1
|
Walter N, Rupp M, Lambert-Delgado A, Mena AEC, Hinterberger T, Loew T. Waning waves of mood: The declining trend of hospitalized patients with affective disorders in Germany. J Affect Disord 2024; 356:162-166. [PMID: 38588728 DOI: 10.1016/j.jad.2024.04.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 03/30/2024] [Accepted: 04/05/2024] [Indexed: 04/10/2024]
Abstract
INTRODUCTION Affective disorders profoundly affect individuals' emotional well-being and quality of life. This study investigates the epidemiology of affective disorders in Germany from 2011 to 2021, focusing on incidence rates, age- and sex-standardized rates, and developmental trends. METHODS Using nationwide data of ICD-10 diagnosis codes from 2011 to 2021, this cross-sectional study analyzed inpatient cases of affective disorders in individuals aged 20 years or older. Age- and sex-standardized incidence rates were calculated based on the population size of each birth cohort in the 16 German federal states. Incidence rate ratios (IRRs) for 2011 to 2021 and 2019 to 2021 were compared with a two-sample z-test. RESULTS Between 2011 and 2021, F30 (manic episode) showed a decline of 42.8 % to an incidence of 4.9 per 100,000 inhabitants, even though not statistically significant (p = 0.322). F31 (bipolar affective disorder) remained relatively stable with a reduction of 15.3 % to an incidence of 13.6 per 100,000 inhabitants in 2021 (p = 0.653). F32 (depressive episode) decreased statistically significant by 25.7 % to an incidence of 64.1 per 100,000 inhabitants (p = 0.072). F33 (recurrent depressive disorder) slightly increased by 18.3 % to an incidence of 94.6 per 100,000 inhabitants (p = 0.267). No statistically significant differences were found when comparing the COVID-19 pandemic year 2021 to 2019 incidences (p ≥ 0.529). CONCLUSION The study provides valuable insights into the changing landscape of affective disorders in Germany over the past decade. The observed decline in incidence rates underscores the importance of continued efforts to promote mental health awareness and access to care.
Collapse
Affiliation(s)
- Nike Walter
- Department for Psychosomatic Medicine, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053 Regensburg, Germany; Department for Trauma Surgery, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053 Regensburg, Germany.
| | - Markus Rupp
- Department for Trauma Surgery, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053 Regensburg, Germany
| | | | | | - Thilo Hinterberger
- Department for Psychosomatic Medicine, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053 Regensburg, Germany
| | - Thomas Loew
- Department for Psychosomatic Medicine, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053 Regensburg, Germany
| |
Collapse
|
2
|
Bender LV, Wirowski N, Lobato AS, Jansen K, Cardoso TDA, Mondin TC, Oses JP, Kapczinski F, Souza LDDM, Silva RAD, Pedrotti Moreira F. The role of metabolic syndrome as a mediator in the relationship between CCL11 levels and the presence of a mood episode with mixed features in young adults with bipolar disorder. J Psychiatr Res 2024; 175:343-349. [PMID: 38761516 DOI: 10.1016/j.jpsychires.2024.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 04/02/2024] [Accepted: 05/02/2024] [Indexed: 05/20/2024]
Abstract
Mixed features presentation in bipolar disorder (BD) represents the most severe form of the disease. BD may lead to cognitive and functional deterioration, a process known as neuroprogression, which appears to be exacerbated by increased serum levels of CCL11, a neuroprogression-related cytokine. Metabolic syndrome (MetS) is highly prevalent in BD, and it is known that the presence of MetS may increase inflammation, which may contribute to increased CCL11 levels, and consequently impact on the severity of the disorder. What is not known is whether the MetS mediates the association between CCL11 levels and the presence of mood episodes with mixed features in BD. Therefore, the aim of this study was to investigate the mediating effect of MetS on the relationship between CCL11 levels and the presence of mood episodes with mixed features in BD, in a population-based study. This is a cross-sectional study that included 184 young adults, 92 with BD and 92 populational controls, matched by sex and age. BD diagnosis was assessed using the Mini International Neuropsychiatric Interview - PLUS. Mood episodes with mixed features was defined according to DSM-IV and DSM-5 criteria. MetS was defined according to the National Cholesterol Education Program (NCEP/ATP III). Substance use was assessed through the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST). CCL11 serum levels were analyzed using the multiplex analysis method Luminex 200™ system. The mediation model was tested using the MedMod module of the JAMOVI 2.4.8 software. Mediation analysis indicated a trend towards significance of MetS mediating the association between CCL11 and the presence of a mood episode with mixed features in BD (p = 0.065). Individuals with BD presenting with a mood episode with mixed features and MetS may have accelerated neuroprogression due to the influence of MetS on CCL11 levels, therefore, assessing for MetS occurrence in this population and implementing early interventions to prevent its development may be effective ways of delaying cognitive impairments related to this cytokine.
Collapse
Affiliation(s)
- Letícia Vasques Bender
- Post Graduation Program in Health and Behavior, Catholic University of Pelotas, Pelotas, RS, Brazil
| | - Natalia Wirowski
- Post Graduation Program in Health and Behavior, Catholic University of Pelotas, Pelotas, RS, Brazil
| | | | - Karen Jansen
- Post Graduation Program in Health and Behavior, Catholic University of Pelotas, Pelotas, RS, Brazil
| | - Taiane de Azevedo Cardoso
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, Australia
| | | | - Jean Pierre Oses
- Post Graduation Program in Biochemistry and Prospecting. Visiting Researcher, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Flávio Kapczinski
- Bipolar Disorder Program, Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil; Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil; Mood disorders Program, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada; Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Porto Alegre, RS, Brazil
| | | | - Ricardo Azevedo da Silva
- Post Graduation Program in Health and Behavior, Catholic University of Pelotas, Pelotas, RS, Brazil
| | - Fernanda Pedrotti Moreira
- Post Graduation Program in Health and Behavior, Catholic University of Pelotas, Pelotas, RS, Brazil.
| |
Collapse
|
3
|
Schoeller F. Primary states of consciousness: A review of historical and contemporary developments. Conscious Cogn 2023; 113:103536. [PMID: 37321024 DOI: 10.1016/j.concog.2023.103536] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 06/01/2023] [Accepted: 06/02/2023] [Indexed: 06/17/2023]
Abstract
Primary states of consciousness are conceived as phylogenetically older states of consciousness as compared to secondary states governed by sociocultural inhibition. The historical development of the concept in psychiatry and neurobiology is reviewed, along with its relationship to theories of consciousness. We suggest that primary states of consciousness are characterized by a temporary breakdown of self-control accompanied by a merging of action, communication, and emotion (ACE fusion), ordinarily segregated in human adults. We examine the neurobiologic basis of this model, including its relation to the phenomenon of neural dedifferentiation, the loss of modularity during altered states of consciousness, and increased corticostriatal connectivity. By shedding light on the importance of primary states of consciousness, this article provides a novel perspective on the role of consciousness as a mechanism of differentiation and control. We discuss potential differentiators underlying a gradient from primary to secondary state of consciousness, suggesting changes in thalamocortical interactions and arousal function. We also propose a set of testable, neurobiologically plausible working hypotheses to account for their distinct phenomenological and neural signatures.
Collapse
Affiliation(s)
- Felix Schoeller
- Institute for Advanced Consciousness Studies, Santa Monica, CA, United States; Massachusetts Institute of Technology, Cambridge, MA, United States.
| |
Collapse
|
4
|
Oliveira LC, Wirowski N, Souza PBD, Lobato AS, Jansen K, de Azevedo Cardoso T, Mondin TC, Oses JP, Kapczinski F, Souza LDDM, Azevedo da Silva R, Pedrotti Moreira F. Childhood trauma, inflammatory biomarkers and the presence of a current depressive episode: Is there a relationship in subjects from a population study? J Psychiatr Res 2023; 158:255-260. [PMID: 36621181 DOI: 10.1016/j.jpsychires.2022.12.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 12/22/2022] [Accepted: 12/23/2022] [Indexed: 12/25/2022]
Abstract
This study aims to compare the serum cytokine levels between controls, individuals with a current depressive episode (CDE) with childhood trauma and individuals with CDE without childhood trauma. This is a cross-sectional with paired sample nested in a population-based study. For the purposes of the current study, subjects who had psychotic symptoms, generalized anxiety disorder, and who refused to perform blood collection were excluded. Subsequently, only individuals who had a current depressive episode were selected (n = 76). Another 76 subjects were randomly paired by sex and age, constituting a population control group. The measurements of serum cytokine levels were performed using the multiplex analysis method. In the group with a CDE, when compared to the population control group, the following cytokines were high: IL-1β, IL-2, IL-4, IL-6, IL-17A, IFN-γ and TNF-α (p < 0.05). On the other hand, there was a decrease in the levels of cytokines IL-10 (p = 0.027) and IL12p70 (p = 0.001). Bonferroni test demonstrates that there is no statistically significant difference in serum cytokine levels between subjects with a CDE, with and without trauma (p > 0.05). In a multivariable logistic regression, adjusting for socioeconomic status, tobacco, alcohol and illicit drugs abuse/dependence, and use of psychiatric medication, we found that cytokines serum levels remained associated with CDE even when adjusted for these potential confounders. Our findings demonstrate that monitoring cytokine levels and immune function may be beneficial in preventing the development of a CDE. However, future research is necessary to investigate the impact of trauma on the relationship between inflammation and CDE.
Collapse
Affiliation(s)
| | - Natália Wirowski
- Post Graduation Program in Health and Behavior, Catholic University of Pelotas, Pelotas, RS, Brazil
| | - Pedro Borges de Souza
- Post Graduation Program in Health and Behavior, Catholic University of Pelotas, Pelotas, RS, Brazil
| | | | - Karen Jansen
- Post Graduation Program in Health and Behavior, Catholic University of Pelotas, Pelotas, RS, Brazil
| | - Taiane de Azevedo Cardoso
- Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Thaíse Campos Mondin
- Pro-rectory of Student Affairs, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Jean Pierre Oses
- Post Graduation Program of Physiological Science, Federal University of Rio Grande, Rio Grande, Rio Grande do Sul, Brazil
| | - Flávio Kapczinski
- Bipolar Disorder Program, Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil; Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil; Mood disorders Program, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada; Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Porto Alegre, RS, Brazil
| | | | - Ricardo Azevedo da Silva
- Post Graduation Program in Health and Behavior, Catholic University of Pelotas, Pelotas, RS, Brazil
| | - Fernanda Pedrotti Moreira
- Post Graduation Program in Health and Behavior, Catholic University of Pelotas, Pelotas, RS, Brazil.
| |
Collapse
|
5
|
Harmanci D, Edelman N, Richardson D, Lunt A, Llewellyn C. How are young people's mental health related to their sexual health and substance use? A systematic review of UK literature. Int J Adolesc Med Health 2023; 35:131-158. [PMID: 36636992 DOI: 10.1515/ijamh-2022-0090] [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: 10/11/2022] [Accepted: 12/15/2022] [Indexed: 01/14/2023]
Abstract
OBJECTIVES The transition from childhood to adulthood is complex and presents challenges to young people's mental health. Mental health impacts and is impacted by a range of contextual and personal factors. Adolescence and young adulthood also coincide with increased experimentation with sex, sexuality and substance use. Addressing the mental health, sexual health and substance-use challenges experienced by young people therefore necessitates an understanding of how these elements relate to one another. By collecting and analysing existing literature, this review aims to identify associations between young people's mental health and sexual health, their mental health and substance use and any resulting gaps-in-knowledge. CONTENT Seven electronic databases were searched between March and May 2021 and updated in May 2022 with terms collated under the categories of "young people", "mental health", "sexual health" and "substance use". English-language articles, presenting data from the UK & Ireland, on young people aged 16-24 years inclusive were screened and subjected to a selection process in accordance with PRISMA guidelines (preregistered on PROSPERO, ref. number CRD42021245096). The quality of the resulting articles were assessed using the Mixed Methods Appraisal Tool (MMAT) and findings were tabulated through a data extraction process. SUMMARY 27 articles were included in the review. Various mental health indices such as depression, anxiety, self-harm, psychotic-like experiences, hypomanic symptoms and binge-purge type eating disorders were found to be associated with higher use of substances such as alcohol, cannabis, ecstasy and generalised drug use. Additionally, mental health indices such as depression, anxiety and self-harm were found to be associated with sex before age 16 and/or unprotected sex at age 16, positive Chlamydia infection and higher levels of sexual activity at a younger age. Overall, cross-sectional associations were stronger than the longitudinal associations presented in the articles. OUTLOOK This review into the specific relations between young people's mental health, sexual health and substance use has revealed the complex and bi-directional nature of these associations, with some conditions and substances having been more extensively investigated (e.g., alcohol and depression/anxiety) as opposed to the relations between young people's sexual health and mental health which is lacking in the UK and Irish context. The findings can help inform mental health related policies and service provisions targeted at young people in the UK and Ireland. Areas for future work are suggested.
