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Ghaemi SN, Angst J, Vohringer PA, Youngstrom EA, Phelps J, Mitchell PB, McIntyre RS, Bauer M, Vieta E, Gershon S. Clinical research diagnostic criteria for bipolar illness (CRDC-BP): rationale and validity. Int J Bipolar Disord 2022; 10:23. [PMID: 36227452 DOI: 10.1186/s40345-022-00267-3] [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: 12/15/2021] [Accepted: 06/16/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In the 1970 s, scientific research on psychiatric nosology was summarized in Research Diagnostic Criteria (RDC), based solely on empirical data, an important source for the third revision of the official nomenclature of the American Psychiatric Association in 1980, the Diagnostic and Statistical Manual, Third Edition (DSM-III). The intervening years, especially with the fourth edition in 1994, saw a shift to a more overtly "pragmatic" approach to diagnostic definitions, which were constructed for many purposes, with research evidence being only one consideration. The latest editions have been criticized as failing to be useful for research. Biological and clinical research rests on the validity of diagnostic definitions that are supported by firm empirical foundations, but critics note that DSM criteria have failed to prioritize research data in favor of "pragmatic" considerations. RESULTS Based on prior work of the International Society for Bipolar Diagnostic Guidelines Task Force, we propose here Clinical Research Diagnostic Criteria for Bipolar Illness (CRDC-BP) for use in research studies, with the hope that these criteria may lead to further refinement of diagnostic definitions for other major mental illnesses in the future. New proposals are provided for mixed states, mood temperaments, and duration of episodes. CONCLUSIONS A new CRDC could provide guidance toward an empirically-based, scientific psychiatric nosology, and provide an alternative clinical diagnostic approach to the DSM system.
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Affiliation(s)
- S Nassir Ghaemi
- Department of Psychiatry, Tufts University, 800 Washington St, Boston, MA, 02111, USA. .,Department of Psychiatry, Harvard Medical School, Boston, USA.
| | | | - Paul A Vohringer
- Department of Psychiatry, Tufts University, 800 Washington St, Boston, MA, 02111, USA.,Department of Psychiatry, University of Chile, Santiago, Chile
| | - Eric A Youngstrom
- Departments of Psychology, Neuroscience, and Psychiatry, University of North Carolina, Chapel Hill, NC, USA
| | - James Phelps
- Department of Psychiatry, Good Samaritan Regional Medical Center, Corvallis, OR, USA
| | - Philip B Mitchell
- Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, Australia
| | - Roger S McIntyre
- Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Michael Bauer
- Department of Psychiatry and Psychotherapy, Carl Gustav Carus University Hospital, Technische Universität Dresden, Dresden, Germany
| | - Eduard Vieta
- Department of Psychiatry and Psychology, Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Samuel Gershon
- Department of Psychiatry, University of Miami, Miami, USA
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2
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Lee CY, Zeng JH, Lee SY, Lu RB, Kuo PH. SNP Data Science for Classification of Bipolar Disorder I and Bipolar Disorder II. IEEE/ACM TRANSACTIONS ON COMPUTATIONAL BIOLOGY AND BIOINFORMATICS 2021; 18:2862-2869. [PMID: 32324560 DOI: 10.1109/tcbb.2020.2988024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Bipolar disorder I (BD-I) and bipolar disorder II (BD-II) have specific characteristics and clear diagnostic criteria, but quite different treatment guidelines. In clinical practice, BD-II is commonly mistaken as a mild form of BD-I. This study uses data science technique to identify the important Single Nucleotide Polymorphisms (SNPs) significantly affecting the classifications of BD-I and BD-II, and develops a set of complementary diagnostic classifiers to enhance the diagnostic process. Screening assessments and SNP genotypes of 316 Han Chinese were performed with the Affymetrix Axiom Genome-Wide TWB Array Plate. The results show that the classifier constructed by 23 SNPs reached the area under curve of ROC (AUC) level of 0.939, while the classifier constructed by 42 SNPs reached the AUC level of 0.9574, which is a mere addition of 1.84 percent. The accuracy rate of classification increased by 3.46 percent. This study also uses Gene Ontology (GO) and Pathway to conduct a functional analysis and identify significant items, including calcium ion binding, GABA-A receptor activity, Rap1 signaling pathway, ECM proteoglycans, IL12-mediated signaling events, Nicotine addiction), and PI3K-Akt signaling pathway. The study can address time-consuming SNPs identification and also quantify the effect of SNP-SNP interactions.
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3
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Franklin C, Dwyer DS. Candidate risk genes for bipolar disorder are highly conserved during evolution and highly interconnected. Bipolar Disord 2021; 23:400-408. [PMID: 32959503 DOI: 10.1111/bdi.12996] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 07/24/2020] [Accepted: 09/12/2020] [Indexed: 12/21/2022]
Abstract
OBJECTIVES Bipolar disorder (BPD) is a highly heritable psychiatric disorder whose genetic complexity and pathogenetic mechanisms are still being unraveled. The main goal of this work was to characterize BPD risk-gene candidates (identified by Nurnberger et al., JAMA Psychiatry 71:657, 2014, and Stahl et al., Nat. Genet. 51:793, 2019) with respect to their evolutionary conservation, associated phenotypes, and extent of gene-gene interactions. METHODS Database searches and BLAST were used to identify homologous counterparts of human BPD risk genes in C. elegans, zebrafish, and Drosophila. Phenotypes associated with the C. elegans genes were annotated and searched. With GeneMANIA, we characterized and quantified gene-gene interactions among members of the BPD gene set in comparison to randomly chosen gene sets of the same size. RESULTS BPD risk genes are highly conserved across species and are enriched for essential genes and genes associated with lethality and altered life span. They are significantly more interactive with each other in comparison to random genes. We identified syntenic blocks of risk genes, which provided potential insights into molecular pathways and co-morbidities associated with BPD including coronary disease, obesity, and decreased life expectancy. CONCLUSIONS BPD risk genes appear to be special in terms of their degree of conservation, interconnectedness, and pleiotropic effects that extend beyond a role in brain function. Key hub genes or pleiotropic regulatory components may represent attractive targets for future drug discovery.
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Affiliation(s)
- Claire Franklin
- School of Medicine, LSU Health Shreveport, Shreveport, LA, USA.,LSU Health Sciences Center New Orleans, Shreveport, LA, USA
| | - Donard S Dwyer
- Departments of Psychiatry and Behavioral Medicine and Pharmacology, Toxicology and Neuroscience, LSU Health Shreveport, Shreveport, LA, USA
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Abstract
Bipolar disorder is a lifelong mood disorder characterized by extreme mood swings between mania and depression. Despite fitness costs associated with increased mortality and significant impairment, bipolar disorder has persisted in the population with a high heritability and a stable prevalence. Creativity and other positive traits have repeatedly been associated with the bipolar spectrum, particularly among unaffected first-degree relatives and those with milder expressions of bipolar traits. This suggests a model in which large doses of risk variants cause illness, but mild to moderate doses confer advantages, which serve to maintain bipolar disorder in the population. Bipolar disorder may thus be better conceptualized as a dimensional trait existing at the extreme of normal population variation in positive temperament, personality, and cognitive traits, aspects of which may reflect a shared vulnerability with creativity. Investigations of this shared vulnerability may provide insight into the genetic mechanisms underlying illness and suggest novel treatments.
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Affiliation(s)
- Tiffany A Greenwood
- Department of Psychiatry, University of California, San Diego, La Jolla, California 92093, USA;
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5
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Azorin J, Kaladjian A, Adida M, Fakra E, Belzeaux R, Hantouche E, Lancrenon S. Factors associated with borderline personality disorder in major depressive patients and their relationship to bipolarity. Eur Psychiatry 2020; 28:463-8. [DOI: 10.1016/j.eurpsy.2012.11.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2012] [Revised: 11/12/2012] [Accepted: 11/23/2012] [Indexed: 12/31/2022] Open
Abstract
AbstractObjectiveTo analyze the interface between borderline personality disorder (BPD) and bipolarity in depressed patients comorbid with BPD.MethodsAs part of National Multi-site Study of 493 consecutive DSM-IV major depressive patients evaluated in at least two semi-structured interviews 1 month apart, 19 (3.9%) had comorbid BPD (BPD+), whereas 474 (96.1%) did not manifest this comorbidity (BPD−).ResultsCompared to BPD (−), BPD (+) patients displayed higher rates of bipolar (BP) disorders and temperaments, an earlier age at onset with a family history of affective illness, more comorbidity, more stressors before the first episode which was more often depressive or mixed, as well as a greater number and severity of affective episodes.ConclusionsThe hypothesis which fitted at best our findings was to consider BPD as a contributory factor in the development of BP disorder, which could have favoured the progression from unipolar major depression to BP disorder. We could not however exclude that some features of BP disorder may have contributed to the development of BPD.
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Wang YS, Lee SY, Chen SL, Chang YH, Wang TY, Lin SH, Wang CL, Huang SY, Lee I, Chen P, Yang Y, Lu RB. Role of DRD2 and ALDH2 genes in bipolar II disorder with and without comorbid anxiety disorder. Eur Psychiatry 2020; 29:142-8. [DOI: 10.1016/j.eurpsy.2013.05.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2013] [Revised: 05/05/2013] [Accepted: 05/06/2013] [Indexed: 10/26/2022] Open
Abstract
AbstractThe presence of comorbid anxiety disorders (AD) and bipolar II disorders (BP-II) compounds disability complicates treatment, worsens prognosis, and has been understudied. The genes involved in metabolizing dopamine and encoding dopamine receptors, such as aldehyde dehydrogenase 2 (ALDH2) and dopamine D2 receptor (DRD2) genes, may be important to the pathogenesis of BP-II comorbid with AD. We aimed to clarify ALDH2 and DRD2 genes for predisposition to BP-II comorbid with and without AD. The sample consisted of 335 subjects BP-II without AD, 127 subjects BP-II with AD and 348 healthy subjects as normal control. The genotypes of the ALDH2 and DRD2 Taq-IA polymorphisms were determined using polymerase chain reactions plus restriction fragment length polymorphism analysis. Logistic regression analysis showed a statistically significant association between DRD2 Taq-I A1/A2 genotype and BP-II with AD (OR = 2.231, P = 0.021). Moreover, a significant interaction of the DRD2 Taq-I A1/A1 and the ALDH2*1*1 genotypes in BP-II without AD was revealed (OR = 5.623, P = 0.001) compared with normal control. Our findings support the hypothesis that a unique genetic distinction between BP-II with and without AD, and suggest a novel association between DRD2 Taq-I A1/A2 genotype and BP-II with AD. Our study also provides further evidence that the ALDH2 and DRD2 genes interact in BP-II, particularly BP-II without AD.
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Şair YB, Sevinçok D, Kutlu A, Çakaloz B, Sevinçok L. The affective temperament traits and pregnancy-related depression in mothers may constitute risk factors for their children with attention deficit and hyperactivity disorder. J OBSTET GYNAECOL 2019; 40:1079-1084. [PMID: 31814479 DOI: 10.1080/01443615.2019.1679741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
We investigated whether the affective temperaments of mothers and maternal depression before and during the index pregnancy are related to the development of Attention-Deficit Hyperactivity Disorder (ADHD) in their children. One hundred and twenty children were screened for the diagnosis of ADHD. After exclusion and inclusion criteria were applied for children and their mothers, we compared the mothers of children with (n = 63) and without ADHD (n = 60) in terms of affective temperament traits, depression before and during the index pregnancy, and some environmental risk factors. The rate of boys were significantly higher among children with ADHD compared to healthy controls. The mothers of children with ADHD had significantly lower education levels, more cigarette consumption during pregnancy, and more depression rates before the pregnancy than those of healthy children. Male gender (p = .002), Hamilton Depression Rating Scale (HDRS) (p = .002), cyclothymic (p = .022), irritable (p = .035) and anxious temperament scores (p = .016) significantly predicted the association between the mothers and their children with ADHD. Our findings might suggest that male child gender, the severity of depression at index pregnancy, higher cyclothymic, irritable, and anxious temperament scores in mothers may constitute as important risk factors for the development of ADHD in their children.Impact statementWhat is already known on this subject? Although the effects of maternal depression on ADHD were extensively investigated, the relationship between affective temperament traits of mothers and ADHD in their children has not been sufficiently examined. To investigate the roles of maternal affective temperament traits and pregnancy-related depression on offspring ADHD would help us to understand the etiopathogenic bases of ADHD.What do the results of this study add? Cyclothymic, irritable and anxious temperaments of mothers were significantly associated with the offspring ADHD after adjusting for the gender, maternal smoking, prepartum and antenatal depression.What are the implications of these findings for clinical practice and/or further research? These findings might demonstrate that some maternal affective temperaments and depression during pregnancy are suggestive of an inherited predisposition to ADHD in offsprings. Longitudinal studies are required to demonstrate the relationship between maternal affective temperament features and the development of affective illness in children with ADHD.
