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Faraone SV, Newcorn JH, Wozniak J, Joshi G, Coffey B, Uchida M, Wilens T, Surman C, Spencer TJ. In Memoriam: Professor Joseph Biederman's Contributions to Child and Adolescent Psychiatry. J Atten Disord 2024; 28:550-582. [PMID: 38334088 PMCID: PMC10947509 DOI: 10.1177/10870547231225818] [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] [Indexed: 02/10/2024]
Abstract
OBJECTIVE To provide an overview of Joe Biederman's contributions to child and adolescent psychiatry. METHOD Nine colleagues described his contributions to: psychopharmacology, comorbidity and genetics, pediatric bipolar disorder, autism spectrum disorders, Tourette's and tic disorders, clinical and neuro biomarkers for pediatric mood disorders, executive functioning, and adult ADHD. RESULTS Joe Biederman left us with many concrete indicators of his contributions to child and adolescent psychiatry. He set up the world's first pediatric psychopharmacology clinic and clinical research program in child adolescent psychiatry. As a young faculty member he began a research program that led to many awards and eventual promotion to full professor at Harvard Medical School. He was for many years the most highly cited researcher in ADHD. He achieved this while maintaining a full clinical load and was widely respected for his clinical acumen. CONCLUSION The world is a better place because Joe Biederman was here.
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Affiliation(s)
| | | | - Janet Wozniak
- Massachusetts General Hospital, Boston, USA
- Harvard Medical School, Boston, MA, USA
| | - Gagan Joshi
- Massachusetts General Hospital, Boston, USA
- Harvard Medical School, Boston, MA, USA
| | | | - Mai Uchida
- Massachusetts General Hospital, Boston, USA
- Harvard Medical School, Boston, MA, USA
| | - Timothy Wilens
- Massachusetts General Hospital, Boston, USA
- Harvard Medical School, Boston, MA, USA
| | - Craig Surman
- Massachusetts General Hospital, Boston, USA
- Harvard Medical School, Boston, MA, USA
| | - Thomas J. Spencer
- Massachusetts General Hospital, Boston, USA
- Harvard Medical School, Boston, MA, USA
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Woodward D, Wilens TE, Yule AM, DiSalvo M, Taubin D, Berger A, Stone M, Wozniak J, Burke C, Biederman J. Examining the clinical correlates of conduct disorder in youth with bipolar disorder. J Affect Disord 2023; 329:300-306. [PMID: 36863464 PMCID: PMC10041394 DOI: 10.1016/j.jad.2023.02.119] [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: 09/19/2022] [Revised: 02/16/2023] [Accepted: 02/22/2023] [Indexed: 03/04/2023]
Abstract
BACKGROUND Conduct Disorder (CD) is highly comorbid with Bipolar Disorder (BP) and this comorbidity is associated with high morbidity and dysfunction. We sought to better understand the clinical characteristics and familiality of comorbid BP + CD by examining children with BP with and without co-morbid CD. METHODS 357 subjects with BP were derived from two independent datasets of youth with and without BP. All subjects were evaluated with structured diagnostic interviews, the Child Behavior Checklist (CBCL), and neuropsychological testing. We stratified the sample of subjects with BP by the presence or absence of CD and compared the two groups on measures of psychopathology, school functioning, and neurocognitive functioning. First-degree relatives of subjects with BP +/- CD were compared on rates of psychopathology in relatives. RESULTS Subjects with BP + CD compared to BP without CD had significantly more impaired scores on the CBCL Aggressive Behavior (p < 0.001), Attention Problems (p = 0.002), Rule-Breaking Behavior (p < 0.001), Social Problems (p < 0.001), Withdrawn/Depressed clinical scales (p = 0.005), the Externalizing Problems (p < 0.001), and Total Problems composite scales(p < 0.001). Subjects with BP + CD had significantly higher rates of oppositional defiant disorder (ODD) (p = 0.002), any SUD (p < 0.001), and cigarette smoking (p = 0.001). First-degree relatives of subjects with BP + CD had significantly higher rates of CD/ODD/ASPD and cigarette smoking compared to first-degree relatives of subjects without CD. LIMITATIONS The generalization of our findings was limited due to a largely homogeneous sample and no CD only comparison group. CONCLUSIONS Given the deleterious outcomes associated with comorbid BP + CD, further efforts in identification and treatment are necessary.
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Affiliation(s)
- Diana Woodward
- Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, United States
| | - Timothy E Wilens
- Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, United States.
| | - Amy M Yule
- Department of Psychiatry, Boston University School of Medicine, Boston Medical Center, 720 Harrison Avenue, Suite 915, Boston, MA 02118, United States
| | - Maura DiSalvo
- Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, United States
| | - Daria Taubin
- Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, United States
| | - Amy Berger
- Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, United States
| | - Mira Stone
- Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, United States
| | - Janet Wozniak
- Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, United States
| | - Colin Burke
- Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, United States
| | - Joseph Biederman
- Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, United States
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Sesso G, Brancati GE, Masi G. Comorbidities in Youth with Bipolar Disorder: Clinical Features and Pharmacological Management. Curr Neuropharmacol 2023; 21:911-934. [PMID: 35794777 PMCID: PMC10227908 DOI: 10.2174/1570159x20666220706104117] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 04/14/2022] [Accepted: 06/13/2022] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Bipolar Disorder (BD) is a highly comorbid condition, and rates of cooccurring disorders are even higher in youth. Comorbid disorders strongly affect clinical presentation, natural course, prognosis, and treatment. METHODS This review focuses on the clinical and treatment implications of the comorbidity between BD and Attention-Deficit/Hyperactivity Disorder, disruptive behavior disorders (Oppositional Defiant Disorder and/or Conduct Disorder), alcohol and substance use disorders, Autism Spectrum Disorder, anxiety disorders, Obsessive-Compulsive Disorder, and eating disorders. RESULTS These associations define specific conditions which are not simply a sum of different clinical pictures, but occur as distinct and complex combinations with specific developmental pathways over time and selective therapeutic requirements. Pharmacological treatments can improve these clinical pictures by addressing the comorbid conditions, though the same treatments may also worsen BD by inducing manic or depressive switches. CONCLUSION The timely identification of BD comorbidities may have relevant clinical implications in terms of symptomatology, course, treatment and outcome. Specific studies addressing the pharmacological management of BD and comorbidities are still scarce, and information is particularly lacking in children and adolescents; for this reason, the present review also included studies conducted on adult samples. Developmentally-sensitive controlled clinical trials are thus warranted to improve the prognosis of these highly complex patients, requiring timely and finely personalized therapies.
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Affiliation(s)
- Gianluca Sesso
- IRCCS Stella Maris, Scientific Institute of Child Neurology and Psychiat., Calambrone (Pisa), Italy
| | | | - Gabriele Masi
- IRCCS Stella Maris, Scientific Institute of Child Neurology and Psychiat., Calambrone (Pisa), Italy
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DiSalvo M, Vater CH, Green A, Woodworth KY, Farrell A, Biederman J, Faraone S. Further Evidence of an Association Between a Positive Child Behavior Checklist-Bipolar Profile and a Diagnosis of Pediatric Bipolar Disorder: A Meta-Analysis. Scand J Child Adolesc Psychiatr Psychol 2023; 11:44-59. [PMID: 37273800 PMCID: PMC10236377 DOI: 10.2478/sjcapp-2023-0005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023] Open
Abstract
Background Previous research has found that a unique profile of the Child Behavior Checklist comprising of aggregate elevations of the Attention, Anxiety/Depression and Aggression scales (A-A-A profile, CBCL-Bipolar (BP) profile, CBCL-Dysregulation profile (DP); henceforth CBCL-BP/DP profile) is associated with a clinical diagnosis of pediatric bipolar (BP) disorder. Objective The main aim of the study is to evaluate the strength of the association between the CBCL-BP/DP profile and the clinical diagnosis of pediatric BP disorder through a meta-analysis. Methods A literature search was performed to identify studies that examined the association between a positive CBCL-BP/DP profile and a clinical diagnosis of pediatric BP disorder. The meta-analyses first examined studies assessing the rates of a positive CBCL-BP/DP profile in youth with BP disorder versus those with 1) ADHD, anxiety/depression, or disruptive behavior disorders (DBDs), and 2) non-bipolar controls. The second analysis evaluated studies examining the rates of pediatric BP disorder in youth with and without a positive CBCL-BP/DP profile. Results Eighteen articles met our inclusion and exclusion criteria, and fifteen articles had adequate data for meta-analysis. Results showed that BP youth were at significantly increased odds of having a positive CBCL-BP/DP profile compared to those with other psychiatric disorders (i.e., ADHD, anxiety/depression, or DBDs) (pooled OR=4.34, 95% CI=2.82, 8.27; p<0.001) and healthy control groups (pooled OR=34.77, 95% CI=2.87, 420.95; p=0.005). Further, meta-analysis results showed that youth with a positive CBCL-BP/DP profile were at significantly increased odds of having a BP disorder diagnosis compared to those without (pooled OR=4.25, 95% CI=2.12, 8.52; p<0.001). Conclusion Our systematic review and meta-analysis of the extant literature provides strong support for the association between the CBCL-BP/DP profile and pediatric BP disorder.
