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Maes M, Jirakran K, Vasupanrajit A, Niu M, Zhou B, Stoyanov DS, Tunvirachaisakul C. The recurrence of illness (ROI) index is a key factor in major depression that indicates increasing immune-linked neurotoxicity and vulnerability to suicidal behaviors. Psychiatry Res 2024; 339:116085. [PMID: 39032358 DOI: 10.1016/j.psychres.2024.116085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2024] [Revised: 07/09/2024] [Accepted: 07/13/2024] [Indexed: 07/23/2024]
Abstract
In this study, we aimed to investigate the associations between the recurrence of illness (ROI) and biomarkers related to an activated immune network, immune-linked neurotoxicity (INT), and a combined INT and atherogenicity index (METAMMUNE). The study involved 67 healthy controls and 66 outpatient MDD (OMDD) participants. We utilized a Multiplex method to measure 48 cytokines and examined INT and METAMMUNE composite scores in association with different ROI indices. Our findings revealed that a ROI index was successfully created by extracting a validated principal component, from the physician-rated or self-declared number of depressive episodes, the frequency of lifetime suicidal ideation and attempts. ROI was significantly associated with INT and METAMMUNE indices, neuroticism, lifetime and current suicidal behaviors, and the phenome. Our analysis also revealed that a significant portion of the variance in the OMDD phenome, which includes current suicidal behaviors, anxiety, and depression, can be accounted for by the regression on INT, ROI, and emotional neglect and abuse. A validated latent construct was successfully extracted from the three ROI components, INT and METAMMUNE indices. The results indicate that increasing ROI indicates heightened immune-metabolic abnormalities, increased risk of suicidal behaviors, and elevated severity of lifetime and current phenome features.
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Affiliation(s)
- Michael Maes
- Sichuan Provincial Center for Mental Health, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610072, China; Key Laboratory of Psychosomatic Medicine, Chinese Academy of Medical Sciences, Chengdu 610072, China; Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; Program in Mental Health, Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; Cognitive Impairment and Dementia Research Unit, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; Cognitive Fitness and Biopsychological Technology Research Unit, Faculty of Medicine Chulalongkorn University, Bangkok 10330, Thailand; Department of Psychiatry, Medical University of Plovdiv, Plovdiv, Bulgaria; Research Institute, Medical University of Plovdiv, Plovdiv, Bulgaria; Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, Korea; Research and Innovation Program for the Development of MU - PLOVDIV-(SRIPD-MUP)", Creation of a Network of Research Higher Schools, National Plan for Recovery and Sustainability, European Union - NextGenerationEU; Center of Excellence for Maximizing Children's Developmental Potential, Department of Pediatric, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
| | - Ketsupar Jirakran
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; Program in Mental Health, Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; Center of Excellence for Maximizing Children's Developmental Potential, Department of Pediatric, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Asara Vasupanrajit
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; Program in Mental Health, Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Mengqi Niu
- Sichuan Provincial Center for Mental Health, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610072, China; Key Laboratory of Psychosomatic Medicine, Chinese Academy of Medical Sciences, Chengdu 610072, China
| | - Bo Zhou
- Sichuan Provincial Center for Mental Health, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610072, China; Key Laboratory of Psychosomatic Medicine, Chinese Academy of Medical Sciences, Chengdu 610072, China
| | - Drozdstoj St Stoyanov
- Department of Psychiatry, Medical University of Plovdiv, Plovdiv, Bulgaria; Research Institute, Medical University of Plovdiv, Plovdiv, Bulgaria; Research and Innovation Program for the Development of MU - PLOVDIV-(SRIPD-MUP)", Creation of a Network of Research Higher Schools, National Plan for Recovery and Sustainability, European Union - NextGenerationEU
| | - Chavit Tunvirachaisakul
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; Program in Mental Health, Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; Cognitive Impairment and Dementia Research Unit, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
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Dempsey RC, Dodd AL, Gooding PA, Jones SH. The Types of Psychosocial Factors Associated with Suicidality Outcomes for People Living with Bipolar Disorder: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:525. [PMID: 38791740 PMCID: PMC11120682 DOI: 10.3390/ijerph21050525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 04/19/2024] [Accepted: 04/20/2024] [Indexed: 05/26/2024]
Abstract
Bipolar Disorder is associated with high rates of suicidal thoughts, behaviors, and outcomes, yet the lived experience of suicidality and Bipolar Disorder is not particularly well understood. Understanding the role of psychosocial aetiologies in suicidality outcomes for those living with Bipolar Disorder is key for developing appropriately targeted interventions focusing on factors that are amenable to change. In line with PRISMA guidance, we conducted a scoping review to identify the types of psychosocial factors studied in relation to the experience of suicidality for people living with Bipolar Disorder diagnoses. Systematic literature searches identified a sample of 166 articles from which key study data were extracted and charted. A narrative synthesis of the reviewed literature is presented ordered by the factors investigated across studies, a frequency count of the types of psychological/social aetiologies studied, and a brief overview of the key findings for each aetiology. Most of the identified literature took the form of quantitative cross-sectional studies, with only one qualitative study and 18 quantitative prospective studies. The most studied aetiologies were trauma (specifically early adverse experiences and childhood traumas) and stressful life events, impulsivity (primarily subjective self-reported trait impulsivity), social support and functioning, and personality/temperament factors. Only six studies in the final sample reported basing their research questions and/or hypotheses on an explicit theoretical model of suicide. The literature was primarily focused on using self-report measurements of key aetiologies and on factors which lead to worsened suicidality rather than focusing on potentially protective or buffering factors. Future research needs to better justify the aetiologies investigated in relation to suicidality outcomes for people living with Bipolar Disorder, including a firmer basis in theory and hypothesis testing, more prospective designs, and the use of alternative assessments of psychosocial aetiologies in addition to self-report questionnaires.
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Affiliation(s)
- Robert C. Dempsey
- Department of Psychology, Faculty of Health and Education, Manchester Metropolitan University, Manchester M15 6BH, UK
| | - Alyson L. Dodd
- Department of Psychology, Faculty of Health & Life Sciences, Northumbria University, Newcastle upon Tyne NE1 8ST, UK
| | - Patricia A. Gooding
- Division of Psychology & Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester M13 9PL, UK
| | - Steven H. Jones
- Spectrum Centre for Mental Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster LA1 4YW, UK
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Chrétienneau C, Spindola LM, Vorspan F, Lagerberg TV, Marie‐Claire C, Bellivier F, Mouly S, Laplanche J, Bloch V, Le Hellard S, Icick R. An epigenetic candidate-gene association study of parental styles in suicide attempters with substance use disorders. Addict Biol 2024; 29:e13392. [PMID: 38564607 PMCID: PMC10986931 DOI: 10.1111/adb.13392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 02/07/2024] [Accepted: 02/27/2024] [Indexed: 04/04/2024]
Abstract
Suicide attempts (SA) are prevalent in substance use disorders (SUD). Epigenetic mechanisms may play a pivotal role in the molecular mechanisms of environmental effects eliciting suicidal behaviour in this population. Hypothalamic-pituitary-adrenal axis (HPA), oxytocin and neurotrophin pathways have been consistently involved in SA, yet , their interplay with childhood adversity remains unclear, particularly in SUD. In 24 outpatients with SUDs, we examined the relation between three parental dysfunctional styles and history of SA with methylation of 32 genes from these pathways, eventually analysing 823 methylation sites. Extensive phenotypic characterization was obtained using a semi-structured interview. Parental style was patient-reported using the Measure of Parental Style (MOPS) questionnaire, analysed with and without imputation of missing items. Linear regressions were performed to adjust for possible confounders, followed by multiple testing correction. We describe both differentially methylated probes (DMPs) and regions (DMRs) for each set of analyses (with and without imputation of MOPS items). Without imputation, five DMRs in OXTR, CRH and NTF3 significantly interacted with MOPS father abuse to increase the risk for lifetime SA, thus covering the three pathways. After imputation of missing MOPS items, two other DMPs from FKBP5 and SOCS3 significantly interacted with each of the three father styles to increase the risk for SA. Although our findings must be interpreted with caution due to small sample size, they suggest implications of stress reactivity genes in the suicidal risk of SUD patients and highlight the significance of father dysfunction as a potential marker of childhood adversity in SUD patients.
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Affiliation(s)
- Clara Chrétienneau
- Département Universitaire de Psychiatrie et de Médecine Addictologique, GHU APHP. NordAssistance Publique – Hôpitaux de ParisParisFrance
- INSERM UMR‐S 1144, Optimisation Thérapeutique en Neurospsychopharmacologie, OTeNUniversité Paris CitéParisFrance
- FHU NOR‐SUD Network of Research in Substance Use DisordersParisFrance
| | - Leticia M. Spindola
- NORMENT, Department of Clinical ScienceUniversity of BergenBergenNorway
- Dr. Einar Martens Research Group for Biological Psychiatry, Department of Medical GeneticsHaukeland University HospitalBergenNorway
| | - Florence Vorspan
- Département Universitaire de Psychiatrie et de Médecine Addictologique, GHU APHP. NordAssistance Publique – Hôpitaux de ParisParisFrance
- INSERM UMR‐S 1144, Optimisation Thérapeutique en Neurospsychopharmacologie, OTeNUniversité Paris CitéParisFrance
- FHU NOR‐SUD Network of Research in Substance Use DisordersParisFrance
| | - Trine Vik Lagerberg
- Division of Mental Health and Addiction Department of Psychology, Faculty of Social SciencesOslo University Hospital | University of Oslo, Oslo, NorwayOsloNorway
| | - Cynthia Marie‐Claire
- INSERM UMR‐S 1144, Optimisation Thérapeutique en Neurospsychopharmacologie, OTeNUniversité Paris CitéParisFrance
- FHU NOR‐SUD Network of Research in Substance Use DisordersParisFrance
| | - Frank Bellivier
- Département Universitaire de Psychiatrie et de Médecine Addictologique, GHU APHP. NordAssistance Publique – Hôpitaux de ParisParisFrance
- INSERM UMR‐S 1144, Optimisation Thérapeutique en Neurospsychopharmacologie, OTeNUniversité Paris CitéParisFrance
- FHU NOR‐SUD Network of Research in Substance Use DisordersParisFrance
| | - Stéphane Mouly
- Department of Internal MedicineLariboisière Hospital, Assistance Publique‐Hôpitaux de ParisParisFrance
- Université Paris CitéParisFrance
| | - Jean‐Louis Laplanche
- INSERM UMR‐S 1144, Optimisation Thérapeutique en Neurospsychopharmacologie, OTeNUniversité Paris CitéParisFrance
- FHU NOR‐SUD Network of Research in Substance Use DisordersParisFrance
| | - Vanessa Bloch
- INSERM UMR‐S 1144, Optimisation Thérapeutique en Neurospsychopharmacologie, OTeNUniversité Paris CitéParisFrance
- FHU NOR‐SUD Network of Research in Substance Use DisordersParisFrance
- Pharmacie HospitalièreAssistance Publique – Hôpitaux de Paris, GHU APHP. NordParisFrance
| | - Stéphanie Le Hellard
- NORMENT, Department of Clinical ScienceUniversity of BergenBergenNorway
- Dr. Einar Martens Research Group for Biological Psychiatry, Department of Medical GeneticsHaukeland University HospitalBergenNorway
| | - Romain Icick
- Département Universitaire de Psychiatrie et de Médecine Addictologique, GHU APHP. NordAssistance Publique – Hôpitaux de ParisParisFrance
- INSERM UMR‐S 1144, Optimisation Thérapeutique en Neurospsychopharmacologie, OTeNUniversité Paris CitéParisFrance
- FHU NOR‐SUD Network of Research in Substance Use DisordersParisFrance
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Lunding SH, Ueland T, Aas M, Høegh MC, Werner MCF, Rødevand L, Johansen IT, Hjell G, Ormerod MBEG, Ringen PA, Ottesen A, Lagerberg TV, Melle I, Andreassen OA, Simonsen C, Steen NE. Tobacco smoking related to childhood trauma mediated by cognitive control and impulsiveness in severe mental disorders. Schizophr Res 2023; 261:236-244. [PMID: 37806047 DOI: 10.1016/j.schres.2023.09.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 05/26/2023] [Accepted: 09/24/2023] [Indexed: 10/10/2023]
Abstract
BACKGROUND People with severe mental disorders (SMDs) show an increased prevalence of tobacco smoking compared to the general population. Tobacco smoking and other adult adverse health behaviors have been associated with traumatic experiences in childhood. In the present study we investigated the relationship between childhood trauma and tobacco smoking in people with SMDs, including the possible mediating role of cognitive- and personality characteristics, i.e. cognitive control, impulsiveness, affective lability and self-esteem. METHODS Enrolled in the study were 871 participants with schizophrenia (SCZ, N = 484) and bipolar (BD, N = 387) spectrum disorders. We assessed tobacco smoking behavior (yes/no and amount), and history of childhood trauma with the Childhood Trauma Questionnaire. Data on cognitive control, impulsiveness, affective lability, and self-esteem were available in subsamples. We performed linear and logistic regressions, and conducted mediation analyses in PROCESS. All analyses were as standard adjusted for age, sex, and diagnostic group. RESULTS Experience of one or more subtypes of childhood trauma was significantly associated with smoking tobacco in SMDs (p = 0.002). There were no significant associations between childhood trauma and amount of tobacco smoking. Cognitive control and impulsiveness were significant mediators between childhood trauma and tobacco smoking. CONCLUSIONS These findings indicate the experience of childhood trauma as a predisposing factor for tobacco smoking in SMDs. Cognitive control and impulsiveness were suggested as mediating mechanisms, indicating the importance of considering inhibition related self-regulatory aspects in efforts to improve health behavior in individuals with SMDs and childhood trauma.
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Affiliation(s)
- Synve Hoffart Lunding
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
| | - Torill Ueland
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Department of Psychology, University of Oslo, Oslo, Norway
| | - Monica Aas
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Margrethe Collier Høegh
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Maren Caroline Frogner Werner
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Linn Rødevand
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Ingrid Torp Johansen
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Gabriela Hjell
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Department of Psychiatry, Ostfold Hospital, Graalum, Norway
| | | | - Petter Andreas Ringen
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Akiah Ottesen
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway
| | - Trine Vik Lagerberg
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Ingrid Melle
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Ole A Andreassen
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Carmen Simonsen
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Early Intervention in Psychosis Advisory Unit for South East Norway, Oslo University Hospital, Oslo, Norway
| | - Nils Eiel Steen
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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Li X, Huang Y, Liu M, Zhang M, Liu Y, Teng T, Liu X, Yu Y, Jiang Y, Ouyang X, Xu M, Lv F, Long Y, Zhou X. Childhood trauma is linked to abnormal static-dynamic brain topology in adolescents with major depressive disorder. Int J Clin Health Psychol 2023; 23:100401. [PMID: 37584055 PMCID: PMC10423886 DOI: 10.1016/j.ijchp.2023.100401] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 07/24/2023] [Indexed: 08/17/2023] Open
Abstract
Childhood trauma is a leading risk factor for adolescents developing major depressive disorder (MDD); however, the underlying neuroimaging mechanisms remain unclear. This study aimed to investigate the association among childhood trauma, MDD and brain dysfunctions by combining static and dynamic brain network models. We recruited 46 first-episode drug-naïve adolescent MDD patients with childhood trauma (MDD-CT), 53 MDD patients without childhood trauma (MDD-nCT), and 90 healthy controls (HCs) for resting-state functional magnetic resonance imaging (fMRI) scans; all participants were aged 13-18 years. Compared to the HCs and MDD-nCT groups, the MDD-CT group exhibited significantly higher global and local efficiency in static brain networks and significantly higher temporal correlation coefficients in dynamic brain network models at the whole-brain level, and altered the local efficiency of default mode network (DMN) and temporal correlation coefficients of DMN, salience (SAN), and attention (ATN) networks at the local perspective. Correlation analysis indicated that altered brain network features and clinical symptoms, childhood trauma, and particularly emotional neglect were highly correlated in adolescents with MDD. This study may provide new evidence for the dysconnectivity hypothesis regarding the associations between childhood trauma and MDD in adolescents from the perspectives of both static and dynamic brain topology.
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Affiliation(s)
- Xuemei Li
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yang Huang
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Mengqi Liu
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Manqi Zhang
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Yang Liu
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Teng Teng
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xueer Liu
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Ying Yu
- Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yuanliang Jiang
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xuan Ouyang
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Ming Xu
- Brainnetome Center and National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing, China
- School of Artificial Intelligence, University of Chinese Academy of Sciences, Beijing, China
| | - Fajin Lv
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yicheng Long
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Xinyu Zhou
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Moller CI, Badcock PB, Hetrick SE, Rice S, Berk M, Witt K, Chanen AM, Dean OM, Gao C, Cotton SM, Davey CG. Predictors of suicidal ideation severity among treatment-seeking young people with major depressive disorder: The role of state and trait anxiety. Aust N Z J Psychiatry 2023; 57:1150-1162. [PMID: 36629043 DOI: 10.1177/00048674221144262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
OBJECTIVE Depression and suicidal ideation are closely intertwined. Yet, among young people with depression, the specific factors that contribute to changes in suicidal ideation over time are uncertain. Factors other than depressive symptom severity, such as comorbid psychopathology and personality traits, might be important contributors. Our aim was to identify contributors to fluctuations in suicidal ideation severity over a 12-week period in young people with major depressive disorder receiving cognitive behavioural therapy. METHODS Data were drawn from two 12-week randomised, placebo-controlled treatment trials. Participants (N = 283) were 15-25 years old, with moderate to severe major depressive disorder. The primary outcome measure was the Suicidal Ideation Questionnaire, administered at baseline and weeks 4, 8 and 12. A series of linear mixed models was conducted to examine the relationship between Suicidal Ideation Questionnaire score and demographic characteristics, comorbid psychopathology, personality traits and alcohol use. RESULTS Depression and anxiety symptom severity, and trait anxiety, independently predicted higher suicidal ideation, after adjusting for the effects of time, demographics, affective instability, non-suicidal self-injury and alcohol use. CONCLUSIONS Both state and trait anxiety are important longitudinal correlates of suicidal ideation in depressed young people receiving cognitive behavioural therapy, independent of depression severity. Reducing acute psychological distress, through reducing depression and anxiety symptom severity, is important, but interventions aimed at treating trait anxiety could also potentially be an effective intervention approach for suicidal ideation in young people with depression.
