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Forthmann B, Kaczykowski K, Benedek M, Holling H. The Manic Idea Creator? A Review and Meta-Analysis of the Relationship between Bipolar Disorder and Creative Cognitive Potential. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6264. [PMID: 37444111 PMCID: PMC10341485 DOI: 10.3390/ijerph20136264] [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: 01/31/2023] [Revised: 06/12/2023] [Accepted: 06/27/2023] [Indexed: 07/15/2023]
Abstract
Even though a relationship between psychopathology and creativity has been postulated since the time of ancient Greece, systematic meta-analyses on this topic are still scarce. Thus, the meta-analysis described here can be considered the first to date that specifically focuses on the relationship between creative potential, as measured by divergent thinking, and bipolar disorder, as opposed to psychopathology in general. An extensive literature search of 4670 screened hits identified 13 suitable studies, including a total of 42 effect sizes and 1857 participants. The random-effects model showed an overall significant, positive, yet diminutively small effect (d = 0.11, 95% CI: [0.002, 0.209], p = 0.045) between divergent thinking and bipolar disorder. A handful of moderators were examined, which revealed a significant moderating effect for bipolar status, as either euthymic (d = 0.14, p = 0.043), subclinical (d = 0.17, p = 0.001), manic (d = 0.25, p = 0.097), or depressed (d = -0.51, p < 0.001). However, moderator analyses should be treated with caution because of the observed confounding of moderators. Finally, none of the employed methods for publication-bias detection revealed any evidence for publication bias. We discuss further results, especially regarding the differences between subclinical and clinical samples.
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Affiliation(s)
- Boris Forthmann
- Institute of Psychology, University of Münster, 48149 Münster, Germany
| | - Karin Kaczykowski
- Institute of Psychology, University of Münster, 48149 Münster, Germany
| | - Mathias Benedek
- Institute of Psychology, University of Graz, 8010 Graz, Austria
| | - Heinz Holling
- Institute of Psychology, University of Münster, 48149 Münster, Germany
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2
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Grunze H, Soyka M. The pharmacotherapeutic management of comorbid bipolar disorder and alcohol use disorder. Expert Opin Pharmacother 2022; 23:1181-1193. [PMID: 35640575 DOI: 10.1080/14656566.2022.2083500] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Comorbidity of bipolar disorder (BD) and alcohol use disorder (AUD) is very frequent resulting in detrimental outcomes, including increased mortality. Diagnosis of AUD in BD and vice versa is often delayed as symptoms of one disorder mimic and obscure the other one. Evidence for pharmacotherapies for people with comorbid BD and AUD remains limited, and further proof-of-concept studies are urgently needed. AREAS COVERED This paper explores the currently available pharmacotherapies for AUD, BD and their usefulness for comorbid BD and AUD. It also covers to some degree the epidemiology, diagnosis, and potential common neurobiological traits of comorbid BD and AUD. EXPERT OPINION The authors conclude that more controlled studies are needed before evidence-based guidance can be drawn up for clinician's use. Since there are no relevant pharmacological interactions, approved medications for AUD can also be used safely in BD. For mood stabilization, lithium should be considered first in adherent persons with BD and comorbid AUD. Alternatives include valproate, lamotrigine, and some atypical antipsychotics, with partial D2/D3 receptor agonism possibly being beneficial in AUD, too.
