An Association Between the Use of Hypnotics and Quit Status in the Treatment of Nicotine Dependence With Varenicline in Bipolar Disorder.
J Clin Psychopharmacol. 2015 Jan 23;
Authors: Forrest PE, Brinson AJ, Gannon JM, George TP, Perkins KA, Chengappa KN
PMID: 25627075 [PubMed - as supplied by publisher]
Oxytocin, testosterone, and human social cognition.
Biol Rev Camb Philos Soc. 2015 Jan 28;
Authors: Crespi BJ
I describe an integrative social-evolutionary model for the adaptive significance of the human oxytocinergic system. The model is based on a role for this hormone in the generation and maintenance of social familiarity and affiliation across five homologous, functionally similar, and sequentially co-opted contexts: mothers with offspring, female and male mates, kin groups, individuals with reciprocity partners, and individuals within cooperating and competing social groups defined by culture. In each situation, oxytocin motivates, mediates and rewards the cognitive and behavioural processes that underlie the formation and dynamics of a more or less stable social group, and promotes a relationship between two or more individuals. Such relationships may be positive (eliciting neurological reward, reducing anxiety and thus indicating fitness-enhancing effects), or negative (increasing anxiety and distress, and thus motivating attempts to alleviate a problematic, fitness-reducing social situation). I also present evidence that testosterone exhibits opposite effects from oxytocin on diverse aspects of cognition and behaviour, most generally by favouring self-oriented, asocial and antisocial behaviours. I apply this model for effects of oxytocin and testosterone to understanding human psychological disorders centrally involving social behaviour. Reduced oxytocin and higher testosterone levels have been associated with under-developed social cognition, especially in autism. By contrast, some combination of oxytocin increased above normal levels, and lower testosterone, has been reported in a notable number of studies of schizophrenia, bipolar disorder and depression, and, in some cases, higher oxytocin involves maladaptively 'hyper-developed' social cognition in these conditions. This pattern of findings suggests that human social cognition and behaviour are structured, in part, by joint and opposing effects of oxytocin and testosterone, and that extremes of such joint effects partially mediate risks and phenotypes of autism and psychotic-affective conditions. These considerations have direct implications for the development of therapies for alleviating disorders of social cognition, and for understanding how such disorders are associated with the evolution of human cognitive-affective architecture.
PMID: 25631363 [PubMed - as supplied by publisher]
Unipolar mania: a necessary diagnostic concept.
Eur Arch Psychiatry Clin Neurosci. 2015 Jan 29;
Authors: Angst J, Grobler C
In the classification of mood disorders, major depressive disorder is separate from bipolar disorders whereas mania is not. Studies on pure mania are therefore rare. Our paper reviews the evidence for distinguishing pure mania (M) and mania with mild depression (Md) from bipolar disorder. Two large epidemiological studies found a prevalence of 1.7-1.8 % of M/Md in adolescents and adults. Several clinical follow-up studies demonstrated good stability of the diagnosis after a previous history of three manic episodes. Compared to bipolar disorder, manic disorder is characterised by a weaker family history for depression, an earlier onset, fewer recurrences and better remission, and is less comorbid with anxiety disorders. In addition, mania is strongly associated with a hyperthymic temperament, manifests more psychotic symptoms and is more often treated with antipsychotics. Twin and family studies find mania to be more heritable than depression and show no significant transmission from depression to mania or from mania to depression. Cardiovascular mortality is elevated among patients with mood disorders generally and is highest among those with mania. In non-Western countries, mania and the manic episodes in bipolar disorder are reported to occur more frequently than in Western countries.
PMID: 25631618 [PubMed - as supplied by publisher]
P2C-Type ATPases and Their Regulation.
Mol Neurobiol. 2015 Jan 29;
Authors: Retamales-Ortega R, Vio CP, Inestrosa NC
P2C-type ATPases are a subfamily of P-type ATPases comprising Na(+)/K(+)-ATPase and H(+)/K(+)-ATPase. Na(+)/K(+)-ATPase is ubiquitously expressed and has been implicated in several neurological diseases, whereas H(+)/K(+)-ATPase is found principally in the colon, stomach, and kidney. Both ATPases have two subunits, ? and ?, but Na(+)/K(+)-ATPase also has a regulatory subunit called FXYD, which has an important role in cancer. The most important functions of these ATPases are homeostasis, potassium regulation, and maintaining a gradient in different cell types, like epithelial cells. Na(+)/K(+)-ATPase has become a center of attention ever since it was proposed that it might play a crucial role in neurological disorders such as bipolar disorder, mania, depression, familial hemiplegic migraine, rapid-onset dystonia parkinsonism, chronic stress, epileptogenesis, and Alzheimer's disease. On the other hand, it has been reported that lithium could have a neuroprotective effect against ouabain, which is the best known Na(+)/K(+)-ATPase inhibitor, but and high concentrations of lithium could affect negatively H(+)/K(+)-ATPase activity, that has a key role in regulating acidosis and potassium deficiencies. Finally, potassium homeostasis regulation is composed of two main mechanisms, extrarenal and renal. Extrarenal mechanism controls plasma levels, shifting potassium from the extracellular to the intracellular, whereas renal mechanism concerns with body balance and is influenced by potassium intake and its urinary excretion. In this article, we discuss the functions, isoforms, and localization of P2C-type ATPases, describe some of their modulators, and discuss their implications in some diseases.
