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Zachos KA, Godin O, Choi J, Jung JH, Aouizerate B, Aubin V, Bellivier F, Raoul Belzeaux R, Courtet P, Dubertret C, Etain B, Haffen E, Antoine Lefrere A, Llorca PM, Olié E, Polosan M, Samalin L, Schwan R, Roux P, Barau C, Richard JR, Tamouza R, Leboyer M, Andreazza AC, Etain B, Olié E, Leboyer M, Haffen E, Llorca PM, Barteau V, Bensalem S, Godin O, Laouamri H, Souryis K, Hotier S, Pelletier A, Hergeta F, Petrucci J, Willaume L, Bellivier F, Hennion V, Marlinge E, Meheust J, Richard A, Carminati M, Francisque H, Dubertret C, Mazer N, Portalier C, Scognamiglio C, Bing A, Laurent P, Gard S, M'Bailara K, Elkael C, Hoorelbeke F, Minois I, Sportich J, Da Ros N, Boukhobza L, Courtet P, Denat S, Deffinis B, Ducasse D, Gachet M, Lengvenyté A, Molière F, Nass L, Tarquini G, Lefrere A, Moreau E, Pastol J, Groppi F, Polomeni H, Bauberg J, Lescalier L, Muraccioli I, Suray A, Cohen R, Kahn JP, Milazzo M, Wajsbrot-Elgrabli O, Bougerol T, Pouchon A, Bertrand A, Fredembach B, Suisse A, Denoual Q, Polosan M, Galliot AM, Brehon L, Bonny G, Durand L, Feuga V, Kayser N, Roux P, Aubin V, Cussac I, Dupont MA, Loftus J, et alZachos KA, Godin O, Choi J, Jung JH, Aouizerate B, Aubin V, Bellivier F, Raoul Belzeaux R, Courtet P, Dubertret C, Etain B, Haffen E, Antoine Lefrere A, Llorca PM, Olié E, Polosan M, Samalin L, Schwan R, Roux P, Barau C, Richard JR, Tamouza R, Leboyer M, Andreazza AC, Etain B, Olié E, Leboyer M, Haffen E, Llorca PM, Barteau V, Bensalem S, Godin O, Laouamri H, Souryis K, Hotier S, Pelletier A, Hergeta F, Petrucci J, Willaume L, Bellivier F, Hennion V, Marlinge E, Meheust J, Richard A, Carminati M, Francisque H, Dubertret C, Mazer N, Portalier C, Scognamiglio C, Bing A, Laurent P, Gard S, M'Bailara K, Elkael C, Hoorelbeke F, Minois I, Sportich J, Da Ros N, Boukhobza L, Courtet P, Denat S, Deffinis B, Ducasse D, Gachet M, Lengvenyté A, Molière F, Nass L, Tarquini G, Lefrere A, Moreau E, Pastol J, Groppi F, Polomeni H, Bauberg J, Lescalier L, Muraccioli I, Suray A, Cohen R, Kahn JP, Milazzo M, Wajsbrot-Elgrabli O, Bougerol T, Pouchon A, Bertrand A, Fredembach B, Suisse A, Denoual Q, Polosan M, Galliot AM, Brehon L, Bonny G, Durand L, Feuga V, Kayser N, Roux P, Aubin V, Cussac I, Dupont MA, Loftus J, Medecin I, Samalin L, Llorca PM, Mennetrier M, Bonnet T, Lacelle D, Vayssié M, Beal C, Blanc O. Diet quality and associations with lactate and metabolic syndrome in bipolar disorder. J Affect Disord 2024; 364:167-177. [PMID: 39117002 DOI: 10.1016/j.jad.2024.05.167] [Show More Authors] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Revised: 05/01/2024] [Accepted: 05/21/2024] [Indexed: 08/10/2024]
Abstract
BACKGROUND Nutrition is largely affected in bipolar disorder (BD), however, there is a lack of understanding on the relationship between dietary categories, BD, and the prevalence of metabolic syndrome. The objective of this study is to examine dietary trends in BD and it is hypothesized that diets with increased consumption of seafood and high-fiber carbohydrates will be correlated to improved patient outcomes, and a lower frequency of metabolic syndrome. METHODS This retrospective cohort study includes two French cohorts. The primary cohort, FACE-BD, includes 268 stable BD patients. The second cohort, I-GIVE, includes healthy controls, both stable and acute BD and schizophrenia patients. Four dietary categories were assessed: meat, seafood, low-fiber and high-fiber carbohydrates. Dietary data from two food frequency questionnaires were normalized using min-max scaling and assessed using various