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Dev DA, Le GH, Kwan ATH, Wong S, Arulmozhi A, Ceban F, Teopiz KM, Meshkat S, Rosenblat JD, Guillen-Burgos HF, Rhee TG, Ho RC, Cao B, d'Andrea G, Sundberg I, McIntyre RS. Comparing suicide completion rates in bipolar I versus bipolar II disorder: A systematic review and meta-analysis. J Affect Disord 2024; 361:480-488. [PMID: 38901691 DOI: 10.1016/j.jad.2024.06.045] [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: 09/23/2023] [Revised: 06/03/2024] [Accepted: 06/15/2024] [Indexed: 06/22/2024]
Abstract
BACKGROUND Bipolar disorder (BD) has a high disease burden and the highest mortality risk in BD comes from suicide. Bipolar disorder type II (BD-II) has been described as a milder form of bipolar disorder; however, extant literature is inconsistent with this description and instead describe illness burden and notably suicidality comparable to persons with bipolar I disorder (BD-I). Towards quantifying the hazard of BD-II, herein we aim via systematic review and meta-analysis to evaluate the rates of completed suicide in BD-I and BD-II. METHOD We conducted a literature search on PubMed, OVID (Embase, Medline) and PsychINFO databases from inception to June 30th, 2023, according to PRISMA guidelines. Articles were selected based on the predetermined eligibility criteria. A meta-analysis was performed, comparing the risk of completed suicide between individuals diagnosed with BD-I to BD-II. RESULTS Four out of eight studies reported higher suicide completion rates in persons living with BD-II when compared to persons living with BD-I; however, two of the studies reported non-significance. Two studies reported significantly higher suicide completion rates for BD-I than BD-II. The pooled odds ratio of BD-II suicide rates to BD-I was 1.00 [95 % CI = 0.75, 1.34]. LIMITATIONS The overarching limitation is the small number of studies and heterogeneity of studies that report on suicide completion in BD-I and BD-II. CONCLUSION Our study underscores the severity of BD-II, with a risk for suicide not dissimilar from BD-I. The greater propensity to depression, comorbidity and rapid-cycling course reported in BD-II are contributing factors to the significant mortality hazard in BD-II.
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Affiliation(s)
- Donovan A Dev
- Brain and Cognition Discovery Foundation, Toronto, ON, Canada; School of Medicine, University College Dublin, Dublin, Ireland; Department of Neuroscience Imaging and Clinical Sciences, University G d'Annunzio, Chieti, Italy.
| | - Gia Han Le
- Brain and Cognition Discovery Foundation, Toronto, ON, Canada; Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada; Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada.
| | - Angela T H Kwan
- Brain and Cognition Discovery Foundation, Toronto, ON, Canada; Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.
| | - Sabrina Wong
- Brain and Cognition Discovery Foundation, Toronto, ON, Canada; Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada; Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada.
| | - Akhilan Arulmozhi
- Brain and Cognition Discovery Foundation, Toronto, ON, Canada; Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
| | - Felicia Ceban
- Brain and Cognition Discovery Foundation, Toronto, ON, Canada; Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada; Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada.
| | - Kayla M Teopiz
- Brain and Cognition Discovery Foundation, Toronto, ON, Canada.
| | - Shakila Meshkat
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
| | - Joshua D Rosenblat
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada; Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada.
| | - Hernan F Guillen-Burgos
- Center for Clinical and Translational Research, Universidad Simón Bolívar, Barranquilla, Colombia; Center for Clinical and Translational Research, Faculty of Medicine, Universidad El Bosque, Bogotá D.C., Colombia; Department of Psychiatry and Mental Health, Pontificia Universidad Javeriana, Bogotá D.C., Colombia..
| | - Taeho Greg Rhee
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA; Department of Public Health Sciences, University of Connecticut School of Medicine, Farmington, CT, USA.
| | - Roger C Ho
- Institute for Health Innovation and Technology (iHealthtech), National University of Singapore, Singapore 117599, Singapore.; Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore.
| | - Bing Cao
- Key Laboratory of Cognition and Personality (SWU), Faculty of Psychology, Ministry of Education, Southwest University, Chongqing 400715, PR China.
| | - Giacomo d'Andrea
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Isak Sundberg
- Department of Neuroscience Psychiatry, Uppsala University Hospital, Uppsala, Sweden.
| | - Roger S McIntyre
- Brain and Cognition Discovery Foundation, Toronto, ON, Canada; Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada; School of Medicine, University College Dublin, Dublin, Ireland; Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
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2
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Serra-Navarro M, Clougher D, Solé B, Sánchez-Moreno J, González-Pinto A, Jiménez E, Amann BL, Balanzá-Martínez V, Tabarés-Seisdedos R, Arango C, Accardo V, García-Portilla MP, Ibáñez Á, Crespo JM, Ayuso-Mateos JL, Amoretti S, Torrent C, Martínez-Aran A, Vieta E. The impact of sex in the effectiveness of functional remediation in bipolar disorder. Acta Psychiatr Scand 2024. [PMID: 39243167 DOI: 10.1111/acps.13748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Revised: 07/31/2024] [Accepted: 08/02/2024] [Indexed: 09/09/2024]
Abstract
BACKGROUND Functional recovery remains a core clinical objective for patients with bipolar disorder (BD). Sociodemographic, clinical, and neurocognitive variables are associated with long-term functional impairment, yet the impact of sex differences is unclear. Functional remediation (FR) is a validated intervention aimed at achieving functional recovery in BD. The present study assessed the effect of sex differences of FR on psychosocial functioning at post-treatment (6-months) and 12-month follow-up (FUP). To the best of our knowledge, this is the first study to explore the role of sex as a factor in the efficacy of FR. METHODS 157 participants with BD were randomly assigned to either FR (N = 77) or treatment as usual group (80). Clinical, sociodemographic, neuropsychological, and functional data were obtained using a comprehensive assessment battery. Sex differences were explored via a general linear model (GLM) for repeated measures to compare the effect of sex on the intervention over time (6 months and FUP). RESULTS Results demonstrated that FR benefits both sexes, males (p = 0.001; d' = 0.88) and females (p = 0.04; d' = 0.57), at 6 months suggesting a generalized functional improvement. Conversely, at 12-month FUP sex differences were observed only in males (p = 0.005; d' = 0.68). CONCLUSIONS FR is a beneficial intervention for males and females after treatment, suggesting that there are no relevant distinct needs. Females may benefit from ongoing psychosocial functioning booster sessions after the intervention to maintain original improvements. Future research exploring sex differences could help to identify strategies to offer personalized FR intervention approaches in individuals with BD.
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Grants
- PI080180 Spanish Ministry of Economy and Competitiveness
- PI08/90825 Spanish Ministry of Economy and Competitiveness
- PI08/90327 Spanish Ministry of Economy and Competitiveness
- PI08/90675 Spanish Ministry of Economy and Competitiveness
- PI08/90224 Spanish Ministry of Economy and Competitiveness
- PI08/90654 Spanish Ministry of Economy and Competitiveness
- PI08/90189 Spanish Ministry of Economy and Competitiveness
- PI08/90916 Spanish Ministry of Economy and Competitiveness
- PI08/90416 Spanish Ministry of Economy and Competitiveness
- PI08/90094 Spanish Ministry of Economy and Competitiveness
- PI11/00637 Spanish Ministry of Economy and Competitiveness
- PI12/00912 Spanish Ministry of Economy and Competitiveness
- PI18/00789 Spanish Ministry of Economy and Competitiveness
- PI21/00787 Spanish Ministry of Economy and Competitiveness
- PI15/00283 Spanish Ministry of Science, Innovation and Universities
- PI18/00805 Spanish Ministry of Science, Innovation and Universities
- PI17/01066 Spanish Ministry of Science, Innovation and Universities
- PI20/00344 Spanish Ministry of Science, Innovation and Universities
- 2021 SGR 1358 Bipolar Disorders Group
- SLT006/17/00357 Bipolar Disorders Group
- CD20/00177 Sara Borrell Doctoral Program
- MV22/00002 MAES mobility fellowship
- CM21/00278 Instituto de Salud Carlos III (ISCIII)
- European Social Fund
- 202234-30 La Marató-TV3 Foundation
- 202234-32 La Marató-TV3 Foundation
- CPI14/00175 "Miguel Servet" postdoctoral contract
- CPII19/00018 Miguel Servet II contract
- Spanish Ministry of Innovation and Science
- European Union (FEDER)
- Spanish Ministry of Science and Innovation
- 2017 SGR 1365 Secretaria d'Universitats i Recerca del Departament d'Economia i Coneixement
- SLT006/17/00177 Departament de Salut de la Generalitat de Catalunya for the Pla estratègic de recerca I innovació en salut
- CB/07/09/0025 CIBER-Consorcio Centro de Investigación Biomédica en Red
- S2022/BMD-7216 Instituto de Salud Carlos III, Ministerio de Ciencia e Innovación; by the Madrid Regional Government
- AGES 3-CM Instituto de Salud Carlos III, Ministerio de Ciencia e Innovación; by the Madrid Regional Government
- PI19/01295 European Union Structural Funds
- PI22/01183 European Union Structural Funds
- ICI21/00089 European Union Structural Funds
- ISCIII-Subdirección General de Evaluación and the Fondo Europeo de Desarrollo Regional (FEDER)
- PI18/0105 ISCIII-Subdirección General de Evaluación y el Fondo Europeo de Desarrollo Regional
- PI21/00713 ISCIII-Subdirección General de Evaluación y el Fondo Europeo de Desarrollo Regional
- 2022111054 CIBERSAM, the Basque Government
- IT1631-22 University of the Basque Country
- PMP21/00051 European Union-NextGenerationEU
- PI19/01024 European Union-NextGenerationEU
- B2017/BMD-3740 AGES-CM-2 CIBERSAM, Madrid Regional Government
- 101034377 Project PRISM-2
- 777394 Project AIMS-2-TRIALS
- 1U01MH124639-01 Horizon Europe, the National Institute of Mental Health of the National Institutes of Health
- 5P50MH115846-03 Horizon Europe, the National Institute of Mental Health of the National Institutes of Health
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Affiliation(s)
- Maria Serra-Navarro
- Bipolar and Depressive Disorders Unit, Department of Psychiatry and Psychology, Hospital Clinic of Barcelona, Barcelona, Spain
- Fundació Clínic per la Recerca Biomèdica-Institut d'Investigacions Biomèdiques August Pi i Sunyer (FCRB-IDIBAPS), Barcelona, Spain
- Department de Medicina, Facultat de Medicina i Ciències de la Salut, Institute of Neurosciences (UBNeuro), Universitat de Barcelona, Barcelona, Spain
- Network Centre for Biomedical Research in Mental Health (CIBERSAM), Health Institute Carlos III (ISCIII), Madrid, Spain
| | - Derek Clougher
- Bipolar and Depressive Disorders Unit, Department of Psychiatry and Psychology, Hospital Clinic of Barcelona, Barcelona, Spain
- Fundació Clínic per la Recerca Biomèdica-Institut d'Investigacions Biomèdiques August Pi i Sunyer (FCRB-IDIBAPS), Barcelona, Spain
- Department de Medicina, Facultat de Medicina i Ciències de la Salut, Institute of Neurosciences (UBNeuro), Universitat de Barcelona, Barcelona, Spain
- Network Centre for Biomedical Research in Mental Health (CIBERSAM), Health Institute Carlos III (ISCIII), Madrid, Spain
- Alava University Hospital, BIOARABA, University of the Basque Country, Vitoria, Spain
| | - Brisa Solé
- Bipolar and Depressive Disorders Unit, Department of Psychiatry and Psychology, Hospital Clinic of Barcelona, Barcelona, Spain
- Fundació Clínic per la Recerca Biomèdica-Institut d'Investigacions Biomèdiques August Pi i Sunyer (FCRB-IDIBAPS), Barcelona, Spain
- Department de Medicina, Facultat de Medicina i Ciències de la Salut, Institute of Neurosciences (UBNeuro), Universitat de Barcelona, Barcelona, Spain
- Network Centre for Biomedical Research in Mental Health (CIBERSAM), Health Institute Carlos III (ISCIII), Madrid, Spain
| | - Jose Sánchez-Moreno
- Bipolar and Depressive Disorders Unit, Department of Psychiatry and Psychology, Hospital Clinic of Barcelona, Barcelona, Spain
- Fundació Clínic per la Recerca Biomèdica-Institut d'Investigacions Biomèdiques August Pi i Sunyer (FCRB-IDIBAPS), Barcelona, Spain
- Department de Medicina, Facultat de Medicina i Ciències de la Salut, Institute of Neurosciences (UBNeuro), Universitat de Barcelona, Barcelona, Spain
- Network Centre for Biomedical Research in Mental Health (CIBERSAM), Health Institute Carlos III (ISCIII), Madrid, Spain
| | - Ana González-Pinto
- Network Centre for Biomedical Research in Mental Health (CIBERSAM), Health Institute Carlos III (ISCIII), Madrid, Spain
- Alava University Hospital, BIOARABA, University of the Basque Country, Vitoria, Spain
| | - Esther Jiménez
- Bipolar and Depressive Disorders Unit, Department of Psychiatry and Psychology, Hospital Clinic of Barcelona, Barcelona, Spain
- Network Centre for Biomedical Research in Mental Health (CIBERSAM), Health Institute Carlos III (ISCIII), Madrid, Spain
- Alava University Hospital, BIOARABA, University of the Basque Country, Vitoria, Spain
| | - Benedikt L Amann
- Network Centre for Biomedical Research in Mental Health (CIBERSAM), Health Institute Carlos III (ISCIII), Madrid, Spain
- Institute of Mental Health, Hospital del Mar Medical Research Institute, Barcelona, Spain
- Department of Medicine and Life Sciences, Pompeu Fabra University, Barcelona, Spain
| | - Vicent Balanzá-Martínez
- Network Centre for Biomedical Research in Mental Health (CIBERSAM), Health Institute Carlos III (ISCIII), Madrid, Spain
- Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, INCLIVA, Valencia, Spain
| | - Rafael Tabarés-Seisdedos
- Network Centre for Biomedical Research in Mental Health (CIBERSAM), Health Institute Carlos III (ISCIII), Madrid, Spain
- Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, INCLIVA, Valencia, Spain
| | - Celso Arango
- Network Centre for Biomedical Research in Mental Health (CIBERSAM), Health Institute Carlos III (ISCIII), Madrid, Spain
- Child and Adolescent Psychiatry Department, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, School of Medicine, Madrid, Spain
| | - Vivian Accardo
- Department of Mental Health and Addiction Services, ASST Spedali Civili of Brescia, Brescia, Italy
| | - María Paz García-Portilla
- Network Centre for Biomedical Research in Mental Health (CIBERSAM), Health Institute Carlos III (ISCIII), Madrid, Spain
- Department of Psychiatry, School of Medicine, Instituto de Neurociencias del Principado de Asturias, INEUROPA, Servicio de Salud del Principado de Asturias (SESPA), University of Oviedo, Oviedo, Spain
| | - Ángela Ibáñez
- Network Centre for Biomedical Research in Mental Health (CIBERSAM), Health Institute Carlos III (ISCIII), Madrid, Spain
- Department of Psychiatry, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Universidad de Alcalá, Madrid, Spain
| | - José Manuel Crespo
- Network Centre for Biomedical Research in Mental Health (CIBERSAM), Health Institute Carlos III (ISCIII), Madrid, Spain
- Department of Psychiatry, Bellvitge Biomedical Research Institute (IDIBELL), University Hospital of Bellvitge, Barcelona, Spain
| | - José Luis Ayuso-Mateos
- Network Centre for Biomedical Research in Mental Health (CIBERSAM), Health Institute Carlos III (ISCIII), Madrid, Spain
- Department of Psychiatry, IIS-IP, Universidad Autónoma de Madrid, Madrid, Spain
| | - Silvia Amoretti
- Psychiatric Genetics Unit, Group of Psychiatry, Mental Health and Addictions, Vall d'Hebron Research Institute (VHIR), Barcelona, Spain
| | - Carla Torrent
- Bipolar and Depressive Disorders Unit, Department of Psychiatry and Psychology, Hospital Clinic of Barcelona, Barcelona, Spain
- Fundació Clínic per la Recerca Biomèdica-Institut d'Investigacions Biomèdiques August Pi i Sunyer (FCRB-IDIBAPS), Barcelona, Spain
- Department de Medicina, Facultat de Medicina i Ciències de la Salut, Institute of Neurosciences (UBNeuro), Universitat de Barcelona, Barcelona, Spain
- Network Centre for Biomedical Research in Mental Health (CIBERSAM), Health Institute Carlos III (ISCIII), Madrid, Spain
| | - Anabel Martínez-Aran
- Bipolar and Depressive Disorders Unit, Department of Psychiatry and Psychology, Hospital Clinic of Barcelona, Barcelona, Spain
- Fundació Clínic per la Recerca Biomèdica-Institut d'Investigacions Biomèdiques August Pi i Sunyer (FCRB-IDIBAPS), Barcelona, Spain
- Department de Medicina, Facultat de Medicina i Ciències de la Salut, Institute of Neurosciences (UBNeuro), Universitat de Barcelona, Barcelona, Spain
- Network Centre for Biomedical Research in Mental Health (CIBERSAM), Health Institute Carlos III (ISCIII), Madrid, Spain
| | - Eduard Vieta
- Bipolar and Depressive Disorders Unit, Department of Psychiatry and Psychology, Hospital Clinic of Barcelona, Barcelona, Spain
- Fundació Clínic per la Recerca Biomèdica-Institut d'Investigacions Biomèdiques August Pi i Sunyer (FCRB-IDIBAPS), Barcelona, Spain
- Department de Medicina, Facultat de Medicina i Ciències de la Salut, Institute of Neurosciences (UBNeuro), Universitat de Barcelona, Barcelona, Spain
- Network Centre for Biomedical Research in Mental Health (CIBERSAM), Health Institute Carlos III (ISCIII), Madrid, Spain
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3
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Cong E, Zhong Y, Wu M, Chen H, Cai Y, Ling Z, Wang Y, Wen H, Hu Y, Zhang H, Li Y, Liu X, Zhong P, Lai W, Xu Y, Wu Y. Hippocampal subfield morphology from first episodes of bipolar disorder type II and major depressive disorder in a drug naïve Chinese cohort. Front Psychiatry 2024; 15:1438144. [PMID: 39119073 PMCID: PMC11306163 DOI: 10.3389/fpsyt.2024.1438144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2024] [Accepted: 07/05/2024] [Indexed: 08/10/2024] Open
Abstract
Introduction Symptoms during the onset of major depressive disorder [MDD] and bipolar disorder type II [BD-II] are similar. The difference of hippocampus subregion could be a biological marker to distinguish MDD from BD-II. Methods We recruited 61 drug-naïve patients with a first-episode MDD and BD-II episode and 30 healthy controls (HC) to participate in a magnetic resonance imaging [MRI] study. We built a general linear model (one-way analysis of covariance) with 22 hippocampal subfields and two total hippocampal volumes as dependent variables, and the diagnosis of MDD, BD-II, and HC as independent variables. We performed pair-wise comparisons of hippocampal subfield volumes between MDD and HC, BD-II and MDD, BD-II and HC with post hoc for primary analysis. Results We identified three regions that differed significantly in size between patients and controls. The left hippocampal fissure, the hippocampal-amygdaloid transition area (HATA), and the right subiculum body were all significantly larger in patients with MDD compared with the HC. In the onset of first-episode of MDD, the hippocampal volume increased significantly, especially on the left side comparing to HC. However, we found differences between MDD and BD-II were not statistically significant. The volume of the left HATA and right subiculum body in BD-II was larger. Conclusions The sample size of this study is relatively small, as it is a cross-sectional comparative study. In both MDD and BD-II groups, the volume of more left subregions appeared to increase. The left subregions were severely injured in the development of depressive disorder.