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Affiliation(s)
- Carl I Moller
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Paul B Badcock
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Sarah E Hetrick
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Department of Psychological Medicine, University of Auckland, Auckland, New Zealand
| | - Simon Rice
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Michael Berk
- The Institute for Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine, Deakin University and Barwon Health, Geelong, VIC, Australia
- The Florey Institute of Neuroscience and Mental Health and Department of Psychiatry, The University of Melbourne, Parkville, VIC, Australia
| | - Katrina Witt
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Andrew M Chanen
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Olivia M Dean
- The Institute for Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine, Deakin University and Barwon Health, Geelong, VIC, Australia
- The Florey Institute of Neuroscience and Mental Health and Department of Psychiatry, The University of Melbourne, Parkville, VIC, Australia
| | - Caroline Gao
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Sue M Cotton
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Christopher G Davey
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Department of Psychiatry, The University of Melbourne, Parkville, VIC, Australia
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7
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Abaatyo J, Favina A, Kaggwa MM. Absconding among admitted patients with bipolar affective disorder diagnosis in Uganda. BMC Psychiatry 2023; 23:318. [PMID: 37142973 PMCID: PMC10161627 DOI: 10.1186/s12888-023-04794-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 04/18/2023] [Indexed: 05/06/2023] Open
Abstract
BACKGROUND Hospitalization is often necessary for individuals with Bipolar affective Disorder (BAD) during severe manic or depressive episodes, as well as for stabilizing treatment regimens. However, a significant proportion of patients admitted for treatment of BAD abscond or leave the hospital without permission during their stay. In addition, patients managed for BAD may have unique characteristics that might force them into absconding. For example, the high prevalence of co-morbid substance use disorder - craving to use substances, suicidal behaviors - attempts to die by suicide, and cluster B personality disorders - characterized by impulsive acts. It is, therefore, essential to understand the factors contributing to absconding among patients with BAD, to facilitate designing strategies for preventing and managing this behavior. METHOD This study was based on a retrospective chart review of the inpatients diagnosed with BAD at a tertiary psychiatry facility in Uganda from January 2018 to December 2021. RESULTS Approximately 7.8% of those with BAD absconded from the hospital. The likelihood of absconding among those with BAD increased with the use of cannabis [adjusted odds ratio (aOR) = 4.00, 95% confidence interval (CI) = 1.22-13.09, p-value = 0.022] and having mood lability [aOR = 2.15, 95% CI = 1.10-4.21, p-value = 0.025]. However, receiving psychotherapy during the admission (aOR = 0.44, 95 CI = 0.26-0.74, p-value = 0.002) and treatment with haloperidol (aOR = 0.39, 95% CI = 0.18-0.83, p-value = 0.014) reduced the likelihood of absconding. CONCLUSION Absconding among patients with BAD is common in Uganda. Those with symptoms of affective lability and those with comorbid cannabis use tend to abscond more, while those who receive haloperidol and psychotherapy are less likely to abscond.
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Affiliation(s)
- Joan Abaatyo
- Department of Psychiatry, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Alain Favina
- Department of Psychiatry, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Mark Mohan Kaggwa
- Department of Psychiatry, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda.
- Department of Psychiatry and Behavioral Neurosciences, McMaster University, Ontario, ON, Canada.
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Maes M, Almulla AF. Research and Diagnostic Algorithmic Rules (RADAR) and RADAR Plots for the First Episode of Major Depressive Disorder: Effects of Childhood and Recent Adverse Experiences on Suicidal Behaviors, Neurocognition and Phenome Features. Brain Sci 2023; 13:brainsci13050714. [PMID: 37239186 DOI: 10.3390/brainsci13050714] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 04/11/2023] [Accepted: 04/20/2023] [Indexed: 05/28/2023] Open
Abstract
Recent studies have proposed valid precision models and valid Research and Diagnostic Algorithmic Rules (RADAR) for recurrent major depressive disorder (MDD). The aim of the current study was to construct precision models and RADAR scores in patients experiencing first-episode MDD and to examine whether adverse childhood experiences (ACE) and negative life events (NLE) are associated with suicidal behaviors (SB), cognitive impairment, and phenome RADAR scores. This study recruited 90 patients with major depressive disorder (MDD) in an acute phase, of whom 71 showed a first-episode MDD (FEM), and 40 controls. We constructed RADAR scores for ACE; NLE encountered in the last year; SB; and severity of depression, anxiety, chronic fatigue, and physiosomatic symptoms using the Hamilton Depression and Anxiety Rating Scales and the FibroFatigue scale. The partial least squares analysis showed that in FEM, one latent vector (labeled the phenome of FEM) could be extracted from depressive, anxiety, fatigue, physiosomatic, melancholia, and insomnia symptoms, SB, and cognitive impairments. The latter were conceptualized as a latent vector extracted from the Verbal Fluency Test, the Mini-Mental State Examination, and ratings of memory and judgement, indicating a generalized cognitive decline (G-CoDe). We found that 60.8% of the variance in the FEM phenome was explained by the cumulative effects of NLE and ACE, in particular emotional neglect and, to a lesser extent, physical abuse. In conclusion, the RADAR scores and plots constructed here should be used in research and clinical settings, rather than the binary diagnosis of MDD based on the DSM-5 or ICD.
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Affiliation(s)
- Michael Maes
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand
- Cognitive Fitness and Technology Research Unit, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand
- Department of Psychiatry, Medical University of Plovdiv, 4002 Plovdiv, Bulgaria
- Research Institute, Medical University Plovdiv, 4002 Plovdiv, Bulgaria
- Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, Republic of Korea
| | - Abbas F Almulla
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand
- Medical Laboratory Technology Department, College of Medical Technology, The Islamic University, Najaf 54001, Iraq
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Research and Diagnostic Algorithmic Rules (RADAR) for mood disorders, recurrence of illness, suicidal behaviours, and the patient's lifetime trajectory. Acta Neuropsychiatr 2023; 35:104-117. [PMID: 36380512 DOI: 10.1017/neu.2022.31] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The top-down Diagnostic and Statistical Manual/International Statistical Classification of Diseases categories of mood disorders are inaccurate, and their dogmatic nature precludes both deductive (as indisputable) and inductive (as top-down) remodelling of case definitions. In trials, psychiatric rating scale scores employed as outcome variables are invalid and rely on folk psychology-like narratives. Using machine learning techniques, we developed a new precision nomothetic model of mood disorders with a recurrence of illness (ROI) index, a new endophenotype class, namely Major Dysmood Disorder (MDMD), characterised by increased ROI, a more severe phenome, and more disabilities. Nonetheless, our previous studies did not compute Research and Diagnostic Algorithmic Rules (RADAR) to diagnose MDMD and score ROI, lifetime (LT), and current suicidal behaviours, as well as the phenome of mood disorders. Here, we provide rules to compute bottom-up RADAR scores for MDMD, ROI, LT and current suicidal ideation and attempts, the phenome of mood disorders, and the lifetime trajectory of mood disorder patients from a family history of mood disorders and substance abuse to adverse childhood experiences, ROI, and the phenome. We also demonstrate how to plot the 12 major scores in a single RADAR graph, which displays all features in a two-dimensional plot. These graphs allow the characteristics of a patient to be displayed as an idiomatic fingerprint, allowing one to estimate the key traits and severity of the illness at a glance. Consequently, biomarker research into mood disorders should use our RADAR scores to examine pan-omics data, which should be used to enlarge our precision models and RADAR graph.
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10
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Kjærstad HL, Macoveanu J, Knudsen GM, Frangou S, Phan KL, Vinberg M, Kessing LV, Miskowiak KW. Neural responses during down-regulation of negative emotion in patients with recently diagnosed bipolar disorder and their unaffected relatives. Psychol Med 2023; 53:1254-1265. [PMID: 37010225 DOI: 10.1017/s0033291721002737] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND Aberrant emotion regulation has been posited as a putative endophenotype of bipolar disorder (BD). We therefore aimed to compare the neural responses during voluntary down-regulation of negative emotions in a large functional magnetic resonance imaging study of BD, patients' unaffected first-degree relatives (URs), and healthy controls (HCs). METHODS We compared neural activity and fronto-limbic functional connectivity during emotion regulation in response to aversive v. neutral pictures in patients recently diagnosed with BD (n = 78) in full/partial remission, their URs (n = 35), and HCs (n = 56). RESULTS Patients showed hypo-activity in the left dorsomedial, dorsolateral, and ventrolateral prefrontal cortex (DMPFC and DLPFC) during emotion regulation while viewing aversive pictures compared to HCs, with URs displaying intermediate neural activity in these regions. There were no significant differences between patients with BD and HCs in functional connectivity from the amygdala during emotion regulation. However, exploratory analysis indicated that URs displayed more negative amygdala-DMPFC coupling compared with HCs and more negative amygdala-cingulate DLPFC coupling compared to patients with BD. At a behavioral level, patients and their URs were less able to dampen negative emotions in response aversive pictures. CONCLUSIONS The findings point to deficient recruitment of prefrontal resources and more negative fronto-amygdala coupling as neural markers of impaired emotion regulation in recently diagnosed remitted patients with BD and their URs, respectively.
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Affiliation(s)
- Hanne Lie Kjærstad
- Copenhagen Affective Disorder research Centre (CADIC), Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, Denmark
| | - Julian Macoveanu
- Copenhagen Affective Disorder research Centre (CADIC), Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, Denmark
| | - Gitte Moos Knudsen
- Neurobiology Research Unit, Copenhagen University Hospital, Rigshospitalet, Denmark
| | - Sophia Frangou
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, USA
| | - K Luan Phan
- Department of Psychiatry and Behavioral Health, The Ohio State University, Columbus, USA
| | - Maj Vinberg
- Copenhagen Affective Disorder research Centre (CADIC), Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, Denmark
- Psychiatric Research Unit, Psychiatric Centre North Zealand, Hillerød, Denmark
| | - Lars Vedel Kessing
- Copenhagen Affective Disorder research Centre (CADIC), Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, Denmark
| | - Kamilla Woznica Miskowiak
- Copenhagen Affective Disorder research Centre (CADIC), Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, Denmark
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
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11
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Sensory gating deficits and childhood trauma in the onset of first-episode schizophrenia. Asian J Psychiatr 2023; 80:103385. [PMID: 36542893 DOI: 10.1016/j.ajp.2022.103385] [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: 05/02/2022] [Revised: 09/09/2022] [Accepted: 09/20/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Studies have shown sensory gating deficits and severe childhood trauma in patients with schizophrenia; however, their relationship with this condition remains unclear. Here, we hypothesized that sensory gating deficits mediate the effects of childhood trauma on schizophrenia onset. METHODS We recruited 79 patients with first-episode schizophrenia (PFES) and 76 health controls (HC). The auditory conditioning (S1) and testing (S2) stimulus paradigm was used to detect P50 sensory gating. The Childhood Trauma Questionnaire (CTQ) was used to assess childhood trauma experiences. RESULTS Compared with HC, the PFES group had more severe childhood trauma experiences together with sensory gating deficits. In a partial correlation analysis, sexual abuse was negatively correlated with the P50 S2 latency, physical neglect was negatively correlated with the S1 latency, while emotional neglect was positively correlated with the S2/S1 ratio and negatively correlated with the S1-S2 difference in the PFES group. However, there was no correlation between the CTQ total and each sub-scores and P50 indicators in the HC. The S1-S2 difference was the mediator between emotional neglect and the onset of schizophrenia. CONCLUSION Childhood trauma might be associated with schizophrenia by influencing sensory gating deficits. Early intervention targeting childhood trauma might reduce the incidence of sensory gating deficits and thus schizophrenia.
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Aas M, Ueland T, Lagerberg TV, Melle I, Aminoff SR, Hoegh MC, Lunding SH, Laskemoen JF, Steen NE, Andreassen OA. Retrospectively assessed childhood trauma experiences are associated with illness severity in mental disorders adjusted for symptom state. Psychiatry Res 2023; 320:115045. [PMID: 36621206 DOI: 10.1016/j.psychres.2022.115045] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Revised: 12/13/2022] [Accepted: 12/27/2022] [Indexed: 12/30/2022]
Abstract
Converging evidence suggests that childhood trauma is a causal factor in schizophrenia (SZ) and in bipolar disorders (BD). Here, we investigated whether retrospective reports are associated with severity of illness, independent of current symptom state in a large sample of participants with SZ or BD. We included 1260 individuals (SZ [n = 461], BD [n = 352]), and healthy controls; HC [n = 447]) recruited from the same catchment area. A history of childhood trauma was obtained with the Childhood Trauma Questionnaire (CTQ). Diagnosis and episodes were obtained with the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I). Clinical symptoms (state) were assessed with the Positive and Negative Syndrome scale (PANSS), the Calgary Depression Scale (CDSS). Trait related illness characteristics were assessed with age at illness onset, number of episodes, and lifetime suicide attempts. Patients who reported multiple types of childhood trauma experiences had significantly more severe illness course including an earlier illness onset, more mood episodes, and increased risk of at least one suicide attempt, also after adjusting for current symptom state. Retrospective assessed childhood trauma experiences are associated with illness severity in mental disorders adjusted for symptom state. Our results strengthen the role of childhood trauma in development of psychopathology.
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Affiliation(s)
- Monica Aas
- NORMENT Centre for Psychosis Research, Oslo University Hospital and University of Oslo, Norway; Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
| | - Torill Ueland
- NORMENT Centre for Psychosis Research, Oslo University Hospital and University of Oslo, Norway
| | - Trine V Lagerberg
- NORMENT Centre for Psychosis Research, Oslo University Hospital and University of Oslo, Norway
| | - Ingrid Melle
- NORMENT Centre for Psychosis Research, Oslo University Hospital and University of Oslo, Norway
| | - Sofie R Aminoff
- NORMENT Centre for Psychosis Research, Oslo University Hospital and University of Oslo, Norway; Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Early Intervention in Psychosis Advisory Unit for South East Norway, Division of Mental Health and Addiction, Oslo University Hospital, Norway
| | - Margrethe C Hoegh
- NORMENT Centre for Psychosis Research, Oslo University Hospital and University of Oslo, Norway
| | - Synve Hoffart Lunding
- NORMENT Centre for Psychosis Research, Oslo University Hospital and University of Oslo, Norway
| | - Jannicke F Laskemoen
- NORMENT Centre for Psychosis Research, Oslo University Hospital and University of Oslo, Norway
| | - Nils Eiel Steen
- NORMENT Centre for Psychosis Research, Oslo University Hospital and University of Oslo, Norway
| | - Ole A Andreassen
- NORMENT Centre for Psychosis Research, Oslo University Hospital and University of Oslo, Norway
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13
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Almeida TC, Fernandes RM, Cunha O. The role of positive childhood experiences in the link between childhood maltreatment and affective lability in a sample of incarcerated men and women. CHILD ABUSE & NEGLECT 2023; 135:105969. [PMID: 36436298 DOI: 10.1016/j.chiabu.2022.105969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 11/10/2022] [Accepted: 11/15/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Individuals with a history of child maltreatment (CM) tend to show high affective lability (AL) and criminal behavior. However, positive childhood experiences (PCEs) may act as a protective factor even in the presence of child maltreatment. OBJECTIVE The present study aimed to analyze the relationship between CM, PCEs, and AL in adulthood, identify the predictors of AL and analyze the moderating role of PCEs in the relationship between CM and AL in a sample of 424 incarcerated men (n = 343) and women (n = 81), aged between 18 and 73 years (M = 37.88). METHODS Participants responded to an online protocol consisting of a sociodemographic questionnaire, the Childhood Trauma Questionnaire (CTQ), the Benevolent Childhood Experiences Scale (BCEs), and the Affective Lability Scale - Short Version (ALS-18). RESULTS CM was positively associated with AL and negatively associated with PCEs, and PCEs are negatively associated with AL. Regression analyses, after controlling for age, sex, and education, confirmed the role of PCEs on AL, above and beyond CM. However, moderation analysis showed that PCEs did not moderate the relationship between CM and AL for either men or women. CONCLUSIONS These results highlight the complexity of human development and behavior from early childhood into adulthood. Further studies are needed to better understand the role of PCEs in the relationship between ACEs and AL among inmates in order to develop more appropriate prevention and intervention programs.
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Affiliation(s)
- Telma Catarina Almeida
- Instituto Universitário Egas Moniz (IUEM), Caparica, Portugal; CiiEM - Centro de Investigação Interdisciplinar Egas Moniz, IUEM, Portugal; LabPSI - Laboratório de Psicologia Egas Moniz, IUEM, Portugal.
| | - Raquel Margarida Fernandes
- Instituto Universitário Egas Moniz (IUEM), Caparica, Portugal; LabPSI - Laboratório de Psicologia Egas Moniz, IUEM, Portugal
| | - Olga Cunha
- Universidade Lusófona do Porto, Portugal; Hei-Lab, Portugal
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14
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Ma M, Xiao C, Ou W, Lv G, Huang M, Zhao X, Qin Y, Ju Y, Zhang Y. Psychometric property study of the Affective Lability Scale-short form in Chinese patients with mood disorders. Front Psychiatry 2023; 14:1160791. [PMID: 37082759 PMCID: PMC10110953 DOI: 10.3389/fpsyt.2023.1160791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 03/14/2023] [Indexed: 04/22/2023] Open
Abstract
Introduction This study aimed to investigate the psychometric properties of the Affective Lability Scale-short form (ALS-SF) among Chinese patients with mood disorders, and to compare ALS-SF subscale scores between patients with major depressive disorder (MDD) and patients with bipolar disorder (BD) depression. Methods A total of 344 patients with mood disorders were included in our study. Participants were measured through a set of questionnaires including the Chinese version of ALS-SF, Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder 7-item (GAD-7), and NEO-Five Factor Inventory (NEO-FFI). Exploratory factor analysis and confirmatory factor analysis were applied to examine the psychometric properties of ALS-SF. Besides, correlation and regression analyses were performed to explore the relationship between affective lability and depression, anxiety, and neuroticism. Independent samples t-tests were used to compare the subscale scores of ALS-SF between the MDD and BD depression groups. Results Results of factor analysis indicated that the model of ALS-SF was consistent with ALS-SF. The ALS-SF showed a solid validity and high internal consistency (Cronbach's alpha = 0.861). In addition, each subscale of ALS-SF was significantly correlated with PHQ-9, GAD-7, and NEO-FFI neuroticism subscale, except for the anger subscale showed no significant correlation with PHQ-9. Besides, the depression/elation and anger factor scores in patients with BD depression were higher than in patients with MDD. Conclusion Our study suggests that the Chinese version of ALS-SF has good reliability and validity for measuring affective lability in Chinese patients with mood disorders. Assessing affective lability would assist clinicians to distinguish between MDD and BP depression and may decrease the risks of misdiagnosis.