PMID: 25631710 [PubMed - as supplied by publisher]
Clinical, demographic, and pharmacologic features of nursing home residents with Huntington's disease.
J Am Med Dir Assoc. 2014 Jun;15(6):423-8
Authors: Zarowitz BJ, O'Shea T, Nance M
BACKGROUND: The purpose of this descriptive, retrospective analysis was to develop a demographic and clinical profile of nursing home residents with a diagnosis of Huntington's disease (HD).
METHODS: Queries were made of a large data repository of linked and de-identified Minimum Data Set version 3.0 and prescription claims records, for the time period of October 1, 2010 through March 31, 2012.
RESULTS: Of 249,811 residents, 340 (0.14%) had a diagnosis of HD; 61% were female and 77.9% were Caucasian. The age range mode was 55-59 years (15%). Approximately one-half of the residents with HD exhibited communication difficulties, 78% had moderate or severe cognitive impairment, and most have significant functional limitations. Depression, dementia, anxiety, psychosis, and bipolar disease were present in 59.4%, 50.9%, 35.9%, and 23.2%, and 9.7%, respectively. Only 21% of residents with HD exhibited troublesome behavioral symptoms. Comorbidities of diabetes and cancer were uncommon (0.3%). Use of physical restraints (excluding bed rails) was considerably higher in residents with HD than in the general nursing home population. Falls were documented in almost one-half of residents. Antipsychotics were used in 61.6% of residents; 16.2% had psychotic symptoms. One was treated with tetrabenazine. Anxiolytics were received by 59.1% of residents, whereas only 35.9% had anxiety noted on Minimum Data Set records.
CONCLUSIONS: The prevalence of HD in US nursing homes is very low (0.14%). Affected residents have significant cognitive and functional impairments, but problematic behaviors are present in only a minority. Serious comorbidities such as cancer and diabetes are rare. Antipsychotics, antidepressants, and anxiolytics are the mainstays of treatment.
PMID: 24613270 [PubMed - indexed for MEDLINE]
Mental Disorders, Comorbidity, and Pre-enlistment Suicidal Behavior Among New Soldiers in the U.S. Army: Results from the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS).
Suicide Life Threat Behav. 2015 Jan 26;
Authors: Nock MK, Ursano RJ, Heeringa SG, Stein MB, Jain S, Raman R, Sun X, Chiu WT, Colpe LJ, Fullerton CS, Gilman SE, Hwang I, Naifeh JA, Rosellini AJ, Sampson NA, Schoenbaum M, Zaslavsky AM, Kessler RC, the Army STARRS Collaborators
We examined the associations between mental disorders and suicidal behavior (ideation, plans, and attempts) among new soldiers using data from the New Soldier Study (NSS) component of the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS; N = 38,507). Most new soldiers with a pre-enlistment history of suicide attempt reported a prior mental disorder (59.0%). Each disorder examined was associated with increased odds of suicidal behavior (ORs = 2.6-8.6). Only PTSD and disorders characterized by irritability and impulsive/aggressive behavior (i.e., bipolar disorder, conduct disorder, oppositional defiant disorder, and attention-deficit/hyperactivity disorder) predicted unplanned attempts among ideators. Mental disorders are important predictors of pre-enlistment suicidal behavior among new soldiers and should figure prominently in suicide screening and prevention efforts.
PMID: 25622860 [PubMed - as supplied by publisher]
Dysregulation of miR-34a links neuronal development to genetic risk factors for bipolar disorder.
Mol Psychiatry. 2015 Jan 27;
Authors: Bavamian S, Mellios N, Lalonde J, Fass DM, Wang J, Sheridan SD, Madison JM, Zhou F, Rueckert EH, Barker D, Perlis RH, Sur M, Haggarty SJ
Bipolar disorder (BD) is a heritable neuropsychiatric disorder with largely unknown pathogenesis. Given their prominent role in brain function and disease, we hypothesized that microRNAs (miRNAs) might be of importance for BD. Here we show that levels of miR-34a, which is predicted to target multiple genes implicated as genetic risk factors for BD, are increased in postmortem cerebellar tissue from BD patients, as well as in BD patient-derived neuronal cultures generated by reprogramming of human fibroblasts into induced neurons or into induced pluripotent stem cells (iPSCs) subsequently differentiated into neurons. Of the predicted miR-34a targets, we validated the BD risk genes ankyrin-3 (ANK3) and voltage-dependent L-type calcium channel subunit beta-3 (CACNB3) as direct miR-34a targets. Using human iPSC-derived neuronal progenitor cells, we further show that enhancement of miR-34a expression impairs neuronal differentiation, expression of synaptic proteins and neuronal morphology, whereas reducing endogenous miR-34a expression enhances dendritic elaboration. Taken together, we propose that miR-34a serves as a critical link between multiple etiological factors for BD and its pathogenesis through the regulation of a molecular network essential for neuronal development and synaptogenesis.Molecular Psychiatry advance online publication, 27 January 2015; doi:10.1038/mp.2014.176.
