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Gorraiz G, Porta G, McMakin DL, Kennard BD, Douaihy AB, Biernesser C, Foxwell AA, Wolfe K, Goldstein T, Brent DA. Factors Associated With Reasons for Living Among Suicidal Adolescents. Arch Suicide Res 2024; 28:471-481. [PMID: 37013700 PMCID: PMC10548347 DOI: 10.1080/13811118.2023.2190367] [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] [Indexed: 04/05/2023]
Abstract
OBJECTIVE The objective of this study was to identify baseline demographic and clinical factors associated with higher scores on the Reasons for Living Inventory for Adolescents (RFL-A) at baseline and over follow-up. METHOD Using data from a pilot clinical trial of a brief intervention for suicidal youth transitioning from inpatient to outpatient, we identified univariate associations of baseline characteristics with RFL-A and used regression to identify the most parsimonious subset of these variables. Finally, we examined to what extent changes in these characteristics over time were related to changes in RFL-A. RESULTS Univariate analyses found that better external functional emotion regulation and social support were associated with higher RFL-A scores; more self-reported depression, internal dysfunctional emotion regulation, sleep disturbance, anxiety, and distress tolerance were associated with lower RFL-A scores. Multiple linear regression identified internal dysfunctional emotion regulation and external functional emotion regulation as the most parsimonious set of characteristics associated with RFL-A. Improvement in internal emotion regulation, sleep, and depression were related to improvements in RFL-A over time. CONCLUSION Our findings indicate that emotion regulation-specifically maladaptive internal strategies and use of external resources-is strongly associated with RFL-A. Improvements in internal emotion regulation (r = 0.57), sleep (r = -0.45), and depression (r = -0.34) were related to increases in RFL-A.
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Affiliation(s)
- G. Gorraiz
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - G. Porta
- UPMC Western Psychiatric Hospital, Pittsburgh, PA, United States
| | - D. L. McMakin
- Department of Psychology, Florida International University, Miami, FL, United States
| | - B. D. Kennard
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, United States
| | - A. B. Douaihy
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
- UPMC Western Psychiatric Hospital, Pittsburgh, PA, United States
| | - C. Biernesser
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - A. A. Foxwell
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, United States
- Children’s Health Medical Center, Dallas, TX, United States
| | - K. Wolfe
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, United States
- Children’s Health Medical Center, Dallas, TX, United States
| | - T. Goldstein
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
- UPMC Western Psychiatric Hospital, Pittsburgh, PA, United States
| | - D. A. Brent
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
- UPMC Western Psychiatric Hospital, Pittsburgh, PA, United States
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Levenson JC, Joseph HM, Merranko J, Hafeman DM, Monk K, Goldstein BI, Axelson D, Sakolsky D, Diler RS, Goldstein T, Birmaher B. Sleep patterns among preschool offspring of parents with and without psychopathology: Association with the development of psychopathology in childhood. Bipolar Disord 2024; 26:176-185. [PMID: 37558614 PMCID: PMC10853485 DOI: 10.1111/bdi.13376] [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] [Indexed: 08/11/2023]
Abstract
BACKGROUND Disturbed sleep during early childhood predicts social-emotional problems. However, it is not known how various early childhood sleep phenotypes are associated with the development of childhood psychopathology, nor whether these relationships vary as a function of parental psychopathology. We identified sleep phenotypes among preschool youth; examined whether these phenotypes were associated with child and parent factors; and determined if early sleep phenotypes predicted later childhood psychopathology. METHODS Using data from the Pittsburgh Bipolar Offspring study, parents with bipolar disorder (BD), non-BD psychopathology, and healthy controls reported about themselves and their offspring (n = 218) when their children were ages 2-5. Offspring and parents were interviewed directly approximately every 2 years from ages 6-18. Latent class analysis (LCA) identified latent sleep classes; we compared these classes on offspring demographics, parental sleep variables, and parental diagnoses. Kaplan-Meier survival models estimated hazard of developing any new-onset Axis-I disorders, as well as BD specifically, for each class. RESULTS The optimal LCA solution featured four sleep classes, which we characterized as (1) good sleep, (2) wake after sleep onset problems, (3) bedtime problems (e.g., trouble falling asleep, resists going to bed), and (4) poor sleep generally. Good sleepers tended to have significantly less parental psychopathology than the other three classes. Risk of developing new-onset Axis-I disorders was highest among the poor sleep class and lowest among the good sleep class. CONCLUSIONS Preschool sleep phenotypes are an important predictor of the development of psychopathology. Future work is needed to understand the biopsychosocial processes underlying these trajectories.
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Affiliation(s)
- Jessica C Levenson
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
- Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Heather M Joseph
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
- Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - John Merranko
- Western Psychiatric Hospital, UPMC, Pittsburgh, Pennsylvania, USA
| | - Danella M Hafeman
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Kelly Monk
- Western Psychiatric Hospital, UPMC, Pittsburgh, Pennsylvania, USA
| | - Benjamin I Goldstein
- Center for Addiction and Mental Health, University of Toronto Faculty of Medicine, Toronto, Ontario, Canada
| | - David Axelson
- Department of Psychiatry and Behavioral Health, Nationwide Children's Hospital and The Ohio State College of Medicine, Columbus, Ohio, USA
| | - Dara Sakolsky
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Rasim S Diler
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Tina Goldstein
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
- Department of Psychology, University of Pittsburgh Dietrich School of Arts and Sciences, Pittsburgh, Pennsylvania, USA
| | - Boris Birmaher
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
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3
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Biernesser C, Win E, Escobar-Viera C, Farzan R, Rose M, Goldstein T. Development and codesign of flourish: A digital suicide prevention intervention for LGBTQ+ youth who have experienced online victimization. Internet Interv 2023; 34:100663. [PMID: 37693013 PMCID: PMC10491770 DOI: 10.1016/j.invent.2023.100663] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 08/28/2023] [Accepted: 08/29/2023] [Indexed: 09/12/2023] Open
Abstract
Background LGBTQ+ youth experience disproportionately high rates of online victimization (OV), referring to harmful remarks, images, or behaviors in online settings, which is associated with suicidal risk. Current services have gaps in supporting LGBTQ+ youth facing OV events. To address these gaps, this study aims to develop Flourish, a digital suicide prevention intervention for LGBTQ+ youth who have experienced OV. Methods Qualitative interviews were conducted with 20 LGBTQ+ youth with past-year history of OV and lifetime history of suicidality, 11 of their parents, and 10 LGBTQ+-serving professionals. Subsequently, an iterative codesign process was conducted with 22 youth through individual and group design sessions, followed by usability testing. Data were recorded and transcribed. Qualitative interviews were analyzed using a qualitative description approach, and data from design sessions and usability testing were analyzed using rapid qualitative techniques. Results Interviews with youth, parents, and professionals suggested preferences for Flourish to be a partially automated, text message intervention leveraging web-based content that is a safe space for LGBTQ+ youth to seek support for OV through education, coping skills, and help-seeking resources. School and mental health services professionals considered the potential for implementing Flourish within youth services settings. Usability testing, assessed through the System Usability Scale, yielded an average rating of 91, indicating excellent perceived usability. Conclusions Flourish has potential to be an acceptable intervention to support LGBTQ+ youth following OV. Future steps will include testing the feasibility and efficacy of Flourish and further examining Flourish's potential for implementation within services for LGBTQ+ youth.
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Affiliation(s)
- Candice Biernesser
- University of Pittsburgh School of Medicine, Department of Psychiatry, United States of America
| | - Emma Win
- University of Pittsburgh School of Medicine, Department of Psychiatry, United States of America
- University of Pittsburgh School of Social Work, United States of America
| | - César Escobar-Viera
- University of Pittsburgh School of Medicine, Department of Psychiatry, United States of America
| | - Rosta Farzan
- University of Pittsburgh, School of Computing and Information, United States of America
| | - Morgan Rose
- University of Pittsburgh School of Medicine, Department of Psychiatry, United States of America
- University of Pittsburgh Dietrich School of Arts and Science, Department of Psychology, United States of America
| | - Tina Goldstein
- University of Pittsburgh School of Medicine, Department of Psychiatry, United States of America
- University of Pittsburgh Dietrich School of Arts and Science, Department of Psychology, United States of America
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4
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Ratheesh A, Hett D, Ramain J, Wong E, Berk L, Conus P, Fristad MA, Goldstein T, Hillegers M, Jauhar S, Kessing LV, Miklowitz DJ, Murray G, Scott J, Tohen M, Yatham LN, Young AH, Berk M, Marwaha S. A systematic review of interventions in the early course of bipolar disorder I or II: a report of the International Society for Bipolar Disorders Taskforce on early intervention. Int J Bipolar Disord 2023; 11:1. [PMID: 36595095 PMCID: PMC9810772 DOI: 10.1186/s40345-022-00275-3] [Citation(s) in RCA: 4] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 11/14/2022] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Given the likelihood of progressive illness in bipolar disorder (BD), it is important to understand the benefits and risks of interventions administered early in illness course. We conducted a systematic review of the effectiveness of interventions in the early course of BD I or II. METHODS We completed a systematic search on MEDLINE, PsycINFO, EMBASE, the Cochrane Central Register of Controlled Trials, CINAHL and Google Scholar from 1/1/1979 till 14/9/2022. We included controlled trials examining intervention effects on symptomatic, course, functional and tolerability outcomes of patients in the 'early course' of BD I or II. We classified patients to be in early course if they (a) were seeking help for the first time for a manic episode, (b) had a lifetime history of up to 3 manic episodes, or (c) had up to 6 lifetime mood episodes. Evidence quality was assessed using the GRADE approach. RESULTS From 4135 unique publications we included 25 reports representing 2212 participants in 16 randomized studies, and 17,714 participants from nine non-randomized studies. Available evidence suggested that in early illness course, lithium use was associated with lower recurrence risk compared with other mood stabilizers. Mood stabilizers were also associated with better global functioning, compared with the use of antipsychotics in the medium term. While summative findings regarding psychological therapies were limited by heterogeneity, family-focused and cognitive-behavioral interventions were associated with reduced recurrence risk or improved symptomatic outcomes. There was some evidence that the same pharmacological interventions were more efficacious in preventing recurrences when utilized in earlier rather than later illness course. CONCLUSIONS AND RECOMMENDATIONS While there are promising initial findings, there is a need for more adequately powered trials to examine the efficacy and tolerability of interventions in youth and adults in early illness course. Specifically, there is a compelling need to compare the relative benefits of lithium with other pharmacological agents in preventing recurrences. In addition to symptomatic outcomes, there should be a greater focus on functional impact and tolerability. Effective pharmacological and psychological interventions should be offered to those in early course of BD, balancing potential risks using shared decision-making approaches.
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Affiliation(s)
- A. Ratheesh
- grid.488501.00000 0004 8032 6923Orygen, 35 Poplar Road, Parkville, VIC Australia ,grid.1008.90000 0001 2179 088XCentre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
| | - D. Hett
- grid.6572.60000 0004 1936 7486Institute for Mental Health, University of Birmingham, Birmingham, UK ,Birmingham and Solihull Mental Health NHS Trust, Birmingham, UK
| | - J. Ramain
- grid.8515.90000 0001 0423 4662TIPP Program, Service of General Psychiatry, Department of Psychiatry, Lausanne University Hospital and Lausanne University, Lausanne, Switzerland
| | - E. Wong
- grid.1008.90000 0001 2179 088XCentre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
| | - L. Berk
- grid.414257.10000 0004 0540 0062IMPACT-The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Deakin University, Geelong, Australia
| | - P. Conus
- grid.8515.90000 0001 0423 4662TIPP Program, Service of General Psychiatry, Department of Psychiatry, Lausanne University Hospital and Lausanne University, Lausanne, Switzerland
| | - M. A. Fristad
- grid.261331.40000 0001 2285 7943Nationwide Children’s Hospital, The Ohio State University, Columbus, USA
| | - T. Goldstein
- grid.21925.3d0000 0004 1936 9000Department of Psychiatry, University of Pittsburgh, Pittsburgh, USA
| | - M. Hillegers
- grid.5645.2000000040459992XDepartment of Child and Adolescent Psychiatry/Psychology, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - S. Jauhar
- grid.13097.3c0000 0001 2322 6764Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK ,grid.415717.10000 0001 2324 5535South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Monks Orchard Road, Beckenham, Kent, BR3 3BX UK
| | - L. V. Kessing
- grid.475435.4Copenhagen Affective Disorder Research Center (CADIC), Psychiatric Center Copenhagen, Copenhagen, Denmark ,grid.5254.60000 0001 0674 042XDepartment of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - D. J. Miklowitz
- grid.19006.3e0000 0000 9632 6718Semel Institute for Neuroscience and Human Behavior, Los Angeles School of Medicine, University of California, Los Angeles, USA
| | - G. Murray
- grid.1027.40000 0004 0409 2862Centre for Mental Health, Swinburne University of Technology, Melbourne, Australia
| | - J. Scott
- grid.1006.70000 0001 0462 7212Institute of Neuroscience, Newcastle University, Newcastle Upon Tyne, UK
| | - M. Tohen
- grid.266832.b0000 0001 2188 8502Department of Psychiatry and Behavioral Sciences, University of New Mexico, Albuquerque, NM USA
| | - L. N. Yatham
- grid.17091.3e0000 0001 2288 9830Department of Psychiatry, University of British Columbia, Vancouver, Canada
| | - A. H. Young
- grid.13097.3c0000 0001 2322 6764Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK ,grid.415717.10000 0001 2324 5535South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Monks Orchard Road, Beckenham, Kent, BR3 3BX UK
| | - M. Berk
- grid.414257.10000 0004 0540 0062IMPACT-The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Deakin University, Geelong, Australia
| | - S. Marwaha
- grid.6572.60000 0004 1936 7486Institute for Mental Health, University of Birmingham, Birmingham, UK ,Birmingham and Solihull Mental Health NHS Trust, Birmingham, UK
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Anmella G, Faurholt‐Jepsen M, Hidalgo‐Mazzei D, Radua J, Passos IC, Kapczinski F, Minuzzi L, Alda M, Meier S, Hajek T, Ballester P, Birmaher B, Hafeman D, Goldstein T, Brietzke E, Duffy A, Haarman B, López‐Jaramillo C, Yatham LN, Lam RW, Isometsa E, Mansur R, McIntyre RS, Mwangi B, Vieta E, Kessing LV. Smartphone-based interventions in bipolar disorder: Systematic review and meta-analyses of efficacy. A position paper from the International Society for Bipolar Disorders (ISBD) Big Data Task Force. Bipolar Disord 2022; 24:580-614. [PMID: 35839276 PMCID: PMC9804696 DOI: 10.1111/bdi.13243] [Citation(s) in RCA: 8] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND The clinical effects of smartphone-based interventions for bipolar disorder (BD) have yet to be established. OBJECTIVES To examine the efficacy of smartphone-based interventions in BD and how the included studies reported user-engagement indicators. METHODS We conducted a systematic search on January 24, 2022, in PubMed, Scopus, Embase, APA PsycINFO, and Web of Science. We used random-effects meta-analysis to calculate the standardized difference (Hedges' g) in pre-post change scores between smartphone intervention and control conditions. The study was pre-registered with PROSPERO (CRD42021226668). RESULTS The literature search identified 6034 studies. Thirteen articles fulfilled the selection criteria. We included seven RCTs and performed meta-analyses comparing the pre-post change in depressive and (hypo)manic symptom severity, functioning, quality of life, and perceived stress between smartphone interventions and control conditions. There was significant heterogeneity among studies and no meta-analysis reached statistical significance. Results were also inconclusive regarding affective relapses and psychiatric readmissions. All studies reported positive user-engagement indicators. CONCLUSION We did not find evidence to support that smartphone interventions may reduce the severity of depressive or manic symptoms in BD. The high heterogeneity of studies supports the need for expert consensus to establish ideally how studies should be designed and the use of more sensitive outcomes, such as affective relapses and psychiatric hospitalizations, as well as the quantification of mood instability. The ISBD Big Data Task Force provides preliminary recommendations to reduce the heterogeneity and achieve more valid evidence in the field.
