Combined influence of medication and symptom severity on visual processing in bipolar disorder

Background Bipolar disorder is a lifelong problem with imperfect available treatments. Recent research has shown potential benefit of nutritional treatment for mood symptoms. The goal of the current study was to determine whether adults with bipolar disorder reported treatment benefit from consuming a micronutrient formula. Methods Self-report data were available from 682 adults who reported a diagnosis of bipolar disorder; 81% were taking psychiatric medications. Those reporting additional diagnoses were excluded, as well as those who provided data <60 times during 180 days of using the micronutrients, leaving 358 for analysis. Results Mean symptom severity was 41% lower than baseline after 3 months (effect size = 0.78), and 45% lower after 6 months (effect size = 0.76) (both paired t-tests significant, p < 0.001). In terms of responder status, 53% experienced ≥50% improvement at 6 months. Half the sample were taking medications approved for bipolar disorder (lithium, anticonvulsants, atypical antipsychotics), and half were either medication-free or taking other medications: the magnitude of treatment benefit did not differ between these two groups. Regression analyses indicated that decreased symptom severity over the 6 months was associated with increasing micronutrient dosage and with reducing medication. Symptom improvements were significant and sustained at 6 months, suggesting that benefits were not attributable to placebo/expectancy effects. Conclusions Further research on this micronutrient formula is warranted.

Download Full-text

The course of bipolar disorder in pregnant versus non-pregnant women

International Journal of Bipolar Disorders ◽

10.1186/s40345-021-00239-z ◽

2021 ◽

Vol 9 (1) ◽

Author(s):

Anja W. M. M. Stevens ◽

Stasja Draisma ◽

Peter J. J. Goossens ◽

Birit F. P. Broekman ◽

Adriaan Honig ◽

...

Keyword(s):

Bipolar Disorder ◽

Pregnant Women ◽

Symptom Severity ◽

Mood State ◽

Daily Basis ◽

Childbearing Age ◽

Mood Symptoms ◽

Severity Scores ◽

And Cluster Analysis ◽

Course Variables

Abstract Background and rationale Although it has been suggested that pregnancy may influence the course of bipolar disorder (BD), studies show contradictory results. Until now, no studies included a finegrained validated method to report mood symptoms on a daily basis, such as the lifechart method (LCM). The aim of the present study is to investigate the course of BD during pregnancy by comparing LCM scores of pregnant and non-pregnant women. Methods Study design: Comparison of LCM scores of two prospective observational BD cohort studies, a cohort of pregnant women (n = 34) and a cohort of non-pregnant women of childbearing age (n = 52). Main study parameters are: (1) proportions of symptomatic and non-symptomatic days; (2) symptom severity, frequency, and duration of episodes; (3) state sequences, longitudinal variation of symptom severity scores. Results No differences in clinical course variables (symptomatic days, average severity scores, frequency, and duration of episodes in BD were found between pregnant and non-pregnant women. With a combination of State Sequence Analysis (SSA) and cluster analysis on the sequences of daily mood scores three comparable clusters were found in both samples: euthymic, moderately ill and severely ill. The distribution differences between pregnant and non-pregnant women were significant, with a majority of the pregnant women (68%) belonging to the moderately ill cluster and a majority of the non-pregnant women (46%) to the euthymic cluster. In pregnant women the average daily variation in mood symptoms as assessed with Shannon’s entropy was less than in non-pregnant women (respectively 0.43 versus 0.56). Conclusions Although the use of daily mood scores revealed no difference in overall course of BD in pregnant versus non-pregnant women, more pregnant than non-pregnant women belonged to the moderately ill cluster, and during pregnancy the variation in mood state was less than in non-pregnant women. Further research is necessary to clarify these findings.

Download Full-text

Decreased homotopic interhemispheric functional connectivity in children with autism spectrum disorder

10.1101/2020.11.08.373126 ◽

2020 ◽

Author(s):

Shuxia Yao ◽

Menghan Zhou ◽

Yuan Zhang ◽

Feng Zhou ◽

Qianqian Zhang ◽

...

