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Jomova K, Raptova R, Alomar SY, Alwasel SH, Nepovimova E, Kuca K, Valko M. Reactive oxygen species, toxicity, oxidative stress, and antioxidants: chronic diseases and aging. Arch Toxicol 2023; 97:2499-2574. [PMID: 37597078 PMCID: PMC10475008 DOI: 10.1007/s00204-023-03562-9] [Citation(s) in RCA: 208] [Impact Index Per Article: 208.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Accepted: 07/24/2023] [Indexed: 08/21/2023]
Abstract
A physiological level of oxygen/nitrogen free radicals and non-radical reactive species (collectively known as ROS/RNS) is termed oxidative eustress or "good stress" and is characterized by low to mild levels of oxidants involved in the regulation of various biochemical transformations such as carboxylation, hydroxylation, peroxidation, or modulation of signal transduction pathways such as Nuclear factor-κB (NF-κB), Mitogen-activated protein kinase (MAPK) cascade, phosphoinositide-3-kinase, nuclear factor erythroid 2-related factor 2 (Nrf2) and other processes. Increased levels of ROS/RNS, generated from both endogenous (mitochondria, NADPH oxidases) and/or exogenous sources (radiation, certain drugs, foods, cigarette smoking, pollution) result in a harmful condition termed oxidative stress ("bad stress"). Although it is widely accepted, that many chronic diseases are multifactorial in origin, they share oxidative stress as a common denominator. Here we review the importance of oxidative stress and the mechanisms through which oxidative stress contributes to the pathological states of an organism. Attention is focused on the chemistry of ROS and RNS (e.g. superoxide radical, hydrogen peroxide, hydroxyl radicals, peroxyl radicals, nitric oxide, peroxynitrite), and their role in oxidative damage of DNA, proteins, and membrane lipids. Quantitative and qualitative assessment of oxidative stress biomarkers is also discussed. Oxidative stress contributes to the pathology of cancer, cardiovascular diseases, diabetes, neurological disorders (Alzheimer's and Parkinson's diseases, Down syndrome), psychiatric diseases (depression, schizophrenia, bipolar disorder), renal disease, lung disease (chronic pulmonary obstruction, lung cancer), and aging. The concerted action of antioxidants to ameliorate the harmful effect of oxidative stress is achieved by antioxidant enzymes (Superoxide dismutases-SODs, catalase, glutathione peroxidase-GPx), and small molecular weight antioxidants (vitamins C and E, flavonoids, carotenoids, melatonin, ergothioneine, and others). Perhaps one of the most effective low molecular weight antioxidants is vitamin E, the first line of defense against the peroxidation of lipids. A promising approach appears to be the use of certain antioxidants (e.g. flavonoids), showing weak prooxidant properties that may boost cellular antioxidant systems and thus act as preventive anticancer agents. Redox metal-based enzyme mimetic compounds as potential pharmaceutical interventions and sirtuins as promising therapeutic targets for age-related diseases and anti-aging strategies are discussed.
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Affiliation(s)
- Klaudia Jomova
- Department of Chemistry, Faculty of Natural Sciences, Constantine the Philosopher University in Nitra, Nitra, 949 74, Slovakia
| | - Renata Raptova
- Faculty of Chemical and Food Technology, Slovak University of Technology, Bratislava, 812 37, Slovakia
| | - Suliman Y Alomar
- Zoology Department, College of Science, King Saud University, 11451, Riyadh, Saudi Arabia
| | - Saleh H Alwasel
- Zoology Department, College of Science, King Saud University, 11451, Riyadh, Saudi Arabia
| | - Eugenie Nepovimova
- Department of Chemistry, Faculty of Sciences, University of Hradec Kralove, 50005, Hradec Kralove, Czech Republic
| | - Kamil Kuca
- Department of Chemistry, Faculty of Sciences, University of Hradec Kralove, 50005, Hradec Kralove, Czech Republic
| | - Marian Valko
- Faculty of Chemical and Food Technology, Slovak University of Technology, Bratislava, 812 37, Slovakia.
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Maruani J, Molière F, Godin O, Yrondi A, Bennabi D, Richieri R, El-Hage W, Allauze E, Anguill L, Bouvard A, Camus V, Dorey JM, Etain B, Fond G, Genty JB, Haffen E, Holtzmann J, Horn M, Kazour F, Nguon AS, Petrucci J, Rey R, Stephan F, Vaiva G, Walter M, Lejoyeux M, Leboyer M, Llorca PM, Courtet P, Aouizerate B, Geoffroy PA. Diurnal symptoms of sleepiness and dysfunction predict future suicidal ideation in a French cohort of outpatients (FACE-DR) with treatment resistant depression: A 1-year prospective study about sleep markers. J Affect Disord 2023; 329:369-378. [PMID: 36842655 DOI: 10.1016/j.jad.2023.02.106] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 02/19/2023] [Accepted: 02/20/2023] [Indexed: 02/26/2023]
Abstract
BACKGROUND Patients suffering from treatment-resistant depression (TRD) are at risk of suicide. Sleep and circadian rhythm alterations are widely recognized as core symptoms of major depressive disorder and are associated with suicidal ideation. Thus, sleep and circadian rhythm alterations may be targeted to prevent suicide. METHODS Patients were recruited from a prospective cohort of the French network of TRD expert centers. Mood, sleep and circadian rhythms were assessed at baseline; suicidal risk was assessed both at baseline and during a one-year follow-up with standardized subjective questionnaires. RESULTS Excessive daytime sleepiness (adjusted odds ratio aOR = 1.7(1-3.3), p = 0.04) and daytime dysfunction (aOR = 1.81(1.16-2.81), p = 0.0085) increased the risk of suicidal thoughts over the one-year follow-up period in patients with TRD after adjustment on age, gender, depression, trauma, anxiety, impulsivity, current daily tobacco smoking and body mass index. Hypnotics intake is associated with a reduced risk of suicidal ideation at one-year follow-up after the same adjustments (OR = 0.73(0.56-0.95), p = 0.019). Other associations between sleep quality or circadian rhythms and suicidal ideations at either baseline or one year did not remain significant in multivariate analyses after the same adjustments. LIMITATIONS Sleep assessments were based on self-reported questionnaires rather than objective measures. CONCLUSIONS Daytime sleepiness and dysfunction are predictors of suicidal ideations, whereas hypnotics intake is associated with a reduced risk of suicidal ideations. Diurnal symptoms of sleep disturbances are therefore red flags to target for preventing suicide in depressed patients, and hypnotics seem efficient in preventing suicide for patients with TRD.
