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Lotfaliany M, Agustini B, Walker AJ, Turner A, Wrobel AL, Williams LJ, Dean OM, Miles S, Rossell SL, Berk M, Mohebbi M. Development of a harmonized sociodemographic and clinical questionnaire for mental health research: A Delphi-method-based consensus recommendation. Aust N Z J Psychiatry 2024; 58:656-667. [PMID: 38845137 PMCID: PMC11308274 DOI: 10.1177/00048674241253452] [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: 08/07/2024]
Abstract
OBJECTIVE Harmonized tools are essential for reliable data sharing and accurate identification of relevant factors in mental health research. The primary objective of this study was to create a harmonized questionnaire to collect demographic, clinical and behavioral data in diverse clinical trials in adult psychiatry. METHODS We conducted a literature review and examined 24 questionnaires used in previously published randomized controlled trials in psychiatry, identifying a total of 27 domains previously explored. Using a Delphi-method process, a task force team comprising experts in psychiatry, epidemiology and statistics selected 15 essential domains for inclusion in the final questionnaire. RESULTS The final selection resulted in a concise set of 22 questions. These questions cover factors such as age, sex, gender, ancestry, education, living arrangement, employment status, home location, relationship status, and history of medical and mental illness. Behavioral factors like physical activity, diet, smoking, alcohol and illicit drug use were also included, along with one question addressing family history of mental illness. Income was excluded due to high confounding and redundancy, while language was included as a measure of migration status. CONCLUSION The recommendation and adoption of this harmonized tool for the assessment of demographic, clinical and behavioral data in mental health research can enhance data consistency and enable comparability across clinical trials.
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Affiliation(s)
- Mojtaba Lotfaliany
- Deakin University, School of Medicine, IMPACT, The Institute for Mental and Physical Health and Clinical Translation, Geelong, Australia
| | - Bruno Agustini
- Deakin University, School of Medicine, IMPACT, The Institute for Mental and Physical Health and Clinical Translation, Geelong, Australia
| | - Adam J Walker
- Deakin University, School of Medicine, IMPACT, The Institute for Mental and Physical Health and Clinical Translation, Geelong, Australia
| | - Alyna Turner
- Deakin University, School of Medicine, IMPACT, The Institute for Mental and Physical Health and Clinical Translation, Geelong, Australia
| | - Anna L Wrobel
- Deakin University, School of Medicine, IMPACT, The Institute for Mental and Physical Health and Clinical Translation, Geelong, Australia
- School of Psychology, Deakin University, Geelong, VIC, Australia
| | - Lana J Williams
- Deakin University, School of Medicine, IMPACT, The Institute for Mental and Physical Health and Clinical Translation, Geelong, Australia
| | - Olivia M Dean
- Deakin University, School of Medicine, IMPACT, The Institute for Mental and Physical Health and Clinical Translation, Geelong, Australia
- Florey Institute for Neuroscience & Mental Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Stephanie Miles
- Orygen, Parkville, VIC, Australia
- Department of Psychological Sciences, Swinburne University of Technology, Hawthorn, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Susan L Rossell
- Centre for Mental Health, Swinburne University of Technology, Melbourne, VIC, Australia
- Psychiatry, St Vincent’s Hospital, Melbourne, VIC, Australia
| | - Michael Berk
- Deakin University, School of Medicine, IMPACT, The Institute for Mental and Physical Health and Clinical Translation, Geelong, Australia
- Florey Institute for Neuroscience & Mental Health, The University of Melbourne, Melbourne, VIC, Australia
- Orygen, Parkville, VIC, Australia
- Department of Psychiatry, The University of Melbourne, Melbourne, VIC, Australia
| | - Mohammadreza Mohebbi
- Biostatistics Unit, Faculty of Health, Deakin University, Burwood, VIC, Australia
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Bozzatello P, Novelli R, Montemagni C, Rocca P, Bellino S. Nutraceuticals in Psychiatric Disorders: A Systematic Review. Int J Mol Sci 2024; 25:4824. [PMID: 38732043 PMCID: PMC11084672 DOI: 10.3390/ijms25094824] [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: 04/04/2024] [Revised: 04/23/2024] [Accepted: 04/25/2024] [Indexed: 05/13/2024] Open
Abstract
Correct nutrition and diet are directly correlated with mental health, functions of the immune system, and gut microbiota composition. Diets with a high content of some nutrients, such as fibers, phytochemicals, and short-chain fatty acids (omega-3 fatty acids), seem to have an anti-inflammatory and protective action on the nervous system. Among nutraceuticals, supplementation of probiotics and omega-3 fatty acids plays a role in improving symptoms of several mental disorders. In this review, we collect data on the efficacy of nutraceuticals in patients with schizophrenia, autism spectrum disorders, major depression, bipolar disorder, and personality disorders. This narrative review aims to provide an overview of recent evidence obtained on this topic, pointing out the direction for future research.