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Affiliation(s)
- Gerard Anmella
- Digital Innovation Group, Bipolar and Depressive Disorders Unit, Institute of NeuroscienceHospital Clinic, University of Barcelona, IDIBAPS, CIBERSAMBarcelonaCataloniaSpain
| | - Maria Faurholt‐Jepsen
- Copenhagen Affective Disorder research Center (CADIC)Psychiatric Center CopenhagenCopenhagenDenmark
| | - Diego Hidalgo‐Mazzei
- Digital Innovation Group, Bipolar and Depressive Disorders Unit, Institute of NeuroscienceHospital Clinic, University of Barcelona, IDIBAPS, CIBERSAMBarcelonaCataloniaSpain
| | - Joaquim Radua
- Imaging of Mood‐ and Anxiety‐Related Disorders (IMARD) groupIDIBAPS, CIBERSAMBarcelonaSpain,Early Psychosis: Interventions and Clinical‐detection (EPIC) lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & NeuroscienceKing's College LondonLondonUK,Centre for Psychiatric Research and Education, Department of Clinical NeuroscienceKarolinska InstitutetStockholmSweden
| | - Ives C. Passos
- Laboratory of Molecular Psychiatry and Bipolar Disorder Program, Programa de Pós‐Graduação em Psiquiatria e Ciências do Comportamento, Centro de Pesquisa Experimental do Hospital de Clínicas de Porto AlegreUniversidade Federal do Rio Grande do SulPorto AlegreBrazil
| | - Flavio Kapczinski
- Department of Psychiatry and Behavioural NeurosciencesMcMaster UniversityHamiltonONCanada
| | - Luciano Minuzzi
- Department of Psychiatry and Behavioural NeurosciencesMcMaster UniversityHamiltonONCanada
| | - Martin Alda
- Department of PsychiatryDalhousie UniversityHalifaxNSCanada
| | - Sandra Meier
- Department of PsychiatryDalhousie UniversityHalifaxNSCanada
| | - Tomas Hajek
- Department of PsychiatryDalhousie UniversityHalifaxNSCanada,National Institute of Mental HealthKlecanyCzech Republic
| | - Pedro Ballester
- Neuroscience Graduate ProgramMcMaster UniversityHamiltonCanada
| | - Boris Birmaher
- Department of Psychiatry, Western Psychiatric Institute and ClinicUniversity of Pittsburgh School of MedicinePittsburghPAUSA
| | - Danella Hafeman
- Department of Psychiatry, Western Psychiatric Institute and ClinicUniversity of Pittsburgh School of MedicinePittsburghPAUSA
| | - Tina Goldstein
- Department of Psychiatry, Western Psychiatric Institute and ClinicUniversity of Pittsburgh School of MedicinePittsburghPAUSA
| | - Elisa Brietzke
- Department of PsychiatryQueen's UniversityKingstonONCanada
| | - Anne Duffy
- Department of PsychiatryQueen's UniversityKingstonONCanada
| | - Benno Haarman
- Department of PsychiatryUniversity Medical Center Groningen, University of GroningenGroningenThe Netherlands
| | - Carlos López‐Jaramillo
- Research Group in Psychiatry, Department of Psychiatry, Faculty of MedicineUniversity of AntioquiaMedellínColombia,Mood Disorders ProgramHospital Universitario San Vicente FundaciónMedellínColombia
| | - Lakshmi N. Yatham
- Department of PsychiatryUniversity of British ColumbiaVancouverBCCanada
| | - Raymond W. Lam
- Department of PsychiatryUniversity of British ColumbiaVancouverBCCanada
| | - Erkki Isometsa
- Department of PsychiatryUniversity of Helsinki and Helsinki University Central HospitalHelsinkiFinland
| | - Rodrigo Mansur
- Mood Disorders Psychopharmacology Unit (MDPU)University Health Network, University of TorontoTorontoONCanada
| | | | - Benson Mwangi
- Department of Psychiatry and Behavioral Sciences, UT Center of Excellence on Mood Disorders, McGovern Medical SchoolThe University of Texas Health Science Center at HoustonHoustonTXUSA
| | - Eduard Vieta
- Digital Innovation Group, Bipolar and Depressive Disorders Unit, Institute of NeuroscienceHospital Clinic, University of Barcelona, IDIBAPS, CIBERSAMBarcelonaCataloniaSpain
| | - Lars Vedel Kessing
- Copenhagen Affective Disorder research Center (CADIC)Psychiatric Center CopenhagenCopenhagenDenmark,Department of Clinical MedicineUniversity of CopenhagenCopenhagenDenmark
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Birmaher B, Merranko J, Hafeman D, Zwicker A, Goldstein B, Axelson D, Goldstein T, Sakolsky D, Diler R, Uher R. The role of bipolar polygenic risk score in the familial transmission of bipolar disorder-An updated analysis. Bipolar Disord 2022; 24:437-440. [PMID: 35319812 DOI: 10.1111/bdi.13205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Boris Birmaher
- Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - John Merranko
- Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Danella Hafeman
- Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Alyson Zwicker
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada.,Dalhousie Medicine New Brunswick, Dalhousie University, Saint John, New Brunswick, Canada
| | - Benjamin Goldstein
- Center for Addiction and Mental Health, University of Toronto Faculty of Medicine, Ontario, Canada
| | - David Axelson
- Nationwide Children's Hospital and The Ohio State College of Medicine, Columbus, Ohio, USA
| | - Tina Goldstein
- Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Dara Sakolsky
- Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Rasim Diler
- Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Rudolf Uher
- Department of Psychiatry, Dalhousie University, Nova Scotia, Canada
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7
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Birmaher B, Hafeman D, Merranko J, Zwicker A, Goldstein B, Goldstein T, Axelson D, Monk K, Hickey MB, Sakolsky D, Iyengar S, Diler R, Nimgaonkar V, Uher R. Role of Polygenic Risk Score in the Familial Transmission of Bipolar Disorder in Youth. JAMA Psychiatry 2022; 79:160-168. [PMID: 34935868 PMCID: PMC8696688 DOI: 10.1001/jamapsychiatry.2021.3700] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
IMPORTANCE Establishing genetic contributions to the transmission of bipolar disorder (BD) from parents to offspring may inform the risk of developing this disorder and further serve to validate BD in youth. OBJECTIVE To evaluate the specific association of BD polygenic risk scores (PRSs) on the familial transmission and validity of pediatric BD. DESIGN, SETTING, AND PARTICIPANTS This community-based case-control longitudinal study (Pittsburgh Biological Offspring Study) included parents with BD I/II and their offspring and parents without BD (healthy or non-BD psychopathology) and their offspring. Participants were recruited between March 2001 and May 2007, and analysis took place from December 2020 to September 2021. EXPOSURES PRSs for BD, major depressive disorder, schizophrenia, and attention-deficit/hyperactivity disorder. MAIN OUTCOMES AND MEASURES Participants were prospectively evaluated using standardized interviews blind to parental diagnosis. DNA was extracted from saliva and genotyped. PRSs were constructed based on independent large-scale genome-wide association studies. RESULTS A total of 156 parents with BD I/II and 180 parents without BD (mean [SD] age, 39.6 [7.9] years; 241 female [72%]) as well as 251 offspring of parents with BD and 158 offspring of parents without BD (mean [SD] age, 10.4 [4.7] years; 213 female [52%]) of European ancestry were analyzed. Participants were assessed a mean of 6.7 times during a mean (SD) of 13 (3.4) years of follow-up (84% retention). More offspring of parents with BD developed BD (58 [23.1%] vs 8 [5.1%]; P < .001) and depression (126 [50.2%] vs 52 [32.9%]; P < .001) compared with offspring of parents without BD. BD PRS was higher in both parents and offspring with BD than parents and offspring without BD (parents: odds ratio, 1.50; 95% CI, 1.19-1.89; P < .001; explained 4.8% of the phenotypic variance vs offspring: hazard ratio, 1.34; 95% CI, 1.03-1.7; P = .02; explained 5.0% of the phenotypic variance). BD PRS did not differ across BD subtypes. In a model combining parental and offspring BD PRS, the parental BD PRS association with offspring BD was fully mediated by offspring BD PRS (hazard ratio, 1.40; 95% CI, 1.05-1.86; P = .02). Parental BD had a stronger direct association than parental or offspring BD PRS with offspring BD risk (hazard ratio, 5.21; 95% CI, 1.86-14.62; P = .002), explaining 30% of the variance. Parental and offspring BD PRS explained 6% of the BD onset variance beyond parental diagnosis. There were no significant between-group differences in PRSs for major depressive disorder, schizophrenia, and attention-deficit/hyperactivity disorder in parents or offspring and they were not significantly associated with BD onset. CONCLUSIONS AND RELEVANCE The findings of this study add to the extant clinical validation of BD in youth. Parental BD and offspring BD PRS independently associated with the risk of BD in offspring. Although this is promising, the association of BD PRS was relatively small and cannot be used alone to determine BD risk until further developments occur.
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Affiliation(s)
- Boris Birmaher
- Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Danella Hafeman
- Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - John Merranko
- Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Alyson Zwicker
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada,Dalhousie Medicine New Brunswick, Dalhousie University, St John, New Brunswick, Canada
| | - Benjamin Goldstein
- Center for Addiction and Mental Health, University of Toronto Faculty of Medicine, Toronto, Ontario, Canada
| | - Tina Goldstein
- Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - David Axelson
- Nationwide Children’s Hospital and Ohio State College of Medicine, Columbus
| | - Kelly Monk
- Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Mary Beth Hickey
- Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Dara Sakolsky
- Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | | | - Rasim Diler
- Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | | | - Rudolf Uher
- Department of Psychiatry, Dalhousie University, Nova Scotia, Canada
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Kruzan KP, Meyerhoff J, Biernesser C, Goldstein T, Reddy M, Mohr DC. Centering Lived Experience in Developing Digital Interventions for Suicide and Self-injurious Behaviors: User-Centered Design Approach. JMIR Ment Health 2021; 8:e31367. [PMID: 34951602 PMCID: PMC8742214 DOI: 10.2196/31367] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 09/13/2021] [Accepted: 10/07/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The prevalence of self-injurious thoughts and behaviors (SITB) signals a growing public health crisis. Despite a recognized need for improved and scalable interventions, the field of SITB intervention faces several challenges: existing interventions are often time and resource intensive, most individuals with SITB do not seek formal mental health care, and efficacious treatments are characterized by small effects. Combined, these challenges indicate a need for improved SITB interventions for individuals in formal treatment and those who are not treatment engaged but are at high risk of worsening mental health and future suicide attempts. OBJECTIVE We present a methodological approach and set of techniques that may address these challenges by centering the lived experience of individuals with SITB in the process of developing needed services: user-centered design (UCD). METHODS We highlight the value of UCD in the context of digital interventions for SITB by describing the UCD approach and explicating how it can be leveraged to include lived experience throughout the development and evaluation process. We provide a detailed case example highlighting 3 phases of the early development process that can be used to design an intervention that is engaging and meets end-user needs. In addition, we point to novel applications of UCD to complement new directions in SITB research. RESULTS In this paper, we offer a 2-pronged approach to meet these challenges. First, in terms of addressing access to effective interventions, digital interventions hold promise to extend the reach of evidence-based treatments outside of brick-and-mortar health care settings. Second, to address challenges related to treatment targets and engagement, we propose involving individuals with lived experience in the design and research process. CONCLUSIONS UCD offers a well-developed and systematic process to center the unique needs, preferences, and perceived barriers of individuals with lived SITB experience in the development and evaluation of digital interventions.
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Affiliation(s)
- Kaylee Payne Kruzan
- Center for Behavioral Intervention Technologies, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Jonah Meyerhoff
- Center for Behavioral Intervention Technologies, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Candice Biernesser
- Department of Psychiatry, University of Pittsburgh Medical Center, Pittsburgh, PA, United States
| | - Tina Goldstein
- Department of Psychiatry, University of Pittsburgh Medical Center, Pittsburgh, PA, United States
| | - Madhu Reddy
- Department of Informatics, Donald Bren School of Information and Computer Sciences, University of California, Irvine, Irvine, CA, United States
| | - David C Mohr
- Center for Behavioral Intervention Technologies, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
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9
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Hamilton JL, Biernesser C, Moreno MA, Porta G, Hamilton E, Johnson K, Poling KD, Sakolsky D, Brent D, Goldstein T. Social media use and prospective suicidal thoughts and behaviors among adolescents at high risk for suicide. Suicide Life Threat Behav 2021; 51:1203-1212. [PMID: 34533227 PMCID: PMC8729160 DOI: 10.1111/sltb.12801] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 01/28/2021] [Revised: 05/19/2021] [Accepted: 08/17/2021] [Indexed: 01/21/2023]
Abstract
OBJECTIVE To examine the relationship between social media use and suicidal thoughts and behaviors among adolescents in the first 30 days of an intensive outpatient program (IOP) for depression and suicidality. METHOD Participants included 100 adolescents who enrolled in an IOP for depression and suicidality and completed baseline measures of social media and weekly measures of depression and suicidal thoughts and behaviors at clinical visits over the next month. RESULTS Lower levels of social media use (overall and messaging) were associated with a greater likelihood of having suicidal ideation with plan over the next 30 days. There was no effect on suicidal behavior. Multilevel modeling indicated no main effects of social media use on depression or average days of suicidal thoughts. However, individuals with lower levels of social media use maintained more depression symptoms and days with passive death wish across the first month of treatment. CONCLUSIONS Among adolescents at high risk for suicide, less engagement in social media may reflect social anhedonia or withdrawal, which may heighten risk for more severe suicidal ideation or impede initial treatment. Findings highlight the importance of considering social media as an additional context when assessing social dysfunction in treatment for depression and suicidality.
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Affiliation(s)
| | | | - Megan A. Moreno
- Department of Pediatrics, University of Wisconsin School of Medicine
| | - Giovanna Porta
- Department of Psychiatry, University of Pittsburgh Medical Center
| | - Edward Hamilton
- Department of Psychiatry, University of Pittsburgh Medical Center
| | - Kelsey Johnson
- Department of Psychiatry, University of Pittsburgh Medical Center
| | | | - Dara Sakolsky
- Department of Psychiatry, University of Pittsburgh Medical Center
| | - David Brent
- Department of Psychiatry, University of Pittsburgh Medical Center
| | - Tina Goldstein
- Department of Psychiatry, University of Pittsburgh Medical Center
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10
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Suffoletto B, Goldstein T, Brent D. A Text Message Intervention for Adolescents With Depression and Their Parents or Caregivers to Overcome Cognitive Barriers to Mental Health Treatment Initiation: Focus Groups and Pilot Trial. JMIR Form Res 2021; 5:e30580. [PMID: 34751665 PMCID: PMC8663469 DOI: 10.2196/30580] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 08/12/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Many adolescents with depression do not pursue mental health treatment following a health care provider referral. We developed a theory-based automated SMS text message intervention (Text to Connect [T2C]) that attempts to reduce cognitive barriers to the initiation of mental health care. OBJECTIVE In this two-phase study, we seek to first understand the potential of T2C and then test its engagement, usability, and potential efficacy among adolescents with depression and their parents or caregivers. METHODS In phase 1, we conducted focus groups with adolescents with depression (n=9) and their parents or caregivers (n=9) separately, and transcripts were examined to determine themes. In phase 2, we conducted an open trial of T2C comprising adolescents with depression referred to mental health care (n=43) and their parents or caregivers (n=28). We assessed usability by examining program engagement, usability ratings, and qualitative feedback at the 4-week follow-up. We also assessed potential effectiveness by examining changes in perceived barriers to treatment and mental health care initiation from baseline to 4 weeks. RESULTS In phase 1, we found that the themes supported the T2C approach. In phase 2, we observed high engagement with daily negative affect check-ins, high usability ratings, and decreased self-reported barriers to mental health treatment over time among adolescents. Overall, 52% (22/42) of the adolescents who completed follow-up reported that they had attended an appointment with a mental health care specialist. Of the 20 adolescents who had not attended a mental health care appointment, 5% (1/20) reported that it was scheduled for a future date, 10% (2/20) reported that the primary care site did not have the ability to help them schedule a mental health care appointment, and 15% (3/20) reported that they were no longer interested in receiving mental health care. CONCLUSIONS The findings from this study suggest that T2C is acceptable to adolescents with depression and most parents or caregivers; it is used at high rates; and it may be helpful to reduce cognitive barriers to mental health care initiation.
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Affiliation(s)
- Brian Suffoletto
- Department of Emergency Medicine, Stanford University, Palo Alto, CA, United States
| | - Tina Goldstein
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, United States
| | - David Brent
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, United States
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11
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Birmaher B, Merranko J, Hafeman D, Goldstein BI, Diler R, Levenson JC, Monk K, Iyengar S, Hickey MB, Sakolsky D, Axelson D, Goldstein T. A Longitudinal Study of Psychiatric Disorders in Offspring of Parents With Bipolar Disorder From Preschool to Adolescence. J Am Acad Child Adolesc Psychiatry 2021; 60:1419-1429. [PMID: 33785405 PMCID: PMC8473582 DOI: 10.1016/j.jaac.2021.02.023] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [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: 08/11/2020] [Revised: 01/25/2021] [Accepted: 02/19/2021] [Indexed: 02/09/2023]
Abstract
OBJECTIVE To compare the prevalence of psychopathology, particularly bipolar disorder (BD), between preschool offspring of parents with BD and community controls. METHOD A total of 116 offspring of BD-I/II parents and 98 controls (53 parents with non-BD psychopathology and 45 healthy parents) were recruited at ages 2 to 5 years and followed on average 9.6 years (on average: 2-5: 1.6 times; after age 5: 4 times) (average ages at intake/last follow-up: 3.8/13.4, retention: 98%). Participants were evaluated with standardized instruments blinded to parental diagnoses. RESULTS After adjusting for confounders, offspring of BD parents only showed more attention-deficit/hyperactivity disorder (ADHD) during ages 2 to 5 years than the other 2 groups. After age 5, offspring of BD parents did not differ from offspring of parents with non-BD psychopathology, but they had more anxiety, ADHD, and behavior problems than offspring of healthy parents. Only offspring of BD parents developed BD-I/II: 3.4% (n = 4) and BD-not-otherwise-specified (BD-NOS): 11.2% (n = 13), with mean onset ages 11.4 and 7.4, respectively. About 70% of offspring with BD had non-BD disorders before BD. Only ADHD, diagnosed before age 6 years, and early-onset parental BD were significantly associated with BD risk. CONCLUSION Most offspring of BD parents did not develop BD, but they were at specific high risk for developing BD, particularly those with preschool ADHD and early-onset parental BD. BD symptoms were scarce during the preschool years and increased throughout the school age, mainly in the form of BD-NOS, a disorder that conveys poor prognosis and high risk to develop BD-I/II. Developing early interventions to delay or, ideally, to prevent its onset are warranted.