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Affiliation(s)
- Heinz Grunze
- Psychiatrie Schwäbisch Hall, Schwäbisch Hall, Germany.,Paracelsus Medical University, Nuremberg, Germany
| | - Michael Soyka
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians- University Munich, Munich, Germany
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3
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Grunze H, Schaefer M, Scherk H, Born C, Preuss UW. Comorbid Bipolar and Alcohol Use Disorder-A Therapeutic Challenge. Front Psychiatry 2021; 12:660432. [PMID: 33833701 PMCID: PMC8021702 DOI: 10.3389/fpsyt.2021.660432] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 03/01/2021] [Indexed: 02/05/2023] Open
Abstract
Comorbidity rates in Bipolar disorder rank highest among major mental disorders, especially comorbid substance use. Besides cannabis, alcohol is the most frequent substance of abuse as it is societally accepted and can be purchased and consumed legally. Estimates for lifetime comorbidity of bipolar disorder and alcohol use disorder are substantial and in the range of 40-70%, both for Bipolar I and II disorder, and with male preponderance. Alcohol use disorder and bipolarity significantly influence each other's severity and prognosis with a more complicated course of both disorders. Modern treatment concepts acknowledge the interplay between these disorders using an integrated therapy approach where both disorders are tackled in the same setting by a multi-professional team. Motivational interviewing, cognitive behavioral and socio- therapies incorporating the family and social environment are cornerstones in psychotherapy whereas the accompanying pharmacological treatment aims to reduce craving and to optimize mood stability. Adding valproate to lithium may reduce alcohol consumption whereas studies with antipsychotics or naltrexone and acamprosate did not affect mood fluctuations or drinking patterns. In summary, there is a continuous need for more research in order to develop evidence-based approaches for integrated treatment of this frequent comorbidity.
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Affiliation(s)
- Heinz Grunze
- Psychiatrie Schwäbisch Hall, Schwäbisch Hall, Germany
- Paracelsus Medical University Nuremberg, Nuremberg, Germany
- *Correspondence: Heinz Grunze
| | - Martin Schaefer
- Klinik für Psychiatrie, Psychotherapie, Psychosomatik, und Suchtmedizin, Evang. Kliniken Essen-Mitte, Essen, Germany
- Klinik für Psychiatrie und Psychotherapie, Campus Charité Mitte, Charité Universitätsmedizin Berlin, Berlin, Germany
| | | | - Christoph Born
- Psychiatrie Schwäbisch Hall, Schwäbisch Hall, Germany
- Paracelsus Medical University Nuremberg, Nuremberg, Germany
| | - Ulrich W. Preuss
- Vitos Klinik Psychiatrie und Psychotherapie, Herborn, Germany
- Klinik für Psychiatrie, Psychotherapie, und Psychosomatik, Martin-Luther-Universität Halle-Wittenberg, Halle, Germany
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4
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Lippard ETC, Mazure CM, Johnston JAY, Spencer L, Weathers J, Pittman B, Wang F, Blumberg HP. Brain circuitry associated with the development of substance use in bipolar disorder and preliminary evidence for sexual dimorphism in adolescents. J Neurosci Res 2017; 95:777-791. [PMID: 27870392 DOI: 10.1002/jnr.23901] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Revised: 07/29/2016] [Accepted: 08/05/2016] [Indexed: 02/06/2023]
Abstract
Substance use disorders and mood disorders are highly comorbid and confer a high risk for adverse outcomes. However, data are limited on the neurodevelopmental basis of this comorbidity. Substance use initiation typically occurs during adolescence, and sex-specific developmental mechanisms are implicated. In this preliminary study, we review the literature and investigate regional gray matter volume (GMV) associated with subsequent substance use problems in adolescents with bipolar disorder (BD) and explore these associations for females and males. Thirty adolescents with DSM-IV-diagnosed BD and minimal alcohol/substance exposure completed baseline structural magnetic resonance imaging scans. At follow-up (on average 6 years post baseline), subjects were administered the CRAFFT interview and categorized into those scoring at high ( ≥ 2: CRAFFTHIGH ) vs. low ( < 2: CRAFFTLOW ) risk for alcohol/substance problems. Lower GMV in prefrontal, insular, and temporopolar cortices were observed at baseline among adolescents with BD reporting subsequent alcohol and cannabis use compared to adolescents with BD who did not (P < 0.005, clusters ≥ 20 voxels). Lower dorsolateral prefrontal GMV was associated with future substance use in both females and males. In females, lower orbitofrontal and insula GMV was associated with future substance use, while in males, lower rostral prefrontal GMV was associated with future use. Lower orbitofrontal, insular, and temporopolar GMV was observed in those who transitioned to smoking tobacco. Findings indicate that GMV development is associated with risk for future substance use problems in adolescents with BD, with results implicating GMV development in regions subserving emotional regulation in females and regions subserving executive processes and attention in males. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Elizabeth T C Lippard
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut.,Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Connecticut