Keyword(s):

Autism Spectrum Disorder ◽

Functional Connectivity ◽

Symptom Severity ◽

Visual Processing ◽

Brain Networks ◽

Cingulate Cortex ◽

Autism Spectrum ◽

Spectrum Disorder ◽

Volume Changes ◽

Processing Network

AbstractWhile a number of functional and structural changes occur in large-scale brain networks in autism spectrum disorder (ASD), reduced interhemispheric resting state functional connectivity (rsFC) between homotopic regions may be of particular importance as a biomarker. ASD is an early-onset developmental disorder and neural alterations are often age-dependent, reflecting dysregulated developmental trajectories, although no studies have investigated whether homotopic interhemispheric rsFC alterations occur in ASD children. The present study conducted a voxel-based homotopic interhemispheric rsFC analysis in 146 SD and 175 typically developing children under age 10 and examined associations with symptom severity in the Autism Brain Imaging Data Exchange datasets. Given the role of corpus callosum (CC) in interhemispheric connectivity and reported CC volume changes in ASD we additionally examined whether there were parallel volumetric changes in ASD children. Results demonstrated decreased homotopic rsFC in ASD children in the medial prefrontal cortex, precuneus and posterior cingulate cortex of the default mode network (DMN), the dorsal anterior cingulate cortex of the salience network, the precentral gyrus and inferior parietal lobule of the mirror neuron system, the lingual, fusiform and inferior occipital gyri of the visual processing network and thalamus. Symptom severity was associated with homotopic rsFC in regions in the DMN and visual processing network. There were no significant CC volume changes in ASD children. The present study shows that reduced homotopic interhemispheric rsFC in brain networks in ASD adults/adolescents is already present in children of 5-10 years old and further supports their potential use as a general ASD biomarker.

Download Full-text

S85. Individual Functional Abnormalities in the Default-Mode Network Predict Symptom Severity in Bipolar Disorder

Biological Psychiatry ◽

10.1016/j.biopsych.2019.03.836 ◽

2019 ◽

Vol 85 (10) ◽

pp. S330

Author(s):

Gaelle Doucet ◽

Delfina Janiri ◽

David Glahn ◽

Sophia Frangou

Keyword(s):

Bipolar Disorder ◽

Default Mode Network ◽

Symptom Severity ◽

Default Mode

Download Full-text

Age-Related Differences in Medication Adherence, Symptoms, and Stigma in Poorly Adherent Adults With Bipolar Disorder

Journal of Geriatric Psychiatry and Neurology ◽

10.1177/0891988719874116 ◽

2019 ◽

Vol 33 (5) ◽

pp. 250-255 ◽

Cited By ~ 1

Author(s):

Stephen Smilowitz ◽

Awais Aftab ◽

Michelle Aebi ◽

Jennifer Levin ◽

Curtis Tatsuoka ◽

...

Keyword(s):

Older Adults ◽

Bipolar Disorder ◽

Medication Adherence ◽

Symptom Severity ◽

Psychiatric Symptoms ◽

Significant Finding ◽

Internalized Stigma ◽

Age Related ◽

Severity Scores ◽

Over Time

Objective: We present a secondary analysis of data reporting differences in medication adherence, psychiatric symptom severity, and internalized stigma levels in older (age ≥ 55 years) versus younger (age < 55 years) adults with bipolar disorder (BD) and poor medication adherence. Methods: Data used for this analysis came from 184 participants in a National Institute of Mental Health–funded randomized controlled trial, comparing a customized adherence enhancement (CAE) intervention intended to promote BD medication adherence with a BD-specific educational program (EDU). At screen, study participants were ≥20% nonadherent with BD medications as measured by the Tablets Routine Questionnaire (TRQ). Psychiatric symptoms, functional status, and internalized stigma were measured using validated scales. Results: Older adults had significantly lower anxiety disorder comorbidity ( P < .01 for 1 or more anxiety disorders), depressive symptom severity scores ( P = .011), and self-stigma scores ( P = .001) compared to their younger counterparts. In the analyses evaluating change over time in TRQ between older and younger participants by treatment arm (ie, CAE and EDU), there was a significant finding of interaction between time, age-group, and treatment arm ( P = .007). Conclusions: Older adults may be less anxious and depressed, with less self-stigma, compared to younger people with BD and poor adherence. With respect to medication adherence, older individuals in EDU appear to do less well than younger individuals over time.