statistical analyses. RESULTS In our primary cohort, the increased high-fiber carbohydrate consumption was correlated to lower prevalence of metabolic syndrome and improved mood. Low-fiber carbohydrate consumption is associated with higher BMI, while higher seafood consumption was correlated to improved mood and delayed age of onset. Results were not replicated in our secondary cohort. LIMITATIONS Our populations were small and two different dietary questionnaires were used; thus, results were used to examine similarities in trends. CONCLUSIONS Overall, various dietary trends were associated with metabolic syndrome, BMI, lactate, mood and age of onset. Improving our understanding of nutrition in BD can provide mechanistic insight, clinically relevant nutritional guidelines for precision medicine and ultimately improve the quality of lives for those with BD.
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Affiliation(s)
- Kassandra A Zachos
- Department of Pharmacology and Toxicology, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada; FACE-BD Clinical Sites and Principal Collaborators in France, France
| | - Ophelia Godin
- INSERM U955 IMRB, Translational Neuropsychiatry laboratory, AP-HP, Hôpital Henri Mondor, DMU IMPACT, Fédération Hospitalo-Universitaire de Médecine de Précision en Psychiatrie (FHU ADAPT), Paris Est Créteil University (UPEC); ECNP Immuno-NeuroPsychiatry Network, France; Fondation FondaMental, Créteil, France
| | - Jaehyoung Choi
- Department of Pharmacology and Toxicology, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Jae H Jung
- Department of Pharmacology and Toxicology, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Bruno Aouizerate
- Fondation FondaMental, Créteil, France; Centre Hospitalier Charles Perrens, Pôle de Psychiatrie Générale et Universitaire, Laboratoire NutriNeuro (UMR INRAE 1286), Université de Bordeaux, Bordeaux, France
| | - Valérie Aubin
- Fondation FondaMental, Créteil, France; Pôle de Psychiatrie, Centre Hospitalier Princesse Grace, Monaco
| | - Frank Bellivier
- Fondation FondaMental, Créteil, France; Université Paris Cité, INSERM UMR-S 1144, Optimisation Thérapeutique en Neuropsychopharmacologie OTeN, Paris, France; AP-HP, Groupe Hospitalo-Universitaire AP-HP Nord, DMU Neurosciences, Hôpital Fernand Widal, Département de Psychiatrie et de Médecine Addictologique, Paris, France
| | - R Raoul Belzeaux
- Fondation FondaMental, Créteil, France; Univ. Montpellier & Department of Psychiatry, CHU de Montpellier, France
| | - Philippe Courtet
- Fondation FondaMental, Créteil, France; IGF, Univ. Montpellier, CNRS, INSERM, Department of Emergency Psychiatry and Acute Care, CHU Montpellier, Montpellier, France
| | - Caroline Dubertret
- Fondation FondaMental, Créteil, France; AP-HP, Groupe Hospitalo-Universitaire AP-HP Nord, DMU ESPRIT, Service de Psychiatrie et Addictologie, Hôpital Louis Mourier, Colombes, France; Université de Paris, Inserm UMR1266, Sorbonne Paris Cité, Faculté de Médecine, Paris, France
| | - Bruno Etain
- Fondation FondaMental, Créteil, France; Université Paris Cité, INSERM UMR-S 1144, Optimisation Thérapeutique en Neuropsychopharmacologie OTeN, Paris, France; AP-HP, Groupe Hospitalo-Universitaire AP-HP Nord, DMU Neurosciences, Hôpital Fernand Widal, Département de Psychiatrie et de Médecine Addictologique, Paris, France
| | - Emmanuel Haffen
- Fondation FondaMental, Créteil, France; Université de Franche-Comté, UMR INSERM 1322 LINC, Service de Psychiatrie de l'Adulte, CIC-1431 INSERM, CHU de Besançon, F-2500, France
| | - A Antoine Lefrere
