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Bauer M, Glenn T, Achtyes ED, Alda M, Agaoglu E, Altınbaş K, Andreassen OA, Angelopoulos E, Ardau R, Aydin M, Ayhan Y, Baethge C, Bauer R, Baune BT, Balaban C, Becerra-Palars C, Behere AP, Behere PB, Belete H, Belete T, Belizario GO, Bellivier F, Belmaker RH, Benedetti F, Berk M, Bersudsky Y, Bicakci Ş, Birabwa-Oketcho H, Bjella TD, Brady C, Cabrera J, Cappucciati M, Castro AMP, Chen WL, Cheung EYW, Chiesa S, Crowe M, Cuomo A, Dallaspezia S, Del Zompo M, Desai P, Dodd S, Etain B, Fagiolini A, Fellendorf FT, Ferensztajn-Rochowiak E, Fiedorowicz JG, Fountoulakis KN, Frye MA, Geoffroy PA, Gitlin MJ, Gonzalez-Pinto A, Gottlieb JF, Grof P, Haarman BCM, Harima H, Hasse-Sousa M, Henry C, Hoffding L, Houenou J, Imbesi M, Isometsä ET, Ivkovic M, Janno S, Johnsen S, Kapczinski F, Karakatsoulis GN, Kardell M, Kessing LV, Kim SJ, König B, Kot TL, Koval M, Kunz M, Lafer B, Landén M, Larsen ER, Lenger M, Licht RW, Lopez-Jaramillo C, MacKenzie A, Madsen HØ, Madsen SAKA, Mahadevan J, Mahardika A, Manchia M, Marsh W, Martinez-Cengotitabengoa M, Martini J, Martiny K, Mashima Y, McLoughlin DM, Meesters Y, Melle I, Meza-Urzúa F, Mikolas P, Mok YM, Monteith S, Moorthy M, Morken G, Mosca E, Mozzhegorov AA, Munoz R, Mythri SV, Nacef F, Nadella RK, Nakanotani T, Nielsen RE, O'Donovan C, Omrani A, Osher Y, Ouali U, Pantovic-Stefanovic M, Pariwatcharakul P, Petite J, Petzold J, Pfennig A, Ruiz YP, Pinna M, Pompili M, Porter RJ, Quiroz D, Rabelo-da-Ponte FD, Ramesar R, Rasgon N, Ratta-Apha W, Ratzenhofer M, Redahan M, Reddy MS, Reif A, Reininghaus EZ, Richards JG, Ritter P, Rybakowski JK, Sathyaputri L, Scippa AM, Simhandl C, Smith D, Smith J, Stackhouse PW, Stein DJ, Stilwell K, Strejilevich S, Su KP, Subramaniam M, Sulaiman AH, Suominen K, Tanra AJ, Tatebayashi Y, Teh WL, Tondo L, Torrent C, Tuinstra D, Uchida T, Vaaler AE, Vieta E, Viswanath B, Yoldi-Negrete M, Yalcinkaya OK, Young AH, Zgueb Y, Whybrow PC. Exploratory study of ultraviolet B (UVB) radiation and age of onset of bipolar disorder. Int J Bipolar Disord 2023; 11:22. [PMID: 37347392 DOI: 10.1186/s40345-023-00303-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 05/16/2023] [Indexed: 06/23/2023] Open
Abstract
BACKGROUND Sunlight contains ultraviolet B (UVB) radiation that triggers the production of vitamin D by skin. Vitamin D has widespread effects on brain function in both developing and adult brains. However, many people live at latitudes (about > 40 N or S) that do not receive enough UVB in winter to produce vitamin D. This exploratory study investigated the association between the age of onset of bipolar I disorder and the threshold for UVB sufficient for vitamin D production in a large global sample. METHODS Data for 6972 patients with bipolar I disorder were obtained at 75 collection sites in 41 countries in both hemispheres. The best model to assess the relation between the threshold for UVB sufficient for vitamin D production and age of onset included 1 or more months below the threshold, family history of mood disorders, and birth cohort. All coefficients estimated at P ≤ 0.001. RESULTS The 6972 patients had an onset in 582 locations in 70 countries, with a mean age of onset of 25.6 years. Of the onset locations, 34.0% had at least 1 month below the threshold for UVB sufficient for vitamin D production. The age of onset at locations with 1 or more months of less than or equal to the threshold for UVB was 1.66 years younger. CONCLUSION UVB and vitamin D may have an important influence on the development of bipolar disorder. Study limitations included a lack of data on patient vitamin D levels, lifestyles, or supplement use. More study of the impacts of UVB and vitamin D in bipolar disorder is needed to evaluate this supposition.
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Affiliation(s)
- Michael Bauer
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany.
| | - Tasha Glenn
- ChronoRecord Association, Fullerton, CA, USA
| | - Eric D Achtyes
- Division of Psychiatry and Behavioral Medicine, Michigan State University College of Human Medicine, Grand Rapids, MI, USA
- Pine Rest Christian Mental Health Services, Grand Rapids, MI, USA
| | - Martin Alda
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
| | - Esen Agaoglu
- Department of Psychiatry, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Kürsat Altınbaş
- Department of Psychiatry, Selcuk University Faculty of Medicine, Mazhar Osman Mood Center, Konya, Turkey
| | - Ole A Andreassen
- NORMENT Centre, Division of Mental Health and Addiction, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Elias Angelopoulos
- Department of Psychiatry, National and Capodistrian University of Athens, Medical School, Eginition Hospital, Athens, Greece
| | - Raffaella Ardau
- Section of Neurosciences and Clinical Pharmacology, Department of Biomedical Sciences, University of Cagliari, Sardinia, Italy
| | - Memduha Aydin
- Department of Psychiatry, Selcuk University Faculty of Medicine, Konya, Turkey
| | - Yavuz Ayhan
- Department of Psychiatry, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Christopher Baethge
- Department of Psychiatry and Psychotherapy, University of Cologne Medical School, Cologne, Germany
| | - Rita Bauer
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Bernhard T Baune
- Department of Psychiatry, University of Münster, Münster, Germany
- Department of Psychiatry, Melbourne Medical School, The University of Melbourne, Melbourne, Australia
- The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Ceylan Balaban
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Johann Wolfgang Goethe-Universität Frankfurt Am Main, Frankfurt Am Main, Germany
| | | | - Aniruddh P Behere
- Department of Pediatrics and Human Development, Michigan State University, Grand Rapids, MI, USA
| | - Prakash B Behere
- Department of Psychiatry, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences (Deemed University), Wardha, India
| | - Habte Belete
- Department of Psychiatry, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Tilahun Belete
- Department of Psychiatry, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Gabriel Okawa Belizario
- Bipolar Disorder Research Program, Department of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil
| | - Frank Bellivier
- Département de Psychiatrie et de Médecine Addictologique, Assistance Publique, Hôpitaux de Paris, INSERM UMR-S1144, Université Paris Cité, Fondation FondaMental, Paris, France
| | - Robert H Belmaker
- Division of Psychiatry, Ben Gurion University of the Negev, Beer Sheva, Israel
| | - Francesco Benedetti
- University Vita-Salute San Raffaele, Milan, Italy
- Psychiatry and Clinical Psychobiology, Division of Neuroscience, San Raffaele Scientific Institute, Milan, Italy
| | - Michael Berk
- IMPACT, The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Deakin University, Geelong, Australia
- Orygen The National Centre of Excellence in Youth Mental Health, Centre for Youth Mental Health, Florey Institute for Neuroscience and Mental Health and the, Department of Psychiatry, The University of Melbourne, Melbourne, Australia
| | - Yuly Bersudsky
- Department of Psychiatry, Faculty of Health Sciences, Beer Sheva Mental Health Center, Ben Gurion University of the Negev, Beer Sheva, Israel
| | - Şule Bicakci
- Department of Psychiatry, Hacettepe University Faculty of Medicine, Ankara, Turkey
- Department of Psychiatry, Baskent University Faculty of Medicine, Ankara, Turkey
| | | | - Thomas D Bjella
- NORMENT Centre, Division of Mental Health and Addiction, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Conan Brady
- Department of Psychiatry, Trinity College Dublin, St Patrick's University Hospital, Dublin, Ireland
| | - Jorge Cabrera
- Mood Disorders Clinic, Dr. Jose Horwitz Psychiatric Institute, Santiago de Chile, Chile
| | | | - Angela Marianne Paredes Castro
- IMPACT, The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Deakin University, Geelong, Australia
| | - Wei-Ling Chen
- Department of Psychiatry, Chiayi Branch, Taichung Veterans General Hospital, Chiayi, Taiwan
| | | | - Silvia Chiesa
- Department of Mental Health and Substance Abuse, Piacenza, Italy
| | - Marie Crowe
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Alessandro Cuomo
- Department of Molecular Medicine, University of Siena School of Medicine, Siena, Italy
| | - Sara Dallaspezia
- Psychiatry and Clinical Psychobiology, Division of Neuroscience, San Raffaele Scientific Institute, Milan, Italy
| | - Maria Del Zompo
- Section of Neurosciences and Clinical Pharmacology, Department of Biomedical Sciences, University of Cagliari, Sardinia, Italy
| | - Pratikkumar Desai
- Division of Psychiatry and Behavioral Medicine, Michigan State University College of Human Medicine, Grand Rapids, MI, USA
- Pine Rest Christian Mental Health Services, Grand Rapids, MI, USA
| | - Seetal Dodd
- IMPACT, The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Deakin University, Geelong, Australia
- Department of Psychiatry, University of Melbourne, Parkville, VIC, Australia
| | - Bruno Etain
- Département de Psychiatrie et de Médecine Addictologique, Assistance Publique, Hôpitaux de Paris, INSERM UMR-S1144, Université Paris Cité, Fondation FondaMental, Paris, France
| | - Andrea Fagiolini
- Department of Molecular Medicine, University of Siena School of Medicine, Siena, Italy
| | - Frederike T Fellendorf
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University Graz, Graz, Austria
| | | | - Jess G Fiedorowicz
- Department of Psychiatry, School of Epidemiology and Public Health, University of Ottawa and The Ottawa Hospital, Ottawa, ON, Canada
| | - Kostas N Fountoulakis
- 3rd Department of Psychiatry, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Mark A Frye
- Department of Psychiatry and Psychology, Mayo Clinic Depression Center, Mayo Clinic, Rochester, MN, USA
| | - Pierre A Geoffroy
- Département de Psychiatrie et d'addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hopital Bichat, Claude Bernard, 75018, Paris, France
- GHU Paris, Psychiatry and Neurosciences, 1 Rue Cabanis, 75014, Paris, France
- Université de Paris, NeuroDiderot, Inserm, FHU I2D2, 75019, Paris, France
| | - Michael J Gitlin
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles (UCLA), Los Angeles, CA, USA
| | - Ana Gonzalez-Pinto
- BIOARABA, Department of Psychiatry, University Hospital of Alava, University of the Basque Country, CIBERSAM, Vitoria, Spain
| | - John F Gottlieb
- Department of Psychiatry, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Paul Grof
- Mood Disorders Center of Ottawa and the Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Bartholomeus C M Haarman
- Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Hirohiko Harima
- Department of Psychiatry, Tokyo Metropolitan Matsuzawa Hospital, Setagaya, Tokyo, Japan
| | - Mathias Hasse-Sousa
- Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Programa de Pós-Graduação em Psicologia, Departamento de Psicologia do Desenvolvimento e da Personalidade, Instituto de Psicologia, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Chantal Henry
- Department of Psychiatry, GHU Paris Psychiatrie and Neurosciences, Université de Paris, F-75014, F-75006, Paris, France
| | - Lone Hoffding
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Josselin Houenou
- Université Paris Est Créteil, INSERM, IMRB, Translational Neuropsychiatry, APHP, Mondor Univ Hospitals, Fondation FondaMental, F-94010, Créteil, France
- Université Paris Saclay, CEA, Neurospin, F-91191, Gif-Sur-Yvette, France
| | | | - Erkki T Isometsä
- Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- National Institute for Health and Welfare, Helsinki, Finland
| | - Maja Ivkovic
- Clinic for Psychiatry, University Clinical Center of Serbia, Belgrade, Serbia
| | - Sven Janno
- Department of Psychiatry, University of Tartu, Tartu, Estonia
| | - Simon Johnsen
- Unit for Psychiatric Research, Aalborg University Hospital, Aalborg, Denmark
| | - Flávio Kapczinski
- Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Gregory N Karakatsoulis
- 3rd Department of Psychiatry, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Mathias Kardell
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Lars Vedel Kessing
- Copenhagen Affective Disorder Research Center (CADIC), Psychiatric Center Copenhagen, Copenhagen, Denmark
| | - Seong Jae Kim
- Department of Psychiatry, Chosun University School of Medicine, Gwangju, Republic of Korea
| | - Barbara König
- BIPOLAR Zentrum Wiener Neustadt, Wiener Neustadt, Austria
| | - Timur L Kot
- Khanty-Mansiysk Clinical Psychoneurological Hospital, Khanty-Mansiysk, Russia
| | - Michael Koval
- Neuroscience Program, Michigan State University, East Lansing, MI, USA
| | - Mauricio Kunz
- Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Beny Lafer
- Bipolar Disorder Research Program, Department of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil
| | - Mikael Landén
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Erik R Larsen
