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Jorge ACR, Montezano BB, de Aguiar KR, Noronha LT, Baldez DP, Watts D, Menezes AMB, Wehrmeister FC, Gonçalves H, Kunz M, Kapczinski F, Passos IC. Early exposure to cannabis and bipolar disorder incidence: Findings from a 22-year birth cohort study in Brazil. Acta Psychiatr Scand 2024; 149:340-349. [PMID: 38378931 DOI: 10.1111/acps.13670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 01/28/2024] [Accepted: 01/31/2024] [Indexed: 02/22/2024]
Abstract
BACKGROUND AND OBJECTIVES Bipolar disorder is a chronic condition affecting millions of people worldwide. Currently, there is some evidence to suggest that cannabis use during adolescence may be an environmental risk factor for its onset, however inconsistencies have been observed across the literature. Considering this, we aimed to assess whether early lifetime cannabis is associated with subsequent bipolar disorder in young adults between 18 and 22 years of age. METHODS Using data from the 1993 Pelotas (Brazil) birth cohort (n = 5249), cannabis exposure was examined at age 18 by self-report, and bipolar disorder diagnosis was measured at age 22 using the Mini International Neuropsychiatric Interview (MINI). In order to control the analysis, we considered socioeconomic status index, sex, skin color, physical abuse by parents and lifetime cocaine use. RESULTS A total of 3781 individuals were evaluated in 2015 aged 22 years, of whom 87 were diagnosed with the bipolar disorder onset after the age of 18. Lifetime cannabis use predicted bipolar disorder onset at 22 years old (OR 1.82, 95% CI [1.10, 2.93]), and the effect remained after adjusting for socioeconomic status, sex, skin color, and physical abuse by parents (OR 2.00, 95% CI [1.20, 3.25]). However, this association was attenuated to statistically non-significant after further adjustment for all available covariates, including lifetime cocaine use (OR 1.79, 95% CI [0.95, 3.19]). We also found similar results for early cocaine use, where the association with bipolar disorder onset did not maintain significance in the multivariate model (OR 1.35, 95% CI [0.62, 2.86]). Otherwise, when we considered cannabis or cocaine lifetime use as a unique feature, our findings showed that the adolescent exposure to cannabis or cocaine increased the odds by 1.95 times of developing bipolar disorder at 22 years age, even when controlling for all other study variables (OR 2.14, 95% CI [1.30, 3.47]). Finally, our models suggest that cocaine use may potentially exert a major influence on the effect of lifetime cannabis use on bipolar disorder onset, and that physical abuse by parents and sex may modify the effect of cannabis use for later bipolar disorder onset. CONCLUSION Based on our findings, early cannabis exposure predicted bipolar disorder onset in young adults, but this association was confounded by cocaine use. Contrary to schizophrenia, cannabis as a sole exposure was not associated with bipolar disorder onset after adjusting for control variables.
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Affiliation(s)
- Alan Cristian Rodrigues Jorge
- Laboratory of Molecular Psychiatry, Centro de Pesquisa Experimental (CPE) and Centro de Pesquisa Clínica (CPC), Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil
- Department of Psychiatry, School of Medicine, Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Bruno Braga Montezano
- Laboratory of Molecular Psychiatry, Centro de Pesquisa Experimental (CPE) and Centro de Pesquisa Clínica (CPC), Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil
- Department of Psychiatry, School of Medicine, Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Kyara Rodrigues de Aguiar
- Laboratory of Molecular Psychiatry, Centro de Pesquisa Experimental (CPE) and Centro de Pesquisa Clínica (CPC), Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil
- Department of Psychiatry, School of Medicine, Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Lucas Tavares Noronha
- Laboratory of Molecular Psychiatry, Centro de Pesquisa Experimental (CPE) and Centro de Pesquisa Clínica (CPC), Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil
- Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Daniel Prates Baldez
- Laboratory of Molecular Psychiatry, Centro de Pesquisa Experimental (CPE) and Centro de Pesquisa Clínica (CPC), Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil
| | - Devon Watts
- Center for Precision Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA
- Psychiatric and Neurodevelopmental Genetics Unit, Massachusetts General Hospital, Boston, Massachusetts, USA
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | | | | | - Helen Gonçalves
- Post graduate Program in Epidemiology, Universidade Federal de Pelotas, Pelotas, Brazil
| | - Maurício Kunz
- Laboratory of Molecular Psychiatry, Centro de Pesquisa Experimental (CPE) and Centro de Pesquisa Clínica (CPC), Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil
- Department of Psychiatry, School of Medicine, Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Flávio Kapczinski
- Laboratory of Molecular Psychiatry, Centro de Pesquisa Experimental (CPE) and Centro de Pesquisa Clínica (CPC), Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil
- Department of Psychiatry, School of Medicine, Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Ives Cavalcante Passos
- Laboratory of Molecular Psychiatry, Centro de Pesquisa Experimental (CPE) and Centro de Pesquisa Clínica (CPC), Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil
- Department of Psychiatry, School of Medicine, Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
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Katz D, Petersen T, Rabideau DJ, Stark A, Pintro K, Alvarez-Hernandez A, Stancroff N, Deng Y, Albury E, Kuperberg M, George N, Amado S, Temes C, Nierenberg AA, Sylvia L. A trial of prolonged exposure therapy for outpatients with comorbid bipolar disorder and posttraumatic stress disorder (PTSD). J Affect Disord 2024; 344:432-439. [PMID: 37802328 DOI: 10.1016/j.jad.2023.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 08/29/2023] [Accepted: 10/03/2023] [Indexed: 10/08/2023]
Abstract
BACKGROUND Bipolar disorder and posttraumatic stress disorder (PTSD) commonly co-occur, but no treatment guidelines exist for this population. Prolonged exposure (PE) is a well-established and efficacious treatment for PTSD, untested in patients with comorbid bipolar disorder. The current study evaluates the feasibility and preliminary efficacy of PE for patients with bipolar disorder and PTSD. METHODS Participants were enrolled in PE and completed assessments of PTSD symptoms, suicidality, state and trait anxiety, depression, and mania at baseline, Sessions 5 and 10, and at 6-months post-treatment. RESULTS 32 patients enrolled in this study, with 75 % (24/32) completing all ten PE sessions and 50 % completing 6-month follow-up assessments. PTSD symptoms decreased from baseline to Session 10 and continued to decrease throughout the follow-up period. Suicidality, measured by implicit associations between self and death, showed a similar pattern of decrease over treatment and follow-up periods. Suicidal thinking and depressive symptoms decreased from baseline through Session 10 and rebounded slightly, remaining below baseline at 6-months follow-up. State and trait anxiety increased initially through Session 5 but then decreased and remained stable. Mania scores remained stable at all assessment periods. LIMITATIONS The study is limited by a small sample size and absence of a control condition. Criterion A trauma was not required, limiting generalizability, and there was significant attrition at follow-up. CONCLUSIONS These findings suggest that PE is a feasible and preliminarily efficacious treatment for patients with bipolar disorder and comorbid PTSD, and support the conduct of a fully powered efficacy of PE for this comorbidity.
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Affiliation(s)
- Douglas Katz
- Massachusetts General Hospital, Boston, MA, United States; Harvard University, Cambridge, MA, United States.
