1
|
Serra-Navarro M, Clougher D, Solé B, Sánchez-Moreno J, González-Pinto A, Jiménez E, Amann BL, Balanzá-Martínez V, Tabarés-Seisdedos R, Arango C, Accardo V, García-Portilla MP, Ibáñez Á, Crespo JM, Ayuso-Mateos JL, Amoretti S, Torrent C, Martínez-Aran A, Vieta E. The impact of sex in the effectiveness of functional remediation in bipolar disorder. Acta Psychiatr Scand 2024. [PMID: 39243167 DOI: 10.1111/acps.13748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Revised: 07/31/2024] [Accepted: 08/02/2024] [Indexed: 09/09/2024]
Abstract
BACKGROUND Functional recovery remains a core clinical objective for patients with bipolar disorder (BD). Sociodemographic, clinical, and neurocognitive variables are associated with long-term functional impairment, yet the impact of sex differences is unclear. Functional remediation (FR) is a validated intervention aimed at achieving functional recovery in BD. The present study assessed the effect of sex differences of FR on psychosocial functioning at post-treatment (6-months) and 12-month follow-up (FUP). To the best of our knowledge, this is the first study to explore the role of sex as a factor in the efficacy of FR. METHODS 157 participants with BD were randomly assigned to either FR (N = 77) or treatment as usual group (80). Clinical, sociodemographic, neuropsychological, and functional data were obtained using a comprehensive assessment battery. Sex differences were explored via a general linear model (GLM) for repeated measures to compare the effect of sex on the intervention over time (6 months and FUP). RESULTS Results demonstrated that FR benefits both sexes, males (p = 0.001; d' = 0.88) and females (p = 0.04; d' = 0.57), at 6 months suggesting a generalized functional improvement. Conversely, at 12-month FUP sex differences were observed only in males (p = 0.005; d' = 0.68). CONCLUSIONS FR is a beneficial intervention for males and females after treatment, suggesting that there are no relevant distinct needs. Females may benefit from ongoing psychosocial functioning booster sessions after the intervention to maintain original improvements. Future research exploring sex differences could help to identify strategies to offer personalized FR intervention approaches in individuals with BD.
Collapse
Grants
- PI080180 Spanish Ministry of Economy and Competitiveness
- PI08/90825 Spanish Ministry of Economy and Competitiveness
- PI08/90327 Spanish Ministry of Economy and Competitiveness
- PI08/90675 Spanish Ministry of Economy and Competitiveness
- PI08/90224 Spanish Ministry of Economy and Competitiveness
- PI08/90654 Spanish Ministry of Economy and Competitiveness
- PI08/90189 Spanish Ministry of Economy and Competitiveness
- PI08/90916 Spanish Ministry of Economy and Competitiveness
- PI08/90416 Spanish Ministry of Economy and Competitiveness
- PI08/90094 Spanish Ministry of Economy and Competitiveness
- PI11/00637 Spanish Ministry of Economy and Competitiveness
- PI12/00912 Spanish Ministry of Economy and Competitiveness
- PI18/00789 Spanish Ministry of Economy and Competitiveness
- PI21/00787 Spanish Ministry of Economy and Competitiveness
- PI15/00283 Spanish Ministry of Science, Innovation and Universities
- PI18/00805 Spanish Ministry of Science, Innovation and Universities
- PI17/01066 Spanish Ministry of Science, Innovation and Universities
- PI20/00344 Spanish Ministry of Science, Innovation and Universities
- 2021 SGR 1358 Bipolar Disorders Group
- SLT006/17/00357 Bipolar Disorders Group
- CD20/00177 Sara Borrell Doctoral Program
- MV22/00002 MAES mobility fellowship
- CM21/00278 Instituto de Salud Carlos III (ISCIII)
