Torsvik A, Brattbakk HR, Trentani A, Holdhus R, Stansberg C, Bartz-Johannessen CA, Hughes T, Steen NE, Melle I, Djurovic S, Andreassen OA, and Steen VM
Aim: This study analyzed time trends in the use of coronary procedures, guideline-based drugs, and 1-year all-cause and presumed cardiovascular mortality (CV) following acute coronary syndrome (ACS) in patients with and without bipolar disorder (BD)., Method: Using Danish registries 497 patients with ACS and BD in the period 1996-2016 were matched 1:2 on age, sex and year of ACS to patients without preexisting psychiatric disease., Results: Patients with BD and ACS received fewer coronary angiography (CAG) compared to psychiatric healthy controls (PHC). However, the difference between the populations decreased over time. For percutaneous coronary intervention (PCI) and coronary artery bypass (CABG) no differences in trend over time were found. In general patients with BD redeemed fewer prescriptions of guideline-based tertiary prophylactic drugs compared to PHCs. The difference remains constant over time for all drugs except for acetylsalicylic acid, lipid-lowering drugs and beta blockers, where the difference decreased. The 1-year all-cause mortality gap and the presumed CV mortality gap remained unchanged., Conclusion: Despite improvements in treatment disparities regarding CAG, acetylsalicylic acid, lipid-lowering drugs and beta-blockers, the treatment gap remained unchanged concerning PCI and CABG. Likewise, patients with BD experienced a lower rate of the remaining redeemed prescriptions. The overall crude mortality risk ratio for patients with BD experiencing ACS remained unchanged over the study period compared to PHC.
Stenzel C, Dalkner N, Unterrainer HF, Birner A, Bengesser SA, Fellendorf FT, Fink A, Fleischmann E, Lenger M, Maget A, Platzer M, Queissner R, Schönthaler E, Tmava-Berisha A, and Reininghaus EZ
Badrfam R, Mostafavi SA, Khaleghi A, Akhondzadeh S, Zandifar A, Farid M, Mohammadian Khonsari N, and Mohammadi MR
Subjects
Double-Blind Method, Drug Therapy, Combination, Humans, Mania, Psychiatric Status Rating Scales, Treatment Outcome, Vitamin B 6 therapeutic use, Bipolar Disorder drug therapy, Lithium therapeutic use
Ribeiro HC, Klassen A, Pedrini M, Carvalho MS, Rizzo LB, Noto MN, Zeni-Graiff M, Sethi S, Fonseca FAH, Tasic L, Hayashi MAF, Cordeiro Q, Brietzke E, and Sussulini A
Lipids are a crucial component of the human brain, serving important structural and functional roles. They are involved in cell function, myelination of neuronal projections, neurotransmission, neural plasticity, energy metabolism, and neuroinflammation. Despite their significance, the role of lipids in the development of mental disorders has not been well understood. This review focused on the potential use of lipids as blood biomarkers for common mental illnesses, such as major depressive disorder, anxiety disorders, bipolar disorder, and schizophrenia. This review also discussed the impact of commonly used psychiatric medications, such as neuroleptics and antidepressants, on lipid metabolism. The obtained data suggested that lipid biomarkers could be useful for diagnosing psychiatric diseases, but further research is needed to better understand the associations between blood lipids and mental disorders and to identify specific biomarker combinations for each disease. [ABSTRACT FROM AUTHOR]
Yana Zorkina, Valeria Ushakova, Aleksandra Ochneva, Anna Tsurina, Olga Abramova, Valeria Savenkova, Anna Goncharova, Irina Alekseenko, Irina Morozova, Daria Riabinina, Georgy Kostyuk, and Anna Morozova
Lipids are a crucial component of the human brain, serving important structural and functional roles. They are involved in cell function, myelination of neuronal projections, neurotransmission, neural plasticity, energy metabolism, and neuroinflammation. Despite their significance, the role of lipids in the development of mental disorders has not been well understood. This review focused on the potential use of lipids as blood biomarkers for common mental illnesses, such as major depressive disorder, anxiety disorders, bipolar disorder, and schizophrenia. This review also discussed the impact of commonly used psychiatric medications, such as neuroleptics and antidepressants, on lipid metabolism. The obtained data suggested that lipid biomarkers could be useful for diagnosing psychiatric diseases, but further research is needed to better understand the associations between blood lipids and mental disorders and to identify specific biomarker combinations for each disease.
Objectives: Cognitive impairment and abnormal glycolipid metabolism are common clinical features of bipolar disorder (BD). The purpose of this study was to investigate the relationship between conventional glycolipid metabolism indicators and cognitive impairment in patients with BD.Methods: A total of 132 drug-naïve patients with BD and 129 healthy controls (HC) were recruited in the study. Five serum glycolipid metabolism indicators were measured and cognitive function was assessed using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) and the Stroop Color-Word Test (Stroop test) for each participant.Results: The scores of immediate memory, attention, language and delayed memory in BD group were significantly lower than those in HC group (P < 0.05). The triglyceride (TG) level in BD group was higher than that in HC group (P = 0.011), and the total cholesterol and high-density lipoprotein cholesterol (HDL) levels were lower than those in HC group (P = 0.026; P = 0.001). Regression analysis showed that TG level was significantly correlated with RBANS total score (β = 0.245, P = 0.008), attention (β = 0.289, P = 0.03) and delayed memory (β = 0.221, P = 0.023). Fasting blood glucose (FBG) level was significantly correlated with language subscale score (β = -0.187, P = 0.046) in BD.Limitations: Cross-sectional design and limited control variables.Conclusions: Elevated FBG and TG levels may be associated with cognitive dysfunction in BD patients. Improving glycolipid metabolism in patients with BD may help to improve certain domain-specific cognitive functions. [ABSTRACT FROM AUTHOR]
Rahim Badrfam, Seyed‐Ali Mostafavi, Ali Khaleghi, Shahin Akhondzadeh, Atefeh Zandifar, Malihe Farid, Nami Mohammadian Khonsari, and Mohammad Reza Mohammadi
Abstract Objective Vitamin B6 has been linked to a variety of probable roles, including anti‐inflammatory, homocysteine‐lowering, serotonin‐regulating, and dopamine‐lowering. In this study, we investigated the possible effect of vitamin B6 on bipolar disorder in manic episode with psychotic feature in a placebo‐controlled double‐blind clinical trial in a psychiatric hospital. Methods This study was performed on 50 patients who were equally divided into two groups (each group included 25 patients) using 80 mg of vitamin B6 daily or placebo. At the beginning and end of the study, they were evaluated for lab tests, inflammatory biomarkers and level of blood homocysteine. Also, at the baseline and in weeks 2, 4, and 8, they were evaluated based on the anthropometric measurements, score obtained from the Young Mania Questionnaire, Mini‐Mental State Examination (MMSE), and the Pittsburgh Sleep Questionnaire. Results Accordingly, based on Yang Mania scoring scale, no significant difference was observed between the two groups receiving vitamin B6 and placebo (22.68 ± 5.39 vs. 21.80 ± 5.39 [p‐value = .51]). Based on MMSE, significant improvement in cognitive status was obtained in group placebo compared to vitamin B6 group (25.24 ± 1.96 vs. 24.40 ± 3.25, respectively [p‐value = .01]). At the Pittsburg scale (total, there was no statistically significant difference between the two groups receiving vitamin B6 and placebo (1.04 ± 0.20 vs. 0.48 ± 0.50 [p‐value = .23]). Additionally, no significant difference was observed between the two groups regarding the anthropometric status. Conclusions According to this study, the daily dose of 80 mg of vitamin B6 for 8 weeks in patients with bipolar disorder in the manic episode with psychotic feature treated daily with lithium, was not associated with a significant improvement in mood status compared to the control–placebo group. It is recommended to perform similar studies in a multi‐center manner with a larger sample size and longer duration.