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Affiliation(s)
- Yaşan Bilge Şair
- Department of Psychiatry, Adnan Menderes University, Aydin, Turkey
| | - Doğa Sevinçok
- Department of Child and Adolescent Psychiatry, Adnan Menderes University, Aydin, Turkey
| | - Ayşe Kutlu
- Department of Child and Adolescent Psychiatry, Dr.Behcet Uz Child Disease and Pediatric Surgery Training and Research Hospital, İzmir, Turkey
| | - Burcu Çakaloz
- Department of Child and Adolescent Psychiatry, Pamukkale University, Denizli, Turkey
| | - Levent Sevinçok
- Department of Psychiatry, Adnan Menderes University, Aydin, Turkey
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8
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Faedda GL, Baldessarini RJ, Marangoni C, Bechdolf A, Berk M, Birmaher B, Conus P, DelBello MP, Duffy AC, Hillegers MHJ, Pfennig A, Post RM, Preisig M, Ratheesh A, Salvatore P, Tohen M, Vázquez GH, Vieta E, Yatham LN, Youngstrom EA, Van Meter A, Correll CU. An International Society of Bipolar Disorders task force report: Precursors and prodromes of bipolar disorder. Bipolar Disord 2019; 21:720-740. [PMID: 31479581 DOI: 10.1111/bdi.12831] [Citation(s) in RCA: 58] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVES To clarify the clinical features preceding the onset of bipolar disorder (BD) has become a public health priority for the prevention of high morbidity and mortality. BD remains frequently under- or misdiagnosed, and under- or mistreated, often for years. METHODS We assessed the predictive value of precursors and prodromes of BD. We assessed precursors of first-lifetime manic or hypomanic episodes with/without mixed features in retrospective and prospective studies. The task force evaluated and summarized separately assessments of familial risk, premorbid personality traits, retrospective, and prospective studies. RESULTS Cyclothymic features, a family history of BD, retrospectively reported attenuated manic symptoms, prospectively identified subthreshold symptoms of hypomania, recurrence of depression, panic anxiety and psychotic features, have been identified as clinical precursors of BD. The prodromal symptoms like [hypo]mania often appears to be long enough to encourage early identification and timely intervention. CONCLUSIONS The predictive value of any risk factor identified remains largely unknown. Prospective controlled studies are urgently needed for prevention and effective treatment.
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Affiliation(s)
- Gianni L Faedda
- Mood Disorders Center, New York, NY, USA.,International Consortium for Mood and Psychotic Disorders Research, McLean Hospital, Belmont, MA, USA
| | - Ross J Baldessarini
- International Consortium for Mood and Psychotic Disorders Research, McLean Hospital, Belmont, MA, USA.,Department of Psychiatry, Harvard Medical School, Mailman Research Center, McLean Hospital, Boston, MA, USA
| | - Ciro Marangoni
- Department of Psychiatry-District 3, ULSS 9 Scaligera, Verona, Italy
| | - Andreas Bechdolf
- Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany.,Department of Psychiatry, Psychotherapy and Psychosomatics, Vivantes Hospital am Urban and Vivantes Hospital im Friedrichschain, Charite Universitätsmedizin, Berlin, Germany
| | - Michael Berk
- IMPACT Strategic Research Centre, University Hospital Geelong, Barwon Health, Deakin University, Geelong, VIC, Australia.,Orygen, The National Center of Excellence in Youth Mental Health, Parkville, VIC, Australia.,The Florey Institute for Neuroscience and Mental Health and the Department of Psychiatry, University of Melbourne, Melbourne, VIC, Australia
| | - Boris Birmaher
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Philippe Conus
- Treatment and Early Intervention in Psychosis Program (TIPP), Département de Psychiatrie CHUV, Université de Lausanne, Lausanne, Switzerland
| | - Melissa P DelBello
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Anne C Duffy
- Department of Psychiatry, Student Wellness Services, Queen's University, Kingston, ON, Canada
| | - Manon H J Hillegers
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands.,Department of Child and Adolescent Psychiatry, Erasmus medical Center Rotterdam, Rotterdam, The Netherlands
| | - Andrea Pfennig
- Department of Psychiatry and Psychotherapy, Carl Gustav Carus University Hospital, Technische Universität Dresden, Dresden, Germany
| | - Robert M Post
- Bipolar Collaborative Network, Bethesda, MD, USA.,Department of Psychiatry, George Washington University School of Medicine, Washington, DC, USA
| | - Martin Preisig
- Department of Psychiatry, University Hospital of Lausanne, Lausanne, Switzerland
| | - Aswin Ratheesh
- IMPACT Strategic Research Centre, University Hospital Geelong, Barwon Health, Deakin University, Geelong, VIC, Australia.,Orygen, The National Center of Excellence in Youth Mental Health, Parkville, VIC, Australia.,The Florey Institute for Neuroscience and Mental Health and the Department of Psychiatry, University of Melbourne, Melbourne, VIC, Australia
| | - Paola Salvatore
- Department of Psychiatry, Harvard Medical School, Mailman Research Center, McLean Hospital, Boston, MA, USA.,Psychiatry Section, Department of Neuroscience, School of Medicine, University of Parma, Parma, Italy
| | - Mauricio Tohen
- Department of Psychiatry & Behavioral Sciences, University of New Mexico Health Sciences Center, Albuquerque, NM, USA
| | - Gustavo H Vázquez
- International Consortium for Mood and Psychotic Disorders Research, McLean Hospital, Belmont, MA, USA.,Psychiatry, Queen's University, Kingston, ON, Canada
| | - Eduard Vieta
- Bipolar Disorder Unit, Institute of Neuroscience, Hospital Clinic, IDIBAPS, CIBERSAM, University of Barcelona, Barcelona, Spain
| | - Lakshmi N Yatham
- Department of Psychiatry, Mood Disorders Centre, University of British Columbia, Vancouver, BD, Canada
| | - Eric A Youngstrom
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Anna Van Meter
- Department of Psychiatry and Molecular Medicine, Hofstra Northwell School of Medicine, Hempstead, NY, USA.,The Zucker Hillside Hospital, Psychiatry Research, Northwell Health, Glen Oaks, NY, USA
| | - Christoph U Correll
- Department of Psychiatry and Molecular Medicine, Hofstra Northwell School of Medicine, Hempstead, NY, USA.,The Zucker Hillside Hospital, Psychiatry Research, Northwell Health, Glen Oaks, NY, USA.,The Feinstein Institute for Medical Research, Center for Psychiatric Neuroscience, Manhasset, NY, USA.,Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany
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9
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Bruce HA, Kochunov P, Mitchell B, Strauss KA, Ament SA, Rowland LM, Du X, Fisseha F, Kavita T, Chiappelli J, Wisner K, Sampath H, Chen S, Kvarta MD, Seneviratne C, Postolache TT, Bellon A, McMahon FJ, Shuldiner A, Elliot Hong L. Clinical and genetic validity of quantitative bipolarity. Transl Psychiatry 2019; 9:228. [PMID: 31527585 PMCID: PMC6746871 DOI: 10.1038/s41398-019-0561-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Revised: 03/04/2019] [Accepted: 04/10/2019] [Indexed: 12/19/2022] Open
Abstract
Research has yet to provide a comprehensive understanding of the genetic basis of bipolar disorder (BP). In genetic studies, defining the phenotype by diagnosis may miss risk-allele carriers without BP. The authors aimed to test whether quantitatively detected subclinical symptoms of bipolarity identifies a heritable trait that infers risk for BP. The Quantitative Bipolarity Scale (QBS) was administered to 310 Old Order Amish or Mennonite individuals from multigenerational pedigrees; 110 individuals had psychiatric diagnoses (20 BP, 61 major depressive disorders (MDD), 3 psychotic disorders, 26 other psychiatric disorders). Familial aggregation of QBS was calculated using the variance components method to derive heritability and shared household effects. The QBS score was significantly higher in BP subjects (31.5 ± 3.6) compared to MDD (16.7 ± 2.0), other psychiatric diagnoses (7.0 ± 1.9), and no psychiatric diagnosis (6.0 ± 0.65) (all p < 0.001). QBS in the whole sample was significantly heritable (h2 = 0.46 ± 0.15, p < 0.001) while the variance attributed to the shared household effect was not significant (p = 0.073). When subjects with psychiatric illness were removed, the QBS heritability was similar (h2 = 0.59 ± 0.18, p < 0.001). These findings suggest that quantitative bipolarity as measured by QBS can separate BP from other psychiatric illnesses yet is significantly heritable with and without BP included in the pedigrees suggesting that the quantitative bipolarity describes a continuous heritable trait that is not driven by a discrete psychiatric diagnosis. Bipolarity trait assessment may be used to supplement the diagnosis of BP in future genetic studies and could be especially useful for capturing subclinical genetic contributions to a BP phenotype.
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Affiliation(s)
- Heather A. Bruce
- 0000 0001 2175 4264grid.411024.2Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21228 USA
| | - Peter Kochunov
- 0000 0001 2175 4264grid.411024.2Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21228 USA
| | - Braxton Mitchell
- 0000 0001 2175 4264grid.411024.2Department of Medicine, University of Maryland School of Medicine, Baltimore, MD 21228 USA
| | - Kevin A. Strauss
- grid.418640.fClinic for Special Children, Strasburg, PA 17579 USA
| | - Seth A. Ament
- 0000 0001 2175 4264grid.411024.2Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21228 USA
| | - Laura M. Rowland
- 0000 0001 2175 4264grid.411024.2Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21228 USA
| | - Xiaoming Du
- 0000 0001 2175 4264grid.411024.2Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21228 USA
| | - Feven Fisseha
- 0000 0001 2175 4264grid.411024.2Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21228 USA
| | - Thangavelu Kavita
- 0000 0001 2175 4264grid.411024.2Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21228 USA
| | - Joshua Chiappelli
- 0000 0001 2175 4264grid.411024.2Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21228 USA
| | - Krista Wisner
- 0000 0001 2175 4264grid.411024.2Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21228 USA
| | - Hemalatha Sampath
- 0000 0001 2175 4264grid.411024.2Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21228 USA
| | - Shuo Chen
- 0000 0001 2175 4264grid.411024.2Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21228 USA
| | - Mark D. Kvarta
- 0000 0001 2175 4264grid.411024.2Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21228 USA
| | - Chamindi Seneviratne
- 0000 0001 2175 4264grid.411024.2Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21228 USA
| | - Teodor T. Postolache
- 0000 0001 2175 4264grid.411024.2Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21228 USA
| | - Alfredo Bellon
- 0000 0001 2097 4281grid.29857.31Hershey Medical Center, Department of Psychiatry, Penn State University School of Medicine, Hershey, PA 17033 USA
| | - Francis J. McMahon
- 0000 0004 0464 0574grid.416868.5Human Genetics Branch, National Institute of Mental Health Intramural Research Program, Bethesda, MD 20892 USA
| | - Alan Shuldiner
- 0000 0001 2175 4264grid.411024.2Department of Medicine, University of Maryland School of Medicine, Baltimore, MD 21228 USA
| | - L. Elliot Hong
- 0000 0001 2175 4264grid.411024.2Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21228 USA
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10
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Pisanu C, Heilbronner U, Squassina A. The Role of Pharmacogenomics in Bipolar Disorder: Moving Towards Precision Medicine. Mol Diagn Ther 2018; 22:409-420. [PMID: 29790107 DOI: 10.1007/s40291-018-0335-y] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Bipolar disorder (BD) is a common and disabling psychiatric condition with a severe socioeconomic impact. BD is treated with mood stabilizers, among which lithium represents the first-line treatment. Lithium alone or in combination is effective in 60% of chronically treated patients, but response remains heterogenous and a large number of patients require a change in therapy after several weeks or months. Many studies have so far tried to identify molecular and genetic markers that could help us to predict response to mood stabilizers or the risk for adverse drug reactions. Pharmacogenetic studies in BD have been for the most part focused on lithium, but the complexity and variability of the response phenotype, together with the unclear mechanism of action of lithium, limited the power of these studies to identify robust biomarkers. Recent pharmacogenomic studies on lithium response have provided promising findings, suggesting that the integration of genome-wide investigations with deep phenotyping, in silico analyses and machine learning could lead us closer to personalized treatments for BD. Nevertheless, to date none of the genes suggested by pharmacogenetic studies on mood stabilizers have been included in any of the genetic tests approved by the Food and Drug Administration (FDA) for drug efficacy. On the other hand, genetic information has been included in drug labels to test for the safety of carbamazepine and valproate. In this review, we will outline available studies investigating the pharmacogenetics and pharmacogenomics of lithium and other mood stabilizers, with a specific focus on the limitations of these studies and potential strategies to overcome them. We will also discuss FDA-approved pharmacogenetic tests for treatments commonly used in the management of BD.
