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Aguglia A, Giacomini G, De Michiel CF, Garbarino N, Lechiara A, Magni C, Meinero M, Verrina E, Costanza A, Amerio A, Amore M, Serafini G. Characterization of Bipolar Disorder I and II: Clinical Features, Comorbidities, and Pharmacological Pattern. ALPHA PSYCHIATRY 2024; 25:472-479. [PMID: 39360293 PMCID: PMC11443285 DOI: 10.5152/alphapsychiatry.2024.241474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Accepted: 04/29/2024] [Indexed: 10/04/2024]
Abstract
Objective Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition provides precise diagnostic criteria to differentiate between bipolar disorder (BD) type I and II; nevertheless, it can be challenging to come up with the right diagnosis. The aim of this study is to evaluate the sociodemographic differences, clinical features, comorbidities, and pharmacological pattern between patients with BD type I and II. Methods A total of 680 patients with BD type I and II were consecutively recruited to our psychiatry department. A semi-structured interview was used to collect several information. Results Patients with BD type I were mostly males, single, with a lower current age, and unemployed compared to patients with BD type II. Furthermore, patients with BD type I showed an earlier age at onset and a significant higher prevalence of psychotic and residual symptoms, a higher number of hospitalizations, and involuntary admissions. On the other hand, patients with BD type II were associated with a significant higher prevalence of lifetime suicide attempts, psychiatric comorbidities, and use of alcohol. Finally, antidepressant drugs were prescribed more often to patients with BD type II, while antipsychotics and mood stabilizers were mostly prescribed in patients with BD type I. Conclusion the differentiation of the 2 nosologic bipolar diagnosis is in line with the current scientific interest, confirming the existence of a markedly different profile between BD type I and II. This differentiation could reduce the heterogeneity of bipolar presentation in research, optimize clinical assessment, and increase the interest in developing more precise and individualized therapeutic strategies, also implementing psychosocial therapies.
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Affiliation(s)
- Andrea Aguglia
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | | | - Clio F De Michiel
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy
| | - Nicolò Garbarino
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy
| | - Alessio Lechiara
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy
| | - Caterina Magni
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy
| | - Matteo Meinero
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy
| | - Edoardo Verrina
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy
| | - Alessandra Costanza
- Department of Psychiatry, Geneva University Hospital (HUG), Geneva, Switzerland
- Department of Psychiatry, Faculty of Biomedical Sciences, University of Italian Switzerland, Lugano, Switzerland
- Department of Psychiatry, Faculty of Medicine, Geneva University, Geneva, Switzerland
| | - Andrea Amerio
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Mario Amore
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy
| | - Gianluca Serafini
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
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Macoveanu J, Fortea L, Kjærstad HL, Coello K, Faurholt-Jepsen M, Fisher PM, Knudsen GM, Radua J, Vieta E, Frangou S, Vinberg M, Kessing LV, Miskowiak KW. Longitudinal changes in resting-state functional connectivity as markers of vulnerability or resilience in first-degree relatives of patients with bipolar disorder. Psychol Med 2024:1-9. [PMID: 38634498 DOI: 10.1017/s0033291724000898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/19/2024]
Abstract
BACKGROUND There is a significant contribution of genetic factors to the etiology of bipolar disorder (BD). Unaffected first-degree relatives of patients (UR) with BD are at increased risk of developing mental disorders and may manifest cognitive impairments and alterations in brain functional and connective dynamics, akin to their affected relatives. METHODS In this prospective longitudinal study, resting-state functional connectivity was used to explore stable and progressive markers of vulnerability i.e. abnormalities shared between UR and BD compared to healthy controls (HC) and resilience i.e. features unique to UR compared to HC and BD in full or partial remission (UR n = 72, mean age = 28.0 ± 7.2 years; HC n = 64, mean age = 30.0 ± 9.7 years; BD patients n = 91, mean age = 30.6 ± 7.7 years). Out of these, 34 UR, 48 BD, and 38 HC were investigated again following a mean time of 1.3 ± 0.4 years. RESULTS At baseline, the UR showed lower connectivity values within the default mode network (DMN), frontoparietal network, and the salience network (SN) compared to HC. This connectivity pattern in UR remained stable over the follow-up period and was not present in BD, suggesting a resilience trait. The UR further demonstrated less negative connectivity between the DMN and SN compared to HC, abnormality that remained stable over time and was also present in BD, suggesting a vulnerability marker. CONCLUSION Our findings indicate the coexistence of both vulnerability-related abnormalities in resting-state connectivity, as well as adaptive changes possibly promoting resilience to psychopathology in individual at familial risk.
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Affiliation(s)
- Julian Macoveanu
- Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, Frederiksberg Hospital, Copenhagen, Denmark
- Neurocogntion and Emotion in Affective Disorders (NEAD) Centre, Psychiatric Centre Copenhagen, and Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Lydia Fortea
- Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Fundació Clínic per la Recerca Biomèdica (FCRB), Barcelona, Spain
- Department of Medicine, Institute of Neuroscience, University of Barcelona, Barcelona, Spain
| | - Hanne Lie Kjærstad
- Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, Frederiksberg Hospital, Copenhagen, Denmark
- Neurocogntion and Emotion in Affective Disorders (NEAD) Centre, Psychiatric Centre Copenhagen, and Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Klara Coello
- Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, Frederiksberg Hospital, Copenhagen, Denmark
| | - Maria Faurholt-Jepsen
- Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, Frederiksberg Hospital, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Patrick M Fisher
- Neurobiology Research Unit, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Drug Design and Pharmacology, University of Copenhagen, Copenhagen, Denmark
| | - Gitte Moos Knudsen
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Neurobiology Research Unit, Copenhagen University Hospital, Copenhagen, Denmark
| | - Joaquim Radua
- Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Fundació Clínic per la Recerca Biomèdica (FCRB), Barcelona, Spain
- Centro de Investigacisón Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Eduard Vieta
- Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Fundació Clínic per la Recerca Biomèdica (FCRB), Barcelona, Spain
- Department of Medicine, Institute of Neuroscience, University of Barcelona, Barcelona, Spain
- Centro de Investigacisón Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Sophia Frangou
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, US
| | - Maj Vinberg
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- The Early Multimodular Prevention and Intervention Research Institution (EMPIRI), Psychiatric Center Northern Zealand, Denmark
| | - Lars Vedel Kessing
- Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, Frederiksberg Hospital, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Kamilla Woznica Miskowiak
- Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, Frederiksberg Hospital, Copenhagen, Denmark
- Neurocogntion and Emotion in Affective Disorders (NEAD) Centre, Psychiatric Centre Copenhagen, and Department of Psychology, University of Copenhagen, Copenhagen, Denmark
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Li R, Wang J, Wang Y, Lin X, Sun C, Xu L. Telomere length as a modifier in the relationship between phthalate metabolites exposure and glucose homeostasis. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2024; 344:123309. [PMID: 38190874 DOI: 10.1016/j.envpol.2024.123309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 12/20/2023] [Accepted: 01/04/2024] [Indexed: 01/10/2024]
Abstract
Given the rising concern over the potential impact of environmental factors on metabolic heath, we conducted a cross-sectional analysis among 645 adults aged 20 and older in the National Health and Nutrition Examination Survey (NHANES), examining the association between nine phthalate metabolites (Mono-n-butyl phthalate (MBP), Mono-ethyl phthalate (MEP), Mono-(2-ethyl)-hexyl phthalate (MEHP), Mono-benzyl phthalate (MBzP), Mono-n-methyl phthalate (MnMP), Mono-(3-carboxy propyl) phthalate (MCPP), Mono-(2-ethyl-5-hydroxyhexyl) phthalate (MEHHP), Mono-(2-ethyl-5-oxohexyl) phthalate (MEOHP), Mono-isobutyl phthalate (MiBP)) and six glucose homeostasis indices (fasting glucose, fasting insulin, hemoglobin A1C (HbA1C), homeostatic model assessment of insulin resistance (HOMA-IR), single Point Insulin Sensitivity Estimator (SPISE), and HOMA-β). Latent Class Analysis identified three phthalate metabolites exposure patterns: high MEP-low MEOHP (n = 282), high MBzP-low MEHHP (n = 214), and high MEHHP, MEOHP (n = 149). The high MBzP-low MEHHP and high MEHHP, MEOHP, versus the high MEP-low MEOHP, exposure groups showed significantly higher levels of fasting insulin (β = 0.126, 95% CI: 0.023-0.228), SPISE (β = 0.091, 95% CI: 0.018-0.164), and HOMA-IR (β = 0.091, 95% CI: 0.018-0.164). In the shorter telomere length group, high MEHHP, MEOHP exposure showed an increase in SPISE levels (β = 0.153, 95% CI: 0.037-0.269), while in the overweight/obese subgroup, high MEHHP, MEOHP exposure was significantly positively associated with HOMA-IR (β = 0.392, 95% CI: 0.150-0.735). Bayesian kernel machine regression analyses showed positive associations between higher combined phthalate exposure and increased glucose homeostasis indices (fasting glucose, HbA1C, fasting insulin, SPISE, and HOMA-IR). The quantile of g-calculation analysis also supported the positive associations with HbA1C, HOMA-IR, and fasting insulin. Our findings indicate that phthalate exposure was positively associated with glucose homeostasis indices, which strengthen the call for proactive measures to reduce phthalate exposure and mitigate potential risks to glucose metabolism.