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Affiliation(s)
- Enzhao Cong
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Tenth People’s Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Yingyan Zhong
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Mengyue Wu
- X-LANCE Lab, Department of Computer Science and Engineering, MoE Key Lab of Artificial Intelligence, AI Institute Shanghai Jiao Tong University, Shanghai, China
| | - Haiying Chen
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yiyun Cai
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zheng Ling
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yun Wang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hui Wen
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yao Hu
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Huifeng Zhang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yan Li
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaohua Liu
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Pingfang Zhong
- Affective Disorder Department, Lincang Psychiatric Hospital, Lincang, China
| | - Weijie Lai
- Psychiatric Department, Zhangzhou Fukang Hospital, Zhangzhou, China
| | - Yifeng Xu
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yan Wu
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Pantovic-Stefanovic M, Petronijevic N, Dunjic-Kostic B, Velimirovic M, Jurisic V, Nikolic T, Dodic S, Ivkovic M. Differentiating Stages of Bipolar and Unipolar Depression-The Possible Role of sICAM-1 and sVCAM-1. Cells 2024; 13:1213. [PMID: 39056795 PMCID: PMC11274993 DOI: 10.3390/cells13141213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2024] [Revised: 06/27/2024] [Accepted: 07/15/2024] [Indexed: 07/28/2024] Open
Abstract
Increased immune-inflammatory activation has been repeatedly linked to etiopathogenesis and the progression of both major depressive disorder (MDD) and bipolar depression (BD). We explore the role of soluble intercellular cell adhesion molecule-1 (sICAM-1) and soluble vascular cell adhesion molecule-1 (sVCAM-1) in diagnostic differentiation and disorder progression in patients with MDD and BD. Serum levels of sICAM-1 and sVCAM-1 were measured in 137 patients (MDD = 93 and BD = 44) and compared with 73 healthy controls. The severity of psychopathology was assessed using the Hamilton Depression Rating Scale and Clinical Global Impression Scale. After adjustment for multiple confounders, we noticed significant downregulation of sVCAM-1 and upregulation of sICAM-1 levels in both patient groups. Decreased sVCAM-1 levels were detected in patients with acute episodes of BD when compared to MDD. Immune mediators were related to indicators of progression in both mood disorders. They also followed different post-treatment normalization patterns in MDD and BD and in relation to the stage of each disorder. Adhesion molecules could potentially be useful in discriminating between patients with MDD and BD and determining the possible progression of the disorders. Future nosological methods should include time-dependent pathoplasticity and biological correlates, at least for affective disorders.
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Affiliation(s)
- Maja Pantovic-Stefanovic
- Department of Bipolar Disorders, Clinic for Psychiatry, University Clinical Centre of Serbia, Pasterova 2, 11000 Belgrade, Serbia; (M.P.-S.)
- School of Medicine, University of Belgrade, Dr Subotica 8 st., 11000 Belgrade, Serbia; (N.P.)
| | - Natasa Petronijevic
- School of Medicine, University of Belgrade, Dr Subotica 8 st., 11000 Belgrade, Serbia; (N.P.)
- Institute of Clinical and Medical Biochemistry, Pasterova 2, 11000 Belgrade, Serbia
| | - Bojana Dunjic-Kostic
- Department of Bipolar Disorders, Clinic for Psychiatry, University Clinical Centre of Serbia, Pasterova 2, 11000 Belgrade, Serbia; (M.P.-S.)
- School of Medicine, University of Belgrade, Dr Subotica 8 st., 11000 Belgrade, Serbia; (N.P.)
| | - Milica Velimirovic
- School of Medicine, University of Belgrade, Dr Subotica 8 st., 11000 Belgrade, Serbia; (N.P.)
- Institute of Clinical and Medical Biochemistry, Pasterova 2, 11000 Belgrade, Serbia
| | - Vladimir Jurisic
- Faculty of Medical Sciences, University of Kragujevac, Svetozara Markovica 69, 11000 Kragujevac, Serbia
| | - Tatjana Nikolic
- School of Medicine, University of Belgrade, Dr Subotica 8 st., 11000 Belgrade, Serbia; (N.P.)
- Institute of Clinical and Medical Biochemistry, Pasterova 2, 11000 Belgrade, Serbia
| | - Sara Dodic
- Department of Bipolar Disorders, Clinic for Psychiatry, University Clinical Centre of Serbia, Pasterova 2, 11000 Belgrade, Serbia; (M.P.-S.)
- School of Medicine, University of Belgrade, Dr Subotica 8 st., 11000 Belgrade, Serbia; (N.P.)
| | - Maja Ivkovic
- Department of Bipolar Disorders, Clinic for Psychiatry, University Clinical Centre of Serbia, Pasterova 2, 11000 Belgrade, Serbia; (M.P.-S.)
- School of Medicine, University of Belgrade, Dr Subotica 8 st., 11000 Belgrade, Serbia; (N.P.)
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Lee SH, Hyung WSW, Youn CE, Chi S, Youn H, Lee MS, Han C, Jeong HG. Trends in Electroconvulsive Therapy Utilization in South Korea: Health Insurance Review Data From 2008 to 2018. Psychiatry Investig 2024; 21:691-700. [PMID: 39089694 PMCID: PMC11298272 DOI: 10.30773/pi.2024.0070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 03/07/2024] [Accepted: 03/17/2024] [Indexed: 08/04/2024] Open
Abstract
OBJECTIVE The study aimed to analyze and clinically correlate 10-year trends in the demographic characteristics of patients receiving electroconvulsive therapy (ECT) to provide an overview of ECT utilization in South Korea. METHODS Using health insurance claims data from 2008 to 2018 retrieved from Health Insurance Review and Assessment Service database in South Korea, we identified individuals undergoing ECT based on procedural codes. Descriptive analysis evaluated baseline clinical characteristics, and trend analysis used a linear regression model. RESULTS The prevalence of ECT increased by 240.49% (0.405/105 inhabitants in 2008 to 0.974/105 inhabitants in 2018). The increasing trend was more pronounced in younger and older patients. The proportion of women consistently exceeded that of men. A rise in the proportion of patients with affective disorders, and a decrease in the proportion of psychotic disorders was observed. More antidepressants and atypical antipsychotics were prescribed to patients undergoing ECT. The proportion of ECT sessions conducted in large hospital inpatient settings also decreased during the observation period. Despite increasing global trends, ECT prevalence in South Korea remains significantly lower than worldwide rates. CONCLUSION This study demonstrated an increasing trend of ECT across a wide range of population demographics and in more accessible settings. The comparatively low prevalence of ECT in Korea compared to other countries might be attributed to insufficient mental health literacy and the stigma associated with ECT. Given the elevated suicide rates in Korea, more extensive adoption of ECT appears imperative.
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Affiliation(s)
- Seung-Hoon Lee
- Department of Psychiatry, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
- Korea University Research Institute of Mental Health, Seoul, Republic of Korea
| | - Won Seok William Hyung
- Department of Psychiatry, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Chae En Youn
- Department of Psychiatry, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Suhyuk Chi
- Department of Psychiatry, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
- Korea University Research Institute of Mental Health, Seoul, Republic of Korea
| | - HyunChul Youn
- Department of Psychiatry, Soonchunhyang University Bucheon Hospital, Bucheon, Republic of Korea
| | - Moon-Soo Lee
- Department of Psychiatry, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
- Korea University Research Institute of Mental Health, Seoul, Republic of Korea
| | - Changsu Han
- Department of Psychiatry, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
- Korea University Research Institute of Mental Health, Seoul, Republic of Korea
| | - Hyun-Ghang Jeong
- Department of Psychiatry, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
- Korea University Research Institute of Mental Health, Seoul, Republic of Korea
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Shahraki Z, Rastkar M, Ramezanpour MR, Ghajarzadeh M. The prevalence and odds of bipolar disorder in women with polycystic ovary syndrome (PCO) disease: a systematic review and meta-analysis. Arch Womens Ment Health 2024; 27:329-336. [PMID: 38217710 DOI: 10.1007/s00737-024-01420-w] [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: 06/22/2023] [Accepted: 01/02/2024] [Indexed: 01/15/2024]
Abstract
BACKGROUND Women with polycystic ovary syndrome (PCO) suffer from psychological difficulties like bipolar disorder. Various studies in the literature report several prevalence rates of bipolar disorder in women with PCO, while there is no systematic review in this field. So, we designed this systematic review and meta-analysis to estimate the pooled prevalence and odds of bipolar disorder in women with PCO disease. METHOD PubMed, Scopus, EMBASE, Web of Science, Google Scholar, and references of the references, conference abstracts were comprehensively searched by two independent researchers. The search was done on May 1st, 2023. RESULTS A literature search revealed 438 records, 35 full texts were evaluated, and finally, 11 studies remained for systematic review. Totally, 73,102 women with PCO and 340,724 controls were evaluated. Among cases, 1471 had bipolar diagnosis vs. 4321 controls. The prevalence of bipolar disorder in women with PCO ranged between 0 and 27%, and the pooled prevalence was estimated as 4% (95% CI, 2-5%; I2, 99.3%, p < 0.001). The odds of bipolar disorder in women with PCO ranged between 0.98 and 8.78, and the pooled estimate was 2.06 (95% CI, 1.61-2.63) (I2, 85.6%; p < 0.001). CONCLUSIONS This systematic review and meta-analysis show that the pooled prevalence of bipolar disorder in women with PCO is 4%, and women with PCO are at a 2-fold higher risk of bipolar disorder.
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Affiliation(s)
- Zahra Shahraki
- Zabol Medical Plants Research Center, Zabol University of Medical Sciences, Zabol, Iran
| | - Mohsen Rastkar
- Students Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Mahsa Ghajarzadeh
- Universal Council of Epidemiology (UCE), Universal Scientific Education and Research Network (USERN), Tehran University of Medical Sciences, Tehran, Iran.
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7
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de Brum GF, Bochi GV. Are Advanced Oxidation Protein Products (AOPPs) Levels Altered in Neuropsychiatric Disorders? An Integrative Review. Mol Neurobiol 2024:10.1007/s12035-024-04122-7. [PMID: 38580854 DOI: 10.1007/s12035-024-04122-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 03/14/2024] [Indexed: 04/07/2024]
Abstract
Neuropsychiatric disorders such as major depressive disorder (MDD), bipolar disorder (BD), and schizophrenia (SZ) are considered a public health problem since it interferes in personal relationships and at work. The pathophysiological mechanisms of these mental disorders are still not completely understood. The variety and heterogeneity of symptoms, as well as the absence of biomarkers, make the diagnosis, prognosis, and treatment of these disorders difficult. However, oxidative stress appears to play a role in the pathophysiology of these diseases. In this context, advanced oxidation protein products (AOPPs) are considered a biomarker of protein oxidative damage and have been associated with neuroinflammatory diseases. In patients with neuropsychiatric disorders, increased levels of AOPPs were associated with the severity of symptoms and decreased quality of life. Thus, the objective of this integrative review is to investigate and discuss the relationship between AOPPs levels and MDD, BD, and SZ. Different databases were consulted and approximately 112 scientific articles were found relating AOPPs and psychiatric disorders. In the majority of studies, the blood levels of AOPPs were increased in MDD, BD, and SZ and associated with the severity of the disorders. Although the association of this marker with the risk of developing one of these mental disorders is more uncertain, some studies have suggested this relationship. Of the twenty-four studies highlighted, only four did not find significant differences in AOPPs levels in patients with the disorders mentioned. In summary, it may be suggested that the assessment of AOPPs levels can be a useful tool in the evaluation of neuropsychiatric disorders, at least for prognostic evaluation. However, the role of this biomarker in the pathophysiology of mental disorders is still unclear, as well as whether reducing its levels represents a potential therapeutic strategy.
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Affiliation(s)
- Gerson Fernandes de Brum
- Center of Health Sciences, Department of Physiology and Pharmacology, Federal University of Santa Maria, Santa Maria, RS, Brazil
- Center of Health Sciences, Postgraduate Program in Pharmacology, Federal University of Santa Maria, Santa Maria, RS, Brazil
| | - Guilherme Vargas Bochi
- Center of Health Sciences, Department of Physiology and Pharmacology, Federal University of Santa Maria, Santa Maria, RS, Brazil.
- Center of Health Sciences, Postgraduate Program in Pharmacology, Federal University of Santa Maria, Santa Maria, RS, Brazil.
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8
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Vieta E, Ghorpade S, Biswas A, Sarkar A, Phansalkar A, Cooper J. Lamotrigine efficacy, safety, and tolerability for women of childbearing age with bipolar I disorder: Meta-analysis from four randomized, placebo-controlled maintenance studies. Eur Neuropsychopharmacol 2024; 78:81-92. [PMID: 37775363 DOI: 10.1016/j.euroneuro.2023.09.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 08/17/2023] [Accepted: 09/04/2023] [Indexed: 10/01/2023]
Abstract
This meta-analysis investigated the efficacy, safety, and tolerability of lamotrigine versus placebo in preventing relapse and recurrence of mood episodes in women of childbearing age with bipolar I disorder. Following up to 16 weeks' open-label lamotrigine treatment, responders were randomized to double-blind treatment, including lamotrigine 100-400 mg/day or placebo, in four trials of up to 76 weeks. Women aged 18-45 years who received ≥ 1 dose of study treatment and had ≥ 1 efficacy assessment in the double-blind phase were pooled for efficacy analysis. The primary outcome was median time to intervention for any mood episode (TIME). Of 717 eligible women in the open-label phase, 287 responded and were randomized to lamotrigine (n = 153) or placebo (n = 134). The randomized group had a mean (SD) of 2.0(2.02) manic and 2.5(2.02) depressive episodes in the 3 years before screening. Median TIME was 323 days with lamotrigine and 127 days with placebo (HR 0.69; 95% CI 0.49, 0.96; p = 0.030). Lamotrigine delayed time to intervention for any depressive episode (HR 0.59; 95% CI 0.39, 0.90; p = 0.014) with no treatment difference for manic episodes (HR 0.91; 95% CI 0.52, 1.58; p = 0.732). 2/717 (< 1%) participants experienced serious rash-related adverse events (AEs) during the open-label phase, and 52/717 (7%) had non-serious rash-related events leading to study withdrawal. Incidence of AEs and AEs leading to withdrawal were similar between lamotrigine and placebo groups. Lamotrigine delayed relapse and recurrence of mood episodes, largely by preventing depressive episodes, and was well tolerated in women of childbearing age.
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Affiliation(s)
- Eduard Vieta
- Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
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9
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Ziemka-Nalecz M, Pawelec P, Ziabska K, Zalewska T. Sex Differences in Brain Disorders. Int J Mol Sci 2023; 24:14571. [PMID: 37834018 PMCID: PMC10572175 DOI: 10.3390/ijms241914571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 09/20/2023] [Accepted: 09/22/2023] [Indexed: 10/15/2023] Open
Abstract
A remarkable feature of the brain is its sexual dimorphism. Sexual dimorphism in brain structure and function is associated with clinical implications documented previously in healthy individuals but also in those who suffer from various brain disorders. Sex-based differences concerning some features such as the risk, prevalence, age of onset, and symptomatology have been confirmed in a range of neurological and neuropsychiatric diseases. The mechanisms responsible for the establishment of sex-based differences between men and women are not fully understood. The present paper provides up-to-date data on sex-related dissimilarities observed in brain disorders and highlights the most relevant features that differ between males and females. The topic is very important as the recognition of disparities between the sexes might allow for the identification of therapeutic targets and pharmacological approaches for intractable neurological and neuropsychiatric disorders.
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Affiliation(s)
| | | | | | - Teresa Zalewska
- NeuroRepair Department, Mossakowski Medical Research Institute, Polish Academy of Sciences, 5, A. Pawinskiego Str., 02-106 Warsaw, Poland; (M.Z.-N.); (P.P.); (K.Z.)