• Chronic systemic inflammation is associated with increased cardiovascular disease. • It is also associated with the pathophysiology of neuroprogressive disorders. • Both can occur with low LDL and low cholesterol: a lipid paradox. • Inflammatory molecules released by activated neutrophils play a crucial role. • The associated molecular mechanisms suggest potential therapeutic targets. Chronic systemic inflammation is associated with an increased risk of cardiovascular disease in an environment of low low-density lipoprotein (LDL) and low total cholesterol and with the pathophysiology of neuroprogressive disorders. The causes and consequences of this lipid paradox are explored. Circulating activated neutrophils can release inflammatory molecules such as myeloperoxidase and the pro-inflammatory cytokines interleukin-1 beta, interleukin-6 and tumour necrosis factor-alpha. Since activated neutrophils are associated with atherosclerosis and cardiovascular disease and with major depressive disorder, bipolar disorder and schizophrenia, it seems reasonable to hypothesise that the inflammatory molecules released by them may act as mediators of the link between systemic inflammation and the development of atherosclerosis in neuroprogressive disorders. This hypothesis is tested by considering the association at a molecular level of systemic inflammation with increased LDL oxidation; increased small dense LDL levels; increased lipoprotein (a) concentration; secretory phospholipase A 2 activation; cytosolic phospholipase A 2 activation; increased platelet activation; decreased apolipoprotein A1 levels and function; decreased paroxonase-1 activity; hyperhomocysteinaemia; and metabolic endotoxaemia. These molecular mechanisms suggest potential therapeutic targets. [ABSTRACT FROM AUTHOR]
INDIVIDUALIZED medicine, BIOMARKERS, RESEARCH personnel, LIPOPROTEIN A, BIPOLAR disorder
Abstract
A recent study published in the International Journal of Molecular Sciences explores the role of circulating biomarkers in personalized medicine. The study utilizes Mendelian Randomization (MR) methods to establish causal relationships between biomarkers and diseases. The researchers identified novel causal relationships between glucose and bipolar disorder, as well as cystatin C and bipolar disorder. Additionally, the study confirmed previously known links between biomarkers and diseases such as urate with gout and creatine with chronic kidney disease. These findings contribute to our understanding of disease etiology and have the potential to improve precision diagnostics and interventions. [Extracted from the article]
A recent study published in Drug Week explores the associations between circulating biomarkers and disease risks using Mendelian Randomization (MR) methods. The study identifies novel causal relationships between glucose and cystatin C with bipolar disorder, as well as confirming previously known links between urate with gout and creatine with chronic kidney disease. Additionally, the study suggests potential causal relationships between certain biomarkers and cardiovascular conditions. The findings contribute to our understanding of disease etiology and may improve precision diagnostics and intervention. It is important to note that this study has not yet undergone peer review. [Extracted from the article]
Jonathan W Birdsall, Samantha L Schmitz, Oluchi J Abosi, Lyndsey E DuBose, Gary L Pierce, and Jess G Fiedorowicz
Subjects
arterial stiffness, bipolar disorder, cardiovascular disease risk, inflammation, lipids, major depressive disorder, mood disorder, pulse wave velocity, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract
Background: Mood disorders have been associated with a variety of cardiovascular disease (CVD) risk factors, including inflammation and large arterial stiffness, particularly while depressed, although longitudinal studies have been limited. Materials and Methods: With measurements at baseline and 8 weeks, the researchers prospectively assessed mood, levels of inflammatory markers (high-sensitivity C-reactive protein and tumor necrosis factor-alpha [TNF-α]), serum lipids, and large arterial stiffness in a cohort of 26 participants with a diagnosis of a mood disorder, enriched for current depression. Depressive symptoms were measured using the Montgomery–Šsberg Depression Rating Scale (MADRS) at baseline and 8 weeks. Associations between depressive symptoms and other measures were assessed using linear mixed models, unadjusted and adjusted for age and body mass index. Results: The mean age of the participants (n = 26) was 41.6 (standard deviation [SD] 12.8) years, and 81% were female. During the study, there was a mean (SD) MADRS score improvement of 9.5 (9.4) from baseline to 8 weeks. Reductions in the primary outcome of tumor necrosis factor-α with improvement in depression fell short of statistical significance (P = 0.076). In secondary analyses, there was a statistically significant association between improved cholesterol ratio (P = 0.038) and triglycerides (P = 0.042) with improvement in depression. There was no statistically significant change in large arterial stiffness during the study. Conclusion: Improved depressive symptoms were associated with improved cholesterol ratios even after adjustment, suggesting a possible mechanism by which acute mood states may influence CVD risk. Future longitudinal studies with extended and intensive follow-up investigating CVD risk related to acute changes and persistence of mood symptoms are warranted.
The First Affiliated Hospital of Zhejiang University in China is conducting a clinical trial, NCT06331286, to examine the impact of dulaglutide adjuvant treatment on cognitive function in bipolar disorder patients with obesity. The trial aims to investigate the effects of dulaglutide injection on cognition in individuals with bipolar disorder. The study includes 60 participants who will be randomly assigned to receive either dulaglutide injection or diet and exercise guidance for 24 weeks. The trial will measure various outcomes, including weight, blood glucose concentration, cholesterol levels, and cognitive test results. Secondary outcomes will also be assessed, such as depression severity and treatment-emergent symptoms. The trial is open to individuals of all genders between the ages of 18 and 65 and is expected to be completed by December 31, 2024. [Extracted from the article]
Background: Cardiovascular disease (CVD) is a major cause of premature death in patients with psychotic disorders, where dyslipidemia occurs frequently. In the pathogenesis of these serious mental disorders, a low-grade inflammation seems to be a possible contributor. Concurrently, systemic inflammation and its interplay with dyslipidemia is a central driver in the pathogenesis of CVD. We hypothesize that evaluation of atherogenic lipid ratios together with inflammatory markers reflecting different inflammatory pathways with relevance for atherogenesis, could give novel information on immune-related mechanisms involved in early CVD risk in patients with psychotic disorders. Methods: As a measure for CVD risk we calculated atherogenic lipid ratios using established sex-specific cut-offs: Total cholesterol/high-density lipoprotein; HDL-c (TC/HDL) and triglyceride/HDL-c (TG/HDL) were evaluated in 571 schizophrenia (SCZ) and 247 bipolar disorder (BD) patients, and in 99 healthy controls (HC). In addition, as a measure of low-grade inflammation, we measured fasting plasma levels of nine stable atherogenic inflammatory markers in patients (SCZ, BD) and in HC. The elevated inflammatory markers and CVD risk in patients, as reflected by TC/HDL and TG/HDL, were further assessed in multivariable analyses adjusting for comorbid cardio-metabolic risk factors. Results: A markedly higher proportion (26%–31%) of patients had increased TC/HDL and TG/HDL ratios compared with HC. Plasma levels of high-sensitivity C-reactive protein (hs-CRP) and myeloperoxidase (MPO) were higher (p<0.05, p<0.001) in patients with psychotic disorders than in HC, and hs-CRP and MPO were independently associated with atherogenic lipid ratios in the multivariable analyses. Conclusions: Our findings suggest that low-grade inflammation and abnormal neutrophil activation may cause increased CVD risk in patients with psychotic disorders. These mechanisms should be further examined to determine the potential for development of novel risk evaluation strategies. [ABSTRACT FROM AUTHOR]