Collapse
Affiliation(s)
- Damla Harmanci
- Department of Primary Care & Public Health, Brighton and Sussex Medical School, Falmer, Brighton, UK
| | - Natalie Edelman
- Department of Primary Care & Public Health, Brighton and Sussex Medical School, Falmer, Brighton, UK.,School of Sport & Health Sciences, University of Brighton, Falmer, Brighton, UK
| | - Daniel Richardson
- Department of Primary Care & Public Health, Brighton and Sussex Medical School, Falmer, Brighton, UK.,University Hospitals Sussex NHS foundation Trust, Brighton, UK
| | - Alexandria Lunt
- Department of Primary Care & Public Health, Brighton and Sussex Medical School, Falmer, Brighton, UK
| | - Carrie Llewellyn
- Department of Primary Care & Public Health, Brighton and Sussex Medical School, Falmer, Brighton, UK
| |
Collapse
|
6
|
Rakovski C, Ballester PL, Montezano BB, Dias de Mattos Souza L, Jansen K, Azevedo da Silva R, Mondin TC, Pedrotti Moreira F, De Boni RB, Frey BN, Kapczinski F, de Azevedo Cardoso T. Predictors of illicit substance abuse/dependence during young adulthood: A machine learning approach. J Psychiatr Res 2023; 157:168-173. [PMID: 36470198 DOI: 10.1016/j.jpsychires.2022.11.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 10/19/2022] [Accepted: 11/21/2022] [Indexed: 11/27/2022]
Abstract
Prior studies have found an especially high prevalence of illicit substance use among adolescents and young adults in Brazil. The current study aimed to employ machine learning techniques to identify predictors of illicit substance abuse/dependence among a large community sample of young adults followed for 5 years. This prospective, population-based cohort study included a sample of young adults between the ages of 18-24 years from Pelotas, Brazil at baseline (T1). The Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) was used to assess illicit substance abuse/dependence. A clinical interview was conducted to collect data on sociodemographic characteristics and psychopathology. Elastic net was used to generate a regularized linear model for the machine learning component of this study, which followed standard machine learning protocols. A total of 1560 young adults were assessed at T1, while 1244 were reassessed at the 5-year follow-up period (T2). The strongest predictors of illicit substance abuse/dependence at baseline (AUC of 0.83) were alcohol abuse/dependence, tobacco abuse/dependence, being in a current major depressive episode, history of a lifetime manic episode, current suicide risk, and male sex. The strongest predictors for illicit substance abuse/dependence at the 5-year follow-up (AUC: 0.79) were tobacco abuse/dependence at T1, history of a lifetime manic episode at T1, male sex, alcohol abuse/dependence at T1, and current suicide risk at T1. Our findings indicate that machine learning techniques hold the potential to predict illicit substance abuse/dependence among young adults using sociodemographic/clinical characteristics, with relatively high accuracy.
Collapse
Affiliation(s)
- Coral Rakovski
- Neuroscience Graduate Program, McMaster University, Hamilton, ON, Canada
| | - Pedro L Ballester
- Neuroscience Graduate Program, McMaster University, Hamilton, ON, Canada
| | - Bruno Braga Montezano
- Health and Behavior Department, Catholic University of Pelotas, Pelotas, RS, Brazil; Bipolar Disorder Program, Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre, Instituto Nacional de Ciência e Tecnologia Translacional em Medicina, Porto Alegre, RS, Brazil; Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
| | | | - Karen Jansen
- Health and Behavior Department, Catholic University of Pelotas, Pelotas, RS, Brazil
| | | | - Thaise Campos Mondin
- Department of Student Affairs, Federal University of Pelotas, Pelotas, RS, Brazil
| | | | - Raquel Brandini De Boni
- Instituto de Comunicação e Informação Cientifica e Tecnológica em Saúde, Oswaldo Cruz Foundation, RJ, Brazil
| | - Benicio N Frey
- Mood Disorders Program, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada; Women's Health Concerns Clinic, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | - Flavio Kapczinski
- Bipolar Disorder Program, Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre, Instituto Nacional de Ciência e Tecnologia Translacional em Medicina, Porto Alegre, RS, Brazil; Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil; Mood Disorders Program, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada; Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Porto Alegre, RS, Brazil
| | - Taiane de Azevedo Cardoso
- Health and Behavior Department, Catholic University of Pelotas, Pelotas, RS, Brazil; Mood Disorders Program, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada.
| |
Collapse
|
7
|
Wang Y, Zhang Y, Wang G, Duan Z, Wilson A, Yang Y, Sun S, Chen R. Latent profile analysis to identify subgroups of Chinese sexual minority adolescents at risk of suicidality. Prev Med 2022; 157:107007. [PMID: 35247440 DOI: 10.1016/j.ypmed.2022.107007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 02/14/2022] [Accepted: 02/26/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND This study aimed to identify latent class profiles of sexual minority adolescents (Men Sexually attracted to Men, Women Sexually attracted to Women, and Bisexual) with elevated suicidal ideation. METHODS Data were collected from 18 secondary schools in China. Sub-group classifications were identified using variables associated with suicidal ideation in sexual minority adolescents, including parental relationship quality, electronic equipment time, school bullying, and sleep quality using the Chinese version of the Pittsburgh Sleep Quality Index to measure sleep. Anxiety was measured using the Generalized Anxiety Disorder 7 (GAD-7), depression was measured using the Patient Health Questionnaire 9 (PHQ-9), hypomania using the Hypomanic Checklist-32 (HCL-32), positive coping style was identified using the Trait Coping Style Questionnaire, and self-efficacy was measured by the General Self-Efficacy Scale. RESULTS Four distinctive profiles were derived from the data. Compared to "low-risk" group (Class 3), the "adolescent with mood problems" group (Class 2) had a 9.81 times higher risk of suicidal ideation; the those who classified as "severe bullied adolescent" (Class 4) had a 9.26 times higher risk of suicidal ideation. and the "adolescents with low self-efficacy" group (Class 1) had a 4.48 times higher risk of suicidal ideation. CONCLUSIONS Sexual minority adolescents with mood problems have the highest risk of suicidal ideation, followed by adolescents frequently being bullied at school. Interventions aimed at reducing suicide risk among sexual minority adolescents may benefit from attending to such profile factors identified in this study to develop targeted clinical care.
Collapse
Affiliation(s)
- Yuanyuan Wang
- Division of Psychology, Faculty of Health and Life Sciences, De Montfort University, Leicester, UK; Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, China; School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, China
| | - Yanwen Zhang
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Guosheng Wang
- Suzhou Guangji Hospital Affiliated Guangji Hospital of Soochow University, Soochow University, Suzhou, China
| | - Zhizhou Duan
- Preventive Health Service, Jiangxi Provincial People's Hospital, Affiliated People's Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Amanda Wilson
- Division of Psychology, Faculty of Health and Life Sciences, De Montfort University, Leicester, UK
| | - Yong Yang
- Suzhou Guangji Hospital Affiliated Guangji Hospital of Soochow University, Soochow University, Suzhou, China.
| | - Shufang Sun
- Brown University School of Public Health, Department of Behavioral and Social Sciences, International Health Institute, USA
| | - Runsen Chen
- Vanke School of Public Health, Tsinghua University, Beijing, China; Institute for Healthy China, Tsinghua University, Beijing, China.
| |
Collapse
|
8
|
Investigating biological rhythms disruptions across the menstrual cycle in women with comorbid bipolar disorder and premenstrual dysphoric disorder. Arch Womens Ment Health 2022; 25:345-353. [PMID: 35226173 DOI: 10.1007/s00737-022-01220-0] [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: 11/02/2021] [Accepted: 02/22/2022] [Indexed: 11/02/2022]
Abstract
We investigated whether women diagnosed with comorbid bipolar disorder (BD) and premenstrual dysphoric disorder (PMDD) experience higher disruptions in biological rhythms in two independent study samples. The first study has a population-based sample of 727 women, including 104 women with PMDD only, 43 women with BD only, 24 women with comorbid PMDD and BD, and 556 women without BD or PMDD (controls). Biological rhythm disruptions were cross-sectionally evaluated using the Biological Rhythms Interview of Assessment in Neuropsychiatry (BRIAN). The second study enrolled 77 outpatient women who completed prospective assessments at two timepoints: during the mid-follicular and the late-luteal phases of their menstrual cycles, using the BRIAN, and included 19 women with PMDD, 16 with BD, 17 with comorbid PMDD and BD, and 25 controls. In the population-based sample, all the diagnostic groups (BD, PMDD, BDPMDD) presented greater biological rhythm disruption than controls. In addition, women with BD presented greater overall biological rhythms disruption, and greater disruption in sleep, activity, and eating patterns, than women with PMDD. In the outpatient sample study, women with BDPMDD showed greater disruption in the social domain than women with PMDD. In the outpatient sample, women with BDPMDD reported significantly higher disruptions in biological rhythms across both the follicular and the luteal phases of the menstrual cycle. The comorbidity between BD and PMDD may affect biological rhythms beyond the luteal phase of the menstrual cycle. These results support previous literature on the increased illness burden of women diagnosed with comorbid BD and PMDD.
Collapse
|
9
|
Farias CDA, Cardoso TDA, da Silva MM, D'Angelo F, Mondin TC, Souza LDDM, da Silva RA, Kapczinski F, Jansen K, Magalhães PVS. Socioeconomic and substance use changes in emerging adults and their relationship with mood disorders in a population-based cohort. Front Psychiatry 2022; 13:932484. [PMID: 36090374 PMCID: PMC9448898 DOI: 10.3389/fpsyt.2022.932484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 08/04/2022] [Indexed: 11/13/2022] Open
Abstract
In this report, we aim to assess the interaction of bipolar disorder and major depressive disorder with the evolution of social roles, economic classification, and substance misuse in emerging adults. This is a longitudinal population-based study (n = 231 at baseline), in which participants were reassessed at a mean of 5 years after baseline. A structured clinical interview was used to diagnose the participants with bipolar disorder and major depression; a control group without mood disorders was included. Men with mood disorders were less likely to be married in the beginning of the study and less likely to work in the follow-up. Women with major depression were less likely to study and more likely to be in a lower economic class at the beginning of the study. In comparison, women with bipolar disorder were less likely to live with their parents and more likely to live with their children in the first wave of the study. Substance misuse was more likely in people with mood disorders, especially in men, and women with bipolar disorder had the highest likelihood in the follow-up. Albeit longitudinal analyses were limited by a possibly insufficient sample size and mediating mechanisms for change, such as stigma, were not explored, the study suggests sex-related specificities regarding the change in social roles and substance use in people with mood disorders. Emerging adults, especially those with mood disorders, are in a period of change and instability and at a greater risk for substance use and abuse.
Collapse
Affiliation(s)
- Clarisse de Azambuja Farias
- Graduate Program in Psychiatry and Behavioral Sciences, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Graduate Program in Health and Behavior, Universidade Católica de Pelotas, Pelotas, Brazil
| | - Taiane de Azevedo Cardoso
- Graduate Program in Health and Behavior, Universidade Católica de Pelotas, Pelotas, Brazil.,Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Marielle Moro da Silva
- Faculty of Medicine, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Francesca D'Angelo
- Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Thaise Campos Mondin
- Graduate Program in Health and Behavior, Universidade Católica de Pelotas, Pelotas, Brazil
| | | | | | - Flavio Kapczinski
- Graduate Program in Psychiatry and Behavioral Sciences, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, ON, Canada.,Faculty of Medicine, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Karen Jansen
- Graduate Program in Health and Behavior, Universidade Católica de Pelotas, Pelotas, Brazil
| | - Pedro V S Magalhães
- Graduate Program in Psychiatry and Behavioral Sciences, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| |
Collapse
|
10
|
Farias CDA, de Azevedo Cardoso T, Campos Mondin T, Dias de Mattos Souza L, Silva RAD, Kapczinski F, Jansen K, Magalhães PVS. Early illness progression in mood disorders: A population-based longitudinal study. Psychiatry Res 2021; 306:114225. [PMID: 34627111 DOI: 10.1016/j.psychres.2021.114225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 09/24/2021] [Accepted: 09/25/2021] [Indexed: 10/20/2022]
Abstract
This study is aimed at assessing changes in functioning among young people from the general population with bipolar disorder and major depressive disorder over a period of five years. Specifically, we hypothesized that significant illness progression would take place during euthymia over time in bipolar disorder. We conducted a longitudinal study with 231 people, assessed at baseline and again at a five-year follow-up. A structured clinical interview was used to diagnose participants with mood disorders. A control group without mood disorders was also included. Functioning was assessed with the Functioning Assessment Short Test, and linear mixed models were used to analyze the effect of psychopathology on change in functioning. Mood disorders were associated with significant functional impairment, but functioning significantly improved in both groups over the 5-year follow-up period. Depressive episodes, however, were associated with worse functioning at follow-up, independently of depression severity. In contrast to our initial hypothesis, we found a worsening of functioning in a five-year period associated only with depressive episodes. This suggests that interventions focused on the prevention of mood episodes early in the course of illness may be particularly promising to reduce adverse functioning outcomes.