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Affiliation(s)
- Boris Birmaher
- Drs. Birmaher, Hafeman, Diler, Levenson, Sakolsky, Goldstein, Mr. Merranko, and Mss. Monk and Hickey are with Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pennsylvania.
| | - John Merranko
- Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pennsylvania
| | - Danella Hafeman
- Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pennsylvania
| | - Benjamin I. Goldstein
- Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pennsylvania
| | - Rasim Diler
- Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pennsylvania
| | - Jessica C. Levenson
- Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pennsylvania
| | - Kelly Monk
- Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pennsylvania
| | | | - Mary Beth Hickey
- Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pennsylvania
| | - Dara Sakolsky
- Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pennsylvania
| | - David Axelson
- Nationwide Children’s Hospital and The Ohio State College of Medicine, Columbus
| | - Tina Goldstein
- Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pennsylvania.; Center for Addiction and Mental Health, University of Toronto Faculty of Medicine, Ontario, Canada
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12
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Suffoletto B, Goldstein T, Gotkiewicz D, Gotkiewicz E, George B, Brent D. Acceptability, Engagement, and Effects of a Mobile Digital Intervention to Support Mental Health for Young Adults Transitioning to College: Pilot Randomized Controlled Trial. JMIR Form Res 2021; 5:e32271. [PMID: 34647893 PMCID: PMC8554670 DOI: 10.2196/32271] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 08/03/2021] [Accepted: 08/03/2021] [Indexed: 01/07/2023] Open
Abstract
Background The transition from high school to college can exacerbate mental health problems in young adults yet barriers prevent seamless mental health care. Existing digital support tools show promise but are not yet designed to optimize engagement or implementation. Objective The goal of the research was to test acceptability and effects of an automated digital Mobile Support Tool for Mental Health (MoST-MH) for young adults transitioning to college. Methods Youths aged 18 years and older with a current mental health diagnosis preparing to transition to college (n=52; 85% female [45/52], 91% White [48/52]) were recruited from a primary care (n=31) and a mental health clinic (n=21). Participants were randomized 2:1 to either receive MoST-MH (n=34) or enhanced Usual Care (eUC; n=18). MoST-MH included periodic text message and web-based check-ins of emotional health, stressors, negative impacts, and self-efficacy that informed tailored self-care support messages. Both eUC and MoST-MH participants received links to a library of psychoeducational videos and were asked to complete web-based versions of the Mental Health Self-Efficacy Scale (MHSES), College Counseling Center Assessment of Psychological Symptoms (CCAPS), and Client Service Receipt Inventory for Mental Health (C-SRI) monthly for 3 months and the Post-Study System Usability Scale (PSSUQ) at 3-months. Results MoST-MH participants were sent a median of 5 (range 3 to 10) text message check-in prompts over the 3-month study period and 100% were completed; participants were sent a median of 2 (range 1 to 8) web-based check-in prompts among which 78% (43/55) were completed. PSSUQ scores indicate high usability (mean score 2.0). Results from the completer analysis demonstrated reductions in mental health symptoms over time and significant between-group effects of MoST-MH compared to eUC on depressive symptom severity (d=0.36, 95% CI 0.08 to 0.64). No significant differences in mental health self-efficacy or mental health health care use were observed. Conclusions In this pilot trial, we found preliminary evidence that MoST-MH was engaged with at high rates and found to be highly usable and reduced depression symptoms relative to eUC among youth with mental health disorders transitioning to college. Findings were measured during the COVID-19 pandemic, and the study was not powered to detect differences in outcomes between groups; therefore, further testing is needed. Trial Registration ClinicalTrials.gov NCT04560075; https://clinicaltrials.gov/ct2/show/NCT04560075
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Affiliation(s)
- Brian Suffoletto
- Department of Emergency Medicine, Stanford University, Palo Alto, CA, United States
| | - Tina Goldstein
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, United States
| | - Dawn Gotkiewicz
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, United States
| | | | - Brandie George
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, United States
| | - David Brent
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, United States
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13
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Wallace M, Kissel N, Hall M, Germain A, Matthews K, Troxel W, Franzen P, Buysse D, Roecklein K, Gunn H, Hasler B, Goldstein T, McMakin D, Szigethy E, Soehner A. 540 Age Trends in Sleep Across the Lifespan: Findings from the Pittsburgh Lifespan Sleep Databank. Sleep 2021. [DOI: 10.1093/sleep/zsab072.538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
Sleep continuously changes over the human lifespan and it does so across multiple dimensions, including duration, timing, efficiency, and variability. Although studies focused on specific developmental periods have shown age-related changes in sleep, methodological differences make it difficult to synthesize information across studies to fully understand precisely when these sleep changes occur. Our goal was to use individual-level actigraphy and self-report sleep data from a single site to characterize age trends and sex differences in actigraphy and self-report sleep dimensions across the healthy human lifespan. To accomplish this goal, we developed the Pittsburgh Lifespan Sleep Databank (PLSD), a large aggregate databank of participants from sleep research studies conducted at the University of Pittsburgh.
Methods
In the present analysis, we included N=1,070 PLSD participants from 21 studies without a major psychiatric, sleep, or medical condition. We used Generalized Additive Models to examine flexible, potentially non-linear relationships between age and sleep dimensions (actigraphy and self-report duration, efficiency, and timing; actigraphy variability) from ages 10 to 87. We also examined whether these sleep characteristics differed by sex across the lifespan.
Results
The most dramatic age-related trends were observed in sleep timing. Actigraphy and self-report sleep onset time shifted later between ages 10–18 and then shifted earlier again during the 20s. Actigraphy and self-report wake-up time also shifted earlier during the mid-20s through late 30s. Self-report duration became shorter from approximately ages 10–20. Self-report sleep efficiency and actigraphy variability both decreased over the entire lifespan. Relative to males, females tended to have earlier self-report sleep onset, higher actigraphy sleep efficiency, and longer actigraphy duration.
Conclusion
By focusing on lifespan sleep rather than specific age segments of the samples, we can provide a unified assessment of age-related changes and sex differences from childhood through older adulthood. An understanding of age trends and sex differences in sleep in healthy individuals – and explicating the timing and nature of these difference – can be used to identify periods of sleep-related risk or resilience and guide intervention efforts.
Support (if any)
University of Pittsburgh Clinical and Translational Science Institute (UL1TR001857).
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14
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Wells HL, Letko M, Lasso G, Ssebide B, Nziza J, Byarugaba DK, Navarrete-Macias I, Liang E, Cranfield M, Han BA, Tingley MW, Diuk-Wasser M, Goldstein T, Johnson CK, Mazet JAK, Chandran K, Munster VJ, Gilardi K, Anthony SJ. The evolutionary history of ACE2 usage within the coronavirus subgenus Sarbecovirus. Virus Evol 2021; 7:veab007. [PMID: 33754082 PMCID: PMC7928622 DOI: 10.1093/ve/veab007] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Severe acute respiratory syndrome coronavirus 1 (SARS-CoV-1) and SARS-CoV-2 are not phylogenetically closely related; however, both use the angiotensin-converting enzyme 2 (ACE2) receptor in humans for cell entry. This is not a universal sarbecovirus trait; for example, many known sarbecoviruses related to SARS-CoV-1 have two deletions in the receptor binding domain of the spike protein that render them incapable of using human ACE2. Here, we report three sequences of a novel sarbecovirus from Rwanda and Uganda that are phylogenetically intermediate to SARS-CoV-1 and SARS-CoV-2 and demonstrate via in vitro studies that they are also unable to utilize human ACE2. Furthermore, we show that the observed pattern of ACE2 usage among sarbecoviruses is best explained by recombination not of SARS-CoV-2, but of SARS-CoV-1 and its relatives. We show that the lineage that includes SARS-CoV-2 is most likely the ancestral ACE2-using lineage, and that recombination with at least one virus from this group conferred ACE2 usage to the lineage including SARS-CoV-1 at some time in the past. We argue that alternative scenarios such as convergent evolution are much less parsimonious; we show that biogeography and patterns of host tropism support the plausibility of a recombination scenario, and we propose a competitive release hypothesis to explain how this recombination event could have occurred and why it is evolutionarily advantageous. The findings provide important insights into the natural history of ACE2 usage for both SARS-CoV-1 and SARS-CoV-2 and a greater understanding of the evolutionary mechanisms that shape zoonotic potential of coronaviruses. This study also underscores the need for increased surveillance for sarbecoviruses in southwestern China, where most ACE2-using viruses have been found to date, as well as other regions such as Africa, where these viruses have only recently been discovered.
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Affiliation(s)
- H L Wells
- Department of Ecology, Evolution, and Environmental Biology, Columbia University, 1200 Amsterdam Ave, New York, NY 10027, USA
| | - M Letko
- Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, 903 S. 4th St, Hamilton, MT 59840, USA.,Paul G. Allen School for Global Animal Health, Washington State University, 1155 College Ave, Pullman, WA 99164, USA
| | - G Lasso
- Department of Microbiology and Immunology, Albert Einstein College of Medicine, 1300 Morris Park Ave, Bronx, NY 10462, USA
| | - B Ssebide
- Gorilla Doctors, c/o MGVP, Inc., 1089 Veterinary Medicine Drive, Davis, CA 95616, USA
| | - J Nziza
- Gorilla Doctors, c/o MGVP, Inc., 1089 Veterinary Medicine Drive, Davis, CA 95616, USA
| | - D K Byarugaba
- Makerere University Walter Reed Project, Plot 42, Nakasero Road, Kampala, Uganda.,Makerere University, College of Veterinary Medicine, Living Stone Road, Kampala, Uganda
| | - I Navarrete-Macias
- Center for Infection and Immunity, Mailman School of Public Health, Columbia University, 722 W 168th St, New York, NY 10032, USA
| | - E Liang
- Center for Infection and Immunity, Mailman School of Public Health, Columbia University, 722 W 168th St, New York, NY 10032, USA
| | - M Cranfield
- One Health Institute and Karen C. Drayer Wildlife Health Center, School of Veterinary Medicine, University of California Davis, 1089 Veterinary Medicine Drive, Davis, CA 95616, USA.,Department of Microbiology and Immunology, University of North Carolina School of Medicine, 125 Mason Farm Road, Chapel Hill, NC 27599, USA
| | - B A Han
- Cary Institute of Ecosystem Studies, 2801 Sharon Turnpike, Millbrook, NY 12545, USA
| | - M W Tingley
- Department of Ecology and Evolutionary Biology, University of California Los Angeles, 612 Charles E. Young Drive South, Los Angeles, CA 90095, USA
| | - M Diuk-Wasser
- Department of Ecology, Evolution, and Environmental Biology, Columbia University, 1200 Amsterdam Ave, New York, NY 10027, USA
| | - T Goldstein
- One Health Institute and Karen C. Drayer Wildlife Health Center, School of Veterinary Medicine, University of California Davis, 1089 Veterinary Medicine Drive, Davis, CA 95616, USA
| | - C K Johnson
- One Health Institute and Karen C. Drayer Wildlife Health Center, School of Veterinary Medicine, University of California Davis, 1089 Veterinary Medicine Drive, Davis, CA 95616, USA
| | - J A K Mazet
- One Health Institute and Karen C. Drayer Wildlife Health Center, School of Veterinary Medicine, University of California Davis, 1089 Veterinary Medicine Drive, Davis, CA 95616, USA
| | - K Chandran
- Department of Microbiology and Immunology, Albert Einstein College of Medicine, 1300 Morris Park Ave, Bronx, NY 10462, USA
| | - V J Munster
- Paul G. Allen School for Global Animal Health, Washington State University, 1155 College Ave, Pullman, WA 99164, USA
| | - K Gilardi
- Makerere University Walter Reed Project, Plot 42, Nakasero Road, Kampala, Uganda.,One Health Institute and Karen C. Drayer Wildlife Health Center, School of Veterinary Medicine, University of California Davis, 1089 Veterinary Medicine Drive, Davis, CA 95616, USA
| | - S J Anthony
- Department of Pathology, Microbiology, and Immunology, School of Veterinary Medicine, University of California Davis, One Shields Avenue, Davis, CA 95616, USA
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15
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Wells H, Letko M, Lasso G, Ssebide B, Nziza J, Byarugaba D, Navarrete-Macias I, Liang E, Cranfield M, Han B, Tingley M, Diuk-Wasser M, Goldstein T, Johnson C, Mazet J, Chandran K, Munster V, Gilardi K, Anthony S. The evolutionary history of ACE2 usage within the coronavirus subgenus Sarbecovirus. bioRxiv 2021:2020.07.07.190546. [PMID: 32676605 PMCID: PMC7359528 DOI: 10.1101/2020.07.07.190546] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
SARS-CoV-1 and SARS-CoV-2 are not phylogenetically closely related; however, both use the ACE2 receptor in humans for cell entry. This is not a universal sarbecovirus trait; for example, many known sarbecoviruses related to SARS-CoV-1 have two deletions in the receptor binding domain of the spike protein that render them incapable of using human ACE2. Here, we report three sequences of a novel sarbecovirus from Rwanda and Uganda which are phylogenetically intermediate to SARS-CoV-1 and SARS-CoV-2 and demonstrate via in vitro studies that they are also unable to utilize human ACE2. Furthermore, we show that the observed pattern of ACE2 usage among sarbecoviruses is best explained by recombination not of SARS-CoV-2, but of SARS-CoV-1 and its relatives. We show that the lineage that includes SARS-CoV-2 is most likely the ancestral ACE2-using lineage, and that recombination with at least one virus from this group conferred ACE2 usage to the lineage including SARS-CoV-1 at some time in the past. We argue that alternative scenarios such as convergent evolution are much less parsimonious; we show that biogeography and patterns of host tropism support the plausibility of a recombination scenario; and we propose a competitive release hypothesis to explain how this recombination event could have occurred and why it is evolutionarily advantageous. The findings provide important insights into the natural history of ACE2 usage for both SARS-CoV-1 and SARS-CoV-2, and a greater understanding of the evolutionary mechanisms that shape zoonotic potential of coronaviruses. This study also underscores the need for increased surveillance for sarbecoviruses in southwestern China, where most ACE2-using viruses have been found to date, as well as other regions such as Africa, where these viruses have only recently been discovered.
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Affiliation(s)
- H.L Wells
- Department of Ecology, Evolution, and Environmental Biology, Columbia University, New York, NY, USA
| | - M Letko
- Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, MT, USA
- Paul G. Allen School for Global Animal Health, Washington State University, Pullman, WA, USA
| | - G Lasso
- Department of Microbiology and Immunology, Albert Einstein College of Medicine, New York, NY 10461, USA
| | - B Ssebide
- Gorilla Doctors, c/o MGVP, Inc., Davis, California, USA
| | - J Nziza
- Gorilla Doctors, c/o MGVP, Inc., Davis, California, USA
| | - D.K Byarugaba
- Makerere University Walter Reed Project, Kampala, Uganda
- Makerere University, College of Veterinary Medicine, Kampala, Uganda
| | - I Navarrete-Macias
- Center for Infection and Immunity, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - E Liang
- Center for Infection and Immunity, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - M Cranfield
- One Health Institute and Karen C. Drayer Wildlife Health Center, School of Veterinary Medicine, University of California Davis, California, USA
- Department of Microbiology and Immunology, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
| | - B.A Han
- Cary Institute of Ecosystem Studies, Millbrook, New York, USA
| | - M.W Tingley
- Department of Ecology and Evolutionary Biology, University of California Los Angeles, Los Angeles, CA, USA
| | - M Diuk-Wasser
- Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, MT, USA
| | - T Goldstein
- One Health Institute and Karen C. Drayer Wildlife Health Center, School of Veterinary Medicine, University of California Davis, California, USA
| | - C.K Johnson
- One Health Institute and Karen C. Drayer Wildlife Health Center, School of Veterinary Medicine, University of California Davis, California, USA
| | - J Mazet
- One Health Institute and Karen C. Drayer Wildlife Health Center, School of Veterinary Medicine, University of California Davis, California, USA
| | - K Chandran
- Gorilla Doctors, c/o MGVP, Inc., Davis, California, USA
| | - V.J Munster
- Paul G. Allen School for Global Animal Health, Washington State University, Pullman, WA, USA
| | - K Gilardi
- Makerere University Walter Reed Project, Kampala, Uganda
- One Health Institute and Karen C. Drayer Wildlife Health Center, School of Veterinary Medicine, University of California Davis, California, USA
| | - S.J Anthony
- Department of Ecology, Evolution, and Environmental Biology, Columbia University, New York, NY, USA
- Department of Pathology, Microbiology, and Immunology, School of Veterinary Medicine, University of California Davis, California, USA
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Lima Santos JP, Brent D, Bertocci M, Mailliard S, Bebko G, Goldstein T, Kim T, Iyengar S, Hafeman D, Fenster-Ehrlich VC, Skeba A, Bonar L, Abdul-Waalee H, Gill M, Merranko J, Birmaher B, Phillips ML, Versace A. White Matter Correlates of Suicidality in Adults With Bipolar Disorder Who Have Been Prospectively Characterized Since Childhood. Biol Psychiatry Cogn Neurosci Neuroimaging 2021; 6:107-116. [PMID: 32919945 PMCID: PMC7796908 DOI: 10.1016/j.bpsc.2020.07.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 07/09/2020] [Accepted: 07/13/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Prevention of suicide in individuals with early-onset bipolar disorder (BD) remains a challenge. Diffusion magnetic resonance imaging studies in BD have identified neural correlates of emotional dysregulation implicated in BD and suicide. Using diffusion magnetic resonance imaging, we sought to identify neural signatures of suicide attempts in adults with childhood-onset BD who have been clinically followed for up to 19 years as part of the COBY (Course and Outcome of Bipolar Youth) study. METHODS Diffusion magnetic resonance imaging data were collected in 68 adults with BD: 20 in the suicide attempter (SA+) group and 48 in the non-suicide attempter (SA-) group. Multivariate analysis of covariance was used to identify the effect of group (SA+, SA-) on mean fractional anisotropy (indirect index of fiber collinearity) in key white matter tracts of emotional regulation. The effect of suicidal ideation and other clinical factors was further explored. False discovery rate was used to account for multiple comparison. Forty healthy control subjects were included. RESULTS Analyses revealed a main effect of group on fractional anisotropy (F5,59 = 3.0, p = .017). Specifically, the SA+ group showed lower fractional anisotropy than the SA- and healthy control groups in the middle portion of the forceps minor (FMIN) (F1,63 = 8.5, p = .010) and in the anterior (F1,63 = 7.8, p = .010) and posterior (F1,63 = 8.7, p = .006) portion of the right cingulum bundle (CB). Abnormalities in the FMIN, but not CB, were also associated with suicidal ideation (F1,64 = 10.6, p = .002) and levels of emotional distress at scan. CONCLUSIONS FMIN and CB abnormalities have been associated with emotional dysregulation in BD. Our findings suggest that the FMIN may represent a generic marker of suicidal ideation and, more broadly, emotional distress, while CB may represent a specific marker of attempted suicide.