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Affiliation(s)
- Paola Bozzatello
- Department of Neuroscience, University of Turin, Via Cherasco 15, 10126 Turin, Italy; (R.N.); (C.M.); (P.R.); (S.B.)
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Sarmiento A, Dean OM, Kavanagh BE, Mohebbi M, Berk M, Dodd S, Cotton SM, Malhi GS, Ng CH, Turner A. The Influence of Personality Disorder Symptoms on Treatment Outcomes in Bipolar Disorder: A Secondary Analysis of a Randomised Controlled Trial: L'influence des symptômes du trouble de la personnalité sur les résultats du traitement dans le trouble bipolaire : Une analyse secondaire d'un essai randomisé contrôlé. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2024; 69:275-287. [PMID: 37964558 PMCID: PMC10924579 DOI: 10.1177/07067437231213558] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2023]
Abstract
OBJECTIVES Many people who are diagnosed with bipolar disorder also have comorbid personality disorder. Few studies have explored how personality disorder may influence pharmacological treatment outcomes. The aim of this study was to conduct a secondary analysis of data from a clinical trial of adjunctive nutraceutical treatments for bipolar depression, to determine whether maladaptive personality traits influence treatment outcomes. METHODS Scores on the Standardised Assessment of Personality - Abbreviated Scale screener were used to classify participants as having bipolar disorder with (n = 119) and without (n = 29) above threshold personality disorder symptoms (personality disorder). Outcome measures included: The Montgomery Åsberg Depression Rating Scale, Clinical Global Impressions and Improvement Severity Scales, Patient Global Impressions-Improvement scale, Bipolar Depression Rating Scale, Range of Impaired Functioning Tool, Social and Occupational Functioning Assessment Scale and Quality of Life and Enjoyment Scale (Quality of Life Enjoyment and Satisfaction Questionnaire-Short Form). Generalised estimated equations examined the two-way interactions of personality disorder by time or treatment and investigated personality disorder as a non-specified predictor of outcomes. RESULTS Over time, the Patient Global Impressions-Improvement scores were significantly higher in those in the personality disorder group. No other significant differences in the two-way interactions of personality disorder by treatment group or personality disorder by time were found. Personality disorder was a significant but non-specific predictor of poorer outcomes on the Bipolar Depression Rating Scale, Range of Impaired Functioning Tool, and Quality of Life Enjoyment and Satisfaction Questionnaire-Short Form, regardless of time or treatment group. CONCLUSIONS This study highlights the potential impact of maladaptive personality traits on treatment outcomes and suggests that the presence of comorbid personality disorder may confer additional burden and compromise treatment outcomes. This warrants further investigation as does the corroboration of these exploratory findings. This is important because understanding the impact of comorbid personality disorder on bipolar disorder may enable the development of effective psychological and pharmacotherapeutic options for personalised treatments.