- Mental Health Department Odense, University Clinic and Department of Regional Health Research, University of Southern Denmark, Esbjerg, Denmark
| | - Melanie Lenger
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University Graz, Graz, Austria
| | - Rasmus W Licht
- Psychiatry, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Carlos Lopez-Jaramillo
- Mood Disorders Program, Hospital Universitario San Vicente Fundación, Research Group in Psychiatry, Department of Psychiatry, Faculty of Medicine, Universidad de Antioquia, Medellín, Colombia
| | - Alan MacKenzie
- Forensic Psychiatry, University of Glasgow, NHS Greater Glasgow and Clyde, Glasgow, UK
| | | | | | - Jayant Mahadevan
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, India
| | - Agustine Mahardika
- Department of Psychiatry, Faculty of Medicine, Mataram University, Mataram, Indonesia
| | - Mirko Manchia
- Department of Pharmacology, Dalhousie University, Halifax, NS, Canada
- Section of Psychiatry, Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
- Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Wendy Marsh
- Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA, USA
| | - Monica Martinez-Cengotitabengoa
- Osakidetza, Basque Health Service, BioAraba Health Research Institute, University of the Basque Country, Bilbao, Spain
- The Psychology Clinic of East Anglia, Norwich, UK
| | - Julia Martini
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Klaus Martiny
- Psychiatric Centre Copenhagen, Copenhagen University Hospitals, Copenhagen, Denmark
| | - Yuki Mashima
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Declan M McLoughlin
- Department of Psychiatry and Trinity College Institute of Neuroscience, Trinity College Dublin, St Patrick's University Hospital, Dublin, Ireland
| | - Ybe Meesters
- Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Ingrid Melle
- NORMENT Centre, Division of Mental Health and Addiction, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Fátima Meza-Urzúa
- Department of Child and Adolescent Psychiatry Und Psychotherapy, SHG Klinikum, Idar-Oberstein, Germany
| | - Pavol Mikolas
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Yee Ming Mok
- Department of Mood and Anxiety Disorders, Institute of Mental Health, Singapore City, Singapore
| | - Scott Monteith
- Michigan State University College of Human Medicine, Traverse City Campus, Traverse City, MI, USA
| | - Muthukumaran Moorthy
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, India
| | - Gunnar Morken
- Department of Mental Health, Norwegian University of Science and Technology, NTNU, Trondheim, Norway
- Department of Psychiatry, St Olavs' University Hospital, Trondheim, Norway
| | - Enrica Mosca
- Section of Neurosciences and Clinical Pharmacology, Department of Biomedical Sciences, University of Cagliari, Sardinia, Italy
| | | | - Rodrigo Munoz
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA
| | - Starlin V Mythri
- Makunda Christian Leprosy and General Hospital, Bazaricherra, Assam, 788727, India
| | - Fethi Nacef
- Razi Hospital, Faculty of Medicine, University of Tunis-El Manar, Tunis, Tunisia
| | - Ravi K Nadella
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, India
| | - Takako Nakanotani
- Tokyo Metropolitan Hiroo Hospital, 2-34-10 Ebisu, Shibuya-Ku, Tokyo, 150-0013, Japan
| | - René Ernst Nielsen
- Psychiatry, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Claire O'Donovan
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
| | - Adel Omrani
- Tunisian Bipolar Forum, Érable Médical Cabinet 324, Lac 2, Tunis, Tunisia
| | - Yamima Osher
- Department of Psychiatry, Faculty of Health Sciences, Beer Sheva Mental Health Center, Ben Gurion University of the Negev, Beer Sheva, Israel
| | - Uta Ouali
- Razi Hospital, Faculty of Medicine, University of Tunis-El Manar, Tunis, Tunisia
| | | | - Pornjira Pariwatcharakul
- Department of Psychiatry, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Joanne Petite
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
| | - Johannes Petzold
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Andrea Pfennig
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | | | - Marco Pinna
- Section of Psychiatry, Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
- Lucio Bini Mood Disorder Center, Cagliari, Italy
| | - Maurizio Pompili
- Department of Neurosciences, Mental Health and Sensory Organs, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Richard J Porter
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Danilo Quiroz
- Deparment of Psychiatry, Diego Portales University, Santiago de Chile, Chile
| | | | - Raj Ramesar
- SA MRC Genomic and Precision Medicine Research Unit, Division of Human Genetics, Department of Pathology, Institute of Infectious Diseases and Molecular, Medicine, University of Cape Town, Cape Town, South Africa
| | - Natalie Rasgon
- Department of Psychiatry and Behavioral Sciences, Stanford School of Medicine, Palo Alto, CA, USA
| | - Woraphat Ratta-Apha
- Department of Psychiatry, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Michaela Ratzenhofer
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University Graz, Graz, Austria
| | - Maria Redahan
- Department of Psychiatry, Trinity College Dublin, St Patrick's University Hospital, Dublin, Ireland
| | - M S Reddy
- Asha Bipolar Clinic, Asha Hospital, Hyderabad, Telangana, India
| | - Andreas Reif
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Johann Wolfgang Goethe-Universität Frankfurt Am Main, Frankfurt Am Main, Germany
| | - Eva Z Reininghaus
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University Graz, Graz, Austria
| | - Jenny Gringer Richards
- Departments of Psychiatry, Epidemiology, and Internal Medicine, Iowa Neuroscience Institute, The University of Iowa, Iowa City, IA, USA
| | - Philipp Ritter
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Janusz K Rybakowski
- Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland
| | - Leela Sathyaputri
- Departments of Psychiatry, Epidemiology, and Internal Medicine, Iowa Neuroscience Institute, The University of Iowa, Iowa City, IA, USA
| | - Angela M Scippa
- Department of Neuroscience and Mental Health, Federal University of Bahia, Salvador, Brazil
| | - Christian Simhandl
- Bipolar Zentrum Wiener Neustadt, Sigmund Freud Privat Universität, Vienna, Austria
| | - Daniel Smith
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, Scotland, UK
| | - José Smith
- AREA, Assistance and Research in Affective Disorders, Buenos Aires, Argentina
| | - Paul W Stackhouse
- Science Directorate/Climate Science Branch, NASA Langley Research Center, Hampton, VA, USA
| | - Dan J Stein
- Department of Psychiatry, MRC Unit on Risk and Resilience in Mental Disorders, University of Cape Town, Cape Town, South Africa
| | - Kellen Stilwell
- Division of Psychiatry and Behavioral Medicine, Michigan State University College of Human Medicine, Grand Rapids, MI, USA
- Pine Rest Christian Mental Health Services, Grand Rapids, MI, USA
| | - Sergio Strejilevich
- AREA, Assistance and Research in Affective Disorders, Buenos Aires, Argentina
| | - Kuan-Pin Su
- College of Medicine, China Medical University (CMU), Taichung, Taiwan
- An-Nan Hospital, China Medical University, Tainan, Taiwan
| | | | - Ahmad Hatim Sulaiman
- Department of Psychological Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Kirsi Suominen
- Department of Social Services and Health Care, Psychiatry, City of Helsinki, Helsinki, Finland
| | - Andi J Tanra
- Department of Psychiatry, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
| | - Yoshitaka Tatebayashi
- Tokyo Metropolitan Hiroo Hospital, 2-34-10 Ebisu, Shibuya-Ku, Tokyo, 150-0013, Japan
| | - Wen Lin Teh
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Leonardo Tondo
- McLean Hospital-Harvard Medical School, Boston, MA, USA
- Mood Disorder Lucio Bini Centers, Cagliari e Rome, Italy
| | - Carla Torrent
- Clinical Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Daniel Tuinstra
- Division of Psychiatry and Behavioral Medicine, Michigan State University College of Human Medicine, Grand Rapids, MI, USA
- Pine Rest Christian Mental Health Services, Grand Rapids, MI, USA
| | - Takahito Uchida
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne, Melbourne, Australia
| | - Arne E Vaaler
- Department of Mental Health, Norwegian University of Science and Technology, NTNU, Trondheim, Norway
- Department of Psychiatry, St Olavs' University Hospital, Trondheim, Norway
| | - Eduard Vieta
- Clinical Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Biju Viswanath
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, India
| | - Maria Yoldi-Negrete
- Subdirección de Investigaciones Clínicas, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñíz, Mexico City, Mexico
| | - Oguz Kaan Yalcinkaya
- Department of Psychiatry, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Allan H Young
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Yosra Zgueb
- Razi Hospital, Faculty of Medicine, University of Tunis-El Manar, Tunis, Tunisia
| | - Peter C Whybrow
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles (UCLA), Los Angeles, CA, USA
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Bauer M, Glenn T, Achtyes ED, Alda M, Agaoglu E, Altınbaş K, Andreassen OA, Angelopoulos E, Ardau R, Aydin M, Ayhan Y, Baethge C, Bauer R, Baune BT, Balaban C, Becerra-Palars C, Behere AP, Behere PB, Belete H, Belete T, Belizario GO, Bellivier F, Belmaker RH, Benedetti F, Berk M, Bersudsky Y, Bicakci Ş, Birabwa-Oketcho H, Bjella TD, Brady C, Cabrera J, Cappucciati M, Castro AMP, Chen WL, Cheung EYW, Chiesa S, Crowe M, Cuomo A, Dallaspezia S, Del Zompo M, Desai P, Dodd S, Etain B, Fagiolini A, Fellendorf FT, Ferensztajn-Rochowiak E, Fiedorowicz JG, Fountoulakis KN, Frye MA, Geoffroy PA, Gonzalez-Pinto A, Gottlieb JF, Grof P, Haarman BCM, Harima H, Hasse-Sousa M, Henry C, Høffding L, Houenou J, Imbesi M, Isometsä ET, Ivkovic M, Janno S, Johnsen S, Kapczinski F, Karakatsoulis GN, Kardell M, Kessing LV, Kim SJ, König B, Kot TL, Koval M, Kunz M, Lafer B, Landén M, Larsen ER, Lenger M, Lewitzka U, Licht RW, Lopez-Jaramillo C, MacKenzie A, Madsen HØ, Madsen SAKA, Mahadevan J, Mahardika A, Manchia M, Marsh W, Martinez-Cengotitabengoa M, Martiny K, Mashima Y, McLoughlin DM, Meesters Y, Melle I, Meza-Urzúa F, Mok YM, Monteith S, Moorthy M, Morken G, Mosca E, Mozzhegorov AA, Munoz R, Mythri SV, Nacef F, Nadella RK, Nakanotani T, Nielsen RE, O'Donovan C, Omrani A, Osher Y, Ouali U, Pantovic-Stefanovic M, Pariwatcharakul P, Petite J, Pfennig A, Ruiz YP, Pinna M, Pompili M, Porter R, Quiroz D, Rabelo-da-Ponte FD, Ramesar R, Rasgon N, Ratta-Apha W, Ratzenhofer M, Redahan M, Reddy MS, Reif A, Reininghaus EZ, Richards JG, Ritter P, Rybakowski JK, Sathyaputri L, Scippa ÂM, Simhandl C, Smith D, Smith J, Stackhouse PW, Stein DJ, Stilwell K, Strejilevich S, Su KP, Subramaniam M, Sulaiman AH, Suominen K, Tanra AJ, Tatebayashi Y, Teh WL, Tondo L, Torrent C, Tuinstra D, Uchida T, Vaaler AE, Vieta E, Viswanath B, Yoldi-Negrete M, Yalcinkaya OK, Young AH, Zgueb Y, Whybrow PC. Association between polarity of first episode and solar insolation in bipolar I disorder. J Psychosom Res 2022; 160:110982. [PMID: 35932492 PMCID: PMC7615104 DOI: 10.1016/j.jpsychores.2022.110982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 06/14/2022] [Accepted: 06/22/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Circadian rhythm disruption is commonly observed in bipolar disorder (BD). Daylight is the most powerful signal to entrain the human circadian clock system. This exploratory study investigated if solar insolation at the onset location was associated with the polarity of the first episode of BD I. Solar insolation is the amount of electromagnetic energy from the Sun striking a surface area of the Earth. METHODS Data from 7488 patients with BD I were collected at 75 sites in 42 countries. The first episode occurred at 591 onset locations in 67 countries at a wide range of latitudes in both hemispheres. Solar insolation values were obtained for every onset location, and the ratio of the minimum mean monthly insolation to the maximum mean monthly insolation was calculated. This ratio is largest near the equator (with little change in solar insolation over the year), and smallest near the poles (where winter insolation is very small compared to summer insolation). This ratio also applies to tropical locations which may have a cloudy wet and clear dry season, rather than winter and summer. RESULTS The larger the change in solar insolation throughout the year (smaller the ratio between the minimum monthly and maximum monthly values), the greater the likelihood the first episode polarity was depression. Other associated variables were being female and increasing percentage of gross domestic product spent on country health expenditures. (All coefficients: P ≤ 0.001). CONCLUSION Increased awareness and research into circadian dysfunction throughout the course of BD is warranted.
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Affiliation(s)
- Michael Bauer
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany.
