Decreased leukocyte telomere length in male patients with chronic bipolar disorder: lack of effect of long-term lithium-treatment

Abstract Objectives: Bipolar disorder (BD) may be connected with accelerated aging, the marker of this can be shorter telomere length (TL). Some data suggest that lithium may exert a protective effect against telomere shortening. The study aimed to compare the telomere length between patients with bipolar disorder and control subjects. The effect of long-term lithium treatment was also assessed. Methods: The study group comprised 41 patients with BD, including 29 patients treated longitudinally with lithium (mean 16.5 years) and 20 healthy people. Telomere length was assessed by the quantitative polymerase chain reaction (qPCR). Results: In the control group, the TL was significantly longer in males than in females. Male bipolar patients had significantly shorter TL compared with the control male group. In bipolar patients, there was no correlation between TL and duration of treatment. The TL was negatively correlated with age in male bipolar patients. Conclusion: The study did not confirm the lithium effect on TL in bipolar patients. TL showed gender differences, being shorter in BD males, compared to control males, and longer in healthy males, compared to control females.

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Investigation Of The Relationship Between Plasma Tryptophan Metabolite Levels And Lithium Treatment Response In Euthymic Bipolar Patients

10.22541/au.162685216.65438507/v1 ◽

2021 ◽

Author(s):

Okan İmre ◽

Kürsat Altıinbas ◽

Sedat Abuşoğlu ◽

Ali Unlu ◽

Mehmet İyisoy

Keyword(s):

Bipolar Disorder ◽

Regression Analysis ◽

Treatment Response ◽

Lithium Treatment ◽

Control Group ◽

Plasma Tryptophan ◽

Tryptophan Metabolites ◽

Tryptophan Metabolite ◽

Bipolar Patients ◽

The Relationship

Objective: Lithium is a cornerstone treatment option in bipolar disorder. Currently, only clinical findings are used to predict the response of lithium treatment but reliable biological marker has not yet been identified. With this background, it was aimed to compare tryptophan metabolite levels between bipolar patients and healthy control group and to investigate the relationship between lithium treatment response and tryptophan metabolite levels of euthymic bipolar patients(BP). Materials and Methods: 52 euthymic BP patients on lithium were included in the study. Sociodemographic and clinical information were recorded and lithium treatment response status was determined according to the Alda scale. Age and gender matched Healthy controls(HC) were selected from the people who admitted to Selcuk University Medical Faculty Hospital Health Board. Plasma tryptophan metabolite levels were compared between BP and HC. The correlation and association between the lithium response levels of the patients and the plasma tryptophan metabolites were evaluated. Results: Plasma tryptophan(TRP), kynurenine(KYN), kynurenine/tryptophan ratio(KYN/TRP), 3-hydroxy-kynurenine(3-HK) and kynurenic acid(KYNA) levels were significantly lower in BP than HC. In the regression analysis, only plasma KYNA concentrations were found to be significantly lower in the responding well to lithium treatment and TRP levels. None of the tryptophan metabolites were found to be associated well response to lithium treatment after the logistic regression analysis. Conclusion: Our findings indicate that KYNA levels might be used as a screening test for discriminating bipolar patients from the HC. TRP levels might be used to predict lithium treatment response in spite of low specifity and low sensitivity levels. Key words: Tryptophan metabolites, lithium treatment response, bipolar disorder

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Differences in telomere length between patients with bipolar disorder and controls are influenced by lithium treatment

Pharmacogenomics ◽

10.2217/pgs-2020-0028 ◽

2020 ◽

Vol 21 (8) ◽

pp. 533-540 ◽

Cited By ~ 1

Author(s):

Claudia Pisanu ◽

Donatella Congiu ◽

Mirko Manchia ◽

Paola Caria ◽

Cristina Cocco ◽

...

Keyword(s):

Bipolar Disorder ◽

Telomere Length ◽

Lithium Treatment ◽

Telomere Shortening ◽

Genome Wide ◽

History Of ◽

Genetically Determined ◽

The Relationship

Aim: To assess the role of lithium treatment in the relationship between bipolar disorder (BD) and leukocyte telomere length (LTL). Materials & methods: We compared LTL between 131 patients with BD, with or without a history of lithium treatment, and 336 controls. We tested the association between genetically determined LTL and BD in two large genome-wide association datasets. Results: Patients with BD with a history lithium treatment showed longer LTL compared with never-treated patients (p = 0.015), and similar LTL compared with controls. Patients never treated with lithium showed shorter LTL compared with controls (p = 0.029). Mendelian randomization analysis showed no association between BD and genetically determined LTL. Conclusion: Our data support previous findings showing that long-term lithium treatment might protect against telomere shortening.

