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Tietbohl-Santos B, Montezano BB, Cardoso TDA, Mondin TC, Moreira FP, Souza LDDM, da Silva RA, Kapczinski F, Jansen K, Passos IC. Exploring protective factors in a high-risk subsample: the pivotal role of paternal support in preventing depression in a cohort of young adults. Trends Psychiatry Psychother 2024. [PMID: 38603522 DOI: 10.47626/2237-6089-2024-0804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 04/10/2024] [Indexed: 04/13/2024]
Abstract
BACKGROUND Major depressive disorder (MDD) is a global concern due to its widespread prevalence and morbidity. Identifying protective factors in high-risk individuals, including those with a familial predisposition, maltreatment history, and socio-economic vulnerabilities, is crucial. METHODS We assessed a high-risk subsample within a young adult population cohort (n = 791; mean age = 31.94 [SD = 2.18]) across three waves. Using multiple regression models to analyse higher education, feeling supported, spirituality, psychotherapy access, higher socioeconomic status, involvement in activities, cohabitation, and family unity in Waves 1 and 2, and their association with MDD resilience at Wave 3. RESULTS In the high-risk group, MDD incidence was 13.7% (n=24). Paternal support had a protective effect on MDD incidence (OR = 0.366; 95% CI [0.137 to 0.955], p = 0.040) and suicidal attempt risk (OR = 0.380; 95% CI [0.150 to 0.956], p = 0.038). Higher resilience scores were also protective (OR = 0.975; 95% CI [0.953 to 0.997], p = 0.030), correlating with reduced BDI (r = 0.0484; B = -0.2202; 95% CI [-0.3572 to -0.0738]; p = 0.003) and MADRS scores (r = 0.0485; B = -0.2204; 95% CI [-0.3574 to -0.0741]; p = 0.003). CONCLUSIONS Our paper emphasizes reorienting the MDD approach, focusing on positive prevention strategies. It highlights fathers' crucial role in family-based interventions and promoting resilience in high-risk populations.
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Affiliation(s)
- Barbara Tietbohl-Santos
- Graduate Program in Psychiatry and Behavioral Sciences, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil. Molecular Psychiatry Laboratory, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil. Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada. Alliance Group, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Bruno Braga Montezano
- Graduate Program in Psychiatry and Behavioral Sciences, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil. Molecular Psychiatry Laboratory, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
| | - Taiane de Azevedo Cardoso
- IMPACT - Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Australia
| | - Thaíse Campos Mondin
- Graduate Program in Health and Behavior, Catholic University of Pelotas, Pelotas, RS, Brazil
| | | | | | | | - Flavio Kapczinski
- Graduate Program in Psychiatry and Behavioral Sciences, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil. Molecular Psychiatry Laboratory, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
| | - Karen Jansen
- Graduate Program in Health and Behavior, Catholic University of Pelotas, Pelotas, RS, Brazil
| | - Ives Cavalcante Passos
- Graduate Program in Psychiatry and Behavioral Sciences, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil. Molecular Psychiatry Laboratory, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
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Larsen E, Murton O, Song X, Joachim D, Watts D, Kapczinski F, Venesky L, Hurowitz G. Validating the efficacy and value proposition of mental fitness vocal biomarkers in a psychiatric population: prospective cohort study. Front Psychiatry 2024; 15:1342835. [PMID: 38505797 PMCID: PMC10948552 DOI: 10.3389/fpsyt.2024.1342835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 02/14/2024] [Indexed: 03/21/2024] Open
Abstract
Background The utility of vocal biomarkers for mental health assessment has gained increasing attention. This study aims to further this line of research by introducing a novel vocal scoring system designed to provide mental fitness tracking insights to users in real-world settings. Methods A prospective cohort study with 104 outpatient psychiatric participants was conducted to validate the "Mental Fitness Vocal Biomarker" (MFVB) score. The MFVB score was derived from eight vocal features, selected based on literature review. Participants' mental health symptom severity was assessed using the M3 Checklist, which serves as a transdiagnostic tool for measuring depression, anxiety, post-traumatic stress disorder, and bipolar symptoms. Results The MFVB demonstrated an ability to stratify individuals by their risk of elevated mental health symptom severity. Continuous observation enhanced the MFVB's efficacy, with risk ratios improving from 1.53 (1.09-2.14, p=0.0138) for single 30-second voice samples to 2.00 (1.21-3.30, p=0.0068) for data aggregated over two weeks. A higher risk ratio of 8.50 (2.31-31.25, p=0.0013) was observed in participants who used the MFVB 5-6 times per week, underscoring the utility of frequent and continuous observation. Participant feedback confirmed the user-friendliness of the application and its perceived benefits. Conclusions The MFVB is a promising tool for objective mental health tracking in real-world conditions, with potential to be a cost-effective, scalable, and privacy-preserving adjunct to traditional psychiatric assessments. User feedback suggests that vocal biomarkers can offer personalized insights and support clinical therapy and other beneficial activities that are associated with improved mental health risks and outcomes.
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Affiliation(s)
| | | | | | | | - Devon Watts
- Neuroscience Graduate Program, Department of Health Sciences, McMaster University, Hamilton, ON, Canada
- St. Joseph’s Healthcare Hamilton, Hamilton, ON, Canada
| | - Flavio Kapczinski
- Neuroscience Graduate Program, Department of Health Sciences, McMaster University, Hamilton, ON, Canada
- Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
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Machado FZ, da Mota MSS, Dos Santos EP, Prasad D, Cardoso TDA, Frey BN, Jansen K, Souza LDDM, Mondin TC, Kapczinski F, Moreira FP, da Silva RA. Factors associated with suicide risk in young women with premenstrual dysphoric disorder: A population-based study. Trends Psychiatry Psychother 2024. [PMID: 38315812 DOI: 10.47626/2237-6089-2023-0718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 01/22/2024] [Indexed: 02/07/2024]
Abstract
PURPOSE Women with premenstrual dysphoric disorder (PMDD) are more likely to report suicide ideation and behavior when compared to women without PMDD. However, there is a lack of studies investigating the risk factors for suicide risk in women with PMDD. Thus, the aim of this study is to assess the factors associated with suicide risk in young women with PMDD. METHODS This is a cross-sectional study including 128 young women with PMDD who were recruited from the community. PMDD and suicide risk were assessed by trained psychologists using the Mini International Neuropsychiatric Interview (MINI-PLUS). Suicide risk evaluation includes six questions that assess suicidal intention, planning and previous attempts. Subjects who answer yes to any of the six questions are classified as having current suicide risk. RESULTS The prevalence of current suicide risk in women with PMDD was 28.1%. The factors associated with suicide risk in this population were: presenting current panic disorder (OR: 18.71 [95% CI: 1.02 - 343.27], p=0.048), a non-white skin color (OR: 4.18 [CI 95%: 1.28 - 13.61], p=0.018), greater severity of depressive symptoms (OR: 1.22 [95% CI: 1.12 - 1.32], < 0.001), and history of childhood trauma (OR: 1.04 [95% CI: 1.01 - 1.08], 0.010). CONCLUSION Our findings indicate that there are key sociodemographic and clinical factors associated with suicide risk in young women with PMDD, enabling clinicians to identify at-risk individuals who could benefit from further screening and interventions.
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Affiliation(s)
- Francine Zanette Machado
- Programa de Pós-Graduação em Saúde e Comportamento, Universidade Católica de Pelotas, Pelotas, RS, Brazil
| | - Manuela Silva Silveira da Mota
- Programa de Pós-Graduação em Saúde e Comportamento, Universidade Católica de Pelotas, Pelotas, RS, Brazil. Laboratório de Cronobiologia e Sono, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil. Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Ester Pereira Dos Santos
- Programa de Pós-Graduação em Saúde e Comportamento, Universidade Católica de Pelotas, Pelotas, RS, Brazil
| | - Divya Prasad
- Women's Health Concerns Clinic, St Joseph's Healthcare Hamilton, ON, Canada
| | - Taiane de Azevedo Cardoso
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, Australia
| | - Benicio N Frey
- Women's Health Concerns Clinic, St Joseph's Healthcare Hamilton, ON, Canada. Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada. Mood Disorders Program, St Joseph's Healthcare Hamilton, Hamilton, ON, Canada
| | - Karen Jansen
- Programa de Pós-Graduação em Saúde e Comportamento, Universidade Católica de Pelotas, Pelotas, RS, Brazil
| | | | - Thaise Campos Mondin
- Programa de Pós-Graduação em Saúde e Comportamento, Universidade Católica de Pelotas, Pelotas, RS, Brazil. Pró-Reitoria de Assuntos Estudantis (PRAE), Universidade Federal de Pelotas, RS, Brazil
| | - Flavio Kapczinski
- Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil. Graduate Program in Psychiatry and Behavioral Sciences, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Fernanda Pedrotti Moreira
- Programa de Pós-Graduação em Saúde e Comportamento, Universidade Católica de Pelotas, Pelotas, RS, Brazil
| | - Ricardo Azevedo da Silva
- Programa de Pós-Graduação em Saúde e Comportamento, Universidade Católica de Pelotas, Pelotas, RS, Brazil
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Lage LAS, Erthal FS, Ribeiro-Alves M, Bastos AF, Balanzá-Martinez V, Kapczinski F, De Boni RB. Changes on risky drinking after the COVID-19 outbreak in Brazil: results from three consecutive web surveys. Trends Psychiatry Psychother 2024. [PMID: 38193496 DOI: 10.47626/2237-6089-2023-0686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 11/21/2023] [Indexed: 01/10/2024]
Abstract
INTRODUCTION Risky drinking (RD) is associated with an increased risk of chronic and infectious diseases, injuries, and violence. This study aimed to assess changes in risky drinking (RD) in Brazil after COVID-19 outbreak, both overall and among individuals with self-reported chronic diseases and mental health disorders. METHODS We conducted three independent, anonymous web surveys in Brazil including adult participants: S1 (April/2020, n=19,257), S2 (August/2020, n=1,590), and S3 (January/2021, n=859). Participants were recruited through adapted snowball sampling and sponsored social network advertisements. RD was assessed using the Alcohol Use Disorder Identification Test-Concise, designed to identify individuals at risk of alcohol-related problems. Logistic regression analyses with bootstrapping (B=2,000) were performed, with stratification by sex, age, education, employment, household size, and the presence of chronic and mental health conditions, as well as lifestyle factors, to address sample imbalances. RESULTS The estimated prevalence of RD was 45.8% [95%CI 45.5, 46.1] in S1, 35.3% [95%CI 34.9, 35.6] in S2, and 33.7% [95%CI 33.3, 34.0] in S3. Participants with chronic diseases consistently presented lower RD prevalence across all three surveys, compared to those without such conditions. Conversely, individuals with mental health disorders presented higher RD prevalence than those without such diagnoses in S1 and S2, but not in S3. DISCUSSION Despite the decrease in RD prevalence, monitoring of alcohol consumption trends remains essential for shaping effective public health policies. Additionally, the observed variations among individuals reporting chronic and mental health disorders highlight the need for targeted interventions in future crises.
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Affiliation(s)
- Luisa Alencar Santos Lage
- Instituto de Psiquiatria (IPUB), Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Fátima Smith Erthal
- Instituto de Psiquiatria (IPUB), Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil. Instituto de Biofísica Carlos Chagas Filho (IBCCF), Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Marcelo Ribeiro-Alves
- Instituto Nacional de Infectologia Evandro Chagas (INI), Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil
| | - Aline Furtado Bastos
- Instituto de Biofísica Carlos Chagas Filho (IBCCF), Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Vicent Balanzá-Martinez
- Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, CIBERSAM, Valencia, Spain
| | - Flavio Kapczinski
- Departamento de Psiquiatria, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil. Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Raquel B De Boni
- Instituto de Comunicação e Informação Cientifica e Tecnológica em Saúde (ICICT), Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil
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Guimarães GO, D'Angelo F, Brouillette K, Souza LDM, da Silva RA, Mondin TC, Pedrotti Moreira F, Kapczinski F, de Azevedo Cardoso T, Jansen K. Incidence and risk factors for anxiety disorders in young adults: A population-based prospective cohort study. Encephale 2023; 49:572-576. [PMID: 36253174 DOI: 10.1016/j.encep.2022.08.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 07/18/2022] [Accepted: 08/04/2022] [Indexed: 11/06/2022]
Abstract
Anxiety disorders are among the most common psychiatric disorders in the general population. Our objective was to describe the cumulative incidence and risk factors of anxiety disorders, including obsessive-compulsive disorder (OCD) and posttraumatic stress disorder (PTSD), in a follow-up of young adults over a five-year period. This is a prospective cohort conducted in two waves. The first took place from 2007 to 2009, in which 1,560 young adults aged between 18 and 24 years were evaluated using the Mini-International Neuropsychiatric Interview (MINI). Subjects were invited to participate in the second wave, which wave took place from 2012 to 2014, where 1,244 young adults were evaluated using the MINI-Plus. Our findings showed a cumulative incidence of 10.9% for any anxiety disorder, 6.5% for generalized anxiety disorder, 6.0% for agoraphobia, 2.0% for OCD, 1.6% for panic disorder, 1.1% for social anxiety and 0.7% for PTSD. Being female and having had a depressive episode were risk factors to develop any anxiety disorder. We observed a high cumulative incidence of anxiety disorders in a population-based sample of young adults. Our data highlights the importance of the early identification of these disorders as this could lead to early illness detection, early illness management and a reduced burden of disease.
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Affiliation(s)
- G O Guimarães
- Department of Health and Behavior, Catholic University of Pelotas - Universidade Católica de Pelotas, Rua Gonçalves Chaves, 373, Sala 424C, 96015-560 Pelotas, RS, Brazil
| | - F D'Angelo
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - K Brouillette
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada; School of Interdisciplinary Science, Life Sciences Program, McMaster University, Hamilton, ON, Canada
| | - L D M Souza
- Department of Health and Behavior, Catholic University of Pelotas - Universidade Católica de Pelotas, Rua Gonçalves Chaves, 373, Sala 424C, 96015-560 Pelotas, RS, Brazil; Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Porto Alegre, Brazil
| | - R A da Silva
- Department of Health and Behavior, Catholic University of Pelotas - Universidade Católica de Pelotas, Rua Gonçalves Chaves, 373, Sala 424C, 96015-560 Pelotas, RS, Brazil; Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Porto Alegre, Brazil
| | - T C Mondin
- Department of Health and Behavior, Catholic University of Pelotas - Universidade Católica de Pelotas, Rua Gonçalves Chaves, 373, Sala 424C, 96015-560 Pelotas, RS, Brazil; Pró-Reitoria de Assuntos Estudantis (PRAE), Universidade Federal de Pelotas, Pelotas, RS, Brazil
| | - F Pedrotti Moreira
- Department of Health and Behavior, Catholic University of Pelotas - Universidade Católica de Pelotas, Rua Gonçalves Chaves, 373, Sala 424C, 96015-560 Pelotas, RS, Brazil; Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Porto Alegre, Brazil
| | - F Kapczinski
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada; Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Porto Alegre, Brazil; Neuroscience Graduate Program, McMaster University, Hamilton, ON, Canada; Departamento de Psiquiatria, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - T de Azevedo Cardoso
- Department of Health and Behavior, Catholic University of Pelotas - Universidade Católica de Pelotas, Rua Gonçalves Chaves, 373, Sala 424C, 96015-560 Pelotas, RS, Brazil; Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada; School of Interdisciplinary Science, Life Sciences Program, McMaster University, Hamilton, ON, Canada; Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Porto Alegre, Brazil
| | - K Jansen
- Department of Health and Behavior, Catholic University of Pelotas - Universidade Católica de Pelotas, Rua Gonçalves Chaves, 373, Sala 424C, 96015-560 Pelotas, RS, Brazil; Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Porto Alegre, Brazil.
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Kapczinski F, Nardi AE. Professor Ellis Alindo D'Arrigo Busnello: a humanist and a scientist with a passion for psychiatry and psychopathology. A great mentor of Brazilian scientific postgraduate programs in psychiatry. Braz J Psychiatry 2023; 45:465-466. [PMID: 37718466 PMCID: PMC10897769 DOI: 10.47626/1516-4446-2023-3332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 08/07/2023] [Indexed: 09/19/2023]
Affiliation(s)
- Flavio Kapczinski
- Departamento de Psiquiatria, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil. Mood Disorders Program, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Antonio E Nardi
- Laboratório de Pânico e Respiração, Instituto de Psiquiatria, Faculdade de Medicina, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil. Dipartimento di Scienze Mediche e Sanità Pubblica, Università di Cagliari, Cagliari, Italy
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Simjanoski M, de Azevedo Cardoso T, Frey BN, Minuzzi L, De Boni RB, Balanzá-Martínez V, Kapczinski F. Lifestyle in bipolar disorder: A cross-sectional study. Spanish Journal of Psychiatry and Mental Health 2023; 16:244-250. [PMID: 37839960 DOI: 10.1016/j.rpsm.2023.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 04/14/2023] [Accepted: 04/27/2023] [Indexed: 10/17/2023]
Abstract
BACKGROUND Modifiable lifestyle behaviors are important factors for improving mental health, yet there has been a lack of research studying lifestyle as a multidimensional construct in bipolar disorder (BD). The aim of this cross-sectional study was to compare the lifestyle patterns of individuals with BD in a current mood episode with healthy controls (HCs) using the Short Multidimensional Inventory Lifestyle Evaluation (SMILE). MATERIALS AND METHODS The sample consisted of 46 individuals with BD currently experiencing a depressive or manic episode and 50 HC, assessed using the MINI International Neuropsychiatric Interview, Montgomery-Åsberg Depression Rating Scale (MADRS), and the Young Mania Rating Scale (YMRS). The SMILE scale assesses lifestyle across seven domains: diet and nutrition, substance abuse, physical activity, stress management, restorative sleep, social support, and environmental exposures. Between-groups comparisons were performed based on the presence of a psychiatric diagnosis and the type of BD episode. RESULTS We found significant differences in the total SMILE score (r=0.75, p<0.001) and in scores from each domain of the scale between BD and HC (p<0.05), where individuals with BD in a depressive or manic episode with or without mixed features reported worse lifestyle across all domains. Differences between individuals with BD in different mood episodes across domains on the SMILE scale were non-significant. CONCLUSION Findings from this study highlight the presence of unhealthy lifestyle patterns in people with BD regardless of the polarity of their mood episode. Implementation of multidimensional lifestyle assessments is an essential step toward detecting the clustering of unhealthy lifestyle patterns in BD.