| | - Tasha Glenn
- ChronoRecord Association, Fullerton, CA, USA
| | - Eric D Achtyes
- Michigan State University College of Human Medicine, Division of Psychiatry & Behavioral Medicine, Grand Rapids, MI, USA; Pine Rest Christian Mental Health Services, Grand Rapids, MI, USA
| | - Martin Alda
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
| | - Esen Agaoglu
- Department of Psychiatry, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Kürşat Altınbaş
- Department of Psychiatry, Selcuk University Faculty of Medicine, Mazhar Osman Mood Center, Konya, Turkey
| | - Ole A Andreassen
- NORMENT Centre, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Elias Angelopoulos
- Department of Psychiatry, National and Capodistrian University of Athens, Medical School, Eginition Hospital, Athens, Greece
| | - Raffaella Ardau
- Section of Neurosciences and Clinical Pharmacology, Department of Biomedical Sciences, University of Cagliari, Sardinia, Italy
| | - Memduha Aydin
- Department of Psychiatry, Selcuk University Faculty of Medicine, Konya, Turkey
| | - Yavuz Ayhan
- Department of Psychiatry, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Christopher Baethge
- Department of Psychiatry and Psychotherapy, University of Cologne Medical School, Cologne, Germany
| | - Rita Bauer
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Bernhard T Baune
- Department of Psychiatry, University of Münster, Münster, Germany; Department of Psychiatry, Melbourne Medical School, The University of Melbourne, Melbourne, Australia; The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Ceylan Balaban
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Johann Wolfgang Goethe-Universität Frankfurt am Main, Frankfurt am Main, Germany
| | | | - Aniruddh P Behere
- Department of Pediatrics and Human Development, Michigan State University, Grand Rapids, MI, USA
| | - Prakash B Behere
- Department of Psychiatry, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences (Deemed University), Wardha, India
| | - Habte Belete
- Department of Psychiatry, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Tilahun Belete
- Department of Psychiatry, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Gabriel Okawa Belizario
- Bipolar Disorder Research Program, Department of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil
| | - Frank Bellivier
- Département de Psychiatrie et de Médecine Addictologique, Assistance Publique - Hôpitaux de Paris, INSERM UMR-S1144, Université de Paris, FondaMental Foundation, Paris, France
| | - Robert H Belmaker
- Professor Emeritus of Psychiatry, Ben Gurion University of the Negev, Beer Sheva, Israel
| | - Francesco Benedetti
- University Vita-Salute San Raffaele, Milan, Italy; Psychiatry & Clinical Psychobiology, Division of Neuroscience, San Raffaele Scientific Institute, Milan, Italy
| | - Michael Berk
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong, Australia; Orygen, The National Centre of Excellence in Youth Mental Health, Centre for Youth Mental Health, Florey Institute for Neuroscience and Mental Health and the Department of Psychiatry, The University of Melbourne, Melbourne, Australia
| | - Yuly Bersudsky
- Department of Psychiatry, Faculty of Health Sciences, Beer Sheva Mental Health Center, Ben Gurion University of the Negev, Beer Sheva, Israel
| | - Şule Bicakci
- Department of Psychiatry, Hacettepe University Faculty of Medicine, Ankara, Turkey; Department of Psychiatry, Baskent University Faculty of Medicine, Ankara, Turkey
| | | | - Thomas D Bjella
- NORMENT Centre, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Conan Brady
- Department of Psychiatry, Trinity College Dublin, St Patrick's University Hospital, Dublin, Ireland
| | - Jorge Cabrera
- Mood Disorders Clinic, Dr. Jose Horwitz Psychiatric Institute, Santiago de Chile, Chile
| | | | - Angela Marianne Paredes Castro
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong, Australia
| | - Wei-Ling Chen
- Department of Psychiatry, Chiayi Branch, Taichung Veterans General Hospital, Chiayi, Taiwan
| | | | - Silvia Chiesa
- Department of Mental Health and Substance Abuse, Piacenza, Italy
| | - Marie Crowe
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Alessandro Cuomo
- Department of Molecular Medicine, University of Siena School of Medicine, Siena, Italy
| | - Sara Dallaspezia
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, San Raffaele Scientific Institute, Milan, Italy
| | - Maria Del Zompo
- Section of Neurosciences and Clinical Pharmacology, Department of Biomedical Sciences, University of Cagliari, Sardinia, Italy
| | | | - Seetal Dodd
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong, Australia; Department of Psychiatry, University of Melbourne, Parkville, Victoria, Australia
| | - Bruno Etain
- Département de Psychiatrie et de Médecine Addictologique, Assistance Publique - Hôpitaux de Paris, INSERM UMR-S1144, Université de Paris, FondaMental Foundation, Paris, France
| | - Andrea Fagiolini
- Department of Molecular Medicine, University of Siena School of Medicine, Siena, Italy
| | - Frederike T Fellendorf
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University Graz, Graz, Austria
| | | | - Jess G Fiedorowicz
- Department of Psychiatry, School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
| | - Kostas N Fountoulakis
- 3rd Department of Psychiatry, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Mark A Frye
- Department of Psychiatry & Psychology, Mayo Clinic Depression Center, Mayo Clinic, Rochester, MN, USA
| | - Pierre A Geoffroy
- Département de psychiatrie et d'addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hopital Bichat - Claude Bernard, F-75018 Paris, France; GHU Paris - Psychiatry & Neurosciences, 1 rue Cabanis, 75014 Paris, France; Université de Paris, NeuroDiderot, Inserm, FHU I2-D2, F-75019 Paris, France
| | - Ana Gonzalez-Pinto
- BIOARABA. Department of Psychiatry, University Hospital of Alava, University of the Basque Country, CIBERSAM, Vitoria, Spain
| | - John F Gottlieb
- Department of Psychiatry, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Paul Grof
- Mood Disorders Center of Ottawa and the Department of Psychiatry, University of Toronto, Canada
| | - Bartholomeus C M Haarman
- Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Hirohiko Harima
- Department of Psychiatry, Tokyo Metropolitan Matsuzawa Hospital, Setagaya, Tokyo, Japan
| | - Mathias Hasse-Sousa
- Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Chantal Henry
- Department of Psychiatry, GHU Paris Psychiatrie & Neurosciences, F-75014, Paris France, Université de Paris, F-75006 Paris, France
| | - Lone Høffding
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Josselin Houenou
- Université Paris Est Créteil, INSERM, IMRB, Translational Neuropsychiatry, APHP, Mondor Univ Hospitals, Fondation FondaMental, F-94010 Créteil, France; Université Paris Saclay, CEA, Neurospin, F-91191 Gif-sur-Yvette, France
| | | | - Erkki T Isometsä
- Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; National Institute for Health and Welfare, Helsinki, Finland
| | - Maja Ivkovic
- University Clinical Center of Serbia, Clinic for Psychiatry, Belgrade, Serbia
| | - Sven Janno
- Department of Psychiatry, University of Tartu, Tartu, Estonia
| | - Simon Johnsen
- Unit for Psychiatric Research, Aalborg University Hospital, Aalborg, Denmark
| | - Flávio Kapczinski
- Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Gregory N Karakatsoulis
- 3rd Department of Psychiatry, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Mathias Kardell
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Lars Vedel Kessing
- Copenhagen Affective Disorder Research Center (CADIC), Psychiatric Center Copenhagen, Rigshospitalet, Copenhagen, Denmark
| | - Seong Jae Kim
- Department of Psychiatry, Chosun University School of Medicine, Gwangju, Republic of Korea
| | - Barbara König
- BIPOLAR Zentrum Wiener Neustadt, Wiener Neustadt, Austria
| | - Timur L Kot
- Khanty-Mansiysk Clinical Psychoneurological Hospital, Khanty-Mansiysk, Russia
| | - Michael Koval
- Department of Neuroscience, Michigan State University, East Lansing, MI, USA
| | - Mauricio Kunz
- Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Beny Lafer
- Bipolar Disorder Research Program, Department of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil
| | - Mikael Landén
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Erik R Larsen
- Mental Health Department Odense, University Clinic and Department of Regional Health Research, University of Southern Denmark, Esbjerg, Denmark
| | - Melanie Lenger
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University Graz, Graz, Austria
| | - Ute Lewitzka
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Rasmus W Licht
- Psychiatry - Aalborg University Hospital, Aalborg, Denmark; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Carlos Lopez-Jaramillo
- Mood Disorders Program, Hospital Universitario San Vicente Fundación, Research Group in Psychiatry, Department of Psychiatry, Faculty of Medicine, Universidad de Antioquia, Medellín, Colombia
| | - Alan MacKenzie
- Forensic Psychiatry, University of Glasgow, NHS Greater Glasgow and Clyde, Glasgow, UK
| | | | | | - Jayant Mahadevan
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, India
| | - Agustine Mahardika
- Department of Psychiatry, Faculty of Medicine, Mataram University, Mataram, Indonesia
| | - Mirko Manchia
- Department of Pharmacology, Dalhousie University, Halifax, Nova Scotia, Canada; Section of Psychiatry, Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy; Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Wendy Marsh
- Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA, USA
| | - Monica Martinez-Cengotitabengoa
- Osakidetza, Basque Health Service, BioAraba Health Research Institute, University of the Basque Country, Spain; The Psychology Clinic of East Anglia, Norwich, United Kingdom
| | - Klaus Martiny
- Copenhagen University Hospitals, Psychiatric Centre Copenhagen, Copenhagen, Denmark
| | - Yuki Mashima
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Declan M McLoughlin
- Dept of Psychiatry & Trinity College Institute of Neuroscience, Trinity College Dublin, St Patrick's University Hospital, Dublin, Ireland
| | - Ybe Meesters
- Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Ingrid Melle
- NORMENT Centre, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Fátima Meza-Urzúa
- Department of Child and Adolescent Psychiatry und Psychotherapy, SHG Klinikum, Idar-Oberstein, Germany
| | - Yee Ming Mok
- Department of Mood and Anxiety disorders, Institute of Mental Health, Singapore City, Singapore
| | - Scott Monteith
- Michigan State University College of Human Medicine, Traverse City Campus, Traverse City, MI, USA
| | - Muthukumaran Moorthy
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, India
| | - Gunnar Morken
- Department of Mental Health, Norwegian University of Science and Technology - NTNU, Trondheim, Norway; Department of Psychiatry, St Olavs' University Hospital, Trondheim, Norway
| | - Enrica Mosca
- Section of Neurosciences and Clinical Pharmacology, Department of Biomedical Sciences, University of Cagliari, Sardinia, Italy
| | | | - Rodrigo Munoz
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA
| | - Starlin V Mythri
- Makunda Christian Leprosy and General Hospital, Bazaricherra, Assam 788727, India
| | - Fethi Nacef
- Razi Hospital, Faculty of Medicine, University of Tunis-El Manar, Tunis, Tunisia
| | - Ravi K Nadella
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, India
| | - Takako Nakanotani
- Affective Disorders Research Project, Tokyo Metropolitan Institute of Medical Science, Setagaya, Tokyo, Japan
| | - René Ernst Nielsen
- Psychiatry - Aalborg University Hospital, Aalborg, Denmark; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Claire O'Donovan
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
| | - Adel Omrani
- Tunisian Bipolar Forum, Érable Médical Cabinet 324, Lac 2, Tunis, Tunisia
| | - Yamima Osher
- Department of Psychiatry, Faculty of Health Sciences, Beer Sheva Mental Health Center, Ben Gurion University of the Negev, Beer Sheva, Israel
| | - Uta Ouali
- Razi Hospital, Faculty of Medicine, University of Tunis-El Manar, Tunis, Tunisia
| | | | - Pornjira Pariwatcharakul
- Department of Psychiatry, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Joanne Petite
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
| | - Andrea Pfennig
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | | | - Marco Pinna
- Section of Psychiatry, Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy; Lucio Bini Mood Disorder Center, Cagliari, Italy
| | - Maurizio Pompili
- Department of Neurosciences, Mental Health and Sensory Organs, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Richard Porter
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Danilo Quiroz
- Deparment of Psychiatry, Diego Portales University, Santiago de Chile, Chile
| | | | - Raj Ramesar
- SA MRC Genomic and Precision Medicine Research Unit, Division of Human Genetics, Department of Pathology, Institute of Infectious Diseases and Molecular Medicine, University of Cape Town, South Africa
| | - Natalie Rasgon
- Department of Psychiatry and Behavioral Sciences, Stanford School of Medicine, Palo Alto, CA, USA
| | - Woraphat Ratta-Apha
- Department of Psychiatry, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Michaela Ratzenhofer
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University Graz, Graz, Austria
| | - Maria Redahan
- Department of Psychiatry, Trinity College Dublin, St Patrick's University Hospital, Dublin, Ireland
| | - M S Reddy
- Asha Bipolar Clinic, Asha Hospital, Hyderabad, Telangana, India
| | - Andreas Reif
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Johann Wolfgang Goethe-Universität Frankfurt am Main, Frankfurt am Main, Germany
| | - Eva Z Reininghaus
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University Graz, Graz, Austria
| | - Jenny Gringer Richards
- Departments of Psychiatry, Epidemiology, and Internal Medicine, Iowa Neuroscience Institute, The University of Iowa, Iowa City, IA, USA
| | - Philipp Ritter
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Janusz K Rybakowski
- Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland
| | - Leela Sathyaputri
- Departments of Psychiatry, Epidemiology, and Internal Medicine, Iowa Neuroscience Institute, The University of Iowa, Iowa City, IA, USA
| | - Ângela M Scippa
- Department of Neuroscience and Mental Health, Federal University of Bahia, Salvador, Brazil
| | - Christian Simhandl
- Bipolar Zentrum Wiener Neustadt, Sigmund Freud Privat Universität, Vienna, Austria
| | - Daniel Smith
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, Scotland, UK
| | - José Smith
- AREA, Assistance and Research in Affective Disorders, Buenos Aires, Argentina
| | - Paul W Stackhouse
- Science Directorate/Climate Science Branch, NASA Langley Research Center, Hampton, VA, USA
| | - Dan J Stein
- Department of Psychiatry, MRC Unit on Risk & Resilience in Mental Disorders, University of Cape Town, Cape Town, South Africa
| | - Kellen Stilwell
- Pine Rest Christian Mental Health Services, Grand Rapids, MI, USA
| | - Sergio Strejilevich
- AREA, Assistance and Research in Affective Disorders, Buenos Aires, Argentina
| | - Kuan-Pin Su
- College of Medicine, China Medical University (CMU), Taichung, Taiwan; An-Nan Hospital, China Medical University, Tainan, Taiwan
| | | | - Ahmad Hatim Sulaiman
- Department of Psychological Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Kirsi Suominen
- Department of Social Services and Health Care, Psychiatry, City of Helsinki, Helsinki, Finland
| | - Andi J Tanra
- Department of Psychiatry, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
| | - Yoshitaka Tatebayashi
- Affective Disorders Research Project, Tokyo Metropolitan Institute of Medical Science, Setagaya, Tokyo, Japan
| | - Wen Lin Teh
- Research Division, Institute of Mental Health, Singapore
| | - Leonardo Tondo
- McLean Hospital-Harvard Medical School, Boston, MA, USA; Mood Disorder Lucio Bini Centers, Cagliari e Roma, Italy
| | - Carla Torrent
- Clinical Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Daniel Tuinstra
- Pine Rest Christian Mental Health Services, Grand Rapids, MI, USA
| | - Takahito Uchida
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan; Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne, Melbourne, Australia
| | - Arne E Vaaler
- Department of Mental Health, Norwegian University of Science and Technology - NTNU, Trondheim, Norway; Department of Psychiatry, St Olavs' University Hospital, Trondheim, Norway
| | - Eduard Vieta
- Clinical Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Biju Viswanath
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, India
| | - Maria Yoldi-Negrete
- Subdirección de Investigaciones Clínicas. Instituto Nacional de Psiquiatría Ramón de la Fuente Muñíz, Mexico City, Mexico
| | - Oguz Kaan Yalcinkaya
- Department of Psychiatry, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Allan H Young
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Yosra Zgueb
- Razi Hospital, Faculty of Medicine, University of Tunis-El Manar, Tunis, Tunisia
| | - Peter C Whybrow
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles (UCLA), Los Angeles, CA, USA
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Bauer M, Glenn T, Achtyes ED, Alda M, Agaoglu E, Altınbaş K, Andreassen OA, Angelopoulos E, Ardau R, Vares EA, Aydin M, Ayhan Y, Baethge C, Bauer R, Baune BT, Balaban C, Becerra-Palars C, Behere AP, Behere PB, Belete H, Belete T, Belizario GO, Bellivier F, Belmaker RH, Benedetti F, Berk M, Bersudsky Y, Bicakci Ş, Birabwa-Oketcho H, Bjella TD, Brady C, Cabrera J, Cappucciati M, Castro AMP, Chen WL, Cheung EYW, Chiesa S, Crowe M, Cuomo A, Dallaspezia S, Del Zompo M, Desai P, Dodd S, Donix M, Etain B, Fagiolini A, Fellendorf FT, Ferensztajn-Rochowiak E, Fiedorowicz JG, Fountoulakis KN, Frye MA, Geoffroy PA, Gonzalez-Pinto A, Gottlieb JF, Grof P, Haarman BCM, Harima H, Hasse-Sousa M, Henry C, Høffding L, Houenou J, Imbesi M, Isometsä ET, Ivkovic M, Janno S, Johnsen S, Kapczinski F, Karakatsoulis GN, Kardell M, Kessing LV, Kim SJ, König B, Kot TL, Koval M, Kunz M, Lafer B, Landén M, Larsen ER, Lenger M, Lewitzka U, Licht RW, Lopez-Jaramillo C, MacKenzie A, Madsen HØ, Madsen SAKA, Mahadevan J, Mahardika A, Manchia M, Marsh W, Martinez-Cengotitabengoa M, Martiny K, Mashima Y, McLoughlin DM, Meesters Y, Melle I, Meza-Urzúa F, Ming MY, Monteith S, Moorthy M, Morken G, Mosca E, Mozzhegorov AA, Munoz R, Mythri SV, Nacef F, Nadella RK, Nakanotani T, Nielsen RE, O'Donovan C, Omrani A, Osher Y, Ouali U, Pantovic-Stefanovic M, Pariwatcharakul P, Petite J, Pfennig A, Ruiz YP, Pilhatsch M, Pinna M, Pompili M, Porter R, Quiroz D, Rabelo-da-Ponte FD, Ramesar R, Rasgon N, Ratta-Apha W, Ratzenhofer M, Redahan M, Reddy MS, Reif A, Reininghaus EZ, Richards JG, Ritter P, Rybakowski JK, Sathyaputri L, Scippa ÂM, Simhandl C, Severus E, Smith D, Smith J, Stackhouse PW, Stein DJ, Stilwell K, Strejilevich S, Su KP, Subramaniam M, Sulaiman AH, Suominen K, Tanra AJ, Tatebayashi Y, Teh WL, Tondo L, Torrent C, Tuinstra D, Uchida T, Vaaler AE, Veeh J, Vieta E, Viswanath B, Yoldi-Negrete M, Yalcinkaya OK, Young AH, Zgueb Y, Whybrow PC. Variations in seasonal solar insolation are associated with a history of suicide attempts in bipolar I disorder. Int J Bipolar Disord 2021; 9:26. [PMID: 34467430 PMCID: PMC8408297 DOI: 10.1186/s40345-021-00231-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 07/13/2021] [Indexed: 01/09/2023] Open
Abstract
Background Bipolar disorder is associated with circadian disruption and a high risk of suicidal behavior. In a previous exploratory study of patients with bipolar I disorder, we found that a history of suicide attempts was associated with differences between winter and summer levels of solar insolation. The purpose of this study was to confirm this finding using international data from 42% more collection sites and 25% more countries. Methods Data analyzed were from 71 prior and new collection sites in 40 countries at a wide range of latitudes. The analysis included 4876 patients with bipolar I disorder, 45% more data than previously analyzed. Of the patients, 1496 (30.7%) had a history of suicide attempt. Solar insolation data, the amount of the sun’s electromagnetic energy striking the surface of the earth, was obtained for each onset location (479 locations in 64 countries). Results This analysis confirmed the results of the exploratory study with the same best model and slightly better statistical significance. There was a significant inverse association between a history of suicide attempts and the ratio of mean winter insolation to mean summer insolation (mean winter insolation/mean summer insolation). This ratio is largest near the equator which has little change in solar insolation over the year, and smallest near the poles where the winter insolation is very small compared to the summer insolation. Other variables in the model associated with an increased risk of suicide attempts were a history of alcohol or substance abuse, female gender, and younger birth cohort. The winter/summer insolation ratio was also replaced with the ratio of minimum mean monthly insolation to the maximum mean monthly insolation to accommodate insolation patterns in the tropics, and nearly identical results were found. All estimated coefficients were significant at p < 0.01. Conclusion A large change in solar insolation, both between winter and summer and between the minimum and maximum monthly values, may increase the risk of suicide attempts in bipolar I disorder. With frequent circadian rhythm dysfunction and suicidal behavior in bipolar disorder, greater understanding of the optimal roles of daylight and electric lighting in circadian entrainment is needed.