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Affiliation(s)
- Maura DiSalvo
- Pediatric Psychopharmacology Program, Division of Child and Adolescent Psychiatry, Massachusetts General Hospital, Boston, United States
| | - Chloe Hutt Vater
- Pediatric Psychopharmacology Program, Division of Child and Adolescent Psychiatry, Massachusetts General Hospital, Boston, United States
| | - Allison Green
- Pediatric Psychopharmacology Program, Division of Child and Adolescent Psychiatry, Massachusetts General Hospital, Boston, United States
- Department of Psychological and Brain Sciences, Indiana University, Indiana, United States
| | - K. Yvonne Woodworth
- Pediatric Psychopharmacology Program, Division of Child and Adolescent Psychiatry, Massachusetts General Hospital, Boston, United States
| | - Abigail Farrell
- Pediatric Psychopharmacology Program, Division of Child and Adolescent Psychiatry, Massachusetts General Hospital, Boston, United States
- Department of Psychology, University of Houston, Houston, United States
| | - Joseph Biederman
- Pediatric Psychopharmacology Program, Division of Child and Adolescent Psychiatry, Massachusetts General Hospital, Boston, United States
- Boston Department of Psychiatry, Massachusetts General Hospital, Boston, United States
| | - Stephen Faraone
- Department of Psychiatry and Behavioral Sciences, SUNY Upstate Medical University, Syracuse, United States
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Wilens TE, Woodward DW, Ko JD, Berger AF, Burke C, Yule AM. The Impact of Pharmacotherapy of Childhood-Onset Psychiatric Disorders on the Development of Substance Use Disorders. J Child Adolesc Psychopharmacol 2022; 32:200-214. [PMID: 35587209 PMCID: PMC9145257 DOI: 10.1089/cap.2022.0016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Background and Objective: Child- and adolescent-onset psychopathology is known to increase the risk for developing substance use and substance use disorders (SUDs). While pharmacotherapy is effective in treating pediatric psychiatric disorders, the impact of medication on the ultimate risk to develop SUDs in these youth remains unclear. Methods: We conducted a Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) systematic review of peer-reviewed literature published on PubMed through November 2021, examining pharmacological treatments of psychiatric disorders in adolescents and young adults and their effect on substance use, misuse, and use disorder development. Results: Our search terms yielded 21 studies examining the impact of pharmacotherapy and later SUD in attention-deficit/hyperactivity disorder (ADHD), two studies on Major Depressive Disorder, and three studies on psychotic disorders. The majority of these studies reported reductions in SUD (N = 14 sides) followed by no effects (N = 10) and enhanced rates of SUD (N = 2). Studies in ADHD also reported that earlier-onset and longer-duration treatment was associated with the largest risk reduction for later SUD. Conclusions: Overall, pharmacological treatments for psychiatric disorders appear to mitigate the development of SUD, especially when treatment is initiated early and for longer durations. More studies on the development of SUD linked to the effects of psychotherapy alone and in combination with medication, medication initiation and duration, adequacy of treatment, non-ADHD disorders, and psychiatric comorbidity are necessary.
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Affiliation(s)
- Timothy E. Wilens
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.,Address correspondence to: Timothy Wilens, MD, Department of Psychiatry, YAW6A, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA
| | - Diana W. Woodward
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Je Deuk Ko
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Amy F. Berger
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Colin Burke
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Amy M. Yule
- Department of Psychiatry, Boston Medical Center, Boston, Massachusetts, USA
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Wozniak J, DiSalvo M, Farrell A, Yule A, Joshi G, Cook E, Faraone SV, Biederman J. Can pediatric bipolar disorder be successfully treated when comorbid with conduct disorder? A secondary analysis of clinical trials of risperidone, olanzapine, quetiapine, ziprasidone, and aripiprazole. J Psychopharmacol 2022; 36:637-644. [PMID: 35510655 DOI: 10.1177/02698811221087673] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Pediatric bipolar disorder (BP) is frequently comorbid with conduct disorder (CD) and its presence adds to the morbidity of BP. While there are no known pharmacological treatments for CD, pediatric BP is responsive to treatment with medications initially indicated for the treatment of psychosis, several of which have Food and Drug Administration (FDA) approval for the treatment of pediatric mania. AIMS The main aim of this secondary analysis was to examine whether pediatric BP comorbid with CD responds similarly to treatment with such selected medications. Considering the well-documented morbidity of CD, this finding could have important clinical and public health significance. METHODS We conducted a secondary analysis of six prospective 8-week open-label trials of selected medications (risperidone, olanzapine, quetiapine, ziprasidone, and aripiprazole) using identical methodology in youth with BP with and without comorbid CD. Results: Of 165 youths with BP, 54% (N = 89) met criteria for comorbid CD. The antimanic effects observed did not significantly differ between BP youths with and without comorbid CD, as measured either by a reduction in Young Mania Rating Scale (YMRS) ⩾ 30% or Clinical Global Impression (CGI)-Improvement ⩽ 2 (p = 0.23), or by the more stringent definition of a reduction in YMRS ⩾ 50% (p = 0.61). CONCLUSION Pediatric BP can be effectively treated with the abovementioned medications in the context of comorbid CD. Based on previous research showing that remission of BP is associated with remission of CD, if confirmed, these findings raise the possibility that antimanic treatment of youth with BP comorbid with CD could have secondary benefits in mitigating the morbidity associated with CD. This is a pilot scale finding, the results of which are promising and should be confirmed by larger and long-term follow-up studies.
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Affiliation(s)
- Janet Wozniak
- Clinical and Research Program in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Boston, MA, USA.,Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Maura DiSalvo
- Clinical and Research Program in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Boston, MA, USA
| | - Abigail Farrell
- Clinical and Research Program in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Boston, MA, USA
| | - Amy Yule
- Clinical and Research Program in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Boston, MA, USA.,Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Gagan Joshi
- Clinical and Research Program in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Boston, MA, USA.,Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Emmaline Cook
- Clinical and Research Program in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Boston, MA, USA
| | - Stephen V Faraone
- Department of Psychiatry and Behavioral Sciences, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Joseph Biederman
- Clinical and Research Program in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Boston, MA, USA.,Department of Psychiatry, Harvard Medical School, Boston, MA, USA
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Menculini G, Steardo L, Verdolini N, Cirimbilli F, Moretti P, Tortorella A. Substance use disorders in bipolar disorders: Clinical correlates and treatment response to mood stabilizers. J Affect Disord 2022; 300:326-333. [PMID: 34990627 DOI: 10.1016/j.jad.2022.01.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Revised: 11/06/2021] [Accepted: 01/01/2022] [Indexed: 12/17/2022]
Abstract
BACKGROUND Substance use disorders (SUD) in bipolar disorders (BD) present relevant impact on psychopathological features and illness course. The present study was aimed at analyzing the clinical correlates of this comorbidity. METHODS In- and outpatients suffering from BD were recruited. Socio-demographic and clinical characteristics were collected. Subjects underwent a psychopathological assessment evaluating affective temperaments and impulsiveness. The appraisal of treatment response to mood stabilizers was conducted with the Alda Scale. Bivariate analyses were used to compare subjects suffering from BD with (SUD-BD) or without comorbid SUD (nSUD-BD) (p<0.05). A logistic regression model was performed to identify specific correlates of SUD in BD. RESULTS Among the 161 included subjects, 63 (39.1%) were diagnosed with comorbid SUD. SUD-BD subjects showed younger age at onset (p = 0.003) and higher prevalence of BD type I diagnosis (BDI) (p<0.001). Furthermore, lifetime mixed features (p<0.001), psychotic symptoms (p<0.001), suicide attempts (p = 0.002), aggression (p = 0.003), antidepressant-induced manic switch (p = 0.003), and poor treatment response (p<0.001) were more frequent in the SUD-BD subgroup. At the logistic regression, SUD revealed a positive association with BD type I diagnosis (Odds Ratio (OR) 4.77, 95% CI 1.66-13.71, p = 0.004) and mixed features (OR 2.54, 95% CI 1.17-5.53, p = 0.019). LIMITATIONS The cross-sectional study design and the relatively small sample size may limit the generalizability of the findings. The retrospective evaluation of comorbid SUD could have biased the outcome assessment. CONCLUSIONS Subjects with BD and SUD are characterized by higher clinical severity and require careful assessment of treatment response.
