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Li S, Lu X, Qiu Y, Teng Z, Zhao Z, Xu X, Tang H, Xiang H, Chen J, Wang B, Wu H. Association between uric acid and cognitive dysfunction: A cross-sectional study with newly diagnosed, drug-naïve with bipolar disorder. J Affect Disord 2023; 327:159-166. [PMID: 36739000 DOI: 10.1016/j.jad.2023.01.105] [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: 07/15/2022] [Revised: 01/14/2023] [Accepted: 01/27/2023] [Indexed: 02/05/2023]
Abstract
BACKGROUND Cognitive impairment is one of the major symptoms of individuals with bipolar disorder (BD). Purine system disorders may play an important role in cognitive dysfunction. So far, the relationship between cognitive deficits and purinergic metabolism in BD has been seldom discussed in previous studies. This study aims to explore its relevance and potential biological mechanisms. METHODS In this cross-sectional study, 205 first time diagnosed drug-naive individuals with BD and 97 healthy volunteers were recruited. The uric acid(UA) level was measured using automatic biochemical analyzer, and cognitive function was assessed by Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) and Stroop color-word test. In addition, general information and clinical symptoms were collected and evaluated. RESULTS In this study, the UA level of BD group (U = 8475.000, p = 0.038) was found to be significantly higher than that of the healthy controls, but the scores of RBANS (t = -11.302, p < 0.001) and Stroop color-word test (t = -6.962, p < 0.001) were significantly lower than that of the healthy controls. In gender subgroup analysis, females had lower UA level and higher RBANS scores. In correlation analysis, the cognitive function of individuals with BD was found to present a significant negative correlation with UA level in attention (r = -0.23, p = 0.001) and delayed memory(r = -0.16, p = 0.022). LIMITATIONS This is a cross-sectional design. CONCLUSION Elevated UA levels may be a potential mechanism of cognitive impairment in BD. This provides a new possible strategy for the prevention and treatment of cognitive impairment in BD.
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Affiliation(s)
- Sujuan Li
- National Clinical Research Center for Mental Disorders, , Department of Psychiatry, China National Technology Institute on Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Xiaozi Lu
- Qingdao Memtal Health Center, Qingdao, China
| | - Yan Qiu
- National Clinical Research Center for Mental Disorders, , Department of Psychiatry, China National Technology Institute on Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Ziwei Teng
- National Clinical Research Center for Mental Disorders, , Department of Psychiatry, China National Technology Institute on Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Ziru Zhao
- National Clinical Research Center for Mental Disorders, , Department of Psychiatry, China National Technology Institute on Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Xuelei Xu
- National Clinical Research Center for Mental Disorders, , Department of Psychiatry, China National Technology Institute on Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Hui Tang
- National Clinical Research Center for Mental Disorders, , Department of Psychiatry, China National Technology Institute on Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Hui Xiang
- National Clinical Research Center for Mental Disorders, , Department of Psychiatry, China National Technology Institute on Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Jindong Chen
- National Clinical Research Center for Mental Disorders, , Department of Psychiatry, China National Technology Institute on Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Bolun Wang
- Department of Radiology, The Second Xiangya Hospital of Central South University, Changsha, China.
| | - Haishan Wu
- National Clinical Research Center for Mental Disorders, , Department of Psychiatry, China National Technology Institute on Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China.
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Sayyah M, Delirrooyfard A, Rahim F. Assessment of the diagnostic performance of two new tools versus routine screening instruments for bipolar disorder: a meta-analysis. REVISTA BRASILEIRA DE PSIQUIATRIA (SAO PAULO, BRAZIL : 1999) 2022; 44:349-361. [PMID: 35588536 PMCID: PMC9169473 DOI: 10.1590/1516-4446-2021-2334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 12/27/2021] [Indexed: 01/10/2023]
Abstract
OBJECTIVE The present meta-analysis was conducted to determine the diagnostic accuracy of the bipolarity index (BI) and Rapid Mode Screener (RMS) as compared with the Bipolar Spectrum Diagnostic Scale (BSDS), the Hypomania Checklist (HCL-32), and the Mood Disorder Questionnaire (MDQ) in people with bipolar disorder (BD). METHODS We systematically searched five databases using standard search terms, and relevant articles published between May 1990 and November 30, 2021 were collected and reviewed. RESULTS Ninety-three original studies were included (n=62,291). At the recommended cutoffs for the BI, HCL-32, BSDS, MDQ, and RMS, the pooled sensitivities were 0.82, 0.75, 0.71, 0.71, and 0.78, respectively, while the corresponding pooled specificities were 0.73, 0.63, 0.73, 0.77, and 0.72, respectively. However, there was evidence that the accuracy of the BI was superior to that of the other tests, with a relative diagnostic odds ratio (RDOR) of 1.22 (0.98-1.52, p < 0.0001). The RMS was significantly more accurate than the other tests, with an RDOR (95%CI) of 0.79 (0.67-0.92, p < 0.0001) for the detection of BD type I (BD-I). However, there was evidence that the accuracy of the MDQ was superior to that of the other tests, with an RDOR of 1.93 (0.89-2.79, p = 0.0019), for the detection of BD type II (BD-II). CONCLUSION The psychometric properties of two new instruments, the BI and RMS, in people with BD were consistent with considerably higher diagnostic accuracy than the HCL-32, BSDS, and MDQ. However, a positive screening should be confirmed by a clinical diagnostic evaluation for BD.