*METABOLIC syndrome, *BIPOLAR disorder, *HEALTH & Nutrition Examination Survey, *HYPERTENSION, *BODY mass index
Abstract
Objective: Previous studies have indicated a convergent and bidirectional relationship between metabolic syndrome (MetS) and bipolar disorder (BD). As most of these studies focused mainly on adults diagnosed with BD, our study aims to investigate and characterize metabolic disturbances in child-adolescents diagnosed with BD. Methods: We retrospectively examined the medical records of psychiatric hospitalizations with admitting diagnosis of BD in child-adolescents (age < 18 years). Body mass index (BMI), lipid profile, fasting blood glucose, and blood pressure were primary variables. National Cholesterol Education Program criteria were used to define MetS. Reference group data was obtained from the National Health and Nutrition Examination Survey study. Statistical analyses included t tests, chi-square tests, and Fisher's exact tests. Results: We identified 140 child-adolescent patients with BD (mean age = 15.12 ± 1.70 years, 53% male). MetS was significantly more common in BD compared to the reference group: 14% (95% confidence interval [95% CI] 8-20) vs. 6.7% (95% CI 4.10-9.2), p = 0.001 with no significant difference by sex. MetS components were higher in the BD group, particularly BMI ≥ 95% (25% vs. 11.8%, p < 0.001) and high blood pressure (17% vs. 8%, p = 0.05). Moreover, female patients had lower odds of high blood pressure (odds ratio = 0.24 [95% CI 0.08-0.69], p = 0.005). Conclusion: Compared with the general child-adolescent population, the prevalence of MetS was significantly higher in patients with BD of same age. This reiterates the notion of an increased risk of MetS in patients diagnosed with BD; and thus, further exploration is warranted. [ABSTRACT FROM AUTHOR]
The prevalence of metabolic syndrome and overweight/obesity is increased in bipolar disorder (BD) compared to the general population and is related to suicidality. The aim of this study was to examine the association between both the rate of suicidal ideation and suicide attempts and metabolic variables in individuals with BD.Anthropometric measures, socio-demographic data, suicide history and serum lipid levels were measured in 215 individuals with BD. Individuals were divided into normal weight, overweight and obese according to their body mass index (BMI), and metabolic syndrome was assessed using "The International Diabetes Federation"-criteria.Of the 215 individuals studied, 80.9% reported suicidal ideation, 35.3% reported at least one suicide attempt and 30.7% were diagnosed with metabolic syndrome. Both metabolic syndrome and BMI were not related to suicide attempts. However, individuals with normal weight had more suicidal ideation than overweight individuals, while obese individuals did not differ from either group. Furthermore, there was no association between suicide attempts or suicidal ideation and serum lipid levels.The cross-sectional design of the study, a non-standardized questionnaire for suicidality, and not controlling the medication intake are limiting factors.Contrary to expectations, a difference was found in the BMI categories and suicidal ideation, but not suicide attempts. Serum lipid levels were found to be unsuitable as possible biomarkers for suicidality in individuals with BD. Special attention should be paid to suicidal ideation and BMI rather than metabolic syndrome or lipid values when treating suicidal individuals with BD.
Background: Inflammation and immune activation have been implicated in the pathogenesis of severe mental disorders and cardiovascular disease (CVD). Despite high level of comorbidity, many studies of the immune system in severe mental disorders have not systematically taken cardiometabolic risk factors into account. Methods: We investigated if inflammatory markers were increased in schizophrenia (SCZ) and affective (AFF) disorders independently of comorbid CVD risk factors. Cardiometabolic risk factors (blood lipids, body mass index and glucose) and CVD-related inflammatory markers CXCL16, soluble interleukin-2 receptor (sIL-2R), soluble CD14 (sCD14), macrophage inhibitory factor and activated leukocyte cell adhesion molecule (ALCAM) were measured in n = 992 patients (SCZ, AFF), and n = 647 healthy controls. We analyzed the inflammatory markers before and after controlling for comorbid cardiometabolic risk factors, and tested for association with psychotropic medication and symptom levels. Results: CXCL16 (p = 0.03) and sIL-2R (p = 7.8 × 10−5) were higher, while sCD14 (p = 0.05) were lower in patients compared to controls after controlling for confounders, with significant differences in SCZ for CXCL16 (p = 0.04) and sIL-2R (p = 1.1 × 10−5). After adjustment for cardiometabolic risk factors higher levels of sIL-2R (p = 0.001) and lower sCD14 (p = 0.002) remained, also in SCZ (sIL-2R, p = 3.0 × 10−4 and sCD14, p = 0.01). The adjustment revealed lower ALCAM levels (p = 0.03) in patients. We found no significant associations with psychotropic medication or symptom levels. Conclusion: The results indicate that inflammation, in particular enhanced T cell activation and impaired monocyte activation, are associated with severe mental disorders independent of comorbid cardiometabolic risk factors. This suggests a role of novel pathophysiological mechanisms in severe mental disorders, particularly SCZ. [ABSTRACT FROM AUTHOR]
DIAGNOSIS of dementia, MENTAL illness, DATA science, SELF-organizing maps, BIPOLAR disorder
Abstract
Based on accumulating evidence of a role of lipid signaling in many physiological and pathophysiological processes including psychiatric diseases, the present data driven analysis was designed to gather information needed to develop a prospective biomarker, using a targeted lipidomics approach covering different lipid mediators. Using unsupervised methods of data structure detection, implemented as hierarchal clustering, emergent self-organizing maps of neuronal networks, and principal component analysis, a cluster structure was found in the input data space comprising plasma concentrations of d = 35 different lipid-markers of various classes acquired in n = 94 subjects with the clinical diagnoses depression, bipolar disorder, ADHD, dementia, or in healthy controls. The structure separated patients with dementia from the other clinical groups, indicating that dementia is associated with a distinct lipid mediator plasma concentrations pattern possibly providing a basis for a future biomarker. This hypothesis was subsequently assessed using supervised machine-learning methods, implemented as random forests or principal component analysis followed by computed ABC analysis used for feature selection, and as random forests, k-nearest neighbors, support vector machines, multilayer perceptron, and naïve Bayesian classifiers to estimate whether the selected lipid mediators provide sufficient information that the diagnosis of dementia can be established at a higher accuracy than by guessing. This succeeded using a set of d = 7 markers comprising GluCerC16:0, Cer24:0, Cer20:0, Cer16:0, Cer24:1, C16 sphinganine, and LacCerC16:0, at an accuracy of 77%. By contrast, using random lipid markers reduced the diagnostic accuracy to values of 65% or less, whereas training the algorithms with randomly permuted data was followed by complete failure to diagnose dementia, emphasizing that the selected lipid mediators were display a particular pattern in this disease possibly qualifying as biomarkers. [ABSTRACT FROM AUTHOR]
PEOPLE with schizophrenia, OLANZAPINE, TREATMENT effectiveness, BIPOLAR disorder, MENTAL illness, DURABILITY
Abstract