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Affiliation(s)
- Michael Bauer
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
| | - Tasha Glenn
- ChronoRecord Association, Fullerton, CA, USA
| | - Eric D Achtyes
- Division of Psychiatry and Behavioral Medicine, Michigan State University College of Human Medicine, Grand Rapids, MI, USA
| | - Martin Alda
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
| | - Esen Agaoglu
- Department of Psychiatry, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Kürşat Altınbaş
- Department of Psychiatry, Selcuk University Faculty of Medicine, Mazhar Osman Mood Center, Konya, Turkey
| | - Ole A Andreassen
- NORMENT Centre, Division of Mental Health and Addiction, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Elias Angelopoulos
- Department of Psychiatry, National and Capodistrian University of Athens, Medical School, Eginition Hospital, Athens, Greece
| | - Raffaella Ardau
- Section of Neurosciences and Clinical Pharmacology, Department of Biomedical Sciences, University of Cagliari, Sardinia, Italy
| | - Edgar Arrua Vares
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Memduha Aydin
- Department of Psychiatry, Selcuk University Faculty of Medicine, Konya, Turkey
| | - Yavuz Ayhan
- Department of Psychiatry, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Christopher Baethge
- Department of Psychiatry and Psychotherapy, University of Cologne Medical School, Cologne, Germany
| | - Rita Bauer
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Bernhard T Baune
- Department of Psychiatry, University of Münster, Munster, Germany.,Department of Psychiatry, Melbourne Medical School, The University of Melbourne, Melbourne, Australia.,The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Ceylan Balaban
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Johann Wolfgang Goethe-Universität Frankfurt am Main, Frankfurt am Main, Germany
| | | | - Aniruddh P Behere
- Child and Adolescent Psychiatry, Helen DeVos Children's Hospital, Michigan State University-CHM, Grand Rapids, MI, USA
| | - Prakash B Behere
- Department of Psychiatry, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences (Deemed University), Wardha, India
| | - Habte Belete
- Department of Psychiatry, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Tilahun Belete
- Department of Psychiatry, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Gabriel Okawa Belizario
- Bipolar Disorder Research Program, Department of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil
| | - Frank Bellivier
- Département de Psychiatrie et de Médecine Addictologique, Assistance Publique-Hôpitaux de Paris, INSERM UMR-S1144, Université de Paris, FondaMental Foundation, Paris, France
| | - Robert H Belmaker
- Professor Emeritus of Psychiatry, Ben Gurion University of the Negev, Beer Sheva, Israel
| | - Francesco Benedetti
- University Vita-Salute San Raffaele, Milan, Italy.,Psychiatry and Clinical Psychobiology, Division of Neuroscience, San Raffaele Scientific Institute, Milan, Italy
| | - Michael Berk
- Deakin University, IMPACT-The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong, Australia.,Orygen, The National Centre of Excellence in Youth Mental Health, Centre for Youth Mental Health, Florey Institute for Neuroscience and Mental Health, Department of Psychiatry, The University of Melbourne, Melbourne, Australia
| | - Yuly Bersudsky
- Department of Psychiatry, Faculty of Health Sciences, Beer Sheva Mental Health Center, Ben Gurion University of the Negev, Beer Sheva, Israel
| | - Şule Bicakci
- Department of Psychiatry, Hacettepe University Faculty of Medicine, Ankara, Turkey.,Department of Psychiatry, Baskent University Faculty of Medicine, Ankara, Turkey
| | | | - Thomas D Bjella
- NORMENT Centre, Division of Mental Health and Addiction, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Conan Brady
- Department of Psychiatry, Trinity College Dublin, St Patrick's University Hospital, Dublin, Ireland
| | - Jorge Cabrera
- Mood Disorders Clinic, Dr. Jose Horwitz Psychiatric Institute, Santiago de Chile, Chile
| | | | - Angela Marianne Paredes Castro
- Deakin University, IMPACT-The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong, Australia
| | - Wei-Ling Chen
- Department of Psychiatry, Chiayi Branch, Taichung Veterans General Hospital, Chiayi, Taiwan
| | | | - Silvia Chiesa
- Department of Mental Health and Substance Abuse, Piacenza, Italy
| | - Marie Crowe
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Alessandro Cuomo
- Department of Molecular Medicine, University of Siena School of Medicine, Siena, Italy
| | - Sara Dallaspezia
- Psychiatry and Clinical Psychobiology, Division of Neuroscience, San Raffaele Scientific Institute, Milan, Italy
| | - Maria Del Zompo
- Section of Neurosciences and Clinical Pharmacology, Department of Biomedical Sciences, University of Cagliari, Sardinia, Italy
| | | | - Seetal Dodd
- Deakin University, IMPACT-The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong, Australia.,Department of Psychiatry, University of Melbourne, Parkville, VIC, Australia
| | - Markus Donix
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Bruno Etain
- Département de Psychiatrie et de Médecine Addictologique, Assistance Publique-Hôpitaux de Paris, INSERM UMR-S1144, Université de Paris, FondaMental Foundation, Paris, France
| | - Andrea Fagiolini
- Department of Molecular Medicine, University of Siena School of Medicine, Siena, Italy
| | - Frederike T Fellendorf
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University Graz, Graz, Austria
| | | | - Jess G Fiedorowicz
- Department of Psychiatry, School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
| | - Kostas N Fountoulakis
- 3rd Department of Psychiatry, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Mark A Frye
- Department of Psychiatry and Psychology, Mayo Clinic Depression Center, Mayo Clinic, Rochester, MN, USA
| | - Pierre A Geoffroy
- Département de Psychiatrie et d'addictologie, AP-HP, Hopital Bichat-Claude Bernard, Paris, France.,GHU Paris-Psychiatry and Neurosciences, 75014, Paris, France.,Université de Paris, NeuroDiderot, Inserm, Paris, France
| | - Ana Gonzalez-Pinto
- BIOARABA, Department of Psychiatry, University Hospital of Alava, University of the Basque Country, CIBERSAM, Vitoria, Spain
| | - John F Gottlieb
- Department of Psychiatry, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Paul Grof
- Mood Disorders Center of Ottawa and the Department of Psychiatry, University of Toronto, Ottawa, Canada
| | - Bartholomeus C M Haarman
- Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Hirohiko Harima
- Department of Psychiatry, Tokyo Metropolitan Matsuzawa Hospital, Setagaya, Tokyo, Japan
| | - Mathias Hasse-Sousa
- Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Chantal Henry
- Department of Psychiatry, GHU Paris Psychiatrie & Neurosciences, 75014, Paris, France.,Université de Paris, 75006, Paris, France
| | - Lone Høffding
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Josselin Houenou
- Université Paris Est Créteil, INSERM, IMRB, Translational Neuropsychiatry, Fondation FondaMental, 94010, Créteil, France.,Université Paris Saclay, CEA, Neurospin, 91191, Gif-sur-Yvette, France
| | | | - Erkki T Isometsä
- Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,National Institute for Health and Welfare, Helsinki, Finland
| | - Maja Ivkovic
- University Clinical Center of Serbia, Clinic for Psychiatry, Belgrade, Serbia
| | - Sven Janno
- Department of Psychiatry, University of Tartu, Tartu, Estonia
| | - Simon Johnsen
- Unit for Psychiatric Research, Aalborg University Hospital, Aalborg, Denmark
| | - Flávio Kapczinski
- Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Gregory N Karakatsoulis
- 3rd Department of Psychiatry, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Mathias Kardell
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Lars Vedel Kessing
- Copenhagen Affective Disorder Research Center (CADIC), Psychiatric Center Copenhagen, Rigshospitalet, Copenhagen, Denmark
| | - Seong Jae Kim
- Department of Psychiatry, Cheongju Hospital, Cheongju, South Korea
| | - Barbara König
- BIPOLAR Zentrum Wiener Neustadt, Wiener Neustadt, Austria
| | - Timur L Kot
- Khanty-Mansiysk Clinical Psychoneurological Hospital, Khanty-Mansiysk, Russia
| | - Michael Koval
- Department of Neuroscience, Michigan State University, East Lansing, MI, USA
| | - Mauricio Kunz
- Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Beny Lafer
- Bipolar Disorder Research Program, Department of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil
| | - Mikael Landén
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Erik R Larsen
- Mental Health Department Odense, University Clinic and Department of Regional Health Research, University of Southern Denmark, Esbjerg, Denmark
| | - Melanie Lenger
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University Graz, Graz, Austria
| | - Ute Lewitzka
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Rasmus W Licht
- Psychiatry, Aalborg University Hospital, Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Carlos Lopez-Jaramillo
- Mood Disorders Program, Hospital Universitario San Vicente Fundación, Research Group in Psychiatry, Department of Psychiatry, Faculty of Medicine, Universidad de Antioquia, Medellín, Colombia
| | - Alan MacKenzie
- Forensic Psychiatry, University of Glasgow, NHS Greater Glasgow and Clyde, Glasgow, UK
| | | | | | - Jayant Mahadevan
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, India
| | - Agustine Mahardika
- Department of Psychiatry, Faculty of Medicine, Mataram University, Mataram, Indonesia
| | - Mirko Manchia
- Department of Pharmacology, Dalhousie University, Halifax, NS, Canada.,Section of Psychiatry, Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy.,Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Wendy Marsh
- Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA, USA
| | | | - Klaus Martiny
- Copenhagen University Hospitals, Psychiatric Centre Copenhagen, Copenhagen, Denmark
| | - Yuki Mashima
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Declan M McLoughlin
- Department of Psychiatry, Trinity College Institute of Neuroscience, Trinity College Dublin, St Patrick's University Hospital, Dublin, Ireland
| | - Ybe Meesters
- Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Ingrid Melle
- NORMENT Centre, Division of Mental Health and Addiction, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Fátima Meza-Urzúa
- National Institute of Psychiatry "Ramón de la Fuente Muñiz", Mexico City, Mexico
| | - Mok Yee Ming
- Department of General Psychiatry, Mood Disorders Unit, Institute of Mental Health, Singapore City, Singapore
| | - Scott Monteith
- Michigan State University College of Human Medicine, Traverse City Campus, Traverse City, MI, USA
| | - Muthukumaran Moorthy
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, India
| | - Gunnar Morken
- Department of Mental Health, Norwegian University of Science and Technology-NTNU, Trondheim, Norway.,Department of Psychiatry, St Olavs' University Hospital, Trondheim, Norway
| | - Enrica Mosca
- Section of Neurosciences and Clinical Pharmacology, Department of Biomedical Sciences, University of Cagliari, Sardinia, Italy
| | | | - Rodrigo Munoz
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA
| | | | - Fethi Nacef
- Razi Hospital, Faculty of Medicine, University of Tunis-El Manar, Tunis, Tunisia
| | - Ravi K Nadella
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, India
| | - Takako Nakanotani
- Affective Disorders Research Project, Tokyo Metropolitan Institute of Medical Science, Setagaya, Tokyo, Japan
| | - René Ernst Nielsen
- Psychiatry, Aalborg University Hospital, Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Claire O'Donovan
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
| | - Adel Omrani
- Tunisian Bipolar Forum, Érable Médical Cabinet 324, Lac 2, Tunis, Tunisia
| | - Yamima Osher
- Department of Psychiatry, Faculty of Health Sciences, Beer Sheva Mental Health Center, Ben Gurion University of the Negev, Beer Sheva, Israel
| | - Uta Ouali
- Razi Hospital, Faculty of Medicine, University of Tunis-El Manar, Tunis, Tunisia
| | | | - Pornjira Pariwatcharakul
- Department of Psychiatry, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Joanne Petite
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
| | - Andrea Pfennig
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | | | - Maximilian Pilhatsch
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.,Department of Psychiatry and Psychotherapy, Elblandklinikum Radebeul, Radebeul, Germany
| | - Marco Pinna
- Section of Psychiatry, Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy.,Lucio Bini Mood Disorder Center, Cagliari, Italy
| | - Maurizio Pompili
- Department of Neurosciences, Mental Health and Sensory Organs, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Richard Porter
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Danilo Quiroz
- Deparment of Psychiatry, Diego Portales University, Santiago de Chile, Chile
| | | | - Raj Ramesar
- SA MRC Genomic and Precision Medicine Research Unit, Division of Human Genetics, Department of Pathology, Institute of Infectious Diseases and Molecular Medicine, University of Cape Town, Cape Town, South Africa
| | - Natalie Rasgon
- Department of Psychiatry and Behavioral Sciences, Stanford School of Medicine, Palo Alto, CA, USA
| | - Woraphat Ratta-Apha
- Department of Psychiatry, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Michaela Ratzenhofer
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University Graz, Graz, Austria
| | - Maria Redahan
- Department of Psychiatry, Trinity College Dublin, St Patrick's University Hospital, Dublin, Ireland