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Affiliation(s)
- Ruiqiang Li
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Jiao Wang
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Ying Wang
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Xiaoyi Lin
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Ce Sun
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Lin Xu
- School of Public Health, Sun Yat-sen University, Guangzhou, China; School of Public Health, The University of Hong Kong, Hong Kong, China; Institute of Applied Health Research, University of Birmingham, Birmingham, UK.
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Avramescu RG, Flores C. We're not in Kansas anymore: ectopic dopaminergic terminals as an explanation for the positive symptoms in psychiatric pathology. J Psychiatry Neurosci 2023; 48:E74-E77. [PMID: 36810305 PMCID: PMC9949873 DOI: 10.1503/jpn.230015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/24/2023] Open
Affiliation(s)
- Radu Gabriel Avramescu
- From the Douglas Mental Health University Institute, Montréal, Que., Canada (Avramescu, Flores); and the Department of Psychiatry and Department of Neurology and Neurosurgery, McGill University, Montréal, Que., Canada (Flores)
| | - Cecilia Flores
- From the Douglas Mental Health University Institute, Montréal, Que., Canada (Avramescu, Flores); and the Department of Psychiatry and Department of Neurology and Neurosurgery, McGill University, Montréal, Que., Canada (Flores)
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5
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Kalman JL, Olde Loohuis LM, Vreeker A, McQuillin A, Stahl EA, Ruderfer D, Grigoroiu-Serbanescu M, Panagiotaropoulou G, Ripke S, Bigdeli TB, Stein F, Meller T, Meinert S, Pelin H, Streit F, Papiol S, Adams MJ, Adolfsson R, Adorjan K, Agartz I, Aminoff SR, Anderson-Schmidt H, Andreassen OA, Ardau R, Aubry JM, Balaban C, Bass N, Baune BT, Bellivier F, Benabarre A, Bengesser S, Berrettini WH, Boks MP, Bromet EJ, Brosch K, Budde M, Byerley W, Cervantes P, Chillotti C, Cichon S, Clark SR, Comes AL, Corvin A, Coryell W, Craddock N, Craig DW, Croarkin PE, Cruceanu C, Czerski PM, Dalkner N, Dannlowski U, Degenhardt F, Del Zompo M, DePaulo JR, Djurovic S, Edenberg HJ, Eissa MA, Elvsåshagen T, Etain B, Fanous AH, Fellendorf F, Fiorentino A, Forstner AJ, Frye MA, Fullerton JM, Gade K, Garnham J, Gershon E, Gill M, Goes FS, Gordon-Smith K, Grof P, Guzman-Parra J, Hahn T, Hasler R, Heilbronner M, Heilbronner U, Jamain S, Jimenez E, Jones I, Jones L, Jonsson L, Kahn RS, Kelsoe JR, Kennedy JL, Kircher T, Kirov G, Kittel-Schneider S, Klöhn-Saghatolislam F, Knowles JA, Kranz TM, Lagerberg TV, Landen M, Lawson WB, Leboyer M, Li QS, Maj M, Malaspina D, Manchia M, Mayoral F, McElroy SL, McInnis MG, McIntosh AM, Medeiros H, Melle I, Milanova V, Mitchell PB, Monteleone P, Monteleone AM, Nöthen MM, Novak T, Nurnberger JI, O'Brien N, O'Connell KS, O'Donovan C, O'Donovan MC, Opel N, Ortiz A, Owen MJ, Pålsson E, Pato C, Pato MT, Pawlak J, Pfarr JK, Pisanu C, Potash JB, Rapaport MH, Reich-Erkelenz D, Reif A, Reininghaus E, Repple J, Richard-Lepouriel H, Rietschel M, Ringwald K, Roberts G, Rouleau G, Schaupp S, Scheftner WA, Schmitt S, Schofield PR, Schubert KO, Schulte EC, Schweizer B, Senner F, Severino G, Sharp S, Slaney C, Smeland OB, Sobell JL, Squassina A, Stopkova P, Strauss J, Tortorella A, Turecki G, Twarowska-Hauser J, Veldic M, Vieta E, Vincent JB, Xu W, Zai CC, Zandi PP, Di Florio A, Smoller JW, Biernacka JM, McMahon FJ, Alda M, Müller-Myhsok B, Koutsouleris N, Falkai P, Freimer NB, Andlauer TF, Schulze TG, Ophoff RA. Characterisation of age and polarity at onset in bipolar disorder. Br J Psychiatry 2021; 219:659-669. [PMID: 35048876 PMCID: PMC8636611 DOI: 10.1192/bjp.2021.102] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 05/26/2021] [Accepted: 07/01/2021] [Indexed: 01/12/2023]
Abstract
BACKGROUND Studying phenotypic and genetic characteristics of age at onset (AAO) and polarity at onset (PAO) in bipolar disorder can provide new insights into disease pathology and facilitate the development of screening tools. AIMS To examine the genetic architecture of AAO and PAO and their association with bipolar disorder disease characteristics. METHOD Genome-wide association studies (GWASs) and polygenic score (PGS) analyses of AAO (n = 12 977) and PAO (n = 6773) were conducted in patients with bipolar disorder from 34 cohorts and a replication sample (n = 2237). The association of onset with disease characteristics was investigated in two of these cohorts. RESULTS Earlier AAO was associated with a higher probability of psychotic symptoms, suicidality, lower educational attainment, not living together and fewer episodes. Depressive onset correlated with suicidality and manic onset correlated with delusions and manic episodes. Systematic differences in AAO between cohorts and continents of origin were observed. This was also reflected in single-nucleotide variant-based heritability estimates, with higher heritabilities for stricter onset definitions. Increased PGS for autism spectrum disorder (β = -0.34 years, s.e. = 0.08), major depression (β = -0.34 years, s.e. = 0.08), schizophrenia (β = -0.39 years, s.e. = 0.08), and educational attainment (β = -0.31 years, s.e. = 0.08) were associated with an earlier AAO. The AAO GWAS identified one significant locus, but this finding did not replicate. Neither GWAS nor PGS analyses yielded significant associations with PAO. CONCLUSIONS AAO and PAO are associated with indicators of bipolar disorder severity. Individuals with an earlier onset show an increased polygenic liability for a broad spectrum of psychiatric traits. Systematic differences in AAO across cohorts, continents and phenotype definitions introduce significant heterogeneity, affecting analyses.
