Bipolar Depressed Patients Research Articles

Efficacy and Safety of Transcranial Direct Current Stimulation as an Add-On Trial Treatment for Acute Bipolar Depression Patients With Suicidal Ideation.

Bipolar depression poses an overwhelming suicide risk. We aimed to examine the efficacy and safety of transcranial direct current stimulation (tDCS) combined with quetiapine in bipolar patients as a suicidal intervention. In a single-center, double-blind, treatment-naive bipolar depression patients with suicidal ideation were randomly assigned to quetiapine in combination with either active (n = 16) or sham (n = 15) tDCS over the left dorsolateral prefrontal cortex for three consecutive weeks. The 30-min, 2-mA tDCS was conducted twice a day on the weekday of the first week and then once a day on the weekdays of the two following weeks. Primary efficacy outcome measure was the change in the Beck Scale for Suicidal Ideation (BSSI). Secondary outcomes included changes on the 17-item Hamilton Depression Rating Scale (HDRS-17) and Montgomery-Asberg Depression Rating Scale (MADRS). Outcome was evaluated on Day 3 and weekend. Safety outcome was based on the reported adverse reactions. Active tDCS was superior to sham tDCS on the BSSI at Day 3 and tended to sustain every weekend during the treatment process, compared to baseline. However, no difference between active and sham in HDRS-17 and MADRS was found. Response and remission rate also supported the antisuicide effect of tDCS, with higher response and remission rate in BSSI, but no antidepressant effect, compared to sham, over time. Regarding safety, active tDCS was well tolerated and all the adverse reactions reported were mild and limited to transient scalp discomfort. The tDCS was effective as an antisuicide treatment for acute bipolar depression patients with suicidal ideation, with minimal side effects reported.

Seasonality in mood disorders: Probing association of accelerometer-derived physical activity with daylength and solar insolation

Mood disorders are the leading cause of disability worldwide. Up to 30 percent of individuals with major depressive disorder (MDD) and bipolar disorder (BD) display a seasonal pattern of onset, a phenomenon now recognized in the official diagnostic manuals (DSM-5 and ICD-11). Very little is known about the influence of day length (photoperiod) and sunlight intensity (solar insolation) on seasonal patterns in MDD and BD. Here we report a quantitative approach to examine the relationship between sunlight measures and objectively measured motor activity patterns to understand environmental factors driving seasonality in MDD and BD. Our generalized linear model (GLM) assessment of the Depresjon dataset, which includes short-term (up to two weeks) motor activity recordings of 23 unipolar and bipolar depressed patients and 32 healthy controls recruited to the study at the University of Bergen Norway (60.4° N latitude, 5.3° E longitude), revealed significant association of accelerometer-derived daytime physical activity with participant’s depressed state (p<0.001), photoperiod (p<0.001), and solar insolation (p<0.001). Our study presents a generalizable strategy to decipher the complex interplay between sunlight, physical activity, and depressed state using open-source digital tools. The ability to identify mood disturbances, particularly in seasonally susceptible individuals, using passive digital biomarker data offers great promise in informing next-generation predictive, personalized diagnostics in mental health.

Disrupted basolateral amygdala circuits supports negative valence bias in depressive states

Negative bias is an essential characteristic of depressive episodes leading patients to attribute more negative valence to environmental cues. This negative bias affects all levels of information processing including emotional response, attention and memory, leading to the development and maintenance of depressive symptoms. In this context, pleasant stimuli become less attractive and unpleasant ones more aversive, yet the related neural circuits underlying this bias remain largely unknown. By studying a mice model for depression chronically receiving corticosterone (CORT), we showed a negative bias in valence attribution to olfactory stimuli that responds to antidepressant drug. This result paralleled the alterations in odor value assignment we observed in bipolar depressed patients. Given the crucial role of amygdala in valence coding and its strong link with depression, we hypothesized that basolateral amygdala (BLA) circuits alterations might support negative shift associated with depressive states. Contrary to humans, where limits in spatial resolution of imaging tools impair easy amygdala segmentation, recently unravelled specific BLA circuits implicated in negative and positive valence attribution could be studied in mice. Combining CTB and rabies-based tracing with ex vivo measurements of neuronal activity, we demonstrated that negative valence bias is supported by disrupted activity of specific BLA circuits during depressive states. Chronic CORT administration induced decreased recruitment of BLA-to-NAc neurons preferentially involved in positive valence encoding, while increasing recruitment of BLA-to-CeA neurons preferentially involved in negative valence encoding. Importantly, this dysfunction was dampened by chemogenetic hyperactivation of BLA-to-NAc neurons. Moreover, altered BLA activity correlated with durable presynaptic connectivity changes coming from the paraventricular nucleus of the thalamus, recently demonstrated as orchestrating valence assignment in the amygdala. Together, our findings suggest that specific BLA circuits alterations might support negative bias in depressive states and provide new avenues for translational research to understand the mechanisms underlying depression and treatment efficacy.