| | - Timothy Petersen
- Massachusetts General Hospital, Boston, MA, United States; Harvard University, Cambridge, MA, United States
| | - Dustin J Rabideau
- Massachusetts General Hospital, Boston, MA, United States; Harvard University, Cambridge, MA, United States
| | - Abigail Stark
- Massachusetts General Hospital, Boston, MA, United States; Harvard University, Cambridge, MA, United States
| | - Kedie Pintro
- Massachusetts General Hospital, Boston, MA, United States
| | | | - Noah Stancroff
- Massachusetts General Hospital, Boston, MA, United States
| | - Yunfeng Deng
- Massachusetts General Hospital, Boston, MA, United States
| | - Evan Albury
- Massachusetts General Hospital, Boston, MA, United States
| | - Maya Kuperberg
- Tel Aviv University, Israel; Beer Yaakov-Ness Ziona Mental Health Center, Israel
| | - Nevita George
- Massachusetts General Hospital, Boston, MA, United States
| | - Selen Amado
- Massachusetts General Hospital, Boston, MA, United States
| | - Christina Temes
- Massachusetts General Hospital, Boston, MA, United States; Harvard University, Cambridge, MA, United States
| | - Andrew A Nierenberg
- Massachusetts General Hospital, Boston, MA, United States; Harvard University, Cambridge, MA, United States
| | - Louisa Sylvia
- Massachusetts General Hospital, Boston, MA, United States; Harvard University, Cambridge, MA, United States
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Yao K, van der Veen T, Thygesen J, Bass N, McQuillin A. Multiple psychiatric polygenic risk scores predict associations between childhood adversity and bipolar disorder. J Affect Disord 2023; 341:137-146. [PMID: 37643680 DOI: 10.1016/j.jad.2023.08.116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Revised: 08/17/2023] [Accepted: 08/23/2023] [Indexed: 08/31/2023]
Abstract
BACKGROUND It remains unclear how adverse childhood experiences (ACE) and increased genetic risk for bipolar disorder (BD) interact to influence BD symptom outcomes. Here we calculated multiple psychiatric polygenic risk scores (PRS) and used the measures of ACE to understand these gene-environment interactions. METHOD 885 BD subjects were included for analyses. BD, ADHD, MDD and SCZ PRSs were calculated using the PRS-CS-auto method. ACEs were evaluated using the Children Life Event Questionnaire (CLEQ). Participants were divided into groups based on the presence of ACE and the total number of ACEs. The associations between total ACE number, PRSs and their interactions were evaluated using multiple linear and logistic regressions. Secondary analyses were performed to evaluate the influence of ACE and PRS on sub-phenotypes of BD. RESULTS The number of ACEs increased with the ADHD PRS. BD participants who had ACEs showed an earlier age of BD onset and higher odds of having rapid cycling. Increased BD PRS was associated with increased odds of developing psychotic symptoms. Higher ADHD PRS was associated with increased odds of having rapid cycling. No prediction effect was observed from MDD and SCZ PRS. And, we found no significant interaction between ACE numbers and any of the PRSs in predicting any selected BD sub-phenotypes. LIMITATIONS The study was limited by sample size, ACE definition, and cross-sectional data collection method. CONCLUSIONS The findings consolidate the importance of considering multiple psychiatric PRSs in predicting symptom outcomes among BD patients.
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Affiliation(s)
- Kai Yao
- Molecular Psychiatry Laboratory, Division of Psychiatry, University College London, London, UK
| | - Tracey van der Veen
- Molecular Psychiatry Laboratory, Division of Psychiatry, University College London, London, UK
| | - Johan Thygesen
- Institute of Health Informatics, University College London, UK
| | - Nick Bass
- Molecular Psychiatry Laboratory, Division of Psychiatry, University College London, London, UK
| | - Andrew McQuillin
- Molecular Psychiatry Laboratory, Division of Psychiatry, University College London, London, UK.
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Chen Q, Kumar V, Mummini S, Pato CN, Pato MT. Traumatic events in childhood and adulthood in a diverse-ancestry sample and their role in bipolar disorder. Psychiatry Res 2023; 326:115259. [PMID: 37276648 PMCID: PMC10586063 DOI: 10.1016/j.psychres.2023.115259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 05/10/2023] [Accepted: 05/18/2023] [Indexed: 06/07/2023]
Abstract
We examined the presence of adverse events in both childhood and adulthood and the prevalence of PTSD in individuals with Bipolar Disorder (BD). There were 191 adults diagnosed with BD Type I and 924 controls, of predominantly African Ancestry (AA). All were administered the GPC-Screening Tool and the BD group the DIPAD. In addition Childhood adversities were measured using the ACE (from 0 to 10), about traumatic events before age 18 and lifetime adversities were measured with 15 questions adapted from the Study of Addiction: Genetics and Environment (A-SAGE (from 0 to 15) for all cases and controls. Probable PTSD (pPTSD) was measured with 4 questions on the GPC screener. Sum scores were calculated for the ACE and A-SAGE by tallying positive responses. Odd Ratios (OR) were used to measure the association between BD and Controls exposure to adversity. BD was associated with a significantly higher mean ACE score and A-SAGE score compared to controls. There was a significantly higher prevalence of pPTSD in the BD (54.5%) versus Controls (6.6%) as well. Greater OR's were seen in the BD compared to Controls for each ACE question (p<0.05). Results were similar for A-SAGE. Limitations include possible recall bias, and missing data.
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Affiliation(s)
- Qianwei Chen
- Robert Wood Johnson Medical School, Rutgers University, New Brunswick, NJ, United States of America
| | - Vandana Kumar
- Department of Psychiatry, Children's Hospital of Philadelphia, Philadelphia, PA, United States of America
| | - Swetha Mummini
- Department of Psychiatry, University of Maryland Medical Center, Baltimore, MD, United States of America
| | - Carlos N Pato
- Department of Psychiatry, Rutgers University, Piscataway, NJ, United States of America
| | - Michele T Pato
- Department of Psychiatry, Rutgers University, Piscataway, NJ, United States of America.
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Li T, Mao Z, Zhao L, Sun Y, Wang C, Bo Q. Childhood trauma and its influence on the clinical features of bipolar disorder. CHILD ABUSE & NEGLECT 2023; 141:106203. [PMID: 37088009 DOI: 10.1016/j.chiabu.2023.106203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 04/03/2023] [Accepted: 04/16/2023] [Indexed: 05/03/2023]
Abstract
BACKGROUND Childhood trauma is an environmental risk factor for bipolar disorder (BD), But its influence on the clinical features of BD has not been examined sufficiently. OBJECTIVE We compared the childhood trauma between patients with BD and healthy controls (HCs) and determined how childhood trauma impacts clinical features, such as severity, mood episodes, and disease duration. PARTICIPANTS AND SETTING The study population comprised patients with BD (in a state of euthymia or depression, n = 90) and HCs (n = 94). METHODS The Structured Clinical Interview for DSM-IV Axis I Disorders was used to diagnose BD and ascertain its clinical features. The Childhood Trauma Questionnaire (CTQ) was used to assess childhood trauma. RESULTS The total CTQ score and scores for the CTQ subscales emotional abuse, sexual abuse, emotional neglect, and physical neglect, significantly differed between the BD and HC groups. Emotional abuse was correlated with higher Hamilton Anxiety Rating Scale (HARS) score and more frequent mood episodes; emotional neglect was correlated with higher HARS score, longer disease duration, and more mood episodes; and total CTQ score was positively correlated with HARS score, disease duration, and mood episodes. Regression analysis showed that emotional neglect significantly predicted HARS score, Hamilton Depression Rating Scale score, and disease duration in the BD group (P < 0.05). CONCLUSIONS Patients with BD have more serious childhood trauma. General childhood trauma, emotional abuse, and emotional neglect negatively affect the clinical features of BD.
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Affiliation(s)
- Tian Li
- The National Clinical Research Center for Mental Disorders, Beijing Key Laboratory of Mental Disorders, Beijing Institute for Brain Disorders Center of Schizophrenia, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing 100069, China
| | - Zhen Mao
- The National Clinical Research Center for Mental Disorders, Beijing Key Laboratory of Mental Disorders, Beijing Institute for Brain Disorders Center of Schizophrenia, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing 100069, China
| | - Lei Zhao
- The National Clinical Research Center for Mental Disorders, Beijing Key Laboratory of Mental Disorders, Beijing Institute for Brain Disorders Center of Schizophrenia, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing 100069, China
| | - Yue Sun
- The National Clinical Research Center for Mental Disorders, Beijing Key Laboratory of Mental Disorders, Beijing Institute for Brain Disorders Center of Schizophrenia, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing 100069, China
| | - Chuanyue Wang
- The National Clinical Research Center for Mental Disorders, Beijing Key Laboratory of Mental Disorders, Beijing Institute for Brain Disorders Center of Schizophrenia, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing 100069, China
| | - Qijing Bo
- The National Clinical Research Center for Mental Disorders, Beijing Key Laboratory of Mental Disorders, Beijing Institute for Brain Disorders Center of Schizophrenia, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing 100069, China.