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Affiliation(s)
- Julia Maruani
- Fondation FondaMental, Creteil, France; Département de psychiatrie et d'addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hôpital Bichat - Claude Bernard, F-75018 Paris, France; Université de Paris, NeuroDiderot, Inserm, FHU I2-D2, F-75019 Paris, France.
| | - Fanny Molière
- Fondation FondaMental, Creteil, France; Department of Emergency Psychiatry and Acute Care, CHU Montpellier, INSERM U1061, Montpellier University, Montpellier, France
| | - Ophelia Godin
- Fondation FondaMental, Creteil, France; INSERM, IMRB, Translational Neuropsychiatry, Fondation FondaMental, 94000 Créteil, France
| | - Antoine Yrondi
- Fondation FondaMental, Creteil, France; Service de Psychiatrie et de Psychologie Médicale de l'adulte (Department of Psychiatry and Adult Medical Psychology), Centre Expert Dépression Résistante FondaMental (FondaMental Advanced Centre of Expertise in Resistant Depression, CHU de Toulouse (University Hospital Centre), Hôpital Purpan, ToNIC Toulouse NeuroImaging Centre, Université de Toulouse (Toulouse University), INSERM, UPS, Toulouse, France
| | - Djamila Bennabi
- Fondation FondaMental, Creteil, France; Service de Psychiatrie, Centre Expert Dépression Résistante FondaMental, CIC-1431 INSERM, CHU de Besançon, Laboratoire de Recherches Intégratives en Neurosciences et Psychologie Cognitive UR-LINC 481, Neurosciences, Université de Bourgogne Franche Comté, Besançon, France
| | - Raphaelle Richieri
- Fondation FondaMental, Creteil, France; Aix Marseille Univ, CNRS, Centrale Marseille, Institut Fresnel, Marseille, France
| | - Wissan El-Hage
- Fondation FondaMental, Creteil, France; CHRU de Tours, UMR 1253, iBrain, Université de Tours, Inserm, Tours, France
| | - Etienne Allauze
- Fondation FondaMental, Creteil, France; Université Clermont Auvergne, CMP-B CHU, CNRS, Clermont Auvergne INP, Institut Pascal, F-63000 Clermont-Ferrand, France
| | - Loic Anguill
- Fondation FondaMental, Creteil, France; Service de Psychiatrie et de Psychologie Médicale de l'adulte (Department of Psychiatry and Adult Medical Psychology), Centre Expert Dépression Résistante FondaMental (FondaMental Advanced Centre of Expertise in Resistant Depression, CHU de Toulouse (University Hospital Centre), Hôpital Purpan, ToNIC Toulouse NeuroImaging Centre, Université de Toulouse (Toulouse University), INSERM, UPS, Toulouse, France
| | - Alexandra Bouvard
- Fondation FondaMental, Creteil, France; Pôle de Psychiatrie Générale et Universitaire (Department of General and University Academic Psychiatry Cluster), Centre de référence régional des pathologies anxieuses et de la dépression (Regional reference center for the management and treatment of anxiety and depressive disorders), Centre Expert Dépression Résistante FondaMental (FondaMental Advan-ced Centre of Expertise in Resistant Depression), CH Charles Perrens, Bordeaux, Laboratoire Nutrition et Neurobiologie intégrée (Integrated Nutrition and Neurobiology Laboratory) (UMR INRAE 1286), Université de Bordeaux (Bordeaux University), France
| | - Vincent Camus
- Fondation FondaMental, Creteil, France; CHRU de Tours, UMR 1253, iBrain, Université de Tours, Inserm, Tours, France
| | - Jean-Michel Dorey
- Fondation FondaMental, Creteil, France; INSERM U1028; CNRS UMR5292; University Lyon 1; Lyon Neuroscience Research Centre; Psychiatric Disorders: from Resistance to Response ΨR2 Team; Centre Hospitalier Le Vinatier (Hospital Centre); F-69678, France
| | - Bruno Etain
- Fondation FondaMental, Creteil, France; Université Paris Cité et AP-HP.Nord, GHU Lariboisière-Fernand Widal, Département de Psychiatrie et de Médecine Addictologique et Fondation Fondamental, Paris, France
| | - Guillaume Fond
- Fondation FondaMental, Creteil, France; Aix-Marseille Univ, School of medicine - La Timone Medical Campus, EA 3279: Department of Epidemiology and Health Economics, Clinical Research Unit, Direction de la Recherche en Santé, 27 Boulevard Jean Moulin, 13005 Marseille, France
| | - Jean-Baptiste Genty
- Fondation FondaMental, Creteil, France; AP-HP, Hôpital Henri Mondor, Département Médico-Universitaire de Psychiatrie et d'Addictologie (DMU IMPACT), Fédération Hospitalo-Universitaire de Médecine de Précision (FHU ADAPT); Université Paris Est Créteil, INSERM U955, IMRB, Laboratoire Neuro-Psychiatrie translationnelle, Fondation FondaMental, F-94010 Créteil, France
| | - Emmanuel Haffen
- Fondation FondaMental, Creteil, France; Service de Psychiatrie, Centre Expert Dépression Résistante FondaMental, CIC-1431 INSERM, CHU de Besançon, Laboratoire de Recherches Intégratives en Neurosciences et Psychologie Cognitive UR-LINC 481, Neurosciences, Université de Bourgogne Franche Comté, Besançon, France
| | - Jérôme Holtzmann
- Fondation FondaMental, Creteil, France; Service Hospitalo-Universitaire de Psychiatrie, CHU Grenoble Alpes, Université Grenoble Alpes, Inserm, U1216, Grenoble Institut Neurosciences (Institute of Neurosciences), 38000 Grenoble, France
| | - Mathilde Horn
- Fondation FondaMental, Creteil, France; Service de Psychiatrie adulte (Department of Adult Psychiatry), Centre Expert Dépression Résistante FondaMental, CHRU de Lille, Hôpital Fontan 1, Lille, France
| | - François Kazour
- Fondation FondaMental, Creteil, France; CHRU de Tours, UMR 1253, iBrain, Université de Tours, Inserm, Tours, France
| | - Anne-Sophie Nguon
- Fondation FondaMental, Creteil, France; Service Hospitalo-Universitaire de Psychiatrie, CHU Grenoble Alpes, Université Grenoble Alpes, Inserm, U1216, Grenoble Institut Neurosciences (Institute of Neurosciences), 38000 Grenoble, France
| | - Jean Petrucci
- Fondation FondaMental, Creteil, France; AP-HP, Hôpital Henri Mondor, Département Médico-Universitaire de Psychiatrie et d'Addictologie (DMU IMPACT), Fédération Hospitalo-Universitaire de Médecine de Précision (FHU ADAPT); Université Paris Est Créteil, INSERM U955, IMRB, Laboratoire Neuro-Psychiatrie translationnelle, Fondation FondaMental, F-94010 Créteil, France