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Affiliation(s)
- Mehdi Sayyah
- Education Development Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Ali Delirrooyfard
- Department of Emergency, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Fakher Rahim
- Research Center of Thalassemia & Hemoglobinopathies, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Metabolomics and Genomics Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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Li S, Qui Y, Teng Z, Chen J, Kang D, Tang H, Xiang H, Wu C, Tan Y, Wang L, Yang Y, Wang B, Wu H. Association Between Bipolar Disorder and Low Bone Mass: A Cross-Sectional Study With Newly Diagnosed, Drug-Naïve Patients. Front Psychiatry 2020; 11:530. [PMID: 32587534 PMCID: PMC7299052 DOI: 10.3389/fpsyt.2020.00530] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Accepted: 05/22/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Medical comorbidities in people with mental disorders have recently gained more attention. People with bipolar disorder (BD) often have comorbid low bone mass, which is associated with increased fracture risk and related severe outcomes. However, few clinical studies on bone metabolism in BD patients are available. This study was designed to assess bone mineral density (BMD) and related influencing factors in a sample of newly diagnosed, drug-naïve individuals with BD and age- and sex-matched healthy controls. METHODS Sixty-one drug-naïve individuals with BD (DSM-V) and 95 healthy volunteers had their lumbar spine (L1-L4) and left hip (Neck/Troch/Ward's) BMD determined by dual-energy X-ray absorptiometry. Besides, sociodemographic and clinical assessment were collected. Between-group comparisons and within subgroup analysis were performed. RESULTS Drug-naïve patients with BD had significantly lower BMD in comparison to healthy controls in multiple sites (L1, L3, Neck, Troch, Ward's, and total hip). On subgroup analysis, overweight individuals with BD had higher bone mass, while females presented reduced BMD. Binary logistic regression showed that low BMD in multiple regions was associated with BD diagnosis, body mass index (BMI), gender, and age. CONCLUSION Drug-naïve individuals with BD have lower BMD when compared to an age- and gender-matched healthy control sample. Low BMI and female gender are factors associated with this outcome. The underlying pathological mechanisms of BD comorbid with osteoporosis should be further explored. CLINICAL TRIAL REGISTRATION www.chictr.org.cn, identifier ChiCTR190002137.
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Affiliation(s)
- Sujuan Li
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China.,National Clinical Research Center for Mental Disorders, Changsha, China
| | - Yan Qui
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China.,National Clinical Research Center for Mental Disorders, Changsha, China
| | - Ziwei Teng
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China.,National Clinical Research Center for Mental Disorders, Changsha, China
| | - Jindong Chen
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China.,National Clinical Research Center for Mental Disorders, Changsha, China
| | - Dongyu Kang
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China.,National Clinical Research Center for Mental Disorders, Changsha, China
| | - Hui Tang
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China.,National Clinical Research Center for Mental Disorders, Changsha, China
| | - Hui Xiang
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China.,National Clinical Research Center for Mental Disorders, Changsha, China
| | - Chujun Wu
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China.,National Clinical Research Center for Mental Disorders, Changsha, China
| | - Yuxi Tan
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China.,National Clinical Research Center for Mental Disorders, Changsha, China
| | - Lu Wang
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China.,National Clinical Research Center for Mental Disorders, Changsha, China
| | - Yanyi Yang
- Health Management Center, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Bolun Wang
- Department of Orthopedics, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Haishan Wu
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China.,National Clinical Research Center for Mental Disorders, Changsha, China
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