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Salvetat N, Checa-Robles FJ, Delacrétaz A, Cayzac C, Dubuc B, Vetter D, Dainat J, Lang JP, Gamma F, Weissmann D. AI algorithm combined with RNA editing-based blood biomarkers to discriminate bipolar from major depressive disorders in an external validation multicentric cohort. J Affect Disord 2024; 356:385-393. [PMID: 38615844 DOI: 10.1016/j.jad.2024.04.022] [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: 08/18/2023] [Revised: 04/02/2024] [Accepted: 04/05/2024] [Indexed: 04/16/2024]
Abstract
Bipolar disorder (BD) is a leading cause of disability worldwide, as it can lead to cognitive and functional impairment and premature mortality. The first episode of BD is usually a depressive episode and is often misdiagnosed as major depressive disorder (MDD). Growing evidence indicates that peripheral immune activation and inflammation are involved in the pathophysiology of BD and MDD. Recently, by developing a panel of RNA editing-based blood biomarkers able to discriminate MDD from depressive BD, we have provided clinicians a new tool to reduce the misdiagnosis delay observed in patients suffering from BD. The present study aimed at validating the diagnostic value of this panel in an external independent multicentric Switzerland-based cohort of 143 patients suffering from moderate to major depression. The RNA-editing based blood biomarker (BMK) algorithm developped allowed to accurately discriminate MDD from depressive BD in an external cohort, with high accuracy, sensitivity and specificity values (82.5 %, 86.4 % and 80.8 %, respectively). These findings further confirm the important role of RNA editing in the physiopathology of mental disorders and emphasize the possible clinical usefulness of the biomarker panel for optimization treatment delay in patients suffering from BD.
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Affiliation(s)
- Nicolas Salvetat
- ALCEDIAG/Sys2Diag, CNRS UMR 9005, Parc Euromédecine, Montpellier, France
| | | | - Aurélie Delacrétaz
- Les Toises. Center for psychiatry and psychotherapy, Lausanne, Switzerland
| | - Christopher Cayzac
- ALCEDIAG/Sys2Diag, CNRS UMR 9005, Parc Euromédecine, Montpellier, France
| | - Benjamin Dubuc
- ALCEDIAG/Sys2Diag, CNRS UMR 9005, Parc Euromédecine, Montpellier, France
| | - Diana Vetter
- ALCEDIAG/Sys2Diag, CNRS UMR 9005, Parc Euromédecine, Montpellier, France
| | - Jacques Dainat
- ALCEDIAG/Sys2Diag, CNRS UMR 9005, Parc Euromédecine, Montpellier, France
| | - Jean-Philippe Lang
- ALCEDIAG/Sys2Diag, CNRS UMR 9005, Parc Euromédecine, Montpellier, France; Les Toises. Center for psychiatry and psychotherapy, Lausanne, Switzerland
| | - Franziska Gamma
- Les Toises. Center for psychiatry and psychotherapy, Lausanne, Switzerland
| | - Dinah Weissmann
- ALCEDIAG/Sys2Diag, CNRS UMR 9005, Parc Euromédecine, Montpellier, France.
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Valenzuela-Pascual C, Mas A, Borràs R, Anmella G, Sanabra M, González-Campos M, Valentí M, Pacchiarotti I, Benabarre A, Grande I, De Prisco M, Oliva V, Bastidas A, Agasi I, Young AH, Garriga M, Murru A, Corponi F, Li BM, de Looff P, Vieta E, Hidalgo-Mazzei D. Sleep-wake variations of electrodermal activity in bipolar disorder. Acta Psychiatr Scand 2024. [PMID: 38890010 DOI: 10.1111/acps.13718] [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: 03/01/2024] [Revised: 05/14/2024] [Accepted: 06/05/2024] [Indexed: 06/20/2024]
Abstract
BACKGROUND Affective states influence the sympathetic nervous system, inducing variations in electrodermal activity (EDA), however, EDA association with bipolar disorder (BD) remains uncertain in real-world settings due to confounders like physical activity and temperature. We analysed EDA separately during sleep and wakefulness due to varying confounders and potential differences in mood state discrimination capacities. METHODS We monitored EDA from 102 participants with BD including 35 manic, 29 depressive, 38 euthymic patients, and 38 healthy controls (HC), for 48 h. Fifteen EDA features were inferred by mixed-effect models for repeated measures considering sleep state, group and covariates. RESULTS Thirteen EDA feature models were significantly influenced by sleep state, notably including phasic peaks (p < 0.001). During wakefulness, phasic peaks showed different values for mania (M [SD] = 6.49 [5.74, 7.23]), euthymia (5.89 [4.83, 6.94]), HC (3.04 [1.65, 4.42]), and depression (3.00 [2.07, 3.92]). Four phasic features during wakefulness better discriminated between HC and mania or euthymia, and between depression and euthymia or mania, compared to sleep. Mixed symptoms, average skin temperature, and anticholinergic medication affected the models, while sex and age did not. CONCLUSION EDA measured from awake recordings better distinguished between BD states than sleep recordings, when controlled by confounders.
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Affiliation(s)
- Clàudia Valenzuela-Pascual
- Department of Psychiatry and Psychology, Hospital Clínic de Barcelona, Catalonia, Barcelona, Spain
- Bipolar and Depressive Disorders Unit, Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Catalonia, Barcelona, Spain
- Biomedical Research Networking Centre Consortium on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Department of Medicine, School of Medicine and Health Sciences, Institute of Neurosciences (UBNeuro), University of Barcelona (UB), Catalonia, Barcelona, Spain
| | - Ariadna Mas
- Department of Psychiatry and Psychology, Hospital Clínic de Barcelona, Catalonia, Barcelona, Spain
- Bipolar and Depressive Disorders Unit, Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Catalonia, Barcelona, Spain
- Biomedical Research Networking Centre Consortium on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Department of Medicine, School of Medicine and Health Sciences, Institute of Neurosciences (UBNeuro), University of Barcelona (UB), Catalonia, Barcelona, Spain
| | - Roger Borràs
- Department of Psychiatry and Psychology, Hospital Clínic de Barcelona, Catalonia, Barcelona, Spain
- Biomedical Research Networking Centre Consortium on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Gerard Anmella
- Department of Psychiatry and Psychology, Hospital Clínic de Barcelona, Catalonia, Barcelona, Spain
- Bipolar and Depressive Disorders Unit, Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Catalonia, Barcelona, Spain
- Biomedical Research Networking Centre Consortium on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Department of Medicine, School of Medicine and Health Sciences, Institute of Neurosciences (UBNeuro), University of Barcelona (UB), Catalonia, Barcelona, Spain
| | - Miriam Sanabra
- Department of Psychiatry and Psychology, Hospital Clínic de Barcelona, Catalonia, Barcelona, Spain
- Bipolar and Depressive Disorders Unit, Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Catalonia, Barcelona, Spain
- Biomedical Research Networking Centre Consortium on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Department of Medicine, School of Medicine and Health Sciences, Institute of Neurosciences (UBNeuro), University of Barcelona (UB), Catalonia, Barcelona, Spain
| | - Meritxell González-Campos
- Department of Psychiatry and Psychology, Hospital Clínic de Barcelona, Catalonia, Barcelona, Spain
- Bipolar and Depressive Disorders Unit, Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Catalonia, Barcelona, Spain
| | - Marc Valentí
- Department of Psychiatry and Psychology, Hospital Clínic de Barcelona, Catalonia, Barcelona, Spain
- Bipolar and Depressive Disorders Unit, Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Catalonia, Barcelona, Spain
- Biomedical Research Networking Centre Consortium on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Department of Medicine, School of Medicine and Health Sciences, Institute of Neurosciences (UBNeuro), University of Barcelona (UB), Catalonia, Barcelona, Spain
| | - Isabella Pacchiarotti
- Department of Psychiatry and Psychology, Hospital Clínic de Barcelona, Catalonia, Barcelona, Spain
- Bipolar and Depressive Disorders Unit, Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Catalonia, Barcelona, Spain
- Biomedical Research Networking Centre Consortium on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Department of Medicine, School of Medicine and Health Sciences, Institute of Neurosciences (UBNeuro), University of Barcelona (UB), Catalonia, Barcelona, Spain
| | - Antoni Benabarre
- Department of Psychiatry and Psychology, Hospital Clínic de Barcelona, Catalonia, Barcelona, Spain
- Bipolar and Depressive Disorders Unit, Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Catalonia, Barcelona, Spain
- Biomedical Research Networking Centre Consortium on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Department of Medicine, School of Medicine and Health Sciences, Institute of Neurosciences (UBNeuro), University of Barcelona (UB), Catalonia, Barcelona, Spain
| | - Iria Grande
- Department of Psychiatry and Psychology, Hospital Clínic de Barcelona, Catalonia, Barcelona, Spain
- Bipolar and Depressive Disorders Unit, Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Catalonia, Barcelona, Spain
- Biomedical Research Networking Centre Consortium on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Department of Medicine, School of Medicine and Health Sciences, Institute of Neurosciences (UBNeuro), University of Barcelona (UB), Catalonia, Barcelona, Spain
| | - Michele De Prisco
- Department of Psychiatry and Psychology, Hospital Clínic de Barcelona, Catalonia, Barcelona, Spain
- Bipolar and Depressive Disorders Unit, Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Catalonia, Barcelona, Spain
- Biomedical Research Networking Centre Consortium on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Department of Medicine, School of Medicine and Health Sciences, Institute of Neurosciences (UBNeuro), University of Barcelona (UB), Catalonia, Barcelona, Spain
| | - Vincenzo Oliva
- Department of Psychiatry and Psychology, Hospital Clínic de Barcelona, Catalonia, Barcelona, Spain
- Bipolar and Depressive Disorders Unit, Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Catalonia, Barcelona, Spain
- Biomedical Research Networking Centre Consortium on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Department of Medicine, School of Medicine and Health Sciences, Institute of Neurosciences (UBNeuro), University of Barcelona (UB), Catalonia, Barcelona, Spain
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Anna Bastidas
- Department of Psychiatry and Psychology, Hospital Clínic de Barcelona, Catalonia, Barcelona, Spain
| | - Isabel Agasi
- Department of Psychiatry and Psychology, Hospital Clínic de Barcelona, Catalonia, Barcelona, Spain
| | - Allan H Young
- Centre for Affective Disorders (CfAD), Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK
| | - Marina Garriga
- Department of Psychiatry and Psychology, Hospital Clínic de Barcelona, Catalonia, Barcelona, Spain
- Bipolar and Depressive Disorders Unit, Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Catalonia, Barcelona, Spain
- Biomedical Research Networking Centre Consortium on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Department of Medicine, School of Medicine and Health Sciences, Institute of Neurosciences (UBNeuro), University of Barcelona (UB), Catalonia, Barcelona, Spain
| | - Andrea Murru
- Department of Psychiatry and Psychology, Hospital Clínic de Barcelona, Catalonia, Barcelona, Spain
- Bipolar and Depressive Disorders Unit, Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Catalonia, Barcelona, Spain
- Biomedical Research Networking Centre Consortium on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Department of Medicine, School of Medicine and Health Sciences, Institute of Neurosciences (UBNeuro), University of Barcelona (UB), Catalonia, Barcelona, Spain
| | - Filippo Corponi
- School of Informatics, University of Edinburgh, Edinburgh, UK
| | - Bryan M Li
- School of Informatics, University of Edinburgh, Edinburgh, UK
| | - Peter de Looff
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
- Fivoor, Science and Treatment Innovation, Expert centre "De Borg", Den Dolder, The Netherlands
| | - Eduard Vieta
- Department of Psychiatry and Psychology, Hospital Clínic de Barcelona, Catalonia, Barcelona, Spain
- Bipolar and Depressive Disorders Unit, Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Catalonia, Barcelona, Spain
- Biomedical Research Networking Centre Consortium on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Department of Medicine, School of Medicine and Health Sciences, Institute of Neurosciences (UBNeuro), University of Barcelona (UB), Catalonia, Barcelona, Spain
| | - Diego Hidalgo-Mazzei
- Department of Psychiatry and Psychology, Hospital Clínic de Barcelona, Catalonia, Barcelona, Spain
- Bipolar and Depressive Disorders Unit, Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Catalonia, Barcelona, Spain
- Biomedical Research Networking Centre Consortium on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Department of Medicine, School of Medicine and Health Sciences, Institute of Neurosciences (UBNeuro), University of Barcelona (UB), Catalonia, Barcelona, Spain
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Li C, Tian H, Li R, Jia F, Wang L, Ma X, Yang L, Zhang Q, Zhang Y, Yao K, Zhuo C. Molecular mechanisms of quetiapine bidirectional regulation of bipolar depression and mania based on network pharmacology and molecular docking: Evidence from computational biology. J Affect Disord 2024; 355:528-539. [PMID: 38518857 DOI: 10.1016/j.jad.2024.03.096] [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: 02/05/2024] [Revised: 03/15/2024] [Accepted: 03/18/2024] [Indexed: 03/24/2024]
Abstract
BACKGROUND Quetiapine monotherapy is recommended as the first-line option for acute mania and acute bipolar depression. However, the mechanism of action of quetiapine is unclear. Network pharmacology and molecular docking were employed to determine the molecular mechanisms of quetiapine bidirectional regulation of bipolar depression and mania. METHODS Putative target genes for quetiapine were collected from the GeneCard, SwissTargetPrediction, and DrugBank databases. Targets for bipolar depression and bipolar mania were identified from the DisGeNET and GeneCards databases. A protein-protein interaction (PPI) network was generated using the String database and imported into Cytoscape. DAVID and the Bioinformatics platform were employed to perform the Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses of the top 15 core targets. The drug-pathway-target-disease network was constructed using Cytoscape. Finally, molecular docking was performed to evaluate the interactions between quetiapine and potential targets. RESULTS Targets for quetiapine actions against bipolar depression (126 targets) and bipolar mania (81 targets) were identified. Based on PPI and KEGG pathway analyses, quetiapine may affect bipolar depression by targeting the MAPK and PI3K/AKT insulin signaling pathways via BDNF, INS, EGFR, IGF1, and NGF, and it may affect bipolar mania by targeting the neuroactive ligand-receptor interaction signaling pathway via HTR1A, HTR1B, HTR2A, DRD2, and GRIN2B. Molecular docking revealed good binding affinity between quetiapine and potential targets. LIMITATIONS Pharmacological experiments should be conducted to verify and further explore these results. CONCLUSIONS Our findings suggest that quetiapine affects bipolar depression and bipolar mania through distinct biological core targets, and thus through different mechanisms. Furthermore, our results provide a theoretical basis for the clinical use of quetiapine and possible directions for new drug development.
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Affiliation(s)
- Chao Li
- Computational Biology Centre (CBC), Tianjin Anding Hospital, Nankai University Affiliated Tianjin Anding Hospital, Tianjin Medical University Affiliated Tianjin Anding Hospital, Tianjin 300222, China; Laboratory of Psychiatric-Neuroimaging-Genetic and Co-morbidity (PGNP_Lab), Tianjin Anding Hospital, Tianjin Mental Health Center of Tianjin Medical University, Tianjin 300222, China
| | - Hongjun Tian
- Animal Imaging Center (AIC) of Tianjin Fourth Center Hospital, Nankai University Affiliated Tianjin Fourth Center Hospital, Tianjin 300140, China
| | - Ranli Li
- Computational Biology Centre (CBC), Tianjin Anding Hospital, Nankai University Affiliated Tianjin Anding Hospital, Tianjin Medical University Affiliated Tianjin Anding Hospital, Tianjin 300222, China
| | - Feng Jia
- Computational Biology Centre (CBC), Tianjin Anding Hospital, Nankai University Affiliated Tianjin Anding Hospital, Tianjin Medical University Affiliated Tianjin Anding Hospital, Tianjin 300222, China
| | - Lina Wang
- Laboratory of Psychiatric-Neuroimaging-Genetic and Co-morbidity (PGNP_Lab), Tianjin Anding Hospital, Tianjin Mental Health Center of Tianjin Medical University, Tianjin 300222, China
| | - Xiaoyan Ma
- Laboratory of Psychiatric-Neuroimaging-Genetic and Co-morbidity (PGNP_Lab), Tianjin Anding Hospital, Tianjin Mental Health Center of Tianjin Medical University, Tianjin 300222, China
| | - Lei Yang
- Laboratory of Psychiatric-Neuroimaging-Genetic and Co-morbidity (PGNP_Lab), Tianjin Anding Hospital, Tianjin Mental Health Center of Tianjin Medical University, Tianjin 300222, China
| | - Qiuyu Zhang
- Laboratory of Psychiatric-Neuroimaging-Genetic and Co-morbidity (PGNP_Lab), Tianjin Anding Hospital, Tianjin Mental Health Center of Tianjin Medical University, Tianjin 300222, China
| | - Ying Zhang
- Laboratory of Psychiatric-Neuroimaging-Genetic and Co-morbidity (PGNP_Lab), Tianjin Anding Hospital, Tianjin Mental Health Center of Tianjin Medical University, Tianjin 300222, China
| | - Kaifang Yao
- Laboratory of Psychiatric-Neuroimaging-Genetic and Co-morbidity (PGNP_Lab), Tianjin Anding Hospital, Tianjin Mental Health Center of Tianjin Medical University, Tianjin 300222, China
| | - Chuanjun Zhuo
- Computational Biology Centre (CBC), Tianjin Anding Hospital, Nankai University Affiliated Tianjin Anding Hospital, Tianjin Medical University Affiliated Tianjin Anding Hospital, Tianjin 300222, China; Laboratory of Psychiatric-Neuroimaging-Genetic and Co-morbidity (PGNP_Lab), Tianjin Anding Hospital, Tianjin Mental Health Center of Tianjin Medical University, Tianjin 300222, China.
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4
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Perra A, Sancassiani F, Cantone E, Pintus E, D’Oca S, Casula A, Littarru S, Zucca S, Tumolillo D, Pinna I, Primavera D, Cossu G, Nardi AE, Kalcev G, Carta MG. An e-Health Psychoeducation Program for Managing the Mental Health of People with Bipolar Disorder during the COVID-19 Pandemic: A Randomized Controlled Study. J Clin Med 2024; 13:3468. [PMID: 38929997 PMCID: PMC11204713 DOI: 10.3390/jcm13123468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2024] [Revised: 06/06/2024] [Accepted: 06/11/2024] [Indexed: 06/28/2024] Open
Abstract
Background: Social rhythm dysregulation has been identified as a determining factor in bipolar disorder (BD) relapses. It directly impacts individuals' quality of life (QoL). This study aims to present preliminary data on the efficacy of an e-health psychoeducational intervention for BD for improving clinical outcomes. Methods: This study used an open-label, crossover, randomized controlled trial design. The inclusion criteria consisted of a BD diagnosis, affiliation with the Consultation Psychiatry and Psychosomatic Center at the University Hospital in Cagliari, Italy, age over 18, and the obtaining of informed consent. Anxiety and depressive symptoms, QoL, and social and biological rhythms were measured using standardized instruments validated in Italian. Results: A total of 36 individuals were included in the experimental group (EG) and 18 in the control group (CG). The final sample consisted of 25 in the EG and 14 in the CG. A statistically significant improvement in QoL was found in the EG post-treatment (p = 0.011). Significant correlations were found between QoL and the dysregulation of biorhythms in the EG at T0 (p = 0.0048) and T1 (p = 0.0014). Conclusions: This study shows that, during extreme distress, an e-health group psychoeducation intervention for people with BD could significantly improve the perception of QoL. The results must be confirmed by studies conducted with larger-sized samples.