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Affiliation(s)
- Claudia Pisanu
- Department of Biomedical Sciences, Section of Neuroscience and Clinical Pharmacology, University of Cagliari, sp 6, 09042, Cagliari, Italy
- Department of Neuroscience, Unit of Functional Pharmacology, Uppsala University, Uppsala, Sweden
| | - Urs Heilbronner
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany
| | - Alessio Squassina
- Department of Biomedical Sciences, Section of Neuroscience and Clinical Pharmacology, University of Cagliari, sp 6, 09042, Cagliari, Italy.
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada.
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11
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Czamara D, Müller-Myhsok B, Lucae S. The P2RX7 polymorphism rs2230912 is associated with depression: A meta-analysis. Prog Neuropsychopharmacol Biol Psychiatry 2018; 82:272-277. [PMID: 29122639 DOI: 10.1016/j.pnpbp.2017.11.003] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Revised: 11/02/2017] [Accepted: 11/06/2017] [Indexed: 12/01/2022]
Abstract
Various studies have investigated whether single nucleotide polymorphisms (SNPs) in the gene purinergic receptor P2X7 (P2RX7), and rs2230912 specifically, were associated with mood disorders. While some studies found positive evidence, a large number of studies reported no significant associations. In a previously published meta-analysis, Feng et al. did not find a significant association and only moderate odds ratios (ORs) in case-control studies. They reported significant findings only for family-based studies. We revisited this finding and conducted a meta-analysis including 8,652 cases and 11,153 controls, adding unpublished results from the Munich Antidepressant Response Signature (MARS) study. We found a significant association between rs2230912 and combined mood disorders (major depressive disorder (MDD) or bipolar disorder (BD)) for the allelic, dominant and heterozygous-disadvantage model, all withstanding the threshold of correction for multiple testing. Stratifying by disorder revealed significant findings for the MDD-subgroup (OR of 1.12 for the allelic model), while the BD-subgroup presented with a lower effect size (OR of 1.05) and no significance. P2RX7 encodes a purinergic receptor which is expressed in the brain and also localized in immune cells. Animal studies and functional studies will be necessary to enlighten its involvement in the etiology of mood disorders and its applicability for pharmacological purposes.
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Affiliation(s)
- D Czamara
- Max Planck Institute of Psychiatry, Munich, Germany.
| | - B Müller-Myhsok
- Max Planck Institute of Psychiatry, Munich, Germany; Munich Cluster of Systems Biology, SyNergy, Germany; Institute of Translational Medicine, University of Liverpool, United Kingdom
| | - S Lucae
- Max Planck Institute of Psychiatry, Munich, Germany
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Salehi B, Khoz S, Sadeghi B, Amanat M, Salehi M. Genealogy Study of Three Generations of Patients with Bipolar Mood Disorder Type I. Indian J Psychol Med 2017; 39:475-480. [PMID: 28852243 PMCID: PMC5559997 DOI: 10.4103/ijpsym.ijpsym_300_16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION The purpose of this research is genealogy examination of three generation of bipolar mood disorder Type I patients. METHODS Patients selected using Poisson sampling method from 100 patients with bipolar mood disorder Type I, referring to a psychiatric center of Amir Kabir Hospital of Arak, Iran. Examine issues such as physical ailments, psychological review of living and deceased family members of each patient, drawn family pedigree using pedigree chart, check the relationship of the different pattern of the autosomal dominant and recessive disease, sex-linked dominant and recessive and linked to Y chromosome have been performed on patients. Different methods used in this study are pedigree chart and young mania rating scale and SPSS and Pearson's correlation test for analyzing the data collected. RESULTS Among the studied inheritance patterns, the most common inheritance pattern was autosomal recessive. There was a significant relationship between age, number of generation, and inheritance patterns with physical ailments in families of patients with bipolar mood disorder (P < 0.05), but there was no significant association with mental illness (P > 0.05). Furthermore, there was a significant relation between generation and skin, gastrointestinal, ovarian, lung, coronary heart disease, diabetes mellitus, hypertension, Cerebrovascular accident (CVA), hyperlipidemia, cardiomyopathy, hypothyroidism, and kidney disease in patients with bipolar affective disorder Type I (P < 0.05). CONCLUSION The results showed that autosomal recessive was the most pattern of inheritance and there is a significant relationship between generation and some physical disorders in patients with bipolar mood disorder Type I.
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Affiliation(s)
- Bahman Salehi
- Department of Psychiatry, Arak University of Medical Sciences, Arak, Iran
| | - Sara Khoz
- Department of Psychiatry, Arak University of Medical Sciences, Arak, Iran
| | - Bahman Sadeghi
- Department of Social Medicine, Arak University of Medical Sciences, Arak, Iran
| | - Manouchehr Amanat
- Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran.,Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mona Salehi
- Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran.,Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
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Greenwood TA. Positive Traits in the Bipolar Spectrum: The Space between Madness and Genius. MOLECULAR NEUROPSYCHIATRY 2017; 2:198-212. [PMID: 28277566 PMCID: PMC5318923 DOI: 10.1159/000452416] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2016] [Accepted: 10/10/2016] [Indexed: 01/25/2023]
Abstract
Bipolar disorder is a severe, lifelong mood disorder for which little is currently understood of the genetic mechanisms underlying risk. By examining related dimensional phenotypes, we may further our understanding of the disorder. Creativity has a historical connection with the bipolar spectrum and is particularly enhanced among unaffected first-degree relatives and those with bipolar spectrum traits. This suggests that some aspects of the bipolar spectrum may confer advantages, while more severe expressions of symptoms negatively influence creative accomplishment. Creativity is a complex, multidimensional construct with both cognitive and affective components, many of which appear to reflect a shared genetic vulnerability with bipolar disorder. It is suggested that a subset of bipolar risk variants confer advantages as positive traits according to an inverted-U-shaped curve with clinically unaffected allele carriers benefitting from the positive traits and serving to maintain the risk alleles in the population. The association of risk genes with creativity in healthy individuals (e.g., NRG1), as well as an overall sharing of common genetic variation between bipolar patients and creative individuals, provides support for this model. Current findings are summarized from a multidisciplinary perspective to demonstrate the feasibility of research in this area to reveal the mechanisms underlying illness.
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Qiu F, Akiskal HS, Kelsoe JR, Greenwood TA. Factor analysis of temperament and personality traits in bipolar patients: Correlates with comorbidity and disorder severity. J Affect Disord 2017; 207:282-290. [PMID: 27741464 PMCID: PMC5107122 DOI: 10.1016/j.jad.2016.08.031] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Revised: 07/07/2016] [Accepted: 08/24/2016] [Indexed: 12/16/2022]
Abstract
BACKGROUND Temperament and personality traits have been suggested as endophenotypes for bipolar disorder based on several lines of evidence, including heritability. Previous work suggested an anxious-reactive factor identified across temperament and personality inventories that produced significant group discrimination and could potentially be useful in genetic analyses. We have attempted to further characterize this factor structure in a sample of bipolar patients. METHODS A sample of 1195 subjects with bipolar I disorder was evaluated, all with complete data available. Dimension reduction across two inventories identified 18 factors explaining 39% of the variance. RESULTS The two largest factors reflected affective instability and general anxiety/worry, respectively. Subsequent analyses of the clinical features associated with bipolar disorder revealed specificity for the factors in a predictable pattern. Cluster analysis of the factors identified a subgroup defined by a strong lack of general anxiety and low affective instability represented by the first two factors. The remaining subjects could be distinguished into two clusters by the presence of either more positive characteristics, including persistence/drive, spirituality, expressivity, and humor, or more negative characteristics of depression and anxiety. LIMITATIONS These analyses involved bipolar I subjects only and must be extended to other bipolar spectrum diagnoses, unaffected relatives, and individuals at risk. CONCLUSIONS These results suggest that temperament and personality measures access latent traits associated with important clinical features of bipolar disorder. By translating clinical variables into quantitative traits, we may identify subgroups of bipolar patients with distinct clinical profiles, thereby facilitating both individual treatment strategies and genetic analyses.
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Affiliation(s)
- Frank Qiu
- Department of Psychiatry, University of California San Diego, La Jolla, CA
| | | | - Hagop S. Akiskal
- Department of Psychiatry, University of California San Diego, La Jolla, CA,San Diego Veterans Affairs Healthcare System, San Diego, CA,International Mood Center, La Jolla, CA
| | - John R. Kelsoe
- Department of Psychiatry, University of California San Diego, La Jolla, CA,San Diego Veterans Affairs Healthcare System, San Diego, CA,Institute for Genomic Medicine, University of California, San Diego, La Jolla, CA
| | - Tiffany A. Greenwood
- Department of Psychiatry, University of California San Diego, La Jolla, CA,Address correspondence to: Tiffany A. Greenwood, Ph.D. Department of Psychiatry, University of California San Diego, 9500 Gilman Drive, MC 0689, La Jolla, CA 92093, Phone: 858-246-1897,
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Molecular analyses of circadian gene variants reveal sex-dependent links between depression and clocks. Transl Psychiatry 2016; 6:e748. [PMID: 26926884 PMCID: PMC4872462 DOI: 10.1038/tp.2016.9] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2015] [Accepted: 12/21/2015] [Indexed: 12/11/2022] Open
Abstract
An extensive literature links circadian irregularities and/or sleep abnormalities to mood disorders. Despite the strong genetic component underlying many mood disorders, however, previous genetic associations between circadian clock gene variants and major depressive disorder (MDD) have been weak. We applied a combined molecular/functional and genetic association approach to circadian gene polymorphisms in sex-stratified populations of control subjects and case subjects suffering from MDD. This approach identified significant sex-dependent associations of common variants of the circadian clock genes hClock, hPer3 and hNpas2 with major depression and demonstrated functional effects of these polymorphisms on the expression or activity of the hCLOCK and hPER3 proteins, respectively. In addition, hCLOCK expression is affected by glucocorticoids, consistent with the sex-dependency of the genetic associations and the modulation of glucocorticoid-mediated stress response, providing a mechanism by which the circadian clock controls outputs that may affect psychiatric disorders. We conclude that genetic polymorphisms in circadian genes (especially hClock and hPer3, where functional assays could be tested) influence risk of developing depression in a sex- and stress-dependent manner. These studies support a genetic connection between circadian disruption and mood disorders, and confirm a key connection between circadian gene variation and major depression.