| | - M S Reddy
- Asha Bipolar Clinic, Asha Hospital, Hyderabad, Telangana, India
| | - Andreas Reif
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Johann Wolfgang Goethe-Universität Frankfurt am Main, Frankfurt am Main, Germany
| | - Eva Z Reininghaus
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University Graz, Graz, Austria
| | - Jenny Gringer Richards
- Departments of Psychiatry, Epidemiology, and Internal Medicine, Iowa Neuroscience Institute, The University of Iowa, Iowa City, IA, USA
| | - Philipp Ritter
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Janusz K Rybakowski
- Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland
| | - Leela Sathyaputri
- Departments of Psychiatry, Epidemiology, and Internal Medicine, Iowa Neuroscience Institute, The University of Iowa, Iowa City, IA, USA
| | - Ângela M Scippa
- Department of Neuroscience and Mental Health, Federal University of Bahia, Salvador, Brazil
| | - Christian Simhandl
- Bipolar Zentrum Wiener Neustadt, Sigmund Freud Privat Universität, Vienna, Austria
| | - Emanuel Severus
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Daniel Smith
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, Scotland, UK
| | - José Smith
- Bipolar Disorder Program, Neuroscience Institute, Favaloro University, Buenos Aires, Argentina
| | - Paul W Stackhouse
- Science Directorate/Climate Science Branch, NASA Langley Research Center, Hampton, VA, USA
| | - Dan J Stein
- Department of Psychiatry, MRC Unit On Risk and Resilience in Mental Disorders, University of Cape Town, Cape Town, South Africa
| | - Kellen Stilwell
- Pine Rest Christian Mental Health Services, Grand Rapids, MI, USA
| | - Sergio Strejilevich
- Bipolar Disorder Program, Neuroscience Institute, Favaloro University, Buenos Aires, Argentina
| | - Kuan-Pin Su
- College of Medicine, China Medical University (CMU), Taichung, Taiwan.,An-Nan Hospital, China Medical University, Tainan, Taiwan
| | | | - Ahmad Hatim Sulaiman
- Department of Psychological Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Kirsi Suominen
- Department of Social Services and Health Care, Psychiatry, City of Helsinki, Helsinki, Finland
| | - Andi J Tanra
- Department of Psychiatry, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
| | - Yoshitaka Tatebayashi
- Affective Disorders Research Project, Tokyo Metropolitan Institute of Medical Science, Setagaya, Tokyo, Japan
| | - Wen Lin Teh
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Leonardo Tondo
- McLean Hospital-Harvard Medical School, Boston, MA, USA.,Mood Disorder Lucio Bini Centers, Cagliari e Roma, Italy
| | - Carla Torrent
- Clinical Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Daniel Tuinstra
- Pine Rest Christian Mental Health Services, Grand Rapids, MI, USA
| | - Takahito Uchida
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Arne E Vaaler
- Department of Mental Health, Norwegian University of Science and Technology-NTNU, Trondheim, Norway.,Department of Psychiatry, St Olavs' University Hospital, Trondheim, Norway
| | - Julia Veeh
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Johann Wolfgang Goethe-Universität Frankfurt am Main, Frankfurt am Main, Germany
| | - Eduard Vieta
- Clinical Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Biju Viswanath
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, India
| | - Maria Yoldi-Negrete
- Subdirección de Investigaciones Clínicas, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñíz, Mexico City, Mexico
| | - Oguz Kaan Yalcinkaya
- Department of Psychiatry, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Allan H Young
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Yosra Zgueb
- Razi Hospital, Faculty of Medicine, University of Tunis-El Manar, Tunis, Tunisia
| | - Peter C Whybrow
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles (UCLA), Los Angeles, CA, USA
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Larsson F, Kardell M, Pålsson E, Landén M. [Bipolar disorder type 1 was the most stable bipolar subdiagnosis]. Lakartidningen 2021; 118:20153. [PMID: 34100265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
DSM-IV subcategorises bipolar disorders into type 1, type 2, and a third not otherwise specified (NOS) category. Although previous works suggest that these subtypes remain reasonably stable over time, it is unclear if subdiagnoses endure over time or if patients are commonly recategorized within the spectrum in a real-world clinical setting. We assessed subdiagnostic stability in 6,374 individuals with bipolar disorder using data from the Swedish national quality assurance register for bipolar disorders (BipoläR). Diagnoses at baseline registration - that could occur at any time point during the course of illness - were compared with diagnoses at follow-up registration 3 years later. Changes in subdiagnoses were analysed in relation to clinical setting, diagnostic procedure, and patient features. We found that 74 %, 67 %, and 47 % of patients diagnosed with bipolar disorder type 1, type 2, and NOS, respectively, retained the same subdiagnosis at the 3-year follow-up. The following factors were associated with higher rate of subdiagnostic transitions: previous suicide attempts, unemployment or low psychosocial function, treatment with antidepressants, and comorbid anxiety, neuropsychiatric, or personality disorder. Conversely, use and duration of mood stabilizer treatment, the use of structured diagnostic instruments, and treatment at an outpatient unit specialized in managing affective disorders were associated with lower likelihood of subdiagnostic transitions. Our findings confirm that bipolar disorder type 1 is the most stable subdiagnostic group, but findings also indicate a significant degree of subdiagnostic instability, particularly in the NOS group.
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Affiliation(s)
- Finn Larsson
- överläkare, bipolärmottagning, Psykiatri affektiva, Sahlgrenska universitetssjukhuset
| | - Mathias Kardell
- statistiker, sektionen för psykiatri och neurokemi, institutionen för neurovetenskap och fysiologi, Sahlgrenska akademin, Göteborgs universitet
| | - Erik Pålsson
- docent, biträdande registerhållare, Nationella kvalitetsregistret för bipolär affektiv sjukdom; sektionen för psykiatri och neurokemi, institutionen för neurovetenskap och fysiologi, Sahlgrenska akademin, Göteborgs universitet, Nationella kvalitetsregistret för bipolär affektiv sjukdom; sektionen för psykiatri och neurokemi, institutionen för neurovetenskap och fysiologi, Sahlgrenska akademin, Göteborgs universitet
| | - Mikael Landén
- professor, överläkare; registerhållare, nationella kvalitetsregistret Bipolär, sektionen för psykiatri och neurokemi, institutionen för neurovetenskap och fysiologi, Sahlgrenska akademin, Göteborgs universitet; institutionen för medi-cinsk epidemiologi och biostatistik, Karolinska institutet
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5
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Sköld M, Rolstad S, Joas E, Kardell M, Pålsson E, Goodwin GM, Landén M. Regional lithium prescription rates and recurrence in bipolar disorder. Int J Bipolar Disord 2021; 9:18. [PMID: 34061259 PMCID: PMC8167923 DOI: 10.1186/s40345-021-00223-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 03/02/2021] [Indexed: 11/22/2022] Open
Abstract
Background Lithium is the best documented maintenance treatment in bipolar disorder, but its use varies considerably across and within countries. It is not known whether regional differences in lithium prescription rates translate to differing regional outcomes. Aims To estimate associations between county specific lithium prescription rates and county specific recurrence odds of bipolar disorder in Sweden. Method Data from 14,616 patients with bipolar I disorder, bipolar II disorder, or bipolar disorder not otherwise specified were extracted from the Swedish national quality assurance register for bipolar disorders (BipoläR). Lithium prescription frequencies were calculated for 21 counties. Logistic regression analyses were run adjusted for confounders, with any type of recurrence as primary outcome, and incident elated and depressive episodes as secondary outcomes. Subsets of patients with bipolar I, II and not otherwise specified disorder were also analysed separately. Results Lithium prescription rates for populations with all bipolar subtypes ranged across counties from 37.7 to 84.9% (mean 52.4%). Higher regional prescription rates were significantly associated with lower rate of any type of recurrence. The association was stronger when bipolar I disorder was analysed separately. Conclusions The advantages for lithium use long acknowledged for bipolar I disorder are also seen for the rest of the bipolar spectrum. Results suggest that population level outcomes of bipolar disorder could be improved by increasing the number of patients using lithium. Supplementary Information The online version contains supplementary material available at 10.1186/s40345-021-00223-7.
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Affiliation(s)
- Martin Sköld
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Blå Stråket 15, 413 45, Gothenburg, Sweden
| | - Sindre Rolstad
- Department of Psychology, Faculty of Social Science, University of Gothenburg, Gothenburg, Sweden
| | - Erik Joas
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Blå Stråket 15, 413 45, Gothenburg, Sweden
| | - Mathias Kardell
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Blå Stråket 15, 413 45, Gothenburg, Sweden
| | - Erik Pålsson
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Blå Stråket 15, 413 45, Gothenburg, Sweden
| | - Guy M Goodwin
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Mikael Landén
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Blå Stråket 15, 413 45, Gothenburg, Sweden. .,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
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6
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Karanti A, Bublik L, Kardell M, Annerbrink K, Lichtenstein P, Runeson B, Pålsson E, Landén M. Patient educational level and management of bipolar disorder. BJPsych Open 2021; 7:e63. [PMID: 33678216 PMCID: PMC8058931 DOI: 10.1192/bjo.2021.19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Socioeconomic factors can affect healthcare management. AIMS The aim was to investigate if patient educational attainment is associated with management of bipolar disorder. METHOD We included patients with bipolar disorder type 1 (n = 4289), type 2 (n = 4020) and not otherwise specified (n = 1756), from the Swedish National Quality Register for Bipolar Disorder (BipoläR). The association between patients' educational level and pharmacological and psychological interventions was analysed by binary logistic regression. We calculated odds ratios after adjusting for demographic and clinical variables. RESULTS Higher education was associated with increased likelihood of receiving psychotherapy (adjusted odds ratio 1.34, 95% CI 91.22-1.46) and psychoeducation (adjusted odds ratio 1.18, 95% CI 1.07-1.46), but with lower likelihood of receiving first-generation antipsychotics (adjusted odds ratio 0.76, 95% CI 0.62-0.94) and tricyclic antidepressants (adjusted odds ratio 0.76, 95% CI 0.59-0.97). Higher education was also associated with lower risk for compulsory in-patient care (adjusted odds ratio 0.79, 95% CI 0.67-0.93). CONCLUSIONS Pharmacological and psychological treatment of bipolar disorder differ depending on patients' educational attainment. The reasons for these disparities remain to be explained.
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Affiliation(s)
- Alina Karanti
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Sweden
| | - Lana Bublik
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Sweden
| | - Mathias Kardell
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Sweden
| | - Kristina Annerbrink
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Sweden
| | - Paul Lichtenstein
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Sweden
| | - Bo Runeson
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Sweden
| | - Erik Pålsson
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Sweden
| | - Mikael Landén
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Sweden; and Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Sweden
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Abstract
OBJECTIVES Large-scale studies on phenotypic differences between bipolar disorder type I (BDI) and type II (BDII) are scarce. METHODS Individuals with BDI (N = 4806) and BDII (N = 3960) were compared with respect to clinical features, illness course, comorbid conditions, suicidality, and socioeconomic factors using data from the Swedish national quality assurance register for bipolar disorders (BipoläR). RESULTS BDII had higher rate of depressive episodes and more frequent suicide attempts than BDI. Furthermore, the BDII group were younger at first sign of mental illness and showed higher prevalence of psychiatric comorbidity but were more likely to have completed higher education and to be self-sustaining than the BDI group. BDII more frequently received psychotherapy, antidepressants, and lamotrigine. BDI patients had higher rate of hospitalizations and elated episodes, higher BMI, and higher rate of endocrine, nutritional, and metabolic diseases. BDI were more likely to receive mood stabilizers, antipsychotic drugs, electroconvulsive therapy, and psychoeducation. CONCLUSIONS These results demonstrate clear differences between BDI and II and counter the notion that BDII is a milder form of BDI, but rather a more complex condition with regard to clinical course and comorbidity.
