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Grigoroiu-Serbanescu M, van der Veen T, Bigdeli T, Herms S, Diaconu CC, Neagu AI, Bass N, Thygesen J, Forstner AJ, Nöthen MM, McQuillin A. Schizophrenia polygenic risk scores, clinical variables and genetic pathways as predictors of phenotypic traits of bipolar I disorder. J Affect Disord 2024; 356:507-518. [PMID: 38640977 DOI: 10.1016/j.jad.2024.04.066] [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: 12/17/2023] [Revised: 04/05/2024] [Accepted: 04/16/2024] [Indexed: 04/21/2024]
Abstract
AIM We investigated the predictive value of polygenic risk scores (PRS) derived from the schizophrenia GWAS (Trubetskoy et al., 2022) (SCZ3) for phenotypic traits of bipolar disorder type-I (BP-I) in 1878 BP-I cases and 2751 controls from Romania and UK. METHODS We used PRSice-v2.3.3 and PRS-CS for computing SCZ3-PRS for testing the predictive power of SCZ3-PRS alone and in combination with clinical variables for several BP-I subphenotypes and for pathway analysis. Non-linear predictive models were also used. RESULTS SCZ3-PRS significantly predicted psychosis, incongruent and congruent psychosis, general age-of-onset (AO) of BP-I, AO-depression, AO-Mania, rapid cycling in univariate regressions. A negative correlation between the number of depressive episodes and psychosis, mainly incongruent and an inverse relationship between increased SCZ3-SNP loading and BP-I-rapid cycling were observed. In random forest models comparing the predictive power of SCZ3-PRS alone and in combination with nine clinical variables, the best predictions were provided by combinations of SCZ3-PRS-CS and clinical variables closely followed by models containing only clinical variables. SCZ3-PRS performed worst. Twenty-two significant pathways underlying psychosis were identified. LIMITATIONS The combined RO-UK sample had a certain degree of heterogeneity of the BP-I severity: only the RO sample and partially the UK sample included hospitalized BP-I cases. The hospitalization is an indicator of illness severity. Not all UK subjects had complete subphenotype information. CONCLUSION Our study shows that the SCZ3-PRS have a modest clinical value for predicting phenotypic traits of BP-I. For clinical use their best performance is in combination with clinical variables.
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Affiliation(s)
- Maria Grigoroiu-Serbanescu
- Psychiatric Genetics Research Unit, Alexandru Obregia Clinical Psychiatric Hospital, Bucharest, Romania.
| | - Tracey van der Veen
- Molecular Psychiatry Laboratory, Division of Psychiatry, University College London, London, UK
| | - Tim Bigdeli
- SUNY Downstate Medical Center, Brooklyn, NY, USA
| | - Stefan Herms
- Department of Biomedicine, University of Basel, Basel, Switzerland; Institute of Human Genetics, University of Bonn, School of Medicine, University Hospital Bonn, Germany
| | | | | | - Nicholas Bass
- Molecular Psychiatry Laboratory, Division of Psychiatry, University College London, London, UK
| | - Johan Thygesen
- Molecular Psychiatry Laboratory, Division of Psychiatry, University College London, London, UK; Institute of Health Informatics, University College London, London, UK
| | - Andreas J Forstner
- Institute of Human Genetics, University of Bonn, School of Medicine, University Hospital Bonn, Germany
| | - Markus M Nöthen
- Institute of Human Genetics, University of Bonn, School of Medicine, University Hospital Bonn, Germany
| | - Andrew McQuillin
- Molecular Psychiatry Laboratory, Division of Psychiatry, University College London, London, UK
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Zimmerman M. The value and limitations of self-administered questionnaires in clinical practice and epidemiological studies. World Psychiatry 2024; 23:210-212. [PMID: 38727038 PMCID: PMC11083863 DOI: 10.1002/wps.21191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/13/2024] Open
Affiliation(s)
- Mark Zimmerman
- Department of Psychiatry and Human Behavior, Brown University School of Medicine, South County Psychiatry, Cranston, RI, USA
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3
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Özer G, Işık İ, Escartín J. Is There Somebody Looking out for Me? A Qualitative Analysis of Bullying Experiences of Individuals Diagnosed with Bipolar Disorder. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:137. [PMID: 38397628 PMCID: PMC10887664 DOI: 10.3390/ijerph21020137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 01/23/2024] [Accepted: 01/25/2024] [Indexed: 02/25/2024]
Abstract
According to the World Health Organisation, there are globally 40 million individuals with bipolar disorder (BD), and they experience stigma and discrimination, as many people with mental illness do. Work bullying (WB) is a common organisational problem, deteriorating the well-being and performance of employees and organisations. Although WB experiences have been researched for over three decades, we do not know much about the experiences of this group and what they need to extend their work-life. The current research aims to understand the workplace bullying experiences of individuals with BD and factors that may foster or hinder their participation in the labour force. The research methodology was based on in-depth interviews with 19 employees diagnosed with BD. Bullying experiences were mapped onto the Negative Acts Questionnaire. The data were analysed using the deductive qualitative content analysis on MAXQDA. Results showed that individuals with BD were exposed to bullying in work settings. Perceived reasons for the negative behaviours were mainly the undesirable individual characteristics of the bully, prejudices toward bipolar disorder, and already-existing toxic behaviours within the organisation. To reduce bullying, participants suggested that, among others, top management include equal and fair treatment of disadvantaged employees as performance criteria for supervisors and that organisations provide training against bullying, investigate complaints, apply sanctions, and establish an inclusive environment. If organisations set a stable and enduring vision, enhance a common identity for all employees, work on team building, and emphasise team efforts and goals, the organisational environment would be more inclusive, and individuals with BD would have longer work lives.
