1
|
Basquin L, Maruani J, Leseur J, Mauries S, Bazin B, Pineau G, Henry C, Lejoyeux M, Geoffroy PA. Study of the different sleep disturbances during the prodromal phase of depression and mania in bipolar disorders. Bipolar Disord 2024. [PMID: 38653574 DOI: 10.1111/bdi.13429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
Abstract
BACKGROUND One of the challenges in bipolar disorder (BD) lies in early detection of the illness and its recurrences, to improve prognosis. Sleep disturbances (SD) have been proposed as reliable predictive markers of conversion. While preliminary studies have explored the relationship between SD and the onset of mood episodes, the results remain heterogeneous and a few have specifically examined patients' perception of prodromal symptoms and their progression until the episode occurs. Identifying prodromes represents a crucial clinical challenge, as it enables early intervention, thereby reducing the severity of BD. Therefore, the objective of this study is to better characterize and evaluate the progressive nature of SD as prodromal symptoms of mood episodes, and patients' perception of it. METHODS Patients diagnosed with BD, either hospitalized or seeking treatment for a (hypo)manic or depressive episode benefited from standardized questionnaires, structured interviews, and self-report questionnaires to evaluate SD prior to the current episode, as well as sociodemographic and clinical information. RESULTS Out of the 41 patients included, 59% spontaneously reported SD prior to the episode, appearing 90 days before depression and 35 days before mania (pre-indexed/spontaneous reports: 51.22% insomnia complaints, 4.88% hypersomnolence complaints, 7.32% parasomnias, 2.44% sleep movements). After inquiry about specific SD, the percentage of patients reporting prodromal SD increased significantly to 83%, appearing 210 days before depression and 112.5 days before mania (post-indexed reports: 75.61% presented with insomnia complaints appearing 150 days before depression and 20 days before mania, 46.34% had hypersomnolence complaints appearing 60 days before depression, 43.9% had parasomnias appearing 210 days before depression and 22.5 days before mania, 36.59% had sleep movements appearing 120 days before depression and 150 days before mania). Of note, bruxism appeared in 35% of patients before mania, and restless legs syndrome in 20% of patients before depression. CONCLUSION This study highlights the very high prevalence of SD prior to a mood episode in patients with BD with differences between depressive and manic episodes. The more systematic screening of sleep alterations of the prodromal phase improved the recognition and characterization of different symptoms onset by patients. This underscores the need for precise questioning regarding sleep patterns in patients, to better identify the moment of transition toward a mood episode, referred to as "Chronos syndrome". The study emphasizes the importance of educating patients about the disorder and its sleep prodromal symptoms to facilitate early intervention and prevent recurrences.
Collapse
Affiliation(s)
- Louise Basquin
- Département de Psychiatrie et d'addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hôpital Bichat - Claude Bernard, Paris, France
- NeuroDiderot, Inserm, FHU I2-D2, Université Paris Cité, Paris, France
| | - Julia Maruani
- Département de Psychiatrie et d'addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hôpital Bichat - Claude Bernard, Paris, France
- NeuroDiderot, Inserm, FHU I2-D2, Université Paris Cité, Paris, France
- GHU Paris - Psychiatrie & Neurosciences, Paris, France
| | - Jeanne Leseur
- Département de Psychiatrie et d'addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hôpital Bichat - Claude Bernard, Paris, France
| | - Sibylle Mauries
- Département de Psychiatrie et d'addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hôpital Bichat - Claude Bernard, Paris, France
- NeuroDiderot, Inserm, FHU I2-D2, Université Paris Cité, Paris, France
- GHU Paris - Psychiatrie & Neurosciences, Paris, France
| | | | - Guillaume Pineau
- Département de Psychiatrie et d'addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hôpital Bichat - Claude Bernard, Paris, France
| | - Chantal Henry
- GHU Paris - Psychiatrie & Neurosciences, Paris, France
- Department of Psychiatry, Service Hospitalo-Universitaire, GHU Paris Psychiatrie & Neurosciences, Paris, France
- Université de Paris, Paris, France
| | - Michel Lejoyeux
- Département de Psychiatrie et d'addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hôpital Bichat - Claude Bernard, Paris, France
- NeuroDiderot, Inserm, FHU I2-D2, Université Paris Cité, Paris, France
- GHU Paris - Psychiatrie & Neurosciences, Paris, France
| | - Pierre A Geoffroy
- Département de Psychiatrie et d'addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hôpital Bichat - Claude Bernard, Paris, France
- NeuroDiderot, Inserm, FHU I2-D2, Université Paris Cité, Paris, France
- GHU Paris - Psychiatrie & Neurosciences, Paris, France
- CNRS UPR 3212, Institute for Cellular and Integrative Neurosciences, Strasbourg, France
| |
Collapse
|
2
|
Miola A, Gardea-Reséndez M, Ortiz-Orendain J, Nunez NA, Ercis M, Coombes BJ, Salgado MF, Gruhlke PM, Michel I, Bostwick JM, McKean AJ, Ozerdem A, Frye MA. Factors associated with suicide attempts in the antecedent illness trajectory of bipolar disorder and schizophrenia. Int J Bipolar Disord 2023; 11:38. [PMID: 38063942 PMCID: PMC10709261 DOI: 10.1186/s40345-023-00318-3] [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: 05/10/2023] [Accepted: 11/08/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Factors associated with suicide attempts during the antecedent illness trajectory of bipolar disorder (BD) and schizophrenia (SZ) are poorly understood. METHODS Utilizing the Rochester Epidemiology Project, individuals born after 1985 in Olmsted County, MN, presented with first episode mania (FEM) or psychosis (FEP), subsequently diagnosed with BD or SZ were identified. Patient demographics, suicidal ideation with plan, self-harm, suicide attempts, psychiatric hospitalizations, substance use, and childhood adversities were quantified using the electronic health record. Analyses pooled BD and SZ groups with a transdiagnostic approach given the two diseases were not yet differentiated. Factors associated with suicide attempts were examined using bivariate methods and multivariable logistic regression modeling. RESULTS A total of 205 individuals with FEM or FEP (BD = 74, SZ = 131) were included. Suicide attempts were identified in 39 (19%) patients. Those with suicide attempts during antecedent illness trajectory were more likely to be female, victims of domestic violence or bullying behavior, and have higher rates of psychiatric hospitalizations, suicidal ideation with plan and/or self-harm, as well as alcohol, drug, and nicotine use before FEM/FEP onset. Based on multivariable logistic regression, three factors remained independently associated with suicidal attempts: psychiatric hospitalization (OR = 5.84, 95% CI 2.09-16.33, p < 0.001), self-harm (OR = 3.46, 95% CI 1.29-9.30, p = 0.014), and nicotine use (OR = 3.02, 95% CI 1.17-7.76, p = 0.022). CONCLUSION Suicidal attempts were prevalent during the antecedents of BD and SZ and were associated with several risk factors before FEM/FEP. Their clinical recognition could contribute to improve early prediction and prevention of suicide during the antecedent illness trajectory of BD and SZ.
Collapse
Affiliation(s)
- Alessandro Miola
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, USA
- Department of Neuroscience (DNS), University of Padova, Padua, Italy
| | - Manuel Gardea-Reséndez
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, USA
- Department of Psychiatry, Universidad Autónoma de Nuevo León, Monterrey, México
| | | | - Nicolas A Nunez
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, USA
| | - Mete Ercis
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, USA
| | - Brandon J Coombes
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, USA
| | | | - Peggy M Gruhlke
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, USA
| | - Ian Michel
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, USA
| | | | - Alastair J McKean
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, USA
| | - Aysegul Ozerdem
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, USA
| | - Mark A Frye
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, USA.
| |
Collapse
|
3
|
Ortiz-Orendain J, Gardea-Resendez M, Castiello-de Obeso S, Golebiowski R, Coombes B, Gruhlke PM, Michel I, Bostwick JM, Morgan RJ, Ozerdem A, Frye MA, McKean AJ. Antecedents to first episode psychosis and mania: Comparing the initial prodromes of schizophrenia and bipolar disorder in a retrospective population cohort. J Affect Disord 2023; 340:25-32. [PMID: 37506772 PMCID: PMC10883376 DOI: 10.1016/j.jad.2023.07.106] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 07/15/2023] [Accepted: 07/23/2023] [Indexed: 07/30/2023]
Abstract
OBJECTIVE We aim to compare the psychiatric antecedents of schizophrenia (SZ) and bipolar disorder (BD). METHODS Using the Rochester Epidemiology Project, we searched for residents of Olmsted County that had a diagnosis of SZ or BD. We confirmed each case using DSM-5 criteria and obtained the psychiatric antecedents. RESULTS We identified 205 cases with first episode psychosis or mania (SZ = 131; BD = 74). The mean age at first visit for mental health reasons was 12.3 ± 6.3 years for SZ and 13.9 ± 5.6 years for BD. The duration of the initial prodrome (time from first mental health visit to first episode) was similar for both groups (SZ 8.3 ± 6.2 years vs BD 7.3 ± 5.9 years). We found that SZ and BD have overlapping antecedents, but SZ was more common in males and in foreign born and had more learning deficits before the first episode. BD was more common in white population and had higher rates of depressive and adjustment disorders prior to first episode. BD also had more affective symptoms, nightmares, and panic attacks before the first episode. Both groups had similarly high rates of substance use (SZ 74 % vs BD 74.3 %), prescription of antidepressants (SZ 46.6 % vs BD 55.4 %) and stimulants (SZ 30.5 % vs BD 22.9 %). CONCLUSIONS The psychiatric antecedents of SZ and BD usually start during adolescence, overlap, and present in unspecific ways. The initial prodromes are more alike than distinct. Further studies are encouraged to continue looking for specific factors that distinguish the antecedents of these two disorders.