- European Social Fund
- 202234-30 La Marató-TV3 Foundation
- 202234-32 La Marató-TV3 Foundation
- CPI14/00175 "Miguel Servet" postdoctoral contract
- CPII19/00018 Miguel Servet II contract
- Spanish Ministry of Innovation and Science
- European Union (FEDER)
- Spanish Ministry of Science and Innovation
- 2017 SGR 1365 Secretaria d'Universitats i Recerca del Departament d'Economia i Coneixement
- SLT006/17/00177 Departament de Salut de la Generalitat de Catalunya for the Pla estratègic de recerca I innovació en salut
- CB/07/09/0025 CIBER-Consorcio Centro de Investigación Biomédica en Red
- S2022/BMD-7216 Instituto de Salud Carlos III, Ministerio de Ciencia e Innovación; by the Madrid Regional Government
- AGES 3-CM Instituto de Salud Carlos III, Ministerio de Ciencia e Innovación; by the Madrid Regional Government
- PI19/01295 European Union Structural Funds
- PI22/01183 European Union Structural Funds
- ICI21/00089 European Union Structural Funds
- ISCIII-Subdirección General de Evaluación and the Fondo Europeo de Desarrollo Regional (FEDER)
- PI18/0105 ISCIII-Subdirección General de Evaluación y el Fondo Europeo de Desarrollo Regional
- PI21/00713 ISCIII-Subdirección General de Evaluación y el Fondo Europeo de Desarrollo Regional
- 2022111054 CIBERSAM, the Basque Government
- IT1631-22 University of the Basque Country
- PMP21/00051 European Union-NextGenerationEU
- PI19/01024 European Union-NextGenerationEU
- B2017/BMD-3740 AGES-CM-2 CIBERSAM, Madrid Regional Government
- 101034377 Project PRISM-2
- 777394 Project AIMS-2-TRIALS
- 1U01MH124639-01 Horizon Europe, the National Institute of Mental Health of the National Institutes of Health
- 5P50MH115846-03 Horizon Europe, the National Institute of Mental Health of the National Institutes of Health
Collapse
Affiliation(s)
- Maria Serra-Navarro
- Bipolar and Depressive Disorders Unit, Department of Psychiatry and Psychology, Hospital Clinic of Barcelona, Barcelona, Spain
- Fundació Clínic per la Recerca Biomèdica-Institut d'Investigacions Biomèdiques August Pi i Sunyer (FCRB-IDIBAPS), Barcelona, Spain
- Department de Medicina, Facultat de Medicina i Ciències de la Salut, Institute of Neurosciences (UBNeuro), Universitat de Barcelona, Barcelona, Spain
- Network Centre for Biomedical Research in Mental Health (CIBERSAM), Health Institute Carlos III (ISCIII), Madrid, Spain
| | - Derek Clougher
- Bipolar and Depressive Disorders Unit, Department of Psychiatry and Psychology, Hospital Clinic of Barcelona, Barcelona, Spain
- Fundació Clínic per la Recerca Biomèdica-Institut d'Investigacions Biomèdiques August Pi i Sunyer (FCRB-IDIBAPS), Barcelona, Spain
- Department de Medicina, Facultat de Medicina i Ciències de la Salut, Institute of Neurosciences (UBNeuro), Universitat de Barcelona, Barcelona, Spain
- Network Centre for Biomedical Research in Mental Health (CIBERSAM), Health Institute Carlos III (ISCIII), Madrid, Spain
- Alava University Hospital, BIOARABA, University of the Basque Country, Vitoria, Spain
| | - Brisa Solé
- Bipolar and Depressive Disorders Unit, Department of Psychiatry and Psychology, Hospital Clinic of Barcelona, Barcelona, Spain
- Fundació Clínic per la Recerca Biomèdica-Institut d'Investigacions Biomèdiques August Pi i Sunyer (FCRB-IDIBAPS), Barcelona, Spain
- Department de Medicina, Facultat de Medicina i Ciències de la Salut, Institute of Neurosciences (UBNeuro), Universitat de Barcelona, Barcelona, Spain
- Network Centre for Biomedical Research in Mental Health (CIBERSAM), Health Institute Carlos III (ISCIII), Madrid, Spain
| | - Jose Sánchez-Moreno