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Affiliation(s)
- João Paulo Lima Santos
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, Pennsylvania.
| | - David Brent
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Michele Bertocci
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Sarrah Mailliard
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Genna Bebko
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Tina Goldstein
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Tae Kim
- Magnetic Resonance Research Center, Department of Radiology, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Satish Iyengar
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Danella Hafeman
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Vilde Chaya Fenster-Ehrlich
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Alexander Skeba
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Lisa Bonar
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Halimah Abdul-Waalee
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - MaryKay Gill
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - John Merranko
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Boris Birmaher
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Mary L Phillips
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Amelia Versace
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, Pennsylvania; Magnetic Resonance Research Center, Department of Radiology, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, Pennsylvania
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17
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Birmaher B, Merranko JA, Gill MK, Hafeman D, Goldstein T, Goldstein B, Hower H, Strober M, Axelson D, Ryan N, Yen S, Diler R, Iyengar S, Kattan MW, Weinstock L, Keller M. Predicting Personalized Risk of Mood Recurrences in Youths and Young Adults With Bipolar Spectrum Disorder. J Am Acad Child Adolesc Psychiatry 2020; 59:1156-1164. [PMID: 31978620 PMCID: PMC7371512 DOI: 10.1016/j.jaac.2019.12.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 06/14/2019] [Revised: 12/04/2019] [Accepted: 01/14/2020] [Indexed: 12/14/2022]
Abstract
OBJECTIVE With each recurrence the prognosis of bipolar disorder (BD) worsens, indicating the need to identify the factors associated with increased recurrence risk. The course of BD is heterogenous and although risk factors for recurrence for the group as a whole have been reported in the literature, identification of risk factors for a specific individual are crucial for developing personalized treatments. METHOD A total of 363 recovered BD youths/young adults from the Course and Outcome of Bipolar Youth (COBY) study were included. Participants were evaluated on average every 7 months for a median of 12.5 years and interviewed with standard instruments. Risk factors of recurrence from the literature were used to build a risk calculator (RC) to predict recurrence risk at different time intervals. RESULTS Approximately 80% of participants had at least one syndromal recurrence and 60% had ≥2 recurrences, particularly depressions. The 6-month and 1-, 2-, 3-, and 5-year RC showed an accuracy between 72% and 82% for predicting any mood recurrences, and up to 80% for depression and 89% for hypo/mania (sensitivity/specificity both 0.74). The most influential recurrence risk factors were shorter recovery lengths, younger age at assessment, earlier mood onset, and more severe prior depression. Although important, other factors associated with recurrence risk, such as interepisodic subsyndromal mood symptoms and comorbidities, did not influence the RC score beyond factors noted above. CONCLUSION The RC provides a useful tool for predicting an individual's recurrence risk of depression and/or hypo/mania in BD youths and for developing personalized interventions and informing research. Replication studies are warranted.
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Affiliation(s)
- Boris Birmaher
- Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
| | - John A. Merranko
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Mary Kay Gill
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Danella Hafeman
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Tina Goldstein
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Benjamin Goldstein
- Department of Psychiatry, Sunnybrook Health Sciences Centre, University of Toronto Faculty of Medicine, Ontario, Canada
| | - Heather Hower
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University; Butler Hospital, Providence, Rhode Island
| | - Michael Strober
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California
| | - David Axelson
- Department of Psychiatry, Nationwide Children’s Hospital and The Ohio State College of Medicine, Columbus, Ohio
| | - Neal Ryan
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Shirley Yen
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University; Butler Hospital, Providence, Rhode Island
| | - Rasim Diler
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Satish Iyengar
- Department of Statistics, University of Pittsburgh, 2717 Cathedral of Learning, Pittsburgh, PA
| | | | - Lauren Weinstock
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University; Butler Hospital, Providence, Rhode Island
| | - Martin Keller
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University; Butler Hospital, Providence, Rhode Island
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18
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Cameron K, Hayes B, Olson SH, Smith BR, Pante J, Laudisoit A, Goldstein T, Joly DO, Bagamboula MPassi R, Lange CE. Detection of first gammaherpesvirus sequences in Central African bats. New Microbes New Infect 2020; 36:100705. [PMID: 32612842 PMCID: PMC7322348 DOI: 10.1016/j.nmni.2020.100705] [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] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 05/23/2020] [Accepted: 05/29/2020] [Indexed: 11/29/2022] Open
Abstract
Herpesviruses have been identified in many species; however, relatively few bat herpesvirus are known, considering the enormous diversity of bats. We used consensus PCR to test bats from the Republic of the Congo and found DNA of two different novel bat herpesviruses. One was detected in a Pipistrellus nanulus, the other in a Triaenops persicus bat and both resemble gammaherpesviruses. On the amino acid level, the amplified sequences differ by 55% from each other, and by 27% and 25% from the next closest known viruses. The findings point towards the diversity of herpesviruses in Central African bats.
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Affiliation(s)
- K Cameron
- Wildlife Conversation Society, Bronx, NY, USA.,United States Fish and Wildlife Service, Bailey's Crossroads, VA, USA
| | - B Hayes
- Monadh, Inveruglas, Kingussie, UK
| | - S H Olson
- Wildlife Conversation Society, Bronx, NY, USA
| | - B R Smith
- One Health Institute, School of Veterinary Medicine, University of California, Davis, CA, USA
| | - J Pante
- One Health Institute, School of Veterinary Medicine, University of California, Davis, CA, USA
| | | | - T Goldstein
- One Health Institute, School of Veterinary Medicine, University of California, Davis, CA, USA
| | - D O Joly
- Wildlife Conversation Society, Bronx, NY, USA.,British Columbia Ministry of Environment and Climate Change Strategy, Victoria, BC, Canada
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Korotun M, Weizman L, Drori A, Zaccaria J, Goldstein T, Litman I, Hahn S, Greenberg H. 0584 Detecting Sleep Disordered Breathing Using Sub-Terahertz Radio-Frequency Micro-Radar. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
New sensor technologies are entering sleep testing at a rapid pace; Neteera™ developed a novel sensor and algorithm for sleep apnea detection utilizing a contact-free, radar-based sensor system. The system utilizes a high-frequency, low-power, directional micro-radar which operates at ~120GHz and a sampling rate of 2500Hz as well as algorithms which are able to detect both pulse and respiratory activity of subjects during sleep.
Methods
Adult subjects undergoing diagnostic PSG for clinical purposes were simultaneously assessed with the novel micro-radar system with sensors under the mattress. Disordered breathing events (DBEs) were scored from the PSG using AASM scoring guidelines and were compared with those detected by the micro-radar sensor. Test data were grouped into three sets: 1. Single under mattress sensor; 2. Two under mattress sensors on each side of the bed (to improve signal capture); 3. After software optimization. The micro-radar sensor detected DBEs but software to describe the type of DBEs (obstructive apnea/central apnea/hypopnea) is still under development. Detection rate of DBEs was compared between the two methodologies and the development sets.
Results
n=22 (12 F, 10 M), Age=50.8±12.4 years, BMI=35.32±7.37 kg/m2. Diagnostic PSG AHI: 19.7±29.4/hr, T90=15.8±25.7%. Percent DBEs missed by the micro-radar sensor: 1st set=14.6±10.6%; 2nd set=9.4±8.3%; 3rd set=1.2±2.6%. Number of DBEs assessed for each set was 646, 1144, 125 events, respectively. With each successive set, the detection rate improved.
Conclusion
A novel micro-radar, non-contact sensor technology can be used to detect DBEs during sleep. Detection rate improved with utilization of two sensors per bed and software optimization. Future software development is expected to improve detection rate and facilitate breathing event classification into obstructive apneas/central apneas/hypopneas.
Support
None.
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Affiliation(s)
| | - L Weizman
- Neteera Technologies Ltd., Jerusalem, ISRAEL
| | - A Drori
- Neteera Technologies Ltd., Jerusalem, ISRAEL
| | - J Zaccaria
- Neteera Technologies Ltd., Jerusalem, ISRAEL
| | | | - I Litman
- Neteera Technologies Ltd., Jerusalem, ISRAEL
| | - S Hahn
- Northwell Health, New Hyde Park, NY
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20
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Shalev A, Merranko J, Gill MK, Goldstein T, Liao F, Goldstein BI, Hower H, Ryan N, Strober M, Iyengar S, Keller M, Yen S, Weinstock LM, Axelson D, Birmaher B. Longitudinal course and risk factors associated with psychosis in bipolar youths. Bipolar Disord 2020; 22:139-154. [PMID: 31749297 PMCID: PMC7085953 DOI: 10.1111/bdi.12877] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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] [Indexed: 01/13/2023]
Abstract
OBJECTIVES To compare the longitudinal clinical course of youths with bipolar disorder (BD) spectrum with lifetime (past, intake, and/or follow-up) psychosis (BDP+) to youths with BD without lifetime psychosis (BDP-). Also, to identify risk factors associated with increased risk of first onset of psychosis during prospective follow-up. METHOD Bipolar disorder youths (BDP+ = 137, BDP- = 233), aged 7-17 years old, were followed on average every 7 months for 11.7 years and were evaluated using standardized instruments. Data were analyzed using linear and generalized linear models for the full sample, as well as for youths who developed first period of psychosis (n = 55). RESULTS After adjusting for confounders, BDP+ youths with one, and in particular ≥2 lifetime psychotic episodes, had higher rates and more severe mood and anxiety symptoms, higher rates of suicidality, psychiatric hospitalizations, and sexual/physical abuse, and poorer psychosocial functioning than BDP- youths. Even before the first onset of psychosis during follow-up, BDP+ youths showed more psychopathology and had more family history of psychiatric illness than those who never developed psychosis. First-onset psychosis was associated with low socioeconomic status (SES), living with one parent, bipolar disorder type one and type two, comorbid anxiety, history of hospitalizations, and family history of mania and suicidality. CONCLUSION BDP+ is associated with poor prognosis and worse clinical picture, even before the onset of psychosis, indicating the need for prompt identification and treatment of these youths. Studies aimed to treat acute symptoms of psychosis, as well as prevent the onset of psychosis, including risk factors amenable to change, are warranted.
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Affiliation(s)
- Amit Shalev
- Department of Psychiatry, Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania,,The Herman Dana Division of Pediatric Psychiatry, Department of Psychiatry, Hadassah Hebrew University Medical Center, Jerusalem Israel
| | - John Merranko
- Department of Psychiatry, Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Mary Kay Gill
- Department of Psychiatry, Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Tina Goldstein
- Department of Psychiatry, Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Fangzi Liao
- Department of Psychiatry, Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | | | - Heather Hower
- Ontario, Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University
| | - Neal Ryan
- Department of Psychiatry, Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | | | - Satish Iyengar
- Department of Statistics, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Martin Keller
- Ontario, Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University
| | - Shirley Yen
- Ontario, Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University
| | - Lauren M. Weinstock
- Ontario, Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University
| | - David Axelson
- Department of Psychiatry, Nationwide Children’s Hospital and The Ohio State University, Columbus, Ohio
| | - Boris Birmaher
- Department of Psychiatry, Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
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21
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Shalev A, Merranko J, Goldstein T, Miklowitz DJ, Axelson D, Goldstein BI, Brent D, Monk K, Hickey MB, Hafeman DM, Sakolsky D, Diler R, Birmaher B. A Longitudinal Study of Family Functioning in Offspring of Parents Diagnosed With Bipolar Disorder. J Am Acad Child Adolesc Psychiatry 2019; 58:961-970. [PMID: 30768400 PMCID: PMC6584080 DOI: 10.1016/j.jaac.2018.10.011] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [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: 06/12/2018] [Revised: 10/26/2018] [Accepted: 12/11/2018] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To compare the longitudinal course of family functioning in offspring of parents with bipolar disorder (BD), offspring of parents with non-BD psychopathology, and offspring of healthy control (HC) parents. METHOD Offspring of parents with BD (256 parents and 481 offspring), parents without BD (82 parents and 162 offspring), and HC parents (88 parents and 175 offspring) 7 to 18 years of age at intake, from the Bipolar Offspring Study (BIOS), were followed for an average of 4.3 years. Family functioning was evaluated using the child- and parent-reported Family Adaptability and Cohesion Scale-II and the Conflict Behavior Questionnaire. The data were analyzed using multivariate multilevel regression, generalized linear estimating equation models, and path analysis. RESULTS Families of parents with BD and parents with non-BD psychopathology showed lower cohesion and adaptability and higher conflict compared with HC families. There were no significant differences in cohesion and adaptability between families of parents with psychopathology. The effect of parental psychopathology on family functioning was mediated by parental psychosocial functioning and, to a lesser extent, offspring disorders. In all 3 groups, parent-reported family conflict was significantly higher than child-reported conflict. Across groups, family cohesion decreased over follow-up, whereas conflict increased. CONCLUSION Any parental psychopathology predicted family impairment. These results were influenced by the offspring's age and were mediated by parental psychosocial functioning and, to a lesser degree, by offspring psychopathology. These findings emphasize the need to routinely assess family functioning in addition to psychopathology and provide appropriate interventions to parents and offspring.
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Affiliation(s)
- Amit Shalev
- Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, PA; Herman Dana Division of Pediatric Psychiatry, Hadassah Hebrew University Medical Center, Jerusalem, Israel.
| | - John Merranko
- Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, PA
| | - Tina Goldstein
- Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, PA
| | - David J. Miklowitz
- Division of Child & Adolescent Psychiatry, UCLA Semel Institute, David Geffen School of Medicine, University of California, Los Angeles
| | - David Axelson
- Children’s Hospital and The Ohio State University, Columbus
| | | | - David Brent
- Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, PA
| | - Kelly Monk
- Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, PA
| | - Mary Beth Hickey
- Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, PA
| | - Danella M. Hafeman
- Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, PA
| | - Dara Sakolsky
- Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, PA
| | - Rasim Diler
- Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, PA
| | - Boris Birmaher
- Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, PA
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22
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Yu K, Chen B, Aran D, Charalel J, Yau C, Wolf DM, van 't Veer LJ, Butte AJ, Goldstein T, Sirota M. Comprehensive transcriptomic analysis of cell lines as models of primary tumors across 22 tumor types. Nat Commun 2019; 10:3574. [PMID: 31395879 PMCID: PMC6687785 DOI: 10.1038/s41467-019-11415-2] [Citation(s) in RCA: 80] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Accepted: 07/10/2019] [Indexed: 01/03/2023] Open
Abstract
Cancer cell lines are a cornerstone of cancer research but previous studies have shown that not all cell lines are equal in their ability to model primary tumors. Here we present a comprehensive pan-cancer analysis utilizing transcriptomic profiles from The Cancer Genome Atlas and the Cancer Cell Line Encyclopedia to evaluate cell lines as models of primary tumors across 22 tumor types. We perform correlation analysis and gene set enrichment analysis to understand the differences between cell lines and primary tumors. Additionally, we classify cell lines into tumor subtypes in 9 tumor types. We present our pancreatic cancer results as a case study and find that the commonly used cell line MIA PaCa-2 is transcriptionally unrepresentative of primary pancreatic adenocarcinomas. Lastly, we propose a new cell line panel, the TCGA-110-CL, for pan-cancer studies. This study provides a resource to help researchers select more representative cell line models. Cell lines are used ubiquitously in cancer research but how well they represent the tumor type they were derived from is variable. Here, the authors compare transcriptomic profiles of 22 tumor types and cell lines and propose a new comprehensive cell line panel for pan-cancer studies.
