Early detection of bipolar disorders and treatment recommendations for help-seeking adolescents and young adults: Findings of the Early Detection and Intervention Center Dresden

Young people at risk for developing bipolar disorder: Two-year findings from the multicenter prospective, naturalistic Early-BipoLife study

Early identification and intervention of individuals with an increased risk for bipolar disorder (BD) may improve the course of illness and prevent long‑term consequences. Early-BipoLife, a multicenter, prospective, naturalistic study, examined risk factors of BD beyond family history in participants aged 15-35 years. At baseline, positively screened help-seeking participants (screenBD at-risk) were recruited at Early Detection Centers and in- and outpatient depression and attention-deficit/hyperactivity disorder (ADHD) settings, references (Ref) drawn from a representative cohort. Participants reported sociodemographics and medical history and were repeatedly examined regarding psychopathology and the course of risk factors. N = 1,083 screenBD at-risk and n = 172 Ref were eligible for baseline assessment. Within the first two years, n = 31 screenBD at-risk (2.9 %) and none of Ref developed a manifest BD. The cumulative transition risk was 0.0028 at the end of multistep assessment, 0.0169 at 12 and 0.0317 at 24 months (p = 0.021). The transition rate with a BD family history was 6.0 %, 4.7 % in the Early Phase Inventory for bipolar disorders (EPIbipolar), 6.6 % in the Bipolar Prodrome Interview and Symptom Scale-Prospective (BPSS-FP) and 3.2 % with extended Bipolar At-Risk - BARS criteria). In comparison to help-seeking young patients from psychosis detection services, transition rates in screenBD at-risk participants were lower. The findings of Early-BipoLife underscore the importance of considering risk factors beyond family history in order to improved early detection and interventions to prevent/ameliorate related impairment in the course of BD. Large long-term cohort studies are crucial to understand the developmental pathways and long-term course of BD, especially in people at- risk.

Psychophysiological effects of rhythmic music combined with aerobic exercise in college students with minimal depressive symptoms

Mental health problems are common during the transition from adolescence to young adulthood. Previous studies reported that rhythmic music plus aerobic exercise can have a beneficial effect on emotional state. We examined whether the beneficial effect differed between aerobic exercise interventions with or without rhythmic music. A sample of 94 college students who either had no depressive symptoms (n ​= ​47) or minimal depressive symptoms (n ​= ​47) underwent 30-min interventions in a randomized and counterbalanced order: rest, rhythmic music, aerobic exercise and aerobic exercise plus rhythmic music. Response time and accuracy of selective attention to positive and negative images were recorded using the spatial cueing paradigm. Participants' heart rate during all conditions and perceived exertion after each condition were measured to clarify physiological and perceptual responses, respectively. The results revealed that a multimodal intervention combining aerobic exercise and rhythmic music had a significant facilitatory effect on attentional bias to positive emotional cues in minimal depressive participants (t ​= ​-2.336, p ​= ​0.024), including less perceived exertion and higher heart rate after/during the intervention process. The single-modality intervention of aerobic exercise had significant positive effects for individuals with no depressive symptoms (t ​= ​-2.510, p ​= ​0.016). The multimodal intervention was more effective than the single-modality intervention for individuals with minimal depressive symptoms, but the single-modality aerobic exercise intervention was more effective for individuals with no depressive symptoms, providing new evidence for the specificity of the intervention effect for people with different degrees of depressive symptoms.