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Affiliation(s)
- Alessandra Perra
- Department of Medical Sciences and Public Health, University of Cagliari, Cittadella Universitaria, S.P. Monserrato-Sestu km 0,700, 09042 Cagliari, Italy; (A.P.); (F.S.); (E.C.); (E.P.); (S.D.); (A.C.); (S.L.); (S.Z.); (D.T.); (I.P.); (D.P.); (G.C.); (M.G.C.)
| | - Federica Sancassiani
- Department of Medical Sciences and Public Health, University of Cagliari, Cittadella Universitaria, S.P. Monserrato-Sestu km 0,700, 09042 Cagliari, Italy; (A.P.); (F.S.); (E.C.); (E.P.); (S.D.); (A.C.); (S.L.); (S.Z.); (D.T.); (I.P.); (D.P.); (G.C.); (M.G.C.)
| | - Elisa Cantone
- Department of Medical Sciences and Public Health, University of Cagliari, Cittadella Universitaria, S.P. Monserrato-Sestu km 0,700, 09042 Cagliari, Italy; (A.P.); (F.S.); (E.C.); (E.P.); (S.D.); (A.C.); (S.L.); (S.Z.); (D.T.); (I.P.); (D.P.); (G.C.); (M.G.C.)
| | - Elisa Pintus
- Department of Medical Sciences and Public Health, University of Cagliari, Cittadella Universitaria, S.P. Monserrato-Sestu km 0,700, 09042 Cagliari, Italy; (A.P.); (F.S.); (E.C.); (E.P.); (S.D.); (A.C.); (S.L.); (S.Z.); (D.T.); (I.P.); (D.P.); (G.C.); (M.G.C.)
| | - Silvia D’Oca
- Department of Medical Sciences and Public Health, University of Cagliari, Cittadella Universitaria, S.P. Monserrato-Sestu km 0,700, 09042 Cagliari, Italy; (A.P.); (F.S.); (E.C.); (E.P.); (S.D.); (A.C.); (S.L.); (S.Z.); (D.T.); (I.P.); (D.P.); (G.C.); (M.G.C.)
| | - Alessio Casula
- Department of Medical Sciences and Public Health, University of Cagliari, Cittadella Universitaria, S.P. Monserrato-Sestu km 0,700, 09042 Cagliari, Italy; (A.P.); (F.S.); (E.C.); (E.P.); (S.D.); (A.C.); (S.L.); (S.Z.); (D.T.); (I.P.); (D.P.); (G.C.); (M.G.C.)
| | - Sara Littarru
- Department of Medical Sciences and Public Health, University of Cagliari, Cittadella Universitaria, S.P. Monserrato-Sestu km 0,700, 09042 Cagliari, Italy; (A.P.); (F.S.); (E.C.); (E.P.); (S.D.); (A.C.); (S.L.); (S.Z.); (D.T.); (I.P.); (D.P.); (G.C.); (M.G.C.)
| | - Sara Zucca
- Department of Medical Sciences and Public Health, University of Cagliari, Cittadella Universitaria, S.P. Monserrato-Sestu km 0,700, 09042 Cagliari, Italy; (A.P.); (F.S.); (E.C.); (E.P.); (S.D.); (A.C.); (S.L.); (S.Z.); (D.T.); (I.P.); (D.P.); (G.C.); (M.G.C.)
| | - Davide Tumolillo
- Department of Medical Sciences and Public Health, University of Cagliari, Cittadella Universitaria, S.P. Monserrato-Sestu km 0,700, 09042 Cagliari, Italy; (A.P.); (F.S.); (E.C.); (E.P.); (S.D.); (A.C.); (S.L.); (S.Z.); (D.T.); (I.P.); (D.P.); (G.C.); (M.G.C.)
| | - Irene Pinna
- Department of Medical Sciences and Public Health, University of Cagliari, Cittadella Universitaria, S.P. Monserrato-Sestu km 0,700, 09042 Cagliari, Italy; (A.P.); (F.S.); (E.C.); (E.P.); (S.D.); (A.C.); (S.L.); (S.Z.); (D.T.); (I.P.); (D.P.); (G.C.); (M.G.C.)
| | - Diego Primavera
- Department of Medical Sciences and Public Health, University of Cagliari, Cittadella Universitaria, S.P. Monserrato-Sestu km 0,700, 09042 Cagliari, Italy; (A.P.); (F.S.); (E.C.); (E.P.); (S.D.); (A.C.); (S.L.); (S.Z.); (D.T.); (I.P.); (D.P.); (G.C.); (M.G.C.)
| | - Giulia Cossu
- Department of Medical Sciences and Public Health, University of Cagliari, Cittadella Universitaria, S.P. Monserrato-Sestu km 0,700, 09042 Cagliari, Italy; (A.P.); (F.S.); (E.C.); (E.P.); (S.D.); (A.C.); (S.L.); (S.Z.); (D.T.); (I.P.); (D.P.); (G.C.); (M.G.C.)
| | - Antonio Egidio Nardi
- Institute of Psychiatry, Federal University of Rio de Janeiro, Rua Visconde de Piraja 407/702, Rio de Janeiro 21941-972, Brazil;
| | - Goce Kalcev
- Department of Medical Sciences and Public Health, University of Cagliari, Cittadella Universitaria, S.P. Monserrato-Sestu km 0,700, 09042 Cagliari, Italy; (A.P.); (F.S.); (E.C.); (E.P.); (S.D.); (A.C.); (S.L.); (S.Z.); (D.T.); (I.P.); (D.P.); (G.C.); (M.G.C.)
| | - Mauro Giovanni Carta
- Department of Medical Sciences and Public Health, University of Cagliari, Cittadella Universitaria, S.P. Monserrato-Sestu km 0,700, 09042 Cagliari, Italy; (A.P.); (F.S.); (E.C.); (E.P.); (S.D.); (A.C.); (S.L.); (S.Z.); (D.T.); (I.P.); (D.P.); (G.C.); (M.G.C.)
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5
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Irastorza-Valera L, Soria-Gómez E, Benitez JM, Montáns FJ, Saucedo-Mora L. Review of the Brain's Behaviour after Injury and Disease for Its Application in an Agent-Based Model (ABM). Biomimetics (Basel) 2024; 9:362. [PMID: 38921242 PMCID: PMC11202129 DOI: 10.3390/biomimetics9060362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2024] [Revised: 05/28/2024] [Accepted: 06/05/2024] [Indexed: 06/27/2024] Open
Abstract
The brain is the most complex organ in the human body and, as such, its study entails great challenges (methodological, theoretical, etc.). Nonetheless, there is a remarkable amount of studies about the consequences of pathological conditions on its development and functioning. This bibliographic review aims to cover mostly findings related to changes in the physical distribution of neurons and their connections-the connectome-both structural and functional, as well as their modelling approaches. It does not intend to offer an extensive description of all conditions affecting the brain; rather, it presents the most common ones. Thus, here, we highlight the need for accurate brain modelling that can subsequently be used to understand brain function and be applied to diagnose, track, and simulate treatments for the most prevalent pathologies affecting the brain.
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Affiliation(s)
- Luis Irastorza-Valera
- E.T.S. de Ingeniería Aeronáutica y del Espacio, Universidad Politécnica de Madrid, Pza. Cardenal Cisneros 3, 28040 Madrid, Spain; (L.I.-V.); (J.M.B.); (F.J.M.)
- PIMM Laboratory, ENSAM–Arts et Métiers ParisTech, 151 Bd de l’Hôpital, 75013 Paris, France
| | - Edgar Soria-Gómez
- Achúcarro Basque Center for Neuroscience, Barrio Sarriena, s/n, 48940 Leioa, Spain;
- Ikerbasque, Basque Foundation for Science, Plaza Euskadi, 5, 48009 Bilbao, Spain
- Department of Neurosciences, University of the Basque Country UPV/EHU, Barrio Sarriena, s/n, 48940 Leioa, Spain
| | - José María Benitez
- E.T.S. de Ingeniería Aeronáutica y del Espacio, Universidad Politécnica de Madrid, Pza. Cardenal Cisneros 3, 28040 Madrid, Spain; (L.I.-V.); (J.M.B.); (F.J.M.)
| | - Francisco J. Montáns
- E.T.S. de Ingeniería Aeronáutica y del Espacio, Universidad Politécnica de Madrid, Pza. Cardenal Cisneros 3, 28040 Madrid, Spain; (L.I.-V.); (J.M.B.); (F.J.M.)
- Department of Mechanical and Aerospace Engineering, Herbert Wertheim College of Engineering, University of Florida, Gainesville, FL 32611, USA
| | - Luis Saucedo-Mora
- E.T.S. de Ingeniería Aeronáutica y del Espacio, Universidad Politécnica de Madrid, Pza. Cardenal Cisneros 3, 28040 Madrid, Spain; (L.I.-V.); (J.M.B.); (F.J.M.)
- Department of Materials, University of Oxford, Parks Road, Oxford OX1 3PJ, UK
- Department of Nuclear Science and Engineering, Massachusetts Institute of Technology (MIT), 77 Massachusetts Ave, Cambridge, MA 02139, USA
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Paljärvi T, Herttua K, Taipale H, Lähteenvuo M, Tanskanen A, Tiihonen J. Cardiovascular mortality in bipolar disorder: Population-based cohort study. Acta Psychiatr Scand 2024. [PMID: 38826056 DOI: 10.1111/acps.13715] [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: 02/20/2024] [Revised: 04/26/2024] [Accepted: 05/20/2024] [Indexed: 06/04/2024]
Abstract
BACKGROUND Limited evidence base on cause-specific excess cardiovascular disease (CVD) mortality in bipolar disorder (BD) is a barrier to developing preventive interventions aimed at reducing the persistent mortality gap in BD. OBJECTIVE To investigate cause-specific CVD mortality in BD. METHODS We identified all individuals aged 15+ years during 2004-2018 with a diagnosis of BD using Finnish nationwide routine data. Standardised mortality ratios (SMR) with 95% confidence intervals (CI) were calculated using the mortality rates in the general population as weights. RESULTS 53,273 individuals with BD (57% women; median age at BD diagnosis, 40 years), were followed up for 428,426 person-years (median, 8.2 years). There were 5988 deaths due to any cause, of which 26% were due to CVD. The leading cause of absolute excess CVD mortality was coronary artery disease (CAD). The leading causes of relative excess mortality were cardiomegaly (SMR, 4.51; 95% CI, 3.58-5.43), venous thromboembolism (3.03; 2.26-3.81), cardiomyopathy (2.46; 1.95-2.97), and hypertensive heart disease (2.12; 1.71-2.54). The leading causes of absolute CVD mortality showed markedly lower relative excess, including CAD (1.47; 1.34-1.61), ischaemic stroke (1.31; 1.06-1.54), and acute myocardial infarction (1.12; 0.98-1.25). Due to the higher relative excess mortality, structural and functional heart disorders contributed as much as atherosclerotic and ischaemic disorders to the absolute excess mortality. CONCLUSIONS Cardiomyopathy and hypertensive heart disease as the leading causes of relative excess mortality emphasise the contribution of structural and functional heart disorders to the overall excess mortality alongside coronary artery disease. Interventions targeted at these modifiable causes of death should be priorities in the prevention of premature excess CVD mortality in BD.
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Affiliation(s)
- Tapio Paljärvi
- Department of Forensic Psychiatry, University of Eastern Finland, Niuvanniemi Hospital, Kuopio, Finland
| | - Kimmo Herttua
- Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Heidi Taipale
- Department of Forensic Psychiatry, University of Eastern Finland, Niuvanniemi Hospital, Kuopio, Finland
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- School of Pharmacy, University of Eastern Finland, Kuopio, Finland
| | - Markku Lähteenvuo
- Department of Forensic Psychiatry, University of Eastern Finland, Niuvanniemi Hospital, Kuopio, Finland
| | - Antti Tanskanen
- Department of Forensic Psychiatry, University of Eastern Finland, Niuvanniemi Hospital, Kuopio, Finland
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Jari Tiihonen
- Department of Forensic Psychiatry, University of Eastern Finland, Niuvanniemi Hospital, Kuopio, Finland
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
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Dell'Osso B, Cremaschi L, Macellaro M, Cafaro R, Girone N. Bipolar disorder staging and the impact it has on its management: an update. Expert Rev Neurother 2024; 24:565-574. [PMID: 38753491 DOI: 10.1080/14737175.2024.2355264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Accepted: 05/10/2024] [Indexed: 05/18/2024]
Abstract
INTRODUCTION The longitudinal course of bipolar disorder (BD) is associated with an active process of neuroprogression, characterized by structural brain alterations and progressive functional impairment. In the last decades, a growing need of a standardized staging model for BD arose, with the aim of a more appropriate definition of stage-specific clinical manifestations and the identification of more customized therapeutic tools. AREAS COVERED The authors review the literature on clinical aspects, neurobiological correlates and treatment issues related to BD progression. Thereafter, they address the definition, constructs, and evolution of the staging concept, focusing on the clinical applications of BD staging models available in literature. EXPERT OPINION Although several staging models for BD have been proposed to date, their application in clinical practice is still relatively scant. This may have a detrimental impact on the clinical and therapeutic management of BD, in terms of early and proper diagnosis as well as tailored treatment interventions according to the different stages of illness. Future research efforts should tend to the integration of recent insights on neuroimaging and epigenetic markers, toward a standardized and multidimensional staging model.
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Affiliation(s)
- Bernardo Dell'Osso
- Department of Biomedical and Clinical Sciences "Luigi Sacco", University of Milan, Milan, Italy
- CRC "Aldo Ravelli" for Neurotechnology and Experimental Brain Therapeutics, University of Milan, Milan, Italy
- Department of Psychiatry and Behavioural Sciences, Stanford University, Stanford, CA, USA
| | - Laura Cremaschi
- Department of Biomedical and Clinical Sciences "Luigi Sacco", University of Milan, Milan, Italy
| | - Monica Macellaro
- Department of Biomedical and Clinical Sciences "Luigi Sacco", University of Milan, Milan, Italy
- CRC "Aldo Ravelli" for Neurotechnology and Experimental Brain Therapeutics, University of Milan, Milan, Italy
| | - Rita Cafaro
- Department of Biomedical and Clinical Sciences "Luigi Sacco", University of Milan, Milan, Italy
| | - Nicolaja Girone
- Department of Biomedical and Clinical Sciences "Luigi Sacco", University of Milan, Milan, Italy
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Razavi MS, Fathi M, Vahednia E, Ardani AR, Honari S, Akbarzadeh F, Talaei A. Cognitive rehabilitation in bipolar spectrum disorder: A systematic review. IBRO Neurosci Rep 2024; 16:509-517. [PMID: 38645887 PMCID: PMC11033165 DOI: 10.1016/j.ibneur.2024.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 04/07/2024] [Accepted: 04/08/2024] [Indexed: 04/23/2024] Open
Abstract
Background and objectives Neurocognitive deficits in bipolar disorder (BD) have a negative impact on the quality of life, even during the euthymic phase. And many studies conducted to improve cognitive deficits in bipolar disorder. This systematic review aims to summarize studies on cognitive rehabilitation (CR) conducted in bipolar patients and evaluate its impact on neurocognitive deficits. The primary objective is to explore how CR interventions can enhance cognitive functioning, treatment outcomes, and overall quality of life in this population. Methods A comprehensive search was conducted on PubMed, Google Scholar, Scopus, Embase, and PsycINFO databases from 1950 to 2023, following the 2015 PRISMA-P guidelines, using search terms related to BD and CR. Results The initial search yielded 371 titles across the five databases. After applying inclusion and exclusion criteria through screening, a total of 23 articles were included in the study. The selected articles evaluated verbal memory, attention, executive functions, and social cognition. Conclusion The findings suggest that CR can be an effective treatment approach for bipolar patients, aimed at enhancing their cognitive abilities, treatment outcomes, and overall quality of life. The primary finding of this study indicates that cognitive-behavioral therapy (CBT) protocols, skill training, and homework exercises, which offer a daily structure, social support, and opportunities for exchanging coping strategies, are more effective in enhancing cognitive functions. However, it is important to acknowledge the notable limitations of this review. Firstly, we did not assess the methodological rigor of the included studies. Additionally, there was a lack of detailed analysis regarding specific cognitive rehabilitation approaches that adhere to core CR principles, resulting in increased heterogeneity within the reviewed studies.
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Affiliation(s)
| | | | - Elham Vahednia
- Psychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Amir Rezaei Ardani
- Psychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Sara Honari
- Psychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Farzad Akbarzadeh
- Psychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ali Talaei
- Psychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
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9
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Wilkowska A, Wiglusz MS, Arciszewska-Leszczuk A, Gałuszko-Węgielnik M, Cubała WJ. Anhedonia in bipolar depression treated with ketamine. Bipolar Disord 2024; 26:356-363. [PMID: 38311367 DOI: 10.1111/bdi.13409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/10/2024]
Abstract
BACKGROUND Bipolar depression is the major cause of morbidity in patients with bipolar disorder. It affects psychosocial functioning and markedly impairs occupational productivity. Anhedonia is one of the most debilitating symptoms of depression contributing to treatment resistance. It correlates with suicidality, low quality of life, social withdrawal, and poor treatment response. Currently, there is no approved treatment specifically targeting anhedonia. Emerging evidence suggests that ketamine possesses anti-anhedonic properties in individuals with depression. OBJECTIVES The aim of this naturalistic open-label study was to investigate the effect of add-on ketamine treatment on anhedonia in treatment resistant bipolar depression. METHODS Our main interest was the change in patient-reported (Snaith-Hamilton Pleasure Scale) and rater-based anhedonia measure (Montgomery-Åsberg Depression Rating Scale-anhedonia subscale). The secondary aim was to analyze the score change in three Inventory of Depressive Symptomatology-Self Report (IDS-SR) domains: mood/cognition, anxiety/somatic, and sleep. Patients underwent assessments at several time points, including baseline, after the third, fifth, and seventh ketamine infusions. Additionally, a follow-up assessment was conducted 1 week following the final ketamine administration. RESULTS We found improvement in anhedonia symptoms according to both patient-reported and rater-based measures. The improvement in IDS-SR domains was most prominent in anxiety/somatic factor and mood/cognition factor, improvement in sleep factor was not observed. No serious adverse events occurred. CONCLUSION Add-on ketamine seems to be a good choice for the treatment of anhedonia in treatment resistant bipolar depression. It also showed a good effect in reducing symptoms of anxiety in this group of patients. Considering unmet needs and the detrimental effect of anhedonia and anxiety, more studies are needed on ketamine treatment in resistant bipolar depression.
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Affiliation(s)
- Alina Wilkowska
- Department of Psychiatry, Faculty of Medicine, Medical University of Gdańsk, Gdańsk, Poland
| | - Mariusz S Wiglusz
- Department of Psychiatry, Faculty of Medicine, Medical University of Gdańsk, Gdańsk, Poland
| | | | | | - Wiesław J Cubała
- Department of Psychiatry, Faculty of Medicine, Medical University of Gdańsk, Gdańsk, Poland
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Pérez-Ramos A, Romero-López-Alberca C, Hidalgo-Figueroa M, Berrocoso E, Pérez-Revuelta JI. A systematic review of the biomarkers associated with cognition and mood state in bipolar disorder. Int J Bipolar Disord 2024; 12:18. [PMID: 38758506 PMCID: PMC11101403 DOI: 10.1186/s40345-024-00340-z] [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: 03/06/2024] [Accepted: 05/02/2024] [Indexed: 05/18/2024] Open
Abstract
BACKGROUND Bipolar disorder (BD) is a severe psychiatric disorder characterized by changes in mood that alternate between (hypo) mania or depression and mixed states, often associated with functional impairment and cognitive dysfunction. But little is known about biomarkers that contribute to the development and sustainment of cognitive deficits. The aim of this study was to review the association between neurocognition and biomarkers across different mood states. METHOD Search databases were Web of Science, Scopus and PubMed. A systematic review was carried out following the PRISMA guidelines. Risk of bias was assessed with the Newcastle-Ottawa Scale. Studies were selected that focused on the correlation between neuroimaging, physiological, genetic or peripheral biomarkers and cognition in at least two phases of BD: depression, (hypo)mania, euthymia or mixed. PROSPERO Registration No.: CRD42023410782. RESULTS A total of 1824 references were screened, identifying 1023 published articles, of which 336 were considered eligible. Only 16 provided information on the association between biomarkers and cognition in the different affective states of BD. The included studies found: (i) Differences in levels of total cholesterol and C reactive protein depending on mood state; (ii) There is no association found between cognition and peripheral biomarkers; (iii) Neuroimaging biomarkers highlighted hypoactivation of frontal areas as distinctive of acute state of BD; (iv) A deactivation failure has been reported in the ventromedial prefrontal cortex (vmPFC), potentially serving as a trait marker of BD. CONCLUSION Only a few recent articles have investigated biomarker-cognition associations in BD mood phases. Our findings underline that there appear to be central regions involved in BD that are observed in all mood states. However, there appear to be underlying mechanisms of cognitive dysfunction that may vary across different mood states in BD. This review highlights the importance of standardizing the data and the assessment of cognition, as well as the need for biomarkers to help prevent acute symptomatic phases of the disease, and the associated functional and cognitive impairment.
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Affiliation(s)
- Anaid Pérez-Ramos
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, Barcelona, Spain
- Centre for Biomedical Research in Mental Health (CIBERSAM), ISCI-III, Madrid, Spain
- Neuropsychopharmacology and Psychobiology Research Group, Department of Neuroscience, Faculty of Medicine, University of Cadiz, Cadiz, Spain
| | - Cristina Romero-López-Alberca
- Centre for Biomedical Research in Mental Health (CIBERSAM), ISCI-III, Madrid, Spain.
- Personality, Evaluation and Psychological Treatment Area, Department of Psychology, University of Cadiz, Cadiz, Spain.
- Biomedical Research and Innovation Institute of Cadiz (INiBICA), Research Unit, Puerta del Mar University Hospital, Cadiz, Spain.
| | - Maria Hidalgo-Figueroa
- Centre for Biomedical Research in Mental Health (CIBERSAM), ISCI-III, Madrid, Spain
- Neuropsychopharmacology and Psychobiology Research Group, Psychobiology Area, Department of Psychology, University of Cadiz, Cadiz, Spain
- Biomedical Research and Innovation Institute of Cadiz (INiBICA), Research Unit, Puerta del Mar University Hospital, Cadiz, Spain
| | - Esther Berrocoso
- Centre for Biomedical Research in Mental Health (CIBERSAM), ISCI-III, Madrid, Spain
- Biomedical Research and Innovation Institute of Cadiz (INiBICA), Research Unit, Puerta del Mar University Hospital, Cadiz, Spain
- Neuropsychopharmacology and Psychobiology Research Group, Department of Neuroscience, Faculty of Medicine, University of Cadiz, Cadiz, Spain
| | - Jose I Pérez-Revuelta
- Centre for Biomedical Research in Mental Health (CIBERSAM), ISCI-III, Madrid, Spain
- Clinical Management of Mental Health Unit, University Hospital of Jerez, Andalusian Health Service, Cadiz, Spain
- Biomedical Research and Innovation Institute of Cadiz (INiBICA), Research Unit, Puerta del Mar University Hospital, Cadiz, Spain
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11
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Kjærstad HL, de Siqueira Rotenberg L, Macoveanu J, Coello K, Faurholt-Jepsen M, Bjertrup AJ, Knudsen GM, Fisher PM, Vinberg M, Kessing LV, Lafer B, Miskowiak KW. Stable neural underpinnings of emotional cognition subgroups in patients newly diagnosed with bipolar disorder: A prospective fMRI study. Bipolar Disord 2024. [PMID: 38698448 DOI: 10.1111/bdi.13444] [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] [Indexed: 05/05/2024]
Abstract
OBJECTIVES This study aimed to investigate the neural underpinnings of emotional cognition subgroups in recently diagnosed patients with bipolar disorder (BD) and change over time over a 15-month follow-up period. METHODS Patients and healthy controls (HC) underwent emotional and nonemotional cognitive assessments and functional magnetic resonance imaging (fMRI) at the baseline (BD n = 87; HC n = 65) and at 15-month follow-up (BD n = 44; HC n = 38). Neural activity during emotion reactivity and regulation in response to aversive pictures was assessed during fMRI. Patients were clustered into subgroups based on their emotional cognition and, with HC, were compared longitudinally on cognition and neural activity during emotion reactivity and regulation. RESULTS Patients were optimally clustered into two subgroups: Subgroup 1 (n = 40, 46%) was characterized by heightened emotional reactivity in negative social scenarios, which persisted over time, but were otherwise cognitively intact. This subgroup exhibited stable left amygdala hyper-activity over time during emotion reactivity compared to subgroup 2. Subgroup 2 (n = 47, 54%) was characterized by global emotional cognitive impairments, including stable difficulties with emotion regulation over time. During emotion regulation across both time points, this group exhibited hypo-activity in the left dorsolateral prefrontal cortex. Additionally, patients in subgroup 2 had poorer nonemotional cognition, had more psychiatric hospital admissions and history of psychotic episodes than those in subgroup 1. CONCLUSIONS Broad impairments in emotional cognition in approximately half of BD patients and associated nonemotional cognitive deficits may originate from insufficient recruitment of prefrontal resources, contributing to poorer clinical outcomes.