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Affiliation(s)
- Gülüm Özer
- Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London SE5 8AF, UK;
| | - İdil Işık
- Department of Psychology, Faculty of Economics, Administrative and Social Sciences, Bahcesehir University, Istanbul 34353, Türkiye;
| | - Jordi Escartín
- Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London SE5 8AF, UK;
- Department of Social Psychology and Quantitative Psychology, University of Barcelona, 08035 Barcelona, Spain
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4
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Pavlova B, Warnock-Parkes E, Alda M, Uher R, Clark DM. Cognitive behavioural therapy for social anxiety disorder in people with bipolar disorder: a case series. Int J Bipolar Disord 2024; 12:1. [PMID: 38180531 PMCID: PMC10769945 DOI: 10.1186/s40345-023-00321-8] [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: 06/20/2023] [Accepted: 11/27/2023] [Indexed: 01/06/2024] Open
Abstract
BACKGROUND Social anxiety disorder increases the likelihood of unfavourable outcomes in people with bipolar disorder. Cognitive behavioural therapy (CBT) is the first-line treatment for social anxiety disorder. However, people with bipolar disorder have been excluded from the studies that this recommendation is based on. METHOD: We completed a case series to obtain initial data on whether CBT is an acceptable, safe, and effective treatment for social anxiety disorder in people with bipolar disorder. RESULTS Eleven euthymic participants with bipolar disorder attended up to sixteen treatment and three follow-up sessions of CBT for social anxiety disorder. Participants attended on average 95% of the offered CBT sessions. No adverse events were reported. Participants' mean score on the Social Phobia Inventory decreased from 46.5 (SD 6.6) before the treatment to 19.8 (SD 11.9) at the end of the sixteen-session intervention and further to 15.8 (SD 10.3) by the end of the 3-month follow-up. This degree of improvement is equivalent to the effect observed in studies of CBT for social anxiety disorder in people without severe mental illness. CONCLUSIONS This case series provides preliminary evidence that CBT is acceptable, safe, and effective for treating social anxiety disorder in people with bipolar disorder during euthymia. A randomized controlled trial is needed to confirm these findings, and to establish whether treatment for social anxiety disorder improves the course of bipolar disorder.
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Affiliation(s)
- Barbara Pavlova
- Department of Psychiatry, Dalhousie University, 5909 Veterans' Memorial Lane, Halifax, NS, B3H 2E2, Canada.
- Nova Scotia Health, Halifax, NS, Canada.
| | - Emma Warnock-Parkes
- Department of Experimental Psychology, University of Oxford, Oxford, UK
- King's College London, London, UK
| | - Martin Alda
- Department of Psychiatry, Dalhousie University, 5909 Veterans' Memorial Lane, Halifax, NS, B3H 2E2, Canada
- Nova Scotia Health, Halifax, NS, Canada
| | - Rudolf Uher
- Department of Psychiatry, Dalhousie University, 5909 Veterans' Memorial Lane, Halifax, NS, B3H 2E2, Canada
- Nova Scotia Health, Halifax, NS, Canada
| | - David M Clark
- Department of Experimental Psychology, University of Oxford, Oxford, UK
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5
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Lane NM, Smith DJ. Bipolar disorder: Diagnosis, treatment and future directions. J R Coll Physicians Edinb 2023; 53:192-196. [PMID: 37649414 DOI: 10.1177/14782715231197577] [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] [Indexed: 09/01/2023] Open
Abstract
Bipolar disorder is a relatively common mental illness, characterised by recurrent episodes of mania (or hypomania) and major depression, and associated with a significant burden of morbidity and premature mortality. Physicians across all specialities are likely to encounter individuals with the condition within their clinical practice. This short review provides an up-to-date overview of the clinical features, epidemiology, pathophysiology, evidence-based management, prognosis and future directions for treatment and research in bipolar disorder. Aspects of cross-specialty relevance are highlighted, including the physical health burden associated with the condition, and the side effects and safety considerations of medication regimes used in bipolar disorder.