Efficacy of pentoxifylline for the treatment of bipolar I/II patients with treatment-resistant depression: A proof-of-concept, randomized, double-blind, placebo-controlled trial

BackgroundImmune dysregulation can play a role in depression pathophysiology, and immunological antagonists can improve depressive symptoms in treatment-resistant bipolar depression (TRD) patients according to studies. ObjectiveTo evaluate the anti-depressant effects of the anti-inflammatory drug, pentoxifylline (PTX) in TRD bipolar I/II adult subjects. MethodsThis 12-week, randomized, double-blind, placebo-controlled, parallel-group trial of 60 participants was conducted at Hawler Psychiatric Hospital and Private Clinic in Erbil, Iraq. Participants were confirmed as being qualified for bipolar I/II depression based on DSM-5 criteria. Data were analyzed using modified intent-to-treat analysis. ResultsThere were no significant differences between the two groups in Hamilton Rating Scale for Depression-17 (HAM-D-17) scores (χ2=1.9, P =.48) or a significant time × treatment interaction (χ2=7.1, P=.54). Nevertheless, a significant effect of time was observed with both groups’ reduction in HAM-D-17 scores from the start to the endpoint (χ2= 2.11, P=.002). Besides, a significant time × treatment × CRP interaction was found (χ2=3.1, P=0.016), where there was more reduction in HAM-D-17 score in PTX-treated subjects with CRP> 7.1 mg/L. The response rate difference between PTX and the placebo group did not reach a significance level (χ2=0.84, p=0.43). Furthermore, serum concentrations of TNF-α, CRP, and IL-6 significantly reduced at week 12 in the PTX group (P=.007,.04, and <.001, respectively). ConclusionThe current proof of concept study found that in terms of overall anti-depressant effectiveness in bipolar patients with TRD, PTX is not superior to placebo. However, it may improve depressive mood in a subpopulation of subjects with a higher pretreatment inflammatory profile.

Treatment-emergent symptoms during short-term ketamine administration in treatment-resistant bipolar depression: A retrospective cross-sectional descriptive study

Symptoms that emerge during pharmacological treatment of bipolar depression are frequently observed, underscoring the necessity for comprehensive treatment monitoring. This observational study sought to observe the correlation of eight intravenous ketamine infusions with treatment-emergent depressive symptoms in treatment-resistant bipolar depression patients who maintained their baseline psychotropic and chronic somatic treatments. Depressive symptoms were evaluated using the Inventory of Depressive Symptomatology Self-Report 30 (IDS-SR30). Treatment-emergent symptoms TES were defined as symptoms absent at baseline but present at the conclusion of the study. The most common TES included decreased appetite, increased weight, hypersomnia, and diurnal mood variation. Conversely, feelings of sadness, altered perceptions of the future, decreased interest in sex, and physical discomfort were absent in all patients. Notably, 13.6 % of patients reported thoughts of death or suicide. Larger-scale studies, integrating clinician-rated and patient-reported outcome measures, are essential to deepen our understanding of treatment-emergent symptoms. Establishing regulatory or professional definitions for treatment-emergent symptoms is warranted to improve the robustness of future research endeavors.

Study on the Correlation between Hcy and Hs-CRP Levels and Cognitive Function in Patients with Bipolar Disorder and Borderline Personality Disorder.