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Affiliation(s)
- Hanne Lie Kjærstad
- Neurocognition and Emotion in Affective Disorders (NEAD) Centre, Psychiatric Centre Copenhagen, Mental Health Services, Capital Region of Denmark, and Department of Psychology, University of Copenhagen, Copenhagen, Denmark
- Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, Frederiksberg Hospital, Frederiksberg, Denmark
| | - Luisa de Siqueira Rotenberg
- Bipolar Disorder Program (PROMAN), Department of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil
| | - Julian Macoveanu
- Neurocognition and Emotion in Affective Disorders (NEAD) Centre, Psychiatric Centre Copenhagen, Mental Health Services, Capital Region of Denmark, and Department of Psychology, University of Copenhagen, Copenhagen, Denmark
- Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, Frederiksberg Hospital, Frederiksberg, Denmark
| | - Klara Coello
- Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, Frederiksberg Hospital, Frederiksberg, Denmark
| | - Maria Faurholt-Jepsen
- Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, Frederiksberg Hospital, Frederiksberg, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Anne Juul Bjertrup
- Neurocognition and Emotion in Affective Disorders (NEAD) Centre, Psychiatric Centre Copenhagen, Mental Health Services, Capital Region of Denmark, and Department of Psychology, University of Copenhagen, Copenhagen, Denmark
- Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, Frederiksberg Hospital, Frederiksberg, Denmark
| | - Gitte M Knudsen
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Neurobiology Research Unit, Copenhagen University Hospital, Rigshospitalet, Denmark
| | - Patrick M Fisher
- Neurobiology Research Unit, Copenhagen University Hospital, Rigshospitalet, Denmark
- Department of Drug Design and Pharmacology, University of Copenhagen, Copenhagen, Denmark
| | - Maj Vinberg
- Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, Frederiksberg Hospital, Frederiksberg, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Mental Health Center, Northern Zealand, Copenhagen University Hospital - Mental Health Services CPH, Copenhagen, Denmark
| | - Lars Vedel Kessing
- Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, Frederiksberg Hospital, Frederiksberg, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Beny Lafer
- Bipolar Disorder Program (PROMAN), Department of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil
| | - Kamilla Woznica Miskowiak
- Neurocognition and Emotion in Affective Disorders (NEAD) Centre, Psychiatric Centre Copenhagen, Mental Health Services, Capital Region of Denmark, and Department of Psychology, University of Copenhagen, Copenhagen, Denmark
- Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, Frederiksberg Hospital, Frederiksberg, Denmark
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12
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Bortolozzi A, Fico G, Berk M, Solmi M, Fornaro M, Quevedo J, Zarate CA, Kessing LV, Vieta E, Carvalho AF. New Advances in the Pharmacology and Toxicology of Lithium: A Neurobiologically Oriented Overview. Pharmacol Rev 2024; 76:323-357. [PMID: 38697859 PMCID: PMC11068842 DOI: 10.1124/pharmrev.120.000007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 02/02/2024] [Accepted: 02/05/2024] [Indexed: 05/05/2024] Open
Abstract
Over the last six decades, lithium has been considered the gold standard treatment for the long-term management of bipolar disorder due to its efficacy in preventing both manic and depressive episodes as well as suicidal behaviors. Nevertheless, despite numerous observed effects on various cellular pathways and biologic systems, the precise mechanism through which lithium stabilizes mood remains elusive. Furthermore, there is recent support for the therapeutic potential of lithium in other brain diseases. This review offers a comprehensive examination of contemporary understanding and predominant theories concerning the diverse mechanisms underlying lithium's effects. These findings are based on investigations utilizing cellular and animal models of neurodegenerative and psychiatric disorders. Recent studies have provided additional support for the significance of glycogen synthase kinase-3 (GSK3) inhibition as a crucial mechanism. Furthermore, research has shed more light on the interconnections between GSK3-mediated neuroprotective, antioxidant, and neuroplasticity processes. Moreover, recent advancements in animal and human models have provided valuable insights into how lithium-induced modifications at the homeostatic synaptic plasticity level may play a pivotal role in its clinical effectiveness. We focused on findings from translational studies suggesting that lithium may interface with microRNA expression. Finally, we are exploring the repurposing potential of lithium beyond bipolar disorder. These recent findings on the therapeutic mechanisms of lithium have provided important clues toward developing predictive models of response to lithium treatment and identifying new biologic targets. SIGNIFICANCE STATEMENT: Lithium is the drug of choice for the treatment of bipolar disorder, but its mechanism of action in stabilizing mood remains elusive. This review presents the latest evidence on lithium's various mechanisms of action. Recent evidence has strengthened glycogen synthase kinase-3 (GSK3) inhibition, changes at the level of homeostatic synaptic plasticity, and regulation of microRNA expression as key mechanisms, providing an intriguing perspective that may help bridge the mechanistic gap between molecular functions and its clinical efficacy as a mood stabilizer.
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Affiliation(s)
- Analia Bortolozzi
- Institut d'Investigacions Biomèdiques de Barcelona (IIBB), Spanish National Research Council (CSIC), Barcelona, Spain (A.B.); Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain (A.B., G.F., E.V.); Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), ISCIII, Madrid, Spain (A.B., G.F., E.V.); Hospital Clinic, Institute of Neuroscience, University of Barcelona, Barcelona, Spain (G.F., E.V.); IMPACT - The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, Victoria, Australia (M.B., A.F.C.); Department of Psychiatry, University of Ottawa, Ontario, Canada (M.S.); The Champlain First Episode Psychosis Program, Department of Mental Health, The Ottawa Hospital, Ontario, Canada (M.S.); Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany (M.S.); Section of Psychiatry, Department of Neuroscience, Reproductive Science and Odontostomatology, Federico II University of Naples, Naples, Italy (M.F.); Center of Excellence on Mood Disorders, Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston (UT Health), Houston, Texas (J.Q.); Experimental Therapeutics and Pathophysiology Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland (C.A.Z.); Copenhagen Affective Disorders Research Centre (CADIC), Psychiatric Center Copenhagen, Rigshospitalet, Denmark (L.V.K.); and Department of Clinical Medicine, University of Copenhagen, Denmark (L.V.K.)
| | - Giovanna Fico
- Institut d'Investigacions Biomèdiques de Barcelona (IIBB), Spanish National Research Council (CSIC), Barcelona, Spain (A.B.); Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain (A.B., G.F., E.V.); Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), ISCIII, Madrid, Spain (A.B., G.F., E.V.); Hospital Clinic, Institute of Neuroscience, University of Barcelona, Barcelona, Spain (G.F., E.V.); IMPACT - The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, Victoria, Australia (M.B., A.F.C.); Department of Psychiatry, University of Ottawa, Ontario, Canada (M.S.); The Champlain First Episode Psychosis Program, Department of Mental Health, The Ottawa Hospital, Ontario, Canada (M.S.); Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany (M.S.); Section of Psychiatry, Department of Neuroscience, Reproductive Science and Odontostomatology, Federico II University of Naples, Naples, Italy (M.F.); Center of Excellence on Mood Disorders, Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston (UT Health), Houston, Texas (J.Q.); Experimental Therapeutics and Pathophysiology Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland (C.A.Z.); Copenhagen Affective Disorders Research Centre (CADIC), Psychiatric Center Copenhagen, Rigshospitalet, Denmark (L.V.K.); and Department of Clinical Medicine, University of Copenhagen, Denmark (L.V.K.)
| | - Michael Berk
- Institut d'Investigacions Biomèdiques de Barcelona (IIBB), Spanish National Research Council (CSIC), Barcelona, Spain (A.B.); Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain (A.B., G.F., E.V.); Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), ISCIII, Madrid, Spain (A.B., G.F., E.V.); Hospital Clinic, Institute of Neuroscience, University of Barcelona, Barcelona, Spain (G.F., E.V.); IMPACT - The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, Victoria, Australia (M.B., A.F.C.); Department of Psychiatry, University of Ottawa, Ontario, Canada (M.S.); The Champlain First Episode Psychosis Program, Department of Mental Health, The Ottawa Hospital, Ontario, Canada (M.S.); Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany (M.S.); Section of Psychiatry, Department of Neuroscience, Reproductive Science and Odontostomatology, Federico II University of Naples, Naples, Italy (M.F.); Center of Excellence on Mood Disorders, Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston (UT Health), Houston, Texas (J.Q.); Experimental Therapeutics and Pathophysiology Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland (C.A.Z.); Copenhagen Affective Disorders Research Centre (CADIC), Psychiatric Center Copenhagen, Rigshospitalet, Denmark (L.V.K.); and Department of Clinical Medicine, University of Copenhagen, Denmark (L.V.K.)
| | - Marco Solmi
- Institut d'Investigacions Biomèdiques de Barcelona (IIBB), Spanish National Research Council (CSIC), Barcelona, Spain (A.B.); Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain (A.B., G.F., E.V.); Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), ISCIII, Madrid, Spain (A.B., G.F., E.V.); Hospital Clinic, Institute of Neuroscience, University of Barcelona, Barcelona, Spain (G.F., E.V.); IMPACT - The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, Victoria, Australia (M.B., A.F.C.); Department of Psychiatry, University of Ottawa, Ontario, Canada (M.S.); The Champlain First Episode Psychosis Program, Department of Mental Health, The Ottawa Hospital, Ontario, Canada (M.S.); Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany (M.S.); Section of Psychiatry, Department of Neuroscience, Reproductive Science and Odontostomatology, Federico II University of Naples, Naples, Italy (M.F.); Center of Excellence on Mood Disorders, Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston (UT Health), Houston, Texas (J.Q.); Experimental Therapeutics and Pathophysiology Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland (C.A.Z.); Copenhagen Affective Disorders Research Centre (CADIC), Psychiatric Center Copenhagen, Rigshospitalet, Denmark (L.V.K.); and Department of Clinical Medicine, University of Copenhagen, Denmark (L.V.K.)
| | - Michele Fornaro
- Institut d'Investigacions Biomèdiques de Barcelona (IIBB), Spanish National Research Council (CSIC), Barcelona, Spain (A.B.); Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain (A.B., G.F., E.V.); Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), ISCIII, Madrid, Spain (A.B., G.F., E.V.); Hospital Clinic, Institute of Neuroscience, University of Barcelona, Barcelona, Spain (G.F., E.V.); IMPACT - The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, Victoria, Australia (M.B., A.F.C.); Department of Psychiatry, University of Ottawa, Ontario, Canada (M.S.); The Champlain First Episode Psychosis Program, Department of Mental Health, The Ottawa Hospital, Ontario, Canada (M.S.); Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany (M.S.); Section of Psychiatry, Department of Neuroscience, Reproductive Science and Odontostomatology, Federico II University of Naples, Naples, Italy (M.F.); Center of Excellence on Mood Disorders, Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston (UT Health), Houston, Texas (J.Q.); Experimental Therapeutics and Pathophysiology Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland (C.A.Z.); Copenhagen Affective Disorders Research Centre (CADIC), Psychiatric Center Copenhagen, Rigshospitalet, Denmark (L.V.K.); and Department of Clinical Medicine, University of Copenhagen, Denmark (L.V.K.)
| | - Joao Quevedo
- Institut d'Investigacions Biomèdiques de Barcelona (IIBB), Spanish National Research Council (CSIC), Barcelona, Spain (A.B.); Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain (A.B., G.F., E.V.); Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), ISCIII, Madrid, Spain (A.B., G.F., E.V.); Hospital Clinic, Institute of Neuroscience, University of Barcelona, Barcelona, Spain (G.F., E.V.); IMPACT - The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, Victoria, Australia (M.B., A.F.C.); Department of Psychiatry, University of Ottawa, Ontario, Canada (M.S.); The Champlain First Episode Psychosis Program, Department of Mental Health, The Ottawa Hospital, Ontario, Canada (M.S.); Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany (M.S.); Section of Psychiatry, Department of Neuroscience, Reproductive Science and Odontostomatology, Federico II University of Naples, Naples, Italy (M.F.); Center of Excellence on Mood Disorders, Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston (UT Health), Houston, Texas (J.Q.); Experimental Therapeutics and Pathophysiology Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland (C.A.Z.); Copenhagen Affective Disorders Research Centre (CADIC), Psychiatric Center Copenhagen, Rigshospitalet, Denmark (L.V.K.); and Department of Clinical Medicine, University of Copenhagen, Denmark (L.V.K.)
| | - Carlos A Zarate
- Institut d'Investigacions Biomèdiques de Barcelona (IIBB), Spanish National Research Council (CSIC), Barcelona, Spain (A.B.); Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain (A.B., G.F., E.V.); Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), ISCIII, Madrid, Spain (A.B., G.F., E.V.); Hospital Clinic, Institute of Neuroscience, University of Barcelona, Barcelona, Spain (G.F., E.V.); IMPACT - The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, Victoria, Australia (M.B., A.F.C.); Department of Psychiatry, University of Ottawa, Ontario, Canada (M.S.); The Champlain First Episode Psychosis Program, Department of Mental Health, The Ottawa Hospital, Ontario, Canada (M.S.); Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany (M.S.); Section of Psychiatry, Department of Neuroscience, Reproductive Science and Odontostomatology, Federico II University of Naples, Naples, Italy (M.F.); Center of Excellence on Mood Disorders, Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston (UT Health), Houston, Texas (J.Q.); Experimental Therapeutics and Pathophysiology Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland (C.A.Z.); Copenhagen Affective Disorders Research Centre (CADIC), Psychiatric Center Copenhagen, Rigshospitalet, Denmark (L.V.K.); and Department of Clinical Medicine, University of Copenhagen, Denmark (L.V.K.)
| | - Lars V Kessing
- Institut d'Investigacions Biomèdiques de Barcelona (IIBB), Spanish National Research Council (CSIC), Barcelona, Spain (A.B.); Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain (A.B., G.F., E.V.); Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), ISCIII, Madrid, Spain (A.B., G.F., E.V.); Hospital Clinic, Institute of Neuroscience, University of Barcelona, Barcelona, Spain (G.F., E.V.); IMPACT - The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, Victoria, Australia (M.B., A.F.C.); Department of Psychiatry, University of Ottawa, Ontario, Canada (M.S.); The Champlain First Episode Psychosis Program, Department of Mental Health, The Ottawa Hospital, Ontario, Canada (M.S.); Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany (M.S.); Section of Psychiatry, Department of Neuroscience, Reproductive Science and Odontostomatology, Federico II University of Naples, Naples, Italy (M.F.); Center of Excellence on Mood Disorders, Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston (UT Health), Houston, Texas (J.Q.); Experimental Therapeutics and Pathophysiology Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland (C.A.Z.); Copenhagen Affective Disorders Research Centre (CADIC), Psychiatric Center Copenhagen, Rigshospitalet, Denmark (L.V.K.); and Department of Clinical Medicine, University of Copenhagen, Denmark (L.V.K.)
| | - Eduard Vieta
- Institut d'Investigacions Biomèdiques de Barcelona (IIBB), Spanish National Research Council (CSIC), Barcelona, Spain (A.B.); Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain (A.B., G.F., E.V.); Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), ISCIII, Madrid, Spain (A.B., G.F., E.V.); Hospital Clinic, Institute of Neuroscience, University of Barcelona, Barcelona, Spain (G.F., E.V.); IMPACT - The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, Victoria, Australia (M.B., A.F.C.); Department of Psychiatry, University of Ottawa, Ontario, Canada (M.S.); The Champlain First Episode Psychosis Program, Department of Mental Health, The Ottawa Hospital, Ontario, Canada (M.S.); Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany (M.S.); Section of Psychiatry, Department of Neuroscience, Reproductive Science and Odontostomatology, Federico II University of Naples, Naples, Italy (M.F.); Center of Excellence on Mood Disorders, Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston (UT Health), Houston, Texas (J.Q.); Experimental Therapeutics and Pathophysiology Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland (C.A.Z.); Copenhagen Affective Disorders Research Centre (CADIC), Psychiatric Center Copenhagen, Rigshospitalet, Denmark (L.V.K.); and Department of Clinical Medicine, University of Copenhagen, Denmark (L.V.K.)
| | - Andre F Carvalho
- Institut d'Investigacions Biomèdiques de Barcelona (IIBB), Spanish National Research Council (CSIC), Barcelona, Spain (A.B.); Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain (A.B., G.F., E.V.); Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), ISCIII, Madrid, Spain (A.B., G.F., E.V.); Hospital Clinic, Institute of Neuroscience, University of Barcelona, Barcelona, Spain (G.F., E.V.); IMPACT - The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, Victoria, Australia (M.B., A.F.C.); Department of Psychiatry, University of Ottawa, Ontario, Canada (M.S.); The Champlain First Episode Psychosis Program, Department of Mental Health, The Ottawa Hospital, Ontario, Canada (M.S.); Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany (M.S.); Section of Psychiatry, Department of Neuroscience, Reproductive Science and Odontostomatology, Federico II University of Naples, Naples, Italy (M.F.); Center of Excellence on Mood Disorders, Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston (UT Health), Houston, Texas (J.Q.); Experimental Therapeutics and Pathophysiology Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland (C.A.Z.); Copenhagen Affective Disorders Research Centre (CADIC), Psychiatric Center Copenhagen, Rigshospitalet, Denmark (L.V.K.); and Department of Clinical Medicine, University of Copenhagen, Denmark (L.V.K.)
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13
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Yoon JH, Lee D, Lee C, Cho E, Lee S, Cazenave-Gassiot A, Kim K, Chae S, Dennis EA, Suh PG. Paradigm shift required for translational research on the brain. Exp Mol Med 2024; 56:1043-1054. [PMID: 38689090 PMCID: PMC11148129 DOI: 10.1038/s12276-024-01218-x] [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: 10/13/2023] [Revised: 02/07/2024] [Accepted: 02/20/2024] [Indexed: 05/02/2024] Open
Abstract
Biomedical research on the brain has led to many discoveries and developments, such as understanding human consciousness and the mind and overcoming brain diseases. However, historical biomedical research on the brain has unique characteristics that differ from those of conventional biomedical research. For example, there are different scientific interpretations due to the high complexity of the brain and insufficient intercommunication between researchers of different disciplines owing to the limited conceptual and technical overlap of distinct backgrounds. Therefore, the development of biomedical research on the brain has been slower than that in other areas. Brain biomedical research has recently undergone a paradigm shift, and conducting patient-centered, large-scale brain biomedical research has become possible using emerging high-throughput analysis tools. Neuroimaging, multiomics, and artificial intelligence technology are the main drivers of this new approach, foreshadowing dramatic advances in translational research. In addition, emerging interdisciplinary cooperative studies provide insights into how unresolved questions in biomedicine can be addressed. This review presents the in-depth aspects of conventional biomedical research and discusses the future of biomedical research on the brain.
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Affiliation(s)
- Jong Hyuk Yoon
- Neurodegenerative Diseases Research Group, Korea Brain Research Institute, Daegu, 41062, Republic of Korea.
| | - Dongha Lee
- Cognitive Science Research Group, Korea Brain Research Institute, Daegu, 41062, Republic of Korea
| | - Chany Lee
- Cognitive Science Research Group, Korea Brain Research Institute, Daegu, 41062, Republic of Korea
| | - Eunji Cho
- Neurodegenerative Diseases Research Group, Korea Brain Research Institute, Daegu, 41062, Republic of Korea
| | - Seulah Lee
- Neurodegenerative Diseases Research Group, Korea Brain Research Institute, Daegu, 41062, Republic of Korea
| | - Amaury Cazenave-Gassiot
- Department of Biochemistry and Precision Medicine Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 119077, Singapore
- Singapore Lipidomics Incubator (SLING), Life Sciences Institute, National University of Singapore, Singapore, 117456, Singapore
| | - Kipom Kim
- Research Strategy Office, Korea Brain Research Institute, Daegu, 41062, Republic of Korea
| | - Sehyun Chae
- Neurovascular Unit Research Group, Korean Brain Research Institute, Daegu, 41062, Republic of Korea
| | - Edward A Dennis
- Department of Pharmacology and Department of Chemistry and Biochemistry, University of California, San Diego, La Jolla, CA, 92093-0601, USA
| | - Pann-Ghill Suh
- Korea Brain Research Institute, Daegu, 41062, Republic of Korea
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14
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Jakobsen P, Côté-Allard U, Riegler MA, Stabell LA, Stautland A, Nordgreen T, Torresen J, Fasmer OB, Oedegaard KJ. Early warning signals observed in motor activity preceding mood state change in bipolar disorder. Bipolar Disord 2024. [PMID: 38639725 DOI: 10.1111/bdi.13430] [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] [Indexed: 04/20/2024]
Abstract
INTRODUCTION Alterations in motor activity are well-established symptoms of bipolar disorder, and time series of motor activity can be considered complex dynamical systems. In such systems, early warning signals (EWS) occur in a critical transition period preceding a sudden shift (tipping point) in the system. EWS are statistical observations occurring due to a system's declining ability to maintain homeostasis when approaching a tipping point. The aim was to identify critical transition periods preceding bipolar mood state changes. METHODS Participants with a validated bipolar diagnosis were included to a one-year follow-up study, with repeated assessments of the participants' mood. Motor activity was recorded continuously by a wrist-worn actigraph. Participants assessed to have relapsed during follow-up were analyzed. Recognized EWS features were extracted from the motor activity data and analyzed by an unsupervised change point detection algorithm, capable of processing multi-dimensional data and developed to identify when the statistical property of a time series changes. RESULTS Of 49 participants, four depressive and four hypomanic/manic relapses among six individuals occurred, recording actigraphy for 23.8 ± 0.2 h/day, for 39.8 ± 4.6 days. The algorithm detected change points in the time series and identified critical transition periods spanning 13.5 ± 7.2 days. For depressions 11.4 ± 1.8, and hypomania/mania 15.6 ± 10.2 days. CONCLUSION The change point detection algorithm seems capable of recognizing impending mood episodes in continuous flowing data streams. Hence, we present an innovative method for forecasting approaching relapses to improve the clinical management of bipolar disorder.
