Influence of maternal bipolar disorder on the biological rhythms of their offspring biological rhythms of offspring at high-risk for BD

SummaryWe offer a contemporary review of studies of the offspring of parents with bipolar disorder and explore the clinical characteristics of these populations. We discuss how different methodological approaches may influence study findings and may explain some of the heterogeneity in the results reported. We also highlight some of the environmental risk factors that may increase the likelihood of transition from an ‘at-risk’ or high-risk state to bipolar disorder. Last, we briefly discuss the implications of study findings for early intervention strategies and comment on such issues as genetic counselling and primary and early secondary prevention programmes.

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Poster #S151 NEUROCOGNITIVE PROFILES IN 7-YEAR-OLD OFFSPRING OF PARENTS WITH SCHIZOPHRENIA OR BIPOLAR DISORDER. PART OF THE HIGH RISK AND RESILIENCE STUDY – VIA 7

Schizophrenia Research ◽

10.1016/s0920-9964(14)70430-x ◽

2014 ◽

Vol 153 ◽

pp. S143-S144

Author(s):

Nicoline Hemager ◽

Jens Richardt Møllegaard Jepsen ◽

Anne Amalie Elgaard Thorup ◽

Camilla Austa Jerlang Christiani ◽

Aja Neergaard Greve ◽

...

Keyword(s):

Bipolar Disorder ◽

High Risk ◽

Risk And Resilience ◽

Neurocognitive Profiles

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Early interventions for youths at high risk for bipolar disorder: a developmental approach

European Child & Adolescent Psychiatry ◽

10.1007/s00787-015-0773-6 ◽

2015 ◽

Vol 25 (3) ◽

pp. 217-233 ◽

Cited By ~ 15

Author(s):

Xavier Benarous ◽

Angèle Consoli ◽

Vanessa Milhiet ◽

David Cohen

Keyword(s):

Bipolar Disorder ◽

High Risk ◽

Early Interventions ◽

Developmental Approach

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Social Cognition, Language, and Social Behavior in 7-Year-Old Children at Familial High-Risk of Developing Schizophrenia or Bipolar Disorder: The Danish High Risk and Resilience Study VIA 7—A Population-Based Cohort Study

Schizophrenia Bulletin ◽

10.1093/schbul/sbz001 ◽

2019 ◽

Vol 45 (6) ◽

pp. 1218-1230 ◽

Cited By ~ 4

Author(s):

Camilla Jerlang Christiani ◽

Jens R M Jepsen ◽

Anne Thorup ◽

Nicoline Hemager ◽

Ditte Ellersgaard ◽

...

Keyword(s):

Bipolar Disorder ◽

Social Cognition ◽

Social Behavior ◽

High Risk ◽

Social Functioning ◽

Population Based ◽

Social Responsiveness ◽

Developmental Phase ◽

Bonferroni Correction ◽

Familial High Risk

Abstract Objective To characterize social cognition, language, and social behavior as potentially shared vulnerability markers in children at familial high-risk of schizophrenia (FHR-SZ) and bipolar disorder (FHR-BP). Methods The Danish High-Risk and Resilience Study VIA7 is a multisite population-based cohort of 522 7-year-old children extracted from the Danish registries. The population-based controls were matched to the FHR-SZ children on age, sex, and municipality. The FHR-BP group followed same inclusion criteria. Data were collected blinded to familial high-risk status. Outcomes were social cognition, language, and social behavior. Results The analysis included 202 FHR-SZ children (girls: 46%), 120 FHR-BP children (girls: 46.7%), and 200 controls (girls: 46.5%). FHR-SZ children displayed significant deficits in language (receptive: d = −0.27, P = .006; pragmatic: d = −0.51, P < .001), social responsiveness (d = −0.54, P < .001), and adaptive social functioning (d = −0.47, P < .001) compared to controls after Bonferroni correction. Compared to FHR-BP children, FHR-SZ children performed significantly poorer on adaptive social functioning (d = −0.29, P = .007) after Bonferroni correction. FHR-BP and FHR-SZ children showed no significant social cognitive impairments compared to controls after Bonferroni correction. Conclusion Language, social responsiveness, and adaptive social functioning deficits seem associated with FHR-SZ but not FHR-BP in this developmental phase. The pattern of results suggests adaptive social functioning impairments may not be shared between FHR-BP and FHR-SZ in this developmental phase and thus not reflective of the shared risk factors for schizophrenia and bipolar disorder.

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Immune processes in high-risk populations for bipolar disorder

Neurology Psychiatry and Brain Research ◽

10.1016/j.npbr.2015.12.050 ◽

2016 ◽

Vol 22 (1) ◽

pp. 20

Author(s):

Gijs Snijders ◽

C. Schiweck ◽

R. Brouwer ◽

L. Grosse ◽

E. Mesman ◽

...

Keyword(s):

Bipolar Disorder ◽

High Risk ◽

High Risk Populations

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Living With Bipolar Disorder in the Time of Covid-19: Biorhythms During the Severe Lockdown in Cagliari, Italy, and the Moderate Lockdown in Tunis, Tunisia

Frontiers in Psychiatry ◽

10.3389/fpsyt.2021.634765 ◽

2021 ◽

Vol 12 ◽

Author(s):

Mauro Giovanni Carta ◽

Uta Ouali ◽

Alessandra Perra ◽

Azza Ben Cheikh Ahmed ◽

Laura Boe ◽

...