Collapse
Affiliation(s)
| | - Manuel Gardea-Resendez
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, USA; Department of Psychiatry, Universidad Autónoma de Nuevo León, Monterrey, Mexico
| | - Santiago Castiello-de Obeso
- Department of Experimental Psychology, University of Oxford, Oxford, UK; Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Mexico
| | | | - Brandon Coombes
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Peggy M Gruhlke
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, USA
| | - Ian Michel
- Mayo Clinic Alix School of Medicine, Rochester, MN, USA
| | | | - Robert J Morgan
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, USA
| | - Aysegul Ozerdem
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, USA
| | - Mark A Frye
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, USA
| | - Alastair J McKean
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, USA.
| |
Collapse
|
4
|
Geoffroy PA. Dark skies before the storm: The Chronos syndrome. Bipolar Disord 2023; 25:608-609. [PMID: 37743769 DOI: 10.1111/bdi.13380] [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: 09/26/2023]
Affiliation(s)
- Pierre A Geoffroy
- Département de psychiatrie et d'addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hopital Bichat-Claude Bernard, Paris, France
- GHU Paris-Psychiatry & Neurosciences, Paris, France
- Université Paris Cité, NeuroDiderot, Inserm, FHU I2-D2, Paris, France
- CNRS UPR 3212, Institute for Cellular and Integrative Neurosciences, Strasbourg, France
| |
Collapse
|
5
|
Seregin AA, Smirnova LP, Dmitrieva EM, Zavialova MG, Simutkin GG, Ivanova SA. Differential Expression of Proteins Associated with Bipolar Disorder as Identified Using the PeptideShaker Software. Int J Mol Sci 2023; 24:15250. [PMID: 37894929 PMCID: PMC10607299 DOI: 10.3390/ijms242015250] [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: 07/28/2023] [Revised: 09/29/2023] [Accepted: 10/06/2023] [Indexed: 10/29/2023] Open
Abstract
The prevalence of bipolar disorder (BD) in modern society is growing rapidly, but due to the lack of paraclinical criteria, its differential diagnosis with other mental disorders is somewhat challenging. In this regard, the relevance of proteomic studies is increasing due to the development of methods for processing large data arrays; this contributes to the discovery of protein patterns of pathological processes and the creation of new methods of diagnosis and treatment. It seems promising to search for proteins involved in the pathogenesis of BD in an easily accessible material-blood serum. Sera from BD patients and healthy individuals were purified via affinity chromatography to isolate 14 major proteins and separated using 1D SDS-PAGE. After trypsinolysis, the proteins in the samples were identified via HPLC/mass spectrometry. Mass spectrometric data were processed using the OMSSA and X!Tandem search algorithms using the UniProtKB database, and the results were analyzed using PeptideShaker. Differences in proteomes were assessed via an unlabeled NSAF-based analysis using a two-tailed Bonferroni-adjusted t-test. When comparing the blood serum proteomes of BD patients and healthy individuals, 10 proteins showed significant differences in NSAF values. Of these, four proteins were predominantly present in BD patients with the maximum NSAF value: 14-3-3 protein zeta/delta; ectonucleoside triphosphate diphosphohydrolase 7; transforming growth factor-beta-induced protein ig-h3; and B-cell CLL/lymphoma 9 protein. Further exploration of the role of these proteins in BD is warranted; conducting such studies will help develop new paraclinical criteria and discover new targets for BD drug therapy.
Collapse
Affiliation(s)
- Alexander A. Seregin
- Mental Health Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk 634014, Russia; (A.A.S.)
| | - Liudmila P. Smirnova
- Mental Health Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk 634014, Russia; (A.A.S.)
| | - Elena M. Dmitrieva
- Mental Health Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk 634014, Russia; (A.A.S.)
| | | | - German G. Simutkin
- Mental Health Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk 634014, Russia; (A.A.S.)
| | - Svetlana A. Ivanova
- Mental Health Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk 634014, Russia; (A.A.S.)
| |
Collapse
|
6
|
Gardea-Resendez M, Ortiz-Orendain J, Miola A, Fuentes Salgado M, Ercis M, Coombes BJ, Gruhlke PM, Bostwick JM, Michel I, Vande Voort JL, Ozerdem A, McKean A, Frye MA, Taylor-Desir M. Racial differences in pathways to care preceding first episode mania or psychosis: a historical cohort prodromal study. Front Psychiatry 2023; 14:1241071. [PMID: 37732076 PMCID: PMC10507622 DOI: 10.3389/fpsyt.2023.1241071] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 08/16/2023] [Indexed: 09/22/2023] Open
Abstract
Background There is evidence suggesting racial disparities in diagnosis and treatment in bipolar disorder (BD) and schizophrenia (SZ). The purpose of this study is to compare psychiatric diagnoses and psychotropic use preceding a first episode of mania (FEM) or psychosis (FEP) in racially diverse patients. Methods Using a comprehensive medical records linkage system (Rochester Epidemiology Project, REP), we retrospectively identified individuals diagnosed with BD or SZ and a documented first episode of mania or psychosis. Illness trajectory before FEP/FEM were characterized as the time from first visit for a mental health complaint to incident case. Pathways to care and clinical events preceding FEP/FEM were compared based on subsequent incident case diagnosis (BD or SZ) and self-reported race (White vs. non-White). Results A total of 205 (FEM = 74; FEP = 131) incident cases were identified in the REP. Duration of psychiatric antecedents was significantly shorter in non-White patients, compared to White patients (2.2 ± 4.3 vs. 7.4 ± 6.6 years; p < 0.001) with an older age at time of first visit for a mental health complaint (15.7 ± 6.3 vs. 11.1 ± 6.0 years; p = 0.005). There were no significant differences by race in FEM pathway to care or age of first seeking mental health. Overall non-White patients had lower rates of psychotropic use. Conclusion These data are unable to ascertain reasons for shorter duration of psychiatric antecedents and later age of seeking care, and more broadly first age of initial symptom presentation. If symptoms are confirmed to be earlier than first time seeking care in both groups, it would be important to identify barriers that racial minorities face to access timely psychiatric care and optimize early intervention strategies.
Collapse
Affiliation(s)
- Manuel Gardea-Resendez
- Department of Psychiatry, Universidad Autónoma de Nuevo León, Monterrey, Mexico
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, United States
| | - Javier Ortiz-Orendain
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, United States
- Department of Psychiatry and Behavioral Sciences, University of New Mexico, Albuquerque, NM, United States
| | - Alessandro Miola
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, United States
- Department of Neuroscience (DNS), University of Padova, Padua, Italy
| | | | - Mete Ercis
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, United States
| | - Brandon J. Coombes
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, United States
| | - Peggy M. Gruhlke
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, United States
| | - J. Michael Bostwick
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, United States
| | - Ian Michel
- Mayo Clinic Alix School of Medicine, Mayo Clinic, Rochester, MN, United States
| | | | - Aysegul Ozerdem
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, United States
| | - Alastair McKean
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, United States
| | - Mark A. Frye
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, United States
| | - Monica Taylor-Desir
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, United States
| |
Collapse
|
7
|
Dondé C, Jaffiol A, Khouri C, Pouchon A, Tamisier R, Lejoyeux M, d'Ortho MP, Polosan M, Geoffroy PA. Sleep disturbances in early clinical stages of psychotic and bipolar disorders: A meta-analysis. Aust N Z J Psychiatry 2022; 56:1068-1079. [PMID: 34971518 DOI: 10.1177/00048674211068395] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To provide a qualitative view and quantitative measure of sleep disturbances across and between early stages - clinical ultra high-risk and first episode - of psychotic and bipolar disorders. METHODS Electronic databases (PubMed, Cochrane, Embase, PsychINFO) were searched up to March 2021 for studies comparing sleep measures between individuals with an early stage and controls. Standard mean deviations (Cohen's d effect sizes) were calculated for all comparisons and pooled with random-effects models. Chi-square tests were used for direct between-subgroups (ultra high-risk vs first episode) comparisons of standard mean deviations. The effects of age, sex ratio, symptoms and treatment were examined in meta-regression analyses. RESULTS A database search identified 13 studies that contrasted sleep measures between individuals with an early stage (N = 537) and controls (N = 360). We observed poorer subjective sleep quality (standard mean deviation = 1.32; 95% confidence interval, [1.01, 1.62]), shorter total sleep time (standard mean deviation =-0.44; 95% confidence interval, [-0.67, -0.21]), lower sleep efficiency (standard mean deviation = -0.72; 95% confidence interval, [-1.08, -0.36]), longer sleep onset latency (standard mean deviation = 0.75; 95% confidence interval, [0.45, 1.06]) and longer duration of wake after sleep onset (standard mean deviation = 0.49; 95% confidence interval, [0.21, 0.77]) were observed in early stages compared to controls. No significant differences were observed for any of the reported electroencephalographic parameters of sleep architecture. No significant between-subgroups differences were observed. Meta-regressions revealed a significant effect of the age and the antipsychotic status on subjective measures of sleep. CONCLUSION The early stage population presents with significant impairments of subjective sleep quality continuity, duration and initiation. Systematic assessments of sleep in early intervention settings may allow early identification and treatment of sleep disturbances in this population.