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10
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Pozzolo Pedro MO, Pozzolo Pedro M, Martins SS, Castaldelli-Maia JM. Alcohol use disorders in patients with bipolar disorder: a systematic review and meta-analysis. Int Rev Psychiatry 2023; 35:450-460. [PMID: 38299650 DOI: 10.1080/09540261.2023.2249548] [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: 06/12/2023] [Accepted: 08/14/2023] [Indexed: 02/02/2024]
Abstract
Alcohol consumption has a key role in more than 200 diseases and health injuries, being an important factor for social and public health costs. Studies with clinical populations show an association between alcohol use disorders (AUD) and bipolar disorder. In this meta-analysis we included studies, reports, or summaries identified in Google Scholar, Lilacs, Medline, and MedCaribe that reported original data published up to 31 January 2023. We included cross-sectional and longitudinal observational studies that investigated the prevalence of AUD in patients with bipolar disorder. We calculated the prevalence rates and conducted a meta-analysis using a random effects model. The meta-analysis included 20 unique studies conducted in 12 countries, with a total sample of 32,886 individuals with bipolar disorder, comprising 17,923 women and 13,963 men, all aged 18 years or older. The prevalence of AUD in individuals with bipolar disorder was found to be 29.12%, while the prevalence of Alcohol Dependence (AD) was 15.87% and the prevalence of Alcohol Abuse (AA) was 18.74%. The high prevalence of AUD individuals with bipolar disorder is important because it highlights the need for targeted interventions to prevent and address comorbid conditions, which may improve treatment outcomes, reduce harm, and promote public health.
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Affiliation(s)
| | | | - Silvia S Martins
- Department of Epidemiology, Columbia Mailman School of Public Health, New York, NY, USA
| | - João Maurício Castaldelli-Maia
- Department of Psychiatry, Medical School, University of São Paulo, São Paulo, Brazil
- Department of Epidemiology, Columbia Mailman School of Public Health, New York, NY, USA
- Department of Neuroscience, Medical School, ABC Health University Center, Santo André, Brazil
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11
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Miola A, Tondo L, Pinna M, Contu M, Baldessarini RJ. Characteristics of rapid cycling in 1261 bipolar disorder patients. Int J Bipolar Disord 2023; 11:21. [PMID: 37271762 DOI: 10.1186/s40345-023-00300-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 05/03/2023] [Indexed: 06/06/2023] Open
Abstract
BACKGROUND Rapid-cycling (RC; ≥ 4 episodes/year) in bipolar disorder (BD) has been recognized since the 1970s and associated with inferior treatment response. However, associations of single years of RC with overall cycling rate, long-term morbidity, and diagnostic subtypes are not clear. RESULTS We compared descriptive and clinical characteristics in 1261 BD patients with/without RC, based on history and prospective follow-up for several years. RC in any previous year was identified in 9.36% of BD subjects (3.74% in BD1, 15.2% BD2), and somewhat more among women than men. RC-BD subjects had 3.21-fold greater average prospective annual rates of recurrence but not hospitalizations, had less difference in %-time-ill, received more mood-stabilizing treatments, and had greater suicidal risk, lacked familial psychiatric illnesses, had more cyclothymic temperament, were more likely to be married, had more siblings and children, experienced early sexual abuse, but were less likely to abuse drugs (not alcohol) or smoke. In multivariable regression modeling, older age, mood-switching with antidepressants, and BD2 > BD1 diagnosis, as well as more episodes/year were independently associated with RC. Notably, prospective mean recurrence rates were below 4/year in 79.5% of previously RC patients, and below 2/year in 48.1%. CONCLUSIONS Lifetime risk of RC in BD was 9.36%, more likely in women, with older age, and in BD2 > BD1. With RC, recurrence rates were much higher, especially for depression with less effect on %-time ill, suggesting shorter episodes. Variable associations with unfavorable outcomes and prospective recurrence rates well below 4/year in most previously RC patients indicate that RC was not a sustained characteristic and probably was associated with use of antidepressants.
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Affiliation(s)
- Alessandro Miola
- Department of Psychiatry, University of Padova, Padua, Italy
- International Consortium for Mood & Psychotic Disorders Research, Mailman Research Center, McLean Hospital, Belmont, Massachusetts, USA
| | - Leonardo Tondo
- International Consortium for Mood & Psychotic Disorders Research, Mailman Research Center, McLean Hospital, Belmont, Massachusetts, USA.
- Lucio Bini Mood Disorder Centers, Cagliari & Rome, Italy.
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA.
| | - Marco Pinna
- Lucio Bini Mood Disorder Centers, Cagliari & Rome, Italy
- Section on Psychiatry, Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
| | - Martina Contu
- Lucio Bini Mood Disorder Centers, Cagliari & Rome, Italy
- Section on Psychiatry, Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
| | - Ross J Baldessarini
- International Consortium for Mood & Psychotic Disorders Research, Mailman Research Center, McLean Hospital, Belmont, Massachusetts, USA
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
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12
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Bhardwaj S, Sinha D, Pawar A, Mane A. Predominant polarity in bipolar affective disorder and its impact on cognition and quality of life. Indian J Psychiatry 2023; 65:641-646. [PMID: 37485407 PMCID: PMC10358811 DOI: 10.4103/indianjpsychiatry.indianjpsychiatry_163_23] [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: 03/11/2023] [Revised: 04/20/2023] [Accepted: 04/23/2023] [Indexed: 07/25/2023] Open
Abstract
Background Bipolar mood disorder or bipolar affective disorder (BPAD) is a chronic illness characterized by phases of mania/hypomania, depression, or mixed episodes. The course of bipolar mood disorder is relapsing in nature. It is associated with high comorbidity rates, a large number of premature deaths due to suicide, and a worse social and work performance. All of those characteristics entail a significant economic impact due to both direct and indirect costs and require an effective diagnostic and therapeutic approach. Lifetime prevalence of BPAD is approximately 4% worldwide. Various attempts have been made to define "predominance" of polarity in BPAD. Need for this Study Our study tries to highlight the existence of predominant polarity by comparing effects of the same on substance consumption, cognitive abilities, quality of life, and preponderance of specific polarity to specific gender. Method After Institutional Ethics Committee Approval and written informed consent, patients who were diagnosed with BPAD attending out-patient department of a tertiary care hospital in Mumbai were recruited. A total of 57 participants were enrolled. The World Health Organization Quality of Life - Brief Scale (WHOQOL BREF) and the Montréal Cognitive Assessment (MoCA) were both used to evaluate the patients' quality of life and cognitive ability, respectively. Discussion and Results Men exhibited manic predominant polarity, while women had depressive predominant polarity, with P value of. 003. Regarding age, illness length, education, substance abuse, family history, and suicide attempts, there was no discernible difference in the polarities. The outcome of female bipolar patients may be improved if the clinician is mindful of the burden of depression, risk of misdiagnosis, and variable therapy response. Interestingly, our study found no significant difference between MoCA scores of those with depressive and manic polarity. Substantial MoCA score differences were found between the groups with depressive polarity and no polarity. Conclusion Men were observed to experience more manic episodes. More women in the study experienced predominantly depressive polarity, highlighting the need to probe for a past history of hypomania or mixed episodes to avoid misdiagnosis as unipolar depression in them. Manic predominate polarity performed better in the physical and psychological domains of the post hoc test for quality-of-life BREF scale. There were substantial MoCA score differences between the groups with depressive polarity and no polarity, with the depressive polarity showing more cognitive decline.
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Affiliation(s)
- Shashank Bhardwaj
- Department of Psychiatry, Dr. R. N. Cooper Hospital and HBT Medical College, Mumbai, Maharashtra, India
| | - Deoraj Sinha
- Department of Psychiatry, Dr. R. N. Cooper Hospital and HBT Medical College, Mumbai, Maharashtra, India
| | - Ami Pawar
- Department of Psychiatry, Dr. R. N. Cooper Hospital and HBT Medical College, Mumbai, Maharashtra, India
| | - Astik Mane
- Department of Psychiatry, Dr. R. N. Cooper Hospital and HBT Medical College, Mumbai, Maharashtra, India
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13
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Cardiometabolic and endocrine comorbidities in women with bipolar disorder: A systematic review. J Affect Disord 2023; 323:841-859. [PMID: 36538952 DOI: 10.1016/j.jad.2022.12.023] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 12/06/2022] [Accepted: 12/07/2022] [Indexed: 12/23/2022]
Abstract
INTRODUCTION Bipolar Disorder (BD) is known to be equally distributed among males and females. The well-documented increased risk of medical comorbidities in patients with BD, in comparison to BD patients without medical comorbidities, shows a negative impact on the course of illness. There is some evidence suggesting that women with BD have higher psychiatric and medical comorbidities in comparison to men with BD, however there is no evidence in comparison to women without BD or other major psychiatric illness. These comorbidities, along with various psychosocial factors, are known to affect the course of BD. METHODS We aimed to systematically review the literature on cardiovascular, metabolic and endocrine comorbidities in women with BD in comparison to men with BD and control women. A comprehensive search of electronic databases including PubMed, PsycINFO, Embase, and SCOPUS was conducted, and a total of 61 identified studies were included in this review. RESULTS Women with BD had higher rates of cardiovascular risk factors/mortality, diabetes mellitus II and thyroid disorders compared to women in the general population. In comparison to men with BD, women with BD had comparable cardiovascular risk but higher prevalence of metabolic and thyroid disorders. LIMITATIONS Gender specific data was limited in multiple studies. CONCLUSIONS Results present a need for gender-specific screening and interventions for various medical comorbidities in patients with BD.
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14
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Apicella M, Serra G, Iannoni ME, Trasolini M, Maglio G, Andracchio E, Vicari S. Gender Differences in the Psychopathology of Mixed Depression in Adolescents with a Major Depressive Episode. Curr Neuropharmacol 2023; 21:1343-1354. [PMID: 36237159 PMCID: PMC10324339 DOI: 10.2174/1570159x20666221012113458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 09/15/2022] [Accepted: 09/16/2022] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Gender differences have been reported in the severity and psychopathological features of major depressive disorders among adults but are poorly reported in adolescent samples. OBJECTIVE This study aimed to examine gender differences in the psychopathology of mixed depression among adolescents. METHODS We analyzed 341 outpatients with the current major depressive episode (MDE) retrospectively to identify patients with DSM-5 MDE with mixed features. We compared examiner-rated depressive and (hypo)manic symptoms and self- and parent-reported symptoms between sexes. RESULTS We identified 76 patients with an MDE with mixed features (67.1% females, 32.9% with bipolar disorder). Depression severity was significantly greater in females versus males (CDRS-R total score 56.2 vs. 48.2, p = 0.014). Depressive symptoms were significantly and independently found to be more severe among females in a logistic regression model, including excessive fatigue (OR 1.68; p = 0.025), low self-esteem (OR 1.67; p = 0.04), excessive weeping (OR 1.62; p = 0.021), and CBCL AAA index (OR 1.04; p = 0.015). None of the depressive symptoms scored greater in males. Males had higher levels of motor activity (2.12 vs. 1.69; p = 0.048) and pressured speech (1.80 vs. 1.24; p = 0.004). Self-rated anxiety (69.3 vs. 56.8, p = 0.047) and CBCL AAA index (207 vs. 189; p = 0.007) were higher in females. CONCLUSION Adolescent depression with mixed features is more severe in women, with a higher expression of core affective symptoms and excessive fatigue. While in males, slightly higher levels of psychomotor activation are reported, in females, emotional dysregulation and excessive weeping may subtend a difference in a broader spectrum of mixed features.
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Affiliation(s)
- Massimo Apicella
- Department of Neuroscience, Child Neuropsychiatry Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Giulia Serra
- Department of Neuroscience, Child Neuropsychiatry Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Maria Elena Iannoni
- Department of Neuroscience, Child Neuropsychiatry Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Monia Trasolini
- Department of Neuroscience, Child Neuropsychiatry Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Gino Maglio
- Department of Neuroscience, Child Neuropsychiatry Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Elisa Andracchio
- Department of Neuroscience, Child Neuropsychiatry Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Stefano Vicari
- Department of Neuroscience, Child Neuropsychiatry Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
- Department of Life Sciences and Public Health, Catholic University, Rome, Italy
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15
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Hashmi AN, Qamar R, Taj R, Zubair UB, Agha Z, Abbasi SA, Azam M. Contributing risk factors of common psychiatric disorders in the Pakistani population. Eur Arch Psychiatry Clin Neurosci 2022:10.1007/s00406-022-01545-y. [PMID: 36583741 DOI: 10.1007/s00406-022-01545-y] [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: 06/26/2022] [Accepted: 12/19/2022] [Indexed: 12/31/2022]
Abstract
With an increasing incidence of psychiatric disorders worldwide, there is a need for a better understanding of the population-specific contributing risk factors that are associated with common psychiatric conditions. This study aimed to assess the correlation between socioeconomic, environmental and clinical features associated with major depression (MDD n = 479), bipolar disorder (BD n = 222) and schizophrenia (SHZ n = 146), in the Pakistani population. Multinomial logistic regression and Pearson's correlation were applied to assess the association and correlation between demographic, socioeconomic, environmental, and clinical features of MDD, BD and SHZ. In the present study, MDD was found to be more prevalent than BD and SHZ. The average age at onset (AAO), was observed to be earlier in females with BD and SHZ, in addition, females with a positive family history of MDD, BD and SHZ also had an earlier AAO. The fitted multinomial logistic regression model indicated a significant association of; aggression, tobacco use, drugs abuse, history of head injuries and family history with BD as compared to MDD, while insomnia and suicidality were significantly associated with MDD. Strong positive correlations were observed mainly between age/AAO, AAO/tobacco use and aggression/insomnia in all three cohorts. In conclusion, the present study identifies possible contributing socio-demographic, biological and environmental factors that are correlated and associated with the psychiatric conditions in the Pakistani population.
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Affiliation(s)
- Aisha Nasir Hashmi
- Translational Genomics Laboratory, Department of Biosciences, COMSATS University Islamabad, Tarlai Kalan, Park Road, Islamabad, 45600, Pakistan
| | - Raheel Qamar
- Science and Technology Sector, ICESCO, Rabat, Morocco.,Pakistan Academy of Sciences, Islamabad, Pakistan
| | - Rizwan Taj
- Department of Psychiatry, Pakistan Institute of Medical Sciences, Islamabad, Pakistan
| | - Usama Bin Zubair
- Department of Psychiatry, Pakistan Institute of Medical Sciences, Islamabad, Pakistan
| | - Zehra Agha
- Translational Genomics Laboratory, Department of Biosciences, COMSATS University Islamabad, Tarlai Kalan, Park Road, Islamabad, 45600, Pakistan
| | - Saddam Akber Abbasi
- Statistics Program, Department of Mathematics, Statistics & Physics, College of Arts and Science, Qatar University, Doha, Qatar. .,Statistical Consulting Unit, College of Arts and Science, Qatar University, 2713, Doha, Qatar.
| | - Maleeha Azam
- Translational Genomics Laboratory, Department of Biosciences, COMSATS University Islamabad, Tarlai Kalan, Park Road, Islamabad, 45600, Pakistan.
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16
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Mianji F, Kirmayer LJ. "Women as Troublemakers": The Hard Sociopolitical Context of Soft Bipolar Disorder in Iran. Cult Med Psychiatry 2022; 46:864-888. [PMID: 34410585 DOI: 10.1007/s11013-021-09743-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/27/2021] [Indexed: 11/26/2022]
Abstract
Gender differences in the prevalence of psychiatric disorders, with higher prevalence of mood and anxiety disorders among women, have been the focus of much debate. In Iran, the adoption of the construct of Bipolar Spectrum Disorder (BSD) and of the concept of "soft bipolarity" has been associated with a large gender difference in rates of diagnosis. This paper discusses the gendered meanings of the diagnosis of BSD in Iran. In this qualitative study, we conducted 25 in-depth semi-structured interviews with prominent psychiatrists and university professors (7 female and 18 male) at six different universities in Iran and 37 in-depth semi-structured interviews with patients (23 female and 14 male, 18-55 years of age) who had received bipolar spectrum disorder diagnosis and treatment, excluding Bipolar I. Findings suggest that the high rate of diagnosis of bipolar spectrum disorder (i.e., subthreshold or soft bipolar disorder) among women in Iran is influenced by gender, sociocultural, political, and economic factors, as well as the diagnostic practices of biomedical psychiatry. The dominant biological psychiatry system in Iran has led many psychiatrists to frame sociopolitically and culturally rooted forms of distress in terms of biomedical categories like soft bipolarity and to limit their interventions to medication. This bioreductionist approach silences the voices of vulnerable groups, including those of women, and marginalizes discussions of problematic institutional and social power. To understand the preference for biomedical explanations, we need to consider not only the economic interests at play in the remaking of human identity in terms of biological being and the globalization of biological psychiatry, but also the resistance to addressing the sociocultural, political, and economic determinants of women's mental suffering in particular contexts.
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Affiliation(s)
- Fahimeh Mianji
- Division of Social and Transcultural Psychiatry, Department of Psychiatry, McGill University, Montreal, Canada.