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Pirkola S, Eriksen HA, Partonen T, Kieseppä T, Veijola J, Jääskeläinen E, Mylläri-Figuerola EM, Salo PM, Paunio T. Seasonal variation in affective and other clinical symptoms among high-risk families for bipolar disorders in an Arctic population. Int J Circumpolar Health 2015; 74:29671. [PMID: 26589395 PMCID: PMC4654770 DOI: 10.3402/ijch.v74.29671] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2015] [Revised: 10/14/2015] [Accepted: 10/26/2015] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND In bipolar disorder (BD), seasonality of symptoms is common and disturbances in circadian rhythms have been reported. OBJECTIVES We identified high-penetrance families in a geographically restricted area in Northern Fennoscandia and studied the seasonal variation of clinical symptoms among BD subjects and their healthy relatives. DESIGN We explored the clinical characteristics of subjects living in Northern Fennoscandia, with extreme annual variation in daylight. Among known indigenous high-risk families for BD, we compared the affected ones (N=16) with their healthy relatives (N=15), and also included 18 healthy non-related controls from the same geographical area. Seasonal fluctuation in clinical measures was followed up at the 4 most demarcated photoperiodic time points of the annual cycle: around the summer solstice and autumn equinox in 2013, the winter solstice in 2013/2014, and the spring equinox in 2014. In the baseline, lifetime manic symptoms [Mood Disorder Questionnaire (MDQ)] and morningness-eveningness questionnaire type (MEQ) were registered, whereas in the follow-up, depressive [Beck Depression Inventory (BDI)] and distress [General Health Questionnaire (GHQ-12)] symptoms and alcohol consumption and sleep were recorded. RESULTS Possibly indicative or statistically significant differences in symptoms between the affected subjects and their healthy relatives were the BDI winter (13.3 vs. 2.6, t=-2.51, p=0.022) and spring scores (12.6 vs. 3.2, t=-1.97, p=0.063) and GHQ winter (4.2 vs. 0.82, t=-2.08, p=0.052) and spring scores (3.8 vs. 0.82, t=-1.97, p=0.063). Scores were higher among the affected subjects, exceeding a possibly diagnostic threshold (10 and 3) at all the time points, and without the notable seasonality which was observed among the healthy relatives. In the overall population, MDQ and MEQ scores had an inverse correlation (-0.384, significant at 0.016), indicating increased lifetime manic behaviour among "the night owl" chronotype subjects. CONCLUSIONS In an Arctic population sample, we found different seasonal fluctuation in mood and distress symptoms and sleep duration scores between subjects with bipolar spectrum disorders and their healthy relatives. Despite the relatively small sample size, the results indicate that the symptoms and signs of BD relate to a disturbance in seasonal variation. Seasonal variation can be considered as an interesting endophenotype for BD and a promising target for further genetic studies.
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Affiliation(s)
- Sami Pirkola
- Department of Psychiatry, University and University Hospital of Oulu, Oulu, Finland.,National Institute of Health and Welfare, Helsinki, Finland.,Depertment of Social Psychiatry, School of Health Sciences, University of Tampere, Tampere, Finland;
| | - Heidi A Eriksen
- Centre of Arctic Medicine, Thule Institute, University of Oulu, Oulu, Finland
| | - Timo Partonen
- National Institute of Health and Welfare, Helsinki, Finland
| | - Tuula Kieseppä
- Helsinki University Central Hospital, University of Helsinki, Helsinki, Finland
| | - Juha Veijola
- Department of Psychiatry, University and University Hospital of Oulu, Oulu, Finland
| | - Erika Jääskeläinen
- Department of Psychiatry, University and University Hospital of Oulu, Oulu, Finland
| | | | - Paula M Salo
- National Institute of Health and Welfare, Helsinki, Finland
| | - Tiina Paunio
- National Institute of Health and Welfare, Helsinki, Finland.,Helsinki University Central Hospital, University of Helsinki, Helsinki, Finland
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Kikhavani S, Taghinejad H. Personality Factor as a Predictor of Depression Score Among Depressed and CHD Patients. J Clin Diagn Res 2015; 9:VC04-VC07. [PMID: 26557596 DOI: 10.7860/jcdr/2015/14337.6668] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2015] [Accepted: 08/13/2015] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Many risk factors can affect depression and coronary disease, these including physiological and psychological risk factors (such as personality traits). OBJECTIVES Our objectives were to examine whether personality factors (The Five-Factor Model) can predict depression score in the depressed and coronary heart disease (CHD) individuals compared to that of healthy subjects. MATERIALS AND METHODS To achieve the above objectives, 100 depressed (Mean=35.90 years, SD=10.59 years), and 100 CHD (Mean=46.42 years, SD=12.52 years), patients and 100 healthy subjects (Mean = 37.97 years, SD =12.49 years) were selected by convenience sampling method. To compare the three groups of participants, ANOVA test was used. Stepwise Multiple Regression Analysis was used to identify the variables that most closely predict the perceived stress and depression scores. Pearson's Correlation Co-efficient was used to examine the correlation between variables. RESULTS In Neuroticism, the CHD patients had significant highest scores, followed by depressed patients. The healthy group had the least scores. In case of Extraversion, Openness and Agreeableness, healthy participants had significant higher scores followed by the depressed and CHD patients. Only in conscientiousness factor, Depressive and CHD groups had statistically less scores compared to the healthy group. Also, high Neuroticism and Age, and low Extraversion were significant protective factors for depression Scores of CHD patients, while high Neuroticism and low Extraversion function as predictors in the depressed and healthy groups. CONCLUSION The effects of Neuroticism and Extraversion on depression have been reported as inconsistent across previous studies. This study indicates that, older CHD individuals with high Neuroticism and low Extraversion scores are more vulnerable for depression.
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Affiliation(s)
- Sattar Kikhavani
- Associate Professor, Department of Clinical Psychology, Prevention of Psychosocial Injuries Research Center, Ilam University of Medical Sciences , Ilam, Iran
| | - Hamid Taghinejad
- Assistant Professor, Department of Nursing, Faculty of Nursing and Midwifery, Ilam University of Medical Sciences , Ilam, Iran
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Van Meter AR, Youngstrom EA. A tale of two diatheses: Temperament, BIS, and BAS as risk factors for mood disorder. J Affect Disord 2015; 180:170-8. [PMID: 25913803 DOI: 10.1016/j.jad.2015.03.053] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2015] [Accepted: 03/26/2015] [Indexed: 12/23/2022]
Abstract
OBJECTIVE Learning more about how biological traits, like temperament and sensitivity in the behavioral inhibition (BIS) and behavioral activation (BAS) systems, relate to mood pathology is consistent with the Research Domain Criteria initiative׳s goal of investigating mechanisms of risk. METHOD Korean young adults (n=128) and American young adults (n=630, of whom 23 has recent treatment for bipolar disorder, and 21for depression) completed self-report questionnaires, including the TEMPS-A, the BIS/BAS scales, Beck Depression Inventory (BDI), and Hypomanic Checklist (HCL-32). Linear regression quantified relations between mood symptoms, sample characteristics, temperament, and BIS/BAS. RESULTS Temperament styles explained 49% of the variance in BDI scores. BIS explained an additional 1% of the variance in BDI scores. BAS Fun and Reward (p<.01), in addition to cyclothymic and hyperthymic temperaments (p<.001) explained 21% of the variance in HCL-32 scores. Sample characteristics were not significant predictors in the full model. LIMITATIONS Differences in sample size, the cross-sectional study design, and lack of collateral report or behavioral measures of constructs are limitations. CONCLUSIONS Affective temperament and BIS/BAS are complementary but distinct constructs. Affective temperament, particularly cyclothymic, may represent a stronger diathesis for mood pathology, and seems potent irrespective of culture or diagnosis. Assessing temperament may help overcome some challenges in diagnosing mood disorders.
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Altınbaş G, Altınbaş K, Gülöksüz SA, Gülöksüz S, Aydemir Ö, Özgen G. Temperament characteristics in patients with panic disorder and their first-degree relatives. Compr Psychiatry 2015; 60:73-7. [PMID: 25967357 DOI: 10.1016/j.comppsych.2015.03.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2014] [Revised: 03/07/2015] [Accepted: 03/28/2015] [Indexed: 10/23/2022] Open
Abstract
AIM Panic disorder is one of the highly heritable anxiety disorders; and temperament characteristics are considered predicting liability to panic disorder. Accumulating evidence suggests temperament characteristics are intermediate phenotypes for clinical conditions. Given this background, we aimed to investigate temperament characteristics in patients with panic disorder, their first-degree relatives, and healthy controls. METHOD Study sample consisted of 60 patients with panic disorder, 37 first-degree relatives of these patients, and 37 age, gender, and education level matched healthy controls (HC). SCID-I, the Panic Agoraphobia Scale, and the State and Trait Anxiety Inventory were applied to assess clinical characteristics of the patient group. Temperament characteristics were assessed using the Temperament Evaluation of Memphis, Pisa, Paris, San Diego Autoquestionnaire (TEMPS-A). RESULTS Anxious, depressive, cyclothymic, and irritable temperament scores of patients were higher than those of HC. There was no difference between the patients and the relatives, with the exception of higher anxious temperament scores in patients. CONCLUSION Overall, our findings suggest that anxious temperament characteristic might be a trait marker for liability to panic disorder. Further research with a prospective design in a larger sample is required to confirm our findings.
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Affiliation(s)
- Gülçin Altınbaş
- Psychiatry Unit, Private Barbaros Clinic, Canakkale, Turkey.
| | - Kürşat Altınbaş
- Department of Psychiatry, School of Medicine, Canakkale Onsekiz Mart University, Canakkale, Turkey
| | | | - Sinan Gülöksüz
- Department of Psychiatry, School of Medicine, Yale University, New Haven, CT, USA; Department of Psychiatry and Neuropsychology, South Limburg Mental Health Research and Teaching Network, EURON, School for Mental Health and Neuroscience MHeNS Maastricht University, Maastricht, The Netherlands
| | - Ömer Aydemir
- Department of Psychiatry, School of Medicine, Celal Bayar University, Manisa, Turkey
| | - Güliz Özgen
- Department of Psychiatry, Bakirkoy Research and Training Hospital for Psychiatry, Neurology, and Neurosurgery, Istanbul, Turkey
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Le Bas J, Newton R, Sore R, Castle D. The prestige model of spectrum bipolarity. Med Hypotheses 2015; 84:122-8. [DOI: 10.1016/j.mehy.2014.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2014] [Revised: 11/13/2014] [Accepted: 12/06/2014] [Indexed: 11/26/2022]
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The DRD2 rs1800497 polymorphism increase the risk of mood disorder: evidence from an update meta-analysis. J Affect Disord 2014; 158:71-7. [PMID: 24655768 DOI: 10.1016/j.jad.2014.01.015] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2013] [Revised: 01/29/2014] [Accepted: 01/29/2014] [Indexed: 12/30/2022]
Abstract
BACKGROUND Growing studies have revealed the association between rs1800497 polymorphism in the dopamine receptor D2 (DRD2) and susceptibility to mood disorder (MD). However, the results remained inconsistent. METHODS To assess the effect of DRD2 rs1800497 polymorphism on MD. We performed a meta-analysis based on eight case-control studies, including a total of 2097 MD cases and 1681 controls. Summary odds ratios (OR) and corresponding 95% confidence intervals (CIs) for DRD2 rs1800497 polymorphism and MD risk were estimated. RESULTS Our meta-analysis indicated that DRD2 rs1800497 was associated with an increased MD risk, especially in Asians. Moreover, in the subgroup analysis by the type of MD, DRD2 rs1800497 polymorphism was observed to increase risk in BP. LIMITATIONS The results should be treated with caution for lacking of data to perform gene-gene and gene-environment interaction. CONCLUSIONS Our results indicated that polymorphism in DRD2 rs1800497 may play a role in development of MD.
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Bullock B, Corlass-Brown J, Murray G. Eveningness and Seasonality are Associated with the Bipolar Disorder Vulnerability Trait. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2014. [DOI: 10.1007/s10862-014-9414-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Gender-specific association of the SLC6A4 and DRD2 gene variants in bipolar disorder. Int J Neuropsychopharmacol 2014; 17:211-22. [PMID: 24229495 DOI: 10.1017/s1461145713001296] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Findings on the association between the risk for developing bipolar disorder and the functions of the serotonin transporter-linked polymorphic region gene (5-HTTLPR) and dopamine D2 receptor gene (DRD2) variants are contradictory. One explanation for this is that a gender difference may exist for genetic contributions. We compared the gender-related main effects and the gene-to-gene interaction between serotonin transporter gene (SLC6A4) and DRD2 in adult male and female patients with bipolar I (BP-I) and bipolar II (BP-II) disorder. Patients with BP-I (n = 400) and BP-II (n = 493), and healthy controls (n = 442) were recruited from Taiwan's Han Chinese population. The genotypes of the 5-HTTLPR and DRD2 Taq-IA polymorphisms were determined using polymerase chain reaction-restriction fragment length polymorphism analysis. Logistic regression analysis showed a significant gender-specific association of the DRD2 A1/A1 and the 5-HTTLPR S/S, S/LG , and LG/LG (S+) (p = 0.01) genotypes in men with BP-I (p = 0.002 and 0.01, respectively) and BP-II (p = 0.001 and 0.007, respectively), but not in women. A significant interaction for the DRD2 A1/A1 and 5-HTTLPR S+ polymorphisms was also found only in men with BP-I and BP-II (p = 0.003 and 0.001, respectively). We provide preliminary evidence for a gender-specific effect of the SLC6A4 and DRD2 gene variants for the risk of BP-I and of BP-II. We also found gender-specific interaction between 5-HTTLPR and DRD2 Taq-IA polymorphisms in patients with bipolar disorder.
