Wien, Austria
| | - Mauro Giovanni Carta
- Department of Medical Sciences and Public Health, University of Cagliari, 09042 Cagliari, Italy
| | - Federica Sancassiani
- Department of Medical Sciences and Public Health, University of Cagliari, 09042 Cagliari, Italy
| |
Collapse
|
2
|
Congiu P, Carta MG, Perra A, Cantone E, Lorrai S, Pintus E, Tusconi M, Cossu G, Redolfi S, Sancassiani F. Prevalence and Risk by Age and Sex of Sleep Dysregulation and Depressive Episodes in Bipolar and Depressive Disorders in a Community Survey in Sardinia, Italy. J Clin Med 2024; 13:4870. [PMID: 39201012 PMCID: PMC11355541 DOI: 10.3390/jcm13164870] [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: 07/14/2024] [Revised: 08/09/2024] [Accepted: 08/16/2024] [Indexed: 09/02/2024] Open
Abstract
Background/Objectives: Sleep disturbances often accompany mood disorders and persistent insomnia after mood symptoms have resolved may be a marker of poor outcome. The association between sleep symptoms and mood disorders seems to change with age and sex. This study aims to assess the frequency of depressive episodes and sleep disorders in the general population through an agile screening questionnaire and to evaluate the association of depressive episodes and sleep symptoms by sex and age categories. Methods: 774 women and 728 men from Sardinia aged > 16 years old were enrolled. The Patient Health Questionnaire (PHQ-9) was administered through a computer-assisted telephonic interview. Results: The frequency of depressive episodes was double in women (10.6% vs. 4.4%; p < 0.0001), with the highest values in women > 75 yo (17.4%). The frequency of sleep dysregulation was double in women (18.7% vs. 9.6%; p < 0.0001), with the highest values in women > 75 yo (35.9%) and the lowest in the group of men > 75 yo. The group of young males showed the lowest frequency of depressive episodes (1.4%) and a frequency of sleep dysregulation (9.1%) similar to that of the other groups of age and sex. Sleep dysregulation without depressive episodes presented a higher distribution in the elderly, both in males (20.7%) and in females (18.5%). No significative differences were found across sex and age groups in the distribution of depressive episodes without sleep dysregulation. Conclusions: The use of an agile screener such as PHQ9 in the general population and/or in populations at risk can be a valuable tool in finding those individuals in whom sleep dysregulation may represent an early warning signal, one that may be thoroughly evaluated to identify and treat possible sleep disorders early.
Collapse
Affiliation(s)
- Patrizia Congiu
- Department of Medical Sciences and Public Health, Sleep Disorder Research Center, University of Cagliari, 09124 Cagliari, Italy; (P.C.); (S.R.)
- Sleep Outpatient Service, Clinica Tommasini di Jerzu, 08044 Jerzu, Italy
| | - Mauro Giovanni Carta
- Department of Medical Sciences and Public Health, Section of Psychiatry, University of Cagliari, 09124 Cagliari, Italy; (M.G.C.); (A.P.); (E.C.); (S.L.); (E.P.); (G.C.); (F.S.)
| | - Alessandra Perra
- Department of Medical Sciences and Public Health, Section of Psychiatry, University of Cagliari, 09124 Cagliari, Italy; (M.G.C.); (A.P.); (E.C.); (S.L.); (E.P.); (G.C.); (F.S.)
| | - Elisa Cantone
- Department of Medical Sciences and Public Health, Section of Psychiatry, University of Cagliari, 09124 Cagliari, Italy; (M.G.C.); (A.P.); (E.C.); (S.L.); (E.P.); (G.C.); (F.S.)
| | - Stefano Lorrai
- Department of Medical Sciences and Public Health, Section of Psychiatry, University of Cagliari, 09124 Cagliari, Italy; (M.G.C.); (A.P.); (E.C.); (S.L.); (E.P.); (G.C.); (F.S.)
| | - Elisa Pintus
- Department of Medical Sciences and Public Health, Section of Psychiatry, University of Cagliari, 09124 Cagliari, Italy; (M.G.C.); (A.P.); (E.C.); (S.L.); (E.P.); (G.C.); (F.S.)
| | | | - Giulia Cossu
- Department of Medical Sciences and Public Health, Section of Psychiatry, University of Cagliari, 09124 Cagliari, Italy; (M.G.C.); (A.P.); (E.C.); (S.L.); (E.P.); (G.C.); (F.S.)
| | - Stefania Redolfi
- Department of Medical Sciences and Public Health, Sleep Disorder Research Center, University of Cagliari, 09124 Cagliari, Italy; (P.C.); (S.R.)
| | - Federica Sancassiani
- Department of Medical Sciences and Public Health, Section of Psychiatry, University of Cagliari, 09124 Cagliari, Italy; (M.G.C.); (A.P.); (E.C.); (S.L.); (E.P.); (G.C.); (F.S.)
| |
Collapse
|
3
|
Primavera D, Cantone E, Cannizzaro GM, Sanna C, Redolfi S. Are Depressive Symptoms in Obstructive Sleep Apnea Attributable to a Syndrome of Dysregulation of Rhythms and Hyperactivity (DYMERS)? J Clin Med 2024; 13:4396. [PMID: 39124663 PMCID: PMC11312976 DOI: 10.3390/jcm13154396] [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: 06/25/2024] [Revised: 07/22/2024] [Accepted: 07/26/2024] [Indexed: 08/12/2024] Open
Abstract
Background: Obstructive sleep apnea (OSA) is characterized by repeated airway obstructions during sleep, causing hypopnea, apnea, intermittent hypoxia, and sleep fragmentation. The severity of OSA is measured using the apnea-hypopnea index (AHI), with AHI ≥ 5 indicating OSA. This study aims to assess the frequency and type of depressive disorder characteristics of OSA patients and to evaluate the impact on quality of life, also considering the presence of hyperactivity. Methods: A case-control study using OSA patients referred to Cagliari's sleep disorder center. Controls were matched by age and sex from community databases. OSA diagnoses were made with AHI > 15. Depressive episodes were identified using BDI-SF, and H-QoL (Health related Quality of Life) was measured with the SF-12, focusing on item 10 for hyper-energy. Results: The clinical sample (n = 25) had a higher frequency of depressive episodes (36%) compared to controls (7% and 4%). Depressed OSA patients had worse H-QoL and higher hyper-energy scores, but the additional burden from depression was relatively low. Conclusions: The OSA sample has a higher frequency of depressive episodes compared to the general population. Depressive episodes in OSA patients are linked to higher scores on item 10 of the SF-12, indicating hyper-energy despite lower overall quality of life scores. While OSA significantly impacts quality of life, the additional burden from depression is less severe than in other chronic diseases. These findings suggest that depressive episodes in OSA may be related to rhythm dysregulation and hyperactivity (DYMERS).
Collapse
Affiliation(s)
- Diego Primavera
- Department of Medical Sciences and Public Health, University of Cagliari, Monserrato Blocco I (CA), 09042 Cagliari, Italy; (D.P.); (S.R.)
| | - Elisa Cantone
- Department of Medical Sciences and Public Health, University of Cagliari, Monserrato Blocco I (CA), 09042 Cagliari, Italy; (D.P.); (S.R.)
| | - Gregorio Marco Cannizzaro
- Research Center of Sleep Disorders, University Hospital D. Casula Monserrato, Monserrato, 09042 Cagliari, Italy; (G.M.C.); (C.S.)
| | - Chiara Sanna
- Research Center of Sleep Disorders, University Hospital D. Casula Monserrato, Monserrato, 09042 Cagliari, Italy; (G.M.C.); (C.S.)
| | - Stefania Redolfi
- Department of Medical Sciences and Public Health, University of Cagliari, Monserrato Blocco I (CA), 09042 Cagliari, Italy; (D.P.); (S.R.)