- Culture and Mental Health Research Unit, Institute of Community and Family Psychiatry, 4333 Chemin de la Côte Ste-Catherine, Montreal, QC, H3T 1E4, Canada.
| | - Laurence J Kirmayer
- Division of Social and Transcultural Psychiatry, Department of Psychiatry, McGill University, Montreal, Canada
- Culture and Mental Health Research Unit, Institute of Community and Family Psychiatry, 4333 Chemin de la Côte Ste-Catherine, Montreal, QC, H3T 1E4, Canada
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17
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Otsuka T, Le HT, Thein ZL, Ihara H, Sato F, Nakao T, Kohsaka A. Deficiency of the circadian clock gene Rev-erbα induces mood disorder-like behaviours and dysregulation of the serotonergic system in mice. Physiol Behav 2022; 256:113960. [PMID: 36115382 DOI: 10.1016/j.physbeh.2022.113960] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 09/06/2022] [Accepted: 09/07/2022] [Indexed: 10/31/2022]
Abstract
Mood disorders such as depression, anxiety, and bipolar disorder are highly associated with disrupted daily rhythms of activity, which are often observed in shift work and sleep disturbance in humans. Recent studies have proposed the REV-ERBα protein as a key circadian nuclear receptor that links behavioural rhythms to mood regulation. However, how the Rev-erbα gene participates in the regulation of mood remains poorly understood. Here, we show that the regulation of the serotonergic (5-HTergic) system, which plays a central role in stress-induced mood behaviours, is markedly disrupted in Rev-erbα-/- mice. Rev-erbα-/- mice exhibit both negative and positive behavioural phenotypes, including anxiety-like and mania-like behaviours, when subjected to a stressful environment. Importantly, Rev-erbα-/- mice show a significant decrease in the expression of a gene that encodes the rate-limiting enzyme of serotonin (5-HT) synthesis in the raphe nuclei (RN). In addition, 5-HT levels in Rev-erbα-/- mice are significantly reduced in the prefrontal cortex, which receives strong inputs from the RN and controls stress-related behaviours. Our findings indicate that Rev-erbα plays an important role in controlling the 5-HTergic system and thus regulates mood and behaviour.
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Affiliation(s)
- Tsuyoshi Otsuka
- Faculty of Applied Biological Sciences, Gifu University, Gifu, 501-1193, Japan; The Second Department of Physiology, Wakayama Medical University, Wakayama 641-8509, Japan.
| | - Hue Thi Le
- The Second Department of Physiology, Wakayama Medical University, Wakayama 641-8509, Japan; Department of Biomedical Engineering, National Cerebral and Cardiovascular Center, Osaka, 564-8565, Japan
| | - Zaw Lin Thein
- The Second Department of Physiology, Wakayama Medical University, Wakayama 641-8509, Japan
| | - Hayato Ihara
- The Department of Radioisotope Laboratory Center, Wakayama Medical University, Wakayama 641-8509, Japan
| | - Fuyuki Sato
- Department of Diagnostic Pathology, Shizuoka Cancer Center, Suntogun, Shizuoka 411-8777, Japan; The Departments of Pathology, Wakayama Medical University, Wakayama 641-8509, Japan
| | - Tomomi Nakao
- The Second Department of Physiology, Wakayama Medical University, Wakayama 641-8509, Japan; The First Department of Internal Medicine, Wakayama Medical University, Wakayama 641-8509, Japan
| | - Akira Kohsaka
- The Second Department of Physiology, Wakayama Medical University, Wakayama 641-8509, Japan
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18
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Markiewicz-Gospodarek A, Górska A, Markiewicz R, Chilimoniuk Z, Czeczelewski M, Baj J, Maciejewski R, Masiak J. The Relationship between Mental Disorders and the COVID-19 Pandemic—Course, Risk Factors, and Potential Consequences. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159573. [PMID: 35954930 PMCID: PMC9368061 DOI: 10.3390/ijerph19159573] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 07/11/2022] [Accepted: 08/02/2022] [Indexed: 01/10/2023]
Abstract
In this review the authors discuss that COVID-19 has already had a direct impact on the physical health of many people and that it appears to have put at risk the mental health of large populations. In this review, we also discuss the relationship between mental disorders and the SARS-CoV-2 infection. We convey the disorders’ risk factors and the more serious mental disorder consequences of COVID-19. People with mental health disorders could be more susceptible to the emotional responses brought on by the COVID-19 epidemic. The COVID-19 pandemic may adversely influence the mental health of patients with already diagnosed mental disorders. For the aim of dealing better with the psychological problems of people afflicted by the COVID-19 pandemic, new psychological procedures are required.
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Affiliation(s)
| | - Aleksandra Górska
- Department of Human Anatomy, Medical University of Lublin, 4 Jaczewskiego St., 20-090 Lublin, Poland
| | - Renata Markiewicz
- Department of Psychiatric Nursing, Medical University of Lublin, 18 Szkolna St., 20-124 Lublin, Poland
| | - Zuzanna Chilimoniuk
- Student Scientific Group, Department of Family Medicine, Medical University of Lublin, 6a (SPSK1) Langiewicza St., 20-032 Lublin, Poland
| | - Marcin Czeczelewski
- Department of Forensic Medicine, Medical University of Lublin, 8b Jaczewskiego St., 20-090 Lublin, Poland
| | - Jacek Baj
- Department of Human Anatomy, Medical University of Lublin, 4 Jaczewskiego St., 20-090 Lublin, Poland
| | - Ryszard Maciejewski
- Department of Human Anatomy, Medical University of Lublin, 4 Jaczewskiego St., 20-090 Lublin, Poland
| | - Jolanta Masiak
- II Department of Psychiatry and Psychiatric Rehabilitation, Medical University of Lublin, 1 Głuska (SPSK Nr 1) St., 20-059 Lublin, Poland
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19
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No Sex Differences in Self-Reported Childhood Maltreatment in Major Depressive and Bipolar Disorders: A Retrospective Study. Brain Sci 2022; 12:brainsci12060804. [PMID: 35741691 PMCID: PMC9220896 DOI: 10.3390/brainsci12060804] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Revised: 06/14/2022] [Accepted: 06/15/2022] [Indexed: 12/10/2022] Open
Abstract
Background: We investigated, for the first time, whether there are any sex differences in retrospective self-reported childhood maltreatment (CM) in Italian adult patients with major depressive disorder (MDD) or bipolar disorder (BD). Furthermore, the potential impacts of patients’ age on the CM self-report were investigated. Methods: This retrospective study used the data documented in the electronic medical records of patients who were hospitalized for a 4-week psychiatric rehabilitation program. CM was assessed using the 28-item Childhood Trauma Questionnaire (CTQ), which evaluates emotional, physical, and sexual abuse, as well as emotional and physical neglect. The linear and logistic regression models were used (α = 0.01). Results: Three hundred thirty-five patients with MDD (255 women and 80 men) and 168 with BD (97 women and 71 men) were included. In both samples, considerable CM rates were identified, but no statistically significant sex differences were detected in the variety of CTQ-based CM aspects. There was a significant association, with no sex differences, between increasing patients’ age and a decreasing burden of CM. Conclusion: Both women and men with MDD or BD experienced a similar and considerable CM burden. Our findings support routine CM assessment in psychiatric clinical practice.
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20
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Clinical Value of Inflammatory and Neurotrophic Biomarkers in Bipolar Disorder: A Systematic Review and Meta-Analysis. Biomedicines 2022; 10:biomedicines10061368. [PMID: 35740389 PMCID: PMC9220136 DOI: 10.3390/biomedicines10061368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 06/03/2022] [Accepted: 06/07/2022] [Indexed: 11/18/2022] Open
Abstract
Bipolar disorder (BD) is a multifactorial chronic psychiatric disease highly defined by genetic, clinical, environmental and social risk factors. The present systematic review and meta-analysis aimed to examine the relationship between inflammatory and neurotrophic factors and clinical, social and environmental factors involved in the development and the characterization of BD. Web of Science, PubMed, PsycINFO, Scopus and Science Direct were searched by two independent reviewers. The systematic review was registered in PROSPERO (CRD42020180626). A total of 51 studies with 4547 patients with a diagnosis of BD were selected for systematic review. Among them, 18 articles were included for meta-analysis. The study found some evidence of associations between BDNF and/or inflammatory factors and different stressors and functional and cognitive impairment, but limitations prevented firm conclusions. The main finding of the meta-analysis was a negative correlation between circulating levels of BDNF and depression severity score (standardized mean difference = −0.22, Confidence Interval 95% = −0.38, −0.05, p = 0.01). Evidence indicates that BDNF has a role in the depressive component of BD. However, the poor consistency found for other inflammatory mediators clearly indicates that highly controlled studies are needed to identity precise biomarkers of this disorder.
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21
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Fico G, Anmella G, Sagué-Villavella M, Gomez-Ramiro M, Hidalgo-Mazzei D, Vieta E, Murru A. Undetermined predominant polarity in a cohort of bipolar disorder patients: Prevalent, severe, and overlooked. J Affect Disord 2022; 303:223-229. [PMID: 35181382 DOI: 10.1016/j.jad.2022.02.042] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 01/13/2022] [Accepted: 02/14/2022] [Indexed: 10/19/2022]
Abstract
OBJECTIVES Predominant polarity (PP) is a concept used to define patients with bipolar disorder (BD) as presenting a tendency to manifest depressive (DPP) or manic (MPP) episodes. Still, the high percentage of patients with an undetermined PP (UPP), has been overlooked in most studies. Thus, we aimed to study UPP and outline its socio-demographic, clinical, and treatment-related features. METHODS Patients were recruited from a BD specialized unit. The sample was divided into three groups according to PP and socio-demographic and clinical variables were compared. Significant variables at univariate comparisons were included in multivariate logistic regression with UPP as the dependent variable. RESULTS A total of 708 BD patients were included, of which 437 with UPP (61.7%). UPP was associated with a higher number of affective relapses, when compared with DPP or MPP (χ2= 28.704, p<0.001). Mixed episodes (OR=1.398; CI=1.118-1.749), aggressive behaviour (OR=1.861; CI=1.190-2.913), seasonality (OR=2.025; CI= 1.289-3.501) and treatment with lamotrigine (OR= 2.101; CI=1.244-3.550) were significantly associated with UPP at the logistic regression. LIMITATIONS Recall bias may have occurred due to mixed episode diagnostic criteria change over the years. No data on the patients' follow-up has been reported on predominant polarity changes. CONCLUSIONS UPP is associated with a higher number of relapses, and different clinical variables related to a severe course of illness. Considering PP in patients with BD may guide the choice for differential treatment approaches having an impact on BD course of illness and patients' prognosis and recovery.
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Affiliation(s)
- Giovanna Fico
- Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, 170 Villarroel st, 12-0, 08036, Barcelona, Catalonia, Spain
| | - Gerard Anmella
- Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, 170 Villarroel st, 12-0, 08036, Barcelona, Catalonia, Spain
| | - Maria Sagué-Villavella
- Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, 170 Villarroel st, 12-0, 08036, Barcelona, Catalonia, Spain
| | - Marta Gomez-Ramiro
- Barcelona Clínic Schizophrenia Unit, Institute of Neuroscience, Hospital Clínic of Barcelona, University of Barcelona, IDIBAPS, Barcelona, Catalonia, Spain
| | - Diego Hidalgo-Mazzei
- Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, 170 Villarroel st, 12-0, 08036, Barcelona, Catalonia, Spain
| | - Eduard Vieta
- Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, 170 Villarroel st, 12-0, 08036, Barcelona, Catalonia, Spain.
| | - Andrea Murru
- Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, 170 Villarroel st, 12-0, 08036, Barcelona, Catalonia, Spain
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22
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Burman CJ, Dempsey RC, Priest HM. Exploring men’s experiences and sense-making of bipolar disorder diagnoses and mood management: a photo-elicitation investigation. CLIN PSYCHOL-UK 2022. [DOI: 10.1080/13284207.2021.2018572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Craig J. Burman
- School of Life Sciences and Education, Staffordshire University, Stoke-on-Trent, UK
| | - Robert C. Dempsey
- Department of Psychology, Faculty of Health, Psychology and Social Care, Manchester Metropolitan University, Manchester, UK
| | - Helena M. Priest
- School of Life Sciences and Education, Staffordshire University, Stoke-on-Trent, UK
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23
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Menculini G, Steardo L, Sciarma T, D'Angelo M, Lanza L, Cinesi G, Cirimbilli F, Moretti P, Verdolini N, De Fazio P, Tortorella A. Sex Differences in Bipolar Disorders: Impact on Psychopathological Features and Treatment Response. Front Psychiatry 2022; 13:926594. [PMID: 35757228 PMCID: PMC9226371 DOI: 10.3389/fpsyt.2022.926594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 05/18/2022] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Sex differences were demonstrated in bipolar disorders (BD) concerning epidemiological, clinical, and psychopathological characteristics, but consensus is lacking. Moreover, data concerning the influence of sex on treatment response in BD is contrasting. The present cross-sectional study aimed to analyze sex differences in a population of BD subjects, with specific focus on psychopathological features and treatment response. MATERIALS AND METHODS Subjects diagnosed with BD according to the Diagnostic and Statistical Manual of Mental Disorders, 5th version (DSM-5) were recruited. Socio-demographic and clinical characteristics were collected. The Hamilton Rating Scale for Depression, the Mania Rating Scale (MRS), the brief version of the Temperament Evaluation of Memphis, Pisa and San Diego-Münster version (briefTEMPS-M), and the Barratt Impulsiveness Scale-11 items (BIS-11) were used for psychopathological assessment. Treatment response was appraised with the Alda Scale. We performed bivariate analyses to compare socio-demographic, clinical, and psychopathological characteristics between men and women (p < 0.05). A logistic regression was run to analyze features that were significantly associated with female sex. RESULTS Among the recruited 219 BD subjects, 119 (54.3%) were females. Women had a lower scholarity (p = 0.015) and were less frequently employed (p = 0.001). As for psychopathological features, a higher MRS total score (p < 0.001) was detected among women, as well as higher BIS-11 total score (p = 0.040), and briefTEMPS-M score for anxious temperament (p = 0.006). Men showed higher prevalence of DSM-5 mixed features (p = 0.025), particularly during a depressive episode (p = 0.014). Women reported longer duration of untreated illness (DUI) (p < 0.001). There were no sex differences in the Alda Scale total score when considering the whole sample, but this was significantly higher among men (p = 0.030) when evaluating subjects treated with anticonvulsants. At the logistic regression, female sex was positively associated with longer DUI (p < 0.001; OR 1.106, 95% CI 1.050-1.165) and higher MRS total score (p < 0.001; OR 1.085, 95% CI 1.044-1.128) and negatively associated with employment (p = 0.003; OR 0.359, 95% CI 0.185-0.698) and DSM-5 mixed features (p = 0.006; OR 0.391, 95% CI 0.200-0.762). CONCLUSIONS The clinical presentation of BD may differ depending on sex. The severity of BD should not be neglected among women, who may also display worse treatment response to anticonvulsants.
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Affiliation(s)
- Giulia Menculini
- Section of Psychiatry, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Luca Steardo
- Psychiatric Unit, Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Tiziana Sciarma
- Section of Psychiatry, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Martina D'Angelo
- Psychiatric Unit, Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Laura Lanza
- Section of Psychiatry, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Gianmarco Cinesi
- Section of Psychiatry, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Federica Cirimbilli
- Section of Psychiatry, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Patrizia Moretti
- Section of Psychiatry, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Norma Verdolini
- Local Health Unit Umbria 1, Department of Mental Health, Mental Health Center of Perugia, Perugia, Italy
| | - Pasquale De Fazio
- Psychiatric Unit, Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Alfonso Tortorella
- Section of Psychiatry, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
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24
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Solé B, Varo C, Torrent C, Montejo L, Jiménez E, Bonnin CDM, Clougher D, Verdolini N, Amoretti S, Piazza F, Borràs R, Pomarol-Clotet E, Sáiz PA, García-Portilla MP, Vieta E, Martínez-Arán A. Sex differences in neurocognitive and psychosocial functioning in bipolar disorder. J Affect Disord 2022; 296:208-215. [PMID: 34610515 DOI: 10.1016/j.jad.2021.09.066] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 09/15/2021] [Accepted: 09/21/2021] [Indexed: 01/10/2023]
Abstract
BACKGROUND Sex differences influence the clinical characteristics and course of illness of bipolar disorder (BD). OBJECTIVE Therefore, the aim of the present study was to examine the role of sex differences in neurocognitive performance and psychosocial functioning in a large sample of euthymic patients suffering from BD. METHODS The sample included 462 individuals, 347 patients with BD (148 males and 199 females) and 115 healthy controls (HC) (45 males and 70 females). Performance on a comprehensive neuropsychological battery assessing six cognitive domains and psychosocial functioning was compared between groups using linear mixed models, with sex and group as main effects, group by sex interactions and center as a random effect. RESULTS Males performed better than females in working memory (p < 0.001), whereas females outperformed males in the verbal learning (p = 0.03) and memory recognition (p = 0.03) tasks. No significant group by sex interactions were detected in cognitive performance. There were no overall sex differences or group by sex interactions in psychosocial functioning. LIMITATIONS Lack of assessment of visuo-spatial working memory. CONCLUSIONS There were no overall sex differences in neurocognition and psychosocial functioning. However, small sex differences in some measures of working memory and verbal memory were found. Individual differences of each patient, including sex perspective, should be considered in order to perform a tailored intervention plan adjusted to specific needs in the context of personalized treatment.
