Abstract
Bipolar disorder (BD) is a chronic mental disorder that affects more than 1% of the population worldwide. Over 65% of patients experience early onset of the disease. Most cases of juvenile bipolar disorder begin with a depressed mood episode, and up to 50% of youth initially diagnosed with major depression go onto developing a BD. Our study aimed to find biomarkers of diagnosis conversion in young patients with mood disorders. We performed a two-year follow-up study on 79 adolescent patients diagnosed with MDD or BD, with a detailed clinical assessment at five visits. We monitored diagnosis change from MDD to BD. The control group consisted of 31 healthy youths. According to the neurodevelopmental and neuroimmunological hypotheses of mood disorders, we analyzed serum levels of brain-derived neurotrophic factor (BDNF), proBDNF, epidermal growth factor (EGF), migration inhibitory factor (MIF), stem cell factor (SCF), and correlations with clinical factors. We detected a significant disease-dependent increase in EGF level in MDD and BP patients at baseline exacerbation of depressive or hypomanic/manic episodes as well as in euthymic state compared to healthy controls. No potential biological predictors of disease conversion were found. Replication studies on a larger cohort of patients are needed.
Highlights
The lifetime prevalence of mood disorders is about 22% [1]
Seventy-nine patients were included in the study: 52 with depression, 27 with bipolar disorder in hypomanic/manic (n = 17), or mixed (n = 10) episode diagnosed according to DSM-IV criteria
Comparing baseline and euthymic state protein concentrations we found a trend Comparing baseline and euthymic state protein concentrations we found a trend totowards an increase in brain-derived neurotrophic factor (BDNF) level in the major depressive disorder (MDD) group during treatment (p = 0.06) and wards an increase in BDNF level in the MDD group during treatment (p = 0.06) and a a significant decrease in epidermal growth factor (EGF) level in the bipolar disorder (BD) group (p = 0.02, power 83%)
Summary
The lifetime prevalence of mood disorders is about 22% [1]. Providing adequate differential diagnosis between major depressive disorder (MDD) and bipolar disorder (BD)remains a clinical challenge. The lifetime prevalence of mood disorders is about 22% [1]. Providing adequate differential diagnosis between major depressive disorder (MDD) and bipolar disorder (BD). Misdiagnosis of BD may imply various adverse outcomes, such as inadequate medication, a greater number of relapses and hospitalizations, more lengthy episodes, and a higher level of social impairment [2]. BD is a chronic mental disorder that affects more than 1% of the population worldwide, with onset usually during adolescence. Its course is associated with high morbidity and mortality rates, making bipolar disorder one of the leading causes of disability. Valid biomarkers or diagnostic tools to help clinicians identify individuals at high risk of conversion to bipolar disorder are still lacking [3]
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