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Affiliation(s)
- Petter Jakobsen
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | | | | | - Lena Antonsen Stabell
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Andrea Stautland
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Tine Nordgreen
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Jim Torresen
- Department of Informatics, University of Oslo, Oslo, Norway
| | - Ole Bernt Fasmer
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Ketil Joachim Oedegaard
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
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15
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Xia Y, Wang X, Sheng J, Hua L, Dai Z, Sun H, Han Y, Yao Z, Lu Q. Response inhibition related neural oscillatory patterns show reliable early identification of bipolar from unipolar depression in a Go/No-Go task. J Affect Disord 2024; 351:414-424. [PMID: 38272369 DOI: 10.1016/j.jad.2024.01.187] [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: 10/10/2023] [Revised: 12/30/2023] [Accepted: 01/18/2024] [Indexed: 01/27/2024]
Abstract
BACKGROUND Response inhibition is a key neurocognitive factor contributing to impulsivity in mood disorders. Here, we explored the common and differential alterations of neural circuits associated with response inhibition in bipolar disorder (BD) and unipolar disorder (UD) and whether the oscillatory signatures can be used as early biomarkers in BD. METHODS 39 patients with BD, 36 patients with UD, 29 patients initially diagnosed with UD who later underwent diagnostic conversion to BD, and 36 healthy controls performed a Go/No-Go task during MEG scanning. We carried out time-frequency and connectivity analysis on MEG data. Further, we performed machine learning using oscillatory features as input to identify bipolar from unipolar depression at the early clinical stage. RESULTS Compared to healthy controls, patients had reduced rIFG-to-pre-SMA connectivity and delayed activity of rIFG. Among patients, lower beta power and higher peak frequency were observed in BD patients than in UD patients. These changes enabled accurate classification between BD and UD with an accuracy of approximately 80 %. CONCLUSIONS The inefficiency of the prefrontal control network is a shared mechanism in mood disorders, while the abnormal activity of rIFG is more specific to BD. Neuronal responses during response inhibition could serve as a diagnostic biomarker for BD in early stage.
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Affiliation(s)
- Yi Xia
- Department of Psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Xiaoqin Wang
- Department of Psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Junling Sheng
- Department of Psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Lingling Hua
- Department of Psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Zhongpeng Dai
- School of Biological Sciences & Medical Engineering, Southeast University, Nanjing 210096, China; Child Development and Learning Science, Key Laboratory of Ministry of Education, Southeast University, Nanjing 210096, China
| | - Hao Sun
- Nanjing Brain Hospital, Medical School of Nanjing University, Nanjing 210093, China
| | - Yinglin Han
- Department of Psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Zhijian Yao
- Department of Psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210029, China; School of Biological Sciences & Medical Engineering, Southeast University, Nanjing 210096, China; Nanjing Brain Hospital, Medical School of Nanjing University, Nanjing 210093, China.
| | - Qing Lu
- School of Biological Sciences & Medical Engineering, Southeast University, Nanjing 210096, China; Child Development and Learning Science, Key Laboratory of Ministry of Education, Southeast University, Nanjing 210096, China.
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16
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Chart-Pascual JP, Montero-Torres M, Ortega MA, Mar-Barrutia L, Zorrilla Martinez I, Alvarez-Mon M, Gonzalez-Pinto A, Alvarez-Mon MA. Areas of interest and sentiment analysis towards second generation antipsychotics, lithium and mood stabilizing anticonvulsants: Unsupervised analysis using Twitter. J Affect Disord 2024; 351:649-660. [PMID: 38290587 DOI: 10.1016/j.jad.2024.01.234] [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: 08/21/2023] [Revised: 01/23/2024] [Accepted: 01/26/2024] [Indexed: 02/01/2024]
Abstract
BACKGROUND Severe mental disorders like Schizophrenia and related psychotic disorders (SRD) or Bipolar Disorder (BD) require pharmacological treatment for relapse prevention and quality of life improvement. Yet, treatment adherence is a challenge, partly due to patients' attitudes and beliefs towards their medication. Social media listening offers insights into patient experiences and preferences, particularly in severe mental disorders. METHODS All tweets posted between 2008 and 2022 mentioning the names of the main drugs used in SRD and BD were analyzed using advanced artificial intelligence techniques such as machine learning, and deep learning, along with natural language processing. RESULTS In this 15-year study analyzing 893,289 tweets, second generation antipsychotics received more mentions in English tweets, whereas mood stabilizers received more tweets in Spanish. English tweets about economic and legal aspects displayed negative emotions, while Spanish tweets seeking advice showed surprise. Moreover, a recurring theme in Spanish tweets was the shortage of medications, evoking feelings of anger among users. LIMITATIONS This study's analysis of Twitter data, while insightful, may not fully capture the nuances of discussions due to the platform's brevity. Additionally, the wide therapeutic use of the studied drugs, complicates the isolation of disorder-specific discourse. Only English and Spanish tweets were examined, limiting the cultural breadth of the findings. CONCLUSION This study emphasizes the importance of social media research in understanding user perceptions of SRD and BD treatments. The results provide valuable insights for clinicians when considering how patients and the general public view and communicate about these treatments in the digital environment.
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Affiliation(s)
- Juan Pablo Chart-Pascual
- Psychiatry Department, Osakidetza Basque Health Service, Araba University Hospital, Vitoria-Gasteiz, Spain; University of the Basque Country UPV/EHU, Vitoria-Gasteiz, Spain; Bioaraba Health Research Institute, Vitoria-Gasteiz, Spain; CIBERSAM.
| | - Maria Montero-Torres
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain; Department of Medicine and Medical Specialities, University of Alcala, 28801 Alcala de Henares, Madrid, Spain
| | - Miguel Angel Ortega
- Cancer Registry and Pathology Department, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Spain; Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain; Department of Medicine and Medical Specialities, University of Alcala, 28801 Alcala de Henares, Madrid, Spain
| | - Lorea Mar-Barrutia
- Psychiatry Department, Osakidetza Basque Health Service, Araba University Hospital, Vitoria-Gasteiz, Spain; Bioaraba Health Research Institute, Vitoria-Gasteiz, Spain; CIBERSAM
| | - Iñaki Zorrilla Martinez
- Psychiatry Department, Osakidetza Basque Health Service, Araba University Hospital, Vitoria-Gasteiz, Spain; University of the Basque Country UPV/EHU, Vitoria-Gasteiz, Spain; Bioaraba Health Research Institute, Vitoria-Gasteiz, Spain; CIBERSAM
| | - Melchor Alvarez-Mon
- Immune System Diseases-Rheumatology and Internal Medicine Service, Centro de Investigación Biomédica en Red Enfermedades Hepáticas y Digestivas, University Hospital Príncipe de Asturias, Alcala de Henares, Spain; Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain; Department of Medicine and Medical Specialities, University of Alcala, 28801 Alcala de Henares, Madrid, Spain
| | - Ana Gonzalez-Pinto
- Psychiatry Department, Osakidetza Basque Health Service, Araba University Hospital, Vitoria-Gasteiz, Spain; University of the Basque Country UPV/EHU, Vitoria-Gasteiz, Spain; Bioaraba Health Research Institute, Vitoria-Gasteiz, Spain; CIBERSAM
| | - Miguel Angel Alvarez-Mon
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain; Department of Medicine and Medical Specialities, University of Alcala, 28801 Alcala de Henares, Madrid, Spain; Department of Psychiatry and Mental Health, Hospital Universitario Infanta Leonor, Madrid, Spain
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17
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Woo YS, Jeong JH, Kang H, Lee K, Shim SH, Kwon YJ, Lee SY, Jang SH, Park YM, Jon DI, Jung MH, Jung YE, Kim MD, Sohn I, Park SY, Song MK, Lim ES, Yoon BH, Bahk WM. Preventive effect of aripiprazole once-monthly on relapse into mood episodes in bipolar disorder: A multicenter, one-year, retrospective, mirror image study. J Affect Disord 2024; 351:381-386. [PMID: 38302064 DOI: 10.1016/j.jad.2024.01.257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 01/25/2024] [Accepted: 01/28/2024] [Indexed: 02/03/2024]
Abstract
BACKGROUND We conducted a one-year, retrospective, mirror-image study to investigate the clinical effectiveness and safety of aripiprazole once monthly (AOM) in patients with bipolar disorder (BD). We compared pre-treatment conditions with outcomes after 12 months of AOM treatment. METHODS Seventy-five bipolar patients were recruited from 12 hospitals in Korea. We included 75 patients with BD who had received at least three AOM treatments from September 2019 to September 2022 and had accessible electronic medical record (EMRs) for the year before and after the baseline visit. RESULTS The overall number of mood episodes significantly decreased from a mean of 1.5 ± 1.2 episodes pre-AOM to 0.5 ± 1.2 episodes post-AOM. Manic episodes significantly decreased from 0.8 ± 0.8 episodes pre-AOM to 0.2 ± 0.5 episodes post-AOM, and depressive episodes significantly decreased from 0.5 ± 0.8 episodes pre-AOM to 0.2 ± 0.6 episodes post-AOM (p = 0.017). Moreover, the number of psychiatric medications and pills and the proportion of patients treated with complex polypharmacy were significantly decreased post-AOM. LIMITATIONS The small sample size was insufficient to fully represent the entire population of individuals with BD, and potential selection bias was introduced due to only including subjects who received AOM three or more times. CONCLUSION The results of this study suggest that AOM can reduce mood episode relapse and may be clinically beneficial in the treatment of BD patients, potentially reducing issues associated with polypharmacy in some individuals.
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Affiliation(s)
- Young Sup Woo
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Jong-Hyun Jeong
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Hangoeunbi Kang
- Department of Psychiatry, Naju National Hospital, Naju, Republic of Korea
| | - Kwanghun Lee
- Department of Psychiatry, Dongguk University College of Medicine, Gyeongju, Republic of Korea
| | - Se-Hoon Shim
- Department of Psychiatry, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Republic of Korea
| | - Young-Joon Kwon
- Department of Psychiatry, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Republic of Korea
| | - Sang-Yeol Lee
- Department of Psychiatry, Wonkwang University Hospital, Wonkwang University School of Medicine, Iksan, Republic of Korea
| | - Seung-Ho Jang
- Department of Psychiatry, Wonkwang University Hospital, Wonkwang University School of Medicine, Iksan, Republic of Korea
| | - Young-Min Park
- Department of Psychiatry, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Republic of Korea; Psychiatric Clinic In Your Brain and Mind, Goyang, Republic of Korea
| | - Duk-In Jon
- Department of Psychiatry, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Republic of Korea
| | - Myung Hun Jung
- Department of Psychiatry, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Republic of Korea; DAON Clinic, Anyang, Republic of Korea
| | - Young-Eun Jung
- Department of Psychiatry, College of Medicine, Jeju National University, Jeju, Republic of Korea
| | - Moon-Doo Kim
- Department of Psychiatry, College of Medicine, Jeju National University, Jeju, Republic of Korea
| | - Inki Sohn
- Department of Psychiatry, Keyo Hospital, Keyo Medical Foundation, Uiwang, Republic of Korea
| | - Sung-Yong Park
- Department of Psychiatry, Keyo Hospital, Keyo Medical Foundation, Uiwang, Republic of Korea
| | - Min-Kyu Song
- St. Mary's Gong-Gam Mental Health Clinic, Siheung, Republic of Korea
| | - Eun-Sung Lim
- Department of Psychiatry, Shinsegae Hyo Hospital, Gimje, Republic of Korea
| | - Bo-Hyun Yoon
- Department of Psychiatry, Naju National Hospital, Naju, Republic of Korea
| | - Won-Myong Bahk
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
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Poulos J, Horvitz-Lennon M, Zelevinsky K, Cristea-Platon T, Huijskens T, Tyagi P, Yan J, Diaz J, Normand SL. Targeted learning in observational studies with multi-valued treatments: An evaluation of antipsychotic drug treatment safety. Stat Med 2024; 43:1489-1508. [PMID: 38314950 DOI: 10.1002/sim.10003] [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: 01/27/2023] [Revised: 11/28/2023] [Accepted: 12/10/2023] [Indexed: 02/07/2024]
Abstract
We investigate estimation of causal effects of multiple competing (multi-valued) treatments in the absence of randomization. Our work is motivated by an intention-to-treat study of the relative cardiometabolic risk of assignment to one of six commonly prescribed antipsychotic drugs in a cohort of nearly 39 000 adults with serious mental illnesses. Doubly-robust estimators, such as targeted minimum loss-based estimation (TMLE), require correct specification of either the treatment model or outcome model to ensure consistent estimation; however, common TMLE implementations estimate treatment probabilities using multiple binomial regressions rather than multinomial regression. We implement a TMLE estimator that uses multinomial treatment assignment and ensemble machine learning to estimate average treatment effects. Our multinomial implementation improves coverage, but does not necessarily reduce bias, relative to the binomial implementation in simulation experiments with varying treatment propensity overlap and event rates. Evaluating the causal effects of the antipsychotics on 3-year diabetes risk or death, we find a safety benefit of moving from a second-generation drug considered among the safest of the second-generation drugs to an infrequently prescribed first-generation drug known for having low cardiometabolic risk.
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Affiliation(s)
- Jason Poulos
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA
| | | | - Katya Zelevinsky
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA
| | | | | | | | | | | | - Sharon-Lise Normand
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA
- Department of Biostatistics, Harvard Chan School of Public Health, Boston, Massachusetts, USA
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19
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Liu X, Su L, Li Y, Yuan H, Zhao A, Yang C, Chen C, Li C. Significant improvements in the olfactory sensitivity of bipolar I disorder patients during euthymia versus manic episodes: a longitudinal study. Front Psychiatry 2024; 15:1348895. [PMID: 38651009 PMCID: PMC11033851 DOI: 10.3389/fpsyt.2024.1348895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Accepted: 03/25/2024] [Indexed: 04/25/2024] Open
Abstract
Introduction Research has indicated that individuals diagnosed with bipolar disorder (BD) might experience alterations in their olfaction or levels of serum tumor necrosis factor-α (TNF-α), but no studies have investigated olfactory function and serum TNF-α in BD patients simultaneously. Moreover, there is a lack of existing research that compares the longitudinal olfactory function between individuals with manic and euthymic BD I. Methods Patients with manic BD I (BDM, n=44) and healthy controls (HCs, n=32) were evaluated symptoms (measured via the Young Manic Rating Scale, YRMS), social function (measured via the Global Assessment Function, GAF), serum TNF-α, and olfactory function (via the Sniffin' Sticks test) including olfactory sensitivity (OS) and olfactory identification (OI). The BDM patients were followed up to the remission period and re-evaluated again. We compared OS, OI and serum TNF-α in manic and euthymic patients with BD I and HCs. We examined the correlation between olfactory function and symptoms, social function, and serum TNF-α in patients with BD I. Results The BDM patients exhibited significantly lower OS and OI compared to the HCs (Z = -2.235, P = 0.025; t = -6.005, P < 0.001), while a positive correlation was observed between OS and GAF score (r = 0.313, P = 0.039). The OS in the BD I remission group (n=25) exhibited significantly superior performance compared to the BDM group (t = -4.056, P < 0.001), and the same as that in the HCs (P = 0.503). The change in OS showed a positive correlation with the decrease in YMRS score (r = 0.445, P = 0.026), and a negative correlation with the course of disease (r = -0.594, P = 0.002). The TNF-α in BD I patients was significantly lower compared to HCs (P < 0.001), and not significantly correlated with olfactory function (all P > 0.05). Conclusion The findings suggest that OS and OI are impaired in BDM patients, and the impaired OS in those patients can be recovered in the remission stage. OI may serve as a potential characteristic marker of BD. OS might be useful as an index for BDM treatment efficacy and prognosis.
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Affiliation(s)
| | | | | | | | | | | | | | - Chunyang Li
- Department of Psychiatry, Shunde WuZhongpei Memorial Hospital, Foshan, Guangdong, China
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20
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Chen J, Amdanee N, Zuo X, Wang Y, Gong M, Yang Y, Li H, Zhang X, Zhang C. Biomarkers of bipolar disorder based on metabolomics: A systematic review. J Affect Disord 2024; 350:492-503. [PMID: 38218254 DOI: 10.1016/j.jad.2024.01.033] [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: 05/22/2023] [Revised: 12/05/2023] [Accepted: 01/03/2024] [Indexed: 01/15/2024]
Abstract
Bipolar disorder (BD) is a severe affective disorder characterized by recurrent episodes of depression or mania/hypomania, which significantly impair cognitive function, life skills, and social abilities of patients. There is little understanding of the neurobiological mechanisms of BD. The diagnosis of BD is primarily based on clinical assessment and psychiatric examination, highlighting the urgent need for objective markers to facilitate the diagnosis of BD. Metabolomics can be used as a diagnostic tool for disease identification and evaluation. This study summarized the altered metabolites in BD and analyzed aberrant metabolic pathways, which might contribute to the diagnosis of BD. Search of PubMed and Web of science for human BD studies related to metabolism to identify articles published up to November 19, 2022 yielded 987 articles. After screening and applying the inclusion and exclusion criteria, 16 untargeted and 11 targeted metabolomics studies were included. Pathway analysis of the potential differential biometabolic markers was performed using the Kyoto encyclopedia of genes and genomes (KEGG). There were 72 upregulated and 134 downregulated biomarkers in the untargeted metabolomics studies using blood samples. Untargeted metabolomics studies utilizing urine specimens revealed the presence of 78 upregulated and 54 downregulated metabolites. The targeted metabolomics studies revealed abnormalities in the metabolism of glutamate and tryptophan. Enrichment analysis revealed that the differential metabolic pathways were mainly involved in the metabolism of glucose, amino acid and fatty acid. These findings suggested that certain metabolic biomarkers or metabolic biomarker panels might serve as a reference for the diagnosis of BD.
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Affiliation(s)
- Jin Chen
- Department of Psychiatry, The Affiliated Xuzhou Oriental Hospital of Xuzhou Medical University, Xuzhou, Jiangsu,221004, China; Department of Geriatric Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu,210000, China
| | - Nousayhah Amdanee
- Department of Geriatric Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu,210000, China
| | - Xiaowei Zuo
- Department of Psychiatry, The Affiliated Xuzhou Oriental Hospital of Xuzhou Medical University, Xuzhou, Jiangsu,221004, China
| | - Yu Wang
- Department of Geriatric Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu,210000, China
| | - Muxin Gong
- Department of Psychiatry, The Affiliated Xuzhou Oriental Hospital of Xuzhou Medical University, Xuzhou, Jiangsu,221004, China
| | - Yujing Yang
- Department of Psychiatry, The Affiliated Xuzhou Oriental Hospital of Xuzhou Medical University, Xuzhou, Jiangsu,221004, China
| | - Hao Li
- Department of Psychiatry, The Affiliated Xuzhou Oriental Hospital of Xuzhou Medical University, Xuzhou, Jiangsu,221004, China
| | - Xiangrong Zhang
- Department of Psychiatry, The Affiliated Xuzhou Oriental Hospital of Xuzhou Medical University, Xuzhou, Jiangsu,221004, China; Department of Geriatric Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu,210000, China.
| | - Caiyi Zhang
- Department of Psychiatry, The Affiliated Xuzhou Oriental Hospital of Xuzhou Medical University, Xuzhou, Jiangsu,221004, China.