- Fondation FondaMental, Créteil, France; Pôle de Psychiatrie, Assistance Publique Hôpitaux de Marseille, Marseille, France; INT-UMR7289, CNRS Aix-Marseille Université, Marseille, France
| | - Pierre-Michel Llorca
- Fondation FondaMental, Créteil, France; Department of Psychiatry, CHU Clermont-Ferrand, University of Clermont Auvergne, CNRS, Clermont Auvergne INP, Institut Pascal (UMR 6602), Clermont-Ferrand, France
| | - Emilie Olié
- Fondation FondaMental, Créteil, France; IGF, Univ. Montpellier, CNRS, INSERM, Department of Emergency Psychiatry and Acute Care, CHU Montpellier, Montpellier, France
| | - Mircea Polosan
- Fondation FondaMental, Créteil, France; Univ. Grenoble Alpes, Inserm, U1216, CHU Grenoble Alpes, Grenoble Institut Neurosciences, Grenoble, France
| | - Ludovic Samalin
- Fondation FondaMental, Créteil, France; Department of Psychiatry, CHU Clermont-Ferrand, University of Clermont Auvergne, CNRS, Clermont Auvergne INP, Institut Pascal (UMR 6602), Clermont-Ferrand, France
| | - Raymund Schwan
- Fondation FondaMental, Créteil, France; Université de Lorraine, Centre Psychothérapique de Nancy, Inserm U1254, Nancy, France
| | - Paul Roux
- Fondation FondaMental, Créteil, France; Centre Hospitalier de Versailles, Service Universitaire de Psychiatrie d'Adulte et d'Addictologie, Le Chesnay, France; Université Paris-Saclay; Université de Versailles Saint-Quentin-En-Yvelines; DisAP-DevPsy-CESP, INSERM UMR1018, Villejuif, France
| | - Caroline Barau
- Plateforme de Ressources Biologiques, HU Henri Mondor, Créteil, France
| | - Jean Romain Richard
- INSERM U955 IMRB, Translational Neuropsychiatry laboratory, AP-HP, Hôpital Henri Mondor, DMU IMPACT, Fédération Hospitalo-Universitaire de Médecine de Précision en Psychiatrie (FHU ADAPT), Paris Est Créteil University (UPEC); ECNP Immuno-NeuroPsychiatry Network, France
| | - Ryad Tamouza
- INSERM U955 IMRB, Translational Neuropsychiatry laboratory, AP-HP, Hôpital Henri Mondor, DMU IMPACT, Fédération Hospitalo-Universitaire de Médecine de Précision en Psychiatrie (FHU ADAPT), Paris Est Créteil University (UPEC); ECNP Immuno-NeuroPsychiatry Network, France
| | - Marion Leboyer
- INSERM U955 IMRB, Translational Neuropsychiatry laboratory, AP-HP, Hôpital Henri Mondor, DMU IMPACT, Fédération Hospitalo-Universitaire de Médecine de Précision en Psychiatrie (FHU ADAPT), Paris Est Créteil University (UPEC); ECNP Immuno-NeuroPsychiatry Network, France; Fondation FondaMental, Créteil, France
| | - Ana C Andreazza
- Department of Pharmacology and Toxicology, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Mitochondrial Innovation Initiative, MITO2i, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
| | - B Etain
- FACE-BD Clinical Coordinating Center (Fondation FondaMental), France; AP-HP, GH Saint-Louis-Lariboisière-Fernand Widal, Pôle Neurosciences, Paris, France
| | - E Olié
- FACE-BD Clinical Coordinating Center (Fondation FondaMental), France; Département d'Urgence et Post Urgence Psychiatrique, CHRU Montpellier, Montpellier, France
| | - M Leboyer
- FACE-BD Clinical Coordinating Center (Fondation FondaMental), France
| | - E Haffen
- FACE-BD Clinical Coordinating Center (Fondation FondaMental), France
| | - P M Llorca
- FACE-BD Clinical Coordinating Center (Fondation FondaMental), France
| | - V Barteau
- FACE-BD Data Coordinating Center (Fondation FondaMental), France
| | - S Bensalem
- FACE-BD Data Coordinating Center (Fondation FondaMental), France
| | - O Godin
- FACE-BD Data Coordinating Center (Fondation FondaMental), France
| | - H Laouamri
- FACE-BD Data Coordinating Center (Fondation FondaMental), France