Alkermes plc has announced the topline results from a phase 3, open-label extension study evaluating the long-term safety, tolerability, and durability of treatment effect of LYBALVI (olanzapine and samidorphan) in patients with schizophrenia, schizophreniform disorder, or bipolar I disorder. The study included 523 participants who received at least one dose of LYBALVI, with 35.9% completing the four-year treatment period. The safety profile of LYBALVI was consistent with previous studies, and patients' symptoms remained stable over the four-year treatment period. The study also found minimal changes in body weight, waist circumference, lipid and glycemic parameters, and the most common adverse events reported were weight gain, headache, anxiety, insomnia, somnolence, nausea, and weight decrease. The results highlight the potential utility of LYBALVI as a maintenance treatment option for these mental health conditions. [Extracted from the article]
Accumulating evidence shows that nitro-oxidative pathways play an important role in the pathophysiology of major depressive disorder (MDD) and bipolar disorder (BD) and maybe anxiety disorders. The current study aims to examine superoxide dismutase (SOD1), catalase, lipid hydroperoxides (LOOH), nitric oxide metabolites (NOx), advanced oxidation protein products (AOPP), malondialdehyde (MDA), glutathione (GSH), paraoxonase 1 (PON1), high-density lipoprotein cholesterol (HDL), and uric acid (UA) in participants with and without generalized anxiety disorder (GAD) co-occurring or not with BD, MDD, or tobacco use disorder. Z unit-weighted composite scores were computed as indices of nitro-oxidative stress driving lipid and protein oxidation. SOD1, LOOH, NOx, and uric acid were significantly higher and HDL and PON1 significantly lower in participants with GAD than in those without GAD. GAD was more adequately predicted by increased SOD + LOOH + NOx and lowered HDL + PON1 composite scores. Composite scores of nitro-oxidative stress coupled with aldehyde and AOPP production were significantly increased in participants with comorbid GAD + MDD as compared with all other study groups, namely MDD, GAD + BD, BD, GAD, and healthy controls. In conclusion, GAD is characterized by increased nitro-oxidative stress and lipid peroxidation and lowered lipid-associated antioxidant defenses, while increased uric acid levels in GAD may protect against aldehyde production and protein oxidation. This study suggests that increased nitro-oxidative stress and especially increased SOD1 activity, NO production, and lipid peroxidation as well as lowered HDL-cholesterol and PON1 activity could be novel drug targets for GAD especially when comorbid with MDD. [ABSTRACT FROM AUTHOR]
AFFECTIVE disorders, BLOOD sugar, CHOLESTEROL, MENTAL depression, FASTING, HIGH density lipoproteins, HYPERLIPIDEMIA, LIPIDS, LOW density lipoproteins, BIPOLAR disorder, PSYCHOSES, TRIGLYCERIDES, DISEASE remission
Abstract
Objective Serum lipid levels may be associated with the affective severity of bipolar disorder, but data on lipid profiles in Asian patients with bipolar disorder and the lipid alterations in different states of opposite polarities are scant. We investigated the lipid profiles of patients in the acute affective, partial, and full remission state in bipolar mania and depression. Methods The physically healthy patients aged between 18 and 45 years with bipolar I disorder, as well as age-matched healthy normal controls were enrolled. We compared the fasting blood levels of glucose, cholesterol, triglyceride, low-density lipoprotein, and high-density lipoprotein of manic or depressed patients in the acute phase and subsequent partial and full remission with those of their normal controls. Results A total of 32 bipolar manic patients (12 women and 20 men), 32 bipolar depressed participants (18 women and 14 men), and 64 healthy control participants took part in this study. The mean cholesterol level in acute mania was significantly lower than that in acute depression (p < 0.025). The lowest rate of dyslipidemia (hypertriglyceridemia or low high-density lipoprotein cholesterol) was observed in acute bipolar mania. Conclusion Circulating lipid profiles may be easily affected by affective states. The acute manic state may be accompanied by state-dependent lower cholesterol and triglyceride levels relative to that in other mood states. [ABSTRACT FROM AUTHOR]
Overall, 1029 participants, including 343 patients with BD who have committed offenses, 343 nonoffending patients with BD, and 343 healthy controls, were included in this retrospective study." Keywords: Biomarkers; Bipolar Disorders; Blood Cells; Bone Marrow Cells; Cell Research; Diagnostics and Screening; Granulocytes; HDL Lipoproteins; Health and Medicine; Hemic and Immune Systems; Immunology; Inflammation; Lipid Research; Lipids; Lipoproteins; Lymphocytes; Manic-Depressive Illness; Mental Health Diseases and Conditions; Monocytes; Mononuclear Leukocytes; Mononuclear Phagocyte System; Neutrophils; Peptides and Proteins; Phagocytes; Proteins; Psychiatry EN Biomarkers Bipolar Disorders Blood Cells Bone Marrow Cells Cell Research Diagnostics and Screening Granulocytes HDL Lipoproteins Health and Medicine Hemic and Immune Systems Immunology Inflammation Lipid Research Lipids Lipoproteins Lymphocytes Manic-Depressive Illness Mental Health Diseases and Conditions Monocytes Mononuclear Leukocytes Mononuclear Phagocyte System Neutrophils Peptides and Proteins Phagocytes Proteins Psychiatry 382 382 1 10/16/23 20231020 NES 231020 2023 OCT 16 (NewsRx) -- By a News Reporter-Staff News Editor at Mental Health Weekly Digest -- Data detailed on bipolar disorders have been presented. The HDL-c levels were significantly lower in the patients with BD who have committed offenses than those of nonoffending patients with BD (p < 0.001). [Extracted from the article]
Background: Balance in the immune system plays roles in bipolar disorder (BD) and its metabolic co-morbidities. Memantine is an NMDA receptor antagonist with anti-inflammatory effects. However, the effects of memantine adjunct treatment on metabolic status of BD are unclear.Methods: During the 12 weeks period, a total of 191 BD patients were enrolled and split into valproate (VPA) + placebo and VPA + memantine (5mg/day) arms. The fasting plasma levels of high-sensitivity C-reactive protein (CRP) and metabolic indices were assessed. BD patients were stratified according to their initial CRP level.Results: A cut-off value of initial CRP level of 2322ng/mL discriminated the waist circumference in these BD patients after 12-week VPA treatment. In the high CRP (> 2322ng/mL) group, patients in the VPA + memantine arm had a significantly decreased in their CRP (p= 0.009), total cholesterol (p= 0.002), LDL (p= 0.002) levels, BMI (p= 0.001), and waist circumference (p< 0.001), compared to those in the VPA + placebo arm. However, analysis of the low CRP group did not showed the effect.Limitations: We recruited BD patients in depressed states and the sample size was relative small. The effects of the fixed dose of memantine on metabolic indices were 12-week follow up in BD patients treated with VPA.Conclusions: BD patients with high initial CRP levels receiving memantine adjunct treatment have a reduced risk of inflammation and metabolic imbalance. Prospective studies are needed to confirm the long-term outcome for memantine adjunct therapy in BD patients. [ABSTRACT FROM AUTHOR]
Heald, Adrian H., Martin, Julie L., Payton, Tony, Khalid, Luma, Anderson, Simon G., Narayanan, R. Prakash, De Hert, Marc, Yung, Alison, and Livingston, Mark
Subjects
*TYPE 2 diabetes risk factors, *AGE distribution, *ANTHROPOMETRY, *BLOOD pressure measurement, *BLOOD sugar, *CONFIDENCE intervals, *MENTAL depression, *HIGH density lipoproteins, *LIPIDS, *LONGITUDINAL method, *LOW density lipoproteins, *BIPOLAR disorder, *MULTIVARIATE analysis, *PRIMARY health care, *PROBABILITY theory, *REGRESSION analysis, *RESEARCH funding, *SCHIZOAFFECTIVE disorders, *SCHIZOPHRENIA, *STATISTICS, *TRIGLYCERIDES, *LOGISTIC regression analysis, *BODY mass index, *RETROSPECTIVE studies, *DATA analysis software, *MEDICAL coding, *ODDS ratio
Abstract