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Affiliation(s)
- Janos L. Kalman
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Germany; Department of Psychiatry and Psychotherapy, University Hospital Munich, Germany; and International Max Planck Research School for Translational Psychiatry, Germany
| | - Loes M. Olde Loohuis
- Center for Neurobehavioral Genetics, Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, USA
| | - Annabel Vreeker
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Centre–Sophia Children’s Hospital, the Netherlands
| | | | - Eli A. Stahl
- Division of Psychiatric Genomics, Mount Sinai School of Medicine, USA
| | - Douglas Ruderfer
- Division of Genetic Medicine, Department of Medicine, Vanderbilt Genetics Institute, Vanderbilt University Medical Center, USA; Department of Biomedical Informatics, Vanderbilt University Medical Center, USA; and Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, USA
| | | | | | - Stephan Ripke
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, USA; and Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, USA
| | - Tim B. Bigdeli
- Department of Psychiatry and Behavioral Sciences, SUNY Downstate Health Sciences University, USA; and VA NY Harbor Healthcare System, USA
| | - Frederike Stein
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Germany
| | - Tina Meller
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Germany; and Center for Mind, Brain and Behavior (CMBB), Germany
| | - Susanne Meinert
- Institute for Translational Psychiatry, Westfälische Wilhelms-Universität Münster, Germany; and Institute for Translational Neuroscience, University of Münster, Germany
| | - Helena Pelin
- International Max Planck Research School for Translational Psychiatry, Germany; and Max Planck Institute of Psychiatry, Germany
| | - Fabian Streit
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Germany
| | - Sergi Papiol
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Germany; Department of Psychiatry and Psychotherapy, University Hospital Munich, Germany; and Centro de Investigación Biomedica en Red de Salud Mental (CIBERSAM), Spain
| | | | - Rolf Adolfsson
- Department of Clinical Sciences, Medical Faculty, Umeå University, Sweden
| | - Kristina Adorjan
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Germany; and Department of Psychiatry and Psychotherapy, University Hospital Munich, Germany
| | - Ingrid Agartz
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Sweden; Department of Psychiatric Research, Diakonhjemmet Hospital, Norway; and NORMENT Centre, Division of Mental Health and Addiction, Institute of Clinical Medicine, University of Oslo, Norway
| | - Sofie R. Aminoff
- Division of Mental Health and Addiction, Oslo University Hospital, Norway; and NORMENT Centre, Inst of Clinical Medicine, University of Oslo, Norway
| | - Heike Anderson-Schmidt
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Germany
| | - Ole A. Andreassen
- NORMENT Centre, Inst of Clinical Medicine, University of Oslo, Norway; and Division of Mental Health and Addiction, Oslo University Hosptial, Norway
| | - Raffaella Ardau
- Unit of Clinical Pharmacology, University Hospital Agency of Cagliari, Italy
| | - Jean-Michel Aubry
- Faculty of medicine, University of Geneva, Switzerland; and Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Germany
| | - Ceylan Balaban
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Germany
| | - Nicholas Bass
- Division of Psychiatry, University College London, UK
| | - Bernhard T. Baune
- Department of Psychiatry, University of Münster, Germany; Department of Psychiatry, Melbourne Medical School, The University of Melbourne, Australia; The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Australia; and Discipline of Psychiatry, Adelaide Medical School, The University of Adelaide, Australia
| | - Frank Bellivier
- Universite de Paris, France; INSERM UMRS 1144, France; and DMU Neurosciences, GHU Lariboisière Fernand Widal, Departement de Psychiatrie, APHP, France
| | - Antoni Benabarre
- Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Spain
| | - Susanne Bengesser
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University Graz, Austria
| | | | - Marco P. Boks
- Psychiatry, UMC Utrecht Brain Center, the Netherlands
| | | | - Katharina Brosch
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Germany
| | - Monika Budde
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Germany
| | | | | | - Catina Chillotti
- Unit of Clinical Pharmacology, University Hospital Agency of Cagliari, Italy
| | - Sven Cichon
- Department of Biomedicine, University of Basel, Switzerland; Institute of Human Genetics, University of Bonn, School of Medicine & University Hospital Bonn, Germany; Institute of Medical Genetics and Pathology, University Hospital Basel, Switzerland; and Institute of Neuroscience and Medicine (INM-1), Research Centre Julich, Germany
| | - Scott R. Clark
- Discipline of Psychiatry, University of Adelaide, Australia; and Bazil Hetzel Institute, Australia
| | - Ashley L. Comes
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Germany; Department of Psychiatry and Psychotherapy, University Hospital Munich, Germany; and International Max Planck Research School for Translational Psychiatry, Germany
| | - Aiden Corvin
- Department of Psychiatry & Trinity Translational Medicine Institute, Trinity College Dublin, Ireland
| | | | - Nick Craddock
- Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, UK
| | | | | | - Cristiana Cruceanu
- Department of Translational Research, Max Planck Institute of Psychiatry, Germany
| | - Piotr M. Czerski
- Department of Psychiatric Genetics, Poznan University of Medical Sciences, Poland
| | - Nina Dalkner
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University Graz, Austria
| | - Udo Dannlowski
- Institute for Translational Psychiatry, Westfälische Wilhelms-Universität Münster, Germany
| | - Franziska Degenhardt
- Institute of Human Genetics, University of Bonn, School of Medicine & University Hospital Bonn, Germany; and Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Essen, University of Duisburg-Essen, Germany
| | - Maria Del Zompo
- Department of Biomedical Science, Section of Neuroscience & Clinical Pharmacology, University of Cagliari, Italy; and Unit of Clinical Pharmacology, University Hospital Agency of Cagliari, Italy
| | - J. Raymond DePaulo
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, USA
| | - Srdjan Djurovic
- Department of Medical Genetics, Oslo University Hospital Ullevål, Norway; and NORMENT, Department of Clinical Science, University of Bergen, Norway
| | - Howard J. Edenberg
- Department of Biochemistry and Molecular Biology, Indiana University School of Medicine, USA
| | | | - Torbjørn Elvsåshagen
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital, Norway
| | - Bruno Etain
- Universite de Paris, France; INSERM UMRS 1144, France; and DMU Neurosciences, GHU Lariboisière Fernand Widal, Departement de Psychiatrie, APHP, France
| | - Ayman H. Fanous
- Department of Psychiatry and Behavioral Sciences, SUNY Downstate Health Sciences University, USA; and VA NY Harbor Healthcare System, USA
| | - Frederike Fellendorf
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University Graz, Austria
| | | | - Andreas J. Forstner
- Institute of Human Genetics, University of Bonn, School of Medicine & University Hospital Bonn, Germany; and Centre for Human Genetics, University of Marburg, Germany
| | - Mark A. Frye
- Department of Psychiatry and Psychology, Mayo Clinic, USA
| | - Janice M. Fullerton
- Neuroscience Research Australia, Australia; and School of Medical Sciences, University of New South Wales, Australia
| | - Katrin Gade
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Germany
| | | | - Elliot Gershon
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, USA; and Department of Human Genetics, University of Chicago, USA
| | - Michael Gill
- Department of Psychiatry & Trinity Translational Medicine Institute, Trinity College Dublin, Ireland
| | - Fernando S. Goes
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, USA
| | | | - Paul Grof
- Mood Disorders Centre of Ottawa, Canada; and Department of Psychiatry, University of Toronto, Canada
| | - Jose Guzman-Parra
- Mental Health Department, University Regional Hospital, Biomedicine Institute (IBIMA), Spain
| | - Tim Hahn
- Institute for Translational Psychiatry, Westfälische Wilhelms-Universität Münster, Germany
| | - Roland Hasler
- Cell Biology, SUNY Downstate Medical Center College of Medicine, USA; and Institute for Genomic Health, SUNY Downstate Medical Center College of Medicine, USA
| | - Maria Heilbronner
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Germany
| | - Urs Heilbronner
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Germany
| | - Stephane Jamain
- Universite Paris Est Creteil, France; and INSERM U 955, Neuropsychiatrie Translationnelle, France
| | - Esther Jimenez
- Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Spain
| | - Ian Jones
- Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, UK
| | - Lisa Jones
- Psychological Medicine, University of Worcester, UK
| | - Lina Jonsson
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Sweden
| | - Rene S. Kahn
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, USA
| | - John R. Kelsoe
- Department of Psychiatry, University of California San Diego, USA
| | - James L. Kennedy
- Department of Psychiatry, University of Toronto, Canada; The Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Canada; and Institute of Medical Science, University of Toronto, Canada
| | - Tilo Kircher
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Germany
| | - George Kirov
- Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, UK
| | - Sarah Kittel-Schneider
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Germany; and Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital Wurzburg, Germany
| | | | - James A. Knowles
- Cell Biology, SUNY Downstate Medical Center College of Medicine, USA; and Institute for Genomic Health, SUNY Downstate Medical Center College of Medicine, USA
| | - Thorsten M. Kranz
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Germany
| | - Trine Vik Lagerberg
- NORMENT Centre, Division of Mental Health and Addiction, Oslo University Hosptial, Norway
| | - Mikael Landen
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Sweden; and Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Sweden
| | - William B. Lawson
- Department of Psychiatry and Behavioral Sciences, Howard University Hospital, USA
| | - Marion Leboyer
- Universite Paris Est Creteil, France; and INSERM U 955, Neuropsychiatrie Translationnelle, France
| | | | - Mario Maj
- Department of Psychiatry, University of Campania ‘Luigi Vanvitelli’, Italy
| | - Dolores Malaspina
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, USA; and Department of Genetics & Genomics, Icahn School of Medicine at Mount Sinai, USA
| | - Mirko Manchia
- Unit of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Italy and Department of Pharmacology, Dalhousie University, Canada
| | - Fermin Mayoral
- Mental Health Department, University Regional Hospital, Biomedicine Institute (IBIMA), Spain
| | | | | | | | - Helena Medeiros
- Institute for Genomic Health, SUNY Downstate Medical Center College of Medicine, USA
| | - Ingrid Melle
- NORMENT Centre, Division of Mental Health and Addiction, Institute of Clinical Medicine and Diakonhjemmet Hospital, University of Oslo, Norway; and Division of Mental Health and Addiction, Oslo University Hospital, Norway
| | - Vihra Milanova
- Psychiatric Clinic, Alexander University Hospital, Bulgaria
| | | | - Palmiero Monteleone
- Department of Medicine, Surgery and Dentistry ‘Scuola Medica Salernitana’, University of Salerno, Italy
| | | | - Markus M. Nöthen
- Institute of Human Genetics, University of Bonn, School of Medicine & University Hospital Bonn, Germany
| | - Tomas Novak
- National Institute of Mental Health, Czech Republic
| | | | - Niamh O'Brien
- Division of Psychiatry, University College London, UK
| | - Kevin S. O'Connell
- Division of Mental Health and Addiction, Oslo University Hospital, Norway; and NORMENT Centre, Inst of Clinical Medicine, University of Oslo, Norway
| | | | - Michael C. O'Donovan
- Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, UK
| | - Nils Opel
- Institute for Translational Psychiatry, Westfälische Wilhelms-Universität Münster, Germany
| | - Abigail Ortiz
- Department of Psychiatry, University of Toronto, Toronto, Canada; and Centre for Addiction and Mental Health, Toronto, Canada
| | - Michael J. Owen
- Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, UK
| | - Erik Pålsson
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Sweden
| | - Carlos Pato
- Institute for Genomic Health, SUNY Downstate Medical Center College of Medicine, USA
| | - Michele T. Pato
- Institute for Genomic Health, SUNY Downstate Medical Center College of Medicine, USA
| | - Joanna Pawlak
- Department of Psychiatric Genetics, Poznan University of Medical Sciences, Poland
| | | | - Claudia Pisanu
- Department of Biomedical Science, Section of Neuroscience & Clinical Pharmacology, University of Cagliari, Italy
| | - James B. Potash
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, USA
| | - Mark H Rapaport
- Department of Psychiatry and Behavioral Sciences, Emory University, USA
| | - Daniela Reich-Erkelenz
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Germany
| | - Andreas Reif
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Germany
| | - Eva Reininghaus
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University Graz, Austria
| | - Jonathan Repple
- Institute for Translational Psychiatry, Westfälische Wilhelms-Universität Münster, Germany
| | | | - Marcella Rietschel
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Germany
| | - Kai Ringwald
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Germany
| | - Gloria Roberts
- School of Psychiatry, University of New South Wales, Australia
| | - Guy Rouleau
- Montreal Neurological Institute, Canada and Department of Neurology, McGill University, Canada
| | - Sabrina Schaupp
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Germany
| | | | - Simon Schmitt
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Germany
| | - Peter R. Schofield
- Neuroscience Research Australia, Australia; and School of Medical Sciences, University of New South Wales, Australia
| | - K. Oliver Schubert
- Discipline of Psychiatry, University of Adelaide, Australia; and Northern Adelaide Mental Health Service, SA Health, Australia
| | - Eva C. Schulte
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Germany; and Department of Psychiatry and Psychotherapy, University Hospital Munich, Germany
| | - Barbara Schweizer
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, USA
| | - Fanny Senner
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Germany; and Department of Psychiatry and Psychotherapy, University Hospital Munich, Germany
| | - Giovanni Severino
- Department of Biomedical Science, Section of Neuroscience & Clinical Pharmacology, University of Cagliari, Italy
| | - Sally Sharp
- Division of Psychiatry, University College London, UK
| | | | - Olav B. Smeland
- Division of Mental Health and Addiction, Oslo University Hospital, Norway; and NORMENT Centre, Inst of Clinical Medicine, University of Oslo, Norway
| | - Janet L. Sobell
- Psychiatry and the Behavioral Sciences, University of Southern California, USA
| | - Alessio Squassina
- Department of Psychiatry, Dalhousie University, Canada; and Department of Biomedical Science, Section of Neuroscience & Clinical Pharmacology, University of Cagliari, Italy
| | | | - John Strauss
- Department of Psychiatry, University of Toronto, Canada; The Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Canada; and Institute of Medical Science, University of Toronto, Canada
| | | | - Gustavo Turecki
- Department of Psychiatry, McGill University, Canada; and Douglas Institute, McGill University, Canada
| | | | - Marin Veldic
- Department of Psychiatry and Psychology, Mayo Clinic, USA
| | - Eduard Vieta
- Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Spain
| | - John B. Vincent
- Department of Psychiatry, University of Toronto, Canada; The Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Canada; and Institute of Medical Science, University of Toronto, Canada
| | - Wei Xu
- Dalla Lana School of Public Health, Biostatistics Division, University of Toronto, Canada
| | - Clement C. Zai
- Department of Psychiatry, University of Toronto, Canada; The Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Canada; Institute of Medical Science, University of Toronto, Canada; Laboratory Medicine and Pathobiology, University of Toronto, Canada; and Harvard T.H. Chan School of Public Health, USA
| | - Peter P. Zandi
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, USA
| | - Arianna Di Florio
- Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, UK
| | - Jordan W. Smoller
- Psychiatric and Neurodevelopmental Genetics Unit, Department of Psychiatry and Center for Genomic Medicine, Massachusetts General Hospital, USA; and Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, USA
| | - Joanna M. Biernacka
- Department of Psychiatry and Psychology, Mayo Clinic, USA; and Department of Health Sciences Research, Mayo Clinic, USA
| | - Francis J. McMahon
- Human Genetics Branch, Intramural Research Program, National Institute of Mental Health, USA
| | - Martin Alda
- National Institute of Mental Health, Czech Republic; and Department of Psychiatry, Dalhousie University, Canada
| | | | - Nikolaos Koutsouleris
- Department of Psychiatry and Psychotherapy, University Hospital Munich, Germany; Max Planck Institute of Psychiatry, Germany; and Institute of Psychiatry, Psychology and Neuroscience, Kings College London, UK
| | - Peter Falkai
- Department of Psychiatry and Psychotherapy, University Hospital Munich, Germany
| | - Nelson B. Freimer
- Center for Neurobehavioral Genetics, Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, USA; and Human Genetics, University of California Los Angeles, USA