Collapse
Affiliation(s)
- Clarisse de Azambuja Farias
- Universidade Federal do Rio Grande do Sul, Hospital de Clínicas de Porto Alegre, Graduate Program in Psychiatry and Behavioral Sciences, Porto Alegre, RS, Brazil.
| | - Taiane de Azevedo Cardoso
- Universidade Católica de Pelotas, Graduate Program in Health and Behavior, Pelotas, RS, Brazil; McMaster University, Department of Psychiatry and Behavioral Neurosciences, Hamilton, Ontario, Canada
| | - Thaise Campos Mondin
- Universidade Católica de Pelotas, Graduate Program in Health and Behavior, Pelotas, RS, Brazil
| | | | | | - Flavio Kapczinski
- Universidade Federal do Rio Grande do Sul, Hospital de Clínicas de Porto Alegre, Graduate Program in Psychiatry and Behavioral Sciences, Porto Alegre, RS, Brazil; McMaster University, Department of Psychiatry and Behavioral Neurosciences, Hamilton, Ontario, Canada
| | - Karen Jansen
- Universidade Católica de Pelotas, Graduate Program in Health and Behavior, Pelotas, RS, Brazil
| | - Pedro V S Magalhães
- Universidade Federal do Rio Grande do Sul, Hospital de Clínicas de Porto Alegre, Graduate Program in Psychiatry and Behavioral Sciences, Porto Alegre, RS, Brazil.
| |
Collapse
|
11
|
Vieira IS, Ferrugem SCR, Reyes AN, Branco JC, Mondin TC, Cardoso TDA, Kapczinski F, Souza LDDM, Jansen K, da Silva RA, Pedrotti Moreira F. Effects of depression and excess body weight on cognition and functioning in young adults: A population-based study. J Affect Disord 2021; 282:401-406. [PMID: 33421869 DOI: 10.1016/j.jad.2020.12.083] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 10/30/2020] [Accepted: 12/22/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The purpose of this study is to assess the independent effects of depression and excess body weight (EBW) on cognition and functioning in a community sample of young adults. METHODS This was a cross-sectional of 943 young adults. The diagnosis of a current depressive episode was performed using the Mini International Neuropsychiatric Interview (MINI). Cognition and functioning were assessed using the Montreal Cognitive Assessment (MoCA) and the Functional Assessment Short Test (FAST), respectively. The EBW was defined as BMI ≥ 25.0 kg/m2. The independent main effects of depression and EBW, as well as the analysis interaction were performed using two-way analysis of covariance (ANCOVA). RESULTS The total sample comprised 943 adults, with 75 (8.0%) individuals diagnosed with a current depressive episode and 493 (52,6%) with EBW. Of the 75 subjects with depression, 40 were identified with EBW comorbidity. Subjects with depression and EBW comorbidity reported greater cognitive and functional impairment, as compared to individuals with depression without EBW. There was a significant interaction between depression and EBW on MoCA total (p<0.001) as well as FAST total (p=0.010), work (p=0.002), cognition (p=0.023), finances (p=0.032) and relationships domains (p=0.008). CONCLUSIONS The adverse effects of depression and EBW are independent and cumulative with respect to cognition and functioning of individuals. The understanding of the complex interactions between cognition, functioning, EBW and depression are important for development of preventive and therapeutic strategies.
Collapse
Affiliation(s)
- Igor Soares Vieira
- Translational Science on Brain Disorders, Programa de Pós-Graduação em Saúde e Comportamento, Universidade Católica de Pelotas, RS, Brazil
| | | | - Amanda Neumann Reyes
- Translational Science on Brain Disorders, Programa de Pós-Graduação em Saúde e Comportamento, Universidade Católica de Pelotas, RS, Brazil
| | - Jerônimo Costa Branco
- Mestrado em Ciências da Saúde e da Vida, Universidade Franciscana, Santa Maria, RS, Brazil
| | - Thaíse Campos Mondin
- Pró-Reitoria de Assuntos Estudantis (PRAE), Universidade Federal de Pelotas, RS, Brazil
| | - Taiane de Azevedo Cardoso
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada; Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Porto Alegre, Brazil
| | - Flávio Kapczinski
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada; Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Porto Alegre, Brazil
| | - Luciano Dias de Mattos Souza
- Translational Science on Brain Disorders, Programa de Pós-Graduação em Saúde e Comportamento, Universidade Católica de Pelotas, RS, Brazil; Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Porto Alegre, Brazil
| | - Karen Jansen
- Translational Science on Brain Disorders, Programa de Pós-Graduação em Saúde e Comportamento, Universidade Católica de Pelotas, RS, Brazil; Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Porto Alegre, Brazil
| | - Ricardo Azevedo da Silva
- Translational Science on Brain Disorders, Programa de Pós-Graduação em Saúde e Comportamento, Universidade Católica de Pelotas, RS, Brazil; Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Porto Alegre, Brazil
| | - Fernanda Pedrotti Moreira
- Translational Science on Brain Disorders, Programa de Pós-Graduação em Saúde e Comportamento, Universidade Católica de Pelotas, RS, Brazil; Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Porto Alegre, Brazil.
| |
Collapse
|
12
|
Bipolar disorder: An evolutionary psychoneuroimmunological approach. Neurosci Biobehav Rev 2021; 122:28-37. [PMID: 33421542 DOI: 10.1016/j.neubiorev.2020.12.031] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 12/19/2020] [Accepted: 12/27/2020] [Indexed: 12/19/2022]
Abstract
Bipolar disorder is a mental health disorder characterized by extreme shifts in mood, high suicide rate, sleep problems, and dysfunction of psychological traits like self-esteem (feeling inferior when depressed and superior when manic). Bipolar disorder is rare among populations that have not adopted contemporary Western lifestyles, which supports the hypothesis that bipolar disorder results from a mismatch between Homo sapiens's evolutionary and current environments. Recent studies have connected bipolar disorder with low-grade inflammation, the malfunctioning of the internal clock, and the resulting sleep disturbances. Stress is often a triggering factor for mania and sleep problems, but stress also causes low-grade inflammation. Since inflammation desynchronizes the internal clock, chronic stress and inflammation are the primary biological mechanisms behind bipolar disorder. Chronic stress and inflammation are driven by contemporary Western lifestyles, including stressful social environments, unhealthy dietary patterns, limited physical activity, and obesity. The treatment of bipolar disorder should focus on reducing stress, stress sensitivity, and inflammation by lifestyle changes rather than just temporarily alleviating symptoms with psychopharmacological interventions.
Collapse
|
13
|
Maia da Silva MN, Porto FHDG, Lopes PMG, Sodré de Castro Prado C, Frota NAF, Alves CHL, Alves GS. Frontotemporal Dementia and Late-Onset Bipolar Disorder: The Many Directions of a Busy Road. Front Psychiatry 2021; 12:768722. [PMID: 34925096 PMCID: PMC8674641 DOI: 10.3389/fpsyt.2021.768722] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 10/13/2021] [Indexed: 12/18/2022] Open
Abstract
It is a common pathway for patients with the behavioral variant of frontotemporal dementia (bvFTD) to be first misdiagnosed with a primary psychiatric disorder, a considerable proportion of them being diagnosed with bipolar disorder (BD). Conversely, not rarely patients presenting in late life with a first episode of mania or atypically severe depression are initially considered to have dementia before the diagnosis of late-onset BD is reached. Beyond some shared features that make these conditions particularly prone to confusion, especially in the elderly, the relationship between bvFTD and BD is far from simple. Patients with BD often have cognitive complaints as part of their psychiatric disorder but are at an increased risk of developing dementia, including FTD. Likewise, apathy and disinhibition, common features of depression and mania, respectively, are among the core features of the bvFTD syndrome, not to mention that depression may coexist with dementia. In this article, we take advantage of the current knowledge on the neurobiology of these two nosologic entities to review their historical and conceptual interplay, highlighting the clinical, genetic and neuroimaging features that may be shared by both disorders or unique to each of them.
Collapse
Affiliation(s)
- Mari N Maia da Silva
- Geriatric Neuropsychiatry Outpatient Service, Nina Rodrigues Hospital, São Luís, Brazil
| | - Fábio Henrique de Gobbi Porto
- Laboratory of Psychiatric Neuroimaging (LIM-21) and Old Age Research Group (PROTER), Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | | | | | - Norberto Anízio Ferreira Frota
- University of Fortaleza (UNIFOR) School of Medicine, Cognitive and Behavioral Neurology Service, Hospital Geral de Fortaleza, Fortaleza, Brazil
| | | | - Gilberto Sousa Alves
- Geriatric Neuropsychiatry Outpatient Service, Nina Rodrigues Hospital, São Luís, Brazil.,Post Graduation in Psychiatry and Mental Health, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| |
Collapse
|
14
|
CCL11 levels in drug-naive bipolar patients: The role of sex and smoking status. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2020. [DOI: 10.1016/j.jadr.2020.100002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
|
15
|
Vieira IS, Pedrotti Moreira F, Mondin TC, Cardoso TDA, Branco JC, Kapczinski F, Jansen K, Souza LDDM, da Silva RA. Resilience as a mediator factor in the relationship between childhood trauma and mood disorder: A community sample of young adults. J Affect Disord 2020; 274:48-53. [PMID: 32469831 DOI: 10.1016/j.jad.2020.04.011] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 03/24/2020] [Accepted: 04/17/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND Studies on the field of mood disorders has mainly focusing on the risk factors associated to develop the illness or the clinical factors associated with the clinical progression. Less attention was given to factors such as resilience that may be associated with better outcomes in the course of mood disorders. In this study, we assessed the mediation effect of resilience on the relationship between childhood trauma and mood disorders, as well as the severity of depressive symptoms in a population-based sample. METHODS This is a cross-sectional study with a community sample of young adults with bipolar disorder (BD), major depressive disorder (MDD), and community controls without any mood disorder. The trauma experiences during childhood were assessed by Childhood Trauma Questionnaire (CTQ). The severity of depressive symptoms was assessed using the Montgomery-Asberg Depression Rating Scale (MADRS) and to assess the resilience was used the Resilience Scale (RS-25). RESULTS All subtypes of trauma were associated with both MDD and BD, however, only physical and emotional abuse differentiated BD from MDD subjects. Bootstrapping-enhanced mediation analyses indicated that resilience partly mediated the association of childhood trauma to both mood disorder and severity of depression. LIMITATION The employed mediation analyses are cross-sectional in nature, which limits any firm conclusions regarding causality. CONCLUSIONS The findings support the clinical assumption that resilient subjects may be partly protected against the detrimental long-term effects of childhood trauma. This study provides important information regarding the relationships among childhood trauma, resilience, and mood disorder.
Collapse
Affiliation(s)
- Igor Soares Vieira
- Translational Science on Brain Disorders, Programa de Pós-Graduação em Saúde e Comportamento, Universidade Católica de Pelotas, RS, Brasil
| | - Fernanda Pedrotti Moreira
- Translational Science on Brain Disorders, Programa de Pós-Graduação em Saúde e Comportamento, Universidade Católica de Pelotas, RS, Brasil; Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Porto Alegre, Brazil
| | - Thaise Campos Mondin
- Pró-Reitoria de Assuntos Estudantis (PRAE), Universidade Federal de Pelotas, RS, Brasil
| | - Taiane de Azevedo Cardoso
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada; Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Porto Alegre, Brazil
| | - Jerônimo Costa Branco
- Mestrado em Ciências da Saúde e da Vida, Universidade Franciscana, Santa Maria, RS, Brasil
| | - Flávio Kapczinski
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada; Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Porto Alegre, Brazil
| | - Karen Jansen
- Translational Science on Brain Disorders, Programa de Pós-Graduação em Saúde e Comportamento, Universidade Católica de Pelotas, RS, Brasil; Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Porto Alegre, Brazil
| | - Luciano Dias de Mattos Souza
- Translational Science on Brain Disorders, Programa de Pós-Graduação em Saúde e Comportamento, Universidade Católica de Pelotas, RS, Brasil; Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Porto Alegre, Brazil
| | - Ricardo Azevedo da Silva
- Translational Science on Brain Disorders, Programa de Pós-Graduação em Saúde e Comportamento, Universidade Católica de Pelotas, RS, Brasil; Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Porto Alegre, Brazil.
| |
Collapse
|
16
|
Vieira IS, Pedrotti Moreira F, Mondin TC, Cardoso TDA, Jansen K, Souza LDDM, da Silva RA. Childhood trauma and bipolar spectrum: a population-based sample of young adults. TRENDS IN PSYCHIATRY AND PSYCHOTHERAPY 2020; 42:115-121. [DOI: 10.1590/2237-6089-2019-0046] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Accepted: 11/12/2019] [Indexed: 11/21/2022]
|
17
|
Sverdlichenko I, Jansen K, Souza LDDM, da Silva RA, Kapczinski F, Cardoso TDA. Mixed episodes and suicide risk: A community sample of young adults. J Affect Disord 2020; 266:252-257. [PMID: 32056885 DOI: 10.1016/j.jad.2020.01.111] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 12/11/2019] [Accepted: 01/20/2020] [Indexed: 11/20/2022]
Abstract
BACKGROUND Suicide is the second leading cause of death among young adults worldwide, and few studies have assessed the factors associated with suicidality in this specific population. Thus, the aim of this study was to assess the association between mixed episodes and suicidality in a community sample of young adults. For this aim, we compared young adults in a mixed episode with individuals in a depressive or (hypo)manic episode, and community controls. METHOD This is a cross-sectional population-based study including young adults aged 18-24 years old. Information about participants' age, sex, self-reported skin color and study status were obtained using a sociodemographic questionnaire. Mixed, (hypo)manic and depressive episodes, as well as suicide risk were assessed using the Mini International Neuropsychiatric Interview. RESULTS The sample included 1560 individuals. Young adults in a mixed episode showed a 13.50 times higher probability to have suicide risk, as compared to community controls (p < 0.001), 5.67 higher probability to have suicide risk as compared to individuals in a (hypo)manic episode (p < 0.001), and 2.18 times higher probability to have suicide risk as compared to young adults in a depressive episode (p < 0.001). LIMITATION The assessment of suicide risk includes both suicide attempts and ideation. CONCLUSION Young adults in a mixed episode showed a higher rate of suicide risk than individuals with depression or mania/hypomania. Considering the already increasing prevalence of suicide among young adults, there is an urgent need for the early diagnosis and treatment of mixed episodes in this specific population.