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Ehrlich TJ, Kim H, Ryan KA, Langenecker SA, Duval ER, Yocum AK, Diaz-Byrd C, Wrobel AL, Dean OM, Cotton SM, Berk M, McInnis MG, Marshall DF. Childhood trauma relates to worse memory functioning in bipolar disorder. J Affect Disord 2023; 333:377-383. [PMID: 37084974 DOI: 10.1016/j.jad.2023.04.056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 04/01/2023] [Accepted: 04/14/2023] [Indexed: 04/23/2023]
Abstract
BACKGROUND Childhood trauma is commonly experienced by individuals diagnosed with bipolar disorder (BP). In BP, childhood trauma is related to a more severe clinical course, but its association with cognition remains unclear. METHODS This study evaluated 405 adult participants diagnosed with BP and 136 controls. Participants completed the Childhood Trauma Questionnaire and a comprehensive neuropsychological battery. High versus low childhood trauma was defined with one standard deviation above the control participant's mean Childhood Trauma Questionnaire score. Neuropsychological data was transformed into eight cognitive factors, including four executive functioning, auditory and visual memory, fine motor, and emotion processing. Multivariate analysis of covariance evaluated group differences in cognition, while adjusting for covariates. RESULTS There were significant differences among the three groups, F(16, 968) = 4.05, p < .001, Wilks' Λ = 0.88, partial η2 = 0.06. Comparing the high and low trauma BP groups, high trauma was related to lower auditory and visual memory factor scores (p < .05). As compared to controls, the BP high trauma group had lower scores on six of eight factors (all p < .01), while the BP low trauma group had lower scores on four of eight factors (all p < .01). LIMITATIONS Analyses of factor score do not address which aspect of the memory process is affected and biomarkers may help guide interventions addressing underlying biological process. CONCLUSIONS Adults diagnosed with BP with higher childhood trauma have worse memory functioning, beyond the lower childhood trauma BP group, highlighting the importance of understanding the long-term cognitive outcomes of childhood trauma.
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Affiliation(s)
- Tobin J Ehrlich
- Heinz C Prechter Bipolar Research Program, Eisenberg Family Depression Center, USA; Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Hanjoo Kim
- Heinz C Prechter Bipolar Research Program, Eisenberg Family Depression Center, USA; Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Kelly A Ryan
- Heinz C Prechter Bipolar Research Program, Eisenberg Family Depression Center, USA; Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | | | - Elizabeth R Duval
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Anastasia K Yocum
- Heinz C Prechter Bipolar Research Program, Eisenberg Family Depression Center, USA; Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Claudia Diaz-Byrd
- Heinz C Prechter Bipolar Research Program, Eisenberg Family Depression Center, USA; Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Anna L Wrobel
- Institute for Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine, Deakin University, Geelong, VIC, Australia; Orygen, Parkville, VIC, Australia
| | - Olivia M Dean
- Institute for Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine, Deakin University, Geelong, VIC, Australia; Florey Institute for Neuroscience and Mental Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Sue M Cotton
- Orygen, Parkville, VIC, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Michael Berk
- Institute for Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine, Deakin University, Geelong, VIC, Australia; Orygen, Parkville, VIC, Australia; Florey Institute for Neuroscience and Mental Health, The University of Melbourne, Melbourne, VIC, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia; Department of Psychiatry, Royal Melbourne Hospital, The University of Melbourne, Parkville, VIC, Australia
| | - Melvin G McInnis
- Heinz C Prechter Bipolar Research Program, Eisenberg Family Depression Center, USA; Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - David F Marshall
- Heinz C Prechter Bipolar Research Program, Eisenberg Family Depression Center, USA; Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA.
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Cumulative trauma in bipolar disorder: An examination of prevalence and outcomes across the lifespan. J Affect Disord 2023; 327:254-261. [PMID: 36566941 DOI: 10.1016/j.jad.2022.12.041] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 09/08/2022] [Accepted: 12/10/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Trauma is highly prevalent in bipolar disorder, and while considerable research has been undertaken in relation to childhood trauma, little is known about the experience and the impact of exposure to multiple trauma types across the lifespan, otherwise known as cumulative trauma. This study aimed to examine the prevalence of cumulative trauma in bipolar disorder and explore its association with illness and other outcomes. METHODS Participants were recruited online globally and comprised 114 adults aged 23 to 73 years with BD-I (41.2 %) or BD-II (58.8 %). Participants completed an online questionnaire containing items regarding symptoms and trauma history followed by a diagnostic interview to confirm their BD diagnosis and assess BD symptoms. RESULTS Cumulative trauma accounted for most of the trauma exposure across both childhood (n = 89; 78.1 %) and adulthood (n = 72; 63.2 %). Those with lifetime cumulative trauma (n = 64; 56 %) were more likely to experience at least one other co-morbid mental health condition in addition to their BD diagnosis (88 %) and report significantly lower ratings of perceived social support compared to those who did not experience any cumulative trauma (N = 15; 13 %). LIMITATIONS This study has been limited by the cross-sectional retrospective design as well as the use of self-selection to participate. CONCLUSIONS Cumulative trauma is highly prevalent in bipolar disorder and is associated with greater likelihood of experiencing a psychiatric comorbidity and decreased levels of social support. More research is needed to explore the nature of this relationship and determine whether increasing social support may be of benefit.
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Dauvermann MR, Costello L, Tronchin G, Holleran L, Mothersill D, Rokita KI, Kane R, Hallahan B, Corvin A, Morris D, McKernan DP, Kelly J, McDonald C, Donohoe G, Cannon DM. Childhood trauma is associated with altered white matter microstructural organization in schizophrenia. Psychiatry Res Neuroimaging 2023; 330:111616. [PMID: 36827958 DOI: 10.1016/j.pscychresns.2023.111616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 02/02/2023] [Accepted: 02/15/2023] [Indexed: 02/24/2023]
Abstract
It has been reported that childhood trauma (CT) is associated with reductions in fractional anisotropy (FA) in individuals with schizophrenia (SZ). Here, we hypothesized that SZ with high levels of CT will show the greatest reductions in FA in frontolimbic and frontoparietal regions compared to healthy controls (HC) with high trauma levels and participants with no/low levels of CT. Thirty-seven SZ and 129 HC with CT experience were dichotomized into groups of 'none/low' or 'high' levels. Participants underwent diffusion-weighted MRI, and Tract-based spatial statistics were employed to assess the main effect of diagnosis, main effect of CT severity irrespective of diagnosis, and interaction between diagnosis and CT severity. SZ showed FA reductions in the corpus callosum and corona radiata compared to HC. Irrespective of a diagnosis, high CT levels (n = 48) were related to FA reductions in frontolimbic and frontoparietal regions compared to those with none/low levels of CT (n = 118). However, no significant interaction between diagnosis and high levels of CT was found (n = 13). Across all participants, we observed effects of CT on late developing frontolimbic and frontoparietal regions, suggesting that the effects of CT severity on white matter organization may be independent of schizophrenia.
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Affiliation(s)
- Maria R Dauvermann
- Center for Neuroimaging, Cognition and Genomics (NICOG), Clinical Neuroimaging Laboratory, Galway Neuroscience Centre, University of Galway, Ireland, Galway, H91TK33, Ireland; Institute for Mental Health, School of Psychology, University of Birmingham, B15 2TT, United Kingdom.