Background: Diabetes, obesity and metabolic syndrome are highly prevalent in patients with severe mental illness and can impose a major physical health burden. Objective: To determine how anthropometric and metabolic features changed over time in a retrospective cohort of people with Severe Mental Illness living in Cheshire, UK. Methods: In all, 1307 individuals on the severe mental illness Register were followed up between 2002 and 2012 in UK general practice. Subjects were identified through a pseudanonymised search of general practice registers. Results: Baseline body mass index was 28.6 kg/m2 increasing to 31.0 at 10-year follow-up (r² = 0.84; p = 0.0002). There was a significant increase in fasting blood glucose from 5.72 to 6.79 mmol/L (r² = 0.48; p = 0.026). Correspondingly, there was a strong positive univariate relation between increase in body mass index and fasting blood glucose (r² = 0.54; p < 0.0001) taking into account all measurements. Fasting blood glucose also increased slightly with age (p = 0.028). With increasing use of statins, total cholesterol fell from 4.5 to 3.9 mmol/L (r² = 0.88; p = 0.0001), as did low-density lipoprotein cholesterol from 3.43 to 2.35 mmol/L (r² = 0.94; p = 0.0001). In multivariate models, adjusting for age, gender, smoking and blood pressure, each unit increase in body mass index (odds ratio = 1.07 [1.01, 1.13]; p = 0.031) and triglycerides (odds ratio = 1.28 (1.06, 1.55); p = 0.009) was independently associated with an increased risk of having type 2 diabetes. Conclusion: Increasing body mass index relates to increasing rates of dysglycaemia over time. Measures to encourage weight reduction should be key strategies to reduce dysglycaemia rates in severe mental illness. Prescribing statins may have been effective in improving the lipid profile in this group. [ABSTRACT FROM AUTHOR]
Terrence T. Currie, Shiva Sharma, Hanjing Wu, Cristian Patrick Zeni, Jair C. Soares, Satyajit Mohite, Luca Lavagnino, and Teresa A. Pigott
Subjects
medicine.medical_specialty, National Health and Nutrition Examination Survey, Bipolar disorder, Population, 03 medical and health sciences, Behavioral Neuroscience, 0302 clinical medicine, Internal medicine, medicine, Blood glucose, Pharmacology (medical), education, National Cholesterol Education Program, Body mass index, education.field_of_study, medicine.diagnostic_test, business.industry, Odds ratio, medicine.disease, Metabolic syndrome, Lipids, Confidence interval, 030227 psychiatry, Psychiatry and Mental health, Child-adolescents, Original Article, business, Lipid profile, 030217 neurology & neurosurgery
Abstract
Objective Previous studies have indicated a convergent and bidirectional relationship between metabolic syndrome (MetS) and bipolar disorder (BD). As most of these studies focused mainly on adults diagnosed with BD, our study aims to investigate and characterize metabolic disturbances in child-adolescents diagnosed with BD. Methods We retrospectively examined the medical records of psychiatric hospitalizations with admitting diagnosis of BD in child-adolescents (age < 18 years). Body mass index (BMI), lipid profile, fasting blood glucose, and blood pressure were primary variables. National Cholesterol Education Program criteria were used to define MetS. Reference group data was obtained from the National Health and Nutrition Examination Survey study. Statistical analyses included t tests, chi-square tests, and Fisher's exact tests. Results We identified 140 child-adolescent patients with BD (mean age = 15.12 ± 1.70 years, 53% male). MetS was significantly more common in BD compared to the reference group: 14% (95% confidence interval [95% CI] 8-20) vs. 6.7% (95% CI 4.1-9.2), p = 0.001 with no significant difference by sex. MetS components were higher in the BD group, particularly BMI ≥ 95% (25% vs. 11.8%, p < 0.001) and high blood pressure (17% vs. 8%, p = 0.05). Moreover, female patients had lower odds of high blood pressure (odds ratio = 0.24 [95% CI 0.08-0.69], p = 0.005). Conclusion Compared with the general child-adolescent population, the prevalence of MetS was significantly higher in patients with BD of same age. This reiterates the notion of an increased risk of MetS in patients diagnosed with BD; and thus, further exploration is warranted.
Background This study aimed to investigate the differences in the serum levels of glucose, lipid, and thyroid function markers between unipolar and bipolar depressed patients, as well as the effect of anhedonia and suicidal thoughts on the levels of these biochemical parameters. Methods A total of 287 unmedicated depressed patients from January 2016 to December 2017 were included in this study, including 92 bipolar depressions and 195 unipolar depressions. Anhedonia was determined using the item 32 of Symptom Checklist (SCL-90). Suicide ideation was assessed by item 15 of SCL-90. Results The bipolar group had significantly lower lipid levels (including triglycerides, cholesterol, low-density lipoprotein cholesterol [LDL], very low-density lipoprotein cholesterol [VLDL]) and insulin resistance index but higher levels of prolactin, low triiodothyronine (T3) and free T3 (FT3) as well as higher incidence of anhedonia as compared with the unipolar group. Depressed patients with anhedonia had significantly higher LDL level than those without anhedonia. Depressed patients with suicidal thoughts had cholesterol and high-density lipoprotein cholesterol (HDL) level. The above-mentioned differences were confirmed by logistic regression analysis. Receiver operating characteristic curve (ROC) analysis showed that the area under the ROC curve (AUC) ranged from 0.546 to 0.685. Conclusion Triglycerides, cholesterol, LDL, VLDL T3, FT3 levels were significantly different between unipolar and bipolar depressed patients, which might have the potential to be the markers for differential diagnosis. Patients with anhedonia had lower LDL level, while patients with suicidal thoughts had higher levels of cholesterol and HDL as compared with the corresponding control groups.
Malihe Farid, Nami Mohammadian Khonsari, Shahin Akhondzadeh, Atefeh Zandifar, Ali Khaleghi, Rahim Badrfam, Seyed-Ali Mostafavi, and Mohammad Reza Mohammadi
Objective Vitamin B6 has been linked to a variety of probable roles, including anti‐inflammatory, homocysteine‐lowering, serotonin‐regulating, and dopamine‐lowering. In this study, we investigated the possible effect of vitamin B6 on bipolar disorder in manic episode with psychotic feature in a placebo‐controlled double‐blind clinical trial in a psychiatric hospital. Methods This study was performed on 50 patients who were equally divided into two groups (each group included 25 patients) using 80 mg of vitamin B6 daily or placebo. At the beginning and end of the study, they were evaluated for lab tests, inflammatory biomarkers and level of blood homocysteine. Also, at the baseline and in weeks 2, 4, and 8, they were evaluated based on the anthropometric measurements, score obtained from the Young Mania Questionnaire, Mini‐Mental State Examination (MMSE), and the Pittsburgh Sleep Questionnaire. Results Accordingly, based on Yang Mania scoring scale, no significant difference was observed between the two groups receiving vitamin B6 and placebo (22.68 ± 5.39 vs. 21.80 ± 5.39 [p‐value = .51]). Based on MMSE, significant improvement in cognitive status was obtained in group placebo compared to vitamin B6 group (25.24 ± 1.96 vs. 24.40 ± 3.25, respectively [p‐value = .01]). At the Pittsburg scale (total, there was no statistically significant difference between the two groups receiving vitamin B6 and placebo (1.04 ± 0.20 vs. 0.48 ± 0.50 [p‐value = .23]). Additionally, no significant difference was observed between the two groups regarding the anthropometric status. Conclusions According to this study, the daily dose of 80 mg of vitamin B6 for 8 weeks in patients with bipolar disorder in the manic episode with psychotic feature treated daily with lithium, was not associated with a significant improvement in mood status compared to the control–placebo group. It is recommended to perform similar studies in a multi‐center manner with a larger sample size and longer duration., The daily dose of 80 mg of vitamin B6 for 8 weeks in patients with bipolar disorder in the manic episode with psychotic feature treated daily with lithium, was not associated with a significant improvement in mood status compared to the control–placebo group.