Collapse
Affiliation(s)
- Irina Sverdlichenko
- Mood Disorders Program, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Karen Jansen
- Department of Health and Behavior, Catholic University of Pelotas, Pelotas, RS, Brazil
| | | | | | - Flavio Kapczinski
- Mood Disorders Program, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Taiane de Azevedo Cardoso
- Mood Disorders Program, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada; Department of Health and Behavior, Catholic University of Pelotas, Pelotas, RS, Brazil.
| |
Collapse
|
18
|
Angst J, Rössler W, Ajdacic-Gross V, Angst F, Wittchen HU, Lieb R, Beesdo-Baum K, Asselmann E, Merikangas KR, Cui L, Andrade LH, Viana MC, Lamers F, Penninx BW, de Azevedo Cardoso T, Jansen K, Dias de Mattos Souza L, Azevedo da Silva R, Kapczinski F, Grobler C, Gholam-Rezaee M, Preisig M, Vandeleur CL. Differences between unipolar mania and bipolar-I disorder: Evidence from nine epidemiological studies. Bipolar Disord 2019; 21:437-448. [PMID: 30475430 DOI: 10.1111/bdi.12732] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVES Although clinical evidence suggests important differences between unipolar mania and bipolar-I disorder (BP-I), epidemiological data are limited. Combining data from nine population-based studies, we compared subjects with mania (M) or mania with mild depression (Md) to those with BP-I with both manic and depressive episodes with respect to demographic and clinical characteristics in order to highlight differences. METHODS Participants were compared for gender, age, age at onset of mania, psychiatric comorbidity, temperament, and family history of mental disorders. Generalized linear mixed models with adjustment for sex and age as well as for each study source were applied. Analyses were performed for the pooled adult and adolescent samples, separately. RESULTS Within the included cohorts, 109 adults and 195 adolescents were diagnosed with M/Md and 323 adults and 182 adolescents with BP-I. In both adult and adolescent samples, there was a male preponderance in M/Md, whereas lifetime generalized anxiety and/panic disorders and suicide attempts were less common in M/Md than in BP-I. Furthermore, adults with mania revealed bulimia/binge eating and drug use disorders less frequently than those with BP-I. CONCLUSIONS The significant differences found in gender and comorbidity between mania and BP-I suggest that unipolar mania, despite its low prevalence, should be established as a separate diagnosis both for clinical and research purposes. In clinical settings, the rarer occurrence of suicide attempts, anxiety, and drug use disorders among individuals with unipolar mania may facilitate successful treatment of the disorder and lead to a more favorable course than that of BP-I disorder.
Collapse
Affiliation(s)
- Jules Angst
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Wulf Rössler
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland.,Laboratory of Neuroscience (LIM 27), Institute of Psychiatry, University of São Paulo, São Paulo, Brazil.,Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Vladeta Ajdacic-Gross
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Felix Angst
- Rehabilitation Clinic, Bad Zurzach, Switzerland
| | - Hans Ulrich Wittchen
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.,Psychiatric University Hospital, Ludwig-Maximilians-University, Munich, Germany
| | - Rosalind Lieb
- Max Planck Institute of Psychiatry, Munich, Germany.,Division of Clinical Psychology and Epidemiology, Department of Psychology, University of Basel, Basel, Switzerland
| | - Katja Beesdo-Baum
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.,Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Eva Asselmann
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.,Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Kathleen R Merikangas
- Genetic Epidemiology Research Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, Maryland
| | - Lihong Cui
- Genetic Epidemiology Research Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, Maryland
| | - Laura H Andrade
- Section of Psychiatric Epidemiology (LIM 23), Department and Institute of Psychiatry, School of Medicine, Universidade de São Paulo, São Paulo, Brazil
| | - Maria C Viana
- Department of Social Medicine, Postgraduate Program in Public Health, Federal University of Espírito Santo, Vitória, Brazil
| | - Femke Lamers
- Department of Psychiatry and Amsterdam Public Health Research Institute, VU University Medical Centre, Amsterdam, The Netherlands
| | - Brenda Wjh Penninx
- Department of Psychiatry and Amsterdam Public Health Research Institute, VU University Medical Centre, Amsterdam, The Netherlands
| | | | - Karen Jansen
- Health and Behavior Graduate Program, Catholic University of Pelotas, Pelotas, Brazil
| | | | | | - Flavio Kapczinski
- Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.,Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Christoffel Grobler
- Elizabeth Donkin Hospital, Port Elizabeth, South Africa.,Nelson Mandela University, Port Elizabeth, South Africa
| | - Mehdi Gholam-Rezaee
- Department of Psychiatry, University Hospital of Lausanne, Prilly, Switzerland
| | - Martin Preisig
- Department of Psychiatry, University Hospital of Lausanne, Prilly, Switzerland
| | | |
Collapse
|
19
|
Farias CDA, Cardoso TDA, Mondin TC, Souza LDDM, da Silva RA, Kapczinski F, Magalhães PVDS, Jansen K. Clinical outcomes and childhood trauma in bipolar disorder: A community sample of young adults. Psychiatry Res 2019; 275:228-232. [PMID: 30928726 DOI: 10.1016/j.psychres.2018.12.114] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Revised: 12/20/2018] [Accepted: 12/20/2018] [Indexed: 10/27/2022]
Abstract
Childhood trauma is a complex experience, much reported by subjects with bipolar disorder. There are still few studies that assess its consequences in a community sample of bipolar in early stage. The aim of the present study is to assess the association between childhood trauma and clinical outcomes, including the global functioning, in a community sample of young adults with bipolar disorder. This is a cross-sectional study with a community sample of subjects with bipolar disorder, from 23 to 30 years old, with and without childhood trauma. The trauma experiences during childhood were assessed by Childhood Trauma Questionnaire (CTQ). The functioning was assessed by Functioning Assessment Short Test (FAST). Ninety subjects with bipolar disorder were included in the study (30 with childhood trauma and 60 without childhood trauma). Young adults with bipolar disorder and childhood trauma showed higher prevalence of current suicide risk, higher severity of depressive symptoms, and higher functioning impairment as compared to subjects with bipolar disorder without childhood trauma. The childhood trauma experiences appear to be an environmental risk factor for worse clinical outcomes and higher functional impairment.
Collapse
Affiliation(s)
- Clarisse de Azambuja Farias
- Programa de Pós-graduação em Psiquiatria e Ciências do Comportamento, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil; Department of Health and Behavior, Catholic University of Pelotas, 373 Goncalves Chaves, 416C room, Zip code 96015-560, Pelotas, RS, Brazil
| | | | - Thaise Campos Mondin
- Department of Health and Behavior, Catholic University of Pelotas, 373 Goncalves Chaves, 416C room, Zip code 96015-560, Pelotas, RS, Brazil
| | - Luciano Dias de Mattos Souza
- Department of Health and Behavior, Catholic University of Pelotas, 373 Goncalves Chaves, 416C room, Zip code 96015-560, Pelotas, RS, Brazil
| | - Ricardo Azevedo da Silva
- Department of Health and Behavior, Catholic University of Pelotas, 373 Goncalves Chaves, 416C room, Zip code 96015-560, Pelotas, RS, Brazil
| | - Flavio Kapczinski
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Pedro Vieira da Silva Magalhães
- Programa de Pós-graduação em Psiquiatria e Ciências do Comportamento, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Karen Jansen
- Department of Health and Behavior, Catholic University of Pelotas, 373 Goncalves Chaves, 416C room, Zip code 96015-560, Pelotas, RS, Brazil.
| |
Collapse
|
20
|
Moreira FP, Jansen K, Cardoso TDA, Mondin TC, Vieira IS, Magalhães PVDS, Kapczinski F, Souza LDDM, da Silva RA, Oses JP, Wiener CD. Metabolic syndrome, depression and anhedonia among young adults. Psychiatry Res 2019; 271:306-310. [PMID: 30522000 DOI: 10.1016/j.psychres.2018.08.009] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Revised: 06/04/2018] [Accepted: 08/05/2018] [Indexed: 01/13/2023]
Abstract
The aim of this study was to assess the association between anhedonia and metabolic syndrome (MetS) in a well-characterized community sample of individuals with a current depressive episode. This is a cross-sectional study with young adults aged 24-30 years old. Depressive episode and the presence of anhedonia was assessed using the Mini International Neuropsychiatric Interview - Plus version (MINI Plus). The MetS was assessed using the National Cholesterol Education Program Adult Treatment Panel III (NCEP/ATP III). The sample included 931 subjects, being 22 had depression without anhedonia, whereas 55 had depression with anhedonia. MetS was more prevalent among subjects with depression and anhedonia (43.6%) when compared to individuals without anhedonia and population control group. Moreover, subjects with depression and anhedonia have a significant increase of levels of glucose, triglycerides, total-cholesterol and LDL-cholesterol, as well as significant decreased in the HDL-cholesterol level. The present study showed that individuals with depression and anhedonia present higher prevalence of MetS. Our study suggests that the use of the concept of anhedonia may contribute to a better understanding of the complex relationship between depression and metabolic syndrome.
Collapse
Affiliation(s)
- Fernanda Pedrotti Moreira
- Translational Science on Brain Disorders, Department of Health and Behavior, Catholic University of Pelotas, Pelotas, RS, Brazil
| | - Karen Jansen
- Translational Science on Brain Disorders, Department of Health and Behavior, Catholic University of Pelotas, Pelotas, RS, Brazil; Molecular Psychiatry, Department of Psychiatry and Behavioral Sciences, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil.
| | - Taiane de Azevedo Cardoso
- Molecular Psychiatry, Department of Psychiatry and Behavioral Sciences, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Thaíse Campos Mondin
- Translational Science on Brain Disorders, Department of Health and Behavior, Catholic University of Pelotas, Pelotas, RS, Brazil
| | - Igor Soares Vieira
- Translational Science on Brain Disorders, Department of Health and Behavior, Catholic University of Pelotas, Pelotas, RS, Brazil
| | - Pedro Vieira da Silva Magalhães
- Molecular Psychiatry, Department of Psychiatry and Behavioral Sciences, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Flavio Kapczinski
- Molecular Psychiatry, Department of Psychiatry and Behavioral Sciences, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil; McMaster University, Hamilton, ON, Canada
| | - Luciano Dias de Mattos Souza
- Translational Science on Brain Disorders, Department of Health and Behavior, Catholic University of Pelotas, Pelotas, RS, Brazil
| | - Ricardo Azevedo da Silva
- Translational Science on Brain Disorders, Department of Health and Behavior, Catholic University of Pelotas, Pelotas, RS, Brazil
| | - Jean Pierre Oses
- Translational Science on Brain Disorders, Department of Health and Behavior, Catholic University of Pelotas, Pelotas, RS, Brazil
| | - Carolina David Wiener
- Translational Science on Brain Disorders, Department of Health and Behavior, Catholic University of Pelotas, Pelotas, RS, Brazil; Department of Epidemiology, Federal University of Pelotas, Pelotas, RS, Brazil
| |
Collapse
|
21
|
Moreira FP, Jansen K, Cardoso TDA, Mondin TC, Magalhães PV, Kapczinski F, Souza LDM, da Silva RA, Oses JP, Wiener CD. Metabolic syndrome and psychiatric disorders: a population-based study. ACTA ACUST UNITED AC 2018; 41:38-43. [PMID: 30328961 PMCID: PMC6781708 DOI: 10.1590/1516-4446-2017-2328] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Accepted: 04/01/2018] [Indexed: 12/25/2022]
Abstract
Objective: To identify the association of metabolic syndrome (MetS) and psychiatric disorders in young adults in southern Brazil. Methods: This population based cross-sectional study involved a total of 1,023 young adults between the ages of 21 and 32 years. Current episodes of psychiatric disorders were assessed using the Mini International Neuropsychiatric Interview – Plus version. MetS was evaluated using the National Cholesterol Education Program Adult Treatment Panel III (NCEP/ATP III). Results: Of the 1,023 participants, 24.3% were identified with MetS, 13.5% were diagnosed with anxiety disorders, 7.5% with current depression, 3.9% with bipolar disorders and 10.1% were at risk of suicide. MetS was associated with ethnicity (p = 0.022), excess weight (p < 0.001), current anxiety disorders (p < 0.001), current mood disorders (bipolar disorder in mood episode and current depression) (p < 0.001), and suicide risk (p < 0.001). Conclusions: MetS was associated with psychiatric disorders. Awareness of factors associated with MetS can help identify high-risk individuals and stimulate disease prevention and control programs, as well as lifestyle changes.
Collapse
Affiliation(s)
- Fernanda Pedrotti Moreira
- Ciência Translacional em Transtornos Cerebrais, Departamento de Saúde e Comportamento, Universidade Católica de Pelotas (UCPel), Pelotas, RS, Brazil
| | - Karen Jansen
- Ciência Translacional em Transtornos Cerebrais, Departamento de Saúde e Comportamento, Universidade Católica de Pelotas (UCPel), Pelotas, RS, Brazil
| | - Taiane de A Cardoso
- Ciência Translacional em Transtornos Cerebrais, Departamento de Saúde e Comportamento, Universidade Católica de Pelotas (UCPel), Pelotas, RS, Brazil
| | - Thaíse C Mondin
- Ciência Translacional em Transtornos Cerebrais, Departamento de Saúde e Comportamento, Universidade Católica de Pelotas (UCPel), Pelotas, RS, Brazil
| | - Pedro V Magalhães
- Psiquiatria Molecular, Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Flavio Kapczinski
- Psiquiatria Molecular, Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.,McMaster University, Hamilton, ON, Canada
| | - Luciano D M Souza
- Ciência Translacional em Transtornos Cerebrais, Departamento de Saúde e Comportamento, Universidade Católica de Pelotas (UCPel), Pelotas, RS, Brazil
| | - Ricardo A da Silva
- Ciência Translacional em Transtornos Cerebrais, Departamento de Saúde e Comportamento, Universidade Católica de Pelotas (UCPel), Pelotas, RS, Brazil
| | - Jean Pierre Oses
- Ciência Translacional em Transtornos Cerebrais, Departamento de Saúde e Comportamento, Universidade Católica de Pelotas (UCPel), Pelotas, RS, Brazil
| | - Carolina D Wiener
- Ciência Translacional em Transtornos Cerebrais, Departamento de Saúde e Comportamento, Universidade Católica de Pelotas (UCPel), Pelotas, RS, Brazil.,Anhanguera Educacional do Rio Grande, Rio Grande, RS, Brazil
| |
Collapse
|
22
|
Cardoso TDA, Mondin TC, Azevedo LB, Toralles LMD, de Mattos Souza LD. Is suicide risk a predictor of diagnosis conversion to bipolar disorder? Psychiatry Res 2018; 268:473-477. [PMID: 30138860 DOI: 10.1016/j.psychres.2018.08.026] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Revised: 06/19/2018] [Accepted: 08/11/2018] [Indexed: 11/29/2022]
Abstract
To assess predictors of the diagnosis of bipolar disorder is important since it is known that the early diagnosis is associated with a better response to the treatment. Thus, the aim of this systematic review is to assess the role of the suicide risk in the diagnosis conversion to bipolar disorder. We searched Pubmed, Bireme, Scopus, and PsycINFO with no year restriction for articles containing the words (suicidal or suicide or suicide risk or suicide attempt) and (conversion or switch) and (bipolar disorder or mania or hypomania or bipolar disorders). The review included four studies, with only one confirming that subjects who converted to bipolar disorder had higher rates of suicide risk than subjects who did not convert to bipolar disorder. The main limitation of this review is that few longitudinal studies assessed the predictors of conversion to bipolar disorders. In conclusion, suicide risk appears to be a predictor of bipolar disorder; nevertheless, more studies are needed to confirm this association.