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Affiliation(s)
- Alina Karanti
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Mathias Kardell
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Erik Joas
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Bo Runeson
- Department of Clinical Neuroscience, Center for Psychiatry Research, Karolinska Institutet, Stockholm, Sweden
| | - Erik Pålsson
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Mikael Landén
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
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8
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Bauer M, Glenn T, Alda M, Andreassen OA, Angelopoulos E, Ardau R, Ayhan Y, Baethge C, Bauer R, Baune BT, Becerra-Palars C, Bellivier F, Belmaker RH, Berk M, Bersudsky Y, Bicakci Ş, Birabwa-Oketcho H, Bjella TD, Cabrera J, Wo Cheung EY, Del Zompo M, Dodd S, Donix M, Etain B, Fagiolini A, Fountoulakis KN, Frye MA, Gonzalez-Pinto A, Gottlieb JF, Grof P, Harima H, Henry C, Isometsä ET, Janno S, Kapczinski F, Kardell M, Khaldi S, Kliwicki S, König B, Kot TL, Krogh R, Kunz M, Lafer B, Landén M, Larsen ER, Lewitzka U, Licht RW, Lopez-Jaramillo C, MacQueen G, Manchia M, Marsh W, Martinez-Cengotitabengoa M, Melle I, Meza-Urzúa F, Ming MY, Monteith S, Morken G, Mosca E, Mozzhegorov AA, Munoz R, Mythri SV, Nacef F, Nadella RK, Nery FG, Nielsen RE, O'Donovan C, Omrani A, Osher Y, Sørensen HØ, Ouali U, Ruiz YP, Pilhatsch M, Pinna M, da Ponte FDR, Quiroz D, Ramesar R, Rasgon N, Reddy MS, Reif A, Ritter P, Rybakowski JK, Sagduyu K, Raghuraman BS, Scippa ÂM, Severus E, Simhandl C, Stackhouse PW, Stein DJ, Strejilevich S, Subramaniam M, Sulaiman AH, Suominen K, Tagata H, Tatebayashi Y, Tondo L, Torrent C, Vaaler AE, Vares E, Veeh J, Vieta E, Viswanath B, Yoldi-Negrete M, Zetin M, Zgueb Y, Whybrow PC. Association between solar insolation and a history of suicide attempts in bipolar I disorder. J Psychiatr Res 2019; 113:1-9. [PMID: 30878786 DOI: 10.1016/j.jpsychires.2019.03.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Revised: 02/05/2019] [Accepted: 03/01/2019] [Indexed: 12/28/2022]
Abstract
In many international studies, rates of completed suicide and suicide attempts have a seasonal pattern that peaks in spring or summer. This exploratory study investigated the association between solar insolation and a history of suicide attempt in patients with bipolar I disorder. Solar insolation is the amount of electromagnetic energy from the Sun striking a surface area on Earth. Data were collected previously from 5536 patients with bipolar I disorder at 50 collection sites in 32 countries at a wide range of latitudes in both hemispheres. Suicide related data were available for 3365 patients from 310 onset locations in 51 countries. 1047 (31.1%) had a history of suicide attempt. There was a significant inverse association between a history of suicide attempt and the ratio of mean winter solar insolation/mean summer solar insolation. This ratio is smallest near the poles where the winter insolation is very small compared to the summer insolation. This ratio is largest near the equator where there is relatively little variation in the insolation over the year. Other variables in the model that were positively associated with suicide attempt were being female, a history of alcohol or substance abuse, and being in a younger birth cohort. Living in a country with a state-sponsored religion decreased the association. (All estimated coefficients p < 0.01). In summary, living in locations with large changes in solar insolation between winter and summer may be associated with increased suicide attempts in patients with bipolar disorder. Further investigation of the impacts of solar insolation on the course of bipolar disorder is needed.
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Affiliation(s)
- Michael Bauer
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
| | - Tasha Glenn
- ChronoRecord Association, Fullerton, CA, USA
| | - Martin Alda
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
| | - Ole A Andreassen
- NORMENT - K.G. Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Elias Angelopoulos
- Department of Psychiatry, National and Capodistrian University of Athens, Medical School, Eginition Hospital, Athens, Greece
| | - Raffaella Ardau
- Section of Neurosciences and Clinical Pharmacology, Department of Biomedical Sciences, University of Cagliari, Sardinia, Italy
| | - Yavuz Ayhan
- Department of Psychiatry, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Christopher Baethge
- Department of Psychiatry and Psychotherapy, University of Cologne Medical School, Cologne, Germany
| | - Rita Bauer
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Bernhard T Baune
- Department of Psychiatry, School of Medicine, University of Adelaide, Adelaide, Australia
| | | | - Frank Bellivier
- Psychiatry and Addiction Medicine. Assistance Publique - Hôpitaux de Paris, INSERM UMR-S1144, Denis Diderot University, René Descartes University, FondaMental Foundation, Paris, France
| | - Robert H Belmaker
- Department of Psychiatry, Faculty of Health Sciences, Beer Sheva Mental Health Center, Ben Gurion University of the Negev, Beer Sheva, Israel
| | - Michael Berk
- Deakin University, IMPACT Strategic Research Centre, School of Medicine, Barwon Health, Geelong, Victoria, Australia; Department of Psychiatry, Orygen, the National Centre for Excellence in Youth Mental Health, the Centre for Youth Mental Health and the Florey Institute for Neuroscience and Mental Health, University of Melbourne, Parkville, Victoria, Australia
| | - Yuly Bersudsky
- Department of Psychiatry, Faculty of Health Sciences, Beer Sheva Mental Health Center, Ben Gurion University of the Negev, Beer Sheva, Israel
| | | | | | - Thomas D Bjella
- NORMENT - K.G. Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Jorge Cabrera
- Mood Disorders Clinic, Dr. Jose Horwitz Psychiatric Institute, Santiago de Chile, Chile
| | - Eric Y Wo Cheung
- Department of General Adult Psychiatry, Castle Peak Hospital, Hong Kong
| | - Maria Del Zompo
- Section of Neurosciences and Clinical Pharmacology, Department of Biomedical Sciences, University of Cagliari, Sardinia, Italy
| | - Seetal Dodd
- Deakin University, IMPACT Strategic Research Centre, School of Medicine, Barwon Health, Geelong, Victoria, Australia; Department of Psychiatry, University of Melbourne, Parkville, Victoria, Australia
| | - Markus Donix
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Bruno Etain
- Psychiatry and Addiction Medicine. Assistance Publique - Hôpitaux de Paris, INSERM UMR-S1144, Denis Diderot University, René Descartes University, FondaMental Foundation, Paris, France
| | - Andrea Fagiolini
- Department of Molecular Medicine and Department of Mental Health (DAI), University of Siena and University of Siena Medical Center (AOUS), Siena, Italy
| | - Kostas N Fountoulakis
- Division of Neurosciences, 3rd Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Mark A Frye
- Department of Psychiatry & Psychology, Mayo Clinic Depression Center, Mayo Clinic, Rochester, MN, USA
| | - Ana Gonzalez-Pinto
- Department of Psychiatry, University Hospital of Alava, University of the Basque Country, CIBERSAM, Vitoria, Spain
| | - John F Gottlieb
- Department of Psychiatry, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Paul Grof
- Mood Disorders Center of Ottawa, University of Toronto, Toronto, ON, Canada
| | - Hirohiko Harima
- Department of Psychiatry, Tokyo Metropolitan Matsuzawa Hospital, Setagaya, Tokyo, Japan
| | - Chantal Henry
- AP-HP, Hopitaux Universitaires Henri Mondor and INSERM U955 (IMRB) and Université Paris Est and Institut Pasteur, Unité Perception et Mémoire, Paris, France
| | - Erkki T Isometsä
- Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; National Institute for Health and Welfare, Helsinki, Finland
| | - Sven Janno
- Department of Psychiatry, University of Tartu, Tartu, Estonia
| | - Flávio Kapczinski
- Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Mathias Kardell
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | | | - Sebastian Kliwicki
- Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland
| | - Barbara König
- BIPOLAR Zentrum Wiener Neustadt, Wiener Neustadt, Austria
| | - Timur L Kot
- Khanty-Mansiysk Clinical Psychoneurological Hospital, Khanty-Mansiysk, Russia
| | - Rikke Krogh
- Department of Affective Disorders, Q, Mood Disorders Research Unit, Aarhus University Hospital, Aarhus, Denmark
| | - Mauricio Kunz
- Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Beny Lafer
- Bipolar Disorder Research Program, Department of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil
| | - Mikael Landén
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy, University of Gothenburg, Gothenburg and Mölndal, Sweden; Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
| | - Erik R Larsen
- Department of Affective Disorders, Q, Mood Disorders Research Unit, Aarhus University Hospital, Aarhus, Denmark
| | - Ute Lewitzka
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Rasmus W Licht
- Unit for Psychiatric Research, Aalborg University Hospital, Psychiatry, Aalborg, Denmark; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Carlos Lopez-Jaramillo
- Mood Disorders Program, Hospital Universitario San Vicente Fundación, Research Group in Psychiatry, Department of Psychiatry, Faculty of Medicine, Universidad de Antioquia, Medellín, Colombia
| | - Glenda MacQueen
- Department of Psychiatry, Faculty of Medicine, University of Calgary, Calgary, AB, Canada
| | - Mirko Manchia
- Department of Pharmacology, Dalhousie University, Halifax, Nova Scotia, Canada; Section of Psychiatry, Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
| | - Wendy Marsh
- Department of Psychiatry, University of Massachusetts, Worcester, MA, USA
| | | | - Ingrid Melle
- NORMENT - K.G. Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Fátima Meza-Urzúa
- National Institute of Psychiatry '"Ramón de la Fuente Muñiz", Mexico City, Mexico
| | - Mok Yee Ming
- Department of General Psychiatry, Mood Disorders Unit, Institute of Mental Health, Singapore City, Singapore
| | - Scott Monteith
- Michigan State University College of Human Medicine, Traverse City Campus, Traverse City, MI, USA
| | - Gunnar Morken
- Department of Mental Health, Norwegian University of Science and Technology - NTNU, Trondheim, Norway; Department of Psychiatry, St Olavs' University Hospital, Trondheim, Norway
| | - Enrica Mosca
- Section of Neurosciences and Clinical Pharmacology, Department of Biomedical Sciences, University of Cagliari, Sardinia, Italy
| | | | - Rodrigo Munoz
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA
| | | | - Fethi Nacef
- Razi Hospital, Faculty of Medicine, University of Tunis-El Manar, Tunis, Tunisia
| | | | - Fabiano G Nery
- Bipolar Disorder Research Program, Department of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil
| | - René E Nielsen
- Unit for Psychiatric Research, Aalborg University Hospital, Psychiatry, Aalborg, Denmark; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Claire O'Donovan
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
| | - Adel Omrani
- Tunisian Bipolar Forum, Érable Médical Cabinet 324, Lac 2, Tunis, Tunisia
| | - Yamima Osher
- Department of Psychiatry, Faculty of Health Sciences, Beer Sheva Mental Health Center, Ben Gurion University of the Negev, Beer Sheva, Israel
| | | | - Uta Ouali
- Razi Hospital, Faculty of Medicine, University of Tunis-El Manar, Tunis, Tunisia
| | | | - Maximilian Pilhatsch
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Marco Pinna
- Lucio Bini Mood Disorder Center, Cagliari, Italy
| | - Francisco D R da Ponte
- Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Danilo Quiroz
- Deparment of Psychiatry, Diego Portales University, Santiago de Chile, Chile
| | - Raj Ramesar
- UCT/MRC Human Genetics Research Unit, Division of Human Genetics, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa
| | - Natalie Rasgon
- Department of Psychiatry and Behavioral Sciences, Stanford School of Medicine, Palo Alto, CA, USA
| | - M S Reddy
- Asha Bipolar Clinic, Asha Hospital, Hyderabad, Telangana, India
| | - Andreas Reif
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Johann Wolfgang Goethe-Universität Frankfurt am Main, Frankfurt am Main, Germany
| | - Philipp Ritter
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Janusz K Rybakowski
- Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland
| | - Kemal Sagduyu
- Department of Psychiatry, University of Missouri Kansas City School of Medicine, Kansas City, MO, USA
| | | | - Ângela M Scippa
- Department of Neuroscience and Mental Health, Federal University of Bahia, Salvador, Brazil
| | - Emanuel Severus
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | | | - Paul W Stackhouse
- Science Directorate/Climate Science Branch, NASA Langley Research Center, Hampton, VA, USA
| | - Dan J Stein
- Department of Psychiatry, MRC Unit on Risk & Resilience in Mental Disorders, University of Cape Town, Cape Town, South Africa
| | - Sergio Strejilevich
- Bipolar Disorder Program, Neuroscience Institute, Favaloro University, Buenos Aires, Argentina
| | | | - Ahmad Hatim Sulaiman
- Department of Psychological Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Kirsi Suominen
- Department of Social Services and Health Care, Psychiatry, City of Helsinki, Finland
| | - Hiromi Tagata
- Department of Psychiatry, Tokyo Metropolitan Matsuzawa Hospital, Setagaya, Tokyo, Japan
| | - Yoshitaka Tatebayashi
- Schizophrenia & Affective Disorders Research Project, Tokyo Metropolitan Institute of Medical Science, Seatagaya, Tokyo, Japan
| | - Leonardo Tondo
- McLean Hospital-Harvard Medical School, Boston, MA, USA; Mood Disorder Lucio Bini Centers, Cagliari e Roma, Italy
| | - Carla Torrent
- Clinical Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Arne E Vaaler
- Department of Mental Health, Norwegian University of Science and Technology - NTNU, Trondheim, Norway; Department of Psychiatry, St Olavs' University Hospital, Trondheim, Norway
| | - Edgar Vares
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Julia Veeh
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Johann Wolfgang Goethe-Universität Frankfurt am Main, Frankfurt am Main, Germany
| | - Eduard Vieta
- Clinical Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | | | - Maria Yoldi-Negrete
- Consejo Nacional de Ciencia y Tecnología - Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de México, Mexico
| | - Mark Zetin
- Department of Psychology, Chapman University, Orange, CA, USA
| | - Yosra Zgueb
- Razi Hospital, Faculty of Medicine, University of Tunis-El Manar, Tunis, Tunisia
| | - Peter C Whybrow
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles (UCLA), Los Angeles, CA, USA
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Dhejne C, Görts Öberg K, Arver S, Kardell M, Werner S, Landén M. 161 Gender congruence and psychiatric morbidity after gender-affirming health care: Relation to childhood adversities and adult stressful life events. J Sex Med 2018. [DOI: 10.1016/j.jsxm.2018.04.162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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10
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Cremaschi L, Kardell M, Johansson V, Isgren A, Sellgren CM, Altamura AC, Hultman CM, Landén M. Prevalences of autoimmune diseases in schizophrenia, bipolar I and II disorder, and controls. Psychiatry Res 2017; 258:9-14. [PMID: 28968513 DOI: 10.1016/j.psychres.2017.09.071] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Revised: 09/18/2017] [Accepted: 09/25/2017] [Indexed: 12/30/2022]
Abstract
Previous studies on the relationship between autoimmune diseases, schizophrenia, and bipolar disorder are mainly based on hospital discharge registers with insufficient coverage of outpatient data. Furthermore, data is scant on the prevalence of autoimmune diseases in bipolar subgroups. Here we estimate the self-reported prevalences of autoimmune diseases in schizophrenia, bipolar disorder type I and II, and controls. Lifetime prevalence of autoimmune diseases was assessed through a structured interview in a sample of 9076 patients (schizophrenia N = 5278, bipolar disorder type I N = 1952, type II N = 1846) and 6485 controls. Comparative analyses were performed using logistic regressions. The prevalence of diabetes type 1 did not differ between groups. Hyperthyroidism, hypothyroidism regardless of lithium effects, rheumatoid arthritis, and polymyalgia rheumatica were most common in bipolar disorder. Systemic lupus erythematosus was less common in bipolar disorder than in the other groups. The rate of autoimmune diseases did not differ significantly between bipolar subgroups. We conclude that prevalences of autoimmune diseases show clear differences between schizophrenia and bipolar disorder, but not between the bipolar subgroups.