| | - Carolyn M Mazure
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut.,Women's Health Research at Yale, Yale School of Medicine, New Haven, Connecticut
| | | | - Linda Spencer
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut
| | - Judah Weathers
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut.,Child Study Center, Yale School of Medicine, New Haven, Connecticut
| | - Brian Pittman
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut
| | - Fei Wang
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut
| | - Hilary P Blumberg
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut.,Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Connecticut.,Women's Health Research at Yale, Yale School of Medicine, New Haven, Connecticut.,Child Study Center, Yale School of Medicine, New Haven, Connecticut
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5
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Personality in patients with substance use disorders according to the co-occurring severe mental illness: A study using the alternative five factor model. PERSONALITY AND INDIVIDUAL DIFFERENCES 2016. [DOI: 10.1016/j.paid.2016.03.028] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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6
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Fernández-Mondragón S, Adan A. Personality in male patients with substance use disorder and/or severe mental illness. Psychiatry Res 2015; 228:488-94. [PMID: 26144586 DOI: 10.1016/j.psychres.2015.05.059] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2014] [Revised: 04/23/2015] [Accepted: 05/25/2015] [Indexed: 10/23/2022]
Abstract
Dual diagnosis (DD) is the coexistence of a substance use disorder (SUD) and severe mental illness (SMI). The aim of this study is to determine for the first time if a specific personality pattern exists for DD patients compared to those who only have SUD or SMI. The sample was composed of 102 male, 34 patients in each group (DD, SUD and SMI). DD and SMI groups included 20 schizophrenic and 14 depressed patients respectively. Cloninger's TCI-R was administered together with a structured interview of sociodemographic and clinical characteristics. All the temperament dimensions and Self-directedness provided differences among groups. The DD and SUD showed significant higher scores in Novelty Seeking regarding SMI, whereas for Harm Avoidance the SUD subjects scored lower with respect to the DD and SMI group. Persistence was significant lower for the DD and SMI groups compared to the SUD patients. The DD obtained low significant scores in Reward Dependence in relation to the SUD and Self-directedness in relation to the SUD and SMI. Our data highlight the presence of a different personality profiles among DD, SUD and SMI disorders. Taking into account the patients' personality can benefit the clinical course and minimize the DD impact.
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Affiliation(s)
- Susana Fernández-Mondragón
- Department of Psychiatry and Clinical Psychobiology, School of Psychology, University of Barcelona, Barcelona, Spain
| | - Ana Adan
- Department of Psychiatry and Clinical Psychobiology, School of Psychology, University of Barcelona, Barcelona, Spain; Institute for Brain, Cognition and Behavior (IR3C), Barcelona, Spain.
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7
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Can SS, Ünlütürk S. Personality traits of substance abusers in Turkish military population. JOURNAL OF SUBSTANCE USE 2013. [DOI: 10.3109/14659891.2013.856477] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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8
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Ortiz ÓM. [Drug Abuse Comorbidity in Bipolar Disorder]. ACTA ACUST UNITED AC 2012; 41:371-83. [PMID: 26573500 DOI: 10.1016/s0034-7450(14)60011-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2012] [Accepted: 06/02/2012] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Drug use among patients with bipolar disorder is greater than the one observed in the general population; psychotic episodes are likely to occur after consumption. This has implications in the prevention, etiology, management, and treatment of the disease. Bipolar disorder pathology is likely to have positive response to pharmacological treatment. Therefore, identifying the strategies with better results to be applied in these patients is fundamental for psychiatrists and primary care physicians. OBJECTIVE Review literature in order to determine the prevalence and characteristics of drug abuse in patients with bipolar disorder and establish the pharmacological strategies that have produced better results. METHODOLOGY Literature review. RESULTS A great variety of studies demonstrate the relationship between bipolar disorder and drug use disorder. These patients are hospitalized more frequently, have an earlier onset of the disease, and present a larger number of depressive episodes and suicide attempts which affect the course of the disease. The drug with better results in the treatment of these patients is Divalproate. Satisfactory results have been also obtained with other mood stabilizers such as carbamazepine, lamotrigine, and the antipsychotic aripiprazole. CONCLUSIONS Substance abuse is present in a large number of patients with bipolar disorder. The Divalproate is the drug that has shown better results in the studies.