Collapse
Affiliation(s)
- Clément Dondé
- Univ. Grenoble Alpes, Inserm, U1216, CHU Grenoble Alpes, Adult Psychiatry Department, Grenoble Institut Neurosciences, 38000 Grenoble, France
| | - Antoine Jaffiol
- Univ. Grenoble Alpes, CHU Grenoble Alpes, Adult Psychiatry Department, 38000 Grenoble, France
| | - Charles Khouri
- Univ. Grenoble Alpes, CHU Grenoble Alpes, HP2, Clinical Pharmacology Department, INSERM CIC1406, 38000 Grenoble, France
| | - Arnaud Pouchon
- Univ. Grenoble Alpes, Inserm, U1216, CHU Grenoble Alpes, Adult Psychiatry Department, Grenoble Institut Neurosciences, 38000 Grenoble, France
| | - Renaud Tamisier
- Univ. Grenoble Alpes, INSERM, CHU Grenoble Alpes, HP2, Pneumology and Physiology Department, Thorax and vessels pole, 38000 Grenoble, France
| | - Michel Lejoyeux
- Université de Paris, Psychiatry and Addictology Department, AP-HP, GHU Paris Nord, DMU Neurosciences, Bichat Hospital - Claude Bernard, GHU Paris - Psychiatry & Neurosciences, Paris, France
| | - Marie-Pia d'Ortho
- Université de Paris, NeuroDiderot, Inserm U1141, Sleep Medicine and Clinical Physiology Department, AP-HP, GHU Paris Nord, DMU DREAM, Bichat Hospital, Paris, France
| | - Mircea Polosan
- Univ. Grenoble Alpes, Inserm, U1216, CHU Grenoble Alpes, Adult Psychiatry Department, Grenoble Institut Neurosciences, 38000 Grenoble, France
| | - Pierre A Geoffroy
- Université de Paris, Psychiatry and Addictology Department, AP-HP, GHU Paris Nord, DMU Neurosciences, Bichat Hospital - Claude Bernard, GHU Paris - Psychiatry & Neurosciences, Paris, France.,Université de Paris, NeuroDiderot, Inserm U1141, Sleep Medicine and Clinical Physiology Department, AP-HP, GHU Paris Nord, DMU DREAM, Bichat Hospital, Paris, France
| |
Collapse
|
8
|
Rodrigues JE, Martinho A, Santos V, Santa C, Madeira N, Martins MJ, Pato CN, Macedo A, Manadas B. Systematic Review and Meta-Analysis on MS-Based Proteomics Applied to Human Peripheral Fluids to Assess Potential Biomarkers of Bipolar Disorder. Int J Mol Sci 2022; 23:ijms23105460. [PMID: 35628270 PMCID: PMC9141521 DOI: 10.3390/ijms23105460] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 05/06/2022] [Accepted: 05/11/2022] [Indexed: 12/22/2022] Open
Abstract
Bipolar disorder (BD) is a clinically heterogeneous condition, presenting a complex underlying etiopathogenesis that is not sufficiently characterized. Without molecular biomarkers being used in the clinical environment, several large screen proteomics studies have been conducted to provide valuable molecular information. Mass spectrometry (MS)-based techniques can be a powerful tool for the identification of disease biomarkers, improving prediction and diagnosis ability. Here, we evaluate the efficacy of MS proteomics applied to human peripheral fluids to assess BD biomarkers and identify relevant networks of biological pathways. Following PRISMA guidelines, we searched for studies using MS proteomics to identify proteomic differences between BD patients and healthy controls (PROSPERO database: CRD42021264955). Fourteen articles fulfilled the inclusion criteria, allowing the identification of 266 differentially expressed proteins. Gene ontology analysis identified complement and coagulation cascades, lipid and cholesterol metabolism, and focal adhesion as the main enriched biological pathways. A meta-analysis was performed for apolipoproteins (A-I, C-III, and E); however, no significant differences were found. Although the proven ability of MS proteomics to characterize BD, there are several confounding factors contributing to the heterogeneity of the findings. In the future, we encourage the scientific community to use broader samples and validation cohorts, integrating omics with bioinformatics tools towards providing a comprehensive understanding of proteome alterations, seeking biomarkers of BD, and contributing to individualized prognosis and stratification strategies, besides aiding in the differential diagnosis.
Collapse
Affiliation(s)
- Joao E. Rodrigues
- CNC—Center for Neuroscience and Cell Biology, University of Coimbra, 3004-504 Coimbra, Portugal; (J.E.R.); (A.M.); (C.S.); (M.J.M.)
- CIBB—Centre for Innovative Biomedicine and Biotechnology, University of Coimbra, 3004-504 Coimbra, Portugal;
| | - Ana Martinho
- CNC—Center for Neuroscience and Cell Biology, University of Coimbra, 3004-504 Coimbra, Portugal; (J.E.R.); (A.M.); (C.S.); (M.J.M.)
- CIBB—Centre for Innovative Biomedicine and Biotechnology, University of Coimbra, 3004-504 Coimbra, Portugal;
| | - Vítor Santos
- CIBB—Centre for Innovative Biomedicine and Biotechnology, University of Coimbra, 3004-504 Coimbra, Portugal;
- Faculty of Medicine, University of Coimbra, 3004-504 Coimbra, Portugal;
- Psychiatry Department, Centro Hospitalar e Universitário de Coimbra, 3004-561 Coimbra, Portugal
| | - Catia Santa
- CNC—Center for Neuroscience and Cell Biology, University of Coimbra, 3004-504 Coimbra, Portugal; (J.E.R.); (A.M.); (C.S.); (M.J.M.)
- CIBB—Centre for Innovative Biomedicine and Biotechnology, University of Coimbra, 3004-504 Coimbra, Portugal;
| | - Nuno Madeira
- Faculty of Medicine, University of Coimbra, 3004-504 Coimbra, Portugal;
- Psychiatry Department, Centro Hospitalar e Universitário de Coimbra, 3004-561 Coimbra, Portugal
- CIBIT—Coimbra Institute for Biomedical Imaging and Translational Research, University of Coimbra, 3000-548 Coimbra, Portugal
| | - Maria J. Martins
- CNC—Center for Neuroscience and Cell Biology, University of Coimbra, 3004-504 Coimbra, Portugal; (J.E.R.); (A.M.); (C.S.); (M.J.M.)
- CIBB—Centre for Innovative Biomedicine and Biotechnology, University of Coimbra, 3004-504 Coimbra, Portugal;
- Medical Services, University of Coimbra Medical Services, 3004-517 Coimbra, Portugal
| | - Carlos N. Pato
- Department of Psychiatry and Behavioral Sciences, SUNY Downstate Health Sciences University, Brooklyn, NY 11203, USA;
| | - Antonio Macedo
- Faculty of Medicine, University of Coimbra, 3004-504 Coimbra, Portugal;
- Psychiatry Department, Centro Hospitalar e Universitário de Coimbra, 3004-561 Coimbra, Portugal
- CIBIT—Coimbra Institute for Biomedical Imaging and Translational Research, University of Coimbra, 3000-548 Coimbra, Portugal
- Correspondence: authors: (A.M.); (B.M.)
| | - Bruno Manadas
- CNC—Center for Neuroscience and Cell Biology, University of Coimbra, 3004-504 Coimbra, Portugal; (J.E.R.); (A.M.); (C.S.); (M.J.M.)
- CIBB—Centre for Innovative Biomedicine and Biotechnology, University of Coimbra, 3004-504 Coimbra, Portugal;
- III Institute for Interdisciplinary Research, University of Coimbra (IIIUC), 3030-789 Coimbra, Portugal
- Correspondence: authors: (A.M.); (B.M.)
| |
Collapse
|
9
|
Kupka R, Duffy A, Scott J, Almeida J, Balanzá‐Martínez V, Birmaher B, Bond DJ, Brietzke E, Chendo I, Frey BN, Grande I, Hafeman D, Hajek T, Hillegers M, Kauer‐Sant’Anna M, Mansur RB, van der Markt A, Post R, Tohen M, Tremain H, Vazquez G, Vieta E, Yatham LN, Berk M, Alda M, Kapczinski F. Consensus on nomenclature for clinical staging models in bipolar disorder: A narrative review from the International Society for Bipolar Disorders (ISBD) Staging Task Force. Bipolar Disord 2021; 23:659-678. [PMID: 34174130 PMCID: PMC9290926 DOI: 10.1111/bdi.13105] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVES Clinical staging is widely used in medicine to map disease progression, inform prognosis, and guide treatment decisions; in psychiatry, however, staging remains a hypothetical construct. To facilitate future research in bipolar disorders (BD), a well-defined nomenclature is needed, especially since diagnosis is often imprecise with blurred boundaries, and a full understanding of pathophysiology is lacking. METHODS Under the auspices of the International Society of Bipolar Disorders, a Task Force of international experts was convened to review, discuss, and integrate findings from the scientific literature relevant to the development of a consensus staging model and standardize a terminology that could be used to advance future research including staging of BD and related disorders. RESULTS Consensus opinion and areas of uncertainty or difference were identified in regard to terms referring to staging as it may apply to BD, to at-risk status and subthreshold stages, and to various clinical stages of BD as it is currently diagnosed. CONCLUSION The use of a standardized nomenclature about the clinical stages of BD will facilitate communication about research on clinical and pathological components of this heterogeneous group of disorders. The concepts presented are based on current evidence, but the template provided allows for further refinements as etiological advances come to light.