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Outcome of Bipolar Disorder on Long-Term Treatment with Lithium

The British Journal of Psychiatry ◽

10.1192/bjp.159.1.123 ◽

1991 ◽

Vol 159 (1) ◽

pp. 123-129 ◽

Cited By ~ 224

Author(s):

Ralph A. O'Connell ◽

Julia A. Mayo ◽

Leslie Flatow ◽

Beverly Cuthbertson ◽

Barbara E. O'Brien

Keyword(s):

Bipolar Disorder ◽

Treatment Outcome ◽

Lithium Treatment ◽

Term Treatment ◽

Poor Outcome ◽

Psychiatric Admissions ◽

Long Term Treatment ◽

Alcohol And Drug Abuse ◽

Bipolar Patients

The long-term treatment outcome of 248 bipolar patients in an out-patient lithium programme was assessed. Over half of the patients (138 or 56%) had no affective episodes in the year observed. Patients were divided into outcome groups according to GAS scores: the outcome for 40% of patients was good, for 41% fair, and for 19% poor. More frequent psychiatric admissions before starting lithium treatment was the best predictor of poor outcome, followed by a negative affective style in the family and lower social class. Current alcohol and drug abuse was associated with poor outcome. Although familial and psychosocial factors were significantly associated with outcome, the findings suggest there may be inherent differences in the pathophysiology of bipolar disorder reflected in an increased frequency of episodes which account for a large variance in lithium treatment outcome.

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The Effect of Long-term Lithium Treatment on Renal Functions in Patients with Bipolar Disorder

European Psychiatry ◽

10.1016/j.eurpsy.2017.01.1889 ◽

2017 ◽

Vol 41 (S1) ◽

pp. S112-S113

Author(s):

B. Ayik ◽

S. Çakır ◽

H. Yazıcı ◽

S. Karabulut

Keyword(s):

Bipolar Disorder ◽

Uric Acid ◽

Serum Creatinine ◽

Negative Impact ◽

Lithium Treatment ◽

High Serum ◽

Control Group ◽

Long Term Effects ◽

Renal Functions

IntroductionThe effect of lithium on tubular functions leading to decreased urinary concentrating ability is recognized. Although there are several studies type, severity and frequency of renal impairment and its correlation with duration of lithium therapy are not well established.ObjectivesTo explore long-term effects of lithium on patients with chronic bipolar disorder.AimsWe aimed to assess patients with bipolar disorder using lithium at least for six years in terms of renal functions, starting from mild impairments to full blown chronic renal failure.MethodsFifty-one patients with bipolar disorder and 38 age and sex matched healthy controls were enrolled for the study. Serum BUN, creatinine, uric acid, electrolytes, calcium (Ca), phosphorus (P), vitamin D (25-OH D3) and eGFR levels were measured. The correlations between renal function and mean lithium levels, duration of lithium treatment and GAF scores were calculated.ResultsMean eGFR level of patients with bipolar disorder was significantly lower than that of controls. Serum creatinine, uric acid, Ca and PTH levels were higher, 25-OH D3 levels were lower in the patients than in controls. The duration of lithium treatment was positively correlated with serum creatinine and uric acid levels, negatively correlated with eGFR levels. Mean lithium levels were positively correlated with serum creatinine levels and negatively correlated with eGFR.ConclusionsThe study revealed that glomerular functioning of the patient group was significantly lower than that of the control group. The findings suggested that both duration of lithium treatment and high serum lithium levels may have a negative impact on glomerular functions.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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The Concentration of the Factors Involved in Trafficking of Stem Cells in Long-Term Treated Bipolar Disorder Patients

European Psychiatry ◽

10.1016/j.eurpsy.2017.01.2165 ◽

2017 ◽

Vol 41 (S1) ◽

pp. S206-S206

Author(s):

J. Kucharska-Mazur ◽

A. Reginia ◽

M. Jabłoński ◽

B. Dołęgowska ◽

J. Rybakowski ◽

...