| | - Laura Costello
- Center for Neuroimaging, Cognition and Genomics (NICOG), Clinical Neuroimaging Laboratory, Galway Neuroscience Centre, University of Galway, Ireland, Galway, H91TK33, Ireland
| | - Giulia Tronchin
- Center for Neuroimaging, Cognition and Genomics (NICOG), Clinical Neuroimaging Laboratory, Galway Neuroscience Centre, University of Galway, Ireland, Galway, H91TK33, Ireland
| | - Laurena Holleran
- Center for Neuroimaging, Cognition and Genomics (NICOG), Clinical Neuroimaging Laboratory, Galway Neuroscience Centre, University of Galway, Ireland, Galway, H91TK33, Ireland
| | - David Mothersill
- Center for Neuroimaging, Cognition and Genomics (NICOG), Clinical Neuroimaging Laboratory, Galway Neuroscience Centre, University of Galway, Ireland, Galway, H91TK33, Ireland; Department of Psychology, School of Business, National College of Ireland, Dublin, Ireland; Department of Psychiatry, Trinity College Dublin, St. James's Hospital, Dublin, Ireland
| | - Karolina I Rokita
- Center for Neuroimaging, Cognition and Genomics (NICOG), Clinical Neuroimaging Laboratory, Galway Neuroscience Centre, University of Galway, Ireland, Galway, H91TK33, Ireland
| | - Ruán Kane
- Center for Neuroimaging, Cognition and Genomics (NICOG), Clinical Neuroimaging Laboratory, Galway Neuroscience Centre, University of Galway, Ireland, Galway, H91TK33, Ireland
| | - Brian Hallahan
- Center for Neuroimaging, Cognition and Genomics (NICOG), Clinical Neuroimaging Laboratory, Galway Neuroscience Centre, University of Galway, Ireland, Galway, H91TK33, Ireland
| | - Aiden Corvin
- Department of Psychology, School of Business, National College of Ireland, Dublin, Ireland
| | - Derek Morris
- Center for Neuroimaging, Cognition and Genomics (NICOG), Clinical Neuroimaging Laboratory, Galway Neuroscience Centre, University of Galway, Ireland, Galway, H91TK33, Ireland
| | - Declan P McKernan
- Center for Neuroimaging, Cognition and Genomics (NICOG), Clinical Neuroimaging Laboratory, Galway Neuroscience Centre, University of Galway, Ireland, Galway, H91TK33, Ireland
| | - John Kelly
- Center for Neuroimaging, Cognition and Genomics (NICOG), Clinical Neuroimaging Laboratory, Galway Neuroscience Centre, University of Galway, Ireland, Galway, H91TK33, Ireland
| | - Colm McDonald
- Center for Neuroimaging, Cognition and Genomics (NICOG), Clinical Neuroimaging Laboratory, Galway Neuroscience Centre, University of Galway, Ireland, Galway, H91TK33, Ireland
| | - Gary Donohoe
- Center for Neuroimaging, Cognition and Genomics (NICOG), Clinical Neuroimaging Laboratory, Galway Neuroscience Centre, University of Galway, Ireland, Galway, H91TK33, Ireland
| | - Dara M Cannon
- Center for Neuroimaging, Cognition and Genomics (NICOG), Clinical Neuroimaging Laboratory, Galway Neuroscience Centre, University of Galway, Ireland, Galway, H91TK33, Ireland
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Brandt JM, Hemager N, Ellersgaard D, Gregersen M, Søndergaard A, Ohland J, Søborg Spang K, Christiani C, Burton BK, Greve A, Hjorthøj C, Mors O, Plessen KJ, Møllegaard Jepsen JR, Nordentoft M, Elgaard Thorup AA. Hair cortisol concentrations and perceived stress in 7-year-old children at familial high-risk of schizophrenia or bipolar disorder. Prog Neuropsychopharmacol Biol Psychiatry 2023; 125:110750. [PMID: 36921662 DOI: 10.1016/j.pnpbp.2023.110750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Revised: 03/02/2023] [Accepted: 03/12/2023] [Indexed: 03/18/2023]
Abstract
BACKGROUND Dysregulation of the HPA-axis, perceived stress and interpersonal trauma are associated with an elevated risk for schizophrenia and bipolar disorder. Being at familial high-risk of these two mental disorders also constitutes an increased risk. In this study, we aimed to investigate hair cortisol concentrations and perceived stress among 7-year-old children at familial high-risk of schizophrenia (FHR-SZ), bipolar disorder (FHR-BP), and population-based controls (controls). METHODS A total of 515 children (mean age 7.8, SD 0.2) from baseline assessment of the Danish High Risk and Resilience Study - VIA 7 participated in this study. Hair cortisol concentrations were analyzed among 322 children (FHR-SZ; N = 111, FHR-BP; N = 82, controls; N = 129). Perceived stress was assessed with the Daily Life Stressor Scale including 512 children (FHR-SZ; N = 195, FHR-BP; N = 118, controls; N = 199). Interpersonal trauma was measured with face-to-face interviews. RESULTS Seven-year-old children at FHR-SZ or FHR-BP did not have a higher level of hair cortisol concentrations compared with controls (FHR-SZ: mean: 5.10, 95%CI 3.69-6.52; FHR-BP: mean: 5.01, 95%CI 3.27-6.72; controls: mean: 4.51, 95%CI 3.61-5.40; p = 0.77). Self-reported perceived stress was higher among children at FHR-SZ and FHR-BP compared with controls (FHR-SZ: mean: 12.09, 95%CI 10.99-13.19; FHR-BP: mean: 10.69, 95%CI 9.38-11.99; controls: mean: 8.90, 95%CI 8.13-9.68; p < 0.001). There was no significant association between hair cortisol concentrations and perceived stress (p = 0.84). Exploratory analyses revealed that interpersonal trauma exposure was neither associated with elevated hair cortisol nor perceived stress. CONCLUSIONS Children at FHR-SZ and FHR-BP did not exhibit higher levels of hair cortisol concentrations at age 7, while both FHR-groups had higher level of self-reported perceived stress compared with controls. Early attention to stress in children at FHR is crucial and these vulnerabilities should be targeted in future interventions studies.
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Affiliation(s)
- Julie Marie Brandt
- CORE - Copenhagen Research Center for Mental Health, Mental Health Services in the Capital Region of Denmark, Mental Health Center Copenhagen, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research - iPSYCH, Denmark; University of Copenhagen - Faculty of Health and Medical Sciences, Denmark.
| | - Nicoline Hemager
- CORE - Copenhagen Research Center for Mental Health, Mental Health Services in the Capital Region of Denmark, Mental Health Center Copenhagen, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research - iPSYCH, Denmark; University of Copenhagen - Faculty of Health and Medical Sciences, Denmark
| | - Ditte Ellersgaard
- CORE - Copenhagen Research Center for Mental Health, Mental Health Services in the Capital Region of Denmark, Mental Health Center Copenhagen, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research - iPSYCH, Denmark
| | - Maja Gregersen
- CORE - Copenhagen Research Center for Mental Health, Mental Health Services in the Capital Region of Denmark, Mental Health Center Copenhagen, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research - iPSYCH, Denmark; University of Copenhagen - Faculty of Health and Medical Sciences, Denmark
| | - Anne Søndergaard
- CORE - Copenhagen Research Center for Mental Health, Mental Health Services in the Capital Region of Denmark, Mental Health Center Copenhagen, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research - iPSYCH, Denmark; University of Copenhagen - Faculty of Health and Medical Sciences, Denmark
| | - Jessica Ohland
- CORE - Copenhagen Research Center for Mental Health, Mental Health Services in the Capital Region of Denmark, Mental Health Center Copenhagen, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research - iPSYCH, Denmark
| | - Katrine Søborg Spang
- CORE - Copenhagen Research Center for Mental Health, Mental Health Services in the Capital Region of Denmark, Mental Health Center Copenhagen, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research - iPSYCH, Denmark
| | - Camilla Christiani
- Mental Health Services in the Capital Region of Denmark, Child and Adolescent Mental Health Center, Denmark
| | - Birgitte Klee Burton
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research - iPSYCH, Denmark; Mental Health Services in the Capital Region of Denmark, Child and Adolescent Mental Health Center, Denmark; Department of Child and Adolescent Psychiatry, Copenhagen University Hospital - Psychiatry Region Zealand, Roskilde, Denmark
| | - Aja Greve
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research - iPSYCH, Denmark; Psychosis Research Unit, Aarhus University Hospital Psychiatry, Skejby, Denmark
| | - Carsten Hjorthøj
- CORE - Copenhagen Research Center for Mental Health, Mental Health Services in the Capital Region of Denmark, Mental Health Center Copenhagen, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research - iPSYCH, Denmark; University of Copenhagen, Department of Public Health, Section of Epidemiology, Denmark
| | - Ole Mors
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research - iPSYCH, Denmark; Psychosis Research Unit, Aarhus University Hospital Psychiatry, Skejby, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, Aarhus University, Denmark
| | - Kerstin Jessica Plessen
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research - iPSYCH, Denmark; Division of Child and Adolescent Psychiatry, Department of Psychiatry, University Hospital Lausanne and University of Lausanne, Denmark
| | - Jens Richardt Møllegaard Jepsen
- CORE - Copenhagen Research Center for Mental Health, Mental Health Services in the Capital Region of Denmark, Mental Health Center Copenhagen, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research - iPSYCH, Denmark; Mental Health Services in the Capital Region of Denmark, Child and Adolescent Mental Health Center, Denmark; Mental Health Services in the Capital Region of Denmark, Center for Neuropsychiatric Schizophrenia Research and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Denmark
| | - Merete Nordentoft
- CORE - Copenhagen Research Center for Mental Health, Mental Health Services in the Capital Region of Denmark, Mental Health Center Copenhagen, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research - iPSYCH, Denmark; University of Copenhagen - Faculty of Health and Medical Sciences, Denmark
| | - Anne Amalie Elgaard Thorup
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research - iPSYCH, Denmark; University of Copenhagen - Faculty of Health and Medical Sciences, Denmark; Mental Health Services in the Capital Region of Denmark, Child and Adolescent Mental Health Center, Denmark
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10
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Montoro I, Moreno L, Mulet P, Miró C, Leunda A, Llaurador-Coll M, Muntané G, Teicher MH, Vilella E, Gutiérrez-Zotes A. Maximal Sensitivity to Child Maltreatment at the Ages of 6 and 11 Years is Associated with the Risk of Bipolar Disorder. JOURNAL OF INTERPERSONAL VIOLENCE 2023; 38:3030-3054. [PMID: 35648643 DOI: 10.1177/08862605221106128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Adverse childhood experiences, including child maltreatment (CM), are relevant environmental risk factors for bipolar disorder (BD). However, little is known about the interaction of the type, duration and frequency of abuse with the timing of abuse in BD. The aim of this study was to investigate the different patterns of childhood trauma (frequency, type and chronology) between BD patients and healthy controls (HCs) and to identify BD-sensitive periods of exposure to CM that could influence functioning outcomes. The Maltreatment and Abuse Chronology Exposure (MACE) scale was used to evaluate the importance of the type and timing of maltreatment in a sample of 60 patients diagnosed with euthymic BD. Additionally, 76 HCs were recruited for comparison. All participants were of European-Caucasian origin and were assessed in the 2016-2019 period. To identify the variables that maximally differentiated the type and timing of exposure to CM between the BD and HC groups, a linear mixed effects model and random forest (RF) analyses were applied. We showed that multiplicity and severity, nonverbal emotional abuse, witnessing interparental violence and emotional neglect were the main factors associated with BD. In addition, regarding the occurrence of maltreatment in BD patients, we identified two sensitive periods with a principal peak at the age of 6 and a secondary peak at the age of 11. Functionality at the assessment time was associated with CM in adolescence for both HC and BD participants. Although the sample size and retrospective nature of the MACE instrument were the main limitations of our study, we were unable to explore the role of variables such as sex or socioeconomic status. We concluded that the multiplicity and sensitivity of CM exposure, mainly of the emotional type, during middle childhood are important risk factors for BD, at least in the European-Caucasian cultural setting.