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Affiliation(s)
| | - Luca Steardo
- Psychiatric Unit, Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Norma Verdolini
- Department of Psychiatry, University of Perugia, Perugia, Italy; Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain
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Lubián-López DM, Moya-Bejarano D, Butrón-Hinojo CA, Marín-Sánchez P, Blasco-Alonso M, Jiménez-López JS, Villegas-Muñoz E, González-Mesa E. Measuring Resilience in Women with Endometriosis. J Clin Med 2021; 10:jcm10245942. [PMID: 34945238 PMCID: PMC8708759 DOI: 10.3390/jcm10245942] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 12/06/2021] [Accepted: 12/14/2021] [Indexed: 12/15/2022] Open
Abstract
Endometriosis is a multifactorial disease with pathophysiological factors not yet well known; it also presents a wide symptomatic range that makes us think about the need for multidisciplinary management. It is a chronic disease in which there is no definitive treatment, and is associated in a large majority of cases with psychological pathology. Connecting comorbidities and multimorbidities on a neurobiological, neuropsychological, and pathophysiological level could significantly contribute to their more successful prevention and treatment. In our study, resilience is analyzed as an adjunctive measure in the management of endometriosis. Methods: A multi-centre, cross-sectional study was performed to analyse resilience levels in a sample of Spanish women suffering from endometriosis. CDRIS-25, CDRIS-10, BDI, the STAI, and the SF-36 Health Questionnaire were used for assessments. A representative group of 202 women with endometriosis was recruited by consecutive sampling. Exploratory and confirmatory factor analyses were performed for both resilience scales. Results: Mean CDRIS-25 and CDRIS-10 scores were 69.58 (SD 15.1) and 29.37 (SD 7.2), respectively. Women with adenomyosis and without signs of deep endometriosis showed the lowest scores. The best predictive model included women’s age, years of endometriosis evolution, number of pregnancies, and history of fertility problems as the best predictive factors. Conclusions: Women build resilience as the number of years of evolution of the disease increases. Symptoms such as dyspareunia and continued abdominal pain were more prevalent among less resilient women.
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Affiliation(s)
- Daniel María Lubián-López
- Department of Obstetrics and Gynecology, University Hospital of Jerez de la Frontera, 11407 Cádiz, Spain;
- Department of Obstetrics and Gynecology, School of Medicine, University of Cádiz, 11003 Cádiz, Spain
| | - Davinia Moya-Bejarano
- Department of Obstetrics and Gynecology, Regional University Hospital of Málaga, 29001 Málaga, Spain; (M.B.-A.); (E.V.-M.); (E.G.-M.)
- Correspondence: (D.M.-B.); (J.S.J.-L.)
| | | | - Pilar Marín-Sánchez
- Department of Obstetrics and Gynecology, University Hospital Virgen de la Arrixaca, 30120 Murcia, Spain;
| | - Marta Blasco-Alonso
- Department of Obstetrics and Gynecology, Regional University Hospital of Málaga, 29001 Málaga, Spain; (M.B.-A.); (E.V.-M.); (E.G.-M.)
| | - Jesús Salvador Jiménez-López
- Department of Obstetrics and Gynecology, Regional University Hospital of Málaga, 29001 Málaga, Spain; (M.B.-A.); (E.V.-M.); (E.G.-M.)
- Correspondence: (D.M.-B.); (J.S.J.-L.)
| | - Emilia Villegas-Muñoz
- Department of Obstetrics and Gynecology, Regional University Hospital of Málaga, 29001 Málaga, Spain; (M.B.-A.); (E.V.-M.); (E.G.-M.)
| | - Ernesto González-Mesa
- Department of Obstetrics and Gynecology, Regional University Hospital of Málaga, 29001 Málaga, Spain; (M.B.-A.); (E.V.-M.); (E.G.-M.)
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Carbone MG, Campo G, Papaleo E, Marazziti D, Maremmani I. The Importance of a Multi-Disciplinary Approach to the Endometriotic Patients: The Relationship between Endometriosis and Psychic Vulnerability. J Clin Med 2021; 10:jcm10081616. [PMID: 33920306 PMCID: PMC8069439 DOI: 10.3390/jcm10081616] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Revised: 04/04/2021] [Accepted: 04/06/2021] [Indexed: 12/24/2022] Open
Abstract
Endometriosis is a chronic inflammatory condition, which is distinguished by the presence of the endometrial-like glands and stroma outside the uterine cavity. Pain and infertility are the most commonly expressed symptoms, occurring in 60% and 40% of cases, respectively. Women with endometriosis, especially those with pelvic pain, also have a greater vulnerability to several psychiatric disorders. There is, in particular, a tendency to contract affective or anxiety disorders as well as panic-agoraphobic and substance use disorders. Endometriosis with pelvic pain, infertility and psychic vulnerability usually leads to disability and a markedly lower quality of life for women of reproductive age. Thus, the burden of endometriosis is not limited to the symptoms and dysfunctions of the disease; it extends to the social, working and emotional spheres, leading to a severe impairment of global functioning. An analysis of scientific literature revealed a close relationship between specific temperamental traits, the expression of several psychiatric symptoms, chronicity of pain, risk of substance use and lower probability of a positive outcome. Endometriosis symptoms and the impact of related psychological consequences, increased vulnerability and the possible onset of psychiatric symptoms may influence coping strategies and weaken resilience, so triggering a vicious cycle leading to a marked deterioration in the quality of life. A multidisciplinary approach consisting of a medical team composed of gynecologists, psychologists, psychiatrists, experts in Dual Disorder, algologists and sexologists, would guarantee the setting of a target and taking the best decision on a personalized treatment plan. That approach would allow the prompt detection of any psychopathological symptoms and improve the endometriosis-related physical symptoms, bringing a healthier quality of life and a greater likelihood of a positive outcome.
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Affiliation(s)
- Manuel Glauco Carbone
- PISA-School of Experimental and Clinical Psychiatry, 56100 Pisa, Italy;
- Department of Medicine and Surgery, Division of Psychiatry, University of Insubria, 21100 Varese, Italy
| | - Giovanni Campo
- Obstetrics and Gynecology Department, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, 20132 Milan, Italy; (G.C.); (E.P.)
| | - Enrico Papaleo
- Obstetrics and Gynecology Department, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, 20132 Milan, Italy; (G.C.); (E.P.)