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Affiliation(s)
- Natalie M Lane
- Department of Psychiatry, Stobhill Hospital, NHS Greater Glasgow & Clyde, Glasgow, UK
| | - Daniel J Smith
- Centre for Clinical Brain Sciences, The University of Edinburgh, Edinburgh, UK
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6
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D'Avanzo B, Barbato A, Monzio Compagnoni M, Caggiu G, Allevi L, Carle F, Di Fiandra T, Ferrara L, Gaddini A, Sanza M, Saponaro A, Scondotto S, Tozzi VD, Giordani C, Corrao G, Lora A. The quality of mental health care for people with bipolar disorders in the Italian mental health system: the QUADIM project. BMC Psychiatry 2023; 23:424. [PMID: 37312076 PMCID: PMC10261835 DOI: 10.1186/s12888-023-04921-7] [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] [Received: 02/22/2023] [Accepted: 05/31/2023] [Indexed: 06/15/2023] Open
Abstract
BACKGROUND The assessment of the quality of care pathways delivered to people with severe mental disorders in a community-based system remains uncommon, especially using healthcare utilization databases. The aim of the study was to evaluate the quality of care provided to people with bipolar disorders taken-in-care by mental health services of four Italian areas (Lombardy, Emilia-Romagna, Lazio, province of Palermo). METHODS Thirty-six quality indicators were implemented to assess quality of mental health care for patients with bipolar disorders, according to three dimensions (accessibility and appropriateness, continuity, and safety). Data were retrieved from healthcare utilization (HCU) databases, which contain data on mental health treatments, hospital admissions, outpatient interventions, laboratory tests and drug prescriptions. RESULTS 29,242 prevalent and 752 incident cases taken-in-care by regional mental health services with a diagnosis of bipolar disorder in 2015 were identified. Age-standardized treated prevalence rate was 16.2 (per 10,000 adult residents) and treated incidence rate 1.3. In the year of evaluation, 97% of prevalent cases had ≥ 1 outpatient/day-care contacts and 88% had ≥ 1 psychiatric visits. The median of outpatient/day-care contacts was 9.3 interventions per-year. Psychoeducation was provided to 3.5% of patients and psychotherapy to 11.5%, with low intensity. 63% prevalent cases were treated with antipsychotics, 71.5% with mood stabilizers, 46.6% with antidepressants. Appropriate laboratory tests were conducted in less than one-third of prevalent patients with a prescription of antipsychotics; three quarters of those with a prescription of lithium. Lower proportions were observed for incident patients. In prevalent patients, the Standardized Mortality Ratio was 1.35 (95% CI: 1.26-1.44): 1.18 (1.07-1.29) in females, 1.60 (1.45-1.77) in males. Heterogeneity across areas was considerable in both cohorts. CONCLUSIONS We found a meaningful treatment gap in bipolar disorders in Italian mental health services, suggesting that the fact they are entirely community-based does not assure sufficient coverage by itself. Continuity of contacts was sufficient, but intensity of care was low, suggesting the risk of suboptimal treatment and low effectiveness. Care pathways were monitored and evaluated using administrative healthcare databases, adding evidence that such data may contribute to assess the quality of clinical pathways in mental health.
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Affiliation(s)
- Barbara D'Avanzo
- Department of Health Policy, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy
| | - Angelo Barbato
- Department of Health Policy, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy
| | - Matteo Monzio Compagnoni
- National Centre for Healthcare Research and Pharmacoepidemiology, University of Milano-Bicocca, Milan, Italy.
- Unit of Biostatistics, Epidemiology and Public Health, Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Street Bicocca degli Arcimboldi, 8, Building U7, Milan, 20126, Italy.
| | - Giulia Caggiu
- National Centre for Healthcare Research and Pharmacoepidemiology, University of Milano-Bicocca, Milan, Italy
- Unit of Biostatistics, Epidemiology and Public Health, Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Street Bicocca degli Arcimboldi, 8, Building U7, Milan, 20126, Italy
- Department of Mental Health and Addiction Services, ASST Lecco, Lecco, Italy
| | - Liliana Allevi
- Department of Mental Health and Addiction Services, ASST Lecco, Lecco, Italy
| | - Flavia Carle
- National Centre for Healthcare Research and Pharmacoepidemiology, University of Milano-Bicocca, Milan, Italy
- Center of Epidemiology and Biostatistics, Polytechnic University of Marche, Ancona, Italy
| | | | - Lucia Ferrara
- Centre of Research on Health and Social Care Management, SDA Bocconi School of Management (Bocconi University, Milan, Italy
| | | | - Michele Sanza
- Department of Mental Health and Substance Abuse, Local Health Trust of Romagna, Cesena, Italy
| | - Alessio Saponaro
- General Directorate of Health and Social Policies, Emilia-Romagna Region, Bologna, Italy
| | - Salvatore Scondotto
- National Centre for Healthcare Research and Pharmacoepidemiology, University of Milano-Bicocca, Milan, Italy
- Department of Health Services and Epidemiological Observatory, Regional Health Authority, Sicily Region, Palermo, Italy
| | - Valeria D Tozzi
- Centre of Research on Health and Social Care Management, SDA Bocconi School of Management (Bocconi University, Milan, Italy
| | | | - Giovanni Corrao
- National Centre for Healthcare Research and Pharmacoepidemiology, University of Milano-Bicocca, Milan, Italy
- Unit of Biostatistics, Epidemiology and Public Health, Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Street Bicocca degli Arcimboldi, 8, Building U7, Milan, 20126, Italy
| | - Antonio Lora
- National Centre for Healthcare Research and Pharmacoepidemiology, University of Milano-Bicocca, Milan, Italy
- Department of Mental Health and Addiction Services, ASST Lecco, Lecco, Italy