| | - Till F.M. Andlauer
- Department of Neurology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Germany
| | - Thomas G. Schulze
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Germany; Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Germany; Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Germany; Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, USA; and Department of Psychiatry and Behavioral Sciences, SUNY Upstate Medical University, USA
| | - Roel A. Ophoff
- Center for Neurobehavioral Genetics, Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, USA; Human Genetics, University of California Los Angeles, USA; and Psychiatry, Erasmus University Medical Center, the Netherlands
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6
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Vaingankar JA, Chong SA, Abdin E, Shafie S, Chua BY, Shahwan S, Verma S, Subramaniam M. Early age of onset of mood, anxiety and alcohol use disorders is associated with sociodemographic characteristics and health outcomes in adults: results from a cross-sectional national survey. Soc Psychiatry Psychiatr Epidemiol 2021; 56:1835-1846. [PMID: 33791821 DOI: 10.1007/s00127-021-02070-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 03/10/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE This cross-sectional study investigated distribution, sociodemographic correlates, and health outcomes in early versus late age of onset (AOO) of mood, anxiety, and alcohol use disorders in Singapore. METHODS The Composite International Diagnostic Interview established lifetime diagnoses of major depressive, bipolar, generalized anxiety, obsessive compulsive and alcohol use disorders in a representative sample of residents aged 18 years and over (n = 6126). The AOO of the individual and any mental disorders were classified into early and late onset using median values as cut-offs. Data included socio-demographic and health background, health utility score, and productivity losses. Multivariable logistic regression analysis was conducted to assess sociodemographic correlates of early versus late AOO of any mental disorder while linear regression analysis investigated the associations between AOO of individual disorders with health utility score and productivity loss. RESULTS Respondents' mean (SD) age was 45.6 (16.5) years, comprising 50.5% women and majority of Chinese ethnicity (75.8%). The median AOO for any of the five studied disorders was 21 years (IQR: 15-29). Lowest AOO was observed for obsessive compulsive disorder (Median: 14, IQR: 11-26). Those aged 35 years and over (versus 18-34) were less likely to have earlier AOO [35-49 years (OR: 0.287; 95% CI: 0.154-0.534); 50-64 years (OR:0.156; 95% CI: 0.068-0.361) and 65 and over (OR:0.112; 95% CI:0.027-0.461)], while Malay ethnicity (versus Chinese) (OR: 2.319; 95% CI: 1.384-3.885) and being never married (versus married) (OR: 2.731; 95% CI: 1.493-4.993) were more likely to have early AOO for any mental disorder. Sample with early (versus late) AOO had a lower health utility score (β = - 0.06,95% CI: - 0.08 to - 0.03) and higher number of days cut down on the type of work (β = 1.61,95% CI: 0.12-3.10) in those with any mental disorders. CONCLUSION This study showed that half of the adults with mood, anxiety or alcohol use disorders in Singapore experienced their illness onset by 21 years of age. Early AOO is associated with sociodemographic background and poor health outcomes. Prevention, early detection, and interventions to improve health outcomes in mental disorders should consider the sociodemographic profile and age at first onset of symptoms in the population.
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Affiliation(s)
- Janhavi Ajit Vaingankar
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747, Singapore.
| | - Siow Ann Chong
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747, Singapore
| | - Edimansyah Abdin
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747, Singapore
| | - Saleha Shafie
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747, Singapore
| | - Boon Yiang Chua
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747, Singapore
| | - Shazana Shahwan
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747, Singapore
| | - Swapna Verma
- Department of Psychosis, Institute of Mental Health, 10 Buangkok View, Singapore, 539747, Singapore.,Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore
| | - Mythily Subramaniam
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747, Singapore
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7
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Studart-Bottó P, Bezerra-Filho S, Sarmento S, Miranda-Scippa Â. Social support in patients with bipolar disorder and differing ages at onset. Clin Psychol Psychother 2021; 29:351-359. [PMID: 34128280 DOI: 10.1002/cpp.2617] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Revised: 05/20/2021] [Accepted: 05/21/2021] [Indexed: 12/18/2022]
Abstract
OBJECTIVE The main purpose of this study was to evaluate the association between age at onset and social support in outpatients with bipolar disorder who were in the recovery phase. We also investigated the association between age at onset and disability. METHODS A total of 180 bipolar disorder I outpatients, of whom 50 had early onset with age at onset ≤18 years old, 108 had middle onset with age at onset between 19 and 39 years old, and 22 had late onset with age at onset ≥40 years old, were assessed with the Medical Outcomes Study Social Support Scale and Sheehan Disability Scale. RESULTS The early onset group had lower tangible social support, longer length of illness, more childless participants, lower income and more suicide attempters than the late onset group. CONCLUSIONS Early onset seems to have inferior outcomes in tangible social support than late onset, but this trend should be considered as a starting point for future studies.
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Affiliation(s)
- Paula Studart-Bottó
- Mood and Anxiety Disorders Program (CETHA), University Hospital, Federal University of Bahia (UFBA), Salvador, Brazil.,Postgraduate Program in Medicine and Health, UFBA, Salvador, Brazil
| | - Severino Bezerra-Filho
- Mood and Anxiety Disorders Program (CETHA), University Hospital, Federal University of Bahia (UFBA), Salvador, Brazil
| | - Stella Sarmento
- Mood and Anxiety Disorders Program (CETHA), University Hospital, Federal University of Bahia (UFBA), Salvador, Brazil.,Postgraduate Program in Medicine and Health, UFBA, Salvador, Brazil
| | - Ângela Miranda-Scippa
- Mood and Anxiety Disorders Program (CETHA), University Hospital, Federal University of Bahia (UFBA), Salvador, Brazil.,Postgraduate Program in Medicine and Health, UFBA, Salvador, Brazil.,Department of Neurosciences and Mental Health, Medical School, UFBA, Salvador, Brazil
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8
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Predominant Polarity and Polarity Index of Maintenance Treatments for Bipolar Disorder: A Validation Study in a Large Naturalistic Sample in Italy. ACTA ACUST UNITED AC 2021; 57:medicina57060598. [PMID: 34200746 PMCID: PMC8230357 DOI: 10.3390/medicina57060598] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Revised: 06/04/2021] [Accepted: 06/09/2021] [Indexed: 12/05/2022]
Abstract
Background and Objectives: Predominant polarity (PP) may be a useful course specifier in at least a significant proportion of patients with Bipolar Disorder (BD), being associated with several clinically relevant correlates. Emerging evidence suggests that the concept of PP might influence the selection of maintenance treatments, based on a drug polarity index (PI) which measures the greater antidepressive vs. antimanic preventive efficacy of mood stabilizers over long-term maintenance treatment. In this study, we aimed to validate the PI in a large sample of Italian BD patients with accurate longitudinal characterization of the clinical course, which ensured a robust definition of the PP. Materials and Methods: Our sample is comprised of 653 patients with BD, divided into groups based on the predominant polarity (manic/hypomanic predominant polarity—MPP, depressive predominant polarity—DPP and no predominant polarity). Subsequently we calculated the mean total polarity index for each group, and we compared the groups. Results: When we examined the mean PI of treatments prescribed to individuals with DPP, MPP and no predominant polarity, calculated using two different methods, we failed to find significant differences, with the exception of the PI calculated with the Popovic method and using the less stringent criterion for predominant polarity (PP50%). Conclusions: Future prospective studies are needed in order to determine whether the predominant polarity is indeed one clinical factor that might guide the clinician in choosing the right mood stabilizer for BD maintenance treatment.