- Reproductive Sciences Laboratory, Division of Genetics and Cell Biology, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, 20132 Milan, Italy
| | - Donatella Marazziti
- 1st Psychiatric Unit, Department of Clinical and Experimental Medicine, Santa Chiara University Hospital, University of Pisa, 56100 Pisa, Italy;
- Saint Camillus International University of Health and Medical Sciences-UniCamillus, 00131 Rome, Italy
| | - Icro Maremmani
- Saint Camillus International University of Health and Medical Sciences-UniCamillus, 00131 Rome, Italy
- Association for the Application of Neuroscientific Knowledge to Social Aims (AU-CNS), 55045 Pietrasanta, Lucca, Italy
- Vincent P. Dole Dual Disorder Unit, 2nd Psychiatric Unit, Santa Chiara University Hospital, University of Pisa, 56100 Pisa, Italy
- G. De Lisio Institute of Behavioral Sciences, 56100 Pisa, Italy
- Correspondence: ; Tel.: +39-050-993045
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Hsu JH, Chien IC, Lin CH. Increased risk of ischemic heart disease in patients with bipolar disorder: A population-based study. J Affect Disord 2021; 281:721-726. [PMID: 33223233 DOI: 10.1016/j.jad.2020.11.083] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 09/10/2020] [Accepted: 11/08/2020] [Indexed: 01/07/2023]
Abstract
OBJECTIVE This study investigated the national prevalence and incidence of ischemic heart disease and associated factors among Taiwanese patients with bipolar disorder. METHODS We used a random sample of 766,427 subjects who were ≥18 years old from the National Health Research Institute database in 2005. Subjects with at least one primary diagnosis of bipolar disorder or ischemic heart disease were identified. We compared the prevalence and incidence of ischemic heart disease in bipolar patients and the general population in 2005 and the same cohort from 2006 to 2010. These associated factors with respect to ischemic heart disease among patients with bipolar disorder were also analyzed. RESULTS The prevalence of ischemic heart disease in patients with bipolar disorder was 1.69 times higher than in the general population (7.85% vs 4.67%; odds ratio 1.69; 95% confidence interval, 1.41-2.03) in 2005. The average annual incidence of ischemic heart disease in patients with bipolar disorder was also 1.60 times higher than in the general population (2.02% vs 1.24; risk ratio 1.60; 95% confidence interval, 1.36-1.90) from 2006 to 2010. The higher prevalence of ischemic heart disease among bipolar patients was associated with increased age, diabetes, hypertension, and antidepressant use. CONCLUSIONS Patients with bipolar disorder had a significantly higher prevalence and incidence of ischemic heart disease than the general population in both sexes, especially at younger ages. Among patients with bipolar disorder, older age, and hyperlipidemia were risk factors of ischemic heart disease.
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Affiliation(s)
- Jer-Hwa Hsu
- Chia-Yi Hospital, Ministry of Health and Welfare, Chiayi, Taiwan
| | - I-Chia Chien
- Bali Psychiatric Center, Ministry of Health and Welfare, New Taipei, Taiwan; National Yang-Ming University, Taipei, Taiwan.
| | - Ching-Heng Lin
- Taichung Veterans General Hospital, Taichung, Taiwan; National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
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11
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Vermeulen JM, Wootton RE, Treur JL, Sallis HM, Jones HJ, Zammit S, van den Brink W, Goodwin GM, de Haan L, Munafò MR. Smoking and the risk for bipolar disorder: evidence from a bidirectional Mendelian randomisation study. Br J Psychiatry 2021; 218:88-94. [PMID: 31526406 DOI: 10.1192/bjp.2019.202] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND There is increasing evidence that smoking is a risk factor for severe mental illness, including bipolar disorder. Conversely, patients with bipolar disorder might smoke more (often) as a result of the psychiatric disorder. AIMS We conducted a bidirectional Mendelian randomisation (MR) study to investigate the direction and evidence for a causal nature of the relationship between smoking and bipolar disorder. METHOD We used publicly available summary statistics from genome-wide association studies on bipolar disorder, smoking initiation, smoking heaviness, smoking cessation and lifetime smoking (i.e. a compound measure of heaviness, duration and cessation). We applied analytical methods with different, orthogonal assumptions to triangulate results, including inverse-variance weighted (IVW), MR-Egger, MR-Egger SIMEX, weighted-median, weighted-mode and Steiger-filtered analyses. RESULTS Across different methods of MR, consistent evidence was found for a positive effect of smoking on the odds of bipolar disorder (smoking initiation ORIVW = 1.46, 95% CI 1.28-1.66, P = 1.44 × 10-8, lifetime smoking ORIVW = 1.72, 95% CI 1.29-2.28, P = 1.8 × 10-4). The MR analyses of the effect of liability to bipolar disorder on smoking provided no clear evidence of a strong causal effect (smoking heaviness betaIVW = 0.028, 95% CI 0.003-0.053, P = 2.9 × 10-2). CONCLUSIONS These findings suggest that smoking initiation and lifetime smoking are likely to be a causal risk factor for developing bipolar disorder. We found some evidence that liability to bipolar disorder increased smoking heaviness. Given that smoking is a modifiable risk factor, these findings further support investment into smoking prevention and treatment in order to reduce mental health problems in future generations.
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Affiliation(s)
- Jentien M Vermeulen
- Medical Doctor, Department of Psychiatry, Amsterdam UMC, University of Amsterdam, The Netherlands
| | - Robyn E Wootton
- Post-doc Researcher, School of Psychological Science, University of Bristol; MRC Integrative Epidemiology Unit, University of Bristol; and NIHR Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and the University of Bristol, UK
| | - Jorien L Treur
- Post-doc Researcher, Department of Psychiatry, Amsterdam UMC, University of Amsterdam, The Netherlands
| | - Hannah M Sallis
- Post-doc Researcher, School of Psychological Science, University of Bristol; and MRC Integrative Epidemiology Unit, University of Bristol, UK
| | - Hannah J Jones
- Post-doc Researcher, Department of Population Health Sciences, Bristol Medical School, University of Bristol; and MRC Integrative Epidemiology Unit, University of Bristol, UK
| | - Stanley Zammit
- Professor of Psychiatric Epidemiology, Department of Population Health Sciences, Bristol Medical School, University of Bristol, UK; and MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, University of Cardiff, UK
| | - Wim van den Brink
- Emeritus Professor of Addiction, Department of Psychiatry, Amsterdam UMC, University of Amsterdam, The Netherlands
| | - Guy M Goodwin
- Professor of Psychiatry, Department of Psychiatry, University of Oxford; and Oxford Health NHS Foundation Trust, Oxford, UK
| | - Lieuwe de Haan
- Professor of Psychotic Disorders, Department of Psychiatry, Amsterdam UMC, University of Amsterdam, The Netherlands
| | - Marcus R Munafò
- Professor of Biological Psychology, School of Psychological Science, University of Bristol, Bristol; MRC Integrative Epidemiology Unit, University of Bristol; and UK Centre for Tobacco and Alcohol Studies, University of Bristol, UK
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12
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High Correspondence Between Child Behavior Checklist Rule Breaking Behavior Scale with Conduct Disorder in Males and Females. Child Psychiatry Hum Dev 2020; 51:978-985. [PMID: 32172405 PMCID: PMC7492452 DOI: 10.1007/s10578-020-00978-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
This study investigated the diagnostic utility of the Child Behavior Checklist (CBCL) Rule-Breaking Behavior scale to identify children of both sexes with conduct disorder (CD). Participants were derived from four independent datasets of children with and without attention deficit hyperactivity disorder and bipolar-I disorder of both sexes. Participants had structured diagnostic interviews with raters blinded to subject ascertainment status. Receiver operating characteristic (ROC) curves were used to examine the scale's ability to identify children with and without CD. The sample consisted of 674 participants (mean age of 11.7 ± 3.3 years, 57% male, 94% Caucasian). The interaction to test if CBCL Rule-Breaking Behavior scores identified males and females with CD differently was not significant, thus we performed ROC analysis in the combined group. The ROC analysis of the scale yielded an area under the curve of 0.9. A score of ≥ 60 on the scale correctly classified 82% of participants with CD with 85% sensitivity, 81% specificity, 48% positive predictive value, 96% negative predictive value. The CBCL Rule-Breaking Behavior scale was an efficient tool to identify children with CD.
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13
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Pascual MA, Levenson JC, Merranko J, Gill MK, Hower H, Yen S, Strober M, Goldstein TR, Goldstein BI, Ryan ND, Weinstock LM, Keller MB, Axelson D, Birmaher B. The Effect of Traumatic Events on the Longitudinal Course and Outcomes of Youth with Bipolar Disorder. J Affect Disord 2020; 274:126-135. [PMID: 32469795 PMCID: PMC7365761 DOI: 10.1016/j.jad.2020.05.131] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2019] [Revised: 04/02/2020] [Accepted: 05/17/2020] [Indexed: 12/01/2022]
Abstract
BACKGROUND Exposure to severe Traumatic Events (TEs) has been associated with poor course and outcomes among individuals with Bipolar Disorder (BD). However, there is limited research on TEs among youth with BD, and few studies are longitudinal. This study prospectively followed a large sample of BD youth, examining the associations of lifetime TEs with their mood and functioning. METHODS BD participants (n=375; mean age=17; range 8-25y) were assessed, on average, every 7 months for a median 8.7 years. Psychopathology and lifetime trauma history were prospectively evaluated using the Longitudinal Interval Follow-Up Evaluation, and a traumatic events screening. RESULTS Accounting for covariates, participants with one or more lifetime TEs (84%) showed earlier BD onset, poorer psychosocial functioning, worse mood symptoms, and more suicidal ideation, comorbidities, and family psychopathology than those without TEs. TEs during recovery periods increased recurrence risk (p<0.02). More TEs were associated with poorer mood course, particularly among victims of violence/abuse (p<0.02). Abused participants (34% physical; 17% sexual) showed earlier onset of substance use disorders, more suicidality and comorbidities compared to those without abuse. Comparisons of mood course before and after abuse occurred, and with participants without abuse, showed worsening mood symptoms after, specifically hypo/mania (p<0.03). LIMITATIONS Prospective data was gathered longitudinally but assessed retrospectively at every follow-up; given approximate dates causality cannot be inferred; TEs severity was not assessed. CONCLUSIONS Severe TEs, particularly abuse, were associated with poorer course and outcomes among BD youth. Prompt screening of trauma and early intervention may be warranted to minimize TEs impact.