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Affiliation(s)
- Irene Montoro
- Hospital Universitari Institut Pere Mata, Reus, Spain
- Institut d'Investigació Sanitària Pere Virgili, CERCA, Reus, Spain
- Universitat Rovira i Virgili, Reus, Spain
| | - Lorena Moreno
- Hospital Universitari Institut Pere Mata, Reus, Spain
- Institut d'Investigació Sanitària Pere Virgili, CERCA, Reus, Spain
- Universitat Rovira i Virgili, Reus, Spain
| | | | - Carlota Miró
- Hospital Universitari Institut Pere Mata, Reus, Spain
| | - Ainhoa Leunda
- Hospital Universitari Institut Pere Mata, Reus, Spain
- Universitat Rovira i Virgili, Reus, Spain
| | - Martí Llaurador-Coll
- Hospital Universitari Institut Pere Mata, Reus, Spain
- Institut d'Investigació Sanitària Pere Virgili, CERCA, Reus, Spain
| | - Gerard Muntané
- Hospital Universitari Institut Pere Mata, Reus, Spain
- Institut d'Investigació Sanitària Pere Virgili, CERCA, Reus, Spain
- Universitat Rovira i Virgili, Reus, Spain
- Centro de Investigación Biomédica en Red en Salud Mental, CIBERSAM, Instituto de Salud Carlos III, Madrid, Spain
| | - Martin H Teicher
- Developmental Biopsychiatry Research Program, 24472McLean Hospital, Belmont, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Elisabet Vilella
- Hospital Universitari Institut Pere Mata, Reus, Spain
- Institut d'Investigació Sanitària Pere Virgili, CERCA, Reus, Spain
- Universitat Rovira i Virgili, Reus, Spain
- Centro de Investigación Biomédica en Red en Salud Mental, CIBERSAM, Instituto de Salud Carlos III, Madrid, Spain
| | - Alfonso Gutiérrez-Zotes
- Hospital Universitari Institut Pere Mata, Reus, Spain
- Institut d'Investigació Sanitària Pere Virgili, CERCA, Reus, Spain
- Universitat Rovira i Virgili, Reus, Spain
- Centro de Investigación Biomédica en Red en Salud Mental, CIBERSAM, Instituto de Salud Carlos III, Madrid, Spain
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11
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Li Z, Liu X, Ma R, Feng S, Zheng S, Zhu H, Yin D, Jia H. Cyclothymic Temperament, Physical Neglect, and Earlier Age of Onset Predict Poor Medication Adherence in Patients With Bipolar Disorder. J Nerv Ment Dis 2023; 211:35-39. [PMID: 36095277 DOI: 10.1097/nmd.0000000000001573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
ABSTRACT Individual-level risk factors may predict poor medication adherence (PMA) in bipolar disorder (BD). This study aimed to evaluate the association between affective temperament, childhood trauma, age of first onset, and PMA in patients with BD in China. A total of 168 patients completed the eight-item Morisky Medication Adherence Scale; the Short Temperament Evaluation of Memphis, Pisa, Paris, and San Diego Autoquestionnaire; and the Childhood Trauma Questionnaire-Short Form. Scores were then compared between PMA and non-PMA groups. Binary logistic regression showed that age of first onset was negatively correlated with PMA ( β = -0.106, p = 0.002), whereas physical neglect and cyclothymic temperament were positively correlated with PMA ( β = 0.143, p = 0.029; β = 0.19, p = 0.001, respectively). These findings indicate that cyclothymic temperament, physical neglect, and earlier onset are predictors of PMA in patients with BD and that such patients may require further attention to improve medical compliance.
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12
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Abstract
Childhood trauma, particularly emotional abuse, is prevalent in bipolar disorder, and affective instability mechanistically explains the relationship between childhood trauma and poor bipolar disorder outcomes. Yet, trauma-focused interventions in bipolar disorder are lacking. This editorial calls for future early interventions to target the effects of childhood trauma and affective instability in this population.
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Affiliation(s)
- Danielle Hett
- Institute for Mental Health, University of Birmingham, UK; and National Centre for Mental Health, The Barberry, Birmingham and Solihull Mental Health Trust, UK
| | - Bruno Etain
- INSERM UMR-S 1144, Université de Paris, France
| | - Steven Marwaha
- Institute for Mental Health, University of Birmingham, UK; National Centre for Mental Health, The Barberry, Birmingham and Solihull Mental Health Trust, UK; and Specialist Mood Disorders Clinic, Zinnia Centre, Birmingham and Solihull Mental Health Trust, UK
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13
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Haddad HW, Boardman E, Williams B, Mouhaffel R, Kaye AM, Kaye AD. Combination Olanzapine and Samidorphan for the Management of Schizophrenia and Bipolar 1 Disorder in Adults: A Narrative Review. Health Psychol Res 2022; 10:34224. [DOI: 10.52965/001c.34224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 01/12/2022] [Indexed: 11/06/2022] Open
Affiliation(s)
| | | | | | | | - Adam M. Kaye
- Thomas J. Long School of Pharmacy and Health Sciences, University of the Pacific
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14
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Brandt JM, Hemager N, Gregersen M, Søndergaard A, Falkenberg Krantz M, Ohland J, Wilms M, Birkehøj Rohd S, Hjorthøj C, Veddum L, Bruun Knudsen C, Krogh Andreassen A, Greve A, Spang KS, Christiani CA, Ellersgaard D, Klee Burton B, Gantriis DL, Bliksted V, Mors O, Plessen KJ, Møllegaard Jepsen JR, Nordentoft M, Elgaard Thorup AA. Childhood trauma in children at familial high risk of schizophrenia or bipolar disorder: A longitudinal study. The Danish High Risk and Resilience Study - VIA 7 and VIA 11. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2022; 61:875-894. [PMID: 35332530 DOI: 10.1111/bjc.12364] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Accepted: 02/24/2022] [Indexed: 12/30/2022]
Abstract
OBJECTIVES Childhood trauma increases the risk of developing mental illness as does being born to parents with schizophrenia or bipolar disorder. We aimed to compare prevalence of lifetime childhood trauma among 11-year-old children at familial high risk of schizophrenia (FHR-SZ) or bipolar disorder (FHR-BP) compared with population-based controls (PBCs). DESIGN The study is a longitudinal, prospective cohort study of children at FHR-SZ, FHR-BP, and PBCs. METHODS A cohort of 512 children at FHR-SZ (N = 199), FHR-BP (N = 118), and PBCs (N = 195) were examined at baseline (mean age 7.8, SD 0.2) and 451 children at FHR-SZ (N = 172), FHR-BP (N = 104), and PBCs (N = 175) were examined at four-year follow-up (mean age 11.9, SD 0.2, retention rate 87.3%). Childhood trauma was measured with a semi-structured interview. RESULTS Children at FHR-BP had an elevated risk of exposure to any lifetime trauma (age 0-11 years) compared with PBCs (OR 2.082, 95%CI 1.223-3.545, p = .007) measured with binary logistic regression. One-way ANOVA revealed that both FHR-groups had a higher lifetime prevalence of exposure to a greater number of types of trauma compared with PBCs (FHR-SZ: observed mean: 1.53, 95%CI 1.29-1.77; FHR-BP: observed mean: 1.56, 95%CI 1.26-1.85; PBCs: observed mean: 0.99, 95%CI 0.82-1.17; p < .001). Binary logistic regression showed that the lifetime risk of exposure to interpersonal trauma (age 0-11 years) was elevated for both FHR-groups (FHR-SZ: OR 3.773, 95%CI 2.122-6.710, p < .001; FHR-BP: OR 3.602, 95%CI 1.913-6.783, p < .001). CONCLUSIONS Children at FHR-SZ and FHR-BP are at increased risk for being exposed to childhood trauma compared with PBCs. This study underscores the need for early detection, support, and prevention of childhood trauma in children at FHR-SZ and FHR-BP.