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Affiliation(s)
- Mohan Ma
- Department of Psychiatry, Second Xiangya Hospital, Central South University, Changsha, Hunan, China
- Mental Health Institute of Central South University, China National Clinical Research Center on Mental Disorders (Xiangya), China National Technology Institute on Mental Disorders, Changsha, Hunan, China
| | - Chuman Xiao
- Department of Psychiatry, Second Xiangya Hospital, Central South University, Changsha, Hunan, China
- Mental Health Institute of Central South University, China National Clinical Research Center on Mental Disorders (Xiangya), China National Technology Institute on Mental Disorders, Changsha, Hunan, China
| | - Wenwen Ou
- Department of Psychiatry, Second Xiangya Hospital, Central South University, Changsha, Hunan, China
- Mental Health Institute of Central South University, China National Clinical Research Center on Mental Disorders (Xiangya), China National Technology Institute on Mental Disorders, Changsha, Hunan, China
| | - Guanyi Lv
- Department of Psychiatry, Second Xiangya Hospital, Central South University, Changsha, Hunan, China
- Mental Health Institute of Central South University, China National Clinical Research Center on Mental Disorders (Xiangya), China National Technology Institute on Mental Disorders, Changsha, Hunan, China
| | - Mei Huang
- Department of Psychiatry, Second Xiangya Hospital, Central South University, Changsha, Hunan, China
- Mental Health Institute of Central South University, China National Clinical Research Center on Mental Disorders (Xiangya), China National Technology Institute on Mental Disorders, Changsha, Hunan, China
| | - Xiaotian Zhao
- Department of Psychiatry, Second Xiangya Hospital, Central South University, Changsha, Hunan, China
- Mental Health Institute of Central South University, China National Clinical Research Center on Mental Disorders (Xiangya), China National Technology Institute on Mental Disorders, Changsha, Hunan, China
| | - Yaqi Qin
- Department of Psychiatry, Second Xiangya Hospital, Central South University, Changsha, Hunan, China
- Mental Health Institute of Central South University, China National Clinical Research Center on Mental Disorders (Xiangya), China National Technology Institute on Mental Disorders, Changsha, Hunan, China
| | - Yumeng Ju
- Department of Psychiatry, Second Xiangya Hospital, Central South University, Changsha, Hunan, China
- Mental Health Institute of Central South University, China National Clinical Research Center on Mental Disorders (Xiangya), China National Technology Institute on Mental Disorders, Changsha, Hunan, China
- *Correspondence: Yumeng Ju, ; Yan Zhang,
| | - Yan Zhang
- Department of Psychiatry, Second Xiangya Hospital, Central South University, Changsha, Hunan, China
- Mental Health Institute of Central South University, China National Clinical Research Center on Mental Disorders (Xiangya), China National Technology Institute on Mental Disorders, Changsha, Hunan, China
- *Correspondence: Yumeng Ju, ; Yan Zhang,
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15
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Alexithymia and depressive symptoms mediated the relationship between childhood trauma and suicidal risk in Chinese male prisoners. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-03975-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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16
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Ernst M, Brähler E, Kampling H, Kruse J, Fegert JM, Plener PL, Beutel ME. Is the end in the beginning? Child maltreatment increases the risk of non-suicidal self-injury and suicide attempts through impaired personality functioning. CHILD ABUSE & NEGLECT 2022; 133:105870. [PMID: 36084408 DOI: 10.1016/j.chiabu.2022.105870] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 07/18/2022] [Accepted: 08/31/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Child maltreatment is a risk factor for a range of mental disorders later in life, including dangerous self-harm and suicide attempts. A better understanding of the mechanisms underlying this association can inform prevention and intervention. OBJECTIVE To investigate personality functioning as a potential mediator of the association of childhood abuse and neglect and self-harm and suicide attempts in the general population. PARTICIPANTS AND SETTING Data were drawn from a representative German population sample (N = 2510). METHODS Participants filled out the Childhood Trauma Questionnaire (CTQ), OPD Structure Questionnaire (OPD-SQS), and items of the Self-Injurious Thoughts and Behaviors Interview (SITBI). In structural equation models, we operationalized impaired personality functioning as the mediator between childhood abuse and neglect and self-harm. RESULTS Individuals with a history of self-harm (combining suicide attempts, N = 47, and non-suicidal self-injury, N = 83) reported more childhood abuse and neglect (d = 1.39, p < .001) and greater impairments in personality functioning (d = 1.64, p < .001) than the rest of the population. The indirect effect via personality functioning accounted for 48.8 % of the total effect of childhood abuse and neglect on self-harm. In more differentiated analyses, emotional abuse showed the strongest association with self-harm. Only physical and sexual abuse had direct effects. CONCLUSIONS The results specify the relationship between child maltreatment and self-harm by demonstrating that it is partly mediated by basic functions of personality assessed using a dimensional measure. These abilities constitute modifiable risk factors that can be addressed by psychotherapy.
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Affiliation(s)
- Mareike Ernst
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany.
| | - Elmar Brähler
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany; Research and Treatment Center Adiposity Diseases, Behavioral Medicine Research Unit, Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Leipzig, Leipzig, Germany
| | - Hanna Kampling
- Department of Psychosomatic Medicine and Psychotherapy, Justus Liebig University Giessen, Giessen, Germany
| | - Johannes Kruse
- Department of Psychosomatic Medicine and Psychotherapy, Justus Liebig University Giessen, Giessen, Germany
| | - Jörg M Fegert
- Department of Child and Adolescent Psychiatry/Psychotherapy, University Hospital Ulm, Ulm, Germany
| | - Paul L Plener
- Department of Child and Adolescent Psychiatry/Psychotherapy, University Hospital Ulm, Ulm, Germany; Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria
| | - Manfred E Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
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Icick R, Shadrin A, Holen B, Karadag N, Lin A, Hindley G, O'Connell K, Frei O, Bahrami S, Høegh MC, Cheng W, Fan CC, Djurovic S, Dale AM, Lagerberg TV, Smeland OB, Andreassen OA. Genetic overlap between mood instability and alcohol-related phenotypes suggests shared biological underpinnings. Neuropsychopharmacology 2022; 47:1883-1891. [PMID: 35953530 PMCID: PMC9485134 DOI: 10.1038/s41386-022-01401-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 06/20/2022] [Accepted: 07/16/2022] [Indexed: 11/09/2022]
Abstract
Alcohol use disorder (AUD) is a pervasive and devastating mental illness with high comorbidity rates with other mental disorders. Understanding the genetic architecture of this comorbidity could be improved by focusing on intermediate traits that show positive genetic correlation with the disorders. Thus, we aimed to characterize the shared vs. unique polygenicity of AUD, alcohol consumption (AC) and mood instability (MOOD) -beyond genetic correlation, and boost discovery for jointly-associated loci. Summary statistics for MOOD (a binary measure of the tendency to report frequent mood swings), AC (number of standard drinks over a typical consumption week) and AUD GWASs (Ns > 200,000) were analyzed to characterize the cross-phenotype associations between MOOD and AC, MOOD and AUD and AC and AUD. To do so, we used a newly established pipeline that combines (i) the bivariate causal mixture model (MiXeR) to quantify polygenic overlap and (ii) the conjunctional false discovery rate (conjFDR) to discover specific jointly associated genomic loci, which were mapped to genes and biological functions. MOOD was highly polygenic (10.4k single nucleotide polymorphisms, SNPs, SD = 2k) compared to AC (4.9k SNPs, SD = 0.6k) and AUD (4.3k SNPs, SD = 2k). The polygenic overlap of MOOD and AC was twice that of MOOD and AUD (98% vs. 49%), with opposite genetic correlation (-0.2 vs. 0.23), as confirmed in independent samples. MOOD&AUD associated SNPs were significantly enriched for brain genes, conversely to MOOD&AC. Among 38 jointly associated loci, fifteen were novel for MOOD, AC and AUD. MOOD, AC and AUD were also strongly associated at the phenotypic level. Overall, using multilevel polygenic quantification, joint loci discovery and functional annotation methods, we evidenced that the polygenic overlap between MOOD and AC/AUD implicated partly shared biological underpinnings, yet, clearly distinct functional patterns between MOOD&AC and MOOD&AUD, suggesting new mechanisms for the comorbidity of AUD with mood disorders.
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Affiliation(s)
- Romain Icick
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo and Division of Mental Health and Addiction, Oslo University Hospital, 0407, Oslo, Norway.
- Université de Paris Cité, INSERM UMR-S1144, F-75006, Paris, France.
| | - Alexey Shadrin
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo and Division of Mental Health and Addiction, Oslo University Hospital, 0407, Oslo, Norway
| | - Børge Holen
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo and Division of Mental Health and Addiction, Oslo University Hospital, 0407, Oslo, Norway
| | - Naz Karadag
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo and Division of Mental Health and Addiction, Oslo University Hospital, 0407, Oslo, Norway
| | - Aihua Lin
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo and Division of Mental Health and Addiction, Oslo University Hospital, 0407, Oslo, Norway
| | - Guy Hindley
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo and Division of Mental Health and Addiction, Oslo University Hospital, 0407, Oslo, Norway
| | - Kevin O'Connell
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo and Division of Mental Health and Addiction, Oslo University Hospital, 0407, Oslo, Norway
| | - Oleksandr Frei
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo and Division of Mental Health and Addiction, Oslo University Hospital, 0407, Oslo, Norway
- Center for Bioinformatics, Department of Informatics, University of Oslo, PO box 1080, Blindern, 0316, Oslo, Norway
| | - Shahram Bahrami
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo and Division of Mental Health and Addiction, Oslo University Hospital, 0407, Oslo, Norway
| | - Margrethe Collier Høegh
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo and Division of Mental Health and Addiction, Oslo University Hospital, 0407, Oslo, Norway
| | - Weiqiu Cheng
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo and Division of Mental Health and Addiction, Oslo University Hospital, 0407, Oslo, Norway
| | - Chun C Fan
- Department of Radiology, University of California, San Diego, La Jolla, CA, 92093, USA
- Multimodal Imaging Laboratory, University of California San Diego, La Jolla, CA, 92093, USA
- Department of Cognitive Science, University of California, San Diego, La Jolla, CA, USA
| | - Srdjan Djurovic
- Department of Medical Genetics, Oslo University Hospital, Oslo, Norway
- NORMENT Centre, Department of Clinical Science, University of Bergen, Bergen, Norway
- KG Jebsen Centre for Neurodevelopmental disorders, University of Oslo, Oslo, Norway
| | - Anders M Dale
- Department of Radiology, University of California, San Diego, La Jolla, CA, 92093, USA
- Multimodal Imaging Laboratory, University of California San Diego, La Jolla, CA, 92093, USA
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
- Department of Neurosciences, University of California San Diego, La Jolla, CA, 92093, USA
| | - Trine Vik Lagerberg
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo and Division of Mental Health and Addiction, Oslo University Hospital, 0407, Oslo, Norway
| | - Olav B Smeland
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo and Division of Mental Health and Addiction, Oslo University Hospital, 0407, Oslo, Norway
| | - Ole A Andreassen
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo and Division of Mental Health and Addiction, Oslo University Hospital, 0407, Oslo, Norway
- KG Jebsen Centre for Neurodevelopmental disorders, University of Oslo, Oslo, Norway
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18
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Wrobel AL, Russell SE, Jayasinghe A, Lotfaliany M, Turner A, Dean OM, Cotton SM, Diaz‐Byrd C, Yocum AK, Duval ER, Ehrlich TJ, Marshall DF, Berk M, McInnis MG. Attachment insecurity partially mediates the relationship between childhood trauma and depression severity in bipolar disorder. Acta Psychiatr Scand 2022; 145:591-603. [PMID: 35243610 PMCID: PMC9314952 DOI: 10.1111/acps.13419] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 02/23/2022] [Accepted: 02/26/2022] [Indexed: 12/17/2022]
Abstract
BACKGROUND Childhood trauma is associated with greater depression severity among individuals with bipolar disorder. However, the mechanisms that explain the link between childhood trauma and depression severity in bipolar disorder remain poorly understood. The mediational role of attachment insecurity in childhood and adulthood was assessed in the current study. METHODS Participants with bipolar disorder (N = 143) completed measures of childhood trauma (Childhood Trauma Questionnaire), attachment insecurity (Experiences in Close Relationships Scale) and depression severity (Hamilton Depression Rating Scale) as part of the Prechter Longitudinal Study of Bipolar Disorder. A sequential mediation model was tested using path analysis: the direct and indirect effects of childhood trauma on depression severity with attachment insecurity (attachment anxiety and avoidance) in childhood (mother and father) and adulthood (partner) as mediators were estimated. RESULTS The final path model demonstrated an excellent fit to the data (comparative fit index = 0.996; root mean square error of approximation = 0.021 [90% confidence interval = 0.000-0.073]). Supporting the hypothesised sequential mediation model, maternal attachment anxiety in childhood and romantic attachment avoidance in adulthood partially mediated the relationship between childhood trauma and depression severity; this effect accounted for 12% of the total effect of childhood trauma on depression severity. CONCLUSION Attachment insecurity in childhood and adulthood form part of the complex mechanism informing why people with bipolar disorder who have a history of childhood trauma experience greater depression severity. Addressing attachment insecurity represents a valuable psychotherapeutic treatment target for bipolar disorder.
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Affiliation(s)
- Anna L. Wrobel
- IMPACT – The Institute for Mental and Physical Health and Clinical TranslationSchool of MedicineDeakin UniversityGeelongVictoriaAustralia
- OrygenParkvilleVictoriaAustralia
| | - Samantha E. Russell
- IMPACT – The Institute for Mental and Physical Health and Clinical TranslationSchool of MedicineDeakin UniversityGeelongVictoriaAustralia
| | - Anuradhi Jayasinghe
- OrygenParkvilleVictoriaAustralia
- School of PsychologyDeakin UniversityGeelongVictoriaAustralia
| | - Mojtaba Lotfaliany
- IMPACT – The Institute for Mental and Physical Health and Clinical TranslationSchool of MedicineDeakin UniversityGeelongVictoriaAustralia
| | - Alyna Turner
- IMPACT – The Institute for Mental and Physical Health and Clinical TranslationSchool of MedicineDeakin UniversityGeelongVictoriaAustralia
- School of Medicine and Public HealthUniversity of NewcastleCallaghanNew South WalesAustralia
| | - Olivia M. Dean
- IMPACT – The Institute for Mental and Physical Health and Clinical TranslationSchool of MedicineDeakin UniversityGeelongVictoriaAustralia
- Florey Institute for Neuroscience and Mental HealthUniversity of MelbourneMelbourneVictoriaAustralia
| | - Sue M. Cotton
- OrygenParkvilleVictoriaAustralia
- Centre for Youth Mental HealthUniversity of MelbourneParkvilleVictoriaAustralia
| | - Claudia Diaz‐Byrd
- Department of PsychiatryUniversity of Michigan Medical SchoolAnn ArborMichiganUSA
| | - Anastasia K. Yocum
- Department of PsychiatryUniversity of Michigan Medical SchoolAnn ArborMichiganUSA
| | - Elizabeth R. Duval
- Department of PsychiatryUniversity of Michigan Medical SchoolAnn ArborMichiganUSA
| | - Tobin J. Ehrlich
- Department of PsychiatryUniversity of Michigan Medical SchoolAnn ArborMichiganUSA
| | - David F. Marshall
- Department of PsychiatryUniversity of Michigan Medical SchoolAnn ArborMichiganUSA
| | - Michael Berk
- IMPACT – The Institute for Mental and Physical Health and Clinical TranslationSchool of MedicineDeakin UniversityGeelongVictoriaAustralia
- OrygenParkvilleVictoriaAustralia
- Florey Institute for Neuroscience and Mental HealthUniversity of MelbourneMelbourneVictoriaAustralia
- Centre for Youth Mental HealthUniversity of MelbourneParkvilleVictoriaAustralia
- Department of PsychiatryRoyal Melbourne HospitalUniversity of MelbourneParkvilleVictoriaAustralia
| | - Melvin G. McInnis
- Department of PsychiatryUniversity of Michigan Medical SchoolAnn ArborMichiganUSA
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19
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Maes M, Rachayon M, Jirakran K, Sodsai P, Klinchanhom S, Debnath M, Basta-Kaim A, Kubera M, Almulla AF, Sughondhabirom A. Adverse Childhood Experiences Predict the Phenome of Affective Disorders and These Effects Are Mediated by Staging, Neuroimmunotoxic and Growth Factor Profiles. Cells 2022; 11:1564. [PMID: 35563878 PMCID: PMC9105661 DOI: 10.3390/cells11091564] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 04/24/2022] [Accepted: 05/02/2022] [Indexed: 02/04/2023] Open
Abstract
Adverse childhood experiences (ACEs) enhance pro-inflammatory and pro-oxidant responses. In affective disorders, recent precision nomothetic psychiatry studies disclosed new pathway phenotypes, including an ROI-reoccurrence of illness (ROI)-oxidative stress latent construct. The aim of the present study is to delineate a) whether ACEs sensitize the M1 macrophage, the T helper cells (Th)1, Th2, and Th17, the IRS (immune-inflammatory-responses system), the CIRS (compensatory immunoregulatory system), and the neuroimmunotoxic and growth factor (GF) profiles and whether they are associated with ROI and the phenome of affective disorders and b) the molecular pathways underpinning the effects of the ACEs. We collected supernatants of stimulated (5 μg/mL of PHA and 25 μg/mL of LPS) and unstimulated diluted whole blood in 20 healthy controls and 30 depressed patients and measured a panel of 27 cytokines/GF using a Luminex method. ACEs (comprising mental and physical trauma, mental neglect, domestic violence, family history of mental disease, and parent loss) are accompanied by the increased stimulated, but not unstimulated, production of M1, Th1, Th2, Th17, IRS, neuroimmunotoxic, and GF profiles and are strongly correlated with ROI and the phenome. A latent vector extracted from the ROI features (recurrent episodes and suicidal behaviors) and the IRS/neuroimmunotoxic/GF profiles explains 66.8% of the variance in the phenome and completely mediates the effects of ACEs on the phenome. Enrichment analysis showed that the ACE-associated sensitization of immune/GF profiles involves JAK-STAT, nuclear factor-κB, tumor necrosis factor-α, G-protein coupled receptor, PI3K/Akt/RAS/MAPK, and hypoxia signaling. In summary, the ACE-induced sensitization of immune pathways and secondary immune hits predicts the phenome of affective disorders.