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7
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Jidong DE, Husain MI, Ike TJ, Husain N, Taru MY, Nnaemeka NC, Francis C, Jack DB, Mwankon SB, Xue S, Pwajok JY, Nyam PP, Murshed M. Bipolar disorders in Nigeria: a mixed-methods study of patients, family caregivers, clinicians, and the community members' perspectives. Int J Bipolar Disord 2023; 11:2. [PMID: 36609729 PMCID: PMC9825686 DOI: 10.1186/s40345-022-00276-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 11/14/2022] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Bipolar Disorders (BDs) are chronic mental health disorders that often result in functional impairment and contribute significantly to the disability-adjusted life years (DALY). BDs are historically under-researched compared to other mental health disorders, especially in Sub-Saharan Africa and Nigeria. DESIGN We adopted a mixed-methods design. Study 1 examined the public knowledge of BDs in relation to sociodemographic outcomes using quantitative data whilst Study 2 qualitatively assessed the lived experiences of patients with BDs, clinicians, and family caregivers. METHODS In Study 1, a non-clinical sample of n = 575 participants responded to a compact questionnaire that examined their knowledge of BDs and how they relate to certain sociodemographic variables. One-way ANOVA was used to analyse quantitative data. Study 2 interviewed N = 15 participants (n = 5 patients with BDs; n = 7 clinicians; n = 3 family caregivers). These semi-structured interviews were audio-recorded, transcribed, and thematically analysed. RESULTS In Study 1, findings showed no statistically significant differences, suggesting low awareness of BDs, especially among vulnerable populations such as young people and older adults. However, there was a trajectory in increased knowledge of BDs among participants between the ages of 25-44 years and part-time workers compared to other ages and employment statuses. In Study 2, qualitative findings showed that BDs are perceived to be genetically and psycho-socially induced by specific lived experiences of patients and their family caregivers. Although psychotropic medications and psychotherapy are available treatment options in Nigeria, cultural and religious beliefs were significant barriers to treatment uptake. CONCLUSIONS This study provides insight into knowledge and beliefs about BDs, including the lived experiences of patients with BDs, their caregivers and clinicians in Nigeria. It highlights the need for further studies assessing Nigeria's feasibility and acceptability of culturally adapted psychosocial interventions for patients with BDs.
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Affiliation(s)
- Dung Ezekiel Jidong
- grid.12361.370000 0001 0727 0669Department of Psychology, Nottingham Trent University, 50 Shakespeare Street, Nottingham, NG1 4FQ UK
| | - M. Ishrat Husain
- grid.155956.b0000 0000 8793 5925Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Canada
| | - Tarela J. Ike
- grid.26597.3f0000 0001 2325 1783Department of Criminology & Sociology, Teesside University, Middlesbrough, UK
| | - Nusrat Husain
- grid.5379.80000000121662407Department of Psychiatry, University of Manchester, Manchester, UK
| | - Maigari Yusufu Taru
- grid.411946.f0000 0004 1783 4052Department of Psychiatry, Jos University Teaching Hospital, Jos, Nigeria
| | - Nwoga Charles Nnaemeka
- grid.411946.f0000 0004 1783 4052Department of Psychiatry, Jos University Teaching Hospital, Jos, Nigeria
| | - Christopher Francis
- grid.12361.370000 0001 0727 0669Department of Psychology, Nottingham Trent University, 50 Shakespeare Street, Nottingham, NG1 4FQ UK
| | - David B. Jack
- Global Mental Health, Dung Jidong Foundation, Jos, Nigeria
| | - Shadrack B. Mwankon
- grid.12361.370000 0001 0727 0669Department of Psychology, Nottingham Trent University, 50 Shakespeare Street, Nottingham, NG1 4FQ UK
| | - Siqi Xue
- grid.155956.b0000 0000 8793 5925Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Canada
| | - Juliet Y. Pwajok
- grid.412989.f0000 0000 8510 4538Department of Psychology, University of Jos, Jos, Nigeria
| | - Pam P. Nyam
- grid.12361.370000 0001 0727 0669Department of Psychology, Nottingham Trent University, 50 Shakespeare Street, Nottingham, NG1 4FQ UK
| | - Maisha Murshed
- grid.12361.370000 0001 0727 0669Department of Psychology, Nottingham Trent University, 50 Shakespeare Street, Nottingham, NG1 4FQ UK
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8
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Bennett CC, Ross MK, Baek E, Kim D, Leow AD. Smartphone accelerometer data as a proxy for clinical data in modeling of bipolar disorder symptom trajectory. NPJ Digit Med 2022; 5:181. [PMID: 36517582 PMCID: PMC9751066 DOI: 10.1038/s41746-022-00741-3] [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: 06/16/2022] [Accepted: 12/02/2022] [Indexed: 12/23/2022] Open
Abstract
Being able to track and predict fluctuations in symptoms of mental health disorders such as bipolar disorder outside the clinic walls is critical for expanding access to care for the global population. To that end, we analyze a dataset of 291 individuals from a smartphone app targeted at bipolar disorder, which contains rich details about their smartphone interactions (including typing dynamics and accelerometer motion) collected everyday over several months, along with more traditional clinical features. The aim is to evaluate whether smartphone accelerometer data could serve as a proxy for traditional clinical data, either by itself or in combination with typing dynamics. Results show that accelerometer data improves the predictive performance of machine learning models by nearly 5% over those previously reported in the literature based only on clinical data and typing dynamics. This suggests it is possible to elicit essentially the same "information" about bipolar symptomology using different data sources, in a variety of settings.