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Affiliation(s)
- Brisa Solé
- Bipolar and Depressive Disorders Unit, Hospital Clinic, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Catalonia, Spain
| | - Cristina Varo
- Bipolar and Depressive Disorders Unit, Hospital Clinic, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Catalonia, Spain
| | - Carla Torrent
- Bipolar and Depressive Disorders Unit, Hospital Clinic, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Catalonia, Spain
| | - Laura Montejo
- Bipolar and Depressive Disorders Unit, Hospital Clinic, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Catalonia, Spain
| | - Esther Jiménez
- Bipolar and Depressive Disorders Unit, Hospital Clinic, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Catalonia, Spain
| | - Caterina Del Mar Bonnin
- Bipolar and Depressive Disorders Unit, Hospital Clinic, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Catalonia, Spain
| | - Derek Clougher
- Bipolar and Depressive Disorders Unit, Hospital Clinic, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Catalonia, Spain
| | - Norma Verdolini
- Bipolar and Depressive Disorders Unit, Hospital Clinic, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Catalonia, Spain
| | - Silvia Amoretti
- Bipolar and Depressive Disorders Unit, Hospital Clinic, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Catalonia, Spain; Barcelona Clinic Schizophrenia Unit, Institute of Neurosciences, University of Barcelona, IDIBAPS, Barcelona, Catalonia, Spain; Department of Psychiatry, Hospital Universitari Vall d'Hebron, Group of Psychiatry, Mental Health and Addictions, Psychiatric Genetics Unit, Vall d'Hebron Research Institute (VHIR), CIBERSAM, Barcelona, Catalonia, Spain
| | - Flavia Piazza
- Department of Psychiatry and Psychology, Clinical Institute of Neuroscience, Hospital Clinic of Barcelona, Barcelona, Catalonia, Spain
| | - Roger Borràs
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Spain
| | - Edith Pomarol-Clotet
- FIDMAG Germanes Hospitalàries, Sant Boi de Llobregat, Barcelona, Spain, Mental Health Research Networking Center (CIBERSAM), Madrid, Spain
| | - Pilar A Sáiz
- Department of Psychiatry, School of Medicine, University of Oviedo, CIBERSAM, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Instituto de Neurociencias del Principado de Asturias (INEUROPA), Servicio de Salud del Principado de Asturias (SESPA), Oviedo, Spain
| | - Maria P García-Portilla
- Department of Psychiatry, School of Medicine, University of Oviedo, CIBERSAM, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Instituto de Neurociencias del Principado de Asturias (INEUROPA), Servicio de Salud del Principado de Asturias (SESPA), Oviedo, Spain
| | - Eduard Vieta
- Bipolar and Depressive Disorders Unit, Hospital Clinic, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Catalonia, Spain.
| | - Anabel Martínez-Arán
- Bipolar and Depressive Disorders Unit, Hospital Clinic, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Catalonia, Spain
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25
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Ikenouchi A, Konno Y, Fujino Y, Adachi N, Kubota Y, Azekawa T, Ueda H, Edagawa K, Katsumoto E, Goto E, Hongo S, Kato M, Tsuboi T, Yasui-Furukori N, Nakagawa A, Kikuchi T, Watanabe K, Yoshimura R. Relationship Between Employment Status and Unstable Periods in Outpatients with Bipolar Disorder: A Multicenter Treatment Survey for Bipolar Disorder in Psychiatric Outpatient Clinics (MUSUBI) Study. Neuropsychiatr Dis Treat 2022; 18:801-809. [PMID: 35422623 PMCID: PMC9005072 DOI: 10.2147/ndt.s353460] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Accepted: 03/22/2022] [Indexed: 11/23/2022] Open
Abstract
PURPOSE To clarify the relationship between the length of unstable periods and employment status of patients with bipolar disorder. PATIENTS AND METHODS Medical records of outpatients with bipolar disorder who visited 176 member clinics of the Japanese Association of Neuro-Psychiatric Clinics were investigated during September-October 2016, and details of their medical care and employment were surveyed using a questionnaire. The odds ratios (ORs) of length of unstable period and unemployment were analyzed with a logistic regression model. RESULTS The study included 816 patients, of whom 707 were employed full-time (continuous employment) and 70 were unemployed (loss of employment). Univariate analysis showed that ORs were statistically significant for patients who were unstable for "almost all" of the year (OR = 10.4 [4.48-24.28] p < 0.001), but not for "few" unstable periods (OR = 1.06 [0.56-1.98] p = 0.849) and for "significant" unstable periods (OR = 1.65 [0.73-3.74] p = 0.231) were not significantly different. Multivariate analysis showed that ORs were statistically "significant" for patients who were unstable for "almost all" (OR = 12.1 [4.37-33.3] p < 0.001), but not for "few" unstable periods (OR = 1.07 [0.55-2.07] p = 0.846) and for "significant" unstable periods (OR = 1.62 [0.66-3.98] p = 0.290) did not differ significantly. CONCLUSION Patients with bipolar disorder with a long unstable period were associated with a higher risk of unemployment.
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Affiliation(s)
- Atsuko Ikenouchi
- Department of Psychiatry, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan.,Medical Center for Dementia, Hospital of the University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Yusuke Konno
- Department of Psychiatry, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan.,Department of Environmental Epidemiology, Institute of Ecological Sciences, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Yoshihisa Fujino
- Department of Environmental Epidemiology, Institute of Ecological Sciences, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Naoto Adachi
- The Japanese Association of Neuro-Psychiatric Clinics, Tokyo, Japan
| | - Yukihisa Kubota
- The Japanese Association of Neuro-Psychiatric Clinics, Tokyo, Japan
| | - Takaharu Azekawa
- The Japanese Association of Neuro-Psychiatric Clinics, Tokyo, Japan
| | - Hitoshi Ueda
- The Japanese Association of Neuro-Psychiatric Clinics, Tokyo, Japan
| | - Koji Edagawa
- The Japanese Association of Neuro-Psychiatric Clinics, Tokyo, Japan
| | - Eiichi Katsumoto
- The Japanese Association of Neuro-Psychiatric Clinics, Tokyo, Japan
| | - Eiichiro Goto
- The Japanese Association of Neuro-Psychiatric Clinics, Tokyo, Japan
| | - Seiji Hongo
- The Japanese Association of Neuro-Psychiatric Clinics, Tokyo, Japan
| | - Masaki Kato
- The Japanese Society of Clinical Neuropsychopharmacology, Tokyo, Japan.,Department of Neuropsychiatry, Kansai Medical University, Osaka, Japan
| | - Takashi Tsuboi
- The Japanese Society of Clinical Neuropsychopharmacology, Tokyo, Japan.,Department of Neuropsychiatry, Kyorin University, Tokyo, Japan
| | - Norio Yasui-Furukori
- The Japanese Society of Clinical Neuropsychopharmacology, Tokyo, Japan.,Department of Psychiatry, Dokkyo Medical University, Tochigi, Japan
| | - Atsuo Nakagawa
- The Japanese Society of Clinical Neuropsychopharmacology, Tokyo, Japan.,Department of Neuropsychiatry, Keio University, Tokyo, Japan
| | - Toshiaki Kikuchi
- The Japanese Society of Clinical Neuropsychopharmacology, Tokyo, Japan.,Department of Neuropsychiatry, Keio University, Tokyo, Japan
| | - Koichiro Watanabe
- The Japanese Society of Clinical Neuropsychopharmacology, Tokyo, Japan.,Department of Neuropsychiatry, Kyorin University, Tokyo, Japan
| | - Reiji Yoshimura
- Department of Psychiatry, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan.,The Japanese Society of Clinical Neuropsychopharmacology, Tokyo, Japan
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26
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Lengvenyte A, Aouizerate B, Aubin V, Loftus J, Marlinge E, Belzeaux R, Dubertret C, Gard S, Haffen E, Schwan R, Llorca PM, Passerieux C, Roux P, Polosan M, Etain B, Leboyer M, Courtet P, Olié E. Violent suicide attempt history in elderly patients with bipolar disorder: The role of sex, abdominal obesity, and verbal memory: Results from the FACE-BD cohort (FondaMental Advanced center of Expertise for Bipolar Disorders). J Affect Disord 2022; 296:265-276. [PMID: 34606799 DOI: 10.1016/j.jad.2021.09.097] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 09/12/2021] [Accepted: 09/26/2021] [Indexed: 12/22/2022]
Abstract
BACKGROUND Bipolar disorder (BD) is a chronic, lifelong condition, associated with increased risk of obesity, cognitive impairment, and suicidal behaviors. Abdominal obesity and a higher risk of violent suicide attempt (SA) seem to be shared correlates with older age, BD, and male sex until middle age when menopause-related female body changes occur. This study aimed at assessing the role of abdominal obesity and cognition in the violent SA burden of individuals with BD. METHODS From the well-defined nationwide cohort FACE-BD (FondaMental Advanced center of Expertise for Bipolar Disorders), we extracted data on 619 euthymic BD patients that were 50 years or older at inclusion. Cross-sectional clinical, cognitive, and metabolic assessments were performed. SA history was based on self-report. RESULTS Violent SA, in contrast to non-violent and no SA, was associated with higher waist circumference, abdominal obesity and poorer California Verbal Learning Test short-delay free recall (CVLT-SDFR) (ANOVA, p < .001, p = .014, and p = .006). Waist circumference and abdominal obesity were associated with violent SA history independently of sex, BD type and anxiety disorder (Exp(B) 1.02, CI 1.00-1.05, p = .018; Exp(B) 2.16, CI 1.00-4.64, p = .009, accordingly). In an exploratory model, waist circumference and CVLT-SDFR performance mediated the association between male sex and violent SA. LIMITATIONS Cross-sectional design and retrospective reporting. CONCLUSIONS Violent SA history was associated with abdominal obesity and poorer verbal memory in older age BD patients. These factors were interlinked and might mediate the association between male sex and violent SA.
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Affiliation(s)
- Aiste Lengvenyte
- Department of Emergency Psychiatry and Post-Acute Care, CHU Montpellier, IGF, University of Montpellier, CNRS, INSERM, 371 Av. du Doyen Gaston Giraud, Montpellier 34090, France; Fondation FondaMental, Créteil, France; Faculty of Medicine, Institute of Clinical Medicine, Psychiatric Clinic, Vilnius University, Vilnius, Lithuania.
| | - Bruno Aouizerate
- Fondation FondaMental, Créteil, France; Department of Clinical and Academic Psychiatry, Charles-Perrens Hospital, Bordeaux, France; France/NutriNeuro, University of Bordeaux, UMR INRAE 1286, Bordeaux, France
| | - Valerie Aubin
- Psychiatric Center, Hospital Princess Grace, Monaco, France
| | - Joséphine Loftus
- Fondation FondaMental, Créteil, France; Psychiatric Center, Hospital Princess Grace, Monaco, France
| | - Emeline Marlinge
- Fondation FondaMental, Créteil, France; GHU Paris Nord, DMU Neurosciences, Hôpital Fernand Widal AP-HP, Université de Paris, INSERM UMRS 1144, Paris, France
| | - Raoul Belzeaux
- Fondation FondaMental, Créteil, France; Pôle de Psychiatrie, Assistance Publique Hôpitaux de Marseille, Marseille, France; CNRS Aix-Marseille Université, INT-UMR7289, Marseille, France
| | - Caroline Dubertret
- Fondation FondaMental, Créteil, France; Groupe Hospitalo-Universitaire AP-HP Nord, DMU ESPRIT, service de Psychiatrie et Addictologie, Faculté de médecine, Hopital Louis Mourier, Inserm, AP-HP, Université de Paris, U1266, Colombes, France
| | - Sebastien Gard
- Fondation FondaMental, Créteil, France; Department of Clinical and Academic Psychiatry, Charles-Perrens Hospital, Bordeaux, France
| | - Emmanuel Haffen
- Fondation FondaMental, Créteil, France; Service de Psychiatrie de l'Adulte, CHU de Besançon, Laboratoire de Neurosciences, Université de Franche-Comté, UBFC, CIC-1431 INSERM, France
| | - Raymund Schwan
- Fondation FondaMental, Créteil, France; Center Psychothérapique de Nancy, Pôle Hospitalo-Universitaire de Psychiatrie d'Adultes du Grand Nancy, Université de Lorraine, INSERM U1114, Nancy, France
| | - Pierre-Michel Llorca
- Fondation FondaMental, Créteil, France; Department of Psychiatry, CHU Clermont-Ferrand, University of Clermont Auvergne, EA 7280, Clermont-Ferrand, France
| | - Christine Passerieux
- Fondation FondaMental, Créteil, France; Service Universitaire de psychiatrie d'adulte et d'addictologie, Le Chesnay, Université Paris-Saclay, DisAP-DevPsy-CESP, Université Versailles Saint-Quentin-En-Yvelines, Center Hospitalier de Versailles, INSERM UMR1018, Villejuif 94807, France
| | - Paul Roux
- Fondation FondaMental, Créteil, France; INSERM, IMRB, Translational Neuropsychiatry, AP-HP, DMU IMPACT, FHU ADAPT, Fondation FondaMental, Universite Paris Est Créteil, Créteil F-94010, France
| | - Mircea Polosan
- Fondation FondaMental, Créteil, France; Service Universitaire de psychiatrie d'adulte et d'addictologie, Le Chesnay, Université Paris-Saclay, DisAP-DevPsy-CESP, Université Versailles Saint-Quentin-En-Yvelines, Center Hospitalier de Versailles, INSERM UMR1018, Villejuif 94807, France
| | - Bruno Etain
- Fondation FondaMental, Créteil, France; GHU Paris Nord, DMU Neurosciences, Hôpital Fernand Widal AP-HP, Université de Paris, INSERM UMRS 1144, Paris, France
| | - Marion Leboyer
- Fondation FondaMental, Créteil, France; INSERM, IMRB, Translational Neuropsychiatry, AP-HP, DMU IMPACT, FHU ADAPT, Fondation FondaMental, Universite Paris Est Créteil, Créteil F-94010, France
| | - Philippe Courtet
- Department of Emergency Psychiatry and Post-Acute Care, CHU Montpellier, IGF, University of Montpellier, CNRS, INSERM, 371 Av. du Doyen Gaston Giraud, Montpellier 34090, France; Fondation FondaMental, Créteil, France
| | - Emilie Olié
- Department of Emergency Psychiatry and Post-Acute Care, CHU Montpellier, IGF, University of Montpellier, CNRS, INSERM, 371 Av. du Doyen Gaston Giraud, Montpellier 34090, France; Fondation FondaMental, Créteil, France
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Bozic S, Vicendese D, Livingston M, Erbas B. Role of psychological distress on long-term risky and heavy-episodic drinking patterns in major cities and rural and remote areas. Aust J Rural Health 2021; 30:25-33. [PMID: 34932257 DOI: 10.1111/ajr.12821] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 06/28/2021] [Accepted: 10/07/2021] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE Psychological distress and alcohol consumption are associated but few studies have focused on the association with problematic drinking in semi-urban and rural settings. In this study, we assessed the role of psychological distress on various measures of problematic drinking in urban, semi-urban and rural settings. DESIGN Retrospective descriptive study Setting SETTING: National Drug Strategy Household Survey population health survey data PARTICIPANTS: 151,341 Australian residents MAIN OUTCOME MEASURES: Problematic alcohol consumption categorised as either heavy-episodic drinking (defined as drinking 5 or more standard drinks at least once in the last 12 months) or long-term risky drinking (defined as drinking more than 730 standard drinks in the past 12 months) was the outcome variables. Psychological distress was identified from the K10 questionnaire. Participants were grouped into area of residence: urban, semi-urban and rural. Sex differences were also explored. RESULTS Poor-to-severe psychological distress was associated with higher odds of both long-term and heavy-episodic drinking. Being male alone increased the risk of both long-term and heavy-episodic drinking in all areas. When stratified by sex, being female and severe levels of psychological distress increased the risk of both long-term risky and heavy-episodic drinking. These risks were greater in non-urban environments. CONCLUSIONS Poor mental health outcomes may exacerbate problematic drinking amongst females, especially those living in non-urban environments. Public health campaigns could both target these at-risk groups of females in non-urban settings and also account for the interplay between problematic drinking and mental health.
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Affiliation(s)
- Stefan Bozic
- School of Psychology and Public Health, La Trobe University, Melbourne, Vic., Australia
| | - Don Vicendese
- The Melbourne School of Population and Global Health, University of Melbourne, Carlton, Vic., Australia.,The Department of Mathematics and Statistics, La Trobe University, Melbourne, Vic., Australia
| | - Michael Livingston
- Centre for Alcohol Policy Research, School of Psychology and Public Health, La Trobe, Melbourne, Vic., Australia.,National Drug Research Institute, Curtin University, Perth, WA, Australia
| | - Bircan Erbas
- School of Psychology and Public Health, La Trobe University, Melbourne, Vic., Australia.,Faculty of Public Health, Universitas Airlangga, Surabaya, Indonesia
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Xu X, Xiang H, Qiu Y, Teng Z, Li S, Huang J, Chen J, Tang H, Jin K, Jiang L, Wang B, Zhao Z, Wu H. Sex differences in cognitive function of first-diagnosed and drug-naïve patients with bipolar disorder. J Affect Disord 2021; 295:431-437. [PMID: 34507223 DOI: 10.1016/j.jad.2021.08.125] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 08/23/2021] [Accepted: 08/29/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND Bipolar disorder (BD) is a severe mental illness that affects more than 1% the world's population with high recurrence rates and a series of comorbidities. Cognitive dysfunction is an endophenotype of BD, but sex influences in cognitive impairment remains unclear. METHOD We evaluated the performance of 139 patients with first-diagnosed, drug-naïve BD (44 males and 95 females) and 92 healthy controls (24 males and 68 females) using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) scale and the Stroop color-word test. RESULT Immediate memory, visuospatial/constructional ability, language, attention, delayed memory, total RBANS score, and Stroop color-word scores were significantly lower in patients with first-diagnosed, drug-naïve BD than healthy participants. Thus, male patients had worse attention and delayed memory scores compared with female patients with BD. Importantly, a worse performance in visuospatial/constructional ability was negatively associated with the Young Mania Rating Scale score in male patients only. CONCLUSION Male patients with first-diagnosed, drug-naïve bipolar disorder had worse cognitive dysfunction than female patients in attention and delayed memory. Cognitive deficits were correlated with mania severity only in male patients. These findings reveal the sexual dimorphism in the cognitive deficits of early BD patients with mild and moderated symptoms for further pathophysiological exploration.
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Affiliation(s)
- Xuelei Xu
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, China National Technology Institute on Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, China
| | - Hui Xiang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, China National Technology Institute on Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, China
| | - Yan Qiu
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, China National Technology Institute on Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, China
| | - Ziwei Teng
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, China National Technology Institute on Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, China
| | - Sujuan Li
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, China National Technology Institute on Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, China
| | - Jing Huang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, China National Technology Institute on Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, China
| | - Jindong Chen
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, China National Technology Institute on Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, China
| | - Hui Tang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, China National Technology Institute on Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, China
| | - Kun Jin
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, China National Technology Institute on Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, China
| | - Lili Jiang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, China National Technology Institute on Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, China
| | - Bolun Wang
- Department of Radiology, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, China
| | - Ziru Zhao
- Xiangya School of Medicine, Central South University, Changsha, Hunan 410013, China
| | - Haishan Wu
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, China National Technology Institute on Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, China.