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Affiliation(s)
- K Yu
- Bakar Computational Health Sciences Institute, University of California San Francisco, San Francisco, 94158, CA, USA.,Department of Pediatrics, University of California, San Francisco, San Francisco, 94143, CA, USA
| | - B Chen
- Department of Pediatrics and Human Development, College of Human Medicine, Michigan State University, Grand Rapids, 49503, MI, USA.,Department of Pharmacology and Toxicology, College of Human Medicine, Michigan State University, Grand Rapids, 49503, MI, USA
| | - D Aran
- Bakar Computational Health Sciences Institute, University of California San Francisco, San Francisco, 94158, CA, USA
| | - J Charalel
- Department of Genetics, Stanford University, Stanford, 94305, CA, USA
| | - C Yau
- Buck Institute for Research on Aging, Novato, 94945, CA, USA.,Department of Surgery, University of California, San Francisco, San Francisco, 94143, CA, USA
| | - D M Wolf
- Department of Surgery, University of California, San Francisco, San Francisco, 94143, CA, USA
| | - L J van 't Veer
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, 94143, CA, USA
| | - A J Butte
- Bakar Computational Health Sciences Institute, University of California San Francisco, San Francisco, 94158, CA, USA.,Department of Pediatrics, University of California, San Francisco, San Francisco, 94143, CA, USA
| | - T Goldstein
- Bakar Computational Health Sciences Institute, University of California San Francisco, San Francisco, 94158, CA, USA
| | - M Sirota
- Bakar Computational Health Sciences Institute, University of California San Francisco, San Francisco, 94158, CA, USA. .,Department of Pediatrics, University of California, San Francisco, San Francisco, 94143, CA, USA.
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Chen Q, Franzen P, Goldstein T, Gratzmiller S. 0897 Low Stability In Rest Activity Rhythms Is Associated With Higher Suicidal Ideation In Adolescents With Bipolar Disorder. Sleep 2019. [DOI: 10.1093/sleep/zsz067.895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Qianyi Chen
- University Of Pittsburgh, Pittsburgh, PA, USA
- Carnegie Mellon University, Pittsburgh, PA, USA
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24
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Goldstein T, Anthony S, Gbakima A, Bird B, Bangura J, Tremeau-Bravard A, Belaganahalli M, Wells H, Dhanota J, Liang E, Grodus M, Jangra R, Dejesus V, Lasso G, Smith B, Jambai A, Kamara B, Kamara S, Bangura W, Monagin C, Shapira S, Johnson CK, Saylors K, Rubin E, Chandran K, Lipkin W, Mazet J. The discovery of a new Ebolavirus, Bombali virus, adds further support for bats as hosts of Ebolaviruses. Int J Infect Dis 2019. [DOI: 10.1016/j.ijid.2018.11.030] [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: 10/27/2022] Open
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25
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Herron E, Murray M, Hilton L, Goldstein T, Ogunleye T, Bailey D. Surface Guided Radiation Therapy as a Replacement for Patient Marks in Treatment of Breast Cancer. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.1400] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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26
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Versace A, Ladouceur CD, Graur S, Acuff HE, Bonar LK, Monk K, McCaffrey A, Yendiki A, Leemans A, Travis MJ, Diwadkar VA, Holland SK, Sunshine JL, Kowatch RA, Horwitz SM, Frazier TW, Arnold LE, Fristad MA, Youngstrom EA, Findling RL, Goldstein BI, Goldstein T, Axelson D, Birmaher B, Phillips ML. Diffusion imaging markers of bipolar versus general psychopathology risk in youth at-risk. Neuropsychopharmacology 2018; 43:2212-2220. [PMID: 29795244 PMCID: PMC6135796 DOI: 10.1038/s41386-018-0083-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Revised: 03/31/2018] [Accepted: 04/10/2018] [Indexed: 12/22/2022]
Abstract
Bipolar disorder (BD) is highly heritable. Thus, studies in first-degree relatives of individuals with BD could lead to the discovery of objective risk markers of BD. Abnormalities in white matter structure reported in at-risk individuals could play an important role in the pathophysiology of BD. Due to the lack of studies with other at-risk offspring, however, it remains unclear whether such abnormalities reflect BD-specific or generic risk markers for future psychopathology. Using a tract-profile approach, we examined 18 major white matter tracts in 38 offspring of BD parents, 36 offspring of comparison parents with non-BD psychopathology (depression, attention-deficit/hyperactivity disorder), and 41 offspring of healthy parents. Both at-risk groups showed significantly lower fractional anisotropy (FA) in left-sided tracts (cingulum, inferior longitudinal fasciculus, forceps minor), and significantly greater FA in right-sided tracts (uncinate fasciculus and inferior longitudinal fasciculus), relative to offspring of healthy parents (P < 0.05). These abnormalities were present in both healthy and affected youth in at-risk groups. Only offspring (particularly healthy offspring) of BD parents showed lower FA in the right superior longitudinal fasciculus relative to healthy offspring of healthy parents (P < 0.05). We show, for the first time, important similarities, and some differences, in white matter structure between offspring of BD and offspring of non-BD parents. Findings suggest that lower left-sided and higher right-sided FA in tracts important for emotional regulation may represent markers of risk for general, rather than BD-specific, psychopathology. Lower FA in the right superior longitudinal fasciculus may protect against development of BD in offspring of BD parents.
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Affiliation(s)
- A Versace
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, PA, USA.
| | - C D Ladouceur
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, PA, USA
| | - S Graur
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, PA, USA
| | - H E Acuff
- Departments of Neuroscience, Psychology, and Psychiatry, Center for Neuroscience, University of Pittsburgh, Pittsburgh, PA, USA
- Medical Scientist Training Program, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - L K Bonar
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, PA, USA
| | - K Monk
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, PA, USA
| | - A McCaffrey
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, PA, USA
| | - A Yendiki
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - A Leemans
- Image Sciences Institute, University Medical Center Utrecht, Utrecht, The Netherlands
| | - M J Travis
- LAMS Consortium, Epping, NSW, 1710, Australia
| | | | - S K Holland
- LAMS Consortium, Epping, NSW, 1710, Australia
| | | | - R A Kowatch
- LAMS Consortium, Epping, NSW, 1710, Australia
| | - S M Horwitz
- LAMS Consortium, Epping, NSW, 1710, Australia
| | - T W Frazier
- LAMS Consortium, Epping, NSW, 1710, Australia
| | - L E Arnold
- Department of Psychiatry, Nationwide Children's Hospital and The Ohio State College of Medicine, Columbus, OH, USA
| | - M A Fristad
- LAMS Consortium, Epping, NSW, 1710, Australia
| | | | | | - B I Goldstein
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - T Goldstein
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, PA, USA
| | - D Axelson
- Department of Psychiatry, Nationwide Children's Hospital and The Ohio State College of Medicine, Columbus, OH, USA
| | - B Birmaher
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, PA, USA
| | - M L Phillips
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, PA, USA
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Kennard BD, Goldstein T, Foxwell AA, McMakin DL, Wolfe K, Biernesser C, Moorehead A, Douaihy A, Zullo L, Wentroble E, Owen V, Zelazny J, Iyengar S, Porta G, Brent D. As Safe as Possible (ASAP): A Brief App-Supported Inpatient Intervention to Prevent Postdischarge Suicidal Behavior in Hospitalized, Suicidal Adolescents. Am J Psychiatry 2018; 175:864-872. [PMID: 30021457 PMCID: PMC6169524 DOI: 10.1176/appi.ajp.2018.17101151] [Citation(s) in RCA: 64] [Impact Index Per Article: 10.7] [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] [Indexed: 12/13/2022]
Abstract
OBJECTIVE The authors report on a pilot study of an inpatient intervention for suicidal adolescents, As Safe as Possible (ASAP), supported by a smartphone app (BRITE) to reduce suicide attempts following hospital discharge. METHOD Across two sites, 66 adolescents hospitalized for suicidal ideation (N=26) or a recent suicide attempt (N=40) were randomly assigned to the ASAP intervention program plus treatment as usual or to treatment as usual alone. ASAP, which focuses on emotion regulation and safety planning, is a 3-hour intervention delivered on the inpatient unit. The BRITE app prompted participants to rate their level of emotional distress on a daily basis and provided personalized strategies for emotion regulation and safety planning. A blind, independent evaluator assessed suicide attempts following hospital discharge and suicidal ideation at 4, 12, and 24 weeks after discharge. RESULTS The ASAP intervention did not have a statistically significant effect on suicide attempt, although findings were in the hypothesized direction for occurrence of an attempt (16% compared with 31%; χ2=1.86, df=1, g=-0.36) and time to an attempt (hazard ratio=0.49, 95% CI=0.16, 1.47). Past history of a suicide attempt was a significant moderator of treatment outcome, with a stronger, albeit nonsignificant, effect of the ASAP intervention among participants with a history of suicide attempt (hazard ratio=0.23, 95% CI=0.05, 1.09). There were no treatment effects on suicidal ideation. The majority of participants (70%) used the BRITE app (median usage, 19 times). Participants reported high satisfaction with both the intervention and the app. CONCLUSIONS The ASAP intervention program shows promise in reducing the incidence of postdischarge suicide attempts among adolescents hospitalized for suicidality and merits further study.
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Affiliation(s)
- Betsy D. Kennard
- Department of Psychiatry, University of Texas Southwestern Medical Center
- Children’s Health of Dallas
| | - Tina Goldstein
- Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center
| | - Aleksandra A. Foxwell
- Department of Psychiatry, University of Texas Southwestern Medical Center
- Children’s Health of Dallas
| | | | - Kristin Wolfe
- Department of Psychiatry, University of Texas Southwestern Medical Center
- Children’s Health of Dallas
| | - Candice Biernesser
- Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center
| | - Alexandra Moorehead
- Department of Psychiatry, University of Texas Southwestern Medical Center
- Children’s Health of Dallas
| | - Antoine Douaihy
- Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center
| | - Lucas Zullo
- Department of Psychiatry, University of Texas Southwestern Medical Center
| | - Erin Wentroble
- Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center
| | - Victoria Owen
- Department of Psychiatry, University of Texas Southwestern Medical Center
- Children’s Health of Dallas
| | - Jamie Zelazny
- Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center
| | | | - Giovanna Porta
- Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center
| | - David Brent
- Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center
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Krantz M, Goldstein T, Rooks B, Merranko J, Liao F, Gill MK, Diler R, Hafeman D, Ryan N, Goldstein B, Yen S, Hower H, Hunt J, Keller M, Strober M, Axelson D, Birmaher B. Sexual Risk Behavior Among Youth With Bipolar Disorder: Identifying Demographic and Clinical Risk Factors. J Am Acad Child Adolesc Psychiatry 2018; 57:118-124. [PMID: 29413144 PMCID: PMC5806213 DOI: 10.1016/j.jaac.2017.11.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [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: 06/26/2017] [Revised: 11/07/2017] [Accepted: 11/21/2017] [Indexed: 11/16/2022]
Abstract
OBJECTIVE This study aims to document rates of sexual activity among youth with bipolar spectrum disorder (BD) and to examine demographic and clinical factors associated with first sexual activity and sexual risk behavior during follow-up. METHOD The sample was drawn from the Course and Outcome of Bipolar Youth (COBY) study of 413 youth 7 to 17 years at baseline who met criteria for bipolar spectrum disorder according to the Schedule for Affective Disorders and Schizophrenia for School-Aged Children. Psychiatric symptoms during follow-up were assessed using the Adolescent Longitudinal Interview Follow-Up Evaluation (ALIFE). Sexual behavior and level of sexual risk (e.g., unprotected sex, multiple partners, and/or partners with known sexually transmitted infections) were assessed by trained evaluators using the ALIFE Psychosocial Functioning Scale. Analyses were conducted in relation to first sexual behavior during follow-up and then to subsequent sexual behaviors (mean 9.7 years, standard deviation 3.2). RESULTS Sexually active COBY youth (n = 292 of 413; 71%) were more likely females, using substances, and not living with both parents. Consistent with findings among healthy youth, earlier first sexual activity in the sample was significantly associated with low socioeconomic status, female sex, comorbid disruptive behavior disorder, and substance use. As with healthy youth, sexual risk behavior during follow-up was significantly associated with non-Caucasian race, low socioeconomic status, substance use, and history of sexual abuse. Of those COBY youth who were sexually active, 11% reported sexual assault or abuse, 36% reported becoming pregnant (or the significant other becoming pregnant), and 15% reported having at least 1 abortion (or the significant other having an abortion) during follow-up. Hypomanic symptoms during follow-up were temporally associated with the greatest risk for sexual risk behavior. CONCLUSION Demographic and clinical factors could help identify youth with bipolar spectrum disorder at significantly greatest risk for sexual activity and sexual risk behavior. Attending to sexual risk behaviors in this population is warranted.
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Affiliation(s)
- Megan Krantz
- Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Tina Goldstein
- Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA.
| | - Brian Rooks
- Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - John Merranko
- Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Fangzi Liao
- Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Mary Kay Gill
- Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Rasim Diler
- Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Danella Hafeman
- Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Neal Ryan
- Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Benjamin Goldstein
- Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
| | - Shirley Yen
- Alpert Medical School and Butler Hospital, Providence
| | - Heather Hower
- Alpert Medical School of Brown University, Providence, RI
| | - Jeffrey Hunt
- Alpert Medical School and Bradley Hospital, Providence
| | | | - Michael Strober
- David Geffen School of Medicine, University of California, Los Angeles
| | - David Axelson
- Nationwide Children's Hospital and The Ohio State College of Medicine, Columbus
| | - Boris Birmaher
- Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA
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Angulo M, Rooks BT, Gill M, Goldstein T, Sakolsky D, Goldstein B, Monk K, Hickey MB, Diler RS, Hafeman D, Merranko J, Axelson D, Birmaher B. Psychometrics of the screen for adult anxiety related disorders (SCAARED)- A new scale for the assessment of DSM-5 anxiety disorders. Psychiatry Res 2017; 253:84-90. [PMID: 28359032 PMCID: PMC5472098 DOI: 10.1016/j.psychres.2017.02.034] [Citation(s) in RCA: 28] [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: 08/24/2016] [Revised: 02/13/2017] [Accepted: 02/16/2017] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To examine the psychometrics of the Screen for Adult Anxiety Related Disorders (SCAARED). METHODS The SCAARED was adapted from the Screen for Child Anxiety Related Emotional Disorders. Participants (N=336) ages 18-27 years old were evaluated using the Structured Clinical Interview for DSM-IV Disorders (SCID). The SCAARED was completed at or within two-weeks before the SCID. The psychometrics of the SCAARED were analyzed using standard statistical analyses including principal components, and Receiver Operant Curve analyses. A replication was performed in an age/sex matched independent sample (N=158). RESULTS The SCAARED showed four factors: somatic/panic/agoraphobia, generalized anxiety, separation anxiety, and social anxiety. The total and each factor scores demonstrated good internal consistency (α=0.86-0.97) and good discriminant validity between anxiety and other disorders and within anxiety disorders for generalized and social anxiety. Area Under the Curve for the total and each of the factor scores ranged between 0.72 and 0.84 (p<0.0001). These results were replicated in the independent sample. CONCLUSIONS The SCAARED showed excellent psychometric properties supporting its use to screen adults for anxiety disorders, longitudinal studies following youth into adulthood and studies comparing child and adult populations. Further replication studies in larger community and clinical samples are indicated.
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Affiliation(s)
- Melina Angulo
- Instituto Nacional de Psiquiatría Ramón de la Fuente, Ciudad de México, México
| | | | - MaryKay Gill
- Western Psychiatric Institute and Clinic and Department of Psychiatry, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Tina Goldstein
- Western Psychiatric Institute and Clinic and Department of Psychiatry, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Dara Sakolsky
- Western Psychiatric Institute and Clinic and Department of Psychiatry, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Benjamin Goldstein
- Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Kelly Monk
- Western Psychiatric Institute and Clinic and Department of Psychiatry, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Mary Beth Hickey
- Western Psychiatric Institute and Clinic and Department of Psychiatry, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Rasim S. Diler
- Western Psychiatric Institute and Clinic and Department of Psychiatry, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Danella Hafeman
- Western Psychiatric Institute and Clinic and Department of Psychiatry, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - John Merranko
- Western Psychiatric Institute and Clinic and Department of Psychiatry, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - David Axelson
- Nationwide Children’s Hospital Research Institute and The Ohio State University College of Medicine, Columbus, Ohio, USA
| | - Boris Birmaher
- Western Psychiatric Institute and Clinic and Department of Psychiatry, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
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Levinsky Y, Berger T, Brameli A, Goldstein T, Akerman E, Mimouni M, Mimouni FB, Amarilyo G. Publication outcomes of neonatology abstracts presented at the Pediatric Academic Societies meeting. J Perinatol 2017; 37:881-885. [PMID: 28383540 DOI: 10.1038/jp.2017.46] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2017] [Accepted: 03/03/2017] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To examine publication outcomes of neonatology abstracts presented at Pediatric Academic Society (PAS) meeting, and to analyze variables affecting publication. STUDY DESIGN All neonatology studies accepted for presentation (oral or poster) at 2008 PAS meeting were identified. A biphasic manual PubMed search of published articles was performed using a pre-designed algorithm. RESULTS A total of 1078 neonatology abstracts were presented at the meeting, among them 481 (44.62%) published by 2016. Abstracts presented orally versus posters (56.11 versus 42.32%; P<0.001) and basic science versus clinical abstracts (53.08 versus 40.2%; P<0.001) were more likely to be published. Positive or negative results of a study or its sample size did not predict rates of publication. CONCLUSIONS Less than half of the abstracts presented at the PAS meeting were published within 8 years. Oral presentations were more likely to be published than posters.Journal of Perinatology advance online publication, 6 April 2017; doi:10.1038/jp.2017.46.