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Affiliation(s)
- Julie Marie Brandt
- CORE - Copenhagen Research Center for Mental Health, Mental Health Services in the Capital Region of Denmark, Mental Health Center Copenhagen, Hellerup, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research - iPSYCH, Aarhus, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Nicoline Hemager
- CORE - Copenhagen Research Center for Mental Health, Mental Health Services in the Capital Region of Denmark, Mental Health Center Copenhagen, Hellerup, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research - iPSYCH, Aarhus, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Maja Gregersen
- CORE - Copenhagen Research Center for Mental Health, Mental Health Services in the Capital Region of Denmark, Mental Health Center Copenhagen, Hellerup, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research - iPSYCH, Aarhus, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Anne Søndergaard
- CORE - Copenhagen Research Center for Mental Health, Mental Health Services in the Capital Region of Denmark, Mental Health Center Copenhagen, Hellerup, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research - iPSYCH, Aarhus, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Mette Falkenberg Krantz
- CORE - Copenhagen Research Center for Mental Health, Mental Health Services in the Capital Region of Denmark, Mental Health Center Copenhagen, Hellerup, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research - iPSYCH, Aarhus, Denmark
| | - Jessica Ohland
- CORE - Copenhagen Research Center for Mental Health, Mental Health Services in the Capital Region of Denmark, Mental Health Center Copenhagen, Hellerup, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research - iPSYCH, Aarhus, Denmark
| | - Martin Wilms
- CORE - Copenhagen Research Center for Mental Health, Mental Health Services in the Capital Region of Denmark, Mental Health Center Copenhagen, Hellerup, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research - iPSYCH, Aarhus, Denmark
| | - Sinnika Birkehøj Rohd
- CORE - Copenhagen Research Center for Mental Health, Mental Health Services in the Capital Region of Denmark, Mental Health Center Copenhagen, Hellerup, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research - iPSYCH, Aarhus, Denmark
| | - Carsten Hjorthøj
- CORE - Copenhagen Research Center for Mental Health, Mental Health Services in the Capital Region of Denmark, Mental Health Center Copenhagen, Hellerup, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research - iPSYCH, Aarhus, Denmark.,Department of Public Health, Section of Epidemiology, University of Copenhagen, Copenhagen, Denmark
| | - Lotte Veddum
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research - iPSYCH, Aarhus, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, Aarhus University, Aarhus, Denmark.,Psychosis Research Unit, Aarhus University Hospital Psychiatry, Skejby, Aarhus, Denmark
| | - Christina Bruun Knudsen
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research - iPSYCH, Aarhus, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, Aarhus University, Aarhus, Denmark.,Psychosis Research Unit, Aarhus University Hospital Psychiatry, Skejby, Aarhus, Denmark
| | - Anna Krogh Andreassen
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research - iPSYCH, Aarhus, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, Aarhus University, Aarhus, Denmark.,Psychosis Research Unit, Aarhus University Hospital Psychiatry, Skejby, Aarhus, Denmark
| | - Aja Greve
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research - iPSYCH, Aarhus, Denmark.,Psychosis Research Unit, Aarhus University Hospital Psychiatry, Skejby, Aarhus, Denmark
| | - Katrine Søborg Spang
- CORE - Copenhagen Research Center for Mental Health, Mental Health Services in the Capital Region of Denmark, Mental Health Center Copenhagen, Hellerup, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research - iPSYCH, Aarhus, Denmark
| | - Camilla Austa Christiani
- Mental Health Services in the Capital Region of Denmark, Child and Adolescent Mental Health Center, Copenhagen, Denmark
| | - Ditte Ellersgaard
- CORE - Copenhagen Research Center for Mental Health, Mental Health Services in the Capital Region of Denmark, Mental Health Center Copenhagen, Hellerup, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research - iPSYCH, Aarhus, Denmark
| | - Birgitte Klee Burton
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research - iPSYCH, Aarhus, Denmark.,Mental Health Services in the Capital Region of Denmark, Child and Adolescent Mental Health Center, Copenhagen, Denmark
| | - Ditte Lou Gantriis
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research - iPSYCH, Aarhus, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, Aarhus University, Aarhus, Denmark.,Psychosis Research Unit, Aarhus University Hospital Psychiatry, Skejby, Aarhus, Denmark
| | - Vibeke Bliksted
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, Aarhus University, Aarhus, Denmark.,Psychosis Research Unit, Aarhus University Hospital Psychiatry, Skejby, Aarhus, Denmark
| | - Ole Mors
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research - iPSYCH, Aarhus, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, Aarhus University, Aarhus, Denmark.,Psychosis Research Unit, Aarhus University Hospital Psychiatry, Skejby, Aarhus, Denmark
| | - Kerstin Jessica Plessen
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research - iPSYCH, Aarhus, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Mental Health Services in the Capital Region of Denmark, Child and Adolescent Mental Health Center, Copenhagen, Denmark.,Division of Child and Adolescent Psychiatry, Department of Psychiatry, University Hospital Lausanne and University of Lausanne, Lausanne, Switzerland
| | - Jens Richardt Møllegaard Jepsen
- CORE - Copenhagen Research Center for Mental Health, Mental Health Services in the Capital Region of Denmark, Mental Health Center Copenhagen, Hellerup, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research - iPSYCH, Aarhus, Denmark.,Mental Health Services in the Capital Region of Denmark, Child and Adolescent Mental Health Center, Copenhagen, Denmark.,Mental Health Services in the Capital Region of Denmark, Center for Neuropsychiatric Schizophrenia Research and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Hellerup, Denmark
| | - Merete Nordentoft
- CORE - Copenhagen Research Center for Mental Health, Mental Health Services in the Capital Region of Denmark, Mental Health Center Copenhagen, Hellerup, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research - iPSYCH, Aarhus, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Anne Amalie Elgaard Thorup
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research - iPSYCH, Aarhus, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Mental Health Services in the Capital Region of Denmark, Child and Adolescent Mental Health Center, Copenhagen, Denmark
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15
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Grillault Laroche D, Godin O, Dansou Y, Belzeaux R, Aouizerate B, Burté T, Courtet P, Dubertret C, Haffen E, Llorca P, Olie E, Roux P, Polosan M, Schwan R, Leboyer M, Bellivier F, Marie-Claire C, Etain B. Influence of childhood maltreatment on prevalence, onset and persistence of psychiatric comorbidities and suicide attempts in bipolar disorders. Eur Psychiatry 2022; 65:e15. [PMID: 35060460 PMCID: PMC8853858 DOI: 10.1192/j.eurpsy.2022.7] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Methods Results Conclusions
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16
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Using Microbiome-Based Approaches to Deprogram Chronic Disorders and Extend the Healthspan following Adverse Childhood Experiences. Microorganisms 2022; 10:microorganisms10020229. [PMID: 35208684 PMCID: PMC8879770 DOI: 10.3390/microorganisms10020229] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 01/04/2022] [Accepted: 01/19/2022] [Indexed: 12/01/2022] Open
Abstract
Adverse childhood experiences (ACEs), which can include child trafficking, are known to program children for disrupted biological cycles, premature aging, microbiome dysbiosis, immune-inflammatory misregulation, and chronic disease multimorbidity. To date, the microbiome has not been a major focus of deprogramming efforts despite its emerging role in every aspect of ACE-related dysbiosis and dysfunction. This article examines: (1) the utility of incorporating microorganism-based, anti-aging approaches to combat ACE-programmed chronic diseases (also known as noncommunicable diseases and conditions, NCDs) and (2) microbiome regulation of core systems biology cycles that affect NCD comorbid risk. In this review, microbiota influence over three key cyclic rhythms (circadian cycles, the sleep cycle, and the lifespan/longevity cycle) as well as tissue inflammation and oxidative stress are discussed as an opportunity to deprogram ACE-driven chronic disorders. Microbiota, particularly those in the gut, have been shown to affect host–microbe interactions regulating the circadian clock, sleep quality, as well as immune function/senescence, and regulation of tissue inflammation. The microimmunosome is one of several systems biology targets of gut microbiota regulation. Furthermore, correcting misregulated inflammation and increased oxidative stress is key to protecting telomere length and lifespan/longevity and extending what has become known as the healthspan. This review article concludes that to reverse the tragedy of ACE-programmed NCDs and premature aging, managing the human holobiont microbiome should become a routine part of healthcare and preventative medicine across the life course.