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Affiliation(s)
- Óscar Medina Ortiz
- Psiqu-iatra, profesor de Psiquiatría, doctor (Ph. D.) en Neurociencias, Facultad de Medicina de la Universidad de los Andes, San Cristóbal, Venezuela.
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9
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Richardson T. Correlates of substance use disorder in bipolar disorder: a systematic review and meta-analysis. ACTA ACUST UNITED AC 2011. [DOI: 10.1080/17523281.2011.578583] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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10
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Roussos P, Giakoumaki SG, Georgakopoulos A, Robakis NK, Bitsios P. The CACNA1C and ANK3 risk alleles impact on affective personality traits and startle reactivity but not on cognition or gating in healthy males. Bipolar Disord 2011; 13:250-9. [PMID: 21676128 DOI: 10.1111/j.1399-5618.2011.00924.x] [Citation(s) in RCA: 79] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
OBJECTIVES The rs10994336 ANK3 and rs1006737 CACNA1C genetic variants have recently been identified as the most consistent, genome-wide significant risk factors for bipolar disorder, while the CACNA1C variant has also been associated with schizophrenia and major depression. The aim of this study was to examine the phenotypic consequences of the risk CACNA1C and ANK3 alleles in a large homogeneous cohort of healthy young males. METHODS We recruited 703 randomly selected, healthy army conscripts (mean age 22.1 ± 3.0 years) from the first wave of the Learning on Genetics of Schizophrenia project in Heraklion, Crete. Of those recruited, 530 subjects entered and completed the study. Subjects were assessed for prepulse inhibition (PPI), startle reactivity, neuropsychology, and personality. RESULTS UNPHASED analysis revealed that the rs1006737 A-allele was associated with lower extraversion and higher harm avoidance, trait anxiety, and paranoid ideation, while the rs10994336 T-allele was associated with lower novelty seeking and behavioral activation scores (p < 0.01). Both alleles were associated with high startle reactivity (p < 0.05). There were no significant associations with any cognitive task performance or PPI. CONCLUSIONS The CACNA1C genotype was associated with proneness to anxiety and negative mood, while the ANK3 genotype was associated with proneness to anhedonia. Both risk genotypes were associated with high startle reactivity, suggesting a role of these polymorphisms in threat/stress signal processing, probably in the hippocampus and/or amygdala. None of the risk genotypes affected sensorimotor gating or behavioral performance in an extensive battery of executive function tests in this cohort of healthy males.
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Affiliation(s)
- Panos Roussos
- Department of Psychiatry and Behavioral Sciences, University of Crete, Heraklion, Greece.
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11
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Carson SH. Creativity and psychopathology: a shared vulnerability model. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2011; 56:144-53. [PMID: 21443821 DOI: 10.1177/070674371105600304] [Citation(s) in RCA: 92] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Creativity is considered a positive personal trait. However, highly creative people have demonstrated elevated risk for certain forms of psychopathology, including mood disorders, schizophrenia spectrum disorders, and alcoholism. A model of shared vulnerability explains the relation between creativity and psychopathology. This model, supported by recent findings from neuroscience and molecular genetics, suggests that the biological determinants conferring risk for psychopathology interact with protective cognitive factors to enhance creative ideation. Elements of shared vulnerability include cognitive disinhibition (which allows more stimuli into conscious awareness), an attentional style driven by novelty salience, and neural hyperconnectivity that may increase associations among disparate stimuli. These vulnerabilities interact with superior meta-cognitive protective factors, such as high IQ, increased working memory capacity, and enhanced cognitive flexibility, to enlarge the range and depth of stimuli available in conscious awareness to be manipulated and combined to form novel and original ideas.
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Affiliation(s)
- Shelley H Carson
- Department of Psychology, Harvard University, Cambridge, Massachusetts 02138, USA.