- Research Center of Sleep Disorders, University Hospital D. Casula Monserrato, Monserrato, 09042 Cagliari, Italy; (G.M.C.); (C.S.)
| |
Collapse
|
4
|
Yao J, Wang S, Li Y, Xu J, Ye R, Shen Y, Chen W, Dai N. How to treat major depressive disorder with shorter-duration hypomanic episodes? A case report. Front Psychiatry 2024; 15:1411882. [PMID: 39077629 PMCID: PMC11284331 DOI: 10.3389/fpsyt.2024.1411882] [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: 04/03/2024] [Accepted: 06/25/2024] [Indexed: 07/31/2024] Open
Abstract
Here we report on a case of a 61-year-old female patient with 7-year history of major depressive disorder with shorter-duration hypomanic episodes who was prescribed with antidepressants which turned out to be ineffective. After a COVID-19 infection, the patient's clinical presentation became sufficient for the diagnosis of bipolar disorder and she was consistently effective on a mood stabilizer and an atypical antipsychotic. The course of treatment in this case suggests bipolar disorder is not a binary disorder, but a continuous spectrum disorder. For patients suffering from major depressive disorder with shorter-duration hypomanic episodes, mood stabilizers and atypical antipsychotics are possibly more suitable than antidepressants.
Collapse
Affiliation(s)
- Jiashu Yao
- Department of Psychiatry, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Shenpang Wang
- Department of Psychiatry, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
- Department of Psychiatry, Shaoxing 7th People’s Hospital, Shaoxing, Zhejiang, China
| | - Yifei Li
- Department of Psychiatry, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Jiating Xu
- Department of Psychiatry, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
- The Second Department of General Psychiatry, The Third Hospital of Quzhou City, Quzhou, Zhejiang, China
| | - Ruihuan Ye
- Department of Psychiatry, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Yuedi Shen
- The Affiliated Hospital of Hangzhou Normal University, Hangzhou Normal University, Hangzhou, Zhejiang, China
| | - Wei Chen
- Department of Psychiatry, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Ning Dai
- Department of Gastroenterology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| |
Collapse
|
5
|
Zhang X, Cheng X, Chen J, Sun J, Yang X, Li W, Chen L, Mao Y, Liu Y, Zeng X, Ye B, Yang C, Li X, Cao L. Distinct global brain connectivity alterations in depressed adolescents with subthreshold mania and the relationship with processing speed: Evidence from sBEAD Cohort. J Affect Disord 2024; 357:97-106. [PMID: 38657768 DOI: 10.1016/j.jad.2024.04.063] [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: 02/19/2024] [Revised: 04/06/2024] [Accepted: 04/15/2024] [Indexed: 04/26/2024]
Abstract
BACKGROUND Bipolar disorder (BD) is a progressive condition. Investigating the neuroimaging mechanisms in depressed adolescents with subthreshold mania (SubMD) facilitates the early identification of BD. However, the global brain connectivity (GBC) patterns in SubMD patients, as well as the relationship with processing speed before the onset of full-blown BD, remain unclear. METHODS The study involved 72 SubMD, 77 depressed adolescents without subthreshold mania (nSubMD), and 69 gender- and age-matched healthy adolescents (HCs). All patients underwent a clinical follow-up ranging from six to twelve months. We calculated the voxel-based graph theory analysis of the GBC map and conducted the TMT-A test to measure the processing speed. RESULTS Compared to HCs and nSubMD, SubMD patients displayed distinctive GBC index patterns: GBC index decreased in the right Medial Superior Frontal Gyrus (SFGmed.R)/Superior Frontal Gyrus (SFG) while increased in the right Precuneus and left Postcentral Gyrus. Both patient groups showed increased GBC index in the right Inferior Temporal Gyrus. An increased GBC value in the right Supplementary Motor Area was exclusively observed in the nSubMD-group. There were opposite changes in the GBC index in SFGmed.R/SFG between two patient groups, with an AUC of 0.727. Additionally, GBC values in SFGmed.R/SFG exhibited a positive correlation with TMT-A scores in SubMD-group. LIMITATIONS Relatively shorter follow-up duration, medications confounding, and modest sample size. CONCLUSION These findings suggest that adolescents with subthreshold BD have specific impairments patterns at the whole brain connectivity level associated with processing speed impairments, providing insights into early identification and intervention strategies for BD.
Collapse
Affiliation(s)
- Xiaofei Zhang
- Department of Child and Adolescent Psychiatry, Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong province 510300, PR China; The First School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong province 510000, PR China
| | - Xiaofang Cheng
- Department of Child and Adolescent Psychiatry, Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong province 510300, PR China
| | - Jianshan Chen
- Department of Child and Adolescent Psychiatry, Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong province 510300, PR China
| | - Jiaqi Sun
- Department of Child and Adolescent Psychiatry, Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong province 510300, PR China
| | - Xiaoyong Yang
- Department of Psychiatry, Guangzhou Medical University, Guangdong province 510300, PR China
| | - Weiming Li
- Department of Child and Adolescent Psychiatry, Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong province 510300, PR China
| | - Lei Chen
- Department of Child and Adolescent Psychiatry, Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong province 510300, PR China
| | - Yimiao Mao
- Department of Child and Adolescent Psychiatry, Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong province 510300, PR China
| | - Yutong Liu
- Department of Child and Adolescent Psychiatry, Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong province 510300, PR China
| | - Xuanlin Zeng
- Department of Child and Adolescent Psychiatry, Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong province 510300, PR China
| | - Biyu Ye
- Department of Child and Adolescent Psychiatry, Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong province 510300, PR China
| | - Chanjuan Yang
- Department of Child and Adolescent Psychiatry, Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong province 510300, PR China
| | - Xuan Li
- Department of Child and Adolescent Psychiatry, Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong province 510300, PR China.
| | - Liping Cao
- Department of Child and Adolescent Psychiatry, Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong province 510300, PR China.
| |
Collapse
|
6
|
Li T, Li R, Zhao L, Sun Y, Wang C, Bo Q. Comparative Analysis of Personality Traits in Major Depressive Disorder and Bipolar Disorder: Impact, Differences, and Associations with Symptoms. Neuropsychiatr Dis Treat 2024; 20:363-371. [PMID: 38415073 PMCID: PMC10898253 DOI: 10.2147/ndt.s451803] [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: 12/11/2023] [Accepted: 02/16/2024] [Indexed: 02/29/2024] Open
Abstract
Purpose This cross-sectional study aimed to compare the personality traits of patients with major depressive disorder (MDD) and bipolar disorder (BD) with those of healthy individuals. The goal was to gain insight into the potential impact of personality traits on the development and manifestation of mood disorders. Methods One hundred seventy-eight patients with mood disorders were analyzed as either MDD or BD, with each group containing euthymic and depressive members: e-MDD, d-MDD, e-BD, and d-BD. Mood status was assessed using the Young Mania Rating Scale (YMRS), and the 17-item Hamilton Depression Rating Scale (HAMD-17). Ninety-five healthy individuals served as controls. Personality traits were assessed with the Eysenck Personality Questionnaire. Results The scores for neuroticism in the patient groups were comparable, but each group had higher scores compared to the control group (P < 0.001). Each patient group exhibited significantly lower scores for extraversion compared to the control group, with e-MDD, d-MDD, and d-BD showing particularly notable differences (P < 0.001); these groups scored significantly lower than the e-BD (P = 0.041, 0.009, 0.038). In patients with BD, there was an inverted association between extraversion score and HAMD total score (P = 0.010, r = -0.27), and a positive association with the YMRS total score (P = 0.022, r = 0.24). In the MDD group, there was a positive association between the neuroticism score and HAMD total score (P = 0.021, r = 0.25). Conclusion Patients with mood disorders are characterized by lower extraversion and higher neuroticism. Level of neuroticism associated with depression severity in MDD. Patients with BD may be more extraverted, but their extraversion can be affected by depressive episodes. Extraversion may be a feature of BD, and may differentiate BD from MDD. Personality traits are related to disease diathesis and state, and shaped by symptom manifestations.