Collapse
Affiliation(s)
- Ralph Kupka
- Department of PsychiatryAmsterdam Public Mental Health Research InsituteAmsterdam UMCVrije UniversiteitAmsterdamThe Netherlands
| | - Anne Duffy
- Department of PsychiatryDivision of Student Mental HealthQueen's UniversityCote Sharp Student Wellness CentreKingstonONCanada,Department of PsychiatryUniversity of OxfordOxfordUK
| | - Jan Scott
- Institute of NeuroscienceNewcastle UniversityNewcastle upon TyneUK,Brain and Mind CentreThe University of SydneySydneyNSWAustralia
| | - Jorge Almeida
- Department of Psychiatry and Behavior SciencesDell Medical SchoolUniversity of Texas at AustinAustinTXUSA
| | - Vicent Balanzá‐Martínez
- Teaching Unit of Psychiatry and Psychological MedicineDepartment of MedicineUniversity of ValenciaCIBERSAMValenciaSpain
| | | | - David J. Bond
- Department of Psychiatry and Behavioral SciencesUniversity of Minnesota Medical SchoolMinneapolisMNUSA
| | - Elisa Brietzke
- Department of PsychiatryQueen's University School of MedicineKingstonONCanada,Centre for Neuroscience StudiesQueen’s UniversityKingstonONCanada
| | - Ines Chendo
- Psychiatry DepartmentDepartment of NeurosciencesHospital Santa MariaLisbonPortugal,Clínica Universitária de PsiquiatriaFaculty of MedicineUniversity of LisbonLisbonPortugal
| | - Benicio N. Frey
- Department of Psychiatry and Behavioural NeurosciencesMcMaster UniversityHamiltonONCanada,Mood Disorders Program and Women's Health Concerns ClinicSt. Joseph's Healthcare HamiltonHamiltonONCanada
| | - Iria Grande
- Barcelona Bipolar Disorders and Depressive UnitHospital ClinicInstitute of NeurosciencesUniversity of BarcelonaIDIBAPSCIBERSAMBarcelonaSpain
| | - Danella Hafeman
- Department of PsychiatryUniversity of Pittsburgh School of MedicinePittsburghPAUSA
| | - Tomas Hajek
- Department of PsychiatryDalhousie UniversityHalifaxNSCanada
| | - Manon Hillegers
- Department of Child and Adolescent Psychiatry/PsychologyErasmus Medical Center‐Sophia Children’s HospitalRotterdamThe Netherlands
| | - Marcia Kauer‐Sant’Anna
- Department of PsychiatryFaculty of MedicineUniversidade Federal do Rio Grande do Sul (UFRGSHospital de Clínicas de Porto Alegre (HCPAPorto AlegreBrazil
| | - Rodrigo B. Mansur
- Mood Disorders Psychopharmacology UnitUniversity Health NetworkTorontoONCanada,Department of PsychiatryUniversity of TorontoTorontoONCanada
| | - Afra van der Markt
- Department of PsychiatryAmsterdam Public Mental Health Research InsituteAmsterdam UMCVrije UniversiteitAmsterdamThe Netherlands
| | - Robert Post
- George Washington University School of MedicineWashingtonDCUSA,Bipolar Collaborative NetworkBethesdaMDUSA
| | - Mauricio Tohen
- Department of Psychiatry and Behavioral SciencesUniversity of New Mexico Health Sciences CenterAlbuquerqueNMUSA
| | - Hailey Tremain
- Centre for Mental HealthFaculty of Health Arts and DesignSwinburne UniversityMelbourneVicAustralia,OrygenThe National Centre of Excellence in Youth Mental HealthParkvilleVicAustralia
| | | | - Eduard Vieta
- Hospital ClinicInstitute of NeuroscienceUniversity of BarcelonaIDIBAPSCIBERSAMBarcelonaSpain
| | - Lakshmi N. Yatham
- Department of PsychiatryUniversity of British ColumbiaVancouverBCCanada
| | - Michael Berk
- IMPACT – the Institute for Mental and Physical Health and Clinical TranslationSchool of MedicineBarwon HealthDeakin UniversityGeelongVicAustralia,OrygenThe National Centre of Excellence in Youth Mental HealthCentre for Youth Mental HealthFlorey Institute for Neuroscience and Mental HealthDepartment of PsychiatryThe University of MelbourneMelbourneVicAustralia
| | - Martin Alda
- Department of PsychiatryMood Disorders ClinicDalhousie UniversityHalifaxNCCanada
| | - Flávio Kapczinski
- St. Joseph’s Healthcare Hamilton McMaster UniversityHamiltonONCanada,Universidade Federal do Rio Grande do SulUFRGSPorto AlegreBrazil
| |
Collapse
|
10
|
Menculini G, Balducci PM, Attademo L, Bernardini F, Moretti P, Tortorella A. Environmental Risk Factors for Bipolar Disorders and High-Risk States in Adolescence: A Systematic Review. ACTA ACUST UNITED AC 2020; 56:medicina56120689. [PMID: 33322430 PMCID: PMC7763529 DOI: 10.3390/medicina56120689] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 11/29/2020] [Accepted: 12/08/2020] [Indexed: 11/16/2022]
Abstract
Background and objectives: A deeper comprehension of the role that environmental risk factors play in the development of adolescent Bipolar Disorder (BD), as well as in the evolution of high-risk states for BD, may entangle further prevention and treatment advances. The present systematic review is aimed at critically summarizing evidence about the role that environmental risk factors play in the development of BD in adolescence and their interaction with BD high-risk states. Materials and Methods: MEDLINE/Pubmed, Scopus and Web of Science datasets were systematically searched until 4 September 2020. Original studies that reported information about the role of environmental risk factors in the development of BD during adolescence, or assessing their influence on the development of psychopathology in high-risk states for BD, were considered for inclusion. Two blind researchers performed title/abstract, full-text screening, and hand-screening of relevant references. The risk of bias was assessed by means of the Newcastle-Ottawa Scale. Results: Fourteen studies were included in the review. Negative stressful life events, particularly sexual and physical abuse, but also emotional mistreatment, were associated with more severe psychopathology in adolescents with BD, as well as with higher risk for developing mood disorders in BD offspring. Similar findings were detected for familial environment-related features, such as parental rejection and low perceived care, while no univocal results were found when analyzing familial functioning. Conclusions: The present systematic review confirmed the relevant role that environmental risk factors, particularly negative stressful live events and family-related features, play in the development of BD psychopathology during adolescence. Future studies are expected to clarify possible further environmental factors that may be implicated in the development of BD during youth that may serve as target of prevention and early treatment strategies.
Collapse
Affiliation(s)
- Giulia Menculini
- Department of Psychiatry, University of Perugia, Piazzale Lucio Severi 1, 06132 Perugia, Italy; (G.M.); (P.M.B.); (P.M.)
| | - Pierfrancesco Maria Balducci
- Department of Psychiatry, University of Perugia, Piazzale Lucio Severi 1, 06132 Perugia, Italy; (G.M.); (P.M.B.); (P.M.)
- CSM Terni, Department of Mental Health, AUSL Umbria 2, Via Bramante 40, 05100 Terni, Italy
| | - Luigi Attademo
- SPDC Potenza, Department of Mental Health, ASP Basilicata, Italian National Health Service, Via Petrone, 85100 Potenza, Italy;
| | - Francesco Bernardini
- Department of Mental Health, AsFO Friuli Occidentale, Via Vecchia Ceramica 1, 33170 Pordenone, Italy;
| | - Patrizia Moretti
- Department of Psychiatry, University of Perugia, Piazzale Lucio Severi 1, 06132 Perugia, Italy; (G.M.); (P.M.B.); (P.M.)
| | - Alfonso Tortorella
- Department of Psychiatry, University of Perugia, Piazzale Lucio Severi 1, 06132 Perugia, Italy; (G.M.); (P.M.B.); (P.M.)