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Affiliation(s)
- Mario Simjanoski
- Neuroscience Graduate Program, McMaster University, 1280 Main St. West, Hamilton, ON, Canada; Department of Psychiatry and Behavioural Neurosciences, McMaster University, 1280 Main St. West, Hamilton, ON, Canada.
| | - Taiane de Azevedo Cardoso
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, 1280 Main St. West, Hamilton, ON, Canada
| | - Benicio N Frey
- Neuroscience Graduate Program, McMaster University, 1280 Main St. West, Hamilton, ON, Canada; Department of Psychiatry and Behavioural Neurosciences, McMaster University, 1280 Main St. West, Hamilton, ON, Canada; Women's Health Concerns Clinic and Mood Disorders Program, St. Joseph's Healthcare, 100 West 5th Street, Hamilton, ON, Canada
| | - Luciano Minuzzi
- Neuroscience Graduate Program, McMaster University, 1280 Main St. West, Hamilton, ON, Canada; Department of Psychiatry and Behavioural Neurosciences, McMaster University, 1280 Main St. West, Hamilton, ON, Canada; Women's Health Concerns Clinic and Mood Disorders Program, St. Joseph's Healthcare, 100 West 5th Street, Hamilton, ON, Canada
| | - Raquel B De Boni
- Institute of Scientific and Technological Communication and Information in Health (ICICT), Oswaldo Cruz Foundation (FIOCRUZ), 4365 Manguinhos, Rio de Janeiro, Brazil
| | - Vicent Balanzá-Martínez
- Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, CIBERSAM, Av. de Blasco Ibáñez, 13, Valencia, Spain
| | - Flavio Kapczinski
- Neuroscience Graduate Program, McMaster University, 1280 Main St. West, Hamilton, ON, Canada; Department of Psychiatry and Behavioural Neurosciences, McMaster University, 1280 Main St. West, Hamilton, ON, Canada; Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Porto Alegre, Brazil; Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Av. Paulo Gama, 110, Porto Alegre, Brazil
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Ornell F, Scherer JN, Schuch JB, Sordi AO, Halpern SC, Rebelatto FP, Bristot G, Kapczinski F, Roglio VS, Pechansky F, Kessler FHP, von Diemen L. Serum BDNF levels increase during early drug withdrawal in alcohol and crack cocaine addiction. Alcohol 2023; 111:1-7. [PMID: 37037287 DOI: 10.1016/j.alcohol.2023.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 04/02/2023] [Accepted: 04/05/2023] [Indexed: 04/12/2023]
Abstract
Brain-derived neurotrophic factor (BDNF) is involved in several drug-induced brain neuroadaptations. The impact of withdrawal from substances that have different neurological mechanisms on BDNF levels is unclear. Our goal was to compare serum BDNF levels in inpatients with alcohol or crack cocaine use disorders during the early withdrawal period, and to evaluate the association with substance-related outcomes. We performed a follow-up study with 101 men under detoxification treatment (drug preference: alcohol [n = 37] and crack cocaine [n = 64]). Blood samples were collected on the 1st and 15th days of hospitalization to measure serum BDNF levels. Serum BDNF levels increased during the early stage of withdrawal (28.2 ± 10.0 vs. 32.6 ± 13.3, p < 0.001), similarly in individuals with alcohol and crack cocaine use. In the alcohol group, BDNF levels on the 15th day of hospitalization were negatively correlated with age (r = -0.394, p = 0.023). Delta BDNF levels were also negatively correlated with BDNF on the 1st day of hospitalization (p = 0.011). No significant correlation was found regarding substance-related outcomes. This is the first study to compare BDNF levels in alcohol and crack cocaine users undergoing similar treatment conditions. These findings could be related to clinical improvement after abstinence or even to drug withdrawal itself, decreasing neuronal injury. Furthermore, age may be a crucial factor, hindering the recovery of neuroplasticity in alcohol users.
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Affiliation(s)
- Felipe Ornell
- Center for Drug and Alcohol Research, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; Graduate Program in Psychiatry and Behavioral Sciences, Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Juliana N Scherer
- Center for Drug and Alcohol Research, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Jaqueline B Schuch
- Center for Drug and Alcohol Research, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; Graduate Program in Psychiatry and Behavioral Sciences, Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
| | - Anne O Sordi
- Center for Drug and Alcohol Research, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Silvia C Halpern
- Center for Drug and Alcohol Research, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Fernando P Rebelatto
- Center for Drug and Alcohol Research, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; Graduate Program in Psychiatry and Behavioral Sciences, Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Giovana Bristot
- Bipolar Disorder Program, Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil; Graduate Program in Biological Sciences: Biochemistry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Flavio Kapczinski
- Graduate Program in Psychiatry and Behavioral Sciences, Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil; Bipolar Disorder Program, Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil; Department of Psychiatry and Behavioural Neurosciences, McMaster University and St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | - Vinicius S Roglio
- Center for Drug and Alcohol Research, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; Graduate Program in Psychiatry and Behavioral Sciences, Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Flavio Pechansky
- Center for Drug and Alcohol Research, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; Graduate Program in Psychiatry and Behavioral Sciences, Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Felix H P Kessler
- Center for Drug and Alcohol Research, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; Graduate Program in Psychiatry and Behavioral Sciences, Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Lisia von Diemen
- Center for Drug and Alcohol Research, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; Graduate Program in Psychiatry and Behavioral Sciences, Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
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9
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Simjanoski M, Patel S, Boni RD, Balanzá-Martínez V, Frey BN, Minuzzi L, Kapczinski F, Cardoso TDA. Lifestyle interventions for bipolar disorders: A systematic review and meta-analysis. Neurosci Biobehav Rev 2023; 152:105257. [PMID: 37263531 DOI: 10.1016/j.neubiorev.2023.105257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 05/05/2023] [Accepted: 05/29/2023] [Indexed: 06/03/2023]
Abstract
This review and meta-analysis aimed to describe the existing literature on interventions for bipolar disorder (BD) targeting the 6 pillars of Lifestyle Psychiatry: diet, physical activity (PA), substance use (SU), sleep, stress management, and social relationships (SR). Randomized Controlled Trials that examined the efficacy of lifestyle interventions targeting improvement in depressive/(hypo)manic symptom severity, lifestyle patterns, functioning, quality of life, and/or circadian rhythms were included. The systematic review included 18 studies, while the meta-analysis included studies targeting the same lifestyle domains and outcomes. Sleep (n = 10), PA (n = 9), and diet (n = 8) were the most targeted domains, while SU, SM and SR were least targeted (n = 4 each). Combined diet and PA interventions led to significant improvements in depressive symptoms (SMD: -0.46; 95%CI: -0.88, -0.04; p = 0.03), and functioning (SMD: -0.47; 95%CI: -0.89, -0.05; p = 0.03). Sleep interventions also led to significant improvements in depressive symptoms (SMD: -0.80; 95%CI: -1.21, -0.39; p < 0.01). Future research should focus on developing more multidimensional lifestyle interventions for a potentially greater impact on clinical and functional outcomes of BD.
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Affiliation(s)
- Mario Simjanoski
- Neuroscience Graduate Program, McMaster University, 1280 Main St. West, Hamilton, ON, Canada; Department of Psychiatry and Behavioural Neurosciences, McMaster University, 1280 Main St. West, Hamilton, ON, Canada.
| | - Swara Patel
- Life Sciences Program, School of Interdisciplinary Science, McMaster University, 1280 Main St. West, Hamilton, ON, Canada
| | - Raquel De Boni
- Institute of Scientific and Technological Communication and Information in Health (ICICT), Oswaldo Cruz Foundation (FIOCRUZ), 4365 Manguinhos, Rio de Janeiro, Brazil
| | - Vicent Balanzá-Martínez
- Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, CIBERSAM, Av. de Blasco Ibáñez, 13, Valencia, Spain
| | - Benicio N Frey
- Neuroscience Graduate Program, McMaster University, 1280 Main St. West, Hamilton, ON, Canada; Department of Psychiatry and Behavioural Neurosciences, McMaster University, 1280 Main St. West, Hamilton, ON, Canada; Women's Health Concerns Clinic and Mood Disorders Program, St. Joseph's Healthcare, 100 West 5th Street, Hamilton, ON, Canada
| | - Luciano Minuzzi
- Neuroscience Graduate Program, McMaster University, 1280 Main St. West, Hamilton, ON, Canada; Department of Psychiatry and Behavioural Neurosciences, McMaster University, 1280 Main St. West, Hamilton, ON, Canada; Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, CIBERSAM, Av. de Blasco Ibáñez, 13, Valencia, Spain
| | - Flavio Kapczinski
- Neuroscience Graduate Program, McMaster University, 1280 Main St. West, Hamilton, ON, Canada; Department of Psychiatry and Behavioural Neurosciences, McMaster University, 1280 Main St. West, Hamilton, ON, Canada; Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Porto Alegre, Brazil
| | - Taiane de Azevedo Cardoso
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, 1280 Main St. West, Hamilton, ON, Canada; Life Sciences Program, School of Interdisciplinary Science, McMaster University, 1280 Main St. West, Hamilton, ON, Canada
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10
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Hillmer A, Chawar C, Lamri A, Hudson J, Kapczinski F, Minuzzi L, Marsh DC, Thabane L, Paterson AD, Samaan Z. Genetics of cannabis use in opioid use disorder: A genome-wide association and polygenic risk score study. PLoS One 2023; 18:e0289059. [PMID: 37494403 PMCID: PMC10370765 DOI: 10.1371/journal.pone.0289059] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 07/10/2023] [Indexed: 07/28/2023] Open
Abstract
BACKGROUND Individuals with an Opioid Use Disorder (OUD) have increased rates of cannabis use in comparison to the general population. Research on the short- and long-term impacts of cannabis use in OUD patients has been inconclusive. A genetic component may contribute to cannabis cravings. AIMS Identify genetic variants associated with cannabis use through Genome-wide Association Study (GWAS) methods and investigate a Polygenic Risk Score (PRS). In addition, we aim to identify any sex differences in effect size for genetic variants reaching or nearing genome-wide significance in the GWAS. METHODS The study outcomes of interest were: regular cannabis use (yes/no) (n = 2616), heaviness of cannabis use (n = 1293) and cannabis cravings (n = 836). Logistic and linear regressions were preformed, respectively, to test the association between genetic variants and each outcome, regular cannabis use and heaviness of cannabis use. GWAS summary statistics from a recent large meta-GWAS investigating cannabis use disorder were used to conduct PRS's. Findings are limited to a European ancestry sample. RESULTS No genome-wide significant associations were found. Rs1813412 (chromosome 17) for regular cannabis use and rs62378502 (chromosome 5) for heaviness of cannabis use were approaching genome-wide significance. Both these SNPs were nominally significant (p<0.05) within males and females, however sex did not modify the association. The PRS identified statistically significant association with cannabis cravings. The variance explained by all PRSs were less than 1.02x10-2. CONCLUSION This study provides promising results in understanding the genetic contribution to cannabis use in individuals living with OUD.
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Affiliation(s)
- Alannah Hillmer
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Caroul Chawar
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Amel Lamri
- Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Jacqueline Hudson
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Flavio Kapczinski
- McMaster University, Hamilton, ON, Canada
- Universidade Federal do Rio Grande do Sol, Porto Alegre, Brazil
| | - Luciano Minuzzi
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | | | - Lehana Thabane
- Department of Health Research Method, Evidence & Impact, Hamilton, ON, Canada
| | - Andrew D Paterson
- Program in Genetics and Genome Biology, The Hospital for Sick Children, Divisions of Biostatistics and Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Zainab Samaan
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
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Ribeiro-Alves M, Lucieri Costa G, Corrêa da Mota J, de Azevedo Cardoso T, Cerezer K, Martini T, Soriano de Sousa MU, Bastos FI, Balanzá-Martínez V, Kapczinski F, De Boni RB. Lifestyle changes during the COVID-19 pandemic in Brazil: results from three consecutive cross-sectional web surveys. BMJ Open 2023; 13:e070328. [PMID: 37423635 DOI: 10.1136/bmjopen-2022-070328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/11/2023] Open
Abstract
OBJECTIVE The importance of a healthy lifestyle in preventing morbidity and mortality is well-established. The COVID-19 pandemic brought about significant lifestyle changes globally, but the extent of these changes in the Brazilian population remains unclear. The objective of this study was to evaluate changes in lifestyle among the Brazilian general population during the first year of the pandemic. DESIGN Three consecutive anonymous web surveys were carried out: survey 1 (S1)-April 2020, S2-August 2020 and S3-January 2021. SETTING Brazil. PARTICIPANTS The study included 19 257 (S1), 1590 (S2) and 859 (S3) participants from the general population, who were ≥18 years, of both sexes, with access to the internet, self-reporting living in Brazil and who agreed to participate after reading the informed consent. PRIMARY OUTCOME Lifestyle changes were assessed using the Short Multidimensional Instrument for Lifestyle Evaluation-Confinement (SMILE-C). The SMILE-C assesses lifestyle across multiple domains including diet, substance use, physical activity, stress management, restorative sleep, social support and environmental exposures. We used a combination of bootstrapping and linear fixed-effect modelling to estimate pairwise mean differences of SMILE-C scores overall and by domain between surveys. RESULTS In all the surveys, participants were mostly women and with a high education level. Mean SMILE-C scores were 186.4 (S1), 187.4 (S2) and 190.5 (S3), indicating a better lifestyle in S3 as compared with S1. The pairwise mean differences of the overall SMILE-C scores were statistically significant (p<0.001). We also observed a better lifestyle over time in all domains except for diet and social support. CONCLUSIONS Our findings indicate that individuals from a large middle-income country, such as Brazil, struggled to restore diet and social relationships after 1 year of the pandemic. These findings have implications for monitoring the long-term consequences of the pandemic, as well as future pandemics.
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Affiliation(s)
- Marcelo Ribeiro-Alves
- Laboratório de Pesquisa Clínica em DST-AIDS, Instituto Nacional de Infectologia Evandro Chagas (INI), Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Giovanna Lucieri Costa
- Escola de Medicina e Cirurgia, Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Taiane de Azevedo Cardoso
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Keila Cerezer
- Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Thais Martini
- Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | | | | | | | - Flavio Kapczinski
- Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil
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12
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Côrte-Real B, Saraiva R, Cordeiro CR, Frey BN, Kapczinski F, de Azevedo Cardoso T. Atypical antipsychotic-induced mania: A systematic review and meta-analysis. J Affect Disord 2023; 333:420-435. [PMID: 37084970 DOI: 10.1016/j.jad.2023.04.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 03/26/2023] [Accepted: 04/14/2023] [Indexed: 04/23/2023]
Abstract
BACKGROUND The possibility of atypical antipsychotics (AA) to induce manic symptoms has been raised by several articles. The objective of this study was to describe whether exposure to AA may induce mania in mood disorders. METHODS We performed a systematic review following the preferred reporting items for systematic reviews and meta-analysis guidelines. The systematic search encompassed all relevant studies published until April 4th, 2022. A meta-analysis testing whether treatment emergent mania (TEM) is more frequent with the use of AA compared with placebo was performed. RESULTS A total of 52 studies were included in the systematic review. We found 24 case reports or case series describing 40 manic/hypomanic episodes allegedly induced by AA. Twenty-one placebo-controlled trials were included in a meta-analysis including 4823 individuals treated with AA and 3252 individuals receiving placebo. Our meta-analysis showed that the use of AA protects against the development of TEM (OR: 0.68 [95 % CI: 0.52-0.89], p = 0.005). LIMITATIONS AA-induced mania/hypomania was not the primary outcome in any of the observational or interventional studies. TEM was not homogeneously defined across studies. In most case reports it was not possible to establish causality between the use of AA and the development of manic symptoms. CONCLUSIONS TEM is more frequent with placebo than with AA, which suggests that AA exposure does not represent a relevant risk for TEM. Mania/hypomania induced by an AA seems to be rare events, since anecdotal evidence from case reports and case series were not observed in observational prospective and interventional studies.
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Affiliation(s)
- Beatriz Côrte-Real
- Department of Psychiatry and Mental Health, Centro Hospitalar Universitário Lisboa Norte, Av Prof. Egas Moniz, 1649-035 Lisboa, Portugal; Psychiatric and Medical Psychology University Clinic, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisboa, Portugal
| | - Rodrigo Saraiva
- Department of Psychiatry and Mental Health, Centro Hospitalar Universitário Lisboa Norte, Av Prof. Egas Moniz, 1649-035 Lisboa, Portugal; Psychiatric and Medical Psychology University Clinic, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisboa, Portugal
| | - Catarina Rodrigues Cordeiro
- Department of Psychiatry and Mental Health, Centro Hospitalar Universitário Lisboa Norte, Av Prof. Egas Moniz, 1649-035 Lisboa, Portugal; Psychiatric and Medical Psychology University Clinic, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisboa, Portugal
| | - Benicio N Frey
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada; Mood Disorders Program and Women's Health Concerns Clinic, St. Joseph's Healthcare Hamilton, Hamilton, ON L8N 3K7, Canada
| | - Flavio Kapczinski
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada; Graduate Program in Psychiatry, Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Porto Alegre, Brazil
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13
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Jansen K, Grellert M, Nexha A, Oses JP, Silva RAD, Souza LDDM, Kapczinski F, Frey BN, de Azevedo Cardoso T. Biological rhythms disruption mediates the association between mother's diagnosis of bipolar disorder and offspring's emotional/behavioral problems. J Affect Disord 2023; 327:230-235. [PMID: 36736792 DOI: 10.1016/j.jad.2023.01.119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 01/23/2023] [Accepted: 01/30/2023] [Indexed: 02/04/2023]
Abstract
OBJECTIVE The current study assesses whether the association between diagnosis of Bipolar Disorder (BD) in mothers and emotional and behavioral problems (EBP) in their offspring is mediated by a disruption in the offspring's biological rhythms. METHODS A probabilistic sample of 492 public school children (ages 7-8, 48 % female) were assessed for biological rhythms disruption and EBP using the Biological Rhythms Interview for Assessment in Neuropsychiatry for Kids and the Strengths and Difficulties Questionnaire, respectively. Mothers' mental health (BD = 64) was evaluated using a standardized clinical interview. A mediation analysis was conducted to assess the effect of the mother's diagnosis of BD on the EBP of their offspring in relation to the offspring's biological rhythms disruptions. RESULTS When compared to offspring of mothers without BD, offspring of mothers with BD showed greater difficulty in maintaining biological rhythms and higher prevalence of EBP. Using the presence of EBP as the outcome, 75 % of the effect of mother's BD diagnosis was mediated by offspring's biological rhythms disruption. CONCLUSIONS Biological rhythms disruption in children fully mediates the effect of the mother's diagnosis of BD on the child's EBP. These data encourage the development of further studies to find effective strategies to prevent and treat biological rhythms disruption in offspring of mothers with BD.