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9
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Abstract
OBJECTIVE Bipolar disorder (BD) is a chronic mental health disorder with significant morbidity and mortality. Age at onset (AAO) may be a key variable in delineating more homogeneous subgroups of BD patients. However, no known research has systematically assessed how BD age-at-onset subgroups should be defined. METHODS We systematically searched the following databases: Cochrane Central Register of Controlled Trials, PsycINFO, MEDLINE, Embase, CINAHL, Scopus, Proquest Dissertations and Theses, Google Scholar and BIOSIS Previews. Original quantitative English language studies investigating AAO in BD were sought. RESULTS A total of 9454 unique publications were identified. Twenty-one of these were included in data analysis (n = 22981 BD participants). Fourteen of these studies (67%, n = 13626 participants) found a trimodal AAO distribution: early-onset (µ = 17.3, σ = 1.19, 45% of sample), mid-onset (µ = 26.0, σ = 1.72, 35%), and late-onset (µ = 41.9, σ = 6.16, 20%). Five studies (24%, n = 1422 participants) described a bimodal AAO distribution: early-onset (µ = 24.3, σ = 6.57, 66% of sample) and late-onset (µ = 46.3, σ = 14.15, 34%). Two studies investigated cohort effects on BD AAO and found that when the sample was not split by cohort, a trimodal AAO was the winning model, but when separated by cohort a bimodal distribution fit the data better. CONCLUSIONS We propose that the field conceptualises bipolar disorder age-at-onset subgroups as referring broadly to life stages. Demarcating BD AAO groups can inform treatment and provide a framework for future research to continue to investigate potential mechanisms of disease onset.
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Affiliation(s)
- Sorcha Bolton
- Department of PsychiatryUniversity of OxfordWarneford HospitalOxfordUK
| | - Jeremy Warner
- University of Oxford Medical SchoolJohn Radcliffe HospitalOxfordUK
| | - Eli Harriss
- Bodleian Health Care LibrariesUniversity of OxfordOxfordUK
| | - John Geddes
- Department of PsychiatryUniversity of OxfordWarneford HospitalOxfordUK,Oxford Health NHS Foundation TrustWarneford HospitalOxfordUK
| | - Kate E. A. Saunders
- Department of PsychiatryUniversity of OxfordWarneford HospitalOxfordUK,Oxford Health NHS Foundation TrustWarneford HospitalOxfordUK
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10
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Perrini F, Matrone M, de Bartolomeis A, Montano A, Amici E, Callovini G, Cuomo I, de Persis S, Lombardozzi G, Battagliese G, Porrari R, Kotzalidis GD, De Filippis S. Developmental trajectories in psychiatric disorders: does substance/alcohol use moderate the effects of affective temperaments as moderators of age at onset? A study in post-acute, hospitalized patients with psychotic or DSM-5 bipolar or major depressive disorders. J Addict Dis 2021; 39:373-387. [PMID: 33587024 DOI: 10.1080/10550887.2021.1886568] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND Age-at-onset (AAO) affects psychiatric disorder outcome; substance (SUDs) or alcohol use disorders (AUDs) may influence their onset. Affective temperaments may affect early AAO and drug-use proneness. Objectives: To investigate whether SUD/AUD moderated temperamental effects in determining AAO of mental disorders. Methods: We included 300 post-acute inpatients with schizophrenia-spectrum and other psychotic (SSOPDs), major depressive (MDD) or bipolar (BD) disorders (168 men; mean age, 40.63 years ± 11.82 men, 43.21 years ± 12.69 women) with (N = 110) or without (N = 190) SUD/AUD. Patients completed cross-sectionally TEMPS-A. We carried moderation analysis with each regression-significant TEMPS temperament as independent variable, SUD/AUD presence/absence as dichotomous moderator, and AAO as dependent variable. Significance was set at p < 0.05. Results: AAO was lower in patients with SUD/AUD diagnosis than in patients without (23.74 ± 10.09 vs. 27.73 ± 10.35, respectively, p = 0.001, η2 = 0.034). SUD/AUD patients scored higher on the hyperthymic (10.22 ± 4.08, p < 0.001, η2 = 0.069) and irritable (8.26 ± 4.69, p < 0.01, η2 = 0.026) temperaments than nonSUD/AUD patients. Moderation analysis showed only direct effects of irritable (β = -0.55, p < 0.005) and hyperthymic (β = -0.95, p < 0.001) temperaments on AAO and no significant SUD/AUD and interaction effects. Limitations. Cross-sectional design. Conclusions: When irritable and hyperthymic traits prevail over other temperaments, AAO is earlier in SSOPDs, MDD, and BD. SUD/AUD presence/absence does not moderate the relationship between temperament and AAO.
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Affiliation(s)
- Filippo Perrini
- Von Siebenthal Neuropsychiatric Hospital, Genzano di Roma, Italy.,Istituto A.T. Beck-Diagnostic Centre, Research and Training in Cognitive-Behavioral Psychotherapy, Rome, Italy
| | - Marta Matrone
- Von Siebenthal Neuropsychiatric Hospital, Genzano di Roma, Italy.,Department of Neuroscience, Reproductive Sciences and Dentistry, Federico II University, Naples, Italy
| | - Andrea de Bartolomeis
- Department of Neuroscience, Reproductive Sciences and Dentistry, Federico II University, Naples, Italy
| | - Antonella Montano
- Istituto A.T. Beck-Diagnostic Centre, Research and Training in Cognitive-Behavioral Psychotherapy, Rome, Italy
| | - Emanuela Amici
- Von Siebenthal Neuropsychiatric Hospital, Genzano di Roma, Italy
| | - Gemma Callovini
- Von Siebenthal Neuropsychiatric Hospital, Genzano di Roma, Italy.,Department of Mental Health, ASL Rieti, Rieti, Italy
| | - Ilaria Cuomo
- Von Siebenthal Neuropsychiatric Hospital, Genzano di Roma, Italy.,Istituto Penitenziario Regina Coeli, ASL RM1, Rome, Italy
| | | | | | - Gemma Battagliese
- Centro di Riferimento Alcologico della Regione Lazio, RM1, Rome, Italy
| | - Raffaella Porrari
- Von Siebenthal Neuropsychiatric Hospital, Genzano di Roma, Italy.,Centro di Riferimento Alcologico della Regione Lazio, RM1, Rome, Italy
| | - Georgios D Kotzalidis
- Von Siebenthal Neuropsychiatric Hospital, Genzano di Roma, Italy.,NESMOS Department, Faculty of Medicine and Psychology, Sapienza University, Rome, Italy
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11
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Manchia M, Vieta E, Smeland OB, Altimus C, Bechdolf A, Bellivier F, Bergink V, Fagiolini A, Geddes JR, Hajek T, Henry C, Kupka R, Lagerberg TV, Licht RW, Martinez-Cengotitabengoa M, Morken G, Nielsen RE, Pinto AG, Reif A, Rietschel M, Ritter P, Schulze TG, Scott J, Severus E, Yildiz A, Kessing LV, Bauer M, Goodwin GM, Andreassen OA. Translating big data to better treatment in bipolar disorder - a manifesto for coordinated action. Eur Neuropsychopharmacol 2020; 36:121-136. [PMID: 32536571 DOI: 10.1016/j.euroneuro.2020.05.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 05/15/2020] [Accepted: 05/24/2020] [Indexed: 12/15/2022]
Abstract
Bipolar disorder (BD) is a major healthcare and socio-economic challenge. Despite its substantial burden on society, the research activity in BD is much smaller than its economic impact appears to demand. There is a consensus that the accurate identification of the underlying pathophysiology for BD is fundamental to realize major health benefits through better treatment and preventive regimens. However, to achieve these goals requires coordinated action and innovative approaches to boost the discovery of the neurobiological underpinnings of BD, and rapid translation of research findings into development and testing of better and more specific treatments. To this end, we here propose that only a large-scale coordinated action can be successful in integrating international big-data approaches with real-world clinical interventions. This could be achieved through the creation of a Global Bipolar Disorder Foundation, which could bring government, industry and philanthropy together in common cause. A global initiative for BD research would come at a highly opportune time given the seminal advances promised for our understanding of the genetic and brain basis of the disease and the obvious areas of unmet clinical need. Such an endeavour would embrace the principles of open science and see the strong involvement of user groups and integration of dissemination and public involvement with the research programs. We believe the time is right for a step change in our approach to understanding, treating and even preventing BD effectively.