| | - Romain Rey
- Fondation FondaMental, Creteil, France; INSERM U1028; CNRS UMR5292; University Lyon 1; Lyon Neuroscience Research Centre; Psychiatric Disorders: from Resistance to Response ΨR2 Team; Centre Hospitalier Le Vinatier (Hospital Centre); F-69678, France
| | - Florian Stephan
- Fondation FondaMental, Creteil, France; Service Hospitalo-Universitaire de Psychiatrie Générale et de Réhabilitation Psycho Sociale 29G01 et 29G02 (University Hospital Department of General Psychiatry and Psychosocial Rehabilitation), Centre Expert Depression Résistante FondaMental, EA 7479, URCI, CHRU de Brest, Hôpital de Bohars, Brest, France
| | - Guillaume Vaiva
- Fondation FondaMental, Creteil, France; Service de Psychiatrie adulte (Department of Adult Psychiatry), Centre Expert Dépression Résistante FondaMental, CHRU de Lille, Hôpital Fontan 1, Lille, France; Centre National de Ressources et Résilience pour les psychotraumatismes (Cn2r Lille Paris), Lille, France
| | - Michel Walter
- Fondation FondaMental, Creteil, France; Service Hospitalo-Universitaire de Psychiatrie Générale et de Réhabilitation Psycho Sociale 29G01 et 29G02 (University Hospital Department of General Psychiatry and Psychosocial Rehabilitation), Centre Expert Depression Résistante FondaMental, EA 7479, URCI, CHRU de Brest, Hôpital de Bohars, Brest, France
| | | | - Michel Lejoyeux
- Département de psychiatrie et d'addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hôpital Bichat - Claude Bernard, F-75018 Paris, France; Université de Paris, NeuroDiderot, Inserm, FHU I2-D2, F-75019 Paris, France; GHU Paris, Psychiatry & Neurosciences, 1 rue Cabanis, 75014 Paris, France
| | - Marion Leboyer
- Fondation FondaMental, Creteil, France; AP-HP, Hôpital Henri Mondor, Département Médico-Universitaire de Psychiatrie et d'Addictologie (DMU IMPACT), Fédération Hospitalo-Universitaire de Médecine de Précision (FHU ADAPT); Université Paris Est Créteil, INSERM U955, IMRB, Laboratoire Neuro-Psychiatrie translationnelle, Fondation FondaMental, F-94010 Créteil, France
| | - Pierre-Michel Llorca
- Fondation FondaMental, Creteil, France; Université Clermont Auvergne, CMP-B CHU, CNRS, Clermont Auvergne INP, Institut Pascal, F-63000 Clermont-Ferrand, France
| | - Philippe Courtet
- Fondation FondaMental, Creteil, France; Department of Emergency Psychiatry and Acute Care, CHU Montpellier, INSERM U1061, Montpellier University, Montpellier, France
| | - Bruno Aouizerate
- Fondation FondaMental, Creteil, France; Pôle de Psychiatrie Générale et Universitaire (Department of General and University Academic Psychiatry Cluster), Centre de référence régional des pathologies anxieuses et de la dépression (Regional reference center for the management and treatment of anxiety and depressive disorders), Centre Expert Dépression Résistante FondaMental (FondaMental Advan-ced Centre of Expertise in Resistant Depression), CH Charles Perrens, Bordeaux, Laboratoire Nutrition et Neurobiologie intégrée (Integrated Nutrition and Neurobiology Laboratory) (UMR INRAE 1286), Université de Bordeaux (Bordeaux University), France
| | - Pierre A Geoffroy
- Fondation FondaMental, Creteil, France; Département de psychiatrie et d'addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hôpital Bichat - Claude Bernard, F-75018 Paris, France; Université de Paris, NeuroDiderot, Inserm, FHU I2-D2, F-75019 Paris, France; CNRS UPR 3212, Institute for Cellular and Integrative Neurosciences, 5 rue Blaise Pascal, 67000 Strasbourg, France; GHU Paris, Psychiatry & Neurosciences, 1 rue Cabanis, 75014 Paris, France.
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Geoffroy PA, Schroder CM, Bourgin P, Maruani J, Lejoyeux M, d'Ortho MP, Couffignal C. Validation of a data collection set for the psychiatric, addiction, sleep and chronobiological assessments of patients with depression: A Delphi study for the SoPsy-depression French national cohort. L'ENCEPHALE 2023; 49:117-123. [PMID: 36257850 DOI: 10.1016/j.encep.2022.07.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 07/08/2022] [Accepted: 07/15/2022] [Indexed: 11/05/2022]
Abstract
OBJECTIVES Despite international efforts to identify biomarkers of depression, none has been transferred to clinical practice, neither for diagnosis, evolution, nor therapeutic response. This led us to build a French national cohort (through the clinical and research network named SoPsy within the French biological psychiatry society (AFPBN) and sleep society (SFRMS)), to better identify markers of sleep and biological rhythms and validate more homogeneous subgroups of patients, but also to specify the manifestations and pathogeneses of depressive disorders. Before inclusions, we sought to provide a predefined, standardized, and robust set of data to be collected in all centers. METHODS A Delphi process was performed to achieve consensus through the independent rating of invited experts, the SoPsy-depression co-investigators (n=34). The initial set open for vote included 94 questionnaires targeting adult and child psychiatry, sleep and addiction. RESULTS Two questionnaire rounds were completed with 94% participation in the first round and 100% participation in the second round. The results of the Delphi survey incorporated the consensus opinion of the 32 members who completed both rounds. Nineteen of the 94 questionnaires achieved consensus at the first round and seventy of 75 at the second round. The five remaining questionnaires were submitted to three experts involved in the steering committee during a dedicated meeting. At the end, 24 questionnaires were retained in the mandatory and 26 in the optional questionnaire set. CONCLUSIONS A validated data collection set of questionnaires is now available to assess psychiatry, addiction, sleep and chronobiology dimensions of depressive disorders.