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Affiliation(s)
- Karen Jansen
- Health and Behavior Department, Catholic University of Pelotas, Brazil; Cogniciência, Pelotas, RS, Brazil
| | - Mateus Grellert
- Departamento de Informática e Estatística, Universidade Federal de Santa Catarina, Brazil
| | - Adile Nexha
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Canada
| | - Jean Pierre Oses
- Programa de Pós-Graduação em Ciências Fisiológicas, Universidade Federal do Rio Grande, Brazil
| | | | | | - Flavio Kapczinski
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Canada; Bipolar Disorder Program, Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil; Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil; Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Porto Alegre, RS, Brazil
| | - Benicio N Frey
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Canada; Women's Health Concerns Clinic, St. Joseph's Healthcare Hamilton, Canada
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14
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Rodrigues Cordeiro C, Côrte-Real BR, Saraiva R, Frey BN, Kapczinski F, de Azevedo Cardoso T. Triggers for acute mood episodes in bipolar disorder: A systematic review. J Psychiatr Res 2023; 161:237-260. [PMID: 36940629 DOI: 10.1016/j.jpsychires.2023.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 02/27/2023] [Accepted: 03/02/2023] [Indexed: 03/23/2023]
Abstract
OBJECTIVES To identify triggers of acute mood episodes in bipolar disorder (BD). METHODS We performed a systematic review in the following databases: Pubmed, Embase, and PsycInfo following the preferred reporting items for systematic reviews and meta-analysis guidelines. The systematic search encompassed all relevant studies published until May 23rd, 2022. RESULTS A total of 108 studies (case reports/case series, interventional, prospective and retrospective studies) were included in the systematic review. While several decompensation triggers were identified, pharmacotherapy was the one with the largest body of evidence, particularly the use of antidepressants as triggers of manic/hypomanic episodes. Other identified triggers for mania were brain stimulation, energy drinks, acetyl-l-carnitine, St. John's wort, seasonal changes, hormonal changes and viral infections. There is a relative paucity of evidence concerning triggers for depressive relapses in BD, with possible triggers including fasting, decreased sleep and stressful life events. CONCLUSIONS This is the first systematic review about triggers/precipitants of relapse in BD. Despite the importance of identification and management of potential triggers for BD decompensation, there is a lack of large observational studies addressing this topic, with most of the included studies being case reports/case series. Notwithstanding these limitations, antidepressant use is the trigger with the strongest evidence for manic relapse. More studies are needed to identify and manage triggers for relapse in BD.
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Affiliation(s)
- Catarina Rodrigues Cordeiro
- Department of Psychiatry and Mental Health, Centro Hospitalar Universitário Lisboa Norte, Av Prof. Egas Moniz, 1649-035, Lisboa, Portugal; Psychiatric and Medical Psychology University Clinic, Faculdade de Medicina, Universidade de Lisboa, 1649-028, Lisboa, Portugal.
| | - Beatriz Romão Côrte-Real
- Department of Psychiatry and Mental Health, Centro Hospitalar Universitário Lisboa Norte, Av Prof. Egas Moniz, 1649-035, Lisboa, Portugal; Psychiatric and Medical Psychology University Clinic, Faculdade de Medicina, Universidade de Lisboa, 1649-028, Lisboa, Portugal
| | - Rodrigo Saraiva
- Department of Psychiatry and Mental Health, Centro Hospitalar Universitário Lisboa Norte, Av Prof. Egas Moniz, 1649-035, Lisboa, Portugal; Psychiatric and Medical Psychology University Clinic, Faculdade de Medicina, Universidade de Lisboa, 1649-028, Lisboa, Portugal
| | - Benicio N Frey
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada; Mood Disorders Program and Women's Health Concerns Clinic, St. Joseph's Healthcare Hamilton, Hamilton, ON, L8N 3K7, Canada
| | - Flavio Kapczinski
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada; Graduate Program in Psychiatry, Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Porto Alegre, Brazil
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15
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Watts D, Mamak M, Moulden H, Upfold C, de Azevedo Cardoso T, Kapczinski F, Chaimowitz G. The HARM models: Predicting longitudinal physical aggression in patients with schizophrenia at an individual level. J Psychiatr Res 2023; 161:91-98. [PMID: 36917868 DOI: 10.1016/j.jpsychires.2023.02.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 02/14/2023] [Accepted: 02/23/2023] [Indexed: 03/16/2023]
Abstract
The prediction and prevention of aggression in individuals with schizophrenia remains a top priority within forensic psychiatric settings. While risk assessment methods are well rooted in forensic psychiatry, there are no available tools to predict longitudinal physical aggression in patients with schizophrenia within forensic settings at an individual level. In the present study, we used evidence-based risk and protective factors, as well as variables related to course of treatment assessed at baseline, to predict prospective incidents of physical aggression (4-month, 12-month, and 18-month follow-up) among 151 patients with schizophrenia within the forensic mental healthcare system. Across our HARM models, the balanced accuracy (sensitivity + specificity/2) of predicting physical aggressive incidents in patients with schizophrenia ranged from 59.73 to 87.33% at 4-month follow-up, 68.31-80.10% at 12-month follow-up, and 46.22-81.63% at 18-month follow-up, respectively. Additionally, we developed separate models, using clinician rated clinical judgement of short term and immediate violent risk, as a measure of comparison. Several modifiable evidence-based predictors of prospective physical aggression in schizophrenia were identified, including impulse control, substance abuse, impulsivity, treatment non-adherence, mood and psychotic symptoms, substance abuse, and poor family support. To the best of our knowledge, our HARM models are the first to predict longitudinal physical aggression at an individual level in patients with schizophrenia in forensic settings. However, it is important to caution that since these machine learning models were developed in the context of forensic settings, they may not be generalisable to individuals with schizophrenia more broadly. Moreover, a low base rate of physical aggression was observed in the testing set (6.0-11.6% across timepoints). As such, larger cohorts will be required to determine the replicability of these findings.
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Affiliation(s)
- Devon Watts
- Neuroscience Graduate Program, McMaster University, Hamilton, Canada.
| | - Mini Mamak
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada.
| | - Heather Moulden
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada.
| | - Casey Upfold
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada.
| | | | - Flavio Kapczinski
- Neuroscience Graduate Program, McMaster University, Hamilton, Canada; Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada; Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Porto Alegre, Brazil.
| | - Gary Chaimowitz
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada.
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16
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Simjanoski M, de Azevedo Cardoso T, Wollenhaupt-Aguiar B, Pfaffenseller B, De Boni RB, Balanzá-Martínez V, Frey BN, Minuzzi L, Kapczinski F. Lifestyle Behaviors, Depression, and Anxiety Among Individuals Living in Canada During the COVID-19 Pandemic. Am J Lifestyle Med 2023; 17:181-193. [PMID: 36883127 PMCID: PMC9157275 DOI: 10.1177/15598276221102097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The aim of our study was to investigate the association between lifestyle behaviors and symptoms of depression and anxiety during the COVID-19 pandemic in Canada. A web survey was conducted between July 3-August 3, 2020, across Canada. The main outcomes considered were a positive screening for depression, as evaluated by the PHQ-2 and positive screening for anxiety, as evaluated by the GAD-7. Lifestyle behaviors were assessed using the Short Multidimensional Lifestyle Inventory Evaluation-Confinement (SMILE-C), an instrument adapted for lifestyle behaviors during the COVID-19 pandemic. The total sample size included 404 participants, of which 24.3% had a positive screen for depression, 20.5% for anxiety, and 15.5% for both. We found significant differences in SMILE-C scores between individuals with a positive and individuals with a negative screen for depression (P < .001). Likewise, there were significant differences in SMILE-C scores between individuals with a positive and individuals with a negative screen for anxiety (P < .001). We found an association between unhealthy lifestyle behaviors and symptoms of depression and anxiety during the COVID-19 lockdown in Canada. The findings highlight the importance of lifestyle medicine (LM) education and targeted lifestyle interventions to promote healthy behaviors and help reduce the burden of mental disorders.
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Affiliation(s)
- Mario Simjanoski
- Neuroscience Graduate Program, McMaster University, Hamilton, Canada.,Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, Canada
| | | | | | - Bianca Pfaffenseller
- Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, Canada
| | - Raquel B De Boni
- Institute of Scientific and Technological Communication and Information in Health (ICICT), Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil
| | - Vicent Balanzá-Martínez
- Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, CIBERSAM, Valencia, Spain
| | - Benicio N Frey
- Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, Canada.,Women's Health Concerns Clinic and Mood Disorders Program, St. Joseph's Healthcare, Hamilton, ON, Canada
| | - Luciano Minuzzi
- Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, Canada
| | - Flavio Kapczinski
- Neuroscience Graduate Program, McMaster University, Hamilton, Canada.,Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, Canada.,Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Porto Alegre, Brazil
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17
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Simjanoski M, McIntyre A, Kapczinski F, Cardoso TDA. Cognitive impairment in bipolar disorder in comparison to mild cognitive impairment and dementia: a systematic review. Trends Psychiatry Psychother 2023; 44. [PMID: 34374270 PMCID: PMC10039729 DOI: 10.47626/2237-6089-2021-0300] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 07/09/2021] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To conduct a systematic review to describe cognitive abilities in bipolar disorder (BD) in comparison to cognitive abilities in mild cognitive impairment (MCI) and dementia. METHODS A literature search was performed with no year or language restrictions. The search yielded 1,461 articles, with 1,261 remaining after removal of duplicates, five of which were suitable for the systematic review: two for the comparison between BD and MCI and three comparing BD and dementia. RESULTS Analyses from our systematic review showed that euthymic individuals with BD present impairments in cognitive domains such as attention and executive functioning, motor skills, conceptual thinking, and visuo-spatial abilities that are equally severe as or more severe than the impairments observed in individuals with MCI. In contrast, studies comparing BD and dementia indicated that Alzheimer's disease (AD) dementia and behavioral variant frontotemporal dementia (bvFTD) both showed greater cognitive deficits than BD during euthymia, whereas BD during a mood episode demonstrated higher cognitive impairments than bvFTD. CONCLUSION Findings from our systematic review suggest that cognitive impairments in euthymic BD fall into a range between the impairments seen in MCI and those seen in dementia. More studies are needed to analyze these comparisons, while also focusing on comparing different clinical stages of BD with MCI and dementia to analyze the progression of the clinical course and cognitive dysfunction in BD.
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Affiliation(s)
- Mario Simjanoski
- Mood Disorders Program, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada. Neuroscience Graduate Program, McMaster University, Hamilton, ON, Canada
| | - Aidan McIntyre
- Mood Disorders Program, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Flavio Kapczinski
- Mood Disorders Program, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada. Neuroscience Graduate Program, McMaster University, Hamilton, ON, Canada
| | - Taiane de Azevedo Cardoso
- Mood Disorders Program, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
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18
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Rakovski C, Ballester PL, Montezano BB, Dias de Mattos Souza L, Jansen K, Azevedo da Silva R, Mondin TC, Pedrotti Moreira F, De Boni RB, Frey BN, Kapczinski F, de Azevedo Cardoso T. Predictors of illicit substance abuse/dependence during young adulthood: A machine learning approach. J Psychiatr Res 2023; 157:168-173. [PMID: 36470198 DOI: 10.1016/j.jpsychires.2022.11.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 10/19/2022] [Accepted: 11/21/2022] [Indexed: 11/27/2022]
Abstract
Prior studies have found an especially high prevalence of illicit substance use among adolescents and young adults in Brazil. The current study aimed to employ machine learning techniques to identify predictors of illicit substance abuse/dependence among a large community sample of young adults followed for 5 years. This prospective, population-based cohort study included a sample of young adults between the ages of 18-24 years from Pelotas, Brazil at baseline (T1). The Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) was used to assess illicit substance abuse/dependence. A clinical interview was conducted to collect data on sociodemographic characteristics and psychopathology. Elastic net was used to generate a regularized linear model for the machine learning component of this study, which followed standard machine learning protocols. A total of 1560 young adults were assessed at T1, while 1244 were reassessed at the 5-year follow-up period (T2). The strongest predictors of illicit substance abuse/dependence at baseline (AUC of 0.83) were alcohol abuse/dependence, tobacco abuse/dependence, being in a current major depressive episode, history of a lifetime manic episode, current suicide risk, and male sex. The strongest predictors for illicit substance abuse/dependence at the 5-year follow-up (AUC: 0.79) were tobacco abuse/dependence at T1, history of a lifetime manic episode at T1, male sex, alcohol abuse/dependence at T1, and current suicide risk at T1. Our findings indicate that machine learning techniques hold the potential to predict illicit substance abuse/dependence among young adults using sociodemographic/clinical characteristics, with relatively high accuracy.
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Affiliation(s)
- Coral Rakovski
- Neuroscience Graduate Program, McMaster University, Hamilton, ON, Canada
| | - Pedro L Ballester
- Neuroscience Graduate Program, McMaster University, Hamilton, ON, Canada
| | - Bruno Braga Montezano
- Health and Behavior Department, Catholic University of Pelotas, Pelotas, RS, Brazil; Bipolar Disorder Program, Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre, Instituto Nacional de Ciência e Tecnologia Translacional em Medicina, Porto Alegre, RS, Brazil; Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
| | | | - Karen Jansen
- Health and Behavior Department, Catholic University of Pelotas, Pelotas, RS, Brazil
| | | | - Thaise Campos Mondin
- Department of Student Affairs, Federal University of Pelotas, Pelotas, RS, Brazil
| | | | - Raquel Brandini De Boni
- Instituto de Comunicação e Informação Cientifica e Tecnológica em Saúde, Oswaldo Cruz Foundation, RJ, Brazil
| | - Benicio N Frey
- Mood Disorders Program, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada; Women's Health Concerns Clinic, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | - Flavio Kapczinski
- Bipolar Disorder Program, Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre, Instituto Nacional de Ciência e Tecnologia Translacional em Medicina, Porto Alegre, RS, Brazil; Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil; Mood Disorders Program, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada; Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Porto Alegre, RS, Brazil
| | - Taiane de Azevedo Cardoso
- Health and Behavior Department, Catholic University of Pelotas, Pelotas, RS, Brazil; Mood Disorders Program, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada.
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19
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Valerio AG, Ornell F, Roglio VS, Scherer JN, Schuch JB, Bristot G, Pechansky F, Kapczinski F, Kessler FHP, von Diemen L. Increase in serum brain-derived neurotrophic factor levels during early withdrawal in severe alcohol users. Trends Psychiatry Psychother 2022; 44:e20210254. [PMID: 34060728 PMCID: PMC10039723 DOI: 10.47626/2237-6089-2021-0254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Accepted: 05/23/2021] [Indexed: 12/16/2022]
Abstract
INTRODUCTION Changes in brain-derived neurotrophic factor (BDNF) have been linked to the neuroadaptative consequences of chronic alcohol use and associated with disease severity and prognosis. Few studies have evaluated the influence of drug withdrawal and clinical and sociodemographic data on BDNF levels in severe alcohol users. OBJECTIVES Our goals were (1) to evaluate variation in BDNF levels during alcohol withdrawal and, (2) to assess the influence of putative confounding factors on BDNF levels. METHODS Our sample consists of 62 men with alcohol use disorder undergoing a detoxification process. Serum BDNF levels were measured using a commercial sandwich-ELISA kit, at two points: before and after the detoxification period. RESULTS We found an increase in BDNF levels during alcohol withdrawal (25.4±9.6 at admission vs. 29.8±10.2 ng/ml at discharge; p < 0.001), even after controlling for potential confounders (positive family history, number of days between blood sample collections, and age) (Generalized Estimating Equation: coefficient = -4.37, 95% confidence interval [95%CI] -6.3; -2.4; p < 0.001). Moreover, individuals who had first-degree relative with alcohol dependence had smaller increases in BDNF levels than individuals with no family history (14.8 [95%CI -5.3; 35.6] vs. 35.3 [95%CI 15.4; 74.8]; p = 0.005). CONCLUSIONS In summary, variation in BDNF levels seems to be influenced by withdrawal in severe alcohol users. A positive family history of alcohol dependence could also be a factor that influences variation in this biomarker.