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Affiliation(s)
- Alessandra Sarmiento
- IMPACT – The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Deakin University, Geelong, VIC, Australia
| | - Olivia M. Dean
- IMPACT – The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Deakin University, Geelong, VIC, Australia
- Florey Institute for Neuroscience and Mental Health, University of Melbourne, Parkville, VIC, Australia
| | - Bianca E. Kavanagh
- IMPACT – The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Deakin University, Geelong, VIC, Australia
- Deakin Rural Health, Deakin University, Warrnambool, VIC, Australia
| | - Mohammadreza Mohebbi
- Faculty of Health, Biostatistics Unit, Deakin University, Geelong, VIC, Australia
| | - Michael Berk
- IMPACT – The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Deakin University, Geelong, VIC, Australia
- Florey Institute for Neuroscience and Mental Health, University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, Australia
| | - Seetal Dodd
- IMPACT – The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Deakin University, Geelong, VIC, Australia
- Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, Australia
| | - Sue M. Cotton
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, Australia
| | - Gin S. Malhi
- Academic Department of Psychiatry, Kolling Institute, Northern Clinical School, Faculty of Medicine and Health, The University of Sydney, NSW, Australia
- CADE Clinic, Royal North Shore Hospital, Northern Sydney Local Health District, NSW, Australia
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Chee H. Ng
- Professorial Unit, The Melbourne Clinic, Department of Psychiatry, The University of Melbourne, Richmond, VIC, Australia
| | - Alyna Turner
- IMPACT – The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Deakin University, Geelong, VIC, Australia
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Hoogervorst MM, van Meijel B, Bruin EKD, Beekman A, Boonstra N, Adriaanse M. The nurse-led GILL eHealth intervention for improving physical health and lifestyle behaviours in clients with severe mental illness: design of a cluster-randomised controlled trial. BMC Psychiatry 2023; 23:672. [PMID: 37715156 PMCID: PMC10504705 DOI: 10.1186/s12888-023-05024-z] [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: 05/22/2023] [Accepted: 07/13/2023] [Indexed: 09/17/2023] Open
Abstract
BACKGROUND Clients with severe mental illness (SMI) have overall poor physical health. SMI reduces life expectancy by 5-17 years, primarily due to physical comorbidity linked to cardiometabolic risks that are mainly driven by unhealthy lifestyle behaviours. To improve physical health in clients with SMI, key elements are systematic somatic screening and lifestyle promotion. The nurse-led GILL eHealth was developed for somatic screening and the implementation of lifestyle activities in clients with SMI. Aims of this study are to evaluate the effectiveness of the GILL eHealth intervention in clients with SMI compared to usual care, and to evaluate the implementation process, and the experiences of clients and healthcare providers with GILL eHealth. METHODS The GILL study encompasses a cluster-randomised controlled trial in approximately 20 mental health care facilities in the Netherlands. The randomisation takes place at the team level, assigning clients to the eHealth intervention or the usual care group. The GILL eHealth intervention consists of two complementary modules for somatic screening and lifestyle promotion, resulting in personalised somatic treatment and lifestyle plans. Trained mental health nurses and nurse practitioners will implement the intervention within the multidisciplinary treatment context, and will guide and support the participants in promoting their physical health, including cardiometabolic risk management. Usual care includes treatment as currently delivered, with national guidelines as frame of reference. We aim to include 258 clients with SMI and a BMI of 27 or higher. Primary outcome is the metabolic syndrome severity score. Secondary outcomes are physical health measurements and participants' reports on physical activity, perceived lifestyle behaviours, quality of life, recovery, psychosocial functioning, and health-related self-efficacy. Measurements will be completed at baseline and at 6 and 12 months. A qualitative process evaluation will be conducted alongside, to evaluate the process of implementation and the experiences of clients and healthcare professionals with GILL eHealth. DISCUSSION The GILL eHealth intervention is expected to be more effective than usual care in improving physical health and lifestyle behaviours among clients with SMI. It will also provide important information on implementation of GILL eHealth in mental health care. If proven effective, GILL eHealth offers a clinically useful tool to improve physical health and lifestyle behaviours. TRIAL REGISTRATION Clinical trial registration NCT05533749, registration date: 8 September 2022.