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O'Connell KS, Coombes BJ. Genetic contributions to bipolar disorder: current status and future directions. Psychol Med 2021; 51:2156-2167. [PMID: 33879273 PMCID: PMC8477227 DOI: 10.1017/s0033291721001252] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 03/12/2021] [Accepted: 03/19/2021] [Indexed: 12/12/2022]
Abstract
Bipolar disorder (BD) is a highly heritable mental disorder and is estimated to affect about 50 million people worldwide. Our understanding of the genetic etiology of BD has greatly increased in recent years with advances in technology and methodology as well as the adoption of international consortiums and large population-based biobanks. It is clear that BD is also highly heterogeneous and polygenic and shows substantial genetic overlap with other psychiatric disorders. Genetic studies of BD suggest that the number of associated loci is expected to substantially increase in larger future studies and with it, improved genetic prediction of the disorder. Still, a number of challenges remain to fully characterize the genetic architecture of BD. First among these is the need to incorporate ancestrally-diverse samples to move research away from a Eurocentric bias that has the potential to exacerbate health disparities already seen in BD. Furthermore, incorporation of population biobanks, registry data, and electronic health records will be required to increase the sample size necessary for continued genetic discovery, while increased deep phenotyping is necessary to elucidate subtypes within BD. Lastly, the role of rare variation in BD remains to be determined. Meeting these challenges will enable improved identification of causal variants for the disorder and also allow for equitable future clinical applications of both genetic risk prediction and therapeutic interventions.
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Affiliation(s)
- Kevin S. O'Connell
- Division of Mental Health and Addiction, NORMENT Centre, Institute of Clinical Medicine, University of Oslo, Oslo University Hospital, 0407Oslo, Norway
| | - Brandon J. Coombes
- Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, USA
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30
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The Prevalence of Cannabis Use Disorder Comorbidity in Individuals With Bipolar Disorder: A Systematic Review and Meta-Analysis. CANADIAN JOURNAL OF ADDICTION 2021. [DOI: 10.1097/cxa.0000000000000123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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31
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Genetic Variations Associated with Long-Term Treatment Response in Bipolar Depression. Genes (Basel) 2021; 12:genes12081259. [PMID: 34440433 PMCID: PMC8391230 DOI: 10.3390/genes12081259] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 08/09/2021] [Accepted: 08/16/2021] [Indexed: 11/17/2022] Open
Abstract
Several pharmacogenetic-based decision support tools for psychoactive medication selection are available. However, the scientific evidence of the gene-drug pairs analyzed is mainly based on pharmacogenetic studies in patients with major depression or schizophrenia, and their clinical utility is mostly assessed in major depression. This study aimed at evaluating the impact of individual genes, with pharmacogenetic relevance in other psychiatric conditions, in the response to treatment in bipolar depression. Seventy-six patients diagnosed with bipolar disorder and an index major depressive episode were included in an observational retrospective study. Sociodemographic and clinical data were collected, and all patients were genotyped using a commercial multigene pharmacogenomic-based tool (Neuropharmagen®, AB-Biotics S.A., Barcelona, Spain). Multiple linear regression was used to identify pharmacogenetic and clinical predictors of efficacy and tolerability of medications. The pharmacogenetic variables response to serotonin-norepinephrine reuptake inhibitors (SNRIs) (ABCB1) and reduced metabolism of quetiapine (CYP3A4) predicted patient response to these medications, respectively. ABCB1 was also linked to the tolerability of SNRIs. An mTOR-related multigenic predictor was also associated with a lower number of adverse effects when including switch and autolytical ideation. Our results suggest that the predictors identified could be useful to guide the pharmacological treatment in bipolar disorder. Additional clinical studies are necessary to confirm these findings.
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Grover S, Avasthi A, Chakravarty R, Dan A, Chakraborty K, Neogi R, Desouza A, Nayak O, Praharaj S, Menon V, Bathla M, Subramanyam AA, Nebhinani N, Ghosh P, Lakdawala B, Bhattacharya R. Predominant polarity in bipolar disorder: Findings from the bipolar disorder course and outcome study from India (BiD-CoIN study). Compr Psychiatry 2021; 109:152249. [PMID: 34298288 DOI: 10.1016/j.comppsych.2021.152249] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Revised: 04/25/2021] [Accepted: 05/01/2021] [Indexed: 11/18/2022] Open
Abstract
AIM This cross-sectional study aimed to assess the predominant polarity (PP) in patients with bipolar disorder (BD) and the factors associated with PP. METHODOLOGY For this study, 773 participants with at least 10 years of illness, were recruited from 14 centres, were evaluated using the National Institute of Mental Health- Retrospective Life Charts to assess the course of illness and PP was determined by both Barcelona proposal and the Harvard Index. RESULTS According to Barcelona proposal for PP, 20.6% of the patients belonged to depressive PP, 45.8% belonged to manic PP and 33.6% belonged to indeterminate polarity. According to Harvard index of PP, 31.6% of the patients belonged to depressive PP, 56.1% belonged to manic polarity and 12.3% of the patients could not be categorized into any of these categories and hence, were considered to have indeterminate polarity. Those with depressive PP were more often having BD-II, had later age of onset, spent more time in episodes, had higher residual depressive symptoms, had lower residual manic symptoms, more often had depression as the first lifetime episode, and less often had at least one psychotic episode. CONCLUSION In the Indian subcontinent, although the prevalence of PP is influenced by the definition used, the most common PP is that of mania.
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Affiliation(s)
- Sandeep Grover
- Post Graduate Institute of Medical Education & Research, Chandigarh, India.
| | - Ajit Avasthi
- Post Graduate Institute of Medical Education & Research, Chandigarh, India
| | - Rahul Chakravarty
- Post Graduate Institute of Medical Education & Research, Chandigarh, India
| | - Amitava Dan
- Burdwan Medical College & Hospital, Burdwan, India
| | | | | | - Avinash Desouza
- Lokmanya Tilak Municipal General Hospital (SION Hospital), Mumbai, India
| | - Omkar Nayak
- Lokmanya Tilak Municipal General Hospital (SION Hospital), Mumbai, India
| | - Samir Praharaj
- Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Vikas Menon
- Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Manish Bathla
- Maharishi Markandeshwar Institute of Medical Sciences & Research, Mullana, Ambala, India
| | | | | | | | - Bhavesh Lakdawala
- Ahmedabad Municipal Corporation Medical Education Trust Medical College, Ahmedabad, India
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Chan JH, Lo C, Hsu CD, Chiu CC, Huang MC, Liao SC, Chen IM, Chen WY, Chen HC, Kuo PH. Premenstrual dysphoric symptoms and lifetime suicide experiences in patients with mood disorder. Gen Hosp Psychiatry 2021; 71:82-87. [PMID: 33965699 DOI: 10.1016/j.genhosppsych.2021.04.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Revised: 04/27/2021] [Accepted: 04/28/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Premenstrual dysphoric symptoms (PMDS) commonly co-occurred with mood disorders and correlated with suicide experiences in women. This study aims to examine the associations between PMDS and lifetime suicide experiences in patients with mood disorders. METHODS Participants were recruited from outpatient settings of two medical centers and one psychiatric hospital in Taiwan. Women aged 18-65 in non-acute state of major depressive disorder or bipolar affective disorder were recruited. PMDS and lifetime suicide experiences were defined by the Schedule for Affective Disorder and Schizophrenia-Lifetime. Lifetime suicide experiences were defined as no suicide experience, suicide plans only and suicide attempts. RESULTS A total of 383 women participated in this study (54.8% of them were diagnosed with major depressive disorder), and 13.8% were diagnosed with PMDS. The prevalence of patients with lifetime suicide plans only and lifetime suicide attempts were 15.9% and 39.7%, respectively. In the univariate analysis, PMDS was correlated with lifetime suicide experience. After controlling for covariates, PMDS was a risk indicator for lifetime suicide attempts (OR: 3.46, 95% CI: 1.43-8.38) but not for suicide plans only (OR: 0.93, 95% CI: 0.28-3.11). CONCLUSIONS PMDS correlated with lifetime suicide experiences in women with non-acute mood disorders. In particular, PMDS exhibited as an independent correlate for lifetime suicide attempts.
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Affiliation(s)
- Jen-Hui Chan
- Department of Psychiatry, National Taiwan University Hospital Hsin-Chu Branch, No.25, Lane 442, Sec.1, Jingguo Rd., Hsinchu City 300, Taiwan
| | - Chen Lo
- Department of Psychiatry, National Taiwan University Hospital, No.7 Chung San South Road, Taipei 10002, Taiwan
| | - Cheng-Dien Hsu
- Department of Psychosomatic Medicine, Taiwan Adventist Hospital, No.424, Sec. 2, Bade Rd., Songshan District, Taipei City 10556, Taiwan
| | - Chih-Chiang Chiu
- Department of Psychiatry, Taipei City Psychiatric Center, Taipei City Hospital, No. 309, Songde Rd., Xinyi Dist., Taipei City 110, Taiwan; Department of Psychiatry, School of Medicine, Taipei Medical University, No. 250, Wuxing St., Xinyi Dist., Taipei City 110, Taiwan
| | - Ming-Chyi Huang
- Department of Psychiatry, Taipei City Psychiatric Center, Taipei City Hospital, No. 309, Songde Rd., Xinyi Dist., Taipei City 110, Taiwan
| | - Shih-Cheng Liao
- Department of Psychiatry, National Taiwan University Hospital, No.7 Chung San South Road, Taipei 10002, Taiwan; Department of Psychiatry, National Taiwan University Medical College, No.1 Jen Ai road section 1, Taipei 100233, Taiwan
| | - I-Ming Chen
- Department of Psychiatry, National Taiwan University Hospital, No.7 Chung San South Road, Taipei 10002, Taiwan
| | - Wen-Yin Chen
- Department of Psychiatry, Taipei City Psychiatric Center, Taipei City Hospital, No. 309, Songde Rd., Xinyi Dist., Taipei City 110, Taiwan
| | - Hsi-Chung Chen
- Department of Psychiatry, National Taiwan University Hospital, No.7 Chung San South Road, Taipei 10002, Taiwan.
| | - Po-Hsiu Kuo
- Department of Psychiatry, National Taiwan University Hospital, No.7 Chung San South Road, Taipei 10002, Taiwan; Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, No. 17 Xuzhou Road, Taipei 100, Taiwan
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Lombardo G, Mondelli V, Dazzan P, Pariante CM. Sex hormones and immune system: A possible interplay in affective disorders? A systematic review. J Affect Disord 2021; 290:1-14. [PMID: 33989924 DOI: 10.1016/j.jad.2021.04.035] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 03/15/2021] [Accepted: 04/20/2021] [Indexed: 12/18/2022]
Abstract
BACKGROUND Sex hormones and the immune system may play a key role in sex differences in affective disorders. The understanding of their interplay may lead to the detection of new sex-specific tailored therapeutic approaches. The aim of this systematic review is to summarise the evidence supporting a possible association between sex hormones and inflammatory biomarkers in people with affective disorders. METHODS A systematic search of the literature published until January 2021 was conducted on PubMed database. The initial search identified a total of 1259 studies; 20 studies investigating inflammatory biomarkers and sex hormones in patients exhibiting depressive symptoms were included: 10 studies focused on patients with affective disorders, and 10 studies focused on women in menopause or in the post-partum period exhibiting depressive symptoms. RESULTS Testosterone and exogenous female sex hormones may play protective roles through their modulation of the immune system, respectively, in male patients with bipolar disorder and in peri-/post-menopausal women with depression. LIMITATIONS The main limitations are the paucity of studies investigating both sex hormones and immune biomarkers, the lack of statistical analyses exploring specifically the association between these two classes of biomarkers, and the great heterogeneity between the participants' samples in the studies. CONCLUSION This review highlights the need to investigate the interplay between sex hormones and immune system in affective disorders. The inconsistent or incomplete evidence may be improved by studies in patients with moderate-high inflammatory levels that specifically evaluate the relationship between sex hormones and the immune system.
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Affiliation(s)
- Giulia Lombardo
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, UK.
| | - Valeria Mondelli
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, UK; National Institute for Health Research Mental Health Biomedical Research Centre, South London and Maudsley NHS Foundation Trust and King's College London, London, UK
| | - Paola Dazzan
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, UK
| | - Carmine Maria Pariante
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, UK; National Institute for Health Research Mental Health Biomedical Research Centre, South London and Maudsley NHS Foundation Trust and King's College London, London, UK
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Predominant Polarity and Polarity Index of Maintenance Treatments for Bipolar Disorder: A Validation Study in a Large Naturalistic Sample in Italy. ACTA ACUST UNITED AC 2021; 57:medicina57060598. [PMID: 34200746 PMCID: PMC8230357 DOI: 10.3390/medicina57060598] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Revised: 06/04/2021] [Accepted: 06/09/2021] [Indexed: 12/05/2022]
Abstract
Background and Objectives: Predominant polarity (PP) may be a useful course specifier in at least a significant proportion of patients with Bipolar Disorder (BD), being associated with several clinically relevant correlates. Emerging evidence suggests that the concept of PP might influence the selection of maintenance treatments, based on a drug polarity index (PI) which measures the greater antidepressive vs. antimanic preventive efficacy of mood stabilizers over long-term maintenance treatment. In this study, we aimed to validate the PI in a large sample of Italian BD patients with accurate longitudinal characterization of the clinical course, which ensured a robust definition of the PP. Materials and Methods: Our sample is comprised of 653 patients with BD, divided into groups based on the predominant polarity (manic/hypomanic predominant polarity—MPP, depressive predominant polarity—DPP and no predominant polarity). Subsequently we calculated the mean total polarity index for each group, and we compared the groups. Results: When we examined the mean PI of treatments prescribed to individuals with DPP, MPP and no predominant polarity, calculated using two different methods, we failed to find significant differences, with the exception of the PI calculated with the Popovic method and using the less stringent criterion for predominant polarity (PP50%). Conclusions: Future prospective studies are needed in order to determine whether the predominant polarity is indeed one clinical factor that might guide the clinician in choosing the right mood stabilizer for BD maintenance treatment.
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Antonietta Furio M, Popovic D, Vieta E, Stukalin Y, Hagin M, Torrent C, Azorin JM, Angst J, Bowden CL, Mosolov S, Young AH, Perugi G. Characterization of rapid cycling bipolar patients presenting with major depressive episode within the BRIDGE-II-MIX study. Bipolar Disord 2021; 23:391-399. [PMID: 32959482 DOI: 10.1111/bdi.12994] [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] [Indexed: 11/28/2022]
Abstract
OBJECTIVES The "Bipolar Disorders: Improving Diagnosis, Guidance, and Education" (BRIDGE-II-Mix) study aimed to estimate the frequency of mixed states in patients with a major depressive episode (MDE) according to different definitions and to compare their clinical validity, looking into specific features such as rapid cycling (RC). METHODS Psychiatric symptoms, socio-demographic, and clinical variables were collected from a sample of 2811 MDE patients, of which 726 (25.8%) were diagnosed with bipolar disorder (BD). The characteristics of bipolar patients with RC (BD-RC) and without (BD-NRC) RC were compared. RESULTS Of 726 BD patients, 159 (21.9%) met DSM-5 criteria for RC. BD-RC group presented a higher number of lifetime depressive episodes (p < 0.001) with shorter duration of depressive episodes, and more psychiatric comorbidities, as well as higher rates of atypical features (p = 0.016) and concomitant (hypo)manic symptoms (irritable mood (p = 0.001); risky behavior (p = 0.005); impulsivity (p = 0.006); and psychomotor agitation (p = 0.029)). Patients with RC had a worse functioning (p = 0.033), more obesity (p = 0.003), and were significantly more likely to be treated with three or more drugs (p = 0.007). CONCLUSIONS Important clinical differences between bipolar patients with and without a RC include more depressive morbidity, higher incidence of anxiety disorders, addiction, bulimia, and borderline personality disorder, as well as atypical features during depression and symptoms such as irritability, risky behavior, impulsivity, and agitation. RC patients had poorer functioning than patients without RC, more obesity, and had to be treated with more drugs.
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Affiliation(s)
- Maria Antonietta Furio
- Barcelona Bipolar Disorders Program, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Dina Popovic
- Barcelona Bipolar Disorders Program, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain.,Abarbanel Mental Health Center, Bat Yam, Israel
| | - Eduard Vieta
- Barcelona Bipolar Disorders Program, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Yelena Stukalin
- School of Behavioral Sciences, Tel Aviv-Yaffo Academic College, Tel-Aviv, Israel
| | - Michal Hagin
- Sheba Medical Center, Tel Hashomer University Hospital, Ramat Gan, Israel
| | - Carla Torrent
- Barcelona Bipolar Disorders Program, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | | | - Jules Angst
- Psychiatrische Universitätsklinik, Zürich, Switzerland
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Yocum AK, Zhai Y, McInnis MG, Han P. Covid-19 pandemic and lockdown impacts: A description in a longitudinal study of bipolar disorder. J Affect Disord 2021; 282:1226-1233. [PMID: 33601700 PMCID: PMC9754803 DOI: 10.1016/j.jad.2021.01.028] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 12/19/2020] [Accepted: 01/10/2021] [Indexed: 01/12/2023]
Abstract
OBJECTIVES To investigate the impact of the SAR-Cov-2 pandemic and lockdown on individuals with bipolar disorder in comparison to healthy controls. METHODS A longitudinal study of 560 participants including 147 healthy controls was conducted between April 30 and May 30, 2020 during a state-wide lockdown. Bi-weekly measures included the Coronavirus Impact Scale, the Pittsburg Sleep Quality Index, the Patient Health Questionnaire, 9-item, and the Generalized Anxiety Disorder scale, 7-item. Generalized estimating equations method was used to examine the longitudinal change of the measures within the lockdown and the change from pre-pandemic period to pandemic period. RESULTS All participants reported an impact of lockdown. Individuals with bipolar disorder reported greater impact from the stay-at-home orders with disruptions in routines, income/employment, social support and pandemic related stress. While these measures improved over time, healthy controls recovered quicker and with greater magnitude than persons with bipolar disorder. Comparing mood symptom severity measures in mid-March through May 2020 to the same time window in 2015-2019 (pre- verses post-pandemic), there were no significant differences among individuals with bipolar disorder, whereas healthy controls showed a significant, albeit transient, increase in mood symptoms. CONCLUSION Everyone was impacted by the SARs-CoV pandemic; however, those with bipolar disorder experienced more life impacting changes from the stay-at-home orders vs healthy controls. These disruptions improved over time but much more slowly than healthy controls. Pre- vs post-pandemic comparisons show a modest but significant increase in mood severity in the healthy controls which was not observed in those with bipolar disorder.