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Affiliation(s)
- Andrei Garziera Valerio
- Centro de Pesquisa em Álcool e Drogas, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil. Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, UFRGS, Porto Alegre, RS, Brazil
| | - Felipe Ornell
- Centro de Pesquisa em Álcool e Drogas, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil. Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, UFRGS, Porto Alegre, RS, Brazil
| | - Vinicius Serafini Roglio
- Centro de Pesquisa em Álcool e Drogas,Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil. Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, UFRGS, Porto Alegre, RS, Brazil
| | - Juliana Nichterwitz Scherer
- Centro de Pesquisa em Álcool e Drogas, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil. Programa de Pós-Graduação em Saúde Coletiva, Universidade do Vale do Rio dos Sinos (Unisinos), São Leopoldo, RS, Brazil
| | - Jaqueline Bohrer Schuch
- Centro de Pesquisa em Álcool e Drogas, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil. Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, UFRGS, Porto Alegre, RS, Brazil
| | - Giovana Bristot
- Laboratório de Psiquiatria Molecular, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil. Programa de Pós-Graduação em Bioquímica, UFRGS, Porto Alegre, RS, Brazil
| | - Flavio Pechansky
- Centro de Pesquisa em Álcool e Drogas, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil. Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, UFRGS, Porto Alegre, RS, Brazil
| | - Flavio Kapczinski
- Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, UFRGS, Porto Alegre, RS, Brazil. Laboratório de Psiquiatria Molecular, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil. Department of Psychiatry and Behavioural Neurosciences, McMaster University and St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada
| | - Felix Henrique Paim Kessler
- Centro de Pesquisa em Álcool e Drogas, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil. Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, UFRGS, Porto Alegre, RS, Brazil
| | - Lisia von Diemen
- Centro de Pesquisa em Álcool e Drogas, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil. Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, UFRGS, Porto Alegre, RS, Brazil
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20
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Watts D, de Azevedo Cardoso T, Librenza-Garcia D, Ballester P, Passos IC, Kessler FHP, Reilly J, Chaimowitz G, Kapczinski F. Predicting criminal and violent outcomes in psychiatry: a meta-analysis of diagnostic accuracy. Transl Psychiatry 2022; 12:470. [PMID: 36347838 PMCID: PMC9643469 DOI: 10.1038/s41398-022-02214-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 07/17/2022] [Accepted: 09/30/2022] [Indexed: 11/10/2022] Open
Abstract
Although reducing criminal outcomes in individuals with mental illness have long been a priority for governments worldwide, there is still a lack of objective and highly accurate tools that can predict these events at an individual level. Predictive machine learning models may provide a unique opportunity to identify those at the highest risk of criminal activity and facilitate personalized rehabilitation strategies. Therefore, this systematic review and meta-analysis aims to describe the diagnostic accuracy of studies using machine learning techniques to predict criminal and violent outcomes in psychiatry. We performed meta-analyses using the mada, meta, and dmetatools packages in R to predict criminal and violent outcomes in psychiatric patients (n = 2428) (Registration Number: CRD42019127169) by searching PubMed, Scopus, and Web of Science for articles published in any language up to April 2022. Twenty studies were included in the systematic review. Overall, studies used single-nucleotide polymorphisms, text analysis, psychometric scales, hospital records, and resting-state regional cerebral blood flow to build predictive models. Of the studies described in the systematic review, nine were included in the present meta-analysis. The area under the curve (AUC) for predicting violent and criminal outcomes in psychiatry was 0.816 (95% Confidence Interval (CI): 70.57-88.15), with a partial AUC of 0.773, and average sensitivity of 73.33% (95% CI: 64.09-79.63), and average specificity of 72.90% (95% CI: 63.98-79.66), respectively. Furthermore, the pooled accuracy across models was 71.45% (95% CI: 60.88-83.86), with a tau squared (τ2) of 0.0424 (95% CI: 0.0184-0.1553). Based on available evidence, we suggest that prospective models include evidence-based risk factors identified in prior actuarial models. Moreover, there is a need for a greater emphasis on identifying biological features and incorporating novel variables which have not been explored in prior literature. Furthermore, available models remain preliminary, and prospective validation with independent datasets, and across cultures, will be required prior to clinical implementation. Nonetheless, predictive machine learning models hold promise in providing clinicians and researchers with actionable tools to improve how we prevent, detect, or intervene in relevant crime and violent-related outcomes in psychiatry.
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Affiliation(s)
- Devon Watts
- grid.25073.330000 0004 1936 8227Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON Canada ,grid.25073.330000 0004 1936 8227Neuroscience Graduate Program, McMaster University, Hamilton, ON Canada
| | - Taiane de Azevedo Cardoso
- grid.25073.330000 0004 1936 8227Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON Canada
| | - Diego Librenza-Garcia
- grid.25073.330000 0004 1936 8227Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON Canada ,grid.8532.c0000 0001 2200 7498Post-Graduation Program in Psychiatry and Behavioural Sciences, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, RS Brazil
| | - Pedro Ballester
- grid.25073.330000 0004 1936 8227Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON Canada ,grid.25073.330000 0004 1936 8227Neuroscience Graduate Program, McMaster University, Hamilton, ON Canada
| | - Ives Cavalcante Passos
- grid.414449.80000 0001 0125 3761Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS Brazil ,Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Porto Alegre, RS Brazil
| | - Felix H. P. Kessler
- grid.414449.80000 0001 0125 3761Center for Drug and Alcohol Research, HCPA, Porto Alegre, RS Brazil
| | - Jim Reilly
- grid.25073.330000 0004 1936 8227Department of Electrical and Computer Engineering, McMaster University, Hamilton, ON Canada
| | - Gary Chaimowitz
- grid.25073.330000 0004 1936 8227Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON Canada ,grid.416721.70000 0001 0742 7355Forensic Psychiatry Program, St. Joseph’s Healthcare Hamilton, Hamilton, ON Canada
| | - Flavio Kapczinski
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada. .,Neuroscience Graduate Program, McMaster University, Hamilton, ON, Canada. .,Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Porto Alegre, RS, Brazil.
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21
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Imran A, Tariq S, Kapczinski F, de Azevedo Cardoso T. Psychological resilience and mood disorders: a systematic review and meta-analysis. Trends Psychiatry Psychother 2022; 46:e20220524. [PMID: 36215270 DOI: 10.47626/2237-6089-2022-0524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 09/20/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVE This systematic review aims to describe the relationship between psychological resilience and mood disorders. METHODS This is a systematic review and meta-analysis. The following databases were searched on November 6, 2020: PubMed, PsycINFO, and Embase. RESULTS Twenty-three articles were included and the majority of the studies included (95.7%) showed that psychological resilience has a positive impact in mood disorders. Our meta-analysis showed that individuals with bipolar disorder presented significantly lower levels of psychological resilience compared to controls (standardized mean difference [SDM]: -0.99 [95% confidence interval {95%CI}: -1.13 to -0.85], p < 0.001). In addition, individuals with depression had significantly lower levels of psychological resilience compared to controls (SDM: -0.71 [95%CI -0.81 to -0.61], p < 0.001). CONCLUSION Our results showed that individuals with mood disorders are less resilient than individuals without mood disorders. Our findings reinforce the importance of investigating interventions that may help to improve psychological resilience considering its positive impact in the context of mood disorders.
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Affiliation(s)
- Areeba Imran
- Life Sciences Program, School of Interdisciplinary Science, McMaster University, Hamilton, ON, Canada
| | - Suleman Tariq
- Health Sciences Program, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Flavio Kapczinski
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada. Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Porto Alegre, RS, Brazil. Laboratório de Psiquiatria Molecular, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil. Departamento de Psiquiatria, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Taiane de Azevedo Cardoso
- Sciences Program, School of Interdisciplinary Science, McMaster University, Hamilton, ON, Canada. Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
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22
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Anmella G, Faurholt‐Jepsen M, Hidalgo‐Mazzei D, Radua J, Passos IC, Kapczinski F, Minuzzi L, Alda M, Meier S, Hajek T, Ballester P, Birmaher B, Hafeman D, Goldstein T, Brietzke E, Duffy A, Haarman B, López‐Jaramillo C, Yatham LN, Lam RW, Isometsa E, Mansur R, McIntyre RS, Mwangi B, Vieta E, Kessing LV. Smartphone-based interventions in bipolar disorder: Systematic review and meta-analyses of efficacy. A position paper from the International Society for Bipolar Disorders (ISBD) Big Data Task Force. Bipolar Disord 2022; 24:580-614. [PMID: 35839276 PMCID: PMC9804696 DOI: 10.1111/bdi.13243] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND The clinical effects of smartphone-based interventions for bipolar disorder (BD) have yet to be established. OBJECTIVES To examine the efficacy of smartphone-based interventions in BD and how the included studies reported user-engagement indicators. METHODS We conducted a systematic search on January 24, 2022, in PubMed, Scopus, Embase, APA PsycINFO, and Web of Science. We used random-effects meta-analysis to calculate the standardized difference (Hedges' g) in pre-post change scores between smartphone intervention and control conditions. The study was pre-registered with PROSPERO (CRD42021226668). RESULTS The literature search identified 6034 studies. Thirteen articles fulfilled the selection criteria. We included seven RCTs and performed meta-analyses comparing the pre-post change in depressive and (hypo)manic symptom severity, functioning, quality of life, and perceived stress between smartphone interventions and control conditions. There was significant heterogeneity among studies and no meta-analysis reached statistical significance. Results were also inconclusive regarding affective relapses and psychiatric readmissions. All studies reported positive user-engagement indicators. CONCLUSION We did not find evidence to support that smartphone interventions may reduce the severity of depressive or manic symptoms in BD. The high heterogeneity of studies supports the need for expert consensus to establish ideally how studies should be designed and the use of more sensitive outcomes, such as affective relapses and psychiatric hospitalizations, as well as the quantification of mood instability. The ISBD Big Data Task Force provides preliminary recommendations to reduce the heterogeneity and achieve more valid evidence in the field.
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Affiliation(s)
- Gerard Anmella
- Digital Innovation Group, Bipolar and Depressive Disorders Unit, Institute of NeuroscienceHospital Clinic, University of Barcelona, IDIBAPS, CIBERSAMBarcelonaCataloniaSpain
| | - Maria Faurholt‐Jepsen
- Copenhagen Affective Disorder research Center (CADIC)Psychiatric Center CopenhagenCopenhagenDenmark
| | - Diego Hidalgo‐Mazzei
- Digital Innovation Group, Bipolar and Depressive Disorders Unit, Institute of NeuroscienceHospital Clinic, University of Barcelona, IDIBAPS, CIBERSAMBarcelonaCataloniaSpain
| | - Joaquim Radua
- Imaging of Mood‐ and Anxiety‐Related Disorders (IMARD) groupIDIBAPS, CIBERSAMBarcelonaSpain,Early Psychosis: Interventions and Clinical‐detection (EPIC) lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & NeuroscienceKing's College LondonLondonUK,Centre for Psychiatric Research and Education, Department of Clinical NeuroscienceKarolinska InstitutetStockholmSweden
| | - Ives C. Passos
- Laboratory of Molecular Psychiatry and Bipolar Disorder Program, Programa de Pós‐Graduação em Psiquiatria e Ciências do Comportamento, Centro de Pesquisa Experimental do Hospital de Clínicas de Porto AlegreUniversidade Federal do Rio Grande do SulPorto AlegreBrazil
| | - Flavio Kapczinski
- Department of Psychiatry and Behavioural NeurosciencesMcMaster UniversityHamiltonONCanada
| | - Luciano Minuzzi
- Department of Psychiatry and Behavioural NeurosciencesMcMaster UniversityHamiltonONCanada
| | - Martin Alda
- Department of PsychiatryDalhousie UniversityHalifaxNSCanada
| | - Sandra Meier
- Department of PsychiatryDalhousie UniversityHalifaxNSCanada
| | - Tomas Hajek
- Department of PsychiatryDalhousie UniversityHalifaxNSCanada,National Institute of Mental HealthKlecanyCzech Republic
| | - Pedro Ballester
- Neuroscience Graduate ProgramMcMaster UniversityHamiltonCanada
| | - Boris Birmaher
- Department of Psychiatry, Western Psychiatric Institute and ClinicUniversity of Pittsburgh School of MedicinePittsburghPAUSA
| | - Danella Hafeman
- Department of Psychiatry, Western Psychiatric Institute and ClinicUniversity of Pittsburgh School of MedicinePittsburghPAUSA
| | - Tina Goldstein
- Department of Psychiatry, Western Psychiatric Institute and ClinicUniversity of Pittsburgh School of MedicinePittsburghPAUSA
| | - Elisa Brietzke
- Department of PsychiatryQueen's UniversityKingstonONCanada
| | - Anne Duffy
- Department of PsychiatryQueen's UniversityKingstonONCanada
| | - Benno Haarman
- Department of PsychiatryUniversity Medical Center Groningen, University of GroningenGroningenThe Netherlands
| | - Carlos López‐Jaramillo
- Research Group in Psychiatry, Department of Psychiatry, Faculty of MedicineUniversity of AntioquiaMedellínColombia,Mood Disorders ProgramHospital Universitario San Vicente FundaciónMedellínColombia
| | - Lakshmi N. Yatham
- Department of PsychiatryUniversity of British ColumbiaVancouverBCCanada
| | - Raymond W. Lam
- Department of PsychiatryUniversity of British ColumbiaVancouverBCCanada
| | - Erkki Isometsa
- Department of PsychiatryUniversity of Helsinki and Helsinki University Central HospitalHelsinkiFinland
| | - Rodrigo Mansur
- Mood Disorders Psychopharmacology Unit (MDPU)University Health Network, University of TorontoTorontoONCanada
| | | | - Benson Mwangi
- Department of Psychiatry and Behavioral Sciences, UT Center of Excellence on Mood Disorders, McGovern Medical SchoolThe University of Texas Health Science Center at HoustonHoustonTXUSA
| | - Eduard Vieta
- Digital Innovation Group, Bipolar and Depressive Disorders Unit, Institute of NeuroscienceHospital Clinic, University of Barcelona, IDIBAPS, CIBERSAMBarcelonaCataloniaSpain
| | - Lars Vedel Kessing
- Copenhagen Affective Disorder research Center (CADIC)Psychiatric Center CopenhagenCopenhagenDenmark,Department of Clinical MedicineUniversity of CopenhagenCopenhagenDenmark
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23
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Sehmbi M, Suh JS, Rowley CD, Minuzzi L, Kapczinski F, Bock NA, Frey BN. Network properties of intracortical myelin associated with psychosocial functioning in bipolar I disorder. Bipolar Disord 2022; 24:539-548. [PMID: 35114029 DOI: 10.1111/bdi.13181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Psychosocial functioning in bipolar disorder (BD) persists even during euthymia and has repeatedly been associated with illness progression and cognitive function. Its neurobiological correlates remain largely unexplored. Using a structural covariance approach, we explored whole cortex intracortical myelin (ICM) and psychosocial functioning in 39 BD type I and 58 matched controls. METHOD T1 -weighted images (3T) optimized for ICM measurement were analyzed using a surface-based approach. The ICM signal was sampled at cortical mid-depth using the MarsAtlas parcellation, and psychosocial functioning was measured via the Functioning Assessment Short Test (FAST). Following construction of structural covariance matrices, graph theoretical measures were calculated for each subject. Within BD and HC groups separately, correlations between network measures and FAST were explored. After accounting for multiple comparisons, significant correlations were tested formally using rank-based regressions accounting for sex differences. RESULTS In BD only, psychosocial functioning was associated with global efficiency (β = -0.312, pcorr = 0.03), local efficiency in the right rostral dorsolateral prefrontal cortex (β = 0.545, pcorr = 0.001) and clustering coefficient in this region (β = 0.497, pcorr = 0.0002) as well as in the right ventromedial prefrontal cortex (β = 0.428, pcorr = 0.002). All results excepting global efficiency remained significant after accounting for severity of depressive symptoms. In contrast, no significant associations between functioning and network measures were observed in the HC group. CONCLUSION These results uncovered a novel brain-behaviour relationship between intracortical myelin signal changes and psychosocial functioning in BD.
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Affiliation(s)
- Manpreet Sehmbi
- Mood Disorders Program, Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Jee Su Suh
- Neuroscience Graduate Program, McMaster University, Hamilton, Ontario, Canada
| | | | - Luciano Minuzzi
- Mood Disorders Program, Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada.,Women's Health Concerns Clinic, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | - Flavio Kapczinski
- Mood Disorders Program, Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Nicholas A Bock
- Department of Psychology, Neuroscience and Behaviour, McMaster University, Hamilton, Ontario, Canada
| | - Benicio N Frey
- Mood Disorders Program, Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada.,Women's Health Concerns Clinic, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
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24
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Jesus-Nunes AP, Leal GC, Correia-Melo FS, Vieira F, Mello RP, Caliman-Fontes AT, Echegaray MVF, Marback RF, Guerreiro-Costa LNF, Souza-Marques B, Santos-Lima C, Souza LS, Bandeira ID, Kapczinski F, Lacerda ALT, Quarantini LC. Clinical predictors of depressive symptom remission and response after racemic ketamine and esketamine infusion in treatment-resistant depression. Hum Psychopharmacol 2022; 37:e2836. [PMID: 35179810 DOI: 10.1002/hup.2836] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 01/11/2022] [Accepted: 02/07/2022] [Indexed: 12/28/2022]
Abstract
BACKGROUND Major depressive disorder (MDD) is a leading cause of disability worldwide and most people do not achieve symptom remission. Treatment-resistant depression (TRD) is characterized by the failure of at least one adequate trial of a major class of antidepressant, with adequate time and dosage. We aimed to identify clinical predictors of depressive symptom remission and response 24 h and 7 days after racemic ketamine and esketamine infusions. METHODS A randomized, double-blind, active-controlled, non-inferiority trial using ketamine and esketamine in TRD. Individuals diagnosed with MDD according to Diagnostic and Statistical Manual of Mental Disorders version IV and fulfilling TRD criteria were recruited from March 2017 to June 2018. Participants received a single subanesthetic dose of ketamine (0.5 mg/kg) or esketamine (0.25 mg/kg) for 40 min. Depressive symptoms were assessed using the Montgomery-Åsberg Depression Rating Scale (MADRS) and symptom remission was defined as a MADRS score ≤7 and response defined as ≥50% reduction in depressive symptom severity, 24 h and 7 days after the infusion. Clinical variables were selected based on previous clinical trials. Stepwise backward logistic regression was used, considering a confidence level of 95%. RESULTS 61 subjects were included: 39 (63.9%) were females with a mean age of 47.2 ± 14.9. Higher number of therapeutic failures (Odds Ratio (OR) = 0.677; 95% confidence interval (CI): 0.47-0.97) and higher severity of illness (OR = 0.912; 95% CI: 0.83-0.99) were associated with fewer remissions of depressive symptoms 7 days after intervention, and with fewer response in 24 h (OR = 0.583; 95% CI: 0,40; 0,84 and OR = 0.909; 95% CI: 0,83; 0,99, respectively). CONCLUSION Number of treatment failures and severity of illness were predictors of fewer remissions and responses of depressive symptoms in this TRD population. Study of predictors of remission may contribute to better selection patients that may benefit from receiving ketamine.
