Does BDNF genotype influence creative output in bipolar I manic patients?

Brain-derived neurotrophic factor genetic polymorphism rs6265 and creativity

The protein brain-derived neurotrophic factor (BDNF) promotes neural plasticity of the central nervous system and plays an important role for learning and memory. A single nucleotide polymorphism (rs6265) at position 66 in the pro-region of the human BDNF gene, resulting in a substitution of the amino acid valine (val) with methionine (met), leads to attenuated BDNF secretion and has been associated with reduced neurocognitive function. Inhomogeneous results have been found regarding the effect of the BDNF genotype on behavior. We determined the BDNF genotype and performance on the Compound Remote Associate (CRA) task as a common measure of creativity in 76 healthy university students. In our main analyses, we did not find significant differences between met-carriers (n = 30) and non-met carriers (n = 46). In a secondary analysis, we found that met-carriers had a slower solution time (medium effect size) for items of medium difficulty. Our results suggest that met-carriers and non-met-carriers do not generally differ regarding their creativity, but non-met-carriers may have a certain advantage when it comes to moderately difficult problems. The wider literature suggests that both genetic variants come with advantages and disadvantages. Future research needs to sharpen our understanding of the disadvantages and, potentially, advantages met allele carriers may have.

Can Brain-Derived Neurotrophic Factor Be Considered a Biomarker for Bipolar Disorder? An Analysis of the Current Evidence

Brain-derived neurotrophic factor (BDNF) plays a key role in brain development, contributing to neuronal survival and neuroplasticity. Previous works have found that BDNF is involved in several neurological or psychiatric diseases. In this review, we aimed to collect all available data on BDNF and bipolar disorder (BD) and assess if BDNF could be considered a biomarker for BD. We searched the most relevant medical databases and included studies reporting original data on BDNF circulating levels or Val66Met polymorphism. Only articles including a direct comparison with healthy controls (HC) and patients diagnosed with BD according to international classification systems were included. Of the 2430 identified articles, 29 were included in the present review. Results of the present review show a reduction in BDNF circulating levels during acute phases of BD compared to HC, which increase after effective therapy of the disorders. The Val66Met polymorphism was related to features usually associated with worse outcomes. High heterogeneity has been observed regarding sample size, clinical differences of included patients, and data analysis approaches, reducing comparisons among studies. Although more studies are needed, BDNF seems to be a promising biomarker for BD.

Bipolar spectrum traits and the space between Madness and Genius: The Muse is in the Dose

Creativity has long been associated with the bipolar spectrum, particularly among unaffected first-degree relatives and those with milder expressions of bipolar traits, suggesting that some aspects of the bipolar spectrum may confer advantages for creativity. Here we took a multifaceted approach to better define the shared vulnerability between creativity and bipolar disorder. We recruited 135 individuals with bipolar disorder, 102 creative controls, and 103 non-creative controls for a total of 340 participants. All participants completed a comprehensive assessment battery that included several self-report temperament and personality questionnaires, a computerized test of cognitive function across multiple domains, and an evaluation of creative performance and achievement. Significant group differences were observed for the hypothesized shared vulnerability traits of hypomanic personality, cyclothymic temperament, impulsivity, and positive schizotypy. While both the creative and bipolar groups demonstrated superior creative ability, the creative group alone revealed enhanced cognitive performance. Accounting for intercorrelations between traits, a combination of openness, hypomanic personality, divergent thinking, and reasoning ability emerged as the strongest predictors of creativity, collectively explaining 34% of the variance in creative achievement and correctly classifying 85% of individuals with high achievement irrespective of diagnosis. These results confirm and extend earlier observations of a shared vulnerability between creativity and bipolar disorder and suggest that mild to moderate expressions of bipolar spectrum traits are associated with enhanced cognitive functioning and creative expression. Further investigation of these traits is needed to clarify the nature of this shared vulnerability and suggest individualized treatment strategies to improve clinical outcomes in bipolar disorder.

Clinical and Cognitive Correlates of Insight in Bipolar Disorder

Insight is greatly impaired in Bipolar Disorder (BD), especially during mania. Cognitive impairment is also present in BD. Despite that, few studies have investigated a possible association between these two aspects. The main goal of the current study is to compare BD affective states regarding performance in cognitive testing and investigate clinical and cognitive predictors for insight loss in BD. The study investigated a sample of 65 patients who were evaluated in one of the BD phases (mania, euthymia or depression). All the subjects underwent neuropsychological evaluation and completed the Insight Scale for Affective Disorders (ISAD). The relationship between level of insight and clinical/cognitive variables was analyzed through multiple regression models. No significant differences were found among BD phases regarding performance on cognitive testing. Insight was more impaired in mania then in depression or euthymia. Predictors for loss of insight were: severity of manic symptoms and impairments in selective attention (Symbol search test), divided attention (Trail making test) and inhibition (Stroop test). The sample size is a potential limitation of the current study. Nevertheless, the results suggest this had limited impact, with group differences being detected for a number of variables. The results found have important clinical importance, suggesting, for example, that rehabilitation of specific cognitive skills may improve insight in BD.