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Affiliation(s)
- P A Geoffroy
- Département de psychiatrie et d'addictologie, GHU Paris Nord, DMU neurosciences, hôpital Bichat - Claude Bernard, AP-HP, 75018 Paris, France; GHU Paris - psychiatry & neurosciences, 1, rue Cabanis, 75014 Paris, France; NeuroDiderot, Inserm, FHU I2-D2, université Paris Cité, 75019 Paris, France; CNRS UPR 3212, Institute for cellular and integrative neurosciences, 67000 Strasbourg, France.
| | - C M Schroder
- CNRS UPR 3212, Institute for cellular and integrative neurosciences, 67000 Strasbourg, France; Department of child and adolescent psychiatry, Strasbourg university and Strasbourg university hospitals, Strasbourg, France; Sleep disorders center & CIRCSom (International Research Center for ChronoSomnology), CHRU, Strasbourg, France
| | - P Bourgin
- CNRS UPR 3212, Institute for cellular and integrative neurosciences, 67000 Strasbourg, France; Sleep disorders center & CIRCSom (International Research Center for ChronoSomnology), CHRU, Strasbourg, France
| | - J Maruani
- Département de psychiatrie et d'addictologie, GHU Paris Nord, DMU neurosciences, hôpital Bichat - Claude Bernard, AP-HP, 75018 Paris, France; GHU Paris - psychiatry & neurosciences, 1, rue Cabanis, 75014 Paris, France; NeuroDiderot, Inserm, FHU I2-D2, université Paris Cité, 75019 Paris, France
| | - M Lejoyeux
- Département de psychiatrie et d'addictologie, GHU Paris Nord, DMU neurosciences, hôpital Bichat - Claude Bernard, AP-HP, 75018 Paris, France; GHU Paris - psychiatry & neurosciences, 1, rue Cabanis, 75014 Paris, France; NeuroDiderot, Inserm, FHU I2-D2, université Paris Cité, 75019 Paris, France
| | - M-P d'Ortho
- NeuroDiderot, Inserm, FHU I2-D2, université Paris Cité, 75019 Paris, France; Service de physiologie - explorations fonctionnelles, centre du sommeil, hôpital Bichat, AP-HP, 75018 Paris, France
| | - C Couffignal
- Département de biostatistique, épidémiologie et recherche clinique, Hôpital Bichat, université Paris Cité, AP-HP, 75018 Paris, France
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Insomnia, sleep loss, and circadian sleep disturbances in mood disorders: a pathway toward neurodegeneration and neuroprogression? A theoretical review. CNS Spectr 2022; 27:298-308. [PMID: 33427150 DOI: 10.1017/s1092852921000018] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
The present paper aims at reviewing and commenting on the relationships between sleep and circadian phasing alterations and neurodegenerative/neuroprogressive processes in mood disorder. We carried out a systematic review, according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, in PubMed, PsycINFO, and Embase electronic databases for literature related to mood disorders, sleep disturbances, and neurodegenerative/neuroprogressive processes in relation to (1) neuroinflammation, (2) activation of the stress system, (3) oxidative stress, (4) accumulation of neurotoxic proteins, and (5) neuroprotection deficit. Seventy articles were collectively selected and analyzed. Experimental and clinical studies revealed that insomnia, conditions of sleep loss, and altered circadian sleep may favor neurodegeneration and neuroprogression in mood disorders. These sleep disturbances may induce a state of chronic inflammation by enhancing neuroinflammation, both directly and indirectly, via microglia and astrocytes activation. They may act as neurobiological stressors that by over-activating the stress system may negatively influence neural plasticity causing neuronal damage. In addition, sleep disturbances may favor the accumulation of neurotoxic proteins, favor oxidative stress, and a deficit in neuroprotection hence contributing to neurodegeneration and neuroprogression. Targeting sleep disturbances in the clinical practice may hold a neuroprotective value for mood disorders.
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Dai W, Liu J, Qiu Y, Teng Z, Li S, Huang J, Xiang H, Tang H, Wang B, Chen J, Wu H. Shared postulations between bipolar disorder and polycystic ovary syndrome pathologies. Prog Neuropsychopharmacol Biol Psychiatry 2022; 115:110498. [PMID: 34929323 DOI: 10.1016/j.pnpbp.2021.110498] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 12/06/2021] [Accepted: 12/12/2021] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Women with bipolar disorder (BD) present a high prevalence of polycystic ovary syndrome (PCOS) and other reproductive disorders even before diagnosis or treatment of the disease. Postulations on the potential molecular mechanisms of comorbid PCOS in women with BD remain limited to influence of medications and need further extension. OBJECTIVES This review focuses on evidence suggesting that common metabolic and immune disorders may play an important role in the development of BD and PCOS. RESULTS The literature covered in this review suggests that metabolic and immune disorders, including the dysfunction of the hypothalamic-pituitary-adrenal axis, chronic inflammatory state, gut microbial alterations, adipokine alterations and circadian rhythm disturbance, are observed in patients with BD and PCOS. Such disorders may be responsible for the increased prevalence of PCOS in the BD population and indicate a susceptibility gene overlap between the two diseases. Current evidence supports postulations of common metabolic and immune disorders as endophenotype in BD as well as in PCOS. CONCLUSIONS Metabolic and immune disorders may be responsible for the comorbid PCOS in the BD population. The identification of hallmark metabolic and immune features common to these two diseases will contribute to the clarification of the effect of BD on the reproductive endocrine function and development of symptomatic treatments targeting the biomarkers of the two diseases.
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Affiliation(s)
- Wenyu Dai
- National Clinical Research Center for Mental Disorders, Department of Psychiatry, China National Technology Institute on Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Jieyu Liu
- Department of Ultrasound Diagnostic, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Yan Qiu
- National Clinical Research Center for Mental Disorders, Department of Psychiatry, China National Technology Institute on Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Ziwei Teng
- National Clinical Research Center for Mental Disorders, Department of Psychiatry, China National Technology Institute on Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Sujuan Li
- National Clinical Research Center for Mental Disorders, Department of Psychiatry, China National Technology Institute on Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Jing Huang
- National Clinical Research Center for Mental Disorders, Department of Psychiatry, China National Technology Institute on Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Hui Xiang
- National Clinical Research Center for Mental Disorders, Department of Psychiatry, China National Technology Institute on Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Hui Tang
- National Clinical Research Center for Mental Disorders, Department of Psychiatry, China National Technology Institute on Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Bolun Wang
- Department of Radiology, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Jindong Chen
- National Clinical Research Center for Mental Disorders, Department of Psychiatry, China National Technology Institute on Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China.
| | - Haishan Wu
- National Clinical Research Center for Mental Disorders, Department of Psychiatry, China National Technology Institute on Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China.