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Affiliation(s)
- Ana Paula Jesus-Nunes
- Programa de Pós-graduação Em Medicina e Saúde, Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, Brazil.,Laboratório de Neuropsicofarmacologia, Hospital Universitário Professor Edgard Santos, Universidade Federal da Bahia, Salvador, Brazil
| | - Gustavo C Leal
- Programa de Pós-graduação Em Medicina e Saúde, Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, Brazil.,Laboratório de Neuropsicofarmacologia, Hospital Universitário Professor Edgard Santos, Universidade Federal da Bahia, Salvador, Brazil
| | - Fernanda S Correia-Melo
- Programa de Pós-graduação Em Medicina e Saúde, Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, Brazil.,Laboratório de Neuropsicofarmacologia, Hospital Universitário Professor Edgard Santos, Universidade Federal da Bahia, Salvador, Brazil
| | - Flávia Vieira
- Programa de Pós-graduação Em Medicina e Saúde, Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, Brazil.,Laboratório de Neuropsicofarmacologia, Hospital Universitário Professor Edgard Santos, Universidade Federal da Bahia, Salvador, Brazil
| | - Rodrigo P Mello
- Programa de Pós-graduação Em Medicina e Saúde, Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, Brazil.,Laboratório de Neuropsicofarmacologia, Hospital Universitário Professor Edgard Santos, Universidade Federal da Bahia, Salvador, Brazil
| | - Ana Teresa Caliman-Fontes
- Laboratório de Neuropsicofarmacologia, Hospital Universitário Professor Edgard Santos, Universidade Federal da Bahia, Salvador, Brazil
| | - Mariana V F Echegaray
- Laboratório de Neuropsicofarmacologia, Hospital Universitário Professor Edgard Santos, Universidade Federal da Bahia, Salvador, Brazil
| | - Roberta F Marback
- Laboratório de Neuropsicofarmacologia, Hospital Universitário Professor Edgard Santos, Universidade Federal da Bahia, Salvador, Brazil
| | - Lívia N F Guerreiro-Costa
- Programa de Pós-graduação Em Medicina e Saúde, Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, Brazil.,Laboratório de Neuropsicofarmacologia, Hospital Universitário Professor Edgard Santos, Universidade Federal da Bahia, Salvador, Brazil
| | - Breno Souza-Marques
- Programa de Pós-graduação Em Medicina e Saúde, Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, Brazil.,Laboratório de Neuropsicofarmacologia, Hospital Universitário Professor Edgard Santos, Universidade Federal da Bahia, Salvador, Brazil
| | - Cassio Santos-Lima
- Laboratório de Neuropsicofarmacologia, Hospital Universitário Professor Edgard Santos, Universidade Federal da Bahia, Salvador, Brazil
| | - Lucca S Souza
- Laboratório de Neuropsicofarmacologia, Hospital Universitário Professor Edgard Santos, Universidade Federal da Bahia, Salvador, Brazil
| | - Igor D Bandeira
- Programa de Pós-graduação Em Medicina e Saúde, Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, Brazil.,Laboratório de Neuropsicofarmacologia, Hospital Universitário Professor Edgard Santos, Universidade Federal da Bahia, Salvador, Brazil
| | - Flavio Kapczinski
- INCT-TM, and Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Acioly L T Lacerda
- Laboratório Interdisciplinar de Neurociências Clínicas, Universidade Federal de São Paulo, São Paulo, Brazil.,Programa de Distúrbios Afetivos, Universidade Federal de São Paulo, São Paulo, Brazil.,BR Trials - Clinical Research, São Paulo, Brazil.,National Institute of Science and Technology in Translational Medicine, CNPq/FAPESP/CAPES, São Paulo, Brazil
| | - Lucas C Quarantini
- Programa de Pós-graduação Em Medicina e Saúde, Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, Brazil.,Laboratório de Neuropsicofarmacologia, Hospital Universitário Professor Edgard Santos, Universidade Federal da Bahia, Salvador, Brazil
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Similon MVM, Paasche C, Krol F, Lerer B, Goodwin GM, Berk M, Meyer-Lindenberg A, Ketter TA, Yatham LN, Goldberg JF, Malhi GS, El-Mallakh R, Licht RW, Young AH, Kapczinski F, Swartz M, Hagin M, Torrent C, Serretti A, Yildiz A, Martínez-Arán A, Strejilevich S, Rybakowski J, Sani G, Grunze H, Vázquez G, Pinto AG, Azorin JM, Nolen W, Sentissi O, López-Jaramillo C, Frey BN, Nierenberg A, Parker G, Bond DJ, Cohen A, Tortorella A, Perugi G, Vieta E, Popovic D. Expert consensus recommendations on the use of randomized clinical trials for drug approval in psychiatry- comparing trial designs. Eur Neuropsychopharmacol 2022; 60:91-99. [PMID: 35665655 DOI: 10.1016/j.euroneuro.2022.05.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 05/02/2022] [Accepted: 05/04/2022] [Indexed: 11/26/2022]
Abstract
The use of randomized clinical trials, in particular placebo-controlled trials, for drug approval, is the subject of long-standing debate in the scientific community and beyond. This study offers consensus recommendations from clinical and academic experts to guide the selection of clinical trial design in psychiatry. Forty-one highly cited clinical psychiatrists and/or researchers participated in a Delphi survey. Consensus statements were developed based on the findings of a published, peer-reviewed systematic review. Participants evaluated statements in two survey rounds, following the Delphi method. The expert panel achieved consensus on 7 of 21 recommendations regarding the use of randomized clinical trials. The endorsed recommendations were: (i) Results from placebo-controlled trials are the most reliable and (ii) are necessary despite the growing placebo-effect; (iii) it is ethical to enroll patients in placebo-arms when established treatment is available, if there is no evidence of increased health risk; (iv) There is a need to approve new drugs with the same efficacy as existing treatments, but with different side-effect profiles; (v) Non-inferiority trials incur an increased risk of approving ineffective medications; (vi) The risk of approving an ineffective drug justifies trial designs that incur higher costs, and (vii) superiority trials incur the risk of rejecting potentially efficacious treatments. The endorsed recommendations inform the choice of trial-design appropriate for approval of psychopharmacological drugs. The recommendations strongly support the use of randomized clinical trials in general, and the use of placebo-controlled trials in particular.
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Affiliation(s)
- Miriam von Mücke Similon
- Abarbanel Mental Health Center, Bat Yam, Israel; Tel Aviv University, Sackler School of Medicine, Israel
| | - Cecilia Paasche
- Abarbanel Mental Health Center, Bat Yam, Israel; Tel Aviv University, Sackler School of Medicine, Israel
| | - Fas Krol
- Leiden University Medical Center, the Netherlands
| | | | - Guy M Goodwin
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Michael Berk
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong, Australia
| | - Andreas Meyer-Lindenberg
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim / University of Heidelberg, Mannheim, Germany
| | - Terence A Ketter
- Department of Psychiatry and Behavioral Sciences Stanford, University School of Medicine Stanford, California, USA
| | - Lakshmi N Yatham
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Joseph F Goldberg
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Gin S Malhi
- The University of Sydney, Faculty of Medicine and Health, Northern Clinical School, Department of Psychiatry, Sydney, New South Wales, Australia; Academic Department of Psychiatry, Royal North Shore Hospital, Northern Sydney Local Health District, St Leonards, NSW 2065 Australia; CADE Clinic, Royal North Shore Hospital, Northern Sydney Local Health District, St Leonards, NSW 2065 Australia
| | - Rif El-Mallakh
- University of Louisville School of Medicine, Louisville, Kentucky, USA
| | - Rasmus W Licht
- Aalborg University Hospital, Psychiatry, Aalborg Denmark and Clinical Department of Medicine, Aalborg University, Aalborg, Denmark
| | - Allan H Young
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London & South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Monks Orchard Road, Beckenham, Kent, BR3 3BX; United Kingdom. Department of Psychiatry, Harvard Medical School, and the Bipolar Clinic and Research Program, Massachusetts General Hospital, Boston, USA
| | - Flavio Kapczinski
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | | | | | - Carla Torrent
- Bipolar Disorders Program, Bipolar Disorders Unit, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Alessandro Serretti
- Department of Biomedical and Neuro Motor Sciences, University of Bologna, Bologna, Italy
| | - Ayşegül Yildiz
- Department of Psychiatry, Dokuz Eylül University, Izmir, Turkey
| | - Anabel Martínez-Arán
- Bipolar Disorders Program, Bipolar Disorders Unit, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | | | - Janusz Rybakowski
- Department of Adult Psychiatry, Poznan University of Medical Sciences, Poland
| | - Gabriele Sani
- Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, Rome, Italy; Department of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Heinz Grunze
- Psychiatrie Schwäbisch Hall & Paracelsus Medical University, Nuremberg, Germany
| | - Gustavo Vázquez
- Department of Psychiatry, School of Medicine, Queen's University, Ontario, Canada
| | - Ana Gonzales Pinto
- Department of Psychiatry, BIOARABA. Araba University Hospital, University of the Basque Country, Vitoria, Spain
| | | | - Willem Nolen
- Psychiatrie, Universitair Medisch Centrum Groningen, the Netherlands
| | - Othman Sentissi
- Division of Adult Psychiatry, Department of Psychiatry, Geneva University Hospital, 2, Chemin du Petit-Bel-Air, CH-1226 Thonex, Switzerland
| | | | - Benicio N Frey
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York; Mood Disorders Program and Women's Health Concerns Clinic, St. Joseph's Healthcare Hamilton, ON, Canada
| | - Andrew Nierenberg
- Bipolar Clinic and Research Program, Massachusetts General Hospital, Boston, MA, USA
| | - Gordon Parker
- School of Psychiatry, University of New South Wales, Australia
| | - David J Bond
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, USA
| | - Adam Cohen
- Leiden University Medical Center, the Netherlands
| | | | | | - Eduard Vieta
- Bipolar Disorders Program, Bipolar Disorders Unit, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Dina Popovic
- Abarbanel Mental Health Center, Bat Yam, Israel.
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26
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Tolsdorf EL, Gojmerac C, Crowson J, Frey BN, Kapczinski F, Duarte D. Conversion to major neurocognitive disorder after COVID-19 in a woman with bipolar disorder: A 6-year longitudinal case report. Bipolar Disord 2022; 24:451-456. [PMID: 35174589 PMCID: PMC9111191 DOI: 10.1111/bdi.13192] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Emma L. Tolsdorf
- Department of Psychiatry and Behavioural NeurosciencesMcMaster UniversityHamiltonOntarioCanada,Neuroscience Graduate ProgramMcMaster UniversityHamiltonOntarioCanada,Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT‐TM)Porto AlegreBrazil
| | - Christina Gojmerac
- Department of Psychiatry and Behavioural NeurosciencesMcMaster UniversityHamiltonOntarioCanada,Seniors Mental Health ProgramSt. Joseph’s Healthcare HamiltonOntarioCanada
| | - Jonathan Crowson
- Department of Psychiatry and Behavioural NeurosciencesMcMaster UniversityHamiltonOntarioCanada,Seniors Mental Health ProgramSt. Joseph’s Healthcare HamiltonOntarioCanada
| | - Benicio N. Frey
- Department of Psychiatry and Behavioural NeurosciencesMcMaster UniversityHamiltonOntarioCanada,Mood Disorders ProgramSt. Joseph’s Healthcare HamiltonOntarioCanada
| | - Flavio Kapczinski
- Department of Psychiatry and Behavioural NeurosciencesMcMaster UniversityHamiltonOntarioCanada,Mood Disorders ProgramSt. Joseph’s Healthcare HamiltonOntarioCanada
| | - Dante Duarte
- Department of Psychiatry and Behavioural NeurosciencesMcMaster UniversityHamiltonOntarioCanada,Seniors Mental Health ProgramSt. Joseph’s Healthcare HamiltonOntarioCanada
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27
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Simjanoski M, Ballester PL, da Mota JC, De Boni RB, Balanzá-Martínez V, Atienza-Carbonell B, Bastos FI, Frey BN, Minuzzi L, Cardoso TDA, Kapczinski F. Lifestyle predictors of depression and anxiety during COVID-19: a machine learning approach. Trends Psychiatry Psychother 2022; 44:e20210365. [PMID: 35240012 PMCID: PMC9991109 DOI: 10.47626/2237-6089-2021-0365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 08/23/2021] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Recent research has suggested an increase in the global prevalence of psychiatric symptoms during the COVID-19 pandemic. This study aimed to assess whether lifestyle behaviors can predict the presence of depression and anxiety in the Brazilian general population, using a model developed in Spain. METHODS A web survey was conducted during April-May 2020, which included the Short Multidimensional Inventory Lifestyle Evaluation (SMILE) scale, assessing lifestyle behaviors during the COVID-19 pandemic. Depression and anxiety were examined using the PHQ-2 and the GAD-7, respectively. Elastic net, random forest, and gradient tree boosting were used to develop predictive models. Each technique used a subset of the Spanish sample to train the models, which were then tested internally (vs. the remainder of the Spanish sample) and externally (vs. the full Brazilian sample), evaluating their effectiveness. RESULTS The study sample included 22,562 individuals (19,069 from Brazil, and 3,493 from Spain). The models developed performed similarly and were equally effective in predicting depression and anxiety in both tests, with internal test AUC-ROC values of 0.85 (depression) and 0.86 (anxiety), and external test AUC-ROC values of 0.85 (depression) and 0.84 (anxiety). Meaning of life was the strongest predictor of depression, while sleep quality was the strongest predictor of anxiety during the COVID-19 epidemic. CONCLUSIONS Specific lifestyle behaviors during the early COVID-19 epidemic successfully predicted the presence of depression and anxiety in a large Brazilian sample using machine learning models developed on a Spanish sample. Targeted interventions focused on promoting healthier lifestyles are encouraged.
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Affiliation(s)
- Mario Simjanoski
- Neuroscience Graduate Program, McMaster University, Hamilton, ON, Canada
| | - Pedro L Ballester
- Neuroscience Graduate Program, McMaster University, Hamilton, ON, Canada
| | - Jurema Corrêa da Mota
- Instituto de Comunicação e Informação Científica e Tecnológica em Saúde (ICICT), Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, RJ, Brazil
| | - Raquel B De Boni
- Instituto de Comunicação e Informação Científica e Tecnológica em Saúde (ICICT), Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, RJ, Brazil
| | - Vicent Balanzá-Martínez
- Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, CIBERSAM, Valencia, Spain
| | | | - Francisco I Bastos
- Instituto de Comunicação e Informação Científica e Tecnológica em Saúde (ICICT), Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, RJ, Brazil
| | - Benicio N Frey
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Luciano Minuzzi
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | | | - Flavio Kapczinski
- Neuroscience Graduate Program, McMaster University, Hamilton, ON, Canada. Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
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28
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Géa LP, Wollenhaupt-Aguiar B, Watts D, Maich W, Kapczinski F, Sharma R, Mishra R, Rosa AR, Frey BN. Investigation of blood-brain barrier disruption in an animal model of mania induced by d-amphetamine. Journal of Affective Disorders Reports 2022. [DOI: 10.1016/j.jadr.2022.100368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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29
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Lalli M, Kapczinski F, Pedrotti Moreira F, de Azevedo Cardoso T. Biological underpinnings for the association between substance use and bipolar disorder. Bipolar Disord 2022; 24:227-228. [PMID: 35642542 DOI: 10.1111/bdi.13201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Mikayla Lalli
- School of Interdisciplinary Science, Life Sciences Program, McMaster University, Hamilton, Ontario, Canada
| | - Flavio Kapczinski
- Mood Disorders Program, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada.,Neuroscience Graduate Program, McMaster University, Hamilton, Ontario, Canada.,Graduate Program in Psychiatry, Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Porto Alegre, Brazil
| | - Fernanda Pedrotti Moreira
- Programa de Pós-Graduação em Saúde e Comportamento, Universidade Católica de Pelotas, Pelotas, Brazil
| | - Taiane de Azevedo Cardoso
- School of Interdisciplinary Science, Life Sciences Program, McMaster University, Hamilton, Ontario, Canada.,Mood Disorders Program, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
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30
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Gogia M, Shah AQ, Kapczinski F, de Azevedo Cardoso T. The impact of substance use disorder comorbidity on cognition of individuals with bipolar disorder: A systematic review. Psychiatry Res 2022; 311:114525. [PMID: 35364335 DOI: 10.1016/j.psychres.2022.114525] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 03/18/2022] [Accepted: 03/20/2022] [Indexed: 12/14/2022]
Abstract
The aim of this study is to describe whether Bipolar Disorder (BD) with Substance Use Disorder (SUD) comorbidity is associated with an increased cognitive impairment as compared to BD without SUD comorbidity. This is a systematic review. The literature search was conducted in three databases: PubMed, PsycINFO and Embase. A total of 2032 studies were screened after removing duplicates. 29 articles were included for full text screening, and a total of 14 articles were included in the systematic review. Multiple cognitive domains were assessed, including verbal, spatial and visual memory, and psychomotor and executive functioning. Over half the articles (64.3%, n=9) identified cognitive impairments in individuals with BD+SUD comorbidity as compared to individuals with BD without SUD comorbidity. In addition, individuals with the comorbidity exhibited more severe impairments on tests of executive functioning, and greater impairments in verbal and visual memory. The studies included in this systematic review reinforce that individual with comorbidity of BD and SUD have increased cognitive impairment as compared to individuals with BD without SUD comorbidity. Executive functioning was the most impaired cognitive domain found across the studies included in this review. Intervention strategies focused on executive functioning would be beneficial for this specific population.
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Affiliation(s)
- Manan Gogia
- School of Interdisciplinary Science, Life Sciences Program, McMaster University, Hamilton, ON, Canada
| | - Aimun Qadeer Shah
- School of Interdisciplinary Science, Life Sciences Program, McMaster University, Hamilton, ON, Canada
| | - Flavio Kapczinski
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada; Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Porto Alegre, Rio Grande do Sul, Brazil; Bipolar Disorder Program, Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil; Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Taiane de Azevedo Cardoso
- School of Interdisciplinary Science, Life Sciences Program, McMaster University, Hamilton, ON, Canada; Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada.