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Noto MN, de Souza Noto C, de Jesus DR, Zugman A, Mansur RB, Berberian AA, Leclerc E, McIntyre RS, Correll CU, Brietzke E. Recognition of bipolar disorder type I before the first manic episode: challenges and developments. Expert Rev Neurother 2014; 13:795-806; quiz 807. [DOI: 10.1586/14737175.2013.811132] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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Fistikçi N, Hacioğlu M, Erek Ş, Tabo A, Erten E, Güler AS, Kalkan M, Saatçioğlu Ö. Differences in Affective Temperaments in Anxiety Disorders: Comparison of Panic Disorder and Obsessive Compulsive Disorder. Noro Psikiyatr Ars 2013; 50:337-343. [PMID: 28360567 DOI: 10.4274/npa.y6464] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2012] [Accepted: 05/18/2012] [Indexed: 12/01/2022] Open
Abstract
INTRODUCTION In this study, probable differences in affective temperament among anxiety disorders were investigated via a comparison of panic disorder (PD) and obsessive-compulsive disorder (OCD). METHOD 44 patients with OCD and 42 patients with PD, who were admitted to Bakirkoy Prof. Dr. Mazhar Osman Research and Training Hospital for Psychiatry, Neurology and Neurosurgery outpatient clinics with complaints of OCD and PD and were diagnosed according to DSM IV criteria, were consecutively included in the study after informed consent was taken. A sociodemographic form, the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID I), Hamilton Depression Rating Scale (HAM-D), Beck Anxiety Inventory, Panic and Agoraphobia Scale, Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) and the temperament evaluation of the Memphis, Pisa, Paris, and San Diego Autoquestionnaire (TEMPS-A) were given to the patients. PD and OCD patients were compared in terms of affective temperament characteristics. RESULTS Mean age, educational status and gender distribution of OCD and PD patients were similar (p>0.05). Dominant depressive temperament was more prominent in OCD group than in PD group (p=0.021). Hyperthymic temperament scores were higher in PD group than in OCD group (p=0.002). Dominant hyperthymic temperament was not encountered in either group. CONCLUSION Dominant depressive temperament was more prominent in OCD group whereas hyperthymic temperament scores were higher in PD group. These findings should be evaluated in studies with larger sample sizes.
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Affiliation(s)
- Nurhan Fistikçi
- Bakırköy Prof. Dr. Mazhar Osman Mental Health and Neurology education and Research Hospital, Clinic of 3 Psychiatry, İstanbul, Turkey
| | - Münevver Hacioğlu
- Bakırköy Prof. Dr. Mazhar Osman Mental Health and Neurology education and Research Hospital, Clinic of 3 Psychiatry, İstanbul, Turkey
| | - Şakire Erek
- Bakırköy Prof. Dr. Mazhar Osman Mental Health and Neurology education and Research Hospital, Clinic of 3 Psychiatry, İstanbul, Turkey
| | - Abdülkadir Tabo
- Bakırköy Prof. Dr. Mazhar Osman Mental Health and Neurology education and Research Hospital, Clinic of Neurosis, İstanbul, Turkey
| | - Evrim Erten
- Bakırköy Prof. Dr. Mazhar Osman Mental Health and Neurology education and Research Hospital, Clinic of 3 Psychiatry, İstanbul, Turkey
| | | | - Murat Kalkan
- Bakırköy Prof. Dr. Mazhar Osman Mental Health and Neurology education and Research Hospital, Clinic of 3 Psychiatry, İstanbul, Turkey
| | - Ömer Saatçioğlu
- Bakırköy Prof. Dr. Mazhar Osman Mental Health and Neurology education and Research Hospital, Clinic of 3 Psychiatry, İstanbul, Turkey
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The development of thought problems: A longitudinal family risk study of offspring of bipolar, unipolar, and well parents. Dev Psychopathol 2013; 25:1079-91. [PMID: 24229550 PMCID: PMC10064983 DOI: 10.1017/s0954579413000382] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AbstractThere is growing evidence that many offspring of parents with bipolar disorder (BD) will develop moderate to severe forms of psychopathology during childhood and adolescence, including thought problems. The purpose of this study was to evaluate the developmental progression of thought problems within the context of a family risk study. Repeated assessments of thought problems, spanning approximately 15 years, were conducted in offspring (N= 192 from 98 families) of parents diagnosed with BD (O-BD), unipolar depression (O-UNI), or no significant psychiatric or medical problems (O-WELL). Survival analysis showed that the O-BD group had the greatest estimated probability of developing thought problems over time, followed by O-UNI, and then O-WELL and O-BD exhibiting higher levels of persistence than O-WELL. Parent-reported thought problems in childhood and adolescence predicted a range of problems in young adulthood. Disturbances in reality testing and other atypical behaviors are likely to disrupt progression through important developmental periods and to associate with poor outcomes. These findings are likely relevant to preventing the occurrence or progression of problems in offspring of bipolar parents. The study of thought problems across development represents an important area of continued research in children at risk for development of affective disorders.
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Greenwood TA, Badner JA, Byerley W, Keck PE, McElroy SL, Remick RA, Sadovnick AD, Kelsoe JR. Heritability and linkage analysis of personality in bipolar disorder. J Affect Disord 2013; 151:748-755. [PMID: 23972719 PMCID: PMC3797235 DOI: 10.1016/j.jad.2013.06.015] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2013] [Accepted: 06/14/2013] [Indexed: 12/19/2022]
Abstract
BACKGROUND The many attempts that have been made to identify genes for bipolar disorder (BD) have met with limited success, which may reflect an inadequacy of diagnosis as an informative and biologically relevant phenotype for genetic studies. Here we have explored aspects of personality as quantitative phenotypes for bipolar disorder through the use of the Temperament and Character Inventory (TCI), which assesses personality in seven dimensions. Four temperament dimensions are assessed: novelty seeking (NS), harm avoidance (HA), reward dependence (RD), and persistence (PS). Three character dimensions are also included: self-directedness (SD), cooperativeness (CO), and self-transcendence (ST). METHODS We compared personality scores between diagnostic groups and assessed heritability in a sample of 101 families collected for genetic studies of BD. A genome-wide SNP linkage analysis was then performed in the subset of 51 families for which genetic data was available. RESULTS Significant group differences were observed between BD subjects, their first-degree relatives, and independent controls for all but RD and PS, and all but HA and RD were found to be significantly heritable in this sample. Linkage analysis of the heritable dimensions produced several suggestive linkage peaks for NS (chromosomes 7q21 and 10p15), PS (chromosomes 6q16, 12p13, and 19p13), and SD (chromosomes 4q35, 8q24, and 18q12). LIMITATIONS The relatively small size of our linkage sample likely limited our ability to reach genome-wide significance in this study. CONCLUSIONS While not genome-wide significant, these results suggest that aspects of personality may prove useful in the identification of genes underlying BD susceptibility.
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Affiliation(s)
| | | | - William Byerley
- Department of Psychiatry, University of California San Francisco, San Francisco, CA,San Francisco Department of Veterans Affairs Medical Center, San Francisco, CA
| | - Paul E. Keck
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, OH
| | - Susan L. McElroy
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, OH,Lindner Center of HOPE, Mason, OH
| | | | | | - John R. Kelsoe
- Department of Psychiatry, University of California San Diego, La Jolla, CA,San Diego Veterans Affairs Healthcare System, San Diego, CA,Institute for Genomic Medicine, University of California, San Diego, La Jolla, CA
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Greenwood TA, Badner JA, Byerley W, Keck PE, McElroy SL, Remick RA, Sadovnick AD, Akiskal HS, Kelsoe JR. Heritability and genome-wide SNP linkage analysis of temperament in bipolar disorder. J Affect Disord 2013; 150:1031-40. [PMID: 23759419 PMCID: PMC3759543 DOI: 10.1016/j.jad.2013.05.035] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2012] [Revised: 05/13/2013] [Accepted: 05/15/2013] [Indexed: 01/30/2023]
Abstract
BACKGROUND The many attempts to identify genes for bipolar disorder (BD) have met with limited success, which has generally been attributed to genetic heterogeneity and small gene effects. However, it is also possible that the categorical phenotypes used in genetic studies of BD are not the most informative or biologically relevant. We have explored aspects of temperament as quantitative phenotypes for BD through the use of the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego Auto-questionnaire (TEMPS-A), which is designed to assess lifelong, milder aspects of bipolar symptomatology and defines five temperaments: hyperthymic, dysthymic, cyclothymic, irritable, and anxious. METHODS We compared temperament scores between diagnostic groups and assessed heritability in a sample of 101 families collected for genetic studies of BD. A genome-wide SNP linkage study was then performed in the subset of 51 families for which genetic data was available. RESULTS Significant group differences were observed between BD subjects, their first-degree relatives, and independent controls, and all five temperaments were found to be significantly heritable, with heritabilities ranging from 21% for the hyperthymic to 52% for the irritable temperaments. Suggestive evidence for linkage was observed for the hyperthymic (chromosomes 1q44, 2p16, 6q16, and 14q23), dysthymic (chromosomes 3p21 and 13q34), and irritable (chromosome 6q24) temperaments. LIMITATIONS The relatively small size of our linkage sample likely limited our ability to reach genome-wide significance in this study. CONCLUSIONS While not genome-wide significant, these results suggest that aspects of temperament may prove useful in the identification of genes underlying BD susceptibility.
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Affiliation(s)
- Tiffany A Greenwood
- Department of Psychiatry, University of California San Diego, La Jolla, CA 92093, USA.
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Harnic D, Pompili M, Mazza M, Innamorati M, Di Nicola M, Catalano V, Bruschi A, Del Bono D, Forte A, Lester D, Girardi P, Bria P, Janiri L. Affective temperaments and psychopathological dimensions of personality in bipolar and cyclothymic patients. Behav Med 2013; 39:17-23. [PMID: 23398272 DOI: 10.1080/08964289.2012.713043] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The aims of the study were: (1) to study possible associations between temperament, personality dimensions, and psychopathological variables in a clinical sample of euthymic patients with bipolar disorder (BD) and cyclothymia; and (2) to assess how Cloninger's temperament and personality dimensions were associated with affective temperaments. Participants, consisting of 60 patients with BD (type I or II) and cyclothymia in the euthymic phase, completed Akiskal's Temperament Evaluation of Memphis, Pisa, Paris, and San Diego-Autoquestionnaire (TEMPS-A), and Cloninger's Temperament and Character Inventory-revised version (TCI-R). The diagnostic groups differed in past hospitalization, for age at onset of the disorder, and on two affective temperaments: the TEMPS-A Hyperthymia, and the TEMPS-A Irritability. There were six significant associations between affective temperaments and Cloninger's personality dimensions, ranging from 0.26 to 0.54. The measures of Akiskal and of Cloninger tap common behavioral features in patients with bipolar disorder and cyclothymia, yet the differences indicate that the two measures are not redundant. BD and cyclothymic patients differed significantly in temperament and personality, differences that may have important implications for treatment.