PMID: 25623948 [PubMed - as supplied by publisher]
Relationship between Personality Disorder Functioning Styles and the Emotional States in Bipolar I and II Disorders.
PLoS One. 2015;10(1):e0117353
Authors: Yao J, Xu Y, Qin Y, Liu J, Shen Y, Wang W, Chen W
BACKGROUND: Bipolar disorder types I (BD I) and II (BD II) behave differently in clinical manifestations, normal personality traits, responses to pharmacotherapies, biochemical backgrounds and neuroimaging activations. How the varied emotional states of BD I and II are related to the comorbid personality disorders remains to be settled.
METHODS: We therefore administered the Plutchick - van Praag Depression Inventory (PVP), the Mood Disorder Questionnaire (MDQ), the Hypomanic Checklist-32 (HCL-32), and the Parker Personality Measure (PERM) in 37 patients with BD I, 34 BD II, and in 76 healthy volunteers.
RESULTS: Compared to the healthy volunteers, patients with BD I and II scored higher on some PERM styles, PVP, MDQ and HCL-32 scales. In BD I, the PERM Borderline style predicted the PVP scale; and Antisocial predicted HCL-32. In BD II, Borderline, Dependant, Paranoid (-) and Schizoid (-) predicted PVP; Borderline predicted MDQ; Passive-Aggressive and Schizoid (-) predicted HCL-32. In controls, Borderline and Narcissistic (-) predicted PVP; Borderline and Dependant (-) predicted MDQ.
CONCLUSION: Besides confirming the different predictability of the 11 functioning styles of personality disorder to BD I and II, we found that the prediction was more common in BD II, which might underlie its higher risk of suicide and poorer treatment outcome.
PMID: 25625553 [PubMed - as supplied by publisher]
Long-acting paliperidone palmitate - interim results of an observational study of its effect on hospitalization.
Int Clin Psychopharmacol. 2014 Jul;29(4):229-34
Authors: Taylor D, Olofinjana O
Paliperidone palmitate (PP) is a recently introduced long-acting atypical, or second-generation, antipsychotic. Published data on PP are currently limited to controlled trials and case reports. In this observational study, we followed up 200 consecutive patients prescribed PP in normal practice. After 1 year, 65% of patients were still receiving PP. The number of admissions to hospital in the year following PP initiation was 0.49/patient compared with 0.69/patient/year, 3 years before initiation (P=0.0001). The mean number of bed days fell from 38.78 to 23.09/patient/year over the corresponding period (P=0.0001). The median number of bed days 3 years before PP initiation was 21.50/year and in the year following PP initiation, it was 0. Outcomes were numerically but not statistically better in those continuing PP than in those who ceased PP within a year of initiation. PP was effective and well-tolerated and, given its positive effect on hospital bed days, broadly cost-effective.
PMID: 24419004 [PubMed - indexed for MEDLINE]
Mania secondary to traumatic brain injury: a case report.
J Neuropsychiatry Clin Neurosci. 2014 Apr 1;26(2):E31
Authors: Zincir SB, Izci F, Acar G
PMID: 24763783 [PubMed - indexed for MEDLINE]
Iatrogenic zolpidem dependence.
J Neuropsychiatry Clin Neurosci. 2014 Apr 1;26(2):E38
Authors: Bhatia MS, Kohli GS
PMID: 24763787 [PubMed - indexed for MEDLINE]
Electroconvulsive therapy induced hyperammonemia and delirium: a case report.
J Neuropsychiatry Clin Neurosci. 2014 Apr 1;26(2):E46-7
Authors: Lee PH, Chiang KT
PMID: 24763792 [PubMed - indexed for MEDLINE]
First manic episode due to discontinuation of valproic acid in a patient with epilepsy.
J Neuropsychiatry Clin Neurosci. 2014 Apr 1;26(2):E60-1
Authors: Köksal A, Dirican AC, Altunkaynak Y, Yildirim EA
PMID: 24763799 [PubMed - indexed for MEDLINE]
Meta-analysis of Cognitive Impairment in First-episode Bipolar Disorder: Comparison with First-episode Schizophrenia and Healthy Controls.
Schizophr Bull. 2015 Jan 23;
Authors: Bora E, Pantelis C
Neurocognitive deficits are evident both in established schizophrenia and bipolar disorder (BP). However, it has been suggested that schizophrenia, but not BP, is characterized by neurodevelopmental abnormalities that can lead to cognitive deficits at the earliest stages of the illness. The aim of this meta-analytic review was to compare neurocognitive deficits in first-episode BP (FEBP) with healthy controls and first-episode schizophrenia (FES) patients. The current meta-analysis included a total of 22 adult studies and involved comparisons of 533 FEBP patients with 1417 healthy controls and 605 FEBP and 822 FES patients. FEBP patients were significantly impaired in all cognitive domains (d = 0.26-0.80) and individual tasks (d = 0.22-0.66) investigated. FES patients significantly underperformed FEBP patients in most cognitive domains (d = 0.05-0.63) and on individual tasks (d = 0.13-0.77). Neuropsychological impairment, which is comparable to chronic BP, was evident in FEBP. Similar to chronic patients, cognitive functions in FEBP lie intermediate between FES and healthy controls. Neurodevelopmental factors are likely to play a significant role not only in schizophrenia but also in BP.