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Affiliation(s)
- Mirko Manchia
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy; Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy; Department of Pharmacology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Eduard Vieta
- Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Olav B Smeland
- NORMENT, Institute of Clinical Medicine, University of Oslo and Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | | | - Andreas Bechdolf
- Vivantes Klinikum im Friedrichshain, Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, Charité-Universitätsmedizin, Berlin, Germany; Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany; ORYGEN, The National Centre of Excellence in Youth Mental Health, Melbourne, Victoria, Australia
| | - Frank Bellivier
- Université de Paris and INSERM UMRS 1144, Paris, France; AP-HP, Groupe Hospitalo-Universitaire AP-HP Nord, Hopital Fernand Widal, DMU Neurosciences, Département de Psychiatrie et de Médecine Addictologique, Paris, France
| | - Veerle Bergink
- Department of Psychiatry - Erasmus Medical Center, Rotterdam, the Netherlands; Department of Psychiatry, Department of Obstetrics, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Andrea Fagiolini
- Department of Molecular Medicine, University of Siena, Siena, Italy
| | - John R Geddes
- Department of Psychiatry and Oxford Health NHS Foundation Trust, University of Oxford, Oxford, United Kingdom
| | - Tomas Hajek
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada; National Institute of Mental Health, Klecany, Czech Republic
| | - Chantal Henry
- Department of Psychiatry, Service Hospitalo-Universitaire, GHU Paris Psychiatrie & Neurosciences, F-75014 Paris, France
| | - Ralph Kupka
- Amsterdam UMC, Vrije Universiteit, Department of Psychiatry, Amsterdam, Netherlands
| | - Trine V Lagerberg
- NORMENT, Institute of Clinical Medicine, University of Oslo and Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Rasmus W Licht
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark; Psychiatry - Aalborg University Hospital, Aalborg, Denmark
| | | | - Gunnar Morken
- Østmarka Department of Psychiatry, St Olav University Hospital, Trondheim, Norway; Department of Mental Health, Faculty of Medicine and Healthsciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - René E Nielsen
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark; Psychiatry - Aalborg University Hospital, Aalborg, Denmark
| | - Ana Gonzalez Pinto
- Hospital Universitario de Alava. BIOARABA, UPV/EHU. CIBERSAM. Vitoria, Spain
| | - Andreas Reif
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Frankfurt am Main, Germany and German Society for Bipolar Disorders (DGBS), Frankfurt am Main, Germany
| | - Marcella Rietschel
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Phillip Ritter
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Thomas G Schulze
- Institute of Psychiatric Phenomics and Genomics, University Hospital, Ludwig-Maximilian University of Munich, Munich, Germany; Department of Psychiatry and Psychotherapy, Ludwig-Maximilian University of Munich, Munich, Germany; Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, Maryland, USA; Department of Psychiatry and Behavioral Sciences, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Jan Scott
- AP-HP, Groupe Hospitalo-Universitaire AP-HP Nord, Hopital Fernand Widal, DMU Neurosciences, Département de Psychiatrie et de Médecine Addictologique, Paris, France; Department of Mental Health, Faculty of Medicine and Healthsciences, Norwegian University of Science and Technology, Trondheim, Norway; Academic Psychiatry, Institute of Neuroscience, Newcastle University, UK
| | - Emanuel Severus
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Aysegul Yildiz
- Dokuz Eylül University Department of Psychiatry, Izmir, Turkey
| | - Lars Vedel Kessing
- Psychiatric Center Copenhagen and University of Copenhagen, Faculty of Health and Medical Sciences, Denmark
| | - Michael Bauer
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Guy M Goodwin
- Department of Psychiatry and Oxford Health NHS Foundation Trust, University of Oxford, Oxford, United Kingdom
| | - Ole A Andreassen
- NORMENT, Institute of Clinical Medicine, University of Oslo and Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.
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12
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Steardo L, Luciano M, Sampogna G, Carbone EA, Caivano V, Di Cerbo A, Giallonardo V, Palummo C, Vece A, Del Vecchio V, De Fazio P, Fiorillo A. Clinical Severity and Calcium Metabolism in Patients with Bipolar Disorder. Brain Sci 2020; 10:brainsci10070417. [PMID: 32630307 PMCID: PMC7408522 DOI: 10.3390/brainsci10070417] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 06/26/2020] [Accepted: 06/29/2020] [Indexed: 02/07/2023] Open
Abstract
Parathyroid hormone (PTH), vitamin D and serum calcium play a key role in several physiological and pathological conditions. Vitamin D and PTH receptors are largely expressed in the central nervous system and are involved in the modulation of inflammatory responses. Few studies investigated the association between calcium homeostasis imbalance and psychiatric disorders. This study aims to assess calcium homeostasis imbalance in patients with bipolar disorder (BD) and its impact on clinical outcome. We recruited 199 patients with BD, who were administered with validated assessment instruments to investigate depressive, manic and anxiety symptoms, affective temperaments, childhood trauma and global functioning. Serum calcium, vitamin D and PTH levels were assessed in all patients. Levels of PTH correlated with several clinical characteristics, including the diagnosis of bipolar disorder type I (BD-I), the presence of psychotic symptoms, lithium treatment, suicidality, total number of acute episodes and of hospitalizations (p < 0.0001) and seasonality (p < 0.05). At the regression analyses, higher levels of PTH were predicted by early age at onset, number of hospitalizations, aggressive behaviors (p < 0.05), higher Childhood Trauma Questionnaire total score (CTQ) (p < 0.001) and treatment with lithium (p = 0.01). Our findings suggest that the calcium homeostasis could play a role in BD patients, and that PTH levels are correlated with the clinical severity of the disorder.
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Affiliation(s)
- Luca Steardo
- Department of Psychiatry, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy; (M.L.); (G.S.); (V.C.); (A.D.C.); (V.G.); (C.P.); (A.V.); (V.D.V.); (A.F.)
- Psychiatric Unit, Department of Health Sciences, University Magna Graecia, 88100 Catanzaro, Italy; (E.A.C.); (P.D.F.)
- Correspondence: ; Tel.: +39-0961712801 or +39-3208612071
| | - Mario Luciano
- Department of Psychiatry, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy; (M.L.); (G.S.); (V.C.); (A.D.C.); (V.G.); (C.P.); (A.V.); (V.D.V.); (A.F.)
| | - Gaia Sampogna
- Department of Psychiatry, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy; (M.L.); (G.S.); (V.C.); (A.D.C.); (V.G.); (C.P.); (A.V.); (V.D.V.); (A.F.)
| | - Elvira Anna Carbone
- Psychiatric Unit, Department of Health Sciences, University Magna Graecia, 88100 Catanzaro, Italy; (E.A.C.); (P.D.F.)
| | - Vito Caivano
- Department of Psychiatry, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy; (M.L.); (G.S.); (V.C.); (A.D.C.); (V.G.); (C.P.); (A.V.); (V.D.V.); (A.F.)
| | - Arcangelo Di Cerbo
- Department of Psychiatry, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy; (M.L.); (G.S.); (V.C.); (A.D.C.); (V.G.); (C.P.); (A.V.); (V.D.V.); (A.F.)
| | - Vincenzo Giallonardo
- Department of Psychiatry, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy; (M.L.); (G.S.); (V.C.); (A.D.C.); (V.G.); (C.P.); (A.V.); (V.D.V.); (A.F.)
| | - Carmela Palummo
- Department of Psychiatry, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy; (M.L.); (G.S.); (V.C.); (A.D.C.); (V.G.); (C.P.); (A.V.); (V.D.V.); (A.F.)
| | - Alfonso Vece
- Department of Psychiatry, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy; (M.L.); (G.S.); (V.C.); (A.D.C.); (V.G.); (C.P.); (A.V.); (V.D.V.); (A.F.)
| | - Valeria Del Vecchio
- Department of Psychiatry, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy; (M.L.); (G.S.); (V.C.); (A.D.C.); (V.G.); (C.P.); (A.V.); (V.D.V.); (A.F.)
| | - Pasquale De Fazio
- Psychiatric Unit, Department of Health Sciences, University Magna Graecia, 88100 Catanzaro, Italy; (E.A.C.); (P.D.F.)
| | - Andrea Fiorillo
- Department of Psychiatry, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy; (M.L.); (G.S.); (V.C.); (A.D.C.); (V.G.); (C.P.); (A.V.); (V.D.V.); (A.F.)