Download Full-text

Symptom severity, self-reported adherence, and electronic pill monitoring in poorly adherent patients with bipolar disorder

Bipolar Disorders ◽

10.1111/bdi.12326 ◽

2015 ◽

Vol 17 (6) ◽

pp. 653-661 ◽

Cited By ~ 16

Author(s):

Martha Sajatovic ◽

Jennifer B Levin ◽

Johnny Sams ◽

Kristin A Cassidy ◽

Kouri Akagi ◽

...

Keyword(s):

Bipolar Disorder ◽

Symptom Severity

Download Full-text

Anxiety linked to symptom severity in bipolar disorder

Springer Healthcare News ◽

10.1007/s40014-012-1324-4 ◽

2012 ◽

Vol 1 (1) ◽

Keyword(s):

Bipolar Disorder ◽

Symptom Severity

Download Full-text

White blood cell count correlates with mood symptom severity and specific mood symptoms in bipolar disorder

Australian & New Zealand Journal of Psychiatry ◽

10.1177/0004867416644508 ◽

2016 ◽

Vol 51 (4) ◽

pp. 355-365 ◽

Cited By ~ 13

Author(s):

Ole Köhler ◽

Louisa G Sylvia ◽

Charles L Bowden ◽

Joseph R Calabrese ◽

Michael Thase ◽

...

Keyword(s):

Bipolar Disorder ◽

Confidence Interval ◽

Blood Cell ◽

Cell Count ◽

White Blood Cell Count ◽

White Blood Cell ◽

Symptom Severity ◽

Rating Scale ◽

Blood Cell Count ◽

Mood Symptom

Objective: Immune alterations may play a role in bipolar disorder etiology; however, the relationship between overall immune system functioning and mood symptom severity is unknown. Methods: The two comparative effectiveness trials, the Clinical and Health Outcomes Initiatives in Comparative Effectiveness for Bipolar Disorder Study (Bipolar CHOICE) and the Lithium Treatment Moderate-Dose Use Study (LiTMUS), were similar trials among patients with bipolar disorder. At study entry, white blood cell count and bipolar mood symptom severity (via Montgomery-Aasberg Depression Rating Scale and Bipolar Inventory of Symptoms Scale) were assessed. We performed analysis of variance and linear regression analyses to investigate relationships between deviations from median white blood cell and multinomial regression analysis between higher and lower white blood cell levels. All analyses were adjusted for age, gender, body mass index, smoking, diabetes, hypertension and hyperlipidemia. Results: Among 482 Bipolar CHOICE participants, for each 1.0 × 109/L white blood cell deviation, the overall Bipolar Inventory of Symptoms Scale severity increased significantly among men (coefficient = 2.13; 95% confidence interval = [0.46, −3.79]; p = 0.013), but not among women (coefficient = 0.87; 95% confidence interval = [−0.87, −2.61]; p = 0.33). Interaction analyses showed a trend toward greater Bipolar Inventory of Symptoms Scale symptom severity among men (coefficient = 1.51; 95% confidence interval = [−0.81, −3.82]; p = 0.2). Among 283 LiTMUS participants, higher deviation from the median white blood cell showed a trend toward higher Montgomery-Aasberg Depression Rating Scale scores among men (coefficient = 1.33; 95% confidence interval = [−0.22, −2.89]; p = 0.09), but not among women (coefficient = 0.34; 95% confidence interval = [−0.64, −1.32]; p = 0.50). When combining LiTMUS and Bipolar CHOICE, Montgomery-Aasberg Depression Rating Scale scores increased significantly among men (coefficient = 1.09; 95% confidence interval = [0.31, −1.87]; p = 0.006) for each 1.0 × 109/L white blood cell deviation, whereas we found a weak association among women (coefficient = 0.55; 95% confidence interval = [−0.20, −1.29]; p = 0.14). Lower and higher white blood cell levels correlated with greater symptom severity and specific symptoms, varying according to gender. Conclusion: Deviations in an overall immune system marker, even within the normal white blood cell range, correlated with mood symptom severity in bipolar disorder, mostly among males. Studies are warranted investigating whether white blood cell count may predict response to mood-stabilizing treatment.

Download Full-text