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21
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Sakrajda K, Bilska K, Czerski PM, Narożna B, Dmitrzak-Węglarz M, Heilmann-Heimbach S, Brockschmidt FF, Herms S, Nöthen MM, Cichon S, Więckowska B, Rybakowski JK, Pawlak J, Szczepankiewicz A. Abelson Helper Integration Site 1 haplotypes and peripheral blood expression associates with lithium response and immunomodulation in bipolar patients. Psychopharmacology (Berl) 2024; 241:727-738. [PMID: 38036661 DOI: 10.1007/s00213-023-06505-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 11/13/2023] [Indexed: 12/02/2023]
Abstract
RATIONALE In bipolar disorder (BD), immunological factors play a role in the pathogenesis and treatment of the illness. Studies showed the potential link between Abelson Helper Integration Site 1 (AHI1) protein, behavioural changes and innate immunity regulation. An immunomodulatory effect was suggested for lithium, a mood stabilizer used in BD treatment. OBJECTIVES We hypothesized that AHI1 may be an important mediator of lithium treatment response. Our study aimed to investigate whether the AHI1 haplotypes and expression associates with lithium treatment response in BD patients. We also examined whether AHI1 expression and lithium treatment correlate with innate inflammatory response genes. RESULTS We genotyped seven AHI1 single nucleotide polymorphisms in 97 euthymic BD patients and found that TG haplotype (rs7739635, rs9494332) was significantly associated with lithium response. We also showed significantly increased AHI1 expression in the blood of lithium responders compared to non-responders and BD patients compared to healthy controls (HC). We analyzed the expression of genes involved in the innate immune response and inflammatory response regulation (TLR4, CASP4, CASP5, NLRP3, IL1A, IL1B, IL6, IL10, IL18) in 21 lithium-treated BD patients, 20 BD patients treated with other mood stabilizer and 19 HC. We found significantly altered expression between BD patients and HC, but not between BD patients treated with different mood stabilizers. CONCLUSIONS Our study suggests the involvement of AHI1 in the lithium mode of action. Moreover, mood-stabilizing treatment associated with the innate immunity-related gene expression in BD patients and only the lithium-treated BD patients showed significantly elevated expression of anti-inflammatory IL10, suggesting lithium's immunomodulatory potential.
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Affiliation(s)
- Kosma Sakrajda
- Molecular and Cell Biology Unit, Poznan University of Medical Sciences, Poznan, Poland.
- Doctoral School, Poznan University of Medical Sciences, Poznan, Poland.
| | - Karolina Bilska
- Department of Psychiatric Genetics, Poznan University of Medical Sciences, Poznan, Poland
| | - Piotr M Czerski
- Department of Psychiatric Genetics, Poznan University of Medical Sciences, Poznan, Poland
| | - Beata Narożna
- Molecular and Cell Biology Unit, Poznan University of Medical Sciences, Poznan, Poland
| | | | - Stefanie Heilmann-Heimbach
- Institute of Human Genetics, University of Bonn, Bonn, Germany
- Department of Genomics, Life & Brain Center, University of Bonn, Bonn, Germany
| | | | - Stefan Herms
- Institute of Human Genetics, University of Bonn, Bonn, Germany
- Department of Biomedicine, University Hospital Basel and University of Basel, Basel, Switzerland
| | - Markus M Nöthen
- Institute of Human Genetics, University of Bonn, Bonn, Germany
- Department of Genomics, Life & Brain Center, University of Bonn, Bonn, Germany
| | - Sven Cichon
- Department of Biomedicine, University Hospital Basel and University of Basel, Basel, Switzerland
- Institute of Medical Genetics and Pathology, University Hospital Basel, Basel, Switzerland
- Institute of Neuroscience and Medicine (INM-1), Research Centre Jülich, Jülich, Germany
| | - Barbara Więckowska
- Department of Computer Sciences and Statistics, Poznan University of Medical Sciences, Poznan, Poland
| | - Janusz K Rybakowski
- Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland
| | - Joanna Pawlak
- Department of Psychiatric Genetics, Poznan University of Medical Sciences, Poznan, Poland
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22
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Lin X, Huang J, Wang S, Zhang K. Bipolar disorder and the gut microbiota: a bibliometric analysis. Front Neurosci 2024; 18:1290826. [PMID: 38576868 PMCID: PMC10991819 DOI: 10.3389/fnins.2024.1290826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 01/18/2024] [Indexed: 04/06/2024] Open
Abstract
Background Previous studies have explored the relationship between bipolar disorder and gut microbiota. However, there has been no bibliometric analysis to summarize and analyze these publications. Our objective was to perform a bibliometric analysis to investigate the current status and frontiers of the publications in the field of the association between bipolar disorder and the gut microbiota. Methods We retrieved publications concerning the interplay between the gut microbiota and bipolar disorder from the Web of Science Core Collection (WoSCC). The analysis was executed using WoSCC's literature analysis tool and VOSviewer 1.6.16. Results In total, we identified 177 publications originating from 362 institutions across 39 countries/regions, and these articles were disseminated in 104 different journals. The most productive institutions, authors, countries/regions, and journals were Zhejiang University contributing 18 publications, Shaohua Hu authoring 12 publications, China with 53 publications, and Frontiers in Psychiatry with 11 publications. The first high-cited document was published in the Journal of Psychiatric Research in 2017, and authored by Evans. In this article, they found gut microbiome composition was associated with BD and its illness severity, and they concluded that targeting the gut microbiota may be helpful to develop the effective treatment for bipolar disorder. The top 5 keywords with the highest frequency except for bipolar disorder and gut microbiota were as follows: depression, inflammation, probiotic, gut-brain axis, and anxiety. Conclusion In conclusion, this is the first bibliometric analysis to explore the publications in the field of the association between bipolar disorder and the gut microbiota. The main research hotspots regarding this field were the characteristics, abundance, and diversity of gut microbiome in bipolar disorder, the role of treatment and gut microbiome in bipolar disorder, microbiome-brain connections in bipolar disorder, and interventions for bipolar disorder based on microbiota composition modification. The number of studies about the association between gut microbiota and bipolar disorder is relatively small, and more studies are needed to expand our understanding the association between gut microbiota and bipolar disorder.
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Affiliation(s)
- Xiaoxiao Lin
- Hangzhou First People’s Hospital, Hangzhou, China
| | - Jinyu Huang
- Hangzhou First People’s Hospital, Hangzhou, China
| | - Shuai Wang
- Hangzhou First People’s Hospital, Hangzhou, China
| | - Kai Zhang
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
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23
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Chaves-Filho A, Eyres C, Blöbaum L, Landwehr A, Tremblay MÈ. The emerging neuroimmune hypothesis of bipolar disorder: An updated overview of neuroimmune and microglial findings. J Neurochem 2024. [PMID: 38504593 DOI: 10.1111/jnc.16098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 02/26/2024] [Accepted: 02/28/2024] [Indexed: 03/21/2024]
Abstract
Bipolar disorder (BD) is a severe and multifactorial disease, with onset usually in young adulthood, which follows a progressive course throughout life. Replicated epidemiological studies have suggested inflammatory mechanisms and neuroimmune risk factors as primary contributors to the onset and development of BD. While not all patients display overt markers of inflammation, significant evidence suggests that aberrant immune signaling contributes to all stages of the disease and seems to be mood phase dependent, likely explaining the heterogeneity of findings observed in this population. As the brain's immune cells, microglia orchestrate the brain's immune response and play a critical role in maintaining the brain's health across the lifespan. Microglia are also highly sensitive to environmental changes and respond to physiological and pathological events by adapting their functions, structure, and molecular expression. Recently, it has been highlighted that instead of a single population of cells, microglia comprise a heterogeneous community with specialized states adjusted according to the local molecular cues and intercellular interactions. Early evidence has highlighted the contribution of microglia to BD neuropathology, notably for severe outcomes, such as suicidality. However, the roles and diversity of microglial states in this disease are still largely undermined. This review brings an updated overview of current literature on the contribution of neuroimmune risk factors for the onset and progression of BD, the most prominent neuroimmune abnormalities (including biomarker, neuroimaging, ex vivo studies) and the most recent findings of microglial involvement in BD neuropathology. Combining these different shreds of evidence, we aim to propose a unifying hypothesis for BD pathophysiology centered on neuroimmune abnormalities and microglia. Also, we highlight the urgent need to apply novel multi-system biology approaches to characterize the diversity of microglial states and functions involved in this enigmatic disorder, which can open bright perspectives for novel biomarkers and therapeutic discoveries.
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Affiliation(s)
- Adriano Chaves-Filho
- Division of Medical Sciences, University of Victoria, Victoria, British Columbia, Canada
- Women Health Research Institute, Vancouver, British Columbia, Canada
- Brain Health Cluster at the Institute on Aging & Lifelong Health (IALH), Victoria, British Columbia, Canada
| | - Capri Eyres
- Division of Medical Sciences, University of Victoria, Victoria, British Columbia, Canada
| | - Leonie Blöbaum
- Division of Medical Sciences, University of Victoria, Victoria, British Columbia, Canada
| | - Antonia Landwehr
- Division of Medical Sciences, University of Victoria, Victoria, British Columbia, Canada
| | - Marie-Ève Tremblay
- Division of Medical Sciences, University of Victoria, Victoria, British Columbia, Canada
- Women Health Research Institute, Vancouver, British Columbia, Canada
- Brain Health Cluster at the Institute on Aging & Lifelong Health (IALH), Victoria, British Columbia, Canada
- Centre for Advanced Materials and Related Technology (CAMTEC), University of Victoria, Victoria, British Columbia, Canada
- Department of Biochemistry and Molecular Biology, University of British Columbia, Vancouver, British Columbia, Canada
- Neurology and Neurosurgery Department, McGill University, Montréal, Quebec, Canada
- Department of Molecular Medicine, Université Laval, Québec City, Quebec, Canada
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24
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Parikh SV, Vande Voort JL, Yocum AK, Achtyes E, Goes FS, Nykamp L, Singh B, Lopez-Vives D, Sera CE, Maixner D, Tarnal V, Severe J, Bartek S, Tye SJ, Rico J, Stoppel CJ, Becerra A, Smart L, Miller CR, Frye MA, Greden JF, Bobo WV. Clinical outcomes in the biomarkers of ketamine (Bio-K) study of open-label IV ketamine for refractory depression. J Affect Disord 2024; 348:143-151. [PMID: 38142892 DOI: 10.1016/j.jad.2023.12.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Revised: 11/28/2023] [Accepted: 12/13/2023] [Indexed: 12/26/2023]
Abstract
OBJECTIVE We conducted an open-label clinical trial ("Bio-K") using IV ketamine for treatment-resistant depression to identify biomarkers linked to remission. Here, we report the clinical efficacy and side effect outcomes of Bio-K. METHODS Across 4 US sites, 75 patients ages 18-65 with treatment-refractory unipolar or bipolar depression received 3 IV ketamine infusions over an 11-day period. Key exclusion criteria were psychotic symptoms, significant substance abuse, unstable medical conditions, and any use of cannabis. Pre-existing antidepressant medication was maintained. Primary outcome was remission as measured by Montgomery-Asberg Depression Rating Scale (MADRS), with secondary outcome of 50 % reduction in Beck Suicide Scale score. Safety monitoring and varying durations of infusions were also key parameters. RESULTS Using remission as MADRS score <10, after 3 infusions 52 % achieved remission, with 67 % achieving response. Of those achieving response after a single infusion, 66 % (22 of 33) reached remission after 3 infusions, while 40 % (16 of 40) non-responders after the first infusion went on to achieve remission after 3 infusions. Only 20 % of non-responders after 2 infusions achieved remission. Most (81 %) participants had significant suicidal ideation at baseline; of these, two-thirds (67 %) experienced at least a 50 % reduction in suicidality. Side effects were minimal. Uniquely, we had three different types of infusion categories, with individuals receiving: (1) slow (100-min) infusions only or (2) regular (40-min) infusions only or (3) a mix of infusion durations. These three infusion groups showed comparable safety and efficacy. Exploration of clinical factors revealed no link between BMI, age, or gender to remission. CONCLUSIONS The consistency of outcomes across 4 clinical sites and across multiple instruments, suggests high acute efficacy and safety of IV ketamine for serious depressive episodes. Duration of infusion did not alter outcomes. Meaningfully, 40 % of non-responders after a single infusion did reach remission subsequently, while only 20 % of non-responders after 2 infusions achieved remission, suggesting early response is suggestive for eventual remission. Our data on varying ketamine infusion duration adds novel insights into the clinical administration of this new treatment for refractory and severe patients. Our limitations included a lack of a control group, necessitating caution about conclusions of efficacy, balanced by the utility of reporting "real-world" outcomes across multiple clinical sites. We could also not separately analyze results for bipolar disorder due to small numbers. Together, the Bio-K clinical results are promising and provide significant sample sizes for forthcoming biological markers analyses.
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Affiliation(s)
| | | | | | - Eric Achtyes
- Pine Rest Christian Mental Health Services, Michigan State University, USA; Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, MI, USA
| | | | - Louis Nykamp
- Pine Rest Christian Mental Health Services, Michigan State University, USA
| | - Balwinder Singh
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | | | | | | | | | | | | | - Susannah J Tye
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Jose Rico
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Cynthia J Stoppel
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | | | - LeAnn Smart
- Pine Rest Christian Mental Health Services, Michigan State University, USA
| | | | - Mark A Frye
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | | | - William V Bobo
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
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25
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Yaghmaei S, Babamohamadi H, Shamsaei F, Ghods AA. Unheard voices: The sexual challenges of families of patients with bipolar disorder: A qualitative content analysis. Bipolar Disord 2024; 26:148-159. [PMID: 37524374 DOI: 10.1111/bdi.13369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/02/2023]
Abstract
OBJECTIVES The aim of this study was to explore the voices of the family members of Bipolar Disorder (BD) patients about the challenges ahead of them. METHODS In this qualitative study, 22 participants shared their experiences of sexual challenges of patients with BD through in-depth, face-to-face, semi-structured interviews. Qualitative content analysis was used for data analysis. RESULTS An overarching theme entitled "Unheard voices" reflected this experience. It comprised four main categories include sexual promiscuity, a change in sexual patterns, sexual support, and sexual indifference. The results revealed that the families of patients with BD have to deal with sexual promiscuity and change in sexual patterns in their family, and the family system attempts to respond to these changes by sexual support mechanisms and sexual indifference. CONCLUSIONS Given the significant impact of healthy sexual behaviors on the quality of life of both the individual and the family, therapists and family support systems are advised to strengthen and educate families to support their patients' sexual health and needs and protect their sexual existence; they should also address the sexual challenges faced by these families as a diagnostic and therapeutic priority, and early sexual health interventions should be provided to these families.
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Affiliation(s)
- Safura Yaghmaei
- Student Research Committee, Semnan University of Medical Sciences, Semnan, Iran
| | - Hassan Babamohamadi
- Nursing Care Research Center, Semnan University of Medical Sciences, Semnan, Iran
- Department of Nursing, Faculty of Nursing and Midwifery, Semnan University of Medical Sciences, Semnan, Iran
| | - Farshid Shamsaei
- Behavioral Disorders and Substance Abuse Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Ali Asghar Ghods
- Nursing Care Research Center, Semnan University of Medical Sciences, Semnan, Iran
- Department of Operating Room, Sorkheh School of Allied Medical Sciences, Semnan University of Medical Sciences, Semnan, Iran
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26
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Arıkan MK, İlhan R, Özulucan MT, Esmeray MT, Günver MG. Predictive Value of qEEG in Manic Switch of Depressed Patients. Clin EEG Neurosci 2024; 55:192-202. [PMID: 37525528 DOI: 10.1177/15500594231190278] [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: 08/02/2023]
Abstract
Backgrounds: More than half of the patients with bipolar disorder (BD) had depressive episodes at the onset of BD. Despite some suggested clinical predictors, there are no certain criteria for predicting which unipolar depression patient switch to manic episodes during the treatment course. Electrophysiological markers can address this issue. Methods: Pretreatment quantitative electroencephalography (qEEG) records of patients diagnosed with major depressive disorder (MDD) or BD at the first visit were included in the study. Patients with MDD were also grouped with manic switch (MS) or MDD based on the diagnosis of later visits. The qEEG spectral power was analyzed across 3 groups, that is, MS, MDD, and BD. Results: Compared to patients whose diagnosis did not change, patients with MS had accelerated high-frequency activities predominantly in the left hemisphere (central-parietal-occipital regions). In contrast, they showed increased slow wave activity predominantly in the right hemisphere (parietal-occipital regions). Conclusion: It can be concluded that searching for electrophysiological markers, which have distinct advantages of repeatability, noninvasiveness, and cost-effectiveness, can facilitate the prediction of the MS.
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Affiliation(s)
| | - Reyhan İlhan
- Kemal Arıkan Psychiatry Clinic, Istanbul, Turkey
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27
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Chen C, Lan Y, Wang Z, Yan W, Yan X, Han J. Causal effects of diabetic retinopathy on depression, anxiety and bipolar disorder in the European population: a Mendelian randomization study. J Endocrinol Invest 2024; 47:585-592. [PMID: 37598399 DOI: 10.1007/s40618-023-02176-3] [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: 05/30/2023] [Accepted: 08/10/2023] [Indexed: 08/22/2023]
Abstract
PURPOSE To verify the causal effects of diabetic retinopathy (DR) on depression, anxiety and bipolar disorder (BD). METHODS Mendelian randomization (MR) analysis was performed to identify the causal relationships between DR and depression or anxiety or BD via using DR-related GWAS data (14,584 cases and 176,010 controls), depression-related GWAS data (59,851 cases and 113,154 controls), anxiety-related GWAS data (7016 cases and 14,745 controls) and BD-related GWAS data (41,917 cases and 371,549 controls). The inverse-variance weighted (IVW) model was adopted to estimate the causal relationship. The outcome was expressed as odds ratio (OR) with 95% confidence intervals (CI). RESULTS The MR analysis results presented that DR was causally associated with a significantly increased risk of BD in the European population (IVW, OR = 1.06, 95%CI [1.03, 1.08], P = 2.44 × 10-6), while DR was unable to causally influence the risk of depression (IVW, OR = 1.01, 95%CI [0.99, 1.04], P = 0.32) and anxiety (IVW, OR = 0.97, 95%CI [0.89, 1.06], P = 0.48) in the European population. Subgroup analysis based on BD identified DR causally increased the risk of bipolar I disorder (BD I) but not bipolar II disorder (BD II). Sensitivity analysis results did not show any pleiotropy and heterogeneity in both groups of analyses, indicating that the results were stable and reliable. CONCLUSIONS The results of the current MR analysis indicated a causal relationship between DR and BD in the European population, while there was no causal connection between DR and depression or anxiety. However, further research is needed to confirm these conclusions.
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Affiliation(s)
- C Chen
- Department of Ophthalmology, Tangdu Hospital, The Air Force Military Medical University, 569 Xinsi Rd, Xi'an, 710038, China
- Department of Ophthalmology, The 900th Hospital of Joint Logistic Support Force, PLA (Clinical Medical College of Fujian Medical University, Dongfang Hospital Affiliated to Xiamen University), Fuzhou, 350025, China
| | - Y Lan
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, 350122, China
| | - Z Wang
- Department of Thoracic Surgery, Tangdu Hospital, The Air Force Military Medical University, Xi'an, 710038, China
| | - W Yan
- Department of Ophthalmology, The 900th Hospital of Joint Logistic Support Force, PLA (Clinical Medical College of Fujian Medical University, Dongfang Hospital Affiliated to Xiamen University), Fuzhou, 350025, China
| | - X Yan
- Department of Thoracic Surgery, Tangdu Hospital, The Air Force Military Medical University, Xi'an, 710038, China.
| | - J Han
- Department of Ophthalmology, Tangdu Hospital, The Air Force Military Medical University, 569 Xinsi Rd, Xi'an, 710038, China.
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Sajatovic M, Rej S, Almeida OP, Altinbas K, Balanzá-Martínez V, Barbosa IG, Beunders AJM, Blumberg HP, Briggs FBS, Dols A, Forester BP, Forlenza OV, Gildengers AG, Jimenez E, Klaus F, Lafer B, Mulsant B, Mwangi B, Nunes PV, Olagunju AT, Oluwaniyi S, Orhan M, Patrick RE, Radua J, Rajji T, Sarna K, Schouws S, Simhandl C, Sekhon H, Soares JC, Sutherland AN, Teixeira AL, Tsai S, Vidal-Rubio S, Vieta E, Yala J, Eyler LT. Bipolar symptoms, somatic burden and functioning in older-age bipolar disorder: A replication study from the global aging & geriatric experiments in bipolar disorder database (GAGE-BD) project. Int J Geriatr Psychiatry 2024; 39:e6057. [PMID: 38511929 DOI: 10.1002/gps.6057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 01/10/2024] [Indexed: 03/22/2024]
Abstract
OBJECTIVES The Global Aging & Geriatric Experiments in Bipolar Disorder Database (GAGE-BD) project pools archival datasets on older age bipolar disorder (OABD). An initial Wave 1 (W1; n = 1369) analysis found both manic and depressive symptoms reduced among older patients. To replicate this finding, we gathered an independent Wave 2 (W2; n = 1232, mean ± standard deviation age 47.2 ± 13.5, 65% women, 49% aged over 50) dataset. DESIGN/METHODS Using mixed models with random effects for cohort, we examined associations between BD symptoms, somatic burden and age and the contribution of these to functioning in W2 and the combined W1 + W2 sample (n = 2601). RESULTS Compared to W1, the W2 sample was younger (p < 0.001), less educated (p < 0.001), more symptomatic (p < 0.001), lower functioning (p < 0.001) and had fewer somatic conditions (p < 0.001). In the full W2, older individuals had reduced manic symptom severity, but age was not associated with depression severity. Age was not associated with functioning in W2. More severe BD symptoms (mania p ≤ 0.001, depression p ≤ 0.001) were associated with worse functioning. Older age was significantly associated with higher somatic burden in the W2 and the W1 + W2 samples, but this burden was not associated with poorer functioning. CONCLUSIONS In a large, independent sample, older age was associated with less severe mania and more somatic burden (consistent with previous findings), but there was no association of depression with age (different from previous findings). Similar to previous findings, worse BD symptom severity was associated with worse functioning, emphasizing the need for symptom relief in OABD to promote better functioning.