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Affiliation(s)
- Maria Andreu Pascual
- Department of Psychiatry, Western Psychiatric Hospital, University of Pittsburgh School of Medicine, 3811 O’Hara St., Pittsburgh, PA, 15213, USA
| | - Jessica C. Levenson
- Department of Psychiatry, Western Psychiatric Hospital, University of Pittsburgh School of Medicine, 3811 O’Hara St., Pittsburgh, PA, 15213, USA
| | - John Merranko
- Department of Psychiatry, Western Psychiatric Hospital, University of Pittsburgh School of Medicine, 3811 O’Hara St., Pittsburgh, PA, 15213, USA
| | - Mary Kay Gill
- Department of Psychiatry, Western Psychiatric Hospital, University of Pittsburgh School of Medicine, 3811 O’Hara St., Pittsburgh, PA, 15213, USA
| | - Heather Hower
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Box G-BH, Providence, RI, 02912, USA.,Department of Health Services, Policy, and Practice, Brown University School of Public Health, 121 South Main Street, Providence, RI, 02903, USA.,Department of Psychiatry, School of Medicine, University of California at San Diego, 4510 Executive Drive, Suite 315, San Diego, CA, 92121, USA
| | - Shirley Yen
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Box G-BH, Providence, RI, 02912, USA.,Massachusetts Mental Health Center and the Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical Center, Boston, MA, 02115, USA
| | - Michael Strober
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California at Los Angeles, 760 Westwood Plaza, Mail Code 175919, Los Angeles, CA, 90095, USA
| | - Tina R. Goldstein
- Department of Psychiatry, Western Psychiatric Hospital, University of Pittsburgh School of Medicine, 3811 O’Hara St., Pittsburgh, PA, 15213, USA
| | - Benjamin I. Goldstein
- Department of Psychiatry, Sunnybrook Health Sciences Centre, University of Toronto Faculty of Medicine, 2075 Bayview Ave., FG-53, Toronto, ON, M4N-3M5, Canada
| | - Neal D. Ryan
- Department of Psychiatry, Western Psychiatric Hospital, University of Pittsburgh School of Medicine, 3811 O’Hara St., Pittsburgh, PA, 15213, USA
| | - Lauren M. Weinstock
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Box G-BH, Providence, RI, 02912, USA.,Butler Hospital, 700 Butler Drive, Providence, RI, 02906, USA
| | - Martin B. Keller
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Box G-BH, Providence, RI, 02912, USA.,Butler Hospital, 700 Butler Drive, Providence, RI, 02906, USA
| | - David Axelson
- Department of Psychiatry, Nationwide Children’s Hospital and The Ohio State College of Medicine, 1670 Upham Dr., Columbus, OH, 43210, USA
| | - Boris Birmaher
- Department of Psychiatry, Western Psychiatric Hospital, University of Pittsburgh School of Medicine, 3811 O’Hara St., Pittsburgh, PA, 15213, USA
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14
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Tiosano S, Nir Z, Gendelman O, Comaneshter D, Amital H, Cohen A, Amital D. The association between systemic lupus erythematosus and bipolar disorder – a big data analysis. Eur Psychiatry 2020; 43:116-119. [DOI: 10.1016/j.eurpsy.2017.03.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Revised: 03/18/2017] [Accepted: 03/21/2017] [Indexed: 12/14/2022] Open
Abstract
AbstractBackground:Systemic lupus erythematosus (SLE) is a chronic, autoimmune disease that has a wide variety of physical manifestations, including neuropsychiatric features. Bipolar disorder (BD) is a chronic, episodic illness, that may present as depression or as mania. The objective of this study was to investigate the association between SLE and BD using big data analysis methods.Methods:Patients with SLE were compared with age- and sex-matched controls regarding the prevalence of BD in a cross-sectional study. Chi-square and t-tests were used for univariate analysis and a logistic regression model was used for multivariate analysis, adjusting for confounders. The study was performed utilizing the chronic disease registry of Clalit Health Services medical database.Results:The study included 5018 SLE patients and 25,090 matched controls. BD was found in a higher prevalence among SLE patients compared to controls (0.62% vs. 0.26%, respectively, P < 0.001). BD patients had a greater prevalence of smokers compared to non-BD patients (62.5% vs 23.5%, respectively, P < 0.001). In a multivariate analysis, smoking and SLE were both found to be significantly associated with BD.Conclusions:SLE was found to be independently associated with BD. These findings may imply that an autoimmune process affecting the central nervous system among SLE patients facilitates the expression of concomitant BD.
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15
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Quantifying the Protective Effects of Stimulants on Functional Outcomes in Attention-Deficit/Hyperactivity Disorder: A Focus on Number Needed to Treat Statistic and Sex Effects. J Adolesc Health 2019; 65:784-789. [PMID: 31350122 PMCID: PMC6874726 DOI: 10.1016/j.jadohealth.2019.05.015] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 05/23/2019] [Accepted: 05/23/2019] [Indexed: 11/20/2022]
Abstract
PURPOSE The aim of the study was to help quantify the protective effects of stimulant treatment on important functional outcomes in attention-deficit/hyperactivity disorder (ADHD) using the number needed to treat (NNT) statistic and examine whether these effects are moderated by sex. METHODS Subjects were derived from three independent samples, two similarly designed case-control, 10-year prospective follow-up studies of boys and girls with and without ADHD grown up and a cross-sectional randomized clinical trial of lisdexamfetamine on driving performance and behavior. For all studies, subjects were evaluated with structured diagnostic interviews. To measure psychopharmacologic treatment in the follow-up studies, we collected information about each subject's stimulant medication use, age at onset, and age at termination of treatment. Subjects in the driving study underwent two driving simulation assessments (premedication and after 6 weeks of treatment on lisdexamfetamine or placebo). For each outcome, we ran a logistic regression model that included an interaction between sex and treatment status. Lifetime rates were used to calculate the NNT statistic. We also calculated adjusted NNT statistics that accounted for sex, age, socioeconomic status, and family intactness. RESULTS The NNTs were very low, ranging from 3 to 10. No interaction effects with sex were detected (all p > .05). The adjusted NNTs mostly remained the same with the exception of any substance use disorder, which increased after controlling for age. CONCLUSIONS Stimulants have strong protective effects on functional outcomes in youth with ADHD that are not moderated by sex. These results support the critical importance of early identification and treatment of children with ADHD of both sexes.
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16
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Wozniak J, Wilens T, DiSalvo M, Farrell A, Wolenski R, Faraone SV, Biederman J. Comorbidity of bipolar I disorder and conduct disorder: a familial risk analysis. Acta Psychiatr Scand 2019; 139:361-368. [PMID: 30758064 PMCID: PMC6476307 DOI: 10.1111/acps.13013] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/11/2019] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To investigate the association between pediatric bipolar I (BP-I) disorder and conduct disorder (CD) using familial risk analysis. METHOD We compared diagnoses in relatives of youth in four proband groups defined by the presence or absence of BP-I and CD: (1) probands with neither CD nor BP-I (probands: N = 550; relatives: N = 1656), (2) probands with CD and without BP-I (probands: N = 40; relatives: N = 127), (3) probands with BP-I and without CD (probands: N = 197; relatives: N = 579), and (4) probands with both CD and BP-I (probands: N = 176; relatives: N = 488). All subjects were evaluated with structured diagnostic interviews, and diagnoses of relatives were made blind to the diagnoses of probands. RESULTS Relatives of probands with BP-I disorder had high rates of BP-I, and relatives of probands with CD had high rates of CD irrespective of the comorbidity with the other disorder. Relatives of probands with the combined condition of CD and BP-I had high rates of the combined condition. CONCLUSION The finding of cosegregation between BP-I disorder and CD is consistent with the hypothesis that the combined condition represents a distinct subtype of either disorder.
