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Carracedo-Sanchidrian D, de Dios-Perrino C, Bayon-Perez C, Rodriguez-Vega B, Bravo-Ortiz MF, Ortega MÁ, González-Pinto AM, Lahera G. Effect of mindfulness-based cognitive therapy vs. psychoeducational intervention on plasma brain-derived neurotrophic factor and cognitive function in bipolar patients: a randomized controlled trial. Front Psychiatry 2024; 14:1279342. [PMID: 38250270 PMCID: PMC10796620 DOI: 10.3389/fpsyt.2023.1279342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 12/13/2023] [Indexed: 01/23/2024] Open
Abstract
Introduction Few controlled trials have assessed the benefits of Mindfulness Based Cognitive Therapy (MBCT) on cognitive functions and brain-derived neurotrophic factor (BDNF) in bipolar disorder (BD). This study aims to evaluate the impact of MBCT adjunctive treatment on these variables. Main hypothesis was that MBCT would improve cognitive functioning and BDNF more than Psychoeducation and TAU. Methods Randomized, multicenter, prospective and single-blinded trial. Included BD outpatients randomly assigned to three treatment arms: MBCT plus treatment as usual (TAU), Psychoeducation plus Tau and TAU. Cognitive functions were assessed with Continuous Performance Test-III, Stroop Test, Trail Making Test, Digit Span and Letter-Number Sequencing from Wechsler Adult Intelligence Scale III, Face Emotion Identification Task and Face Emotion Discrimination Task. BDNF serum level was measured with ELISA. Patients were assessed at baseline, 8 weeks and 6 months. Results Eighty-four patients were recruited (TAU = 10, Psychoeducation = 34, MBCT = 40). No significant differences between treatment groups were found. MBCT does not achieve better results than Psychoeducation or TAU. Discussion Being Psychoeducation and TAU efficient interventions, as well as the scarce duration of a more complex intervention, such as MBCT, are suggested as explanatory variables of these results. Trial registration ClinicalTrials.gov: NCT02133170. Registered 04/30/2014.
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Affiliation(s)
- Diego Carracedo-Sanchidrian
- Department of Psychiatry, University Hospital La Paz, Madrid, Spain
- La Paz Hospital Institute for Health Research (IdiPAZ), Madrid, Spain
| | - Consuelo de Dios-Perrino
- Department of Psychiatry, University Hospital La Paz, Madrid, Spain
- La Paz Hospital Institute for Health Research (IdiPAZ), Madrid, Spain
- Autonomous University of Madrid (UAM), Madrid, Spain
| | - Carmen Bayon-Perez
- Department of Psychiatry, University Hospital La Paz, Madrid, Spain
- La Paz Hospital Institute for Health Research (IdiPAZ), Madrid, Spain
- Autonomous University of Madrid (UAM), Madrid, Spain
| | - Beatriz Rodriguez-Vega
- Department of Psychiatry, University Hospital La Paz, Madrid, Spain
- La Paz Hospital Institute for Health Research (IdiPAZ), Madrid, Spain
- Autonomous University of Madrid (UAM), Madrid, Spain
| | - Maria-Fe Bravo-Ortiz
- Department of Psychiatry, University Hospital La Paz, Madrid, Spain
- La Paz Hospital Institute for Health Research (IdiPAZ), Madrid, Spain
- Autonomous University of Madrid (UAM), Madrid, Spain
| | - Miguel Á. Ortega
- Faculty of Medicine and Health Sciences, University of Alcalá, Madrid, Spain
- CIBERSAM, Ramón y Cajal Institute of Sanitary Research (IRYCIS), Madrid, Spain
| | - Ana-Maria González-Pinto
- BIOARABA, UPV/EHU, CIBERSAM, Department of Psychiatry, Hospital Santiago Apostol, Vitoria, Spain
| | - Guillermo Lahera
- Faculty of Medicine and Health Sciences, University of Alcalá, Madrid, Spain
- CIBERSAM, Ramón y Cajal Institute of Sanitary Research (IRYCIS), Madrid, Spain
- Principe de Asturias University Hospital, Alcalá, Spain
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Shkundin A, Halaris A. Associations of BDNF/BDNF-AS SNPs with Depression, Schizophrenia, and Bipolar Disorder. J Pers Med 2023; 13:1395. [PMID: 37763162 PMCID: PMC10533016 DOI: 10.3390/jpm13091395] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Revised: 09/12/2023] [Accepted: 09/15/2023] [Indexed: 09/29/2023] Open
Abstract