PMID: 25616505 [PubMed - as supplied by publisher]
The importance of anxiety States in bipolar disorder.
Curr Psychiatry Rep. 2015 Feb;17(2):540
Authors: Goes FS
Anxiety symptoms and syndromes are common in bipolar disorders, occurring in over half of all subjects with bipolar disorder type I. Despite methodological and diagnostic inconsistencies, most studies have shown a robust association between the presence of a broadly defined comorbid anxiety disorder and important indices of clinical morbidity in bipolar disorder, including a greater number of depressive episodes, worse treatment outcomes, and elevated risk of attempting suicide. Anxiety symptoms and/or syndromes often precede the onset of bipolar disorder and may represent a clinical phenotype of increased risk in subjects with prodromal symptoms. Although the causal relationship between anxiety and bipolar disorders remains unresolved, the multifactorial nature of most psychiatric phenotypes suggests that even with progress towards more biologically valid phenotypes, the "phenomenon" of comorbidity is likely to remain a clinical reality. Treatment studies of bipolar patients with comorbid anxiety have begun to provide preliminary evidence for the role of specific pharmacological and psychotherapeutic treatments, but these need to be confirmed in more definitive trials. Hence, there is an immediate need for further research to help guide assessment and help identify appropriate treatments for comorbid conditions.
PMID: 25617037 [PubMed - in process]
Treatment moderators of child- and family-focused cognitive-behavioral therapy for pediatric bipolar disorder.
J Am Acad Child Adolesc Psychiatry. 2015 Feb;54(2):116-25
Authors: Weinstein SM, Henry DB, Katz AC, Peters AT, West AE
OBJECTIVE: Prior work has demonstrated the efficacy of child- and family-focused cognitive-behavioral therapy (CFF-CBT) versus enhanced treatment as usual (TAU; unstructured psychotherapy) for pediatric bipolar disorder (PBD). The current study builds on primary findings by examining baseline child, parent, and family characteristics as moderators of symptom response trajectories.
METHOD: A total of 69 youth aged 7 to 13 years (mean = 9.19 years, SD = 1.61 years) with DSM-IV-TR bipolar I, II, or not otherwise specified (NOS) were randomly assigned, with family members, to CFF-CBT or TAU. Both treatments consisted of 12 weekly sessions and 6 monthly booster sessions. Participants were assessed at baseline, 4, 8, and 12 weeks, and 6-month follow-up on mania and depression symptoms and overall psychiatric severity. Parents and youth also provided self-report data on baseline characteristics.
RESULTS: CFF-CBT demonstrated greater efficacy for youth depressive symptoms relative to TAU for parents with higher baseline depressive symptoms and lower income, and marginally for families with higher cohesion. In addition, youth with lower baseline depression and youth with higher self-esteem showed a poorer response to TAU versus CFF-CBT on mania symptom outcomes. Age, sex, baseline mania symptoms, comorbidity, and suicidality did not moderate treatment response.
CONCLUSION: Results indicate that CFF-CBT was relatively immune to the presence of treatment moderators. Findings suggest the need for specialized treatment to address symptoms of PBD in the context of parental symptomatology and financial stress.
PMID: 25617252 [PubMed - in process]
Trajectories of medication attitudes and adherence behavior change in non-adherent bipolar patients.
Compr Psychiatry. 2014 Dec 27;
Authors: Levin JB, Tatsuoka C, Cassidy KA, Aebi ME, Sajatovic M
OBJECTIVES: While medication treatment is necessary for the successful management of bipolar disorder (BD), non-adherence rates are up to 60%. Although medication attitudes are believed to be relevant to adherence behavior, few studies have investigated the trajectories of adherence change. This study evaluated attitudinal correlates of adherence conversion in 86 poorly adherent individuals with BD.
METHODS: This secondary analysis pooled data from two uncontrolled prospective trials of customized adherence enhancement (CAE), a psychosocial intervention delivered over 4-6weeks. Poor adherence was defined as missing at least 20% of prescribed BD medication based on the self-reported Tablets Routine Questionnaire (TRQ). The sample was dichotomized into converters who achieved good adherence (N=44) and non-converters who remained poorly adherent (N=21). Converters vs. non-converters were compared on adherence, attitudes, and symptoms at baseline, 6weeks and 3months.
RESULTS: At baseline, converters and non-converters were similar demographically and clinically, but converters were less non-adherent (32% doses missed) than non-converters (59% missed). At 6weeks, converters had better attitudes than non-converters. At 3months, converters maintained improvements, but group differences were less pronounced due to some improvement in non-converters. Converters had better adherence at 3months and trajectories differed for the groups on attitudes. Symptoms gradually improved for both converters and non-converters.