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Palagini L, Geoffroy PA, Riemann D. Sleep markers in psychiatry: do insomnia and disturbed sleep play as markers of disrupted neuroplasticity in mood disorders? A proposed model. Curr Med Chem 2021; 29:5595-5605. [PMID: 34906053 DOI: 10.2174/0929867328666211214164907] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 08/31/2021] [Accepted: 09/05/2021] [Indexed: 11/22/2022]
Abstract
INTRODUCTION Since insomnia and disturbed sleep may affect neuroplasticity, we aimed at reviewing their potential role as markers of disrupted neuroplasticity involved in mood disorders. METHOD We performed a systematic review, according to PRIMA, on PubMed, PsycINFO and Embase electronic databases for literature regarding mood disorders, insomnia, sleep loss/deprivation in relation to different pathways involved in the impairment of neuroplasticity in mood disorders such as 1] alterations in neurodevelopment 2] activation of the stress system 3] neuroinflammation 4] neurodegeneration/neuroprogression, 4] deficit in neuroprotection. RESULTS Sixty-five articles were analyzed and a narrative/ theoretical review was conducted. Studies showed that insomnia, sleep loss and sleep deprivation might impair brain plasticity of those areas involved in mood regulation throughout different pathways. Insomnia and disrupted sleep may act as neurobiological stressors that by over-activating the stress and inflammatory systems may affect neural plasticity causing neuronal damage. In addition, disturbed sleep may favor a deficit in neuroprotection hence contributing to impaired neuroplasticity. CONCLUSIONS Insomnia and disturbed sleep may play a role as markers of alteration in brain plasticity in mood disorders. Assessing and targeting insomnia in the clinical practice may potentially play a neuroprotective role, contributing to "repairing" alterations in neuroplasticity or to the functional recovery of those areas involved in mood and emotion regulation.
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Affiliation(s)
- Laura Palagini
- Department of Experimental and Clinic Medicine, Section of Psychiatry, University of Pisa, Via Roma 67, 56100, Pisa. Italy
| | - Pierre Alexis Geoffroy
- Département de psychiatrie et d'addictologie, AP-HP, Hopital Bichat - Claude Bernard, F-75018 Paris, France; Université de Paris, NeuroDiderot, Inserm U1141, F-75019 Paris. France
| | - Dieter Riemann
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg. Germany
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Mady N, Linnaranta O, Demchenko I, Carboni-Jiménez A, Maduro A, Tounkara F, Sapkota RP, Brunet A. Actigraphic patterns, impulsivity, and mood instability in bipolar disorder, borderline personality disorder, and healthy controls. Acta Psychiatr Scand 2020; 142:154-155. [PMID: 32623718 DOI: 10.1111/acps.13207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 06/19/2020] [Accepted: 06/25/2020] [Indexed: 11/28/2022]
Affiliation(s)
- N Mady
- Psychiatry, McGill University Faculty of Medicine, Montreal, QC, Canada
| | - O Linnaranta
- Psychiatry, McGill University Faculty of Medicine, Montreal, QC, Canada
| | - I Demchenko
- Integrated Program in Neuroscience, McGill University, Montreal, QC, Canada
| | - A Carboni-Jiménez
- Psychiatry, McGill University Faculty of Medicine, Montreal, QC, Canada
| | - A Maduro
- Psychiatry, McGill University Faculty of Medicine, Montreal, QC, Canada
| | - F Tounkara
- Integrated Program in Neuroscience, McGill University, Montreal, QC, Canada
| | - R P Sapkota
- Psychiatry, McGill University Faculty of Medicine, Montreal, QC, Canada
| | - A Brunet
- Psychiatry, McGill University Faculty of Medicine, Montreal, QC, Canada.,Psychosocial Division, Douglas Mental Health University Institute, Montreal, QC, Canada
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8
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Palagini L, Manni R, Aguglia E, Amore M, Brugnoli R, Girardi P, Grassi L, Mencacci C, Plazzi G, Minervino A, Nobili L, Biggio G. Expert Opinions and Consensus Recommendations for the Evaluation and Management of Insomnia in Clinical Practice: Joint Statements of Five Italian Scientific Societies. Front Psychiatry 2020; 11:558. [PMID: 32670104 PMCID: PMC7332855 DOI: 10.3389/fpsyt.2020.00558] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Accepted: 06/01/2020] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Insomnia is the most commonly reported sleep problem in industrialized countries worldwide being present in about 36.8% of the general population. In Italy, such a percentage seems to be even higher. Although insomnia can be an independent disorder, it is most frequently observed as a comorbid condition and may precipitate, exacerbate, or prolong a broad range of comorbid conditions including physical and mental illnesses. Evaluating and targeting insomnia in the Italian clinical practice should be a priority. METHODS The present expert options and recommendations development process was based on the RAND/UCLA Appropriateness Method for conceptualizing, designing, and carrying out the appropriateness of procedures for the diagnosis and treatment. Only available options in Italy were taken into considerations. RESULTS We evaluated 12 international guidelines and 12 most recent systematic reviews for insomnia evaluation and treatment produced in the last 10 years. CONCLUSIONS Our findings suggested that symptoms of insomnia must always be assessed in the Italian clinical practice by evaluating nocturnal and daytime symptoms, comorbid conditions and lifestyle. In a patient with chronic insomnia with and without comorbidity, insomnia treatment should be always initiated. CBT-Insomnia therapy should be the first option accordingly to availability. The choice of the drug should be based on different factors such as type of insomnia, age, comorbidities, and potential side effects. Melatonin 2 mg prolonged release should be the first choice in subjects >55 years. If the choice would be a Z-drug or a short-acting benzodiazepine (in subjects <65 years old) or a sedating antidepressant, the use should be in the short term (≤4 weeks) and then proceeds to tapering under clinical monitoring.
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Affiliation(s)
- Laura Palagini
- Psychiatry Division, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Raffaele Manni
- Unit of Sleep Medicine and Epilepsy, IRCCS Mondino Foundation Pavia, Pavia, Italy
| | - Eugenio Aguglia
- Department of Experimental and Clinical Medicine, Psychiatric Clinic University Hospital “Gaspare Rodolico”, University of Catania, Catania, Italy
| | - Mario Amore
- Section of Psychiatry, Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Roberto Brugnoli
- Department of Neuroscience, Mental Health, and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Sant'Andrea University Hospital, Sapienza University, Rome, Italy
| | - Paolo Girardi
- Department of Neuroscience, Mental Health, and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Sant'Andrea University Hospital, Sapienza University, Rome, Italy
| | - Luigi Grassi
- Department of Biomedical and Specialty Surgical Sciences, Institute of Psychiatry, University of Ferrara, Ferrara, Italy
| | - Claudio Mencacci
- Department of Neuroscience, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Giuseppe Plazzi
- Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | | | - Lino Nobili
- Department of Neuroscience (DINOGMI), University of Genoa, Genoa, Italy
- Child Neuropsychiatry, IRCCS Istituto G. Gaslini, Genoa, Italy
| | - Giovanni Biggio
- Department of Life and Environmental Sciences, University of Cagliari, Cagliari, Italy
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9
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Oliveira MAB, Epifano K, Mathur S, Carvalho FG, Scop M, Carissimi A, Francisco AP, Garay LLS, Adan A, Hidalgo MP, Frey BN. Validation of the English version of the Mood Rhythm Instrument. BMC Psychol 2020; 8:35. [PMID: 32303262 PMCID: PMC7165411 DOI: 10.1186/s40359-020-00397-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Accepted: 03/23/2020] [Indexed: 12/27/2022] Open
Abstract
Background Disruption of biological rhythms has been linked to the pathophysiology of mental disorders. However, little is known regarding the rhythmicity of mood symptoms due to the lack of validated clinical questionnaires. A better understanding of the rhythmicity of mood symptoms can help identifying individuals whose severity of mood symptoms follows an altered circadian rhythm. The objective of this study was to validate the English version of the Mood Rhythm Instrument (MRhI), a self-reported measure of self-perceived rhythmicity of mood symptoms and behaviours, in a sample of the general population from Canada. Methods After the translation process, the final English version of the Mood Rhythm Instrument (MRhI-English) was applied on participants recruited at McMaster University and St. Joseph’s Healthcare Hamilton campuses. Individuals were also asked to answer the Reduced Morningness-Eveningness Questionnaire (rMEQ). Results Four hundred one individuals completed the English version of the MRhI and the rMEQ. The MRhI-English presented a Cronbach’s alpha of 0.75. The factorial analysis grouped the MRhI-15 items in 3 factors (cognitive, affective and somatic), with affective items having a lower frequency of self-reported 24-h peaks. Comparison between sexes showed that women reported a higher frequency of daily peaks in irritability, anxiety, sadness and talking to friends, while men exhibited peaks more frequently in problem-solving, sexual arousal and motivation to exercise. Conclusions Our findings suggest that the English version of the MRhI displayed good internal consistency. Future directions will include the use of the MRhI instrument in individuals with mood disorders, aiming to provide a better understanding of the relationship between daily patterns of mood variability and mental health outcomes.