- Correspondence: ; Tel.: +39-(07)-5578-3194
| |
Collapse
|
11
|
Pfennig A, Leopold K, Martini J, Boehme A, Lambert M, Stamm T, Bermpohl F, Reif A, Kittel-Schneider S, Juckel G, Fallgatter AJ, Kircher T, Jansen A, Pfeiffer S, Berndt C, Rottmann-Wolf M, Sauer C, Ritter P, Correll CU, Bechdolf A, Falkenberg I, Bauer M. Improving early recognition and intervention in people at increased risk for the development of bipolar disorder: study protocol of a prospective-longitudinal, naturalistic cohort study (Early-BipoLife). Int J Bipolar Disord 2020; 8:22. [PMID: 32607662 PMCID: PMC7326843 DOI: 10.1186/s40345-020-00183-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Accepted: 03/07/2020] [Indexed: 12/12/2022] Open
Abstract
Background Bipolar disorders (BD) belong to the most severe mental disorders, characterized by an early onset and recurrent, severe episodes or a chronic course with poor psychosocial functioning in a proportion of patients. Many patients with BD experience substantial symptomatology months or even years before full BD manifestation. Adequate diagnosis and treatment is often delayed, which is associated with a worse outcome. This study aims to prospectively evaluate and improve early recognition and intervention strategies for persons at-risk for BD. Methods Early-BipoLife is a prospective-longitudinal cohort study of 1419 participants (aged 15–35 years) with at least five waves of assessment over a period of at least 2 years (baseline, 6, 12, 18 and 24 months). A research consortium of ten university and teaching hospitals across Germany conducts this study. The following risk groups (RGs) were recruited: RG I: help-seeking youth and young adults consulting early recognition centres/facilities presenting ≥ 1 of the proposed risk factors for BD, RG II: in-/outpatients with unipolar depressive syndrome, and RG III: in-/outpatients with attention-deficit/hyperactivity disorder (ADHD). The reference cohort was selected from the German representative IMAGEN cohort. Over the study period, the natural course of risk and resilience factors, early symptoms of BD and changes of symptom severity (including conversion to manifest BD) are observed. Psychometric properties of recently developed, structured instruments on potential risk factors for conversion to BD and subsyndromal symptomatology (Bipolar Prodrome Symptom Scale, Bipolar at-risk criteria, EPIbipolar) and biomarkers that potentially improve prediction are investigated. Moreover, actual treatment recommendations are monitored in the participating specialized services and compared to recently postulated clinical categorization and treatment guidance in the field of early BD. Discussion Findings from this study will contribute to an improved knowledge about the natural course of BD, from the onset of first noticeable symptoms (precursors) to fully developed BD, and about mechanisms of conversion from subthreshold to manifest BD. Moreover, these generated data will provide information for the development of evidence-based guidelines for early-targeted detection and preventive intervention for people at risk for BD.
Collapse
Affiliation(s)
- Andrea Pfennig
- Department of Psychiatry and Psychotherapy, Carl Gustav Carus University Hospital, Technische Universität Dresden, Fetscherstraße 74, 01307, Dresden, Germany.
| | - Karolina Leopold
- Department of Psychiatry, Psychotherapy and Psychosomatics, Vivantes Klinikum Am Urban, Berlin, Germany
| | - Julia Martini
- Department of Psychiatry and Psychotherapy, Carl Gustav Carus University Hospital, Technische Universität Dresden, Fetscherstraße 74, 01307, Dresden, Germany
| | - Anne Boehme
- Department of Psychiatry and Psychotherapy, Carl Gustav Carus University Hospital, Technische Universität Dresden, Fetscherstraße 74, 01307, Dresden, Germany
| | - Martin Lambert
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Thomas Stamm
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Berlin, Germany.,Department of Psychiatry, Psychotherapy and Psychosomatic, Medical School Brandenburg, Neuruppin, Germany
| | - Felix Bermpohl
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Andreas Reif
- Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Frankfurt, Germany
| | - Sarah Kittel-Schneider
- Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Frankfurt, Germany
| | - Georg Juckel
- Department of Psychiatry and Psychotherapy, LWL-University Hospital Bochum, Ruhr-University Bochum, Bochum, Germany
| | - Andreas J Fallgatter
- Department of General Psychiatry and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
| | - Tilo Kircher
- Department of Psychiatry and Psychotherapy, University Hospital Marburg, Marburg, Germany
| | - Andreas Jansen
- Department of Psychiatry and Psychotherapy, University Hospital Marburg, Marburg, Germany
| | - Steffi Pfeiffer
- Department of Psychiatry and Psychotherapy, Carl Gustav Carus University Hospital, Technische Universität Dresden, Fetscherstraße 74, 01307, Dresden, Germany
| | - Christina Berndt
- Department of Psychiatry and Psychotherapy, Carl Gustav Carus University Hospital, Technische Universität Dresden, Fetscherstraße 74, 01307, Dresden, Germany
| | - Maren Rottmann-Wolf
- Department of Psychiatry and Psychotherapy, Carl Gustav Carus University Hospital, Technische Universität Dresden, Fetscherstraße 74, 01307, Dresden, Germany
| | - Cathrin Sauer
- Department of Psychiatry and Psychotherapy, Carl Gustav Carus University Hospital, Technische Universität Dresden, Fetscherstraße 74, 01307, Dresden, Germany
| | - Philipp Ritter
- Department of Psychiatry and Psychotherapy, Carl Gustav Carus University Hospital, Technische Universität Dresden, Fetscherstraße 74, 01307, Dresden, Germany
| | - Christoph U Correll
- The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, The Zucker Hillside Hospital, Glen Oaks, NY, USA.,Department of Child- and Adolescent Psychiatry, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Andreas Bechdolf
- Department of Psychiatry, Psychotherapy and Psychosomatics, Vivantes Klinikum Am Urban, Berlin, Germany
| | - Irina Falkenberg
- Department of Psychiatry and Psychotherapy, University Hospital Marburg, Marburg, Germany
| | - Michael Bauer
- Department of Psychiatry and Psychotherapy, Carl Gustav Carus University Hospital, Technische Universität Dresden, Fetscherstraße 74, 01307, Dresden, Germany
| |
Collapse
|
12
|
Loftus J, Scott J, Vorspan F, Icick R, Henry C, Gard S, Kahn JP, Leboyer M, Bellivier F, Etain B. Psychiatric comorbidities in bipolar disorders: An examination of the prevalence and chronology of onset according to sex and bipolar subtype. J Affect Disord 2020; 267:258-263. [PMID: 32217226 DOI: 10.1016/j.jad.2020.02.035] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2019] [Revised: 02/05/2020] [Accepted: 02/18/2020] [Indexed: 12/20/2022]
Abstract
OBJECTIVES Bipolar Disorder (BD) is frequently comorbid with other psychiatric disorders. However, few studies systematically examine which disorders are more likely to occur pre- or post-BD onset. We examine the prevalence and Age At Onset (AAO) of psychiatric conditions in adults with BD. METHODS A structured clinical interview was used to assess lifetime history and AAO of alcohol and cannabis misuse, suicide attempts, anxiety and eating disorders in a French sample of euthymic patients with BD (n = 739). Regression analyses were used to test for statistically significant associations between rates and AAO of comorbidities in BD groups stratified by sex or subtype. RESULTS Prevalence of alcohol and cannabis misuse was associated with male sex and BD-I subtype; whilst most anxiety and eating disorders were associated with female sex. The AAO of most comorbid conditions preceded that of BD, except for panic disorder, agoraphobia and alcohol misuse. Few variations were observed in AAO of comorbidities according to groups. LIMITATIONS All assessments were retrospective, so estimates of prevalence rates and especially exact AAO of some comorbidities are at risk of recall bias. CONCLUSIONS Sex and BD subtype are associated with different rates of comorbid disorders. However, there were minimal between group differences in median AAO of comorbidities. By describing the chronological sequence of comorbidities in BD we were able to demonstrate that a minority of comorbidities typically occurred post-onset of BD. This is noteworthy as these disorders might be amenable to interventions aimed at early secondary prevention.
Collapse
Affiliation(s)
- J Loftus
- Centre Expert Trouble Bipolaire, Hospital Princesse Grace, Monaco; Fondation Fondamental, Créteil, France
| | - J Scott
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK; Université de Paris, Paris, France
| | - F Vorspan
- Université de Paris, Paris, France; AP-HP, GH Saint-Louis-Lariboisière-Fernand-Widal, Département de Psychiatrie et de Médecine Addictologique, DMU Neurosciences, Paris, France; Inserm UMRS 1144, Paris, France
| | - R Icick
- Université de Paris, Paris, France; AP-HP, GH Saint-Louis-Lariboisière-Fernand-Widal, Département de Psychiatrie et de Médecine Addictologique, DMU Neurosciences, Paris, France; Inserm UMRS 1144, Paris, France
| | - C Henry
- Fondation Fondamental, Créteil, France; Institut Pasteur, Unité Perception et Mémoire, Paris, France; Université Paris-Est-Créteil, Creteil, France; Département Médico-Universitaire Psychiatrie et Addictologie, DMU IMPACT, AP-HP, Hôpitaux Universitaires H. Mondor, Créteil, France
| | - S Gard
- Fondation Fondamental, Créteil, France; Hôpital Charles-Perrens, Centre Expert Trouble Bipolaire, Service de psychiatrie adulte, Pôle 3-4-7, Bordeaux, France
| | - J P Kahn
- Fondation Fondamental, Créteil, France; Université de Lorraine, CHRU de Nancy, Nancy, France and Fondation Santé des Etudiants de France (FSEF), Paris, France
| | - M Leboyer
- Fondation Fondamental, Créteil, France; Université Paris-Est-Créteil, Creteil, France; Département Médico-Universitaire Psychiatrie et Addictologie, DMU IMPACT, AP-HP, Hôpitaux Universitaires H. Mondor, Créteil, France; INSERM U955, Equipe 15 Psychiatrie Translationnelle, Creteil, France
| | - F Bellivier
- Fondation Fondamental, Créteil, France; Université de Paris, Paris, France; AP-HP, GH Saint-Louis-Lariboisière-Fernand-Widal, Département de Psychiatrie et de Médecine Addictologique, DMU Neurosciences, Paris, France; Inserm UMRS 1144, Paris, France
| | - B Etain
- Fondation Fondamental, Créteil, France; Université de Paris, Paris, France; AP-HP, GH Saint-Louis-Lariboisière-Fernand-Widal, Département de Psychiatrie et de Médecine Addictologique, DMU Neurosciences, Paris, France; Inserm UMRS 1144, Paris, France.