This study aims to explore the correlation and clinical significance of homocysteine and high-sensitivity C-reactive protein levels with cognitive function in patients with bipolar disorder (BD) and borderline personality disorder (BPD). Patients with BD admitted to our hospital from January 2022 to December 2022 were chosen retrospectively. BPD patients were categorized into comorbidity groups, while those without BPD were assigned to non-comorbidity groups, each consisting of 60 cases. Enzyme-linked immunosorbent assay (ELISA) was utilized to assess serum levels of homocysteine (Hcy) and high-sensitivity C-reactive protein (hs-CRP) in both patient groups. Clinical symptoms were evaluated by the Hamilton Depression Rating Scale (HAMD) and the Young Mania Rating Scale (YMRS). Cognitive function was evaluated and compared using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Pearson correlation analysis was performed on the correlation between patients' serum Hcy and hs-CRP levels and HAMD, YMRS, and RBANS scores. In the comorbidity group, patients exhibited significantly elevated serum Hcy and hs-CRP levels compared to the non-comorbidity group (p < 0.05). Patients in the comorbidity group displayed higher HAMD and YMRS scores than those in the non-comorbidity group (p < 0.05). Additionally, attention, speech, visual span, immediate memory, and delayed memory in the comorbidity group were notably lower than in the non-comorbidity group (p < 0.05). The speech, visual span, and immediate memory of RBANS in bipolar depressive patients with comorbid BPD were lower than those in bipolar depressive patients without comorbid BPD (p < 0.05), the speech of RBANS in bipolar manic patients with comorbid BPD was lower than those in bipolar manic patients without comorbid BPD (p < 0.05). Pearson correlation analysis showed that the expression of Hcy and hs-CRP in the comorbid group was positively correlated with HAMD and YMRS scores, and negatively correlated with attention, speech, visual span, immediate memory, and delayed memory, and these differences were statistically significant (p < 0.05). High serum Hcy and hs-CRP expression levels may regulate inflammatory responses, aggravating cognitive impairment in patients with BD and BPD. Serum Hcy and hs-CRP expression levels are significantly related to cognitive dysfunction. They are expected to guide the prevention and treatment of BD comorbid BPD patients.

Unipolar and Bipolar Depressed Inpatients: correlations with Vitamin D and Cognitive Symptoms

Introduction Cognitive symptoms are the main factor of discomfort in depressed patients, persisting even during clinical remission (Conradi et al. Psychol Med 2011;41:1165-74) and inevitably compromising their quality of life (Fehnel et al. CNS Spectr 2013;25:1-10). Several studies have suggested the neuroprotective role of vitamin D, both through actions on the genome and rapid non-genomic mechanisms; so, low serum vitamin D levels are related to poorer cognitive performance (Goodwill et al. JAGS 2017;2:1-8), depressive disorders (Kjærgaard et al. Psyc Res 2011;190:221-225) and suicide risk (Umhau et al. PLoS One 2013;8:e51543).Objectivesto investigate relationships between serum vitamin D levels, depressive symptoms and cognitive performance in unipolar and bipolar depressed adults hospitalized for Major Depressive Episode (MDE).Methods80 patients (34 M and 46 F; average age 48,96±14,17 years; 40% with bipolar depression) were examined. Depression was investigated using Hamilton Rating Scale for Depression (HAM-D), while cognitive functions were explored by: Rey Auditory Verbal Learning Test (RAVLT) and Rey-Osterrieth Complex Figure (ROCF) to assess verbal and visuospatial memory, respectively; Trail Making Test (TMT) and Stroop Color and Word Test to assess attention, spatial planning and cognitive flexibility. Venous blood sampling was used to determine serum Vitamin D levels (average level 15,67 ± 8,7 ng/ml).Results At first, the serum level of vitamin D was found to be inversely correlated with HAM-D scores (p=0,0079), so that lower concentrations of vitamin D is related to greater severity of depression. In addiction, there were strongly significative positive correlations between low vitamin D levels and poorer RAVLT and ROCF scores and strongly significative negative correlations between vitamin serum level and higher scores in TMT and STROOP test, so that calcidiol deficit is associated with poor cognitive performance. Similarly, patients with higher HAM-D scores were found to have a greater cognitive impairment (lower RAVLT e ROCF scores and higher TMT e STROOP scores).Conclusions In accordance with previous works, our study supports the close relationship between serum vitamin D levels and depressive morbidity. During MDE hypovitaminosis D is related to worse disease indices, such as severity of affective symptoms and cognitive impairment, without substantial differences between clinical manifestations of unipolar and bipolar depression, both in terms of affective and cognitive symptoms and disease severity. Considering that cognitive deficits are truly disabling because they may resist to common antidepressant treatments and, as a result, persist during stages of clinical remission, vitamin d supplementation, by minimizing cognitive dysfunction, could be a good strategy to reduce the risk of relapses and to improve patients’ functioning and quality of life.Disclosure of InterestNone Declared