Lila R. Shapiro, Kody G. Kennedy, Mikaela K. Dimick, and Benjamin I. Goldstein
Subjects
Psychiatry and Mental health, Clinical Psychology, Mania, Young Adult, Bipolar Disorder, Cross-Sectional Studies, Adolescent, Cholesterol, HDL, Humans, Lipids
Abstract
Abnormal blood lipid levels are common in individuals with bipolar disorder (BD). Previous studies have revealed lipid-mood associations in adults with BD, but no data on this relationship is available in youth populations. This cross-sectional study examined the associations of lipid levels with mood states and symptoms in a cohort of youth with BD.Participants were youth with BD and healthy controls (HCs) between the ages of 13-20 years. We compared the levels of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides (TG), and TG/HDL-C ratio between 4 participant episode groups: BD-euthymic (n = 28), BD-depressed (n = 29) BD-hypomanic/mixed (n = 31), and HCs (n = 89). We also examined for dimensional associations of lipids with mania and depression scores in the overall BD group and within BD episode subgroups.TG levels were significantly higher in the BD-euthymic group (p = 0.008, d = 0.59) and in the BD-mixed/hypomanic group (p = 0.03, d = 0.44) compared to the HC group. TG/HDL-C ratio was also higher in the BD-euthymic group compared to the HC group (p = 0.01, d = 0.51). No dimensional associations were found between lipids and mood symptom scores in the overall BD group. However, within the BD-mixed/hypomanic subgroup, higher mania scores were associated with higher TG (β = 0.42, p = 0.04), TG/HDL-C ratio (β = 0.59, p = 0.002), and lower HDL-C (β = 0.56 p = 0.002).Youth with BD demonstrate atherogenic lipid profiles. Higher atherogenic lipids were associated with hypomanic but, contrasting adult BD studies, not depressive symptoms. Future prospective studies are warranted to evaluate the temporal association between lipids and mood among youth with BD.
Morrato, Elaine H., Campagna, Elizabeth J., Brewer, Sarah E., Dickinson, L. Miriam, Thomas, Deborah S. K., Miller, Benjamin F., Dearing, James, Druss, Benjamin G., and Lindrooth, Richard C.
Subjects
MEDICAID, ANTIPSYCHOTIC agents, CARE of people, PEOPLE with mental illness, CLINICAL trials, MENTAL health services, META-analysis, MANAGEMENT, BLOOD sugar analysis, MEDICAID law, MEDICAL screening -- Law & legislation, DRUG therapy for schizophrenia, STATE health plans, LIPIDS, LONGITUDINAL method, BIPOLAR disorder, ORAL drug administration, QUESTIONNAIRES, RESEARCH funding, RISK assessment, SCHIZOPHRENIA, RETROSPECTIVE studies, LAW
Abstract
Importance: Medicaid quality indicators track diabetes mellitus and cardiovascular disease screening in adults receiving antipsychotics and/or those with serious mental illness.Objective: To inform performance improvement interventions by evaluating the relative importance of patient, prescriber, and practice factors affecting metabolic testing.Design, Setting, and Participants: A retrospective cohort study was conducted using Missouri Medicaid administrative claims data (January 1, 2010, to December 31, 2012) linked with prescriber market data. The analysis included 9316 adults (age, 18-64 years) who were starting antipsychotic medication. Secondary analysis included the subset of adults (n = 1813) for whom prescriber knowledge, attitudes, and behavior survey data were available. Generalized estimating equations were performed to identify factors associated with failure to receive annual testing during antipsychotic treatment (adjusted odds ratio [OR], <1 favor testing). Data analysis was performed from October 1, 2014, to February 18, 2016.Exposure: Oral second-generation antipsychotics.Main Outcomes and Measures: A medical claim for glucose or lipid testing occurring within 180 days before and after the antipsychotic prescription claim.Results: The 9317 patients (mean [SD] age, 37.6 [12.0] years) initiated antipsychotic medication in a variety of prescriber specialty-settings: 24.3%, community mental health center (CMHC); 27.6%, non-CMHC behavioral health; 24.3%, primary care practitioners; and 23.8%, other/unknown. Annual testing rates were 79.6% for glucose and 41.2% for lipids. Failure to test glucose and lipids was most strongly associated with patient factors and health care utilization. To illustrate by using findings from glucose modeling (reported as adjusted OR [95% CI]), lower failure to receive testing was associated with older age (40-49 vs 18-29 years; 0.64 [0.55-0.74]), diagnosis of schizophrenia or bipolar disorder (0.55 [0.44-0.67]), cardiometabolic comorbidity (dyslipidemia, 0.28 [0.22-0.37]), hypertension (0.59 [0.50-0.69]), and greater outpatient utilization (>6 encounters vs none; 0.33 [0.28-0.39]). Analysis incorporating prescriber practice information found lower failure to receive glucose testing if the patient received care at a CMHC (0.74 [0.64-0.85]) or if the initiating prescriber was a primary care practitioner (0.81 [0.66-1.00]). However, the initiating prescriber specialty-setting was not associated with lipid testing.Conclusions and Relevance: Compared with prior reports, progress has been made to improve diabetes screening, but lipid screening remains particularly underutilized. Medicaid performance improvement initiatives should target all prescriber settings and not just behavioral health. [ABSTRACT FROM AUTHOR]
Aim This study aimed to assess the probability of developing a lipid test abnormality over time, among first-time users of antipsychotic medications with affective psychosis. Methods Survival analysis was used to analyse data from an early intervention in psychosis programme for the first 53 consecutive and eligible cases of patients between the ages of 14 and 40 years who had a diagnosis of affective psychosis. Data on initiation of antipsychotic medications and lipid laboratory test results were abstracted from chart reviews. Results Within the first 18 months of receiving antipsychotic medications, the probability of surviving without an abnormal lipid test was only 25% (confidence interval 95%: 13.1%, 40.4%). The median time to the development of an abnormal test was 8 months for males and 12 months for females ( P < 0.001). Conclusions Additional studies are needed to document the incidence over time of abnormal lipid tests to inform clinicians about the optimal frequency of monitoring. [ABSTRACT FROM AUTHOR]
BIPOLAR disorder, MENTAL illness, MEDICAL research, RESEARCH institutes, HDL cholesterol, OLANZAPINE
Abstract
Research on LOS and its influencing factors in BD is limited in China." Biochemicals, Biochemistry, Bipolar Disorders, Chemicals, Health and Medicine, Hospitals, Lipid Research, Lipids, Lipoproteins, Manic-Depressive Illness, Mental Disorders, Mental Health Diseases and Conditions, Psychiatry Keywords: Biochemicals; Biochemistry; Bipolar Disorders; Chemicals; Health and Medicine; Hospitals; Lipid Research; Lipids; Lipoproteins; Manic-Depressive Illness; Mental Disorders; Mental Health Diseases and Conditions; Psychiatry EN Biochemicals Biochemistry Bipolar Disorders Chemicals Health and Medicine Hospitals Lipid Research Lipids Lipoproteins Manic-Depressive Illness Mental Disorders Mental Health Diseases and Conditions Psychiatry 2023 MAR 13 (NewsRx) -- By a News Reporter-Staff News Editor at Mental Health Weekly Digest -- Research findings on bipolar disorders are discussed in a new report. [Extracted from the article]
PEOPLE with mental illness, KETOGENIC diet, COMPULSIVE eating, BIPOLAR disorder, BORDERLINE personality disorder, ACETONEMIA, METABOLIC disorders, OBESITY, CARDIOVASCULAR diseases
Abstract
Keywords: Clinical Trial Identifier NCT05705063; Lipid Research; Lipids; Lipoproteins; Peptide Hormones; Peptide Proteins; Proinsulin; Psychiatric; Psychiatry; Risk and Prevention; Therapy EN Clinical Trial Identifier NCT05705063 Lipid Research Lipids Lipoproteins Peptide Hormones Peptide Proteins Proinsulin Psychiatric Psychiatry Risk and Prevention Therapy 2023 FEB 13 (NewsRx) -- By a News Reporter-Staff News Editor at Clinical Trials Week -- Staff editors report on the newly launched clinical trial, NCT05705063, which has the following summary description: "To initiate a low-carbohydrate, high-fat (LCHF) or ketogenic dietary (KD) intervention among a cohort of outpatients with bipolar illness who also have metabolic abnormalities, overweight/obesity, and/or are currently taking psychotropic medications experiencing metabolic side effects." ECollection 2022.