| |
Collapse
|
13
|
Morton E, Murray G. Assessment and treatment of sleep problems in bipolar disorder—A guide for psychologists and clinically focused review. Clin Psychol Psychother 2020; 27:364-377. [DOI: 10.1002/cpp.2433] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Revised: 01/21/2020] [Accepted: 02/04/2020] [Indexed: 12/21/2022]
Affiliation(s)
- Emma Morton
- Department of Psychiatry, Faculty of MedicineUniversity of British Columbia Vancouver British Columbia Canada
- Centre for Mental Health, Faculty of Health, Arts and DesignSwinburne University of Technology Melbourne Victoria Australia
| | - Greg Murray
- Centre for Mental Health, Faculty of Health, Arts and DesignSwinburne University of Technology Melbourne Victoria Australia
| |
Collapse
|
14
|
Jalbrzikowski M, Freedman D, Hegarty CE, Mennigen E, Karlsgodt KH, Olde Loohuis LM, Ophoff RA, Gur RE, Bearden CE. Structural Brain Alterations in Youth With Psychosis and Bipolar Spectrum Symptoms. J Am Acad Child Adolesc Psychiatry 2019; 58:1079-1091. [PMID: 30768396 PMCID: PMC7110691 DOI: 10.1016/j.jaac.2018.11.012] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Revised: 11/26/2018] [Accepted: 01/10/2019] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Adults with established diagnoses of serious mental illness (bipolar disorder and schizophrenia) exhibit structural brain abnormalities, yet less is known about how such abnormalities manifest earlier in development. METHOD Cross-sectional data publicly available from the Philadelphia Neurodevelopmental Cohort (PNC) were analyzed. Structural magnetic resonance neuroimaging data were collected on a subset of the PNC (N = 989; 9-22 years old). Cortical thickness, surface area (SA), and subcortical volumes were calculated. Study participants were assessed for psychiatric symptomatology using a structured interview and the following groups were created: typically developing (n = 376), psychosis spectrum (PS; n = 113), bipolar spectrum (BP; n = 117), and BP + PS (n = 109). Group and developmental differences in structural magnetic resonance neuroimaging measures were examined. In addition, the extent to which any structural aberration was related to neurocognition, global functioning, and clinical symptomatology was examined. RESULTS Compared with other groups, PS youth exhibited significantly decreased SA in the orbitofrontal, cingulate, precentral, and postcentral regions. PS youth also exhibited deceased thalamic volume compared with all other groups. The strongest effects for precentral and posterior cingulate SA decreases were seen during early adolescence (13-15 years old) in PS youth. The strongest effects for decreases in thalamic volume and orbitofrontal and postcentral SA were observed in mid-adolescence (16-18 years) in PS youth. Across groups, better overall functioning was associated with increased lateral orbitofrontal SA. Increased postcentral SA was associated with better executive cognition and less severe negative symptoms in the entire sample. CONCLUSION In a community-based sample, decreased cortical SA and thalamic volume were present early in adolescent development in youth with PS symptoms, but not in youth with BP symptoms or with BP and PS symptoms. These findings point to potential biological distinctions between PS and BP conditions, which could suggest additional biomarkers relevant to early identification.
Collapse
Affiliation(s)
| | - David Freedman
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles
| | | | - Eva Mennigen
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles
| | | | | | - Roel A Ophoff
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles; Center for Neurobehavioral Genetics, University of California, Los Angeles
| | - Raquel E Gur
- Lifespan Brain Institute, Penn Medicine and Children's Hospital of Philadelphia, University of Pennsylvania, PA
| | - Carrie E Bearden
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles; Center for Neurobehavioral Genetics, University of California, Los Angeles; University of California, Los Angeles
| |
Collapse
|
15
|
Abstract
In psychiatry, clinical staging raises awareness of the need to understand disease trajectories and heterotypic continuity; it draws attention to individuals at risk of developing disorders, such as those with a family history or subsyndromal presentations; and it actively promotes greater attention to prevention strategies and interventions for individuals at ultra-high risk of developing a severe mental disorder. Staging paradigms have been increasingly applied in early intervention in psychoses, but there are issues in broadening the scope of clinical staging to the more prevalent affective disorders. For example, it is potentially more complex to devise a model that considers the varying clinical presentations of the late prodromal stage of bipolar disorder and where to locate depressive episodes that precede the first manic episode and how to describe subthreshold manic syndromes, especially hypomania. The above issues might be resolved if we had a greater understanding of the risk factors, biomarkers or endophenotypes for the onset and progression of bipolar disorder. This level of understanding is not yet available in psychiatry, but clinical staging may help us improve our knowledge of the pathophysiological correlates of disease progression and reduce our over-reliance on cross-sectional assessments of symptoms in bipolar disorders.
Collapse
Affiliation(s)
- J Scott
- Academic Psychiatry, Institute of Neuroscience, Newcastle University, Newcastle-upon-Tyne, United Kingdom.
| | - C Henry
- Institut pasteur, unité perception et mémoire, F-75015 Paris, France - Université Paris-Est, UMR S955, UPEC, F-94000 Créteil, France - AP-HP, Hôpital Henri-Mondor, Albert-Chenevier, pôle de psychiatrie, F-94000 Créteil, France
| |
Collapse
|
16
|
Meluken I, Ottesen N, Harmer C, Macoveanu J, Siebner H, Kessing L, Vinberg M, Miskowiak K. Neural response to emotional faces in monozygotic twins: association with familial risk of affective disorders. J Psychiatry Neurosci 2019; 44:277-286. [PMID: 30942564 PMCID: PMC6606430 DOI: 10.1503/jpn.170246] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Aberrant neural and cognitive response to emotional faces has been observed in people at familial risk of an affective disorder. In this functional MRI study of monozygotic twins, we explored neural correlates of the attentional avoidance of emotional faces that we had previously observed in high-risk versus affected twins, and whether an abnormal neural response to emotional faces represents a risk endophenotype. METHODS We recruited unaffected monozygotic twins with a co-twin history of mood episodes (high-risk), monozygotic twins with previous mood episodes (affected) and monozygotic twins with no personal or first-degree history of mood episodes (low-risk) between December 2014 and January 2017 based on a nationwide register linkage. Participants viewed fearful and happy faces while performing a gender discrimination task during functional MRI (fMRI) and performed emotional faces dot-probe and facial expression recognition tasks outside the scanner. RESULTS A total of 129 monozygotic twins underwent whole-brain fMRI. Highrisk twins (n = 38) displayed greater medial and superior prefrontal response to emotional faces than affected twins (n = 62). This greater activity correlated with stronger attentional avoidance of emotional faces in high-risk twins. In contrast, high-risk and affected twins showed no aberrant neural activity to emotional faces compared with low-risk twins (n = 29). LIMITATIONS A limitation of this study was its cross-sectional design. CONCLUSION Greater recruitment of the medial and superior prefrontal cortex during implicit emotion processing in high-risk versus affected twins may represent a compensatory or resilience mechanism. In contrast, aberrant neural response to emotional faces does not seem to be a risk endophenotype for affective disorders.