Unipolar and Bipolar Depression : Which Differences?

IntroductionDepression is a common mental disorder whose management remains delicate, given the trans-nosographic nature of this syndrome. Two common types of depression are bipolar and unipolar depression. Although they share many similar symptoms, several differences between the two pathologies are suggested in prior studies.ObjectivesWe aimed to compare the disease characteristics and evolution of unipolar and bipolar depressed patients.MethodsWe conducted a retrospective descriptive and analytical study among medical records of 167 patients hospitalized for a depressive episode (DE) at the Psychiatry “B” Department, Hedi Chaker University Hospital (Sfax, Tunisia), during the period between 2015 and 2017. Patients were divided into two groups according to DSM-5 criteria: those with bipolar disorder I or II (bipolar depression) versus those with major depressive disorder (unipolar depression).ResultsThe mean age of our patients was 37.6 years, with a female predominance (sex-ration F/M =1.7). The age of onset of the disease was earlier in bipolar depressed patients (29.36 versus 31.89), without a significant relationship. Family psychiatric history was significantly more prevalent in bipolar disorder patients (73.5% versus 37.3%; p&lt;0.001). Bipolar patients are more likely to be unemployed (65.3% versus 50.8%), but without a significant relationship.Bipolar patients were more likely to be hospitalized for suicide attempts (44.9% versus 35.6%; p=0.2).ConclusionsDistinguishing between major depressive disorder and bipolar disorder is important because there are differences in the optimal management of these conditions.Disclosure of InterestNone Declared

Cariprazine add-on in resistant bipolar depression. Long-term effectiveness and safety data from a multicentric real-world experience

IntroductionPersistent depressive episodes and subsyndromic depressive symptoms frequently characterize mood alterations in bipolar disorder (BD) and negatively influence quality of life and suicide risk. BD patients with predominant depressive episodes generally show significantly higher treatment resistance rates. Although not specifically approved in Italy for bipolar depression, recently published observational data suggest that the cariprazine add-on may be a potential effective short-term treatment for resistant bipolar depression. Nevertheless data on long-term cariprazine treatment are lacking.ObjectivesThis study evaluated the efficacy and safety of long-term cariprazine augmentation in patients suffering from treatment-resistant bipolar depression.Methods30 resistant bipolar depressed patients, whose resistance was defined according to The CINP Guidelines on the Definition and Evidence-Based Interventions for Treatment-Resistant Bipolar Disorder, were treated with cariprazine 1,5 -3 mg flexible dose for 4 weeks, added to previous mood stabilizing and/or antidepressant treatment. Psychopathology at time 0 and at 4, 8, 12, 16, 20, 24 weeks of treatment was evaluated using the Hamilton Depression Rating Scale (HDRS), the Hamilton Anxiety Rating Scale (HARS), the Young Mania Rating Scale (YMRS) and the Bipolar Depression Rating Scale (BDRS); safety and tolerability was measured by the UKU Side Effect Rating Scale. The drop-out rate was assessed throughout the study duration.ResultsCariprazine add-on was effective in the study sample but only during the first 4 weeks of treatment. Improvement in depression scores started from the first week, reaching about 40% mean HDRS score reduction at T4; a moderate ulterior decrease (-15%) was reached at T24 but was accompanied by a significant drop-out rate; anxiety symptoms improved (mean HARS score reduction 37% at T4) mainly during the first 4 weeks. The treatment was generally well tolerated. From week 4 to 24 we observed a near 70% drop-out rate (18 total drop-outs) with maximum drop-outs between weeks 4-8 (n=7) and 18-24 (n=7). Discontinuation causes were inefficacy (5/18); clinical worsening (10/18); side effects (3/18); hypomanic shift (2/18).ConclusionsDespite the relatively small population examined and the observational design, our results suggest that cariprazine may represent an effective and safe short-term enhancement strategy in resistant bipolar depression. Long-term treatment, in this sample, did not lead to significant improvements and was burdened by a high drop-out rate, mainly due to inefficacy/clinical worsening. Further studies on larger samples are needed to confirm these preliminary findings, both in short-term and in longer observations.Disclosure of InterestNone Declared

