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The connection between vascular and brain metrics is well-studied in older adults, but neglected in youth and in psychiatric populations at increased cardiovascular risk. We therefore examined the association of retinal vascular caliber with cerebral blood flow (CBF) in adolescents with and without bipolar disorder (BD).Ninety-four adolescents (n = 48 BD, n = 46 controls) completed retinal fundus imaging, yielding estimates of arteriolar and venular diameter. Arterial spin labelling MRI was performed to measure CBF. We tested for associations between retinal vascular caliber and CBF in regions of interest; anterior cingulate cortex (ACC), middle frontal gyrus, and hippocampus in BD and controls separately. Complementary voxel-wise analyses were also performed.In the BD group, higher arteriovenous ratio (AVR) was associated with greater ACC CBF (β = 0.34, pLimited sample size; young, medically healthy sample limits signal detection; cross-sectional design.This study reveals that higher AVR is associated with higher regional CBF in adolescents with BD. Present findings advance understanding of potential neurofunctional mechanisms linking retinal vascular caliber with psychiatric diagnoses. This proof-of-concept study was designed to generate initial insights to guide future studies focusing on the vascular-brain connection in youth and in psychiatry.

While multiple studies have examined prevalence and correlates of police contact in adults with bipolar disorder (BD), literature on this topic in youth is sparse. We therefore examined the prevalence and correlates of police contact amongst youth with BD.The study included 197 youth with BD and 127 healthy controls, ages 14-20 years. Semi-structured interviews were used to determine diagnoses, treatment and police contact. The Life Problems Inventory examined self-reported trait impulsivity and emotional dysregulation. Analyses examined demographic and clinical variables among youth with versus without lifetime police contact. Variables that were associated with police contact at p0.1 in univariate analyses were evaluated in a logistic regression model. Specific reasons for police contact, determined based on chart review, are reported descriptively.Lifetime prevalence of police contact was significantly higher amongst youth with BD versus healthy controls (36% versus. 3%; χ The cross-sectional and retrospective study design precludes conclusions regarding directionality of the observed associations and/or causal inferences.One third of youth with BD experienced police contact. Correlates generally aligned with those observed with adults. Future longitudinal research is warranted to understand distal and proximal antecedents of police contact, with the goal of developing strategies to prevent police contact, incarceration, and related consequences.

Brain function is highly reliant on cerebral blood flow (CBF). Despite the availability of multiple methods of evaluating CBF, this approach is currently underutilized in bipolar disorder research. While CBF offers its own unique advantages, it is also relevant to other functional and structural imaging modalities. Measures of CBF may offer important insights into the etiopathology of bipolar disorder given its connection to cerebral metabolism, cardiovascular risk, and microvascular function, all domains relevant to bipolar disorder. This chapter outlines how CBF is measured and summarizes literature to date regarding CBF difference across mood states, CBF in relation to other psychiatric populations, and the association of CBF with psychiatric treatments and treatment response. Finally, we propose an integrative supply-demand model outlining why anomalous perfusion may be observed in bipolar disorder and the possibility of engaging CBF as a novel treatment target. Future, prospective studies are needed to examine CBF as it relates to course of illness, vascular pathology, and treatment in bipolar disorder across the lifespan.

Early-onset bipolar disorder (BD) is associated with a more severe illness as well as a number of clinical factors among adults. Early-onset can be categorized as childhood- (age 13) or adolescent- (age ≥ 13) onset, with the two displaying different clinical profiles. We set out to examine differences in clinical, and familial characteristics among adolescents with childhood- versus adolescent-onset BD.The study included 195 adolescents with BD, ages 14-18 years. Age of onset was determined retrospectively by self-report. Participants completed the semi-structured K-SADS-PL diagnostic interviews along with self-reported dimensional scales. Analyses examined between-group differences for clinical and familial variables. Variables associated with age of onset at p 0.1 in univariate analyses were evaluated in a logistic regression model.Approximately one-fifth of participants had childhood-onset BD (n = 35; 17.9%). A number of clinical and familial factors were significantly associated with childhood-onset BD. However, there were no significant differences in depressive and manic symptom severity. In multivariate analyses, the variables most strongly associated with childhood-onset were police contact, and family history of suicidal ideation. Smoking and psychiatric hospitalization were associated with adolescent-onset.In this large clinical sample of adolescents with BD, one-fifth reported childhood-onset BD. Correlates of childhood-onset generally aligned with those observed in the literature. Future research is warranted to better understand the genetic and environmental implications of high familial loading of psychopathology associated with childhood-onset, and to integrate age-related treatment and prevention strategies.

Objectives Vascular‐brain associations are well established in adults but neglected in youth and psychiatric populations, who are at greater cardiovascular risk. We therefore examined the association of retinal vascular caliber with regional brain structure in adolescents with and without bipolar disorder (BD). Methods One hundred and three adolescents (n = 51 BD, n = 52 healthy control [HC]) completed retinal fundus imaging, yielding arteriolar and venular diameters, followed by T1‐weighted 3‐Tesla MRI. Region of interest (ROI) analyses examined ventrolateral prefrontal cortex (vlPFC) and ventromedial prefrontal cortex (vmPFC), anterior cingulate cortex (ACC), amygdala, and hippocampus, complemented by vertex‐wise analyses. Linear regression assessed the association between retinal measures and brain structure, adjusting for covariates including age, sex, BMI, and intracranial volume (ICV). Results In the overall sample, arteriolar caliber was negatively associated with ACC volume (β = −0.20, puncorrected = .046) and surface area (β = −0.19, puncorrected = .049). There were no other significant ROI findings. Vertex‐wise analyses detected several significant positive bilateral associations of arteriovenous ratio (AVR) with volume and surface area in regions including rostral middle frontal gyrus (left p = .001; right p = .006), isthmus cingulate cortex (left and right p

Background Early-onset Bipolar Disorder (BD) is associated with a more severe illness as well as a number of clinical factors amongst adults. Early-onset can be categorised as childhood- (age

Premature cardiovascular disease, occurring over a decade earlier in bipolar disorder as compared with the general population, contributes significantly to early mortality. This association cannot be explained by medication use, lifestyle, or traditional cardiovascular risk factors alone. Negative clinical outcomes, including amount of time spent symptomatic, suicide risk, and number of psychiatric comorbidities, are all notably elevated in patients at higher cardiovascular risk. In spite of robust data that support significantly elevated risk and burden within bipolar disorder, clinical training still does not underscore this link, and little focus has been placed on intentionally targeting the vascular system to ameliorate psychiatric symptoms. Numerous emerging cardiovascular biomarkers may help to better explain this vascular-bipolar link and uncover underlying pathophysiology and new treatment targets.