Brain-Derived Neurotrophic Factor (BDNF) is crucial for various aspects of neuronal development and function, including synaptic plasticity, neurotransmitter release, and supporting neuronal differentiation, growth, and survival. It is involved in the formation and preservation of dopaminergic, serotonergic, GABAergic, and cholinergic neurons, facilitating efficient stimulus transmission within the synaptic system and contributing to learning, memory, and overall cognition. Furthermore, BDNF demonstrates involvement in neuroinflammation and showcases neuroprotective effects. In contrast, BDNF antisense RNA (BDNF-AS) is linked to the regulation and control of BDNF, facilitating its suppression and contributing to neurotoxicity, apoptosis, and decreased cell viability. This review article aims to comprehensively overview the significance of single nucleotide polymorphisms (SNPs) in BDNF/BDNF-AS genes within psychiatric conditions, with a specific focus on their associations with depression, schizophrenia, and bipolar disorder. The independent influence of each BDNF/BDNF-AS gene variation, as well as the interplay between SNPs and their linkage disequilibrium, environmental factors, including early-life experiences, and interactions with other genes, lead to alterations in brain architecture and function, shaping vulnerability to mental health disorders. The potential translational applications of BDNF/BDNF-AS polymorphism knowledge can revolutionize personalized medicine, predict disease susceptibility, treatment outcomes, and guide the selection of interventions tailored to individual patients.
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Affiliation(s)
| | - Angelos Halaris
- Department of Psychiatry and Behavioral Neurosciences, Loyola University Chicago Stritch School of Medicine, Loyola University Medical Center, Maywood, IL 60153, USA
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Chen PH, Tsai SY, Pan CH, Chen YL, Su SS, Chen CC, Kuo CJ. Prevalence and 5-year trend of incidence for medical illnesses after the diagnosis of bipolar disorder: A nationwide cohort study. Aust N Z J Psychiatry 2022; 56:1164-1176. [PMID: 34558298 DOI: 10.1177/00048674211046891] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Medical comorbidities are prevalent in patients with bipolar disorder. Evaluating longitudinal trends of the incidence of medical illnesses enables implementation of early prevention strategies to reduce the high mortality rate in this at-risk population. However, the incidence risks of medical illnesses in the early stages of bipolar disorder remain unclear. This study investigated the incidence and 5-year trend of medical illnesses following bipolar disorder diagnosis. METHODS We identified 11,884 patients aged 13-40 years who were newly diagnosed as having bipolar disorder during 1996-2012 and 47,536 age- and sex-matched controls (1:4 ratio) who represented the general population from Taiwan's National Health Insurance Research Database. We estimated the prevalence and incidence of individual medical illnesses yearly across the first 5 years after the index date. The adjusted incidence rate ratio was calculated to compare the occurrence of specific medical illnesses each year between the bipolar disorder group and control group using the Poisson regression model. RESULTS Apart from the prevalence, the adjusted incidence rate ratios of most medical illnesses were >1.00 across the first 5-year period after bipolar disorder diagnosis. Cerebrovascular diseases, ischaemic heart disease, congestive heart failure, other forms of heart disease, renal disease and human immunodeficiency virus infection exhibited the highest adjusted incidence rate ratios during the first year. Except for that of renal disease, the 5-year trends of the adjusted incidence rate ratios decreased for cerebrovascular diseases, cardiovascular diseases (e.g. ischaemic heart disease, other forms of heart disease, and vein and lymphatic disease), gastrointestinal diseases (e.g. chronic hepatic disease and ulcer disease) and communicable diseases (e.g. human immunodeficiency virus infection, upper respiratory tract infection and pneumonia). CONCLUSION Incidence risks of medical illnesses are increased in the first year after bipolar disorder diagnosis. Clinicians must carefully evaluate medical illnesses during this period because the mortality rates from medical illnesses are particularly high in people with bipolar disorder.