- Bipolar and Depressive Disorders Unit, Department of Psychiatry and Psychology, Hospital Clinic of Barcelona, Barcelona, Spain
- Fundació Clínic per la Recerca Biomèdica-Institut d'Investigacions Biomèdiques August Pi i Sunyer (FCRB-IDIBAPS), Barcelona, Spain
- Department de Medicina, Facultat de Medicina i Ciències de la Salut, Institute of Neurosciences (UBNeuro), Universitat de Barcelona, Barcelona, Spain
- Network Centre for Biomedical Research in Mental Health (CIBERSAM), Health Institute Carlos III (ISCIII), Madrid, Spain
| | - Ana González-Pinto
- Network Centre for Biomedical Research in Mental Health (CIBERSAM), Health Institute Carlos III (ISCIII), Madrid, Spain
- Alava University Hospital, BIOARABA, University of the Basque Country, Vitoria, Spain
| | - Esther Jiménez
- Bipolar and Depressive Disorders Unit, Department of Psychiatry and Psychology, Hospital Clinic of Barcelona, Barcelona, Spain
- Network Centre for Biomedical Research in Mental Health (CIBERSAM), Health Institute Carlos III (ISCIII), Madrid, Spain
- Alava University Hospital, BIOARABA, University of the Basque Country, Vitoria, Spain
| | - Benedikt L Amann
- Network Centre for Biomedical Research in Mental Health (CIBERSAM), Health Institute Carlos III (ISCIII), Madrid, Spain
- Institute of Mental Health, Hospital del Mar Medical Research Institute, Barcelona, Spain
- Department of Medicine and Life Sciences, Pompeu Fabra University, Barcelona, Spain
| | - Vicent Balanzá-Martínez
- Network Centre for Biomedical Research in Mental Health (CIBERSAM), Health Institute Carlos III (ISCIII), Madrid, Spain
- Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, INCLIVA, Valencia, Spain
| | - Rafael Tabarés-Seisdedos
- Network Centre for Biomedical Research in Mental Health (CIBERSAM), Health Institute Carlos III (ISCIII), Madrid, Spain
- Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, INCLIVA, Valencia, Spain
| | - Celso Arango
- Network Centre for Biomedical Research in Mental Health (CIBERSAM), Health Institute Carlos III (ISCIII), Madrid, Spain
- Child and Adolescent Psychiatry Department, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, School of Medicine, Madrid, Spain
| | - Vivian Accardo
- Department of Mental Health and Addiction Services, ASST Spedali Civili of Brescia, Brescia, Italy
| | - María Paz García-Portilla
- Network Centre for Biomedical Research in Mental Health (CIBERSAM), Health Institute Carlos III (ISCIII), Madrid, Spain
- Department of Psychiatry, School of Medicine, Instituto de Neurociencias del Principado de Asturias, INEUROPA, Servicio de Salud del Principado de Asturias (SESPA), University of Oviedo, Oviedo, Spain
| | - Ángela Ibáñez
- Network Centre for Biomedical Research in Mental Health (CIBERSAM), Health Institute Carlos III (ISCIII), Madrid, Spain
- Department of Psychiatry, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Universidad de Alcalá, Madrid, Spain
| | - José Manuel Crespo
- Network Centre for Biomedical Research in Mental Health (CIBERSAM), Health Institute Carlos III (ISCIII), Madrid, Spain
- Department of Psychiatry, Bellvitge Biomedical Research Institute (IDIBELL), University Hospital of Bellvitge, Barcelona, Spain
| | - José Luis Ayuso-Mateos
- Network Centre for Biomedical Research in Mental Health (CIBERSAM), Health Institute Carlos III (ISCIII), Madrid, Spain
- Department of Psychiatry, IIS-IP, Universidad Autónoma de Madrid, Madrid, Spain
| | - Silvia Amoretti
- Psychiatric Genetics Unit, Group of Psychiatry, Mental Health and Addictions, Vall d'Hebron Research Institute (VHIR), Barcelona, Spain
| | - Carla Torrent