| | - K Souryis
- FACE-BD Data Coordinating Center (Fondation FondaMental), France
| | - S Hotier
- AP-HP, DHU PePSY, Pôle de Psychiatrie et d'Addictologie des Hôpitaux Universitaires H Mondor, Créteil, France
| | - A Pelletier
- AP-HP, DHU PePSY, Pôle de Psychiatrie et d'Addictologie des Hôpitaux Universitaires H Mondor, Créteil, France
| | - F Hergeta
- AP-HP, DHU PePSY, Pôle de Psychiatrie et d'Addictologie des Hôpitaux Universitaires H Mondor, Créteil, France
| | - J Petrucci
- AP-HP, DHU PePSY, Pôle de Psychiatrie et d'Addictologie des Hôpitaux Universitaires H Mondor, Créteil, France
| | - L Willaume
- AP-HP, DHU PePSY, Pôle de Psychiatrie et d'Addictologie des Hôpitaux Universitaires H Mondor, Créteil, France
| | - F Bellivier
- AP-HP, GH Saint-Louis-Lariboisière-Fernand Widal, Pôle Neurosciences, Paris, France
| | - V Hennion
- AP-HP, GH Saint-Louis-Lariboisière-Fernand Widal, Pôle Neurosciences, Paris, France
| | - E Marlinge
- AP-HP, GH Saint-Louis-Lariboisière-Fernand Widal, Pôle Neurosciences, Paris, France
| | - J Meheust
- AP-HP, GH Saint-Louis-Lariboisière-Fernand Widal, Pôle Neurosciences, Paris, France
| | - A Richard
- AP-HP, GH Saint-Louis-Lariboisière-Fernand Widal, Pôle Neurosciences, Paris, France
| | - M Carminati
- AP-HP, GH Saint-Louis-Lariboisière-Fernand Widal, Pôle Neurosciences, Paris, France
| | - H Francisque
- AP-HP, GH Saint-Louis-Lariboisière-Fernand Widal, Pôle Neurosciences, Paris, France
| | - C Dubertret
- APHP, Groupe Hospitalo-universitaire AP-HP Nord, DMU ESPRIT, Service de Psychiatrie et Addictologie, Hôpital Louis Mourier, Colombes, France; Centre Hospitalier Princesse Grace, Monaco
| | - N Mazer
- APHP, Groupe Hospitalo-universitaire AP-HP Nord, DMU ESPRIT, Service de Psychiatrie et Addictologie, Hôpital Louis Mourier, Colombes, France; AHPH, Departement de Psychiatrie, Hopital Louis Mourier, Colombes, France
| | - C Portalier
- APHP, Groupe Hospitalo-universitaire AP-HP Nord, DMU ESPRIT, Service de Psychiatrie et Addictologie, Hôpital Louis Mourier, Colombes, France
| | - C Scognamiglio
- APHP, Groupe Hospitalo-universitaire AP-HP Nord, DMU ESPRIT, Service de Psychiatrie et Addictologie, Hôpital Louis Mourier, Colombes, France
| | - A Bing
- APHP, Groupe Hospitalo-universitaire AP-HP Nord, DMU ESPRIT, Service de Psychiatrie et Addictologie, Hôpital Louis Mourier, Colombes, France
| | - P Laurent
- APHP, Groupe Hospitalo-universitaire AP-HP Nord, DMU ESPRIT, Service de Psychiatrie et Addictologie, Hôpital Louis Mourier, Colombes, France; AHPH, Departement de Psychiatrie, Hopital Louis Mourier, Colombes, France
| | - S Gard
- Hôpital C. Perrens, Centre Expert Trouble Bipolaire, Pôle de Psychiatrie Générale et Universitaire, France
| | - K M'Bailara
- Hôpital C. Perrens, Centre Expert Trouble Bipolaire, Pôle de Psychiatrie Générale et Universitaire, France
| | - C Elkael
- Hôpital C. Perrens, Centre Expert Trouble Bipolaire, Pôle de Psychiatrie Générale et Universitaire, France
| | - F Hoorelbeke
- Hôpital C. Perrens, Centre Expert Trouble Bipolaire, Pôle de Psychiatrie Générale et Universitaire, France
| | - I Minois
- Hôpital C. Perrens, Centre Expert Trouble Bipolaire, Pôle de Psychiatrie Générale et Universitaire, France
| | - J Sportich
- Hôpital C. Perrens, Centre Expert Trouble Bipolaire, Pôle de Psychiatrie Générale et Universitaire, France
| | - N Da Ros
- Hôpital C. Perrens, Centre Expert Trouble Bipolaire, Pôle de Psychiatrie Générale et Universitaire, France
| | - L Boukhobza
- Département d'Urgence et Post Urgence Psychiatrique, CHRU Montpellier, Montpellier, France
| | - P Courtet