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Affiliation(s)
- Laura Cremaschi
- Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, The Sahlgrenska Academy, University of Gothenburg, Blå Stråket 15, 3 tr, Sahlgrenska University hospital, SE 413 45 Gothenburg, Sweden; Dipartimento di Neuroscienze e Salute Mentale, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Mathias Kardell
- Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, The Sahlgrenska Academy, University of Gothenburg, Blå Stråket 15, 3 tr, Sahlgrenska University hospital, SE 413 45 Gothenburg, Sweden
| | - Viktoria Johansson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Anniella Isgren
- Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, The Sahlgrenska Academy, University of Gothenburg, Blå Stråket 15, 3 tr, Sahlgrenska University hospital, SE 413 45 Gothenburg, Sweden
| | - Carl M Sellgren
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA; Psychiatric and Neurodevelopmental Genetics Unit, Center for Human Genetics Research, Massachusetts General Hospital, Boston, MA, USA
| | - A Carlo Altamura
- Dipartimento di Neuroscienze e Salute Mentale, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Christina M Hultman
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Mikael Landén
- Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, The Sahlgrenska Academy, University of Gothenburg, Blå Stråket 15, 3 tr, Sahlgrenska University hospital, SE 413 45 Gothenburg, Sweden; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
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11
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Bauer M, Glenn T, Alda M, Aleksandrovich MA, Andreassen OA, Angelopoulos E, Ardau R, Ayhan Y, Baethge C, Bharathram SR, Bauer R, Baune BT, Becerra-Palars C, Bellivier F, Belmaker RH, Berk M, Bersudsky Y, Bicakci Ş, Birabwa-Oketcho H, Bjella TD, Bossini L, Cabrera J, Cheung EYW, Del Zompo M, Dodd S, Donix M, Etain B, Fagiolini A, Fountoulakis KN, Frye MA, Gonzalez-Pinto A, Gottlieb JF, Grof P, Harima H, Henry C, Isometsä ET, Janno S, Kapczinski F, Kardell M, Khaldi S, Kliwicki S, König B, Kot TL, Krogh R, Kunz M, Lafer B, Landén M, Larsen ER, Lewitzka U, Licht RW, Lopez-Jaramillo C, MacQueen G, Manchia M, Marsh W, Martinez-Cengotitabengoa M, Melle I, Meza-Urzúa F, Yee Ming M, Monteith S, Morken G, Mosca E, Munoz R, Mythri SV, Nacef F, Nadella RK, Nery FG, Nielsen RE, O'Donovan C, Omrani A, Osher Y, Østermark Sørensen H, Ouali U, Pica Ruiz Y, Pilhatsch M, Pinna M, da Ponte FDR, Quiroz D, Ramesar R, Rasgon N, Reddy MS, Reif A, Ritter P, Rybakowski JK, Sagduyu K, Scippa ÂM, Severus E, Simhandl C, Stein DJ, Strejilevich S, Subramaniam M, Sulaiman AH, Suominen K, Tagata H, Tatebayashi Y, Tondo L, Torrent C, Vaaler AE, Veeh J, Vieta E, Viswanath B, Yoldi-Negrete M, Zetin M, Zgueb Y, Whybrow PC. Solar insolation in springtime influences age of onset of bipolar I disorder. Acta Psychiatr Scand 2017; 136:571-582. [PMID: 28722128 DOI: 10.1111/acps.12772] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/16/2017] [Indexed: 01/19/2023]
Abstract
OBJECTIVE To confirm prior findings that the larger the maximum monthly increase in solar insolation in springtime, the younger the age of onset of bipolar disorder. METHOD Data were collected from 5536 patients at 50 sites in 32 countries on six continents. Onset occurred at 456 locations in 57 countries. Variables included solar insolation, birth-cohort, family history, polarity of first episode and country physician density. RESULTS There was a significant, inverse association between the maximum monthly increase in solar insolation at the onset location, and the age of onset. This effect was reduced in those without a family history of mood disorders and with a first episode of mania rather than depression. The maximum monthly increase occurred in springtime. The youngest birth-cohort had the youngest age of onset. All prior relationships were confirmed using both the entire sample, and only the youngest birth-cohort (all estimated coefficients P < 0.001). CONCLUSION A large increase in springtime solar insolation may impact the onset of bipolar disorder, especially with a family history of mood disorders. Recent societal changes that affect light exposure (LED lighting, mobile devices backlit with LEDs) may influence adaptability to a springtime circadian challenge.
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Affiliation(s)
- M Bauer
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - T Glenn
- ChronoRecord Association, Fullerton, CA, USA
| | - M Alda
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
| | | | - O A Andreassen
- NORMENT - K.G. Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - E Angelopoulos
- Department of Psychiatry, Medical School, Eginition Hospital, National and Capodistrian University of Athens, Athens, Greece
| | - R Ardau
- Section of Neurosciences and Clinical Pharmacology, Department of Biomedical Sciences, University of Cagliari, Sardinia, Italy
| | - Y Ayhan
- Department of Psychiatry, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - C Baethge
- Department of Psychiatry and Psychotherapy, University of Cologne Medical School, Cologne, Germany
| | | | - R Bauer
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - B T Baune
- Department of Psychiatry, School of Medicine, University of Adelaide, Adelaide, SA, Australia
| | - C Becerra-Palars
- National Institute of Psychiatry '"Ramón de la Fuente Muñiz", Mexico City, Mexico
| | - F Bellivier
- Psychiatry and Addiction Medicine, Assistance Publique - Hôpitaux de Paris, FondaMental Foundation, INSERM UMR-S1144, Denis Diderot University, René Descartes University, Paris, France
| | - R H Belmaker
- Department of Psychiatry, Faculty of Health Sciences, Beer Sheva Mental Health Center, Ben Gurion University of the Negev, Beer Sheva, Israel
| | - M Berk
- IMPACT Strategic Research Centre, School of Medicine, Barwon Health, Deakin University, Geelong, Vic., Australia.,Department of Psychiatry, Orygen, the National Centre for Excellence in Youth Mental Health, the Centre for Youth Mental Health and the Florey Institute for Neuroscience and Mental Health, University of Melbourne, Parkville, Vic., Australia
| | - Y Bersudsky
- Department of Psychiatry, Faculty of Health Sciences, Beer Sheva Mental Health Center, Ben Gurion University of the Negev, Beer Sheva, Israel
| | - Ş Bicakci
- Department of Psychiatry, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | | | - T D Bjella
- NORMENT - K.G. Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - L Bossini
- Department of Molecular Medicine and Department of Mental Health (DAI), University of Siena and University of Siena Medical Center (AOUS), Siena, Italy
| | - J Cabrera
- Mood Disorders Clinic, Dr. Jose Horwitz Psychiatric Institute, Santiago de Chile, Chile
| | - E Y W Cheung
- Department of General Adult Psychiatry, Castle Peak Hospital, Tuen Mun, Hong Kong
| | - M Del Zompo
- Section of Neurosciences and Clinical Pharmacology, Department of Biomedical Sciences, University of Cagliari, Sardinia, Italy
| | - S Dodd
- IMPACT Strategic Research Centre, School of Medicine, Barwon Health, Deakin University, Geelong, Vic., Australia.,Department of Psychiatry, University of Melbourneo, Parkville, Vic, Australia
| | - M Donix
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - B Etain
- Psychiatry and Addiction Medicine, Assistance Publique - Hôpitaux de Paris, FondaMental Foundation, INSERM UMR-S1144, Denis Diderot University, René Descartes University, Paris, France
| | - A Fagiolini
- Department of Molecular Medicine and Department of Mental Health (DAI), University of Siena and University of Siena Medical Center (AOUS), Siena, Italy
| | - K N Fountoulakis
- Division of Neurosciences, 3rd Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - M A Frye
- Department of Psychiatry & Psychology, Mayo Clinic Depression Center, Mayo Clinic, Rochester, MN, USA
| | - A Gonzalez-Pinto
- Department of Psychiatry, University Hospital of Alava, University of the Basque Country, CIBERSAM, Vitoria, Spain
| | - J F Gottlieb
- Department of Psychiatry, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - P Grof
- Mood Disorders Center of Ottawa, University of Toronto, Toronto, ON, Canada
| | - H Harima
- Department of Psychiatry, Tokyo Metropolitan Matsuzawa Hospital, Setagaya, Tokyo, Japan
| | - C Henry
- AP-HP, Hopitaux Universitaires Henri Mondor and INSERM U955 (IMRB) and Université Paris Est and Institut Pasteur, Unité Perception et Mémoire, Paris, France
| | - E T Isometsä
- Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,National Institute for Health and Welfare, Helsinki, Finland
| | - S Janno
- Department of Psychiatry, University of Tartu, Tartu, Estonia
| | - F Kapczinski
- Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - M Kardell
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - S Khaldi
- Private practice, Tunis, Tunisia
| | - S Kliwicki
- Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland
| | - B König
- BIPOLAR Zentrum Wiener Neustadt, Wiener Neustadt, Austria
| | - T L Kot
- Khanty-Mansiysk Clinical Psychoneurological Hospital, Khanty-Mansiysk, Russia
| | - R Krogh
- Department of Affective Disorders, Q, Mood Disorders Research Unit, Aarhus University Hospital, Aarhus, Denmark
| | - M Kunz
- Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - B Lafer
- Bipolar Disorder Research Program, Department of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil
| | - M Landén
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy, University of Gothenburg, Gothenburg and Mölndal, Sweden.,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - E R Larsen
- Department of Affective Disorders, Q, Mood Disorders Research Unit, Aarhus University Hospital, Aarhus, Denmark
| | - U Lewitzka
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - R W Licht
- Unit for Psychiatric Research, Aalborg University Hospital, Psychiatry, Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - C Lopez-Jaramillo
- Mood Disorders Program, Hospital Universitario San Vicente Fundación, Research Group in Psychiatry, Department of Psychiatry, Faculty of Medicine, Universidad de Antioquia, Medellín, Colombia
| | - G MacQueen
- Department of Psychiatry, Faculty of Medicine, University of Calgary, Calgary, AB, Canada
| | - M Manchia
- Section of Psychiatry, Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
| | - W Marsh
- Department of Psychiatry, University of Massachusetts, Worcester, MA, USA
| | - M Martinez-Cengotitabengoa
- Department of Psychiatry, University Hospital of Alava, University of the Basque Country, CIBERSAM, Vitoria, Spain
| | - I Melle
- NORMENT - K.G. Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - F Meza-Urzúa
- National Institute of Psychiatry '"Ramón de la Fuente Muñiz", Mexico City, Mexico
| | - M Yee Ming
- Department of General Psychiatry, Mood Disorders Unit, Institute of Mental Health, Singapore City, Singapore
| | - S Monteith
- Traverse City Campus, Michigan State University College of Human Medicine, Traverse City, MI, USA
| | - G Morken
- Department of Mental Health, Norwegian University of Science and Technology - NTNU, Trondheim, Norway.,Department of Psychiatry, St Olavs' University Hospital, Trondheim, Norway
| | - E Mosca
- Section of Neurosciences and Clinical Pharmacology, Department of Biomedical Sciences, University of Cagliari, Sardinia, Italy
| | - R Munoz
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA
| | - S V Mythri
- Asha Bipolar Clinic, Asha Hospital, Hyderabad, Telangana, India
| | - F Nacef
- Razi Hospital, Faculty of Medicine, University of Tunis-El Manar, Tunis, Tunisia
| | - R K Nadella
- Department of Psychiatry, NIMHANS, Bangalore, India
| | - F G Nery
- Bipolar Disorder Research Program, Department of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil
| | - R E Nielsen
- Unit for Psychiatric Research, Aalborg University Hospital, Psychiatry, Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - C O'Donovan
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
| | - A Omrani
- Tunisian Bipolar Forum, Érable Médical Cabinet 324, Tunis, Tunisia
| | - Y Osher
- Department of Psychiatry, Faculty of Health Sciences, Beer Sheva Mental Health Center, Ben Gurion University of the Negev, Beer Sheva, Israel
| | - H Østermark Sørensen
- Unit for Psychiatric Research, Aalborg University Hospital, Psychiatry, Aalborg, Denmark
| | - U Ouali
- Razi Hospital, Faculty of Medicine, University of Tunis-El Manar, Tunis, Tunisia
| | - Y Pica Ruiz
- Hospital "Ángeles del Pedregal", Mexico City, Mexico
| | - M Pilhatsch
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - M Pinna
- Lucio Bini Mood Disorder Center, Cagliari, Italy
| | - F D R da Ponte
- Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - D Quiroz
- Deparment of Psychiatry, Diego Portales University, Santiago de Chile, Chile
| | - R Ramesar
- UCT/MRC Human Genetics Research Unit, Division of Human Genetics, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa
| | - N Rasgon
- Department of Psychiatry and Behavioral Sciences, Stanford School of Medicine, Palo Alto, CA, USA
| | - M S Reddy
- Asha Bipolar Clinic, Asha Hospital, Hyderabad, Telangana, India
| | - A Reif
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Johann Wolfgang Goethe-Universität Frankfurt am Main, Frankfurt am Main, Germany
| | - P Ritter
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - J K Rybakowski
- Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland
| | - K Sagduyu
- Department of Psychiatry, University of Missouri Kansas City School of Medicine, Kansas City, MO, USA
| | - Â M Scippa
- Department of Neuroscience and Mental Health, Federal University of Bahia, Salvador, Brazil
| | - E Severus
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - C Simhandl
- BIPOLAR Zentrum Wiener Neustadt, Wiener Neustadt, Austria
| | - D J Stein
- Department of Psychiatry, MRC Unit on Risk & Resilience in Mental Disorders, University of Cape Town, Cape Town, South Africa
| | - S Strejilevich
- Bipolar Disorder Program, Neuroscience Institute, Favaloro University, Buenos Aires, Argentina
| | - M Subramaniam
- Research Division, Institute of Mental Health, Singapore City, Singapore
| | - A H Sulaiman
- Department of Psychological Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - K Suominen
- Department of Social Services and Health Care, Psychiatry, City of Helsinki, Helsinki, Finland
| | - H Tagata
- Department of Psychiatry, Tokyo Metropolitan Matsuzawa Hospital, Setagaya, Tokyo, Japan
| | - Y Tatebayashi
- Schizophrenia & Affective Disorders Research Project, Tokyo Metropolitan Institute of Medical Science, Seatagaya, Tokyo, Japan
| | - L Tondo
- McLean Hospital-Harvard Medical School, Boston, MA, USA.,Mood Disorder Lucio Bini Centers, Cagliari e Roma, Italy
| | - C Torrent
- Clinical Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - A E Vaaler
- Department of Mental Health, Norwegian University of Science and Technology - NTNU, Trondheim, Norway.,Department of Psychiatry, St Olavs' University Hospital, Trondheim, Norway
| | - J Veeh
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Johann Wolfgang Goethe-Universität Frankfurt am Main, Frankfurt am Main, Germany
| | - E Vieta
- Clinical Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - B Viswanath
- Department of Psychiatry, NIMHANS, Bangalore, India
| | - M Yoldi-Negrete
- Consejo Nacional de Ciencia y Tecnología - Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de México, Mexico
| | - M Zetin
- Department of Psychology, Chapman University, Orange, CA, USA
| | - Y Zgueb
- Razi Hospital, Faculty of Medicine, University of Tunis-El Manar, Tunis, Tunisia
| | - P C Whybrow
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior University of California Los Angeles (UCLA), Los Angeles, CA, USA
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12
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Najar H, Joas E, Kardell M, Pålsson E, Landén M. Weight gain with add-on second-generation antipsychotics in bipolar disorder: a naturalistic study. Acta Psychiatr Scand 2017; 135:606-611. [PMID: 28407229 DOI: 10.1111/acps.12737] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/22/2017] [Indexed: 12/31/2022]
Abstract
OBJECTIVE Our aim was to investigate the prevalence and magnitude of weight gain in-patients with bipolar disorder when treated with a second-generation antipsychotic as an add-on treatment to a mood stabilizer in routine clinical practice. METHODS Data were derived from the quality register for bipolar disorder in Sweden (BipoläR). Patients with bipolar disorder who started add-on treatment with a SGA (n = 575) were compared at next yearly follow-up with age and sex matched patients who were only treated with a mood stabilizer (n = 566). The primary outcome measure was change in body weight and body mass index (BMI). We also assessed the prevalence of clinically significant weight gain defined as ≥7% gain in body weight. RESULTS The group that received add-on treatment with antipsychotics neither gained more weight nor were at higher risk for a clinically significant weight gain than the reference group. Instead, factors associated with clinically significant weight gain were female sex, young age, low-baseline BMI, and occurrence of manic/hypomanic episodes. CONCLUSION We found no evidence of an overall increased risk of weight gain for patients with bipolar disorder after receiving add-on SGA to a mood stabilizer in a routine clinical setting.