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Affiliation(s)
- Casey C. Bennett
- grid.49606.3d0000 0001 1364 9317Department of Intelligence Computing, Hanyang University, Seoul, Korea ,grid.254920.80000 0001 0707 2013Department of Computing, DePaul University, Chicago, IL USA
| | - Mindy K. Ross
- grid.185648.60000 0001 2175 0319Department of Psychiatry, University of Illinois–Chicago, Chicago, IL USA
| | - EuGene Baek
- grid.49606.3d0000 0001 1364 9317Department of Intelligence Computing, Hanyang University, Seoul, Korea
| | - Dohyeon Kim
- grid.49606.3d0000 0001 1364 9317Department of Intelligence Computing, Hanyang University, Seoul, Korea
| | - Alex D. Leow
- grid.185648.60000 0001 2175 0319Department of Psychiatry, University of Illinois–Chicago, Chicago, IL USA ,grid.185648.60000 0001 2175 0319Dept. of Biomedical Engineering, University of Illinois–Chicago, Chicago, IL USA
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Konuk N, Karaahmet E, Angın Ü, Kılıç A, Kökrek Z. Evaluation of mood disorder questionnaire positivity and associated factors in a population-based screening study. PSICOLOGIA, REFLEXAO E CRITICA : REVISTA SEMESTRAL DO DEPARTAMENTO DE PSICOLOGIA DA UFRGS 2022; 35:26. [PMID: 35951270 PMCID: PMC9372238 DOI: 10.1186/s41155-022-00229-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 07/29/2022] [Indexed: 11/13/2022]
Abstract
The Mood Disorders Questionnaire (MDQ) is a 3-item scale that is frequently used in bipolar disorders (BD) screening and questions the symptoms of BD, its effect on functionality, and the coexistence of symptoms. The aim of this study is to evaluate the prevalence of positive screening of the MDQ among general population and to investigate the associated risk factors. In this cross-sectional study, the sample was randomly selected from household data to represent the city population. A total of 432 participants were asked to fill in MDQ, CAGE (cutting down, annoyance by criticism, guilty feeling, and eye-openers) questionnaire, which consists of four clinical interview questions proven to aid in the diagnosis of alcoholism, and clinical and sociodemographic data form. The Cronbach’s alpha value of our current study was 0.813 for MDQ. The prevalence of MDQ positivity was found 7.6%. The estimated prevalence rate of bipolar disorders varied between 0.3 and 13.4% according to different cut-off values. Multivariate logistic regression models showed that the presence of possible alcohol addiction, shift work history, and body mass index (BMI) were statistically significant predictors of MDQ positivity. The prevalence of MDQ positivity found is similar to studies in literature. Keeping in mind that psychometric properties of the MDQ, positive screen results should be cautiously interpreted due to the presence of other risk factors and comorbidities.
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Affiliation(s)
- Numan Konuk
- Department of Psychiatry, Faculty of Medicine, Düzce University, Yörükler Mah., Konuralp Campus, Merkez, Düzce, 81620, Istanbul, Turkey
| | - Elif Karaahmet
- Department of Psychology, Faculty of Science and Literature, Haliç University, Sütlüce Mah., İmrahor Cd., No. 82, Sütlüce, 34445, Istanbul, Turkey
| | - Ülkem Angın
- Prof. Dr. Cemil Taşçıoğlu City Hospital, Department of Psychiatry, Ministry of Health Istanbul Provincial Health Directorate, Kaptan Paşa, SSK Okmeydanı Hst., No. 25, Şişli, 34384, Istanbul, Turkey
| | - Alperen Kılıç
- Department of Psychiatry, Faculty of Medicine, Istanbul Medipol University, TEM Avrupa Otoyolu Göztepe Çıkışı No: 1, Bağcılar, 34214, İstanbul, Turkey.