Task-state skin potential abnormalities can distinguish major depressive disorder and bipolar depression from healthy controls

Early detection of bipolar depression (BPD) and major depressive disorder (MDD) has been challenging due to the lack of reliable and easily measurable biological markers. This study aimed to investigate the accuracy of discriminating patients with mood disorders from healthy controls based on task state skin potential characteristics and their correlation with individual indicators of oxidative stress. A total of 77 patients with BPD, 53 patients with MDD, and 79 healthy controls were recruited. A custom-made device, previously shown to be sufficiently accurate, was used to collect skin potential data during six emotion-inducing tasks involving video, pictorial, or textual stimuli. Blood indicators reflecting individual levels of oxidative stress were collected. A discriminant model based on the support vector machine (SVM) algorithm was constructed for discriminant analysis. MDD and BPD patients were found to have abnormal skin potential characteristics on most tasks. The accuracy of the SVM model built with SP features to discriminate MDD patients from healthy controls was 78% (sensitivity 78%, specificity 82%). The SVM model gave an accuracy of 59% (sensitivity 59%, specificity 79%) in classifying BPD patients, MDD patients, and healthy controls into three groups. Significant correlations were also found between oxidative stress indicators in the blood of patients and certain SP features. Patients with depression and bipolar depression have abnormalities in task-state skin potential that partially reflect the pathological mechanism of the illness, and the abnormalities are potential biological markers of affective disorders.

Razlike u indikatorima inflamacije obolelih od bipolarne i unipolarne depresije

Introduction/Aim: Patients with bipolar disorder, unrecognized and with a delayed onset of manic or hypomanic episodes are often mistakenly diagnosed with unipolar depression (UD) due to shared symptomatology. The two disorders, however, have related but not identical etiopathogenesis. Immune system alterations might play a crucial role in both the onset and manifestation of these conditions. This study aimed to compare immune markers between patients with bipolar depression (BD) and unipolar depression (UD) and explore their associations with acute episode characteristics and disease progression. Material and Methods: This retrospective study included patients with BD (n=60) and UD (n=242) who were hospitalized within a two year period and whose sociodemographic information, acute episode and course of illness characteristics, and indicators of inflammation were available. Results: Patients with BD exhibited elevated mean platelet volume (MPV) compared to those with UD. MPV levels correlated with clinical characteristics in both groups; higher MPV was observed in UD patients with an earlier age of onset and a longer duration of illness. In BD patients, elevated MPV was associated with the severity of psychopathology, particularly in individuals with a history of suicide attempts and a prolonged duration of untreated disorder. Conclusion: This study indicates the presence of chronic low-grade inflammation in specific subpopulations of patients with affective disorders. Immune changes are distinct in regard to the polarity of the disorder and could be a potential indicator of the severity of psychopathology and illness chronicity.

Brain functional changes across mood states in bipolar disorder: from a large-scale network perspective.