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Affiliation(s)
- Janet Wozniak
- Pediatric Psychopharmacology Program, Division of Child
Psychiatry, Massachusetts General Hospital, Boston, MA 02114, USA,Department of Psychiatry, Massachusetts General Hospital
and Harvard Medical School, Boston, MA 02114, USA
| | - Timothy Wilens
- Pediatric Psychopharmacology Program, Division of Child
Psychiatry, Massachusetts General Hospital, Boston, MA 02114, USA,Department of Psychiatry, Massachusetts General Hospital
and Harvard Medical School, Boston, MA 02114, USA
| | - Maura DiSalvo
- Pediatric Psychopharmacology Program, Division of Child
Psychiatry, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Abigail Farrell
- Pediatric Psychopharmacology Program, Division of Child
Psychiatry, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Rebecca Wolenski
- Pediatric Psychopharmacology Program, Division of Child
Psychiatry, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Stephen V. Faraone
- Department of Psychiatry and Behavioral Sciences, SUNY
Upstate Medical University, Syracuse, New York, USA
| | - Joseph Biederman
- Pediatric Psychopharmacology Program, Division of Child
Psychiatry, Massachusetts General Hospital, Boston, MA 02114, USA,Department of Psychiatry, Massachusetts General Hospital
and Harvard Medical School, Boston, MA 02114, USA
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17
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The role of neurotrophic factors in manic-, anxious- and depressive-like behaviors induced by amphetamine sensitization: Implications to the animal model of bipolar disorder. J Affect Disord 2019; 245:1106-1113. [PMID: 30699853 DOI: 10.1016/j.jad.2018.10.370] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Revised: 09/26/2018] [Accepted: 10/05/2018] [Indexed: 12/13/2022]
Abstract
BACKGROUND Bipolar disorder (BD) and substance use disorders share common symptoms, such as behavioral sensitization. Amphetamine-induced behavioral sensitization can serve as an animal model of BD. Neurotrophic factors have an important role in BD pathophysiology. This study evaluated the effects of amphetamine sensitization on behavior and neurotrophic factor levels in the brains of rats. METHODS Wistar rats received daily intraperitoneal (i.p) injections of dextroamphetamine (d-AMPH) 2 mg/kg or saline for 14 days. After seven days of withdrawal, the animals were challenged with d-AMPH (0.5 mg/kg, i.p) and locomotor behavior was assessed. In a second protocol, rats were similarly treated with d-AMPH (2 mg/kg, i.p) for 14 days. After withdrawal, without d-AMPH challenge, depressive- and anxiety-like behaviors were evaluated through forced swimming test and elevated plus maze. Levels of brain-derived neurotrophic factor (BDNF), nerve growth factor (NGF), neurotrophin 3 (NT-3), neurotrophin 4/5 (NT-4/5) and glial-derived neurotrophic factor (GDNF) were evaluated in the frontal cortex, hippocampus, and striatum. RESULTS D-AMPH for 14 days augmented locomotor sensitization to a lower dose of d-AMPH (0.5 mg/kg) after the withdrawal. d-AMPH withdrawal induced depressive- and anxious-like behaviors. BDNF, NGF, and GDNF levels were decreased, while NT-3 and NT-4 levels were increased in brains after d-AMPH sensitization. LIMITATIONS Although d-AMPH induces manic-like behavior, the mechanisms underlying these effects can also be related to phenotypes of drug abuse. CONCLUSIONS Together, vulnerability to mania-like behavior following d-AMPH challenge and extensive neurotrophic alterations, suggest amphetamine-induced behavioral sensitization is a good model of BD pathophysiology.
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18
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Freund N, Jordan CJ, Lukkes JL, Norman KJ, Andersen SL. Juvenile exposure to methylphenidate and guanfacine in rats: effects on early delay discounting and later cocaine-taking behavior. Psychopharmacology (Berl) 2019; 236:685-698. [PMID: 30411140 DOI: 10.1007/s00213-018-5096-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Accepted: 10/26/2018] [Indexed: 12/18/2022]
Abstract
RATIONALE Both methylphenidate (MPH), a catecholamine reuptake blocker, and guanfacine, an alpha2A agonist, are used to treat attention-deficit hyperactivity disorder (ADHD). Childhood impulsivity, including delay discounting, is associated with increased substance use during adolescence. These effects can be mitigated by juvenile exposure to MPH, but less is known about the long-term effects of developmental exposure to guanfacine in males and females. OBJECTIVE This study aims to determine sex differences and dose-dependent effects of juvenile exposure to MPH or guanfacine on delay-discounting and later cocaine self-administration. METHODS The dose-dependent effects of vehicle, MPH (0.5, 1, and 2 mg/kg p.o.) or guanfacine (0.003, 0.03, and 0.3 mg/kg, i.p.) on discounting were determined in male and female Sprague-Dawley rats beginning at postnatal day (P)20. At P90, the amount, motivation, and sensitivity to cocaine following early drug exposure were determined with self-administration. RESULTS Guanfacine, but not MPH, significantly reduced weight by 22.9 ± 4.6% in females. MPH dose dependently decreased delay discounting in both juvenile males and females, while guanfacine was only effective in males. Discounting was associated with cocaine self-administration in vehicle males (R2 = -0.4, P < 0.05) and self-administration was reduced by guanfacine treatment (0.3 mg/kg). Guanfacine significantly decreased cocaine sensitivity in both sexes. CONCLUSIONS These data suggest that MPH is effective in reducing delay discounting in both sexes. Due to both weight loss and ineffectiveness on discounting in females, guanfacine should be used only in males to reduce delay discounting and later cocaine use.
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Affiliation(s)
- Nadja Freund
- Laboratory of Developmental Neuropharmacology, McLean Hospital, Harvard Medical School, Belmont, MA, USA.,Department of Psychiatry, McLean Hospital, Harvard Medical School, Mailstop 333, 115 Mill Street, Belmont, MA, 02478, USA.,Division of Experimental and Molecular Psychiatry, LWL University Hospital Bochum, Bochum, Germany.,Department of Psychiatry, Psychotherapy and Preventive Medicine, Ruhr-University Bochum, Bochum, Germany
| | - Chloe J Jordan
- Laboratory of Developmental Neuropharmacology, McLean Hospital, Harvard Medical School, Belmont, MA, USA.,Department of Psychiatry, McLean Hospital, Harvard Medical School, Mailstop 333, 115 Mill Street, Belmont, MA, 02478, USA.,Molecular Targets and Medications Discovery Branch, National Institute on Drug Abuse, Intramural Research Program, Baltimore, MD, USA
| | - Jodi L Lukkes
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Kevin J Norman
- Laboratory of Developmental Neuropharmacology, McLean Hospital, Harvard Medical School, Belmont, MA, USA
| | - Susan L Andersen
- Laboratory of Developmental Neuropharmacology, McLean Hospital, Harvard Medical School, Belmont, MA, USA. .,Department of Psychiatry, McLean Hospital, Harvard Medical School, Mailstop 333, 115 Mill Street, Belmont, MA, 02478, USA.