- Département d'Urgence et Post Urgence Psychiatrique, CHRU Montpellier, Montpellier, France
| | - S Denat
- Département d'Urgence et Post Urgence Psychiatrique, CHRU Montpellier, Montpellier, France
| | - B Deffinis
- Département d'Urgence et Post Urgence Psychiatrique, CHRU Montpellier, Montpellier, France
| | - D Ducasse
- Département d'Urgence et Post Urgence Psychiatrique, CHRU Montpellier, Montpellier, France
| | - M Gachet
- Département d'Urgence et Post Urgence Psychiatrique, CHRU Montpellier, Montpellier, France
| | - A Lengvenyté
- Département d'Urgence et Post Urgence Psychiatrique, CHRU Montpellier, Montpellier, France
| | - F Molière
- Département d'Urgence et Post Urgence Psychiatrique, CHRU Montpellier, Montpellier, France
| | - L Nass
- Département d'Urgence et Post Urgence Psychiatrique, CHRU Montpellier, Montpellier, France
| | - G Tarquini
- Département d'Urgence et Post Urgence Psychiatrique, CHRU Montpellier, Montpellier, France
| | - A Lefrere
- Pôle de Psychiatrie, addictologie et pédopsychiatrie, Hôpital Sainte Marguerite, Marseille, France
| | - E Moreau
- Pôle de Psychiatrie, addictologie et pédopsychiatrie, Hôpital Sainte Marguerite, Marseille, France
| | - J Pastol
- Pôle de Psychiatrie, addictologie et pédopsychiatrie, Hôpital Sainte Marguerite, Marseille, France
| | - F Groppi
- Pôle de Psychiatrie, addictologie et pédopsychiatrie, Hôpital Sainte Marguerite, Marseille, France
| | - H Polomeni
- Pôle de Psychiatrie, addictologie et pédopsychiatrie, Hôpital Sainte Marguerite, Marseille, France
| | - J Bauberg
- Pôle de Psychiatrie, addictologie et pédopsychiatrie, Hôpital Sainte Marguerite, Marseille, France
| | - L Lescalier
- Pôle de Psychiatrie, addictologie et pédopsychiatrie, Hôpital Sainte Marguerite, Marseille, France
| | - I Muraccioli
- Pôle de Psychiatrie, addictologie et pédopsychiatrie, Hôpital Sainte Marguerite, Marseille, France
| | - A Suray
- Pôle de Psychiatrie, addictologie et pédopsychiatrie, Hôpital Sainte Marguerite, Marseille, France
| | - R Cohen
- Service de Psychiatrie et Psychologie Clinique, CHU de Nancy, Hôpitaux de Brabois, Vandoeuvre Les Nancy, France
| | - J P Kahn
- Service de Psychiatrie et Psychologie Clinique, CHU de Nancy, Hôpitaux de Brabois, Vandoeuvre Les Nancy, France
| | - M Milazzo
- Service de Psychiatrie et Psychologie Clinique, CHU de Nancy, Hôpitaux de Brabois, Vandoeuvre Les Nancy, France
| | - O Wajsbrot-Elgrabli
- Service de Psychiatrie et Psychologie Clinique, CHU de Nancy, Hôpitaux de Brabois, Vandoeuvre Les Nancy, France
| | - T Bougerol
- Service Universitaire de Psychiatrie, CHU de Grenoble et des Alpes, Grenoble, France
| | - A Pouchon
- Service Universitaire de Psychiatrie, CHU de Grenoble et des Alpes, Grenoble, France
| | - A Bertrand
- Service Universitaire de Psychiatrie, CHU de Grenoble et des Alpes, Grenoble, France
| | - B Fredembach
- Service Universitaire de Psychiatrie, CHU de Grenoble et des Alpes, Grenoble, France
| | - A Suisse
- Service Universitaire de Psychiatrie, CHU de Grenoble et des Alpes, Grenoble, France
| | - Q Denoual
- Service Universitaire de Psychiatrie, CHU de Grenoble et des Alpes, Grenoble, France
| | - M Polosan
- Service Universitaire de Psychiatrie, CHU de Grenoble et des Alpes, Grenoble, France
| | - A M Galliot
- Centre Hospitalier de Versailles, Service U niversitaire de Psychiatrie d'adultes et d'addictologie, Le Chesnay, France
| | - L Brehon
- Centre Hospitalier de Versailles, Service U niversitaire de Psychiatrie d'adultes et d'addictologie, Le Chesnay, France
| | - G Bonny