Keyword(s):

Bipolar Disorder ◽

Depressive Symptoms ◽

Rating Scale ◽

Biological Rhythms ◽

Short Term ◽

Female Age ◽

Future Studies ◽

Restrictive Measures ◽

Depressive Episodes ◽

Hamilton Rating Scale

Background: Restrictions during Covid-19 pandemic lockdown, in which rhythms of life have been compromised, can influence the course of bipolar disorder (BD). This study follows patients with bipolar disorder living in two geographically close cities (Cagliari and Tunis), but with different lockdown conditions: less severe in Tunis.Methods: Two cohorts were evaluated during lockdown (April 2020, t0) and 2 months later with lockdown lifted for a month (t1). Individuals were: over 18 years old without gender exclusion, BD I or II, in care for at least 1 year, received a clinical interview in the month before the start of the lockdown, stable clinically before the lockdown. The assessment was conducted by telephone by a psychiatrist or psychologist with good knowledge of patients. Diagnoses were made according to DSM-5 criteria. Depressive symptoms were collected through the Hamilton Rating Scale for Depression; cut-off 14 indicative of depressive episode. Circadian rhythms were measured using the BRIAN scale.Results: Forty individuals in Cagliari (70%female, age 48.57 ± 11.64) and 30 in Tunis (53.3% Female, age 41.8 ± 13.22) were recruited. In Cagliari at t0 45% had depressive episodes against none in Tunis, a similar difference appeared at t1. At t0 and t1 the Cagliari sample had more dysfunctional scores in the overall BRIAN scale and in the areas of sleep, activities and social rhythms; no differences were found in nutrition, both samples had predominantly nocturnal rhythm. In Cagliari at t0 and t1, the depressive sub-group showed more dysfunctional scores in the BRIAN areas sleep, activity, and nutrition. However, the differences in biological rhythms resulted, through ANCOVA analysis, independent of the co-presence of depressive symptoms.Discussion: A rigid lockdown could expose people with BD to depressive relapse through dysregulation of biological rhythms. The return to more functional rhythms did not appear 1 month after lockdown. The rekindling of the pandemic and the restoration of new restrictive measures will prevent, at least in the short term, the beneficial effect of a return to normality of the two cohorts.This was a limited exploratory study; future studies with larger samples and longer observational time are needed to verify the hypothesis.

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Critical Predictors for the Early Detection of Conversion From Unipolar Major Depressive Disorder to Bipolar Disorder: Nationwide Population-Based Retrospective Cohort Study (Preprint)

10.2196/preprints.14278 ◽

2019 ◽

Author(s):

Ya-Han Hu ◽

Kuanchin Chen ◽

I-Chiu Chang ◽

Cheng-Che Shen

Keyword(s):

Bipolar Disorder ◽

Major Depressive Disorder ◽

Cohort Study ◽

High Risk ◽

Retrospective Cohort ◽

Risk Group ◽

Population Based ◽

Major Depressive ◽

Risk Stratification Model

BACKGROUND Unipolar major depressive disorder (MDD) and bipolar disorder are two major mood disorders. The two disorders have different treatment strategies and prognoses. However, bipolar disorder may begin with depression and could be diagnosed as MDD in the initial stage, which may later contribute to treatment failure. Previous studies indicated that a high proportion of patients diagnosed with MDD will develop bipolar disorder over time. This kind of hidden bipolar disorder may contribute to the treatment resistance observed in patients with MDD. OBJECTIVE In this population-based study, our aim was to investigate the rate and risk factors of a diagnostic change from unipolar MDD to bipolar disorder during a 10-year follow-up. Furthermore, a risk stratification model was developed for MDD-to-bipolar disorder conversion. METHODS We conducted a retrospective cohort study involving patients who were newly diagnosed with MDD between January 1, 2000, and December 31, 2004, by using the Taiwan National Health Insurance Research Database. All patients with depression were observed until (1) diagnosis of bipolar disorder by a psychiatrist, (2) death, or (3) December 31, 2013. All patients with depression were divided into the following two groups, according to whether bipolar disorder was diagnosed during the follow-up period: converted group and nonconverted group. Six groups of variables within the first 6 months of enrollment, including personal characteristics, physical comorbidities, psychiatric comorbidities, health care usage behaviors, disorder severity, and psychotropic use, were extracted and were included in a classiﬁcation and regression tree (CART) analysis to generate a risk stratification model for MDD-to-bipolar disorder conversion. RESULTS Our study enrolled 2820 patients with MDD. During the follow-up period, 536 patients were diagnosed with bipolar disorder (conversion rate=19.0%). The CART method identified five variables (kinds of antipsychotics used within the first 6 months of enrollment, kinds of antidepressants used within the first 6 months of enrollment, total psychiatric outpatient visits, kinds of benzodiazepines used within one visit, and use of mood stabilizers) as significant predictors of the risk of bipolar disorder conversion. This risk CART was able to stratify patients into high-, medium-, and low-risk groups with regard to bipolar disorder conversion. In the high-risk group, 61.5%-100% of patients with depression eventually developed bipolar disorder. On the other hand, in the low-risk group, only 6.4%-14.3% of patients with depression developed bipolar disorder. CONCLUSIONS The CART method identified five variables as significant predictors of bipolar disorder conversion. In a simple two- to four-step process, these variables permit the identification of patients with low, intermediate, or high risk of bipolar disorder conversion. The developed model can be applied to routine clinical practice for the early diagnosis of bipolar disorder.

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