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13
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Liu SK, Chang JC, Tsai HJ, Wu CS. Comparisons of the clinical outcomes between early- and adult-onset bipolar disorders: A prospective cohort analysis. J Affect Disord 2020; 260:1-10. [PMID: 31493631 DOI: 10.1016/j.jad.2019.08.084] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Revised: 06/30/2019] [Accepted: 08/28/2019] [Indexed: 11/17/2022]
Abstract
BACKGROUND This study aimed to explore the impact of age-at-onset on clinical outcomes in bipolar-spectrum disorders, including the development of alcohol or substance use disorder, suicidality, and psychiatric hospitalization. METHODS This population-based study enrolled newly-diagnosed bipolar-spectrum patients, including 4,367 patients with early-onset bipolar disorder (EOBD), 64,787 patients with adult-onset bipolar disorder (AOBD), and the same number of age-controlled comparison subjects without bipolar disorder, from Taiwan's National Health Insurance Research Database. Time-dependent covariate Cox regression models were used to estimate the effect of age-at-onset on clinical outcomes with adjustment for pre-existing psychiatric comorbid conditions and pharmacological treatment patterns. Sensitivity analyses using different definitions of study sample and age cutoffs were conducted. RESULTS The average follow-up duration was 5.7 years. After adjustment with time-dependent covariates and chronological age, there were no significant differences in the risks for developing new-onset alcohol or substance use disorders and psychiatric hospitalization between EOBD and AOBD patients. Although EOBD patients had a higher risk of hospitalization for suicide and self-harm than did AOBD patients in primary analysis, this finding did not replicated in the sensitivity analyses. LIMITATIONS The symptom profile and severity of bipolar disorder was not available in the NHIRD; therefore, surrogate indicators of clinical outcome might not be sensitive enough to detect the subtle differences. CONCLUSIONS EOBD and AOBD patients had similar risks for developing alcohol or substance use disorders. Their risk of psychiatric hospitalization was similar. Whether EOBD patients might have a higher risk of hospitalization for suicide and self-harm warrants further investigations.
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Affiliation(s)
- Shi-Kai Liu
- Centre for Addiction and Mental Health, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Jung-Chi Chang
- Department of Psychiatry, National Taiwan University Hospital, Hsin-Chu Branch, Hsin-Chu, Taiwan
| | - Hui-Ju Tsai
- Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Taiwan
| | - Chi-Shin Wu
- Department of Psychiatry, National Taiwan University Hospital, No. 7, Chung-Shan South Road, Taipei 10002, Taiwan.
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14
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Abstract
BACKGROUND Cannabis use in young people is common and associated with psychiatric disorders. However, the prospective link between cannabis use and bipolar disorder symptoms has rarely been investigated. The study hypothesis was that adolescent cannabis use is associated with hypomania in early adulthood via several potential etiological pathways. METHODS Data were used from the Avon Longitudinal Study of Parents and Children, a UK birth cohort study. The prospective link between cannabis use at age 17 and hypomania at age 22-23 years was tested using regression analysis, adjusted for gender, early environmental risk factors, alcohol and drug use, and depression and psychotic symptoms at age 18 years. Path analysis examined direct and indirect effects of the link and whether gender, childhood family adversity, or childhood abuse are associated with hypomania via an increased risk of cannabis use. RESULTS Data were available on 3370 participants. Cannabis use at least 2-3 times weekly was associated with later hypomania (OR = 2.21, 95% CI = 1.49-3.28) after adjustment. There was a dose-response relationship (any use vs weekly). Cannabis use mediated the association of both childhood sexual abuse and hypomania, and male gender and hypomania. The cannabis use-hypomania link was not mediated by depression or psychotic symptoms. CONCLUSIONS Adolescent cannabis use may be an independent risk factor for future hypomania, and the nature of the association suggests a potential causal link. Cannabis use mediates the link between childhood abuse and future hypomania. As such it might be a useful target for indicated prevention of hypomania.
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Affiliation(s)
- Steven Marwaha
- Unit of Mental Health and Wellbeing, Warwick Medical School, University of Warwick, Coventry, UK
- Affective Disorders Service, Caludon Centre, Coventry, UK
- To whom correspondence should be addressed; Mental Health and Wellbeing Unit, Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK; tel: +44-2476-151046, fax: +44-24-7646-1606, e-mail:
| | - Catherine Winsper
- Unit of Mental Health and Wellbeing, Warwick Medical School, University of Warwick, Coventry, UK
| | - Paul Bebbington
- Division of Psychiatry, University College London, London, UK
| | - Daniel Smith
- University of Glasgow, Gartnavel Royal Hospital, Glasgow, UK
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15
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Alves GS, Knöchel C, Paulitsch MA, Reinke B, Carvalho AF, Feddern R, Prvulovic D, Sudo FK, Pantel J, Reif A, Oertel V. White Matter Microstructural Changes and Episodic Memory Disturbances in Late-Onset Bipolar Disorder. Front Psychiatry 2018; 9:480. [PMID: 30356890 PMCID: PMC6190894 DOI: 10.3389/fpsyt.2018.00480] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Accepted: 09/13/2018] [Indexed: 12/31/2022] Open
Abstract
Background: Bipolar disorder (BD) has been associated with distributed network disruption, but little is known on how different clinical subtypes, particularly those with an earlier and later onset of disease, are related to connectivity changes in white matter (WM) tracts. Methods: Diffusion tensor imaging (DTI) and volumetric measures were carried out in early-onset bipolar patients [(EOD) (n = 16)], late-onset bipolar disorder [(LOD)(n = 14)] and healthy controls (n = 32). We also computed ROI analysis of gray matter (GM) and white matter (WM) volumes using the regions with significant group differences in the DTI parameters. Cognitive and behavior measurements were analyzed between groups. Results: Lower fraction of anisotropy (FA) in the right hemisphere comprising anterior thalamic radiation, fornix, posterior cingulate, internal capsule, splenium of corpus callosum was observed in the LOD in comparison with EOD; additionally, lower FA was also found in the LOD in comparison with healthy controls, mostly in the right hemisphere and comprising fibers of the splenium of the corpus callosum, cingulum, superior frontal gyrus and posterior thalamic radiation; LOD also showed worse episodic memory performance than EOD; no statistical significant differences between mood symptoms, WM and GM volumes were found between BD groups. Conclusion: Even after correcting for age differences, LOD was associated with more extensive WM microstructural changes and worse episodic memory performance than EOD; these findings suggest that changes in the WM fiber integrity may be associated with a later presentation of BD, possibly due to mechanisms other than neuroprogression. However, these findings deserve replication in larger, prospective, studies.
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Affiliation(s)
- Gilberto Sousa Alves
- Institute of General Medicine, Goethe University, Frankfurt/Main, Germany.,Translational Psychiatry Group, Universidade Federal do Ceará, Fortaleza, Brazil
| | - Christian Knöchel
- Laboratory of Neuroscience, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe University, Frankfurt/Main, Germany
| | | | - Britta Reinke
- Laboratory of Neuroscience, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe University, Frankfurt/Main, Germany
| | - André F Carvalho
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Richard Feddern
- Translational Psychiatry Group, Universidade Federal do Ceará, Fortaleza, Brazil
| | - David Prvulovic
- Laboratory of Neuroscience, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe University, Frankfurt/Main, Germany
| | - Felipe Kenji Sudo
- Department of Psychology, Pontifical Catholic University of Rio de Janeiro, Rio de Janeiro, Brazil.,Memory Clinic, D' Or Institute for Research and Education, Rio de Janeiro, Brazil
| | - Johannes Pantel
- Institute of General Medicine, Goethe University, Frankfurt/Main, Germany
| | - Andreas Reif
- Laboratory of Neuroscience, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe University, Frankfurt/Main, Germany
| | - Viola Oertel
- Laboratory of Neuroscience, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe University, Frankfurt/Main, Germany
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