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Affiliation(s)
- Y Levinsky
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Pediatrics B, Schneider Children's Medical Center of Israel, Tel Aviv University, Petah Tikva, Israel
| | - T Berger
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Pediatrics B, Schneider Children's Medical Center of Israel, Tel Aviv University, Petah Tikva, Israel
| | - A Brameli
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Pediatrics B, Schneider Children's Medical Center of Israel, Tel Aviv University, Petah Tikva, Israel
| | - T Goldstein
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Pediatrics B, Schneider Children's Medical Center of Israel, Tel Aviv University, Petah Tikva, Israel
| | - E Akerman
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - M Mimouni
- Department of Ophthalmology, Rambam Health Care Campus, Haifa, Israel
| | - F B Mimouni
- Department of Neonatology, Shaare Zedek Medical Center, Jerusalem, Israel
| | - G Amarilyo
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Pediatrics B, Schneider Children's Medical Center of Israel, Tel Aviv University, Petah Tikva, Israel
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Fauquier DA, Litz J, Sanchez S, Colegrove K, Schwacke LH, Hart L, Saliki J, Smith C, Goldstein T, Bowen-Stevens S, McFee W, Fougeres E, Mase-Guthrie B, Stratton E, Ewing R, Venn-Watson S, Carmichael RH, Clemons-Chevis C, Hatchett W, Shannon D, Shippee S, Smith S, Staggs L, Tumlin MC, Wingers NL, Rowles TK. Evaluation of morbillivirus exposure in cetaceans from the northern Gulf of Mexico 2010-2014. ENDANGER SPECIES RES 2017. [DOI: 10.3354/esr00772] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Hafeman DM, Merranko J, Axelson D, Goldstein BI, Goldstein T, Monk K, Hickey MB, Sakolsky D, Diler R, Iyengar S, Brent D, Kupfer D, Birmaher B. Toward the Definition of a Bipolar Prodrome: Dimensional Predictors of Bipolar Spectrum Disorders in At-Risk Youths. Am J Psychiatry 2016; 173:695-704. [PMID: 26892940 PMCID: PMC4930393 DOI: 10.1176/appi.ajp.2015.15040414] [Citation(s) in RCA: 138] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
OBJECTIVE The authors sought to assess dimensional symptomatic predictors of new-onset bipolar spectrum disorders in youths at familial risk of bipolar disorder ("at-risk" youths). METHOD Offspring 6-18 years old of parents with bipolar I or II disorder (N=359) and community comparison offspring (N=220) were recruited. At baseline, 8.4% of the offspring of bipolar parents had a bipolar spectrum disorder. Over 8 years, 14.7% of offspring for whom follow-up data were available (44/299) developed a new-onset bipolar spectrum disorder (15 with bipolar I or II disorder). Measures collected at baseline and follow-up were reduced using factor analyses, and factors (both at baseline and at the visit prior to conversion or last contact) were assessed as predictors of new-onset bipolar spectrum disorders. RESULTS Relative to comparison offspring, at-risk and bipolar offspring had higher baseline levels of anxiety/depression, inattention/disinhibition, externalizing, subsyndromal manic, and affective lability symptoms. The strongest predictors of new-onset bipolar spectrum disorders were baseline anxiety/depression, baseline and proximal affective lability, and proximal subsyndromal manic symptoms (p<0.05). While affective lability and anxiety/depression were elevated throughout follow-up in those who later developed a bipolar spectrum disorder, manic symptoms increased up to the point of conversion. A path analysis supported the hypothesis that affective lability at baseline predicts a new-onset bipolar spectrum disorder in part through increased manic symptoms at the visit prior to conversion; earlier parental age at mood disorder onset was also significantly associated with an increased risk of conversion. While youths without anxiety/depression, affective lability, and mania (and with a parent with older age at mood disorder onset) had a 2% predicted chance of conversion to a bipolar spectrum disorder, those with all risk factors had a 49% predicted chance of conversion. CONCLUSIONS Dimensional measures of anxiety/depression, affective lability, and mania are important predictors of new-onset bipolar spectrum disorders in at-risk youths. These symptoms emerged from among numerous other candidates, underscoring the potential clinical and research utility of these findings.
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Affiliation(s)
| | | | - David Axelson
- Department of Psychiatry, Nationwide Children’s Hospital and The Ohio State University
| | | | | | - Kelly Monk
- Department of Psychiatry, University of Pittsburgh
| | | | | | - Rasim Diler
- Department of Psychiatry, University of Pittsburgh
| | | | - David Brent
- Department of Psychiatry, University of Pittsburgh
| | - David Kupfer
- Department of Psychiatry, University of Pittsburgh
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Schaffer A, Isometsä ET, Azorin JM, Cassidy F, Goldstein T, Rihmer Z, Sinyor M, Tondo L, Moreno DH, Turecki G, Reis C, Kessing LV, Ha K, Weizman A, Beautrais A, Chou YH, Diazgranados N, Levitt AJ, Zarate CA, Yatham L. A review of factors associated with greater likelihood of suicide attempts and suicide deaths in bipolar disorder: Part II of a report of the International Society for Bipolar Disorders Task Force on Suicide in Bipolar Disorder. Aust N Z J Psychiatry 2015; 49:1006-20. [PMID: 26175498 PMCID: PMC5858693 DOI: 10.1177/0004867415594428] [Citation(s) in RCA: 73] [Impact Index Per Article: 8.1] [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] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Many factors influence the likelihood of suicide attempts or deaths in persons with bipolar disorder. One key aim of the International Society for Bipolar Disorders Task Force on Suicide was to summarize the available literature on the presence and magnitude of effect of these factors. METHODS A systematic review of studies published from 1 January 1980 to 30 May 2014 identified using keywords 'bipolar disorder' and 'suicide attempts or suicide'. This specific paper examined all reports on factors putatively associated with suicide attempts or suicide deaths in bipolar disorder samples. Factors were subcategorized into: (1) sociodemographics, (2) clinical characteristics of bipolar disorder, (3) comorbidities, and (4) other clinical variables. RESULTS We identified 141 studies that examined how 20 specific factors influenced the likelihood of suicide attempts or deaths. While the level of evidence and degree of confluence varied across factors, there was at least one study that found an effect for each of the following factors: sex, age, race, marital status, religious affiliation, age of illness onset, duration of illness, bipolar disorder subtype, polarity of first episode, polarity of current/recent episode, predominant polarity, mood episode characteristics, psychosis, psychiatric comorbidity, personality characteristics, sexual dysfunction, first-degree family history of suicide or mood disorders, past suicide attempts, early life trauma, and psychosocial precipitants. CONCLUSION There is a wealth of data on factors that influence the likelihood of suicide attempts and suicide deaths in people with bipolar disorder. Given the heterogeneity of study samples and designs, further research is needed to replicate and determine the magnitude of effect of most of these factors. This approach can ultimately lead to enhanced risk stratification for patients with bipolar disorder.
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Affiliation(s)
- Ayal Schaffer
- Task Force on Suicide, The International Society for Bipolar Disorders (ISBD), Pittsburgh, PA, USA; Mood and Anxiety Disorders Program, Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Erkki T Isometsä
- Department of Psychiatry, Institute of Clinical Medicine, University of Helsinki, Helsinki, Finland
| | - Jean-Michel Azorin
- Department of Adult Psychiatry, Sainte Marguerite Hospital, Marseille, France; University of Aix-Marseille II, Marseille, France
| | - Frederick Cassidy
- Division of Brain Stimulation and Neurophysiology, Department of Psychiatry and Behavioural Sciences, Duke University, Durham, NC, USA
| | - Tina Goldstein
- Department of Child and Adolescent Psychiatry, Western Psychiatric Institute and Clinic, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Zoltán Rihmer
- Department of Clinical and Theoretical Mental Health, and Department of Psychiatry and Psychotherapy, Semmelweis Medical University, Budapest, Hungary
| | - Mark Sinyor
- Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Leonardo Tondo
- Lucio Bini Center, Cagliari, Italy; Harvard Medical School, Boston, MA, USA; McLean Hospital, Belmont, MA, USA
| | - Doris H Moreno
- Section of Psychiatric Epidemiology, and Mood Disorders Unit, Department and Institute of Psychiatry, University of São Paulo, São Paulo, Brazil
| | - Gustavo Turecki
- Research and Academic Affairs, Department of Psychiatry, McGill University, Montréal, QC, Canada; McGill Group for Suicide Studies, Montréal, QC, Canada; Depressive Disorders Program, Douglas Institute, Montréal, QC, Canada; Departments of Psychiatry, Human Genetics, and Neurology and Neurosurgery, McGill University, Montréal, QC, Canada
| | - Catherine Reis
- Mood and Anxiety Disorders Program, Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Lars Vedel Kessing
- Psychiatric Center Copenhagen, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Kyooseob Ha
- Mood Disorders Clinic and Affective Neuroscience Laboratory, Seoul National University Bundang Hospital, Seongnam, Republic of Korea; Korea Association for Suicide Prevention, Seoul, Republic of Korea
| | - Abraham Weizman
- Laboratory of Biological Psychiatry, The Felsenstein Medical Research Center, Petah Tikva, Israel; Research Unit, Geha Mental Health Center, Petah Tikva, Israel; Department of Psychiatry, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Annette Beautrais
- Department of Emergency Medicine, Yale School of Medicine, Yale University, New Haven, CT, USA
| | - Yuan-Hwa Chou
- Section of Psychosomatic Medicine, Department of Psychiatry, Taipei Veterans General Hospital, National Yang-Ming University, Taipei, Taiwan
| | - Nancy Diazgranados
- Laboratory of Clinical and Translational Studies, National Institute of Alcohol Abuse and Alcoholism, Bethesda, MD, USA
| | - Anthony J Levitt
- Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Carlos A Zarate
- Experimental Therapeutics & Pathophysiology Branch, Division Intramural Research Programs, National Institute of Mental Health, Bethesda, MD, USA
| | - Lakshmi Yatham
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
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Kennard BD, Biernesser C, Wolfe KL, Foxwell AA, Craddock Lee SJ, Rial KV, Patel S, Cheng C, Goldstein T, McMakin D, Blastos B, Douaihy A, Zelazny J, Brent DA. Developing a Brief Suicide Prevention Intervention and Mobile Phone Application: a Qualitative Report. J Technol Hum Serv 2015; 33:345-357. [PMID: 26977137 PMCID: PMC4788636 DOI: 10.1080/15228835.2015.1106384] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Suicide is the second leading cause of death among youth and has become a serious public health problem. There has been limited research on strategies to decrease the likelihood of reattempt in adolescents. As phase one of a treatment development study, clinicians, parents and adolescents participated in qualitative interviews in order to gain new perspectives on developing a targeted intervention and a safety plan phone application for suicide prevention. Participants indicated that transition of care, specific treatment targets and safety planning were important parts of treatment. In addition, all participants endorsed the use of a smartphone application for these purposes.
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Affiliation(s)
- Beth D Kennard
- University of Texas Southwestern Medical Center; Children's Health
| | | | - Kristin L Wolfe
- University of Texas Southwestern Medical Center; Children's Health
| | | | | | - Katie V Rial
- University of Texas Southwestern Medical Center; Children's Health
| | - Sarita Patel
- University of Texas Southwestern Medical Center; Children's Health
| | | | - Tina Goldstein
- University of Pittsburgh; Western Psychiatric Institute and Clinic
| | - Dana McMakin
- University of Pittsburgh; Western Psychiatric Institute and Clinic
| | | | - Antoine Douaihy
- University of Pittsburgh; Western Psychiatric Institute and Clinic
| | - Jamie Zelazny
- University of Pittsburgh; Western Psychiatric Institute and Clinic
| | - David A Brent
- University of Pittsburgh; Western Psychiatric Institute and Clinic
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Schaffer A, Isometsä ET, Tondo L, Moreno DH, Sinyor M, Kessing LV, Turecki G, Weizman A, Azorin JM, Ha K, Reis C, Cassidy F, Goldstein T, Rihmer Z, Beautrais A, Chou YH, Diazgranados N, Levitt AJ, Zarate CA, Yatham L. Epidemiology, neurobiology and pharmacological interventions related to suicide deaths and suicide attempts in bipolar disorder: Part I of a report of the International Society for Bipolar Disorders Task Force on Suicide in Bipolar Disorder. Aust N Z J Psychiatry 2015; 49:785-802. [PMID: 26185269 PMCID: PMC5116383 DOI: 10.1177/0004867415594427] [Citation(s) in RCA: 81] [Impact Index Per Article: 9.0] [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] [Indexed: 12/27/2022]
Abstract
OBJECTIVES Bipolar disorder is associated with elevated risk of suicide attempts and deaths. Key aims of the International Society for Bipolar Disorders Task Force on Suicide included examining the extant literature on epidemiology, neurobiology and pharmacotherapy related to suicide attempts and deaths in bipolar disorder. METHODS Systematic review of studies from 1 January 1980 to 30 May 2014 examining suicide attempts or deaths in bipolar disorder, with a specific focus on the incidence and characterization of suicide attempts and deaths, genetic and non-genetic biological studies and pharmacotherapy studies specific to bipolar disorder. We conducted pooled, weighted analyses of suicide rates. RESULTS The pooled suicide rate in bipolar disorder is 164 per 100,000 person-years (95% confidence interval = [5, 324]). Sex-specific data on suicide rates identified a 1.7:1 ratio in men compared to women. People with bipolar disorder account for 3.4-14% of all suicide deaths, with self-poisoning and hanging being the most common methods. Epidemiological studies report that 23-26% of people with bipolar disorder attempt suicide, with higher rates in clinical samples. There are numerous genetic associations with suicide attempts and deaths in bipolar disorder, but few replication studies. Data on treatment with lithium or anticonvulsants are strongly suggestive for prevention of suicide attempts and deaths, but additional data are required before relative anti-suicide effects can be confirmed. There were limited data on potential anti-suicide effects of treatment with antipsychotics or antidepressants. CONCLUSION This analysis identified a lower estimated suicide rate in bipolar disorder than what was previously published. Understanding the overall risk of suicide deaths and attempts, and the most common methods, are important building blocks to greater awareness and improved interventions for suicide prevention in bipolar disorder. Replication of genetic findings and stronger prospective data on treatment options are required before more decisive conclusions can be made regarding the neurobiology and specific treatment of suicide risk in bipolar disorder.
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Affiliation(s)
- Ayal Schaffer
- Task Force on Suicide, The International Society for Bipolar Disorders (ISBD), Pittsburgh, PA, USA; Mood and Anxiety Disorders Program, Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Erkki T Isometsä
- Department of Psychiatry, Institute of Clinical Medicine, University of Helsinki, Helsinki, Finland
| | - Leonardo Tondo
- Lucio Bini Center, Cagliari, Italy; Harvard Medical School, Boston, MA, USA; McLean Hospital, Belmont, MA, USA
| | - Doris H Moreno
- Section of Psychiatric Epidemiology and Mood Disorders Unit, Department and Institute of Psychiatry, University of São Paulo, São Paulo, Brazil
| | - Mark Sinyor
- Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Lars Vedel Kessing
- Psychiatric Center Copenhagen, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Gustavo Turecki
- Research and Academic Affairs, Department of Psychiatry, McGill University, Montréal, QC, Canada; McGill Group for Suicide Studies, Montréal, QC, Canada; Depressive Disorders Program, Douglas Institute, Montréal, QC, Canada; Departments of Psychiatry, Human Genetics, and Neurology and Neurosurgery, McGill University, Montréal, QC, Canada
| | - Abraham Weizman
- Laboratory of Biological Psychiatry, The Felsenstein Medical Research Center, Petah Tikva, Israel; Research Unit, Geha Mental Health Center, Petah Tikva, Israel; Department of Psychiatry, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Jean-Michel Azorin
- Department of Adult Psychiatry, Sainte Marguerite Hospital, Marseille, France; University of Aix-Marseille II, Marseille, France
| | - Kyooseob Ha
- Mood Disorders Clinic and Affective Neuroscience Laboratory, Seoul National University Bundang Hospital, Seongnam, Republic of Korea; Korea Association for Suicide Prevention, Seoul, Republic of Korea
| | - Catherine Reis
- Mood and Anxiety Disorders Program, Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Frederick Cassidy
- Division of Brain Stimulation and Neurophysiology, Department of Psychiatry and Behavioural Sciences, Duke University, Durham, NC, USA
| | - Tina Goldstein
- Department of Child and Adolescent Psychiatry, Western Psychiatric Institute and Clinic, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Zoltán Rihmer
- Department of Clinical and Theoretical Mental Health, and Department of Psychiatry and Psychotherapy, Semmelweis Medical University, Budapest, Hungary
| | - Annette Beautrais
- Department of Emergency Medicine, Yale School of Medicine, Yale University, New Haven, CT, USA
| | - Yuan-Hwa Chou
- Section of Psychosomatic Medicine, Department of Psychiatry, Taipei Veterans General Hospital, National Yang-Ming University, Taipei, Taiwan
| | - Nancy Diazgranados
- Laboratory of Clinical and Translational Studies, National Institute of Alcohol Abuse and Alcoholism, Bethesda, MD, USA
| | - Anthony J Levitt
- Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Carlos A Zarate
- Experimental Therapeutics & Pathophysiology Branch, Division of Intramural Research Programs, National Institute of Mental Health, Bethesda, MD, USA
| | - Lakshmi Yatham
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
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Axelson D, Goldstein B, Goldstein T, Monk K, Yu H, Hickey MB, Sakolsky D, Diler R, Hafeman D, Merranko J, Iyengar S, Brent D, Kupfer D, Birmaher B. Diagnostic Precursors to Bipolar Disorder in Offspring of Parents With Bipolar Disorder: A Longitudinal Study. Am J Psychiatry 2015; 172:638-46. [PMID: 25734353 PMCID: PMC4489996 DOI: 10.1176/appi.ajp.2014.14010035] [Citation(s) in RCA: 169] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVE The authors sought to identify diagnostic risk factors of manic, mixed, or hypomanic episodes in the offspring of parents with bipolar disorder ("high-risk offspring"). METHOD High-risk offspring 6-18 years old (N=391) and demographically matched offspring (N=248) of community parents without bipolar disorder were assessed longitudinally with standardized diagnostic instruments by staff blind to parental diagnoses. Follow-up assessments were completed in 91% of the offspring (mean follow-up interval, 2.5 years; mean follow-up duration, 6.8 years). RESULTS Compared with community offspring, high-risk offspring had significantly higher rates of subthreshold mania or hypomania (13.3% compared with 1.2%), manic, mixed, or hypomanic episodes (9.2% compared with 0.8%), and major depressive episodes (32.0% compared with 14.9%). They also had higher rates of attention deficit hyperactivity disorder (30.7% compared with 18.1%), disruptive behavior disorders (27.4% compared with 15.3%), anxiety disorders (39.9% compared with 21.8%), and substance use disorders (19.9% compared with 10.1%), but not unipolar major depressive disorder (major depression with no bipolarity; 18.9% compared with 13.7%). Multivariate Cox regressions showed that in the high-risk offspring, subthreshold manic or hypomanic episodes (hazard ratio=2.29), major depressive episodes (hazard ratio=1.99), and disruptive behavior disorders (hazard ratio=2.12) were associated with subsequent manic, mixed, or hypomanic episodes. Only subthreshold manic or hypomanic episodes (hazard ratio=7.57) were associated when analyses were restricted to prospective data. CONCLUSIONS Subthreshold manic or hypomanic episodes were a diagnostic risk factor for the development of manic, mixed, or hypomanic episodes in the offspring of parents with bipolar disorder and should be a target for clinical assessment and treatment research. Major depressive episodes and disruptive behavior disorders are also indications for close clinical monitoring of emergent bipolarity in high-risk offspring.