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31
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Lira SB, Vieira F, Cavalcanti DE, Souza-Marques B, Netto LR, Correia-Melo FS, Leal GC, Pereira JL, Santos LL, Guedes GM, Teles CA, Cardoso TDA, Miranda-Scippa Â, Kapczinski F, Lacerda ALT, Koenen KC, Turecki G, Quarantini LC. Suicide attempt, impulsivity, and exposure to trauma in college students. Braz J Psychiatry 2022; 44:279-288. [PMID: 35262616 PMCID: PMC9169478 DOI: 10.1590/1516-4446-2021-2175] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 11/02/2021] [Indexed: 11/21/2022]
Abstract
OBJECTIVES Past suicide attempt (SA) is one of the most important risk factors for suicide death. An ideation-to-action framework posits that impulsivity, potentially traumatic events, and mental disorders also play a role in increasing suicide risk. This study aimed to assess the association between trait impulsivity, lifetime exposure to trauma, and post-traumatic stress disorder (PTSD) with SA in a sample of Brazilian college students. METHODS A total of 2,137 participants filled self-reported questionnaires consisting of a sociodemographic and clinical questionnaire, Trauma History Questionnaire, Post-Traumatic Stress Disorder Checklist - Civilian version, and Barratt Impulsiveness Scale. RESULTS Our findings suggest that trait impulsivity may be interpreted as exerting a distal effect on SA, even in the presence of other variables - such as trauma history, psychological neglect, and PTSD - which also increase the odds of SA. High and medium levels of impulsivity, history of trauma, and PTSD increased the likelihood of SA. CONCLUSIONS Intervention strategies to prevent SA may target trait impulsivity and exposure to traumatic experiences.
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Affiliation(s)
- Sidnei B Lira
- Programa de Pós-graduação em Medicina e Saúde, Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, BA, Brazil
| | - Flávia Vieira
- Programa de Pós-graduação em Medicina e Saúde, Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, BA, Brazil.,Laboratório de Neuropsicofarmacologia, Serviço de Psiquiatria, Hospital Universitário Professor Edgard Santos, Universidade Federal da Bahia, Salvador, BA, Brazil
| | - Diogo E Cavalcanti
- Centro Universitário Social da Bahia, Salvador, BA, Brazil.,Centro Universitário Jorge Amado, Salvador, BA, Brazil
| | - Breno Souza-Marques
- Programa de Pós-graduação em Medicina e Saúde, Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, BA, Brazil.,Laboratório de Neuropsicofarmacologia, Serviço de Psiquiatria, Hospital Universitário Professor Edgard Santos, Universidade Federal da Bahia, Salvador, BA, Brazil
| | - Liana R Netto
- Programa de Pós-graduação em Medicina e Saúde, Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, BA, Brazil
| | - Fernanda S Correia-Melo
- Programa de Pós-graduação em Medicina e Saúde, Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, BA, Brazil.,Laboratório de Neuropsicofarmacologia, Serviço de Psiquiatria, Hospital Universitário Professor Edgard Santos, Universidade Federal da Bahia, Salvador, BA, Brazil
| | - Gustavo C Leal
- Programa de Pós-graduação em Medicina e Saúde, Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, BA, Brazil.,Laboratório de Neuropsicofarmacologia, Serviço de Psiquiatria, Hospital Universitário Professor Edgard Santos, Universidade Federal da Bahia, Salvador, BA, Brazil
| | - Juliana L Pereira
- Programa de Pós-graduação em Medicina e Saúde, Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, BA, Brazil
| | - Lene L Santos
- Programa de Pós-graduação em Medicina e Saúde, Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, BA, Brazil
| | - Gisela M Guedes
- Programa de Pós-graduação em Medicina e Saúde, Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, BA, Brazil
| | - Carlos A Teles
- Centro de Pesquisa Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, BA, Brazil
| | - Taiane de A Cardoso
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Ângela Miranda-Scippa
- Programa de Pós-graduação em Medicina e Saúde, Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, BA, Brazil
| | - Flavio Kapczinski
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Acioly L T Lacerda
- Laboratório Interdisciplinar de Neurociências Clínicas, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - Karestan C Koenen
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Gustavo Turecki
- McGill Group for Suicide Studies, Douglas Mental Health University Institute & Department of Psychiatry, McGill University, Montreal, Canada
| | - Lucas C Quarantini
- Programa de Pós-graduação em Medicina e Saúde, Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, BA, Brazil.,Laboratório de Neuropsicofarmacologia, Serviço de Psiquiatria, Hospital Universitário Professor Edgard Santos, Universidade Federal da Bahia, Salvador, BA, Brazil
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Gomes FA, Cerqueira RO, Lee Y, Mansur RB, Kapczinski F, McIntyre RS, Yatham LN, Berk M, Milev R, Brietzke E. What not to use in bipolar disorders: A systematic review of non-recommended treatments in clinical practice guidelines. J Affect Disord 2022; 298:565-576. [PMID: 34758372 DOI: 10.1016/j.jad.2021.11.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 10/30/2021] [Accepted: 11/03/2021] [Indexed: 01/06/2023]
Abstract
BACKGROUND Clinical practice guidelines (CPG) are an important tool for implementation of evidence-based clinical care. Despite clinical trials showing lack of efficacy of some agents in bipolar disorder (BD), they are still frequently prescribed in clinical practice. The objective of this study was to systematically review the CPG recommendations on pharmacological interventions with evidence against their use due to lack of efficacy data and/or due to serious safety concerns. METHODS A systematic literature search identified 29 guidelines published by national and international organizations during the 1994-2020 period. Information was extracted regarding how the recommendations framed non-use of treatments in particular clinical situations as well as the actual recommendation in the guideline. RESULTS Twenty-three guidelines (79%) mentioned at least one non-recommended treatment. The terms used to qualify recommendations varied amongst guidelines and included: "not recommended" "no recommendation" and "negative evidence". Lamotrigine, topiramate and gabapentin were commonly cited as non-recommended treatments for mania and most CPG did not recommend monotherapy with antidepressants, aripiprazole, risperidone, and ziprasidone for treatment of acute bipolar depression. Most guidelines made recommendations about lack of efficacy data or potential harm in treatments for BD but there is a significant variation in the way this information is conveyed to the reader. LIMITATIONS Non-recommended treatments were based on their use for BD episodes or maintenance but specific medications may benefit patients when treating comorbid conditions. CONCLUSIONS The absence of a uniform language and recommendations in current guidelines may be an additional complicating factor in the implementation of evidence-based treatments in BD.
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Affiliation(s)
- Fabiano A Gomes
- Neurobiology of Mood Disorders Laboratory, Centre for Neuroscience Studies (CNS), Queen's University, 76 Stuart St., Burr 4., Kingston, ON, Canada; Kingston Health Sciences Centre-KGH Site, Kingston, ON, Canada; Department of Psychiatry, Queen's University School of Medicine, Kingston, ON, Canada.
| | - Raphael O Cerqueira
- Department of Psychiatry, Federal University of Sao Paulo (Unifesp), Sao Paulo, SP, Brazil
| | - Yena Lee
- Mood Disorders Psychopharmacology Unit (MDPU), Toronto Western Hospital, University Health Network (UHN), Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada
| | - Rodrigo B Mansur
- Mood Disorders Psychopharmacology Unit (MDPU), Toronto Western Hospital, University Health Network (UHN), Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada
| | - Flavio Kapczinski
- Department of Psychiatry and Behavioural Neurosciences and Neuroscience Graduate Program, McMaster University, Hamilton, ON, Canada; Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Porto Alegre, RS, Brazil; Bipolar Disorder Program, Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil; Department of Psychiatry, Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Roger S McIntyre
- Mood Disorders Psychopharmacology Unit (MDPU), Toronto Western Hospital, University Health Network (UHN), Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada
| | - Lakshmi N Yatham
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Michael Berk
- Deakin University, IMPACT - The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong, Australia; Orygen, The National Centre of Excellence in Youth Mental Health, Centre for Youth Mental Health, Florey Institute for Neuroscience and Mental Health and the Department of Psychiatry, The University of Melbourne, Melbourne, Australia
| | - Roumen Milev
- Department of Psychiatry, Queen's University School of Medicine, Kingston, ON, Canada; Centre for Neuroscience Studies, Queen's University, Kingston, Canada; Providence Care Hospital, Kingston, Canada
| | - Elisa Brietzke
- Neurobiology of Mood Disorders Laboratory, Centre for Neuroscience Studies (CNS), Queen's University, 76 Stuart St., Burr 4., Kingston, ON, Canada; Kingston Health Sciences Centre-KGH Site, Kingston, ON, Canada; Department of Psychiatry, Queen's University School of Medicine, Kingston, ON, Canada
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33
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Varghese S, Frey BN, Schneider MA, Kapczinski F, de Azevedo Cardoso T. Functional and cognitive impairment in the first episode of depression: A systematic review. Acta Psychiatr Scand 2022; 145:156-185. [PMID: 34758106 DOI: 10.1111/acps.13385] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 10/27/2021] [Accepted: 11/07/2021] [Indexed: 12/11/2022]
Abstract
OBJECTIVES To describe the cognitive and functional impairment in individuals with the first episode of major depressive disorder (MDD) as compared to controls and individuals with recurrent MDD. Also to describe the functional and cognitive trajectory after the first episode of MDD. METHODS A total of 52 studies were included in our systematic review. 32 studies compared the cognitive performance between first episode of depression (FED) and controls, 11 studies compared the cognitive performance between recurrent depression (RD) and FED, 10 compared global functioning between RD and FED, four studies assessed cognition in FED over time, and two studies assessed global functioning in FED over time. RESULTS The majority of studies (n = 22/32, 68.8%) found that FED subjects performed significantly worse than controls on cognitive tests, with processing speed (n = 12) and executive/working memory (n = 11) being the most commonly impaired domains. Seven out of 11 studies (63.6%) found that RD performed significantly worse than FED, with verbal learning and memory being the most commonly impaired domain (n = 4). Most studies (n = 7/10, 70%) did not find a significant difference in global functioning between RD and FED. In three of four longitudinal studies assessing cognition, subgroup analyses were used instead of directly assessing cognition in FED over time while the remaining study found significant cognitive declines over time in FED when compared to controls. The two longitudinal studies assessing functional trajectory found that functioning significantly improved over time, possibly due to the improvement of depressive symptoms. CONCLUSION There is strong evidence that cognitive impairment is present during the first episode of depression, and individuals with multiple episodes display greater cognitive impairment than individuals with a single episode. Future studies aimed at identifying predictors of cognitive and functional impairment after the first episode of depression are needed to describe the functional and cognitive trajectory of individuals with the first episode of MDD over time.
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Affiliation(s)
- Shawn Varghese
- Undergraduate Medical Education (UGME), McMaster University, Hamilton, Ontario, Canada
| | - Benicio N Frey
- Mood Disorders Program, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada.,Women's Health Concerns Clinic, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | - Maiko A Schneider
- Mood Disorders Program, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada.,Youth Wellness Centre, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | - Flavio Kapczinski
- Mood Disorders Program, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada.,Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Porto Alegre, Rio Grande do Sul, Brazil.,Bipolar Disorder Program, Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil.,Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Taiane de Azevedo Cardoso
- Mood Disorders Program, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
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34
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Duarte D, El-Hagrassy MM, Couto T, Gurgel W, Frey BN, Kapczinski F, Corrêa H. Physician suicide demographics and the COVID-19 pandemic. Braz J Psychiatry 2022; 44:124-135. [PMID: 35081210 PMCID: PMC9041957 DOI: 10.1590/1516-4446-2021-1865] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 08/30/2021] [Indexed: 01/19/2023]
Abstract
Objective: Methods: Results: Conclusions:
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Affiliation(s)
| | | | | | | | - Benicio N. Frey
- McMaster University, Canada; St. Joseph’s Healthcare Hamilton, Canada
| | - Flavio Kapczinski
- McMaster University, Canada; Universidade Federal do Rio Grande do Sul, Brazil
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35
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Affiliation(s)
- Ives Cavalcante Passos
- Laboratory of Molecular Psychiatry, Centro de Pesquisa Experimental (CPE) and Centro de Pesquisa Clínica (CPC), Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Rio Grande do Sul, Brazil.,Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Porto Alegre, Rio Grande do Sul, Brazil.,Department of Psychiatry, School of Medicine, Graduate Program in Psychiatry and Behavioral Sciences, 28124Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Pedro Ballester
- Neuroscience Graduate Program, 3710McMaster University, Hamilton, Ontario, Canada
| | - Francisco Diego Rabelo-da-Ponte
- Laboratory of Molecular Psychiatry, Centro de Pesquisa Experimental (CPE) and Centro de Pesquisa Clínica (CPC), Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Rio Grande do Sul, Brazil.,Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Porto Alegre, Rio Grande do Sul, Brazil.,Department of Psychiatry, School of Medicine, Graduate Program in Psychiatry and Behavioral Sciences, 28124Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Flavio Kapczinski
- Department of Psychiatry and Behavioural Neurosciences, 3710McMaster University, Hamilton, Ontario, Canada
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36
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Farias CDA, Cardoso TDA, da Silva MM, D'Angelo F, Mondin TC, Souza LDDM, da Silva RA, Kapczinski F, Jansen K, Magalhães PVS. Socioeconomic and substance use changes in emerging adults and their relationship with mood disorders in a population-based cohort. Front Psychiatry 2022; 13:932484. [PMID: 36090374 PMCID: PMC9448898 DOI: 10.3389/fpsyt.2022.932484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 08/04/2022] [Indexed: 11/13/2022] Open
Abstract
In this report, we aim to assess the interaction of bipolar disorder and major depressive disorder with the evolution of social roles, economic classification, and substance misuse in emerging adults. This is a longitudinal population-based study (n = 231 at baseline), in which participants were reassessed at a mean of 5 years after baseline. A structured clinical interview was used to diagnose the participants with bipolar disorder and major depression; a control group without mood disorders was included. Men with mood disorders were less likely to be married in the beginning of the study and less likely to work in the follow-up. Women with major depression were less likely to study and more likely to be in a lower economic class at the beginning of the study. In comparison, women with bipolar disorder were less likely to live with their parents and more likely to live with their children in the first wave of the study. Substance misuse was more likely in people with mood disorders, especially in men, and women with bipolar disorder had the highest likelihood in the follow-up. Albeit longitudinal analyses were limited by a possibly insufficient sample size and mediating mechanisms for change, such as stigma, were not explored, the study suggests sex-related specificities regarding the change in social roles and substance use in people with mood disorders. Emerging adults, especially those with mood disorders, are in a period of change and instability and at a greater risk for substance use and abuse.
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Affiliation(s)
- Clarisse de Azambuja Farias
- Graduate Program in Psychiatry and Behavioral Sciences, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Graduate Program in Health and Behavior, Universidade Católica de Pelotas, Pelotas, Brazil
| | - Taiane de Azevedo Cardoso
- Graduate Program in Health and Behavior, Universidade Católica de Pelotas, Pelotas, Brazil.,Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Marielle Moro da Silva
- Faculty of Medicine, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Francesca D'Angelo
- Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Thaise Campos Mondin
- Graduate Program in Health and Behavior, Universidade Católica de Pelotas, Pelotas, Brazil
| | | | | | - Flavio Kapczinski
- Graduate Program in Psychiatry and Behavioral Sciences, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, ON, Canada.,Faculty of Medicine, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Karen Jansen
- Graduate Program in Health and Behavior, Universidade Católica de Pelotas, Pelotas, Brazil
| | - Pedro V S Magalhães
- Graduate Program in Psychiatry and Behavioral Sciences, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
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37
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Rakovski C, Cardoso TDA, da Mota JC, Bastos FI, Kapczinski F, De Boni RB. Underage drinking in Brazil: findings from a community household survey. Braz J Psychiatry 2021; 44:257-263. [PMID: 34932691 PMCID: PMC9169469 DOI: 10.1590/1516-4446-2021-2103] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 08/27/2021] [Indexed: 11/30/2022]
Abstract
Objectives: Previous studies have estimated the 30-day prevalence of alcohol use to be approximately 21% among youth in Brazil, despite the legal drinking age of 18 years. The present study aimed to determine the prevalence of underage drinking and its associated factors among adolescents in Brazil. Methods: The 3rd National Survey on Drug Use by the Brazilian Population (III Levantamento Nacional sobre o Uso de Drogas pela População Brasileira) is a nationwide, multi-stage, probability-sample household survey. Herein, youth between the ages of 12-17 years were included. Lifetime and 12-month alcohol use prevalence were estimated. Factors associated with 12-month alcohol use were evaluated through multivariate analysis considering survey weights and design. Results: Overall, 628 youth were interviewed. Estimated lifetime and 12-month alcohol use were 34.3% (standard error [SE] = 1.9) and 22.2% (SE = 1.7), respectively. Factors associated with 12-month drinking were: other/no religion vs. Christianity; living in rural vs. urban areas; self-reported diagnosis of depression vs. no self-reported depression; lifetime tobacco use vs. no history of tobacco use; and any illicit drug use vs. no history of illicit drug use. Conclusion: Considering that alcohol use is a major risk factor for early death among Brazilian youth, our findings highlight the importance of preventative measures to reduce underage drinking.
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Affiliation(s)
- Coral Rakovski
- Neuroscience Graduate Program, McMaster University, Hamilton, ON, Canada
| | | | - Jurema Corrêa da Mota
- Instituto de Comunicação e Informação Científica e Tecnológica em Saúde, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
| | - Francisco I Bastos
- Instituto de Comunicação e Informação Científica e Tecnológica em Saúde, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
| | - Flavio Kapczinski
- Neuroscience Graduate Program, McMaster University, Hamilton, ON, Canada.,Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada.,Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, Departamento de Psiquiatria, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.,Centro de Pesquisa Experimental, Laboratório de Psiquiatria Molecular, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil.,Centro de Pesquisa Clínica, Laboratório de Psiquiatria Molecular, HCPA, Porto Alegre, RS, Brazil
| | - Raquel Brandini De Boni
- Instituto de Comunicação e Informação Científica e Tecnológica em Saúde, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
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38
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Chawar C, Hillmer A, Lamri A, Kapczinski F, Thabane L, Pare G, Samaan Z. Implications of OPRM1 and CYP2B6 variants on treatment outcomes in methadone-maintained patients in Ontario: Exploring sex differences. PLoS One 2021; 16:e0261201. [PMID: 34910759 PMCID: PMC8673616 DOI: 10.1371/journal.pone.0261201] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Accepted: 11/28/2021] [Indexed: 11/19/2022] Open
Abstract
Genetic variants in the OPRM1 and CYP2B6 genes, respectively coding for an opioid receptor and methadone metabolizers, have been linked to negative treatment outcomes in patients undergoing methadone maintenance treatment, with little consensus on their effect. This study aims to test the associations between pre-selected SNPs of OPRM1 and CYP2B6 and outcomes of continued opioid use, relapse, and methadone dose. It also aims to observe differences in associations within the sexes. 1,172 participants treated with methadone (nMale = 666, nFemale = 506) were included in this study. SNPs rs73568641 and rs7451325 from OPRM1 and all the tested CYP2B6 SNPs were detected to be in high linkage disequilibrium. Though no associations were found to be significant, noteworthy differences were observed in associations of OPRM1 rs73568641 and CYP2B6 rs3745274 with treatment outcomes between males and females. Further research is needed to determine if sex-specific differences are present.