- Centre Hospitalier de Versailles, Service U niversitaire de Psychiatrie d'adultes et d'addictologie, Le Chesnay, France
| | - L Durand
- Centre Hospitalier de Versailles, Service U niversitaire de Psychiatrie d'adultes et d'addictologie, Le Chesnay, France
| | - V Feuga
- Centre Hospitalier de Versailles, Service U niversitaire de Psychiatrie d'adultes et d'addictologie, Le Chesnay, France
| | - N Kayser
- Centre Hospitalier de Versailles, Service U niversitaire de Psychiatrie d'adultes et d'addictologie, Le Chesnay, France
| | - P Roux
- Centre Hospitalier de Versailles, Service U niversitaire de Psychiatrie d'adultes et d'addictologie, Le Chesnay, France
| | - V Aubin
- Centre Hospitalier Princesse Grace, Monaco
| | - I Cussac
- Centre Hospitalier Princesse Grace, Monaco
| | - M A Dupont
- Centre Hospitalier Princesse Grace, Monaco
| | - J Loftus
- Centre Hospitalier Princesse Grace, Monaco
| | - I Medecin
- Centre Hospitalier Princesse Grace, Monaco
| | - L Samalin
- Service de Psychiatrie d'adultes B, Centre Expert Trouble Bipolaire, CHU de Clermont-Ferrand, Clermont-Ferrand, France
| | - P M Llorca
- Service de Psychiatrie d'adultes B, Centre Expert Trouble Bipolaire, CHU de Clermont-Ferrand, Clermont-Ferrand, France
| | - M Mennetrier
- Service de Psychiatrie d'adultes B, Centre Expert Trouble Bipolaire, CHU de Clermont-Ferrand, Clermont-Ferrand, France
| | - T Bonnet
- Service de Psychiatrie d'adultes B, Centre Expert Trouble Bipolaire, CHU de Clermont-Ferrand, Clermont-Ferrand, France
| | - D Lacelle
- Service de Psychiatrie d'adultes B, Centre Expert Trouble Bipolaire, CHU de Clermont-Ferrand, Clermont-Ferrand, France
| | - M Vayssié
- Service de Psychiatrie d'adultes B, Centre Expert Trouble Bipolaire, CHU de Clermont-Ferrand, Clermont-Ferrand, France
| | - C Beal
- Service de Psychiatrie d'adultes B, Centre Expert Trouble Bipolaire, CHU de Clermont-Ferrand, Clermont-Ferrand, France
| | - O Blanc
- Service de Psychiatrie d'adultes B, Centre Expert Trouble Bipolaire, CHU de Clermont-Ferrand, Clermont-Ferrand, France
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Miola A, De Prisco M, Lussignoli M, Meda N, Dughiero E, Costa R, Nunez NA, Fornaro M, Veldic M, Frye MA, Vieta E, Solmi M, Radua J, Sambataro F. Prediction of medical admissions after psychiatric inpatient hospitalization in bipolar disorder: a retrospective cohort study. Front Psychiatry 2024; 15:1435199. [PMID: 39290307 PMCID: PMC11406175 DOI: 10.3389/fpsyt.2024.1435199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2024] [Accepted: 07/16/2024] [Indexed: 09/19/2024] Open
Abstract
Objective Bipolar Disorder (BD) is a severe mental illness associated with high rates of general medical comorbidity, reduced life expectancy, and premature mortality. Although BD has been associated with high medical hospitalization, the factors that contribute to this risk remain largely unexplored. We used baseline medical and psychiatric records to develop a supervised machine learning model to predict general medical admissions after discharge from psychiatric hospitalization. Methods In this retrospective three-year cohort study of 71 patients diagnosed with BD (mean age=52.19 years, females=56.33%), lasso regression models combining medical and psychiatric records, as well as those using them separately, were fitted and their predictive power was estimated using a leave-one-out cross-validation procedure. Results The proportion of medical admissions in patients with BD was higher compared with age- and sex-matched hospitalizations in the same region (25.4% vs. 8.48%). The lasso model fairly accurately predicted the outcome (area under the curve [AUC]=69.5%, 95%C.I.