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Schaffer A, Isometsä ET, Tondo L, Moreno D, Turecki G, Reis C, Cassidy F, Sinyor M, Azorin JM, Kessing LV, Ha K, Goldstein T, Weizman A, Beautrais A, Chou YH, Diazgranados N, Levitt AJ, Zarate CA, Rihmer Z, Yatham LN. International Society for Bipolar Disorders Task Force on Suicide: meta-analyses and meta-regression of correlates of suicide attempts and suicide deaths in bipolar disorder. Bipolar Disord 2015; 17:1-16. [PMID: 25329791 PMCID: PMC6296224 DOI: 10.1111/bdi.12271] [Citation(s) in RCA: 213] [Impact Index Per Article: 23.7] [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: 05/01/2014] [Accepted: 09/05/2014] [Indexed: 12/21/2022]
Abstract
OBJECTIVES Bipolar disorder is associated with a high risk of suicide attempts and suicide death. The main objective of the present study was to identify and quantify the demographic and clinical correlates of attempted and completed suicide in people with bipolar disorder. METHODS Within the framework of the International Society for Bipolar Disorders Task Force on Suicide, a systematic review of articles published since 1980, characterized by the key terms bipolar disorder and 'suicide attempts' or 'suicide', was conducted, and data extracted for analysis from all eligible articles. Demographic and clinical variables for which ≥ 3 studies with usable data were available were meta-analyzed using fixed or random-effects models for association with suicide attempts and suicide deaths. There was considerable heterogeneity in the methods employed by the included studies. RESULTS Variables significantly associated with suicide attempts were: female gender, younger age at illness onset, depressive polarity of first illness episode, depressive polarity of current or most recent episode, comorbid anxiety disorder, any comorbid substance use disorder, alcohol use disorder, any illicit substance use, comorbid cluster B/borderline personality disorder, and first-degree family history of suicide. Suicide deaths were significantly associated with male gender and first-degree family history of suicide. CONCLUSIONS This paper reports on the presence and magnitude of the correlates of suicide attempts and suicide deaths in bipolar disorder. These findings do not address causation, and the heterogeneity of data sources should limit the direct clinical ranking of correlates. Our results nonetheless support the notion of incorporating diagnosis-specific data in the development of models of understanding suicide in bipolar disorder.
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Affiliation(s)
- Ayal Schaffer
- Department of Psychiatry, Sunnybrook Health Sciences Centre and Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Erkki T Isometsä
- Institute of Clinical Medicine University of Helsinki, Helsinki, Finland
| | - Leonardo Tondo
- Lucio Bini Center, Cagliari, Italy and Harvard Medical School, McLean Hospital, Boston, MA, USA
| | - Doris Moreno
- Department and Institute of Psychiatry, University of São Paulo, São Paulo, Brazil
| | - Gustavo Turecki
- Departments of Psychiatry, Human Genetics, and Neurology & Neurosurgery, McGill University, Montreal, QC, Canada
| | - Catherine Reis
- Department of Psychiatry, Sunnybrook Health Sciences Centre and Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Frederick Cassidy
- Department of Psychiatry and Behavioural Sciences, Duke University, Durham, USA
| | - Mark Sinyor
- Department of Psychiatry, Sunnybrook Health Sciences Centre and Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Jean-Michel Azorin
- Department of Psychiatry, University of Aix-Marseille II, Marseille, France
| | - Lars Vedel Kessing
- Faculty of Health Sciences, University of Copenhagen, Psychiatric Center Copenhagen Department, Copenhagen, Denmark
| | - Kyooseob Ha
- Department of Psychiatry, Seoul National University, Bundang Hospital, Seoul, Republic of Korea
| | - Tina Goldstein
- Department of Child and Adolescent Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Abraham Weizman
- Department of Psychiatry, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Annette Beautrais
- Department of Emergency Medicine, Yale School of Medicine, Yale University, New Haven, CT, USA
| | - Yuan-Hwa Chou
- Department of Psychiatry, Taipei Veterans General Hospital and National Yang Ming University, Taipei, Taiwan
| | | | - Anthony J Levitt
- Department of Psychiatry, Sunnybrook Health Sciences Centre and Department of Psychiatry, University of Toronto, Toronto, Canada
| | | | - Zoltán Rihmer
- Department of Clinical and Theoretical Mental Health and Department of Psychiatry and Psychotherapy, Semmelweis Medical University, Budapest, Hungary
| | - Lakshmi N Yatham
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
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Frank E, Benabou M, Bentzley B, Bianchi M, Goldstein T, Konopka G, Maywood E, Pritchett D, Sheaves B, Thomas J. Influencing circadian and sleep-wake regulation for prevention and intervention in mood and anxiety disorders: what makes a good homeostat? Ann N Y Acad Sci 2014; 1334:1-25. [PMID: 25532787 PMCID: PMC4350368 DOI: 10.1111/nyas.12600] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
All living organisms depend on homeostasis, the complex set of interacting metabolic chemical reactions for maintaining life and well-being. This is no less true for psychiatric well-being than for physical well-being. Indeed, a focus on homeostasis forces us to see how inextricably linked mental and physical well-being are. This paper focuses on these linkages. In particular, it addresses the ways in which understanding of disturbed homeostasis may aid in creating classes of patients with mood and anxiety disorders based on such phenotypes. At the cellular level, we may be able to compensate for the inability to study living brain tissue through the study of homeostatic mechanisms in fibroblasts, pluripotent human cells, and mitochondria and determine how homeostasis is disturbed at the level of these peripheral tissues through exogenous stress. We also emphasize the remarkable opportunities for enhancing knowledge in this area that are offered by advances in technology. The study of human behavior, especially when combined with our greatly improved capacity to study unique but isolated populations, offers particularly clear windows into the relationships among genetic, environmental, and behavioral contributions to homeostasis.
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Affiliation(s)
- Ellen Frank
- Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Marion Benabou
- Human Genetics and Cognitive Functions, Institut Pasteur, Paris, France
| | - Brandon Bentzley
- Department of Neurosciences, Medical University of South Carolina, Charleston, South Carolina
| | - Matt Bianchi
- Department of Neurology, Sleep Division, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Tina Goldstein
- Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Genevieve Konopka
- Department of Neuroscience, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Elizabeth Maywood
- Neurobiology Division, MRC Laboratory of Molecular Biology, Cambridge Biomedical Campus, Cambridge, United Kingdom
| | - David Pritchett
- Nuffield Department of Clinical Neurosciences (Nuffield Laboratory of Ophthalmology), University of Oxford, John Radcliffe Hospital, Oxford, United Kingdom
| | - Bryony Sheaves
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, United Kingdom
| | - Jessica Thomas
- Molecular Sleep Laboratory, Glostrup University Hospital, Glostrup, Denmark
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Goldstein T, Smith L, Grande D, Zeltsman D. 286 * INTEGRATING BIODEGRADABLE 3D-BIOPRINTING TECHNOLOGY INTO TRACHEAL RECONSTRUCTION. Interact Cardiovasc Thorac Surg 2014. [DOI: 10.1093/icvts/ivu276.286] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Maoz H, Goldstein T, Goldstein BI, Axelson DA, Fan J, Hickey MB, Monk K, Sakolsky D, Diler RS, Brent D, Kupfer DJ, Birmaher B. The effects of parental mood on reports of their children's psychopathology. J Am Acad Child Adolesc Psychiatry 2014; 53:1111-22.e5. [PMID: 25245355 PMCID: PMC4173133 DOI: 10.1016/j.jaac.2014.07.005] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [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: 03/31/2014] [Revised: 07/18/2014] [Accepted: 07/24/2014] [Indexed: 11/30/2022]
Abstract
OBJECTIVE In this study, we aimed to assess whether current mood state (depressed or manic/hypomanic) among parents with a mood disorder would affect their reports of their offspring's psychopathology. METHOD Sixty-five parents with current depression, 42 parents with current mania/hypomania, 181 parents with mood disorder in remission, and their offspring (n = 479, aged 6-18 years) completed assessments of offspring psychopathology as part of the Pittsburgh Bipolar Offspring Study (BIOS). We compared rates of offspring psychopathology assessed using the following: a clinician-administered semi-structured interview with parent and child using the Schedule for Affective Disorders and Schizophrenia for School-Age Children (K-SADS); parent-reported Child Behavior Checklist (CBCL); offspring self-reported Youth Self Reports (YSR) for those 11 years and older (n = 250); and teachers' reports when available (n = 209). RESULTS There were no between-group differences in rates of psychopathology yielded from the K-SADS, except for more depressive disorders in offspring of parents with current mania/hypomania compared to offspring of parents in remission. Conversely, using the CBCL and comparing with parents who were in remission, parents with current depression reported significantly more externalizing psychopathology in offspring, whereas parents with current mania/hypomania reported more externalizing and internalizing psychopathology in their offspring. On the YSR, offspring of parents with current mania/hypomania had more internalizing psychopathology compared to offspring of parents in remission. Teacher's reports showed no between-group differences in rates of any psychopathology. CONCLUSION Parental active mood symptomatology, especially during a manic/hypomanic episode, significantly affects their reports of their offspring's psychopathology. Trained interviewers reduce potential report bias. Clinicians and studies assessing children's psychopathology should take into account parental current mood state.
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Affiliation(s)
- Hagai Maoz
- Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pennsylvania
| | - Tina Goldstein
- Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pennsylvania
| | | | - David A. Axelson
- Nationwide Children's Hospital and The Ohio State College of Medicine, Columbus, Ohio
| | - Jieyu Fan
- Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pennsylvania
| | - Mary Beth Hickey
- Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pennsylvania
| | - Kelly Monk
- Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pennsylvania
| | - Dara Sakolsky
- Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pennsylvania
| | - Rasim S. Diler
- Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pennsylvania
| | - David Brent
- Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pennsylvania
| | - David J. Kupfer
- Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pennsylvania
| | - Boris Birmaher
- Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pennsylvania.
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Sparks GM, Axelson DA, Yu H, Ha W, Ballester J, Diler RS, Goldstein B, Goldstein T, Hickey MB, Ladouceur CD, Monk K, Sakolsky D, Birmaher B. Disruptive mood dysregulation disorder and chronic irritability in youth at familial risk for bipolar disorder. J Am Acad Child Adolesc Psychiatry 2014; 53:408-16. [PMID: 24655650 PMCID: PMC4049528 DOI: 10.1016/j.jaac.2013.12.026] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [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: 07/03/2012] [Revised: 10/31/2013] [Accepted: 01/16/2014] [Indexed: 01/12/2023]
Abstract
OBJECTIVE Disruptive mood dysregulation disorder (DMDD) is a new diagnosis in the DSM-5. Youth with a family history of bipolar disorder (BD) are at increased risk for BD and non-bipolar psychopathology. No studies to date have examined rates of DMDD among offspring of parents with BD. This study examines the risk for DMDD in offspring of parents with BD compared to community controls and considers rates of chronic irritability (independent of a DMDD diagnosis) across diagnoses in youth with parents with BD. METHOD Modified DMDD criteria were applied post hoc to 375 offspring of parents with BD and 241 offspring, aged 6 to 17 years, of community control parents. We calculated odds ratios using generalized linear mixed models. In addition, we explored associations with a severe chronic irritability phenotype and various diagnoses in the high-risk cohort. RESULTS Offspring of parents with BD were more likely to meet criteria for DMDD than were the offspring of community control parents (Odds ratio [OR] = 8.3, 6.7% vs. 0.8%), even when controlling for demographic variables and comorbid parental diagnoses (OR = 5.4). They also had higher rates of chronic irritability compared to community controls (12.5% vs. 2.5%, χ(2) = 18.8, p < .005). Within the offspring of parents with BD, the chronic irritability phenotype was frequently present in offspring with diagnoses of BD, depression, attention-deficit/hyperactivity disorder, and disruptive behavior disorders. CONCLUSIONS Like other non-BD diagnoses, family history of BD increases the risk for DMDD. Severe chronic irritability and temper tantrums are the core features of DMDD, and are associated with mood and behavioral disorders in youth at risk for BD.
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Affiliation(s)
- Garrett M. Sparks
- Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine
| | - David A. Axelson
- Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine
| | - Haifeng Yu
- Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine
| | - Wonho Ha
- Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine
| | - Javier Ballester
- Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine
| | - Rasim S. Diler
- Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine
| | | | - Tina Goldstein
- Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine
| | - Mary Beth Hickey
- Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine
| | - Cecile D. Ladouceur
- Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine
| | - Kelly Monk
- Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine
| | - Dara Sakolsky
- Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine
| | - Boris Birmaher
- Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine
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Maoz H, Goldstein T, Axelson DA, Goldstein BI, Fan J, Hickey MB, Monk K, Sakolsky D, Diler RS, Brent D, Iyengar S, Kupfer DJ, Birmaher B. Dimensional psychopathology in preschool offspring of parents with bipolar disorder. J Child Psychol Psychiatry 2014; 55:144-53. [PMID: 24372351 PMCID: PMC4017915 DOI: 10.1111/jcpp.12137] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [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: 07/16/2013] [Indexed: 12/25/2022]
Abstract
BACKGROUND The purpose of this study is to compare the dimensional psychopathology, as ascertained by parental report, in preschool offspring of parents with bipolar disorder (BP) and offspring of community control parents. METHODS 122 preschool offspring (mean age 3.3 years) of 84 parents with BP, with 102 offspring of 65 control parents (36 healthy, 29 with non-BP psychopathology), were evaluated using the Child Behavior Checklist (CBCL), the CBCL-Dysregulation Profile (CBCL-DP), the Early Childhood Inventory (ECI-4), and the Emotionality Activity Sociability (EAS) survey. Teachers' Report Forms (TRF) were available for 51 preschoolers. RESULTS After adjusting for confounders, offspring of parents with BP showed higher scores in the CBCL total, externalizing, somatic, sleep, aggressive, and CBCL-DP subscales; the ECI-4 sleep problem scale; and the EAS total and emotionality scale. The proportion of offspring with CBCL T-scores ≥ 2 SD above the norm was significantly higher on most CBCL subscales and the CBCL-DP in offspring of parents with BP compared to offspring of controls even after excluding offspring with attention deficit hyperactivity disorder and/or oppositional defiant disorder. Compared to offspring of parents with BP-I, offspring of parents with BP-II showed significantly higher scores in total and most CBCL subscales, the ECI-4 anxiety and sleep scales and the EAS emotionality scale. For both groups of parents, there were significant correlations between CBCL and TRF scores (r = .32-.38, p-values ≤.02). CONCLUSIONS Independent of categorical axis-I psychopathology and other demographic or clinical factors in both biological parents, preschool offspring of parents with BP have significantly greater aggression, mood dysregulation, sleep disturbances, and somatic complaints compared to offspring of control parents. Interventions to target these symptoms are warranted.