https://www.ncbi.nlm.nih.gov/pubmed?term=36483840 - Sethi S, Ford JM. 2022 Nov 29;14(23):5074. doi: 10.3390/nu14235074.
https://www.ncbi.nlm.nih.gov/pubmed?term=32773576 - Sethi S, Sinha A, Gearhardt AN. [Extracted from the article]
Samantha L. Schmitz, Gary L. Pierce, Oluchi Abosi, Lyndsey E. DuBose, Jonathan W Birdsall, and Jess G. Fiedorowicz
Subjects
bipolar disorder, medicine.medical_specialty, major depressive disorder, business.industry, pulse wave velocity, Blood lipids, mood disorder, medicine.disease, Article, cardiovascular disease risk, lipids, Mood, arterial stiffness, Mood disorders, inflammation, Internal medicine, RC666-701, Arterial stiffness, medicine, Major depressive disorder, Diseases of the circulatory (Cardiovascular) system, Bipolar disorder, business, Pulse wave velocity, Body mass index
Abstract
Background: Mood disorders have been associated with a variety of cardiovascular disease (CVD) risk factors, including inflammation and large arterial stiffness, particularly while depressed, although longitudinal studies have been limited. Materials and Methods: With measurements at baseline and 8 weeks, the researchers prospectively assessed mood, levels of inflammatory markers (high-sensitivity C-reactive protein and tumor necrosis factor-alpha [TNF-α]), serum lipids, and large arterial stiffness in a cohort of 26 participants with a diagnosis of a mood disorder, enriched for current depression. Depressive symptoms were measured using the Montgomery–Ssberg Depression Rating Scale (MADRS) at baseline and 8 weeks. Associations between depressive symptoms and other measures were assessed using linear mixed models, unadjusted and adjusted for age and body mass index. Results: The mean age of the participants (n = 26) was 41.6 (standard deviation [SD] 12.8) years, and 81% were female. During the study, there was a mean (SD) MADRS score improvement of 9.5 (9.4) from baseline to 8 weeks. Reductions in the primary outcome of tumor necrosis factor-α with improvement in depression fell short of statistical significance (P = 0.076). In secondary analyses, there was a statistically significant association between improved cholesterol ratio (P = 0.038) and triglycerides (P = 0.042) with improvement in depression. There was no statistically significant change in large arterial stiffness during the study. Conclusion: Improved depressive symptoms were associated with improved cholesterol ratios even after adjustment, suggesting a possible mechanism by which acute mood states may influence CVD risk. Future longitudinal studies with extended and intensive follow-up investigating CVD risk related to acute changes and persistence of mood symptoms are warranted.
Tuula Kieseppä, Teemu Mäntylä, Maija Lindgren, Jaakko Reinikainen, Minna Torniainen-Holm, Eva Rikandi, Jouko Sundvall, Jaana Suvisaari, Jaakko Keinanen, Outi Mantere, Department of Psychiatry, Clinicum, University of Helsinki, Nuorisopsykiatria, Children's Hospital, HUS Children and Adolescents, and HUS Psychiatry
Psychosis is associated with low-grade inflammation as measured by high-sensitivity C-reactive protein (hs-CRP), a risk factor for cardiovascular events and mortality in the general population. We investigated the relationship between hs-CRP and anthropometric and metabolic changes in first-episode psychosis (FEP) during the first treatment year. We recruited 95 FEP patients and 62 controls, and measured longitudinal changes in hs-CRP, weight, waist circumference, insulin resistance, and lipids. We used linear mixed models to analyze the longitudinal relationship between hs-CRP and clinical, anthropometric and metabolic measures. At baseline, patients with FEP had higher levels of insulin resistance, total and low-density lipoprotein cholesterol, apolipoprotein B, and triglycerides. Baseline weight, waist circumference, hs-CRP, fasting glucose, and high-density lipoprotein cholesterol were similar between patients and controls. Marked increases in anthropometric measures and hs-CRP were observed in FEP during the 12-month follow-up. However, glucose and lipid parameters did not change significantly. In the mixed models, waist circumference and female sex were significant predictors of hs-CRP levels in FEP. Prevention of the early development of abdominal obesity in FEP is crucial, as abdominal obesity is accompanied by chronic low-grade inflammation, which increases further the cardiovascular risk in this vulnerable population.
*ANALYSIS of variance, *BLOOD pressure measurement, *CHI-squared test, *HIGH density lipoproteins, *INTERVIEWING, *LIPIDS, *LOW density lipoproteins, *BIPOLAR disorder, *PROBABILITY theory, *PSYCHIATRISTS, *SUICIDAL behavior, *METABOLIC syndrome, *BODY mass index, *CROSS-sectional method, *DATA analysis software, *WAIST circumference, *DESCRIPTIVE statistics
Abstract
Objective.The aim of the present study was to provide further evidence of (1) metabolic syndrome and blood lipid profile differences between suicide attempting and non-attempting patients with bipolar disorder (BPD) I and to assess these differences (2) as a function of acute depressive or manic phase.Methods.Fifty inpatients (mean age: 36.14 years 48% males) with BPD I took part in the study. After recruitment, patients were clustered in four groups: 13 suicide attempters (SAs) assessed during a manic phase, 12 SAs assessed during a depressive phase, 15 non-SAs assessed during a manic phase, and 10 non-SAs assessed during a depressive phase. Body mass index (BMI), metabolic syndrome, blood pressure, blood lipids (cholesterol, high- and low-density lipids, and triglyceride), and fasting blood sugar were assessed.Results.Neither metabolic syndrome, blood lipid values, fasting blood sugar, nor BMI or blood pressure differed between the SAs and non-SAs, or between patients in an acute manic phase and those in a depressed phase. The overall prevalence of metabolic syndrome was 26.0%.Conclusion. Among patients with BPD I neither the occurrence of metabolic syndrome nor lipid values or fasting blood sugar are reliable biomarkers of suicidal behavior during either acute depressive or manic phase. [ABSTRACT FROM AUTHOR]
Objectives. To assess the relationship between lifetime suicide attempts (SAs), serum lipid values, and metabolic syndrome (MetS) in patients with bipolar disorders (BPD). Methods. Eighty patients with BPD took part in the study (M = 40.60 years). After psychiatric diagnosis, demographic data, SAs, and serum lipids were measured and MetS was calculated. Results. 70% reported at least one suicide attempt. 52.5% suffered from MetS. Suicide attempters had higher cholesterol values. SAs were associated with a family history of suicide, current mood state, and lower educational level. SAs were unrelated to MetS. Conclusions. In patients with BPD, against expectations, the occurrence of SAs was associated with higher cholesterol values. Serum lipid values are not suitable as a biological trait marker to predict SAs. [ABSTRACT FROM AUTHOR]
*NEURONS, *INOSITOL phosphates, *LIPIDS, *CELL communication, *THERAPEUTIC use of lithium, *VALPROIC acid, *THERAPEUTICS, *BIPOLAR disorder
Abstract
The synthesis of inositol provides precursors of inositol lipids and inositol phosphates that are pivotal for cell signaling. Mood stabilizers lithium and valproic acid, used for treating bipolar disorder, cause cellular inositol depletion, which has been proposed as a therapeutic mechanism of action of both drugs. Despite the importance of inositol, the requirement for inositol synthesis in neuronal cells is not well understood. Here, we examined inositol effects on proliferation of SK-N- SH neuroblastoma cells. The essential role of inositol synthesis in proliferation is underscored by the findings that exogenous inositol was dispensable for proliferation, and inhibition of inositol synthesis decreased proliferation. Interestingly, the inhibition of inositol synthesis by knocking down INO1, which encodes inositol-3-phosphate synthase, the rate-limiting enzyme of inositol synthesis, led to the inactivation of GSK-3α by increasing the inhibitory phosphorylation of this kinase. Similarly, the mood stabilizer valproic acid effected transient decreases in intracellular inositol, leading to inactivation of GSK-3α. As GSK-3 inhibition has been proposed as a likely therapeutic mechanism of action, the finding that inhibition of inositol synthesis results in the inactivation of GSK-3α suggests a unifying hypothesis for mechanism of mood-stabilizing drugs. [ABSTRACT FROM AUTHOR]