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Affiliation(s)
- Anastasia K Yocum
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States
| | - Yuqi Zhai
- Department of Biostatistics, University of Michigan, Ann Arbor, MI, United States
| | - Melvin G McInnis
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States
| | - Peisong Han
- Department of Biostatistics, University of Michigan, Ann Arbor, MI, United States.
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38
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Jiang X, Wu F, Zhang Y, Li H, Kang J, Kong L, Wang F, Tang Y. Gender differences of amplitude of low-frequency fluctuations in bipolar disorder: A resting state fMRI study. J Affect Disord 2021; 280:189-196. [PMID: 33217701 DOI: 10.1016/j.jad.2020.11.087] [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: 05/07/2020] [Revised: 09/27/2020] [Accepted: 11/08/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND The clinical and epidemiological features of bipolar disorder (BD) between females and males have many differences. The association between brain function and gender in BD is unknown. This research aimed to investigate the association between brain function and gender in BD by using amplitude of low-frequency fluctuations (ALFFs). METHODS Ninety-eight patients (49 females and 49 males) with BD and 171 matched healthy controls (HCs, 89 females and 82 males) were recruited for resting-state functional magnetic resonance imaging. ALFF was used to estimate brain function. RESULTS A main effect of diagnosis in ALFF was observed in the dorsal lateral prefrontal cortex (DLPFC), ventral prefrontal cortex (VPFC), caudate and occipital lobe. A main effect of gender in ALFF was found in the right VPFC, DLPFC, thalamus, and occipital lobe. A main effect of diagnosis gender interaction in ALFF was observed in the left DLPFC. Analyses of two-sample t-test indicated that male patients with BD had increased ALFF in the right hippocampus, right amygdala, left caudate, and left DLPFC, and decreased ALFF in the occipital lobe compared with male HC. Female patients with BD demonstrated increased ALFF in the right VPFC and right DLPFC compared with female HC. Male patients with BD exhibited increased ALFF in the right VPFC and left DLPFC and decreased ALFF in the occipital lobe compared with female patients with BD. LIMITATIONS This study did not consider the effect of medications and emotional states on brain activity. CONCLUSIONS Results suggested gender differences in the dysfunctions of the cortico-limbic neural system in BD.
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Affiliation(s)
- Xuejun Jiang
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, China; Department of Gerontology, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, China
| | - Feng Wu
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, China
| | - Yifan Zhang
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, China
| | - Huizi Li
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, China
| | - Jiahui Kang
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, China
| | - Lingtao Kong
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, China.
| | - Fei Wang
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, China; Department of Radiology, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, China
| | - Yanqing Tang
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, China; Department of Gerontology, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, China
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39
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Dell'Osso B, Cafaro R, Ketter TA. Has Bipolar Disorder become a predominantly female gender related condition? Analysis of recently published large sample studies. Int J Bipolar Disord 2021; 9:3. [PMID: 33392912 PMCID: PMC7779377 DOI: 10.1186/s40345-020-00207-z] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Accepted: 09/29/2020] [Indexed: 02/07/2023] Open
Abstract
Bipolar Disorders (BD) are disabling and severe psychiatric disorders, commonly perceived as equally affecting both men and women. The prevalence of BD in the general population has been growing over the last decade, however, few epidemiological studies are available regarding BD gender distribution, leaving unanswered the question whether the often reported increment of BD diagnosis could be gender specific. In fact, BD in female patients can often be misdiagnosed as MDD, leaving such women non correctly treated for longer times than their male counterparts. From this perspective, we searched literature for large sample (> 1000 subjects) studies published in the last decade (2010 onward) on BD patients. We included ten large sample studies that reported the gender distribution of their samples, and we therefore analysed them. Our results show a higher preponderance of female patients in every sample and sub-sample of BDI and BDII, supporting our hypothesis of an increase in BD diagnosis in females. BD in women presents with higher rates of rapid cycling, depressive polarity and suicide attempts, characteristics of non inferior severity compared to males; prompt recognition and adequate treatment of BD is therefore crucial to reduce risks and improve quality of life of affected women. In this regard, our results could lead the way for national or international epidemiological studies with the aim of more accurately assessing gender-specific prevalence of BD.
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Affiliation(s)
- Bernardo Dell'Osso
- Department of Biomedical and Clinical Sciences Luigi Sacco, Department of Mental Health, University of Milan, ASST Fatebenefratelli-Sacco, Milano, Italy. .,CRC Aldo Ravelli, Milano, Italy. .,Department of Psychiatry and Behavioural Sciences, Stanford University, Stanford, CA, USA.
| | - Rita Cafaro
- Department of Biomedical and Clinical Sciences Luigi Sacco, Department of Mental Health, University of Milan, ASST Fatebenefratelli-Sacco, Milano, Italy
| | - Terence A Ketter
- Department of Psychiatry and Behavioural Sciences, Stanford University, Stanford, CA, USA
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40
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Holm M, Taipale H, Tanskanen A, Tiihonen J, Mitterdorfer‐Rutz E. Employment among people with schizophrenia or bipolar disorder: A population-based study using nationwide registers. Acta Psychiatr Scand 2021; 143:61-71. [PMID: 33155273 PMCID: PMC7839734 DOI: 10.1111/acps.13254] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Revised: 10/22/2020] [Accepted: 10/26/2020] [Indexed: 12/18/2022]
Abstract
OBJECTIVE To assess the employment rate and the related background factors among people with schizophrenia or bipolar disorder. METHODS We identified all people in Sweden aged 18-64 years diagnosed with schizophrenia or bipolar disorder in nationwide registers in the years 2006-2013. The identified individuals were grouped by main activity or source of income. The association between background factors and employment was analyzed with generalized estimating equations (GEE). RESULTS Three years before the first psychosis or bipolar disorder diagnosis, 24% of the individuals with schizophrenia and 45% of the individuals with bipolar disorder were employed. However, the employment rate dropped around the time of the first diagnosis. Five years later, 10% of the individuals with schizophrenia and 34% of the individuals with bipolar disorder were employed. The most important factors associated with employment after diagnosis were a high level of education, older age at the first registered diagnosis, no substance use disorder, and a low number of previous hospitalizations. Marriage or cohabiting, higher level of education, and higher age at the first diagnosis were associated with an increased employment rate especially among people with schizophrenia, and substance use was associated with a lower employment rate, especially among people with bipolar disorder. Men with bipolar disorder had a higher employment rate than women. CONCLUSION The employment rate is low among people with schizophrenia and higher among people with bipolar disorder. The association of background characteristics with employment was mostly in the same direction both in schizophrenia and in bipolar disorder.
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Affiliation(s)
- Minna Holm
- Mental Health UnitFinnish Institute for Health and WelfareHelsinkiFinland,Department of Clinical NeuroscienceKarolinska InstitutetStockholmSweden
| | - Heidi Taipale
- Department of Clinical NeuroscienceKarolinska InstitutetStockholmSweden,School of PharmacyUniversity of Eastern FinlandKuopioFinland,Department of Forensic PsychiatryNiuvanniemi HospitalUniversity of Eastern FinlandKuopioFinland
| | - Antti Tanskanen
- Department of Clinical NeuroscienceKarolinska InstitutetStockholmSweden,Department of Forensic PsychiatryNiuvanniemi HospitalUniversity of Eastern FinlandKuopioFinland,The Impact Assessment UnitNational Institute for Health and WelfareHelsinkiFinland
| | - Jari Tiihonen
- Department of Clinical NeuroscienceKarolinska InstitutetStockholmSweden,Department of Forensic PsychiatryNiuvanniemi HospitalUniversity of Eastern FinlandKuopioFinland
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41
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Van Rheenen TE, Meyer D, Neill E, Phillipou A, Tan EJ, Toh WL, Rossell SL. Mental health status of individuals with a mood-disorder during the COVID-19 pandemic in Australia: Initial results from the COLLATE project. J Affect Disord 2020; 275:69-77. [PMID: 32658826 PMCID: PMC7331562 DOI: 10.1016/j.jad.2020.06.037] [Citation(s) in RCA: 129] [Impact Index Per Article: 32.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 06/18/2020] [Accepted: 06/23/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Physical-distancing strategies during the coronavirus (COVID-19) pandemic may be particularly detrimental to the mental health of individuals with a pre-existing mood disorder. Data on the mental health status of these individuals during the current pandemic is sparse, and their current mental health needs unclear. METHOD We characterised COVID-19 related lifestyle changes, primary concerns and psychological distress in n=1292 respondents self-reporting a mood disorder (either bipolar disorder or depressive disorder) and n=3167 respondents without any reported mental disorder from the COLLATE (COvid-19 and you: mentaL heaLth in AusTralia now survEy) project; an Australian national survey launched on April 1st 2020. RESULTS Psychological distress was heightened in the mood disorder group compared to the group with no mental disorder, with stress and depression further elevated in respondents with bipolar disorder compared to those with depressive disorder; and men with bipolar disorder having even higher levels of depression than women with bipolar disorder. Respondents with bipolar disorder were particularly concerned about financial issues associated with COVID-19 compared to those with depressive disorder and those with no mental disorder. Adverse changes to lifestyle behaviours were more prevalent in respondents with a mood disorder and linked to higher levels of distress. LIMITATIONS Mood disorder was self-reported and was not clinically verified. CONCLUSIONS Current psychological distress levels are elevated in individuals with mood disorder and are associated with maladaptive situational and lifestyle changes occurring in response to COVID-19.
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Affiliation(s)
- Tamsyn E Van Rheenen
- Melbourne Neuropsychiatry Centre, The University of Melbourne, Level 3, Alan Gilbert Building, 161 Barry St, Carlton, Victory 3053, Australia; Centre for Mental Health, Swinburne University of Technology, Melbourne, Victory, Australia.
| | - Denny Meyer
- Centre for Mental Health, Swinburne University of Technology, Melbourne, Victory, Australia
| | - Erica Neill
- Centre for Mental Health, Swinburne University of Technology, Melbourne, Victory, Australia; Department of Mental Health, St Vincent's Hospital, Melbourne, Victory, Australia; Department of Psychiatry, The University of Melbourne, Melbourne, Victory, Australia
| | - Andrea Phillipou
- Centre for Mental Health, Swinburne University of Technology, Melbourne, Victory, Australia; Department of Mental Health, St Vincent's Hospital, Melbourne, Victory, Australia; Department of Mental Health, Austin Hospital, Melbourne, Victory, Australia; Department of Psychiatry, The University of Melbourne, Melbourne, Victory, Australia
| | - Eric J Tan
- Centre for Mental Health, Swinburne University of Technology, Melbourne, Victory, Australia; Department of Mental Health, St Vincent's Hospital, Melbourne, Victory, Australia
| | - Wei Lin Toh
- Centre for Mental Health, Swinburne University of Technology, Melbourne, Victory, Australia
| | - Susan L Rossell
- Centre for Mental Health, Swinburne University of Technology, Melbourne, Victory, Australia; Department of Mental Health, St Vincent's Hospital, Melbourne, Victory, Australia
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42
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Haddad C, Sacre H, Hallit S, Obeid S, Al-Zein D, Nabout R, Zoghbi M, Haddad G. Prevalence of comorbidities and correlates of hospital readmission rate in patients with acute mania: A one-year retrospective data from a tertiary care. Perspect Psychiatr Care 2020; 56:753-759. [PMID: 31828814 DOI: 10.1111/ppc.12464] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 11/24/2019] [Accepted: 12/06/2019] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE To assess the prevalence of medical comorbidities in acute manic patients over a period of 1 year, and to evaluate correlates of the readmission rate. DESIGN/METHODS A retrospective observational study was conducted on 158 acute manic patients from 2016 to 2017. RESULTS The most common physical comorbidity was obesity (36.1%) followed by cardiovascular disorders (15.2%) and liver dysfunctions (9.3%). Male gender was associated with higher readmission rate (Beta = -0.260), while taking anticholinergic drugs (Beta = -0.338) and having a family history of psychiatric disorders (Beta = -0.222) were associated with lower readmission rate. PRACTICAL IMPLICATIONS The study results may help physicians and other clinicians understand the burden of illness recurrence in bipolar disorder type I patients and adopt effective strategies to prevent relapse, taking into account all comorbidities.
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Affiliation(s)
- Chadia Haddad
- Departments of Research, Psychology and Psychiatry, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon
| | - Hala Sacre
- Drug Information Center, Order of Pharmacists of Lebanon, Beirut, Lebanon.,INSPECT-LB: Institut National de Sante Publique, Epidemiologie Clinique et Toxicologie, Beirut, Lebanon
| | - Souheil Hallit
- INSPECT-LB: Institut National de Sante Publique, Epidemiologie Clinique et Toxicologie, Beirut, Lebanon.,Faculty of Medicine and Medicine Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon
| | - Sahar Obeid
- Departments of Research, Psychology and Psychiatry, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon.,INSPECT-LB: Institut National de Sante Publique, Epidemiologie Clinique et Toxicologie, Beirut, Lebanon.,Department of Psychology, Faculty of Arts and Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon
| | - Darine Al-Zein
- Department of Life and Earth Sciences, Faculty of Sciences II, Lebanese University, Beirut, Lebanon
| | - Rita Nabout
- Department of Life and Earth Sciences, Faculty of Sciences II, Lebanese University, Beirut, Lebanon
| | - Marouan Zoghbi
- Departments of Research, Psychology and Psychiatry, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon.,Department of Family Medicine, Saint-Joseph University, Beirut, Lebanon
| | - Georges Haddad
- Departments of Research, Psychology and Psychiatry, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon.,Faculty of Medicine and Medicine Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon.,Department of Life and Earth Sciences, Faculty of Sciences II, Lebanese University, Beirut, Lebanon
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43
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Perich T, Ussher J, Fraser I, Perz J. Quality of life and psychological symptoms for women with bipolar disorder - a comparison between reproductive, menopause transition and post-menopause phases. Maturitas 2020; 143:72-77. [PMID: 33308639 DOI: 10.1016/j.maturitas.2020.09.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 08/31/2020] [Accepted: 09/11/2020] [Indexed: 01/29/2023]
Abstract
OBJECTIVE The menopause transition may be associated with increased symptoms for women living with bipolar disorder; however, few have explored how this compares with other reproductive phases. The aim of this study was to compare women at reproductive, menopause transition and post-menopause phases on measures of quality of life and psychological symptoms associated with bipolar disorder. STUDY DESIGN Women with bipolar disorder took part in a large international survey conducted online and were categorised into reproductive stages using the STRAW and Monash criteria. The 498 participants were divided into three groups: 202 (41%) in the reproductive age group, 101 (20%) in the menopause transition group and 195 (39%) in the post-menopause group. MAIN OUTCOME MEASURES The Menopause Rating Scale (MRS), the Depression Anxiety and Stress Scales - 21 (DASS-21), the Altman Mania Rating Scale (ASRM) and the Bipolar Disorder Quality of Life scale (BD-QoL). RESULTS BD-QoL scores were significantly lower in the menopause transition group than in the other groups and that group was more likely to report being constantly depressed over the past year than the other groups. Anxiety was significantly higher in the menopause transition and post-menopause groups compared with the reproductive age group. CONCLUSIONS Quality of life and depression are impacted by the menopause transition for women with bipolar disorder. However, anxiety may be a clinical issue for women in both the post-menopause and the menopause transition phases. Research is needed to determine how symptoms vary across the reproductive life cycle for women with bipolar disorder and if targeted treatments may assist.
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Affiliation(s)
- Tania Perich
- Clinical and Health Psychology Research Initiative (CaHPRI), School of Psychology, Western Sydney University, Australia; Translational Health Research Institute, Western Sydney University, Australia.
| | - Jane Ussher
- Translational Health Research Institute, Western Sydney University, Australia
| | - Isabel Fraser
- Clinical and Health Psychology Research Initiative (CaHPRI), School of Psychology, Western Sydney University, Australia
| | - Janette Perz
- Translational Health Research Institute, Western Sydney University, Australia
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44
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Asth L, Tiago PRF, Costa LRF, Holanda VAD, Pacifico S, Zaveri NT, Calo' G, Ruzza C, Gavioli EC. Effects of non-peptide nociceptin/orphanin FQ receptor ligands on methylphenidate-induced hyperactivity in mice: Implications for bipolar disorders. Neuropeptides 2020; 82:102059. [PMID: 32600667 DOI: 10.1016/j.npep.2020.102059] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 06/09/2020] [Accepted: 06/09/2020] [Indexed: 01/11/2023]
Abstract
Bipolar disorder is a psychiatric pathology characterized by biphasic mood episodes of mania or hypomania and depression. The pharmacotherapy of bipolar disorder has significant adverse effects impairing treatment adherence and patient quality of life. The N/OFQ-NOP receptor system has been widely implicated with mood disorders. Clinical and preclinical findings suggest antidepressants actions for NOP antagonists. More recently, the administration of NOP agonists has shown to promote depressant states. The present study aimed to investigate the effects of non-peptide NOP ligands in methylphenidate-induced manic-like behavior in mice. The NOP agonist Ro 65-6570 (0.01-1 mg/kg, ip), at the higher dose, did not affect spontaneous locomotion per se, but prevented the methylphenidate (10 mg/kg, sc)-induced hyperlocomotion. The NOP partial agonist AT-090 (0.001-0.03 mg/kg, ip) and the NOP antagonist SB-612111 (1-10 mg/kg, ip) did not significantly affect the psychostimulant-induced hyperactivity. Experiments performed with mice lacking the NOP receptor (NOP(-/-)) demonstrated that the treatment with methylphenidate induced similar hyperlocomotion in NOP(-/-) and NOP(+/+) mice. In conclusion, these findings suggest a potential role for NOP agonists in the prevention of manic states, especially by counteracting the hyperactivity symptom of bipolar patients. However, more studies are necessary in order to evaluate these compounds in other features of bipolar disorder.