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Affiliation(s)
- Michael Maes
- Department of Psychiatry, Faculty of Medicine, King Chulalongkorn Memorial Hospital, Chulalongkorn University and The Thai Red Cross Society, Bangkok 10330, Thailand; (M.R.); (K.J.); (A.F.A.); (A.S.)
- IMPACT Strategic Research Center, Barwon Health, Geelong 3220, Australia
- Department of Psychiatry, Medical University of Plovdiv, 4000 Plovdiv, Bulgaria
| | - Muanpetch Rachayon
- Department of Psychiatry, Faculty of Medicine, King Chulalongkorn Memorial Hospital, Chulalongkorn University and The Thai Red Cross Society, Bangkok 10330, Thailand; (M.R.); (K.J.); (A.F.A.); (A.S.)
| | - Ketsupar Jirakran
- Department of Psychiatry, Faculty of Medicine, King Chulalongkorn Memorial Hospital, Chulalongkorn University and The Thai Red Cross Society, Bangkok 10330, Thailand; (M.R.); (K.J.); (A.F.A.); (A.S.)
- Maximizing Thai Children’s Developmental Potential Research Unit, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand
| | - Pimpayao Sodsai
- Center of Excellence in Immunology and Immune-Mediated Diseases, Department of Microbiology, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand; (P.S.); (S.K.)
- Division of Immunology, Department of Microbiology, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand
| | - Siriwan Klinchanhom
- Center of Excellence in Immunology and Immune-Mediated Diseases, Department of Microbiology, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand; (P.S.); (S.K.)
- Division of Immunology, Department of Microbiology, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand
| | - Monojit Debnath
- Department of Human Genetics, National Institute of Mental Health and Neurosciences, Bangalore 560 029, India;
| | - Agnieska Basta-Kaim
- Department of Experimental Neuroendocrinology, Maj Institute of Pharmacology, Polish Academy of Sciences, 31-343 Kraków, Poland; (A.B.-K.); (M.K.)
| | - Marta Kubera
- Department of Experimental Neuroendocrinology, Maj Institute of Pharmacology, Polish Academy of Sciences, 31-343 Kraków, Poland; (A.B.-K.); (M.K.)
| | - Abbas F. Almulla
- Department of Psychiatry, Faculty of Medicine, King Chulalongkorn Memorial Hospital, Chulalongkorn University and The Thai Red Cross Society, Bangkok 10330, Thailand; (M.R.); (K.J.); (A.F.A.); (A.S.)
- Medical Laboratory Technology Department, College of Medical Technology, The Islamic University, Najaf 54001, Iraq
| | - Atapol Sughondhabirom
- Department of Psychiatry, Faculty of Medicine, King Chulalongkorn Memorial Hospital, Chulalongkorn University and The Thai Red Cross Society, Bangkok 10330, Thailand; (M.R.); (K.J.); (A.F.A.); (A.S.)
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20
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Hjelseng IV, Vaskinn A, Ueland T, Lunding SH, Reponen EJ, Steen NE, Andreassen OA, Aas M. Childhood trauma is associated with poorer social functioning in severe mental disorders both during an active illness phase and in remission. Schizophr Res 2022; 243:241-246. [PMID: 32222348 DOI: 10.1016/j.schres.2020.03.015] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 03/02/2020] [Accepted: 03/07/2020] [Indexed: 11/16/2022]
Abstract
BACKGROUND Impaired social functioning is a core feature of schizophrenia spectrum (SZS) and bipolar spectrum disorders (BDS). Childhood traumatic events are more frequent in SZS and BDS than in healthy individuals (HC), and could represent a cumulative risk for reduced social functioning beyond experiencing ongoing clinical symptoms. METHODS The study comprised 1039 individuals (SZS [n = 348]; BDS [n = 262], and HC [n = 429]). Childhood trauma and level of social functioning was assessed by the Childhood Trauma Questionnaire (CTQ) and the Social Functioning Scale (SFS), respectively. Diagnosis was obtained by the Structured Clinical Interview (SCID) for the Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV). RESULTS Patients had poorer social functioning (F = 819.18, p ˂ 0.001, Cohen's d = 0.44) and reported more childhood trauma experiences than HC (X2 = 289.0, p < .001) than HC. Patients with at least one moderate to severe trauma had poorer social functioning than patients without childhood trauma (F = 8.16, p = .004, Cohen's d = 0.17). Within the patients, a cumulative relationship was observed in that more severe childhood trauma was associated with lower social functioning (F = 2.65, p = .02, Cohen's d = 0.20). No significant associations were observed for having at least one moderate to severe trauma or cumulative traumas on social functioning in the HC. Follow-up analysis showed that patients in remission childhood trauma also had poorer social functioning. CONCLUSION Patients who reported childhood trauma experiences had poorer social functioning both during an active illness phase and in remission.
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Affiliation(s)
- Ingrid Varvin Hjelseng
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo, and Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway; Department of Psychology, University of Copenhagen, Denmark
| | - Anja Vaskinn
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo, and Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Torill Ueland
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo, and Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway; Department of Psychology, University of Copenhagen, Denmark; Department of Psychology, University of Oslo, Norway
| | - Synve Hoffart Lunding
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo, and Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Elina J Reponen
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo, and Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Nils Eiel Steen
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo, and Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Ole A Andreassen
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo, and Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Monica Aas
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo, and Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.
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21
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Lippard ETC, Nemeroff CB. Going beyond risk factor: Childhood maltreatment and associated modifiable targets to improve life-long outcomes in mood disorders. Pharmacol Biochem Behav 2022; 215:173361. [PMID: 35219755 DOI: 10.1016/j.pbb.2022.173361] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 02/17/2022] [Accepted: 02/20/2022] [Indexed: 01/26/2023]
Abstract
Childhood maltreatment increases risk for mood disorders and is associated with earlier onset-and more pernicious disease course following onset-of mood disorders. While the majority of studies to date have been cross-sectional, longitudinal studies are emerging and support the devastating role(s) childhood maltreatment has on development of, and illness course in, mood disorders. This manuscript extends prior reviews to emphasize more recent work, highlighting longitudinal data, and discusses treatment studies that provide clues to mechanisms that mediate disease risk, course, relapse, and treatment response. Evidence suggesting systemic inflammation, alterations in hypothalamic-pituitary-adrenal (HPA) axis function and corticotropin-releasing factor (CRF) neural systems, genetic and other familial factors as mechanisms that mediate risk and onset of, and illness course in, mood disorders following childhood maltreatment is discussed. Risky behaviors following maltreatment, e.g., substance use and unhealthy lifestyles, may further exacerbate alterations in the HPA axis, CRF neural systems, and systematic inflammation to contribute to a more pernicious disease course. More research on sex differences and the impact of maltreatment in vulnerable populations is needed. Future research needs to be aimed at leveraging knowledge on modifiable targets, going beyond childhood maltreatment as a risk factor, to inform prevention and treatment strategies and foster trauma-informed care.
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Affiliation(s)
- Elizabeth T C Lippard
- Department of Psychiatry and Behavioral Sciences, Dell Medical School, University of Texas, Austin, TX, USA; Institute of Early Life Adversity Research, Dell Medical School, University of Texas, Austin, TX, USA; Waggoner Center for Alcohol and Addiction Research, University of Texas, Austin, TX, USA; Department of Psychology, University of Texas, Austin, TX, USA; Mulva Clinic for Neuroscience, Dell Medical School, University of Texas, Austin, TX, USA.
| | - Charles B Nemeroff
- Department of Psychiatry and Behavioral Sciences, Dell Medical School, University of Texas, Austin, TX, USA; Institute of Early Life Adversity Research, Dell Medical School, University of Texas, Austin, TX, USA; Waggoner Center for Alcohol and Addiction Research, University of Texas, Austin, TX, USA; Mulva Clinic for Neuroscience, Dell Medical School, University of Texas, Austin, TX, USA
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22
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Grillault Laroche D, Godin O, Belzeaux R, M'Bailara K, Loftus J, Courtet P, Dubertret C, Haffen E, Llorca PM, Olie E, Passerieux C, Polosan M, Schwan R, Leboyer M, Bellivier F, Marie-Claire C, Etain B. Association between childhood maltreatment and the clinical course of bipolar disorders: A survival analysis of mood recurrences. Acta Psychiatr Scand 2022; 145:373-383. [PMID: 35080248 DOI: 10.1111/acps.13401] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 01/08/2022] [Accepted: 01/16/2022] [Indexed: 12/17/2022]
Abstract
OBJECTIVES Childhood maltreatment, also referred as childhood trauma, increases the severity of bipolar disorders (BD). Childhood maltreatment has been associated with more frequent mood recurrences, however, mostly in retrospective studies. Since scarce, further prospective studies are required to identify whether childhood maltreatment may be associated with the time to recurrence in BD. METHODS Individuals with BD (N = 2008) were assessed clinically and for childhood maltreatment at baseline, and followed up for two years. The cumulative probability of mood recurrence over time was estimated with the Turnbull's extension of the Kaplan-Meier analysis for interval-censored data, including childhood maltreatment as a whole, and then maltreatment subtypes as predictors. Analyses were adjusted for potential confounding factors. RESULTS The median duration of follow-up was 22.3 months (IQR:12.0-24.8). Univariable analyses showed associations between childhood maltreatment, in particular all types of abuses (emotional, physical, and sexual) or emotional neglect, and a shorter time to recurrence (all p < 0.001). When including potential confounders into the multivariable models, the time to mood recurrence was associated with multiple/severe childhood maltreatment (i.e., total score above the 75th percentile) (HR = 1.32 95%CI (1.11-1.57), p = 0.002), and more specifically with moderate/severe physical abuse (HR = 1.44 95%CI(1.21-1.73), p < 0.0001). Living alone, lifetime anxiety disorders, lifetime number of mood episodes, baseline depressive and (hypo)manic symptoms, and baseline use of atypical antipsychotics were also associated with the time to recurrence. CONCLUSIONS In addition to typical predictors of mood recurrences, an exposure to multiple/severe forms of childhood maltreatment, and more specifically to moderate to severe physical abuse, may increase the risk for a mood recurrence in BD. This leads to the recommendations of more scrutiny and denser follow-up of the individuals having been exposed to such early-life stressors.
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Affiliation(s)
- Diane Grillault Laroche
- AP-HP, Groupe Hospitalo-universitaire AP-HP Nord, DMU Neurosciences, Hôpital Fernand Widal, Département de Psychiatrie et de Médecine Addictologique, Paris, France.,Université de Paris, INSERM UMR-S 1144, Optimisation Thérapeutique en Neuropsychopharmacologie OTeN, Paris, France
| | - Ophélia Godin
- Univ Paris Est Créteil, INSERM U955, IMRB, Translational NeuroPsychiatry laboratory, Créteil, France.,AP-HP, Hôpitaux Universitaires Henri Mondor, Département Médico-Universitaire de Psychiatrie et d'Addictologie (DMU IMPACT), Fédération Hospitalo-Universitaire de Médecine de Précision en Psychiatrie (FHU ADAPT), Créteil, France.,Fondation FondaMental, Créteil, France
| | - Raoul Belzeaux
- Fondation FondaMental, Créteil, France.,Pôle de Psychiatrie, Assistance Publique Hôpitaux de Marseille, Marseille, France.,INT-UMR7289, CNRS Aix-Marseille Université, Marseille, France
| | - Katia M'Bailara
- Fondation FondaMental, Créteil, France.,Centre Hospitalier Charles Perrens, Bordeaux, France.,Université de Bordeaux, Centre Hospitalier Charles Perrens, Laboratoire NutriNeuro (UMR INRA 1286), Université de Bordeaux, Bordeaux, France
| | - Joséphine Loftus
- Fondation FondaMental, Créteil, France.,Pôle de Psychiatrie, Centre Hospitalier Princesse Grace, Monaco
| | - Philippe Courtet
- Fondation FondaMental, Créteil, France.,Department of Emergency Psychiatry and Acute Care, CHU Montpellier, IGF, Univ. Montpellier, CNRS, INSERM, Montpellier, France
| | - Caroline Dubertret
- Fondation FondaMental, Créteil, France.,Université de Paris, Paris, France.,AP-HP, Groupe Hospitalo-universitaire AP-HP Nord, DMU ESPRIT, Service de Psychiatrie et Addictologie, Hôpital Louis Mourier, Colombes, France.,Université de Paris, Inserm UMR1266, Sorbonne Paris Cité, Faculté de Médecine, France
| | - Emmanuel Haffen
- Fondation FondaMental, Créteil, France.,Département de Psychiatrie Clinique, CIC-1431 INSERM, CHU de Besançon, Besançon, France.,EA481 Neurosciences, Université Bourgogne Franche-Comté, Besançon, France
| | - Pierre Michel Llorca
- Fondation FondaMental, Créteil, France.,Centre Hospitalier et Universitaire, Département de Psychiatrie, Clermont-Ferrand, France.,Université d'Auvergne, Clermont-Ferrand, France
| | - Emilie Olie
- Fondation FondaMental, Créteil, France.,Department of Emergency Psychiatry and Acute Care, CHU Montpellier, IGF, Univ. Montpellier, CNRS, INSERM, Montpellier, France
| | - Christine Passerieux
- Fondation FondaMental, Créteil, France.,Centre Hospitalier de Versailles, Service Universitaire de Psychiatrie d'adulte et d'addictologie, Le Chesnay, France.,Equipe « PsyDev », CESP, Université Versailles Saint-Quentin-en-Yvelines - Paris-Saclay, Inserm, Villejuif, France
| | - Mircea Polosan
- Fondation FondaMental, Créteil, France.,Université Grenoble Alpes, CHU de Grenoble et des Alpes, Grenoble Institut des Neurosciences (GIN) Inserm U 1216, Grenoble, France
| | - Raymund Schwan
- Fondation FondaMental, Créteil, France.,Université de Lorraine, Centre Psychothérapique de Nancy, Inserm U1114, Nancy, France
| | | | - Marion Leboyer
- Univ Paris Est Créteil, INSERM U955, IMRB, Translational NeuroPsychiatry laboratory, Créteil, France.,AP-HP, Hôpitaux Universitaires Henri Mondor, Département Médico-Universitaire de Psychiatrie et d'Addictologie (DMU IMPACT), Fédération Hospitalo-Universitaire de Médecine de Précision en Psychiatrie (FHU ADAPT), Créteil, France.,Fondation FondaMental, Créteil, France
| | - Frank Bellivier
- AP-HP, Groupe Hospitalo-universitaire AP-HP Nord, DMU Neurosciences, Hôpital Fernand Widal, Département de Psychiatrie et de Médecine Addictologique, Paris, France.,Université de Paris, INSERM UMR-S 1144, Optimisation Thérapeutique en Neuropsychopharmacologie OTeN, Paris, France.,Fondation FondaMental, Créteil, France.,Université de Paris, Paris, France
| | - Cynthia Marie-Claire
- Université de Paris, INSERM UMR-S 1144, Optimisation Thérapeutique en Neuropsychopharmacologie OTeN, Paris, France
| | - Bruno Etain
- AP-HP, Groupe Hospitalo-universitaire AP-HP Nord, DMU Neurosciences, Hôpital Fernand Widal, Département de Psychiatrie et de Médecine Addictologique, Paris, France.,Université de Paris, INSERM UMR-S 1144, Optimisation Thérapeutique en Neuropsychopharmacologie OTeN, Paris, France.,Fondation FondaMental, Créteil, France.,Université de Paris, Paris, France
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23
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Heo IS, Kwon YJ, Lee HY, Lee HS, Yoon HJ, Shim SH, Kim JS. Electrophysiological Changes Related to Childhood Trauma in Patients with Major Depressive Disorder: An Event-related Potential Study. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE 2022; 20:167-179. [PMID: 35078959 PMCID: PMC8813325 DOI: 10.9758/cpn.2022.20.1.167] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 06/21/2021] [Accepted: 07/12/2021] [Indexed: 11/18/2022]
Abstract
Objective Methods Results Conclusion
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Affiliation(s)
- In Soo Heo
- Department of Psychiatry, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea
| | - Young Joon Kwon
- Department of Psychiatry, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea
| | - Hwa-Young Lee
- Department of Psychiatry, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea
| | - Ho Sung Lee
- Department of Pulmonology and Allergy, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea
| | - Hee-Jung Yoon
- The Korean Society of Infectious Diseases, Seoul, Korea
| | - Se-Hoon Shim
- Department of Psychiatry, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea
| | - Ji Sun Kim
- Department of Psychiatry, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea
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24
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Risch N, Dubois J, M’bailara K, Cussac I, Etain B, Belzeaux R, Dubertret C, Haffen E, Schwan R, Samalin L, Roux P, Polosan M, Leboyer M, Courtet P, Olié E. Self-Reported Pain and Emotional Reactivity in Bipolar Disorder: A Prospective FACE-BD Study. J Clin Med 2022; 11:jcm11030893. [PMID: 35160345 PMCID: PMC8836480 DOI: 10.3390/jcm11030893] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 01/24/2022] [Accepted: 02/01/2022] [Indexed: 02/05/2023] Open
Abstract
In patients with bipolar disorder (BD), pain prevalence is close to 30%. It is important to determine whether pain influences BD course and to identify factors associated with pain in BD in order to guide BD management. This naturalistic, prospective study used data on 880 patients with BD from the French FACE-BD cohort who were divided into two groups according to the presence or absence of pain. Multivariate models were used to test whether pain was associated with affective states and personality traits while controlling for confounders. Then, multivariate models were used to test whether pain at baseline predicted global life functioning and depressive symptomatology at one year. At baseline, 22% of patients self-reported pain. The pain was associated with depressive symptomatology, levels of emotional reactivity in a quadratic relationship, and a composite variable of personality traits (affective lability, affective intensity, hostility/anger, and impulsivity). At one year, the pain was predictive of depression and lower global life functioning. Pain worsens mental health and well-being in patients with BD. The role of emotions, depression, and personality traits in pain has to be elucidated to better understand the high prevalence of pain in BD and to promote specific therapeutic strategies for patients experiencing pain.