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Affiliation(s)
- Meike M Hoogervorst
- Department of Psychiatry, Amsterdam UMC and Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.
| | - Berno van Meijel
- Department of Psychiatry, Amsterdam UMC and Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
- Department of Health, Sports and Welfare, Inholland University of Applied Sciences, Amsterdam, The Netherlands
- Parnassia Psychiatric Institute, Parnassia Academy, The Hague, The Netherlands
| | - Esther Krijnen-de Bruin
- Department of Health, Sports and Welfare, Inholland University of Applied Sciences, Amsterdam, The Netherlands
| | - Aartjan Beekman
- Department of Psychiatry, Amsterdam UMC and Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Nynke Boonstra
- Department of Psychiatry, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
- NHL Stenden, University of Applied Sciences, Leeuwarden, The Netherlands
- KieN VIP Mental Health Care Services, Leeuwarden, The Netherlands
| | - Marcel Adriaanse
- Department of Health Sciences, Vrije Universiteit Amsterdam and Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
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Lafer B, Duarte CC, Greve JMD, Dos Santos Silva PR, de Almeida KM, Belizario GO, Neves LM. Structured physical exercise for bipolar depression: an open-label, proof-of concept study. Int J Bipolar Disord 2023; 11:14. [PMID: 37085592 PMCID: PMC10121991 DOI: 10.1186/s40345-023-00294-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Accepted: 04/05/2023] [Indexed: 04/23/2023] Open
Abstract
BACKGROUND Physical exercise (PE) is a recommended lifestyle intervention for different mental disorders and has shown specific positive therapeutic effects in unipolar depressive disorder. Considering the similar symptomatology of the depressive phase in patients with bipolar disorder (BD) and unipolar depressive disorder, it is reasonable to suggest that PE may also be beneficial for bipolar depression. However, there is an absence of studies evaluating the antidepressant effect of a structured PE intervention in BD. METHODS This is an open-label, single-arm study trial. Fifteen patients with a diagnosis of BD Type I or Type II, presenting a depressive episode were included in the study. After physical and functional evaluation, patients participated in supervised training sessions with aerobics followed by strength exercises, three times per week, for 12 weeks (36 training sessions). Depressive and manic symptoms were assessed at baseline and 2, 4, 8, and 12 weeks. Additionally, quality of Life and functioning were assessed at baseline and 4, 8, and 12 weeks). Finally, we tested cardiorespiratory fitness, muscle strength and body composition at baseline and week-12. RESULTS The mean (± SD) Montgomery Asberg Depression Rating Scale (MADRS) score at baseline was 23.6 ± 8.3 points and after 12 weeks of PE the mean score was 10.2 ± 4.8 points. Nine patients (82%) presented an antidepressant response defined as a reduction of more than 50% of depressive symptoms at week 12 with five of those patients (45%) presenting criteria for full remission. A large and significant Cohen's D Effect Size (pre-post) was verified for MADRS reduction [1.98 (95% Confidence interval = 0.88 to 3.08)]. We did not detect a significant change in manic symptoms, functioning, and quality of life during the 12-week follow-up. At week-12, all patients increased their muscular strength (one repetition maximal test - 1RM) and reduced the percentage of body fat (spectral bioelectrical impedance analysis). CONCLUSIONS This study, using rigorous criteria and a structured intervention, provides valid pilot data, showing the feasibility of a structured PE intervention for the treatment of depressive symptoms in BD, and suggesting a potential adjunctive antidepressant effect. Moreover, PE showed a positive impact on muscle strength and body composition. This should be further verified by randomized controlled studies.