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12
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Kim B, Joo YH, Kim SY, Lim JH, Kim EO. Personality traits and affective morbidity in patients with bipolar I disorder: the five-factor model perspective. Psychiatry Res 2011; 185:135-40. [PMID: 20566218 DOI: 10.1016/j.psychres.2010.05.020] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2009] [Revised: 04/13/2010] [Accepted: 05/28/2010] [Indexed: 01/03/2023]
Abstract
In this study, we aimed to extend the present knowledge regarding the relationship of personality traits, as specified by the five-factor model (FFM), with the affective morbidity of bipolar I disorder. The primary aim of this study is to investigate the association of personality traits with affective morbidity, particularly with hospitalization for depressive, manic, or mixed episodes, in patients with bipolar I disorder. The Revised NEO Personality Inventory was administered to 83 subjects who showed a euthymic mood state. Multivariate Poisson regression analysis was performed to identify associations between five domains of personality and the number of hospitalizations for affective episode(s) (manic, depressive, and mixed state). As a secondary research interest, we attempted to determine personality traits which would be significantly different between subjects with Affective Switch from mania into depression Without Euthymia (ASWE) and non-ASWE. The Neuroticism score was positively associated with the number of hospitalization for depression and the total number of hospitalizations Extraversion and Openness scores showed a negative relationship with the number of hospitalizations for depression and the total number of hospitalizations. We found that ASWE patients showed significantly higher Neuroticism scores than did the non-ASWE group. However, there was no significant association between the hospitalization for manic episode and any particular personality trait based on the FFM. This study reveals that personality traits based on the FFM may contribute to an increased likelihood of depressive morbidity and switch into depression.
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Affiliation(s)
- Byungsu Kim
- Health Promotion Center, Asan Medical Center, Seoul, South Korea.
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13
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Roussos P, Giakoumaki SG, Bitsios P. Cognitive and emotional processing associated with the Season of Birth and dopamine D4 receptor gene. Neuropsychologia 2010; 48:3926-33. [PMID: 20875435 DOI: 10.1016/j.neuropsychologia.2010.09.021] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2010] [Revised: 09/14/2010] [Accepted: 09/17/2010] [Indexed: 01/16/2023]
Abstract
The 7-repeats variant of the dopamine D4 receptor (7R) VNTR polymorphism has been associated with higher novelty seeking (NS) and disadvantageous decision making in the Iowa Gambling Task (IGT). Season of Birth (SOB) is a significant determinant of NS. SOB and L-DRD4 genetic polymorphism may independently and interactively influence similar behaviors through their common effects on the dopaminergic system. Two hundred and twenty-seven healthy males grouped in summer-born/4-repeats (4R) (n=75), winter-born/4R (n=90), summer-born/7R (n=31) and winter-born/7R (n=31) groups, completed multimodal assessment for personality, planning for problem solving and decision making. Winter-born/7R subjects had significantly worse IGT performance throughout the task compared to 4R individuals, while summer-born 7R subjects had intermediate, although not significantly different performance. Moreover, winter-born/7R subjects had increased behavioral approach to reward without parallel reduction in sensitivity to fear or to social approval cues. The DRD4-by-SOB groups did not differ in planning for problem solving. These results suggest that a DRD4-by-SOB interaction is associated with increased behavioral approach to reward and risk taking but efficient problem solving. In addition, these results further support the hypothesis that SOB modifies the behavioral expression of dopaminergic genetic polymorphism. SOB should be included in future studies of risky behaviors and behavioral genetic studies of the dopamine system.
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Affiliation(s)
- Panos Roussos
- Department of Psychiatry and Behavioral Sciences, Faculty of Medicine, University of Crete, Heraklion, Crete, Greece
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14
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Giakoumaki SG, Bitsios P, Frangou S, Roussos P, Aasen I, Galea A, Kumari V. Low baseline startle and deficient affective startle modulation in remitted bipolar disorder patients and their unaffected siblings. Psychophysiology 2010; 47:659-68. [PMID: 20233338 DOI: 10.1111/j.1469-8986.2010.00977.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
We examined whether startle abnormalities are present in bipolar disorder (BD) patients and their unaffected siblings. Twenty-one remitted patients with BD, 19 unaffected siblings, and 42 controls were presented with 18 pleasant, 18 unpleasant, and 18 neutral pictures. Acoustic probes (104 dB) were presented during 12 of 18 pictures in each affective category at 300, 3000, and 4500 ms after picture onset, so that there were 4 pictures per valence per probe onset type. Baseline startle was assessed during blank screens and was found reduced in patients and sibling groups. We found startle inhibition with the 300 probes and a linear increase in amplitude with valence with the late probes in controls; these effects were absent in patients and their siblings. Low startle and blunted startle reactivity may represent trait deficits in remitted BD patients and their relatives, possibly associated with attentional deficits and adaptive down-regulation of emotion.