Collapse
Affiliation(s)
- Tian Li
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders & Beijing Institute for Brain Disorders Center of Schizophrenia, Beijing Anding Hospital, Capital Medical University, Beijing, 100088, People's Republic of China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, 100069, People's Republic of China
| | - Ruinan Li
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders & Beijing Institute for Brain Disorders Center of Schizophrenia, Beijing Anding Hospital, Capital Medical University, Beijing, 100088, People's Republic of China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, 100069, People's Republic of China
| | - Lei Zhao
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders & Beijing Institute for Brain Disorders Center of Schizophrenia, Beijing Anding Hospital, Capital Medical University, Beijing, 100088, People's Republic of China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, 100069, People's Republic of China
| | - Yue Sun
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders & Beijing Institute for Brain Disorders Center of Schizophrenia, Beijing Anding Hospital, Capital Medical University, Beijing, 100088, People's Republic of China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, 100069, People's Republic of China
| | - Chuanyue Wang
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders & Beijing Institute for Brain Disorders Center of Schizophrenia, Beijing Anding Hospital, Capital Medical University, Beijing, 100088, People's Republic of China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, 100069, People's Republic of China
| | - Qijing Bo
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders & Beijing Institute for Brain Disorders Center of Schizophrenia, Beijing Anding Hospital, Capital Medical University, Beijing, 100088, People's Republic of China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, 100069, People's Republic of China
| |
Collapse
|
7
|
Langholm C, Breitinger S, Gray L, Goes F, Walker A, Xiong A, Stopel C, Zandi P, Frye MA, Torous J. Classifying and clustering mood disorder patients using smartphone data from a feasibility study. NPJ Digit Med 2023; 6:238. [PMID: 38129571 PMCID: PMC10739731 DOI: 10.1038/s41746-023-00977-7] [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: 04/24/2023] [Accepted: 11/29/2023] [Indexed: 12/23/2023] Open
Abstract
Differentiating between bipolar disorder and major depressive disorder can be challenging for clinicians. The diagnostic process might benefit from new ways of monitoring the phenotypes of these disorders. Smartphone data might offer insight in this regard. Today, smartphones collect dense, multimodal data from which behavioral metrics can be derived. Distinct patterns in these metrics have the potential to differentiate the two conditions. To examine the feasibility of smartphone-based phenotyping, two study sites (Mayo Clinic, Johns Hopkins University) recruited patients with bipolar I disorder (BPI), bipolar II disorder (BPII), major depressive disorder (MDD), and undiagnosed controls for a 12-week observational study. On their smartphones, study participants used a digital phenotyping app (mindLAMP) for data collection. While in use, mindLAMP gathered real-time geolocation, accelerometer, and screen-state (on/off) data. mindLAMP was also used for EMA delivery. MindLAMP data was then used as input variables in binary classification, three-group k-nearest neighbors (KNN) classification, and k-means clustering. The best-performing binary classification model was able to classify patients as control or non-control with an AUC of 0.91 (random forest). The model that performed best at classifying patients as having MDD or bipolar I/II had an AUC of 0.62 (logistic regression). The k-means clustering model had a silhouette score of 0.46 and an ARI of 0.27. Results support the potential for digital phenotyping methods to cluster depression, bipolar disorder, and healthy controls. However, due to inconsistencies in accuracy, more data streams are required before these methods can be applied to clinical practice.
Collapse
Affiliation(s)
- Carsten Langholm
- Division of Digital Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, 02115, USA
| | - Scott Breitinger
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, 55902, USA
| | - Lucy Gray
- Division of Digital Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, 02115, USA
| | - Fernando Goes
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, 21218, USA
| | - Alex Walker
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, 21218, USA
| | - Ashley Xiong
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, 55902, USA
| | - Cindy Stopel
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, 55902, USA
| | - Peter Zandi
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, 21218, USA
| | - Mark A Frye
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, 55902, USA
| | - John Torous
- Division of Digital Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, 02115, USA.
| |
Collapse
|
8
|
Lee DY, Choi B, Kim C, Fridgeirsson E, Reps J, Kim M, Kim J, Jang JW, Rhee SY, Seo WW, Lee S, Son SJ, Park RW. Privacy-Preserving Federated Model Predicting Bipolar Transition in Patients With Depression: Prediction Model Development Study. J Med Internet Res 2023; 25:e46165. [PMID: 37471130 PMCID: PMC10401196 DOI: 10.2196/46165] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 03/10/2023] [Accepted: 06/29/2023] [Indexed: 07/21/2023] Open
Abstract
BACKGROUND Mood disorder has emerged as a serious concern for public health; in particular, bipolar disorder has a less favorable prognosis than depression. Although prompt recognition of depression conversion to bipolar disorder is needed, early prediction is challenging due to overlapping symptoms. Recently, there have been attempts to develop a prediction model by using federated learning. Federated learning in medical fields is a method for training multi-institutional machine learning models without patient-level data sharing. OBJECTIVE This study aims to develop and validate a federated, differentially private multi-institutional bipolar transition prediction model. METHODS This retrospective study enrolled patients diagnosed with the first depressive episode at 5 tertiary hospitals in South Korea. We developed models for predicting bipolar transition by using data from 17,631 patients in 4 institutions. Further, we used data from 4541 patients for external validation from 1 institution. We created standardized pipelines to extract large-scale clinical features from the 4 institutions without any code modification. Moreover, we performed feature selection in a federated environment for computational efficiency and applied differential privacy to gradient updates. Finally, we compared the federated and the 4 local models developed with each hospital's data on internal and external validation data sets. RESULTS In the internal data set, 279 out of 17,631 patients showed bipolar disorder transition. In the external data set, 39 out of 4541 patients showed bipolar disorder transition. The average performance of the federated model in the internal test (area under the curve [AUC] 0.726) and external validation (AUC 0.719) data sets was higher than that of the other locally developed models (AUC 0.642-0.707 and AUC 0.642-0.699, respectively). In the federated model, classifications were driven by several predictors such as the Charlson index (low scores were associated with bipolar transition, which may be due to younger age), severe depression, anxiolytics, young age, and visiting months (the bipolar transition was associated with seasonality, especially during the spring and summer months). CONCLUSIONS We developed and validated a differentially private federated model by using distributed multi-institutional psychiatric data with standardized pipelines in a real-world environment. The federated model performed better than models using local data only.