Collapse
Affiliation(s)
| | - Thaíse Campos Mondin
- Universidade Católica de Pelotas - Programa de Pós-Graduação em Saúde e Comportamento, Brazil
| | - Laura Barzoni Azevedo
- Universidade Católica de Pelotas - Programa de Pós-Graduação em Saúde e Comportamento, Brazil
| | | | | |
Collapse
|
23
|
Prevalence and factors associated with Premenstrual Dysphoric Disorder: A community sample of young adult women. Psychiatry Res 2018; 268:42-45. [PMID: 29986177 DOI: 10.1016/j.psychres.2018.06.005] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Revised: 03/27/2018] [Accepted: 06/05/2018] [Indexed: 11/20/2022]
Abstract
Premenstrual Dysphoric Disorder (PMDD) was recently included in DSM-5 as a full diagnostic category. Few studies have investigated PMDD in a community sample of young adults, especially in Brazil. Thus, the objective of this study was to evaluate the prevalence and the factors associated with PMDD in a community sample of 727 young adult women between the 18 and 24 years of age in southern Brazil. This was a cross-sectional population-based study. The data were collected from 2012 to 2014. PMDD was assessed using the Mini International Neuropsychiatry Interview (M.I.N.I. - Plus). The prevalence of PMDD was 17.6%. PMDD was significantly higher among older women, and in women from lower socio-economic status. A trend towards significance was found for women without a current occupation (study or work). The comorbidities significantly associated with PMDD were current major depression disorder, agoraphobia, bipolar disorder, current suicide risk, generalized anxiety disorder, social phobia, and specific phobia. The high prevalence found in the present study should be interpreted considering a retrospective report. However, our data showed that clinicians should be alert for PMDD symptoms, especially among young adult women.
Collapse
|
24
|
Siddique SA, Tamilselvan T, Vishnupriya M, Balamurugan E. Evaluation of Neurotransmitter Alterations in Four Distinct Brain Regions After Rapid Eye Movement Sleep Deprivation (REMSD) Induced Mania-Like Behaviour in Swiss Albino Mice. Neurochem Res 2018; 43:1171-1181. [PMID: 29671235 DOI: 10.1007/s11064-018-2533-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Revised: 04/11/2018] [Accepted: 04/16/2018] [Indexed: 11/25/2022]
Abstract
A number of neurotransmitter systems have been implicated in contributing to the pathology of mood disorders, including those of dopamine (DA), serotonin (5-HT), norepinephrine (NE) and γ-aminobutyric acid (GABA). Rapid eye movement sleep deprivation (REMSD) alters most of the neurotransmitters, which may have adverse behavioural changes and other health consequences like mania and other psychiatric disorders. The exact role of REMSD altered neurotransmitter levels and the manner in which emerging consequences lead to mania-like behaviour is poorly understood. Thus, we sought to verify the levels of neurotransmitter changes after 48, 72 and 96 h of REMSD induced mania-like behaviour in mice. We performed modified multiple platform (MMP) method of depriving the REM sleep and one group maintained as a control. To measure the hyperactivity through locomotion, exploration and behavioural despair, we performed the Open Field Test (OFT) and the Forced Swim Test (FST). Quantitative determinations of DA, 5-HT, NE and GABA concentrations in four distinct brain regions (cerebral cortex, hippocampus, midbrain, and pons) were determined by the spectrofluorimetric method. These experiments showed higher locomotion and increased swimming, struggling/climbing and decreased mobility among REMSD animals as well as disrupted concentrations of the majority of the studied neurotransmitters during REMSD. Our study indicated that REMSD results in mania-like behaviour in mice and associated disruption to neurotransmitter levels, although the exact mechanisms by which these take place remain to be determined.
Collapse
Affiliation(s)
- Saiful Alom Siddique
- Department of Biochemistry and Biotechnology, Faculty of Science, Annamalai University, Annamalainagar, Tamilnadu, 608 002, India
| | - Thangavel Tamilselvan
- Department of Biochemistry and Biotechnology, Faculty of Science, Annamalai University, Annamalainagar, Tamilnadu, 608 002, India
| | - Manikkannan Vishnupriya
- Department of Biochemistry and Biotechnology, Faculty of Science, Annamalai University, Annamalainagar, Tamilnadu, 608 002, India
| | - Elumalai Balamurugan
- Department of Biochemistry and Biotechnology, Faculty of Science, Annamalai University, Annamalainagar, Tamilnadu, 608 002, India.
| |
Collapse
|
25
|
Vieira DC, de Azevedo Cardoso T, Mondin TC, Jansen K, da Silva RA, de Mattos Souza LD, Kapczinski F, Magalhães PVS. Mood disorders and prospective suicidality in young adults: a population-based cohort study. Acta Psychiatr Scand 2018; 137:109-115. [PMID: 29280477 DOI: 10.1111/acps.12846] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/27/2017] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To assess the prospective associations of mood disorders and suicidality in a community sample of young adults from south Brazil. METHOD Prospective population-based cohort study. Young adults (18-24 years old) were recruited and followed up on 5 years later; people were interviewed at their homes. Suicidality, as well as mood and anxiety disorders, was assessed using the Mini-International Neuropsychiatric Interview. The impact of mood episodes on suicidality was both evaluated when they occurred in the same wave (a current episode) and when suicidality occurred prospectively, with suicidality measured at follow-up (a past episode). RESULTS The sample included 1560 young adults at baseline, with 1244 reassessed at follow-up (80.6%). Depressive episodes, both current and past, had a significant impact on suicidality in the final multivariable model. Manic episodes, however, were less consistently associated with suicidality. CONCLUSION Depressive episodes have a strong, independent, and robust association with prospective suicidality. The association between manic episodes and suicidality, on the other hand, was dependent on the analysis and deserves further exploration.
Collapse
Affiliation(s)
- D C Vieira
- Post Graduate Program in Psychiatry and Behavioral Sciences, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - T de Azevedo Cardoso
- Post-Graduate Program in Health and Behavior, Catholic University of Pelotas, Pelotas, RS, Brazil
| | - T C Mondin
- Post-Graduate Program in Health and Behavior, Catholic University of Pelotas, Pelotas, RS, Brazil
| | - K Jansen
- Post Graduate Program in Psychiatry and Behavioral Sciences, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.,Post-Graduate Program in Health and Behavior, Catholic University of Pelotas, Pelotas, RS, Brazil
| | - R A da Silva
- Post-Graduate Program in Health and Behavior, Catholic University of Pelotas, Pelotas, RS, Brazil
| | - L D de Mattos Souza
- Post-Graduate Program in Health and Behavior, Catholic University of Pelotas, Pelotas, RS, Brazil
| | - F Kapczinski
- Post Graduate Program in Psychiatry and Behavioral Sciences, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.,Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - P V S Magalhães
- Post Graduate Program in Psychiatry and Behavioral Sciences, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| |
Collapse
|
26
|
Moreira FP, Jansen K, Cardoso TDA, Mondin TC, Magalhães PVDS, Kapczinski F, Souza LDDM, da Silva RA, Oses JP, Wiener CD. Metabolic syndrome in subjects with bipolar disorder and major depressive disorder in a current depressive episode: Population-based study: Metabolic syndrome in current depressive episode. J Psychiatr Res 2017; 92:119-123. [PMID: 28433948 DOI: 10.1016/j.jpsychires.2017.03.025] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Revised: 03/23/2017] [Accepted: 03/31/2017] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To assess the differences in the prevalence of the metabolic syndrome (MetS) and their components in young adults with bipolar disorder (BD) and major depressive disorder (MDD) in a current depressive episode. METHODS This was a cross-sectional study with young adults aged 24-30 years old. Depressive episode (bipolar or unipolar) was assessed using the Mini International Neuropsychiatric Interview - Plus version (MINI Plus). The MetS was assessed using the National Cholesterol Education Program Adult Treatment Panel III (NCEP/ATP III). RESULTS The sample included 972 subjects with a mean age of 25.81 (±2.17) years. Both BD and MDD patients showed higher prevalence of MetS compared to the population sample (BD = 46.9%, MDD = 35.1%, population = 22.1%, p < 0.001). Higher levels of glucose, total cholesterol and LDL cholesterol, Body Mass Index, low levels of HDL cholesterol, and a higher prevalence of abdominal obesity were observed in both BD and MDD individuals with current depressive episode compared to the general population. Moreover, there was a significant difference on BMI values in the case of BD and MDD subjects (p = 0.016). CONCLUSION Metabolic components were significantly associated with the presence of depressive symptoms, independently of the diagnosis.
Collapse
Affiliation(s)
- Fernanda Pedrotti Moreira
- Translational Science on Brain Disorders, Department of Health and Behavior, Catholic University of Pelotas, Pelotas, RS, Brazil
| | - Karen Jansen
- Translational Science on Brain Disorders, Department of Health and Behavior, Catholic University of Pelotas, Pelotas, RS, Brazil; Molecular Psychiatry, Postgraduate Program in Psychiatry and Behavioral Sciences, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil.
| | - Taiane de Azevedo Cardoso
- Translational Science on Brain Disorders, Department of Health and Behavior, Catholic University of Pelotas, Pelotas, RS, Brazil
| | - Thaíse Campos Mondin
- Translational Science on Brain Disorders, Department of Health and Behavior, Catholic University of Pelotas, Pelotas, RS, Brazil
| | - Pedro Vieira da Silva Magalhães
- Molecular Psychiatry, Postgraduate Program in Psychiatry and Behavioral Sciences, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Flávio Kapczinski
- Molecular Psychiatry, Postgraduate Program in Psychiatry and Behavioral Sciences, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil; McMaster University, Hamilton, ON, Canada
| | - Luciano Dias de Mattos Souza
- Translational Science on Brain Disorders, Department of Health and Behavior, Catholic University of Pelotas, Pelotas, RS, Brazil
| | - Ricardo Azevedo da Silva
- Translational Science on Brain Disorders, Department of Health and Behavior, Catholic University of Pelotas, Pelotas, RS, Brazil
| | - Jean Pierre Oses
- Translational Science on Brain Disorders, Department of Health and Behavior, Catholic University of Pelotas, Pelotas, RS, Brazil
| | - Carolina David Wiener
- Translational Science on Brain Disorders, Department of Health and Behavior, Catholic University of Pelotas, Pelotas, RS, Brazil; Department of Epidemiology, Federal University of Pelotas, Pelotas, RS, Brazil
| |
Collapse
|
27
|
Wiener CD, Moreira FP, Cardoso TA, Mondin TC, da Silva Magalhães PV, Kapczinski F, de Mattos Souza LD, da Silva RA, Oses JP, Jansen K. Inflammatory cytokines and functional impairment in drug-free subjects with mood disorder. J Neuroimmunol 2017; 307:33-36. [DOI: 10.1016/j.jneuroim.2017.03.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Revised: 02/06/2017] [Accepted: 03/06/2017] [Indexed: 02/08/2023]
|
28
|
Reyes AN, Cardoso TA, Jansen K, Mondin TC, Souza LDM, Magalhães PVS, Kapczinski F, Silva RA. Functional impairment and cognitive performance in mood disorders: A community sample of young adults. Psychiatry Res 2017; 251:85-89. [PMID: 28189942 DOI: 10.1016/j.psychres.2017.01.069] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2016] [Revised: 11/23/2016] [Accepted: 01/24/2017] [Indexed: 11/17/2022]
Abstract
The aim of this study was to compare the global functioning and cognitive performance in a community sample of young adults with mood disorders versus community controls. This was a cross-sectional study nested in a cohort study with a community sample. Data was collected from February 2012 to June 2014; specifically, at a mean of five years after the first phase, all young adults were invited to participate in a re-evaluation. Mini International Neuropsychiatric Interview - PLUS (MINI-PLUS) was used for the diagnosis of mood disorders. The Functional Assessment Short Test (FAST) and the Montreal Cognitive Assessment (MoCA) were used to assess the global functioning, and cognitive performance, respectively. Were included 1258 subjects. Functional impairment was greater in subjects with bipolar disorder when compared to community controls, and there were no differences between major depressive disorder and community controls. There were no significant differences in cognitive performance between young adults with mood disorders when compared to community controls. Functional impairment is a marker for bipolar disorder in young adults; however, gross cognitive impairment assessed by a screening test is not, possibly because cognition is impaired in more advanced stages of the disorder.