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Affiliation(s)
- Nathan Risch
- Institute of Functional Genomics, University of Montpellier, CNRS, INSERM, 34094 Montpellier, France; (J.D.); (P.C.); (E.O.)
- Department of Emergency Psychiatry and Post-Acute Care, CHU Montpellier, 34295 Montpellier, France
- Clinique de la Lironde, Clinea Psychiatrie, 34980 Saint-Clément-de-Rivière, France
- Correspondence: ; Tel.: +33-46-733-8581
| | - Jonathan Dubois
- Institute of Functional Genomics, University of Montpellier, CNRS, INSERM, 34094 Montpellier, France; (J.D.); (P.C.); (E.O.)
- Department of Emergency Psychiatry and Post-Acute Care, CHU Montpellier, 34295 Montpellier, France
| | - Katia M’bailara
- Fondation FondaMental, 94000 Créteil, France; (K.M.); (I.C.); (B.E.); (R.B.); (C.D.); (E.H.); (R.S.); (L.S.); (P.R.); (M.P.); (M.L.)
- LabPsy, University of Bordeaux, EA 4139, F-33000 Bordeaux, France
- Department of Clinical and Academic Psychiatry, Charles-Perrens Hospital, 33076 Bordeaux, France
| | - Irena Cussac
- Fondation FondaMental, 94000 Créteil, France; (K.M.); (I.C.); (B.E.); (R.B.); (C.D.); (E.H.); (R.S.); (L.S.); (P.R.); (M.P.); (M.L.)
- Psychiatric Center, Hospital Princesse Grace, 1 Ave. Pasteur, 98000 Monaco, Monaco
| | - Bruno Etain
- Fondation FondaMental, 94000 Créteil, France; (K.M.); (I.C.); (B.E.); (R.B.); (C.D.); (E.H.); (R.S.); (L.S.); (P.R.); (M.P.); (M.L.)
- AP-HP, GHU Paris Nord, DMU Neurosciences, Hôpital Fernand Widal, 75010 Paris, France
- INSERM UMRS 1144-Université de Paris, 75006 Paris, France
| | - Raoul Belzeaux
- Fondation FondaMental, 94000 Créteil, France; (K.M.); (I.C.); (B.E.); (R.B.); (C.D.); (E.H.); (R.S.); (L.S.); (P.R.); (M.P.); (M.L.)
- Pôle de Psychiatrie, Assistance Publique Hôpitaux de Marseille, 13005 Marseille, France
- INT-UMR 7289, CNRS Aix-Marseille Université, 13385 Marseille, France
| | - Caroline Dubertret
- Fondation FondaMental, 94000 Créteil, France; (K.M.); (I.C.); (B.E.); (R.B.); (C.D.); (E.H.); (R.S.); (L.S.); (P.R.); (M.P.); (M.L.)
- Department of Psychiatry, University of Paris, AP-HP, Louis Mourier Hospital, INSERM UMR 1266 Paris, 92700 Colombes, France
| | - Emmanuel Haffen
- Fondation FondaMental, 94000 Créteil, France; (K.M.); (I.C.); (B.E.); (R.B.); (C.D.); (E.H.); (R.S.); (L.S.); (P.R.); (M.P.); (M.L.)
- Service de Psychiatrie de l’Adulte, CIC-1431 INSERM, CHU de Besançon, Laboratoire de Neurosciences, Université de Franche-Comté, UBFC, 25000 Besançon, France
| | - Raymund Schwan
- Fondation FondaMental, 94000 Créteil, France; (K.M.); (I.C.); (B.E.); (R.B.); (C.D.); (E.H.); (R.S.); (L.S.); (P.R.); (M.P.); (M.L.)
- Université de Lorraine, Centre Psychothérapique de Nancy, Pôle Hospitalo-Universitaire de Psychiatrie d’Adultes du Grand Nancy, INSERM U1254, 54000 Nancy, France
| | - Ludovic Samalin
- Fondation FondaMental, 94000 Créteil, France; (K.M.); (I.C.); (B.E.); (R.B.); (C.D.); (E.H.); (R.S.); (L.S.); (P.R.); (M.P.); (M.L.)
- CHU Clermont-Ferrand, Department of Psychiatry, University of Clermont Auvergne, UMR 6602 Institut Pascal (IP), 63178 Clermont-Ferrand, France
| | - Paul Roux
- Fondation FondaMental, 94000 Créteil, France; (K.M.); (I.C.); (B.E.); (R.B.); (C.D.); (E.H.); (R.S.); (L.S.); (P.R.); (M.P.); (M.L.)
- Centre Hospitalier de Versailles, Service de Psychiatrie et D’addictologie Adulte, Le Chesnay, EA 4047 HANDIReSP, UFR des Sciences de la Santé Simone Veil, Université Versailles Saint-Quentin-en-Yvelines, Versailles, France and Université Paris-Saclay, UVSQ, Inserm, CESP, Equipe “PsyDev”, 94807 Villejuif, France
| | - Mircea Polosan
- Fondation FondaMental, 94000 Créteil, France; (K.M.); (I.C.); (B.E.); (R.B.); (C.D.); (E.H.); (R.S.); (L.S.); (P.R.); (M.P.); (M.L.)
- Université Grenoble Alpes, Inserm U1216, Grenoble Institut de Neurosciences, CHU de Grenoble, F-38000 Grenoble, France
| | - Marion Leboyer
- Fondation FondaMental, 94000 Créteil, France; (K.M.); (I.C.); (B.E.); (R.B.); (C.D.); (E.H.); (R.S.); (L.S.); (P.R.); (M.P.); (M.L.)
- Université Paris Est Creteil (UPEC), AP-HP, Hôpitaux Universitaires «H. Mondor», DMU IMPACT, INSERM, IMRB, Translational Neuropsychiatry, Fondation FondaMental, F-94010 Creteil, France
| | - Philippe Courtet
- Institute of Functional Genomics, University of Montpellier, CNRS, INSERM, 34094 Montpellier, France; (J.D.); (P.C.); (E.O.)
- Department of Emergency Psychiatry and Post-Acute Care, CHU Montpellier, 34295 Montpellier, France
- Fondation FondaMental, 94000 Créteil, France; (K.M.); (I.C.); (B.E.); (R.B.); (C.D.); (E.H.); (R.S.); (L.S.); (P.R.); (M.P.); (M.L.)
| | - Emilie Olié
- Institute of Functional Genomics, University of Montpellier, CNRS, INSERM, 34094 Montpellier, France; (J.D.); (P.C.); (E.O.)
- Department of Emergency Psychiatry and Post-Acute Care, CHU Montpellier, 34295 Montpellier, France
- Fondation FondaMental, 94000 Créteil, France; (K.M.); (I.C.); (B.E.); (R.B.); (C.D.); (E.H.); (R.S.); (L.S.); (P.R.); (M.P.); (M.L.)
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Grillault Laroche D, Godin O, Dansou Y, Belzeaux R, Aouizerate B, Burté T, Courtet P, Dubertret C, Haffen E, Llorca P, Olie E, Roux P, Polosan M, Schwan R, Leboyer M, Bellivier F, Marie-Claire C, Etain B. Influence of childhood maltreatment on prevalence, onset and persistence of psychiatric comorbidities and suicide attempts in bipolar disorders. Eur Psychiatry 2022; 65:e15. [PMID: 35060460 PMCID: PMC8853858 DOI: 10.1192/j.eurpsy.2022.7] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Methods Results Conclusions
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Grandison G, Karatzias T, Fyvie C, Hyland P, O'Connor RC, Dickson A. Suicidal Histories in Adults Experiencing Psychological Trauma: Exploring Vulnerability and Protective Factors. Arch Suicide Res 2022; 26:155-168. [PMID: 32348712 DOI: 10.1080/13811118.2020.1758262] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVE This study aimed to identify vulnerability and protective factors for suicidal histories among adults experiencing psychological trauma. METHOD Adults seeking treatment for psychological trauma (N = 113) completed self-report questionnaires measuring childhood trauma history, self-concept, relational functioning, emotion regulation, living arrangements, employment status, marital status, and suicidal history. Independent samples t-tests were used to determine variables on which those with and without suicidal histories differed significantly. These variables were then entered into a binary logistic regression model to identify factors which independently distinguished between those with and without a suicidal history. RESULTS Univariate differences were found for childhood emotional abuse (CEA), childhood emotional neglect (CEN), emotion deactivation, and employment status, with those in the suicidal history group scoring higher on all of these. CEA (OR = 1.13, 95% CI = 1.01-1.27) and employment status (OR = 4.12, 95% CI = 1.23-13.73) remained significant predictors of suicidal status in the multivariable logistic regression. CONCLUSIONS CEA was an independent vulnerability factor for suicidal risk, highlighting the need for clinicians to assess exposure to such trauma in those presenting with proximal traumatic experiences. Being in employment was an independent protective factor against suicidal risk, highlighting the importance of social buffers or networks when faced with traumatic situations.
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27
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Xu S, Chen Y, Li Y, Yang S, Lu Y, Li L, Huang M, Ma M, Ou W, Lv G, Zhao X, Qin Y, Ju Y, Zhang Y, Li L. Factor structure and psychometric properties of the affective lability scale-short form in Chinese adolescents. Front Psychiatry 2022; 13:881541. [PMID: 36465311 PMCID: PMC9713808 DOI: 10.3389/fpsyt.2022.881541] [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: 02/22/2022] [Accepted: 10/27/2022] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE Previous studies on the reliability and validity of the Affective Lability Scale short-form (ALS-SF) have only been evaluated in adults, which may not be able to generalize to the adolescent population. We aimed to examine the factor structure, the reliability and validity of ALS-SF among Chinese adolescents and construct an adolescent form of ALS (ALS-AF). METHODS A total of 1,439 middle school students were investigated with a broad survey including ALS-SF, Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder 7-item (GAD-7), Connor-Davidson Resilience Scale 10-item (CD-RISC-10) and non-suicidal self-injury (NSSI) behavior self-report. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were conducted to investigate the structural validity of ALS-SF and construct ALS-AF. Cronbach's α was used to assess the internal consistency and reliability of the scale. Factor loading, Average Variance Extracted (AVE) and Composite Reliability (CR) were applied to measure the convergent validity and divergent validity. Besides, Correlation and regression analyses were used to explore the relationship between affective lability and depression, anxiety, NSSI and resilience. RESULTS Factor analysis failed to support the original three-factor model of 18-item ALS-SF and confirmed the three-factor model of 15-item ALS-AF. The ALS-AF showed good internal consistency as well as strong convergent and discriminative validity. Besides, ALS-AF was positively correlated with PHQ-9, GAD-7 and self-harm, and was negatively associated with resilience. CONCLUSION Our study shows that the ALS-AF has good reliability and validity for testing affective lability in Chinese adolescents.
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Affiliation(s)
- Shuyin Xu
- Department of Psychiatry and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Yafei Chen
- Xiangya Medical School, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Yunjing Li
- Department of Psychiatry and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Siqi Yang
- Department of Psychiatry and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Yimei Lu
- Department of Psychiatry and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Liang Li
- Department of Psychiatry and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Mei Huang
- Department of Psychiatry and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Mohan Ma
- Department of Psychiatry and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Wenwen Ou
- Department of Psychiatry and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Guanyi Lv
- Department of Psychiatry and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Xiaotian Zhao
- Department of Psychiatry and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Yaqi Qin
- Department of Psychiatry and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Yumeng Ju
- Department of Psychiatry and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Yan Zhang
- Department of Psychiatry and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Lingjiang Li
- Department of Psychiatry and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
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Høegh MC, Melle I, Aminoff SR, Haatveit B, Olsen SH, Huflåtten IB, Ueland T, Lagerberg TV. Characterization of affective lability across subgroups of psychosis spectrum disorders. Int J Bipolar Disord 2021; 9:34. [PMID: 34734342 PMCID: PMC8566621 DOI: 10.1186/s40345-021-00238-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 09/15/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Affective lability is elevated and associated with increased clinical burden in psychosis spectrum disorders. The extent to which the level, structure and dispersion of affective lability varies between the specific disorders included in the psychosis spectrum is however unclear. To have potential value as a treatment target, further characterization of affective lability in these populations is necessary. The main aim of our study was to investigate differences in the architecture of affective lability in different psychosis spectrum disorders, and if putative differences remained when we controlled for current symptom status. METHODS Affective lability was measured with The Affective Lability Scale Short Form (ALS-SF) in participants with schizophrenia (SZ, n = 76), bipolar I disorder (BD-I, n = 105), bipolar II disorder (BD-II, n = 68) and a mixed psychosis-affective group (MP, n = 48). Multiple analyses of covariance were conducted to compare the ALS-SF total and subdimension scores of the diagnostic groups, correcting for current psychotic, affective and anxiety symptoms, substance use and sex. Double generalized linear models were performed to compare the dispersion of affective lability in the different groups. RESULTS Overall group differences in affective lability remained significant after adjusting for covariates (p = .001). BD-II had higher affective lability compared to SZ and BD-I (p = .004), with no significant differences between SZ and BD-I. There were no significant differences in the contributions of ALS-SF dimensions to the total affective lability or in dispersion of affective lability between the groups. CONCLUSIONS This study provides the construct of affective lability in psychosis spectrum disorders with more granular details that may have implications for research and clinical care. It demonstrates that despite overlap in core symptom profiles, BD-I is more similar to SZ than it is to BD-II concerning affective lability and the BD groups should consequently be studied apart. Further, affective lability appears to be characterized by fluctuations between depressive- and other affective states across different psychosis spectrum disorders, indicating that affective lability may be related to internalizing problems in these disorders. Finally, although the level varies between groups, affective lability is evenly spread and not driven by extremes across psychosis spectrum disorders and should be assessed irrespective of diagnosis.
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Affiliation(s)
- Margrethe Collier Høegh
- CoE NORMENT, Norwegian Centre for Mental Disorders Research, Division of Mental Health and Addiction, University of Oslo and Oslo University Hospital, Building 49, Ullevål sykehus, Nydalen, PO Box 4956, 0424, Oslo, Norway.
| | - Ingrid Melle
- CoE NORMENT, Norwegian Centre for Mental Disorders Research, Division of Mental Health and Addiction, University of Oslo and Oslo University Hospital, Building 49, Ullevål sykehus, Nydalen, PO Box 4956, 0424, Oslo, Norway
| | - Sofie R Aminoff
- CoE NORMENT, Norwegian Centre for Mental Disorders Research, Division of Mental Health and Addiction, University of Oslo and Oslo University Hospital, Building 49, Ullevål sykehus, Nydalen, PO Box 4956, 0424, Oslo, Norway.,Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Beathe Haatveit
- CoE NORMENT, Norwegian Centre for Mental Disorders Research, Division of Mental Health and Addiction, University of Oslo and Oslo University Hospital, Building 49, Ullevål sykehus, Nydalen, PO Box 4956, 0424, Oslo, Norway
| | - Stine Holmstul Olsen
- CoE NORMENT, Norwegian Centre for Mental Disorders Research, Division of Mental Health and Addiction, University of Oslo and Oslo University Hospital, Building 49, Ullevål sykehus, Nydalen, PO Box 4956, 0424, Oslo, Norway
| | - Idun B Huflåtten
- CoE NORMENT, Norwegian Centre for Mental Disorders Research, Division of Mental Health and Addiction, University of Oslo and Oslo University Hospital, Building 49, Ullevål sykehus, Nydalen, PO Box 4956, 0424, Oslo, Norway
| | - Torill Ueland
- CoE NORMENT, Norwegian Centre for Mental Disorders Research, Division of Mental Health and Addiction, University of Oslo and Oslo University Hospital, Building 49, Ullevål sykehus, Nydalen, PO Box 4956, 0424, Oslo, Norway.,Department of Psychology, University of Oslo, Oslo, Norway
| | - Trine Vik Lagerberg
- CoE NORMENT, Norwegian Centre for Mental Disorders Research, Division of Mental Health and Addiction, University of Oslo and Oslo University Hospital, Building 49, Ullevål sykehus, Nydalen, PO Box 4956, 0424, Oslo, Norway
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Thumfart KM, Jawaid A, Bright K, Flachsmann M, Mansuy IM. Epigenetics of childhood trauma: Long term sequelae and potential for treatment. Neurosci Biobehav Rev 2021; 132:1049-1066. [PMID: 34742726 DOI: 10.1016/j.neubiorev.2021.10.042] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 10/17/2021] [Accepted: 10/29/2021] [Indexed: 12/17/2022]
Abstract
Childhood trauma (CT) can have persistent effects on the brain and is one of the major risk factors for neuropsychiatric diseases in adulthood. Recent advances in the field of epigenetics suggest that epigenetic factors such as DNA methylation and histone modifications, as well as regulatory processes involving non-coding RNA are associated with the long-term sequelae of CT. This narrative review summarizes current knowledge on the epigenetic basis of CT and describes studies in animal models and human subjects examining how the epigenome and transcriptome are modified by CT in the brain. It discusses psychological and pharmacological interventions that can counteract epigenetic changes induced by CT and the need to establish longitudinal assessment after CT for developing more effective diagnostics and treatment strategies based on epigenetic targets.
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Affiliation(s)
- Kristina M Thumfart
- Laboratory of Neuroepigenetics, Brain Research Institute, University of Zürich and Institute for Neuroscience of the Swiss Federal Institute of Technology, Winterthurerstrasse 190, CH-8057, Zürich, Switzerland
| | - Ali Jawaid
- Laboratory of Neuroepigenetics, Brain Research Institute, University of Zürich and Institute for Neuroscience of the Swiss Federal Institute of Technology, Winterthurerstrasse 190, CH-8057, Zürich, Switzerland; Laboratory for Translational Research in Neuropsychiatric Disorders (TREND), BRAINCITY: Center of Excellence for Neural Plasticity and Brain Disorders, Nencki Institute of Experimental Biology, Ludwika Pasteura 3, Warsaw, 02-093, Poland
| | - Kristina Bright
- Swiss Federal Institute of Technology Zurich, Zurich, Switzerland
| | - Marc Flachsmann
- Swiss Federal Institute of Technology Zurich, Zurich, Switzerland
| | - Isabelle M Mansuy
- Laboratory of Neuroepigenetics, Brain Research Institute, University of Zürich and Institute for Neuroscience of the Swiss Federal Institute of Technology, Winterthurerstrasse 190, CH-8057, Zürich, Switzerland.