Collapse
Affiliation(s)
- Dong Yun Lee
- Department of Biomedical Informatics, Ajou University School of Medicine, Suwon-si, Republic of Korea
| | - Byungjin Choi
- Department of Biomedical Informatics, Ajou University School of Medicine, Suwon-si, Republic of Korea
| | - Chungsoo Kim
- Department of Biomedical Sciences, Ajou University Graduate School of Medicine, Suwon-si, Republic of Korea
| | - Egill Fridgeirsson
- Department of Medical Informatics, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Jenna Reps
- Observational Health Data Analytics, Janssen Research and Development, Titusville, NJ, United States
| | - Myoungsuk Kim
- Data Solution Team, Evidnet Co, Ltd, Sungnam, Republic of Korea
| | - Jihyeong Kim
- Data Solution Team, Evidnet Co, Ltd, Sungnam, Republic of Korea
| | - Jae-Won Jang
- Department of Neurology, Kangwon National University Hospital, Kangwon National University School of Medicine, Chuncheon, Republic of Korea
| | - Sang Youl Rhee
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Seoul, Republic of Korea
- Department of Endocrinology and Metabolism, Kyung Hee University College of Medicine, Seoul, Republic of Korea
| | - Won-Woo Seo
- Department of Internal Medicine, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Republic of Korea
| | - Seunghoon Lee
- Department of Psychiatry, Myongji Hospital, Goyang, Republic of Korea
| | - Sang Joon Son
- Department of Psychiatry, Ajou University School of Medicine, Suwon-si, Republic of Korea
| | - Rae Woong Park
- Department of Biomedical Informatics, Ajou University School of Medicine, Suwon-si, Republic of Korea
- Department of Biomedical Sciences, Ajou University Graduate School of Medicine, Suwon-si, Republic of Korea
| |
Collapse
|
9
|
Ettore E, Müller P, Hinze J, Benoit M, Giordana B, Postin D, Lecomte A, Lindsay H, Robert P, König A. Digital Phenotyping for Differential Diagnosis of Major Depressive Episode: Narrative Review. JMIR Ment Health 2023; 10:e37225. [PMID: 36689265 PMCID: PMC9903183 DOI: 10.2196/37225] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 09/02/2022] [Accepted: 09/30/2022] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Major depressive episode (MDE) is a common clinical syndrome. It can be found in different pathologies such as major depressive disorder (MDD), bipolar disorder (BD), posttraumatic stress disorder (PTSD), or even occur in the context of psychological trauma. However, only 1 syndrome is described in international classifications (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition [DSM-5]/International Classification of Diseases 11th Revision [ICD-11]), which do not take into account the underlying pathology at the origin of the MDE. Clinical interviews are currently the best source of information to obtain the etiological diagnosis of MDE. Nevertheless, it does not allow an early diagnosis and there are no objective measures of extracted clinical information. To remedy this, the use of digital tools and their correlation with clinical symptomatology could be useful. OBJECTIVE We aimed to review the current application of digital tools for MDE diagnosis while highlighting shortcomings for further research. In addition, our work was focused on digital devices easy to use during clinical interview and mental health issues where depression is common. METHODS We conducted a narrative review of the use of digital tools during clinical interviews for MDE by searching papers published in PubMed/MEDLINE, Web of Science, and Google Scholar databases since February 2010. The search was conducted from June to September 2021. Potentially relevant papers were then compared against a checklist for relevance and reviewed independently for inclusion, with focus on 4 allocated topics of (1) automated voice analysis, behavior analysis by (2) video and physiological measures, (3) heart rate variability (HRV), and (4) electrodermal activity (EDA). For this purpose, we were interested in 4 frequently found clinical conditions in which MDE can occur: (1) MDD, (2) BD, (3) PTSD, and (4) psychological trauma. RESULTS A total of 74 relevant papers on the subject were qualitatively analyzed and the information was synthesized. Thus, a digital phenotype of MDE seems to emerge consisting of modifications in speech features (namely, temporal, prosodic, spectral, source, and formants) and in speech content, modifications in nonverbal behavior (head, hand, body and eyes movement, facial expressivity, and gaze), and a decrease in physiological measurements (HRV and EDA). We not only found similarities but also differences when MDE occurs in MDD, BD, PTSD, or psychological trauma. However, comparative studies were rare in BD or PTSD conditions, which does not allow us to identify clear and distinct digital phenotypes. CONCLUSIONS Our search identified markers from several modalities that hold promise for helping with a more objective diagnosis of MDE. To validate their potential, further longitudinal and prospective studies are needed.
Collapse
Affiliation(s)
- Eric Ettore
- Department of Psychiatry and Memory Clinic, University Hospital of Nice, Nice, France
| | - Philipp Müller
- Research Department Cognitive Assistants, Deutsches Forschungszentrum für Künstliche Intelligenz GmbH, Saarbrücken, Germany
| | - Jonas Hinze
- Department of Psychiatry and Psychotherapy, Saarland University Medical Center, Hombourg, Germany
| | - Michel Benoit
- Department of Psychiatry, Hopital Pasteur, University Hospital of Nice, Nice, France
| | - Bruno Giordana
- Department of Psychiatry, Hopital Pasteur, University Hospital of Nice, Nice, France
| | - Danilo Postin
- Department of Psychiatry, School of Medicine and Health Sciences, Carl von Ossietzky University of Oldenburg, Bad Zwischenahn, Germany
| | - Amandine Lecomte
- Research Department Sémagramme Team, Institut national de recherche en informatique et en automatique, Nancy, France
| | - Hali Lindsay
- Research Department Cognitive Assistants, Deutsches Forschungszentrum für Künstliche Intelligenz GmbH, Saarbrücken, Germany
| | - Philippe Robert
- Research Department, Cognition-Behaviour-Technology Lab, University Côte d'Azur, Nice, France
| | - Alexandra König
- Research Department Stars Team, Institut national de recherche en informatique et en automatique, Sophia Antipolis - Valbonne, France
| |
Collapse
|
10
|
Ghaemi SN, Angst J, Vohringer PA, Youngstrom EA, Phelps J, Mitchell PB, McIntyre RS, Bauer M, Vieta E, Gershon S. Clinical research diagnostic criteria for bipolar illness (CRDC-BP): rationale and validity. Int J Bipolar Disord 2022; 10:23. [PMID: 36227452 DOI: 10.1186/s40345-022-00267-3] [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: 12/15/2021] [Accepted: 06/16/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In the 1970 s, scientific research on psychiatric nosology was summarized in Research Diagnostic Criteria (RDC), based solely on empirical data, an important source for the third revision of the official nomenclature of the American Psychiatric Association in 1980, the Diagnostic and Statistical Manual, Third Edition (DSM-III). The intervening years, especially with the fourth edition in 1994, saw a shift to a more overtly "pragmatic" approach to diagnostic definitions, which were constructed for many purposes, with research evidence being only one consideration. The latest editions have been criticized as failing to be useful for research. Biological and clinical research rests on the validity of diagnostic definitions that are supported by firm empirical foundations, but critics note that DSM criteria have failed to prioritize research data in favor of "pragmatic" considerations. RESULTS Based on prior work of the International Society for Bipolar Diagnostic Guidelines Task Force, we propose here Clinical Research Diagnostic Criteria for Bipolar Illness (CRDC-BP) for use in research studies, with the hope that these criteria may lead to further refinement of diagnostic definitions for other major mental illnesses in the future. New proposals are provided for mixed states, mood temperaments, and duration of episodes. CONCLUSIONS A new CRDC could provide guidance toward an empirically-based, scientific psychiatric nosology, and provide an alternative clinical diagnostic approach to the DSM system.
Collapse
Affiliation(s)
- S Nassir Ghaemi
- Department of Psychiatry, Tufts University, 800 Washington St, Boston, MA, 02111, USA. .,Department of Psychiatry, Harvard Medical School, Boston, USA.
| | | | - Paul A Vohringer
- Department of Psychiatry, Tufts University, 800 Washington St, Boston, MA, 02111, USA.,Department of Psychiatry, University of Chile, Santiago, Chile
| | - Eric A Youngstrom
- Departments of Psychology, Neuroscience, and Psychiatry, University of North Carolina, Chapel Hill, NC, USA
| | - James Phelps
- Department of Psychiatry, Good Samaritan Regional Medical Center, Corvallis, OR, USA
| | - Philip B Mitchell
- Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, Australia
| | - Roger S McIntyre
- Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Michael Bauer
- Department of Psychiatry and Psychotherapy, Carl Gustav Carus University Hospital, Technische Universität Dresden, Dresden, Germany
| | - Eduard Vieta
- Department of Psychiatry and Psychology, Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Samuel Gershon
- Department of Psychiatry, University of Miami, Miami, USA
| |
Collapse
|
11
|
|
12
|
Nestsiarovich A, Reps JM, Matheny ME, DuVall SL, Lynch KE, Beaton M, Jiang X, Spotnitz M, Pfohl SR, Shah NH, Torre CO, Reich CG, Lee DY, Son SJ, You SC, Park RW, Ryan PB, Lambert CG. Predictors of diagnostic transition from major depressive disorder to bipolar disorder: a retrospective observational network study. Transl Psychiatry 2021; 11:642. [PMID: 34930903 PMCID: PMC8688463 DOI: 10.1038/s41398-021-01760-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 11/25/2021] [Accepted: 12/01/2021] [Indexed: 12/02/2022] Open
Abstract
Many patients with bipolar disorder (BD) are initially misdiagnosed with major depressive disorder (MDD) and are treated with antidepressants, whose potential iatrogenic effects are widely discussed. It is unknown whether MDD is a comorbidity of BD or its earlier stage, and no consensus exists on individual conversion predictors, delaying BD's timely recognition and treatment. We aimed to build a predictive model of MDD to BD conversion and to validate it across a multi-national network of patient databases using the standardization afforded by the Observational Medical Outcomes Partnership (OMOP) common data model. Five "training" US databases were retrospectively analyzed: IBM MarketScan CCAE, MDCR, MDCD, Optum EHR, and Optum Claims. Cyclops regularized logistic regression models were developed on one-year MDD-BD conversion with all standard covariates from the HADES PatientLevelPrediction package. Time-to-conversion Kaplan-Meier analysis was performed up to a decade after MDD, stratified by model-estimated risk. External validation of the final prediction model was performed across 9 patient record databases within the Observational Health Data Sciences and Informatics (OHDSI) network internationally. The model's area under the curve (AUC) varied 0.633-0.745 (µ = 0.689) across the five US training databases. Nine variables predicted one-year MDD-BD transition. Factors that increased risk were: younger age, severe depression, psychosis, anxiety, substance misuse, self-harm thoughts/actions, and prior mental disorder. AUCs of the validation datasets ranged 0.570-0.785 (µ = 0.664). An assessment algorithm was built for MDD to BD conversion that allows distinguishing as much as 100-fold risk differences among patients and validates well across multiple international data sources.