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Affiliation(s)
- Stella G Giakoumaki
- Department of Psychiatry & Behavioral Sciences, Faculty of Medicine, University of Crete, Heraklion 71003, Greece
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15
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Olvera RL, Fonseca M, Caetano SC, Hatch JP, Hunter K, Nicoletti M, Pliszka SR, Cloninger CR, Soares JC. Assessment of personality dimensions in children and adolescents with bipolar disorder using the Junior Temperament and Character Inventory. J Child Adolesc Psychopharmacol 2009; 19:13-21. [PMID: 19232019 PMCID: PMC2762645 DOI: 10.1089/cap.2008.029] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE We compared temperament and character traits in children and adolescents with bipolar disorder (BP) and healthy control (HC) subjects. METHOD Sixty nine subjects (38 BP and 31 HC), 8-17 years old, were assessed with the Kiddie Schedule for Affective Disorders and Schizophrenia-Present and Lifetime. Temperament and character traits were measured with parent and child versions of the Junior Temperament and Character Inventory. RESULTS BP subjects scored higher on novelty seeking, harm avoidance, and fantasy subscales, and lower on reward dependence, persistence, self-directedness, and cooperativeness compared to HC (all p < 0.007), by child and parent reports. These findings were consistent in both children and adolescents. Higher parent-rated novelty seeking, lower self-directedness, and lower cooperativeness were associated with co-morbid attention-deficit/hyperactivity disorder (ADHD). Lower parent-rated reward dependence was associated with co-morbid conduct disorder, and higher child-rated persistence was associated with co-morbid anxiety. CONCLUSIONS These findings support previous reports of differences in temperament in BP children and adolescents and may assist in a greater understating of BP children and adolescents beyond mood symptomatology.
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Affiliation(s)
- Rene L. Olvera
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, University of Sao Paulo School of Medicine, Sao Paulo, Brazil.,Department of Psychiatry, University of Sao Paulo School of Medicine, Sao Paulo, Brazil
| | - Manoela Fonseca
- Division of Psychiatric Genetics, Department of Psychiatry, University of Sao Paulo School of Medicine, Sao Paulo, Brazil.,Psychiatry Research Unit, Federal University of Rio Grande do Sul, School of Medicine, Porto Alegre, Brazil
| | - Sheila C. Caetano
- Department of Psychiatry, University of Sao Paulo School of Medicine, Sao Paulo, Brazil
| | - John P. Hatch
- Department of Psychiatry, University of Sao Paulo School of Medicine, Sao Paulo, Brazil.,Department of Orthodontics, The University of Texas Health Science Center at San Antonio, San Antonio, Texas
| | - Kristina Hunter
- Department of Psychiatry, University of Sao Paulo School of Medicine, Sao Paulo, Brazil
| | - Mark Nicoletti
- Center of Excellence for Research and Treatment of Bipolar Disorder, Department of Psychiatry, UNC School of Medicine, Chapel Hill, North Carolina
| | - Steven R. Pliszka
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, University of Sao Paulo School of Medicine, Sao Paulo, Brazil.,Department of Psychiatry, University of Sao Paulo School of Medicine, Sao Paulo, Brazil
| | - C. Robert Cloninger
- Department of Psychiatry, Washington University School of Medicine, Saint Louis, Missouri
| | - Jair C. Soares
- Brain Imaging and Neuropsychopharmacology, UNC School of Medicine, Chapel Hill, North Carolina
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16
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Bailly D. Troubles bipolaires et abus de substances. Encephale 2007. [DOI: 10.1016/s0013-7006(07)78682-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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