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Affiliation(s)
- Martha Sajatovic
- Case Western Reserve University School of Medicine, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
| | - Soham Rej
- Jewish General Hospital/Lady Davis Hospital, McGill University, Montreal, Québec, Canada
| | - Osvaldo P Almeida
- University of Western Australia, Perth, Western Australia, Australia
| | - Kursat Altinbas
- Selçuk University Medical Faculty, Department of Psychiatry, Mazhar Osman Mood Clinic, Konya, Turkey
| | - Vicent Balanzá-Martínez
- Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, CIBERSAM, Valencia, Spain
| | - Izabela G Barbosa
- Mental Health Department, Medicine School, Minas Gerais University, Belo Horizonte, Brazil
| | - Alexandra J M Beunders
- GGZ inGeest, Amsterdam UMC, Vrije Universiteit Amsterdam, Psychiatry, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Hilary P Blumberg
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA
| | - Farren B S Briggs
- Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - Annemiek Dols
- Amsterdam UMC, VU University, Amsterdam Neuroscience, Amsterdam, The Netherlands
- Department of Psychiatry, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Brent P Forester
- Division of Geriatric Psychiatry, McLean Hospital, Belmont, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Orestes V Forlenza
- Laboratory of Neuroscience (LIM-27), Department and Institute of Psychiatry, HCFMUSP, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Ariel G Gildengers
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Esther Jimenez
- Bipolar and Depressive Disorders Unit, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, ISCIII Barcelona, Barcelona, Catalonia, Spain
| | - Federica Klaus
- Department of Psychiatry, University of California, San Diego, California, USA
| | - Beny Lafer
- Department of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil
| | - Benoit Mulsant
- Department of Psychiatry, University of Toronto, Center for Addiction & Mental Health, Toronto, Ontario, Canada
| | - Benson Mwangi
- Department of Psychiatry and Behavioral Sciences, McGovern Medical School, UTHealth Houston, Houston, Texas, USA
| | - Paula Villela Nunes
- Department of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil
| | - Andrew T Olagunju
- Department of Psychiatry and Behavioral Neurosciences, McMaster University/St Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | | | - Melis Orhan
- Department of Clinical Psychology, Leiden University, Leiden, The Netherlands
| | - Regan E Patrick
- Division of Geriatric Psychiatry, McLean Hospital, Belmont, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Joaquim Radua
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), CIBERSAM, Instituto de Salud Carlos III, University of Barcelona, Barcelona, Spain
| | - Tarek Rajji
- Department of Psychiatry, Toronto Dementia Research Alliance, University of Toronto, Toronto, Ontario, Canada
| | - Kaylee Sarna
- Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - Sigfried Schouws
- GGZ inGeest, Amsterdam UMC, VU Medical Center, Amsterdam, The Netherlands
| | - Christian Simhandl
- Medical Faculty, Bipolar Center Wiener Neustadt, Sigmund Freud University Vienna, Wien, Austria
| | - Harmehr Sekhon
- Department of Psychiatry, Jewish General Hospital/Lady Davis Institute, McGill University, Montreal, Quebec, Canada
| | - Jair C Soares
- Department of Psychiatry and Behavioral Sciences, University of Texas/McGovern Medical School, Houston, Texas, USA
| | - Ashley N Sutherland
- Department of Psychiatry, University of California, San Diego, California, USA
- Desert-Pacific Mental Illness Research Education and Clinical Center, VA San Diego Healthcare System, San Diego, California, USA
| | - Antonio L Teixeira
- Department of Psychiatry and Behavioral Sciences, University of Texas/McGovern Medical School, Houston, Texas, USA
- Faculdade Santa Casa BH, Belo Horizonte, Brazil
| | - Shangying Tsai
- Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | | | - Eduard Vieta
- Bipolar and Depressive Disorders Unit, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, ISCIII Barcelona, Barcelona, Catalonia, Spain
| | - Joy Yala
- Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - Lisa T Eyler
- Department of Psychiatry, University of California, San Diego, California, USA
- Desert-Pacific Mental Illness Research Education and Clinical Center, VA San Diego Healthcare System, San Diego, California, USA
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Cerimele JM, Franta G, Blanchard BE, Leasure W, Fortney JC. Bipolar Disorder Symptom Monitoring Measures: A Mixed-Methods Study of Patient Preferences. J Acad Consult Liaison Psychiatry 2024; 65:148-156. [PMID: 37967752 PMCID: PMC11032232 DOI: 10.1016/j.jaclp.2023.11.266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 10/17/2023] [Accepted: 11/09/2023] [Indexed: 11/17/2023]
Abstract
OBJECTIVE To determine the perceived acceptability and helpfulness of bipolar disorder symptom measures and rank the measures in order of preference among individuals with bipolar disorder. METHODS We recruited 20 participants 18 years of age or older with any type of bipolar disorder from a primary care clinical site and a national advocacy organization. We used a simultaneous complementary mixed-method design involving completion of symptom measures, a semistructured interview, and numerical ranking of measures. Participants completed three symptom measures or combination of measures: 1) Affective Self-Rating Scale; 2) combination Patient Mania Questionnaire-9 (PMQ-9) and Patient Health Questionnaire-9 (PHQ-9); and 3) combination Altman Self-Rating Mania Rating Scale and PHQ-9. A semistructured interview was conducted, and participants ranked their preferences for measures. Interviews focused on participants' rationale for measuring preferences. Interviews were analyzed by two psychiatrist-investigators using content analysis, and themes were determined. Average rank of each measure was determined. RESULTS The average rank for each measure was 1.48 for the combination PMQ-9 and PHQ-9, 1.68 for the Affective Self-Rating Scale, and 2.85 for the combination Altman Self-Rating Mania Rating Scale and PHQ-9, indicating that the combination PMQ-9 and PHQ-9 (top-ranked measure by 55% of participants) was the most preferred among the three measures. Major themes that emerged from the data were: 1) measure format; 2) patient experience; 3) clinical practice; and 4) therapeutic effects. CONCLUSIONS Individuals with bipolar disorder preferred the combination PMQ-9 and PHQ-9 for use in monitoring treatment due to perceived strengths such as format, ease of completion and interpretation, accurate description of experiences, and feasibility of use in practice.
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Affiliation(s)
- Joseph M Cerimele
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA.
| | - Gabriel Franta
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA
| | - Brittany E Blanchard
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA
| | - William Leasure
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN
| | - John C Fortney
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA; Department of Veterans Affairs, HSR&D Center of Innovation for Veteran-Centered and Value-Driven Care, VA Puget Sound Health Care System, Seattle, WA
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Chen L, Xu YY, Lin JY, Ji ZP, Yang F, Tan S, Wang G, Fang Y, Lu Z, Yang H, Hu J, Chen Z, Huang Y, Sun J, Wang X, Li H, Zhang J, Wang Y, Su Y, Zhao Y, Si T. The prevalence and clinical correlates of suicide attempts in patients with bipolar disorder misdiagnosed with major depressive disorder: Results from a national survey in China. Asian J Psychiatr 2024; 93:103958. [PMID: 38364597 DOI: 10.1016/j.ajp.2024.103958] [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: 10/30/2023] [Revised: 01/13/2024] [Accepted: 02/02/2024] [Indexed: 02/18/2024]
Abstract
BACKGROUND AND AIM Suicide is nearly always associated with underlying mental disorders. Risk factors for suicide attempts (SAs) in patients with bipolar disorder (BD) misdiagnosed with major depressive disorder (MDD) remain unelucidated. This study was to evaluate the prevalence and clinical risk factors of SAs in Chinese patients with BD misdiagnosed with MDD. METHODS A total of 1487 patients with MDD from 13 mental health institutions in China were enrolled. Mini International Neuropsychiatric Interview (MINI) was used to identify patients with BD who are misdiagnosed as MDD. The general sociodemographic and clinical data of the patients were collected and MINI suicide module was used to identify patients with SAs in these misdiagnosed patients. RESULTS In China, 20.6% of patients with BD were incorrectly diagnosed as having MDD. Among these misdiagnosed patients, 26.5% had attempted suicide. These patients tended to be older, had a higher number of hospitalizations, and were more likely to experience frequent and seasonal depressive episodes with atypical features, psychotic symptoms, and suicidal thoughts. Frequent depressive episodes and suicidal thoughts during depression were identified as independent risk factors for SAs. Additionally, significant sociodemographic and clinical differences were found between individuals misdiagnosed with MDD in BD and patients with MDD who have attempted suicide. CONCLUSIONS This study highlights the importance of accurate diagnosis in individuals with BD and provide valuable insights for the targeted identification and intervention of individuals with BD misdiagnosed as having MDD and those with genuine MDD, particularly in relation to suicidal behavior.
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Affiliation(s)
- Lin Chen
- Beijing Huilongguan Hospital, Peking University, Beijing, China
| | - Yu-Yu Xu
- Universiti Tunku Abdul Rahman (UTAR), Kampar, Malaysia
| | - Jing-Yu Lin
- Beijing Huilongguan Hospital, Peking University, Beijing, China
| | - Zhen Peng Ji
- School of Public Health, Peking University Health Science Center, Beijing, China
| | - Fude Yang
- Beijing Huilongguan Hospital, Peking University, Beijing, China
| | - Shuping Tan
- Beijing Huilongguan Hospital, Peking University, Beijing, China
| | - Gang Wang
- Mood Disorders Center, Beijing Anding Hospital, Capital Medical University, China
| | - YiRu Fang
- Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zheng Lu
- Shanghai Tongji Hospital, Tongji University Medical School, Shanghai, China
| | - HaiChen Yang
- Division of Mood Disorders, Shenzhen Mental Health Center, Guangdong province, China
| | - Jian Hu
- The First Hospital of Harbin Medical University, Heilongjiang province, China
| | - ZhiYu Chen
- Hangzhou Seventh People's Hospital, Zhejiang province, China
| | - Yi Huang
- West China Hospital, Sichuan University, Sichuan province, China
| | - Jing Sun
- The Affiliated Brain Hospital, Nanjing Medical University, Jiangsu province, China
| | - Xiaoping Wang
- Mental Health Institute, The Second Xiangya Hospital, Central South University, Hunan province, China
| | - Huichun Li
- The Second Affiliated Hospital, College of Medicine, Zhejiang University, Zhejiang province, China
| | - Jinbei Zhang
- The Third Affiliated Hospital of Sun Yat-Sen University, Guangdong province, China
| | - Ying Wang
- The 261st hospital of PLA, Beijing, China
| | - Yunai Su
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), China
| | - Yanli Zhao
- Beijing Huilongguan Hospital, Peking University, Beijing, China.
| | - Tianmei Si
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), China.
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Hsu CW, Lai ECC, Chen YCB, Kao HY. Valproic acid monitoring: Serum prediction using a machine learning framework from multicenter real-world data. J Affect Disord 2024; 347:85-91. [PMID: 37992772 DOI: 10.1016/j.jad.2023.11.047] [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: 06/30/2023] [Revised: 11/02/2023] [Accepted: 11/15/2023] [Indexed: 11/24/2023]
Abstract
BACKGROUND Our study employs machine learning to predict serum valproic acid (VPA) concentrations, aiming to contribute to the development of non-invasive assays for therapeutic drug monitoring. METHODS Medical records from 2002 to 2019 were obtained from the Taiwan Chang Gung Research Database. Using various machine learning algorithms, we developed predictive models to classify serum VPA concentrations into two categories (1-50 μg/ml or 51-100 μg/ml) and predicted the exact concentration value. The models were trained on 5142 samples and tested on 644 independent samples. Accuracy was the main metric used to evaluate model performance, with a tolerance of 20 μg/ml for continuous variables. Furthermore, we identified important features and developed simplified models with fewer features. RESULTS The models achieved an average accuracy of 0.80-0.86 for binary outcomes and 0.72-0.88 for continuous outcome. Ten top features associated with higher serum VPA levels included higher VPA last and daily doses, bipolar disorder or schizophrenia spectrum disorder diagnoses, elevated levels of serum albumin, calcium, and creatinine, low platelet count, low percentage of segmented white blood cells, and low red cell distribution width-coefficient of variation. The simplified models had an average accuracy of 0.82-0.86 for binary outcome and 0.70-0.86 for continuous outcome. LIMITATIONS The study's predictive model lacked external test data from outside the hospital for validation. CONCLUSIONS Machine learning models have the potential to integrate real-world data and predict VPA concentrations, providing a promising tool for reducing the need for frequent monitoring of serum levels in clinical practice.
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Affiliation(s)
- Chih-Wei Hsu
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan; Department of Computer Science and Information Engineering, National Cheng Kung University, Tainan, Taiwan
| | - Edward Chia-Cheng Lai
- School of Pharmacy, Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yang-Chieh Brian Chen
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
| | - Hung-Yu Kao
- Department of Computer Science and Information Engineering, National Cheng Kung University, Tainan, Taiwan.
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Cho WM, Hsu TW, Cheng CM, Chang WH, Tsai SJ, Bai YM, Su TP, Chen TJ, Chen MH, Liang CS. Cause-specific mortality and comorbid neurodevelopmental disorder in 167,515 patients with bipolar disorder: An entire population longitudinal study. J Affect Disord 2024; 347:463-468. [PMID: 38065473 DOI: 10.1016/j.jad.2023.12.007] [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: 05/24/2023] [Revised: 10/28/2023] [Accepted: 12/02/2023] [Indexed: 01/08/2024]
Abstract
OBJECTIVE Studies addressing premature mortality in bipolar disorder (BD) patients are limited by small sample sizes. Herein, we used almost 99 % of the population of Taiwan to address this issue, and its association with comorbid neurodevelopmental disorders and severe BD. METHODS Between 2003 and 2017, we enrolled 167,515 individuals with BD and controls matched 1:4 for sex and birth year from the National Health Insurance Database linked to the Database of National Death Registry in Taiwan. Time-dependent Cox regression models were used to examine cause-specific mortality (all-cause, natural, and unnatural causes [accidents or suicide]). RESULTS With adjustments of sex, age, income, urbanization, and physical conditions, suicide was associated with the highest risk of mortality (reported as hazard ratio with 95 % confidence interval: 9.15; 8.53-9.81) among BD patients, followed by unnatural (4.94; 4.72-5.17), accidental (2.15; 1.99-2.32), and natural causes (1.02; 1.00-1.05). Comorbid attention-deficiency hyperactivity disorder did not contribute to the increased risk of cause-specific mortality; however, comorbid autism spectrum disorder (ASD) increased such risks, particularly for natural (3.00; 1.85-4.88) and accidental causes (7.47; 1.80-31.1). Cause-specific mortality revealed a linear trend with the frequency of psychiatric hospitalization (all, p for trend <0.001), and BD patients hospitalized twice or more each year had 34.63-fold increased risk of suicide mortality (26.03-46.07). CONCLUSIONS BD patients with a higher frequency of psychiatric hospitalization have the highest risk of suicide mortality, and comorbid ASD was associated with an increased risk of natural and accidental causes of mortality.
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Affiliation(s)
- Wei-Min Cho
- Department of Pharmacy Administration, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan
| | - Tien-Wei Hsu
- Department of Psychiatry, E-DA Dachang Hospital, I-Shou Univerisity, Kaohsiung, Taiwan; Department of Psychiatry, E-DA Hospital, I-Shou Univerisity, Kaohsiung, Taiwan.
| | - Chih-Ming Cheng
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Psychiatry, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Wen-Han Chang
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Shih-Jen Tsai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Psychiatry, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Ya-Mei Bai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Psychiatry, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Tung-Ping Su
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Psychiatry, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Department of Psychiatry, General Cheng Hsin Hospital, Taipei, Taiwan
| | - Tzeng-Ji Chen
- Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; Institute of Hospital and Health Care Administration, National Yang Ming Chiao Tung University, Taipei, Taiwan; Department of Family Medicine, Taipei Veterans General Hospital, Hsinchu Branch, Hsinchu, Taiwan
| | - Mu-Hong Chen
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Psychiatry, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
| | - Chih-Sung Liang
- Department of Psychiatry, Beitou Branch, Tri-Service General Hospital, Taipei, Taiwan; Department of Psychiatry, National Defense Medical Center, Taipei, Taiwan
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Zhu H, Qu Y, Du Z, Zhou Q, Shen Y, Jiang Y, Zhou Z, Zhou H. Mining and analysis of adverse event signals of Cariprazine based on the real-world data of FAERS database. J Affect Disord 2024; 347:45-50. [PMID: 37992768 DOI: 10.1016/j.jad.2023.11.076] [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: 08/16/2023] [Revised: 11/16/2023] [Accepted: 11/19/2023] [Indexed: 11/24/2023]
Abstract
OBJECTIVE This study aims to analyze the adverse events (AEs) of Cariprazine based on the FAERS database, providing evidence for its safety surveillance. METHODS For signal quantification of Cariprazine-related AEs, we used disproportionality analysis including the Ratio of Odds Ratio (ROR), Proportional Reporting Ratio (PRR), Bayesian Confidence Propagation Neural Network (BCPNN), and Multi-Item Gamma Poisson Shrinker (MGPS) algorithms. RESULTS We selected Cariprazine-related AE reports from the FAERS database from the fourth quarter of 2015 to the first quarter of 2023, and performed a detailed data analysis. Out of a total of 12,278,580 case reports, 3659 were found to be directly related to Cariprazine. We identified 140 Preferred Terms (PT) to describe these AEs, finding that they involved 27 organ systems. Specifically, AEs related to eye disorders such as Cataract cortical, Cataract nuclear, Accommodation disorder, Lenticular opacities, Oculogyric crisis, Dyschromatopsia were not explicitly mentioned in the drug's leaflet, indicating the presence of new ADR signals. CONCLUSION Analysis of the FAERS database identified AEs associated with Cariprazine, notably in eye disorders not previously documented in the drug's official leaflet. These findings emphasize the need for continuous post-market surveillance and awareness among healthcare professionals regarding potential new ADR signals.
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Affiliation(s)
- Haohao Zhu
- Mental Health Center of Jiangnan University, Wuxi Central Rehabilitation Hospital, Wuxi, Jiangsu, China
| | - Yucai Qu
- Mental Health Center of Jiangnan University, Wuxi Central Rehabilitation Hospital, Wuxi, Jiangsu, China
| | - Zhiqiang Du
- Mental Health Center of Jiangnan University, Wuxi Central Rehabilitation Hospital, Wuxi, Jiangsu, China
| | - Qin Zhou
- Mental Health Center of Jiangnan University, Wuxi Central Rehabilitation Hospital, Wuxi, Jiangsu, China
| | - Yuan Shen
- Mental Health Center of Jiangnan University, Wuxi Central Rehabilitation Hospital, Wuxi, Jiangsu, China
| | - Ying Jiang
- Mental Health Center of Jiangnan University, Wuxi Central Rehabilitation Hospital, Wuxi, Jiangsu, China.
| | - Zhenhe Zhou
- Mental Health Center of Jiangnan University, Wuxi Central Rehabilitation Hospital, Wuxi, Jiangsu, China.
| | - Hongliang Zhou
- Department of Psychology, The Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu, China.
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Krys K, Kostoula O, van Tilburg WAP, Mosca O, Lee JH, Maricchiolo F, Kosiarczyk A, Kocimska-Bortnowska A, Torres C, Hitokoto H, Liew K, Bond MH, Lun VMC, Vignoles VL, Zelenski JM, Haas BW, Park J, Vauclair CM, Kwiatkowska A, Roczniewska M, Witoszek N, Işık İ, Kosakowska-Berezecka N, Domínguez-Espinosa A, Yeung JC, Górski M, Adamovic M, Albert I, Pavlopoulos V, Fülöp M, Sirlopu D, Okvitawanli A, Boer D, Teyssier J, Malyonova A, Gavreliuc A, Serdarevich U, Akotia CS, Appoh L, Mira DMA, Baltin A, Denoux P, Esteves CS, Gamsakhurdia V, Garðarsdóttir RB, Igbokwe DO, Igou ER, Kascakova N, Klůzová Kracˇmárová L, Kronberger N, Barrientos PE, Mohoricć T, Murdock E, Mustaffa NF, Nader M, Nadi A, van Osch Y, Pavlović Z, Polácˇková Šolcová I, Rizwan M, Romashov V, Røysamb E, Sargautyte R, Schwarz B, Selecká L, Selim HA, Stogianni M, Sun CR, Wojtczuk-Turek A, Xing C, Uchida Y. Happiness Maximization Is a WEIRD Way of Living. PERSPECTIVES ON PSYCHOLOGICAL SCIENCE 2024:17456916231208367. [PMID: 38350096 DOI: 10.1177/17456916231208367] [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: 02/15/2024]
Abstract
Psychological science tends to treat subjective well-being and happiness synonymously. We start from the assumption that subjective well-being is more than being happy to ask the fundamental question: What is the ideal level of happiness? From a cross-cultural perspective, we propose that the idealization of attaining maximum levels of happiness may be especially characteristic of Western, educated, industrial, rich, and democratic (WEIRD) societies but less so for others. Searching for an explanation for why "happiness maximization" might have emerged in these societies, we turn to studies linking cultures to their eco-environmental habitat. We discuss the premise that WEIRD cultures emerged in an exceptionally benign ecological habitat (i.e., faced relatively light existential pressures compared with other regions). We review the influence of the Gulf Stream on the Northwestern European climate as a source of these comparatively benign geographical conditions. We propose that the ecological conditions in which WEIRD societies emerged afforded them a basis to endorse happiness as a value and to idealize attaining its maximum level. To provide a nomological network for happiness maximization, we also studied some of its potential side effects, namely alcohol and drug consumption and abuse and the prevalence of mania. To evaluate our hypothesis, we reanalyze data from two large-scale studies on ideal levels of personal life satisfaction-the most common operationalization of happiness in psychology-involving respondents from 61 countries. We conclude that societies whose members seek to maximize happiness tend to be characterized as WEIRD, and generalizing this across societies can prove problematic if adopted at the ideological and policy level.