Collapse
Affiliation(s)
- Anastasiya Nestsiarovich
- University of New Mexico Health Sciences Center, Department of Internal Medicine, Center for Global Health, Albuquerque, NM, USA
| | - Jenna M Reps
- Janssen Research and Development, Raritan, NJ, USA
| | - Michael E Matheny
- Vanderbilt University, Department of Biomedical Informatics, Department of Medicine, Department of Biostatistics, Nashville, TN, USA
- Tennessee Valley Healthcare System VA, Nashville, TN, USA
| | - Scott L DuVall
- Veterans Affairs Informatics and Computing Infrastructure, VA Salt Lake City Health Care System, Salt Lake City, UT, USA
- University of Utah, Department of Internal Medicine, Salt Lake City, UT, USA
| | - Kristine E Lynch
- Veterans Affairs Informatics and Computing Infrastructure, VA Salt Lake City Health Care System, Salt Lake City, UT, USA
- University of Utah, Department of Internal Medicine, Salt Lake City, UT, USA
| | - Maura Beaton
- Columbia University Irving Medical Center, Department of Biomedical Informatics, New York, NY, USA
| | - Xinzhuo Jiang
- Columbia University Irving Medical Center, Department of Biomedical Informatics, New York, NY, USA
| | - Matthew Spotnitz
- Columbia University Irving Medical Center, Department of Biomedical Informatics, New York, NY, USA
| | - Stephen R Pfohl
- Stanford University, Stanford Center for Biomedical Informatics Research, Stanford, CA, USA
| | - Nigam H Shah
- Stanford University, Stanford Center for Biomedical Informatics Research, Stanford, CA, USA
| | | | | | - Dong Yun Lee
- Ajou University School of Medicine, Department of Psychiatry, Suwon, Republic of Korea
| | - Sang Joon Son
- Ajou University School of Medicine, Department of Psychiatry, Suwon, Republic of Korea
| | - Seng Chan You
- Ajou University School of Medicine, Department of Biomedical Informatics, Suwon, Republic of Korea
| | - Rae Woong Park
- Ajou University School of Medicine, Department of Biomedical Informatics, Suwon, Republic of Korea
| | - Patrick B Ryan
- Janssen Research and Development, Raritan, NJ, USA
- Columbia University Irving Medical Center, Department of Biomedical Informatics, New York, NY, USA
| | - Christophe G Lambert
- University of New Mexico Health Sciences Center, Department of Internal Medicine, Center for Global Health, Albuquerque, NM, USA.
- University of New Mexico Health Sciences Center, Department of Internal Medicine, Center for Global Health, Division of Translational Informatics, Albuquerque, NM, USA.
| |
Collapse
|
13
|
Buoli M, Gattoni E, Collantoni E, Monteleone AM, Solmi M, Longo L, Ribolsi M, Santambrogio J, Bersani FS, Aguglia A, Serafini G, Signorelli MS, Dell'Osso B, Luciano M, Galderisi S. Factors influencing lithium versus valproate prescription preference in the maintenance treatment of bipolar patients: a report from the Italian Early Career Psychiatrists (SOPSI-GG). Int J Psychiatry Clin Pract 2021; 25:82-89. [PMID: 33380246 DOI: 10.1080/13651501.2020.1865405] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND Objective of the present manuscript is to investigate, among Italian early career psychiatrists (ECPs), prescriber and patient-related factors associated with lithium or valproate preference to treat patients affected by Bipolar Disorder (BD). METHODS An on-line survey was carried out among 252 ECPs, investigating their prescription patterns in relation to lithium and the differences with prescription of valproate. Collected data were compared according to lithium or valproate prescription preference in the long-term treatment of BD by χ2 tests for qualitative variables. RESULTS Over two thirds of ECPs preferred lithium over valproate for the maintenance treatment of BD. Less than half of the sample used lithium as first-line agent for mania or major depression, and less than one third for mixed episodes. Factors associated with lithium preference as first-line maintenance treatment include perception of having a good knowledge of lithium (p < 0.001) and complete satisfaction with education on lithium (p < 0.001). One of the main factors to prefer valproate was the concern about long-term side effects of lithium (p < 0.001). CONCLUSIONS Type of education, source of information, clinical experience and safety concerns influence the choice of lithium versus valproate in the long-term treatment of BD. Present findings may guide educational training of ECPs.KEY POINTSLithium has been less prescribed in the last years for long-term treatment of Bipolar Disorder.Educational and clinical factors seem to influence the attitude to prescribe lithium.Only half of the Italian early career psychiatrists declare to have at least an adequate knowledge of lithium.Residency program in psychiatry should consider the implementation of education on lithium.
Collapse
Affiliation(s)
- Massimiliano Buoli
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Eleonora Gattoni
- Department of Translational Medicine, Institute of Psychiatry, Università del Piemonte Orientale, Novara, Italy.,Institute of Psychiatry, Maggiore della Carità Hospital of Novara, Novara, Italy
| | | | - Alessio Maria Monteleone
- Department of Psychiatry, University of Campania "L. Vanvitelli", Largo Madonna Delle Grazie, Naples, Italy
| | - Marco Solmi
- Neurosciences Department, University of Padua, Padua, Italy
| | - Luisa Longo
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy; Azienda Ospedaliero-Universitaria Consorziale Policlinico, Bari, Italy
| | | | - Jacopo Santambrogio
- Department of Medicine and Surgery, School of Medicine and Surgery, University of Milano Bicocca, Milan, Italy
| | | | - Andrea Aguglia
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Gianluca Serafini
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Maria Salvina Signorelli
- Department of Clinical and Experimental Medicine, AOU Policlinico Hospital, University of Catania, Catania, Italy
| | - Bernardo Dell'Osso
- Department of Biomedical and Clinical Sciences, "Luigi Sacco", Psychiatry Unit 2, ASST-Fatebenefratelli-Sacco, Milan, Italy.,Department of Psychiatry and Behavioral Sciences, Bipolar Disorders Clinic, Stanford University, Stanford, CA, USA.,CRC "Aldo Ravelli" for Neurotechnology and Experimental Brain Therapeutics University of Milan, Milan, Italy
| | - Mario Luciano
- Department of Psychiatry, University of Campania "L. Vanvitelli", Largo Madonna Delle Grazie, Naples, Italy
| | - Silvana Galderisi
- Department of Psychiatry, University of Campania "L. Vanvitelli", Largo Madonna Delle Grazie, Naples, Italy
| |
Collapse
|
14
|
Möller HJ. The place of comorbidity and of subtle psychopathological evaluation. Eur Arch Psychiatry Clin Neurosci 2020; 270:939-940. [PMID: 33095370 DOI: 10.1007/s00406-020-01198-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- Hans-Jürgen Möller
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, München, Germany.