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Affiliation(s)
- H Najar
- Institute of Neuroscience and Physiology, Section of Psychiatry and Neurochemistry, University of Gothenburg, Gothenburg, Sweden
| | - E Joas
- Institute of Neuroscience and Physiology, Section of Psychiatry and Neurochemistry, University of Gothenburg, Gothenburg, Sweden
| | - M Kardell
- Institute of Neuroscience and Physiology, Section of Psychiatry and Neurochemistry, University of Gothenburg, Gothenburg, Sweden
| | - E Pålsson
- Institute of Neuroscience and Physiology, Section of Psychiatry and Neurochemistry, University of Gothenburg, Gothenburg, Sweden
| | - M Landén
- Institute of Neuroscience and Physiology, Section of Psychiatry and Neurochemistry, University of Gothenburg, Gothenburg, Sweden.,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
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13
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Persson C, Kardell M, Karanti A, Isgren A, Annerbrink K, Landen M. [Prescribed drug use for bipolar disorder type I and II in clinical practice]. Lakartidningen 2017; 114:D77T. [PMID: 28094832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Prescribed drug use for bipolar disorder type I and II in clinical practice Practice guidelines based on available evidence and clinical consensus are available for the treatment of bipolar disorder. We surveyed to which extent those guidelines are implemented in clinical practice in Sweden. We analysed pharmacological treatment in patients with bipolar disorder in 2015 using the national quality register for bipolar disorder (BipoläR). We compared bipolar disorder type I (BDI) with type bipolar disorder type II (BDII). The vast majority of patients were prescribed a mood stabilizer either as monotherapy or as a part of combination therapy (BDI 87%, BDII 83%, p<0.001). Whereas lithium was the most common mood stabilizer in type I (BDI 65%, BDII 40%, p<0.001), lamotrigine was the most common mood stabilizer in type II (BDI 18%, BDII 42%, p<0.001). Antidepressants were less common in BDI than BDII (35% vs. 53%, p<0.001). Antipsychotic drugs (first or second generation) were more frequently used in BDI than BDII (49% vs 35%, p<0.001). Central stimulants were rarely used (BDI 3.1%, BDII 6.6%, p<0.001). Combining a mood stabilizer with an antipsychotic drug was more common in BDI than BDII (27% vs. 12%, p<0.001), whereas combining a mood stabilizer with an antidepressant was less common in BDI than BDII (16% vs 28%, p<0.001). We conclude that most patients are prescribed mood stabilizers and that the differences between BDI and BDII are rational given the differences in clinical manifestations. The use of antidepressants is surprisingly high given the long-standing debate about the risk and effectiveness of this class in bipolar disorder.
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Affiliation(s)
- Charlotte Persson
- Sahlgrenska universitetssjukhuset - Psykiatri Psykos Göteborg, Sweden Sahlgrenska universitetssjukhuset - Psykiatri Psykos Göteborg, Sweden
| | - Mathias Kardell
- BipoläR- Nationella kvalitetsregistret för bipolär affektiv sjukdom - Göteborgs universitet Göteborg, Sweden National Quality Register for bipolar disorder BipoläR - University of Gothenburg Gothenburg, Sweden
| | - Alina Karanti
- Institutionen för neurovetenskap och fysiologi, Göteborgs universitet - Sektionen för psykiatri och neurokemi Göteborg, Sweden Neuroscience and Physiology - Psychiatry and Neurochemistry, University of Gothenburg Gothenburg, Sweden
| | - Anniella Isgren
- Sahlgrenska akademin vid Göteborgs universitet - Institutionen för neurovetenskap och fysiologi Göteborg, Sweden Sahlgrenska akademin vid Göteborgs universitet - Institutionen för neurovetenskap och fysiologi Göteborg, Sweden
| | - Kristina Annerbrink
- Sahlgrenska akademin vid Göteborgs universitet - Institutionen för neurovetenskap och fysiologi Göteborg, Sweden Sahlgrenska akademin vid Göteborgs universitet - Institutionen för neurovetenskap och fysiologi Göteborg, Sweden
| | - Mikael Landen
- Institutionen för neurovetenskap och fysiologi, Göteborgs universitet - Sektionen för psykiatri och neurokemi Göteborg, Sweden Institutionen för neurovetenskap och fysiologi, Göteborgs universitet - Sektionen för psykiatri och neurokemi Göteborg, Sweden
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14
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Kardell M, Magnusson M, Sandborg M, Alm Carlsson G, Jeuthe J, Malusek A. AUTOMATIC SEGMENTATION OF PELVIS FOR BRACHYTHERAPY OF PROSTATE. Radiat Prot Dosimetry 2016; 169:398-404. [PMID: 26567322 DOI: 10.1093/rpd/ncv461] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Advanced model-based iterative reconstruction algorithms in quantitative computed tomography (CT) perform automatic segmentation of tissues to estimate material properties of the imaged object. Compared with conventional methods, these algorithms may improve quality of reconstructed images and accuracy of radiation treatment planning. Automatic segmentation of tissues is, however, a difficult task. The aim of this work was to develop and evaluate an algorithm that automatically segments tissues in CT images of the male pelvis. The newly developed algorithm (MK2014) combines histogram matching, thresholding, region growing, deformable model and atlas-based registration techniques for the segmentation of bones, adipose tissue, prostate and muscles in CT images. Visual inspection of segmented images showed that the algorithm performed well for the five analysed images. The tissues were identified and outlined with accuracy sufficient for the dual-energy iterative reconstruction algorithm whose aim is to improve the accuracy of radiation treatment planning in brachytherapy of the prostate.
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Affiliation(s)
- M Kardell
- Medical Radiation Physics, Department of Medical and Health Sciences and Center for Medical Image Science and Visualisation, Linköping University, SE-58185 Linköping, Sweden
| | - M Magnusson
- Medical Radiation Physics, Department of Medical and Health Sciences and Center for Medical Image Science and Visualisation, Linköping University, SE-58185 Linköping, Sweden Computer Vision Laboratory, Department of Electrical Engineering, Linköping University, SE-58183 Linköping, Sweden
| | - M Sandborg
- Medical Radiation Physics, Department of Medical and Health Sciences and Center for Medical Image Science and Visualisation, Linköping University, SE-58185 Linköping, Sweden
| | - G Alm Carlsson
- Medical Radiation Physics, Department of Medical and Health Sciences and Center for Medical Image Science and Visualisation, Linköping University, SE-58185 Linköping, Sweden
| | - J Jeuthe
- Medical Radiation Physics, Department of Medical and Health Sciences and Center for Medical Image Science and Visualisation, Linköping University, SE-58185 Linköping, Sweden
| | - A Malusek
- Medical Radiation Physics, Department of Medical and Health Sciences and Center for Medical Image Science and Visualisation, Linköping University, SE-58185 Linköping, Sweden
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15
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Karanti A, Kardell M, Lundberg U, Landén M. Changes in mood stabilizer prescription patterns in bipolar disorder. J Affect Disord 2016; 195:50-6. [PMID: 26859073 DOI: 10.1016/j.jad.2016.01.043] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2015] [Revised: 01/06/2016] [Accepted: 01/28/2016] [Indexed: 02/01/2023]
Abstract
BACKGROUND Lithium is a first line treatment option in bipolar disorder, but several alternative treatments have been introduced in recent years, such as antiepileptic and atypical antipsychotic drugs. Little is known about how this has changed the prescription patterns. We investigated possible changes in the use of mood stabilizers and antidepressants in Sweden during 2007-2013. METHODS Data was collected from Swedish registers: the National Quality Assurance Register for bipolar disorder (BipoläR), the Prescribed Drug Register, and the Patient Register. Logistic regression models with drug use as outcomes were used to adjust for confounding factors such as sex, age, year of registration, and subtypes of bipolar disorder. RESULTS In both bipolar subtypes, lithium use decreased steadily during the study period, while the use of lamotrigine and quetiapine increased. The use of valproate decreased in bipolar II disorder and the use of olanzapine decreased among women. The use of antidepressant remained principally unchanged but increased somewhat in bipolar I disorder. LIMITATIONS We only report data from 2007 as the coverage of BipoläR prior to 2007 was too low to allow for reliable analyses. CONCLUSION Significant changes in the prescription of drugs in the treatment of bipolar disorder have occurred in recent years in Sweden. Further studies are needed to clarify whether these changes alter the outcome in bipolar disorder.
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Affiliation(s)
- Alina Karanti
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
| | - Mathias Kardell
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; National Quality Register for Bipolar Disorder (BipoläR), Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Ulrika Lundberg
- National Quality Register for Bipolar Disorder (BipoläR), Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Mikael Landén
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; National Quality Register for Bipolar Disorder (BipoläR), Sahlgrenska University Hospital, Gothenburg, Sweden; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
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Karanti A, Kardell M, Lundberg U, Landén M. [Changes in prescription patterns to patients with bipolar syndromes. Increased use of lamotrigine and decreased use of lithium]. Lakartidningen 2014; 111:2284-2286. [PMID: 25514669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Lithium is a first line option in the maintenance treatment of bipolar disorder, but several alternative treatment regimens have been introduced in recent years, among them treatment with antiepileptic compounds and atypical antipsychotic drugs. Little is known about if and how this has changed the prescription patterns of mood stabilizers. We analysed trends in prescription of mood stabilisers in Sweden using the national quality register for bipolar disorder (BipoläR), the Prescribed Drug Register, and the Patient Register during the years 2007-2011. We found that lithium use decreased while lamotrigine use increased in bipolar patients. These changes could not be ex-plained by differences in bipolar subtypes; lithium use decreased in both bipolar type I and type II, and the use of lamotrigine increased in bipolar type II. Lithium use was more common in men, whereas lamotrigine use was more common in women. The prescription of other mood stabilisers did not change during these years.
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Affiliation(s)
- Alina Karanti
- Institutionen för neurovetenskap och fysiologi, Göteborgs universitet - Sektionen för psykiatri och neurokemi Göteborg, Sweden Neuroscience and Physiology - Psychiatry and Neurochemistry, University of Gothenburg Gothenburg, Sweden
| | - Mathias Kardell
- BipoläR- Nationella kvalitetsregistret för bipolär affektiv sjukdom - Göteborgs universitet Göteborg, Sweden National Quality Register for bipolar disorder BipoläR - University of Gothenburg Gothenburg, Sweden
| | - Ulrika Lundberg
- BipoläR- Nationella kvalitetsregistret för bipolär affektiv sjukdom - Göteborgs universitet Göteborg, Sweden - Borås, Sweden
| | - Mikael Landén
- Institutionen för neurovetenskap och fysiologi, Göteborgs universitet - Sektionen för psykiatri och neurokemi Göteborg, Sweden Institutionen för neurovetenskap och fysiologi, Göteborgs universitet - Sektionen för psykiatri och neurokemi Göteborg, Sweden
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