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Affiliation(s)
- Melissa A B Oliveira
- Laboratório de Cronobiologia e Sono do Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil.,Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento - Faculdade de Medicina, UFRGS, Porto Alegre, Rio Grande do Sul, Brazil
| | - Kristina Epifano
- Department of Psychology, Neuroscience & Behaviour, McMaster University, Hamilton, ON, Canada
| | - Salina Mathur
- Department of Psychology, Neuroscience & Behaviour, McMaster University, Hamilton, ON, Canada
| | - Felipe Gutiérrez Carvalho
- Laboratório de Cronobiologia e Sono do Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil.,Mood Disorders Program and Women's Health Concerns Clinic, St. Joseph's Healthcare, Hamilton, ON, Canada
| | - Marina Scop
- Laboratório de Cronobiologia e Sono do Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil
| | - Alicia Carissimi
- Laboratório de Cronobiologia e Sono do Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil.,Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento - Faculdade de Medicina, UFRGS, Porto Alegre, Rio Grande do Sul, Brazil
| | - Ana Paula Francisco
- Laboratório de Cronobiologia e Sono do Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil
| | - Luciene L S Garay
- Laboratório de Cronobiologia e Sono do Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil
| | - Ana Adan
- Department of Clinical Psychology and Psychobiology, School of Psychology, University of Barcelona, Barcelona, Spain.,Institute of Neurosciences, University of Barcelona, Barcelona, Spain
| | - Maria Paz Hidalgo
- Laboratório de Cronobiologia e Sono do Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil.,Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento - Faculdade de Medicina, UFRGS, Porto Alegre, Rio Grande do Sul, Brazil
| | - Benicio N Frey
- Mood Disorders Program and Women's Health Concerns Clinic, St. Joseph's Healthcare, Hamilton, ON, Canada. .,Department of Psychiatry and Behavioural Neurosciences, McMaster University, 100 West 5th Street, Suite C124, Hamilton, ON, L8N 3K7, Canada.
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10
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Morton E, Murray G. Assessment and treatment of sleep problems in bipolar disorder—A guide for psychologists and clinically focused review. Clin Psychol Psychother 2020; 27:364-377. [DOI: 10.1002/cpp.2433] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Revised: 01/21/2020] [Accepted: 02/04/2020] [Indexed: 12/21/2022]
Affiliation(s)
- Emma Morton
- Department of Psychiatry, Faculty of MedicineUniversity of British Columbia Vancouver British Columbia Canada
- Centre for Mental Health, Faculty of Health, Arts and DesignSwinburne University of Technology Melbourne Victoria Australia
| | - Greg Murray
- Centre for Mental Health, Faculty of Health, Arts and DesignSwinburne University of Technology Melbourne Victoria Australia
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11
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Steardo L, de Filippis R, Carbone EA, Segura-Garcia C, Verkhratsky A, De Fazio P. Sleep Disturbance in Bipolar Disorder: Neuroglia and Circadian Rhythms. Front Psychiatry 2019; 10:501. [PMID: 31379620 PMCID: PMC6656854 DOI: 10.3389/fpsyt.2019.00501] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Accepted: 06/25/2019] [Indexed: 12/22/2022] Open
Abstract
The worldwide prevalence of sleep disorders is approximately 50%, with an even higher occurrence in a psychiatric population. Bipolar disorder (BD) is a severe mental illness characterized by shifts in mood and activity. The BD syndrome also involves heterogeneous symptomatology, including cognitive dysfunctions and impairments of the autonomic nervous system. Sleep abnormalities are frequently associated with BD and are often a good predictor of a mood swing. Preservation of stable sleep-wake cycles is therefore a key to the maintenance of stability in BD, indicating the crucial role of circadian rhythms in this syndrome. The symptom most widespread in BD is insomnia, followed by excessive daytime sleepiness, nightmares, difficulty falling asleep or maintaining sleep, poor sleep quality, sleep talking, sleep walking, and obstructive sleep apnea. Alterations in the structure or duration of sleep are reported in all phases of BD. Understanding the role of neuroglia in BD and in various aspects of sleep is in nascent state. Contributions of the different types of glial cells to BD and sleep abnormalities are discussed in this paper.