| |
Collapse
|
15
|
Alciati A, Atzeni F, Caldirola D, Perna G, Sarzi-Puttini P. The Co-Morbidity between Bipolar and Panic Disorder in Fibromyalgia Syndrome. J Clin Med 2020; 9:jcm9113619. [PMID: 33182759 PMCID: PMC7697979 DOI: 10.3390/jcm9113619] [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] [Received: 10/01/2020] [Revised: 10/30/2020] [Accepted: 11/05/2020] [Indexed: 11/29/2022] Open
Abstract
About half of the patients with fibromyalgia (FM) had a lifetime major depression episode and one third had a panic disorder (PD). Because the co-morbidity between bipolar disorder (BD) and PD marks a specific subtype of BD we aimed to investigate if co-morbid BD/PD (comBD/PD) occurs more frequently than the single disorder in FM patients and evaluate the clinical significance and timing of this co-morbidity. Further, we explored the role of co-morbid subthreshold BD and PD. In 118 patients with FM, lifetime threshold and sub-threshold mood disorders and PD were diagnosed with Diagnostic and Statistical Manual of Mental Disorders-IV-Text Revision (DSM-IV-TR) Clinical Interview. Demographic and clinical variables were compared in co-morbid BD/PD (comBD/PD) and not co-morbid BD/PD (nocomBD/PD) subgroups. The co-morbidity BD/PD was seen in 46.6% of FM patients and in 68.6% when patients with minor bipolar (MinBD) and sub-threshold panic were included. These rates are higher than those of the general population and BD outpatients. There were no statistically significant differences between threshold and sub-threshold comBD/PD and nocom-BD/PD subgroups in demographic and clinical parameters. In the majority of patients (78.2%), the onset of comBD/PD preceded or was contemporary with FM. These findings support the hypothesis that comBD/PD is related to the development of FM in a subgroup of patients.
Collapse
Affiliation(s)
- Alessandra Alciati
- Department of Clinical Neurosciences, Hermanas Hospitalarias, Villa San Benedetto Menni Hospital, Albese con Cassano, via Roma 16, 22032 Como, Italy; (D.C.); (G.P.)
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090 Pieve, Emanuele-Milan, Italy
- Correspondence:
| | - Fabiola Atzeni
- Rheumatology Unit, Department of Internal Medicine, University of Messina, Via Consolare Valeria 1, 98100 Messina, Italy;
| | - Daniela Caldirola
- Department of Clinical Neurosciences, Hermanas Hospitalarias, Villa San Benedetto Menni Hospital, Albese con Cassano, via Roma 16, 22032 Como, Italy; (D.C.); (G.P.)
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090 Pieve, Emanuele-Milan, Italy
| | - Giampaolo Perna
- Department of Clinical Neurosciences, Hermanas Hospitalarias, Villa San Benedetto Menni Hospital, Albese con Cassano, via Roma 16, 22032 Como, Italy; (D.C.); (G.P.)
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090 Pieve, Emanuele-Milan, Italy
- Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine and Life Sciences, University of Maastricht, 6200 Maastricht, The Netherlands
- Department of Psychiatry and Behavioral Sciences, Leonard Miller School of Medicine, University of Miami, Miami, FL 33136-1015, USA
| | - Piercarlo Sarzi-Puttini
- Rheumatology Unit, Internal Medicine Department, ASST Fatebenefratelli-Sacco, Via GB Grassi 74, 20157 Milan, Italy;
| |
Collapse
|
16
|
Godman B, Grobler C, Van-De-Lisle M, Wale J, Barbosa WB, Massele A, Opondo P, Petrova G, Tachkov K, Sefah I, Abdulsalim S, Alrasheedy AA, Unnikrishnan MK, Garuoliene K, Bamitale K, Kibuule D, Kalemeera F, Fadare J, Khan TA, Hussain S, Bochenek T, Kalungia AC, Mwanza J, Martin AP, Hill R, Barbui C. Pharmacotherapeutic interventions for bipolar disorder type II: addressing multiple symptoms and approaches with a particular emphasis on strategies in lower and middle-income countries. Expert Opin Pharmacother 2020; 20:2237-2255. [PMID: 31762343 DOI: 10.1080/14656566.2019.1684473] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Introduction: Appropriately managing mental disorders is a growing priority across countries in view of the impact on morbidity and mortality. This includes patients with bipolar disorders (BD). Management of BD is a concern as this is a complex disease with often misdiagnosis, which is a major issue in lower and middle-income countries (LMICs) with typically a limited number of trained personnel and resources. This needs to be addressed.Areas covered: Medicines are the cornerstone of managing patients with Bipolar II across countries including LMICs. The choice of medicines, especially antipsychotics, is important in LMICs with high rates of diabetes and HIV. However, care is currently compromised in LMICs by issues such as the stigma, cultural beliefs, a limited number of trained professionals and high patient co-payments.Expert opinion: Encouragingly, some LMICs have introduced guidelines for patients with BD; however, this is very variable. Strategies for the future include addressing the lack of national guidelines for patients with BD, improving resources for mental disorders including personnel, improving medicine availability and patients' rights, and monitoring prescribing against agreed guidelines. A number of strategies have been identified to improve the treatment of patients with Bipolar II in LMICs, and will be followed up.
Collapse
Affiliation(s)
- Brian Godman
- Department of Pharmacoepidemiology, Strathclyde Institute of Pharmacy and Biomedicial Sciences, University of Strathclyde, Glasgow, UK.,Division of Clinical Pharmacology, Karolinska, Karolinska Institutet, Stockholm, Sweden.,Department of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University, Garankuwa, South Africa.,Health Economics Centre, University of Liverpool Management School, Liverpool, UK
| | - Christoffel Grobler
- Elizabeth Donkin Hospital, Port Elizabeth, South Africa.,Walter Sisulu University, East London, South Africa.,Nelson Mandela University, Port Elizabeth, South Africa
| | | | - Janney Wale
- Independent consumer advocate, Brunswick, Australia
| | - Wallace Breno Barbosa
- Department of Social Pharmacy, College of Pharmacy, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Amos Massele
- Department of Biomedical Sciences, Faculty of Medicine, University of Botswana, Gaborone, Botswana
| | - Philip Opondo
- Department of Psychiatry, Faculty of Medicine, University of Botswana, Gaborone, Botswana
| | - Guenka Petrova
- Faculty of Pharmacy, Department of Social Pharmacy and Pharmacoeconomics, Medical University of Sofia, Sofia, Bulgaria
| | - Konstantin Tachkov
- Faculty of Pharmacy, Department of Social Pharmacy and Pharmacoeconomics, Medical University of Sofia, Sofia, Bulgaria
| | - Israel Sefah
- Department of Pharmacy, Keta Municipal Hospital, Ghana Health Service, Keta, Ghana
| | - Suhaj Abdulsalim
- Unaizah College of Pharmacy, Qassim University, Buraidah Saudi Arabia
| | | | | | - Kristina Garuoliene
- Department of Pathology, Forensic Medicine and Pharmacology, Faculty of Medicine, Vilnius University, Lithuania and Ministry of Health, Vilnius, Lithuania
| | - Kayode Bamitale
- School of Pharmacy, Faculty of Health Sciences, University of Namibia, Windhoek, Namibia
| | - Dan Kibuule
- School of Pharmacy, Faculty of Health Sciences, University of Namibia, Windhoek, Namibia
| | - Francis Kalemeera
- School of Pharmacy, Faculty of Health Sciences, University of Namibia, Windhoek, Namibia
| | - Joseph Fadare
- Department of Pharmacology and Therapeutics, College of Medicine, Ekiti State University, Ado-Ekiti, Nigeria
| | | | | | - Tomasz Bochenek
- Department of Drug Management, Faculty of Health Sciences, Jagiellonian University Medical College, Krakow, Poland
| | | | - James Mwanza
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of Zambia, Lusaka, Zambia
| | - Antony P Martin
- Health Economics Centre, University of Liverpool Management School, Liverpool, UK.,HCD Economics, The Innovation Centre, Daresbury, UK
| | - Ruaraidh Hill
- Liverpool Reviews and Implementation Group, Whelan Building, Liverpool University, Liverpool, UK
| | - Corrado Barbui
- WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona Italy
| |
Collapse
|
17
|
"Do depressive and manic symptoms differentially impact on functioning in acute depression? Results from a large, cross-sectional study". J Affect Disord 2020; 261:30-39. [PMID: 31600585 DOI: 10.1016/j.jad.2019.09.070] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Revised: 09/17/2019] [Accepted: 09/29/2019] [Indexed: 11/21/2022]
Abstract
BACKGROUND Diagnostic criteria for a major depressive episode capture heterogeneous presentations across unipolar (UD) and bipolar (BD) and first-onset (FDE) depression. We evaluated the contribution of each depressive and (hypo)manic symptom to worse functioning in UD/BD/FDE subgroups. METHODS A post-hoc analysis of the BRIDGE-II-Mix study. Acutely depressed patients were stratified into UD, BD and FDE. Each (hypo)manic or depressive symptom was included in a diagnosis-specific logistic regression model with functioning as dependent variable. Better/worse functioning was set with median diagnosis-specific GAF scores cutoffs. All p values were two-tailed. Statistical significance was set at p < 0.05. RESULTS A total of 2768/2811 depressed individuals were enrolled. In BD (N = 716), "recurrent thoughts of death" (OR 2.48, p < 0.0001) and "feelings of worthlessness" (OR 2.28, p < 0.0001) among depressive symptoms, "aggressiveness" (OR 1.67, p = 0.022) as the unique (hypo)manic symptom, significantly contributed to worse functioning. In UD (N = 1357), "depressed mood" (OR 5.6, p = 0.031) and "diminished interest or pleasure" (OR 4.77, p < 0.0001) among depressive, "grandiosity" (OR 3.5, p = 0.014) among (hypo)manic symptoms, most significantly contributed to worse functioning. In FDE (N = 677) "recurrent thoughts of death" (OR 1.99, p < 0.0001) and "insomnia/hypersomnia" (OR 1.88, p = 0.039) among depressive, "grandiosity" (OR 5.98, p = 0.038) as (hypo)manic symptoms significantly contributed to worse functioning. LIMITATIONS The post-hoc and cross-sectional design do not allow for prognostic or causal inferences. CONCLUSIONS Key depressive and (hypo)manic symptoms distinctively associate with worse functional outcome in acute depression, with differential diagnostic-specific magnitude of effect. Core depressive symptoms are associated with worse functioning in unipolar depression, but not in bipolar or first-episode depression.