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17
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Quidé Y, Watkeys OJ, Girshkin L, Kaur M, Carr VJ, Cairns MJ, Green MJ. Interactive effects of polygenic risk and cognitive subtype on brain morphology in schizophrenia spectrum and bipolar disorders. Eur Arch Psychiatry Clin Neurosci 2022; 272:1205-1218. [PMID: 35792918 PMCID: PMC9508053 DOI: 10.1007/s00406-022-01450-4] [Citation(s) in RCA: 2] [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: 09/17/2021] [Accepted: 06/12/2022] [Indexed: 11/29/2022]
Abstract
Grey matter volume (GMV) may be associated with polygenic risk for schizophrenia (PRS-SZ) and severe cognitive deficits in people with schizophrenia, schizoaffective disorder (collectively SSD), and bipolar disorder (BD). This study examined the interactive effects of PRS-SZ and cognitive subtypes of SSD and BD in relation to GMV. Two-step cluster analysis was performed on 146 clinical cases (69 SSD and 77 BD) assessed on eight cognitive domains (verbal and visual memory, executive function, processing speed, visual processing, language ability, working memory, and planning). Among them, 55 BD, 51 SSD, and 58 healthy controls (HC), contributed to focal analyses of the relationships between cognitive subtypes, PRS-SZ and their interaction on GMV. Two distinct cognitive subtypes were evident among the combined sample of cases: a 'cognitive deficit' group (CD; N = 31, 20SSD/11BD) showed severe impairment across all cognitive indices, and a 'cognitively spared' (CS; N = 75; 31SSD/44BD) group showed intermediate cognitive performance that was significantly worse than the HC group but better than the CD subgroup. A cognitive subgroup-by-PRS-SZ interaction was significantly associated with GMV in the left precentral gyrus. Moderation analyses revealed a significant negative relationship between PRS-SZ and GMV in the CD group only. At low and average (but not high) PRS-SZ, larger precentral GMV was evident in the CD group compared to both CS and HC groups, and in the CS group compared to HCs. This study provides evidence for a relationship between regional GMV changes and PRS-SZ in psychosis spectrum cases with cognitive deficits, but not in cases cognitively spared.
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Affiliation(s)
- Yann Quidé
- School of Clinical Medicine, Discipline of Psychiatry and Mental Health, University of New South Wales (UNSW), Sydney, NSW Australia ,Neuroscience Research Australia, Randwick, NSW Australia
| | - Oliver J. Watkeys
- School of Clinical Medicine, Discipline of Psychiatry and Mental Health, University of New South Wales (UNSW), Sydney, NSW Australia ,Neuroscience Research Australia, Randwick, NSW Australia
| | - Leah Girshkin
- School of Clinical Medicine, Discipline of Psychiatry and Mental Health, University of New South Wales (UNSW), Sydney, NSW Australia ,Neuroscience Research Australia, Randwick, NSW Australia
| | - Manreena Kaur
- School of Clinical Medicine, Discipline of Psychiatry and Mental Health, University of New South Wales (UNSW), Sydney, NSW Australia ,Neuroscience Research Australia, Randwick, NSW Australia
| | - Vaughan J. Carr
- School of Clinical Medicine, Discipline of Psychiatry and Mental Health, University of New South Wales (UNSW), Sydney, NSW Australia ,Neuroscience Research Australia, Randwick, NSW Australia ,Department of Psychiatry, Monash University, Clayton, VIC Australia
| | - Murray J. Cairns
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, NSW Australia ,Centre for Brain and Mental Health Research, University of Newcastle, Callaghan, NSW Australia ,Hunter Medical Research Institute, New Lambton Heights, NSW Australia
| | - Melissa J. Green
- School of Clinical Medicine, Discipline of Psychiatry and Mental Health, University of New South Wales (UNSW), Sydney, NSW Australia ,Neuroscience Research Australia, Randwick, NSW Australia
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18
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Olgiati P, Serretti A. Post-traumatic stress disorder and childhood emotional abuse are markers of subthreshold bipolarity and worse treatment outcome in major depressive disorder. Int Clin Psychopharmacol 2022; 37:1-8. [PMID: 34686642 PMCID: PMC9648980 DOI: 10.1097/yic.0000000000000380] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 09/20/2021] [Indexed: 11/26/2022]
Abstract
Post-traumatic stress disorder (PTSD) and childhood maltreatment (CMT: parental neglect; emotional, physical and sexual abuse) have been linked to bipolar disorder but they are also common in major depressive disorder (MDD). Our objective was to investigate their association with the bipolar spectrum and antidepressant treatment outcome in 482 outpatients with DSM-IV MDD treated in the Combining Medications to Enhance Depression Outcomes trial for 28 weeks Bipolar spectrum score included age of onset <21 years, subthreshold hypomania (a period of elated or irritable mood with at least two concurrent hypomanic symptoms, which did not fulfill DSM criteria for hypomanic/manic episode) and depressive mixed state (DMX). PTSD subjects (n = 107; 22%) had more severe depression (P < 0.0001), work and social impairment (P = 0.0031), comorbid anxiety disorders (P < 0.0001) and increased suicidality (P = 0.0003). Bipolar spectrum score was higher with PTSD comorbidity (P = 0.0063) and childhood emotional abuse (P = 0.0001). PTSD comorbidity was associated with residual suicidality (P = 0.0218) after 6 weeks of antidepressant use whereas childhood emotional abuse [odds ratio (OR), 1.01-2.22], subthreshold hypomania (OR, 1.04-4.09) and DMX (OR, 1.00-4.19) were predictors of mood switch. These results corroborate the role of PTSD and childhood emotional abuse as markers of bipolar spectrum and prognostic factors during antidepressant treatment.
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Affiliation(s)
- Paolo Olgiati
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Alessandro Serretti
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
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19
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Godin O, Gaube G, Olié E, Belzeaux R, Bellivier F, Loftus J, Courtet P, Dubertret C, Llorca PM, Gard S, Henry C, Schwan R, Passerieux C, Polosan M, Samalin L, Leboyer M, Etain B. Childhood maltreatment and metabolic syndrome in bipolar disorders: In search of moderators. Psychoneuroendocrinology 2021; 131:105327. [PMID: 34182249 DOI: 10.1016/j.psyneuen.2021.105327] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 05/25/2021] [Accepted: 06/11/2021] [Indexed: 11/17/2022]
Abstract
As compared to the general population, adult individuals with bipolar disorders (BD) have higher mortality rates due to cardiovascular diseases and higher prevalence of Metabolic Syndrome (MetS). Recent evidence suggests that childhood maltreatment may contribute to the cardiovascular burden in individuals with BD. However, studies are scarce, with limited sample sizes and inconsistent results. We explored the associations between a self-reported history of childhood maltreatment and MetS (and its subcomponents) in a large sample of 2390 individuals with BD. Childhood maltreatment was assessed using the Childhood Trauma Questionnaire and MetS was defined according to the revised criteria of the ATEP III. We suggested associations between childhood maltreatment and the presence of MetS in men and in younger individuals. The association between childhood maltreatment and the presence of MetS in the early onset subgroup was not significant after adjustment for site of recruitment and level of education. Hence, some links between childhood maltreatment and MetS might exist only in specific subgroups of individuals with BD, but confirmation is required in independent and large samples, while taking into account potential confounders. This would help defining how psychosocial interventions that target childhood maltreatment and its consequences may be beneficial for physical health.