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Affiliation(s)
- Caroul Chawar
- Neuroscience Graduate Program, McMaster University, Hamilton, ON, Canada
- Department of Psychiatry and Behavioural Neurosciences, St. Joseph’s Healthcare Hamilton, Hamilton, ON, Canada
| | - Alannah Hillmer
- Neuroscience Graduate Program, McMaster University, Hamilton, ON, Canada
- Department of Psychiatry and Behavioural Neurosciences, St. Joseph’s Healthcare Hamilton, Hamilton, ON, Canada
| | - Amel Lamri
- Department of Medicine, McMaster University, Hamilton, ON, Canada
- Population Health Research Institute, Hamilton, ON, Canada
| | - Flavio Kapczinski
- Department of Psychiatry and Behavioural Neurosciences, St. Joseph’s Healthcare Hamilton, Hamilton, ON, Canada
| | - Lehana Thabane
- Population Health Research Institute, Hamilton, ON, Canada
- Department of Health Research Method, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
- Father Sean O’Sullivan Research Centre, St. Joseph’s Healthcare Hamilton, Hamilton, ON, Canada
| | - Guillaume Pare
- Population Health Research Institute, Hamilton, ON, Canada
- Department of Health Research Method, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
| | - Zainab Samaan
- Department of Psychiatry and Behavioural Neurosciences, St. Joseph’s Healthcare Hamilton, Hamilton, ON, Canada
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39
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Ballester PL, Cardoso TDA, Moreira FP, da Silva RA, Mondin TC, Araujo RM, Kapczinski F, Frey BN, Jansen K, de Mattos Souza LD. 5-year incidence of suicide-risk in youth: A gradient tree boosting and SHAP study. J Affect Disord 2021; 295:1049-1056. [PMID: 34706413 DOI: 10.1016/j.jad.2021.08.033] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 07/15/2021] [Accepted: 08/21/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Machine learning methods for suicidal behavior so far have failed to be implemented as a prediction tool. In order to use the capabilities of machine learning to model complex phenomenon, we assessed the predictors of suicide risk using state-of-the-art model explanation methods. METHODS Prospective cohort study including a community sample of 1,560 young adults aged between 18 and 24. The first wave took place between 2007 and 2009, and the second wave took place between 2012 and 2014. Sociodemographic and clinical characteristics were assessed at baseline. Incidence of suicide risk at five-years of follow-up was the main outcome. The outcome was assessed using the Mini Neuropsychiatric Interview (MINI) at both waves. RESULTS The risk factors for the incidence of suicide risk at follow-up were: female sex, lower socioeconomic status, older age, not studying, presence of common mental disorder symptoms, and poor quality of life. The interaction between overall health and socioeconomic status in relation to suicide risk was also captured and shows a shift from protection to risk by socioeconomic status as overall health increases. LIMITATIONS Proximal factors associated with the incidence of suicide risk were not assessed. CONCLUSIONS Our findings indicate that factors related to poor quality of life, not studying, and common mental disorder symptoms of young adults are already in place prior to suicide risk. Most factors present critical non-linear patterns that were identified. These findings are clinically relevant because they can help clinicians to early detect suicide risk.
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Affiliation(s)
- Pedro L Ballester
- Neuroscience Graduate Program, McMaster University, Hamilton, ON, Canada
| | - Taiane de A Cardoso
- Department of Health and Behavior, Catholic University of Pelotas, Pelotas, RS, Brazil; Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Porto Alegre, RS, Brazil; Mood Disorders Program, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Fernanda Pedrotti Moreira
- Department of Health and Behavior, Catholic University of Pelotas, Pelotas, RS, Brazil; Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Porto Alegre, RS, Brazil
| | - Ricardo A da Silva
- Department of Health and Behavior, Catholic University of Pelotas, Pelotas, RS, Brazil; Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Porto Alegre, RS, Brazil
| | - Thaíse Campos Mondin
- Department of Student Affairs, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Ricardo M Araujo
- Center for Technological Development, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Flavio Kapczinski
- Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Porto Alegre, RS, Brazil; Mood Disorders Program, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada; Bipolar Disorder Program, Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre, Instituto Nacional de Ciência e Tecnologia Translacional em Medicina, Porto Alegre, RS, Brazil; Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Benicio N Frey
- Mood Disorders Program, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada; Women's Health Concerns Clinic, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | - Karen Jansen
- Department of Health and Behavior, Catholic University of Pelotas, Pelotas, RS, Brazil; Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Porto Alegre, RS, Brazil
| | - Luciano D de Mattos Souza
- Department of Health and Behavior, Catholic University of Pelotas, Pelotas, RS, Brazil; Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Porto Alegre, RS, Brazil.
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40
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Lalli M, Brouillette K, Kapczinski F, de Azevedo Cardoso T. Substance use as a risk factor for bipolar disorder: A systematic review. J Psychiatr Res 2021; 144:285-295. [PMID: 34710665 DOI: 10.1016/j.jpsychires.2021.10.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 09/08/2021] [Accepted: 10/18/2021] [Indexed: 11/26/2022]
Abstract
Detecting substance use as a predictor of bipolar disorder (BD) is important for clinicians to perform accurate and early diagnosis, as well as better manage the treatment of individuals with BD. The aim of this systematic review was to describe whether substance use is a predictor of BD. A literature search was conducted using the following databases: PubMed, PsycINFO, and Embase. All eligible studies published up to February 9, 2021 were included. This systematic review included 22 studies. We found that 66.7% of the studies assessing overall substance use found that overall substance use was a risk factor for BD. Regarding the specific substances assessed, cannabis use was described as a risk factor for BD in 55.6% of the studies, nonmedical use of prescription medications was a risk factor for BD in 50% of the studies, nicotine was found as a risk factor for BD in 50% of the studies, and alcohol use was described as a risk factor for BD in 42.9% of the studies assessing it. Only one study assessed whether cocaine use was a risk factor for BD and found a significant association. Interestingly, some studies suggested that the greater frequency of cannabis use was associated with greater risk to develop BD or hypomanic/manic symptoms. In conclusion, there is evidence supporting that substance use is a risk factor for BD. Importantly, when assessing the risk factors for BD related to psychoactive substance use, special attention should be given for the frequency of cannabis use.
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Affiliation(s)
- Mikayla Lalli
- School of Interdisciplinary Science, Life Sciences Program, McMaster University, Hamilton, ON, Canada
| | - Khadija Brouillette
- School of Interdisciplinary Science, Life Sciences Program, McMaster University, Hamilton, ON, Canada
| | - Flavio Kapczinski
- Mood Disorders Program, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada; Neuroscience Graduate Program, McMaster University, Hamilton, ON, Canada; Graduate Program in Psychiatry, Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Porto Alegre, Brazil
| | - Taiane de Azevedo Cardoso
- School of Interdisciplinary Science, Life Sciences Program, McMaster University, Hamilton, ON, Canada; Mood Disorders Program, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada.
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41
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Yatham LN, Chakrabarty T, Bond DJ, Schaffer A, Beaulieu S, Parikh SV, McIntyre RS, Milev RV, Alda M, Vazquez G, Ravindran AV, Frey BN, Sharma V, Goldstein BI, Rej S, O'Donovan C, Tourjman V, Kozicky JM, Kauer-Sant'Anna M, Malhi G, Suppes T, Vieta E, Kapczinski F, Kanba S, Lam RW, Kennedy SH, Calabrese J, Berk M, Post R. Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) recommendations for the management of patients with bipolar disorder with mixed presentations. Bipolar Disord 2021; 23:767-788. [PMID: 34599629 DOI: 10.1111/bdi.13135] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVES The 2018 Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) guidelines provided clinicians with pragmatic treatment recommendations for bipolar disorder (BD). While these guidelines included commentary on how mixed features may direct treatment selection, specific recommendations were not provided-a critical gap which the current update aims to address. METHOD Overview of research regarding mixed presentations in BD, with treatment recommendations developed using a modified CANMAT/ISBD rating methodology. Limitations are discussed, including the dearth of high-quality data and reliance on expert opinion. RESULTS No agents met threshold for first-line treatment of DSM-5 manic or depressive episodes with mixed features. For mania + mixed features second-line treatment options include asenapine, cariprazine, divalproex, and aripiprazole. In depression + mixed features, cariprazine and lurasidone are recommended as second-line options. For DSM-IV defined mixed episodes, with a longer history of research, asenapine and aripiprazole are first-line, and olanzapine (monotherapy or combination), carbamazepine, and divalproex are second-line. Research on maintenance treatments following a DSM-5 mixed presentation is extremely limited, with third-line recommendations based on expert opinion. For maintenance treatment following a DSM-IV mixed episode, quetiapine (monotherapy or combination) is first-line, and lithium and olanzapine identified as second-line options. CONCLUSION The CANMAT and ISBD groups hope these guidelines provide valuable support for clinicians providing care to patients experiencing mixed presentations, as well as further influence investment in research to improve diagnosis and treatment of this common and complex clinical state.
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Affiliation(s)
- Lakshmi N Yatham
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Trisha Chakrabarty
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
| | - David J Bond
- Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Ayal Schaffer
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Serge Beaulieu
- Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Sagar V Parikh
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA
| | - Roger S McIntyre
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Roumen V Milev
- Department of Psychiatry, Queens University, Kingston, Ontario, Canada
| | - Martin Alda
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Gustavo Vazquez
- Department of Psychiatry, Queens University, Kingston, Ontario, Canada
| | - Arun V Ravindran
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Benicio N Frey
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, and St. Joseph's Healthcare, Hamilton, Ontario, Canada
| | - Verinder Sharma
- Departments of Psychiatry and Obstetrics & Gynaecology, Western University, London, Ontario, Canada
| | | | - Soham Rej
- Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Claire O'Donovan
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Valerie Tourjman
- Department of Psychiatry and addiction, University of Montreal, Montreal, QC, Canada
| | | | - Marcia Kauer-Sant'Anna
- Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Gin Malhi
- Department of Psychiatry, University of Sydney, Sydney, Australia
| | - Trisha Suppes
- Department of Psychiatry and Behavioural Sciences, Stanford School of Medicine and VA Palo Alto Health Care System, Palo Alto, California, USA
| | - Eduard Vieta
- Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Flavio Kapczinski
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, and St. Joseph's Healthcare, Hamilton, Ontario, Canada
| | - Shigenobu Kanba
- Department of Neuropsychiatry, Kyushu University, Fukuoka, Japan
| | - Raymond W Lam
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Sidney H Kennedy
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Joseph Calabrese
- Department of Psychiatry, Western Reserve University, Cleveland, Ohio, USA
| | - Michael Berk
- IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Deakin University, Geelong, Australia
| | - Robert Post
- Department of Psychiatry, George Washington University, Washington, District of Columbia, USA
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Farias CDA, de Azevedo Cardoso T, Campos Mondin T, Dias de Mattos Souza L, Silva RAD, Kapczinski F, Jansen K, Magalhães PVS. Early illness progression in mood disorders: A population-based longitudinal study. Psychiatry Res 2021; 306:114225. [PMID: 34627111 DOI: 10.1016/j.psychres.2021.114225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 09/24/2021] [Accepted: 09/25/2021] [Indexed: 10/20/2022]
Abstract
This study is aimed at assessing changes in functioning among young people from the general population with bipolar disorder and major depressive disorder over a period of five years. Specifically, we hypothesized that significant illness progression would take place during euthymia over time in bipolar disorder. We conducted a longitudinal study with 231 people, assessed at baseline and again at a five-year follow-up. A structured clinical interview was used to diagnose participants with mood disorders. A control group without mood disorders was also included. Functioning was assessed with the Functioning Assessment Short Test, and linear mixed models were used to analyze the effect of psychopathology on change in functioning. Mood disorders were associated with significant functional impairment, but functioning significantly improved in both groups over the 5-year follow-up period. Depressive episodes, however, were associated with worse functioning at follow-up, independently of depression severity. In contrast to our initial hypothesis, we found a worsening of functioning in a five-year period associated only with depressive episodes. This suggests that interventions focused on the prevention of mood episodes early in the course of illness may be particularly promising to reduce adverse functioning outcomes.
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Affiliation(s)
- Clarisse de Azambuja Farias
- Universidade Federal do Rio Grande do Sul, Hospital de Clínicas de Porto Alegre, Graduate Program in Psychiatry and Behavioral Sciences, Porto Alegre, RS, Brazil.
| | - Taiane de Azevedo Cardoso
- Universidade Católica de Pelotas, Graduate Program in Health and Behavior, Pelotas, RS, Brazil; McMaster University, Department of Psychiatry and Behavioral Neurosciences, Hamilton, Ontario, Canada
| | - Thaise Campos Mondin
- Universidade Católica de Pelotas, Graduate Program in Health and Behavior, Pelotas, RS, Brazil
| | | | | | - Flavio Kapczinski
- Universidade Federal do Rio Grande do Sul, Hospital de Clínicas de Porto Alegre, Graduate Program in Psychiatry and Behavioral Sciences, Porto Alegre, RS, Brazil; McMaster University, Department of Psychiatry and Behavioral Neurosciences, Hamilton, Ontario, Canada
| | - Karen Jansen
- Universidade Católica de Pelotas, Graduate Program in Health and Behavior, Pelotas, RS, Brazil
| | - Pedro V S Magalhães
- Universidade Federal do Rio Grande do Sul, Hospital de Clínicas de Porto Alegre, Graduate Program in Psychiatry and Behavioral Sciences, Porto Alegre, RS, Brazil.
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Cervera-Martínez J, Atienza-Carbonell B, Mota JC, Bobes-Bascarán T, Crespo-Facorro B, Esteban C, García-Portilla MP, Gomes-da-Costa S, González-Pinto A, Jaén-Moreno MJ, Sarramea F, Vieta E, Zorrilla I, Tabarés-Seisdedos R, Kapczinski F, De Boni RB, Balanzá-Martínez V. Lifestyle changes and mental health during the COVID-19 pandemic: A repeated, cross-sectional web survey. J Affect Disord 2021; 295:173-182. [PMID: 34469856 PMCID: PMC8418875 DOI: 10.1016/j.jad.2021.08.020] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Revised: 08/06/2021] [Accepted: 08/18/2021] [Indexed: 12/01/2022]
Abstract
BACKGROUND This study aimed to compare self-reported changes on lifestyle behaviors during two phases of the COVID-19 pandemic in Spain, and to evaluate clinical and sociodemographic factors associated with lifestyles. METHODS Two cross-sectional web surveys were conducted during lockdown (April 15-May 15, 2020) and seven months later (November 16-December 16, 2020). Lifestyle behaviors were self-reported by a multidimensional scale (SMILE-C). Two separate samples of respondents were analyzed. A multivariate regression model was performed to evaluate the association of SMILE-C scores with demographic and clinical variables. RESULTS The sample comprised, 3412 participants from the first survey (S1) and in the S1 and 3635 from the second (S2). SMILE-C score decreased across surveys (p < 0.001). The rates of positive screenings for depression and anxiety were similar between the surveys, whereas those for alcohol abuse decreased (p < 0.001). Most participants in S2 reported that their lifestyle had not changed compared to those before the pandemic. Variables independently associated with an unhealthier lifestyle were working as an essential worker, lower educational level, previous mental disease, worse self-rated health, totally/moderate changes on diet, sleep or social support, as well as positive screenings for alcohol abuse, anxiety and depression. LIMITATIONS The cross-sectional design and recruitment by non-probabilistic methods limit inferring causality and the external validity of the results. CONCLUSIONS Overall lifestyle worsened seven months after the lockdown in Spain. Several demographic and clinical factors were associated with lifestyle scores. The contribution of common mental disorders to unhealthier lifestyles should be considered in order to prevent the negative impact of the pandemic.
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Affiliation(s)
- Jose Cervera-Martínez
- Hospital de Denia-Marina Salud, Alicante, Spain,Department of Medicine, University of Valencia, Valencia, Spain
| | | | - Jurema C. Mota
- Institute of Scientific and Technological Communication and Information in Health (ICICT), Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil
| | - Teresa Bobes-Bascarán
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain,Servicio de Salud del Principado de Asturias (SESPA), Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain,Department of Psychology, University of Oviedo, Oviedo, Spain
| | - Benedicto Crespo-Facorro
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain,Hospital Universitario Virgen del Rocío, IBIS, Seville, Spain,University of Sevilla, Seville, Spain
| | | | - María Paz García-Portilla
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain,Servicio de Salud del Principado de Asturias (SESPA), Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain,Department of Psychiatry, School of Medicine, University of Oviedo, Oviedo, Spain
| | - Susana Gomes-da-Costa
- Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, Barcelona, Catalonia, Spain
| | - Ana González-Pinto
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain,Hospital Universitario de Alava. BIOARABA, UPV-EHU, Vitoria, Spain
| | - M. José Jaén-Moreno
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain,Departamento de Ciencias Morfológicas y Sociosanitarias, Universidad de Córdoba, Córdoba, Spain
| | - Fernando Sarramea
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain,Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain,Hospital Universitario Reina Sofía, Universidad de Córdoba, Córdoba, Spain
| | - Eduard Vieta
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain,Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, Barcelona, Catalonia, Spain
| | - Iñaki Zorrilla
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain,Hospital Universitario de Alava. BIOARABA, UPV-EHU, Vitoria, Spain
| | - Rafael Tabarés-Seisdedos
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain,Department of Medicine, Teaching Unit of Psychiatry and Psychological Medicine, University of Valencia, Blasco Ibáñez, 15, Valencia 46010, Spain
| | - Flavio Kapczinski
- Departament of Psychiatry and Behavioral Neurosciences, McMaster University, Mood Disorders Program, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada,Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Porto Alegre, RS, Brazil
| | - Raquel B. De Boni
- Institute of Scientific and Technological Communication and Information in Health (ICICT), Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil
| | - Vicent Balanzá-Martínez
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Department of Medicine, Teaching Unit of Psychiatry and Psychological Medicine, University of Valencia, Blasco Ibáñez, 15, Valencia 46010, Spain.