CONCLUSIONS: Over two-thirds of poorly adherent BD patients who received CAE converted to good adherence. Improved medication attitudes may be a driver of improved adherence behavior and ultimately reduce BD symptoms.
PMID: 25617964 [PubMed - as supplied by publisher]
Real-life decision making of Serious Mental Illness patients: Opt-in and opt-out research participation.
Isr J Psychiatry Relat Sci. 2014;51(3):199-203
Authors: Or A, Baruch Y, Tadger S, Barak Y
BACKGROUND: Patients' decisions in relation to participation in clinical research depend on individual values and relevant outcomes. Presenting possible decisions by way of defaults (opt-in or opt-out) has been used to achieve desired outcomes. Our objective was to characterize patients willing to participate in clinical research and to assess the impact of defaults on patients with Serious Mental Illness (schizophrenia, schizoaffective disorder, major depression and bipolar disorder; SMI) during the decision process.
METHODS: Patients with SMI were requested to accept or reject participation in a novel drug treatment study using either the (1) opt-in condition, wherein they were told that our center's policy is not to include them in drug studies; (2) the opt-out condition, wherein they were told that our center's policy is to include them in drug studies; and the (3) neutral condition that required patients to state their preference with no prior information.
RESULTS: 311 patients with SMI completed the brief questionnaire within 48 hours of admission to a psychiatric ward. There were 227 (73%) patients suffering from schizophrenia and schizoaffective disorder, 40 (13%) suffering from bipolar disorder and 44 (14%) suffering from major depressive disorder. There were 156 men (50%) and 155 women in the sample, mean age 47.8±16.2 years. In the opt-in condition, 58% abstained, while 42% opted-in (p=0.003). In the opt-out condition, 58% participated, while 42% opted-out. In the neutral condition 51% indicated willingness to participate, 33% refused and 16% were undecided. The "willing" patient was characterized by younger age, previous hospitalizations, affective illness and more comorbid physical disorders.
CONCLUSION: Taken together these findings reveal the "profile" of patients with SMI willing to participate in clinical research and demonstrate an increase in participation preferences through the use of defaults.
PMID: 25618284 [PubMed - in process]
Neurocognitive functioning in the premorbid stage and in the first episode of bipolar disorder: A systematic review.
Psychiatry Res. 2015 Jan 8;
Authors: Martino DJ, Samamé C, Ibañez A, Strejilevich SA
It is well known that patients with bipolar disorder (BD) have cognitive impairments even during periods of euthymia. However, to date it remains unclear the moment when these deficits onset. Therefore, the aim of this study was to review the evidence focusing on the cognitive status of patients with BD in their premorbid stage and in their first episode. An extensive search was conducted through the online databases Pubmed/PsychInfo, covering the period between 1980 and 2014. A total of 23 studies were selected for the review (nine studies explored premorbid stage of people who lately develop BD and 14 examined first-episodes in bipolar patients). There is evidence that general intelligence is not impaired in the premorbid stage. Impairments in verbal memory, attention, and executive functions tend to be present during and after the first episode. Preliminary evidence suggests that these deficits in specific cognitive domains might precede the onset of illness.
PMID: 25618475 [PubMed - as supplied by publisher]
Lithium and sexual dysfunction: an under-researched area.
Hum Psychopharmacol. 2015 Jan 26;
Authors: Elnazer HY, Sampson A, Baldwin D
OBJECTIVE: Lithium treatment remains an important part of the management of many patients with bipolar disorder, but the incidence of treatment-emergent sexual dysfunction with lithium is uncertain, and little is known about how it might be managed.
METHOD: Systematic computerised literature search of preclinical and clinical studies.
RESULTS: Thirteen relevant papers were identified. Preclinical studies suggest lithium can reduce testosterone levels and impair nitric oxide mediated relaxation of cavernosal tissue. Clinical reports suggest lithium may reduce sexual thoughts and desire, worsen erectile function and reduce sexual satisfaction. Concomitant benzodiazepine prescription with lithium is associated with an increased risk of sexual dysfunction. Sexual dysfunction during lithium treatment appears significantly associated with a lower level of overall functioning and may reduce compliance.
CONCLUSION: The findings of this systematic review reveal the paucity of information about the incidence, associated factors and management of sexual dysfunction with lithium treatment and highlight the need for well-designed studies in this area. Copyright © 2015 John Wiley & Sons, Ltd.
PMID: 25619161 [PubMed - as supplied by publisher]
FT-IR spectroscopy and multivariate analysis as an auxiliary tool for diagnosis of mental disorders: Bipolar and schizophrenia cases.