- Bipolar and Depressive Disorders Unit, Department of Psychiatry and Psychology, Hospital Clinic of Barcelona, Barcelona, Spain
- Fundació Clínic per la Recerca Biomèdica-Institut d'Investigacions Biomèdiques August Pi i Sunyer (FCRB-IDIBAPS), Barcelona, Spain
- Department de Medicina, Facultat de Medicina i Ciències de la Salut, Institute of Neurosciences (UBNeuro), Universitat de Barcelona, Barcelona, Spain
- Network Centre for Biomedical Research in Mental Health (CIBERSAM), Health Institute Carlos III (ISCIII), Madrid, Spain
| | - Anabel Martínez-Aran
- Bipolar and Depressive Disorders Unit, Department of Psychiatry and Psychology, Hospital Clinic of Barcelona, Barcelona, Spain
- Fundació Clínic per la Recerca Biomèdica-Institut d'Investigacions Biomèdiques August Pi i Sunyer (FCRB-IDIBAPS), Barcelona, Spain
- Department de Medicina, Facultat de Medicina i Ciències de la Salut, Institute of Neurosciences (UBNeuro), Universitat de Barcelona, Barcelona, Spain
- Network Centre for Biomedical Research in Mental Health (CIBERSAM), Health Institute Carlos III (ISCIII), Madrid, Spain
| | - Eduard Vieta
- Bipolar and Depressive Disorders Unit, Department of Psychiatry and Psychology, Hospital Clinic of Barcelona, Barcelona, Spain
- Fundació Clínic per la Recerca Biomèdica-Institut d'Investigacions Biomèdiques August Pi i Sunyer (FCRB-IDIBAPS), Barcelona, Spain
- Department de Medicina, Facultat de Medicina i Ciències de la Salut, Institute of Neurosciences (UBNeuro), Universitat de Barcelona, Barcelona, Spain
- Network Centre for Biomedical Research in Mental Health (CIBERSAM), Health Institute Carlos III (ISCIII), Madrid, Spain
| |
Collapse
|
2
|
Carracedo-Sanchidrian D, de Dios-Perrino C, Bayon-Perez C, Rodriguez-Vega B, Bravo-Ortiz MF, Ortega MÁ, González-Pinto AM, Lahera G. Effect of mindfulness-based cognitive therapy vs. psychoeducational intervention on plasma brain-derived neurotrophic factor and cognitive function in bipolar patients: a randomized controlled trial. Front Psychiatry 2024; 14:1279342. [PMID: 38250270 PMCID: PMC10796620 DOI: 10.3389/fpsyt.2023.1279342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 12/13/2023] [Indexed: 01/23/2024] Open
Abstract
Introduction Few controlled trials have assessed the benefits of Mindfulness Based Cognitive Therapy (MBCT) on cognitive functions and brain-derived neurotrophic factor (BDNF) in bipolar disorder (BD). This study aims to evaluate the impact of MBCT adjunctive treatment on these variables. Main hypothesis was that MBCT would improve cognitive functioning and BDNF more than Psychoeducation and TAU. Methods Randomized, multicenter, prospective and single-blinded trial. Included BD outpatients randomly assigned to three treatment arms: MBCT plus treatment as usual (TAU), Psychoeducation plus Tau and TAU. Cognitive functions were assessed with Continuous Performance Test-III, Stroop Test, Trail Making Test, Digit Span and Letter-Number Sequencing from Wechsler Adult Intelligence Scale III, Face Emotion Identification Task and Face Emotion Discrimination Task. BDNF serum level was measured with ELISA. Patients were assessed at baseline, 8 weeks and 6 months. Results Eighty-four patients were recruited (TAU = 10, Psychoeducation = 34, MBCT = 40). No significant differences between treatment groups were found. MBCT does not achieve better results than Psychoeducation or TAU. Discussion Being Psychoeducation and TAU efficient interventions, as well as the scarce duration of a more complex intervention, such as MBCT, are suggested as explanatory variables of these results. Trial registration ClinicalTrials.gov: NCT02133170. Registered 04/30/2014.