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Affiliation(s)
- Beny Lafer
- Bipolar Disorder Program (PROMAN), Department of Psychiatry, University of São Paulo Medical School, Rua Dr. Ovídio Pires de Campos, 785, São Paulo, Brazil.
| | - Cicera Claudinea Duarte
- Bipolar Disorder Program (PROMAN), Department of Psychiatry, University of São Paulo Medical School, Rua Dr. Ovídio Pires de Campos, 785, São Paulo, Brazil
| | - Julia Maria D'Andrea Greve
- Movement Studies Laboratory, Department of Orthopedics and Traumatology, University of São Paulo Medical School, São Paulo, Brazil
| | - Paulo Roberto Dos Santos Silva
- Movement Studies Laboratory, Department of Orthopedics and Traumatology, University of São Paulo Medical School, São Paulo, Brazil
| | - Karla Mathias de Almeida
- Bipolar Disorder Program (PROMAN), Department of Psychiatry, University of São Paulo Medical School, Rua Dr. Ovídio Pires de Campos, 785, São Paulo, Brazil
| | - Gabriel Okawa Belizario
- Bipolar Disorder Program (PROMAN), Department of Psychiatry, University of São Paulo Medical School, Rua Dr. Ovídio Pires de Campos, 785, São Paulo, Brazil
| | - Lucas Melo Neves
- Bipolar Disorder Program (PROMAN), Department of Psychiatry, University of São Paulo Medical School, Rua Dr. Ovídio Pires de Campos, 785, São Paulo, Brazil
- Post-graduate Program in Health Sciences, Santo Amaro University, São Paulo, Brazil
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Falkai P, Schmitt A, Rosenbeiger CP, Maurus I, Hattenkofer L, Hasan A, Malchow B, Heim-Ohmayer P, Halle M, Heitkamp M. Aerobic exercise in severe mental illness: requirements from the perspective of sports medicine. Eur Arch Psychiatry Clin Neurosci 2022; 272:643-677. [PMID: 34873635 PMCID: PMC9095557 DOI: 10.1007/s00406-021-01360-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 11/24/2021] [Indexed: 12/21/2022]
Abstract
Major depression, bipolar disorder, and schizophrenia are severe mental illnesses. Despite receiving psychopharmacological and psychosocial treatments, about half of patients develop a chronic course with residual cognitive and negative symptoms and have a high risk for cardiovascular disease and reduced life expectancy. Therefore, add-on innovative treatment approaches are needed to improve outcome. Aerobic exercise interventions have been shown to improve global functioning, cognition, and negative and depressive symptoms in these patients. The basic mechanism of these exercise-related changes has been reported to be improved brain plasticity, e.g., increased volume of disease-related brain regions such as the hippocampus. The optimal type, duration, and frequency of exercise have not yet been determined and need to be addressed in supervised physical exercise studies. Because of the low physical activity levels, lack of drive related to negative and depressive symptoms, and high prevalence of cardiovascular comorbidities in patients with severe mental illness, besides aiming to improve symptoms of mental illness, exercise interventions should also aim to increase cardiorespiratory fitness, which they should comprehensively assess by direct measurements of maximal oxygen uptake. Based on the recommendations for developing cardiorespiratory fitness by the American College of Sports Medicine, 150 min moderate-intensity training per week or vigorous-intensity exercise training for 75 min per week are appropriate. Most studies have had relatively short intervention periods, so future studies should focus on long-term adherence to exercise by implementing motivational strategies supported by telemedicine and by identifying and targeting typical barriers to exercise in this patient population.
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Affiliation(s)
- Peter Falkai
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Nussbaumstrasse 7, 80336 Munich, Germany
| | - Andrea Schmitt
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Nussbaumstrasse 7, 80336 Munich, Germany ,Laboratory of Neuroscience (LIM27), Institute of Psychiatry, University of São Paulo, São Paulo, Brazil
| | - Christian P. Rosenbeiger
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Nussbaumstrasse 7, 80336 Munich, Germany
| | - Isabel Maurus
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Nussbaumstrasse 7, 80336, Munich, Germany.