Creativity and Mood Disorder: A Systematic Review and Meta-Analysis

Although the belief that creativity is related to psychopathology is prevalent, empirical evidence is limited. Research findings relating to mood disorder in particular are mixed, possibly as a result of differing research approaches (e.g., assessing the creativity of individuals with versus without mood disorder opposed to the prevalence of mood disorder in creative versus noncreative individuals). Therefore, a systematic review and meta-analysis were conducted to investigate prior research examining the link between mood disorder and creativity from three distinct research approaches. Multilevel random effects models were used to calculate the overall effect size for studies that assessed (a) creativity in a clinical versus nonclinical sample ( k = 13), (b) mood disorder in a creative versus noncreative sample ( k = 10), and (c) the correlation between dimensional measures of creativity and mood disorder symptoms ( k = 15). Potential moderators were examined using meta-regression and subgroup analyses, as significant heterogeneity was detected among the effects in all three analyses. Results reveal a differential strength and pattern of effects across the three analyses, suggesting that the relationship between creativity and mood disorder differs according to the research approach. The theoretical implications of results and potential mechanisms responsible for the relationship between creativity and mood disorder are discussed.

Performance of Bipolar Disorder Patients in Attention Testing: Comparison with Normal Controls and Among Manic, Depressive, and Euthymic Phases

Several studies on cognition in bipolar disorder (BD) have been developed on the last decade. Neuropsychological evaluation of attention in BD patients is fundamental since alterations in attention affect other cognitive functions. Evaluate if performance of BD patients in attention tests varies according to each phase of the disease and verify if there are differences in attention when comparing BD patients with normal controls. The study included 101 BD patients, with ages between 18 and 65 years, being 52 euthymic, 22 manic and 27 depressive, besides 30 normal controls. All subjects were evaluated though Hamilton Depression Scale, Young Mania Rating Scale and Global Assessment of Functioning, bipolar version (CGI-BP). Attention was evaluated through a neuropsychological battery. Normal controls had a better performance in selective attention tests than BD patients. No differences were found among manic, depressive and euthymic phases. Attention is markedly impaired in BD. Nevertheless, the results of this study do not imply that the severity of the attention deficit in BD patients varies according to decease phase.

The assessment of creativity in creativity/psychopathology research - a systematic review

INTRODUCTION

The possible link between creativity and psychopathology has been a long time focus of research up to the present day. However, this research is hampered by methodological problems, especially the definition and assessment of creativity. This makes interpretation and comparison of studies difficult and possibly accounts for the contradictory results of this research.

METHODS

In this systematic review of the literature, research articles in the field of creativity and psychopathology were searched for creativity assessment tools. The tools used in the collected articles are presented and discussed.

RESULTS

The results indicate that a multitude of creativity assessment tools were used, that many studies only used one tool to assess creativity and that most of these tools were only used in a limited number of studies. A few assessment tools stand out by a more frequent use, also outside psychopathological research, and more solid psychometric properties.

CONCLUSION

Most scales used to evaluate creativity have poor psychometric properties. The scattered methodology to assess creativity compromises the generalizability and validity of this research. The field should creatively develop new validated instruments.

Epigenetic Modulation of Mood Disorders

BACKGROUND

Mood disorders are expressed in many heterogeneous forms, varying from anxiety to severe major clinical depression. The disorders are expressed in individual variety through manifestations governed by co-morbidities, symptom frequency, severity, and duration, and the effects of genes on phenotypes. The underlying etiologies of mood disorders consist of complex interactive operations of genetic and environmental factors. The notion of endophenotypes, which encompasses the markers of several underlying liabilities to the disorders, may facilitate efforts to detect and define, through staging, the genetic risks inherent to the extreme complexity of disease state.

AIMS

This review evaluates the role of genetic biomarkers in assisting clinical diagnosis, identification of risk factors, and treatment of mood disorders.

METHODS

Through a systematic assessment of studies investigating the epigenetic basis for mood disorders, the present review examines the interaction of genes and environment underlying the pathophysiology of these disorders.

RESULTS

The majority of research findings suggest that the notion of endophenotypes, which encompasses the markers of several underlying liabilities to the disorders, may facilitate efforts to detect and define, through staging, the genetic risks inherent to the extreme complexity of the disease states. Several strategies under development and refinement show the propensity for derivation of essential elements in the etiopathogenesis of the disorders affecting drug-efficacy, drug metabolism, and drug adverse effects, e.g., with regard to selective serotonin reuptake inhibitors. These include: transporter gene expression and genes encoding receptor systems, hypothalamic-pituitary-adrenal axis factors, neurotrophic factors, and inflammatory factors affecting neuroimmune function. Nevertheless, procedural considerations of pharmacogenetics presume the parallel investment of policies and regulations to withstand eventual attempts at misuse, thereby ensuring patient integrity.

CONCLUSIONS

Identification of genetic biomarkers facilitates choice of treatment, prediction of response, and prognosis of outcome over a wide spectrum of symptoms associated with affective states, thereby optimizing clinical practice procedures. Epigenetic regulation of primary brain signaling, e.g., serotonin and hypothalamic-pituitary-adrenal function, and factors governing their metabolism are necessary considerations. The participation of neurotrophic factors remains indispensable for neurogenesis, survival, and functional maintenance of brain systems.