Collapse
Affiliation(s)
- Amanda N Reyes
- Universidade Católica de Pelotas - Programa de Pós-Graduação em Saúde e Comportamento, Brazil
| | - Taiane A Cardoso
- Laboratório de Psiquiatria Molecular, Hospital de Clínicas de Porto Alegre; Universidade Federal do Rio Grande do Sul - Programa de Pós-Graduação em Ciências Médicas, Psiquiatria, Brazil
| | - Karen Jansen
- Universidade Católica de Pelotas - Programa de Pós-Graduação em Saúde e Comportamento, Brazil
| | - Thaíse C Mondin
- Universidade Católica de Pelotas - Programa de Pós-Graduação em Saúde e Comportamento, Brazil
| | - Luciano D M Souza
- Universidade Católica de Pelotas - Programa de Pós-Graduação em Saúde e Comportamento, Brazil
| | - Pedro V S Magalhães
- Laboratório de Psiquiatria Molecular, Hospital de Clínicas de Porto Alegre; Universidade Federal do Rio Grande do Sul - Programa de Pós-Graduação em Ciências Médicas, Psiquiatria, Brazil
| | - Flavio Kapczinski
- Laboratório de Psiquiatria Molecular, Hospital de Clínicas de Porto Alegre; Universidade Federal do Rio Grande do Sul - Programa de Pós-Graduação em Ciências Médicas, Psiquiatria, Brazil
| | - Ricardo A Silva
- Universidade Católica de Pelotas - Programa de Pós-Graduação em Saúde e Comportamento, Brazil.
| |
Collapse
|
29
|
Jansen K, Cardoso TA, Fries GR, Branco JC, Silva RA, Kauer-Sant'Anna M, Kapczinski F, Magalhaes PVS. Childhood trauma, family history, and their association with mood disorders in early adulthood. Acta Psychiatr Scand 2016; 134:281-6. [PMID: 26826334 DOI: 10.1111/acps.12551] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/14/2015] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To assess the prevalence of childhood trauma and types of trauma on mood disorders among young adults in a population-based sample. We further gathered data on family history of mood disorders to test the hypothesis that childhood trauma is a mediating factor for the association between family history of mood disorder and mood disorder in adulthood. METHOD This is a cross-sectional study, including young adults with bipolar disorder, major depressive disorder, and matched controls without any mood disorder. Childhood trauma was assessed using the Childhood Trauma Questionnaire (CTQ). The Hicks and Tingley implementation was employed to assess whether trauma is a mediator of the effect of family history on diagnosis of any mood disorder. RESULTS All types of trauma were associated with both major depression and bipolar disorder, with the exception of sexual abuse, which was only associated with bipolar disorder. Moreover, family history of psychiatric illness was also associated with mood disorder in adulthood and with childhood trauma. Using the presence of any mood disorder as the outcome, a third of the effect of having any family history of mood disorder was mediated via childhood trauma. CONCLUSION This investigation provides further support, in a population-based sample of young adults, of the association between childhood trauma and mood disorders, with sexual abuse being specifically linked with bipolar disorder. The hypothesis that childhood trauma would function as a partial mediator of the association between family history of mood disorder and mood disorder in adulthood was also confirmed.
Collapse
Affiliation(s)
- K Jansen
- Translational Science on Brain Disorders, Department of Health and Behavior, Catholic University of Pelotas (Universidade Católica de Pelotas), Pelotas, Brazil. .,Department of Psychiatry & Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, USA.
| | - T A Cardoso
- Translational Science on Brain Disorders, Department of Health and Behavior, Catholic University of Pelotas (Universidade Católica de Pelotas), Pelotas, Brazil.,Department of Psychiatry & Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - G R Fries
- Department of Psychiatry & Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, USA.,Laboratório de Psiquiatria Molecular, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - J C Branco
- Translational Science on Brain Disorders, Department of Health and Behavior, Catholic University of Pelotas (Universidade Católica de Pelotas), Pelotas, Brazil
| | - R A Silva
- Translational Science on Brain Disorders, Department of Health and Behavior, Catholic University of Pelotas (Universidade Católica de Pelotas), Pelotas, Brazil
| | - M Kauer-Sant'Anna
- Laboratório de Psiquiatria Molecular, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - F Kapczinski
- Department of Psychiatry & Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, USA.,Laboratório de Psiquiatria Molecular, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - P V S Magalhaes
- Laboratório de Psiquiatria Molecular, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| |
Collapse
|
30
|
Moreira FP, Jansen K, Mondin TC, Cardoso TDA, Magalhães PVDS, Kapczinski F, Frey BN, Oses JP, Souza LDDM, da Silva RA, Wiener CD. Biological rhythms, metabolic syndrome and current depressive episode in a community sample. Psychoneuroendocrinology 2016; 72:34-9. [PMID: 27343724 DOI: 10.1016/j.psyneuen.2016.06.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2016] [Revised: 06/08/2016] [Accepted: 06/09/2016] [Indexed: 11/28/2022]
Abstract
The purpose of this study was to assess the disruption in biological rhythms and metabolic syndrome (MetS) in individuals with depressive episode. This was a cross-sectional, population-based study with a representative sample of 905 young adults. Current depressive episode were confirmed by a psychologist using the Mini International Neuropsychiatric Interview (MINI)-Plus. Self-reported biological rhythms were assessed using the Biological Rhythms Interview of Assessment in Neuropsychiatry (BRIAN). MetS was defined using modified NCEP/ATPIII criteria. Significant main effects of current depressive episode (p<0.001, η(2)=0.163) and MetS (p=0.001, η(2)=0.011) were observed on total BRIAN score. There was a significant interaction between depression and MetS in total biological rhythm scores (p=0.002, η(2)=0.011) as well as sleep (p=0.001, η(2)=0.016) and social domains (p<0.001, η(2)=0.014). In the depressive group, subjects with MetS had a higher disruption in total BRIAN scores (p=0.010), sleep domain (p=0.004), social domain (p=0.005) and in the eating pattern domain approached the level of significance (p=0.098), when compared to subjects with no MetS. The results of the present study showed that self-reported disruptions in biological rhythms are associated with key components of the MetS in community adults with MDD. The understanding of the complex interactions between biological rhythms, MetS and depression are important in the development of preventive and therapeutic strategies.
Collapse
Affiliation(s)
| | - Karen Jansen
- Postgraduate Program in Health and Behavior, Universidade Católica de Pelotas, Pelotas, RS, Brazil.
| | - Thaíse Campos Mondin
- Postgraduate Program in Health and Behavior, Universidade Católica de Pelotas, Pelotas, RS, Brazil
| | | | | | - Flavio Kapczinski
- Department of Psychiatry and Forensic Medicine, Universidade Federal do Rio Grande do Sul, RS, Brazil
| | - Benicio N Frey
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Jean Pierre Oses
- Postgraduate Program in Health and Behavior, Universidade Católica de Pelotas, Pelotas, RS, Brazil
| | | | - Ricardo Azevedo da Silva
- Postgraduate Program in Health and Behavior, Universidade Católica de Pelotas, Pelotas, RS, Brazil
| | - Carolina David Wiener
- Postgraduate Program in Health and Behavior, Universidade Católica de Pelotas, Pelotas, RS, Brazil
| |
Collapse
|
31
|
Cardoso TDA, Mondin TC, Souza LDDM, da Silva RA, Magalhães PVS, Kapczinski F, Jansen K. Functioning in bipolar disorder with substance abuse/dependence in a community sample of young adults. J Affect Disord 2015; 187:179-82. [PMID: 26339928 DOI: 10.1016/j.jad.2015.08.046] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2015] [Revised: 08/20/2015] [Accepted: 08/21/2015] [Indexed: 11/28/2022]
Abstract
AIM To assess the functional impairment of young adults with bipolar disorder with substance abuse/dependence comorbidity. METHOD Cross-sectional study within a community sample. Bipolar Disorder was assessed by qualified psychologists using The Mini International Neuropsychiatric Interview - PLUS (MINI-PLUS). Substance abuse and dependence was assessed using the "Alcohol, Smoking and Substance Involvement Screening Test" (ASSIST). Functional impairment was assessed using the Functional Assessment Short Test (FAST). RESULTS The sample included 1259 young adults. The prevalence of Bipolar Disorder (BD) without Substance Abuse/Dependence (SAD) comorbidity was 5.9% (n=74), and the prevalence of bipolar disorder with substance abuse/dependence comorbidity was 1.4% (n=17). Both groups showed higher impairment in overall functioning, interpersonal relationship, and leisure time as compared to controls. In addition, BD+SAD showed higher impairment in the cognitive functioning domain of FAST. LIMITATION A battery of neuropsychological tests was not performed. CONCLUSION Functional impairment is associated with BD, independently of substance abuse or dependence. In addition, BD+SAD present a more severe impairment in the cognitive domain of FAST as compared to controls.
Collapse
Affiliation(s)
- Taiane de Azevedo Cardoso
- Universidade Católica de Pelotas - Programa de Pós-Graduação em Saúde e Comportamento, Brazil; University of Texas Health Science Center at Houston - Department of Psychiatry, United States
| | - Thaise Campos Mondin
- Universidade Católica de Pelotas - Programa de Pós-Graduação em Saúde e Comportamento, Brazil
| | | | | | - Pedro V S Magalhães
- Laboratório de Psiquiatria Molecular, Hospital de Clínicas de Porto Alegre; Universidade Federal do Rio Grande do Sul - Programa de Pós-Graduação em Ciências Médicas: Psiquiatria, Brazil
| | - Flavio Kapczinski
- Laboratório de Psiquiatria Molecular, Hospital de Clínicas de Porto Alegre; Universidade Federal do Rio Grande do Sul - Programa de Pós-Graduação em Ciências Médicas: Psiquiatria, Brazil
| | - Karen Jansen
- Universidade Católica de Pelotas - Programa de Pós-Graduação em Saúde e Comportamento, Brazil; University of Texas Health Science Center at Houston - Department of Psychiatry, United States.
| |
Collapse
|
32
|
Duarte Faria A, Cardoso TDA, Campos Mondin T, Souza LDDM, Magalhaes PVDS, Patrick Zeni C, Silva RAD, Kapczinski F, Jansen K. Biological rhythms in bipolar and depressive disorders: A community study with drug-naïve young adults. J Affect Disord 2015; 186:145-8. [PMID: 26241662 DOI: 10.1016/j.jad.2015.07.004] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2015] [Revised: 06/19/2015] [Accepted: 07/04/2015] [Indexed: 01/18/2023]
Abstract
AIM To assess biological rhythm disruptions among drug-naïve young adults with bipolar disorder (BD), major depressive disorder (MDD), and community controls. METHODS This was a cross-sectional study nested in a population-based study. BD and MDD were diagnosed using the Structured Clinical Interview for DSM-IV. Biological rhythm disruptions were assessed using the Biological Rhythm Interview of Assessment in Neuropsychiatry (BRIAN). RESULTS Two hundred seventeen subjects were assessed (49 BD, 74 MDD, and 94 community controls). Biological rhythm disruption was higher in subjects with BD (40.32±9.92; p<0.001) and MDD (36.23±8.71; p<0.001) than community controls (27.67±6.88). Subjects with BD had a higher BRIAN total score (p=0.028) and higher disruption in sleep/social domains (p=0.018) as compared to MDD. In addition, the BRIAN scores were higher in current MDD, euthymic BD, and BD in current episode group, as compared to community controls. LIMITATION Cross-sectional design. Absence of assessment of biomarkers of biological rhythms. CONCLUSION Bipolar disorder and major depressive disorder are associated with disruption in biological rhythm. In addition, disruption in sleep/social rhythms is higher in subjects with BD when compared to subjects with MDD. We also verified biological rhythm disruption in subjects with BD during euthymic status, but not in remitted MDD. Regulation of biological rhythm may be a means to identify patients with mood disorders and potentially differentiate MDD from BD.
Collapse
Affiliation(s)
| | - Taiane de Azevedo Cardoso
- Universidade Catolica de Pelotas (UCPel), Brazil; University of Texas Health Science Center at Houston (UTHealth), United States
| | | | | | | | | | | | - Flavio Kapczinski
- Universidade Federal do Rio Grande do Sul (UFRGS), Brazil; University of Texas Health Science Center at Houston (UTHealth), United States
| | - Karen Jansen
- Universidade Catolica de Pelotas (UCPel), Brazil; University of Texas Health Science Center at Houston (UTHealth), United States.
| |
Collapse
|
33
|
Abstract
The objective was to evaluate the effect of psychoeducation on biological rhythm and in the reduction of depressive, anxious, and manic symptoms at 12 months' follow-up. This was a randomized clinical trial with young adults aged 18 to 29 years, diagnosed with bipolar disorder. Biological rhythm was assessed with the Biological Rhythm Interview Assessment in Neuropsychiatry (BRIAN). Participants were randomized for combined intervention (psychoeducation plus medication) or treatment-as-usual (medication alone). The sample consisted of 61 patients (29 TAU; 32 combined intervention). Although it failed to separate by a marginal difference, the combined intervention seems to be more effective than TAU in relation to improvement of depressive symptoms at post-intervention (p = 0.074) and regulation of sleep/social domain at 6 months' follow-up (p = 0.057). Improvement of depressive symptoms as well as regulation of sleep and social activities are known to prevent episode onset and thus improve long-term outcomes.