Collapse
Affiliation(s)
- Diego Carracedo-Sanchidrian
- Department of Psychiatry, University Hospital La Paz, Madrid, Spain
- La Paz Hospital Institute for Health Research (IdiPAZ), Madrid, Spain
| | - Consuelo de Dios-Perrino
- Department of Psychiatry, University Hospital La Paz, Madrid, Spain
- La Paz Hospital Institute for Health Research (IdiPAZ), Madrid, Spain
- Autonomous University of Madrid (UAM), Madrid, Spain
| | - Carmen Bayon-Perez
- Department of Psychiatry, University Hospital La Paz, Madrid, Spain
- La Paz Hospital Institute for Health Research (IdiPAZ), Madrid, Spain
- Autonomous University of Madrid (UAM), Madrid, Spain
| | - Beatriz Rodriguez-Vega
- Department of Psychiatry, University Hospital La Paz, Madrid, Spain
- La Paz Hospital Institute for Health Research (IdiPAZ), Madrid, Spain
- Autonomous University of Madrid (UAM), Madrid, Spain
| | - Maria-Fe Bravo-Ortiz
- Department of Psychiatry, University Hospital La Paz, Madrid, Spain
- La Paz Hospital Institute for Health Research (IdiPAZ), Madrid, Spain
- Autonomous University of Madrid (UAM), Madrid, Spain
| | - Miguel Á. Ortega
- Faculty of Medicine and Health Sciences, University of Alcalá, Madrid, Spain
- CIBERSAM, Ramón y Cajal Institute of Sanitary Research (IRYCIS), Madrid, Spain
| | - Ana-Maria González-Pinto
- BIOARABA, UPV/EHU, CIBERSAM, Department of Psychiatry, Hospital Santiago Apostol, Vitoria, Spain
| | - Guillermo Lahera
- Faculty of Medicine and Health Sciences, University of Alcalá, Madrid, Spain
- CIBERSAM, Ramón y Cajal Institute of Sanitary Research (IRYCIS), Madrid, Spain
- Principe de Asturias University Hospital, Alcalá, Spain
| |
Collapse
|
3
|
Simjanoski M, de Azevedo Cardoso T, Frey BN, Minuzzi L, De Boni RB, Balanzá-Martínez V, Kapczinski F. Lifestyle in bipolar disorder: A cross-sectional study. SPANISH JOURNAL OF PSYCHIATRY AND MENTAL HEALTH 2023; 16:244-250. [PMID: 37839960 DOI: 10.1016/j.rpsm.2023.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 04/14/2023] [Accepted: 04/27/2023] [Indexed: 10/17/2023]
Abstract
BACKGROUND Modifiable lifestyle behaviors are important factors for improving mental health, yet there has been a lack of research studying lifestyle as a multidimensional construct in bipolar disorder (BD). The aim of this cross-sectional study was to compare the lifestyle patterns of individuals with BD in a current mood episode with healthy controls (HCs) using the Short Multidimensional Inventory Lifestyle Evaluation (SMILE). MATERIALS AND METHODS The sample consisted of 46 individuals with BD currently experiencing a depressive or manic episode and 50 HC, assessed using the MINI International Neuropsychiatric Interview, Montgomery-Åsberg Depression Rating Scale (MADRS), and the Young Mania Rating Scale (YMRS). The SMILE scale assesses lifestyle across seven domains: diet and nutrition, substance abuse, physical activity, stress management, restorative sleep, social support, and environmental exposures. Between-groups comparisons were performed based on the presence of a psychiatric diagnosis and the type of BD episode. RESULTS We found significant differences in the total SMILE score (r=0.75, p<0.001) and in scores from each domain of the scale between BD and HC (p<0.05), where individuals with BD in a depressive or manic episode with or without mixed features reported worse lifestyle across all domains. Differences between individuals with BD in different mood episodes across domains on the SMILE scale were non-significant. CONCLUSION Findings from this study highlight the presence of unhealthy lifestyle patterns in people with BD regardless of the polarity of their mood episode. Implementation of multidimensional lifestyle assessments is an essential step toward detecting the clustering of unhealthy lifestyle patterns in BD.
Collapse
Affiliation(s)
- Mario Simjanoski
- Neuroscience Graduate Program, McMaster University, 1280 Main St. West, Hamilton, ON, Canada; Department of Psychiatry and Behavioural Neurosciences, McMaster University, 1280 Main St. West, Hamilton, ON, Canada.