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Psychometric properties of the Chinese (Mandarin) TEMPS-A: a population study of 985 non-clinical subjects in China. J Affect Disord 2013; 147:29-33. [PMID: 23384971 DOI: 10.1016/j.jad.2012.12.024] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2012] [Revised: 12/25/2012] [Accepted: 12/26/2012] [Indexed: 12/21/2022]
Abstract
BACKGROUND The TEMPS-A (Temperament Evaluation of Memphis, Pisa, Paris and San Diego) is a 110-item auto-questionnaire (self-rated) which consists of five temperament scales: depressive, cyclothymic, hyperthymic, irritable and anxious temperaments. It has been translated into over 25 languages and validated in at least 12, with broad cross-cultural cogency. This is a first attempt to validate the TEMPS-A in a very large Chinese population speaking Mandarin. METHODS The Chinese TEMPS-A was adapted from the original English version following a rigorous process of forward translation and backward translation (after the approval of the English back translation by H.S.A. and K.K.A.), it was administered to 985 non-clinical Chinese subjects aged between 18-60 years (53.8% female) in four communities in Guangzhou City, China. A subset of 105 subjects was retested approximately six weeks later. Standard psychometric tests of reliability and validation were performed. RESULTS The test-retest reliability for depressive (0.74), cyclothymic (0.71), hyperthymic (0.67), irritable (0.66) and anxious (0.83) were respectively as shown in the parentheses. For internal consistency, Chronbach alphas coefficients were 0.68, 0.85, 0.82, 0.83 and 0.87, respectively. Exploratory factor analysis revealed 2 super factors, Factor I loading on anxious, cyclothymic, irritable, and depressive temperaments; and Factor II loading on hyperthymic. Depressive, cyclothymic, irritable and anxious temperaments were correlated with each other. Males had significantly higher scores than females for the hyperthymic and irritable temperaments. The prevalence of the dominant depressive (2.9%), cyclothymic (5.6%), hyperthymic (1.3%), irritable (7.0%) and anxious (5.3%) temperaments were respectively as shown in the parentheses. LIMITATIONS Although it is likely that generalizability of our scale is good for the entire Mandarin-speaking ethnic composition of China today, future research is needed to establish this conclusively. CONCLUSION The Chinese TEMPS-A standardized on one of the largest non-clinical samples in any of the other national studies to date, has good internal consistency, coheres well with validated versions in other languages. The findings suggest that it is a psychometrically sound instrument to assess affective temperaments in clinical and biological studies in China.
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Landaas ET, Halmøy A, Oedegaard KJ, Fasmer OB, Haavik J. The impact of cyclothymic temperament in adult ADHD. J Affect Disord 2012; 142:241-7. [PMID: 22840630 DOI: 10.1016/j.jad.2012.04.034] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2012] [Revised: 03/08/2012] [Accepted: 04/17/2012] [Indexed: 01/29/2023]
Abstract
BACKGROUND Attention-Deficit/Hyperactivity Disorder (ADHD) is a prevalent neurodevelopmental disorder in children and adults. Many ADHD patients experience affective symptoms that resemble the cyclothymic temperament trait, which is suggested to be a part of the bipolar spectrum. However, the relationship between adult ADHD and cyclothymic temperament has never been systematically studied. METHODS A sample of 586 clinically diagnosed Norwegian adult ADHD patients and 721 population derived controls responded to the 21-item cyclothymic subscale of the Temperament Evaluation of Memphis, Pisa, Paris and San Diego auto-questionnaire (TEMPS-A). Self-reported data on psychiatric symptoms, comorbidity, educational and occupational level, and known comorbidity in family members, including bipolar disorder, was also obtained. RESULTS The mean TEMPS-A scores were 13.0 for patients and 4.6 for controls (p<0.001), and 71% of the patients compared to 13% of the controls were classified as having a cyclothymic temperament (TEMPS score ≥11 points). Among ADHD patients, cyclothymic temperament was strongly associated with more childhood and adult ADHD symptoms, lower educational and occupational achievements and increased psychiatric comorbidity, including bipolar disorder (10%). In addition, 49% screened positive on the Mood Disorder Questionnaire. LIMITATIONS Although the cyclothymic TEMPS-A scale has been used in clinical settings in Norway for many years, it has not yet been officially validated. CONCLUSIONS Cyclothymic temperament is highly prevalent in adults with ADHD, and this characterises a subgroup of more psychiatrically impaired individuals, possibly reflecting an underlying affective instability with a pathophysiology closer to the bipolar spectrum disorders.
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Affiliation(s)
- E T Landaas
- Department of Biomedicine, University of Bergen, Bergen, Norway.
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Lee SY, Chen SL, Chen SH, Chu CH, Chang YH, Lin SH, Huang SY, Tzeng NS, Kuo PH, Lee IH, Yeh TL, Yang YK, Lu RB. Interaction of the DRD3 and BDNF gene variants in subtyped bipolar disorder. Prog Neuropsychopharmacol Biol Psychiatry 2012; 39:382-7. [PMID: 22877924 DOI: 10.1016/j.pnpbp.2012.07.015] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2012] [Revised: 07/19/2012] [Accepted: 07/25/2012] [Indexed: 10/28/2022]
Abstract
OBJECTIVES Bipolar disorder is a severe mental disorder with prominent genetic etiologic factors. Dopaminergic dysfunction has been implicated in the pathogenesis of bipolar disorder, which suggests that the dopamine D3 receptor gene (DRD3) is a strong candidate gene. The brain-derived neurotrophic factor (BDNF) gene has been implicated in the etiology of bipolar disorder. We examined the association between the BDNF Val66Met and DRD3 Ser9Gly polymorphisms with two subtypes of bipolar disorder: bipolar-I and -II. Because BDNF regulates DRD3 expression (1), we also examined possible interactions between these genes. METHODS We recruited 964 participants: 268 with bipolar-I, 436 with bipolar-II, and 260 healthy controls. The genotypes of the BDNF Val66Met and DRD3 Ser9Gly polymorphisms were determined using polymerase chain reactions plus restriction fragment length polymorphism analysis. RESULTS Logistic regression analysis showed a significant main effect for the Val/Val genotype of the BDNF Val66Met polymorphism (P=0.020), which predicted bipolar-II patients. Significant interaction effects for the BDNF Val66Met Val/Val genotype and both DRD3 Ser9Gly Ser/Ser and Ser/Gly genotypes were found only in bipolar-II patients (P=0.027 and 0.006, respectively). CONCLUSION We provide initial evidence that the BDNF Val66Met and DRD3 Ser9Gly genotypes interact only in bipolar-II disorder and that bipolar-I and bipolar-II may be genetically distinct.
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Affiliation(s)
- Sheng-Yu Lee
- Department of Psychiatry, National Cheng Kung University, Tainan, Taiwan
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Kim B, Lim JH, Kim SY, Joo YH. Comparative Study of Personality Traits in Patients with Bipolar I and II Disorder from the Five-Factor Model Perspective. Psychiatry Investig 2012; 9:347-53. [PMID: 23251198 PMCID: PMC3521110 DOI: 10.4306/pi.2012.9.4.347] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2012] [Revised: 06/08/2012] [Accepted: 07/12/2012] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE The distinguishing features of Bipolar I Disorder (BD I) from Bipolar II Disorder (BD II) may reflect a separation in enduring trait dimension between the two subtypes. We therefore assessed the similarities and differences in personality traits in patients with BD I and BD II from the perspective of the Five-Factor Model (FFM). METHODS The revised NEO Personality Inventory (NEO-PI-R) was administered to 85 BD I (47 females, 38 males) and 43 BD II (23 females, 20 males) patients. All included patients were in remission from their most recent episode and in a euthymic state for at least 8 weeks prior to study entry. RESULTS BDII patients scored higher than BD I patients on the Neuroticism dimension and its four corresponding facets (Anxiety, Depression, Self-consciousness, and Vulnerability). In contrast, BD II patients scored lower than BD I patients on the Extraversion dimension and its facet, Positive emotion. Competence and Achievement-striving facets within the Conscientiousness dimension were significantly lower for BD II than for BD I patients. There were no significant between-group differences in the Openness and Agreeableness dimensions. CONCLUSION Disparities in personality traits were observed between BD I and BD II patients from the FFM perspective. BD II patients had higher Neuroticism and lower Extraversion than BD I patients, which are differentiating natures between the two subtypes based on the FFM.
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Affiliation(s)
- Byungsu Kim
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jong-Han Lim
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Seong Yoon Kim
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Yeon Ho Joo
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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Abstract
The genetic basis for bipolar disorder (BPD) is complex with the involvement of multiple genes. As it is well established that cyclic adenosine monophosphate (cAMP) signaling regulates behavior, we tested variants in 29 genes that encode components of this signaling pathway for associations with BPD type I (BPD I) and BPD type II (BPD II). A total of 1172 individuals with BPD I, 516 individuals with BPD II and 1728 controls were analyzed. Single SNP (single-nucleotide polymorphism), haplotype and SNP × SNP interactions were examined for association with BPD. Several statistically significant single-SNP associations were observed between BPD I and variants in the PDE10A gene and between BPD II and variants in the DISC1 and GNAS genes. Haplotype analysis supported the conclusion that variation in these genes is associated with BPD. We followed-up PDE10A's association with BPD I by sequencing a 23-kb region in 30 subjects homozygous for seven minor allele risk SNPs and discovered eight additional rare variants (minor allele frequency < 1%). These single-nucleotide variants were genotyped in 999 BPD cases and 801 controls. We obtained a significant association for these variants in the combined sample using multiple methods for rare variant analysis. After using newly developed methods to account for potential bias from sequencing BPD cases only, the results remained significant. In addition, SNP × SNP interaction studies suggested that variants in several cAMP signaling pathway genes interact to increase the risk of BPD. This report is among the first to use multiple rare variant analysis methods following common tagSNPs associations with BPD.
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Abstract
Bipolar disorder (BD) and major depressive disorder (MDD) are heritable neuropsychiatric disorders associated with disrupted circadian rhythms. The hypothesis that circadian clock dysfunction plays a causal role in these disorders has endured for decades but has been difficult to test and remains controversial. In the meantime, the discovery of clock genes and cellular clocks has revolutionized our understanding of circadian timing. Cellular circadian clocks are located in the suprachiasmatic nucleus (SCN), the brain’s primary circadian pacemaker, but also throughout the brain and peripheral tissues. In BD and MDD patients, defects have been found in SCN-dependent rhythms of body temperature and melatonin release. However, these are imperfect and indirect indicators of SCN function. Moreover, the SCN may not be particularly relevant to mood regulation, whereas the lateral habenula, ventral tegmentum, and hippocampus, which also contain cellular clocks, have established roles in this regard. Dysfunction in these non-SCN clocks could contribute directly to the pathophysiology of BD/MDD. We hypothesize that circadian clock dysfunction in non-SCN clocks is a trait marker of mood disorders, encoded by pathological genetic variants. Because network features of the SCN render it uniquely resistant to perturbation, previous studies of SCN outputs in mood disorders patients may have failed to detect genetic defects affecting non-SCN clocks, which include not only mood-regulating neurons in the brain but also peripheral cells accessible in human subjects. Therefore, reporters of rhythmic clock gene expression in cells from patients or mouse models could provide a direct assay of the molecular gears of the clock, in cellular clocks that are likely to be more representative than the SCN of mood-regulating neurons in patients. This approach, informed by the new insights and tools of modern chronobiology, will allow a more definitive test of the role of cellular circadian clocks in mood disorders.
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Affiliation(s)
- Michael J. McCarthy
- Department of Psychiatry, Veterans Affairs San Diego Healthcare System, San Diego, CA
- Department of Psychiatry and Center for Chronobiology, University of California, San Diego, CA
| | - David K. Welsh
- Department of Psychiatry, Veterans Affairs San Diego Healthcare System, San Diego, CA
- Department of Psychiatry and Center for Chronobiology, University of California, San Diego, CA
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Greenwood TA, Akiskal HS, Akiskal KK, Kelsoe JR. Genome-wide association study of temperament in bipolar disorder reveals significant associations with three novel Loci. Biol Psychiatry 2012; 72:303-10. [PMID: 22365631 PMCID: PMC3925336 DOI: 10.1016/j.biopsych.2012.01.018] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2011] [Revised: 01/04/2012] [Accepted: 01/06/2012] [Indexed: 10/28/2022]
Abstract
BACKGROUND The many attempts to identify genes for bipolar disorder (BD) have met with limited success, which has generally been attributed to genetic heterogeneity and small gene effects. However, it is also possible that the categorical phenotypes used in genetic studies of BD are not the most informative or biologically relevant. Although quantitative phenotypes provide an alternative to categorical phenotypes based on diagnosis, they have not been fully exploited in BD genetics due to the lack of accessible biological measures. We have explored aspects of temperament as quantitative phenotypes that might define subtypes of BD with different clinical features and courses of illness. Temperament is a heritable personality factor that establishes the baseline level of reactivity, mood, and energy of a person. METHODS We have performed a genome-wide association study with genotype data from the Bipolar Genome Study and 1263 bipolar subjects that had completed the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego Autoquestionnaire (TEMPS-A). The TEMPS-A is designed to assess lifelong, milder aspects of bipolar symptomatology and defines five temperaments: hyperthymic, dysthymic, cyclothymic, irritable, and anxious. RESULTS The irritable temperament produced the most significant result with a genome-wide significant p value of 1.7 × 10(-8) on chromosome 1. The hyperthymic temperament produced additional genome-wide significant p values of 4.1 × 10(-8) and 2.1 × 10(-8) on chromosomes 12 and 22, respectively. CONCLUSIONS These results suggest that aspects of temperament might define subtypes of BD that are more clinically and genetically homogenous, which might aid in the identification of predisposing genetic variants.