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Affiliation(s)
- Kuba Krys
- Institute of Psychology, Polish Academy of Sciences
| | - Olga Kostoula
- Institute of Psychology, Johannes Kepler University Linz
| | | | - Oriana Mosca
- Department of Education, Psychology, and Philosophy, University of Cagliari
| | - J Hannah Lee
- Department of Psychology, Indiana University Northwest
| | | | | | | | | | | | - Kongmeng Liew
- Graduate School of Human and Environmental Studies, Kyoto University
- School of Psychology, Speech and Hearing, University of Canterbury
| | - Michael H Bond
- Department of Management and Marketing, Faculty of Business, Hong Kong Polytechnic University
| | | | | | | | | | - Joonha Park
- Graduate School of Management, NUCB Business School
| | - Christin-Melanie Vauclair
- Centre for Psychological Research and Social Intervention (CIS-Iscte), Iscte-Instituto Universitário de Lisboa
| | | | - Marta Roczniewska
- SWPS University
- Department of Learning, Informatics, Management and Ethics, Medical Management Centre, Karolinska Institutet
| | - Nina Witoszek
- Centre for Development and the Environment, University of Oslo
| | - İdil Işık
- Psychology Department, Bahçeşehir University
| | | | | | | | - Maciej Górski
- Institute of Psychology, Polish Academy of Sciences
- Faculty of Psychology, University of Warsaw
| | | | - Isabelle Albert
- Department of Behavioural and Cognitive Sciences, University of Luxembourg
| | | | - Márta Fülöp
- Institute of Psychology, Károli Gáspár University of the Reformed Church
- Research Centre of Natural Sciences, Institute of Cognitive Neuroscience and Psychology, Eötvös Loránd Research Network, Budapest, Hungary
| | - David Sirlopu
- Faculty of Psychology and Humanities, Universidad San Sebastián, Concepción
| | | | - Diana Boer
- Institute of Psychology, University of Koblenz
| | - Julien Teyssier
- Département Psychologie Clinique Du Sujet, Université Toulouse II
| | - Arina Malyonova
- Department of General and Social Psychology, Dostoevsky Omsk State University
| | | | | | - Charity S Akotia
- Department of Psychology, School of Social Sciences, University of Ghana
| | - Lily Appoh
- Faculty of Nursing and Health Sciences, Nord University
| | | | - Arno Baltin
- School of Natural Sciences and Health, Tallinn University
| | - Patrick Denoux
- Département Psychologie Clinique Du Sujet, Université Toulouse II
| | - Carla Sofia Esteves
- Universidade Católica Portuguesa, Católica Lisbon School of Business and Economics, Católica Lisbon Research Unit in Business and Economics
| | | | | | | | - Eric R Igou
- Department of Psychology, University of Limerick
| | - Natalia Kascakova
- Olomouc University Social Health Institute, Palacky University
- Psychiatric Clinic Pro Mente Sana, Bratislava, Slovakia
| | | | | | | | - Tamara Mohoricć
- Department of Psychology, Faculty of Humanities and Social Sciences, University of Rijeka
| | - Elke Murdock
- Department of Behavioural and Cognitive Sciences, University of Luxembourg
| | - Nur Fariza Mustaffa
- Department of Business Administration, International Islamic University Malaysia
| | - Martin Nader
- Department of Psychological Studies, Universidad ICESI
| | - Azar Nadi
- Institute of Psychology, Polish Academy of Sciences
| | - Yvette van Osch
- Department of Social Psychology, Tilburg School of Social and Behavioral Sciences, Tilburg University
| | - Zoran Pavlović
- Department of Psychology, Faculty of Philosophy University of Belgrade
| | | | | | | | | | - Ruta Sargautyte
- Institute of Psychology, Faculty of Philosophy, Vilnius University
| | - Beate Schwarz
- Department of Applied Psychology, Zurich University of Applied Sciences
| | | | | | | | - Chien-Ru Sun
- Department of Psychology, National Chengchi University
| | | | - Cai Xing
- Department of Psychology, Renmin University of China
| | - Yukiko Uchida
- Institute for the Future of Human Society, Kyoto University
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Shao X, Chen Z, Yu J, Lu F, Chen S, Xu J, Yao Y, Liu B, Yang P, Jiang Q, Hu B. Ultralow-cost piezoelectric sensor constructed by thermal compression bonding for long-term biomechanical signal monitoring in chronic mental disorders. NANOSCALE 2024; 16:2974-2982. [PMID: 38258372 DOI: 10.1039/d3nr06297j] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2024]
Abstract
Wearable bioelectronic devices, which circumvent issues related to the large size and high cost of clinical equipment, have emerged as powerful tools for the auxiliary diagnosis and long-term monitoring of chronic psychiatric diseases. Current devices often integrate multiple intricate and expensive devices to ensure accurate diagnosis. However, their high cost and complexity hinder widespread clinical application and long-term user compliance. Herein, we developed an ultralow-cost poly(vinylidene fluoride)/zinc oxide nanofiber film-based piezoelectric sensor in a thermal compression bonding process. Our piezoelectric sensor exhibits remarkable sensitivity (13.4 mV N-1), rapid response (8 ms), and exceptional stability over 2000 compression/release cycles, all at a negligibly low fabrication cost. We demonstrate that pulse wave, blink, and speech signals can be acquired by the sensor, proposing a single biomechanical modality to monitor multiple physiological traits associated with bipolar disorder. This ultralow-cost and mass-producible piezoelectric sensor paves the way for extensive long-term monitoring and immediate feedback for bipolar disorder management.
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Affiliation(s)
- Xiaodong Shao
- The Affiliated Eye Hospital of Nanjing Medical University, Nanjing Medical University, Nanjing 210029, China.
| | - Zenan Chen
- School of Biomedical Engineering and Informatics, Nanjing Medical University, Nanjing 211166, China
| | - Junxiao Yu
- The Affiliated Changzhou Second People's Hospital of Nanjing Medical University, Changzhou Second People's Hospital, Changzhou Medical Center, Nanjing Medical University, Changzhou 213161, China
| | - Fangzhou Lu
- School of Biomedical Engineering and Informatics, Nanjing Medical University, Nanjing 211166, China
| | - Shisheng Chen
- School of Biomedical Engineering and Informatics, Nanjing Medical University, Nanjing 211166, China
| | - Jingfeng Xu
- School of Biomedical Engineering and Informatics, Nanjing Medical University, Nanjing 211166, China
| | - Yihao Yao
- School of Biomedical Engineering and Informatics, Nanjing Medical University, Nanjing 211166, China
| | - Bin Liu
- School of Biomedical Engineering and Informatics, Nanjing Medical University, Nanjing 211166, China
| | - Ping Yang
- School of Materials and Engineering, Nanjing Institute of Technology, Nanjing 211167, China
| | - Qin Jiang
- The Affiliated Eye Hospital of Nanjing Medical University, Nanjing Medical University, Nanjing 210029, China.
| | - Benhui Hu
- The Affiliated Eye Hospital of Nanjing Medical University, Nanjing Medical University, Nanjing 210029, China.
- School of Biomedical Engineering and Informatics, Nanjing Medical University, Nanjing 211166, China
- Jiangsu Province Hospital, Nanjing Medical University First Affiliated Hospital, Nanjing 210029, China
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Chen P, Sajatovic M, Briggs FBS, Mulsant B, Dols AA, Gildengers A, Yala J, Beunders AJM, Blumberg HP, Rej S, Forlenza OV, Jimenez E, Schouws S, Orhan M, Sutherland AN, Vieta E, Tsai S, Sarna K, Eyler LT. Sociodemographic and clinical characteristics of people with oldest older age bipolar disorder in a global sample: Results from the global aging and geriatric experiments in bipolar disorder project. Int J Geriatr Psychiatry 2024; 39:e6073. [PMID: 38393311 DOI: 10.1002/gps.6073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Accepted: 02/14/2024] [Indexed: 02/25/2024]
Abstract
OBJECTS Studies of older age bipolar disorder (OABD) have mostly focused on "younger old" individuals. Little is known about the oldest OABD (OOABD) individuals aged ≥70 years old. The Global Aging and Geriatric Experiments in Bipolar Disorder (GAGE-BD) project provides an opportunity to evaluate the OOABD group to understand their characteristics compared to younger groups. METHODS We conducted cross-sectional analyses of the GAGE-BD database, an integrated, harmonized dataset from 19 international studies. We compared the sociodemographic and clinical characteristics of those aged <50 (YABD, n = 184), 50-69 (OABD, n = 881), and ≥70 (OOABD, n = 304). To standardize the comparisons between age categories and all characteristics, we used multinomial logistic regression models with age category as the dependent variable, with each characteristic as the independent variable, and clustering of standard errors to account for the correlation between observations from each of the studies. RESULTS OOABD and OABD had lower severity of manic symptoms (Mean YMRS = 3.3, 3.8 respectively) than YABD (YMRS = 7.6), and lower depressive symptoms (% of absent = 65.4%, and 59.5% respectively) than YABD (18.3%). OOABD and OABD had higher physical burden than YABD, especially in the cardiovascular domain (prevalence = 65% in OOABD, 41% in OABD and 17% in YABD); OOABD had the highest prevalence (56%) in the musculoskeletal domain (significantly differed from 39% in OABD and 31% in YABD which didn't differ from each other). Overall, OOABD had significant cumulative physical burden in numbers of domains (mean = 4) compared to both OABD (mean = 2) and YABD (mean = 1). OOABD had the lowest rates of suicidal thoughts (10%), which significantly differed from YABD (26%) though didn't differ from OABD (21%). Functional status was higher in both OOABD (GAF = 63) and OABD (GAF = 64), though only OABD had significantly higher function than YABD (GAF = 59). CONCLUSIONS OOABD have unique features, suggesting that (1) OOABD individuals may be easier to manage psychiatrically, but require more attention to comorbid physical conditions; (2) OOABD is a survivor cohort associated with resilience despite high medical burden, warranting both qualitative and quantitative methods to better understand how to advance clinical care and ways to age successfully with BD.
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Affiliation(s)
- Peijun Chen
- Department of Psychiatry, Geriatric Psychiatry Division, Geriatric Research, Education and Clinical Center (GRECC), Case Western Reserve University School of Medicine, VA Northeast Ohio Healthcare System, Cleveland, Ohio, USA
| | - Martha Sajatovic
- Department of Psychiatry, Case Western Reserve University School of Medicine, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
| | - Farren B S Briggs
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Benoit Mulsant
- Department of Psychiatry, University of Toronto, Center for Addiction & Mental Health, Toronto, Ontario, Canada
| | - Annemiek A Dols
- GGZ inGeest, Amsterdam, the Netherlands
- Amsterdam UMC, Location Vrije Universiteit Amsterdam, Psychiatry, Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
- Amsterdam Neuroscience, Amsterdam, the Netherlands
| | - Ariel Gildengers
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Joy Yala
- Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - Alexandra J M Beunders
- GGZ inGeest, Amsterdam, the Netherlands
- Amsterdam UMC, Location Vrije Universiteit Amsterdam, Psychiatry, Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - Hilary P Blumberg
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA
| | - Soham Rej
- Department of Psychiatry, Jewish General Hospital/Lady Davis Institute, McGill University, Montreal, Quebec, Canada
| | - Orestes V Forlenza
- Department and Institute of Psychiatry, Laboratory of Neuroscience (LIM-27), HCFMUSP, Faculdade de Medicina da Universidade de São Paulo, São Paulo, São Paulo, Brazil
| | - Esther Jimenez
- Bipolar and Depressive Disorders Unit, Hospital Clinic, University of Barcelona, Institute of Neuroscience, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
- Department of Psychiatry, Hospital Universitario de Alava, BIOARABA, UPV/EHU, CIBERSAM, Vitoria, Spain
| | - Sigfried Schouws
- GGZ inGeest, Amsterdam, the Netherlands
- Amsterdam UMC, Location Vrije Universiteit Amsterdam, Psychiatry, Amsterdam, the Netherlands
| | - Melis Orhan
- Department of Clinical Psychology, Leiden University, Leiden, the Netherlands
| | - Ashley N Sutherland
- Department of Psychiatry, University of California San Diego, San Diego, California, USA
- Desert-Pacific Mental Illness Research Education and Clinical Center, VA San Diego Healthcare System, San Diego, California, USA
| | - Eduard Vieta
- Bipolar and Depressive Disorders Unit, Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Shangying Tsai
- Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Kaylee Sarna
- Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - Lisa T Eyler
- Department of Psychiatry, University of California San Diego, San Diego, California, USA
- Desert-Pacific Mental Illness Research Education and Clinical Center, VA San Diego Healthcare System, San Diego, California, USA
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Wolfe C, McCoin N. Bipolar Disorders in the Emergency Department. Emerg Med Clin North Am 2024; 42:115-124. [PMID: 37977743 DOI: 10.1016/j.emc.2023.06.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
Affective disorders affect the way that people think and feel and are classified into unipolar disorders and bipolar disorders. Bipolar disorders represent a spectrum of these chronic mental health illnesses. Patients with bipolar disorder have high recurrence of acute symptoms, and on average spend 20% of their life in exacerbations characterized by mania, depression, or psychosis. Given the increased morbidity and mortality associated with bipolar disorders, it is imperative that the emergency physician remain vigilant when these patients seek emergency care.
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Affiliation(s)
- Carmen Wolfe
- Department of Emergency Medicine, Tristar Skyline Medical Center, 3443 Dickerson Pike, Suite 230, Nashville, TN 37207, USA.
| | - Nicole McCoin
- Department of Emergency Medicine, Ochsner Medical Center, 1514 Jefferson Highway, New Orleans, LA 70121, USA
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38
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Belge JB, Sabbe BGCC. Long-acting second-generation injectable antipsychotics for the maintenance treatment of bipolar disorder: a narrative review. Expert Opin Pharmacother 2024; 25:295-299. [PMID: 38465894 DOI: 10.1080/14656566.2024.2329743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 03/08/2024] [Indexed: 03/12/2024]
Abstract
INTRODUCTION Non-adherence to medication significantly affects bipolar disorder outcomes. Long-Acting Injectable antipsychotics show promise by ensuring adherence and averting relapses. AREAS COVERED This narrative review sought to evaluate the efficacy of second-generation injectable antipsychotics in bipolar disorder through searches in Embase, MEDLINE, and PsycInfo for randomized controlled trials and mirror-image studies.Risperidone and aripiprazole Long-Acting Injectables demonstrated effectiveness in preventing mood recurrences compared to placebos in adults with bipolar disorder. They showed superiority in preventing mania/hypomania relapses over placebos but did not appear to significantly outperform active oral controls. Notably, active controls seem to be more effective in preventing depression relapses than Long-Acting Injectables. Mirror-Image studies point toward the reduction of hospitalization rates following LAI initiation. EXPERT OPINION The available evidence points thus toward the efficacy of LAIs, especially in managing manic episodes and reducing hospitalizations, The current evidence does not however immediately support prioritizing LAIs over oral medications in bipolar disorder treatment. More high-quality studies, especially comparing LAIs directly with active controls, are crucial to gain a comprehensive understanding of their efficacy. These findings highlight the need for further research to guide clinicians in optimizing treatment strategies for bipolar disorder.
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Affiliation(s)
- Jean-Baptiste Belge
- Department of Psychiatry, Collaborative Antwerp Psychiatric Research Institute (CAPRI), Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium
- Department of Psychiatry, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Bernard G C C Sabbe
- Department of Psychiatry, Collaborative Antwerp Psychiatric Research Institute (CAPRI), Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium
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Gonzalez-Torres C, Mulsant BH, Husain MI, Alda M, Young RC, Ortiz A. Challenges in defining treatment-resistant mania in adults: A systematic review. Bipolar Disord 2024; 26:7-21. [PMID: 37963496 PMCID: PMC10922285 DOI: 10.1111/bdi.13383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2023]
Abstract
OBJECTIVES To review the definitions of treatment-resistant mania (TRM) in the literature and propose criteria for an operationalized definition. METHODS A systematic search of five databases (MEDLINE, EMBASE, PsychInfo, Cochrane Central, and CINAHL) and data extraction of eligible articles. RESULTS In total, 47 articles addressing the concept of TRM were included, comprising 16 case reports, 11 case series, 3 randomized clinical trials, 8 open-label clinical trials, 1 experimental study, 7 narrative reviews, and 1 systematic review. While reviews discussed several challenges in defining TRM, definitions varied substantially based on different criteria for severity of mania, duration of mania, and use of specific therapeutic agents with minimal dosages and duration of treatment. Only a handful of the reviewed articles operationalized these criteria. CONCLUSION While the concept of TRM has been discussed in the literature for over three decades, we could not find an agreed-upon operationalized definition based on specific criteria. We propose and discuss a possible definition that could be used by clinicians to guide their practice and by researchers to assess the prevalence of TRM and develop and test interventions targeting TRM.
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Affiliation(s)
- Christina Gonzalez-Torres
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Benoit H. Mulsant
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - M. Ishrat Husain
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Martin Alda
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
- National Institute of Mental Health, Klecany, Czech Republic
| | - Robert C. Young
- Department of Psychiatry, Weil Cornell Medicine, New York, New York, US
| | - Abigail Ortiz
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
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Wu Y, Su YA, Zhu L, Li J, Si T. Advances in functional MRI research in bipolar disorder: from the perspective of mood states. Gen Psychiatr 2024; 37:e101398. [PMID: 38292862 PMCID: PMC10826570 DOI: 10.1136/gpsych-2023-101398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 12/20/2023] [Indexed: 02/01/2024] Open
Abstract
Bipolar disorder is characterised by recurrent and alternating episodes of mania/hypomania and depression. Current breakthroughs in functional MRI techniques have uncovered the functional neuroanatomy of bipolar disorder. However, the pathophysiology underlying mood instability, mood switching and the development of extreme mood states is less well understood. This review presents a comprehensive overview of current evidence from functional MRI studies from the perspective of mood states. We first summarise the disrupted brain activation patterns and functional connectivity that have been reported in bipolar disorder, irrespective of the mood state. We next focus on research that solely included patients in a single mood state for a better understanding of the pathophysiology of bipolar disorder and research comparing patients with different mood states to dissect mood state-related effects. Finally, we briefly summarise current theoretical models and conclude this review by proposing potential avenues for future research. A comprehensive understanding of the pathophysiology with consideration of mood states could not only deepen our understanding of how acute mood episodes develop at a neurophysiological level but could also facilitate the identification of biological targets for personalised treatment and the development of new interventions for bipolar disorder.
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Affiliation(s)
- Yankun Wu
- Department of Clinical Psychopharmacology, Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Yun-Ai Su
- Department of Clinical Psychopharmacology, Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Linlin Zhu
- Department of Clinical Psychopharmacology, Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Jitao Li
- Department of Clinical Psychopharmacology, Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Tianmei Si
- Department of Clinical Psychopharmacology, Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
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Walsh CG, Ripperger MA, Hu Y, Sheu YH, Lee H, Wilimitis D, Zheutlin AB, Rocha D, Choi KW, Castro VM, Kirchner HL, Chabris CF, Davis LK, Smoller JW. Development and multi-site external validation of a generalizable risk prediction model for bipolar disorder. Transl Psychiatry 2024; 14:58. [PMID: 38272862 PMCID: PMC10810911 DOI: 10.1038/s41398-023-02720-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 11/29/2023] [Accepted: 12/15/2023] [Indexed: 01/27/2024] Open
Abstract
Bipolar disorder is a leading contributor to disability, premature mortality, and suicide. Early identification of risk for bipolar disorder using generalizable predictive models trained on diverse cohorts around the United States could improve targeted assessment of high risk individuals, reduce misdiagnosis, and improve the allocation of limited mental health resources. This observational case-control study intended to develop and validate generalizable predictive models of bipolar disorder as part of the multisite, multinational PsycheMERGE Network across diverse and large biobanks with linked electronic health records (EHRs) from three academic medical centers: in the Northeast (Massachusetts General Brigham), the Mid-Atlantic (Geisinger) and the Mid-South (Vanderbilt University Medical Center). Predictive models were developed and valid with multiple algorithms at each study site: random forests, gradient boosting machines, penalized regression, including stacked ensemble learning algorithms combining them. Predictors were limited to widely available EHR-based features agnostic to a common data model including demographics, diagnostic codes, and medications. The main study outcome was bipolar disorder diagnosis as defined by the International Cohort Collection for Bipolar Disorder, 2015. In total, the study included records for 3,529,569 patients including 12,533 cases (0.3%) of bipolar disorder. After internal and external validation, algorithms demonstrated optimal performance in their respective development sites. The stacked ensemble achieved the best combination of overall discrimination (AUC = 0.82-0.87) and calibration performance with positive predictive values above 5% in the highest risk quantiles at all three study sites. In conclusion, generalizable predictive models of risk for bipolar disorder can be feasibly developed across diverse sites to enable precision medicine. Comparison of a range of machine learning methods indicated that an ensemble approach provides the best performance overall but required local retraining. These models will be disseminated via the PsycheMERGE Network website.