| | - Zekeriya Kökrek
- Department of Psychology, Faculty of Humanities and Social Sciences, İstanbul Ticaret University, Sütlüce, İmrahor Cd. No. 90, Beyoğlu, 34445, Istanbul, Turkey
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10
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Denissoff A, Mustonen A, Alakokkare A, Scott JG, Sami MB, Miettunen J, Niemelä S. Is early exposure to cannabis associated with bipolar disorder? Results from a Finnish birth cohort study. Addiction 2022; 117:2264-2272. [PMID: 35315149 PMCID: PMC9545505 DOI: 10.1111/add.15881] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 03/08/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND AND AIMS There are few longitudinal studies assessing the association of cannabis use and subsequent onset of bipolar disorder. We aimed to measure the association between early cannabis exposure and subsequent bipolar disorder. DESIGN, SETTING AND PARTICIPANTS Observational study linking a sample from the northern Finland birth cohort 1986 (n = 6325) to nation-wide register data to examine the association of life-time cannabis exposure at age 15/16 years and subsequent bipolar disorder until age 33 (until the end of 2018); 6325 individuals (48.8% males) were included in the analysis. MEASUREMENTS Cannabis exposure was measured via self-report. Bipolar disorder was measured via bipolar disorder-related diagnostic codes (ICD-10: F30.xx, F31.xx) collected from the Care Register for Health Care 2001-18, the Register of Primary Health Care Visits 2011-18, the medication reimbursement register of the Social Insurance Institution of Finland 2001-05 and the disability pensions of the Finnish Center for Pensions 2001-16. Potential confounders included demographic characteristics, parental psychiatric disorders, emotional and behavioral problems and other substance use. FINDINGS Three hundred and fifty-two adolescents (5.6%) reported any cannabis use until the age of 15-16 years. Of the whole sample, 66 (1.0%) were diagnosed with bipolar disorder. Adolescent cannabis use was associated with bipolar disorder [hazard ratio (HR) = 3.46; 95% confidence interval (CI) = 1.81-6.61]. This association remained statistically significant after adjusting for sex, family structure and parental psychiatric disorders (HR = 3.00; 95% CI = 1.47-6.13) and after further adjusting for adolescent emotional and behavioral problems (HR = 2.34; 95% CI = 1.11-4.94). Further adjustments for frequent alcohol intoxications, daily smoking and lifetime illicit drug use attenuated the associations to statistically non-significant. CONCLUSIONS In Finland, the positive association between early cannabis exposure and subsequent development of bipolar disorder appears to be confounded by other substance use.
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Affiliation(s)
- Alexander Denissoff
- Faculty of Medicine, Department of PsychiatryUniversity of TurkuTurkuFinland,Addiction Psychiatry Unit, Department of PsychiatryTurku University HospitalTurkuFinland
| | - Antti Mustonen
- Faculty of Medicine and Health TechnologyTampere UniversityTampereFinland,Department of PsychiatrySeinäjoki Central HospitalSeinäjokiFinland
| | - Anni‐Emilia Alakokkare
- Faculty of Medicine, Department of PsychiatryUniversity of TurkuTurkuFinland,Medical Research Center OuluOulu University Hospital and University of OuluOuluFinland
| | - James G. Scott
- QIMR Berghofer Medical Research InstituteHerstonQldAustralia,Metro North Mental Health ServiceHerstonQldAustralia
| | - Musa B. Sami
- Institute of Mental HealthUniversity of NottinghamNottinghamUK,Nottinghamshire Healthcare TrustNottinghamUK
| | - Jouko Miettunen
- Medical Research Center OuluOulu University Hospital and University of OuluOuluFinland,Center for Life Course Health ResearchUniversity of OuluOuluFinland
| | - Solja Niemelä
- Faculty of Medicine, Department of PsychiatryUniversity of TurkuTurkuFinland,Addiction Psychiatry Unit, Department of PsychiatryTurku University HospitalTurkuFinland
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Chen C, Chen Y, Huang Q, Yan S, Zhu J. Self-Care Ability of Patients With Severe Mental Disorders: Based on Community Patients Investigation in Beijing, China. Front Public Health 2022; 10:847098. [PMID: 35719645 PMCID: PMC9198226 DOI: 10.3389/fpubh.2022.847098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Accepted: 04/25/2022] [Indexed: 11/21/2022] Open
Abstract
Background Severe Mental Disorders have become a topic of increasing interest in research due to their serious consequences for the quality of life and functioning. In the pages that follow, it will be argued that the self-care ability and its influencing factors among patients with severe mental disorders in Beijing, according to the questionnaire survey in 2019. Methods Proportionate stratified sampling was used to select representative patients as samples. The demographic characteristics of were obtained from the Management Information System for Severe Mental Disorders and the questionnaires. The self-care ability was measured by self-made scales. Descriptive statistics, t-test, and multiple linear regression were used to analyze the data. Results We surveyed 662 people and found that the deficiency of self-care ability is common in patients with severe mental disorders. Self-care ability was positively correlated with educated levels and guardian takes care of alone, and negatively correlated with age, course of disease and physical disease (P < 0.05). From a dimensional perspective, the daily basic activity was positively correlated with educated levels and negatively correlated with physical disease (P < 0.05); the housework ability was positively correlated with gender, educated levels and medication adherence, and negatively correlated with source of income and physical disease (P < 0.05); the social function was positively correlated with educated levels, guardian takes care of alone and medication adherence, and negatively correlated with age, source of income, course of disease and physical disease (P < 0.05). Conclusion The self-care ability of patients with severe mental disorders is affected by many factors, including patient characteristics and social factors. Therefore, targeted interventions are needed to help patients restore their self-care ability, which requires the joint efforts of the government and the whole society.