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Affiliation(s)
| | - Hagop S. Akiskal
- Department of Psychiatry, University of California, San Diego, La Jolla, CA,International Mood Center, La Jolla, CA,VA San Diego VA Healthcare System, San Diego, CA
| | | | | | - John R. Kelsoe
- Department of Psychiatry, University of California, San Diego, La Jolla, CA,VA San Diego VA Healthcare System, San Diego, CA,Institute of Genomic Medicine, University of California, San Diego, La Jolla, CA
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Lee SY, Chen SL, Chang YH, Chu CH, Huang SY, Tzeng NS, Wang CL, Lin SH, Lee IH, Yeh TL, Yang YK, Lu RB. The ALDH2 and 5-HT2A genes interacted in bipolar-I but not bipolar-II disorder. Prog Neuropsychopharmacol Biol Psychiatry 2012; 38:247-51. [PMID: 22564712 DOI: 10.1016/j.pnpbp.2012.04.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2012] [Revised: 04/05/2012] [Accepted: 04/06/2012] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Clarifying the similarities and differences between the two most common subtypes of bipolar disorder, bipolar-I and bipolar-II, is essential for improving our understanding of them. Because the serotonergic system has been implicated in the pathogenesis of bipolar disorder, it may be important to investigate genes such as the aldehyde dehydrogenase 2 (ALDH2) and serotonin 2A receptor genes, which are involved in metabolizing serotonin and encoding serotonin receptors. We examined the association of the ALDH2 and 5-HT2A-A1438G polymorphisms with bipolar I and II and possible interactions between these genes. METHODS One thousand forty-nine participants were recruited: 249 with bipolar-I, 456 with bipolar-II, and 344 healthy controls. The genotypes of the ALDH2 and 5HT2A-A1438G polymorphisms were determined using polymerase chain reactions plus restriction fragment length polymorphism analysis. RESULTS Logistic regression analysis showed a significant effect of the ALDH2 and the 5-HT2A-A1438G polymorphisms, and a significant interaction effect for the A/G genotypes of the 5-HT2A-A1438G polymorphism and the ALDH2*1*1 genotypes (p=0.004) discriminated between bipolar-I patients and controls without bipolar disorder. These polymorphisms, however, were not associated with bipolar-II disorder. LIMITATIONS The significant differences of age and gender between patients and controls limit the comparison, although statistical adjustments were made for them. CONCLUSION Our findings provide initial evidence that the ALDH2 and 5-HT2A genes interact in bipolar-I but not in bipolar-II disorder. Our findings suggest a unique genetic distinction between bipolar-I and bipolar-II.
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Affiliation(s)
- Sheng-Yu Lee
- Department of Psychiatry, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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Huang CC, Chang YH, Lee SY, Chen SL, Chen SH, Chu CH, Huang SY, Tzeng NS, Lee IH, Yeh TL, Yang YK, Lu RB. The interaction between BDNF and DRD2 in bipolar II disorder but not in bipolar I disorder. Am J Med Genet B Neuropsychiatr Genet 2012; 159B:501-7. [PMID: 22514151 DOI: 10.1002/ajmg.b.32055] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2011] [Accepted: 04/04/2012] [Indexed: 12/17/2022]
Abstract
Bipolar I (BP-I) and bipolar II (BP-II) disorders are the two most common subtypes of bipolar disorder. However, most studies have not differentiated bipolar disorder into BP-I and BP-II groups, for which the underlying etiology differentiating these two subtypes remains unclear. The genetic association between both subtypes is essential for improving our understanding. The dopamine D2 receptor/ankyrin repeat and kinase domain containing 1 (DRD2/ANKK1), one of the dopaminergic pathways, as well as the brain-derived neurotrophic factor (BDNF) gene, were reported as candidate genes in the etiology of bipolar disorder. Therefore, we examined the contribution of the BDNF and DRD2/ANKK1 genes and their interaction to the differentiation of BP-I and BP-II. Seven hundred ninety-two participants were recruited: 208 with BP-I, 329 with BP-II, and 255 healthy controls. The genotypes of the BDNF and DRD2/ANKK1 Taq1A polymorphisms were determined using polymerase chain reactions plus restriction fragment length polymorphism analysis. A significant main effect for the Val/Val genotype of the BDNF Val66Met polymorphism predicted BP-II patients. The significant interaction effect for the Val/Val genotype of the BDNF Val66Met polymorphism and A1/A2 genotype of DRD2/ANKK1 Taq1A polymorphism was found only in BP-II patients. We provide initial evidence that the BDNF Val66Me and DRD2/ANKK1 Taq1A polymorphisms interact only in BP-II disorder and that BP-I and BP-II are genetically distinct.
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Affiliation(s)
- Chih-Chun Huang
- Department of Medicine, National Cheng Kung University Hospital, Tainan, Taiwan
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A survey of genomic studies supports association of circadian clock genes with bipolar disorder spectrum illnesses and lithium response. PLoS One 2012; 7:e32091. [PMID: 22384149 PMCID: PMC3285204 DOI: 10.1371/journal.pone.0032091] [Citation(s) in RCA: 121] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2011] [Accepted: 01/23/2012] [Indexed: 11/19/2022] Open
Abstract
Circadian rhythm abnormalities in bipolar disorder (BD) have led to a search for genetic abnormalities in circadian “clock genes” associated with BD. However, no significant clock gene findings have emerged from genome-wide association studies (GWAS). At least three factors could account for this discrepancy: complex traits are polygenic, the organization of the clock is more complex than previously recognized, and/or genetic risk for BD may be shared across multiple illnesses. To investigate these issues, we considered the clock gene network at three levels: essential “core” clock genes, upstream circadian clock modulators, and downstream clock controlled genes. Using relaxed thresholds for GWAS statistical significance, we determined the rates of clock vs. control genetic associations with BD, and four additional illnesses that share clinical features and/or genetic risk with BD (major depression, schizophrenia, attention deficit/hyperactivity). Then we compared the results to a set of lithium-responsive genes. Associations with BD-spectrum illnesses and lithium-responsiveness were both enriched among core clock genes but not among upstream clock modulators. Associations with BD-spectrum illnesses and lithium-responsiveness were also enriched among pervasively rhythmic clock-controlled genes but not among genes that were less pervasively rhythmic or non-rhythmic. Our analysis reveals previously unrecognized associations between clock genes and BD-spectrum illnesses, partly reconciling previously discordant results from past GWAS and candidate gene studies.
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Chang YH, Chen SL, Chen SH, Chu CH, Lee SY, Yang HF, Tzeng NS, Lee IH, Chen PS, Yeh TL, Huang SY, Chou KR, Yang YK, Ko HC, Lu RB, Angst J. Low anxiety disorder comorbidity rate in bipolar disorders in Han Chinese in Taiwan. Prog Neuropsychopharmacol Biol Psychiatry 2012; 36:194-7. [PMID: 21996277 DOI: 10.1016/j.pnpbp.2011.09.013] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2011] [Revised: 09/27/2011] [Accepted: 09/28/2011] [Indexed: 01/12/2023]
Abstract
OBJECTIVES Studies report high comorbidity of lifetime anxiety disorders with bipolar disorders in Western patients, but it is unclear in Taiwan. The authors explored the comorbidity of anxiety disorders in different bipolar disorder subtypes in Han Chinese in Taiwan. METHODS Three hundred twenty-five patients with bipolar disorder (bipolar I: 120; bipolar II: 205) disorder were recruited from two general medical outpatient services. They were evaluated and their diagnoses confirmed by a psychiatrist using the Chinese version of the Modified Schedule of Affective Disorder and Schizophrenia-Lifetime. The exclusion criteria were: any DSM-IV-TR Axis I diagnosis, other than bipolar disorder, being outside the 18-65-year-old age range, any other major and minor mental illnesses except anxiety disorder, any neurological disorders or organic mental disorders. RESULTS Thirty-two (26.7%) of patients were comorbid with lifetime anxiety disorder and bipolar I, 80 (39.0%) with lifetime anxiety disorder and bipolar II, 7 (5.8%) were comorbid with two or more anxiety disorders and bipolar I, and 27 (13.2%) with two or more anxiety disorders and bipolar II. CONCLUSION That more than twice as many bipolar II than bipolar I patients reported two or more anxiety disorders implies that the complication is more prevalent in bipolar II patients.
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Affiliation(s)
- Yun-Hsuan Chang
- Division of Clinical Psychology, Institute of Allied Health Sciences, Department of Psychiatry, College of Medicine, National Cheng Kung University, and National Cheng Kung University Hospital, Tainan, Taiwan
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Lee SY, Chen SL, Chen SH, Huang SY, Tzeng NS, Chang YH, Wang CL, Lee IH, Yeh TL, Yang YK, Lu RB. The COMT and DRD3 genes interacted in bipolar I but not bipolar II disorder. World J Biol Psychiatry 2011; 12:385-91. [PMID: 20698735 DOI: 10.3109/15622975.2010.505298] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES. Clarifying the association between bipolar I and bipolar II disorders at the genetic level is essential for improving our understanding of them. In this study, we evaluated the hypothesis that the dopaminergic polymorphisms are risk factors for bipolar disorders. We examined the association between the catechol-O-methyltransferase (COMT) Val158Met and dopamine D3 receptor (DRD3) Ser9Gly polymorphisms and bipolar I and II disorders, as well as possible interactions between these genes. METHODS. Seven hundred and eleven participants were recruited: 205 with bipolar I, 270 with bipolar II, and 236 healthy controls. The genotypes of the COMT Val158Met and DRD3 Ser9Gly polymorphisms were determined using polymerase chain reactions plus restriction fragment length polymorphism analysis. RESULTS. Logistic regression analyses showed a statistically significant main effect for the Met/Met genotype of the COMT Val158Met polymorphism (P=0.032) and a significant interaction effect for the Met/Met genotype of the COMT Val158Met and Ser/Ser genotypes of the DRD3 Ser9Gly polymorphism (P=0.001) predicted bipolar I patients. However, there was no association between the COMT Val158Met or DRD3 Ser9Gly and bipolar II. CONCLUSIONS. We provide initial evidence that the COMT Val158Met and DRD3 Ser9Gly genotypes interact in bipolar I and bipolar II disorders and that bipolar I and bipolar II are genetically distinct.