| | - Lisa Hattenkofer
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Nussbaumstrasse 7, 80336 Munich, Germany
| | - Alkomiet Hasan
- Department of Psychiatry and Psychosomatics of the University Augsburg, Medical Faculty, Bezirkskrankenhaus Augsburg, University of Augsburg, Augsburg, Germany
| | - Berend Malchow
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Von-Siebold-Str. 5, 37075 Göttingen, Germany
| | - Pascale Heim-Ohmayer
- Department of Prevention and Sports Medicine, Medical Faculty, Technical University of Munich, University Hospital ‘Klinikum Rechts der Isar’, Munich, Germany
| | - Martin Halle
- Department of Prevention and Sports Medicine, Medical Faculty, Technical University of Munich, University Hospital ‘Klinikum Rechts der Isar’, Munich, Germany ,DZHK (German Center for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany
| | - Melanie Heitkamp
- Department of Prevention and Sports Medicine, Medical Faculty, Technical University of Munich, University Hospital ‘Klinikum Rechts der Isar’, Munich, Germany
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Wang X, Luo H, Zhang Y, Mao M, Lu Y, Zhang Z, Jiang C, Luo Q. Effect of online aerobic exercise training in patients with bipolar depression: Protocol of a randomized clinical trial. Front Psychiatry 2022; 13:1011978. [PMID: 36458119 PMCID: PMC9705266 DOI: 10.3389/fpsyt.2022.1011978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 10/21/2022] [Indexed: 11/11/2022] Open
Abstract
INTRODUCTION Bipolar disorder (BD) is a common and debilitating mental illness that affects about 400 million people worldwide, decreasing their functionality and quality of life. Medication and psychotherapy are recommended for treatment of BD, while some evidence indicates that exercise could improve the clinical outcome of BD. This study aims to investigate whether exercise intervention could reduce the mood symptoms and inflammation level of BD. METHODS This is a longitudinal, interventional, randomized, and single-blind trial. We plan to recruit 94 patients diagnosed with BD in depression episode. Patients will be randomly assigned to treatment as usual + aerobic exercise group (intervention group) and treatment as usual (TAU) only group, at a ratio of 1:1. The intervention group will undergo 40-min aerobic exercise training twice a week for eight weeks. The primary outcome of this study is the mean change of Hamilton Depression Rating Scale 17 (HAMD 17) scores from baseline to week 8. The Young Manic Rating Scale (YMRS), Self-Rating Depression Scale (SDS), and Interleukin-6 (IL-6), Tumor necrosis factor-α (TNF-α) and C-reactive protein (CRP) levels will also be measured. The measurements will be performed at baseline, immediately after intervention and two months after intervention. DISCUSSION Aerobic exercise training + treatment is expected to bring more benefits to BD patients than TAU only. This trial might provide stronger evidence of physical exercise efficacy for BD treatment. CLINICAL TRIAL REGISTRATION This study was approved by the Chinese Clinical Trial Registry (Registration Code: ChiCTR2200057159). Registered on 1 March 2022.
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Affiliation(s)
- Xueqian Wang
- Department of Psychiatry, First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Huirong Luo
- Department of Psychiatry, First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yinlin Zhang
- Department of Psychiatry, First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Maolin Mao
- Department of Psychiatry, First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yulin Lu
- Department of Psychiatry, Banan People's Hospital of Chongqing, Chongqing, China
| | - Zheng Zhang
- Department of Psychiatry, First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Chunfeng Jiang
- Chongqing Hospital of Traditional Chinese Medicine, Chongqing, China
| | - Qinghua Luo
- Department of Psychiatry, First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Bipolar disorder: An evolutionary psychoneuroimmunological approach. Neurosci Biobehav Rev 2021; 122:28-37. [PMID: 33421542 DOI: 10.1016/j.neubiorev.2020.12.031] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 12/19/2020] [Accepted: 12/27/2020] [Indexed: 12/19/2022]
Abstract
Bipolar disorder is a mental health disorder characterized by extreme shifts in mood, high suicide rate, sleep problems, and dysfunction of psychological traits like self-esteem (feeling inferior when depressed and superior when manic). Bipolar disorder is rare among populations that have not adopted contemporary Western lifestyles, which supports the hypothesis that bipolar disorder results from a mismatch between Homo sapiens's evolutionary and current environments. Recent studies have connected bipolar disorder with low-grade inflammation, the malfunctioning of the internal clock, and the resulting sleep disturbances. Stress is often a triggering factor for mania and sleep problems, but stress also causes low-grade inflammation. Since inflammation desynchronizes the internal clock, chronic stress and inflammation are the primary biological mechanisms behind bipolar disorder. Chronic stress and inflammation are driven by contemporary Western lifestyles, including stressful social environments, unhealthy dietary patterns, limited physical activity, and obesity. The treatment of bipolar disorder should focus on reducing stress, stress sensitivity, and inflammation by lifestyle changes rather than just temporarily alleviating symptoms with psychopharmacological interventions.