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Affiliation(s)
- Chen Chen
- School of Public Health, Capital Medical University, Beijing, China.,Research Center for Capital Health Management and Policy, Beijing, China
| | - Yun Chen
- The National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China.,Beijing Institute of Mental Health, Beijing, China
| | - Qingzhi Huang
- The National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China.,Beijing Institute of Mental Health, Beijing, China
| | - Shengming Yan
- Department of Sociology, Peking University, Beijing, China
| | - Junli Zhu
- School of Public Health, Capital Medical University, Beijing, China.,Research Center for Capital Health Management and Policy, Beijing, China
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Wren GH, Humby T, Thompson AR, Davies W. Mood symptoms, neurodevelopmental traits, and their contributory factors in X-linked ichthyosis, ichthyosis vulgaris and psoriasis. Clin Exp Dermatol 2022; 47:1097-1108. [PMID: 35104372 PMCID: PMC9314151 DOI: 10.1111/ced.15116] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 01/26/2022] [Accepted: 01/27/2022] [Indexed: 11/28/2022]
Abstract
Background High rates of adverse mood/neurodevelopmental traits are seen in multiple dermatological conditions, and can significantly affect patient quality of life. Understanding the sex‐specific nature, magnitude, impact and basis of such traits in lesser‐studied conditions like ichthyosis, is important for developing effective interventions. Aim To quantify and compare relevant psychological traits in men with X‐linked ichthyosis (XLI, n = 54) or in XLI carrier women (n = 83) and in patients with ichthyosis vulgaris (IV, men n = 23, women n = 59) or psoriasis (men n = 30, women n = 122), and to identify factors self‐reported to contribute most towards depressive, anxious and irritable phenotypes. Methods Participants recruited via relevant charities or social media completed an online survey of established questionnaires. Data were analysed by sex and skin condition, and compared with general population data. Results Compared with the general population, there was a higher rate of lifetime prevalence of mood disorder diagnoses across all groups and of neurodevelopmental disorder diagnoses in the XLI groups. The groups exhibited similarly significant elevations in recent mood symptoms (Cohen d statistic 0.95–1.28, P < 0.001) and neurodevelopmental traits (d = 0.31–0.91, P < 0.05) compared with general population controls, and self‐reported moderate effects on quality of life and stigmatization. There were strong positive associations between neurodevelopmental traits and recent mood symptoms (r > 0.47, P < 0.01), and between feelings of stigmatization and quality of life, particularly in men. Numerous factors were identified as contributing significantly to mood symptoms in a condition or sex‐specific, or condition or sex‐independent, manner. Conclusion We found that individuals with XLI, IV or psoriasis show higher levels of mood disorder diagnoses and symptoms than matched general population controls, and that the prevalence and severity of these is similar across conditions. We also identified a number of factors potentially conferring either general or condition‐specific risk of adverse mood symptoms in the three skin conditions, which could be targeted clinically and/or through education programmes. In clinical practice, recognizing mood/neurodevelopmental problems in ichthyosis and psoriasis, and addressing the predisposing factors identified by this study should benefit the mental health of affected individuals.
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Affiliation(s)
| | - Trevor Humby
- School of Psychology, Cardiff University, Cardiff, UK
| | - Andrew R Thompson
- School of Psychology, Cardiff University, Cardiff, UK.,South Wales Clinical Psychology Doctoral Programme, Cardiff, Vale University Health Board, Cardiff, UK
| | - William Davies
- School of Psychology, Cardiff University, Cardiff, UK.,Neuroscience and Mental Health Research Institute, Cardiff University, Cardiff, UK.,MRC Centre for Neuropsychiatric Genetics and Genomics and Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, UK
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Specific cultural factors are associated with the incidence and burden of bipolar disorder: An ecological analysis of data from 115 countries. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2021. [DOI: 10.1016/j.jadr.2021.100203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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15
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Recart VM, Spohr L, Soares MSP, Luduvico KP, Stefanello FM, Spanevello RM. Therapeutic approaches employing natural compounds and derivatives for treating bipolar disorder: emphasis on experimental models of the manic phase. Metab Brain Dis 2021; 36:1481-1499. [PMID: 34264451 DOI: 10.1007/s11011-021-00776-7] [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: 12/30/2020] [Accepted: 06/06/2021] [Indexed: 12/19/2022]
Abstract
Bipolar disorder (BD) is a complex psychiatric disease characterized by mood swings that include episodes of mania and depression. Given its cyclical nature, BD is especially hard to model; however, the standard practice has been to mimic manic episodes in animal models. Despite scientific advances, the pathophysiology of BD is not fully understood, and treatment remains limited. In the last years, natural products have emerged as potential neuroprotective agents for the treatment of psychiatric diseases. Thus, the aim of this review was to explore the therapeutic potential of natural compounds and derivatives against BD, taking into account preclinical and clinical studies. Reliable articles indexed in databases such as PubMed, Web of Science and Science Direct were used. In clinical studies, treatment with herbal plants extracts, omega-3, inositol, n-acetylcysteine and vitamin D has been associated with a clinical improvement in symptoms of mania and depression in BD patients. In animal models, it has been shown that red fruits extracts, curcumin, quercetin, gallic acid, alpha-lipoic acid and carvone can modulate many neurochemical pathways involved in the pathophysiology of manic episodes. Thus, this review appointed the advances in the consumption of natural compounds and derivatives as an important therapeutic strategy to mitigate the symptoms of BD.