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19
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Yule A, Fitzgerald M, Wilens T, Wozniak J, Woodworth KY, Pulli A, Uchida M, Faraone SV, Biederman J. Further Evidence of the Diagnostic Utility of the Child Behavior Checklist for Identifying Pediatric Bipolar I Disorder. Scand J Child Adolesc Psychiatr Psychol 2019; 7:29-36. [PMID: 32995342 PMCID: PMC7521745 DOI: 10.21307/sjcapp-2019-006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Background: Pediatric bipolar (BP) disorder is a prevalent and highly morbid disorder. While structured diagnostic interviews have been developed to aid in the diagnosis of pediatric BP disorder, these tools are lengthy, costly and not widely available. One possible diagnostic aid is the Child Behavior Checklist (CBCL). Objective: To assess the diagnostic utility of the CBCL-BP profile to identify children with a diagnosis of BP-I disorder. Method: Subjects were derived from four independent data sets of children and adolescents with and without attention deficit hyperactivity disorder and BP-I. Subjects were recruited from pediatric and psychiatric clinics and the community. All subjects had structured clinical interviews with raters blinded to subject ascertainment status. We used an empirically derived profile from the CBCL consisting of an aggregate t-score from the Attention, Anxiety/Depression and Aggression subscales (CBCL-BP profile) to operationalize the presence or absence of BP symptoms. Receiver operating characteristic (ROC) curves were used to examine the ability of the CBCL-BP profile to identify children with and without a structured interview diagnosis of BP-I disorder. Results: The sample consisted of 661 subjects (mean age: 11.7 ± 3.3 years, 57% male and 94% Caucasian). In total, 20 percent of participants (n = 130) met structured interview criteria for a full diagnosis of BP-I disorder. The ROC analysis of the CBCL-BP profile yielded an area under the curve (AUC) of 0.91. A t-score of ≥ 195 on the CBCL-BP profile correctly classified 86% of subjects with BP-I disorder with 80% sensitivity, 87% specificity, 61% positive predictive value (PPV) and 95% negative predictive value (NPV). Conclusion: The CBCL-BP profile efficiently discriminated pediatric subjects with and without a structured interview diagnosis of BP-I disorder. Findings suggest that the CBCL-BP profile may be an efficient tool to help identify children who are very likely to suffer from BP-I disorder.
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Affiliation(s)
- Amy Yule
- Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Boston, MA.,Department of Psychiatry, Harvard Medical School, Boston, MA
| | - Maura Fitzgerald
- Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Boston, MA
| | - Timothy Wilens
- Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Boston, MA.,Department of Psychiatry, Harvard Medical School, Boston, MA
| | - Janet Wozniak
- Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Boston, MA.,Department of Psychiatry, Harvard Medical School, Boston, MA
| | - K Yvonne Woodworth
- Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Boston, MA
| | - Alexa Pulli
- Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Boston, MA
| | - Mai Uchida
- Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Boston, MA.,Department of Psychiatry, Harvard Medical School, Boston, MA
| | - Stephen V Faraone
- Departments of Psychiatry and of Neuroscience and Physiology, SUNY Upstate Medical University, Syracuse, NY.,K.G. Jebsen Centre for Psychiatric Disorders, Department of Biomedicine, University of Bergen, Bergen, Norway
| | - Joseph Biederman
- Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Boston, MA.,Department of Psychiatry, Harvard Medical School, Boston, MA
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20
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Biederman J, Fitzgerald M, Woodworth KY, Yule A, Noyes E, Biederman I, Faraone SV, Wilens T, Wozniak J. Does the course of manic symptoms in pediatric bipolar disorder impact the course of conduct disorder? Findings from four prospective datasets. J Affect Disord 2018; 238:244-249. [PMID: 29890451 PMCID: PMC6082174 DOI: 10.1016/j.jad.2018.05.020] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2018] [Revised: 04/10/2018] [Accepted: 05/16/2018] [Indexed: 12/24/2022]
Abstract
BACKGROUND To assess whether the course of pediatric bipolar-I (BP-I) disorder impacts the course of conduct disorder (CD)/antisocial personality disorder (ASPD). We hypothesized that remission of manic symptoms in BP-I youth will be associated with remission of CD/ASPD. METHODS We used data from four longitudinal datasets of carefully characterized and comprehensively assessed youth with structured diagnostic interview based diagnoses of BP-I disorder and CD/ASPD assessed at baseline in childhood and at follow-up onto adolescent years. The baseline sample consisted of 240 subjects with full BP-I disorder. The average follow-up time was 6.6 ± 2.4 years. RESULTS Subjects with remitting BP-I disorder in adolescent years had a significantly lower one-year prevalence of CD or ASPD compared to those with persistent BP-I disorder (χ2 = 10.35, p = 0.001). LIMITATIONS Our inferences were derived from the examination of naturalistic longitudinal follow-up data and not results of a clinical trial. CONCLUSIONS Results indicate that remission of manic symptoms at the adolescent follow up in youth with BP-I disorder were associated with a significant decrease in rates of CD/ASPD. These results suggest that targeting manic symptoms in youth with BP-I disorder could mitigate the course of CD/ASPD in youth. Considering the high morbidity and disability associated CD/ASPD in youth and the limited treatment options available to address it, if replicated, these findings would have very important clinical and public health significance.
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Affiliation(s)
- Joseph Biederman
- Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Boston, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA.
| | - Maura Fitzgerald
- Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Boston, MA, USA
| | - K Yvonne Woodworth
- Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Boston, MA, USA
| | - Amy Yule
- Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Boston, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Elizabeth Noyes
- Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Boston, MA, USA
| | - Itai Biederman
- Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Boston, MA, USA
| | - Stephen V Faraone
- Department of Psychiatry and of Neuroscience and Physiology, SUNY Upstate Medical University, Syracuse, NY, USA; K.G. Jebsen Centre for Psychiatric Disorders, Department of Biomedicine, University of Bergen, Bergen, Norway
| | - Timothy Wilens
- Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Boston, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Janet Wozniak
- Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Boston, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA
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21
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Kridin K, Zelber-Sagi S, Comaneshter D, Cohen AD. Bipolar Disorder Associated with Another Autoimmune Disease-Pemphigus: A Population-based Study. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2018; 63:474-480. [PMID: 29108425 PMCID: PMC6099770 DOI: 10.1177/0706743717740344] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
OBJECTIVES Recent evidence suggests a notable role for inflammation and immune dysregulation in the neuroprogression of bipolar disorders (BD). Several autoimmune comorbidities have been reported in association with BD. However, the epidemiological relationship between pemphigus and BD has not yet been elucidated. We aimed to estimate the association between pemphigus and BD using a large-scale, real-life computerized database. METHODS Data for this study were retrieved from the database of the Clalit Health Services, the largest, state-mandated, health service organization in Israel. This study was designed as a cross-sectional study. The proportion of patients with BD was compared between patients diagnosed with pemphigus and age-, sex-, and ethnicity-matched control subjects. A logistic regression model was performed to estimate how pemphigus and other covariates contributed as risk factors for BD. RESULTS A total of 1,985 pemphigus cases and 9,874 controls were included in the study. The prevalence of BD was greater in cases with pemphigus than in controls (1.0% v. 0.5%, respectively; P = 0.023). This coexistence was more prominent among patients of Jewish ethnicity. After controlling for confounders, such as age, sex, ethnicity, socioeconomic status, drug abuse, alcohol abuse, smoking, healthcare utilization, and comorbidities, pemphigus demonstrated a substantial independent association with BD (OR, 1.7; 95% CI, 1.0 to 2.9). CONCLUSIONS Pemphigus is significantly associated with BD. Patients with pemphigus should be assessed for comorbid BD. Experimental research is needed to better recognize the biological mechanisms underlying this observation.
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Affiliation(s)
- Khalaf Kridin
- Department of Dermatology, Rambam Health Care Campus, Haifa, Israel
- Khalaf Kridin MD, Department of Dermatology, Rambam Health Care Campus, POB 9602 Haifa 31096, Israel.
| | - Shira Zelber-Sagi
- School of Public Health, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
| | - Doron Comaneshter
- Department of Quality Measurements and Research, Chief Physician’s Office, Clalit Health Services, Tel Aviv, Israel
| | - Arnon D. Cohen
- Department of Quality Measurements and Research, Chief Physician’s Office, Clalit Health Services, Tel Aviv, Israel
- Siaal Research Center for Family Medicine and Primary Care, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
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22
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Ayerbe L, Forgnone I, Addo J, Siguero A, Gelati S, Ayis S. Hypertension risk and clinical care in patients with bipolar disorder or schizophrenia; a systematic review and meta-analysis. J Affect Disord 2018; 225:665-670. [PMID: 28915505 DOI: 10.1016/j.jad.2017.09.002] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Accepted: 09/02/2017] [Indexed: 12/22/2022]
Abstract
BACKGROUND A higher cardiovascular morbidity and mortality has been observed in patients with bipolar disorder (BPD) or schizophrenia, partly due to an increased risk of hypertension (HTN), or a less effective care of it. This systematic review and meta-analysis, presents a critical appraisal and summary of the studies addressing the risk of HTN, or the differences in its care, for those with schizophrenia or BPD. METHODS Prospective studies were searched in PubMed, Embase, PsycINFO, Scopus, and the Web of Science, from database inception to June 2017. A meta-analysis was undertaken to obtain pooled estimates of the risk of HTN. RESULTS Five studies reporting the risk of HTN, and five studies presenting differences in its clinical care, were identified. An increased risk of HTN was observed for BPD patients, with an overall Incidence Rate Ratio 1.27(1.15-1.40). The pooled Incidence Rate Ratio of HTN for those with schizophrenia was 0.94 (0.75 - 1.14). A poorer care of HTN (lower rates of screening, prescription, and adherence) was reported in four studies of schizophrenia, and two of BPD patients, compared to people without these conditions. LIMITATIONS reduced number of studies on risk and care of HTN on patients with BPD or schizophrenia. CONCLUSIONS Limited evidence suggests that patients with BPD have a higher risk of HTN. Patients with schizophrenia and BPD receive poor care of HTN. Understanding the risk of HTN, and the differences in its care, is essential for clinicians to reduce the cardiovascular morbidity and overall mortality of these patients.