| | - Taiane de Azevedo Cardoso
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, 1280 Main St. West, Hamilton, ON, Canada
| | - Benicio N Frey
- Neuroscience Graduate Program, McMaster University, 1280 Main St. West, Hamilton, ON, Canada; Department of Psychiatry and Behavioural Neurosciences, McMaster University, 1280 Main St. West, Hamilton, ON, Canada; Women's Health Concerns Clinic and Mood Disorders Program, St. Joseph's Healthcare, 100 West 5th Street, Hamilton, ON, Canada
| | - Luciano Minuzzi
- Neuroscience Graduate Program, McMaster University, 1280 Main St. West, Hamilton, ON, Canada; Department of Psychiatry and Behavioural Neurosciences, McMaster University, 1280 Main St. West, Hamilton, ON, Canada; Women's Health Concerns Clinic and Mood Disorders Program, St. Joseph's Healthcare, 100 West 5th Street, Hamilton, ON, Canada
| | - Raquel B De Boni
- Institute of Scientific and Technological Communication and Information in Health (ICICT), Oswaldo Cruz Foundation (FIOCRUZ), 4365 Manguinhos, Rio de Janeiro, Brazil
| | - Vicent Balanzá-Martínez
- Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, CIBERSAM, Av. de Blasco Ibáñez, 13, Valencia, Spain
| | - Flavio Kapczinski
- Neuroscience Graduate Program, McMaster University, 1280 Main St. West, Hamilton, ON, Canada; Department of Psychiatry and Behavioural Neurosciences, McMaster University, 1280 Main St. West, Hamilton, ON, Canada; Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Porto Alegre, Brazil; Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Av. Paulo Gama, 110, Porto Alegre, Brazil
| |
Collapse
|
4
|
Kjærstad HL, Varo C, Meluken I, Vieta E, Vinberg M, Kessing LV, Miskowiak KW. Emotional cognition subgroups in unaffected first-degree relatives of patients with mood disorders. Psychol Med 2023; 53:2328-2338. [PMID: 37310310 DOI: 10.1017/s0033291721004165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Patients with major depressive disorder (MDD) or bipolar disorder (BD) exhibit difficulties with emotional cognition even during remission. There is evidence for aberrant emotional cognition in unaffected relatives of patients with these mood disorders, but studies are conflicting. We aimed to investigate whether emotional cognition in unaffected first-degree relatives of patients with mood disorders is characterised by heterogeneity using a data-driven approach. METHODS Data from 94 unaffected relatives (33 of MDD patients; 61 of BD patients) and 203 healthy controls were pooled from two cohort studies. Emotional cognition was assessed with the Social Scenarios Test, Facial Expression Recognition Test and Faces Dot-Probe Test. Hierarchical cluster analysis was conducted using emotional cognition data from the 94 unaffected relatives. The resulting emotional cognition clusters and controls were compared for emotional and non-emotional cognition, demographic characteristics and functioning. RESULTS Two distinct clusters of unaffected relatives were identified: a relatively 'emotionally preserved' cluster (55%; 40% relatives of MDD probands) and an 'emotionally blunted' cluster (45%; 29% relatives of MDD probands). 'Emotionally blunted' relatives presented with poorer neurocognitive performance (global cognition p = 0.010), heightened subsyndromal mania symptoms (p = 0.004), lower years of education (p = 0.004) and difficulties with interpersonal functioning (p = 0.005) than controls, whereas 'emotionally preserved' relatives were comparable to controls on these measures. CONCLUSIONS Our findings show discrete emotional cognition profiles that occur across healthy first-degree relatives of patients with MDD and BD. These emotional cognition clusters may provide insight into emotional cognitive markers of genetically distinct subgroups of individuals at familial risk of mood disorders.
Collapse
Affiliation(s)
- Hanne Lie Kjærstad
- Mental Health Services, Capital Region of Denmark, Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Cristina Varo
- Bipolar and Depressive Disorders Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Iselin Meluken
- Mental Health Services, Capital Region of Denmark, Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Eduard Vieta
- Bipolar and Depressive Disorders Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Maj Vinberg
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Mental Health Services, Capital Region of Denmark, Psychiatric Centre North Zealand, Hillerød, Denmark
| | - Lars Vedel Kessing
- Mental Health Services, Capital Region of Denmark, Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Kamilla Woznica Miskowiak
- Mental Health Services, Capital Region of Denmark, Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| |
Collapse
|
5
|
Luján-Lujan EM, García-León MÁ, Rodriguez-Cano E, Huertas-Martínez S, Roldan-Merino J, Puig-Llobet M, Miguel-Ruiz MD, Salvador R, Vieta E, Pomarol-Clotet E. Validity of the Functioning Assessment Short Tests (FAST), in patients with schizophrenia. REVISTA DE PSIQUIATRIA Y SALUD MENTAL 2022; 15:157-166. [PMID: 36175283 DOI: 10.1016/j.rpsmen.2022.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 01/31/2022] [Indexed: 06/16/2023]
Abstract