=55-84.1; sensitivity=61.1%, specificity=75.5%, balanced accuracy=68.3%). Notably, pre-existing cardiovascular, neurological, or osteomuscular diseases collectively accounted for more than 90% of the influence on the model. The accuracy of the model based on medical records was slightly inferior (AUC=68.7%, 95%C.I. = 54.6-82.9), while that of the model based on psychiatric records only was below chance (AUC=61.8%, 95%C.I.=46.2-77.4). Conclusion Our findings support the need to monitor medical comorbidities during clinical decision-making to tailor and implement effective preventive measures in people with BD. Further research with larger sample sizes and prospective cohorts is warranted to replicate these findings and validate the predictive model.
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Affiliation(s)
- Alessandro Miola
- Department of Neuroscience, University of Padova, Padua, Italy
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, United States
| | - Michele De Prisco
- Bipolar and Depressive Disorders Unit, Hospital Clinic de Barcelona, Barcelona, Spain
- Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Department of Medicine, Faculty of Medicine and Health Sciences, Institute of Neurosciences (UBNeuro), University of Barcelona (UB), Barcelona, Spain
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), Barcelona, Spain
| | | | - Nicola Meda
- Department of Neuroscience, University of Padova, Padua, Italy
| | - Elisa Dughiero
- Department of Neuroscience, University of Padova, Padua, Italy
| | - Riccardo Costa
- Department of Neuroscience, University of Padova, Padua, Italy
| | - Nicolas A Nunez
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, United States
- Department of Psychiatry, University of Utah, Salt Lake City, UT, United States
| | - Michele Fornaro
- Department of Psychiatry, Federico II University of Naples, Naples, Italy
| | - Marin Veldic
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, United States
| | - Mark A Frye
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, United States
| | - Eduard Vieta
- Bipolar and Depressive Disorders Unit, Hospital Clinic de Barcelona, Barcelona, Spain
- Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Department of Medicine, Faculty of Medicine and Health Sciences, Institute of Neurosciences (UBNeuro), University of Barcelona (UB), Barcelona, Spain
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), Barcelona, Spain
| | - Marco Solmi
- SCIENCES lab, Department of Psychiatry, University of Ottawa, Ottawa, ON, Canada
- Department of Mental Health, The Ottawa Hospital, Ottawa, ON, Canada
- Ottawa Hospital Research Institute (OHRI) Clinical Epidemiology Program University of Ottawa, Ottawa, ON, Canada
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
- Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany
| | - Joaquim Radua
- Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), Barcelona, Spain
| | - Fabio Sambataro
- Department of Neuroscience, University of Padova, Padua, Italy
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Romo-Nava F, Blom T, Cuellar-Barboza AB, Barrera FJ, Miola A, Mori NN, Prieto ML, Veldic M, Singh B, Gardea-Resendez M, Nunez NA, Ozerdem A, Biernacka JM, Frye MA, McElroy SL. Clinical characterization of patients with bipolar disorder and a history of asthma: An exploratory study. J Psychiatr Res 2023; 164:8-14. [PMID: 37290273 DOI: 10.1016/j.jpsychires.2023.05.061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 04/07/2023] [Accepted: 05/16/2023] [Indexed: 06/10/2023]
Abstract