Spectrochim Acta A Mol Biomol Spectrosc. 2015 Jan 13;
Authors: Ogruc Ildiz G, Arslan M, Unsalan O, Araujo-Andrade C, Kurt E, Karatepe HT, Yilmaz A, Yalcinkaya OB, Herken H
In this study, a methodology based on Fourier-transform infrared spectroscopy and principal component analysis and partial least square methods is proposed for the analysis of blood plasma samples in order to identify spectral changes correlated with some biomarkers associated with schizophrenia and bipolarity. Our main goal was to use the spectral information for the calibration of statistical models to discriminate and classify blood plasma samples belonging to bipolar and schizophrenic patients. IR spectra of 30 samples of blood plasma obtained from each, bipolar and schizophrenic patients and healthy control group were collected. The results obtained from principal component analysis (PCA) show a clear discrimination between the bipolar (BP), schizophrenic (SZ) and control group' (CG) blood samples that also give possibility to identify three main regions that show the major differences correlated with both mental disorders (biomarkers). Furthermore, a model for the classification of the blood samples was calibrated using partial least square discriminant analysis (PLS-DA), allowing the correct classification of BP, SZ and CG samples. The results obtained applying this methodology suggest that it can be used as a complimentary diagnostic tool for the detection and discrimination of these mental diseases.
PMID: 25619859 [PubMed - as supplied by publisher]
Altered Subcellular Distribution of the 75-kDa DISC1 Isoform, cAMP Accumulation, and Decreased Neuronal Migration in Schizophrenia and Bipolar Disorder: Implications for Neurodevelopment.
CNS Neurosci Ther. 2015 Jan 24;
Authors: Muñoz-Estrada J, Benítez-King G, Berlanga C, Meza I
BACKGROUND: DISC1 (Disrupted-In-Schizophrenia-1) is considered a genetic risk factor for schizophrenia (SZ) and bipolar disorder (BD). DISC1 regulates microtubule stability, migration, and cAMP signaling in mammalian cell lines and mouse brain tissue. cAMP is a regulator of microtubule organization and migration in neurons. Aberrant microtubule organization has been observed in olfactory neuronal precursors (ONP) derived from patients with SZ and BD, which suggests involvement of DISC1 and cAMP. However, the biology of DISC1 in the physiopathology of psychiatric conditions remains elusive.
AIMS: Herein, utilizing ONP obtained from SZ, BD patients and healthy subjects, we have studied DISC1 expression, protein levels, and subcellular distribution by qRT-PCR, immunoblotting, subcellular fractionation, and confocal microscopy. Cell migration and cAMP accumulation were assessed by Transwell and PKA competition assays.
RESULTS: We found increased levels of the 75-kDa DISC1 isoform in total cell extracts of ONP from patients with SZ and BD compared with controls. Subcellular distribution showed a significant decrease of cytoplasmic DISC1 concomitant with its augmented levels in transcription sites. Moreover, significant cAMP accumulation and diminished migration were also observed in patients' cells.
CONCLUSION: Alterations of DISC1 levels and its cellular distribution, which negatively modify cAMP homeostasis, microtubule organization, and cell migration, in ONP from patients with SZ and BD, suggest that their presence in early stages of brain development may impact brain maturation and function.
PMID: 25620115 [PubMed - as supplied by publisher]
PIOGLITAZONE ADJUNCTIVE THERAPY FOR DEPRESSIVE EPISODE OF BIPOLAR DISORDER: A RANDOMIZED, DOUBLE-BLIND, PLACEBO-CONTROLLED TRIAL.
Depress Anxiety. 2015 Jan 23;
Authors: Zeinoddini A, Sorayani M, Hassanzadeh E, Arbabi M, Farokhnia M, Salimi S, Ghaleiha A, Akhondzadeh S
BACKGROUND: The antidepressive effect of pioglitazone has been noted in patients with major depressive disorder in absence of metabolic syndrome. This study was conducted to evaluate the safety and efficacy of pioglitazone in patients with bipolar depression without concomitant metabolic syndrome or diabetes.
METHOD: Forty-eight outpatients with the diagnosis of bipolar I disorder and a major depressive episode participated in a parallel, randomized, double-blind, placebo-controlled trial, and 44 patients underwent 6-week treatment with either pioglitazone (30 mg/day) or placebo as an adjunctive treatment to lithium. Therapeutic serum lithium levels of 0.6-0.8 mEq/L were required for two or more consecutive weeks immediately before starting pioglitazone and during the 6-week study. Patients were evaluated using Hamilton Depression Rating Scale (HDRS) and Young Mania Rating Scale (YMRS) at baseline and weeks 1, 2, 4, and 6. The primary outcome was to evaluate the efficacy of pioglitazone in improving the depressive symptoms.
RESULT: General linear model repeated measures showed significant effect for time × treatment interaction on the HDRS scores [F(2.78, 116.65) = 4.77, P = .005]. Significantly greater reduction was observed in HDRS scores in the pioglitazone group than the placebo group from baseline HDRS score at weeks 2, 4, and 6, P = .003, .006, and .006, respectively. No serious adverse event was observed.
CONCLUSION: This study showed that pioglitazone could be a tolerable and effective adjunctive therapy for improving depressive symptoms in bipolar disorder without type 2 diabetes or metabolic syndrome.
PMID: 25620378 [PubMed - as supplied by publisher]
Psychosocial interventions in the treatment of youth diagnosed or at high-risk for pediatric bipolar disorder: A review of the literature.