INTRODUCTION Functional impairment in schizophrenia is one of the main features of the disorder and implies a great impact on the patient's quality of life. The Brief Functioning Assessment Scale (FAST), originally validated in bipolar disorder, has also been validated for its application in other mental disorders. However, we only found one study on the reliability and validity of the Brazilian version in schizophrenia. The purpose of this study was to analyze the psychometric properties of the Spanish version of the FAST in patients diagnosed with schizophrenia. MATERIAL AND METHODS A total of 226 patients with a diagnosis of schizophrenia were evaluated by mean the FAST, the GAF and the self-care requirements scale (ERA). Scale properties were analyzed in terms of internal consistency, inter-observer agreement and test-retest reliability. Convergent validity with the GAF and ERA scales was also analyzed, as well as construct validity by means of a Confirmatory Factor Analysis (CFA). RESULTS For the total scale, the results showed high internal consistency (Cronbach's Alpha of, 87), as well as good inter-observer (ICC=,86) and test-retest (ICC=,77) agreement. Concurrent validity with the GAF scale was discrete (r=-,32; P<,001) and with the ERA scale was moderate (r=,50; P<,001). CFA showed an internal structure that matched the six factors proposed by the original scale, with a good level of item saturation for each factor. CONCLUSIONS The FAST scale showed good psychometric properties in terms of reliability and validity in its Spanish version for its application in patients with schizophrenia. It can be considered as a good tool to assess different areas of functional impairment in clinical practice and research.
Collapse
Affiliation(s)
- Eva María Luján-Lujan
- Complejo Asistencial en Salud Mental Benito Menni, Sant Boi de Llobregat, Barcelona, Spain.
| | - María Ángeles García-León
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain; Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Madrid, Spain.
| | | | - Sergi Huertas-Martínez
- Complejo Asistencial en Salud Mental Benito Menni, Sant Boi de Llobregat, Barcelona, Spain
| | | | | | | | - Raimon Salvador
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain; Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Madrid, Spain
| | - Eduard Vieta
- Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Madrid, Spain; Hospital Clinic de Barcelona, Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Institut de Neurociències, Universidad de Barcelona, Barcelona, Spain
| | - Edith Pomarol-Clotet
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain; Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Madrid, Spain
| |
Collapse
|
6
|
Functional Remediation for Older Adults with Bipolar Disorder (FROA-BD): study protocol for a randomized controlled trial. REVISTA DE PSIQUIATRIA Y SALUD MENTAL 2022. [DOI: 10.1016/j.rpsm.2022.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
|
7
|
Luján-Lujan EM, García-León MÁ, Rodriguez-Cano E, Huertas-Martínez S, Puig-Llobet M, Miguel-Ruiz MD, Salvador R, Vieta E, Pomarol-Clotet E. Validación de la versión española de la escala de funcionamiento breve (FAST) en pacientes diagnosticados de esquizofrenia. REVISTA DE PSIQUIATRIA Y SALUD MENTAL 2022. [DOI: 10.1016/j.rpsm.2022.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
8
|
Solé B, Martínez-Aran A, Vieta E, Torrent C. Commentary on "The 2020 Royal Australian and New Zealand College of psychiatrists clinical practice guidelines for mood disorders: Bipolar disorder summary". Bipolar Disord 2021; 23:513-514. [PMID: 33706410 DOI: 10.1111/bdi.13073] [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: 03/05/2021] [Accepted: 03/09/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Brisa Solé
- Bipolar and Depressive Disorders Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Anabel Martínez-Aran
- Bipolar and Depressive Disorders Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Eduard Vieta
- Bipolar and Depressive Disorders Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Carla Torrent
- Bipolar and Depressive Disorders Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| |
Collapse
|
9
|
A prospective longitudinal study searching for predictors of response to group psychoeducation in bipolar disorder. J Affect Disord 2020; 274:1113-1121. [PMID: 32663939 DOI: 10.1016/j.jad.2020.02.047] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 02/10/2020] [Accepted: 02/27/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND The efficacy of adjunctive group psychoeducation in bipolar disorder has been proven although treatment response differ among individuals. The aim of this study was to characterize responders and non-responders to group psychoeducation in order to identify baseline variables that could predict treatment response. METHODS The sample was composed of 103 medicated euthymic patients with bipolar disorder referred to 21 sessions of group psychoeducation (6 months). Sociodemographic and clinical variables, temperament, circadian rhythms, BDNF, cognitive and psychosocial functioning were collected. At the 18-month endpoint, the patients were split in two groups on the basis of having suffered any recurrence. Significant group differences were included in a logistic regression analysis. RESULTS Ninety patients out of 103 engaged in group psychoeducation, 47 of whom (52.2%) responded to psychoeducation and 43 (47.8%) did not. Recurrences occurred more often in the follow-up, the most common being depression. Responders and non-responders differed in gender, age at diagnosis, latency of diagnosis, temperament, attention composite score and BDNF. Lower age at diagnosis of bipolar disorder, lower cyclothimic temperament scores and being male -which was associated with bipolar type I and a trend to more previous manic episodes- were significantly related to a better response to psychoeducation in the regression analysis. LIMITATIONS No control group. CONCLUSIONS This study identifies age at diagnosis as a significant modifiable risk factor of treatment response, highlighting the need for early identification of bipolar disorder. Existing programs should be adjusted to the characteristics of specific subpopulations in the framework of a personalized approach.