Exploring the neural basis related to different mood states is a critical issue for understanding the pathophysiology underlying mood switching in bipolar disorder (BD), but research has been scarce and inconsistent. Resting-state functional magnetic resonance imaging data were acquired from 162 patients with BD: 33 (hypo)manic, 64 euthymic, and 65 depressive, and 80 healthy controls (HCs). The differences of large-scale brain network functional connectivity (FC) between the four groups were compared and correlated with clinical characteristics. To validate the generalizability of our findings, we recruited a small longitudinal independent sample of BD patients (n = 11). In addition, we examined topological nodal properties across four groups as exploratory analysis. A specific strengthened pattern of network FC, predominantly involving the default mode network (DMN), was observed in (hypo)manic patients when compared with HCs and bipolar patients in other mood states. Longitudinal observation revealed an increase in several network FCs in patients during (hypo)manic episode. Both samples evidenced an increase in the FC between the DMN and ventral attention network, and between the DMN and limbic network (LN) related to (hypo)mania. The altered network connections were correlated with mania severity and positive affect. Bipolar depressive patients exhibited decreased FC within the LN compared with HCs. The exploratory analysis also revealed an increase in degree in (hypo)manic patients. Our findings identify a distributed pattern of large-scale network disturbances in the unique context of (hypo)mania and thus provide new evidence for our understanding of the neural mechanism of BD.

Sexual dysfunction in bipolar depression: Gender differences.

To find sexual dysfunction in acute-phase bipolar depression patients and subsequently characterize the gender-wise differences in sexual functioning. A cross-sectional, descriptive, observational, purposeful, and hospital-based study was done with 45 patients (age range: 18-59 years) with moderate to severe acute phase bipolar depression (HAM-D scores >18). The domain-wise (Pleasure, Desire/Frequency Desire/Interest, Arousal/Excitement, and Orgasm/Completion) sexual functioning was assessed by the Change in Sexual Functioning Questionnaire (CSFQ-14) (≤41 for females, ≤47 for males as a cut-off for dysfunction). This study is registered in the CTRI (Clinical Trials Registry India, Number: CTRI-2021-07-035182). The prevalence of sexual dysfunction was 91% of bipolar disorder patients with more male participants (53.3%) compared to females (46.7%). The mean HAM-D score for the study sample was 27.93 ± 8.035. The female gender had more dysfunctional scores in desire/frequency (t = 2.229, P = 0.031), desire/interest (t = 2.448, P = 0.019), orgasm/completion (t = 2.974, P = 0.005), and overall total CSFQ (t = 2.946, P = 0.005). The odds of sexual dysfunction were significant given a one-unit increase in suicidal ideation in the index episode (adjusted OR = 1.222, 95% CI: 1.004-1.488, P = .049). Acute-phase bipolar patients have very high sexual dysfunction rates. Females have both global and specific sexual response cycle deficits in comparison to acute phase bipolar depressed males. Future trials shall amuse neurobiology grounded, more individualistic sexual rehabilitation-based interventional paradigms, and longitudinal research models in acute phase bipolar depression.

Electroconvulsive therapy is associated with increased immunoreactivity of neuroplasticity markers in the hippocampus of depressed patients

Electroconvulsive therapy (ECT) is an effective therapy for depression, but its cellular effects on the human brain remain elusive. In rodents, electroconvulsive shocks increase proliferation and the expression of plasticity markers in the hippocampal dentate gyrus (DG), suggesting increased neurogenesis. Furthermore, MRI studies in depressed patients have demonstrated increases in DG volume after ECT, that were notably paralleled by a decrease in depressive mood scores. Whether ECT also triggers cellular plasticity, inflammation or possibly injury in the human hippocampus, was unknown. We here performed a first explorative, anatomical study on the human post-mortem hippocampus of a unique, well-documented cohort of bipolar or unipolar depressed patients, who had received ECT in the 5 years prior to their death. They were compared to age-matched patients with a depressive disorder who had not received ECT and to matched healthy controls. Upon histopathological examination, no indications were observed for major hippocampal cell loss, overt cytoarchitectural changes or classic neuropathology in these 3 groups, nor were obvious differences present in inflammatory markers for astrocytes or microglia. Whereas the numbers of proliferating cells expressing Ki-67 was not different, we found a significantly higher percentage of cells positive for Doublecortin, a marker commonly used for young neurons and cellular plasticity, in the subgranular zone and CA4 / hilus of the hippocampus of ECT patients. Also, the percentage of positive Stathmin 1 cells was significantly higher in the subgranular zone of ECT patients, indicating neuroplasticity. These first post-mortem observations suggest that ECT has no damaging effects but may rather have induced neuroplasticity in the DG of depressed patients.