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Affiliation(s)
- Ophelia Godin
- Fondation FondaMental, Créteil, France; Univ Paris Est Créteil, INSERM, IMRB, Translational Neuropsychiatry, AP-HP, DMU IMPACT, FHU ADAPT, Fondation FondaMental, F-94010 Créteil, France.
| | - Géraud Gaube
- APHP, Sorbonne Université, Département Medico-Universitaire Neurosciences, Unité de Psychiatrie, Psychotraumatologie et Addictions, Hôpital Tenon, Paris, France
| | - Emilie Olié
- Fondation FondaMental, Créteil, France; Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France; PSNREC, Univ Montpellier, INSERM, CHU Montpellier, Montpellier, France
| | - Raoul Belzeaux
- Fondation FondaMental, Créteil, France; Pôle de Psychiatrie, Assistance Publique Hôpitaux de Marseille, Marseille, France; INT-UMR7289, CNRS Aix-Marseille Université, Marseille, France
| | - Frank Bellivier
- Fondation FondaMental, Créteil, France; Assistance Publique des Hôpitaux de Paris (AP-HP) Paris. Nord, GHU Saint-Louis - Lariboisière - Fernand Widal, DMU Neurosciences, Département de Psychiatrie et de Médecine Addictologique, INSERM UMRS 1144, Université de Paris, Paris, France
| | - Joséphine Loftus
- Fondation FondaMental, Créteil, France; Pôle de Psychiatrie, Centre Hospitalier Princesse Grace, Monaco, France
| | - Philippe Courtet
- Fondation FondaMental, Créteil, France; Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France; PSNREC, Univ Montpellier, INSERM, CHU Montpellier, Montpellier, France
| | - Caroline Dubertret
- Fondation FondaMental, Créteil, France; AP-HP, Groupe Hospitalo-universitaire Nord, DMU ESPRIT, service de Psychiatrie et Addictologie, Hopital Louis Mourier, Colombes, Inserm U1266, Faculté de médecine, Université de Paris, France
| | - Pierre-Michel Llorca
- Fondation FondaMental, Créteil, France; CHU Clermont-Ferrand, Department of Psychiatry, University of Clermont Auvergne, EA7280, Clermont-Ferrand, France
| | - Sebastien Gard
- Fondation FondaMental, Créteil, France; Centre Expert Troubles Bipolaires, Service de Psychiatrie Adulte, Hôpital Charles-Perrens, Bordeaux, France
| | - Chantal Henry
- Department of Psychiatry, Service Hospitalo-Universitaire, GHU Paris Psychiatrie & Neuroscience, F-75014 Paris, France
| | - Raymund Schwan
- Fondation FondaMental, Créteil, France; Université de Lorraine, Inserm U1114, Centre Psychothérapique de Nancy, Nancy, France
| | - Christine Passerieux
- Fondation FondaMental, Créteil, France; Service Universitaire de Psychiatrie d'Adultes, Centre Hospitalier de Versailles, Le Chesnay, Service Universitaire de Psychiatrie d'Adultes, Centre Hospitalier de Versailles, Le Chesnay,Université Paris-Saclay, UVSQ, Inserm, CESP, Team "DevPsy", 94807 Villejuif, France
| | - Mircea Polosan
- Fondation FondaMental, Créteil, France; Université Grenoble Alpes, CHU de Grenoble et des Alpes, Grenoble Institut des Neurosciences (GIN) Inserm U 1216, Grenoble, France
| | - Ludovic Samalin
- Fondation FondaMental, Créteil, France; CHU Clermont-Ferrand, Department of Psychiatry, University of Clermont Auvergne, EA7280, Clermont-Ferrand, France
| | - Marion Leboyer
- Fondation FondaMental, Créteil, France; Univ Paris Est Créteil, INSERM, IMRB, Translational Neuropsychiatry, AP-HP, DMU IMPACT, FHU ADAPT, Fondation FondaMental, F-94010 Créteil, France
| | - Bruno Etain
- Fondation FondaMental, Créteil, France; Assistance Publique des Hôpitaux de Paris (AP-HP) Paris. Nord, GHU Saint-Louis - Lariboisière - Fernand Widal, DMU Neurosciences, Département de Psychiatrie et de Médecine Addictologique, INSERM UMRS 1144, Université de Paris, Paris, France
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20
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Lebovitz JG, Millett CE, Shanahan M, Levy-Carrick NC, Burdick KE. The impact of lifetime interpersonal and intentional trauma on cognition and vulnerability to psychosis in bipolar disorder. BJPsych Open 2021. [PMCID: PMC8444053 DOI: 10.1192/bjo.2021.991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background
Studies have shown that over half of individuals with bipolar disorder experience early-life trauma, which may influence clinical outcomes, including suicidality and presence of psychotic features. However, studies report inconsistent findings regarding the effect of trauma on cognitive outcomes in bipolar disorder.
Aims
Our study explores the effect of lifetime trauma on the level of vulnerability to psychosis and cognitive performance in participants with bipolar disorder.
Method
We evaluated lifetime trauma history in 236 participants with a diagnosis of bipolar disorder type 1 or 2, using the Structured Clinical Interview for DSM-IV and the Childhood Trauma Questionnaire. We classified trauma types based on the Substance Abuse and Mental Health Services Administration's concept of trauma, which characterises the type of experienced trauma (e.g. interpersonal and intentional, accidental or naturally occurring). Our primary outcome measures of interest were vulnerability to psychosis (Schizotypal Personality Questionnaire), cognitive performance (MATRICS Consensus Cognitive Battery) and social functioning (Social Adjustment Scale Self-Report).
Results
Multivariate analysis of covariance showed a significant effect of trauma type on the Schizotypal Personality Questionnaire cognitive–perceptual domain (F(3) = 6.7, P < 0.001). The no-trauma group had lower cognitive–perceptual schizotypal features compared with the accidental and intentional trauma (P < 0.001) and interpersonal and intentional trauma (P = 0.01) groups.
Conclusions
Our results highlight the need for careful trauma inquiry in patients with bipolar disorder, and consideration of how trauma-focused or -informed treatments may be an integral part of treatment planning to improve outcomes in bipolar disorder.
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21
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Kieseppä V, Jokela M, Holm M, Suvisaari J, Gissler M, Lehti V. Post-traumatic stress disorder among immigrants living in Finland: Comorbidity and mental health service use. Psychiatry Res 2021; 300:113940. [PMID: 33906030 DOI: 10.1016/j.psychres.2021.113940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Accepted: 04/10/2021] [Indexed: 11/26/2022]
Abstract
The aim of this study was to compare differences in comorbidity between immigrants and Finnish-born controls, and to examine the treatment received by immigrants with PTSD. Our original data included all the immigrants living in Finland by the end of 2010 and matched controls. For this study, we selected individuals who had received a diagnosis of PTSD during 2010-2015 (immigrants: n = 754, Finnish-born controls: n = 311). We compared the frequency of different comorbid conditions between immigrants and natives. Multinomial logistic regression was used to predict categorized treatment intensity with the region of origin and length of residence among the immigrants. Psychiatric comorbidity was much more extensive among the Finnish-born controls than among immigrants. Immigrants from Africa and the Middle East more often received treatment of low intensity compared with immigrants from Western countries. The length of residence was associated with more frequent treatment. The important differences in comorbidity and background characteristics between immigrants and natives should be taken into account in planning treatment guidelines for PTSD. The disparities in treatment intensity across different immigrant groups indicate a need to improve the services for immigrants with PTSD.
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Affiliation(s)
- Valentina Kieseppä
- Equality Unit, Finnish Institute for Health and Welfare, Helsinki, Finland.
| | - Markus Jokela
- Department of Psychology and Logopedics, Medicum, University of Helsinki, Helsinki, Finland
| | - Minna Holm
- Equality Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Jaana Suvisaari
- Equality Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Mika Gissler
- Information Services Department, Finnish Institute for Health and Welfare, Helsinki, Finland; Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Solna, Sweden
| | - Venla Lehti
- Equality Unit, Finnish Institute for Health and Welfare, Helsinki, Finland; Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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