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Affiliation(s)
- Sheng-Yu Lee
- Department of Psychiatry, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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Gandotra S, Ram D, Kour J, Praharaj SK. Association between affective temperaments and bipolar spectrum disorders: preliminary perspectives from a controlled family study. Psychopathology 2011; 44:216-24. [PMID: 21502773 DOI: 10.1159/000322691] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2009] [Accepted: 11/05/2010] [Indexed: 11/19/2022]
Abstract
BACKGROUND The study aimed at determining the temperamental underpinnings of bipolar spectrum disorders (BSD) in the first-degree relatives (FDR) of patients with bipolar I disorder in comparison with control subjects. SAMPLING AND METHODS The sample consisted of 198 subjects: 33 bipolar I probands and their 33 FDR in the experimental group, 33 schizophrenia probands and their 33 FDR in the patient control group, and 33 normal healthy controls and their 33 FDR. The affective temperament and the BSD were assessed using the Temperament Evaluation of the Memphis, Pisa, Paris, and San Diego Autoquestionnaire and the criteria of Ghaemi et al. [Can J Psychiatry 2002;47:125-134], respectively. RESULTS Among the FDR of bipolar I probands, 27.3% satisfied the diagnosis of BSD, which was significantly higher than in the other groups (relative risk = 6, 95% CI = 1.74-20.69). Bipolar probands were significantly more hyperthymic as compared to controls (relative risk = 2, 95% CI = 1.34-2.98), and both the FDR of the bipolar and the FDR of the patient control groups were significantly more hyperthymic as compared to the FDR of the normal controls (relative risk = 1.52, 95% CI = 0.93-2.51). FDR (of bipolar patients) with BSD had a significantly higher total irritable temperament score as compared to FDR (of bipolar patients) without BSD (mean difference = 2.07, 95% CI = 0.64-3.50). CONCLUSIONS Our findings support the fact that the whole spectrum of bipolarity is transmitted in susceptible families. The graded distribution of hyperthymia suggests it to be a milder expression of bipolarity in the FDR of bipolar patients. The irritable temperament appears to be a specific vulnerability marker for the development of BSD.
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Rahman OA, Sasvari-Szekely M, Szekely A, Faludi G, Guttman A, Nemoda Z. Analysis of a polymorphic microRNA target site in the purinergic receptor P2RX7 gene. Electrophoresis 2010; 31:1790-5. [PMID: 20446288 DOI: 10.1002/elps.200900664] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
The recent discovery of post-transcriptional regulation by microRNAs (miRNAs) drew our attention to SNPs of putative miRNA target sites in candidate genes of depression-related psychiatric disorders. The P2RX7 (purinergic receptor P2X, ligand-gated ion channel, 7) gene has been suggested as a candidate for major depressive and bipolar disorder, because of repeated associations with the rs2230912 (Gln460Arg) polymorphism. As this polymorphism is located at the end of the coding region, we considered a possible linkage with SNP(s) in putative miRNA target sites of the 3' untranslated region. Based on our in silico search, the rs1653625 fulfilled this criterion. This SNP, however, is surrounded with polycytosine and polyadenine tracts, which hindered its analysis until now. In this study, we describe a readily applicable genotyping method for rs1653625 by applying a primer that introduces mismatched nucleotides to create a restriction enzyme cleavage site. The resulting allele-specific products with 19 base pair difference were separated by both traditional horizontal agarose gel electrophoresis and multicapillary gel electrophoresis. The developed genotyping method was applied in our depression-related association study.
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Affiliation(s)
- Omar Abdul Rahman
- Institute of Medical Chemistry, Molecular Biology and Pathobiochemistry, Semmelweis University, Budapest, Hungary
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The ALDH2 and DRD2/ANKK1 genes interacted in bipolar II but not bipolar I disorder. Pharmacogenet Genomics 2010; 20:500-6. [PMID: 20577142 DOI: 10.1097/fpc.0b013e32833caa2b] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Di Florio A, Hamshere M, Forty L, Green EK, Grozeva D, Jones I, Caesar S, Fraser C, Gordon-Smith K, Jones L, Craddock N, Smith DJ. Affective temperaments across the bipolar-unipolar spectrum: examination of the TEMPS-A in 927 patients and controls. J Affect Disord 2010; 123:42-51. [PMID: 19883944 DOI: 10.1016/j.jad.2009.09.020] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2009] [Revised: 09/28/2009] [Accepted: 09/28/2009] [Indexed: 01/03/2023]
Abstract
OBJECTIVE There is currently a great deal of interest in the use of affective temperaments as possible intermediate phenotypes for bipolar disorder. However, much of the literature in this area is conflicting. Our aims were to test the hypothesis of a gradient in affective temperament scores, as measured by the Temperament Evaluation of Memphis, Pisa, Paris and San Diego (TEMPS-A), from bipolar disorder type I (BP-I), through bipolar disorder type II (BP-II), recurrent major depressive disorder (MDD-R), and a control group (CG) in the largest sample to date of 927 subjects. METHODS Non parametric tests were used to compare TEMPS-A scores between diagnostic groups and multinomial logistic regression was used to test the association between TEMPS-A scores and diagnosis while controlling for current mood state, age and gender. RESULTS Although the BP-II group scored higher than the BP-I and MDD-R groups on several TEMPS-A subscales, these differences were not significant when confounding variables were controlled for. The dysthymic subscale differentiated between affected and controls and the anxious subscale differentiated the MDD-R group from controls. LIMITATIONS The cross-sectional design did not allow us to evaluate potential longitudinal changes of temperament scores, which were assessed only with a self-report questionnaire. CONCLUSION We failed to find evidence of a gradient in affective temperament scores. Both unipolar and bipolar patients reported high dysthymic scores relative to controls, perhaps supporting a unitary view of depression across the bipolar-unipolar spectrum. Taking account of potential confounders will be important in future studies which seek to use affective temperaments as intermediate phenotypes in genetic research.
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Affiliation(s)
- Arianna Di Florio
- MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University School of Medicine, University Hospital of Wales, Cardiff, CF14 4XN, UK.
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Single nucleotide polymorphisms that were identified in affective mood disorders affect ATP-activated P2X7 receptor functions. J Psychiatr Res 2010; 44:347-55. [PMID: 19931869 DOI: 10.1016/j.jpsychires.2009.10.005] [Citation(s) in RCA: 98] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2009] [Revised: 10/09/2009] [Accepted: 10/12/2009] [Indexed: 01/08/2023]
Abstract
Genetic linkage studies have previously identified many single non-synonymous nucleotide polymorphisms (SNPs) in the human P2RX7 gene in individuals with affective mood disorders. The P2RX7 gene encodes the P2X(7) receptor (P2X(7)R) that operates as an ATP-activated Ca(2+)-permeable cationic channel and induces formation of a large pore, the two functional properties that are critical for the physiological and pathological roles of the receptor. The current knowledge regarding the effects of SNPs on the P2X(7)R functional properties, which is indispensable to help elucidate the disease mechanism, is limited. In this study, we introduced by site-directed mutagenesis twelve SNP mutations in the human P2X(7) receptor that were previously identified in or associated with affective mood disorders, expressed the resultant mutants in human embryonic kidney cells, and characterized their functional properties by electrophysiology. All mutations except Q460R gave rise to profound effects on the P2X(7)R function. G150R, E186K and I568N conferred complete loss of function. V76A, R117W, L191P, T357S and E496A resulted in strong impairment of, whereas H155Y and A348T caused significant increase in, both ATP-activated ion channel function and pore formation. Q521H reduced the receptor's sensitivity to extracellular Ca(2+) inhibition. An atomic structure model of the human P2X(7)R, based on the crystal structure of the zebrafish P2X(4) receptor, suggests that the SNP mutational effects may result from changes in subunit interaction, agonist binding and/or channel gating. These results provide essential knowledge for a better understanding of the relationships between human P2RX7 SNPs and associated pathologies as well as the receptor structure-function relationships.
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Joo EJ, Greenwood TA, Schork N, McKinney RA, Sadovnick AD, Remick RA, Keck PE, McElroy SL, Kelsoe JR. Suggestive evidence for linkage of ADHD features in bipolar disorder to chromosome 10p14. Am J Med Genet B Neuropsychiatr Genet 2010; 153B:260-8. [PMID: 19603423 DOI: 10.1002/ajmg.b.31005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Higher rates of bipolar disorder amongst the first-degree relatives of probands with ADHD, and increased rates of ADHD in the relatives of bipolar probands have been reported in many studies. This suggests some commonality in the genetic basis for bipolar disorder and ADHD. We hypothesized that ADHD symptoms in bipolar disorder may access a quantitative subphenotype that is genetically less complex and therefore advantageous for mapping studies. The Wender Utah Rating Scale (WURS) was used to quantify ADHD features in 57 bipolar families collected for linkage studies. The factor structure of the WURS was first examined, and heritability was estimated. Linkage analysis was then conducted using the WURS total score and factor scores as quantitative traits. Three factors were identified: impulsivity and defiant behavior, mood instability and anxiety, and inattention. The total WURS and factor scores were each significantly heritable (0.34 <h(2r) < 0.49) in bipolar families. The inattention factor obtained maximum evidence of linkage on chromosome 10p14 (LOD = 3.35, 25 cM). A LOD score of 2.06 for the total WURS score was found on chromosome 12q24 region. Childhood ADHD features in patients with bipolar disorder are heritable and may represent a genetically distinct dimension of illness. 10p14, in particular may contain a locus for inattention in bipolar disorder. Quantitative dimensional phenotypes such as this may be useful for both mapping of genes and understanding the role of genes in bipolar disorder.
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Affiliation(s)
- Eun-Jeong Joo
- Department of Psychiatry, University of California, San Diego, La Jolla, California, USA
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Saunders EFH, Zhang P, Copeland JN, Mclnnis MG, Zöllner S. Suggestive linkage at 9p22 in bipolar disorder weighted by alcohol abuse. Am J Med Genet B Neuropsychiatr Genet 2009; 150B:1133-8. [PMID: 19259988 DOI: 10.1002/ajmg.b.30937] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Bipolar disorder (BP) is a highly heritable disorder, however attempts to map genetic risk factors are challenging. One possible reason for these difficulties is the genetic heterogeneity of BP. Hence, focusing on clinically homogeneous families to create a genetically more homogeneous sample may increase the power of finding a specific variant. Alcohol abuse (AA) and alcohol dependence (AD) are familial in BP families, and these families may carry a specific risk variant for BP. We tested this hypothesis by performing a genome-wide linkage scan in 638 pedigrees (1,835 individuals) from the National Institute of Mental Health Genetics Initiative for BP, weighting the evidence for linkage according to the family's frequency of AA or AD. Using AA weighting, we identified a linkage region on 9p22.2 with an NPL score of 3.23. The region had previously been identified in a meta-analysis of linkage in bipolar disorder. We used permutation analysis to assess if weighting by AA increased the linkage signal more than expected by chance and observed a significant P-value (P = 0.048). Therefore, the genetic risk factor for BP on 9p22.2 has an increased effect in families with high levels of AA. In summary, we present an example of using covariates such as AA and AD to define subtypes of BP, demonstrate how using such subtypes can improve the power of a linkage scan, and demonstrate statistical approaches to validate the suggested interaction.
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Regeer EJ, Krabbendam L, De Graaf R, Have MT, Nolen WA, Van Os J. Berkson's bias and the mood dimensions of bipolar disorder. Int J Methods Psychiatr Res 2009; 18:279-86. [PMID: 19708034 PMCID: PMC6878283 DOI: 10.1002/mpr.290] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2007] [Revised: 12/11/2007] [Accepted: 01/22/2008] [Indexed: 01/20/2023] Open
Abstract
In this paper we examined whether manic and depressive dimensions independently contribute to mental health service use and determined the degree of comorbidity between manic and depressive dimensions in individuals with and without mental health service use. If both depressive and manic episodes independently influence help-seeking behaviour, a higher level of comorbidity between these dimensions would be found in clinical as compared to non-clinical samples (i.e. Berkson's Bias). Data were derived from the Netherlands Mental Health Survey and Incidence Study (NEMESIS), a prospective epidemiological survey in a representative sample of the Dutch population (N = 7076). Dimensions of depression and mania and mental health service use (MHSU) were assessed with the Composite International Diagnostic Interview (CIDI) at baseline, and prospectively one and three years later. Logistic regression was used to test whether depressive and manic dimensions both had independent effects on mental health service use. The degree of mania-comorbidity given the presence of depressive dimension was assessed as a function of MHSU, both retrospectively and prospectively. Manic and depressive dimensions contributed independently to mental health service use. Mania-comorbidity given the presence of depressive dimension was significantly higher in individuals with mental health service use than in those without, both retrospectively (16.7% versus 7.1%, p = 0.000) and prospectively (10.8% versus 6.6%, p = 0.017). We conclude that the bipolar phenotype consists of manic and depressive dimensions that may be much more loosely associated than (Berkson) biased clinical observations suggest. A dimension-specific approach may be more productive in clarifying the aetiology of mood dysregulation.
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Affiliation(s)
- E J Regeer
- Altrecht Institute for Mental Health Care, Utrecht, The Netherlands.
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