Cognitive distortions and perfectionism during bipolar and unipolar depressive episode

BackgroundThe aim of the current study was to compare bipolar depression (BD) and unipolar depression (UD) patients and healthy controls in terms of their cognitive distortions and perfectionist traits during acute depressive episodes.ResultsThe current dissertation study is a cross-sectional study consisting of 80 patients with unipolar depression, 80 patients with bipolar depression, and 80 healthy controls. Sociodemographic and Clinical Data Form, Cognitive Distortion Scale (CDS), Frost’s Multidimensional Perfectionism Scale (FMPS), Hamilton Anxiety Rating Scale (HARS), Hamilton Depression Rating Scale (HDRS), and Young Mania Rating Scale (YMRS) were used as measurement tools. Healthy controls were selected on the basis that they had the same gender and age distribution as the other participants. It was found that patients with unipolar and bipolar depression had statistically equal but higher total CDS interpersonal and personal achievement scores than healthy controls, and all subtypes of the CDS labeling score were higher in the unipolar depression group than in the other groups. It was found that both depression groups had higher FMPS self-oriented and social-oriented perfectionism scores than healthy controls, lower others-oriented perfectionism scores than healthy controls, and there were no statistically significant differences between them in terms of perfectionism subtypes.ConclusionsIn the light of the research data, it was found that the patients with bipolar/unipolar depression had more cognitive distortion than healthy controls and cognitive distortion was not significantly different in the two groups. According to the research data, it is observed that perfectionism is higher in unipolar depression than in bipolar depression. The data obtained have the potential to provide a theoretical basis for a psychotherapeutic approach.

Systemic inflammation and oxidative stress markers in patients with unipolar and bipolar depression: A large-scale study

ObjectiveNumerous studies have demonstrated that neutrophil/HDL ratio (NHR), lymphocyte/HDL ratio (LHR), monocyte/HDL (MHR) ratio, platelet/HDL ratio (PHR), neutrophil/ALB ratio (NAR) and platelet/ALB ratio (PAR) can serve as systemic inflammation and oxidative stress markers in a variety of diseases. However, few studies have estimated the associations of these markers with unipolar depression (UD) and bipolar depression (BD), as well as psychotic symptoms in UD and BD. Methods6297 UD patients, 1828 BD patients and 7630 healthy subjects were recruited. The differences in these indicators among different groups were compared, and the influencing factors for the occurrence of UD or BD and psychotic symptoms were analyzed. ResultsThese ratios displayed unique variation patterns across different diagnostic groups. BD group exhibited higher NHR, LHR, MHR, NAR and lower PAR than UD and HC groups, UD group showed higher MHR than HC group. The psychotic UD group had higher NHR, LHR, MHR and NAR than non-psychotic UD group. Higher LHR, MHR, NAR and lower PAR were risk factors in BD when compared to UD group. ConclusionsOur study demonstrated differences in inflammation and oxidative stress profile between UD and BD patients, as well as between subjects with or without psychotic symptom exist, highlighting the role of inflammation and oxidative stress in the pathophysiology of UD and BD.

Bipolar Tanılı Hastalarda Azalmış GPER düzeyleri

Objectives: There is increasing evidence in the literature that estrogen and its receptors play an important role in the etiopathogenesis of bipolar disorder due to gender differences in the course, severity and peak periods of the disease. In this context, GPER, which is defined in the reproductive system as well as the nervous system, endocrine system and cardiovascular system, and mediates the neurological benefits of estradiol; It is important to better understand its role in this disease. Method: In this study, we aimed to compare serum GPER levels in euthymic bipolar disorder and healthy controls matched for age, sex and body mass index. Results: In this study, we found decreased serum GPER levels in both genders separately and in total in the patient groups compared to the control groups. Conclusion: Our results should be considered preliminary and should be repeated in more homogeneous groups with larger samples. In addition, we believe that further studies should be conducted on the therapeutic efficacy of G1 in depressive bipolar patients.