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Affiliation(s)
- Pao-Huan Chen
- Department of Psychiatry, Taipei Medical University Hospital, Taipei.,Psychiatric Research Center, Taipei Medical University Hospital, Taipei.,Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei
| | - Shang-Ying Tsai
- Department of Psychiatry, Taipei Medical University Hospital, Taipei.,Psychiatric Research Center, Taipei Medical University Hospital, Taipei.,Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei
| | - Chun-Hung Pan
- Department of Psychiatry, Taipei City Psychiatric Center, Taipei City Hospital, Taipei.,Department of Psychology, National Chengchi University, Taipei
| | - Yi-Lung Chen
- Department of Psychiatry, Taipei City Psychiatric Center, Taipei City Hospital, Taipei.,Department of Counseling Psychology, Chinese Culture University, Taipei
| | - Sheng-Siang Su
- Department of Psychiatry, Taipei City Psychiatric Center, Taipei City Hospital, Taipei
| | - Chiao-Chicy Chen
- Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei.,Department of Psychiatry, Mackay Memorial Hospital, Taipei.,Department of Psychiatry, Mackay Medical College, Taipei
| | - Chian-Jue Kuo
- Psychiatric Research Center, Taipei Medical University Hospital, Taipei.,Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei.,Department of Psychiatry, Taipei City Psychiatric Center, Taipei City Hospital, Taipei
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Su L, Shuai Y, Mou S, Shen Y, Shen X, Shen Z, Zhang X. Development and validation of a nomogram based on lymphocyte subsets to distinguish bipolar depression from major depressive disorder. Front Psychiatry 2022; 13:1017888. [PMID: 36276314 PMCID: PMC9583168 DOI: 10.3389/fpsyt.2022.1017888] [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: 08/12/2022] [Accepted: 09/13/2022] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE Bipolar depression (BD) and major depressive disorder (MDD) are both common affective disorders. The common depression episodes make it difficult to distinguish between them, even for experienced clinicians. Failure to properly diagnose them in a timely manner leads to inappropriate treatment strategies. Therefore, it is important to distinguish between BD and MDD. The aim of this study was to develop and validate a nomogram model that distinguishes BD from MDD based on the characteristics of lymphocyte subsets. MATERIALS AND METHODS A prospective cross-sectional study was performed. Blood samples were obtained from participants who met the inclusion criteria. The least absolute shrinkage and selection operator (LASSO) regression model was used for factor selection. A differential diagnosis nomogram for BD and MDD was developed using multivariable logistic regression and the area under the curve (AUC) with 95% confidence interval (CI) was calculated, as well as the internal validation using a bootstrap algorithm with 1,000 repetitions. Calibration curve and decision curve analysis (DCA) were used to evaluate the calibration and clinical utility of the nomogram, respectively. RESULTS A total of 166 participants who were diagnosed with BD (83 cases) or MDD (83 cases), as well as 101 healthy controls (HCs) between June 2018 and January 2022 were enrolled in this study. CD19+ B cells, CD3+ T cells, CD3-CD16/56+ NK cells, and total lymphocyte counts were strong predictors of the diagnosis of BD and MDD and were included in the differential diagnosis nomogram. The AUC of the nomogram and internal validation were 0.922 (95%; CI, 0.879-0.965), and 0.911 (95% CI, 0.838-0.844), respectively. The calibration curve used to discriminate BD from MDD showed optimal agreement between the nomogram and the actual diagnosis. The results of DCA showed that the net clinical benefit was significant. CONCLUSION This is an easy-to-use, repeatable, and economical nomogram for differential diagnosis that can help clinicians in the individual diagnosis of BD and MDD patients, reduce the risk of misdiagnosis, facilitate the formulation of appropriate treatment strategies and intervention plans.