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Affiliation(s)
- Colin G Walsh
- Vanderbilt University Medical Center Health System, Nashville, TN, USA.
| | | | - Yirui Hu
- Geisinger Health System, Danville, PA, USA
| | - Yi-Han Sheu
- Massachusetts General-Brigham Health System, Boston, MA, USA
- Center for Precision Psychiatry, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Hyunjoon Lee
- Vanderbilt University Medical Center Health System, Nashville, TN, USA
| | - Drew Wilimitis
- Vanderbilt University Medical Center Health System, Nashville, TN, USA
| | | | | | - Karmel W Choi
- Massachusetts General-Brigham Health System, Boston, MA, USA
| | - Victor M Castro
- Massachusetts General-Brigham Health System, Boston, MA, USA
| | | | | | - Lea K Davis
- Vanderbilt University Medical Center Health System, Nashville, TN, USA
| | - Jordan W Smoller
- Massachusetts General-Brigham Health System, Boston, MA, USA
- Center for Precision Psychiatry, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
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Iazzolino AM, Valenza M, D’Angelo M, Longobardi G, Stefano VD, Visalli G, Steardo L, Scuderi C, Steardo L. The Impact of Complex PTSD on Suicide Risk in Patients with Bipolar Disorder: A Cross-Sectional Study. J Clin Med 2024; 13:673. [PMID: 38337367 PMCID: PMC10856776 DOI: 10.3390/jcm13030673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 01/17/2024] [Accepted: 01/22/2024] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND Patients with bipolar disorder (BD) are more likely than the general population to experience traumatic events, particularly during childhood, and these may predict and be a risk factor for the development of complex PTSD (cPTSD). The presence of multiple traumas plays a relevant role from a psychopathological point of view, but little is known about the effect this may have on suicide attempts in patients with BD. METHODS A cross-sectional study was conducted comparing socio-demographic and clinical characteristics, recruiting 344 patients diagnosed with BD I and II, screened for the presence (or absence) of cPTSD using the International Trauma Questionnaire (ITQ). Suicide attempts were assessed directly during the clinical interview and from the patient's medical record. RESULTS The results emerging from the study indicate that cPTSD can be considered a risk factor for suicide attempts in patients with BD. Furthermore, evidence is provided to support the idea that cPTSD is highly prevalent in patients with BD and is related to a higher psychopathological burden. CONCLUSIONS The results recommend an urgent and comprehensive assessment of suicidal risk in patients with comorbidity of both bipolar disorder and cPTSD. There is a crucial demand for early intervention initiatives and proactive prevention strategies to address the intricate intersection of these mental health challenges.
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Affiliation(s)
- Anna Maria Iazzolino
- Psychiatry Unit, Department of Health Sciences, University of Catanzaro Magna Graecia, 88100 Catanzaro, Italy; (M.D.); (G.L.); (V.D.S.); (G.V.); (L.S.J.)
| | - Marta Valenza
- Department of Physiology and Pharmacology “Vittorio Erspamer”, Sapienza University of Rome, 00185 Rome, Italy; (M.V.); (L.S.); (C.S.)
| | - Martina D’Angelo
- Psychiatry Unit, Department of Health Sciences, University of Catanzaro Magna Graecia, 88100 Catanzaro, Italy; (M.D.); (G.L.); (V.D.S.); (G.V.); (L.S.J.)
| | - Grazia Longobardi
- Psychiatry Unit, Department of Health Sciences, University of Catanzaro Magna Graecia, 88100 Catanzaro, Italy; (M.D.); (G.L.); (V.D.S.); (G.V.); (L.S.J.)
| | - Valeria Di Stefano
- Psychiatry Unit, Department of Health Sciences, University of Catanzaro Magna Graecia, 88100 Catanzaro, Italy; (M.D.); (G.L.); (V.D.S.); (G.V.); (L.S.J.)
| | - Giulia Visalli
- Psychiatry Unit, Department of Health Sciences, University of Catanzaro Magna Graecia, 88100 Catanzaro, Italy; (M.D.); (G.L.); (V.D.S.); (G.V.); (L.S.J.)
| | - Luca Steardo
- Department of Physiology and Pharmacology “Vittorio Erspamer”, Sapienza University of Rome, 00185 Rome, Italy; (M.V.); (L.S.); (C.S.)
- University Giustino Fortunato, 82100 Benevento, Italy
| | - Caterina Scuderi
- Department of Physiology and Pharmacology “Vittorio Erspamer”, Sapienza University of Rome, 00185 Rome, Italy; (M.V.); (L.S.); (C.S.)
| | - Luca Steardo
- Psychiatry Unit, Department of Health Sciences, University of Catanzaro Magna Graecia, 88100 Catanzaro, Italy; (M.D.); (G.L.); (V.D.S.); (G.V.); (L.S.J.)
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Shuy YK, Santharan S, Chew QH, Sim K. International Trends in Lithium Use for Pharmacotherapy and Clinical Correlates in Bipolar Disorder: A Scoping Review. Brain Sci 2024; 14:102. [PMID: 38275522 PMCID: PMC10813799 DOI: 10.3390/brainsci14010102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 01/17/2024] [Accepted: 01/18/2024] [Indexed: 01/27/2024] Open
Abstract
Lithium remains an effective option in the treatment of bipolar disorder (BD). Thus, we aim to characterize the pharmaco-epidemiological patterns of lithium use internationally over time and elucidate clinical correlates associated with BD using a scoping review, which was conducted using the methodological framework by Arksey and O'Malley (2005). We searched several databases for studies that examined the prescriptions for lithium and clinical associations in BD from inception until December 2023. This review included 55 articles from 1967 to 2023, which collected data from North America (n = 24, 43.6%), Europe (n = 20, 36.4%), and Asia (n = 11, 20.0%). The overall prescription rates ranged from 3.3% to 84% (33.4% before and 30.6% after the median year cutoffs). Over time, there was a decline in lithium use in North America (27.7% before 2010 to 17.1% after 2010) and Europe (36.7% before 2003 to 35.7% after 2003), and a mild increase in Asia (25.0% before 2003 to 26.2% after 2003). Lithium use was associated with specific demographic (e.g., age, male gender) and clinical factors (e.g., lower suicide risk). Overall, we found a trend of declining lithium use internationally, particularly in the West. Specific clinical correlates can support clinical decision-making for continued lithium use.
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Affiliation(s)
- Yao Kang Shuy
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore 308232, Singapore;
| | - Sanjana Santharan
- Department of Emergency and Crisis Care, Institute of Mental Health, Singapore 539747, Singapore;
| | - Qian Hui Chew
- Research Division, Institute of Mental Health, Singapore 539747, Singapore;
| | - Kang Sim
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore 308232, Singapore;
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore
- West Region, Institute of Mental Health, Singapore 539747, Singapore
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Zandifar A, Mousavi S, Schmidt NB, Badrfam R, Seif E, Qorbani M, Mehrabani Natanzi M. Efficacy of vitamins B1 and B6 as an adjunctive therapy to lithium in bipolar-I disorder: A double-blind, randomized, placebo-controlled, clinical trial. J Affect Disord 2024; 345:103-111. [PMID: 37866735 DOI: 10.1016/j.jad.2023.10.121] [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: 02/12/2023] [Revised: 09/08/2023] [Accepted: 10/17/2023] [Indexed: 10/24/2023]
Abstract
BACKGROUND The use of adjunctive therapy for bipolar disorder is increasingly considered to increase the efficacy of standard treatments. In this randomized clinical trial, we evaluated the effect of vitamins B1 and B6 in separate treatment arms on mood symptoms, cognitive status, and sleep quality in hospitalized patients with bipolar disorder in manic episodes. METHOD In addition to receiving standard lithium treatment, participants (N = 66) were randomized to one of three conditions: 100 mg of vitamin B1, 40 mg of vitamin B6, or placebo. Outcomes were assessed one and 8 weeks of daily treatment, including the Young Mania Rating Scale (YMRS), Pittsburgh Sleep Quality Scale (PSQI), and Mini-Mental State Examination (MMSE). This study was performed between December 2020 and September 2021 based on the registration code number IRCT20200307046712N1. RESULTS Vitamin B6 had a significant effect (P value < 0.025 as significant) on mood improvement compared to placebo (F (1, 27.42) = 30.25, P < 0.001, r = 0.72), but vitamin B1 had no significant effect on mood improvement compared to Placebo (F (1/35.68) = 4.76, P = 0.036, r = 0.34). The contrasts between groups on PSQI showed a significant effect (P value < 0.025 as significant) of vitamin B6 over placebo for sleep status improvement (F (1/32.91) = 16.24, P < 0.001, r = 0.57) and also a significant effect of vitamin B1 over placebo (F (1/41.21) = 13.32, P < 0.001, r = 0.49). CONCLUSIONS The use of vitamin B6 as an adjunctive therapy to lithium can be associated with the improvement of mood symptoms in patients with bipolar disorder in the midst of a manic episode.
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Affiliation(s)
- Atefeh Zandifar
- Department of Psychiatry, Imam Hossein Hospital, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran; Social Determinants of Health Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Shaghayegh Mousavi
- Research Committee, Alborz University of Medical Sciences, Karaj, Alborz, Iran
| | | | - Rahim Badrfam
- Department of Psychiatry, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran.
| | - Ehsan Seif
- Research Committee, Alborz University of Medical Sciences, Karaj, Alborz, Iran
| | - Mostafa Qorbani
- Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran; Chronic Diseases Research Center, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahboobeh Mehrabani Natanzi
- Evidence-BASED Phytotherapy and Complementary Medicine Research Center, Alborz University of Medical Sciences, Karaj, Iran
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Samamé C. What do psychiatrists do with hypotheses proven false? The case of neuroprogression in bipolar disorders. Psychol Med 2024; 54:41-42. [PMID: 37947198 DOI: 10.1017/s0033291723003318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2023]
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Messedi M, Makni-Ayadi F. 24S-Hydroxycholesterol in Neuropsychiatric Diseases: Schizophrenia, Autism Spectrum Disorder, and Bipolar Disorder. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2024; 1440:293-304. [PMID: 38036886 DOI: 10.1007/978-3-031-43883-7_15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/02/2023]
Abstract
Neuropsychiatric diseases (NPDs) are severe, debilitating psychiatric conditions that affect the nervous system. These are among the most challenging disorders in medicine. Some examples include Alzheimer's, anxiety disorders, autism spectrum disorder, bipolar disorder, and schizophrenia. NPDs represent an ever-increasing burden on public health and are prevalent throughout the world. For most of these diseases, the particular etiopathogeneses are still enigmatic. NPDs are also associated with structural and functional changes in the brain, along with altered neurotransmitter and neuroendocrine systems.Approximately 25% of the total human body cholesterol is located in the brain. Its involvement in neuronal functions starts in the early growth stages and remains important throughout adulthood. It is also an integral part of the neuronal membrane, ensuring membrane lipid organization and regulating membrane fluidity. The main mechanism for removing cholesterol from the brain is cholesterol 24-hydroxylation by cytochrome P450 46A1 (CYP46A1), an enzyme specifically found in the central nervous system. Although research on 24S-OHC and its role in neuropsychiatric diseases is still in its early stages, this oxidized cholesterol metabolite is thought to play a crucial role in the etiology of NPDs. 24S-OHC can affect neurons, astrocytes, oligodendrocytes, and vascular cells. In addition to regulating the homeostasis of cholesterol in the brain, this oxysterol is involved in neurotransmission, oxidative stress, and inflammation. The role of 24S-OHC in NPDs has been found to be controversial in terms of the findings so far. There are several intriguing discrepancies in the data gathered so far regarding 24S-OHC and NPDs. In fact, 24S-OHC levels were reported to have decreased in a number of NPDs and increased in others.Hence, in this chapter, we first summarize the available data regarding 24S-OHC as a biomarker in NPDs, including schizophrenia, autism spectrum disorder, and bipolar disorder. Then, we present a brief synopsis of the pharmacological targeting of 24S-OHC levels through the modulation of CYP46A1 activity.
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Affiliation(s)
- Meriam Messedi
- Research Laboratory "Molecular Basis of Human Diseases", LR19ES13, Sfax Medicine School, University of Sfax, Sfax, Tunisia
| | - Fatma Makni-Ayadi
- Research Laboratory "Molecular Basis of Human Diseases", LR19ES13, Sfax Medicine School, University of Sfax, Sfax, Tunisia
- Department of Clinical biochemistry, Habib Bourguiba Hospital, Sfax, Tunisia
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47
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Hsu CW, Chou PH, Brunoni AR, Hung KC, Tseng PT, Liang CS, Carvalho AF, Vieta E, Tu YK, Lin PY, Chu CS, Hsu TW, Chen YCB, Li CT. Comparing different non-invasive brain stimulation interventions for bipolar depression treatment: A network meta-analysis of randomized controlled trials. Neurosci Biobehav Rev 2024; 156:105483. [PMID: 38056187 DOI: 10.1016/j.neubiorev.2023.105483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Revised: 11/04/2023] [Accepted: 11/24/2023] [Indexed: 12/08/2023]
Abstract
Non-invasive brain stimulation (NIBS) is a promising treatment for bipolar depression. We systematically searched for randomized controlled trials on NIBS for treating bipolar depression (INPLASY No: 202340019). Eighteen articles (N = 617) were eligible for network meta-analysis. Effect sizes were reported as standardized mean differences (SMDs) or odds ratios (ORs) with 95% confidence intervals (CIs). Anodal transcranial direct current stimulation over F3 plus cathodal transcranial direct current stimulation over F4 (a-tDCS-F3 +c-tDCS-F4; SMD = -1.18, 95%CIs = -1.66 to -0.69, N = 77), high-definition tDCS over F3 (HD-tDCS-F3; -1.17, -2.00 to -0.35, 25), high frequency deep transcranial magnetic stimulation (HF-dTMS; -0.81, -1.62 to -0.001, 25), and high frequency repetitive TMS over F3 plus low frequency repetitive TMS over F4 (HF-rTMS-F3 +LF-rTMS-F4; -0.77, -1.43 to -0.11, 38) significantly improved depressive symptoms compared to sham controls. Only a-tDCS-F3 +c-tDCS-F4 (OR = 4.53, 95%CIs = 1.51-13.65) and HF-rTMS-F3 +LF-rTMS-F4 (4.69, 1.02-21.56) showed higher response rates. No active NIBS interventions exhibited significant differences in dropout or side effect rates, compared with sham controls.
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Affiliation(s)
- Chih-Wei Hsu
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Po-Han Chou
- Dr. Chou's Mental Health Clinic; Department of Psychiatry, China Medical University Hsinchu Hospital, China Medical University, Hsinchu, Taiwan
| | - Andre R Brunoni
- Service of Interdisciplinary Neuromodulation, National Institute of Biomarkers in Psychiatry, Laboratory of Neurosciences (LIM-27), Departamento e Instituto de Psiquiatria, Faculdade de Medicina da University of Sao Paulo, Sao Paulo, Brazil; Departamento de Ciências Médicas, Faculdade de Medicina da University of Sao Paulo, Sao Paulo, Brazil
| | - Kuo-Chuan Hung
- Department of Anesthesiology, Chi Mei Medical Center, Tainan, Taiwan
| | - Ping-Tao Tseng
- Department of Psychology, College of Medical and Health Science, Asia University, Taichung, Taiwan; Prospect Clinic for Otorhinolaryngology & Neurology, Kaohsiung, Taiwan; Institute of Biomedical Sciences, National Sun Yat-sen University, Kaohsiung, Taiwan; Institute of Precision Medicine, National Sun Yat-sen University, Kaohsiung City, Taiwan
| | - Chih-Sung Liang
- Department of Psychiatry, Beitou Branch, Tri-Service General Hospital; School of Medicine, National Defense Medical Center, Taipei, Taiwan; Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan
| | - Andre F Carvalho
- Innovation in Mental and Physical Health and Clinical Treatment (IMPACT) Strategic Research Centre, School of Medicine, Barwon Health, Deakin University, Geelong, VIC, Australia
| | - Eduard Vieta
- Bipolar and Depressive Disorders Unit, Hospital Clinic, IDIBAPS, CIBERSAM, University of Barcelona, Barcelona, Catalonia, Spain
| | - Yu-Kang Tu
- Institute of Health Data Analytics & Statistics, College of Public Health, National Taiwan University, Taipei, Taiwan; Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan
| | - Pao-Yen Lin
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Che-Sheng Chu
- Center for Geriatric and Gerontology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Tien-Wei Hsu
- Department of Psychiatry, E-Da Dachang Hospital, I-Shou University, Kaohsiung, Taiwan; Department of Psychiatry, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan
| | - Yang-Chieh Brian Chen
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
| | - Cheng-Ta Li
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Division of Psychiatry, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Institute of Brain Science and Brain Research Center, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
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Wu J, Qi S, Yu W, Gao Y, Ma J. Regional Homogeneity of the Left Posterior Cingulate Gyrus May Be a Potential Imaging Biomarker of Manic Episodes in First-Episode, Drug-Naive Bipolar Disorder. Neuropsychiatr Dis Treat 2023; 19:2775-2785. [PMID: 38106358 PMCID: PMC10725752 DOI: 10.2147/ndt.s441021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 12/07/2023] [Indexed: 12/19/2023] Open
Abstract
Introduction Abnormal brain networks with emotional response in bipolar disorder (BD). However, there have been few studies on the local consistency between manic episodes in drug-naive first-episode BD patients and healthy controls (HCs). The purpose of this study is to evaluate the utility of neural activity values analyzed by Regional Homogeneity (ReHo). Methods Thirty-seven manic episodes in first-episode, drug-naive BD patients and 37 HCs participated in resting-state functional magnetic resonance rescanning and scale estimation. Reho and receiver operating characteristic (ROC) curve methods were used to analyze the imaging data. Support vector machine (SVM) method was used to analyze ReHo in different brain regions. Results Compared to HCs, ReHo increased in the left middle temporal gyrus (MTG.L), posterior cingulate gyrus (PCG), inferior parietal gyrus, and bilateral angular gyrus, and decreased in the left dorsolateral superior frontal gyrus in target group. The ROC results showed that the ReHo value of the left PCG could discriminate the target group from the HCs, and the AUC was 0.8766. In addition, the results of the support vector machine show that the increase in ReHo value in the left PCG can effectively discriminate the patients from the controls, with accuracy, sensitivity, and specificity of 86.02%, 86.49%, and 81.08%, respectively. Conclusion The increased activity of the left PCG may contribute new evidence of participation in the pathophysiology of manic episodes in first-episode, drug-naive BD patients. The Reho value of the left posterior cingulate gyrus may be a potential neuroimaging biomarker to discriminate target group from HCs.
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Affiliation(s)
- Jiajia Wu
- Department of Psychiatry, Wuhan Mental Health Center, Wuhan, People’s Republic of China
- Wuhan Hospital for Psychotherapy, Wuhan, People’s Republic of China
| | - Shuangyu Qi
- Department of Psychiatry, Wuhan Mental Health Center, Wuhan, People’s Republic of China
- Wuhan Hospital for Psychotherapy, Wuhan, People’s Republic of China
| | - Wei Yu
- Department of Psychiatry, Xianning Bode Mental Hospital, Xianning, People’s Republic of China
| | - Yujun Gao
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, People’s Republic of China
| | - Jun Ma
- Department of Psychiatry, Wuhan Mental Health Center, Wuhan, People’s Republic of China
- Wuhan Hospital for Psychotherapy, Wuhan, People’s Republic of China
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, People’s Republic of China
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Wilkowska A, Cubała WJ. Short-term ketamine use in bipolar depression: a review of the evidence for short-term treatment management. Front Psychiatry 2023; 14:1322752. [PMID: 38144471 PMCID: PMC10739517 DOI: 10.3389/fpsyt.2023.1322752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 11/27/2023] [Indexed: 12/26/2023] Open
Abstract
Bipolar depression constitutes a major problem in psychiatry. It correlates with high suicidality, treatment resistance, chronicity, and poor quality of life. Registered treatment for bipolar depression is limited and insufficient. There is an urgent need for implementing new therapeutic strategies. Intranasal ketamine's enantiomer-esketamine is a novel rapid-acting antidepressant with proven efficacy in treatment-resistant depression. Research on bipolar depression, although not as comprehensive, indicates that it may be a viable and safe substitute with minimal risk for mood polarity changes. Reports suggest that ketamine treatment in bipolar depression may reduce suicidal tendencies, decrease anhedonia, and alleviate anxiety. Ketamine's mood-stabilizing properties are also hypothesized. In this narrative review, we focus on ketamine use as an add-on to standard medication for the acute treatment of bipolar depression.
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Affiliation(s)
- Alina Wilkowska
- Department of Psychiatry, Faculty of Medicine, Medical University of Gdańsk, Gdańsk, Poland
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Muriel NS, López Resa P, Moraleda Sepúlveda E. Linguistic characteristics in bipolar disorder versus borderline personality disorder. Sci Rep 2023; 13:21715. [PMID: 38065986 PMCID: PMC10709396 DOI: 10.1038/s41598-023-46038-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 10/26/2023] [Indexed: 12/18/2023] Open
Abstract
Scientific evidence has documented throughout the research carried out in recent years, the neuropsychological, behavioral and adaptive difficulties presented by people with Bipolar Disorder and Borderline Personality Disorder at different stages of their development. However, little importance has been given to other factors such as communication, especially in the adult population. The objective of this research was to know the language characteristics presented by people from both groups and the differences in linguistic development. The sample consisted of 60 participants between the ages of 17 and 42:31 of them with a diagnosis of Borderline Personality Disorder and the remaining 29 with a diagnosis of Bipolar Disorder. The standardized evaluation instruments were: the Social Skills Scale and the Pragmatic Competence Questionnaire completed by three different informants (families, professionals and the own person). The results obtained show that both populations manifest linguistic difficulties in adulthood and that there are differences depending on the perception of the agent involved in the language assessment. These results are highly relevant since they provide up-to-date information about language level, support the need for language intervention in adulthood, and reflect a different communicative profile in Bipolar Disorder and Borderline Personality Disorder.
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Affiliation(s)
- Noelia Santos Muriel
- Department of Psychology, Faculty of Health Sciences, University of Castilla-La-Mancha, Avda Real Fábrica de la Seda s/n, 45600, Talavera de la Reina, Spain
| | - Patricia López Resa
- Department of Psychology, Faculty of Health Sciences, University of Castilla-La-Mancha, Avda Real Fábrica de la Seda s/n, 45600, Talavera de la Reina, Spain
| | - Esther Moraleda Sepúlveda
- Department of Psychology, Faculty of Pychology, University Complutense, Campus de Somosaguas, 28223, Pozuelo de Alarcón, Madrid, Spain.
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