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Giménez-Palomo A, Dodd S, Anmella G, Carvalho AF, Scaini G, Quevedo J, Pacchiarotti I, Vieta E, Berk M. The Role of Mitochondria in Mood Disorders: From Physiology to Pathophysiology and to Treatment. Front Psychiatry 2021; 12:546801. [PMID: 34295268 PMCID: PMC8291901 DOI: 10.3389/fpsyt.2021.546801] [Citation(s) in RCA: 51] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Accepted: 05/24/2021] [Indexed: 12/30/2022] Open
Abstract
Mitochondria are cellular organelles involved in several biological processes, especially in energy production. Several studies have found a relationship between mitochondrial dysfunction and mood disorders, such as major depressive disorder and bipolar disorder. Impairments in energy production are found in these disorders together with higher levels of oxidative stress. Recently, many agents capable of enhancing antioxidant defenses or mitochondrial functioning have been studied for the treatment of mood disorders as adjuvant therapy to current pharmacological treatments. A better knowledge of mitochondrial physiology and pathophysiology might allow the identification of new therapeutic targets and the development and study of novel effective therapies to treat these specific mitochondrial impairments. This could be especially beneficial for treatment-resistant patients. In this article, we provide a focused narrative review of the currently available evidence supporting the involvement of mitochondrial dysfunction in mood disorders, the effects of current therapies on mitochondrial functions, and novel targeted therapies acting on mitochondrial pathways that might be useful for the treatment of mood disorders.
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Affiliation(s)
- Anna Giménez-Palomo
- Bipolar and Depressives Disorders Unit, Hospital Clínic, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Mental Health Research Networking Center (CIBERSAM), Madrid, Spain
| | - Seetal Dodd
- Deakin University, The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong, VIC, Australia.,Department of Psychiatry, Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Gerard Anmella
- Bipolar and Depressives Disorders Unit, Hospital Clínic, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Mental Health Research Networking Center (CIBERSAM), Madrid, Spain
| | - Andre F Carvalho
- Centre for Addiction and Mental Health, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Giselli Scaini
- Translational Psychiatry Program, Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Joao Quevedo
- Translational Psychiatry Program, Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, United States.,Neuroscience Graduate Program, The University of Texas MD Anderson Cancer Center UTHealth Graduate School of Biomedical Sciences, Houston, TX, United States.,Translational Psychiatry Laboratory, Graduate Program in Health Sciences, University of Southern Santa Catarina, Criciúma, Brazil.,Center of Excellence in Mood Disorders, Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Isabella Pacchiarotti
- Bipolar and Depressives Disorders Unit, Hospital Clínic, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Mental Health Research Networking Center (CIBERSAM), Madrid, Spain
| | - Eduard Vieta
- Bipolar and Depressives Disorders Unit, Hospital Clínic, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Mental Health Research Networking Center (CIBERSAM), Madrid, Spain
| | - Michael Berk
- School of Medicine, The Institute for Mental and Physical Health and Clinical Translation, Deakin University, Barwon Health, Geelong, VIC, Australia.,Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia.,Centre for Youth Mental Health, Florey Institute for Neuroscience and Mental Health and the Department of Psychiatry, The University of Melbourne, Melbourne, VIC, Australia
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