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30
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Janiri D, Moccia L, Dattoli L, Pepe M, Molinaro M, De Martin V, Chieffo D, Di Nicola M, Fiorillo A, Janiri L, Sani G. Emotional dysregulation mediates the impact of childhood trauma on psychological distress: First Italian data during the early phase of COVID-19 outbreak. Aust N Z J Psychiatry 2021; 55:1071-1078. [PMID: 33715469 DOI: 10.1177/0004867421998802] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND The coronavirus disease 2019 pandemic represents an unprecedented traumatic stressor to mental health. Psychological distress is considered a reliable proxy for psychopathology and can be negatively influenced by childhood trauma through sensitization effects. Emotion dysregulation has been proposed as a potential mediator of this mechanism. We aimed to test this hypothesis in a national Italian sample assessed in the early phase of the coronavirus disease 2019 outbreak. METHODS We investigated the relationship between psychological distress and childhood trauma in 500 healthy participants assessed through a survey-based study, after the coronavirus disease 2019 pandemic lockdown in Italy. Levels of psychological distress and history of childhood trauma were obtained using the Kessler-10 (K10) and the Childhood Trauma Questionnaire, respectively. We used bootstrapped mediation analysis to test the mediator role of emotional dysregulation, measured through the Difficulties in Emotion Regulation Scale, on the effect of childhood trauma on psychological distress. RESULTS In total, 190 (38%) reported psychological distress related to the coronavirus disease 2019 outbreak. Individuals with psychological distress experienced more childhood trauma, specifically emotional abuse (F = 23.51, df = 1, p < 0.001) and neglect (F = 10.98, df = 1, p = 0.001). After modelling the effect of emotional dysregulation, the impact of childhood trauma on coronavirus disease 2019-related psychological distress resulted in indirect effects and mediated by deficits in emotion regulation mechanisms (bootstrapped lower level of confidence interval = 0.345, upper level of confidence interval = 0.598). CONCLUSION Childhood trauma is associated with increased vulnerability to the stressful effect of the coronavirus disease 2019 outbreak. Our data suggest that emotional dysregulation may represent a dimension mediating the impact of childhood trauma on coronavirus disease 2019-related psychological distress and may be considered as specific target for interventions aiming at empowering resilience.
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Affiliation(s)
- Delfina Janiri
- Department of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.,Department of Psychiatry and Neurology, Sapienza University of Rome, Rome, Italy
| | - Lorenzo Moccia
- Department of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.,Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Luigi Dattoli
- Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Maria Pepe
- Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Marzia Molinaro
- Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Valentina De Martin
- Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Daniela Chieffo
- Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Marco Di Nicola
- Department of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.,Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Andrea Fiorillo
- Department of Psychiatry, University of Campania 'L. Vanvitelli', Naples, Italy
| | - Luigi Janiri
- Department of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.,Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Gabriele Sani
- Department of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.,Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, Rome, Italy
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31
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Icick R, Karsinti E, Brousse G, Chrétienneau C, Trabut JB, Belforte B, Coeuru P, Moisan D, Deschenau A, Cottencin O, Gay A, Lack P, Pelissier-Alicot AL, Dupuy G, Fortias M, Etain B, Lépine JP, Laplanche JL, Bellivier F, Vorspan F, Bloch V. Childhood trauma and the severity of past suicide attempts in outpatients with cocaine use disorders. Subst Abus 2021; 43:623-632. [PMID: 34597243 DOI: 10.1080/08897077.2021.1975875] [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: 10/20/2022]
Abstract
INTRODUCTION Suicide attempts have been associated with both cocaine use disorder (CocUD) and childhood trauma. We investigated how childhood trauma is an independent risk factor for serious and recurrent suicide attempts in CocUD. Method: 298 outpatients (23% women) with CocUD underwent standardized assessments of substance dependence (Diagnostic and Statistical Manual-mental disorders, fourth edition, text revised), impulsiveness, resilience, and childhood trauma, using validated tools. Suicide attempts history was categorized as single vs. recurrent or non-serious vs. serious depending on the lifetime number of suicide attempts and the potential or actual lethality of the worst attempt reported, respectively. Bivariate and multinomial regression analyses were used to characterize which childhood trauma patterns were associated with the suicide attempts groups. Results: 58% of CocUD patients reported childhood trauma. Recurrent and serious suicide attempts clustered together and were thus combined into "severe SA." Severe suicide attempt risk increased proportionally to the number of childhood traumas (test for trend, p = 9 × 10-7). Non-severe suicide attempt risk increased with impulsiveness and decreased with resilience. In multinomial regression models, a higher number of traumas and emotional abuse were independently and only associated with severe vs. non-severe suicide attempts (effect size = 0.82, AUC = 0.7). The study was limited by its cross-sectional design. Conclusion: These preferential associations between childhood trauma and severe suicide attempts warrant specific monitoring of suicide attempts risk in CocUD, regardless of the severity of addiction profiles.
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Affiliation(s)
- Romain Icick
- Département de Psychiatrie et de Médecine Addictologique, Assistance Publique - Hôpitaux de Paris (AP-HP), Groupe Hospitalier Saint-Louis - Lariboisière - Fernand Widal, Paris, France.,INSERM U1144, "Therapeutic Optimization in Neuropsychopharmacology", Paris, France.,INSERM UMR-S1144, Université de Paris, Paris, France
| | - Emily Karsinti
- Département de Psychiatrie et de Médecine Addictologique, Assistance Publique - Hôpitaux de Paris (AP-HP), Groupe Hospitalier Saint-Louis - Lariboisière - Fernand Widal, Paris, France.,INSERM U1144, "Therapeutic Optimization in Neuropsychopharmacology", Paris, France.,ED139, Laboratoire CLIPSYD, Paris Nanterre University, Nanterre, France
| | - Georges Brousse
- INSERM UMR-1107, Neuro-Dol, Université Clermont-Auvergne, Clermont-Ferrand, France
| | - Clara Chrétienneau
- INSERM U1144, "Therapeutic Optimization in Neuropsychopharmacology", Paris, France
| | | | - Beatriz Belforte
- APHP, Hôpital Européen Georges Pompidou, CSAPA Monte-Cristo, Paris, France
| | | | | | | | - Olivier Cottencin
- Université de Lille, CHU Lille - Psychiaty and Addiction Medicine Department, INSERM U1172 - Lille Neuroscience & Cognition Centre (LiNC), Plasticity & SubjectivitY team, Lille, France
| | - Aurélia Gay
- Service d'Addictologie, CHU St Etienne, Saint Etienne, France
| | | | | | - Gaël Dupuy
- Département de Psychiatrie et de Médecine Addictologique, Assistance Publique - Hôpitaux de Paris (AP-HP), Groupe Hospitalier Saint-Louis - Lariboisière - Fernand Widal, Paris, France
| | - Maeva Fortias
- Département de Psychiatrie et de Médecine Addictologique, Assistance Publique - Hôpitaux de Paris (AP-HP), Groupe Hospitalier Saint-Louis - Lariboisière - Fernand Widal, Paris, France
| | - Bruno Etain
- Département de Psychiatrie et de Médecine Addictologique, Assistance Publique - Hôpitaux de Paris (AP-HP), Groupe Hospitalier Saint-Louis - Lariboisière - Fernand Widal, Paris, France.,INSERM U1144, "Therapeutic Optimization in Neuropsychopharmacology", Paris, France.,INSERM UMR-S1144, Université de Paris, Paris, France
| | - Jean-Pierre Lépine
- Département de Psychiatrie et de Médecine Addictologique, Assistance Publique - Hôpitaux de Paris (AP-HP), Groupe Hospitalier Saint-Louis - Lariboisière - Fernand Widal, Paris, France.,INSERM U1144, "Therapeutic Optimization in Neuropsychopharmacology", Paris, France.,INSERM UMR-S1144, Université de Paris, Paris, France
| | - Jean-Louis Laplanche
- Département de Psychiatrie et de Médecine Addictologique, Assistance Publique - Hôpitaux de Paris (AP-HP), Groupe Hospitalier Saint-Louis - Lariboisière - Fernand Widal, Paris, France.,INSERM U1144, "Therapeutic Optimization in Neuropsychopharmacology", Paris, France.,INSERM UMR-S1144, Université de Paris, Paris, France
| | - Frank Bellivier
- Département de Psychiatrie et de Médecine Addictologique, Assistance Publique - Hôpitaux de Paris (AP-HP), Groupe Hospitalier Saint-Louis - Lariboisière - Fernand Widal, Paris, France.,INSERM U1144, "Therapeutic Optimization in Neuropsychopharmacology", Paris, France.,INSERM UMR-S1144, Université de Paris, Paris, France
| | - Florence Vorspan
- Département de Psychiatrie et de Médecine Addictologique, Assistance Publique - Hôpitaux de Paris (AP-HP), Groupe Hospitalier Saint-Louis - Lariboisière - Fernand Widal, Paris, France.,INSERM U1144, "Therapeutic Optimization in Neuropsychopharmacology", Paris, France.,INSERM UMR-S1144, Université de Paris, Paris, France
| | - Vanessa Bloch
- Département de Psychiatrie et de Médecine Addictologique, Assistance Publique - Hôpitaux de Paris (AP-HP), Groupe Hospitalier Saint-Louis - Lariboisière - Fernand Widal, Paris, France.,INSERM U1144, "Therapeutic Optimization in Neuropsychopharmacology", Paris, France.,INSERM UMR-S1144, Université de Paris, Paris, France
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Zhou Y, Huang J, Zhang P, Tong J, Fan F, Gou M, Cui Y, Luo X, Tan S, Wang Z, Feng W, Yang F, Tian B, Tian L, Savransky A, Hare S, Ryan MC, Goldwaser E, Chiappelli J, Chen S, Kochunov P, Kvarta M, Tan Y, Hong LE. Allostatic Load Effects on Cortical and Cognitive Deficits in Essentially Normotensive, Normoweight Patients with Schizophrenia. Schizophr Bull 2021; 47:1048-1057. [PMID: 33501486 PMCID: PMC8266595 DOI: 10.1093/schbul/sbaa196] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Reduced cortical gray matter integrity and cognitive abilities are among core deficits in schizophrenia. We hypothesized that higher allostatic load (AL) that accounts for exposure to chronic stress is a contributor to structural and cognitive deficits in schizophrenia. One hundred and sixty-seven schizophrenia patients who were on average with normal weight, normal systolic, and diastolic blood pressure and 72 healthy controls were enrolled in the study. Group differences in subclinical cardiovascular, metabolic, immune, and neuroendocrine biological markers as indexed by AL and contribution of AL components to the structural and cognitive deficits in schizophrenia were explored. Compared with controls, schizophrenia patients who were normotensive, normoweight, and had low total cholesterol levels still had significantly higher AL mainly due to lower high-density lipoprotein cholesterol and higher heart rate, waist-hip ratio, hemoglobinA1c, hypersensitive C-reactive protein, and overnight-urine cortisol levels. Patients also had decreased whole-brain mean cortical thickness, and lower cognition assessed by the MATRICS consensus cognitive battery. AL was inversely correlated with mean cortical thickness and cognition in schizophrenia, while none of these relationships existed in controls. Mediation analyses showed the effect of AL on cognitive deficits in schizophrenia was significantly mediated by cortical thinning, and the most significant mediating cortical area was the left superior frontal gyrus. Cortical thickness may act as a mediator between AL and cognitive deficits in schizophrenia. Early intervention strategies to reduce cortical thinning and cognitive dysfunction in schizophrenia should target specific aspects of their high AL in addition to weight gain, hypertension and high cholesterol levels.
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Affiliation(s)
- Yanfang Zhou
- Peking University HuiLongGuan Clinical Medical School, Beijing Huilongguan Hospital, Beijing, P.R. China
| | - Junchao Huang
- Peking University HuiLongGuan Clinical Medical School, Beijing Huilongguan Hospital, Beijing, P.R. China
| | - Ping Zhang
- Peking University HuiLongGuan Clinical Medical School, Beijing Huilongguan Hospital, Beijing, P.R. China
| | - Jinghui Tong
- Peking University HuiLongGuan Clinical Medical School, Beijing Huilongguan Hospital, Beijing, P.R. China
| | - Fengmei Fan
- Peking University HuiLongGuan Clinical Medical School, Beijing Huilongguan Hospital, Beijing, P.R. China
| | - Mengzhuang Gou
- Peking University HuiLongGuan Clinical Medical School, Beijing Huilongguan Hospital, Beijing, P.R. China
| | - Yimin Cui
- Department of Pharmacy, Peking University First Hospital, Beijing, P.R. China
| | - Xingguang Luo
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT
| | - Shuping Tan
- Peking University HuiLongGuan Clinical Medical School, Beijing Huilongguan Hospital, Beijing, P.R. China
| | - Zhiren Wang
- Peking University HuiLongGuan Clinical Medical School, Beijing Huilongguan Hospital, Beijing, P.R. China
| | - Wei Feng
- Peking University HuiLongGuan Clinical Medical School, Beijing Huilongguan Hospital, Beijing, P.R. China
| | - Fude Yang
- Peking University HuiLongGuan Clinical Medical School, Beijing Huilongguan Hospital, Beijing, P.R. China
| | - Baopeng Tian
- Peking University HuiLongGuan Clinical Medical School, Beijing Huilongguan Hospital, Beijing, P.R. China
| | - Li Tian
- Institute of Biomedicine and Translational Medicine, Department of Physiology, Faculty of Medicine, University of Tartu, Tartu, Estonia
| | - Anya Savransky
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD
| | - Stephanie Hare
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD
| | - Meghann C Ryan
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD
| | - Eric Goldwaser
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD
| | - Joshua Chiappelli
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD
| | - Shuo Chen
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD
| | - Peter Kochunov
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD
| | - Mark Kvarta
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD
| | - Yunlong Tan
- Peking University HuiLongGuan Clinical Medical School, Beijing Huilongguan Hospital, Beijing, P.R. China
| | - L Elliot Hong
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD
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Kameg BN. Bipolar disorder: Treatment strategies for women of childbearing age. Perspect Psychiatr Care 2021; 57:1244-1249. [PMID: 33164215 DOI: 10.1111/ppc.12680] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Revised: 09/16/2020] [Accepted: 10/20/2020] [Indexed: 11/29/2022] Open
Abstract
PURPOSE Bipolar disorder is associated with increased rates of morbidity and mortality, magnified in women of childbearing age. The purpose of this paper is to provide an overview of the differential diagnosis and management of bipolar disorder in women of childbearing age. CONCLUSIONS Differential diagnoses for bipolar disorder include depressive disorders, anxiety disorders, trauma-related disorders, attention-deficit/hyperactivity disorder, and personality disorders. Pharmacotherapeutic options for the treatment of bipolar disorder include lithium, anti-epileptic medications, and atypical antipsychotics. In regard to women of childbearing age, consideration of risks, benefits, and alternative therapies is needed before initiating therapy. PRACTICE IMPLICATIONS Caring for patients with bipolar disorder, particularly women of childbearing age, requires careful differentiation of bipolar disorder from other mental health problems, and prudent consideration of pharmacotherapeutic options.
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Affiliation(s)
- Brayden N Kameg
- Department of Health and Community Systems, University of Pittsburgh School of Nursing, Pittsburgh, Pennsylvania, USA
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Lunding SH, Simonsen C, Aas M, Rødevand L, Werner MCF, Laskemoen JF, Hjell G, Ringen PA, Lagerberg TV, Melle I, Andreassen OA, Ueland T, Steen NE. Childhood trauma and cardiometabolic risk in severe mental disorders: The mediating role of cognitive control. Eur Psychiatry 2021; 64:e24. [PMID: 33775258 PMCID: PMC8084596 DOI: 10.1192/j.eurpsy.2021.14] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Background Cardiometabolic risk is increased in severe mental disorders (SMDs), and there appears to be a relationship between childhood trauma and cardiometabolic risk, possibly related to adverse health behavior. The current study examined the association between childhood trauma and serum lipids and adiposity in SMDs and the potential mediating role of cognitive and personality characteristics. Methods Participants with schizophrenia and bipolar spectrum disorders (N = 819) were included, cardiometabolic risk factors (serum lipids, body mass index, and waist circumference) were measured, and history of childhood trauma was assessed by the Childhood Trauma Questionnaire. Cognitive and personality characteristics were available in subsamples, with assessments of cognitive control, impulsiveness, self-esteem, and affective lability. Linear regressions and mediation analyses with Hayes’ PROCESS were performed, adjusting for age, sex, antipsychotic agent propensity of metabolic side-effect, and diagnostic group. Results Experience of three or more subtypes of childhood trauma was positively associated with waist circumference in patients with SMDs (p = 0.014). There were no other significant associations between trauma variables and lipid or adiposity measures in the total sample. Cognitive control was a significant mediator between experience of one or two subtypes of childhood trauma and waist circumference. Conclusions The results indicate childhood trauma as a predisposing factor for increased waist circumference in individuals with SMDs. Poorer cognitive control, suggestive of adverse health behavior, might be a mediating factor of the association, and the findings indicate the potential importance of increased focus on these factors in prevention and treatment regimens targeting cardiometabolic health.
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Affiliation(s)
- Synve Hoffart Lunding
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Carmen Simonsen
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Early Intervention in Psychosis Advisory Unit for South East Norway, Oslo University Hospital, Oslo, Norway
| | - Monica Aas
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Linn Rødevand
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Maren Caroline Frogner Werner
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Jannicke Fjæra Laskemoen
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Gabriela Hjell
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Psychiatry, Ostfold Hospital, Graalum, Norway
| | - Petter Andreas Ringen
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Trine Vik Lagerberg
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Ingrid Melle
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Ole A Andreassen
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Torill Ueland
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Psychology, University of Oslo, Oslo, Norway
| | - Nils Eiel Steen
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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Abstract
In this chapter, we will focus on childhood maltreatment and its role in the vulnerability to BD.We will review how childhood maltreatment and trauma not only predispose to the development of BD but also to a more unstable, pernicious, and severe clinical expression of the disorder. This environmental risk factor is suggested to be part of a multiple hit model of vulnerability, involving not only early stressors (prenatal and postnatal ones) but also interactions with the genetic background of individuals and with other stressors occurring later in life. We will also review how childhood maltreatment and trauma may modify the brain functioning and circuits and alter some biological pathways in BD, hence leading to psychopathology. Finally, we will briefly discuss the implications for clinical practice and treatment.
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Affiliation(s)
- Bruno Etain
- Université de Paris, Paris, France.