INTRODUCTION Bipolar disorder (BD) and asthma are leading causes of morbidity in the US and frequently co-occur. OBJECTIVES We evaluated the clinical features and comorbidities of patients with BD and a history of asthma. METHODS In a cross-sectional analysis from the Mayo Clinic Bipolar Biobank, we explored the clinical characteristics of the BD and an asthma phenotype and fitted a multivariable regression model to identify risk factors for asthma. RESULTS A total of 721 individuals with BD were included. From these, 140 (19%) had a history of asthma. In a multivariable model only sex and evening chronotype were significant predictors of asthma with the odds ratios and 95% confidence intervals being 1.65 (1.00, 2.72; p=0.05) and 1.99 (1.25, 3.17; p < 0.01), respectively. Individuals with asthma had higher odds of having other medical comorbidities after adjusting for age, sex, and site including hypertension (OR = 2.29 (95% CI 1.42, 3.71); p < 0.01), fibromyalgia (2.29 (1.16, 4.51); p=0.02), obstructive sleep apnea (2.03 (1.18, 3.50); p=0.01), migraine (1.98 (1.31, 3.00); p < 0.01), osteoarthritis (2.08 (1.20, 3.61); p < 0.01), and COPD (2.80 (1.14, 6.84); p=0.02). Finally, individuals currently on lithium were less likely to have a history of asthma (0.48 (0.32, 0.71); p < 0.01). CONCLUSION A history of asthma is common among patients with BD and is associated with being female and having an evening chronotype, as well as with increased odds of having other medical comorbidities. A lower likelihood of a history of asthma among those currently on lithium is an intriguing finding with potential clinical implications that warrants further study.
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Affiliation(s)
- Francisco Romo-Nava
- Lindner Center of HOPE, Mason, OH, USA; Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
| | - Thomas Blom
- Lindner Center of HOPE, Mason, OH, USA; Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Alfredo B Cuellar-Barboza
- Department of Psychiatry, Universidad Autonoma de Nuevo Leon, Monterrey, Mexico; Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, USA
| | - Francisco J Barrera
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Alessandro Miola
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, USA
| | - Nicole N Mori
- Lindner Center of HOPE, Mason, OH, USA; Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Miguel L Prieto
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, USA; Center for Biomedical Research and Innovation, Universidad de los Andes, Santiago, Chile; Department of Psychiatry, Faculty of Medicine, Universidad de los Andes, Santiago, Chile; Mental Health Service, Clínica Universidad de los Andes, Santiago, Chile
| | - Marin Veldic
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, USA
| | - Balwinder Singh
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, USA
| | - Manuel Gardea-Resendez
- Department of Psychiatry, Universidad Autonoma de Nuevo Leon, Monterrey, Mexico; Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, USA
| | - Nicolas A Nunez
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, USA
| | - Aysegul Ozerdem
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, USA
| | - Joanna M Biernacka
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, USA; Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Mark A Frye
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, USA
| | - Susan L McElroy
- Lindner Center of HOPE, Mason, OH, USA; Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH, USA
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