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Affiliation(s)
- Luca Steardo
- Psychiatric Unit, Department of Health Sciences, University Magna Graecia, Catanzaro, Italy
| | - Renato de Filippis
- Psychiatric Unit, Department of Health Sciences, University Magna Graecia, Catanzaro, Italy
| | - Elvira Anna Carbone
- Psychiatric Unit, Department of Health Sciences, University Magna Graecia, Catanzaro, Italy
| | - Cristina Segura-Garcia
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Alexei Verkhratsky
- Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
- Achucarro Center for Neuroscience, IKERBASQUE, Bilbao, Spain
| | - Pasquale De Fazio
- Psychiatric Unit, Department of Health Sciences, University Magna Graecia, Catanzaro, Italy
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12
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Fekih‐Romdhane F, Jendoubi J, Saguem BN, Ridha R, Cheour M. The link between sleep disturbances and suicidal thoughts and behaviors in remitted bipolar I patients. J Clin Psychol 2019; 75:1643-1657. [DOI: 10.1002/jclp.22793] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Revised: 03/20/2019] [Accepted: 04/01/2019] [Indexed: 11/09/2022]
Affiliation(s)
- Feten Fekih‐Romdhane
- Faculty of Medicine of TunisTunis El Manar University Tunisia
- Psychiatry Department "E"Razi HospitalMannouba Tunisia
| | - Jihen Jendoubi
- Faculty of Medicine of TunisTunis El Manar University Tunisia
- Psychiatry Department "E"Razi HospitalMannouba Tunisia
| | - Bochra Nourhène Saguem
- Faculty of Medicine of TunisTunis El Manar University Tunisia
- Psychiatry Department "E"Razi HospitalMannouba Tunisia
| | - Rym Ridha
- Faculty of Medicine of TunisTunis El Manar University Tunisia
- Psychiatry Department "E"Razi HospitalMannouba Tunisia
| | - Majda Cheour
- Faculty of Medicine of TunisTunis El Manar University Tunisia
- Psychiatry Department "E"Razi HospitalMannouba Tunisia
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13
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Palagini L, Bastien CH, Marazziti D, Ellis JG, Riemann D. The key role of insomnia and sleep loss in the dysregulation of multiple systems involved in mood disorders: A proposed model. J Sleep Res 2019; 28:e12841. [DOI: 10.1111/jsr.12841] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Revised: 09/20/2018] [Accepted: 02/12/2019] [Indexed: 12/18/2022]
Affiliation(s)
- Laura Palagini
- Department of Clinical and Experimental Medicine Psychiatric Unit University of Pisa Pisa Italy
| | | | - Donatella Marazziti
- Department of Clinical and Experimental Medicine Psychiatric Unit University of Pisa Pisa Italy
| | - Jason G. Ellis
- Northumbria Sleep Research Laboratory Northumbria University Newcastle‐upon‐Tyne UK
| | - Dieter Riemann
- Department of Clinical Psychology and Psychophysiology/Sleep Medicine Center for Mental Disorders University of Freiburg Freiburg Germany
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14
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Palagini L, Cipollone G, Masci I, Caruso D, Paolilli F, Perugi G, Riemann D. Insomnia symptoms predict emotional dysregulation, impulsivity and suicidality in depressive bipolar II patients with mixed features. Compr Psychiatry 2019; 89:46-51. [PMID: 30593973 DOI: 10.1016/j.comppsych.2018.12.009] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Revised: 11/30/2018] [Accepted: 12/15/2018] [Indexed: 01/06/2023] Open
Abstract
INTRODUCTION Insomnia symptoms are very common in Bipolar Disorder. Our aim was to assess the potential association between insomnia, emotion dysregulation and suicidality in subjects with Bipolar Disorder. METHODS Seventy-seven subjects with Bipolar Disorder type II with a depressive episode with mixed features were recruited. Patients were assessed with SCID-DSM-5, the Insomnia Severity Index (ISI), the Difficulties in Emotion Regulation Scale (DERS), the Scale for Suicide Ideation (SSI) while evaluating manic and depressive symptoms. RESULTS Subjects with insomnia symptoms compared to those without showed higher scores in the DERS scale and subscales, including impulsivity, and in the SSI scale. Insomnia symptoms significantly predicted the severity of depressive symptoms, emotion dysregulation, and suicidality in subjects with bipolar disorder. In particular, insomnia was related to difficulties in some areas of emotion regulation including impulsivity. Emotion dysregulation significantly mediated the association between insomnia and depressive symptoms (Z = 2.9, p = 0.004). Furthermore, emotional impulsivity mediated the association between insomnia symptoms and suicidality (Z = 2.2, p = 0.03). CONCLUSION In our study, subjects with bipolar disorder suffering from insomnia experienced a greater severity of depressive symptoms and suicidality compared to subjects without insomnia. Insomnia was associated with emotion dysregulation, impulsivity and suicidality. Further research is necessary to investigate if these latter features may benefit from early insomnia treatment in subjects with bipolar disorder.
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Affiliation(s)
- Laura Palagini
- Department of Clinical and Experimental Medicine, Psychiatric Section, University of Pisa, Azienda Ospedaliera Universitaria Pisana (AOUP), Pisa, Italy.
| | - Giada Cipollone
- Department of Clinical and Experimental Medicine, Psychiatric Section, University of Pisa, Azienda Ospedaliera Universitaria Pisana (AOUP), Pisa, Italy
| | - Isabella Masci
- Department of Clinical and Experimental Medicine, Psychiatric Section, University of Pisa, Azienda Ospedaliera Universitaria Pisana (AOUP), Pisa, Italy
| | - Danila Caruso
- Department of Clinical and Experimental Medicine, Psychiatric Section, University of Pisa, Azienda Ospedaliera Universitaria Pisana (AOUP), Pisa, Italy
| | - Francescoluigi Paolilli
- Department of Clinical and Experimental Medicine, Psychiatric Section, University of Pisa, Azienda Ospedaliera Universitaria Pisana (AOUP), Pisa, Italy
| | - Giulio Perugi
- Department of Clinical and Experimental Medicine, Psychiatric Section, University of Pisa, Azienda Ospedaliera Universitaria Pisana (AOUP), Pisa, Italy
| | - Dieter Riemann
- Department of Clinical Psychology and Psychophysiology/ Sleep Medicine, Center for Mental Disorders, University of Freiburg, Freiburg, Germany
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15
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Oliveira T, Marinho V, Carvalho V, Magalhães F, Rocha K, Ayres C, Teixeira S, Nunes M, Bastos VH, Pinto GR. Genetic polymorphisms associated with circadian rhythm dysregulation provide new perspectives on bipolar disorder. Bipolar Disord 2018; 20:515-522. [PMID: 29441659 DOI: 10.1111/bdi.12624] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Revised: 10/24/2017] [Accepted: 01/07/2018] [Indexed: 12/31/2022]
Abstract
OBJECTIVES The objective of this study was to present a broad view of how genetic polymorphisms in genes that control the rhythmicity and function of circadian rhythm may influence the etiology, pathophysiology and treatment of bipolar disorder (BD). METHODS A bibliographic search was performed to identify and select papers reporting studies on variations in circadian genes and BD. A search of Medline, Google Scholar, Scopus, and Web of Science was carried out to review the literature. RESULTS Several studies provide evidence of contributions of variations in circadian genes to disease etiology, pathophysiological variations and lithium drug response. Dysfunction of the sleep-wake cycle, an important brain function regulator, is indicated as the primary means by which circadian gene variations act in mood disorders. CONCLUSIONS Investigations of the effects of circadian genes have suggested that the chronotype offers hope for guiding and improving management of patients with BD. However, BD is a disease of a complex nature and presents multiple endophenotypes determined by different associations between genetics and the environment. Thus, new genomic studies to delimit variations that may help improve the clinical condition of these patients are extremely important.
