Hormonal level and serum serotonin in patients with first episode mania: a case–control study

Efficacy of vitamins B1 and B6 as an adjunctive therapy to lithium in bipolar-I disorder: A double-blind, randomized, placebo-controlled, clinical trial

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.

Explainable Gated Recurrent Unit to explore the effect of co-exposure to multiple air pollutants and meteorological conditions on mental health outcomes

Mental health conditions have the potential to be worsened by air pollution or other climate-sensitive factors. Few studies have empirically examined those associations when we faced to co-exposures, as well as interaction effects. There would be an urgent need to use deep learning to handle complex co-exposures that might interact in multiple ways, and the model performance reinforced by SHapely Additive exPlanations (SHAP) enabled our predictions interpretable and hence actionable. Here, to evaluate the mixed effect of short-term co-exposure, we conducted a time-series analysis using approximately 1.47 million hospital outpatient visits of mental disorders (i.e., depressive disorder-DD, Schizophrenia-SP, Anxiety Disorder-AD, Bipolar Disorder-BD, Attention Deficit and Hyperactivity Disorder-ADHD, Autism Spectrum Disorder-ASD), with matched meteorological observations from 2015 through 2019 in Nanjing, China. The global insights of gated recurrent unit model revealed that most of input features with similar effect size caused the illness risk of SP and ASD increase, and most markedly, 73% of relative humidity, 44.6 µg/m³ of NO₂, and 14.1 µg/m³ of SO₂ at 5-year average level associated with 2.27, 1.14, and 1.29 visits increase for DD, SP, and AD, respectively. Both synergic and antagonistic effect among informative paired-features were distinguished from local feature dependence. Interestingly, variation tendencies of excessive visits of bipolar disorder when atmospheric pressure, PM_2.5, and O₃ interacted with one another were inconsistent. Our results provided added qualitative and quantitative support for the conclusion that short-term co-exposure to ambient air pollutants and meteorological conditions posed threats to human mental health.

Activation of SIRT-1 Signalling in the Prevention of Bipolar Disorder and Related Neurocomplications: Target Activators and Influences on Neurological Dysfunctions

SIRT-1 (silent mating-type information regulation 2 homolog-1) is a protein found in neuronal nuclei, microglia, and astrocyte cells of the brain. It is sometimes referred to as NAD + -dependent deacetylase (nicotinamide adenine dinucleotide). The activation of sirtuins (SIRT-1-7) has been shown to protect against a wide range of disorders, including neurodegenerative and neuropsychiatric disorders. SIRT-1 has gained considerable interest from these families because of its early link to long-life expansion and calorie restriction involvement. SIRT-1 is necessary for gene silencing, cell cycle regulation, fat and glucose metabolism, oxidative stress, ageing, and memory formation. In this review, we investigate the role of SIRT-1 downregulation in the progression of bipolar disorder (BD) and neurological abnormalities, as well as related neurological alterations such as genetic dysfunction, neurotransmitter imbalance, oxidative stress-induced apoptosis, and mitochondrial dysfunction. BD is a psychiatric disease distinguished by extreme mood fluctuations that range from depressive lows to manic highs. BD is a complicated disorder with numerous clinical signs and neurocomplications that produce significant behavioural problems. SIRT-1 deficiency in the brain has been demonstrated to affect the activity of its transcription factors and molecular changes, including genetic defects. SIRT-1 is now being studied as a potential therapeutic target for a range of brain disorders. A recent study also found that activating SIRT-1 signalling performs a protective effect in avoiding depression and mania-like behaviours. Furthermore, this review investigates the potential mechanisms by which SIRT-1 regulates neuronal transmission and neurogenesis. As a result of our review, we revealed that SIRT-1 activators have neuroprotective potential in BD and related neurological dysfunctions.