Rev Psiquiatr Salud Ment. 2015 Jan 22;
Authors: Frías Á, Palma C, Farriols N
Pediatric bipolar disorder (PBD) has emerged as a research field in which psychosocial treatments have provided a plethora of empirical findings over the last decade. We addressed this issue through a systematic review aimed of establishing their effectiveness and feasibility as adjunctive therapies for youth with PBD or at high-risk for PBD. A comprehensive search of databases was performed between 1990 and September 2014. Overall, 33 studies were specifically related to the issue and 20 of them were original articles. Evidence suggests that both «multi-family psychoeducational psychotherapy» and «family-focused therapy» are possible effective treatments for PBD. Likewise, «child and family-focused cognitive-behavioral therapy» may be characterized as a treatment in its experimental phase. The remaining therapies fail to obtain enough empirical support due to inconsistent findings among clinical trials or data solely based on case reports. Studies of psychosocial treatments provide concluding results concerning their feasibility and acceptability. Larger sample sizes and more randomized controlled trials are mandatory for diminishing methodological shortcomings encountered in the treatments displayed.
PMID: 25620426 [PubMed - as supplied by publisher]
Bipolar disorder: role of immune-inflammatory cytokines, oxidative and nitrosative stress and tryptophan catabolites.
Curr Psychiatry Rep. 2015 Feb;17(2):541
Authors: Anderson G, Maes M
Bipolar disorder (BD) is a complex disorder with a range of presentations. BD is defined by the presentation of symptoms of mania or depression, with classification dependent on patient/family reports and behavioural observations. Recent work has investigated the biological underpinnings of BD, highlighting the role played by increased immune-inflammatory activity, which is readily indicated by changes in pro-inflammatory cytokines or signalling, both centrally and systemically, e.g. increased interleukin-6 trans-signalling. Here, we review the recent data on immune-inflammatory pathways and cytokine changes in BD. Such changes are intimately linked to changes in oxidative and nitrosative stress (O&NS) and neuroregulatory tryptophan catabolites (TRYCATs), both centrally and peripherally. TRYCATs take tryptophan away from serotonin, N-acetylserotonin and melatonin synthesis, driving it down the TRYCAT pathway, predominantly as a result of the pro-inflammatory cytokine induction of indoleamine 2,3-dioxygenase. This has led to an emerging biological perspective on the aetiology, course and treatment of BD. Such data also better integrates the numerous comorbidities associated with BD, including addiction, cardiovascular disorders and increased reporting of pain. Immune-inflammatory, O&NS and TRYCAT pathways are also likely to be relevant biological underpinnings to the significant decrease in life expectancy in BD.
PMID: 25620790 [PubMed - in process]
Treating Insomnia Improves Mood State, Sleep, and Functioning in Bipolar Disorder: A Pilot Randomized Controlled Trial.
J Consult Clin Psychol. 2015 Jan 26;
Authors: Harvey AG, Soehner AM, Kaplan KA, Hein K, Lee J, Kanady J, Li D, Rabe-Hesketh S, Ketter TA, Neylan TC, Buysse DJ
Objective: To determine if a treatment for interepisode bipolar disorder I patients with insomnia improves mood state, sleep, and functioning. Method: Alongside psychiatric care, interepisode bipolar disorder I participants with insomnia were randomly allocated to a bipolar disorder-specific modification of cognitive behavior therapy for insomnia (CBTI-BP; n = 30) or psychoeducation (PE; n = 28) as a comparison condition. Outcomes were assessed at baseline, the end of 8 sessions of treatment, and 6 months later. This pilot was conducted to determine initial feasibility and generate effect size estimates. Results: During the 6-month follow-up, the CBTI-BP group had fewer days in a bipolar episode relative to the PE group (3.3 days vs. 25.5 days). The CBTI-BP group also experienced a significantly lower hypomania/mania relapse rate (4.6% vs. 31.6%) and a marginally lower overall mood episode relapse rate (13.6% vs. 42.1%) compared with the PE group. Relative to PE, CBTI-BP reduced insomnia severity and led to higher rates of insomnia remission at posttreatment and marginally higher rates at 6 months. Both CBTI-BP and PE showed statistically significant improvement on selected sleep and functional impairment measures. The effects of treatment were well sustained through follow-up for most outcomes, although some decline on secondary sleep benefits was observed. Conclusions: CBTI-BP was associated with reduced risk of mood episode relapse and improved sleep and functioning on certain outcomes in bipolar disorder. Hence, sleep disturbance appears to be an important pathway contributing to bipolar disorder. The need to develop bipolar disorder-specific sleep diary scoring standards is highlighted. (PsycINFO Database Record (c) 2015 APA, all rights reserved).
PMID: 25622197 [PubMed - as supplied by publisher]
[Lithium can be given to patients on haemodialysis treatment.]
Ugeskr Laeger. 2015 Jan 26;177(2A)
Authors: Kancir AS, Viftrup JE, Pedersen EB
Lithium-induced nephropathy is a known complication of lithium treatment in bipolar disorder. Treatment with lithium should be discontinued, if there is evidence of lithium-induced nephropathy. However, lithium can be given to patients with end-stage-renal-disease on haemodialysis treatment, if there is no other way to control the bipolar disorder. We report one patient who was successfully treated with lithium in parallel with haemodialysis.