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Affiliation(s)
- Thomaz Oliveira
- Brain Mapping and Plasticity Laboratory, Federal University of Piauí, Parnaíba, Brazil
- Genetics and Molecular Biology Laboratory, Federal University of Piauí, Parnaíba, Brazil
| | - Victor Marinho
- Brain Mapping and Plasticity Laboratory, Federal University of Piauí, Parnaíba, Brazil
- Genetics and Molecular Biology Laboratory, Federal University of Piauí, Parnaíba, Brazil
- The Northeast Biotechnology Network (RENORBIO), Federal University of Piauí, Teresina, Brazil
| | - Valécia Carvalho
- Brain Mapping and Plasticity Laboratory, Federal University of Piauí, Parnaíba, Brazil
- The Northeast Biotechnology Network (RENORBIO), Federal University of Piauí, Teresina, Brazil
| | - Francisco Magalhães
- Brain Mapping and Plasticity Laboratory, Federal University of Piauí, Parnaíba, Brazil
- The Northeast Biotechnology Network (RENORBIO), Federal University of Piauí, Teresina, Brazil
| | - Kaline Rocha
- Brain Mapping and Plasticity Laboratory, Federal University of Piauí, Parnaíba, Brazil
- The Northeast Biotechnology Network (RENORBIO), Federal University of Piauí, Teresina, Brazil
| | - Carla Ayres
- Brain Mapping and Plasticity Laboratory, Federal University of Piauí, Parnaíba, Brazil
| | - Silmar Teixeira
- Brain Mapping and Plasticity Laboratory, Federal University of Piauí, Parnaíba, Brazil
- The Northeast Biotechnology Network (RENORBIO), Federal University of Piauí, Teresina, Brazil
| | - Monara Nunes
- Brain Mapping and Functionality Laboratory, Federal University of Piauí, Parnaíba, Brazil
| | - Victor Hugo Bastos
- Brain Mapping and Functionality Laboratory, Federal University of Piauí, Parnaíba, Brazil
| | - Giovanny R Pinto
- Genetics and Molecular Biology Laboratory, Federal University of Piauí, Parnaíba, Brazil
- The Northeast Biotechnology Network (RENORBIO), Federal University of Piauí, Teresina, Brazil
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16
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Samalin L, Boyer L, Murru A, Pacchiarotti I, Reinares M, Bonnin CM, Torrent C, Verdolini N, Pancheri C, de Chazeron I, Boucekine M, Geoffroy PA, Bellivier F, Llorca PM, Vieta E. Residual depressive symptoms, sleep disturbance and perceived cognitive impairment as determinants of functioning in patients with bipolar disorder. J Affect Disord 2017; 210:280-286. [PMID: 28068616 DOI: 10.1016/j.jad.2016.12.054] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Revised: 12/07/2016] [Accepted: 12/31/2016] [Indexed: 12/12/2022]
Abstract
BACKGROUND Many patients with bipolar disorder (BD) experience residual symptoms during their inter-episodic periods. The study aimed to analyse the relationship between residual depressive symptoms, sleep disturbances and self-reported cognitive impairment as determinants of psychosocial functioning in a large sample of euthymic BD patients. METHODS This was a cross-sectional study of 468 euthymic BD outpatients. We evaluated the residual depressive symptoms with the Bipolar Depression Rating Scale, the sleep disturbances with the Pittsburgh Sleep Quality Index, the perceived cognitive performance using visual analogic scales and functioning with the Functioning Assessment Short Test. Structural equation modelling (SEM) was used to describe the relationships among the residual depressive symptoms, sleep disturbances, perceived cognitive performance and functioning. RESULTS SEM showed good fit with normed chi square=2.46, comparative fit index=0.94, root mean square error of approximation=0.05 and standardized root mean square residuals=0.06. This model revealed that residual depressive symptoms (path coefficient =0.37) and perceived cognitive performance (path coefficient=0.27) were the most important features significantly related to psychosocial functioning. Sleep disturbances were indirectly associated with functioning via residual depressive symptoms and perceived cognitive performance (path coefficient=0.23). CONCLUSIONS This study contributes to a better understanding of the determinants of psychosocial functioning during the inter-episodic periods of BD patients. These findings should facilitate decision-making in therapeutics to improve the functional outcomes of BD during this period.
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Affiliation(s)
- Ludovic Samalin
- CHU Clermont-Ferrand, Department of Psychiatry, EA 7280, University of Auvergne, Clermont-Ferrand, France; Bipolar Disorder Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain; Fondation FondaMental, Créteil, France.
| | - Laurent Boyer
- Aix-Marseille University, EA 3279, Public Health, Chronic Diseases and Quality of Life research Unit, Marseille, France
| | - Andrea Murru
- Bipolar Disorder Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Isabella Pacchiarotti
- Bipolar Disorder Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - María Reinares
- Bipolar Disorder Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Caterina Mar Bonnin
- Bipolar Disorder Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Carla Torrent
- Bipolar Disorder Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Norma Verdolini
- Bipolar Disorder Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain; Division of Psychiatry, Clinical Psychology and Rehabilitation, Department of Medicine, Santa Maria della Misericordia Hospital, University of Perugia, Perugia, Italy
| | - Corinna Pancheri
- Policlinico Umberto I of Rome, La Sapienza University of Roma, Department of Neurology and Psychiatry, Rome, Italy
| | - Ingrid de Chazeron
- CHU Clermont-Ferrand, Department of Psychiatry, EA 7280, University of Auvergne, Clermont-Ferrand, France
| | - Mohamed Boucekine
- Aix-Marseille University, EA 3279, Public Health, Chronic Diseases and Quality of Life research Unit, Marseille, France
| | - Pierre-Alexis Geoffroy
- Fondation FondaMental, Créteil, France; Inserm U1144, Paris, France; Université Paris Diderot, Sorbonne Paris Cité, UMR-S 1144, Paris, France; AP-HP, GH Saint-Louis - Lariboisiére - F. Widal,Widal, Pôle de Psychiatrie et de Médecine Addictologique, Paris, France
| | - Frank Bellivier
- Fondation FondaMental, Créteil, France; Inserm U1144, Paris, France; Université Paris Diderot, Sorbonne Paris Cité, UMR-S 1144, Paris, France; AP-HP, GH Saint-Louis - Lariboisiére - F. Widal,Widal, Pôle de Psychiatrie et de Médecine Addictologique, Paris, France
| | - Pierre-Michel Llorca
- CHU Clermont-Ferrand, Department of Psychiatry, EA 7280, University of Auvergne, Clermont-Ferrand, France; Fondation FondaMental, Créteil, France
| | - Eduard Vieta
- Bipolar Disorder Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
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