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Affiliation(s)
- Liming Su
- Department of Neurosis and Psychosomatic Diseases, Huzhou Third Municipal Hospital, The Affiliated Hospital of Huzhou University, Huzhou, China
| | - Yibing Shuai
- Department of Neurosis and Psychosomatic Diseases, Huzhou Third Municipal Hospital, The Affiliated Hospital of Huzhou University, Huzhou, China
| | - Shaoqi Mou
- Department of Psychiatry, Wenzhou Medical University, Wenzhou, China
| | - Yue Shen
- Department of Neurosis and Psychosomatic Diseases, Huzhou Third Municipal Hospital, The Affiliated Hospital of Huzhou University, Huzhou, China
| | - Xinhua Shen
- Department of Neurosis and Psychosomatic Diseases, Huzhou Third Municipal Hospital, The Affiliated Hospital of Huzhou University, Huzhou, China
| | - Zhongxia Shen
- Department of Neurosis and Psychosomatic Diseases, Huzhou Third Municipal Hospital, The Affiliated Hospital of Huzhou University, Huzhou, China
| | - Xiaomei Zhang
- Department of Neurosis and Psychosomatic Diseases, Huzhou Third Municipal Hospital, The Affiliated Hospital of Huzhou University, Huzhou, China
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Studart-Bottó P, Bezerra-Filho S, Sarmento S, Miranda-Scippa Â. Social support in patients with bipolar disorder and differing ages at onset. Clin Psychol Psychother 2021; 29:351-359. [PMID: 34128280 DOI: 10.1002/cpp.2617] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Revised: 05/20/2021] [Accepted: 05/21/2021] [Indexed: 12/18/2022]
Abstract
OBJECTIVE The main purpose of this study was to evaluate the association between age at onset and social support in outpatients with bipolar disorder who were in the recovery phase. We also investigated the association between age at onset and disability. METHODS A total of 180 bipolar disorder I outpatients, of whom 50 had early onset with age at onset ≤18 years old, 108 had middle onset with age at onset between 19 and 39 years old, and 22 had late onset with age at onset ≥40 years old, were assessed with the Medical Outcomes Study Social Support Scale and Sheehan Disability Scale. RESULTS The early onset group had lower tangible social support, longer length of illness, more childless participants, lower income and more suicide attempters than the late onset group. CONCLUSIONS Early onset seems to have inferior outcomes in tangible social support than late onset, but this trend should be considered as a starting point for future studies.
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Affiliation(s)
- Paula Studart-Bottó
- Mood and Anxiety Disorders Program (CETHA), University Hospital, Federal University of Bahia (UFBA), Salvador, Brazil.,Postgraduate Program in Medicine and Health, UFBA, Salvador, Brazil
| | - Severino Bezerra-Filho
- Mood and Anxiety Disorders Program (CETHA), University Hospital, Federal University of Bahia (UFBA), Salvador, Brazil
| | - Stella Sarmento
- Mood and Anxiety Disorders Program (CETHA), University Hospital, Federal University of Bahia (UFBA), Salvador, Brazil.,Postgraduate Program in Medicine and Health, UFBA, Salvador, Brazil
| | - Ângela Miranda-Scippa
- Mood and Anxiety Disorders Program (CETHA), University Hospital, Federal University of Bahia (UFBA), Salvador, Brazil.,Postgraduate Program in Medicine and Health, UFBA, Salvador, Brazil.,Department of Neurosciences and Mental Health, Medical School, UFBA, Salvador, Brazil
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