Collapse
|
34
|
Dell'Aglio JC, Basso LA, Argimon IIDL, Arteche A. Systematic review of the prevalence of bipolar disorder and bipolar spectrum disorders in population-based studies. TRENDS IN PSYCHIATRY AND PSYCHOTHERAPY 2015; 35:99-105. [PMID: 25923299 DOI: 10.1590/s2237-60892013000200002] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2012] [Accepted: 01/28/2013] [Indexed: 11/22/2022]
Abstract
This paper describes the findings of a systematic literature review aimed at providing an overview of the lifetime prevalence of bipolar disorder and bipolar spectrum disorders in population-based studies. Databases MEDLINE, ProQuest, Psychnet, and Web of Science were browsed for papers published in English between 1999 and May 2012 using the following search string: bipolar disorders OR bipolar spectrum disorders AND prevalence OR cross-sectional OR epidemiology AND population-based OR non-clinical OR community based. The search yielded a total of 434 papers, but only those published in peer-reviewed journals and with samples aged ≥ 18 years were included, resulting in a final sample of 18 papers. Results revealed rather heterogeneous findings concerning the prevalence of bipolar disorders and bipolar spectrum disorders. Lifetime prevalence of bipolar disorder ranged from 0.1 to 7.5%, whereas lifetime prevalence of bipolar spectrum disorders ranged from 2.4 to 15.1%. Differences in the rates of bipolar disorder and bipolar spectrum disorders may be related to the consideration of subthreshold criteria upon diagnosis. Differences in the prevalence of different subtypes of the disorder are discussed in light of diagnostic criteria and instruments applied.
Collapse
Affiliation(s)
| | - Lissia Ana Basso
- WP Centro de Psicoterapia Cognitivo-Comportamental, Santa Maria, RS, Brazil
| | | | | |
Collapse
|
35
|
Branco JC, Jansen K, Oses JP, de Mattos Souza LD, da Silva Alves GDG, Lara DR, da Silva RA. Practice of leisure-time physical activities and episodes of mood alteration amongst men and women. J Affect Disord 2014; 169:165-9. [PMID: 25194785 DOI: 10.1016/j.jad.2014.08.020] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2014] [Accepted: 08/12/2014] [Indexed: 10/24/2022]
Abstract
OBJECTIVE To evaluate the prevalence of leisure-time physical activity and episodes of mood alteration in a population-based sample of adults, and its relation with gender. METHOD This is a cross-sectional population-based study with young adults aged between 18 and 35 years old. Sample selection was performed by clusters. The practice of physical activity was evaluated through the International Physical Activity Questionnaire (IPAQ), whereas mood disorders were evaluated using a short structured diagnostic interview-the Mini International Neuropsychiatric Interview (MINI) for DSM-IV and ICD-10 psychiatric disorders. LIMITATION Causal inferences are limited due the study׳s design. RESULTS Sample consisted of 1953 young adults. The prevalence of leisure-time physical activity and of depressive episodes in the total sample was 25.3% and 17.2%, respectively. The prevalence of activity amongst men was 1.18 (CI 95% 1.18-1.32) times higher than in the women׳s group, whereas depression was 1.87 (CI 95% 1.41-2.47) times more prevalent amongst women than men. The prevalence of physical activity was not different between women (p=0.287), nor between men (p=0.895) regarding the presence of mania/hypomania episode. CONCLUSION The prevalence of physical activity and depression was different concerning gender. The prevalence of physical activity is lower amongst women, whereas the prevalence of depression is higher amongst women when compared to men.
Collapse
Affiliation(s)
- Jerônimo Costa Branco
- Programa de Pós-Graduação em Saúde e Comportamento da Universidade Católica de Pelotas, Rua Félix da Cunha, 412, Centro, 96010-000 Pelotas, RS, Brazil
| | - Karen Jansen
- Programa de Pós-Graduação em Saúde e Comportamento da Universidade Católica de Pelotas, Rua Félix da Cunha, 412, Centro, 96010-000 Pelotas, RS, Brazil
| | - Jean Pierre Oses
- Programa de Pós-Graduação em Saúde e Comportamento da Universidade Católica de Pelotas, Rua Félix da Cunha, 412, Centro, 96010-000 Pelotas, RS, Brazil
| | - Luciano Dias de Mattos Souza
- Programa de Pós-Graduação em Saúde e Comportamento da Universidade Católica de Pelotas, Rua Félix da Cunha, 412, Centro, 96010-000 Pelotas, RS, Brazil
| | - Giovanna Del Grande da Silva Alves
- Programa de Pós-Graduação em Saúde e Comportamento da Universidade Católica de Pelotas, Rua Félix da Cunha, 412, Centro, 96010-000 Pelotas, RS, Brazil
| | - Diogo Rizzato Lara
- Pontifícia Universidade Católica do Rio Grande do Sul (PUC-RS), Av. Ipiranga, 6681 Pd 12 A, Partenon, 90670-100 Porto Alegre, RS, Brazil
| | - Ricardo Azevedo da Silva
- Programa de Pós-Graduação em Saúde e Comportamento da Universidade Católica de Pelotas, Rua Félix da Cunha, 412, Centro, 96010-000 Pelotas, RS, Brazil.
| |
Collapse
|
36
|
Silva MT, Galvao TF, Martins SS, Pereira MG. Prevalence of depression morbidity among Brazilian adults: a systematic review and meta-analysis. BRAZILIAN JOURNAL OF PSYCHIATRY 2014; 36:262-70. [DOI: 10.1590/1516-4446-2013-1294] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2013] [Accepted: 03/26/2014] [Indexed: 11/22/2022]
|
37
|
Jansen K, Cardoso TDA, Mondin TC, Matos MBD, Souza LDDM, Pinheiro RT, Magalhães PVDS, Silva RAD. Eventos de vida estressores e episódios de humor: uma amostra comunitária. CIENCIA & SAUDE COLETIVA 2014; 19:3941-6. [DOI: 10.1590/1413-81232014199.12932013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2013] [Accepted: 10/08/2013] [Indexed: 11/21/2022] Open
Abstract
Transtornos de humor são consequentes de uma interação entre fatores biológicos e ambientais. O objetivo deste estudo foi identificar associações entre eventos vitais estressores e transtornos de humor em uma amostra comunitária de jovens do Sul do Brasil. Trata-se de estudo transversal de base populacional com jovens de 18 a 24 anos. A seleção da amostra foi realizada por conglomerados. Os episódios de alteração do humor foram avaliados através da Mini International Neuropsychiatric Interview , enquanto os eventos vitais estressores foram mensurados através da escala de reajustamento social de Holmes e Rahe. A amostra foi de 1172 jovens. A proporção de eventos vitais estressores no último ano, em cada categoria, no total da amostra, foi de: 53,8% trabalho, 42,4% perda de suporte social, 63,8% família, 50,9% mudanças ambientais, 61,1% dificuldades pessoais e 38,7% finanças. Houve associação significativa entre eventos vitais estressores e episódios de alteração de humor. Foi verificada maior ocorrência de eventos vitais estressores entre os jovens em episódio misto, quando comparados aos jovens em episódio depressivo, (hipo) maníaco e controles. Esses achados sugerem uma interação psicossocial entre eventos vitais estressores e os episódios de alteração de humor.
Collapse
|
38
|
Narvaez JCM, Jansen K, Pinheiro RT, Kapczinski F, Silva RA, Pechansky F, Magalhães PVS. Violent and sexual behaviors and lifetime use of crack cocaine: a population-based study in Brazil. Soc Psychiatry Psychiatr Epidemiol 2014; 49:1249-55. [PMID: 24519271 DOI: 10.1007/s00127-014-0830-3] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2013] [Accepted: 01/19/2014] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To estimate the prevalence of lifetime use of crack cocaine and to assess associations with violent and sexual behaviors in young adults selected from the general population of Pelotas, Southern Brazil. METHODS This cross-sectional population-based study included 1,560 participants aged 18-24 years. The use of alcohol and other substances, including crack cocaine, was assessed using the alcohol, smoking and substance involvement screening test. Other variables included violent behaviors, firearm possession, and sexual risk behaviors. The frequency of antisocial personality disorder was also investigated. Associations were analyzed using a crude model and models adjusted for sex, social class, and the use of snorted cocaine. RESULTS Lifetime prevalence of crack cocaine use was 2.51 %, and it was higher among males and individuals coming from more vulnerable social classes (D or E). In the final multivariate models, lifetime use of crack cocaine was associated with episodes of aggression and firearm possession, as well as with a higher chance of not having used condom in the last sexual intercourse. In less conservative models, crack cocaine use was associated with other violent and sexual risk behaviors. DISCUSSION The strong association observed between lifetime use of crack cocaine and different violent and sexual risk behaviors underscores relevant characteristics of people who use crack cocaine. Improving our understanding of possible causal chains leading to such associations should be a priority in future studies.
Collapse
Affiliation(s)
- Joana C M Narvaez
- Laboratório de Psiquiatria Molecular, National Institute for Translational Medicine, Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul, Ramiro Barcelos, 2350, Porto Alegre, RS, CEP 90035-003, Brazil,
| | | | | | | | | | | | | |
Collapse
|
39
|
Narvaez JCM, Jansen K, Pinheiro RT, Kapczinski F, Silva RA, Pechansky F, Magalhães PV. Psychiatric and substance-use comorbidities associated with lifetime crack cocaine use in young adults in the general population. Compr Psychiatry 2014; 55:1369-76. [PMID: 24933652 DOI: 10.1016/j.comppsych.2014.04.021] [Citation(s) in RCA: 75] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2014] [Revised: 04/29/2014] [Accepted: 04/29/2014] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE To assess the association between lifetime crack cocaine use and psychiatric (post-traumatic stress disorder, current depression, current dysthymia, generalized anxiety disorder, panic disorder with agoraphobia, social phobia, as well as SRQ scores and suicide risk) and substance-use disorders (tobacco, alcohol, cannabis, cocaine, amphetamine, inhalants, sedatives, hallucinogens and opioids) in youth in the general population of the city of Pelotas, RS. METHOD This was a cross-sectional population-based study, involving 1560 participants between 18 and 24 ears old. Lifetime substance use and abuse were investigated using the ASSIST inventory. Psychiatric comorbidities were assessed using the Mini-International Neuropsychiatric Interview and symptoms of common mental disorders were evaluated with the Self-Reported Questionnaire (SRQ). RESULTS The prevalence of lifetime crack cocaine use in the sample was 2.5%. Its use was associated with total SRW scores and the presence of post-traumatic stress disorder, antisocial personality disorder and suicide risk in the final regression model. Tobacco, alcohol, cannabis, cocaine, amphetamine and cocaine dependence were also associated with lifetime use of crack cocaine. DISCUSSION Youth with a history of crack cocaine use had a higher prevalence of psychiatric conditions such as post-traumatic stress disorder, as well as an increased risk of tobacco, alcohol, cannabis, cocaine, amphetamine and inhalant use and dependence.
Collapse
Affiliation(s)
- Joana C M Narvaez
- National Institute for Translational Medicine, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; Center for Drug and Alcohol Research, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Karen Jansen
- Graduate Program in Health and Behavior, Universidade Católica de Pelotas, Pelotas, Brazil
| | - Ricardo T Pinheiro
- Graduate Program in Health and Behavior, Universidade Católica de Pelotas, Pelotas, Brazil
| | - Flávio Kapczinski
- National Institute for Translational Medicine, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Ricardo A Silva
- Graduate Program in Health and Behavior, Universidade Católica de Pelotas, Pelotas, Brazil
| | - Flávio Pechansky
- Center for Drug and Alcohol Research, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Pedro V Magalhães
- National Institute for Translational Medicine, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
| |
Collapse
|
40
|
Mota R, Gazal M, Acosta BA, de Leon PB, Jansen K, Pinheiro RT, Souza LD, Silva RA, Oses JP, Quevedo L, Lara DR, Ghisleni G, Kaster MP. Interleukin-1β is associated with depressive episode in major depression but not in bipolar disorder. J Psychiatr Res 2013; 47:2011-4. [PMID: 24074516 DOI: 10.1016/j.jpsychires.2013.08.020] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2013] [Revised: 08/05/2013] [Accepted: 08/26/2013] [Indexed: 01/20/2023]
Abstract
Our work was sought to investigate possible changes in peripheral levels of interleukin-1β (IL-1β) according to the diagnosis of major depression (MD) and bipolar disorder (BD) and in different mood episodes. This is a cross-sectional nested in a population-based study comparing 240 young adults (80 controls, 80 MD and 80 BD), balanced for age and gender. Serum levels of IL-1β were significantly higher in MD when compared to control or BD subjects. In addition, when divided by current mood episode, MD subjects in current depression presented higher IL-1β levels than controls. No differences in IL-1β levels were found between different episodes of BD (euthymic, depressed, mania or mixed). Moreover, the use of psychiatric medication was very low in our sample and not associated with changes in IL-1β levels. In conclusion, increased peripheral IL-1β might be a useful marker associated with a depressive episode in the context of MD.