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Affiliation(s)
- Hagai Maoz
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Tina Goldstein
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - David A. Axelson
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Benjamin I. Goldstein
- Department of Psychiatry, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
| | - Jieyu Fan
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Mary Beth Hickey
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Kelly Monk
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Dara Sakolsky
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Rasim S. Diler
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - David Brent
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Satish Iyengar
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - David J. Kupfer
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Boris Birmaher
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
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Goldstein T, Serok E. New Approach to Improve Eating Habits. J Acad Nutr Diet 2013. [DOI: 10.1016/j.jand.2013.06.137] [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: 10/26/2022]
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Birmaher B, Goldstein BI, Axelson DA, Monk K, Hickey MB, Fan J, Iyengar S, Ha W, Diler RS, Goldstein T, Brent D, Ladouceur CD, Sakolsky D, Kupfer DJ. Mood lability among offspring of parents with bipolar disorder and community controls. Bipolar Disord 2013; 15:253-63. [PMID: 23551755 PMCID: PMC3644367 DOI: 10.1111/bdi.12060] [Citation(s) in RCA: 44] [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: 05/16/2012] [Accepted: 12/31/2012] [Indexed: 01/03/2023]
Abstract
OBJECTIVES Early identification of bipolar disorder (BP) symptomatology is crucial for improving the prognosis of this illness. Increased mood lability has been reported in BP. However, mood lability is ubiquitous across psychiatric disorders and may be a marker of severe psychopathology and not specific to BP. To clarify this issue, this study examined the prevalence of mood lability and its components in offspring of BP parents and offspring of community control parents recruited through the Pittsburgh Bipolar Offspring Study. METHODS Forty-one school-age BP offspring of 38 BP parents, 257 healthy or non-BP offspring of 174 BP parents, and 192 offspring of 117 control parents completed a scale that was developed to evaluate mood lability in youth, i.e., the Children's Affective Lability Scale (CALS). RESULTS A factor analysis of the parental CALS, and in part the child CALS, revealed Irritability, Mania, and Anxiety/Depression factors, with most of the variance explained by the Irritability factor. After adjusting for confounding factors (e.g., parental and offspring non-BP psychopathology), BP offspring of BP parents showed the highest parental and child total and factor scores, followed by the non-BP offspring of BP parents, and then the offspring of the controls. CONCLUSIONS Mood lability overall and mania-like, anxious/depressed, and particularly irritability symptoms may be a prodromal phenotype of BP among offspring of parents with BP. Prospective studies are warranted to clarify whether these symptoms will predict the development of BP and/or other psychopathology. If confirmed, these symptoms may become a target of treatment and biological studies before BP develops.
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Affiliation(s)
- Boris Birmaher
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA.
| | - Benjamin I Goldstein
- Department of Psychiatry, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - David A Axelson
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Kelly Monk
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Mary Beth Hickey
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Jieyu Fan
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Satish Iyengar
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Wonho Ha
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Rasim S Diler
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Tina Goldstein
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - David Brent
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Cecile D Ladouceur
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Dara Sakolsky
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - David J Kupfer
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
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Anthony SJ, Ojeda-Flores R, Rico-Chávez O, Navarrete-Macias I, Zambrana-Torrelio CM, Rostal MK, Epstein JH, Tipps T, Liang E, Sanchez-Leon M, Sotomayor-Bonilla J, Aguirre AA, Ávila-Flores R, Medellín RA, Goldstein T, Suzán G, Daszak P, Lipkin WI. Coronaviruses in bats from Mexico. J Gen Virol 2013; 94:1028-1038. [PMID: 23364191 PMCID: PMC3709589 DOI: 10.1099/vir.0.049759-0] [Citation(s) in RCA: 127] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Bats are reservoirs for a wide range of human pathogens including Nipah, Hendra, rabies, Ebola, Marburg and severe acute respiratory syndrome coronavirus (CoV). The recent implication of a novel beta (β)-CoV as the cause of fatal respiratory disease in the Middle East emphasizes the importance of surveillance for CoVs that have potential to move from bats into the human population. In a screen of 606 bats from 42 different species in Campeche, Chiapas and Mexico City we identified 13 distinct CoVs. Nine were alpha (α)-CoVs; four were β-CoVs. Twelve were novel. Analyses of these viruses in the context of their hosts and ecological habitat indicated that host species is a strong selective driver in CoV evolution, even in allopatric populations separated by significant geographical distance; and that a single species/genus of bat can contain multiple CoVs. A β-CoV with 96.5 % amino acid identity to the β-CoV associated with human disease in the Middle East was found in a Nyctinomops laticaudatus bat, suggesting that efforts to identify the viral reservoir should include surveillance of the bat families Molossidae/Vespertilionidae, or the closely related Nycteridae/Emballonuridae. While it is important to investigate unknown viral diversity in bats, it is also important to remember that the majority of viruses they carry will not pose any clinical risk, and bats should not be stigmatized ubiquitously as significant threats to public health.
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Affiliation(s)
- S J Anthony
- EcoHealth Alliance, 460 West 34th Street, NY, USA
- Center for Infection and Immunity, Mailman School of Public Health, Columbia University, 722 West 168th Street, NY, USA
| | - R Ojeda-Flores
- Facultad de Medicina Veterinaria y Zootecnia, Universidad Nacional Autónoma de México, Ciudad Universitaria, 04510, México D.F. Mexico
| | - O Rico-Chávez
- Facultad de Medicina Veterinaria y Zootecnia, Universidad Nacional Autónoma de México, Ciudad Universitaria, 04510, México D.F. Mexico
| | - I Navarrete-Macias
- Center for Infection and Immunity, Mailman School of Public Health, Columbia University, 722 West 168th Street, NY, USA
| | | | - M K Rostal
- EcoHealth Alliance, 460 West 34th Street, NY, USA
| | - J H Epstein
- EcoHealth Alliance, 460 West 34th Street, NY, USA
| | - T Tipps
- EcoHealth Alliance, 460 West 34th Street, NY, USA
| | - E Liang
- EcoHealth Alliance, 460 West 34th Street, NY, USA
- Center for Infection and Immunity, Mailman School of Public Health, Columbia University, 722 West 168th Street, NY, USA
| | - M Sanchez-Leon
- EcoHealth Alliance, 460 West 34th Street, NY, USA
- Center for Infection and Immunity, Mailman School of Public Health, Columbia University, 722 West 168th Street, NY, USA
| | - J Sotomayor-Bonilla
- Facultad de Medicina Veterinaria y Zootecnia, Universidad Nacional Autónoma de México, Ciudad Universitaria, 04510, México D.F. Mexico
| | - A A Aguirre
- George Mason University, 1500 Remount Road, Front Royal, Virginia, USA
| | - R Ávila-Flores
- Facultad de Medicina Veterinaria y Zootecnia, Universidad Nacional Autónoma de México, Ciudad Universitaria, 04510, México D.F. Mexico
| | - R A Medellín
- Instituto de Ecología, Universidad Nacional Autónoma de México, Ap. Postal 70-275, 04510, México, D.F. Mexico
| | - T Goldstein
- One Health Institute, School of Veterinary Medicine, One Shields Ave, University of California Davis, California USA
| | - G Suzán
- Facultad de Medicina Veterinaria y Zootecnia, Universidad Nacional Autónoma de México, Ciudad Universitaria, 04510, México D.F. Mexico
| | - P Daszak
- EcoHealth Alliance, 460 West 34th Street, NY, USA
| | - W I Lipkin
- Center for Infection and Immunity, Mailman School of Public Health, Columbia University, 722 West 168th Street, NY, USA
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Topor DR, Swenson L, Hunt J, Birmaher B, Strober M, Yen S, Hoeppner B, Case B, Hower H, Weinstock LM, Ryan N, Goldstein B, Goldstein T, Gill MK, Axelson D, Keller M. Manic symptoms in youth with bipolar disorder: factor analysis by age of symptom onset and current age. J Affect Disord 2013; 145:409-12. [PMID: 23021377 PMCID: PMC3535567 DOI: 10.1016/j.jad.2012.06.024] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [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: 02/01/2012] [Revised: 05/31/2012] [Accepted: 06/12/2012] [Indexed: 12/11/2022]
Abstract
BACKGROUND Factor analysis has been used to identify potential clinical subtypes of mania in pediatric bipolar disorder. Results vary in the number of factors retained. The present study used a formal diagnostic instrument to examine how symptoms of mania in young people are expressed, depending on age of symptom onset and current age. METHODS Trained clinicians completed the Schedule of Affective Disorders and Schizophrenia for School-Age Children (K-SADS) Mania Rating Scale (MRS) with parents of 163 children with child-onset of symptoms (before age 12), 94 adolescents with child-onset of symptoms, and 90 adolescents with adolescent-onset of symptoms (after age 12). Factor analysis of symptom ratings during the most severe lifetime manic episode was performed for each age group. RESULTS Symptom factor structures were established for each age group. Two factors were evident for children with child-onset of symptoms ("activated/pleasure seeking" and "labile/disorganized"), one factor was present for adolescents with child-onset of symptoms ("activated/pleasure seeking/disorganized") and two factors were evident for adolescents with adolescent-onset of symptoms ("activated/pleasure seeking" and "disorganized/psychotic"). The factor structures for children with child-onset and adolescents with adolescent-onset of symptoms were highly similar, with the latter factor structure including psychotic symptoms. LIMITATIONS Limitations include reliance on retrospective parent report and potential issues with generalizability. CONCLUSIONS Findings suggest mania symptomatology is largely similar when examined by both age of onset and current age, with some notable differences. Specifically, psychotic symptoms begin emerging as a distinct factor in adolescents with adolescent-onset of symptoms.
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Affiliation(s)
- David R. Topor
- VA Boston Healthcare System, Boston, MA and Department of Psychiatry, Harvard Medical School, Boston, MA
| | - Lance Swenson
- Department of Psychology, Suffolk University, Boston, MA
| | - Jeffrey Hunt
- Department of Psychiatry and Butler and Bradley Hospitals, The Warren Alpert Medical School of Brown University, Providence, RI
| | - Boris Birmaher
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Michael Strober
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA
| | - Shirley Yen
- Department of Psychiatry and Butler and Bradley Hospitals, The Warren Alpert Medical School of Brown University, Providence, RI
| | - Bettina Hoeppner
- Department of Psychiatry and Butler and Bradley Hospitals, The Warren Alpert Medical School of Brown University, Providence, RI
| | - Brady Case
- Department of Psychiatry and Butler and Bradley Hospitals, The Warren Alpert Medical School of Brown University, Providence, RI
| | - Heather Hower
- Department of Psychiatry and Butler and Bradley Hospitals, The Warren Alpert Medical School of Brown University, Providence, RI
| | - Lauren M. Weinstock
- Department of Psychiatry and Butler and Bradley Hospitals, The Warren Alpert Medical School of Brown University, Providence, RI
| | - Neal Ryan
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Benjamin Goldstein
- University of Toronto, Faculty of Medicine, Department of Psychiatry, Sunnybrook Health Services Centre, Assistant Professor of Psychiatry
| | - Tina Goldstein
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Mary Kay Gill
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, Pittsburgh, PA
| | - David Axelson
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Martin Keller
- Department of Psychiatry and Butler and Bradley Hospitals, The Warren Alpert Medical School of Brown University, Providence, RI
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Hueper K, Vogel-Claussen J, Parikh M, Austin J, Bluemke D, Carr J, Goldstein T, Gomes A, Hoffman E, Lima J, Barr G. Veränderungen der Lungenperfusion bei Patienten mit chronisch obstruktiver Lungenerkrankung (COPD) - die MESA COPD Studie. ROFO-FORTSCHR RONTG 2012. [DOI: 10.1055/s-0032-1311254] [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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Ballester J, Goldstein T, Goldstein B, Obreja M, Axelson D, Monk K, Hickey M, Iyengar S, Farchione T, Kupfer DJ, Brent D, Birmaher B. Is bipolar disorder specifically associated with aggression? Bipolar Disord 2012; 14:283-90. [PMID: 22548901 PMCID: PMC3342837 DOI: 10.1111/j.1399-5618.2012.01006.x] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.6] [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] [Indexed: 10/28/2022]
Abstract
OBJECTIVE Several studies have suggested that bipolar disorder (BP) in adults is associated with aggressive behaviors. However, most studies have included only inpatients and have not taken into consideration possible confounding factors. The goal of the present study was to compare the prevalence of aggression in subjects with BP compared to subjects with other, non-BP psychopathology and healthy controls. METHODS Subjects with bipolar I disorder (BP-I) and bipolar II disorder (BP-II) (n = 255), non-BP psychopathology (n = 85), and healthy controls (n = 84) were recruited. Aggression was measured using the Aggression Questionnaire (AQ). Group comparisons were adjusted for demographic and clinical differences (e.g., comorbid disorders) and multiple comparisons. The effects of the subtype of BP, current versus past episode, polarity of current episode, psychosis, the presence of irritable mania/hypomania only, and pharmacological treatment were examined. RESULTS Subjects with BP showed significantly higher total and subscale AQ scores (raw and T-scores) when compared to subjects with non-BP psychopathology and healthy controls. Exclusion of subjects with current mood episodes and those with common comorbid disorders yielded similar results. There were no effects of BP subtype, polarity of the current episode, irritable manic/hypomanic episodes only, or current use of pharmacological treatments. Independent of the severity of BP and polarity of the episode, those in a current mood episode showed significantly higher AQ scores than those not in a current mood episode. Subjects with current psychosis showed significantly higher total AQ score, hostility, and anger than those without current psychosis. CONCLUSIONS Subjects with BP display greater rates of anger and aggressive behaviors, especially during acute and psychotic episodes. Early identification and management of these behaviors is warranted.
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Affiliation(s)
| | - Tina Goldstein
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Benjamin Goldstein
- Sunnybrook Health Sciences Centre, University of Toronto Faculty of Medicine, Toronto, ON, Canada
| | | | - David Axelson
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Kelly Monk
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - MaryBeth Hickey
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Satish Iyengar
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Tiffany Farchione
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - David J Kupfer
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - David Brent
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Boris Birmaher
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
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Hueper K, Zapf A, Skrok J, Pinheiro A, Goldstein T, Zheng J, Abraham R, Wacker F, Bluemke D, Abraham T, Vogel-Claussen J. Bei Patienten mit hypertropher Kardiomyopathie sind myokardiales Late Enhancement, T2-Signalveränderungen, links-ventrikuläre Hypertrophie und hohes Alter assoziiert mit einer lokal reduzierten myokardialen Ruheperfusion. ROFO-FORTSCHR RONTG 2012. [DOI: 10.1055/s-0031-1300879] [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: 10/14/2022]
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Diler RS, Birmaher B, Axelson D, Obreja M, Monk K, Hickey MB, Goldstein B, Goldstein T, Sakolsky D, Iyengar S, Brent D, Kupfer D. Dimensional psychopathology in offspring of parents with bipolar disorder. Bipolar Disord 2011; 13:670-8. [PMID: 22085480 PMCID: PMC3226755 DOI: 10.1111/j.1399-5618.2011.00966.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [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] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To compare the dimensional psychopathology in offspring of parents with bipolar disorder (BP) with offspring of community control parents as assessed by the Child Behavior Checklist (CBCL). METHODS Offspring of parents with BP, who were healthy or had non-BP disorders (any psychiatric disorder other than BP; n = 319) or who had bipolar spectrum disorders (n = 35), and offspring of community controls (n = 235) ages 6-18 years were compared using the CBCL, the CBCL-Dysregulation Profile (CBCL-DP), and a sum of the CBCL items associated with mood lability. The results were adjusted for multiple comparisons and for any significant between-group demographic and clinical differences in both biological parents and offspring. RESULTS With few exceptions, several CBCL (e.g., Total, Internalizing, and Aggression Problems), CBCL-DP, and mood lability scores in non-BP offspring of parents with BP were significantly higher than in offspring of control parents. In addition, both groups of offspring showed significantly lower scores in most scales when compared with offspring of parents with BP who had already developed BP. Similar results were obtained when analyzing the rates of subjects with CBCL T-scores that were two standard deviations or higher above the mean. CONCLUSIONS Even before developing BP, offspring of parents with BP had more severe and higher rates of dimensional psychopathology than offspring of control parents. Prospective follow-up studies in non-BP offspring of parents with BP are warranted to evaluate whether these dimensional profiles are prodromal manifestations of mood or other disorders, and can predict those who are at higher risk to develop BP.
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Affiliation(s)
- Rasim Somer Diler
- Department of Psychiatry, University of Pittsburgh, School of Medicine, Pittsburgh, PA, USA.
| | - Boris Birmaher
- Department of Psychiatry, University of Pittsburgh, School of Medicine, Pittsburgh, PA
| | - David Axelson
- Department of Psychiatry, University of Pittsburgh, School of Medicine, Pittsburgh, PA
| | - Mihaela Obreja
- Department of Psychiatry, University of Pittsburgh, School of Medicine, Pittsburgh, PA
| | - Kelly Monk
- Department of Psychiatry, University of Pittsburgh, School of Medicine, Pittsburgh, PA
| | - Mary Beth Hickey
- Department of Psychiatry, University of Pittsburgh, School of Medicine, Pittsburgh, PA
| | - Benjamin Goldstein
- Department of Psychiatry, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
| | - Tina Goldstein
- Department of Psychiatry, University of Pittsburgh, School of Medicine, Pittsburgh, PA
| | - Dara Sakolsky
- Department of Psychiatry, University of Pittsburgh, School of Medicine, Pittsburgh, PA
| | - Satish Iyengar
- Department of Statistics, University of Pittsburgh, School of Medicine, Pittsburgh, PA
| | - David Brent
- Department of Psychiatry, University of Pittsburgh, School of Medicine, Pittsburgh, PA
| | - David Kupfer
- Department of Psychiatry, University of Pittsburgh, School of Medicine, Pittsburgh, PA
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