- INSERM U1144, Faculté de Pharmacie de Paris, Université de Paris, Paris, France.
- Assistance Publique des Hôpitaux de Paris P-HP, GHU Saint-Louis - Lariboisière - F. Widal, Département de Psychiatrie et de Médecine Addictologique, Paris, France.
| | - Monica Aas
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
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Immature defense mechanisms mediate the relationship between childhood trauma and onset of bipolar disorder. J Affect Disord 2021; 278:672-677. [PMID: 33125910 DOI: 10.1016/j.jad.2020.10.029] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 08/28/2020] [Accepted: 10/12/2020] [Indexed: 11/20/2022]
Abstract
BACKGROUND Accumulating evidence has converged to suggest that childhood trauma may contribute to bipolar disorder (BD). This study aimed to investigate the patterns of childhood trauma among patients with bipolar I (BD-I) and bipolar II (BD-II) disorders, according to DSM-IV and in contrast with healthy volunteers. We also explored whether the relationship between childhood trauma and onset of bipolar disorder is mediated by immature defense mechanisms. METHODS Participants were patients with BD-I (n=44) and BD-II (n = 42), and healthy controls (HCs, n = 43). Childhood traumatic experiences and defense mechanisms were assessed by the Childhood Trauma Questionnaire (CTQ) and the Defense Style Questionnaire (DSQ), respectively. RESULTS BD patients experienced more severe childhood trauma than HCs. Physical neglect sub-score and total score of the CTQ had both direct and indirect effects on the diagnosis of BD-I, and an immature defense style mediated the indirect effects. The diagnosis of BD-II was mainly related to the physical neglect and emotional abuse subs-core and total score of the CTQ, as mediated by the immature defense mechanisms. BD-I and BD-II significantly differed in the emotional abuse sub-score of the CTQ. CONCLUSIONS Physical neglect sub-score and total score of the CTQ were associated with the diagnosis of BD (both BD-I and BD-II), as mediated by an immature defense style. Furthermore, emotional abuse might be an important risk factor for BD-II compared to BD-I. These findings may inform risk reduction and psychosocial intervention strategies to prevent and treat patients with bipolar disorders.
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37
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Paino M, Ordóñez-Camblor N, Fonseca-Pedrero E, García-Álvarez L, Pizarro-Ruiz JP. Development and Validation of an Instrument for the Detection of Early Traumatic Experiences (ExpTra-S) in Patients With Psychosis. Front Psychol 2020; 11:528213. [PMID: 33192770 PMCID: PMC7658315 DOI: 10.3389/fpsyg.2020.528213] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2020] [Accepted: 10/06/2020] [Indexed: 11/19/2022] Open
Abstract
The risk of the appearance of psychosis may reflect the existence of an underlying vulnerability, which may be influenced by environmental factors such as early traumatic experiences. This means that in clinical practice, the assessment of and approach to previous traumatic events is important in persons with psychotic disorders. The psychometric assessment of trauma has advanced considerably in recent years; however, there is no instrument that has been constructed and validated specifically for the evaluation of early traumatic experiences in the clinical population with psychosis. The main goal of this study was to present the construction and validation process of the Screening of Early Traumatic Experiences in Patients with Severe Mental Illness (ExpTra-S). The sample consisted of 114 patients who had experienced at least one psychotic episode (M = 35.5 years of age; SD = 9.26) and a comparison group of 153 young adults (M = 20.8 years of age; SD = 1.8). The factor analysis revealed an essentially one-dimensional structure. The ExpTra-S was associated with the positive dimension of the psychosis phenotype but not with the negative or affective dimensions, or subjective experiences. No items displayed differential functioning for sex and age. The ordinal alpha for the total score was 0.96. The patients with psychosis had a higher score for early traumatic experiences in comparison with the non-clinical group. The results obtained showed that the measuring instrument developed, the ExpTra-S, is a brief, simple, and useful measuring instrument for assessing the presence of early traumatic experiences in patients with severe mental illness.
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Affiliation(s)
- Mercedes Paino
- Department of Psychology, University of Oviedo, Oviedo, Spain
| | | | - Eduardo Fonseca-Pedrero
- Educational Sciences, University of La Rioja, Logroño, Spain.,Center for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain
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38
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Marwaha S, Briley PM, Perry A, Rankin P, DiFlorio A, Craddock N, Jones I, Broome M, Gordon-Smith K, Jones L. Explaining why childhood abuse is a risk factor for poorer clinical course in bipolar disorder: a path analysis of 923 people with bipolar I disorder. Psychol Med 2020; 50:2346-2354. [PMID: 31530330 PMCID: PMC7610181 DOI: 10.1017/s0033291719002411] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Revised: 06/19/2019] [Accepted: 08/19/2019] [Indexed: 11/07/2022]
Abstract
BACKGROUND Childhood abuse is a risk factor for poorer illness course in bipolar disorder, but the reasons why are unclear. Trait-like features such as affective instability and impulsivity could be part of the explanation. We aimed to examine whether childhood abuse was associated with clinical features of bipolar disorder, and whether associations were mediated by affective instability or impulsivity. METHODS We analysed data from 923 people with bipolar I disorder recruited by the Bipolar Disorder Research Network. Adjusted associations between childhood abuse, affective instability and impulsivity and eight clinical variables were analysed. A path analysis examined the direct and indirect links between childhood abuse and clinical features with affective instability and impulsivity as mediators. RESULTS Affective instability significantly mediated the association between childhood abuse and earlier age of onset [effect estimate (θ)/standard error (SE): 2.49], number of depressive (θ/SE: 2.08) and manic episodes/illness year (θ/SE: 1.32), anxiety disorders (θ/SE: 1.98) and rapid cycling (θ/SE: 2.25). Impulsivity significantly mediated the association between childhood abuse and manic episodes/illness year (θ/SE: 1.79), anxiety disorders (θ/SE: 1.59), rapid cycling (θ/SE: 1.809), suicidal behaviour (θ/SE: 2.12) and substance misuse (θ/SE: 3.09). Measures of path analysis fit indicated an excellent fit to the data. CONCLUSIONS Affective instability and impulsivity are likely part of the mechanism of why childhood abuse increases risk of poorer clinical course in bipolar disorder, with each showing some selectivity in pathways. They are potential novel targets for intervention to improve outcome in bipolar disorder.
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Affiliation(s)
- Steven Marwaha
- Institute for Mental Health, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
| | - Paul M. Briley
- Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - Amy Perry
- Psychological Medicine, University of Worcester, Worcester, UK
| | - Phillip Rankin
- Brighton and Sussex University Hospitals Trust, Brighton, UK
| | - Arianna DiFlorio
- National Centre for Mental Health, Cardiff University, Cardiff, UK
| | - Nick Craddock
- National Centre for Mental Health, Cardiff University, Cardiff, UK
| | - Ian Jones
- National Centre for Mental Health, Cardiff University, Cardiff, UK
| | - Matthew Broome
- Institute for Mental Health, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
| | | | - Lisa Jones
- Psychological Medicine, University of Worcester, Worcester, UK
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Høegh MC, Melle I, Aminoff SR, Laskemoen JF, Büchmann CB, Ueland T, Lagerberg TV. Affective lability across psychosis spectrum disorders. Eur Psychiatry 2020; 63:e53. [PMID: 32372737 PMCID: PMC7355177 DOI: 10.1192/j.eurpsy.2020.44] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Background. Despite apparent clinical remission, individuals with psychotic disorders often experience significant impairments across functional domains. Thus, there is a need to search beyond management of core symptoms to optimize treatment outcomes. Affective dysregulation is considered a risk factor for poor clinical and functional outcomes in many mental disorders, but research investigating such features in psychosis, particularly in schizophrenia, is limited. We aimed to investigate the level of affective lability (AL) in participants with schizophrenia- and bipolar spectrum disorders (n = 222) compared to healthy controls (n = 140), as well as clinical correlates of AL in the diagnostic groups. Methods. The Affective Lability Scale (ALS-SF) was used to measure total score of AL and subscores covering the domains of anxiety/depression, depression/elation, and anger. An analysis of covariance was performed to compare the ALS-SF total score between groups, correcting for potential confounders, as well as standard multiple regression analyses for diagnosis-specific investigations of the relationship between AL and demographic and clinical features. Results. Both the schizophrenia- and bipolar spectrum group had significantly higher ALS-SF total score compared to controls (p < 0.001), and no significant differences between the patient groups were found. In the schizophrenia group, current psychotic and depressive symptoms were significantly and independently associated with AL (p = 0.012 and p = 0.024, respectively). Conclusions. The findings indicate that AL is elevated in psychotic disorders and that it transcends diagnostic boundaries. Further research into the causal relationship between psychotic and affective symptoms and AL, as well as its role as a potential therapeutic target in psychosis spectrum disorders, is warranted.
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Affiliation(s)
- Margrethe Collier Høegh
- NORMENT, Centre for Research on Mental Disorders, Division of Mental Health and Addiction, University of Oslo and Oslo University Hospital, Oslo, Norway
| | - Ingrid Melle
- NORMENT, Centre for Research on Mental Disorders, Division of Mental Health and Addiction, University of Oslo and Oslo University Hospital, Oslo, Norway
| | - Sofie R Aminoff
- NORMENT, Centre for Research on Mental Disorders, Division of Mental Health and Addiction, University of Oslo and Oslo University Hospital, Oslo, Norway.,Oslo University Hospital, Division of Mental Health and Addiction, Oslo, Norway
| | - Jannicke Fjæra Laskemoen
- NORMENT, Centre for Research on Mental Disorders, Division of Mental Health and Addiction, University of Oslo and Oslo University Hospital, Oslo, Norway
| | - Camilla Bakkalia Büchmann
- NORMENT, Centre for Research on Mental Disorders, Division of Mental Health and Addiction, University of Oslo and Oslo University Hospital, Oslo, Norway
| | - Torill Ueland
- NORMENT, Centre for Research on Mental Disorders, Division of Mental Health and Addiction, University of Oslo and Oslo University Hospital, Oslo, Norway.,Department of Psychology, University of Oslo, Oslo, Norway
| | - Trine Vik Lagerberg
- NORMENT, Centre for Research on Mental Disorders, Division of Mental Health and Addiction, University of Oslo and Oslo University Hospital, Oslo, Norway
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40
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Mediating role of borderline personality disorder traits in the effects of childhood maltreatment on suicidal behaviour among mood disorder patients. Eur Psychiatry 2020; 44:53-60. [DOI: 10.1016/j.eurpsy.2017.03.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Revised: 03/23/2017] [Accepted: 03/23/2017] [Indexed: 11/23/2022] Open
Abstract
AbstractBackground:Substantial evidence supports an association between childhood maltreatment and suicidal behaviour. However, few studies have examined factors mediating this relationship among patients with unipolar or bipolar mood disorders.Methods:Depressive disorder and bipolar disorder (ICD-10-DCR) patients (n = 287) from the Helsinki University Psychiatric Consortium (HUPC) Study were surveyed on self-reported childhood experiences, current depressive symptoms, borderline personality disorder traits, and lifetime suicidal behaviour. Psychiatric records served to complement the information on suicide attempts. We examined by formal mediation analyses whether (1) the effect of childhood maltreatment on suicidal behaviour is mediated through borderline personality disorder traits and (2) the mediation effect differs between lifetime suicidal ideation and lifetime suicide attempts.Results:The impact of childhood maltreatment in multivariate models on either lifetime suicidal ideation or lifetime suicide attempts showed comparable total effects. In formal mediation analyses, borderline personality disorder traits mediated all of the total effect of childhood maltreatment on lifetime suicide attempts, but only one fifth of the total effect on lifetime suicidal ideation. The mediation effect was stronger for lifetime suicide attempts than for lifetime suicidal ideation (P = 0.002) and independent of current depressive symptoms.Conclusions:The mechanisms of the effect of childhood maltreatment on suicidal ideation versus suicide attempts may diverge among psychiatric patients with mood disorders. Borderline personality disorder traits may contribute to these mechanisms, although the influence appears considerably stronger for suicide attempts than for suicidal ideation.
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41
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Acosta JR, Librenza-Garcia D, Watts D, Francisco AP, Zórtea F, Raffa B, Kohmann A, Mugnol FE, Motta GL, Tramontina S, Passos IC. Bullying and psychotic symptoms in youth with bipolar disorder. J Affect Disord 2020; 265:603-610. [PMID: 31787423 DOI: 10.1016/j.jad.2019.11.101] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 09/27/2019] [Accepted: 11/21/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND Childhood trauma is associated with psychosis in adults with bipolar disorder (BD). Although bullying represents a widespread form of childhood trauma, no studies thus far have investigated the association of bullying and psychosis in pediatric bipolar disorder (PBD). We aim to examine the association between psychosis in PBD with bullying victimization. METHODS We included 64 children and adolescents (age± mean= 12±3.43) outpatients with BD spectrum disorders. Psychiatric diagnoses were assessed with the semi- structured interview Schedule for Affective Disorders and Schizophrenia for School Age Children-Present and Lifetime (KSADS-PL) version with additional depression and manic symptom items derived from the Washington University in St. Louis Kiddie Schedule for Affective Disorders (WASH-U-KSADS). Bullying, demographic, and clinical variables were assessed during the clinical interview. RESULTS A lifetime history of psychotic symptoms was associated with bullying (p = 0.002), suicidal behavior (p = 0.006), low socioeconomic status (p = 0.04), and severity of PBD (p = 0.02). Only bullying (OR = 7.3; 95%CI = 2-32) and suicidal behavior (OR = 7.6; 95%CI = 1.5-47.8) remained significant after adjustment for confounders. In a supplementary analysis, we developed a model using supervised machine learning to identify the most relevant variables that differentiated participants with psychotic symptoms, which included bullying, Clinical Global Impression-Severity scale (CGI-S), and suicidal behavior (accuracy = 75%, [p = 0.03]; sensitivity = 77.91%; specificity = 69.05%; area under the curve [AUC] = 0.86). LIMITATIONS Small sample, cross-sectional design, and generalizability of findings beyond the outpatient clinical sample. CONCLUSIONS Findings underscore the importance of assessing bullying in PBD participants. Future longitudinal studies with larger samples are needed to replicate our findings and determine causality.
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Affiliation(s)
- Jandira Rahmeier Acosta
- Program for Children and Adolescents with Bipolar Disorder (ProCAB), Division of Child and Adolescent Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil; Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento - Faculdade de Medicina, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre (RS), Brazil.
| | - Diego Librenza-Garcia
- Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento - Faculdade de Medicina, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre (RS), Brazil; Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada
| | - Devon Watts
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada
| | - Ana Paula Francisco
- Program for Children and Adolescents with Bipolar Disorder (ProCAB), Division of Child and Adolescent Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil; Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento - Faculdade de Medicina, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre (RS), Brazil; Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada
| | - Franco Zórtea
- Program for Children and Adolescents with Bipolar Disorder (ProCAB), Division of Child and Adolescent Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Bruno Raffa
- Program for Children and Adolescents with Bipolar Disorder (ProCAB), Division of Child and Adolescent Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil; Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento - Faculdade de Medicina, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre (RS), Brazil
| | - André Kohmann
- Program for Children and Adolescents with Bipolar Disorder (ProCAB), Division of Child and Adolescent Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Fabiana Eloisa Mugnol
- Program for Children and Adolescents with Bipolar Disorder (ProCAB), Division of Child and Adolescent Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Gledis Lisiane Motta
- Program for Children and Adolescents with Bipolar Disorder (ProCAB), Division of Child and Adolescent Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Silzá Tramontina
- Program for Children and Adolescents with Bipolar Disorder (ProCAB), Division of Child and Adolescent Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Ives Cavalcante Passos
- Laboratory of Molecular Psychiatry and Bipolar Disorder Program, HCPA, UFRGS, Porto Alegre, RS, Brazil.
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Swann AC, Lijffijt M, Simonetti A. Temporal Structure of Mixed States: Does Sensitization Link Life Course to Episodes? Psychiatr Clin North Am 2020; 43:153-165. [PMID: 32008682 DOI: 10.1016/j.psc.2019.10.005] [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] [Indexed: 10/25/2022]
Abstract
Susceptibility to combined depressive and manic syndromes correlates strongly with arousal-related symptoms including impulsivity, anxiety and agitation. This relationship to a driven, "mixed" activation-depression state, generated by a life-long process, was described in classical times. Course of illness in mixed states includes increased episode frequency, duration, earlier onset, and association with addiction- and trauma/stress-related disorders. Mixed episodes have catecholamine and hypothalamic-pituitary-adrenocortical activity increased beyond nonmixed states of similar symptom severity. These properties resemble behavioral sensitization, where salient, survival-related stimuli (traumatic or rewarding) can generate persistently exaggerated responses with disrupted arousal and reward, with potential for suicide and other severe consequences.
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Affiliation(s)
- Alan C Swann
- Department of Psychiatry, Baylor College of Medicine, 1977 Butler Boulevard, Suite E4.400, Houston, TX 77030, USA; Mental Health Care Line, Michael E. DeBakey VAMC, 2002 East Holcombe Boulevard, Houston, TX 77030, USA.
| | - Marijn Lijffijt
- Department of Psychiatry, Baylor College of Medicine, 1977 Butler Boulevard, Suite E4.400, Houston, TX 77030, USA
| | - Alessio Simonetti
- Department of Psychiatry, Baylor College of Medicine, 1977 Butler Boulevard, Suite E4.400, Houston, TX 77030, USA; Department of Psychiatry and Neurology, Sapienza University of Rome, Rome, Italy
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43
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Janiri D, Kotzalidis GD, De Chiara L, Koukopoulos AE, Aas M, Sani G. The Ring of Fire: Childhood Trauma, Emotional Reactivity, and Mixed States in Mood Disorders. Psychiatr Clin North Am 2020; 43:69-82. [PMID: 32008689 DOI: 10.1016/j.psc.2019.10.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Childhood trauma (CT) is strongly associated with bipolar disorder, possibly through emotional hyperreactivity (EH). Mixed symptoms/states (MSs) are associated with increased illness severity. The authors tested through a systematic review the association between CT and MSs. The authors systematically looked for studies exploring associations between MSs and CT, CT and EH, and EH and MSs. Most literature agrees that MSs are associated with CT; the latter was found to be associated to EH, which is in turn associated with MSs. The literature supports an association between CT and later development of MSs, possibly mediated through EH.