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Affiliation(s)
- Laila Asth
- Department of Biophysics and Pharmacology, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Pamella R F Tiago
- Department of Biophysics and Pharmacology, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Layse R F Costa
- Department of Biophysics and Pharmacology, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Victor A D Holanda
- Department of Biophysics and Pharmacology, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Salvatore Pacifico
- Department of Chemical and Pharmaceutical Sciences, University of Ferrara, 44121 Ferrara, Italy
| | - Nurulain T Zaveri
- Astraea Therapeutics, LLC., 320 Logue Avenue, Mountain View, CA 94043, United States
| | - Girolamo Calo'
- Department of Medical Sciences, Section of Pharmacology, University of Ferrara, 44121 Ferrara, Italy
| | - Chiara Ruzza
- Department of Medical Sciences, Section of Pharmacology, University of Ferrara, 44121 Ferrara, Italy; Technopole of Ferrara, LTTA Laboratory for Advanced Therapies, Ferrara, Italy
| | - Elaine C Gavioli
- Department of Biophysics and Pharmacology, Federal University of Rio Grande do Norte, Natal, Brazil.
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45
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Zhang L, Verwer RWH, Lucassen PJ, Huitinga I, Swaab DF. Sex difference in glia gene expression in the dorsolateral prefrontal cortex in bipolar disorder: Relation to psychotic features. J Psychiatr Res 2020; 125:66-74. [PMID: 32208195 DOI: 10.1016/j.jpsychires.2020.03.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 02/16/2020] [Accepted: 03/09/2020] [Indexed: 12/30/2022]
Abstract
BACKGROUND Suicide, psychotic features and gender influence the epidemiology and clinical prognosis of bipolar disorder (BD). Differences in glial function between the genders might contribute to these clinical variables. Here we studied expression of glial genes in human post-mortem prefrontal cortex of BD and control subjects in relation to suicide, psychotic features and sex. METHODS Real time PCR was used to detect transcriptional alterations of 16 glia-related genes in two brain areas, the dorsolateral prefrontal cortex (DLPFC) and anterior cingulate cortex (ACC), from 30 patients with BD subdivided by suicide and psychotic features, and from 34 well-matched control cases. RESULTS We found no evidence of immune activation in BD. Instead, we found three microglial genes to be downregulated in the DLPFC of non-suicidal individuals with BD, i.e. CD68, triggering receptor expressed on myeloid cells 2 (TREM2) and purinergic receptor 12 (P2RY12). A remarkable sex difference was observed in the DLPFC of patients with BD: 14 glia-related genes were expressed at significantly higher levels in males, including all three glial cell types. A subset analysis showed that the sex differences were closely associated with the presence of psychotic features. CONCLUSIONS No evidence of immune activation was found in these two brain regions in BD. The sex-specific differences in glial gene expression in BD, found particularly in patients with psychotic features, may be associated with the potential co-existence of mania and psychotic features and could potentially contribute to the gender-biased characteristics in BD.
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Affiliation(s)
- Lin Zhang
- Neuropsychiatric Disorders Group, Netherlands Institute for Neuroscience, An Institute of the Royal Netherlands Academy of Arts and Sciences, Amsterdam, the Netherlands
| | - Ronald W H Verwer
- Neuropsychiatric Disorders Group, Netherlands Institute for Neuroscience, An Institute of the Royal Netherlands Academy of Arts and Sciences, Amsterdam, the Netherlands
| | - Paul J Lucassen
- Brain Plasticity Group, Faculty of Science, Swammerdam Institute for Life Sciences, University of Amsterdam, Amsterdam, the Netherlands
| | - Inge Huitinga
- Brain Plasticity Group, Faculty of Science, Swammerdam Institute for Life Sciences, University of Amsterdam, Amsterdam, the Netherlands; Neuroimmunology Group, Netherlands Institute for Neuroscience, An Institute of the Royal Netherlands Academy of Arts and Sciences, Amsterdam, the Netherlands
| | - Dick F Swaab
- Neuropsychiatric Disorders Group, Netherlands Institute for Neuroscience, An Institute of the Royal Netherlands Academy of Arts and Sciences, Amsterdam, the Netherlands.
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Fountoulakis KN, Yatham LN, Grunze H, Vieta E, Young AH, Blier P, Tohen M, Kasper S, Moeller HJ. The CINP Guidelines on the Definition and Evidence-Based Interventions for Treatment-Resistant Bipolar Disorder. Int J Neuropsychopharmacol 2020; 23:230-256. [PMID: 31802122 PMCID: PMC7177170 DOI: 10.1093/ijnp/pyz064] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 11/26/2019] [Accepted: 12/04/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Resistant bipolar disorder is a major mental health problem related to significant disability and overall cost. The aim of the current study was to perform a systematic review of the literature concerning (1) the definition of treatment resistance in bipolar disorder, (2) its clinical and (3) neurobiological correlates, and (4) the evidence-based treatment options for treatment-resistant bipolar disorder and for eventually developing guidelines for the treatment of this condition. MATERIALS AND METHODS The PRISMA method was used to identify all published papers relevant to the definition of treatment resistance in bipolar disorder and the associated evidence-based treatment options. The MEDLINE was searched to April 22, 2018. RESULTS Criteria were developed for the identification of resistance in bipolar disorder concerning all phases. The search of the literature identified all published studies concerning treatment options. The data were classified according to strength, and separate guidelines regarding resistant acute mania, acute bipolar depression, and the maintenance phase were developed. DISCUSSION The definition of resistance in bipolar disorder is by itself difficult due to the complexity of the clinical picture, course, and treatment options. The current guidelines are the first, to our knowledge, developed specifically for the treatment of resistant bipolar disorder patients, and they also include an operationalized definition of treatment resistance. They were based on a thorough and deep search of the literature and utilize as much as possible an evidence-based approach.
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Affiliation(s)
- Konstantinos N Fountoulakis
- 3rd Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
- Correspondence: Konstantinos N. Fountoulakis, MD, 6, Odysseos str (1st Parodos Ampelonon str.), 55535 Pylaia Thessaloniki, Greece ()
| | - Lakshmi N Yatham
- Department of Psychiatry, University of British Columbia, Mood Disorders Centre of Excellence, Djavad Mowafaghian Centre for Brain Health, Vancouver, Canada
| | - Heinz Grunze
- Psychiatrie Schwäbisch Hall & Paracelsus Medical University, Nuremberg, Germany
| | - Eduard Vieta
- Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Allan H Young
- Centre for Affective Disorders, Institute of Psychiatry, Psychology and Neuroscience, King’s College, London, UK
| | - Pierre Blier
- The Royal Institute of Mental Health Research, Department of Psychiatry, University of Ottawa, Ottawa, Canada
| | - Mauricio Tohen
- Department of Psychiatry and Behavioral Sciences, University of New Mexico Health Sciences Center, Albuquerque, NM
| | - Siegfried Kasper
- Department of Psychiatry and Psychotherapy, Medical University Vienna, MUV, AKH, Vienna
- Center for Brain Research, Medical University Vienna, MUV, Vienna, Austria
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Di Florio A, Craddock N, van den Bree M. Alcohol misuse in bipolar disorder. A systematic review and meta-analysis of comorbidity rates. Eur Psychiatry 2020; 29:117-24. [DOI: 10.1016/j.eurpsy.2013.07.004] [Citation(s) in RCA: 72] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2013] [Revised: 07/18/2013] [Accepted: 07/27/2013] [Indexed: 01/24/2023] Open
Abstract
AbstractAims:To assess the comorbidity rates of alcohol use disorders (AUDs) in bipolar disorder (BD) and to explore possible sources of heterogeneity.Methods:Studies were identified through database searches. Meta-analytic techniques were employed to aggregate data on lifetime comorbidity and to explore possible sources of heterogeneity. Funnel plots were used to detect publication bias.Results:In clinical studies, AUDs affected more than one in three subjects with BD. Significant heterogeneity was found, which was largely explained by the geographical location of study populations and gender ratio of participants. AUDs affected more than one in five women and two in five men.Conclusion:AUDs are highly prevalent in BD. Our study revealed a substantial heterogeneity across studies. Further research including control groups is needed. Patients with BD should be assessed for current and previous AUDs.
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Abulseoud OA, Şenormancı G, Şenormancı Ö, Güçlü O, Schleyer B, Camsari U. Sex difference in the progression of manic symptoms during acute hospitalization: A prospective pilot study. Brain Behav 2020; 10:e01568. [PMID: 32053271 PMCID: PMC7066352 DOI: 10.1002/brb3.1568] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 01/06/2020] [Accepted: 01/27/2020] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVES Acute mania is a serious medical condition that impacts men and women equally. Longtime presentation of manic symptoms is sex-dependent; however, little is known about acute symptoms of mania. The objective of this study is to track and compare acute manic symptoms for sex differences during inpatient hospitalization. METHODS All patients with bipolar mania admitted to a large university hospital between January and October 2017 were invited to participate in this longitudinal naturalistic follow-up study. Manic (YMRS), depressive (MADRS), and psychotic (PAS) symptoms were tracked daily from admission to discharge. RESULTS The total YMRS scores decreased significantly overtime (p < .0001) in both male (n = 34) and female (n = 23) patients (p = .7). However, male patients scored significantly higher in sexual interest (p = .01), disruptive and aggressive behavior (p = .01), and appearance (p < .001) while females had better insight into their illness (p = .01). Males and females received similar doses of lithium (p = .1), but males received significantly higher doses of valproic acid (VPA) in comparison with females (p = .003). However, plasma lithium and VPA concentrations at discharge were not significantly different between sexes. CONCLUSION Our results show sex differences in the progression of certain domains of manic symptoms in a cohort of 23 female and 34 male patients admitted to a large academic center in Turkey. Males, in this sample, exhibited more sexual interest, disruptive and aggressive behaviors, better grooming, and less insight compared to females. While these results are concordant with our preclinical findings and with anecdotal clinical observations, replication in larger samples is needed.
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Affiliation(s)
- Osama A Abulseoud
- Neuroimaging Research Branch, IRP, National Institute on Drug Abuse, Baltimore, MD, USA
| | - Güliz Şenormancı
- University of Health Sciences Bursa Yüksek İhtisas Training and Research Hospital Psychiatry Department, Bursa, Turkey
| | - Ömer Şenormancı
- University of Health Sciences Bursa Yüksek İhtisas Training and Research Hospital Psychiatry Department, Bursa, Turkey
| | - Oya Güçlü
- Bakirkoy Research & Training Hospital for Psychiatry, Neurology, Neurosurgery and Psychiatry Department, İstanbul, Turkey
| | - Brooke Schleyer
- Neuroimaging Research Branch, IRP, National Institute on Drug Abuse, Baltimore, MD, USA
| | - Ulas Camsari
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
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Mosheva M, Serretti A, Stukalin Y, Fabbri C, Hagin M, Horev S, Mantovani V, Bin S, Mattiaccio A, Nivoli A, Vieta E, Popovic D. Association between CANCA1C gene rs1034936 polymorphism and alcohol dependence in bipolar disorder. J Affect Disord 2020; 261:181-186. [PMID: 31634677 DOI: 10.1016/j.jad.2019.10.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 09/10/2019] [Accepted: 10/09/2019] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Bipolar disorder (BD) is a highly heritable and disabling mental illness, commonly associated with substance abuse, being alcohol abuse the most frequent. Comorbid BD and substance abuse disorders are often associated with high levels of health service utilization and destabilization of the course of illness resulting in poor treatment outcomes. Although recent genome-wide association studies have detected a number of risk genes for BD, the data is still sparse and inconclusive for those genes that may contribute to the increased risk of comorbid alcohol abuse (AA) in BD. The primary aim of the present study was to investigate the effects of 46 single-nucleotide polymorphisms (SNPs) within eight genes on different phenotypes of BD patients, such as comorbid alcohol abuse. We further assessed clinical variables associated with AA. METHODS One-hundred fifty-eight BD I and II patients were enrolled in a naturalistic cohort study. Genomic DNA of 92 patients was extracted from whole blood using standard procedures and 46 tag SNPs in eight genes of interest (ANK, CACNA1C, CACNB2, FKBP5, GRM7, ITIH3, SYNE1 and TCF4) were genotyped. RESULTS Seventy-one patients out of 158 (45%) satisfied diagnostic criteria for comorbid AA. Among 46 SNPs analyzed, the only SNP associated with comorbid AA was rs1034936 polymorphism in the CANCA1C gene. This polymorphism was also associated with lifetime cocaine abuse, manic switch and current atypical antipsychotics. CONCLUSIONS Our findings suggest a role of rs1034936 CACNA1C gene variant in BD-AA group. Despite their preliminary nature, the present results may provide new insight on mechanisms underlying AA in BD.
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Affiliation(s)
- Mariela Mosheva
- Bipolar Disorders Programme, Psychiatry B, Sheba Medical Center, Tel Hashomer, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Alessandro Serretti
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Yelena Stukalin
- School of Behavioral Sciences, Tel Aviv-Yaffo Academic College, Tel-Aviv, Israel
| | - Chiara Fabbri
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Michal Hagin
- Bipolar Disorders Programme, Psychiatry B, Sheba Medical Center, Tel Hashomer, Israel
| | - Sagi Horev
- Bipolar Disorders Programme, Psychiatry B, Sheba Medical Center, Tel Hashomer, Israel; Semmelewis University, Budapest, Hungary
| | - Vilma Mantovani
- Centre for Applied Biomedical Research - CRBA, University of Bologna, St. Orsola Hospital, Bologna, Italy
| | - Sofia Bin
- Centre for Applied Biomedical Research - CRBA, University of Bologna, St. Orsola Hospital, Bologna, Italy
| | - Alessandro Mattiaccio
- Centre for Applied Biomedical Research - CRBA, University of Bologna, St. Orsola Hospital, Bologna, Italy
| | - Alessandra Nivoli
- Clinica Psichiatrica, Dipartimento di Medicina Clinica e Sperimentale, University of Sassari, Italy
| | - Eduard Vieta
- Barcelona Bipolar Disorders Program, Hospital Clinic, IDIBAPS, CIBERSAM, University of Barcelona, Spain
| | - Dina Popovic
- Bipolar Disorders Programme, Psychiatry B, Sheba Medical Center, Tel Hashomer, Israel.
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Ragazan DC, Eberhard J, Berge J. Sex-Specific Associations Between Bipolar Disorder Pharmacological Maintenance Therapies and Inpatient Rehospitalizations: A 9-Year Swedish National Registry Study. Front Psychiatry 2020; 11:598946. [PMID: 33262715 PMCID: PMC7688467 DOI: 10.3389/fpsyt.2020.598946] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 10/12/2020] [Indexed: 12/11/2022] Open
Abstract
Background: Long-term pharmacological maintenance therapy is often essential among people with bipolar disorder to reduce the need for inpatient care. Sex-specific responses to maintenance therapies are expected but remain largely unknown. Here, we examined for sex-specific associations between common maintenance therapies for bipolar disorder with inpatient rehospitalizations following patients' index discharges during 2006-2014. Methods: Population-based data on maintenance therapies and rehospitalizations were extracted from Swedish national registries. We adopted the within-individual design to compare the time on- vs. off- maintenance therapy for males and females, respectively. Extended stratified Cox proportional hazards regression models were employed to quantify the rate of rehospitalization as a function of common maintenance drugs and other important time-varying control variables. Results: Our primary analysis included 22,681 bipolar disorder rehospitalizations by 6,400 males and 9,588 (60.0%) females over an observation time of 62,813 person-years. The time spent on- vs. off- maintenance lithium, lamotrigine, quetiapine, or olanzapine was statistically significant upon adjustment among either sex for reducing the rate of bipolar rehospitalizations. Adjusted sex-specific statistically significant associations were also observed. Among females, the time on- (vs. off-) long-acting injectable risperidone reduced the rate of bipolar rehospitalizations by 73% (56-84%), carbamazepine by 44% (18-62%), aripiprazole by 29% (13-42%), and valproate by 23% (11-33%); whereas among males, ziprasidone by 65% (41-79%). Conclusion: The effectiveness of most maintenance therapies is generally comparable and uniform among both males and females. Despite some statistically significant sex-specific associations, estimates for each drug were fairly consistent between sexes.
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Affiliation(s)
- Dragos C Ragazan
- Division of Psychiatry, Department of Clinical Sciences Lund, Faculty of Medicine, Lund University, Lund, Sweden.,Vancouver Coastal Health Authority, University of British Columbia Hospital Detwiller Pavilion, Vancouver, BC, Canada
| | - Jonas Eberhard
- Division of Psychiatry, Department of Clinical Sciences Lund, Faculty of Medicine, Lund University, Lund, Sweden.,Region Skåne, Adult Psychiatry Clinic Helsingborg, Helsingborg, Sweden
| | - Jonas Berge
- Division of Psychiatry, Department of Clinical Sciences Lund, Faculty of Medicine, Lund University, Lund, Sweden.,Region Skåne, Adult Psychiatry Clinic Malmö, Addiction Centre Malmö, Malmö, Sweden
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