Collapse
Affiliation(s)
- Rosana Mota
- Programa de Pós-Graduação em Saúde e Comportamento, Universidade Católica de Pelotas, Brazil
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
41
|
Yip SW, Chandler RA, Rogers RD, Mackay CE, Goodwin GM. White matter alterations in antipsychotic- and mood stabilizer-naïve individuals with bipolar II/NOS disorder. NEUROIMAGE-CLINICAL 2013; 3:271-8. [PMID: 24273712 PMCID: PMC3814955 DOI: 10.1016/j.nicl.2013.08.005] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/01/2013] [Revised: 07/30/2013] [Accepted: 08/04/2013] [Indexed: 01/16/2023]
Abstract
Structural magnetic resonance imaging (MRI) studies using voxel-based morphometry (VBM) and tract-based spatial statistics (TBSS) have been inconsistent in demonstrating impairments in gray matter (GM) and white matter (WM) structures in bipolar disorder (BD). This may be a consequence of significant confounding effects of medication, illness history and selection of controls in existing studies. Study of bipolar II or not-otherwise-specified (BD II/NOS) disorder provides a solution to these confounds and a bridge to unipolar cases across the affective spectrum. Thirty-eight euthymic, antipsychotic- and mood stabilizer-naïve young adults (mean age = 20.9 years) with BD II/NOS and 37 age-, cognitive ability- and gender-matched healthy controls (HCs) underwent MRI. Voxel-wise and regional gray matter volume comparisons were conducted using voxel-based morphometry (VBM). Tract-based spatial statistics (TBSS) were used to assess whole-brain WM, as indexed using fractional anisotropy (FA), mean diffusivity (MD), parallel and perpendicular diffusion values. No between-group differences were observed for whole-brain VBM comparisons. By contrast, in comparison to HCs, participants with BD II/NOS had significant widespread reductions in FA and increased MD and perpendicular diffusion values in virtually all the major cortical white matter tracts. These data suggest pathophysiological involvement of WM microstructures - but not GM macrostructures - in high functioning BD II/NOS patients at an early age and before significant clinical adversity has been recorded. We propose that white matter development is a valid candidate target for understanding genetic and environmental antecedents to bipolar disorder and mood disorder more generally.
Collapse
Affiliation(s)
- Sarah W Yip
- Department of Psychiatry, University of Oxford, Oxford OX3 7JX, United Kingdom
| | | | | | | | | |
Collapse
|
42
|
Gender-based differences in oxidative stress parameters do not underlie the differences in mood disorders susceptibility between sexes. Eur Psychiatry 2013; 29:58-63. [PMID: 23850061 DOI: 10.1016/j.eurpsy.2013.05.006] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2012] [Revised: 04/29/2013] [Accepted: 05/23/2013] [Indexed: 12/14/2022] Open
Abstract
The present study aimed to determine whether any gender-related difference exists concerning oxidative stress parameters in a population of 231 subjects, and if these changes might be related to gender-associated differences in major depressive disorder (MDD) or bipolar disorder (BD) vulnerability. This is a case-control nested in a population-based study. The initial psychopathology screen was performed with the Mini-International Neuropsychiatric Interview and the diagnostic was further confirmed with the Structured Clinical Interview for DSM-IV. Blood samples were obtained after the interview and the oxidative stress parameters such as uric acid, advanced oxidation protein product (PCC) and lipid hydroperoxides (TBARS) were determined. Our results indicated a higher prevalence of MDD and BD in women when compared to men. In addition, significant gender differences were found in the levels of PCC (0.27±0.27 vs. 0.40±0.31nmol CO/mg protein, men vs. women, respectively; P=0.02) and uric acid (4.88±1.39mg/dL vs. 3.53±1.02mg/dL, men vs. women, respectively; P=0.0001), but not in TBARS (0.013±0.01nmol/mg of protein vs. 0.017±0.02nmol/mg of protein, men vs. women respectively; P=0.243). After sample stratification by gender, no association was found between oxidative stress parameters and clinical diagnosis of MDD and BD for women (P=0.516 for PCC; P=0.620 for TBARS P=0.727 for uric acid) and men (P=0.367 for PCC; P=0.372 for TBARS P=0.664 for uric acid). In this study, women seem more susceptible to oxidative stress than male. However, these gender-based differences do not seem to provide a biochemical basis for the epidemiologic differences in mood disorders susceptibility between sexes.
Collapse
|
43
|
Lopez Molina MA, Jansen K, Drews C, Pinheiro R, Silva R, Souza L. Major depressive disorder symptoms in male and female young adults. PSYCHOL HEALTH MED 2013; 19:136-45. [DOI: 10.1080/13548506.2013.793369] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
44
|
Pompeia S, Gouveia JR, Galduróz JCF. Acute mood effect of donepezil in young, healthy volunteers. Hum Psychopharmacol 2013; 28:263-9. [PMID: 23653426 DOI: 10.1002/hup.2319] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2012] [Accepted: 03/20/2013] [Indexed: 12/31/2022]
Abstract
OBJECTIVE Chronic use of the acetylcholinesterase inhibitor donepezil has been found to improve mood or to induce mania/hypomania in many neuropsychiatric patients with altered cholinergic and dopaminergic tone. Our aim was to determine whether acutely administered donepezil would alter mood in volunteers with no such alterations. METHODS This investigation was a double-blind, crossover design study of 15 young, healthy male participants who were allocated in random order to three oral treatments: placebo and 5-mg and 7.5-mg donepezil (doses which exert clinical and acute cognitive effects without considerable peripheral side effects). At the theoretical peak-plasma concentrations of donepezil, volunteers rated how they felt on validated questionnaires, which included various dimensions of subjective feelings. We also assessed changes in brain-derived neurotrophic factor (BDNF), which is increased by donepezil after chronic regimes and is related to modulation of mood. RESULTS Donepezil significantly increased ratings of vigour and anxiety symptoms (medium effect sizes). No changes in bodily symptoms or BDNF were observed. CONCLUSIONS Acute donepezil administration in participants with unaltered cholinergic and dopaminergic tone led to positive and negative changes in affect. These results call for further research on the direct mood effects of donepezil.
Collapse
Affiliation(s)
- Sabine Pompeia
- Departamento de Psicobiologia, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil.
| | | | | |
Collapse
|
45
|
Jansen K, Campos Mondin T, Azevedo Cardoso TD, Costa Ores LD, de Mattos Souza LD, Tavares Pinheiro R, da Silva Magalhães PV, da Silva RA. Quality of life and mood disorder episodes: community sample. J Affect Disord 2013; 147:123-7. [PMID: 23246208 DOI: 10.1016/j.jad.2012.10.021] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2012] [Revised: 10/05/2012] [Accepted: 10/23/2012] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To assess quality of life among Brazilian young adults who are 18-24 years old and who experience depressive, manic/hypomanic, and mixed episodes. METHOD This is a cross-sectional population-based study. The sample was selected in clusters. Mood disorders were assessed using a short, structured diagnostic interview-the Mini International Neuropsychiatric Interview (MINI) for DSM-IV and ICD-10 psychiatric disorders. Quality of life was assessed by the MOS 36-item Short-form General Health Survey (SF-36). RESULTS The sample comprised 1560 young adults. The prevalence ratio of mood disorder episodes were as follows: 10.0% depressive episode, 2.3% manic/hypomanic episode, and 2.4% mixed episode. Lower scores were found in all domains of quality of life among young adults who experience mood disorder episodes when compared to the general population (p<0.001 in the eight domains of the SF-36). Moreover, the impact on quality of life was higher among young adults with mixed episodes, followed by depressive episodes. CONCLUSION Young adults with mood disorders, even without a previous diagnosis of bipolar disorder, have an impaired quality of life in comparison to the general population.
Collapse
Affiliation(s)
- Karen Jansen
- Programa de Pós-Graduação em Saúde e Comportamento, Universidade Católica de Pelotas, 412 Pelotas, Pelotas, RS 96010-000, Brazil
| | | | | | | | | | | | | | | |
Collapse
|
46
|
Homish GG, Marshall D, Dubovsky SL, Leonard K. Predictors of later bipolar disorder in patients with subthreshold symptoms. J Affect Disord 2013; 144:129-33. [PMID: 22842021 DOI: 10.1016/j.jad.2012.06.020] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2012] [Accepted: 06/13/2012] [Indexed: 10/28/2022]
Abstract
INTRODUCTION The clinical significance of subthreshold bipolar disorder (SBD), which is characterized by an insufficient number or severity of hypomanic symptoms to qualify for a formal bipolar disorder diagnosis, remains to be determined. METHODS We examined the outcomes three years later (2004-2005; Wave 2) of 40,512 civilian, non-institutionalized subjects who endorsed elation and/or irritability but did not meet full criteria for lifetime mania or hypomania in 2001-2002 (Wave 1). RESULTS The likelihood of developing a clear episode of mania or hypomania by Wave 2 was significantly increased in subjects with elation or only irritability at Wave 1 compared with subjects who did not endorse either (OR 2.8, p<0.01 for each). Endorsement of both symptoms at Wave 1 increased the likelihood of a new episode of mania or hypomania 4.6 times, which was significantly higher than for those with only elation or irritability (p<.05 for each). LIMITATIONS SBD was not limited to depression, reducing comparability to previous studies. Despite the large sample size, there were not enough subjects to determine the impact of different numbers and types of additional symptoms on bipolar outcome. Although the majority of subjects were followed between the two Waves, the total duration of follow-up was probably too short to determine the long-term conversion rate to mania or hypomania. CONCLUSIONS Elation and/or irritability, especially if accompanied by trouble concentrating, racing thoughts or hyperactivity, may represent a prodrome of formal bipolar disorder that indicate close follow-up and cautious use of antidepressants.
Collapse
Affiliation(s)
- Gregory G Homish
- Department of Community Health and Health Behavior; University at Buffalo, 462 Grider St, Room 1182, Buffalo, NY 14215, USA
| | | | | | | |
Collapse
|
47
|
Warren CG, Dubovsky SL. New approaches for the management of bipolar disorder: role of sublingual asenapine in the treatment of mania. Neuropsychiatr Dis Treat 2013; 9:753-8. [PMID: 23785236 PMCID: PMC3682805 DOI: 10.2147/ndt.s16078] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2013] [Indexed: 12/02/2022] Open
Abstract
Bipolar disorder is a prevalent disorder that tends to become progressive without treatment and with inadequate treatment. Second generation (atypical) antipsychotic drugs have increasingly been used as adjunctive treatment or monotherapy for mania, but they have the potential for significant adverse effects and their role in maintenance treatment remains unclear. Asenapine is a new atypical antipsychotic medication formulated in a sublingual preparation that has been studied for mania but not maintenance therapy. Evidence indicating efficacy, adverse effects, and potential benefits and drawbacks of using asenapine in the treatment of bipolar disorder based on currently available published data are summarized.
Collapse
Affiliation(s)
- Calvert G Warren
- Department of Psychiatry, State University of New York at Buffalo, Buffalo, NY, USA
| | | |
Collapse
|
48
|
Early functional impairment in bipolar youth: a nested population-based case-control study. J Affect Disord 2012; 142:208-12. [PMID: 22959682 DOI: 10.1016/j.jad.2012.04.028] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2012] [Accepted: 04/17/2012] [Indexed: 12/12/2022]
Abstract
OBJECTIVES The objective of this report is to evaluate functioning in bipolar disorder in a population-based sample of young adults (18 to 24 years old). To this end, people with bipolar disorder were compared with matched participants with only depressive episodes and control subjects without a history of mood episodes. METHODS Case-control study nested in a population-based sample. Caseness was confirmed with the Structured Clinical Interview for DSM-IV. The Functioning Assessment Short Test was used as a measure of general functioning. A multivariate model was elaborated to account for potential confounders. RESULTS The sample consisted of 231 subjects. Both bipolar disorder (coef=0.60, SE=0.14, p<0.001) and major depression (coef=0.44, SE=0.14, p=0.001) were associated with functioning in the multivariate model. Current depressive symptoms appeared to influence functioning in those with major depression (Z=2.05, p=0.04), but not in those with bipolar disorder (Z=0.78, p=0.43). LIMITATION Neuropsychological testing was not performed and we see it as an important limitation of this study. CONCLUSION This population-based study further reinforces the notion that functional impairment is a fundamental characteristic of bipolar illness. It is present from early stages and is not completely explained by mood symptoms.
Collapse
|
49
|
Peripheral oxidative damage in early-stage mood disorders: a nested population-based case-control study. Int J Neuropsychopharmacol 2012; 15:1043-50. [PMID: 22008234 DOI: 10.1017/s1461145711001532] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Systemic toxicity is a relevant dimension of pathophysiology in bipolar disorder, and oxidative damage is one potential link between central and peripheral pathology. Although there is mounting evidence that chronic bipolar disorder is associated with oxidative stress, studies in the early stages of bipolar disorder are scarce, and heavily reliant on clinical in lieu of population studies. The objective of this study was to confirm leading hypotheses about the role of oxidative damage in bipolar disorder. To that end, we nested a case-control study in a population-based study of young adults aged 18-24 yr. After an initial psychopathology screen, all people with a lifetime history of (hypo)mania and matched controls underwent a structured diagnostic interview. This yielded a sample of 231 participants, in whom we measured serum protein carbonyl content (PCC) and thiobarbituric acid reactive substances (TBARS). People with bipolar disorder had higher PCC levels than healthy subjects. Those with major depression were not different from control subjects in either PCC or TBARS levels. Both bipolar disorder and major depression were associated with higher PCC levels in the a priori regression model controlling for possible confounders. These findings indicate that protein oxidative damage is present from early stages and can be seen as a sign of early illness activity in mood disorders.
Collapse
|
50
|
Abstract
PURPOSE OF REVIEW Many studies - including meta-analyses - do not distinguish between bipolar I and II disorder. The aim of this study is to review the recent literature on the prevalence, correlates, consequences, and treatment patterns of bipolar II disorder. RECENT FINDINGS In the past 2 years, several important studies have been conducted in the bipolar II field. The World Mental Health Survey initiative provides us with prevalence rate across 11 countries, while several meta-analyses on suicide and neurocognition directly compared bipolar I with bipolar II, informing us on the severe consequences of bipolar II disorder. Results from studies showed that the lifetime prevalence rate of bipolar II disorder in adults across 11 countries was 0.4%. Rates of bipolar II disorder in prospective studies of adolescents are substantially greater, with lifetime rates approaching 3-4%. SUMMARY Evidence from these studies regarding comparable clinical consequences, patterns of comorbidity, suicide attempts, family history, and treatment patterns to bipolar I disorder document the validity of the bipolar II subtype.
Collapse
|