Collapse
|
18
|
Han YL, Dai ZP, Ridwan MC, Lin PH, Zhou HL, Wang HF, Yao ZJ, Lu Q. Connectivity of the Frontal Cortical Oscillatory Dynamics Underlying Inhibitory Control During a Go/No-Go Task as a Predictive Biomarker in Major Depression. Front Psychiatry 2020; 11:707. [PMID: 32848905 PMCID: PMC7416643 DOI: 10.3389/fpsyt.2020.00707] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Accepted: 07/06/2020] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Major depressive disorder (MDD) is characterized by core functional deficits in cognitive inhibition, which is crucial for emotion regulation. To assess the response to ruminative and negative mood states, it was hypothesized that MDD patients have prolonged disparities in the oscillatory dynamics of the frontal cortical regions across the life course of the disease. METHOD A "go/no-go" response inhibition paradigm was tested in 31 MDD patients and 19 age-matched healthy controls after magnetoencephalography (MEG) scanning. The use of minimum norm estimates (MNE) examined the changes of inhibitory control network which included the right inferior frontal gyrus (rIFG), pre-supplementary motor area (preSMA), and left primary motor cortex (lM1). The power spectrum (PS) within each node and the functional connectivity (FC) between nodes were compared between two groups. Furthermore, Pearson correlation was calculated to estimate the relationship between altered FC and clinical features. RESULT PS was significantly reduced in left motor and preSMA of MDD patients in both beta (13-30 Hz) and low gamma (30-50 Hz) bands. Compared to the HC group, the MDD group demonstrated higher connectivity between lM1 and preSMA in the beta band (t = 3.214, p = 0.002, FDR corrected) and showed reduced connectivity between preSMA and rIFG in the low gamma band (t = -2.612, p = 0.012, FDR corrected). The FC between lM1 and preSMA in the beta band was positively correlated with illness duration (r = 0.475, p = 0.005, FDR corrected), while the FC between preSMA and rIFG in the low gamma band was negatively correlated with illness duration (r = -0.509, p = 0.002, FDR corrected) and retardation factor scores (r = -0.288, p = 0.022, uncorrected). CONCLUSION In this study, a clinical neurophysiological signature of cognitive inhibition leading to sustained negative affect as well as functional non-recovery in MDD patients is highlighted. Duration of illness (DI) plays a key role in negative emotional processing, heighten rumination, impulsivity, and disinhibition.
Collapse
Affiliation(s)
- Ying-Lin Han
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Zhong-Peng Dai
- School of Biological Sciences & Medical Engineering, Southeast University, Nanjing, China.,Key Laboratory of Child Development and Learning Science, Ministry of Education, Southeast University, Nanjing, China
| | - Mohammad Chattun Ridwan
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Pin-Hua Lin
- Medical School of Nanjing University, Nanjing Brain Hospital, Nanjing, China
| | - Hong-Liang Zhou
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Hao-Fei Wang
- Department of Psychology, Jiangsu Province Hospital Affiliated to Nanjing Medical University , Nanjing, China
| | - Zhi-Jian Yao
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China.,School of Biological Sciences & Medical Engineering, Southeast University, Nanjing, China.,Medical School of Nanjing University, Nanjing Brain Hospital, Nanjing, China
| | - Qing Lu
- School of Biological Sciences & Medical Engineering, Southeast University, Nanjing, China.,Key Laboratory of Child Development and Learning Science, Ministry of Education, Southeast University, Nanjing, China
| |
Collapse
|
19
|
Malhi GS, Outhred T, Irwin L. Bipolar II Disorder Is a Myth. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2019; 64:531-536. [PMID: 31060361 PMCID: PMC6681518 DOI: 10.1177/0706743719847341] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- Gin S Malhi
- 1 University of Sydney, Northern Clinical School, Sydney, NSW, Australia.,2 Department of Academic Psychiatry, Northern Sydney Local Health District, St Leonards, NSW, Australia.,3 CADE Clinic, Royal North Shore Hospital, Northern Sydney Local Health District, St Leonards, NSW, Australia
| | - Tim Outhred
- 1 University of Sydney, Northern Clinical School, Sydney, NSW, Australia.,2 Department of Academic Psychiatry, Northern Sydney Local Health District, St Leonards, NSW, Australia.,3 CADE Clinic, Royal North Shore Hospital, Northern Sydney Local Health District, St Leonards, NSW, Australia
| | - Lauren Irwin
- 1 University of Sydney, Northern Clinical School, Sydney, NSW, Australia.,2 Department of Academic Psychiatry, Northern Sydney Local Health District, St Leonards, NSW, Australia.,3 CADE Clinic, Royal North Shore Hospital, Northern Sydney Local Health District, St Leonards, NSW, Australia
| |
Collapse
|
20
|
Goh KK, Chen CH, Chiu YH, Lu ML. Lamotrigine augmentation in treatment-resistant unipolar depression: A comprehensive meta-analysis of efficacy and safety. J Psychopharmacol 2019; 33:700-713. [PMID: 31081449 DOI: 10.1177/0269881119844199] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE Augmentation strategies are commonly applied when an individual is unresponsive to antidepressant monotherapy. Lamotrigine is currently considered at best only as second line augmentation for treatment-resistant unipolar depression while its clinical efficacy and safety profiles remain inconclusive. We intended to assess the therapeutic effects and safety profiles of lamotrigine augmentation in patients with treatment-resistant unipolar depression by conducting a meta-analysis. METHODS MEDLINE, Embase, EBSCO, Cochrane, Web of Science, Scopus, Wanfang and Ariniti databases were searched. Coprimary outcomes, including changes in severity of depression and response rate, were measured in this study. Secondary outcomes were defined as the safety profile of the intervention, including reported discontinuation rate and adverse events. RESULTS Eight double-blinded randomized controlled trials with 677 patients overall were included. Significant improvements in Hamilton Rating Scale for Depression scores and response rates were shown in lamotrigine augmentation groups compared with control groups, of which the pooled result of six Chinese studies showed positive effects of Hamilton Rating Scale for Depression improvement while the pooled result of two non-Chinese studies was statistically non-significant. Patients with more severe illness and longer duration of illness were more effectively treated with lamotrigine augmentation. The magnitude of depression improvement after lamotrigine augmentation was higher in patients treated with selective serotonin reuptake inhibitors than those treated with serotonin-norepinephrine reuptake inhibitors. Lamotrigine augmentation is well-tolerated in terms of all-cause discontinuation rate and adverse events. CONCLUSIONS Lamotrigine augmentation may serve as a possible choice for patients with treatment-resistant unipolar depression and further trials are warranted to clarify the optimal dosage of lamotrigine augmentation together with the treatment duration and safety over time.
