Environment risk factors have different impact on bipolar and psychotic disorders: an analysis of MHGP survey

PM2.5 and PM10 air pollution peaks are associated with emergency department visits for psychotic and mood disorders

Particulate matters with a diameter of less than 10 µm (PM10) or less than 2.5 µm (PM2.5) are major air pollutants. Their relationship to psychiatric disorders has not yet been extensively studied. We aimed to explore the relationship between PM10 and PM2.5 air pollution peaks and the daily number of emergency visits for psychotic and mood disorders. Clinical data were collected from the Emergency Department of a Paris suburb (Créteil, France) from 2008 to 2018. Air pollution data were measured by the Paris region air quality network (Airparif) and collected from public databases. Pollution peak periods were defined as days for which the daily mean level of PM was above nationally predefined warning thresholds (20 µg/m3 for PM2.5, and 50 µg/m3 for PM10), and the 6 following days. Multivariable analyses compared the number of daily visits for psychotic and mood (unipolar and bipolar) disorders according to pollution peak, using negative binomial regression. After adjustment on meteorological variables (temperature, humidity, amount of sunshine in minutes), the daily number of emergency visits for psychotic disorders was significantly higher during PM2.5 and PM10 air pollution peak periods; while the number of visits for unipolar depressive disorders was higher only during PM10 peak periods (β = 0.059, p-value = 0.034). There were no significant differences between peak and non-peak periods for bipolar disorders. Differences in the effects of PM air pollution on psychotic and mood disorders should be analyzed in further studies.

A Latent Class Analysis of Manic and Psychotic Symptoms

Bipolar spectrum disorders encompass heterogeneous clinical manifestations and comorbidities. A latent class analysis (LCA) was performed in 1846 subjects who experienced an episode of abnormally elevated or irritable mood to identify homogeneous groups of subjects, based on the distribution of 11 manic and 7 psychotic symptoms. LCA identified five classes: 1) two classes with irritability and with low and high level of psychosis (respectively "irritable," 29.1% of the sample, and "irritable-psychotic," 16.2%); 2) a class with expansive mood and hyperactivity ("expansive-hyperactive," 12.7%); and 3) two classes with manic symptoms and high and low level of psychosis ("manic-psychotic," 15.0%, and "manic," 27.2%). "Irritable" displayed lower rates of depressive episode, panic, and substance use disorders. Manic-psychotic displayed higher rates of depressive episode, panic, generalized anxiety, and substance use disorders. Use of mental health treatment more frequent in manic-psychotic and manic classes. Five classes of bipolar spectrum disorders were characterized by different sociodemographic and clinical patterns.

Shorter and longer durations of sleep are associated with an increased twelve-month prevalence of psychiatric and substance use disorders: Findings from a nationally representative survey of US adults (NESARC-III)

The lack of comprehensive data on the association between psychiatric and substance use disorders and habitual sleep duration represents a major health information gap. This study examines the 12-month prevalence of mental disorders stratified by duration of sleep. Data were drawn from face-to-face interviews conducted in the National Epidemiologic Survey on Alcohol and Related Conditions III, a nationally representative survey of US adults (N = 36,309). There were 1893 (5.26%) participants who reported <5h of sleep/night; 2434(6.76%) 5 h/night; 7621(21.17%) 6 h/night; 9620(26.72%) 7 h/night; 11,186(31.07%) 8 h/night, and 3245(9.01%) ≥9 h/night. A U-shaped association was observed between sleep duration and all mental disorders. The prevalence of mental disorders was 55% for individuals with <5 h/night and 47.81% for ≥9 h/night, versus 28.24% for the 7 h/night (aOR = 1.90 and 1.39 respectively). The greatest odds ratios were for the <5 h/night group, with an increased risk above 3-fold for panic disorder (PD), post-traumatic stress disorder (PTSD), psychotic disorder, and suicide attempt; between 2 and 3 fold for major depressive disorder (MDD), bipolar disorder (BD), and generalized anxiety disorder (GAD); and between 1 and 2 fold for tobacco and drug use disorders, specific and social phobias. The ≥9 h/night group had an increased risk above 1 to 2-fold regarding tobacco and drug use disorders, MDD, BD, PD, social phobia, GAD, PTSD, psychotic disorder, and suicide attempt. U-shaped associations exist between sleep duration and mental disorders, calling for respect to recommendations for adequate sleep duration in routine clinical care as well as to actions for primary prevention in public health settings.