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Affiliation(s)
- Vânia Machado Recart
- Programa de Pós-Graduação em Bioquímica e Bioprospecção - Laboratório de Neuroquímica, Inflamação e Câncer, Centro de Ciências Químicas, Farmacêuticas e de Alimentos, Universidade Federal de Pelotas, Campus Universitário S/N, Capão Do Leão, Pelotas, RS, 96010-900, Brazil
| | - Luiza Spohr
- Programa de Pós-Graduação em Bioquímica e Bioprospecção - Laboratório de Neuroquímica, Inflamação e Câncer, Centro de Ciências Químicas, Farmacêuticas e de Alimentos, Universidade Federal de Pelotas, Campus Universitário S/N, Capão Do Leão, Pelotas, RS, 96010-900, Brazil
| | - Mayara Sandrielly Pereira Soares
- Programa de Pós-Graduação em Bioquímica e Bioprospecção - Laboratório de Neuroquímica, Inflamação e Câncer, Centro de Ciências Químicas, Farmacêuticas e de Alimentos, Universidade Federal de Pelotas, Campus Universitário S/N, Capão Do Leão, Pelotas, RS, 96010-900, Brazil
| | - Karina Pereira Luduvico
- Programa de Pós-Graduação em Bioquímica e Bioprospecção - Laboratório de Biomarcadores, Centro de Ciências Químicas, Farmacêuticas e de Alimentos, Universidade Federal de Pelotas, Campus Universitário S/N, Pelotas, RS, Brazil
| | - Francieli Moro Stefanello
- Programa de Pós-Graduação em Bioquímica e Bioprospecção - Laboratório de Biomarcadores, Centro de Ciências Químicas, Farmacêuticas e de Alimentos, Universidade Federal de Pelotas, Campus Universitário S/N, Pelotas, RS, Brazil
| | - Roselia Maria Spanevello
- Programa de Pós-Graduação em Bioquímica e Bioprospecção - Laboratório de Neuroquímica, Inflamação e Câncer, Centro de Ciências Químicas, Farmacêuticas e de Alimentos, Universidade Federal de Pelotas, Campus Universitário S/N, Capão Do Leão, Pelotas, RS, 96010-900, Brazil.
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Zimmerman M. Using Screening Scales for Bipolar Disorder in Epidemiologic Studies: Lessons Not Yet Learned. J Affect Disord 2021; 292:708-713. [PMID: 34161888 DOI: 10.1016/j.jad.2021.06.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Accepted: 06/05/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND In a recent issue in the journal, Humpston, Bebbington, and Marwaha (2021) reported the results of the first large epidemiological study of bipolar disorder in England. The prevalence estimate of bipolar disorder was based on the Mood Disorders Questionnaire (MDQ), a self-administered screening scale for a lifetime history of mania/hypomania. Humpston and colleagues found that the prevalence of bipolar disorder in England was similar to the rates in other parts of the world, and they stated that most individuals with bipolar disorder in England did not receive treatment for the disorder in the past year. A better understanding of the statistics of screening and the performance of the MDQ would indicate that the conclusions drawn from the epidemiological study are not justified. METHODS I review the principles and statistics of diagnostic screening and how screening is distinguished from case-finding. I then review the performance of the MDQ in the general population and calculate the positive predictive value of the MDQ in the study by Humpston and colleagues. RESULTS The developers of the MDQ reported a sensitivity of 28.1% and specificity of 97.2% in the general population based on a cutoff score of 7. Using this same cutoff, Humpston and colleagues reported the prevalence of "probable" bipolar disorder was 1.7%. Based on these data, the positive predictive value of the MDQ would be only 14.8%. LIMITATIONS Humpson et al. did not compare the MDQ to a diagnostic interview in their study; thus, the performance of the MDQ was estimated from another general population study. CONCLUSIONS When studying a disorder with a relatively low prevalence, it is near impossible for a screening test to have sufficient positive predictive value to be used to validly compare the individuals who do and do not screen positive. Most of the individuals whom Humpston et al. considered to have "probable" bipolar disorder would not have received the diagnosis had they been directly interviewed. Thus, the results of the Humpston et al. study are not a valid indicator of the correlates of bipolar disorder in the general population of England.
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Affiliation(s)
- Mark Zimmerman
- Department of Psychiatry and Human Behavior, Brown University School of Medicine, Rhode Island Hospital, Providence, RI..
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