Keyword(s):

Stem Cells ◽

Bipolar Disorder ◽

Peripheral Blood ◽

Lithium Treatment ◽

Control Group ◽

Complement Cascade ◽

Regeneration System ◽

Sphingosine 1 Phosphate

IntroductionAfter analysis of biological and pharmacological data, we formulated the hypothesis that the factors involved in trafficking of stem cells could be engaged in aetiology of bipolar disorder (BP).AimsIn this study, we considered the role of complement cascade proteins, stromal derived factor-1 (SDF-1), and sphingosine-1-phosphate (S1P) in long-term treated BP.MethodsA group of 30 patients with BP, without the history of lithium treatment, was examined in remission and compared with a group of 30 healthy volunteers. In peripheral blood, we have analysed the concentration of stromal derived factor-1 (SDF-1), sphingosine-1-phosphate (S1P), and some proteins of the complement cascade (C3a, C5a, C5b-9).ResultsPeripheral blood concentration of C3a, C5a, C5b-9 and SDF-1 was significantly higher in BP group compared to control group. The concentration of S1P does not distinguish BP patients from controls.ConclusionOur results suggest the possible role of the regeneration system in aetiology of BP.This work was supported by grant POIG.01.01.02-00-109/09.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Long-term lithium treatment of bipolar disorder influences very small embryonic-like stem cells and mRNA expression of pluripotency and glial markers

10.26226/morressier.5971be83d462b80290b52f69 ◽

2017 ◽

Author(s):

Ewa Ferensztajn

Keyword(s):

Stem Cells ◽

Bipolar Disorder ◽

Mrna Expression ◽

Lithium Treatment

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Affective Temperaments and Illness Severity in Patients with Bipolar Disorder

Medicina ◽

10.3390/medicina57010054 ◽

2021 ◽

Vol 57 (1) ◽

pp. 54

Author(s):

Mario Luciano ◽

Luca Steardo ◽

Gaia Sampogna ◽

Vito Caivano ◽

Carmen Ciampi ◽

...

Keyword(s):

Quality Of Life ◽

Bipolar Disorder ◽

Protective Factor ◽

Psychiatric Symptoms ◽

Control Group ◽

Term Outcome ◽

Long Term Outcome ◽

Affective Temperaments

Background and objectives: Bipolar disorder (BD) is one of the most burdensome psychiatric illnesses, being associated with a negative long-term outcome and the highest suicide rate. Although affective temperaments can impact on BD long-term outcome, their role remains poorly investigated. The aims of the present study are to describe the clinical characteristics of patients with BD more frequently associated with the different affective temperaments and to assess the relation between affective temperaments and severity of clinical picture in a sample of patients with BD. Materials and Methods: A total of 199 patients have been recruited in the outpatients units of two university sites. Patients’ psychiatric symptoms, affective temperaments, and quality of life were investigated through validated assessment instruments. Results: Predominant cyclothymic and irritable temperaments are associated to higher number of relapses, poorer quality of life, higher rates of aggressive behaviors, and suicide attempts. Conversely, the predominant hyperthymic disposition was a protective factor for several outcome measures, including relapse rate, severity of anxiety, depressive and manic symptoms, suicidality, and earlier age at onset. One limitationo of the present study is that the recruitment took place in two university sites; therefore, our findings cannot be fully generalized to the whole community of BD patients. Other limitations are the lack of a control group and the cross-sectional design of the study. Conclusions: The early identification of affective temperaments can help clinicians to identify those BD patients who are more likely to show a poor long-term outcome. An early screening of affective temperaments can be useful to develop targeted integrated pharmacological and psychosocial interventions.

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Self-esteem in Recovered Bipolar and Unipolar Out-patients

The British Journal of Psychiatry ◽

10.1192/bjp.163.6.755 ◽

1993 ◽

Vol 163 (6) ◽

pp. 755-762 ◽

Cited By ~ 41

Author(s):

D. Pardoen ◽

F. Bauwens ◽

A. Tracy ◽

F. Martin ◽

J. Mendlewicz

Keyword(s):

Social Adjustment ◽

Clinical Characteristics ◽

Self Esteem ◽

Normal Control Group ◽

Basic Component ◽

Control Group ◽

Bipolar Patients ◽

The Relationship ◽

Depressive Patients

The hypothesis of a low self-esteem in depressive patients was tested using the Rosenberg Self-Esteem Scale in 24 recovered unipolar and 27 recovered bipolar patients, compared with a normal control group of 26 subjects matched for age and sex. The hypothesis was confirmed only for unipolars; bipolar patients presented a self-esteem score not significantly different from normal scores. Self-esteem was not related to clinical characteristics of the affective disorder, suggesting that low self-esteem may be a basic component of a depression-prone personality. The investigation of the relationship between self-esteem and social adjustment confirmed the presence of social conformism in bipolar patients and rigidly set low self-esteem in unipolar patients. These results should stimulate the evaluation of different psychotherapeutic treatments in the long-term psychosocial management of affectively ill patients.

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