Collapse
Affiliation(s)
- Iselin Meluken
- From the Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, University Hospital of Copenhagen, Rigshospitalet, and University of Copenhagen, Denmark (Meluken, Ottesen, Macoveanu, Kessing, Vinberg, Miskowiak); the Department of Psychology, University of Copenhagen, Copenhagen, Denmark (Miskowiak); the Department of Psychiatry, University of Oxford, Oxford, United Kingdom (Harmer); the Danish Research Centre of Magnetic Resonance, Copenhagen University Hospital Hvidovre, Denmark (Meluken, Siebner, Miskowiak); and the Department of Neurology, Copenhagen University Hospital, Bispebjerg, University of Copenhagen, Denmark (Siebner)
| | - Ninja Ottesen
- From the Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, University Hospital of Copenhagen, Rigshospitalet, and University of Copenhagen, Denmark (Meluken, Ottesen, Macoveanu, Kessing, Vinberg, Miskowiak); the Department of Psychology, University of Copenhagen, Copenhagen, Denmark (Miskowiak); the Department of Psychiatry, University of Oxford, Oxford, United Kingdom (Harmer); the Danish Research Centre of Magnetic Resonance, Copenhagen University Hospital Hvidovre, Denmark (Meluken, Siebner, Miskowiak); and the Department of Neurology, Copenhagen University Hospital, Bispebjerg, University of Copenhagen, Denmark (Siebner)
| | - Catherine Harmer
- From the Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, University Hospital of Copenhagen, Rigshospitalet, and University of Copenhagen, Denmark (Meluken, Ottesen, Macoveanu, Kessing, Vinberg, Miskowiak); the Department of Psychology, University of Copenhagen, Copenhagen, Denmark (Miskowiak); the Department of Psychiatry, University of Oxford, Oxford, United Kingdom (Harmer); the Danish Research Centre of Magnetic Resonance, Copenhagen University Hospital Hvidovre, Denmark (Meluken, Siebner, Miskowiak); and the Department of Neurology, Copenhagen University Hospital, Bispebjerg, University of Copenhagen, Denmark (Siebner)
| | - Julian Macoveanu
- From the Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, University Hospital of Copenhagen, Rigshospitalet, and University of Copenhagen, Denmark (Meluken, Ottesen, Macoveanu, Kessing, Vinberg, Miskowiak); the Department of Psychology, University of Copenhagen, Copenhagen, Denmark (Miskowiak); the Department of Psychiatry, University of Oxford, Oxford, United Kingdom (Harmer); the Danish Research Centre of Magnetic Resonance, Copenhagen University Hospital Hvidovre, Denmark (Meluken, Siebner, Miskowiak); and the Department of Neurology, Copenhagen University Hospital, Bispebjerg, University of Copenhagen, Denmark (Siebner)
| | - Hartwig Siebner
- From the Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, University Hospital of Copenhagen, Rigshospitalet, and University of Copenhagen, Denmark (Meluken, Ottesen, Macoveanu, Kessing, Vinberg, Miskowiak); the Department of Psychology, University of Copenhagen, Copenhagen, Denmark (Miskowiak); the Department of Psychiatry, University of Oxford, Oxford, United Kingdom (Harmer); the Danish Research Centre of Magnetic Resonance, Copenhagen University Hospital Hvidovre, Denmark (Meluken, Siebner, Miskowiak); and the Department of Neurology, Copenhagen University Hospital, Bispebjerg, University of Copenhagen, Denmark (Siebner)
| | - Lars Kessing
- From the Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, University Hospital of Copenhagen, Rigshospitalet, and University of Copenhagen, Denmark (Meluken, Ottesen, Macoveanu, Kessing, Vinberg, Miskowiak); the Department of Psychology, University of Copenhagen, Copenhagen, Denmark (Miskowiak); the Department of Psychiatry, University of Oxford, Oxford, United Kingdom (Harmer); the Danish Research Centre of Magnetic Resonance, Copenhagen University Hospital Hvidovre, Denmark (Meluken, Siebner, Miskowiak); and the Department of Neurology, Copenhagen University Hospital, Bispebjerg, University of Copenhagen, Denmark (Siebner)
| | - Maj Vinberg
- From the Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, University Hospital of Copenhagen, Rigshospitalet, and University of Copenhagen, Denmark (Meluken, Ottesen, Macoveanu, Kessing, Vinberg, Miskowiak); the Department of Psychology, University of Copenhagen, Copenhagen, Denmark (Miskowiak); the Department of Psychiatry, University of Oxford, Oxford, United Kingdom (Harmer); the Danish Research Centre of Magnetic Resonance, Copenhagen University Hospital Hvidovre, Denmark (Meluken, Siebner, Miskowiak); and the Department of Neurology, Copenhagen University Hospital, Bispebjerg, University of Copenhagen, Denmark (Siebner)
| | - Kamilla Miskowiak
- From the Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, University Hospital of Copenhagen, Rigshospitalet, and University of Copenhagen, Denmark (Meluken, Ottesen, Macoveanu, Kessing, Vinberg, Miskowiak); the Department of Psychology, University of Copenhagen, Copenhagen, Denmark (Miskowiak); the Department of Psychiatry, University of Oxford, Oxford, United Kingdom (Harmer); the Danish Research Centre of Magnetic Resonance, Copenhagen University Hospital Hvidovre, Denmark (Meluken, Siebner, Miskowiak); and the Department of Neurology, Copenhagen University Hospital, Bispebjerg, University of Copenhagen, Denmark (Siebner)
| |
Collapse
|
17
|
A systematic review on sleep alterations anticipating the onset of bipolar disorder. Eur Psychiatry 2019; 58:45-53. [DOI: 10.1016/j.eurpsy.2019.02.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Revised: 01/23/2019] [Accepted: 02/08/2019] [Indexed: 12/14/2022] Open
Abstract
AbstractBackground:Sleep alterations are frequent occurrence in Bipolar Disorder (BD), both in acute and interepisodic phases. Sleep alterations have been also described both long before BD onset, as aspecific risk syndromes, or as immediate prodromes of BD onset. The aim of the present study is to systematically review the relationship between sleep alterations anticipating for the full-blown onset of BD, both in general and according to specific polarities of onset.Methods:A systematic literature research according to PRISMA statement and considering: 1. prospective studies about BD patients’ offspring with sleep alterations who later developed BD. 2. prospective studies assessing patients with sleep disorders who later developed BD. 3. retrospective studies on BD patients where sleep alterations before BD onset of the disease were reported.Results:A total of 16 studies were included in this review. Sleep disturbances may frequently appear 1 year before the onset of BD or more, often during childhood or adolescence. A decreased need for sleep may precede the onset of the illness, specially a manic episode, while insomnia appears to anticipate either a manic or a depressive episode. Hypersomnia seems to precede bipolar depressive episodes.Conclusions:Sleep alterations frequently appear long before the onset of BD, and appear to be related specifically to the polarity of the index episode. The detection and treatment of sleep alterations in special high risk populations may help achieving an earlier detection of the illness.
Collapse
|
18
|
Preti A, Carta MG, Petretto DR. Factor structure models of the SCL-90-R: Replicability across community samples of adolescents. Psychiatry Res 2019; 272:491-498. [PMID: 30611969 DOI: 10.1016/j.psychres.2018.12.146] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Revised: 12/01/2018] [Accepted: 12/28/2018] [Indexed: 11/28/2022]
Abstract
Derogatis' Symptom Checklist-90-Revised (SCL-90-R) is one of the most widely used measures of psychological distress in both the clinical and the research settings, although its factor structure is still debated. In this study, the factor structure of the SCL-90-R has been investigated in two independent samples of Italian adolescents. Two samples of 817 (urban sample) and 507 (rural sample) adolescents attending high schools were involved. Confirmatory factorial analysis (CFA) was used alongside hierarchical nested, progressively constrained models to assess configural, metric and scalar invariance of the best models fitted by CFA. The standard nine-factor structure of the SCL-90-R resulted reproducible and invariant between the two samples, in both its correlated and hierarchical second-order implementations. Estimated reliability of the nine scales of the SCL-90-R was optimal. This study also confirmed the reproducibility of the bifactor models of the SCL-90-R with nine orthogonally independent factors and with nine correlated primary factors, which have been tested in some recent studies. Overall, the SCL-90-R measures both common and unique features of psychological distress in community samples. The measurement invariance across different levels of psychological distress in the factor structure of the SCL-90-R is an issue deserving further testing and investigation.
Collapse
Affiliation(s)
- Antonio Preti
- Center for Liaison Psychiatry and Psychosomatics, University Hospital, University of Cagliari, Cagliari, Italy; Section on Clinical Psychology, Department of Education, Psychology, Philosophy, University of Cagliari, Cagliari, Italy; Genneruxi Medical Center, Cagliari, Italy.
| | - Mauro Giovanni Carta
- Center for Liaison Psychiatry and Psychosomatics, University Hospital, University of Cagliari, Cagliari, Italy
| | - Donatella Rita Petretto
- Section on Clinical Psychology, Department of Education, Psychology, Philosophy, University of Cagliari, Cagliari, Italy
| |
Collapse
|
19
|
Areas of uncertainties and unmet needs in bipolar disorders: clinical and research perspectives. Lancet Psychiatry 2018; 5:930-939. [PMID: 30146246 DOI: 10.1016/s2215-0366(18)30253-0] [Citation(s) in RCA: 65] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 06/14/2018] [Accepted: 06/14/2018] [Indexed: 12/11/2022]
Abstract
This Review discusses crucial areas related to the identification, clinical presentation, course, and therapeutic management of bipolar disorder, a major psychiatric illness. Bipolar disorder is often misdiagnosed, leading to inappropriate, inadequate, or delayed treatment. Even when bipolar disorder is successfully diagnosed, its clinical management presents several major challenges, including how best to optimise treatment for an individual patient, and how to balance the benefits and risks of polypharmacy. We discuss the major unmet needs in the diagnosis and management of bipolar disorder in this Review, including improvement of adequate recognition and intervention in at-risk and early-disease stages, identification of reliable warning signs and prevention of relapses in unstable and rapid cycling patients, treatment of refractory depression, and prevention of suicide. Taken together, there are several promising opportunities for improving treatment of bipolar disorder to deliver medical care that is more personalised.