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Chawar C, Hillmer A, Sanger S, D’Elia A, Panesar B, Guan L, Xie DX, Bansal N, Abdullah A, Kapczinski F, Pare G, Thabane L, Samaan Z. A systematic review of GWAS identified SNPs associated with outcomes of medications for opioid use disorder. Addict Sci Clin Pract 2021; 16:70. [PMID: 34838141 PMCID: PMC8627063 DOI: 10.1186/s13722-021-00278-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Accepted: 11/10/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Patients with opioid use disorder (OUD) display an interindividual variability in their response to medications for opioid use disorder (MOUD). A genetic basis may explain the variability in this response. However, no consensus has been reached regarding which genetic variants significantly contribute to MOUD outcomes. OBJECTIVES This systematic review aims to summarize genome-wide significant findings on MOUD outcomes and critically appraise the quality of the studies involved. METHODS Databases searched from inception until August 21st, 2020 include: MEDLINE, Web of Science, EMBASE, CINAHL and Pre-CINAHL, GWAS Catalog and GWAS Central. The included studies had to be GWASs that assessed MOUD in an OUD population. All studies were screened in duplicate. The quality of the included studies was scored and assessed using the Q-Genie tool. Quantitative analysis, as planned in the protocol, was not feasible, so the studies were analyzed qualitatively. RESULTS Our search identified 7292 studies. Five studies meeting the eligibility criteria were included. However, only three studies reported results that met our significance threshold of p ≤ 1.0 × 10-7. In total, 43 genetic variants were identified. Variants corresponding to CNIH3 were reported to be associated with daily heroin injection in Europeans, OPRM1, TRIB2, and ZNF146 with methadone dose in African Americans, EYS with methadone dose in Europeans, and SPON1 and intergenic regions in chromosomes 9 and 3 with plasma concentrations of S-methadone, R-methadone, and R-EDDP, respectively, in Han Chinese. LIMITATIONS The limitations of this study include not being able to synthesize the data in a quantitative way and a conservative eligibility and data collection model. CONCLUSION The results from this systematic review will aid in highlighting significant genetic variants that can be replicated in future OUD pharmacogenetics research to ascertain their role in patient-specific MOUD outcomes. Systematic review registration number CRD42020169121.
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Affiliation(s)
- Caroul Chawar
- Neuroscience Graduate Program, McMaster University, Hamilton, ON Canada
- Department of Psychiatry and Behavioural Neurosciences, St. Joseph’s Healthcare Hamilton, 100 West 5th St., Hamilton, ON L8N3K7 Canada
| | - Alannah Hillmer
- Neuroscience Graduate Program, McMaster University, Hamilton, ON Canada
- Department of Psychiatry and Behavioural Neurosciences, St. Joseph’s Healthcare Hamilton, 100 West 5th St., Hamilton, ON L8N3K7 Canada
| | - Stephanie Sanger
- Health Sciences Library, McMaster University, Hamilton, ON Canada
| | - Alessia D’Elia
- Neuroscience Graduate Program, McMaster University, Hamilton, ON Canada
- Department of Psychiatry and Behavioural Neurosciences, St. Joseph’s Healthcare Hamilton, 100 West 5th St., Hamilton, ON L8N3K7 Canada
| | - Balpreet Panesar
- Neuroscience Graduate Program, McMaster University, Hamilton, ON Canada
- Department of Psychiatry and Behavioural Neurosciences, St. Joseph’s Healthcare Hamilton, 100 West 5th St., Hamilton, ON L8N3K7 Canada
| | - Lucy Guan
- Department of Psychiatry and Behavioural Neurosciences, St. Joseph’s Healthcare Hamilton, 100 West 5th St., Hamilton, ON L8N3K7 Canada
- Health Sciences Program, McMaster University, Hamilton, ON Canada
| | - Dave Xiaofei Xie
- Department of Psychiatry and Behavioural Neurosciences, St. Joseph’s Healthcare Hamilton, 100 West 5th St., Hamilton, ON L8N3K7 Canada
- Health Sciences Program, McMaster University, Hamilton, ON Canada
| | - Nandini Bansal
- Department of Psychiatry and Behavioural Neurosciences, St. Joseph’s Healthcare Hamilton, 100 West 5th St., Hamilton, ON L8N3K7 Canada
- Health Sciences Program, McMaster University, Hamilton, ON Canada
| | - Aamna Abdullah
- Department of Psychiatry and Behavioural Neurosciences, St. Joseph’s Healthcare Hamilton, 100 West 5th St., Hamilton, ON L8N3K7 Canada
- Health Sciences Program, McMaster University, Hamilton, ON Canada
| | - Flavio Kapczinski
- Department of Psychiatry and Behavioural Neurosciences, St. Joseph’s Healthcare Hamilton, 100 West 5th St., Hamilton, ON L8N3K7 Canada
| | - Guillaume Pare
- Population Health Research Institute, Hamilton, ON Canada
- Department of Health Research Method, Evidence, and Impact, McMaster University, Hamilton, ON Canada
| | - Lehana Thabane
- Population Health Research Institute, Hamilton, ON Canada
- Department of Health Research Method, Evidence, and Impact, McMaster University, Hamilton, ON Canada
- Father Sean O’Sullivan Research Centre, St. Joseph’s Healthcare Hamilton, Hamilton, ON Canada
| | - Zainab Samaan
- Department of Psychiatry and Behavioural Neurosciences, St. Joseph’s Healthcare Hamilton, 100 West 5th St., Hamilton, ON L8N3K7 Canada
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Roman Meller M, Patel S, Duarte D, Kapczinski F, de Azevedo Cardoso T. Bipolar disorder and frontotemporal dementia: A systematic review. Acta Psychiatr Scand 2021; 144:433-447. [PMID: 34390495 DOI: 10.1111/acps.13362] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 08/09/2021] [Accepted: 08/10/2021] [Indexed: 12/13/2022]
Abstract
OBJECTIVES To detail the biological, clinical and neurocognitive characteristics differentiating bipolar disorder (BD) from frontotemporal dementia (FTD) and to investigate whether BD is a risk factor for FTD. METHODS A total of 16 studies were included in this systematic review. Five studies described biological and/or neurocognitive characteristics between patients with BD and FTD, and 11 studies investigated whether BD was a risk factor for FTD. RESULTS Individuals with FTD presented higher levels of serum neurofilament light chain, greater grey matter reduction in frontal, parietal and temporal lobes, and increased slow wave oscillations in channels F3, F4, T3, T5, T4 and T6 within an electroencephalogram (EEG), relative to individuals with BD. Patients with FTD presented greater deficits in executive function and theory of mind compared to patients with BD in a euthymic state, and more deficits in verbal fluency compared to patients with BD in a current mood episode. Patients with BD in a current mood episode showed greater impairment in attention, working memory, verbal memory and executive function relative to individuals with FTD. In addition, retrospective studies showed that 10.2%-11.6% of patients with behavioural variant FTD (bvFTD) had a preceding history of BD. CONCLUSION Biological and neurocognitive characteristics help to distinguish between BD and FTD, and it may help to reach a more precise diagnosis. In addition, individuals with BD are at higher risk of developing FTD. More studies are needed to identify the predictors of the conversion between BD to FTD.
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Affiliation(s)
- Marina Roman Meller
- Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil
| | - Swara Patel
- School of Interdisciplinary Science, Life Sciences Program, McMaster University, Hamilton, Ontario, Canada
| | - Dante Duarte
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Flavio Kapczinski
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada.,Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Porto Alegre, Brazil.,Bipolar Disorder Program, Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.,Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Taiane de Azevedo Cardoso
- School of Interdisciplinary Science, Life Sciences Program, McMaster University, Hamilton, Ontario, Canada.,Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
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Watts D, D’Souza J, Azevedo MA, Chaimowitz G, Kapczinski F. Stigmatized individuals: a case for precision ethics. Trends Psychiatry Psychother 2021; 45:e20210354. [PMID: 34551242 PMCID: PMC10164405 DOI: 10.47626/2237-6089-2021-0354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 07/18/2021] [Indexed: 11/20/2022]
Affiliation(s)
- Devon Watts
- St. Joseph’s Healthcare HamiltonHamiltonONCanada St. Joseph’s Healthcare Hamilton, Hamilton, ON, Canada.
- Neuroscience Graduate ProgramMcMaster UniversityHamiltonONCanada Neuroscience Graduate Program, McMaster University, Hamilton, ON, Canada.
| | - Jeff D’Souza
- Institute on Ethics & Policy for InnovationMcMaster UniversityHamiltonONCanada Institute on Ethics & Policy for Innovation, McMaster University, Hamilton, ON, Canada.
| | - Marco Antonio Azevedo
- Escola de HumanidadesUniversidade do Vale do Rio dos SinosSão LeopoldoRSBrazil Escola de Humanidades, Universidade do Vale do Rio dos Sinos, São Leopoldo, RS, Brazil.
| | - Gary Chaimowitz
- St. Joseph’s Healthcare HamiltonHamiltonONCanada St. Joseph’s Healthcare Hamilton, Hamilton, ON, Canada.
- Department of Psychiatry and Behavioural NeurosciencesMcMaster UniversityHamiltonONCanada Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada.
| | - Flavio Kapczinski
- St. Joseph’s Healthcare HamiltonHamiltonONCanada St. Joseph’s Healthcare Hamilton, Hamilton, ON, Canada.
- Neuroscience Graduate ProgramMcMaster UniversityHamiltonONCanada Neuroscience Graduate Program, McMaster University, Hamilton, ON, Canada.
- Instituto Nacional de Ciência e Tecnologia Translacional em MedicinaPorto AlegreBrazil Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Porto Alegre, Brazil.
- Department of Psychiatry and Behavioural NeurosciencesMcMaster UniversityHamiltonONCanada Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada.
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De Boni RB, Ribeiro-Alves M, Mota JC, Gomes M, Balanzá-Martínez V, Kapczinski F, Bastos FI. The cumulative effect of multiple dimensions of lifestyle on risky drinking during the Covid-19 pandemic. Prev Med 2021; 150:106718. [PMID: 34242667 PMCID: PMC8662552 DOI: 10.1016/j.ypmed.2021.106718] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 05/11/2021] [Accepted: 07/03/2021] [Indexed: 02/07/2023]
Abstract
Lifestyle impacts morbidity and mortality worldwide. Herein, we evaluated the association of a multidimensional lifestyle measure and its domains (diet/nutrition, substance use, physical activity, social, stress management, sleep, environmental exposure) with risky drinking. Also, we analyzed the cumulative effect of unhealthy domains in the likelihood of presenting risky drinking. To reach these objectives, data from a web survey conducted in Brazil and Spain was analyzed. The main outcome was risky drinking assessed by the AUDIT-C. Lifestyle was measured using the Short Multidimensional Inventory Lifestyle Evaluation (SMILE). Fixed logistic models were used to evaluate associations between lifestyle and risky drinking. Between April and May 2020, 22,785 individuals answered the survey. The prevalence of risky drinking was 45.6% in Brazil and 30.8% in Spain. The SMILE score was lower (unhealthier lifestyle) among at-risk drinkers. Worse scores on Diet, Substance use, Stress management and Environment were associated with an increased likelihood of risky drinking. The higher the number of unhealthy domains, the higher the likelihood of presenting risky drinking: adjusted odds ratio (aOR) for risky drinking was 1.15 (IC95% 0.98-1.35) and 23.42 (IC95% 3.08-178.02) for those presenting worse lifestyle in 1 and 5 domains, respectively. Finally, interactions suggest that improvement in lifestyle domains would have a larger effect in Spain than in Brazil. Our results suggest that future interventions aiming at reducing Risky drinking may benefit from strategies targeting multiple domains of lifestyle.
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Affiliation(s)
- Raquel B De Boni
- Institute of Scientific and Technological Communication and Information in Health (ICICT), Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil.
| | - Marcelo Ribeiro-Alves
- Instituto Nacional de Infectologia Evandro Chagas (INI), Fundação Oswaldo Cruz (Fiocruz), Rio de Janeiro, Brazil
| | - Jurema C Mota
- Institute of Scientific and Technological Communication and Information in Health (ICICT), Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil
| | - Mariana Gomes
- Universidade Federal do Estado do Rio de Janeiro, Escola de Medicina e Cirurgia (EMC - Unirio), Rio de Janeiro, Brazil
| | - Vicent Balanzá-Martínez
- Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, CIBERSAM, Valencia, Spain
| | - Flavio Kapczinski
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, 100 West 5th Street, Hamilton, ON L8N 3K7, Canada; Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Bipolar Disorder Program, Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA), Brazil; Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Francisco I Bastos
- Institute of Scientific and Technological Communication and Information in Health (ICICT), Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil
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Hillmer A, Chawar C, Sanger S, D’Elia A, Butt M, Kapoor R, Kapczinski F, Thabane L, Samaan Z. Genetic basis of cannabis use: a systematic review. BMC Med Genomics 2021; 14:203. [PMID: 34384432 PMCID: PMC8359088 DOI: 10.1186/s12920-021-01035-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 07/15/2021] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND With the increase in cannabis use rates, cannabis use disorder is being reported as one of the most common drug use disorders globally. Cannabis use has several known physical, psychological, and social adverse events, such as altered judgement, poor educational outcomes, and respiratory symptoms. The propensity for taking cannabis and the development of a cannabis use disorder may be genetically influenced for some individuals. Heritability estimates suggest a genetic basis for cannabis use, and several genome-wide association studies (GWASs) have identified possible regions of association, albeit with inconsistent findings. This systematic review aims to summarize the findings from GWASs investigating cannabis use and cannabis use disorder. METHODS This systematic review incorporates articles that have performed a GWAS investigating cannabis use or cannabis use disorder. MEDLINE, Web of Science, EMBASE, CINAHL, GWAS Catalog, GWAS Central, and NIH Database of Genotype and Phenotype were searched using a comprehensive search strategy. All studies were screened in duplicate, and the quality of evidence was assessed using the quality of genetic association studies (Q-Genie) tool. All studies underwent qualitative synthesis; however, quantitative analysis was not feasible. RESULTS Our search identified 5984 articles. Six studies met our eligibility criteria and were included in this review. All six studies reported results that met our significance threshold of p ≤ 1.0 × 10-7. In total 96 genetic variants were identified. While meta-analysis was not possible, this review identified the following genes, ANKFN1, INTS7, PI4K2B, CSMD1, CST7, ACSS1, and SCN9A, to be associated with cannabis use. These regions were previously reported in different mental health conditions, however not in relation to cannabis use. CONCLUSION This systematic review summarized GWAS findings within the field of cannabis research. While a meta-analysis was not possible, the summary of findings serves to inform future candidate gene studies and replication efforts. Systematic Review Registration PROSPERO CRD42020176016.
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Affiliation(s)
- Alannah Hillmer
- Neuroscience Graduate Program, Department of Psychiatry and Behavioural Neurosciences, McMaster University, 100 West 5th St., Hamilton, ON L8N 3K7 Canada
| | - Caroul Chawar
- Neuroscience Graduate Program, Department of Psychiatry and Behavioural Neurosciences, McMaster University, 100 West 5th St., Hamilton, ON L8N 3K7 Canada
| | - Stephanie Sanger
- Health Science Library, McMaster University, 1280 Main St. W., Hamilton, ON L8S 4L8 Canada
| | - Alessia D’Elia
- Neuroscience Graduate Program, Department of Psychiatry and Behavioural Neurosciences, McMaster University, 100 West 5th St., Hamilton, ON L8N 3K7 Canada
| | - Mehreen Butt
- Integrated Science Program, McMaster University, 1280 Main St. W., Hamilton, ON L8S 4L8 Canada
| | - Raveena Kapoor
- Michael G. DeGroote School of Medicine, McMaster University, 1280 Main St. W., Hamilton, ON L8S 4L8 Canada
| | - Flavio Kapczinski
- Neuroscience Graduate Program, Department of Psychiatry and Behavioural Neurosciences, McMaster University, 100 West 5th St., Hamilton, ON L8N 3K7 Canada
| | - Lehana Thabane
- Department of Health Research Method, Evidence and Impact, 1280 Main St. W., Hamilton, ON L8S 4L8 Canada
| | - Zainab Samaan
- Neuroscience Graduate Program, Department of Psychiatry and Behavioural Neurosciences, McMaster University, 100 West 5th St., Hamilton, ON L8N 3K7 Canada
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Kapczinski F, Nardi AE, Quevedo J. Unveiling the neurobiology of learning and memory: the lifetime accomplishments of Ivan Izquierdo (1937-2021). ACTA ACUST UNITED AC 2021. [PMID: 33852691 PMCID: PMC8352728 DOI: 10.1590/1516-4446-2021-1805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Flavio Kapczinski
- Departamento de Psiquiatria, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.,Mood Disorders Program, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Antonio E Nardi
- Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro (URFJ), Rio de Janeiro, RJ, Brazil
| | - João Quevedo
- Translational Psychiatry Program, Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA.,Center of Excellence on Mood Disorders, Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, UTHealth, Houston, TX, USA.,Neuroscience Graduate Program, The University of Texas MD Anderson Cancer Center, Graduate School of Biomedical Sciences, UTHealth, Houston, TX, USA.,Laboratório de Psiquiatria Translacional, Programa de Pós-Graduação em Ciências da Saúde, Universidade do Extremo Sul Catarinense (UNESC), Criciúma, SC, Brazil
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Kapczinski F, Pfaffenseller B, Dursun SM, de Azevedo Cardoso T. Clozapine for bipolar disorder: What do we know so far and what next? Bipolar Disord 2021; 23:115-116. [PMID: 33719158 DOI: 10.1111/bdi.13050] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 12/15/2020] [Accepted: 01/21/2021] [Indexed: 12/27/2022]
Affiliation(s)
- Flavio Kapczinski
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada.,Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Porto Alegre, Brazil.,Graduate Program in Psychiatry, Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Bianca Pfaffenseller
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Serdar M Dursun
- Department of Psychiatry, University of Alberta, Edmonton, AB, Canada
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