Collapse
|
10
|
Neurocognitive impairment and evidence-based treatment options in Bipolar disorder. Ann Gen Psychiatry 2020; 19:54. [PMID: 32983247 PMCID: PMC7513501 DOI: 10.1186/s12991-020-00304-4] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Accepted: 09/17/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The current paper briefly summarizes the literature on the neurocognitive deficit and its treatment in BD patients. METHODS The material was chosen on the basis of previous systematic reviews the author has taken part in. RESULTS The data so far suggest that the deficit is qualitatively similar but quantitatively milder in comparison to schizophrenia, it is present already since the first episode, is weakly related to mood symptoms and somewhat stronger to psychotic symptoms, it probably determines much of the disability and treatment is problematic. This deficit is also present during periods of euthymia. The possible adverse effect of psychotropic medication is rather small if any at all and is confounded by the specific clinical symptoms, for which medication is used for their treatment. This is especially true concerning antipsychotics and psychotic symptoms. The origin and the etiopathogenesis of the core neurocognitive impairment remain elusive. The presence of a neurodegenerative and of a neurodevelopmental component has both data in favor and against and they are both the focus of debate. CONCLUSIONS Treatment of the neurocognitive deficit and restoration of functioning is problematic. The data are limited and treatment options are few and with a weak overall effect. Pharmacological treatments, ECT and rTMS present some hard data, while the literature is inconclusive concerning psychotherapeutic interventions.
Collapse
|
11
|
Abohamza E, Weickert T, Ali M, Moustafa AA. Reward and punishment learning in schizophrenia and bipolar disorder. Behav Brain Res 2019; 381:112298. [PMID: 31622639 DOI: 10.1016/j.bbr.2019.112298] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2019] [Revised: 09/25/2019] [Accepted: 10/09/2019] [Indexed: 11/17/2022]
Abstract
Prior studies on reward learning deficits in psychiatric disorders have used probabilistic learning tasks, making it unclear whether impairment is due to the probabilistic nature of the task rather than reward processing. In this study, we tested probabilistic vs. deterministic reward and punishment learning in healthy controls and three patient groups: schizophrenia (SZ), psychotic bipolar disorder (BD), and nonpsychotic BD. Experimental results show that reward learning was impaired in patients with SZ and patients with psychotic BD in the probabilistic learning task compared to patients with nonpsychotic BD and healthy controls. In contrast, punishment learning in the probabilistic task was impaired in patients with nonpsychotic BD compared to the other patient groups and healthy controls. There were no significant differences among all groups in the deterministic learning task scores. We also found that Hamilton Depression Scale scores negatively correlated with probabilistic learning performance. Our data may suggest that reward learning impairment may be due to the nature of the task as well as subtype of BD.
Collapse
Affiliation(s)
- Eid Abohamza
- Department of Social Sciences, College of Arts and Sciences, Qatar University, Doha, Qatar.
| | - Thomas Weickert
- School of Psychiatry, University of New South Wales, Kensington, NSW, Australia; Neuroscience Research Australia, Randwick, NSW, Australia
| | - Manal Ali
- Institute of Psychiatry, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Ahmed A Moustafa
- School of Social Sciences and Psychology & Marcs Institute for Brain and Behaviour, Western Sydney University, Sydney, NSW, Australia
| |
Collapse
|