Unipolar ve Bipolar Depresif Bozuklukta Bazı Hematolojik Parametrelerin

Background: Major depressive disorder and bipolar disorder, which are the most severe types of mood disorders, are among the diseases that cause the most disability worldwide. One of the biggest challenges in providing early and effective treatment in mood disorders is the inability to make an early differential diagnosis between UD and BD. Many studies have suggested that neuroinflammation may play a role in the pathophysiology of mood disorders. Neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), and monocyte/lymphocyte ratio (MLR) are relatively cheap hematological parameters recommended to measure the level of inflammation. This study aimed to examine the potential role of inflammatory processes in the pathogenesis of unipolar depression(UD) and bipolar depression(BD) by analyzing various hematologic markers, including NLR, PLR, and MLR Materials and Methods: The patient group comprised 54 individuals(UD: 31, BD: 23), while the healthy control(HC) group comprised 40 individuals. The study compared the values of hematologic markers between the groups. Results:The study found significant differences only in the levels of NLR among the analyzed hematologic markers(p=0.004). When the UD and BD groups were compared with HC separately, NLR was significantly higher in both the UD and BD groups compared to the HC group(p=0.002, p=0.015). When UD and BD were compared with each other, there was no significant difference in terms of NLR(P=0,416). Conclusions: In our study, although there was no significant difference between BD and UD in terms of NLR, PLR and MLR, the higher NLR in both patient groups compared to HC suggests the presence of inflammation in both BD and UD patients. More evidence is needed to evaluate it as a disease-specific marker.

Euthymic and depressed bipolar patients are characterized by different RNA editing patterns in blood

Bipolar disorder (BD) is a worldwide leading cause of disability. Inflammation roles in this disease is well established. ADAR1-mediated RNA editing is one of the key mechanisms regulating the inflammatory response. We have identified a panel of RNA editing-based blood biomarkers which allowed to discriminate unipolar from BD depression with high accuracy. We confirmed here the diagnostic value of this panel in a new cohort of BD patients recruited in Brazil. We also identified new combinations which allow a clear discrimination of BD from healthy controls and among BD subgroups, confirming that RNA editing is a key mechanism in BD.

Unipolar and Bipolar Depression Detection and Classification Based on Actigraphic Registration of Motor Activity Using Machine Learning and Uniform Manifold Approximation and Projection Methods.

Modern technology frequently uses wearable sensors to monitor many aspects of human behavior. Since continuous records of heart rate and activity levels are typically gathered, the data generated by these devices have a lot of promise beyond counting the number of daily steps or calories expended. Due to the patient's inability to obtain the necessary information to understand their conditions and detect illness, such as depression, objectively, methods for evaluating various mental disorders, such as the Montgomery-Asberg depression rating scale (MADRS) and observations, currently require a significant amount of effort on the part of specialists. In this study, a novel dataset was provided, comprising sensor data gathered from depressed patients. The dataset included 32 healthy controls and 23 unipolar and bipolar depressive patients with motor activity recordings. Along with the sensor data collected over several days of continuous measurement for each patient, some demographic information was also offered. The result of the experiment showed that less than 70 of the 100 epochs of the model's training were completed. The Cohen Kappa score did not even pass 0.1 in the validation set, due to an imbalance in the class distribution, whereas in the second experiment, the majority of scores peaked in about 20 epochs, but because training continued during each epoch, it took much longer for the loss to decline before it fell below 0.1. In the second experiment, the model soon reached an accuracy of 0.991, which is as expected given the outcome of the UMAP dimensionality reduction. In the last experiment, UMAP and neural networks worked together to produce the best outcomes. They used a variety of machine learning classification algorithms, including the nearest neighbors, linear kernel SVM, Gaussian process, and random forest. This paper used the UMAP unsupervised machine learning dimensionality reduction without the neural network and showed a slightly lower score (QDA). By considering the ratings of the patient's depressive symptoms that were completed by medical specialists, it is possible to better understand the relationship between depression and motor activity.