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Affiliation(s)
- Delfina Janiri
- Sapienza School of Medicine and Psychology, Sant'Andrea University Hospital, UOC Psichiatria, Via di Grottarossa, 1035-1039, Rome 00189, Italy; ICAHN School of Medicine and Mount Sinai, New York, NY, USA; Centro Lucio Bini, Via Crescenzio 42, Rome 00193, Italy
| | - Georgios D Kotzalidis
- Centro Lucio Bini, Via Crescenzio 42, Rome 00193, Italy; School of Medicine and Psychology, NESMOS Department (Neuroscience, Mental Health and Sensory Organs) Sapienza University, Sant'Andrea Hospital, Via di Grottarossa 1035-1038, Rome 00189, Italy.
| | - Lavinia De Chiara
- Centro Lucio Bini, Via Crescenzio 42, Rome 00193, Italy; School of Medicine and Psychology, NESMOS Department (Neuroscience, Mental Health and Sensory Organs) Sapienza University, Sant'Andrea Hospital, Via di Grottarossa 1035-1038, Rome 00189, Italy
| | - Alexia Emilia Koukopoulos
- Centro Lucio Bini, Via Crescenzio 42, Rome 00193, Italy; Department of Human Neurosciences, University of Rome "Sapienza", Viale dell'Università 30, Roma 00185, Italy
| | - Monica Aas
- NORMENT K.G Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Institute of Clinical Medicine, University of Oslo, Oslo University Hospital, Bygg 49, Ullevål Sykehus, PO Box 4956, Nydalen, Oslo 0424, Norway
| | - Gabriele Sani
- Institute of Psychiatry, Università Cattolica del Sacro Cuore, Rome, Italy; Department of Psychiatry, Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy
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44
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Abstract
The construct of mixed states is a robust clinical entity with a high variability of prevalence according to different diagnostic criteria. Despite the changes over the years, current official diagnostic criteria still have poor clinical usefulness. Premorbid characteristics with a potential high clinical importance such as temperament, personality, and emotional reactivity are understudied in patients with mixed states and excluded from the current nosologic systems. The authors provide an overview of current nosography and clinical pictures of mixed states and discuss the role of temperament, personality, and emotional reactivity in mixed states.
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45
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Aas M, Ueland T, Inova A, Melle I, Andreassen OA, Steen NE. Childhood Trauma Is Nominally Associated With Elevated Cortisol Metabolism in Severe Mental Disorder. Front Psychiatry 2020; 11:391. [PMID: 32528319 PMCID: PMC7247816 DOI: 10.3389/fpsyt.2020.00391] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Accepted: 04/17/2020] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVE Individuals exposed to childhood trauma display longstanding modifications of the Hypothalamic-Pituitary-Adrenal (HPA) axis, as well as cognitive impairments. Schizophrenia spectrum disorder (SZ) and bipolar disorders (BD) are characterised by higher prevalence of childhood trauma, abnormal HPA axis, and cognitive dysfunction. Elevated cortisol metabolism was recently demonstrated in both disorders. However, it is yet to be established if childhood adversity is associated with cortisol metabolism in this population, and how this may be associated with cognitive function. METHODS One-hundred-and-fourteen participants with a DSM-IV SZ or BD diagnosis took part in the study. Diagnoses were evaluated by the Structured Clinical Interview for DSM-IV Axis I disorders (SCID-I). Estimated cortisol metabolizing activity (5α-reductase and 5β-reductase) was assessed by urinary free cortisol, and metabolites. All patients underwent cognitive assessment and completed the Childhood Trauma Questionnaire. RESULTS Estimated 5β-reductase activity was elevated in participant with childhood physical abuse (r = 0.26, p = 0.005). After adjusting for age, sex and diagnosis, physical abuse was still nominally associated with elevated 5β-reductase. Moreover, only high 5α-reductase activity was negatively correlated with working memory and executive performance (r = -0.23, p = 0.01; r = -0.19, p = 0.05, respectively), however this disappeared after adjusting for age, sex and diagnosis. Cortisol metabolism did not mediate the association between childhood trauma and cognitive function. CONCLUSIONS Our study indicates that childhood physical abuse is associated with elevated cortisol metabolism (5β-reductase) in adults with a SZ or BD disorder. However, our study did not support cortisol metabolism as a mediator between childhood trauma experiences and cognitive function within these disorders.
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Affiliation(s)
- Monica Aas
- NORMENT, Psychosis Research Unit, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Torill Ueland
- NORMENT, Psychosis Research Unit, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.,Department of Psychology, University of Oslo, Oslo, Norway
| | - Amina Inova
- NORMENT, Psychosis Research Unit, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Ingrid Melle
- NORMENT, Psychosis Research Unit, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Ole A Andreassen
- NORMENT, Psychosis Research Unit, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.,NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Nils Eiel Steen
- NORMENT, Psychosis Research Unit, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.,NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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46
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Lippard ET, Nemeroff CB. The Devastating Clinical Consequences of Child Abuse and Neglect: Increased Disease Vulnerability and Poor Treatment Response in Mood Disorders. Am J Psychiatry 2020; 177:20-36. [PMID: 31537091 PMCID: PMC6939135 DOI: 10.1176/appi.ajp.2019.19010020] [Citation(s) in RCA: 219] [Impact Index Per Article: 54.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
A large body of evidence has demonstrated that exposure to childhood maltreatment at any stage of development can have long-lasting consequences. It is associated with a marked increase in risk for psychiatric and medical disorders. This review summarizes the literature investigating the effects of childhood maltreatment on disease vulnerability for mood disorders, specifically summarizing cross-sectional and more recent longitudinal studies demonstrating that childhood maltreatment is more prevalent and is associated with increased risk for first mood episode, episode recurrence, greater comorbidities, and increased risk for suicidal ideation and attempts in individuals with mood disorders. It summarizes the persistent alterations associated with childhood maltreatment, including alterations in the hypothalamic-pituitary-adrenal axis and inflammatory cytokines, which may contribute to disease vulnerability and a more pernicious disease course. The authors discuss several candidate genes and environmental factors (for example, substance use) that may alter disease vulnerability and illness course and neurobiological associations that may mediate these relationships following childhood maltreatment. Studies provide insight into modifiable mechanisms and provide direction to improve both treatment and prevention strategies.
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Affiliation(s)
- Elizabeth T.C. Lippard
- Department of Psychiatry, Dell Medical School, University of Texas, Austin, TX, USA,Institute of Early Life Adversity Research, Dell Medical School, University of Texas, Austin, TX USA,Waggoner Center for Alcohol and Addiction Research, University of Texas, Austin, TX USA,Department of Psychology, University of Texas, Austin, TX, USA,Mulva Clinic for Neuroscience, Dell Medical School, University of Texas, Austin, TX
| | - Charles B. Nemeroff
- Department of Psychiatry, Dell Medical School, University of Texas, Austin, TX, USA,Institute of Early Life Adversity Research, Dell Medical School, University of Texas, Austin, TX USA,Waggoner Center for Alcohol and Addiction Research, University of Texas, Austin, TX USA,Mulva Clinic for Neuroscience, Dell Medical School, University of Texas, Austin, TX
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47
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Lengvenyte A, Conejero I, Courtet P, Olié E. Biological bases of suicidal behaviours: A narrative review. Eur J Neurosci 2019; 53:330-351. [PMID: 31793103 DOI: 10.1111/ejn.14635] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Revised: 11/05/2019] [Accepted: 11/28/2019] [Indexed: 12/13/2022]
Abstract
Suicidal behaviour is a multifaceted phenomenon that concerns all human populations. It has been suggested that a complex interaction between the individual genetic profile and environmental factors throughout life underlies the pathophysiology of suicidal behaviour. Although epidemiological and genetic studies suggest the existence of a genetic component, exposure to biological and psychosocial adversities, especially during critical developmental periods, also contributes to altering the biological responses to threat and pleasure. This results in amplified maladaptive cognitive and behavioural traits and states associated with suicidal behaviours. Alterations in the cognitive inhibition and decision-making capacity have been implicated in suicidal behaviours. Structural and functional changes in key brain regions and networks, such as prefrontal cortex, insula and default mode network, may underlie this relationship. Furthermore, the shift from health to suicidal behaviour incorporates complex and dynamic changes in the immune and stress responses, monoaminergic system, gonadal system and neuroplasticity. In this review, we describe the major findings of epidemiological, genetic, neuroanatomical, neuropsychological, immunological and neuroendocrinological studies on suicide behaviours to provide a solid background for future research in this field. This broad overview of the biological bases of suicide should promote neuroscience research on suicidal behaviours. This might lead to improved biological models and to the identification of evidence-based biomarkers, treatment options and preventive strategies.
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Affiliation(s)
- Aiste Lengvenyte
- Department of Emergency Psychiatry & Acute Care, CHU Montpellier, University of Montpellier, Montpellier, France.,Faculty of Medicine, Institute of Clinical Medicine, Psychiatric Clinic, Vilnius University, Vilnius, Lithuania
| | - Ismael Conejero
- Neuropsychiatry: Epidemiological and Clinical Research, Inserm Unit 1061, Montpellier, France.,Department of Psychiatry, CHU Nimes, University of Montpellier, Montpellier, France
| | - Philippe Courtet
- Department of Emergency Psychiatry & Acute Care, CHU Montpellier, University of Montpellier, Montpellier, France.,Neuropsychiatry: Epidemiological and Clinical Research, Inserm Unit 1061, Montpellier, France
| | - Emilie Olié
- Department of Emergency Psychiatry & Acute Care, CHU Montpellier, University of Montpellier, Montpellier, France.,Neuropsychiatry: Epidemiological and Clinical Research, Inserm Unit 1061, Montpellier, France
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48
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Jiang S, Postovit L, Cattaneo A, Binder EB, Aitchison KJ. Epigenetic Modifications in Stress Response Genes Associated With Childhood Trauma. Front Psychiatry 2019; 10:808. [PMID: 31780969 PMCID: PMC6857662 DOI: 10.3389/fpsyt.2019.00808] [Citation(s) in RCA: 112] [Impact Index Per Article: 22.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Accepted: 10/11/2019] [Indexed: 12/12/2022] Open
Abstract
Adverse childhood experiences (ACEs) may be referred to by other terms (e.g., early life adversity or stress and childhood trauma) and have a lifelong impact on mental and physical health. For example, childhood trauma has been associated with posttraumatic stress disorder (PTSD), anxiety, depression, bipolar disorder, diabetes, and cardiovascular disease. The heritability of ACE-related phenotypes such as PTSD, depression, and resilience is low to moderate, and, moreover, is very variable for a given phenotype, which implies that gene by environment interactions (such as through epigenetic modifications) may be involved in the onset of these phenotypes. Currently, there is increasing interest in the investigation of epigenetic contributions to ACE-induced differential health outcomes. Although there are a number of studies in this field, there are still research gaps. In this review, the basic concepts of epigenetic modifications (such as methylation) and the function of the hypothalamic-pituitary-adrenal (HPA) axis in the stress response are outlined. Examples of specific genes undergoing methylation in association with ACE-induced differential health outcomes are provided. Limitations in this field, e.g., uncertain clinical diagnosis, conceptual inconsistencies, and technical drawbacks, are reviewed, with suggestions for advances using new technologies and novel research directions. We thereby provide a platform on which the field of ACE-induced phenotypes in mental health may build.
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Affiliation(s)
- Shui Jiang
- Department of Medical Genetics, University of Alberta, Edmonton, AB, Canada
| | - Lynne Postovit
- Department of Oncology, University of Alberta, Edmonton, AB, Canada
| | - Annamaria Cattaneo
- Biological Psychiatric Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Elisabeth B. Binder
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich, Germany
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, United States
| | - Katherine J. Aitchison
- Department of Medical Genetics, University of Alberta, Edmonton, AB, Canada
- Department of Psychiatry, University of Alberta, Edmonton, AB, Canada
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49
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Icick R, Melle I, Etain B, Ringen PA, Aminoff SR, Leboyer M, Aas M, Henry C, Bjella TD, Andreassen OA, Bellivier F, Lagerberg TV. Tobacco smoking and other substance use disorders associated with recurrent suicide attempts in bipolar disorder. J Affect Disord 2019; 256:348-357. [PMID: 31202989 DOI: 10.1016/j.jad.2019.05.075] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Revised: 04/08/2019] [Accepted: 05/30/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND Suicide attempts (SA) are more frequent in bipolar disorder (BD) than in most other mental disorders. Prevention strategies would benefit from identifying the risk factors of SA recurrence in BD. Substance use disorders (SUD) (including tobacco-related) are strongly associated with both BD and SA, however, their specific role for the recurrence of SA in BD remains inadequately investigated. Thus, we tested if tobacco smoking - with or without other SUDs - was independently associated with recurrent SA in BD. METHODS 916 patients from France and Norway with ascertained diagnoses of BD and reliable data about SA and SUD were classified as having no, single, or recurrent (≥2) SA. Five SUD groups were built according to the presence/absence/combination of tobacco, alcohol (AUD) and cannabis use disorders. Multinomial logistic regression was used to identify the correlates of SA recurrence. RESULTS 338 (37%) individuals reported at least one SA, half of whom (173, 51%) reported recurrence. SUD comorbidity was: tobacco smoking only, 397 (43%), tobacco smoking with at least another SUD, 179 (20%). Regression analysis showed that tobacco smoking, both alone and comorbid with AUD, depressive polarity of BD onset and female gender were independently associated with recurrent SA. LIMITATIONS Lack of data regarding the relative courses of SA and SUD and cross-national differences in main variables. CONCLUSION Tobacco smoking with- or without additional SUD can be important risk factors of SA recurrence in BD, which is likely to inform both research and prevention strategies.
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Affiliation(s)
- R Icick
- Inserm, U1144, Paris F-75006, France; Paris Diderot University, UMR-S 1144, Paris F-75013, France; Assistance Publique - Hôpitaux de Paris, University Hospitals Saint-Louis - Lariboisière - F. Widal, Departement of Psychiatry and Addiction Medicine, Paris F-75010, France; FondaMental Foundation, Créteil F-94000, France.
| | - I Melle
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway; NORMENT, KG Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - B Etain
- Inserm, U1144, Paris F-75006, France; Paris Diderot University, UMR-S 1144, Paris F-75013, France; Assistance Publique - Hôpitaux de Paris, University Hospitals Saint-Louis - Lariboisière - F. Widal, Departement of Psychiatry and Addiction Medicine, Paris F-75010, France; FondaMental Foundation, Créteil F-94000, France
| | - P A Ringen
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - S R Aminoff
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway; NORMENT, KG Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - M Leboyer
- FondaMental Foundation, Créteil F-94000, France; Inserm U955, Psychiatric Genetics Team, Créteil F-94000, France; Paris Est University, Faculty of medicine, Créteil F-94000, France; Assistance Publique - Hôpitaux de Paris, University Hospitals Henri Mondor, DHU PePsy, Psychiatry Center, Créteil F-94000, France
| | - M Aas
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway; NORMENT, KG Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - C Henry
- FondaMental Foundation, Créteil F-94000, France; Paris Est University, Faculty of medicine, Créteil F-94000, France
| | - T D Bjella
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway; NORMENT, KG Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - O A Andreassen
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway; NORMENT, KG Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - F Bellivier
- Inserm, U1144, Paris F-75006, France; Paris Diderot University, UMR-S 1144, Paris F-75013, France; Assistance Publique - Hôpitaux de Paris, University Hospitals Saint-Louis - Lariboisière - F. Widal, Departement of Psychiatry and Addiction Medicine, Paris F-75010, France; FondaMental Foundation, Créteil F-94000, France
| | - T V Lagerberg
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway; NORMENT, KG Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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50
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Strejilevich S, Szmulewicz A, Igoa A, Marengo E, Caravotta P, Martino D. Episodic density, subsyndromic symptoms, and mood instability in late-life bipolar disorders: A 5-year follow-up study. Int J Geriatr Psychiatry 2019; 34:950-956. [PMID: 30864181 DOI: 10.1002/gps.5094] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Accepted: 03/05/2019] [Indexed: 01/22/2023]
Abstract
OBJECTIVES Characterization of clinical course in old age bipolar disorder (OABD) is scarce and based solely on episode density (ED). The aim of this study was to explore mood instability (MI) and subsyndromal symptomatology (SS) in a prospective cohort of OABD. Further, we contrasted these measures with a cohort of young age bipolar disorder (YABD). METHODS Life charts from weekly mood ratings were used to compute the number of weeks spent with subsyndromal symptoms (SD), the ED, and the MI during follow-up for a cohort of OABD (N = 38) that excluded late onset BD. Linear and logistic regression models were fitted to compare the clinical course of OABD with a cohort of YABD (N = 52) and to explore the relationship between these measures and functional outcomes. RESULTS Median follow-up was 5 years (IQR: 3.6-7.9). OABD (61.6 years, SD: 8.3) spent 15%, 6%, and 3% of their follow-up with depressive, manic, and mixed symptoms, respectively, and suffered 4.2 mood changes per year (SD: 2.6). No significant differences between OABD and YABD regarding ED or MI emerged in multivariate analysis, while a higher subsyndromal manic symptom burden was observed in OABD (β coefficient: 3.79, 95%CI: 0.4-7.2). Both SS and MI were associated with functional outcomes in OABD. CONCLUSIONS The course of illness throughout OABD was similar to the one observed in YABD except for a higher subsyndromal manic burden. This study extended the association of MI and SD with global functioning to the late-life BD.
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Affiliation(s)
- Sergio Strejilevich
- ÁREA, Assistance and Research in Affective Disorders, Buenos Aires, Argentina.,Bipolar Disorder Program, Neurosciences Institute, Favaloro University, Buenos Aires, Argentina
| | - Alejandro Szmulewicz
- ÁREA, Assistance and Research in Affective Disorders, Buenos Aires, Argentina.,Harvard TH Chan School of Public Health, Boston, MA, USA.,Department of Pharmacology, University of Buenos Aires, Buenos Aires, Argentina
| | - Ana Igoa
- ÁREA, Assistance and Research in Affective Disorders, Buenos Aires, Argentina
| | - Eliana Marengo
- ÁREA, Assistance and Research in Affective Disorders, Buenos Aires, Argentina
| | - Pablo Caravotta
- ÁREA, Assistance and Research in Affective Disorders, Buenos Aires, Argentina
| | - Diego Martino
- ÁREA, Assistance and Research in Affective Disorders, Buenos Aires, Argentina.,National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina
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