P. A. Mel’nikov, Anna Morozova, M P Valikhov, Yana Zorkina, Alexander G. Majouga, V. M. Ushakova, E. A. Zubkov, Olga Abramova, and Vladimir P. Chekhonin
Subjects
Polymers, Pharmaceutical Science, 02 engineering and technology, Disease, Review, Bioinformatics, 030226 pharmacology & pharmacy, Analytical Chemistry, Amyloid beta-Protein Precursor, 0302 clinical medicine, Drug Delivery Systems, Drug Discovery, Neurons, bipolar disorder, Drug Carriers, Nanocontainer, 021001 nanoscience & nanotechnology, anxiety, Anxiety Disorders, Lipids, Antidepressive Agents, Neuroprotective Agents, Chemistry (miscellaneous), Blood-Brain Barrier, Drug delivery, depression, Molecular Medicine, Anxiety, Emulsions, medicine.symptom, 0210 nano-technology, Alzheimer’s disease, Anxiety disorder, Antipsychotic Agents, tau Proteins, Permeability, lcsh:QD241-441, 03 medical and health sciences, Pharmacotherapy, lcsh:Organic chemistry, Alzheimer Disease, medicine, Animals, Humans, Bipolar disorder, Physical and Theoretical Chemistry, nanocarriers, business.industry, Organic Chemistry, medicine.disease, schizophrenia, Anti-Anxiety Agents, Drug Design, Nanoparticles, Nanocarriers, business, BBB
Abstract
Neuropsychiatric diseases are one of the main causes of disability, affecting millions of people. Various drugs are used for its treatment, although no effective therapy has been found yet. The blood brain barrier (BBB) significantly complicates drugs delivery to the target cells in the brain tissues. One of the problem-solving methods is the usage of nanocontainer systems. In this review we summarized the data about nanoparticles drug delivery systems and their application for the treatment of neuropsychiatric disorders. Firstly, we described and characterized types of nanocarriers: inorganic nanoparticles, polymeric and lipid nanocarriers, their advantages and disadvantages. We discussed ways to interact with nerve tissue and methods of BBB penetration. We provided a summary of nanotechnology-based pharmacotherapy of schizophrenia, bipolar disorder, depression, anxiety disorder and Alzheimer’s disease, where development of nanocontainer drugs derives the most active. We described various experimental drugs for the treatment of Alzheimer’s disease that include vector nanocontainers targeted on β-amyloid or tau-protein. Integrally, nanoparticles can substantially improve the drug delivery as its implication can increase BBB permeability, the pharmacodynamics and bioavailability of applied drugs. Thus, nanotechnology is anticipated to overcome the limitations of existing pharmacotherapy of psychiatric disorders and to effectively combine various treatment modalities in that direction.
IntroductionEvidence for a possible association between a low level of cholesterol and increased suicidal behaviour has accumulated in the recent 3 decades. The present study investigates whether lipid levels can make state-dependent markers of suicidal behaviour in Polish patients with mood disorder recently admitted to a psychiatric hospital owing to an acute depressive episode.Materials and methodsThe study was conducted on 223 patients (73 male and 150 female) with unipolar (n=171) and bipolar (n=52) depression. They were interviewed to assess any occurrence of suicidal thoughts, suicidal tendencies and/or suicidal attempts during the 3 months before admission. Laboratory measurements [total cholesterol, low density lipoprotein (LDL) cholesterol, high density lipoprotein (HDL) cholesterol, triglycerides and total lipids] were obtained within 24–72 h after hospital admission.ResultsSuicidal thoughts, tendencies, and attempts were associated with low total cholesterol, LDL cholesterol, and total lipids in both male and female patients, in both diagnostic categories. Triglycerides were significantly lower in male and female patients with suicidal thoughts compared with their non-suicidal counterparts. No association with suicidality was found with HDL cholesterol.ConclusionsThe results of our study support a majority of research showing the association in depressed patients between suicidal behaviour and low levels of total and LDL cholesterol. In addition, the data suggest a similar association with low total lipids, and in some instances, with low triglycerides. [ABSTRACT FROM AUTHOR]
Objective There are several models of staging in bipolar disorder ( BD), but none has been validated. The aims of this study were to empirically investigate clinical variables that may be useful to classify patients in clusters according to stage and study the association with biomarkers as biological validators. Method This was a historical cohort study. Patients ( n = 115) diagnosed with BD and not in an acute episode and first-degree relatives of patients diagnosed with BD ( n = 25) were recruited. Sociodemographic, clinical, and functional data were collected. Serum cytokines, brain-derived neurotrophic factor, and biomarkers of lipid and protein oxidation were assessed. Cluster analysis was carried out to build a model of staging, and logistic regression was conducted to study associations between the model and biomarkers. Results Cluster analysis divided the sample into two equitable groups, denominated early and late stage, with empirical cutoffs for the Functioning Assessment Short Test score, number of episodes, age at onset of the disorder, and time elapsed since first episode. In the logistic regression, IL-6 was associated with late stage ( P = 0.029). Conclusion This study supports that clinical, functional, and biochemical variables may help to define a classification of staging in BD. [ABSTRACT FROM AUTHOR]
Kris Kopski, Kris A. Ohnsorg, Patrick J. O'Connor, Rebecca C. Rossom, JoAnn M. Sperl-Hillen, Stephen C. Waring, A. Lauren Crain, and Allise M. Taran
Subjects
Adult, Male, medicine.medical_specialty, Adolescent, education, Blood Pressure, Disease, Health Promotion, Clinical decision support system, Article, Body Mass Index, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Risk Factors, Intervention (counseling), mental disorders, medicine, Tobacco Smoking, Humans, Pharmacology (medical), 030212 general & internal medicine, Bipolar disorder, Risk factor, Cause of death, Aged, Glycated Hemoglobin, 030505 public health, Primary Health Care, business.industry, Mental Disorders, General Medicine, Middle Aged, Mental illness, medicine.disease, Decision Support Systems, Clinical, Lipids, Schizophrenia, Cardiovascular Diseases, Heart Disease Risk Factors, Research Design, Emergency medicine, Female, 0305 other medical science, business
Abstract
Background Cardiovascular (CV) disease is the leading cause of death for people with serious mental illness (SMI), but clinicians are often slow to address this risk. Methods/Design 78 Midwestern primary care clinics were randomized to receive or not receive access to a clinical decision support (CDS) tool. Between March 2016 and September 2018, primary care clinicians (PCPs) received CDS alerts during visits with adult patients with SMI who met minimal inclusion criteria and had at least one CV risk factor not at goal. The PCP CDS included a summary of six modifiable CV risk factors and patient-specific treatment recommendations. Psychiatrists received CDS alerts during their next visit with an eligible patient with SMI that alerted them to an elevated body mass index or recent weight gain and the presence of an obesogenic SMI medication. Study outcomes include total modifiable CV risk, six modifiable CV risk factors, and use of obesogenic SMI medications. Discussion This cluster-randomized pragmatic trial allowed PCPs and psychiatrists the opportunity to improve CV risk in a timely manner for patients with SMI. Effectiveness will be assessed using an intent-to-treat analysis, and outcomes will be assessed largely through electronic health record data harvested by the CDS tool itself. In total, 10,347 patients with SMI had an index primary care visit in a randomized clinic, and 8937 patients had at least one follow-up visit. Analyses are ongoing, and trial results are expected in mid-2020. Trial registration ClinicalTrials.gov Identifier: NCT02451670