Collapse
Affiliation(s)
- Kah Kheng Goh
- 1 Department of Psychiatry, Wan-Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Chun-Hsin Chen
- 1 Department of Psychiatry, Wan-Fang Hospital, Taipei Medical University, Taipei, Taiwan.,2 Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Yi-Hang Chiu
- 1 Department of Psychiatry, Wan-Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Mong-Liang Lu
- 1 Department of Psychiatry, Wan-Fang Hospital, Taipei Medical University, Taipei, Taiwan.,2 Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| |
Collapse
|
21
|
Yuan H, Zhu X, Luo Q, Halim A, Halim M, Yao H, Cai Y, Shi S. Early symptom non-improvement and aggravation are associated with the treatment response to SSRIs in MDD: a real-world study. Neuropsychiatr Dis Treat 2019; 15:957-966. [PMID: 31354272 PMCID: PMC6586220 DOI: 10.2147/ndt.s196533] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
PURPOSE Early improvement in major depressive disorder is defined as a reduction of ≥20% in the 17-item Hamilton Depression Rating Scale (HAM-D-17) score at the second week after initiation of treatment, predicting long-term treatment response. However, there remains no effective strategy for switching medications when a patient fails to reach early improvement at the second week. This study focused on the predictive value of early symptom changes in each item of the HAM-D-17 scale for treatment response to selective serotonin reuptake inhibitor (SSRI) monotherapy and to provide a reference for switching antidepressants to enhance early treatment efficacy. PATIENTS AND METHODS Our study was an observational, real-world study that enrolled 90 treatment-naïve patients experiencing their first episode of major depressive disorder in the outpatient department of Huashan Hospital. Patients who did not achieve the threshold of early improvement in the second week after starting treatment were switched to alternative SSRI monotherapy. Patient follow-up occurred at 2, 4, 8, and 12 weeks after the initiation of treatment. We analyzed the relationship between the change in each symptom on the HAM-D-17 scale and treatment efficacy. RESULTS Early improvement predicted the treatment response at 12 weeks (χ 2=19.249, P<0.001), whereas early non-improvement in insomnia and anxiety was associated with a poor response (OR =9.487, 95% CI: 1.312-68.588 and OR =12.947, 95% CI: 1.99-82.246, respectively). At week 2, general somatic symptom aggravation was associated with a poorer response (OR =73.337, 95% CI: 2.232->999.999); treatment-emergent headache and tremor were associated with treatment efficacy (t=-9.521, P<0.001 and t=3.660, P=0.001, respectively). In addition, the increase in suicidal thoughts, once treatment began, had no relationship with the treatment response (OR =0.821, P=0.872). CONCLUSION This study suggested that patients with early non-improvement in insomnia and anxiety were not suitable for switches in SSRI monotherapy. Patients with treatment-emergent symptoms, especially headaches and tremors, were not suitable for switching from monotherapy to another SSRI.
Collapse
Affiliation(s)
- Hsinsung Yuan
- Psychiatry Department of Huashan Hospital, Fudan University, Shanghai, People's Republic of China, .,Psychiatry Department of Nanjing Brain Hospital, Nanjing, People's Republic of China
| | - Xiao Zhu
- Psychiatry Department of Huashan Hospital, Fudan University, Shanghai, People's Republic of China,
| | - Qiang Luo
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, People's Republic of China.,Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence (Ministry of Education), Fudan University, Shanghai, People's Republic of China
| | - Alice Halim
- Shanghai Medical College, Fudan University, Shanghai, People's Republic of China
| | - Michael Halim
- Shanghai Medical College, Fudan University, Shanghai, People's Republic of China
| | - Hao Yao
- Shanghai Medical College, Fudan University, Shanghai, People's Republic of China
| | - Yiyun Cai
- Psychiatry Department of Huashan Hospital, Fudan University, Shanghai, People's Republic of China, .,Shanghai Mental Health Center, Shanghai, People's Republic of China,
| | - Shenxun Shi
- Psychiatry Department of Huashan Hospital, Fudan University, Shanghai, People's Republic of China, .,Shanghai Mental Health Center, Shanghai, People's Republic of China,
| |
Collapse
|
22
|
Damborská A, Tomescu MI, Honzírková E, Barteček R, Hořínková J, Fedorová S, Ondruš Š, Michel CM. EEG Resting-State Large-Scale Brain Network Dynamics Are Related to Depressive Symptoms. Front Psychiatry 2019; 10:548. [PMID: 31474881 PMCID: PMC6704975 DOI: 10.3389/fpsyt.2019.00548] [Citation(s) in RCA: 57] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2019] [Accepted: 07/15/2019] [Indexed: 01/01/2023] Open
Abstract
Background: The few previous studies on resting-state electroencephalography (EEG) microstates in depressive patients suggest altered temporal characteristics of microstates compared to those of healthy subjects. We tested whether resting-state microstate temporal characteristics could capture large-scale brain network dynamic activity relevant to depressive symptomatology. Methods: To evaluate a possible relationship between the resting-state large-scale brain network dynamics and depressive symptoms, we performed EEG microstate analysis in 19 patients with moderate to severe depression in bipolar affective disorder, depressive episode, and recurrent depressive disorder and in 19 healthy controls. Results: Microstate analysis revealed six classes of microstates (A-F) in global clustering across all subjects. There were no between-group differences in the temporal characteristics of microstates. In the patient group, higher depressive symptomatology on the Montgomery-Åsberg Depression Rating Scale correlated with higher occurrence of microstate A (Spearman's rank correlation, r = 0.70, p < 0.01). Conclusion: Our results suggest that the observed interindividual differences in resting-state EEG microstate parameters could reflect altered large-scale brain network dynamics relevant to depressive symptomatology during depressive episodes. Replication in larger cohort is needed to assess the utility of the microstate analysis approach in an objective depression assessment at the individual level.
Collapse
Affiliation(s)
- Alena Damborská
- Department of Basic Neurosciences, Campus Biotech, University of Geneva, Geneva, Switzerland.,Department of Psychiatry, Faculty of Medicine, Masaryk University and University Hospital Brno, Brno, Czechia
| | - Miralena I Tomescu
- Department of Basic Neurosciences, Campus Biotech, University of Geneva, Geneva, Switzerland
| | - Eliška Honzírková
- Department of Psychiatry, Faculty of Medicine, Masaryk University and University Hospital Brno, Brno, Czechia
| | - Richard Barteček
- Department of Psychiatry, Faculty of Medicine, Masaryk University and University Hospital Brno, Brno, Czechia
| | - Jana Hořínková
- Department of Psychiatry, Faculty of Medicine, Masaryk University and University Hospital Brno, Brno, Czechia
| | - Sylvie Fedorová
- Department of Psychiatry, Faculty of Medicine, Masaryk University and University Hospital Brno, Brno, Czechia
| | - Šimon Ondruš
- Department of Psychiatry, Faculty of Medicine, Masaryk University and University Hospital Brno, Brno, Czechia
| | - Christoph M Michel
- Department of Basic Neurosciences, Campus Biotech, University of Geneva, Geneva, Switzerland.,Lemanic Biomedical Imaging Centre (CIBM), Geneva, Switzerland
| |
Collapse
|
23
|
Falkai P, Schmitt A, Koutsouleris N. Impaired recovery in affective disorders and schizophrenia: sharing a common pathophysiology? Eur Arch Psychiatry Clin Neurosci 2018; 268:739-740. [PMID: 30374704 DOI: 10.1007/s00406-018-0951-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Peter Falkai
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Andrea Schmitt
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany.
| | - Nikolaos Koutsouleris
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| |
Collapse
|