Collapse
|
20
|
Rowland TA, Marwaha S. Epidemiology and risk factors for bipolar disorder. Ther Adv Psychopharmacol 2018; 8:251-269. [PMID: 30181867 PMCID: PMC6116765 DOI: 10.1177/2045125318769235] [Citation(s) in RCA: 198] [Impact Index Per Article: 33.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Accepted: 03/13/2018] [Indexed: 12/20/2022] Open
Abstract
Bipolar disorder is a multifactorial illness with uncertain aetiology. Knowledge of potential risk factors enables clinicians to identify patients who are more likely to develop bipolar disorder, which directs further investigation, follow up and caution when prescribing. Ideally, identifying directly causative factors for bipolar disorder would enable intervention on an individual or population level to prevent the development of the illness, and improve outcomes through earlier treatment. This article reviews the epidemiology of bipolar disorder, along with putative demographic, genetic and environmental risk factors, while assessing the strength of these associations and to what extent they might be said to be 'causative'. While numerous genetic and environmental risk factors have been identified, the attributable risk of individual factors is often small, and most are not specific to bipolar disorder but are associated with several mental illnesses. Therefore, while some genetic and environmental factors have strong evidence supporting their association with bipolar disorder, fewer have sufficient evidence to establish causality. There is increasing interest in the role of specific gene-environment interactions, as well as the mechanisms by which risk factors interact to lead to bipolar disorder.
Collapse
Affiliation(s)
- Tobias A Rowland
- Unit of Mental Health and Wellbeing, Division of Health Sciences, University of Warwick, Coventry, CV4 7AL, UK
| | - Steven Marwaha
- Division of Health Sciences, University of Warwick, Coventry, UK
| |
Collapse
|
21
|
Haussleiter IS, Lorek S, Zeschel E, Mattausch S, Meyers M, Juckel G. At-risk symptoms of bipolar disorder in a university student cohort. Psychiatry Res 2018; 265:324-333. [PMID: 29778054 DOI: 10.1016/j.psychres.2018.05.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Revised: 04/17/2018] [Accepted: 05/02/2018] [Indexed: 10/16/2022]
Abstract
To assess the occurrence and frequency of bipolar at-risk symptoms in a large sample of previously undiagnosed students using the new screening tool Bochumer Screeningbogen Bipolar (BSB). 2329 students of the Ruhr-University Bochum, Germany completed online demographic data as well as various self-rating questionnaires (BSB; Hypomania Checklist 32; Altman Self-Rating Mania Scale; Beck Depression Inventory). Within the student cohort (64.4% female, mean age 24.3 years) every fifth student currently suffered from moderate to severe depressive symptoms; every sixth student had already thought about suicide and every other student reported a history of mood swings. The most frequently reported depressive symptoms included physical exhaustion, depressed mood, and tiredness. The most frequently reported (hypo)manic symptoms included physical agitation, feeling extremely energetic, and lack of concentration. The BSB showed good convergent validity with other established questionnaires capturing depressive or (hypo)manic symptoms, as well as a stable administration of underlying constructs. The BSB correlated significantly with the already established applied questionnaires. The predictive power of the BSB regarding the development of bipolar disorder cannot be correctly quantified at present. The further purpose of this exploratory web-based study should be to examine the validity of the presented measures in a longitudinal design.
Collapse
Affiliation(s)
- Ida S Haussleiter
- Department of Psychiatry, LWL University Hospital Bochum, Germany; Institute of Mental Health, LWL University Hospital Bochum, Germany.
| | - Sandra Lorek
- Department of Psychiatry, LWL University Hospital Bochum, Germany; Institute of Mental Health, LWL University Hospital Bochum, Germany
| | - Eike Zeschel
- Department of Psychiatry, LWL University Hospital Bochum, Germany
| | - Svenja Mattausch
- Institute of Mental Health, LWL University Hospital Bochum, Germany
| | - Milena Meyers
- Institute of Mental Health, LWL University Hospital Bochum, Germany
| | - Georg Juckel
- Department of Psychiatry, LWL University Hospital Bochum, Germany; Institute of Mental Health, LWL University Hospital Bochum, Germany
| |
Collapse
|
22
|
Prevalence of psychopathology in bipolar high-risk offspring and siblings: a meta-analysis. Eur Child Adolesc Psychiatry 2018; 27:823-837. [PMID: 28936622 DOI: 10.1007/s00787-017-1050-7] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2017] [Accepted: 09/13/2017] [Indexed: 02/08/2023]
Abstract
This meta-analysis aimed to update existing data on the comparison of prevalence rates of psychopathology primarily among offspring with at least one parent with bipolar disorder (BD) and offspring of parents without psychiatric illness. Seventeen studies were derived from a systematic search of PsychInfo, Medline, Scopus and Embase. Inclusion criteria were use of a control offspring group, standardized diagnostic procedures and reporting of clear frequency data. Risk of psychopathology was estimated by aggregating frequency data from selected studies. Compared to control offspring, high-risk BD offspring are nine times more likely to have a bipolar-type disorder, almost two and a half times more likely to develop a non-BD affective disorder and over two times more likely to develop at least one anxiety disorder. High-risk offspring also showed a significant increased risk of other non-mood psychopathology such as attention deficit hyperactivity disorder (ADHD), any type of behavioral disorder and substance use disorder (SUDs). Risk of developing a broad range of affective and non-affective psychopathology is significantly higher in high-risk BD offspring. Identifying clinical presentations of this genetically high-risk cohort is important in establishing appropriate preventative treatment.
Collapse
|
23
|
Lee TY, Lee J, Kim M, Choe E, Kwon JS. Can We Predict Psychosis Outside the Clinical High-Risk State? A Systematic Review of Non-Psychotic Risk Syndromes for Mental Disorders. Schizophr Bull 2018; 44:276-285. [PMID: 29438561 PMCID: PMC5814842 DOI: 10.1093/schbul/sbx173] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Recent evidence has suggested that psychosis could develop not only in people at clinical high risk for psychosis (CHR-P) but also in those with clinical risk syndromes for emergent nonpsychotic mental disorders. The proportion of people with these clinical risk syndromes who will develop psychosis rather than to other nonpsychotic mental disorders is undetermined. Electronic databases were searched for studies reporting on clinical risk syndromes for the development of emergent nonpsychotic mental disorders. Incidence of emerging psychotic and nonpsychotic mental disorders defined on the ICD or DSM. Of a total of 9 studies relating to 3006 nonpsychotic at-risk individuals were included. Within prospective studies (n = 4, sample = 1051), the pooled incidence of new psychotic disorders across these clinical risk syndromes was of 12.9 per 1000 person-years (95% CI: 4.3 to 38.6) and that of nonpsychotic disorders (n = 3, sample = 538) was of 43.5 per 1000 person-years (95% CI: 30.9 to 61.3). Psychotic disorders may emerge outside the CHR-P paradigm, from clinical risk syndromes for incident nonpsychotic disorders, albeit at lower rates than in the CHR-P group. The clinical risk syndromes for emerging nonpsychotic disorders may exhibit a pluripotential risk of developing several types of mental disorders compared with CHR-P. If substantiated by future research, the current findings suggest that it may be useful to move beyond the current strategy of identifying individuals meeting CHR-P criteria only.
Collapse
Affiliation(s)
- Tae Young Lee
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Junhee Lee
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Minah Kim
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Eugenie Choe
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jun Soo Kwon
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea,Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, Republic of Korea,To whom correspondence should be addressed; Department of Psychiatry, Seoul National University College of Medicine, 101 Daehak-no, Chongno-gu, Seoul 03035, Republic of Korea; e-mail:
| |
Collapse
|
24
|
Zalpuri I, Singh MK. Treatment of psychiatric symptoms among offspring of parents with bipolar disorder. ACTA ACUST UNITED AC 2017; 4:341-356. [PMID: 29503793 DOI: 10.1007/s40501-017-0126-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Purpose of Review Bipolar disorder is highly familial and has a protracted and diagnostically confusing prodrome. This review critically evaluates recently published literature relevant to the treatment of psychiatric symptoms in high-risk offspring of parents with Bipolar Disorder. Recent Findings Non-pharmacological treatment options including psychotherapy, resilience promotion through good sleep, diet, and exercise hygiene, and omega-3 fatty acid supplementation are important first line interventions for high-risk offspring. There has been some success in treating this population with open-label trials with mood stabilizers and atypical antipsychotics; however, these results have not been replicated in randomized controlled trails. Summary Despite some progress in early identification of symptoms in offspring of parents with Bipolar Disorder, there is scarce evidence supporting the treatment of these high-risk youth to prevent psychiatric symptoms from progressing to threshold bipolar or other psychiatric disorders. There is a need for prospective and randomized trials and research that identifies reliable biomarkers to individualize treatments for these youth.
Collapse
Affiliation(s)
- Isheeta Zalpuri
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA
| | - Manpreet K Singh
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA
| |
Collapse
|