PMID: 25612969 [PubMed - as supplied by publisher]
Diminished serum repetin levels in patients with schizophrenia and bipolar disorder.
Sci Rep. 2015;5:7977
Authors: Wang S, Ren H, Xu J, Yu Y, Han S, Qiao H, Cheng S, Xu C, An S, Ju B, Yu C, Wang C, Wang T, Yang Z, Taylor EW, Zhao L
Repetin (RPTN) protein is a member of S100 family and is known to be expressed in the normal epidermis. Here we show that RPTN is ubiquitously expressed in both mouse and human brain, with relatively high levels in choroid plexus, hippocampus and prefrontal cortex. To investigate the expression of RPTN in neuropsychiatric disorders, we determined serum levels of RPTN in patients with schizophrenia (n = 88) or bipolar disorder (n = 34) and in chronic psychostimulant users (n = 91). We also studied its expression in a mouse model of chronic unpredictable mild stress (CUMS). The results showed that serum RPTN levels were significantly diminished in patients with schizophrenia and bipolar disorder or in psychostimulant users, compared with healthy subjects (n = 115) or age-matched controls (n = 92) (p < 0.0001). In CUMS mice, RPTN expression in hippocampus and prefrontal cortex was reduced with progression of the CUMS procedure; the serum RPTN level remained unchanged. Since CUMS is a model for depression and methamphetamine (METH) abuse induced psychosis recapitulates many of the psychotic symptoms of schizophrenia, the results from this study may imply that RPTN plays a potential role in emotional and cognitive processing; its decrease in serum may indicate its involvement in the pathogenesis of schizophrenia and bipolar disorder.
PMID: 25613293 [PubMed - in process]
Novel risk factors associated with current suicidal ideation and lifetime suicide attempt in individuals with spinal cord injury.
Arch Phys Med Rehabil. 2015 Jan 19;
Authors: McCullumsmith CB, Kalpazian C, Richards JS, Forchheimer M, Heinemann A, Richardson E, Wilson C, Barber J, Temkin N, Fann JR, Bombardier CH, PRISMS Investigators
OBJECTIVE: To determine unique associations for suicidal ideation and historical suicide attempts among individuals with spinal cord injury (SCI).
DESIGN: Cross-sectional analysis SETTING: Outpatient PARTICIPANTS: 2,533 individuals with SCI 18 years or older with a history of traumatic SCI.
INTERVENTIONS: None MAIN OUTCOME MEASURES: Any suicidal ideation in the prior 2 weeks (PHQ-9 item; SI) and any historical suicide attempt (SA).
RESULTS: 323 (13.3%) reported SI in the prior 2 weeks and 179 (7.4%) reported historical SA. After controlling for other factors, both historical SA and current SI were associated with study site and current level of depression. Additionally, SA was associated with less education, younger age at injury, having current or prior treatment for depression, and having bipolar disorder or schizophrenia. SI was associated with more years since injury and previous SA. Several psychological factors were associated with current SI and historical SAs, including lower environmental reward and less positive affect. Additionally, control of one's community activities and spiritual well-being were associated with current SI. Severity of SCI also was associated in bivariate comparisons with the 47% of the SAs which occurred after injury.
CONCLUSION: Several unique associations for SI and historical SA in individuals with SCI were identified, including level of environmental reward and control, spiritual well-being and severity of SCI. These factors bear further investigation as prospective risk factors for suicidal behavior after SCI.
PMID: 25613597 [PubMed - as supplied by publisher]
Lithium treatment and risk for dementia in adults with bipolar disorder: population-based cohort study.
Br J Psychiatry. 2015 Jan 22;
Authors: Gerhard T, Devanand DP, Huang C, Crystal S, Olfson M
Background Lithium inhibits glycogen synthase kinase 3, an enzyme implicated in the pathogenesis of dementia. Aims To examine the association of lithium and dementia risk in a large claims-based US cohort of publicly insured older adults with bipolar disorder. Method The cohort included individuals ?50 years diagnosed with bipolar disorder who did not receive dementia-related services during the prior year. Each follow-up day was classified by past-year cumulative duration of lithium use (0, 1-60, 61-300 and 301-365 days). Dementia diagnosis was the study outcome. Anticonvulsants commonly used as mood stabilisers served as a negative control. Results Compared with non-use, 301-365 days of lithium exposure was associated with significantly reduced dementia risk (hazard ratio (HR) = 0.77, 95% CI 0.60-0.99). No corresponding association was observed for shorter lithium exposures (HR = 1.04, 95% CI 0.83-1.31 for 61-300 days; HR = 1.07, 95% CI 0.67-1.71 for 1-60 days) or for any exposure to anticonvulsants. Conclusions Continuous lithium treatment may reduce dementia risk in older adults with bipolar disorder.
PMID: 25614530 [PubMed - as supplied by publisher]