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Affiliation(s)
- Luis Ayerbe
- Centre of Primary Care and Public Health, Queen Mary University of London, London, United Kingdom.
| | - Ivo Forgnone
- Cerro del Aire Primary Care Centre, Madrid, Spain; Dr Cirajas Primary Care Centre, Madrid, Spain
| | - Juliet Addo
- Department of Non-communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Ana Siguero
- Dr Cirajas Primary Care Centre, Madrid, Spain
| | - Stefano Gelati
- Mental Health Service, South Essex Partnership University NHS Foundation Trust Rochford, United Kingdom
| | - Salma Ayis
- Division of Health and Social care Research, King's College London, London, United Kingdom
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23
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Chao M, Li X, McGue M. The Causal Role of Alcohol Use in Adolescent Externalizing and Internalizing Problems: A Mendelian Randomization Study. Alcohol Clin Exp Res 2017; 41:1953-1960. [PMID: 28876462 DOI: 10.1111/acer.13493] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Accepted: 08/25/2017] [Indexed: 11/26/2022]
Abstract
BACKGROUND The co-occurrence of alcohol use and externalizing/internalizing problems threatens adolescents' mental health. Research on whether alcohol use and these problems are causal and the direction of the potential causal relationships is needed to understand the mechanisms of the co-occurrence. METHODS A Mendelian randomization analysis was conducted in which the aldehyde dehydrogenase 2 (ALDH2) rs671 polymorphism was used as an instrumental variable for alcohol use phenotypes. In total, 1,608 Chinese adolescents (mean age 14.11 ± 1.83 years) were genotyped for the ALDH2 rs671 polymorphism. Three externalizing problems (aggression, delinquency, and attention problems) were measured with the Youth Self-Report inventory, and 2 internalizing problems (depression and anxiety) were measured with the self-reported Children's Depression Inventory and the Trait subscale of the State-Trait Anxiety Inventory. RESULTS Alcohol use was positively associated with all 3 externalizing and 2 internalizing problems, and the ALDH2 polymorphism had a significant effect on alcohol use. Aggression and attention problems were also significantly affected by the ALDH2 polymorphism, whereas no significant association was observed between the ALDH2 polymorphism and delinquency, anxiety, or depression. CONCLUSIONS The results suggest that alcohol use is a cause of adolescent aggression and attention problems but not adolescent delinquency, anxiety, or depression.
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Affiliation(s)
- Miao Chao
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chaoyang District, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Xinying Li
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chaoyang District, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Matt McGue
- Department of Psychology, University of Minnesota, Minneapolis, Minnesota
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24
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Hsu JH, Chien IC, Lin CH. Increased risk of chronic obstructive pulmonary disease in patients with bipolar disorder: A population-based study. J Affect Disord 2017; 220:43-48. [PMID: 28582646 DOI: 10.1016/j.jad.2017.05.049] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2017] [Revised: 05/20/2017] [Accepted: 05/30/2017] [Indexed: 12/15/2022]
Abstract
BACKGROUND We conducted this nationwide study to examine the prevalence and incidence of chronic obstructive pulmonary disease (COPD) among patients with bipolar disorder in Taiwan. METHODS We used a random sample of 766,427 subjects who were aged ≥18 years in 2005. Patients with at least one primary diagnosis of bipolar disorder were identified. Study participants with one primary or secondary diagnosis of COPD for either ambulatory or inpatient care were also identified. We compared the prevalence of COPD in patients with bipolar disorder and the general population in 2005. In addition, we further investigated this cohort from 2006 to 2010 to detect incident cases of COPD in patients with bipolar disorder compared with the general population. The factors associated with COPD among patients with bipolar disorder were also analyzed. RESULTS The prevalence of COPD in patients with bipolar disorder was higher than in the general population in 2005 (5.68% vs. 2.88%, odds ratio 2.03; 95% confidence interval, 1.53-2.67). The average annual incidence of COPD in patients with bipolar disorder was also higher than in the general population (2.03% vs. 1.03%, risk ratio 1.94; 95% confidence interval, 1.65-2.29) from 2006 to 2010. LIMITATIONS Some risk factors for COPD such as substance use, obesity, or lifestyle pattern were not available in this study. CONCLUSIONS Patients with bipolar disorder had a higher prevalence and incidence of COPD compared with the general population. Higher prevalence of COPD among bipolar patients was associated with increased age, males, hypertension, and second-generation antidepressant use.
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Affiliation(s)
- Jer-Hwa Hsu
- Chia- Yi Hospital, Ministry of Health and Welfare, Chiayi, Taiwan
| | - I-Chia Chien
- Tsaotun Psychiatric Center, Ministry of Health and Welfare, Nantou, Taiwan; Department of Public Health & Institute of Public Health, National Yang-Ming University, Taipei, Taiwan.
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25
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Messer T, Lammers G, Müller-Siecheneder F, Schmidt RF, Latifi S. Substance abuse in patients with bipolar disorder: A systematic review and meta-analysis. Psychiatry Res 2017; 253:338-350. [PMID: 28419959 DOI: 10.1016/j.psychres.2017.02.067] [Citation(s) in RCA: 75] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Revised: 02/11/2017] [Accepted: 02/12/2017] [Indexed: 12/25/2022]
Abstract
By considering the debilitating outcome of co-occurring of bipolar disorder (BD) and substance abuse, determination of risk factors of substance use disorders (SUD: abuse or dependence of drugs and/or alcohol) is essential to identify the susceptible patients. The purpose of this study was to clarify the major determinant factors of SUD among adults with BD by reviewing the relevant literature. We systematically searched electronic databases including PubMed (MEDLINE), EMBASE, OVID, Cochrane and Scopus for human studies addressing the co-existence of bipolar disorder and SUD. All potential published papers up to September 2016 have been reviewed. The statistical analysis was performed using Comprehensive Meta-analysis version 2. Male gender (Odds ratio: 2.191 (95% CI: 1.121-4.281), P 0.022), number of manic episodes (P: 0.001) and previous history of suicidality (Odds ratio: 1.758 (95% CI: 1.156-2.674), P: 0.008) were associated to SUD in patients with BD. SUD was not related to age, subtype of BD, hospitalization and co-existence of anxiety disorders or psychotic symptoms. SUD affects many aspects of BD regarding clinical course, psychopathology and prognosis. Our study demonstrates that male gender, history of higher number of manic episodes and suicidality are associated to higher susceptibility to SUD. Thus, assignment of more intensive therapeutic interventions should be considered in patients with increased risk of drug abuse to prevent development of SUD.
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Affiliation(s)
- Thomas Messer
- Danuvius Klinik GmbH, Pfaffenhofen an der Ilm, Technischen Universität München, Bavaria, Germany
| | - Gero Lammers
- Danuvius Klinik GmbH, Pfaffenhofen an der Ilm, Technischen Universität München, Bavaria, Germany
| | | | - Raluca-Florela Schmidt
- Danuvius Klinik GmbH, Pfaffenhofen an der Ilm, Technischen Universität München, Bavaria, Germany
| | - Sahar Latifi
- Danuvius Klinik GmbH, Pfaffenhofen an der Ilm, Technischen Universität München, Bavaria, Germany.
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